resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Let the Patient Tell Their Story
Often when a patient presents with an injury, they want to tell their story. People by nature like to talk about themselves, particularly when they're worried about their health.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 1)
When we think of lower back pain, we tend to think in terms of the lower lumbar spine and the SI joint. These joints and their discs are obviously important. However, we tend to miss fixations that occur just above – in the upper lumbar spine. Three questions come to mind: 1) Why is the upper lumbar spine so important? 2) Why do we miss the fixations here? 3) How can we adjust them?
The Science Behind Happiness
Are you happy right now? Whether yes or no, there are a myriad of reasons why you feel that way. A whole academic discipline has developed to find out what causes or obstructs happiness, and how to amplify it.
A Glimpse Into China's Top Brain Hospital
The sounds of the city pass through the open window are overwhelming the microphone - car horns, construction machinery - and then there's the family at the adjacent bed talking loudly on cell phones, yet you can still hear the faint beep of our patients monitoring equipment.
News in Brief
NBCE Launches Computer-Based Testing Era; California Chiropractors Get Expanded DOT Exam Privileges; New Jeff Hays Documentary.
The Truth About Herbs
I appreciate the effort and research put into the article written in the June issue of Acupuncture Today regarding pesticides and Chinese herbs.
The Problem With Prolonged Sitting
We need to constantly talk to our patients about spending less time sitting and about what can go wrong with poor sitting postures. The fact is we sit too long in repetitive malpositions.
Rethinking GMO: Less Panic, More Context
Some of you may have noticed that after writing parts 1 and 2 of “Genetic Modification of Organisms for Human Consumption” a while back [Nov. 15, 2013 and Jan. 1, 2014 issues], part 3 never appeared.
Healing Community Trauma in Israel and Palestine
It's the beginning of August and Israel and Hamas have just agreed to a 72-hour ceasefire after a month of brutal fighting. In the last four weeks, 1,830 Palestinians and 67 Israelis have been killed.
Thoughts to Live By
When speaking to your patients about their health make sure to ponder the following points and have them assess if they are making themselves even more sick by the thoughts they have about life. Are these some of the traits and thoughts that your patients might have?
Medicalization and Mindfulness
The past several years have seen a veritable explosion of research on mindfulness. Research abstracts we've published in each issue of Health Insights Today under the heading "Mind-Body News" have increasingly reported on studies about mindfulness interventions.
If You Get a Request for Records, Respond!
In our previous two articles, we discussed two of the main reasons for denial when chiropractic records are reviewed by Medicare contractors.
Uncle Sam Needs You
Scrutiny into the Department of Veterans Affairs (DVA) continues to grow after efforts to reform the DVA by the former Secretary of Veterans Affairs, Eric Shinseki, were deemed "a stunning period of dysfunction" by Senate Minority Leader Mitch McConnell (R-Ky.).
The Spirit of the Point
After receiving a large amount of positive feedback on my San Zhen Protocols series, I have decided to focus this article on some relevant clinical aspects of acupuncture therapy prior to moving on to San Zhen Protocols III.
Thoracolumbar Syndrome: The Great Mimic
The thoracolumbar junction is a common area of joint dysfunction. The most obvious cause is dysfunctional breathing or lack of diaphragmatic breathing. Treating this breathing problem will ultimately be the long-term cure for the syndrome.
History of Animal Acupuncture: Part II
In Part I of this article, I had gone back to 1969 and tried to describe the atmosphere and events of that year that engulfed many of the younger generation, some who were all the core members of the National Acupuncture Association.
MPA Media Wins Seven Publishing Awards
MPA Media, publisher of Acupuncture Today, among other titles, has been recognized for editorial and design excellence with an unprecendented seven publishing awards by the ASBPE, the nation's largest organization for business-to-business publications.
Improving Our Political Effectiveness
The November 2014 elections are right around the corner; members of Congress, governors and state legislators are all running. Now is a good time to talk frankly about our overall political involvement.
A Healthy Dose of Failure is Vital to Your Success
As an acupuncturist I tend to see people after they have already suffered for years and "tried everything." They are so desperate for some relief that they want to know everything about how to get better, right now.
Get Ready For AOM Day
This year, AOM Day 2014 falls on Friday, (October 24th). This is a great opportunity to make your AOM Day celebration or event even bigger by extending it throughout the weekend!
When Big Pharma Meets Chinese Medicine
Earlier this year, Bayer made a media splash with their decision to buy the Dihon Pharmaceutical Group Co., a Chinese TCM manufacturer.
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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