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Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. After two treatments for back pain, a patient presents for a third session complaining of rapid breathing and wheezing that is made worse during cold weather.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
June, 2014, Vol. 14, Issue 06
Traditional Thai Massage Improves Bone Formation in Postmenopausal Women
By Massage Therapy Foundation Contributor
Contributed by April V Neufeld, BS, LMP, Jolie Haun, PhD, LMT, Derek Austin, MS, CMT, CSCS
When you were young, your parents may have told you drinking milk would give you healthy bones. As adults, we learn that activities such as exercise are also necessary in helping our body maintain bone density and decrease the risk of osteoporosis. This month, we will discuss a recent study showing how promoting healthy bones can be as easy as receiving Thai massage while lying relaxed on a floor mat.
A study performed at the Endocrine and Metabolism Unit of Ramathibodi Hospital in Bangkok, Thailand, and subsequently published in BMC: Complementary and Alternative Medicine (2013), examined the effects of traditional Thai massage on bone formation in postmenopausal women. The researchers speculated that the pressure exerted by the massage therapist on the patient may, "induce strain in the skeleton and affect bone, similar to other means of applying mechanical load."
Forty-eight postmenopausal women participated; subjects diagnosed with any disorders affecting bone metabolism such as diabetes, cancer or rheumatoid arthritis, among others, were excluded. A randomized crossover design was used, meaning each participant was in the control and the treatment group. In describing the design, the authors wrote, "Subjects in the treatment group underwent a two-hour session of Thai traditional massage twice a week for four weeks, while no intervention was given to subjects in the control group. After a two-week washout period, subjects were switched to the other arm of intervention for four weeks." Additionally, the subjects were asked to avoid exercise for 24 hours and to fast for a minimum of 10 hours prior to the morning blood test. In order to track changes in biochemical markers of bone turnover, each subject had measurements taken of their body and bone composition, as well as the bone mineral density of their first four lumbar vertebrae, neck of the femur and hip as a whole.
The methods of the study described the traditional Thai massage in moderate detail. A single massage practitioner performed Thai massage for two-hour sessions that involved direct pressure by the heel of outstretched hands on the subject's body for about a one to two second duration. The researchers outlined the subject's position (lying on back, lying on side, lying on chest) and various positions of the practitioner with photos. However, inadequate detail was given describing the amount of pressure being applied by the massage therapist. And, while the researchers indicated that the massage therapists applied pressure using the heel of the hand, the photos clearly indicated that fingers and broad hand positions were also used.
In a previous study, the researchers measured that a single two-hour treatment of traditional Thai massage increased the markers for bone formation by 4.8%. This current study indicated that two treatments per week resulted in higher markers, with the biggest improvement noted in the older women with smaller body frames (14.8% ± 3.3%). This is exciting news for older women who are concerned about osteoporosis and are not actively involved in a strength training routine, as well as for massage therapists who frequently use compressive techniques during treatments. The researchers discussed several other studies related to this project. Previous research has indicated that massage will decrease bone pain, improve bone growth and promote lean mass and bone growth in the early postnatal period. Additionally, people who participate in physical activity in addition to massage during the peri-neonatal period have improved bone formation. However, there is little research on the effects of massage on bone metabolism in adults.
As many people already know, performing mechanical load exercises (i.e. weightlifting and load bearing exercises such as walking and running) put strain on our skeletal muscles that then induces bone growth. Active and passive exercises will improve bone mass and decrease bone loss. What research has not yet shown is whether a light load must be accompanied by a high frequency in order to be as effective as a heavy weight with low frequency. It may be possible that low-impact activities such as walking or receiving massage must be repeated more often to receive the same benefits in terms of bone formation of someone lifting heavy weights less often. When speaking with our patients, we should note that this study indicates that Thai massage should be performed two times per week to have an impact on bone markers.
Though these findings are intriguing, the researchers discussed several limitations to the study. Most notably, this study does not specifically indicate that increased bone markers will result in increased bone mass and reduced fractures. Additionally, this study had a fairly small subject pool (n=48). It is also unclear if the effects of this study could be generalized to all massage therapists since only a single massage therapist was used to provide the Thai massage. The researchers also failed to mention the qualifications or education training of the massage practitioner. Future studies with this team should provide more details about the massage itself, such as qualification standards and a massage protocol for consistency and replication. One additional limitation was noted, in that the researchers indicated that while they excluded subjects taking medications for osteoporosis, they did include seven subjects who had osteoporosis at the spine, femoral neck or hip. Including women with an existing history of osteoporosis would certainly impact the results.
Despite the limitations of this research, the findings still have important implications for research and practice. First, we often think of outcomes associated with massage related to stress and pain reduction, however this study demonstrated healing effects of Thai massage that might not have otherwise been considered by most. This research extends the body of knowledge in massage research outcomes and can be used to help practitioners explain the impact of their work in promoting healthy bones. As practitioners and researchers work together to explore the impacts of Thai massage and other touch modalities on diverse outcomes, we continue to expand the knowledge of this work and its application to the larger field of health and wellness.
If you would like to read more details about this study, you can find the link to the full article at Biomed Central or visit the Massage Therapy Foundation's archive of research review articles.
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