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Resolving Medial Arch Suspicions: The Navicular Drop Test
Healthy feet have three distinct arches: medial longitudinal, lateral longitudinal and anterior transverse.
The Kidney Official
The Kidney is known as the Official Who Controls the Waterways. In Western medical terms, a major function of the Kidneys is to filter the blood. Every day, a person's kidneys process about 200 liters of blood to sift out about two liters of waste and excess water.
Deciphering The New CMS 1500 Claim Form
Q: I am confused on using the new 1500 form, particularly Block 14 and Block 15. What is required and how do I properly fill these out? And do I actually have to use this new form or may I continue using the old version?
The Acupuncture Success Express
Time is passing very quickly these days. We are atoms half the way through the year of the horse. You could call it "horse racing season" for this profession. Perhaps it is time for reinvention during this time.
Inside Liver Failure, Cirrhosis and Cancer
The Liver belongs to Wood in Five Element Theory and is in charge of Dispersing and Expanding which means all the processing and detoxifying of harmful substances such as medications and chemicals require the efforts of the Liver.
Looking For Answers In Many Places
I am sure we have all heard the old adage: "When the only tool in your toolbox is a hammer, everything starts to look like a nail."
Talking to Skeptical MDs: "Just the Facts, Ma'am"
The first lesson in public speaking is to know your audience. This is particularly applicable when talking to skeptical medical doctors about chiropractic. You have to understand where they are coming from and speak the language they understand.
Best Practices for Website Success
If one asked 10 years ago whether a website was relevant I was the first to suggest no. Yet as the world moves increasingly towards electronic information there is a dire need to have a website for your practice. Your website is actually your electronic calling card.
Advice for Young Doctors
When I began practice, I was just shy of my 25th birthday. I was young and I looked it. I had been told this would be a problem when starting a practice – and it was. Older patients often paused when they entered for care.
F4CP: New Campaign to Promote Chiropractic as a Career
The F4CP has announced a "targeted cooperative campaign" that will engage doctors of chiropractic and chiropractic students, as well as chiropractic colleges, chiropractic media, state associations and vendors, to encourage DCs to recommend a chiropractic career to patients, family and friends.
Hazards in the Environment Making Your Patients Sick
Working both separately and together, Western and Chinese medicine have many successes in the treatment of the myriad diseases that afflict human beings in modern times.
Not Another Typical Drug Company Lawsuit
It's becoming more common to see drug manufacturers negotiate "false claims" settlements for millions and billions of dollars.1-2 Most of these settlements have to do with violations in the marketing of the drugs they produce and sell.
Getting Athletes Back in the Game: Low-Level Laser Therapy for Sports Injuries
Sports injury rehabilitation is all about getting back in the game quickly and with optimal health. A relatively new tool for the treatment of sports injuries is finding global success, and it is doing so in a fast, efficient way.
Primary Lateral Sclerosis: A Condition With a Chiropractic Connection
Primary lateral sclerosis (PLS) is a slowly progressive, adult degenerative disease of the upper motor neurons characterized by progressive spasticity or stiffness. It is a clinical diagnosis that has been avoided because it is (largely) a diagnosis of exclusion.
Healing With Simple, Healthy Food
When it comes to your health, there is no better way to take control and create positive outcomes than by focusing on diet and lifestyle. As chiropractors, you know the power that regular self-care has for your patients.
Super Bowl Chiropractor
With opening night of the 2014 National Football League season only a month away, what better time to talk to Dr. Jim Kurtz, team chiropractor for the defending Super Bowl champion Seattle Seahawks?
Medical Qigong for the Heart: Part II
Chinese Medicine is rich in commentary regarding the emotions and how they affect our qi.
Looking Back: Abstracts From Chiropractic History
D.D. Palmer's Technique for the Posterior Apical Prominence; An Early Attempt to Achieve Consensus on Subluxation; Chiropractic Subject Headings: Past, Present and Future; Mabel Palmer: A History of Chiropractic That Almost Wasn't.
The Gluteal-Knee Connection
The underlying causes of knee pain and dysfunction are rarely isolated to the knee. The knee is a relatively stable joint with limited intrinsic ability to adapt to aberrant motion.
Offline Marketing Techniques: Opportunities to Help Grow Your Business
In a world becoming increasingly dominated by connected devices, when we think of marketing, we often think of online and social media marketing. Considerable attention is given to Facebook and Twitter, as well as CPC [cost-per-click] advertising.
Post-Concussion Patient Care: Relevance of the Chiropractic Adjustment
There is a widespread understanding within the profession of the general guidelines for care of the concussion patient. These include guidelines for physical and cognitive rest, return to normal activities and so forth.
Spotlight on Acupuncture Research at IRCIMH
Acupuncture and Traditional Chinese Medicine were well-represented at the International Research Congress on Integrative Medicine and Health (IRCIMH)- 2014 which took place in Miami from May 13–16.
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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