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The Roots of Insomnia
One of the most common clinical presentations is insomnia. Next to digestive disorders, sleep disorders are one of the most common complaints the clinician will encounter in daily practice.
Forgotten Options for Musculoskeletal Health
Challenges with musculoskeletal health are of tremendous concern for many people today.
Yo San University Helps Make LA Communities Healthier
An element of healthcare training often overlooked is the residual benefit to communities served by Acupuncture and Oriental Medicine (AOM) schools nationwide.
Window of the Sky Points
The acupuncture points known as Window of the Sky are a modern creation. There is no reference in Chinese medical texts for an acupuncture point category called Window of the Sky.
East Meets West
Gung Hay Fat Choi. Welcome to the year of the Monkey. There will be fireworks for both January and February this year. What great celebrations.
Chiropractic Around the World: WFC Country Reports December 2015
The following country updates are reprinted with permission from the December 2015 World Federation of Chiropractic (WFC) Quarterly World Report. Information is excepted for space and edited to DC-specific style guidelines.
How to Humanize Your Content to Create Stronger Relationships
Content marketing is about building relationships, whether that is through updates on social media, offers on your website, blog posts, email campaigns, or even printed material. Now days a business needs to make a human connection.
Integrative Medicine Can Shape the Profession
As the AOM profession struggles to define the role of "integrative" medicine within their practices their schools and organizations, students, faculty, alumni and administrators at schools wrestle with discussions of how much, where, how, and what to "integrate."
Ethics: The Glue That Holds Us Together
Kudos to the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) for creating a code of ethics for the nationwide profession and for deciding to make courses in ethics a requirement for certification renewal.
Do Doctors Lie to Patients? (Do You Lie to Yours?)
In a previous column ["When Patients Lie (Bribe or Flatter)," Oct. 1, 2015], I discussed the issue of patients lying to doctors, and the many reasons why this can occur.
Is There a Neurological Basis and Correction for Macular Degeneration?
Macular degeneration, aka AMD (age-related macular degeneration), is a common eye disease and a leading cause of blindness in people age 50 years and older, according to the National Institutes of Health National Eye Institute.
Diet, Nutrition and the Context of Risk (Part 1)
Food and supplement safety is a topic that often comes up when I speak to chiropractors for CE relicensing, even when it is not the advertised subject.
Treating Pain: The Hypermobile Coccyx
When I write about the coccyx, I recognize that I am talking about a relatively small subset of patients. When I write for Dynamic Chiropractic, I am trying to reach 60,000 chiropractors.
Percussion Therapy: An Experiment
My study of qi began more than 20 years ago — long before my study of TCM, points or pathways. It all started with an awareness in my hands and physical manifestations in the way of blockages while working on clients.
Taking Another Step Toward a Secure Future
In 2008, the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) released a literature review on chiropractic care for low back disorders.
Asking the Insurance Rep the Right Questions
One of the first or last questions a potential patient often asks is: "Do you take insurance?" An ill-informed or optimistic, "yes" can result in delayed or non-payment. Instead, just say: "Let me check if you are eligible first."
Enhancing Performance in Cross-Fit Athletes
Cross-fitness centers are expanding in number and increasing in popularity. To remain relevant to this growing portion of society, practitioners need to learn about the exercises and injuries common to this group.
From Antiquity to Modernity: Huang Qin Tang at Yale Medical School, Part 1
Traditional Chinese medicine is a coherent medical system with several unique characteristics: it originated almost 3,000 years ago; in its area of origin, it has been practiced without interruption since its inception.
Billing and Coding for Moxibustion
Q: I am trying to locate a code for cupping and moxibustion, and have had various fellow acupuncturists indicate that they bill using the existing codes for heat, 97010 hot packs or 97026 infra-red for moxa and 97016 vasopneumatic device for cupping.
Changing the Cultural View of Medicine
Many hospitals in the U.S. are incorporating integrative clinics that include Traditional Chinese Medicine. Cleveland Clinic has led the charge for adding a traditional Chinese herbal medicine clinic to their existing acupuncture program.
Lab Rats (Roaming the Streets)
The title of this article is an accurate description of American consumers (regardless of age) in the modern era.
Interprofessionalism: What it Means and Why You Should Care
Interprofessionalism in education and in practice is a growing trend across health care in the United States. The idea that team-based care and collaborative practice can improve health care has been around more than 50 years.
The Clinical Versatility of Milk Thistle (Part 2)
Evidence is growing that the silymarin complex of flavonolignans from milk thistle can impact serum ferritin and iron overload in various clinical circumstances.
RAND Study Recruiting DCs
Dr. Ian Coulter, RAND / Samueli chair for integrative medicine and senior health policy researcher for the RAND Corporation, has issued a call for participation, recruiting doctors of chiropractic for a practice-based research study that will examine "the impact of evidence, outcomes, costs and patient preferences on the choice of treatment for chronic low back pain and neck pain."
The MRI: What to Do With the Results
As I wrote in my previous article on this topic, it is my goal for you, the doctor, to be an expert in interpreting MRI images yourself; and to be able to independently make decisions based upon a combination of clinical presentations and findings, followed by the MRI images.
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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