resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Essentials of Assessment: The Squat
The squat is a simple, fast and functional tool to evaluate patient symmetry and function. As simple and easy as it is to implement, it can yield considerable amounts of valuable, clinically relevant information.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
The Power of Eccentric Exercise: Hamstring Injury Prevention and Rehab
For almost 20 years, I've worked with professional athletes who make a living by running really fast. It goes without saying that hamstring injury (HSI) prevention and rehabilitation is a big part of what they expect from a sports chiropractor.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
Recording and Appropriate Billing of Timed Physical Medicine Services
There is a common misunderstanding about timed therapy services and although you do have some knowledge of timed service documentation, based on your comment on the 8-minute rule, your understanding is correct, but incomplete.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
How to Find and Fix TL Nerve Impingements
The thoracolumbar junction (TLJ) and the peripheral sensory nerves that exit from it are frequent, important and rarely recognized sources of lower back, pelvic and hip pain. Let's outline a clear exam protocol for diagnosing the problem.
Musculoskeletal Disorders Take Center Stage
Looking for the latest on the musculoskeletal pain epidemic and the increasing premium placed on preventive strategies including chiropractic? Check out The Impact of Musculoskeletal Disorders on Americans – Opportunities for Action.
The IME System: A Current Public Health Risk and Solutions That Are Working
I strongly believe in the independent medical examination (IME) system. There are far too many doctors in every profession who are not following E&M protocols and never claim MMI (maximum medical improvement) has occurred for their patients, which has caused financial stress for many private and public carriers.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
Vitamin D Fails to Help Knee OA? The Proper Perspective
The March 8, 2016 issue of JAMA includes a study about vitamin D supplementation for osteoarthritis of the knee. This is a really weird study.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
Business Lesson #1: Adapt or Else
My wife and I recently enjoyed an excellent meal at a restaurant recommended by some friends. We often have concerns about restaurant recommendations, as many have been disappointing.
June, 2004, Vol. 04, Issue 06
Setting the Record Straight: Massage Gets a Bad Rap in National Report
By Rebecca J. Razo
Over the years, the massage profession has been no stranger to adversity. Many battles have been fought, and won, to protect the reputations of the profession and massage professionals throughout the country.Fortunately, an increasing number of studies and news reports have helped validate massage and other forms of complementary and alternative medicine (CAM) in treating pain and dysfunction. (See the top story in this issue: "Newsweek Validates Complementary and Alternative Therapies for Back Pain" www.massagetoday.com/archives/2004/06/01.html) With all of the positive aspects of the advancing massage profession, it can be disheartening when media reports indict massage as a harmful practice with little or no supporting evidence.
Such was the case in April 2004, when a short segment ran on national television suggesting that massage can be dangerous. The segment, which was written, produced and distributed by Ivanhoe Broadcast News - a health news-gathering service that produces daily media reports - was subsequently posted on several Web sites.1 One report, "Massages Could Cause More Pain Than Relief," ran on a major Southern California network with the following introduction: "People often feel better right after a relaxing massage, but many people leave the table feeling even worse. Experts say what you don't know about massage may cause more pain than relief."2
The feature discussed the case of Mary Schreiner, who had sought massage after suffering injuries in two major accidents. Schreiner claimed she felt fine during and immediately following massage, but that the treatments ultimately aggravated her injuries; in the end, Schreiner received cortisone injections to manage her pain.1,2
The piece quoted only one expert, Dr. Robert Gotlin, a physical rehabilitation specialist with Beth Israel Medical Center in New York City, who made three blanket statements in relation to massage, including that 15 percent of massage patients need corrective treatment following massage; thin people should avoid deep-tissue massage because of potential injury; and a client's likelihood of receiving a safe massage is better from a "therapist with credentials from the American Massage Therapy Association."1,2
In an initial phone interview, Dr. Gotlin told Massage Today that his true message was not made clear in the television segment, and that he was not given the opportunity to proofread the piece before it went to production3 -- a statement Stacie Overton, Director of Medical Programming for Ivanhoe, vehemently denies. "We fact-check everything we do," Overton said. "If he had a problem, I wish he had said something ... if [he thought the piece] was presented poorly."4
Dr. Gotlin indicated that the segment was originally intended to address what he perceives is a problem in the massage profession. "The impetus for this piece is the recent increase in storefront 'pay-by-the-minute' massage centers," he said. "For the hundreds of patients seen monthly for complaints of musculoskeletal pain ... [an] increasingly common modality tied to pain symptoms is storefront 'pay-by-the-minute' massages."5 But Overton denies the piece was ever intended to cover massage mishaps in storefront-type operations. "I would have never accepted that story," she said.4
When queried about his claim that 15 percent of massage patients need corrective treatment, Dr. Gotlin told Massage Today that his statistic was derived from unofficial, nonscientific assessments of thousands of patients from his private practice over the past two to three years. "This was a practice comment," he said.
However, transcripts of Ivanhoe's original interview, which were fact-checked and approved by Dr. Gotlin prior to production, show-- although he openly admits his conclusions are based on "trial and error" evaluations of his own patients -- that Dr. Gotlin never clarifies his statistical assessment is based on those same in-office patient evaluations; consequently, this omission resulted in an innacurate depiction of massage injuries.6,7,8
Moreover, Dr. Gotlin, who claims to see roughly five to six patients a week for injuries following massage, agreed that his patients usually have pre-existing injuries that are merely exacerbated -- not caused by -- massage.3 The feature never makes this point clear.
In reality, it is "rare for a well-trained massage therapist to give a bad massage," remarked AMTA President Laurel Freeman. "There are very few malpractice claims filed against massage therapists for injury."9 Moreover, the number of documented injuries is extremely low.
According to a study conducted by massage educator Keith Eric Grant, PhD, and published in the October 2003 issue of the Journal of Bodywork and Movement Therapies: "There are extremely few reported cases of injury related to massage within the indexed health care literature. While statements have occurred in newspapers that would seem to indicate that massage has a high potential and probability for causing injury, such anecdotal statements have no support in the medical literature or in insurance statistics."10
And a study published late last year in Rheumatolgy indicates that although "massage is not entirely risk free ... serious adverse events are probably true rarities."11
"I seriously question the judgment if not the ethics of [Gotlin's] pronouncements to the media," Dr. Grant said. "If Dr. Gotlin had clinical observations to report, doing so by a journal article or letter to the editor would have been a fully appropriate and useful contribution to the ongoing professional dialogue and development of the massage profession." Dr. Grant further noted that Dr. Gotlin's statements were made "in a manner potentially misleading to the public."12
Still, Dr. Gotlin stressed his support of massage therapy when properly indicated, and affirmed that his concern is for those who self-treat with massage prior to seeking appropriate medical care for pre-existing injuries. "For those who are without pain and wish the comforts of soft-tissue massage ... this is not the population I am speaking of," he said. "It is those who have complaints of neck or back pain accompanied by arm and/or leg pain, which manifests at night, or pain along with muscle weakness ... conditions which should undergo a medical evaluation before embarking on any therapy.
"Massage therapy may be an excellent modality choice if not contraindicated," he continued. "Many patients are not [told] to seek medical advice by the storefront massage therapist. In fact, there is usually no discussion of any related symptoms."5 Yet, Dr. Gotlin's support of massage therapy was not a point made central to the feature that aired.
James Waslaski, international lecturer on orthopedic massage, chronic pain and sports injuries, believes that massage often receives negative press because of ongoing "turf wars" between health care professionals, and affirms that "many advanced disciplines within [the massage] profession have a very low chance of making an existing injury worse.
"I do recommend that people become certified in advanced [massage] disciplines ... to assure that proper assessment is done prior to treatment. By referring out [to other qualified therapists], certain complicated conditions ... would not become exacerbated by massage treatments. In fact, many times for soft tissue injuries, muscle relaxants and cortisone injections will only mask the patient's symptoms instead of treating the underlying structural imbalance causing the pain," Waslaski said.13
Another of Dr. Gotlin's claims was that thin people should not receive deep-tissue massage. "The most common body habitus seen with complaints of increased symptoms with deep massage is the ectomorph. Those who are thin may suffer the greatest ill effects of deep-tissue massage, likely due to the close proximity of the massaging hands to inflamed nerves and muscles," he said.5
But according to Waslaski, "deep tissue massage can indeed be performed safely on thin individuals." Waslaski affirms that most orthopedic massage instruction stresses the importance in teaching massage to remain "always pain free," which may involve "superficial to deep, myofascial spreading routine, avoiding bony landmarks to increase blood flow to ischemic areas ... gentle trigger point techniques to referral pain patterns in short muscle groups and gentle stretching ... to assist the body back to a state of balance.
"In my opinion, muscle groups shorten because of repetitive use or poor postures," he continued. "It is our role to lengthen those short muscle groups in a pain free fashion. We should never cause pain in our treatments, and [must conduct] a thorough assessment of [the] patient prior to doing the treatment," Waslaski added.13
Freeman agrees. "Thin people have skin and muscles just like people who are heavier. The more important question is: 'What is the person's sensitivity level?'"9
Although Dr. Gotlin is on record saying that those seeking massage should ask if "the therapist [is] certified by the AMTA,"7 he amended his statement to Massage Today, stating instead that consumers should seek a massage therapist "who is certified/licensed by an organization such as the AMTA."5
He also wants the public to know that his intentions were noble: "The intent of ... my media pieces is to 'advise' consumers ... to increase awareness of the indications/contraindications and risk/benefit ratios for the many therapeutic options available," he said. "I am an advocate and believer in massage therapy."5
Although some may construe this report as a setback to the massage industry, Freeman emphasizes how far the profession has come over the past several years. "Massage has been growing at an incredible rate," she said. "In the last seven years, AMTA's consumer surveys have shown the percentage of American adults receiving massage jump from 8 percent to 21 percent; the number of articles written about massage have gone from 3,700 per year to over 15,000; and the massage profession is listed in the American Medical Association's Health Professions Career & Education Directory."9
Editor's note: Due to the transient nature of the Internet, some links may no longer be accessible.
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