resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
February, 2005, Vol. 05, Issue 02
We Get Letters and E-Mail
By Editorial Staff
Massage Today encourages letters to the editor to discuss matters relating to the publication's content. Letters may be edited for space and clarity, and published in a future issue or online.Please send all correspondence by e-mail to r regular mail to:
Editor's note: The following letter is in response to Cliff Korn's article "Thought on Being Part of Medicince" in the October issue (www.massagetoday.com/archives/2004/10/09.html).
"Instead of cramming to know it all, let's focus on turning out stunning graduates with solid basic skills"
Mr. Korn states that he finds it "important that we do both" (relaxation and clinical massage), then proceeds to put his expectations on the entire profession by assuming that "our public shares his expectations! Quite presumptuous!
Who exactly is "our public?" I've been a successful massage therapist for 14 years, practicing relaxation massage exclusively. My public has never had any problem with this, and it has not affected my ability to build a practice wherever I've lived. I feel relaxation massage is medical massage at its finest: preventative medicine, as stress accounts for over 70 percent of visits to doctors!
Since Mr. Korn is so fond of us being a part of medicine, let me ask how many patients expect to see one doctor for "orthopedic issues, stress-related issues, sports-injury prevention, etc." Family doctors are General Practitioners and as the title implies they practice general medicine, referring patients to specialists as necessary for treatment of more specific ailments. This is how I practice my profession as well, referring my clients to bodywork specialists when I feel they would benefit from a different approach.
I simply have no interest in practicing clinical massage but I am a huge proponent of its benefits and never hesitate to refer my clients to qualified rehab therapists. Nor do I hesitate to refer clients to energy workers, Shiatsu practitioners, nutritionists, aromatherapists, body movement therapists, etc. The list is endless as massage embodies the essence of holistic health! How can we hope to be experts in all such modalities? Impossible!
The fact is that true clinical massage requires a great deal of advanced training and hands-on practice to honor the ethic "do no harm," as we must do if it truly is "all about the clients." It is impossible to include this training/practice in a 500-hour entry-level program. And there's the rub!
Must we expand entry-level programs to accomodate this neurotic need to be a "part of medicine?" Many programs are moving up to 750-1,000 hours in order to include more clinical approaches. In my opinion this is a dangerous move. A little knowledge is indeed a dangerous thing and that's exactly what we have in students graduating from such programs. They have not yet mastered basic strokes, but they are expected to understand assessment and corrective techniques that take years of study and practice to grasp. Instead of cramming to know it all, let's focus on turning out stunning graduates with solid basic skills who may choose their own courses for further study!
Gail Frei, LMT
Editor's note: The following letters are in response to Bruce Klein's letter in the November issue (We Get Letters and E-mail, www.massagetoday.com/archives/2004/11/18.html).
"It's well known among spinal surgeons that cerebral spinal fluid does indeed pulse"
I am a massage therapist, exclusively practicing CranioSacral Therapy (CST). I also teach several courses for the Upledger Institute. Before becoming a massage therapist, however, I was a scientist. I have a PhD in theoretical physics from Rice University, and I did research in physics at the Massachusetts Institute of Technology for a number of years. I would like to address the question of why no movement of the cerebral spinal fluid (CSF) is discernable on an MRI and why serial CT scans are possible even if cranial bones move.
Leaving aside the question of whether placing the body in a very high magnetic field or bombarding it with X-rays will disrupt subtle physiological processes, how much fluid movement actually occurs and would one expect to be able to detect it if it were present? The amount of fluid movement within each cycle of the craniosacral rhythm (CSR) is very easily estimated. The average adult human has approximately 600ml of CSF in their system at any given time. That CSF is replaced on average 3 to 4 times per day. That means the brain produces about 600ml of CSF every 6 to 8 hours. The CSR has a frequency of 6 to 12 cycles per minute, or a period of 5 to 10 seconds per cycle. This corresponds to somewhere between 2,000 and 4,000 cycles of the CSR in a 6-hour period. Thus, the amount of CSF produced in a single cycle is somewhere between 0.15 and 0.3ml, much too small of a change to be detected by an MRI. There is movement of the CSF through the brain, but it is very slow. Any given cycle only moves the CSF a small amount, but cumulatively there is enough movement to replace the fluid several times per day.
Even though the fluid production in any one cycle is minute, the pressure changes that occur due to that fluid production are easily palpable. Dr. Upledger (et al.) has published several papers demonstrating rhythmic movement of cranial bones (citations for these papers are available from the Upledger Institute). He showed that cranial bones move rhythmically with average amplitude of about 0.010" or about the thickness of a piece of paper. A movement of this magnitude is easily palpable to the human hand. While I am not familiar with the resolution of a typical CT scanner, it would have to be of the order of 0.010" or less in order to detect the CSR. Even if it were able to detect it, such a small movement would cause only an imperceptible blurring of the image and would in no way prevent one from taking serial scans of a human head.
As a scientist, it does not surprise me at all that the CSR does not show up on MRIs or CT scans, nor does it surprise me that we can easily palpate the CSR - the human hand is a much more sensitive detection instrument than any imaging machine that is available today. What does surprise me is the continuing controversy over the existence of a rhythmic movement in the body that is easily palpable, even by laymen, and whose existence was clearly demonstrated by experiment many years ago.
Tim Hutton, LMP, CST-D
I would like to respond to Bruce Klein's letter challenging cranial movement. First, it's well known among spinal surgeons that cerebral spinal fluid (CSF) does indeed pulse. I observed a laminectomy (removal of the back half of the vertebrae, fully exposing the spinal cord in its coverings) on one of my patients. The CSF pulse was plainly visible - indeed, the neurosurgeon pointed it out. Second, saying that the cranial bones don't move shows that Dr. Klein is not current on his anatomy. Older anatomy texts claim that the bones are fused and don't move. Not so in those of more recent vintage. Actually, only the English anatomy tradition, which we by culture follow, once claimed that the skull bones don't move. The Italian anatomists have always acknowledged that they do.
As to why CSF-flow and cranial bone movement doesn't show in MRIs and CTs: The flow and the bone movements are dramatically slow compared to blood. Other tissues move during MRI exams - the lungs, esophagus, etc. - yet they visualize perfectly well. Cranial suture movement would probably show if one was specifically looking for it and had comparable images taken the few seconds apart between maximum and minimum displacement. But the easiest way to understand cranial-bone pulsing movement is to take the time to feel it for yourself; it's not all that hard to do.
Edward Rowland, MA, DC
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