resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
The IME System: A Current Public Health Risk and Solutions That Are Working
I strongly believe in the independent medical examination (IME) system. There are far too many doctors in every profession who are not following E&M protocols and never claim MMI (maximum medical improvement) has occurred for their patients, which has caused financial stress for many private and public carriers.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Recording and Appropriate Billing of Timed Physical Medicine Services
There is a common misunderstanding about timed therapy services and although you do have some knowledge of timed service documentation, based on your comment on the 8-minute rule, your understanding is correct, but incomplete.
Vitamin D Fails to Help Knee OA? The Proper Perspective
The March 8, 2016 issue of JAMA includes a study about vitamin D supplementation for osteoarthritis of the knee. This is a really weird study.
How to Find and Fix TL Nerve Impingements
The thoracolumbar junction (TLJ) and the peripheral sensory nerves that exit from it are frequent, important and rarely recognized sources of lower back, pelvic and hip pain. Let's outline a clear exam protocol for diagnosing the problem.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
The Power of Eccentric Exercise: Hamstring Injury Prevention and Rehab
For almost 20 years, I've worked with professional athletes who make a living by running really fast. It goes without saying that hamstring injury (HSI) prevention and rehabilitation is a big part of what they expect from a sports chiropractor.
Musculoskeletal Disorders Take Center Stage
Looking for the latest on the musculoskeletal pain epidemic and the increasing premium placed on preventive strategies including chiropractic? Check out The Impact of Musculoskeletal Disorders on Americans – Opportunities for Action.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
Business Lesson #1: Adapt or Else
My wife and I recently enjoyed an excellent meal at a restaurant recommended by some friends. We often have concerns about restaurant recommendations, as many have been disappointing.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Essentials of Assessment: The Squat
The squat is a simple, fast and functional tool to evaluate patient symmetry and function. As simple and easy as it is to implement, it can yield considerable amounts of valuable, clinically relevant information.
January, 2006, Vol. 06, Issue 01
Prenatal Massage During the First Trimester
By Elaine Stillerman, LMT
Among some of the myths and old wives' tales surrounding prenatal massage is the misguided belief that massage should be avoided during the first trimester. It's fair to say that under the skilled hands of a certified prenatal practitioner, massage during the first trimester is not only safe, but can be especially supportive during the transitional first months.
One of the reasons many practitioners and spas refuse to massage first-trimester clients is the fear of causing a miscarriage.Miscarriage is defined as a spontaneous loss of a pregnancy before the fetus is viable, which generally means before 20 weeks gestation. (An early spontaneous abortion occurs within the first 12 weeks; a late spontaneous abortion happens within weeks 12-20.) Almost 90 percent of miscarriages occur within the first eight weeks, so the reasoning concludes that if you avoid the massage, you will avoid the miscarriage. Unfortunately, this logic is not based on science, but rather on litigious concerns.
Miscarriages occur very frequently, perhaps in as often as half of confirmed pregnancies, and most miscarriages can't be avoided. They rarely are caused by anything expectant women do or don't do. In nearly half of all known losses, the embryo was chromosomally abnormal and not viable or able to sustain life. Other possible risk factors include genital and reproductive structural abnormalities (retroversion of the uterus, bicornuate uterus, fibroid tumors, etc.), infections (chlamydia, rubella, listeria, ureaplasma, mycoplasma), maternal disease (diabetes, renal disease, thyroid conditions, nutritional deficiencies), ectopic pregnancies, hormonal imbalances, immunological rejection, maternal age (the older the gravida, the greater the risk of miscarriage), and environmental factors such as first- or second-hand smoke, excessive alcohol consumption, exposure to organic solvents, and excessive radiation. Massage is not a contributing factor in any of these physical or environmental circumstances, and is not causative in a miscarriage.
In early pregnancy, symptoms of a miscarriage include bleeding, abdominal pain or cramping, and lower back, thigh or pelvic pain. In late pregnancy, a miscarriage is accompanied by heavy bleeding, including the passage of blood clots and intense uterine contractions. If a client presents any of these symptoms, massage obviously is contraindicated.
The other explanation practitioners use to avoid first-trimester massage is the issue of morning sickness. Nearly 85 percent to 90 percent of pregnant women experience morning sickness and nausea in early pregnancy; for 10 percent of them, the problem persists beyond the first trimester. While it's clearly accepted that massage for anyone nauseous or vomiting is contraindicated, you can make appointments to massage your pregnant clients when they are not experiencing symptoms. These treatments effectively can reduce the severity of symptoms.
There are other suggestions you can make to your pregnant clients to reduce morning sickness. They should eat small but frequent meals throughout the day. Eating a protein-rich meal or snack before bed will reduce morning nausea. Protein takes a long time to digest, and they won't wake up with an empty, gnawing feeling in their stomachs. Cut up a fresh lemon into wedges and put the wedges in a plastic bag. They can inhale the lemon as needed. One drop of peppermint oil in honey water every hour helps some women. Other women find ginger tea, ginger ale and ginger candies very soothing. Drinking red raspberry-leaf tea or sucking on the pit of an umeboshi plum (found in health food stores or Oriental groceries) can settle the stomach. Stimulation of acupuncture point Pericardium 6 by wearing motion sickness "sea bands" or with digital stimulation is extremely effective in eradicating or minimizing nausea. This point is located on each forearm, 1 1/2 inches below the wrist, in the middle of the inner forearm.
Press for a count of 6-10 and repeat a total of 6-10 times.
Another concern regarding first-trimester massage includes avoidance of abdominal massage due to the fear of dislodging the placenta. This is another unfounded fear. It's strongly advised to ask the client's permission before massaging her abdomen at any stage of the pregnancy, and the abdominal massage always should be done with an open palm, light pressure and gentle effleurage following a clockwise direction, but the placenta is attached firmly to the uterus and appropriate massage will not damage or dislodge this strong attachment.
Properly trained prenatal massage practitioners can safely and effectively address first-trimester concerns. For those of you who work in establishments where first-trimester massage is avoided, liability is a major contributing factor to this decision. Since this business policy has been set by the management, you have to adhere to what management decrees. In private practice, however, you can base your decision on science and appropriate training, not fear or misconceptions.
Click here for previous articles by Elaine Stillerman, LMT.
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