resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
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.
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.
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.
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%.
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.
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.
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.
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.
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.
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).
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.
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.
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.
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.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
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.
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.
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.
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.
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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