resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
The Top Seven Website Mistakes Clinics Make
The majority of acupuncture clinics finally have a website for their business. Having a website is crucial for being found online through Google, Facebook and review sites like Yelp.
Old TCM Sayings: Treat the Front to Treat the Back
Chinese medicine college was, and always will be, a memorable time. It was a time of massive personal and professional growth.
The CDC came out with a report in March 2013 that suggests 1 in 50 children will be diagnosed somewhere on the autism spectrum – significantly higher than the 1 in 86 figure that came out in 2007. What does this mean moving forward, particularly for children?
Finding Balance in the Clinic
This past December, I celebrated 11 years in practice. I seriously don't know where the time went. I feel beyond blessed and grateful to be practicing our profound and beautiful medicine and to be helping guide my patients restore a state of optimal health.
Help Your Parents Stay Engaged
As much as parents may wish it were so, children do not come with an instruction manual. There's no "how to" that can be followed and no two children are alike, so what works with one generally won't work with the next.
Put the Social Back Into Social Media
Social media is more than a passing fad, it is definitely here to stay. Social media apps and channels of distribution may evolve, but the concept of social media is now big business and a part of all our lives.
It might have been a miserable start to the day in the heart of downtown San Diego. A heavy rain had soaked the large homeless population congregating near the intersection of Third Avenue and Ash Street as they waited for a free breakfast to be served at the First Lutheran Church on the corner.
Let's Speak With One Voice in 2015
For the longest time, the chiropractic profession has attempted to achieve some form of unity. On a political level, this was characterized by an ultimately unsuccessful two-year merger effort between ACA and ICA leadership from 1986-1988.
Reflections: The Art of Teaching Asian Medicine
Over the past three decades, my global workshops have been translated into German, Swiss German, French, Romansch, Spanish, Lithuanian and Xhosa. Time to offer you new teachers a few tips!
Case Histories from Bali: Treating Balinese Chidren with TCB and Shonishin
When I moved to the island of Bali in 2005, I offered my services in Bumi Sehat, which means Healthy Mother Earth, a free birthing center for poor and disadvantaged local women located in Ubud.
The Conscious Evolution of Healing, Part 2
The idea of transmission is very important in the Chinese medical classics. According to author Claude Larre, the ancient Chinese were highly interested in the connection between things. Nothing was looked at as an isolated entity.
Cell Health (Part 2)
Dr. Barsten, your book is about restoring "cell vitality." Can you briefly define the term? Cell vitality is more than the mere absence of symptoms or pathology, but optimum structural, physiological and energetic health.
Acupuncture and Homeopathy: Bioenergetic Brothers
Acupuncture and homeopathy share an important healing principle: bioenergetics. "Bio" means "life," so bioenergetics is literally "life energy."
Are You Really a Healthy Eater?
I always giggle a little bit (to myself) when someone comes into my office and informs me that they are a healthy eater. What exactly does that mean? Does that mean they eat sugar in moderation? And what's that, exactly?
News in Brief
An Encouraging Sign at Palmer; NBCE Announces Retirement of Longtime Director of Testing.
Leaving Footprints on Capitol Hill: Tribute to Dr. Kenneth Luedtke (1930-2014)
It was with great sadness that I heard of the passing of Dr. Ken Luedtke.
Connecting the Dots
In 2002, I published a book on patient examination procedures that included information on the procedural coding of the recommended examinations. The book should have been published in 2000, but I had trouble finding a publisher. Why?
Neuroscience: Where Western Medicine and Chinese Medicine Can Come Together
The recent advances in neuroscience are truly incredible. With this expansion of scientific knowledge, I would like to see even more research into the neuroscientific basic of acupuncture and Chinese Medicine.
It's Time to Create a Strong Acupuncture Footprint
Footprints in the sand. Footprints in the snow. Where do these footprints go? Some are big, some are small, but footprints are made by all.
Mind-Body in Motion
A central goal of low back pain treatment involves the correction of dysfunctional movement patterns believed to be responsible for spinal overload.
January, 2011, Vol. 11, Issue 01
Rehabilitation: The Protocol Defined
By Whitney Lowe, LMT
Orthopedic massage is a highly effective system for addressing soft-tissue pain and injury complaints. What makes this approach so effective with a wide variety of movement system disorders is the fact that it is a comprehensive treatment approach and not just a massage technique.In the mid-1990s, I proposed a model for an orthopedic massage system that included four primary components. These four components are: 1) orthopedic assessment, 2) matching the physiology of the tissue injury with the physiological effects of treatment, 3) using a variety of treatment approaches, and 4) appropriate use of the rehabilitation protocol. It is this fourth and final component of the system (the rehabilitation protocol) that requires some additional explanation, as it is a comprehensive topic on its own.
In the late 1980s through the 1990s, I spent a number of years working in orthopedic, chiropractic, and physical therapy clinics. These experiences were invaluable in helping to shape and mold my understanding of how to evaluate and treat all kinds of soft-tissue injuries. It was during this time that I began to observe an interesting pattern occurring with many of the patients who were being seen in treatment.
As part of the treatment process, patients were often given rehabilitative exercises to perform. Many of the patients performed the exercises, but then reported that their condition actually worsened instead of improving. While it is natural to assume that some people might not benefit from a particular treatment approach, there was a disproportionate number of people who were having adverse effects to this treatment regimen. Many people were being given strengthening and conditioning exercises when there was still a serious tissue dysfunction present. The strengthening exercises then aggravated the existing complaint. This situation started me investigating what could be different in the treatment approach to prevent this large number of adverse outcomes. It was out of this exploration that I developed the rehabilitation protocol concept as a fundamental component of the orthopedic massage system.
Soft-tissue pain and injury conditions may involve fiber damage like that occurring in muscle strains or ligament sprains. In other situations the dysfunction may simply result from impaired function, like that seen in myofascial trigger point pathologies or nerve impingement syndromes. However, despite the wide array of tissue pathologies there is a progression of tissue healing that is similar in all these conditions. As clinicians our treatments must maximize and take advantage of this healing response. Appropriate use of the rehabilitation protocol helps you accomplish this crucial treatment goal.
The rehabilitation protocol has four separate stages: normalize the soft tissue dysfunction, improve flexibility, reestablish appropriate movement patterns, and strength conditioning. Let's take a look at each one of these stages in greater detail to understand how they work with your massage treatments.
The first stage is to normalize soft tissue dysfunction. Regardless of what type of tissue injury or dysfunction has occurred the first thing that must happen is to bring that tissue dysfunction back to its normal state or at least as close to its normal state as possible. For example, if there is a muscle strain with torn fibers, normalizing the soft tissue dysfunction means addressing the torn muscle fibers and resultant scar tissue with deep transverse friction massage. If the primary dysfunction is a myofascial trigger point, normalizing the soft tissue dysfunction involves neutralizing that trigger point so the muscle spindle cells are not overly activated and the muscle tissue can return to its normal state.
The second stage is to improve flexibility. Soft tissues require adequate flexibility and pliability to work at their optimal state. If they are bound and restricted by scar tissue, movement and function are impaired. In the event that muscles are chronically tight from excessive trigger point activity, there are likely to be biomechanical distortions or problems in the regions acted upon by those muscles. Full restoration of functional movement cannot return if adequate flexibility is not restored. Once the soft-tissue dysfunction has been normalized and tissue flexibility has been restored, it is now appropriate to move on to the next stage.
The third stage is to re-establish appropriate movement patterns. Proper movement patterns need to be introduced to the soft tissues in the healing process to encourage optimal function. There are many ways to restore proper movement patterns after a soft-tissue injury. Sometimes movement restoration includes specific exercises such as those performed in physical therapy or a movement-oriented discipline like Feldenkrais or Aston Patterning. In other situations restoring proper movement might simply be making ergonomic changes in a person's workstation or the way in which they engage with tools in their daily activities. The initial tissue dysfunction must be addressed and flexibility restored before these correct movement patterns can be reinforced. If the first two stages have not been accomplished it will not be easy, or in some cases even possible, to restore proper movement patterns.
The final stage is strengthening and conditioning. It is this stage which is often performed too early in the rehabilitative environment. Strengthening or conditioning activities do not require you to be lifting weights in a gym or working out in a formal exercise facility. Sometimes it is as simple as training your body for the demands it faces. For example, massage therapists benefit from hand and finger strengthening exercises which could be performed with simple rubber bands. These conditioning methods prepare the practitioner for the physical demands of daily work activities.
In most cases, a massage therapist is not directly involved with strengthening or conditioning activities for the individual if those activities are being performed for the purpose of injury rehabilitation, as it is outside our scope of practice. However, knowledge of the process of strengthening and conditioning is exceptionally valuable and will help guide appropriate treatment decisions throughout the course of treatment.
The rehabilitation protocol should be considered a set of guidelines, not strict rules. There is a progression through the rehabilitation protocol from the first stage through the fourth. However, it should not be viewed as a strict process where all of the first stage must be accomplished before moving to the second stage and all of the second stage accomplished before moving to the third, etc. There can be overlap between the different stages, but you should see your client's soft-tissue injury or pain complaint move through these stages and not jump to the end of the protocol before the earlier stages have been mostly accomplished.
It is our job to recognize what stage our clients are at in the rehabilitation protocol and adjust our treatment approaches accordingly. It is through accurate orthopedic assessment processes that we make the determination of where they are in the recovery process. Once you understand and appropriately apply the rehabilitation protocol you will find much greater success in your treatment outcomes with a wide variety of pain and injury complaints.
Click here for more information about Whitney Lowe, LMT.
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