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9 Common Causes of Thyroid Imbalance and How You Can Help
How you sleep, how easily you wake up, and how much energy and stamina you have during the day are directly related to levels of the thyroid hormones.
Pain Underfoot: Metatarsalgia
Foot pain can interfere significantly with normal activities and severely limit participation in sports. Metatarsalgia is foot pain involving the metatarsal bones in the forefoot – the complaint of pain on the bottom of the ball of the foot.
News in Brief
National Chiropractic Health Month: Be Proactive; Collegiate Roundup: Academic Appointments at Parker, Logan.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
Chiropractic Research in Review
Chiropractic Treatment of Lateral Epicondylitis; Cost / Benefit Analysis: Different Doses of SMT for Low Back Pain; Imaging for Occult Rib and Costal Cartilage Fractures; Treating Neck Pain: Thoracic Thrust Manipulation vs. Non-Thrust Mobilization.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
MPA Media Wins 7 Publishing Awards
MPA Media, publisher of Dynamic Chiropractic and DC Practice Insights, among other titles, has been recognized for editorial and design excellence with an unprecedented seven publishing awards by the American Society of Business Publication Editors (ASBPE), the nation's largest organization for business-to-business publications.
Waking Up the Gluteus Maximus
In previous articles in this series, we expounded on the importance of the gluteus maximus (GM) in athletic performance and protecting the knee from injury. We also know there is a link between iliotibial band syndrome and GM weakness.
Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
CCE Finally Takes a "Baby Step" Toward Reform
During a 16-month period from October 2010 to February 2012, I devoted four separate columns to the heavy-handed attempt by the Council on Chiropractic Education to radically change the chiropractic profession through the accreditation process.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
A Vibrating Capsule for Constipation? Relevance to Your Chiropractic Practice
The relationship between gastrointestinal (GI) complaints and back pain is not typically written about or discussed.
Why Young People Need Chiropractic Now More Than Ever
According to a recent study published in BMC Musculoskeletal Disorders, "It is now widely acknowledged that neck pain (NP), mid back pain (MBP), and low back pain (LBP) (spinal pain) start early in life and that the lifetime prevalence increases rapidly during adolescence to reach adult levels at the age of 18."
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
March, 2003, Vol. 03, Issue 03
Swimming Upstream Toward Effective Practice
By Keith Eric Grant, PhD, NCTMB
Every now and again, I find myself grabbing some morsel of thought and running upstream through the frothing waters of accepted massage opinion, much like a salmon returning to its home waters. Today's morsel stems from a question posed to me about "how to improve the profession of massage." The center current of opinion, down which most previous effort has run, is that credibility for massage practice is obtainable by coercing the profession together through licensing and mandatory certification. Licensing, however, was never a tool designed by the government to imbue credibility and excellence of practice. It was only intended to protect the public from practices that could cause great physical or economic harm, and for which reasonable consumer knowledge and caution were inadequate remedies. There are no medical statistics indicating that massage practices, especially at the levels covered by licensing, fall into this camp. Similarly, mandatory certification has fallen short of addressing needs of practice that are sufficiently focused to be evident and useful. Applied nonspecifically, certification exams needlessly eliminate many people who are not proficient at short-term memorization, yet could contribute successfully into the more kinesthetic subpractices of massage. Such exams also are often too general to benefit subpractices more dependent on the manipulation of remembered details.4,5
Instead of the route of government-coerced cohesion, I believe it is past time to acknowledge and value our diversity of subpractices. It is time to create guidelines that provide specific guidance to schools, students and employers for what we actually do in different venues or subpractices of massage. I have taken a rough cut at defining a set of such subpractices in Table 1.
Note that the subpractices do not organize in a single line of increasing knowledge and skills. Likewise, the various subpractices are not all at the same level of knowledge and skills, but simply in different directions of applied technique. Therefore, we can talk about tiers and experience meaningfully only within a given subpractice. Across the total scope of practices, there are different needs for details of anatomy and clinical technique; skills of basic touch and human presence; formality of personal appearance; business skills; and interpersonal skills of communication, psychology and sociology. In many of the areas, communication skills and understanding of the applicable psychology may be as or more important to outcomes than particulars of massage technique. The importance of attitude and support noted for sports injuries is equally applicable to supporting recovery from illness in hospital settings or enhancing quality of life for the aged.2,7
My examination of guidelines on the process of creating guidelines has resulted in Table 2. Key aspects of the process are that it be evidence-based; involve all key players; and allow for its own evolution. We must take on the intensive process of first defining massage subpractices, then working with all affected parties to define knowledge, skills and abilities needed to practice effectively in each venue. It is only by hammering out a rough consensus of all participants for each subpractice that we will achieve workable guidelines. It is only when such guidelines have proven to be both useful and widely used that they should be considered as standards.
In seeking to form guidelines that promote our ability to engage effectively in a subpractice of massage, it follows immediately that we need a measure for effectiveness. In this, we owe a debt to the Italian economist Vilfredo Pareto (1848-1923). In 1906, Pareto observed that 20 percent of the Italian people owned 80 percent of their country's accumulated wealth. This 80/20 rule of imbalance has since been found to be applicable to many situations.6, 8
Based on the 80/20 rule, we may reasonably expect that, day to day, 80% of the tasks will be performable using about 20% of the subpractice expert's domain-specific knowledge and skills. The implication is that, if a person entering the subpractice comes with this 20% of the subpractice down cold, they will be able to accomplish much without having to stop constantly to consult a mentor or information resource. In all likelihood, they will have much more time and leeway to accumulate incrementally via experience the subsequent 80% of skills and knowledge. By encoding such expectations into guidelines that meet the criteria of Table 2, I believe that we can do much to make our efforts at training and practice more effective.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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