resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
After two treatments for back pain, a patient presents for a third
session complaining of rapid breathing and wheezing that is made worse
during cold weather.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
March, 2012, Vol. 12, Issue 03
A New Method for Dealing with Hip Rotators
By Shari Auth, MA, Lac., LMT, NCBTMB
Remember "Piece Goods Often Go On Quilts" or as my anatomy teacher taught us, "Pirformis and the Go-Go Queens?" Both are memorization tools for recalling the names of the six deep lateral rotators of the hip.The first letter of both phrases corresponds to the first letter of one of the rotators (i.e. piriformis, gemellus superior, obtuator internus, etc.) Left-brain knowledge crammed in during massage school all to be forgotten later, with the exception of the fashionable piriformis. We may have forgotten the names, but in clinical practice, hip rotators are hard to forget. Tight hip rotators contribute to lumbago, sciatica, turn-out in the legs and feet, and just plain old hip pain in people who travel, sit or clench too much.
Clients hip rotators can be contracted and short for a long time before prompting them to see a massage therapist. For the average person, yogis and dancers aside, this is one of those hard-to-reach, hard-to-stretch and overall unconscious places.
The Auth Method is a system of massage that makes the health and well-being of the practitioner's body the priority, without sacrificing results. The method was developed with the belief that with the right tools, technique and body mechanics, performing massage can be effortless. In the Auth Method, the forearms are the preferred massage tool for the majority of massage work for a few reasons. The forearms are more durable massage tools than the hands, fingers or thumbs, so you can work longer on your clients with less wear and tear on your body. When it comes to hip rotators, this durability provides a strong tool for getting into the deep muscles of the pelvis. Let's face it, the hands, fingers and thumbs are no match for the large muscles of the hips.
Massaging the hip rotators with the fingers or thumbs can be pokey and uncomfortable for the client. When using the forearms, you have a broad surface area of contact, so the sensation is smooth and not pokey. This broad contact is ideal for working larger muscles groups because you can massage more of your clients in less time. Finally, the forearms are perfect for leaning into. I recommend using body weight instead of muscular force when massaging. Using muscular force is exhausting and runs the risk of working too deep. By using body weight, you'll naturally sink to the first layer of tight tissue; as that layer releases, you'll sink to the next layer of tight tissue. Work patiently, layer by layer, to create a deep tissue massage experience that is painless for your client and effortless for you.
Stretch and Release
Placing a muscle in a stretched position while performing massage is a wonderful tool for a massage therapist, because it intensifies the massage without further taxing the massage therapist. Extra effort by the therapist isn't needed for the recipient to receive deeper work. This comes in handy when you're working on a large or muscular client. Taking a muscle off the stretch softens the muscle and allows the practitioner to sink deeper into the muscle. Alternating between putting a muscle on and off the stretch while massaging is an effective technique for releasing a muscle. It incorporates all the benefits of stretching with massage, coupled with the benefits of taking a muscle off the stretch.
First Things First: Warming Up the Hip
Because the hip rotators are deep to the gluteus maximus, it is necessary to first massage the gluteus maximus. After the gluteus maximus has released, it is easier to contact and work with the deep rotators. With your client in prone position, undrape their hip. Tuck the drape securely under either leg. The drape should cover the client's midline. Effleurage the hip and leg, sufficiently spreading oil throughout. Stand alongside the table at the level of your client's anterior superior iliac spine facing down the table toward their feet. Spread your legs a legs-length apart with either leg in front. If the leg closest to the table is in front, try leaning your hip against the table for comfort. Rest your forearm closest to your client just below the iliac crest with your elbow skimming the lateral border of the sacrum. Be mindful to use your upper forearm versus your middle of lower forearm. Using the upper forearm provides you with more leverage.
Rest your other hand on your client's leg. (Image 1) Gradually lean your body weight onto your forearm and sink into your client's hip muscles. The massage table should be low enough that you can comfortably drop your body weight onto your client and high enough that your back is straight. Glide down your client's hips, tracing the border of the sacrum with the edge of your forearm and ending the stroke at the ischial tuberosity. Keep your forearm parallel with the massage table so you have a broad base of contact, this will ensure that your massage stroke isn't too pokey. (Image 2) Repeat the stroke as needed to warm up the hip and release the gluteus maximus.
Deep Hip Rotators
To massage the hip rotators with a stretch, pick up your client's ankle and bend their knee to 90 degrees. (Image 3) Repeat the same hip stroke with the knee bent; when you reach the vicinity of the rotators, about halfway down the sacrum, move their ankle and lower leg laterally. (Image 4) This will put the hip rotators on a stretch. You will feel the rotators become taut as they are being stretched. This taut quality will increase the intensity of the massage for your client, so be mindful not to overstretch or apply too much body weight onto the area. You may only have to move the ankle a couple of inches until the rotators have an adequate stretch — proceed slowly. By massaging the hip rotators in the stretched position, you are able to release tight hip rotators as well as lengthen short hip rotators.
Slowly bring the ankle back so it's hovering over the knee, releasing the stretch in the rotators, softening the tissue and allowing you to sink in deeper on the rotators. Repeat this stretch and release over the entire region of the rotators, increasing the stretch as necessary, moving slow and steady. This is a deep and often tight area for our clients. Encourage your clients to breath into their hips during this work. This will relax them and promote circulation in the area.
Releasing tight rotators can reduce turn-out in the legs, changing the alignment through your client's lower body. I have noticed that my clients are more grounded, centered and relaxed after receiving deep bodywork in the hips. Check in with your own body when massaging. Be conscious of keeping your shoulders relaxed, back straight and legs active. Remember, this is your time, too. At the end of the massage, if our clients are more relaxed but we are more tense, we have only succeeded in transferring tension rather than reducing it. Massage, even in deep areas of the body, can and should be easy on your body.
Shari Auth, MA, Lac., LMT, NCBTMB, is a licensed massage therapist and acupuncturist, and is certified in the Rolf method of structural integra-tion. She is the creator of the Auth Method and has a full-time practice in New York City. Auth teaches continuing education workshops and has a DVD, Auth Method of Therapeutic Massage: A Guide to Using the Forearms. For more information, visit www.authmethod.com or www.shariauth.com.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.