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Pain Underfoot: Metatarsalgia
Foot pain can interfere significantly with normal activities and severely limit participation in sports. Metatarsalgia is foot pain involving the metatarsal bones in the forefoot – the complaint of pain on the bottom of the ball of the foot.
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.
Chiropractic Research in Review
Chiropractic Treatment of Lateral Epicondylitis; Cost / Benefit Analysis: Different Doses of SMT for Low Back Pain; Imaging for Occult Rib and Costal Cartilage Fractures; Treating Neck Pain: Thoracic Thrust Manipulation vs. Non-Thrust Mobilization.
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.
Why Young People Need Chiropractic Now More Than Ever
According to a recent study published in BMC Musculoskeletal Disorders, "It is now widely acknowledged that neck pain (NP), mid back pain (MBP), and low back pain (LBP) (spinal pain) start early in life and that the lifetime prevalence increases rapidly during adolescence to reach adult levels at the age of 18."
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.
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.
MPA Media Wins 7 Publishing Awards
MPA Media, publisher of Dynamic Chiropractic and DC Practice Insights, among other titles, has been recognized for editorial and design excellence with an unprecedented seven publishing awards by the American Society of Business Publication Editors (ASBPE), the nation's largest organization for business-to-business publications.
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.
9 Common Causes of Thyroid Imbalance and How You Can Help
How you sleep, how easily you wake up, and how much energy and stamina you have during the day are directly related to levels of the thyroid hormones.
CCE Finally Takes a "Baby Step" Toward Reform
During a 16-month period from October 2010 to February 2012, I devoted four separate columns to the heavy-handed attempt by the Council on Chiropractic Education to radically change the chiropractic profession through the accreditation process.
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.
A Vibrating Capsule for Constipation? Relevance to Your Chiropractic Practice
The relationship between gastrointestinal (GI) complaints and back pain is not typically written about or discussed.
Waking Up the Gluteus Maximus
In previous articles in this series, we expounded on the importance of the gluteus maximus (GM) in athletic performance and protecting the knee from injury. We also know there is a link between iliotibial band syndrome and GM weakness.
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!
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
Don't Turn a 2 Into a 10
The Wong-Baker FACES Pain Rating Scale1 is so useful because it can be used by almost anyone. Patients can use the numbers associated with the faces depicted on the scale or select the face that demonstrates their current level of pain from 0-10.
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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