resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Look, Listen and Learn to Code
Study of the Current Procedural Terminology (CPT) Evaluation and Management (E&M) coding system can leave a doctor of chiropractic a bit confused. The description of the five new-patient and five established-patient examination codes takes up several pages in most coding books. The degree of detail and charts used to describe the codes can be overwhelming.
Gallop Confidently Into The New Year
Happy New Year! As you may know, this is the year of the Wooden Horse. I received a wonderful gift for Christmas. It is a beautiful glass sculpture of a horse, by Luili Gong Fong, a Chinese artist.
Betraying Patients and the Profession
Imagine flying from New York to Paris on a jumbo 747. Your thoughts are on your vacation and experiencing the City of Lights. Midway over the Atlantic Ocean, you overhear the flight attendants talking in muffled voices.
We Get Letters & E-Mail
Let's Restore Integrity to Health Care – Starting With Us; MDs Offer More – So Can We.
The Importance of Staying Focused
Our world is so full of over stimulation and constant information. We live in a fast paced, ever-changing society. If you seek you will receive.
Acupuncture Ambassadors: A Chat with Leader Anthony M. Giovanniello, MSAc,LAc
When you first meet Anthony Giovanniello, you realize he's a humble practitioner, yet is bursting with a type of dedication that you can't help but be overwhelmingly inspired by.
The Urinary Bladder Official
The Bladder Official is known as the Official Who Controls the Storage of Water. In Western medical terms, this organ collects the urine excreted by the kidneys.
An Alternate Method For Choosing The Right Formula For Your Patients
A constant question for us in the clinic is when to make adjustments and when to stay the course. A patient comes in and says, "Things are the same as last week."
Why Stretching Doesn't Work
Like most chiropractors, a good part of my day is spent working with sedentary office workers who spend eight to 12 hours a day glued to a desk chair in front of a computer.
The Many Faces of Cervical Compression
When evaluating the neck, there are any number of orthopedic tests to be considered.
Common Disorders of the Temporomandibular Joint
The evaluation and management of craniofacial pain is a complex endeavor, which often encompasses the presence of temporomandibular joint disorders.
Putting Public Health Into Action: Thinking Globally, Acting Locally
The Chiropractic Health Care section of the American Public Health Association (APHA) met at the 141st APHA Annual Meeting and Exposition in Boston late last year, and it was another triumph for chiropractic and its public health advocates.
Climbing the Ladder of Opportunity (Part 1)
President Obama spoke of building "ladders of opportunity" in his State of the Union and Inauguration addresses.
Peer Points: Spreading The Word
Pedram Shojai describes his venture into Traditional Chinese Medicine as a journey led by various "mystical experiences." Shojai decided to change the course of his career when he looked deeper into the basics of TCM.
Ask and You May Receive
A friend of my mother has had a problem with her ears for almost 20 years. Whenever the wind blows, it sends shooting pain through her jaw. She has seen any number of medical specialists over that time, but with no relief.
News in Brief
Parker Announces Executive Director of Parker Professional; Athletic TIPS Program Getting Financial Support; ANJC Award Recipients Named.
Using Facial and Scalp Acupuncture To Treat Neuromuscular Facial Conditions
As a practitioner and instructor of facial rejuvenation acupuncture I have gotten many calls over the past 10 years from individuals seeking help for various conditions affecting the facial muscles, nerves, and overall function of the face.
The Deficiency Myth
If you went to the same kind of medical school I did and took the same kind of licensing exam I took, you were trained to seek out and expect to find primary deficiencies here in the U.S.
Increased Breast Cancer Risk: Another Implication of High Cholesterol
In addition to being a known risk factor for heart and cardiovascular disease, recent studies have highlighted the link between high cholesterol and increased risk of breast cancer. Breast cancer is the second most common malignancy in women after skin cancer.
New Knee, New Pain (Part 2)
The patient presented to the chiropractic clinic with symptoms of genu varum and pain on the medial aspect of the tibiofemoral joint.
An Introduction to Evidence-Based Clinical Practice - Again
One of your patients is in for treatment and catches you off guard by asking you a question about a news article she recently read. It seems that a new intervention for back pain was found to reduce the rate of serious side effects by 50 percent.
Embracing the Light
Four years, ago I was diagnosed with a labral tear in my hip that was excruciating and "required surgery" according to an orthopedic surgeon. I tried everything and although the symptoms had mostly abated, I had to give up Yoga practice and everything that could exacerbate the tear.
Qigong to Empower Our Youth
Qigong is an ancient form of exercise and meditation used to promote longevity and health. This practice has traditionally been used by adults to balance the body through mindfulness, focused breathing and gentle movements.
Gaining an Independent Occupational Code with the U.S. Bureau of Labor Statistics
One of the most important national activities currently taking place in relation to the development of the field of AOM profession is the Department of Labor's Bureau of Labor Statistics' (BLS) revision of the 2010 Standard Occupational Classification (SOC) system.
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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