resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Fibromyalgia: Put the Pain in Its Place
While some fibromyalgia patients respond favorably to regular chiropractic care, others experience minimal relief. Unfortunately, many of these patients must rely on pharmacological management to relieve their constant pain.
Knee Pain From the Kinetic Chain
As practitioners of manual medicine, chiropractors often treat patients suffering from knee pain.
Immunizations by Colorado DCs: Really?
You probably didn't hear about it, but back on Nov. 21, 2013, the Board of Directors of the Colorado Chiropractic Association (CCA) adopted "immunization authority" for Colorado DCs as its No. 2 legislative goal.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
Remembering Clarence Gonstead and 50 Years of the Gonstead Clinic
Dr. Clarence Selmer Gonstead (1898-1978) took chiropractic practice from back-alley bone setting to an understandable biomechanical science. His life was dedicated to clinical competency.
Physical Exam 101: The Hands
I am sure you are familiar with the old adage: "When the only tool in your toolbox is a hammer, everything starts to look like a nail."
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
Why You Should Include the Single-Leg Stance Test in Every Patient Assessment
The single-leg stance (SLS) test, also known as the single-limb stance test, unipedal stance test or one-legged stance / balance test, is often used in the geriatric population to assess static postural and balance control.
Curbing Label Overwhelm
For the average consumer, reading a food package can be overwhelming: natural, organic, non-GMO, gluten free, free range ... you get the picture.
The Science of Stretching
In 1986, Rob DeCastella set a course record by running the Boston Marathon in 2:07:51, just 39 seconds off the world record.
Vaccines and Chiropractic: Evidence-Based Medicine or Medical Dogma?
Right or wrong, the chiropractic profession has historically been against vaccinations. However, a growing trend within the profession is seeking to reverse this position.
Are You a Bad Chiropractic Patient?
My father was a great DC. In fact, as you might expect, he was the doctor of chiropractic I measured all other doctors against. Sadly, he died at age 61 when I was in my early 30s.
Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
Coding for the Subluxation: ICD-9 vs. ICD-10
When I attended chiropractic school, I was taught that chiropractors approach health care differently than the traditional medical establishment.
May, 2013, Vol. 13, Issue 05
Soft Tissue Tools Help Post-Natal Calf Pain: A Case Study
By Massage Therapy Foundation Contributor
Contributed By Derek R. Austin, BS, MS, CMT, Sandra K. Anderson, BA, LMT, ABT and April V. Neufeld, BS, LMP, NCTMB
Do you use massage tools in your practice? Do you work with post-natal women? If so, this month's Massage Therapy Foundation (MTF) research column features a case study that might interest you.According to the Massage Therapy Foundation's website (www.massagetherapyfoundation.org) a case study documents a massage therapist's experience with an individual client. Case studies help the practitioner and the massage therapy profession improve communication and critical thinking skills, and they can contribute to future research and clinical practice. If you are a massage therapy student, read on to see how you can enter the MTF Student Case Report Contest.
We all want to save our thumbs and have long, pain-free careers. This month, the MTF is reviewing what could be called massage tool research. It is not a commonly researched topic, so we are highlighting information from the Department of Physical Therapy at Indiana University. In this case study, Amy Bayliss, et al, reported on how instrument-assisted soft tissue mobilization (ISTM) was used to treat a post-natal patient with chronic calf pain.
Musculoskeletal pain is often reported by women at the end of pregnancy and following delivery. While lower back pain is most common in pre-natal women, non-specific lower leg pain is another common symptom reported during pregnancy. Such pain is thought to decline at some point after delivery. However, massage therapists know that this musculoskeletal pain can linger and is often successfully treated with massage. One method is cross-fiber friction (CFF), sometimes known as Cyriax technique. ISTM is based upon the concepts of CFF, applied with a uniquely-shaped instrument.
The patient in this case study was a 35-year-old female who had a two-year history of right mid-calf pain, beginning during the last trimester of her first pregnancy. The calf pain was preceded by severe lower leg edema. On a scale of 1 to 10, the pain was described as a dull ache, rating 2 on the day of examination, 0 at best and 5 on her worst day. Pain with deep palpation was an 8. There were no relieving activities and her symptoms were aggravated by direct pressure on the calf such as crossing her legs, and by activities that created tension in her calf, such as walking up stairs, jogging or strength training. The calf pain limited her activities of daily living, including standing and lifting her 35 pound son.
There were no significant issues with the arteries, veins or nerves, or with the endocrine and gastrointestinal systems. Additionally, the hip, sacroiliac joint and lumbar spine were cleared of dysfunction. An MRI was considered normal, although a dense soft tissue abnormality in the small superficial venous tissue network was noted that corresponded to the patient's pain in the right calf. Range of motion testing was normal. The instruments used by the physical therapist during treatment were those specifically for Graston Technique. The Graston Technique is a form of ISTM combined with a targeted stretching and strengthening program. (Currently, Graston tools are limited to chiropractors, physical therapists and athletic trainers and are restricted from massage therapists.)
The goals of treatment were for the patient to be able to stand for two hours, sit cross-legged and walk up stairs without right calf pain, as she was previously able to do. The patient also wanted to be able to lift 40 pounds from floor to waist without right calf pain so she could lift her child. The patient received nine treatment sessions over eight weeks, consisting of a 5 minute warm-up of brisk walking, 6 to 8 minutes of ISTM on the posterior right calf, standing stretches for gastrocnemius and soleus, eccentric exercise for the right calf and ice for 10 minutes to reduce inflammation.
On reassessment after eight weeks, soft tissue quality of the right calf was considered normal, meaning supple and easily moved. Additionally, her pain was reduced from 8 with deep palpation to 0. Her pain at rest had also improved to 0 and 0 to 1 with activity. Follow-up at one month and four months showed no return of pain. A follow-up MRI was not possible because the patient became pregnant three months after conclusion of treatment.
This study has several notable limitations for immediate application into massage practice including being a case report without experimental or comparison groups; featuring patented tools and techniques requiring specialized training and expense; and excluding any massage techniques such as gliding, kneading or compression, which are commonly used during a massage session.
Additionally, two points represent the gap between the work physical therapists and massage therapists do. First, the term "trigger point" never appears in this case study, even though it could be a possible cause of the tender mass in the patient's calf. Second, the authors write, "One of the consequences of targeted soft tissue mobilization and in particular ISTM is bruising over the site of the soft tissue dysfunction." They include an image of the patient's bruise, clearly visible after a treatment session and a few inches in diameter. Most massage therapists adjust their pressure to avoid bruising clients.
The authors conclude, "ISTM offers a mechanical advantage afforded to the clinician as well as the potential to minimize the clinician's joint stress. […] Allowing the tools to absorb mechanical stress rather than the therapist's hands has the potential to reduce over-use injury to the treating clinician." While the evidence is still preliminary, it points toward the continued use of massage tools. However, as massage therapists cannot practice Graston Technique, the application of this research to massage practice is unfortunately limited. Although alternative massage tools may be as effective, massage therapists should continue to rely on clinical judgment when deciding whether to use massage tools in practice.
To learn more about the effects of massage therapy, review the Massage Therapy Foundation article archives, read accepted MTF Research Grant abstracts, or search PubMed for massage therapy studies. For more information on Graston Technique, see their website.
Are you a massage therapy student with an interesting case of your own? The MTF Student Case Report Contest submission deadline is June 1, 2013. The Massage Therapy Foundation has offered Case Report Contests since 2006 to provide massage and bodywork practitioners and students a way to develop research skills and enhance their ability to provide evidence informed massage to the public. Cash prizes are available to the winners of each contest, contingent on publication of the case report.
Click here for more information about Massage Therapy Foundation Contributor.
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