resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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.
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).
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
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.
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.
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.
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.
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.
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.
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.
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%.
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.
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.
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.
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.
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.
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.
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.
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.
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).
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
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.
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.
March, 2014, Vol. 14, Issue 03
Ending the Energy Debate
By David Lauterstein, RMT
There have been many recent online discussions in our field about "energy" and the role it may or may not play in our work and education. Many people have noted regretfully that some of the discussions have given rise to divisiveness somewhat uncharacteristic in our field.Partly, this may be a function of "social" media. When it comes to sorting out emotions, it is not a very effective medium. This reminds us that, unlike massage and the world of "high touch" in which compassion is the rule, the Internet and the world of "high tech" is not a very effective context for resolving difficult emotions.
What everyone does appear to agree on is enhancing the quality of education and therapists. It may be helpful to look at what role "energy" may or may not play in improving massage education and in therapy. First, we need to know what we are talking about. What does energy mean? Importantly, it is a word for which there is more than one definition. The definitions of "energy" refer to two quite different things – a quality of action and a physical phenomenon.
Here is the definition from the free online dictionary:
The first two definitions are more subjective and refer to the world of experience and a quality of action. The second two definitions are more objective, referring to measurable physical phenomena described by science. As we look at the energetic aspect of massage and bodywork, let's keep these varying definitions in mind.
We can note in the beginning that the energetic aspect of massage refers more to the quality of action and touch, than to the scientific, objective definition. Is massage "energy work?" If we mean by energy work, pure energy work done off-the-body, it is fairly easy to say "no." Massage involves touching the body and often is defined expressly as soft tissue manipulation in textbooks and in many state laws.
Is there an energetic aspect to touch therapy done on-the-body? Using the quality of action definitions above, we can say "yes." The quality of our touch may be considered energetic. Quantifiable aspects such as pressure may be measured, but the energetic aspect is more subjectively experienced.
We need to remember that massage can (and should) be objectively studied, but it is experienced subjectively by the client. Clients are interested in feeling better, in having more pleasure, less pain, more relaxation and more energy. Using the first two definitions we see these are subjective goals, facilitated by both the structural and energetic clarity with which we engage the tissues and the nervous system of the body.
Where both the pro- and anti-energy camps get in trouble is when they leap to the objective definitions of energy. The pro-energy folks wish to see the energy aspect of massage and bodywork as objectively existing, like electricity or magnetism. While these may be intriguing metaphors for the energetic aspect of our work, there is little if any proof that the energy spoken of by some massage therapists and bodyworkers exists objectively. Again and again, we need to return to the fact that the energetic aspect refers most directly to subjective experience. This makes it no less real, our experience is real – but like thought and emotion, like love – you can't find it under a microscope.
Now the elusiveness of how to describe subjective/energetic experience has given rise to various terminologies. Some people are attracted to a particular language describing the energetic aspect because that was what they were taught or they find those concepts and vocabularies illuminating of their own experience as receivers and as givers. Some people find helpful the languages of chi or meridians, prana, kundalini, chakras, bio-energy, élan vital, psychology or phenomenology, etc. Some people prefer language referring primarily to the nervous and endocrine systems, seeing the experience of energy largely as a projection of the brain.
How can and should we reflect these varying views in our education? No one is saying this should a mandatory part of basic curricula, however, there are some ways various educators may choose in a balanced way to cover this topic.
We may cover some of energetic aspects of massage and bodywork in our history classes. Asian concepts linking up energy and anatomy have played a role in the history of massage. The "humours" in medieval medicine; the assumption of links between the spiritual and physical aspects of health; the energetic understandings of psychology and, most recently, psychoneuroimmunology – any or all of these may be helpful in producing students with a fuller picture of our work and its roots in the history of manual and mind-body therapy.
We can note that many modalities explicitly integrate structural and energetic work – zero balancing, deep massage, some forms of myofascial release. And many more assume this is what's happening – shiatsu, Thai massage, rolfing, etc.
We should cover how conscious and unconscious beliefs affect health. Chronic mindsets and chronic emotional conditions can exacerbate or even cause a variety of tension-syndromes. The placebo effect is powerful. Ted Kaptchuk, author and acupuncturist and colleagues mostly from Harvard have created a "Program in Placebo Studies and the Therapeutic Encounter." It is equally important for students to also understand the nocebo effect – the harm that can be caused by uncaring healthcare that may evoke negative feelings in the client. Placebo and nocebo effects of course may be considered as within the realm of the energetics of touch.
In looking at assessment skills and the therapeutic relationship, it is important that we consider posture, movement, and the energetics that may underlie those. We may agree on what we should not do:
We should not talk to clients about their "energy." Diagnosis, whether structural or energetic, is not within our scope of practice. When a massage therapist or bodyworker talks to the client about their energy, they are way beyond the boundaries of massage (and basic etiquette) and quite likely to evoke the nocebo affect by verbally attributing certain energy characteristics to a client.
We should be conscious that when we are touching people, it is a contact which is more than just physical. This means we need to take responsibility for the energetic as well physical effects of our interaction and touch. We need to recognize that we are touching both structure and energy.
Massage is an art and a science. We depend on research and scientific knowledge to enable us to work effectively with our clients. At the same time, every session is a person-to-person, moment-to-moment improvisation that calls for a subtle sensitivity to the medium we are working with. In the case of massage/bodywork, our medium is the most complex and sensitive life form known to exist. Of course, we need art and science. Of course, we need to know this person is a profound integration of structure and energy, tissue and issues, and to be sensitive to what is both objectively true and subjectively experienced.
To argue for or against either the structural or energetic perspective is like arguing which of your two eyes you ought to see out of. By honoring both what research and what subjective experiences teach us, we arrive at the highest quality of touch, education and therapeutic benefit. Without science, without a respect for knowledge and structure, we lose our commitment to truth; without art, without a respect for subjective, energetic experience, we lose our commitment to the soul and beauty of our work. We see better and more truly with both eyes.
David Lauterstein is Co-Director of Lauterstein-Conway Massage School in Austin, Texas. He is author of "The Deep Massage Book" and "Putting the Soul Back in the Body." David has been inducted into the Massage Therapy Hall of Fame, received AMTA's Jerome Perlinski Teacher of the Year Award, and in 2013, was recognized as "Educator of the Year" by the Alliance for Massage Therapy Education. For more info, visit www.TLCschool.com.
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