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The Acupuncturist's Problem
I want share with you some observations and insights into what seems to be the most common problem my colleagues in the acupuncture profession struggles with. If you also struggle with this problem, I hope you get a valuable "aha" moment from reading this.
Integrating Art with Clinical Practice for Patients with PTSD: The Artemis Project
Are you restricted by those one-on-one clinic dynamics? Why not join colleagues and clients in experimental group settings? Three of us volunteered to do just that in Austin on behalf of women veteranss from all branches of the service.
Functional Hip Impingement (Part 1)
Every time I sit down to write an article, I realize how much more there is to know about musculoskeletal pain. I also learn something new every time. (I want to give special thanks to Lucy Whyte Ferguson for assisting with this article.)
Applying the Thin Skull Principle
The "thin skull" principle, also known as the "you take your victim as you find them" principle, is a legal principle that can be summed up by the following statement.
Term Limits: What's in a Word?
It was the French historian and philosopher Voltaire who once declared the Holy Roman Empire was neither holy nor Roman nor an empire.
Optimism = Compassion = Trust
A randomized clinical trial recently published online in JAMA Oncology examined how patients viewed their doctor based upon how the practitioner presented bad news to the patient.
How Much Do You Know About the Benefits of Birds Nest?
Edible bird's nest is the nest made by the Swiftlet bird of Southeast Asia that is usually prepared as a soup and prized in Chinese culture as a healthful delicacy.
Medicine is Clumsy, Don't You Be
All medical systems have clumsiness in them. If the technique isn't, the practitioner is. Everyone in every form of medicine is striving to improve. That is why we call it practice.
A House Divided?
The American Chiropractic Association's House of Delegates voted on 30 resolutions at its annual business meeting in Washington D.C., but two in particular took immediate center stage due to their controversial nature.
Animal Acupuncture: A Case Study in the Treatment of Traumatic Injury in the Equine
The rise of animal acupuncture in the U.S. began in the early 1970's as a result of the work by members of the National Acupuncture Association in Westwood, Calif.
The Tide is Rising in the Acupuncture Profession
Former President Ronald Regan said, "When the tide rises all boats float." The tide is rising for the acupuncture profession. Many forces outside the profession are helping the tides to rise.
PCOM Granted Regional Accreditation
Pacific College of Oriental Medicine (PCOM) recently announce it has received regional accreditation from the Western Association of Schools and Colleges (WASC). This achievement reflects five years of hard work on the part of faculty, staff, and students.
Marijuana, Apathy and Chinese Medicine, Part 1
This article was written in response to the unheeded acceptance of marijuana as a harmless substance that potentially does good when used for the medical relief of pain.
Turning a Blind Eye to History – and Reality
The American Medical Association is taking the Supreme Court's Feb. 25, 2015 decision exactly as it always does – by turning a blind eye to history, legal precedent and reality.
Low Back Pain in Professional Golf: A Common Muscular Relationship
Every sport creates its own unique demands on the body. Some sports require such a myriad of body positions that assessing pathology is often difficult and unpredictable.
A View From the ER
The University of Western States has inked an innovative agreement with local nonprofit health system Legacy Health whereby UWS sports-medicine fellows can experience observational clinical rotations in emergency-room settings within the Legacy system.
The Challenges of Integrating Eastern and Western Medicine
My Masters thesis was titled, "The Challenges of Integrating Eastern and Western Medicine," which highlighted several reasons why it is hard for these two worlds to mix.
Talking to Patients About Lumbar Facet Denervation (Medial Branch Neurotomy)
Lumbar facet denervation, more appropriately termed medial branch neurotomy (MBN), is a procedure that may be considered when patients suffer from recalcitrant non-radicular axial back and/or leg pain.
5 Tips for Using Pinterest to Market Your Practice
Pinterest is a very popular, but often under-utilized, social media platform where people can bookmark, or "pin," fun and interesting things from all across the internet.
Sleep, Less Sleep or No Sleep?
I had a dream I wasn't getting enough sleep. It was a very realistic dream, even though I was probably slightly awake and not really deep dreaming. Most likely I had been dozing, caught in that twilight of sleep and wakefulness.
March, 2012, Vol. 12, Issue 03
The Relationship Between Doctors and Massage: A Look at the Past
By Judi Calvert, LMP
In 1888, a practicing physician in Carlsbad, Bohemia, by the name of Emil Kleen MD, PhD, wrote a book called the Handbook of Massage in his Swedish language. Dr. Kleen's work was translated into several languages.German writers of that time also began to write books on the subject of massage. Kleen wrote his book as an introduction for younger students of medicine to the indications and contraindications of massage. It was Kleen's "desire to combat the oft-expressed inclination to advance massage to the dignity of an exclusive method of treatment."
Kleen wanted the students and readers of his book to, "look upon massage as I do myself, viz., as a remedial measure, among many, that is capable of being frequently employed, but which is seldom to be resorted to by itself alone."
There were not many illustrations in Kleen's first book because he did not think they would be necessary, considering there were centers teaching massage at the time. His second book, published in 1921, was essentially the same text with some revisions and additions, along with several illustrations. Both books have wonderful chapters titled, "Massage to Diseases of the Joints and Eyes," "Massage for Frostbite," and "Contraindications to Massage."
Kleen's books were intended to support the continuation of manual therapy work that was so successful during World War I. The physicians of Europe, as well as Kleen, believed that manual therapies were very important as a part of their medical practice. Thus, he wrote about the benefits of massage to bring awareness to other doctors around the world. Kleen was a critic of lay practitioners. He and most physicians at the time believed massage was only valuable when performed by physicians and under their direction.
In Kleen's first book, he distinguishes between massage and gymnastics--a recurrent theme in his writings that drew criticism. His distinction was important when it came to applying either massage or gymnastics to the specific medical conditions. Kleen's description of massage was, "a mechanical action which if performed on the soft tissues, for a therapeutical purpose, by means of certain manipulations, namely, stroking, rubbing, kneading and striking." His definition of gymnastics was, "it involves the exercise of the organs of motion." Both forms of treatment he felt had, "many points in common." Kleen felt that most of the writers of the time did not distinguish the difference between these treatments. For the sake of being consistent, he thought it best to, "speak of the manipulations of massage, and of the movements of gymnastics." He felt that both practices were "branches of mechano-therapy, along with orthopaedeics." The conception of massage, in its entirety, embraces not only the manipulation of massage, but also their modes of action."
Here's a question for readers: Do you think that mechano-therapy came first or massage? Dr. Kleen felt that, based on his readings of history that, "on the whole, gymnastics have emerged within the domain of science earlier than massage, since the scientific requirements of the first are much more easily fulfilled than those of the latter." To prove his point, Kleen includes a time line in his book and wrote about several countries that pioneered mechano-therapy and massage.
Of those renowned physicians mentioned in Kleen's book were the Greeks. Kleen, "acclaims Asclepiaedes as the Father of mechano-therapy, for the invention of several devices designed to produce fluid movement through swinging, vibration or violent motion." Asclepiades was a Greek physician who practiced and taught medicine from 124-40 BC. Asclepiades also used massage extensively in his practice.
In the 1860's, Kleen felt that it was Dr. Mezger, of Amsterdam, who achieved fame in spreading the "impulse" of massage. Mezger convinced the public how important massage was and through his teachings to German and Scandinavian students, he had a great influence on the standing of massage by introducing it to the medical world.
The Technique of Massage
Kleen felt that "massage was an easy art, requiring less practice and skill than many other mechanical procedures which recur frequently in our calling, in which we all demand a certain amount of dexterity of ourselves--- as, for instance, in using the laryngoscope or the catheter, the performance of ordinary surgical operations, etc. To be a good masseur one must study anatomy and physiology and pathology." This was the difference that Dr. Kleen felt between a trained or untrained masseur.
The masseur had to have, "normal upper extremities, that are not too weak — the hands especially should not be too lean or small — and some aptness for mechanical work." So I guess people whose hands were either too big or too small were simply out of luck and had to find another career. Kleen believed that students of massage should spend time with an "expert teacher" to learn the correct techniques. When the student gets out on his own, Dr. Kleen felt that each student should, "work out his own technique which soon becomes as characteristic as his own handwriting."
Developing the skills required for accurate palpation tools is the hardest thing to achieve for the masseur, both then and now. This may have been where the phrase, "practice, practice and more practice" came about. Dr. Kleen felt that massage was usually best when given with the hand. He did mention that other masseurs used a variety of tools along with massage done by the hand. The hand techniques performed by the masseur were classified by the Mezger's School using the French terms "Effleurage," "Frictions," "Petrissage," and "Tapotement." I laughed my head off when I read that the Mezger School taught their students to use hog lard as a medium on the skin of massage patients.
Some things never change over time with beginners in massage. Using too much force is something all of them have in common. Dr. Kleen felt that, "on the other hand, professional masseurs go to the other extreme." Kleen felt that in some cases greater force with the hands to the tissues was necessary and if it caused, "spots to show up," the effect was minor and disappears quickly. Dr. Kleen wanted to correct statements some writers made that masseurs should, "not be too energetic as to cause sugillations or discolorations of the skin and that every spot of that sort is a reproach to the masseur."
What was great to learn from Dr. Kleen's book was that masseurs were using hypnotism and hypnotic suggestions with their patients along with massage. They were having wonderful results, but Dr. Kleen wanted to wait a few years before he would discuss it further. I have used hypnotism in my massage practice for a short period of time and also had good results. It was a research project that I did on clients who had been in a bad car accident. Dr. Kleen's book is a wonderful reference from the past, full of valuable information that is relevant today about massage, shared by doctors who had the courage to step out of their box to study, learn and teach massage along with the medicine that they practices in the late 1800's.
Click here for more information about Judi Calvert, LMP.
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