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Help Update the LBP Practice Guideline
The Council on Chiropractic Guidelines and Practice Parameters has announced the release of an updated Clinical Practice Guideline for Chiropractic Management of Low Back Pain for stakeholder review and comment.
B Vitamins Improve Memory, Prevent Brain Atrophy
The 2010 OPTIMA study showed that the accelerated rate of brain atrophy in elderly with mild cognitive impairment could be slowed via supplementation with homocysteine-lowering B vitamins, which included folic acid, vitamin B12 and vitamin B6.
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
Avoid Random Treatment of Trigger Points (Part 2)
We must acknowledge that the fascia, which surrounds literally everything in our bodies, including every muscle fiber, is more than just a covering.
Primary Spine Care: Addressing Concerns & Criticisms
The Dec. 1, 2013 issue of Dynamic Chiropractic included an article describing the implementation of a training program for primary spine practitioners (PSP) within a metropolitan region and supported by a large BC/BS plan.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
Interpersonal Skills 101: Enhancing the Value of Our Patient Interactions
Recently, I read an interesting article in our local newspaper titled "The Value of Human Interaction." The article presented comments from a senior editor for Fortune magazine who discussed "Civility in the Business World."
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
Low Back Pain: Posture and Movement Analysis
When performing static and dynamic movement analysis of the lumbopelvic hip area, begin with standing visual posture analysis of the pelvis, and then perform lumbar range of motion and assess what you might see during normal versus abnormal lumbar flexion motion.
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
Impacting Chiropractic's Future With Technology
When it comes to electronic health records (EHR), Robert Moberg and Dr. Steven Kraus are two of the leading industry experts on the topic.
A Reality Check – and a Chance to Educate
Imagine working in the public relations department of nutrition retailer General Nutrition Corporation (GNC) and reading the The New York Times announce...
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
Expanding Access, Branch by Branch
The big news coming from Capitol Hill isn't merely the recent introduction of a pair of bills designed to expand chiropractic services in the Veterans Affairs and military health care systems; after all, similar legislation has made its way through Congress before, never reaching the Oval Office for presidential signature.
Atypical Femoral Fractures and Bisphosphonate Use: What to Watch For
Bisphosphonates (BP) are popular drugs, with more than 8 billion in sales in 2008; however, profits have declined as patents began expiring. Nonetheless, BP remain the most commonly prescribed drugs for patients at risk of osteoporotic fractures, with several million prescriptions written every year.
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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