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History of Animal Acupuncture: Part II
In Part I of this article, I had gone back to 1969 and tried to describe the atmosphere and events of that year that engulfed many of the younger generation, some who were all the core members of the National Acupuncture Association.
The Truth About Herbs
I appreciate the effort and research put into the article written in the June issue of Acupuncture Today regarding pesticides and Chinese herbs.
The Science Behind Happiness
Are you happy right now? Whether yes or no, there are a myriad of reasons why you feel that way. A whole academic discipline has developed to find out what causes or obstructs happiness, and how to amplify it.
Improving Our Political Effectiveness
The November 2014 elections are right around the corner; members of Congress, governors and state legislators are all running. Now is a good time to talk frankly about our overall political involvement.
News in Brief
NBCE Launches Computer-Based Testing Era; California Chiropractors Get Expanded DOT Exam Privileges; New Jeff Hays Documentary.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 1)
When we think of lower back pain, we tend to think in terms of the lower lumbar spine and the SI joint. These joints and their discs are obviously important. However, we tend to miss fixations that occur just above – in the upper lumbar spine. Three questions come to mind: 1) Why is the upper lumbar spine so important? 2) Why do we miss the fixations here? 3) How can we adjust them?
Rethinking GMO: Less Panic, More Context
Some of you may have noticed that after writing parts 1 and 2 of “Genetic Modification of Organisms for Human Consumption” a while back [Nov. 15, 2013 and Jan. 1, 2014 issues], part 3 never appeared.
Get Ready For AOM Day
This year, AOM Day 2014 falls on Friday, (October 24th). This is a great opportunity to make your AOM Day celebration or event even bigger by extending it throughout the weekend!
The Spirit of the Point
After receiving a large amount of positive feedback on my San Zhen Protocols series, I have decided to focus this article on some relevant clinical aspects of acupuncture therapy prior to moving on to San Zhen Protocols III.
Help Secure Our Future by Sharing It
The National Board of Chiropractic Examiners (NBCE) conducts one of the most comprehensive surveys of the U.S. chiropractic profession every 4-5 years.
MPA Media Wins Seven Publishing Awards
MPA Media, publisher of Acupuncture Today, among other titles, has been recognized for editorial and design excellence with an unprecendented seven publishing awards by the ASBPE, the nation's largest organization for business-to-business publications.
Thoracolumbar Syndrome: The Great Mimic
The thoracolumbar junction is a common area of joint dysfunction. The most obvious cause is dysfunctional breathing or lack of diaphragmatic breathing. Treating this breathing problem will ultimately be the long-term cure for the syndrome.
A Healthy Dose of Failure is Vital to Your Success
As an acupuncturist I tend to see people after they have already suffered for years and "tried everything." They are so desperate for some relief that they want to know everything about how to get better, right now.
When Big Pharma Meets Chinese Medicine
Earlier this year, Bayer made a media splash with their decision to buy the Dihon Pharmaceutical Group Co., a Chinese TCM manufacturer.
The Problem With Prolonged Sitting
We need to constantly talk to our patients about spending less time sitting and about what can go wrong with poor sitting postures. The fact is we sit too long in repetitive malpositions.
If You Get a Request for Records, Respond!
In our previous two articles, we discussed two of the main reasons for denial when chiropractic records are reviewed by Medicare contractors.
Let the Patient Tell Their Story
Often when a patient presents with an injury, they want to tell their story. People by nature like to talk about themselves, particularly when they're worried about their health.
Uncle Sam Needs You
Scrutiny into the Department of Veterans Affairs (DVA) continues to grow after efforts to reform the DVA by the former Secretary of Veterans Affairs, Eric Shinseki, were deemed "a stunning period of dysfunction" by Senate Minority Leader Mitch McConnell (R-Ky.).
Medicalization and Mindfulness
The past several years have seen a veritable explosion of research on mindfulness. Research abstracts we've published in each issue of Health Insights Today under the heading "Mind-Body News" have increasingly reported on studies about mindfulness interventions.
Healing Community Trauma in Israel and Palestine
It's the beginning of August and Israel and Hamas have just agreed to a 72-hour ceasefire after a month of brutal fighting. In the last four weeks, 1,830 Palestinians and 67 Israelis have been killed.
Thoughts to Live By
When speaking to your patients about their health make sure to ponder the following points and have them assess if they are making themselves even more sick by the thoughts they have about life. Are these some of the traits and thoughts that your patients might have?
A Glimpse Into China's Top Brain Hospital
The sounds of the city pass through the open window are overwhelming the microphone - car horns, construction machinery - and then there's the family at the adjacent bed talking loudly on cell phones, yet you can still hear the faint beep of our patients monitoring equipment.
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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