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Q&A With the First VA Chiropractic Residents
As you may have read previously, a major step forward for the profession occurred in July 2014 when the Department of Veterans Affairs began piloting a chiropractic residency program at five locations.
NCCAOM Video Contest
The NCCAOM is excited to announce the launch of the second annual video contest "Because it Works!" 2015.
Key Changes and Updates to the 7th Edition CNT Manual
Acupuncture Today recently interviewed Jennifer Brett, ND, L.Ac. regarding the updates to the CNT manaul.
Treatment of PTSD: An Opportunity for the Practice of Integrated Medicine
PTSD is widespread across America today. Not only do many of our honored men and women in uniform bring it home with them from the war zones they have been active in, but it often follows any life-threatening event people go through when their lives have been in danger.
Integrative Medicine for the Underserved: A Seat at the Table
Numerous organizations have risen to the challenge of providing care to medically-underserved populations and here we feature one such group.
The Source-Luo Point Combination, Part 2
The Da Cheng includes symptoms for the source-luo points that indicate when to use them for treatment. Yang defines the method as the guest-host (it is one of a variety of acupuncture point combinations called guest-host).
The Three Heater Official
This Official, belonging to the element Fire, is responsible for maintaining and regulating the heating system of the body, mind, and spirit. It is named for its function. The trunk is divided into three "burning spaces" or "jiaos."
Chinese Doctors Poke Holes in Australian Study
A recent Australian clinical trial, published in the Journal of the American Medical Association (JAMA) in 2014 by Rana Hinman, et el., evaluating the effectiveness of both needle and laser acupuncture for chronic knee pain.
Marketing with a Microphone
When given an option, it stands to reason that people prefer to do business with those they know, like, and trust.
News in Brief
Investigating the Cellular Impact of Mechanical Force; National Board Seats (Not-So) New Officers at Annual Meeting.
I was sitting in a Pizza Hut in Peoria, Ill., with my friend Reggie, sometime in the spring of my senior year in college, when he started doodling on his paper placemat. In those days, the company had a picture of U.S. on the mats, showing all the locations of the "Huts" in the country.
Creating Relationships at Southwest Symposium
The month of May brought many interesting activities. As I have said in many previous columns this year, this profession is moving in a very exciting direction. Make sure you are getting involved. If you're not, you just might get left behind.
Desert: A Metaphor from the Study of Genetics
In most of the human lives I know about, there are stretches of time which feel stagnant, or worse. We can feel adrift, or wounded and sidelined, and these times don't seem to carry much usefulness while they are unfolding.
Meet Cheyenne: Your Future Colleague
Allow me to introduce you to Cheyenne (Chey), the daughter of some of our family's closest friends. We attend and serve at the same church together, and have known each other for many years.
Should You Change an Athlete's Natural Running Form?
Once past the ankle, impact forces travel at about 200 mph into the knee. In addition to allowing the quad to absorb force, bending the knee (E) prevents the hip and pelvis from moving up and down too much (F), which is important for injury prevention and efficiency.
The Risks I Took
We all take risks when we choose this profession. For some, it is not knowing if you can make a living practicing TCM. For others, it is parental or cultural disapproval.
Free Yourself From the Pocketbook Practice
Let's take a journey together; there's an important lesson to be learned. Imagine a town or city just like yours.
Leg-Length Inequality and Pelvic Fixation: A New Approach to the Negative Derifield (Part 3)
A patient with sacroiliac fixation and dysfunction ordinarily demonstrates a noticeable leg-length inequality when placed in the prone position on the adjusting table.
Sports Medicine 101: Surgery or No Surgery?
In the world of sports medicine, many careers are saved by surgeries that correct traumatic damage to the body. Muscle tears, ligament damage, fractures, spinal disc herniations, and joint instabilities are a few of the issues frequently addressed with surgical intervention.
Going On-Site With Chiropractic Care
The Foundation for Chiropractic Progress has released a position paper highlighting the financial, clinical and patient-satisfaction benefits of providing chiropractic care at on-site corporate health clinics.
Nomenclature and Classification of Lumbar Disc Pathology: Version 2.0
The Nomenclature and Classification of Lumbar Disc Pathology consensus, published in 2001 by the collaborative efforts of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology, has guided radiologists, clinicians and the public for more than a decade.
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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