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Healing With TCM at San Quentin State Prison
For the prisoners at San Quentin State Prison, life-sentences are the reality of every day life. It is not often that prisoners get the opportunity to use alternative medicine to deal with common ailments they encounter behind bars such as, depression, anxiety and pain.
Dr. George Goodman and His Legacy to Logan University
Those who knew him called him a revered leader, a visionary and one of chiropractic's biggest advocates. George A. Goodman, DC, Logan University's sixth and longest-serving president, passed away on Sept. 9. He was 70 years old.
Sports Science: What's in That Drink?
Athletes frequently ask me what the best liquid is to drink during exercise – water or a sports drink? Water provides the necessary hydration, but unfortunately, it lacks the key nutrients to aid in performance and recovery.
The Tao of Gender
If you think gender is as simple as having a new client check off the "male" or "female" box on your intake form, we hope this article will expand your understanding and thus the reach of your health care.
Uncle Sam Needs You (Part 2)
Where chiropractic care has been used in the military health services, it has been deemed very successful.
CMT & Stroke Risk: Myth vs. Fact
By now, most of you have probably heard that the American Heart Association recently published a statement regarding the association between cervical dissection (CD) and cervical manipulative therapy (CMT).
The Case for Immunization
As long as I have been a chiropractor, I have seen many in this profession oppose vaccinations. Indeed, it has often been taken as a "given" that to be a principled chiropractor requires a curmudgeon's willingness to hold aloft that banner of opposition.
The Wonders of Light Therapy: An Interview with Wes Burwell
I first met Wes Burwell in 2011 when he was teaching a class on light. Since then, every time I hear him speak, his understanding of the benefits, function and capacity of light has evolved.
To The Finish Line With the Help of TCM
When acupuncturist Eddy De Smedt pursued a career in Traditional Chinese Medicine, he knew he wanted to make a difference.
Correcting Pelvic Rotation Around the Long Axis: Adjustment Protocol
The pelvis can be considered a ring that can misalign on the sacrum rotating around the long axis. The following is a description of an adjustment that helps to correct sacroiliac rotation around the long axis.
Simple Ways To Find True Happiness
Patients in our clinics are always seeking happiness. As their health advocate, we need to ensure we inform them that in order to find happiness, they have to make sure to identify what makes them happy in the first place.
Lime Jello on Morphine
Taste is in the eyes... actually the mouth... of the beholder. My food preferences have changed, lightening from the food of my youth. My parents loved heavy eastern European cuisine and I loved it as a child. Now I enjoy leaner, healthier whole foods.
Essential Orthopedic Testing: Tests That Involve Standing on One Leg
Since these tests have a common mechanism of performance (standing on one leg), there are differential diagnostic concerns during testing. The tests cannot be completely isolated from each other for performance.
Commingling Money: 12 Questions for the ACA About the CHAMP / NCLAF Merger
The American Chiropractic Association recently announced it was merging the National Chiropractic Legal Action Fund and the Chiropractic Health Advocacy and Mobilization Project into a single entity that will support both legal and legislative actions.
Communication 101: Please Explain Yourself!
Twice this past week, I overheard conversations about chiropractic. As you can imagine, it is a topic my ears naturally pick up. In both cases, a patient was talking to a friend about their experience with a chiropractor.
Jingei Diagnosis: An Effective and Powerful Diagnostic
I graduated from the Kotatama Institute under the direction of Drs. Masahilo and Katsuharu Nakazono in 1984. As a student, I was exposed to the practice of most of the various theories and modalites of Oriental Medicine.
Managing Patient Expectations About Acupuncture
Last year, I attended the Pacific Symposium in San Diego for the first time in six or seven years. It was the 25th anniversary of this event, and on one evening there was a panel discussion with the title; "What is Qi?."
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 2)
As mentioned in part 1, using a flexion-distraction table is a great way to unlock this particular fixation. You have found the stuck segment. You have determined whether it is unilateral, midline or bilateral.
AOMA Strengthens Leadership Team
AOMA Graduate School of Integrative Medicine, a leading college of acupuncture & herbal medicine, announced the appointment of Donna LaPoint Hurta, MBA as the new VP of Finance & Operations this Fall.
Pulse Diagnosis: What We Know
I am still finding pearls of wisdom from the books and papers that I inherited from my pulse diagnosis mentor Jim Ramholz.
Chiropractic Research in Review
Predicting Pain With Disability in Office Workers; Traction Approaches for Discogenic Cervical Radiculopathy; Intra-Articular Gas Bubbles Following Manipulation; Nonresponsive Chronic Ankle Sprains: Think Tendon Rupture.
Managing Today's Fertility Patient
I recently received an email from one of my fertility patients: "Got my lab results back. FSH is 11, AMH is 0.7. My doctor said these numbers aren't good. I guess I'm infertile. Just as a thought. Just set up an appointment to speak with an adoption agency."
September, 2009, Vol. 9, Issue 09
Knowledge Translation in Massage Therapy
By Whitney Lowe, LMT
I recently received an e-mail from a practitioner concerned about a study he had read about massage. The study reported that massage did not aid the removal of lactic acid from the body nor did it increase circulation, both commonly reported effects of massage.He was concerned that what he had learned in school wasn't true and perhaps his work was not that helpful after all.
Are these issues true, and do they mean that massage isn't all it's cracked up to be? Well, yes and no. Research has established for some time that massage does not speed the removal of lactic acid from the body. Does that mean massage isn't useful in reducing soft-tissue pain and disability? Certainly not. On the contrary, this finding actually helps us better understand the physiological effects of massage.
What about massage not helping increase circulation? This one is a little trickier. Most of the studies investigating the effect of massage on increased circulation have focused on blood flow increases through major vessels. Massage does not increase blood circulation through these larger vessels. However, rarely do these studies investigate circulation through small capillaries in muscle tissue and skin. Increases in small capillary blood flow bring fresh oxygenated blood to muscle tissue and produce hyperemia (the characteristic redness) in the skin.
What this story illustrates is a need we currently have in all health care professions, including massage. This need is addressed by a discipline known as knowledge translation. Knowledge translation (KT) is the process of integrating research findings into clinical practice. A recent study investigating knowledge translation in medical practice noted that it takes about 20 years for advances in medical knowledge to be incorporated into clinical practice.1 This lag time is one reason that myths persist, such as the role of massage in removing lactic acid from the blood.
How Does KT Fit with Massage
There is increasing emphasis on the importance of research in the massage profession. New findings allow massage professionals to refine clinical treatments so effective care can be provided. An example of how integrating science is relevant for massage comes from recent research into the pathology of overuse tendon disorders. It is now recognized that most overuse tendon disorders involve degeneration of the collagen matrix within the tendon structure (tendinosis) and not an inflammatory condition resulting from torn tendon fibers (tendinitis).
For years, the primary massage treatment strategy for overuse tendon disorders has been deep transverse friction. Treatment protocols emphasized friction applied in a transverse direction to re-align the scar tissue from torn tendon fibers. Today, we know that the primary benefit of friction massage is actually the combination of pressure and movement in stimulating fibroblast production, thereby enhancing the tendon's healing process.
This finding has important implications for treating problems such as bicipital tendinosis in the shoulder. Deep transverse friction treatments applied to the bicipital tendon run the risk of popping the muscle's tendon out of the bicipital groove. It is now understood that tendinosis is effectively treated with longitudinal friction since pressure and movement, not pressure direction, are the key.
Challenges to Implementing Research
There are reasons why research is not more quickly integrated into health care fields, including the massage profession. The volume of information currently being published is simply overwhelming. One study suggested that for physicians to keep abreast of current findings, they would have to read 19 original articles each day.2
Another issue is the sheer complexity of the research; interpreting information from a study can be difficult. In other cases, such as the massage article mentioned above, the findings can be misinterpreted if the study's design and methodology are not more closely analyzed.
Another challenge for integrating research into practice is long-held beliefs or practices. This challenge is captured by a wonderful quote from the Canadian researcher Serge Gracovetsky. At a fascinating presentation at the 2007 Fascia Congress in Boston, he stated, "Medicine is perhaps the only discipline in which an attractive idea can survive experimental annihilation." In order to advance the health care professions, there needs to be adaptability and willingness to change practice patterns in response to new research findings.
Research Integration Barriers
The problem of integrating scientific research into massage therapy centers on several key issues. The first is access. Knowing how and where to access primary source Web sites and journal articles remains a barrier for many clinicians. It is also very difficult for full-time professionals to find the time required to look up and read material.
A second barrier is the material itself, often written in difficult medical jargon, with methodologies unfamiliar to the massage professional. The answer to this problem lies with both the source and the recipient. First, the massage professional needs to develop clinical reasoning (see my MT column March 2009) and research literacy skills. Being capable of interpreting and evaluating research, as well as analyzing methodology, is critical. An individual must be able to read an article or research study, evaluate and critique aspects of it, and then conceive how its findings may relate to clinical practice.
On the other side of the equation, those scientists producing published materials must be able to write clearly and well (which is why many choose to use technical writers). They also need to find ways to get their materials out to relevant communities. The gap between scientist and clinician is fundamentally both a communication problem and a mechanism issue. What mechanism is being used to get material to the clinician? What format and how accessible? Answering this dilemma is what KT is about.
Knowledge Translation as a Solution
The increasing complexity of our health care system and the volume of published literature require an increased emphasis on KT strategies. Finding ways to make research more accessible and improving research literacy among clinicians is critical to the profession.
Massage therapists have a wonderful resource in the Massage Therapy Foundation, which is dedicated to improving access to and expanding resources for massage professionals. There are now two peer-reviewed publications available, the Journal of Bodywork & Movement Therapies and the International Journal of Therapeutic Massage & Bodywork (an open access online journal from the Massage Therapy Foundation).
In addition, massage educators - both basic training and continuing-education providers - have important roles in KT. Many CE educators already make current research an integral part of their programs, but many more could improve this aspect of their teachings. There is an increasing movement to make research literacy part of the initial training programs for massage students. As more people within the field develop research literacy, the move to bring research into clinical practice will grow.
The more clinicians incorporate the latest findings from quality clinical research, the more effective and successful they become in their practice. With that, the more the profession can continue to develop as a legitimate and critical part of the health care industry.
Click here for more information about Whitney Lowe, LMT.
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