resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Nutrition for Menopause: Front-Line Therapy for All Phases
Of all the changes women experience during their reproductive life, there is no doubt the most dreaded are the three phases of menopause. This is not surprising since all of the symptoms associated with menopause are replete with unpleasantness.
Shoulder Rehab: Start With the Scapula
The scapula is an incredible display of elegance and movement within the biomechanics of human motion. It's evolved for mobility and stability in the scapulo-thoracic region, giving us the ability to do things that are uniquely human, such as throwing with accuracy.
True Practice Mobility for the Chiropractic Profession
When natural disasters occur, chiropractors can literally travel to the other side of the world to offer humanitarian relief in less than a day. The chiropractor's license to legally practice, however, can't make it past the state line.
Anti-Aging With Dr. Ping Zhang
Jennifer Waters, TCM practitioner and writer of the Acupuncture Today column, "Talking With the Masters" sat down with Dr. Ping Zhang to discuss aniti-aging with acupuncture.
Let's Clear Up the Collection Confusion
This is an often-misunderstood practice swirling with misinformation. First, a few basics: Insurance is a contract between the patient and the insurance company. The insurance company is simply making a payment for services or care on behalf of the patient.
A Conversation With Dr. Betty Edmond
This month's column is an exclusive interview with Betty Edmond MD, newly elected CEO/President of the AOMA Graduate School of Integrative Medicine in Austin, Texas.
Low Back Pain in Running Athletes
After 7 million years of adapting to upright postures, the lumbar spine and pelvis have become remarkably adept at managing ground-reactive forces associated with running.
News in Brief
Updated Neck Pain & Whiplash Guideline; Attention, IHS DCs; New VP of Institutional Advancement At Palmer; N.J. DC Interns At U.S. Olympic Training Center; Chiropractic Society Of R.I. On The Front Lines.
Prepare for the End, From the Beginning: Wealth Building and Retirement with the Tao
Yin and yang flow into and out from one another continually. Beginnings become endings and endings become beginnings again. Wholeness and cycles are the nature of Tao.
An Education in Gluten Sensitivity
A relatively new syndrome officially documented as non-celiac gluten sensitivity (NCGS) or gluten sensitivity (GS) was officially recognized and published in the new list of gluten-related disorders in 2012.
Acupuncture Points: Broadening Our Scope and Diagnostic Work
As every practitioner knows, the correct diagnosis is everything. Most healing disciplines rely on the use of symptomatology for their treatment implementation. Beyond symptomatology, we have clinical tests to provide more objective findings.
The Acupuncture Channel System (Part 1)
The earliest Chinese reference to channels is in the Mawangdui Medical Manuscripts,1 which are dated to the Warring States period of the Zhou Dynasty (475 BC-221 AD). The text presents 11 channels. There are no acupuncture points listed in those channels.
Crow Like the Rooster
As we welcome in the Year of the Rooster, we look at some of its major characteristics: confidence and communication, which suits the image we have of the Rooster...strutting in the farmyard, crowing to the others that it's time to wake up.
Qigong for Substance Abuse
It is commonly believed that substance abuse, in addition to harming one’s physiological state, hurts the spirit. There is also a belief that one’s spirit does not weaken due to substance abuse, but rather, the person finds solace in addiction due to an already weak spirit.
Flirting With Alternative Therapies
There are about as many adjunct therapies being marketed to acupuncturists as there are acupuncturists. While some may remain purist in their application of traditional Chinese medicine, others choose to explore new horizons of treatment.
Another Step Forward for Chiropractic
Chiropractic is now available to 86,000-plus Latter-Day Saints missionaries and you are invited to become a provider. LDS membership in not required; our only concern is that our missionaries get the best quality care available.
An Opportunity & a Responsibility
Nearly 80 Americans die from an opioid-related overdose every day, and spine-related pain is one of the principle drivers of opioid use. This unfortunate situation creates both an opportunity and a responsibility.
A New Year and Vision for the ACA
Inadequate pain management coupled with the epidemic of prescription opioid overuse and abuse has taken a severe toll on the lives of millions of people in the United States. Every day, more than 1,000 people are treated in the ER for misusing prescription opioids.
The Case Report: A Valuable Tool
Case reports are a valuable form of descriptive research. The most basic form of practice-based research, a case report is a detailed account of the history, presenting symptoms, assessment, observations, treatment and follow-up of an individual patient, discussed in the context of prior and potential future research.
Scar Reduction With Acupuncture & Microneedling (Part 2)
Protocols & treatment Timing
Five Branches University Has First Hospital TCM Residency
Established in 1984, Five Branches University (FBU) has campuses in Santa Cruz and San Jose, Calif., which serve the communities of Santa Cruz, the Monterey Bay, and Silicon Valley.
The winter season is upon us and offers unique challenges for the clinician and patient alike. To effectively navigate through the winter season there are two main TCM medicinals, Huang Qi and Gan Jiang, to consider, as well as two important formulas which feature these two TCM treasures.
August, 2005, Vol. 05, Issue 08
Medical Conditions in Massage Practice, Part III: Interviewing for Medications
By Tracy Walton, LMT, MS
Thanks to better training and texts, massage therapists tell me their knowledge of contraindications is growing. But many still report gaps in knowing how to interview for contraindications and how to apply the answers in the session.This series of articles has offered some suggestions for closing those gaps. In Part I, I wrote about my own intake attempts early in my career and how my interview changed over time. I also offered one important interview question regarding client activity level and types of activities with examples of the information it can bring to light for the massage session. In Part II, we added the question "Are you in a physician's care?" with follow-up questions. This question alerts the therapist to medical conditions that might pose contraindications.
Now let's turn to a third all-purpose intake question, which follows the second question nicely: "Are you taking any medications?" Along with a few follow-up questions, this question yields useful information during an intake. Unfortunately, the information in this territory can seem cryptic: drug names are notoriously foreign-sounding and long (amoxicillin, amitryptiline), sound similar (celexa, celebrex, cialis), and many of us misspell them. The good news is that massage therapists can use information about meds without having to go to pharmacy school. By asking a few follow-up questions for each medication and doing a little investigation, we can determine which massage contraindications or modifications to use. Below are some follow-up questions with some examples of how the MT might use the answers.
How do you spell that?
Correct spelling may come from the client or a little more investigation. Correct spelling is key to looking up a medication - perhaps not in the moment, but at some point for your learning. If the client can't provide the correct spelling ("It's those little yellow pills" or "The ones I use for thyroid"), it's still possible to get the needed information. But at some point determine the closest spelling possible. Search engines on the Internet can be quite forgiving with less than perfect spelling. For example, suppose you have a client with Crohn's disease on a medication that neither of you can spell correctly. If you type in "methatrexate" or even "methatrexate Crohn's disease," Google will return a kind message to you: "Did you mean methotrexate?" There are numerous sites about medications. One I use is www.drugs.com, which lists consumer information alphabetically by drug. Many drugs also have their own Web sites, including coumadin.com or prednisone.com. These sites have general information about the drug, including why it's prescribed and side effects.
What is the medication for? What is it designed to do?
This may unearth a medical condition to ask more about, especially if the condition affects tissue or organ function. Bringing it to light, the MT may need to follow contraindications for the condition itself. Suppose a client lists medications for hypertension and heart disease. The medication may not resolve the problem entirely but may just control it, and the disease is still present. Hypertension or heart disease could require modifications in client position, pressure used on the legs in case of a risk of blood clots (DVT), and other modifications. If the condition itself puts someone at risk for stroke, the massage therapist should not use pressure near the carotid artery or on any pulse points. If the client is taking ibuprofen or aspirin for the pain of an unstable injury, treat the area as unstable and avoid stretching or other strong passive movement in that area, and refer the client to his/her physician. Stronger pain medications, such as narcotics, interfere with perception and the ability to give the MT feedback about pressure. The practitioner should only use gentle pressure and joint movements to avoid causing injury.
Self-medication is vital information that comes from asking this question. Upon finding out that a client self-medicates for musculoskeletal pain, sleeplessness, headaches, etc., the massage therapist should suggest (sometimes strongly) for the client to see a physician or other health care provider for diagnosis and additional help.
Is the medication effective?
This question gets at over- or under-treatment, and there is some overlap with the question above. If a medication is not effective in reducing blood pressure, for example, treat the client as if he/she has high blood pressure and investigate massage contraindications accordingly.1 If a medication is good at preventing blood clots it will probably cause easy bruising, so lighten the massage pressure. Coumadin, a blood-thinner (anticoagulant), is one such medication. It is commonly presented as a massage therapy contraindication, but only one element of massage - pressure - is contraindicated. Use follow-up questions to determine how much pressure is too much. Some people experience mild bruising as the medication carries out its task; others have more severe problems as the right dose is determined over time. Other elements of massage therapy, including stroking, kneading, joint movement, etc., may be perfectly acceptable as long as they are carried out with gentle pressure.
Are there any side-effects or complications of the medication?
If so, other massage adaptations may be necessary for each side-effect or complication. This question has some overlap with the question above. If pain medication is so strong that it causes drowsiness in a client, he/she should not receive a vigorous massage. If it makes the client urinate frequently, he/she may need to get up during the session. If a drug (such as prednisone or other steroid medication) causes a change in fluid balance and produces swelling, massage should not attempt to shift fluids dramatically from tissue to vessels, or along vessels. A gentle session is in order. Some practitioners have advanced training and specialization in stronger work with pathologies, injuries, swelling, and scars, but most basic therapists should follow an important rule of thumb: a body adapting to strong medicine does not need the additional burden of adapting to a strong massage. More information on massage and medications is available from trainings and textbooks.2
Looking back at the questions above, note that some overlap can occur in the information gleaned. This is as it should be. The best interviews give the client several ways to respond to the most vital information. If the client doesn't mention "easy bruising" after the third question, perhaps he or she will recall it after the fourth question. Avoid too many redundant questions that prolong an interview, but give clients more than one chance to recall and mention key information.
This series has provided three all-purpose questions for the interview:
Each question can spark longer conversation, and it takes skill to move the interview along in the right direction - toward the massage table for a safe, effective, thoughtful massage. Interviews are longer for some clients, shorter for others. In most cases, ideal intake interviews are brief but also allow for a thorough, efficient transfer of information. At times these goals seem at cross-purposes, but with experience interviewing becomes easier. Thorough interviews lead to safe treatment for the increasing number of people seeking massage therapy. In addition, a good interview enriches each massage session and the therapeutic relationship with each client.
Click here for more information about Tracy Walton, LMT, MS.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.