resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
The Urinary Bladder Official
The Bladder Official is known as the Official Who Controls the Storage of Water. In Western medical terms, this organ collects the urine excreted by the kidneys.
Peer Points: Spreading The Word
Pedram Shojai describes his venture into Traditional Chinese Medicine as a journey led by various "mystical experiences." Shojai decided to change the course of his career when he looked deeper into the basics of TCM.
The Many Faces of Cervical Compression
When evaluating the neck, there are any number of orthopedic tests to be considered.
Gaining an Independent Occupational Code with the U.S. Bureau of Labor Statistics
One of the most important national activities currently taking place in relation to the development of the field of AOM profession is the Department of Labor's Bureau of Labor Statistics' (BLS) revision of the 2010 Standard Occupational Classification (SOC) system.
Betraying Patients and the Profession
Imagine flying from New York to Paris on a jumbo 747. Your thoughts are on your vacation and experiencing the City of Lights. Midway over the Atlantic Ocean, you overhear the flight attendants talking in muffled voices.
Increased Breast Cancer Risk: Another Implication of High Cholesterol
In addition to being a known risk factor for heart and cardiovascular disease, recent studies have highlighted the link between high cholesterol and increased risk of breast cancer. Breast cancer is the second most common malignancy in women after skin cancer.
An Alternate Method For Choosing The Right Formula For Your Patients
A constant question for us in the clinic is when to make adjustments and when to stay the course. A patient comes in and says, "Things are the same as last week."
Look, Listen and Learn to Code
Study of the Current Procedural Terminology (CPT) Evaluation and Management (E&M) coding system can leave a doctor of chiropractic a bit confused. The description of the five new-patient and five established-patient examination codes takes up several pages in most coding books. The degree of detail and charts used to describe the codes can be overwhelming.
Acupuncture Ambassadors: A Chat with Leader Anthony M. Giovanniello, MSAc,LAc
When you first meet Anthony Giovanniello, you realize he's a humble practitioner, yet is bursting with a type of dedication that you can't help but be overwhelmingly inspired by.
Common Disorders of the Temporomandibular Joint
The evaluation and management of craniofacial pain is a complex endeavor, which often encompasses the presence of temporomandibular joint disorders.
Putting Public Health Into Action: Thinking Globally, Acting Locally
The Chiropractic Health Care section of the American Public Health Association (APHA) met at the 141st APHA Annual Meeting and Exposition in Boston late last year, and it was another triumph for chiropractic and its public health advocates.
Why Stretching Doesn't Work
Like most chiropractors, a good part of my day is spent working with sedentary office workers who spend eight to 12 hours a day glued to a desk chair in front of a computer.
Qigong to Empower Our Youth
Qigong is an ancient form of exercise and meditation used to promote longevity and health. This practice has traditionally been used by adults to balance the body through mindfulness, focused breathing and gentle movements.
We Get Letters & E-Mail
Let's Restore Integrity to Health Care – Starting With Us; MDs Offer More – So Can We.
The Importance of Staying Focused
Our world is so full of over stimulation and constant information. We live in a fast paced, ever-changing society. If you seek you will receive.
Using Facial and Scalp Acupuncture To Treat Neuromuscular Facial Conditions
As a practitioner and instructor of facial rejuvenation acupuncture I have gotten many calls over the past 10 years from individuals seeking help for various conditions affecting the facial muscles, nerves, and overall function of the face.
Ask and You May Receive
A friend of my mother has had a problem with her ears for almost 20 years. Whenever the wind blows, it sends shooting pain through her jaw. She has seen any number of medical specialists over that time, but with no relief.
Climbing the Ladder of Opportunity (Part 1)
President Obama spoke of building "ladders of opportunity" in his State of the Union and Inauguration addresses.
The Deficiency Myth
If you went to the same kind of medical school I did and took the same kind of licensing exam I took, you were trained to seek out and expect to find primary deficiencies here in the U.S.
An Introduction to Evidence-Based Clinical Practice - Again
One of your patients is in for treatment and catches you off guard by asking you a question about a news article she recently read. It seems that a new intervention for back pain was found to reduce the rate of serious side effects by 50 percent.
New Knee, New Pain (Part 2)
The patient presented to the chiropractic clinic with symptoms of genu varum and pain on the medial aspect of the tibiofemoral joint.
Embracing the Light
Four years, ago I was diagnosed with a labral tear in my hip that was excruciating and "required surgery" according to an orthopedic surgeon. I tried everything and although the symptoms had mostly abated, I had to give up Yoga practice and everything that could exacerbate the tear.
News in Brief
Parker Announces Executive Director of Parker Professional; Athletic TIPS Program Getting Financial Support; ANJC Award Recipients Named.
Preserving the Natural Resources and Culture of Chinese Herbal Medicine
As the world experiences unprecedented population growth and ever-increasing ecological pressures, the topic of preserving Chinese medicine's natural resources has attracted steadily increasing attention from practitioners.
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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