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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.
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).
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."
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
The Heart Protector
On the physical level, the Pericardium is a double-layered sac of fibrous tissue that envelops the Heart. The space between the layers is filled with serous fluid that protects the Heart from external shock or trauma and lubricates to allow for normal Heart movement.
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.
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?."
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.
May, 2011, Vol. 11, Issue 05
Research Provides Evidence of Physiological Mechanism For Stress Reduction Resulting From Touch Massage
By Massage Therapy Foundation Contributor
As massage therapy gains popularity as one of the most commonly, used modalities among those offered in complementary and alternative medicine, more research is addressing the physiological effects and mechanisms of massage.This month's Massage Therapy Foundation research synopsis reviews an intriguing study out of Umea University, in Sweden, that evaluated the physiological effects of touch massage and was published in the journal, Autonomic Neuroscience: Basic and Clinical.
Like other massage modalities, touch massage is provided to decrease stress, anxiety and pain. Often massage therapists observe decreases in blood pressure, heart rate, and respiration. These observations suggest massage modalities influence the autonomic nervous system and alter an individual's stress response. The autonomic nervous system is comprised of sympathetic and parasympathetic activity. It controls involuntary bodily functions, such as breathing and the heartbeat. Simply put these two synergistic components act as internal stress (sympathetic) and relaxation (parasympathetic) response systems, which work to maintain autonomic balance. The autonomic nervous system and stress response mechanisms have received considerable attention for explaining a physiological mechanism of massage. Lindgren and colleagues tackled the arduous task of evaluating the physiological effects of touch massage on stress responses in 22 healthy volunteers using a battery of bio-markers to identify autonomic nervous system responses.
Lindgren and colleagues used a crossover design method to conduct this study. In a crossover design, each participant is in both groups (treatment and control). At two separate occasions, each individual either receives the treatment of touch massage or rests in the supine position as a control. Using this method, participants can function as their own comparison with and without the treatment. Though crossover design has many advantages, like requiring smaller sample sizes, the disadvantage of crossover design methods is the carryover effect, where the treatment has lingering effects. If there were a strong carryover effect, we would expect to see the participants who receive treatment first having a different baseline when they return for the control session. However, there were no significant differences between massage first and rest first in the baseline measures taken immediately before the second session, so carryover effects should not influence these results.
Participants received touch massage on their hands and feet, which "consisted of stroking movements on the ventral and dorsal side of hands and feet along with circular movements on each finger and toe. Touch massage was performed for 80 min in the following order: 20 min each on the left hand, the right hand, the right foot, and the left foot." Participants in the control group rested in the same setting. Outcomes measures included heart rate and heart rate variability (the variation in time between heart beats), cortisol stress hormone levels from saliva, blood glucose, and serum insulin. Data were collected before, during, and after touch massage or rest session.
The main finding in this study for Lindgren and colleagues was, "After 5 minutes of touch massage there was a significant decrease in heart rate lasting for 65 min, indicating reduced stress response." Though findings suggested significant changes across several measures, "the only significant differences between the groups were the decreases in heart rate after 45 minutes and in the HF component [high frequency domain of heart rate variability] after 5 minutes." Group differences between treatment and control groups are typically the focus of studies such as this one, because these differences measure the effect resulting from the treatment. Though there were no significant differences between groups in levels of cortisol, glucose, and insulin, "Saliva cortisol and insulin levels decreased significantly after intervention, while the serum glucose level remained stable. A similar pattern, although less prominent was observed in the control group." The findings from this study suggest, "Touch massage reduces the heart rate by decreasing sympathetic nervous activity and evoking a compensatory decreased parasympathetic nervous activity in order to maintain autonomic balance." These findings suggest that after receiving touch massage the participants experienced a biological relaxation response - producing the experience of stress reduction.
As with all research, this study identified limitations to interpreting the findings of this study. First, "calm music" was played during the sessions, which could have had an effect; however, music was used in both groups, therefore touch massage served as the single outcome. Second, as with most massage studies the interpersonal interaction between the therapist and recipient could have affected the treatment. We cannot eliminate the effects of this interaction especially since there was no "sham massage" or "therapeutic touch" group included as a level in between treatment and control. One other potential limitation of the study is that the authors reported that five participants' heart rate and heart rate variability data were excluded due to arrhythmias. Given the already small sample size of less than two dozen individuals, decreasing the sample size by almost 25% for these data points could impact the ability to interpret and generalize these data findings. Further, it is possible that the trend observed of a greater decrease in cortisol following touch massage than following quiet rest and insulin level in this study could prove to be significant with larger sample sizes in future studies. Larger randomized clinical trials will provide evidence for generalizable findings to inform consumers about the effects and physiological mechanisms of touch massage.
This study provides evidence that supports one of the most popular theories for explaining the relaxing effects of massage therapy. Specifically, Lindgren and colleagues found that touch massage significantly reduces cortisol, although not significantly more so than quiet rest, and that massage significantly lowers heart rate. The findings of this study warrant future research to evaluate these physiological mechanisms in larger controlled clinical trials and with more diverse populations. But what does this mean for providers and touch massage recipients? Whether in a non-clinical or clinical setting touch massage can reduce stress for clients and patients. Though this is not likely new information to many providers, as observations of stress reduction are commonplace in the massage setting, Lindgren and colleagues have provided evidence to substantiate these observations, which support incorporating touch massage in individuals' wellness and healthcare plans to facilitate stress reduction and promote personal health.
Source: Lindgren L, Rundgren S, Winsö O, Lehtipalo S, Wiklund U, Karlsson M, Stenlund H, Jacobsson C, Brulin C. Physiological responses to touch massage in healthy volunteers. Autonomic Neuroscience: Basic and Clinical. 2010; 158: 105-110.
For more information about the Massage Therapy Foundation, visit www.massagetherapyfoundation.org.
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