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Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
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 previous articles by Judi Calvert, LMP.
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