resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
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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