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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.
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.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
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.
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.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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?
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?
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.
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.
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.
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.
June, 2005, Vol. 05, Issue 06
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 or regular mail to:
Regarding the National Certification Board
It's been said that criticism is free advice offered by people who truly care. So on behalf of the NCBTMB, thank you for caring about national certification and for the chance to share an insider's view ("Lots of Stuff," May 2005, www.massagetoday.com/archives/2005/05/07.html).
Things are not always as they appear. Tempting as it may be to point fingers when the going gets tough, the board is sensitive to the recent controversy and takes personal responsibility for the decisions and leadership of the NCBTMB. That said, the nomination process was flawed and required intervention. The board made changes to the process and continues to review policies that ensure propriety, and help us practice what we preach.
Losing two executive directors, a board chair and chair-elect, has been extraordinary. While others may view them as detrimental, these events have helped the board reconnect with the principles of consensus and accountability and thus made it possible for us to let go of an 11-year relationship with our management company. Quite simply, the NCBTMB is transitioning from adolescence to young adulthood, and growing up. We appreciate that a mature organization values its stakeholders, understands its purpose, recognizes its strengths, identifies how it needs to grow, and implements strategies to that end. By electing Elizabeth McIntyre - an experienced and qualified board member - as chair-elect, seeking an executive director whose loyalty is to certificants, and hiring personnel who value the industry, we hope to demonstrate our learning and that we're listening to those we serve.
Cliff, please continue to voice your concerns as you see them and join us as we begin a new era for the NCBTMB. Together we can discover the good that is yet to come.
Garnet Adair, chair NCBTMB
I appreciated your article in the April 2005 issue that puts some serious questions to representatives of the National Certification Board ("Winds of Change Blowing at NCBTMB," www.massagetoday.com/archives/2005/04/01.html). One point that I would like to highlight and would like to see addressed further is the following quote from Garnet Adair:
This statement makes it sound as though the candidates who take the test actually get to discuss any concerns they have over difficult or unclear questions with someone who can do something about it; this is decidedly not so. When I took my exam back in December 2000, I was not even allowed to see which questions I missed - just that I passed the exam. And as I understand it, candidates are also not allowed to remove test questions from the test site. How are they supposed to remember the unclear questions after answering 160 test questions? And to whom could they even address these concerns?
Real "beta testing" in the computer software world involves users who actively test a new piece or component of software and offer feedback to the programmers and designers about how it can work better. As I see it, there is no feedback mechanism to the NCB. I am beginning to agree with those who feel that the NCB's power is getting out of control.
Andrea Porter, LMT
I had the opportunity to read the article and interviews regarding the NCBTMB and just had to e-mail you. I certainly had to chuckle when I read the reply to Massage Today's question regarding the monopolization of the massage therapy profession by the NCBTMB and AMTA. The response was: "They are another professional related organization. One is a membership organization; one is a voluntary certification."
Voluntary? It has been my experience in dealing with states that use the NCBTMB as their certifying exam that it is anything but voluntary. I just needed to voice my opinion.
Marie A. Ruberto, Managing Director
"Rather than reinvent the wheel, let's clarify our use of already defined terms"
Since every profession needs a clear scope of practice, it was refreshing to read Ralph Stephens' March 2005 editorial titled "What Scope of Practice?" (www.massagetoday.com/archives/2005/03/11.html). While I agree with Mr. Stephens regarding our need for a well-defined, cohesive scope of practice, any massage legislation must be inclusive of our entire profession to represent more than special interests. As a 25-year practitioner and massage educator, I am often dismayed with the widespread impression of many massage graduates that they are medical practitioners able to treat condition Y with technique Z. How did a "medical" scope of practice - that a massage therapist can evaluate, diagnose and treat soft-tissue disorders - seep into so many massage training programs?
This approach creates several problems. First of all, massage therapists generally lack training in a preliminary step of this cause-effect equation - evaluation X. Before being qualified to evaluate soft-tissue disorders, physical therapists undergo four to six years of education and training. Also, they are often required to gain some years of clinical experience before being allowed to practice evaluation on their own. Although competent and well-trained manual massage therapists help many people with soft tissue problems, it is doubtful that evaluation skills could ever be adequately taught in 500-1,000 hour massage therapy programs.
Second, evaluation is prohibited by the scope of massage practice defined in many state laws. Both the American Medical Massage Association (AMMA) and the American Medical Massage Therapy Association (AMMTA) recommend and/or require specific continuing education classes to standardize evaluation and treatment skills in medical massage (Mr. Stephens' classes are on both lists).
Yet 24 states with licensing laws include statements to this effect: Massage is defined as excluding the diagnosis or treatment of illness or disease or any service or procedure for which a license to practice medicine, nursing, chiropractic therapy, physical therapy, occupational therapy, acupuncture, or podiatry is required by law. Since many of the manual therapy techniques advocated as medical massage arose within the practice of medicine and physical therapy, conflict is inherent if we practice them within an X-Y-Z medical protocol.
While my preference is for the more personal, holistic approach to manual therapy offered by "medical" massage therapists, as both a client and practitioner I will continue to rely on medical professionals for evaluation and diagnosis.
Consulting with them about the medical conditions of our clients builds bridges between our professions. Furthermore, given the history of costly legislative battles between chiropractors, physical therapists, occupational therapists, and others squabbling over "turf," it is highly unlikely that even a well-organized massage coalition will ever be able to afford the lobbying clout to change the laws already on the books. And do we want to?
Rather than be PT wannabes, let us own and promote what massage already offers: effective methods that promote deep, profound relaxation; pain, muscle tension and stress reduction; and the enhancement of health and well-being. Practitioners can still practice "medical/orthopedic massage" within a remedial / holistic context (already written into many state laws) to alleviate symptoms and improve the structural balance of a client.
Rather than reinvent the wheel, let's clarify our use of already defined terms. Since "medical" is defined as relating to the science or practice of medicine or treatment of disease, "medical massage" should be inclusive of all massage methods applied to people with medical conditions. Many agree that what the AMMA and AMMTA call medical massage is better described as orthopedic massage. Why not call it what it actually is?
Third, advocates of the medical/orthopedic massage would separate the profession into relaxation and therapeutic modalities. Why? Relaxation massage is therapeutic. It just may be the truest application of medical massage for the injured, ill and dying today. Medically based relaxation massage deserves more acknowledgment than it receives.
Since I may be ill and for sure will be dying some day (as will you), I take great comfort in knowing that many massage therapists today practice in hospitals and hospices. Read the state laws and it becomes apparent that massage does have a defined scope of practice that is fundamentally holistic. We simply need to hone it and then collectively and proudly own it.
Mary Ann Foster, BA, CMT
I completely agree with Mr. Stephens that a simple scope of practice is easy to sell politically. The scope of practice he describes is essentially diagnosing and treating minor myofascial conditions using manual manipulation, mechanical and electrical devices, and nonprescription medication. This scope of practice is proven to be successful, as it is the scope of practice of the chiropractic and/or physical therapy profession.
Allowing a massage therapist to use electricity, manual manipulation or to diagnose is a difficult political sell. First, it infringes on the chiropractic and PT professions. More importantly, it is difficult convince most people that a vocationally trained massage therapist is capable of diagnosing problems. At present, diagnosis of myofascial problems is limited to college-educated people. If you strip out the controversial language, the scope of practice becomes the treatment of minor myofascial conditions. This may work.
Bruce Klein, ND
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