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Help Update the LBP Practice Guideline
The Council on Chiropractic Guidelines and Practice Parameters has announced the release of an updated Clinical Practice Guideline for Chiropractic Management of Low Back Pain for stakeholder review and comment.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
Avoid Random Treatment of Trigger Points (Part 2)
We must acknowledge that the fascia, which surrounds literally everything in our bodies, including every muscle fiber, is more than just a covering.
Expanding Access, Branch by Branch
The big news coming from Capitol Hill isn't merely the recent introduction of a pair of bills designed to expand chiropractic services in the Veterans Affairs and military health care systems; after all, similar legislation has made its way through Congress before, never reaching the Oval Office for presidential signature.
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
A Reality Check – and a Chance to Educate
Imagine working in the public relations department of nutrition retailer General Nutrition Corporation (GNC) and reading the The New York Times announce...
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
Impacting Chiropractic's Future With Technology
When it comes to electronic health records (EHR), Robert Moberg and Dr. Steven Kraus are two of the leading industry experts on the topic.
Interpersonal Skills 101: Enhancing the Value of Our Patient Interactions
Recently, I read an interesting article in our local newspaper titled "The Value of Human Interaction." The article presented comments from a senior editor for Fortune magazine who discussed "Civility in the Business World."
Atypical Femoral Fractures and Bisphosphonate Use: What to Watch For
Bisphosphonates (BP) are popular drugs, with more than 8 billion in sales in 2008; however, profits have declined as patents began expiring. Nonetheless, BP remain the most commonly prescribed drugs for patients at risk of osteoporotic fractures, with several million prescriptions written every year.
B Vitamins Improve Memory, Prevent Brain Atrophy
The 2010 OPTIMA study showed that the accelerated rate of brain atrophy in elderly with mild cognitive impairment could be slowed via supplementation with homocysteine-lowering B vitamins, which included folic acid, vitamin B12 and vitamin B6.
Primary Spine Care: Addressing Concerns & Criticisms
The Dec. 1, 2013 issue of Dynamic Chiropractic included an article describing the implementation of a training program for primary spine practitioners (PSP) within a metropolitan region and supported by a large BC/BS plan.
Low Back Pain: Posture and Movement Analysis
When performing static and dynamic movement analysis of the lumbopelvic hip area, begin with standing visual posture analysis of the pelvis, and then perform lumbar range of motion and assess what you might see during normal versus abnormal lumbar flexion motion.
June, 2006, Vol. 06, Issue 06
Massage and Embodiment
By Keith Eric Grant, PhD, NCTMB
Finding myself in the full spring of the second half of the first decade of the 21st century seems cause enough for a bit of reflection on touch and training.Part of this comes from having had weeks of rain and drab grey light in central California, now suddenly giving way to blue skies, scattered wisps of clouds, warm sunlight, bird song and gentle breezes laden with hints of flowers, grasses and herbs. A spirit could choose far worse times and places to be embodied.
One of the modern paradigms of massage is to induce relaxation. The techniques required for relaxation massage are simple and easily taught, the results often depending as much on intent and connection with the client as with the technique. It's ironic that those wishing to focus only on providing relaxation massage to their clients have been subjected both to the scorn of other practitioners and to legislation requiring far more hours of training than needed simply to provide positive touch. The irony lies in missing the value of the gift of human time and relaxation in our 24/7 world. It's estimated that stress costs business $300 billion per year, contributes significantly to loss of health, increased domestic and workplace violence and loss of community connection.8 Honor those who serve the human needs of others. Enough said.
A second paradigm of massage has been to focus on massage as health care. While certifications and state regulation has been touted to address this paradigm, what has been provided is a relatively empty facade. The vagueness of massage education requirements is a major reason that two "medical massage" organizations have arisen, as well as the basis of the incapacity noted by Ralph Stephens in his March 2006 Massage Today column, "Education - Where Does Advanced Begin?" (www.massagetoday.com/archives/2006/03/02.html). Current "standards without outcome specifics" also are the reason I've both tackled the Massage Medical Applications Project 7 and am working as part of a small group, under the auspices of the Massage Therapy Foundation, to define best practices for massage as health care. Such projects exist because guidelines, based on research and objective evidence, don't currently exist.
Ralph Stephens points out problems with corporate influence on massage training in his May 2006 column, "Put Your Hands on Your Monitor - Part 1" (www.massagetoday.com/archives/2006/05/10.html). I differ from Ralph slightly in believing that massage schools are part of the profession, rather than just the business infrastructure, to the extent that those running programs are immersed within massage. I agree with him where massage is simply another add-on area of training. In California, dedicated massage schools continue to resist a larger vocational school organization's desire for legislative policies that would undercut their economic niche and viability.
My third paradigm, the impact of massage on the quality of body-sense or embodiment of the client, has been largely ignored by those looking at massage as tissue-specific health care. Such work, traditionally taught by holistically-oriented massage schools, is not likely to be picked up by corporate career schools. It might appeal to a massage degree program, but these are still few.
The truly amazing aspect of our embodiment is that we inherently have a cohesive sense of our own bodies. The leap from input signals from a myriad of sensors to an integrated body sense is indicative of the unconscious processing capabilities of our brains. Our abilities in spatial integration have profound consequences to our health. From research on phantom limb pain, Ronald Melzack concludes that we have a neuromatrix analog of our physical bodies, dependent both on input and on current state for its sensory output. Recent haptic research by Martin Grunwald suggests that distortions in tactile integration may contribute to anorexia and may be treatable by sensory stimulation. For some, sensory processing is challenging - the feelings of overload restricting the choices of clothing to those which minimize disruptive input4. For many others, the tactile nature of clothing and fabrics, described by terms such as hand, weight, drape, and texture, is part of the joy of embodiment.
Practicing massage as sensory reframing has no lack for material to draw from. Maurice Merleau-Ponty set out a philosophical framework more than a half century ago.6
Deane Juhan describes the sensory benefits of bodywork as "a cumulative process of [clients] getting to know their own bodies and their own sensations from a fresh perspective, a process that continues to help them discover who and what they are and to learn to exercise some measure of self-control over many of the vagaries of their physical and emotional symptoms."5 Donald Bakal lays the same stress on developing body awareness as a path to healing in Minding the Body.1 The lack we face is not in material to teach, but in the value being given to it by the profession of massage. It is material ill-suited to the concept of massage as the application of anatomical knowledge and tissue-specific techniques to a passive client. It does not fall within the circle of value, and thus the "career" teaching, set by a standardized test. We either begin to accord more value to this material and those who teach it, or we might soon count it as part of the unintended collateral damage of the rush to massage as a standardized profession. Whether it's the future consideration of massage teachers or of massage historians is our individually made collective choice in the policies we set and the values we promote.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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