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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.
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!
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.
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.
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."
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.
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.
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.
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.
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.
News in Brief
National Chiropractic Health Month: Be Proactive; Collegiate Roundup: Academic Appointments at Parker, Logan.
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.
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.
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.
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.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
July, 2014, Vol. 14, Issue 07
Prone Position Syndrome
By David Lauterstein, RMT
How many times have you been receiving a massage and noticed after 40 minutes that you are still lying face down? Your sinuses have filled up. Your face and jaw are being deformed by the face cradle, leading to a related symptom, "cradle face." Your pelvis has been stuck in one awkward position for the much of the session.If you're a knowledgeable receiver, you may already be wondering what will be left out of the massage, because, after 40 minutes prone, receiving mostly back and shoulder work, there is no way the lower body, front torso, arms, hands, head and neck can be adequately addressed. How many times has a therapist apologized for leaving something out because they "didn't have enough time" or they simply ignored it? How many times have you gotten off the massage table and found some symptoms worse from being prone too long or sore from certain areas overworked or underworked?
Much of this can be traced to what I have named, "Prone Position Syndrome" or PPS for short. I'm being both funny and serious in bringing this up. This syndrome is obvious, but I've not often heard it identified as one of the major problems with massages these days. Why do therapists cause PPS so often? What are the causes and problems of PPS and what is the cure?
The first poblem is the lack of education regarding the importance of timing in a massage. What's the cure? Take a better history and determine a game plan for what body segments you will emphasize and approximately how much time you will spend on them. Get client agreement regarding your plan. Then monitor your timing as you go.
The belief that more is better – especially when it comes to working tense areas. The assumption that more force or that more repetitions will improve the session especially affects therapists' work with the back and posterior shoulder girdle. What's the cure? Realize less is often more! The thing that relaxes muscles' tensing is the nervous system. So honestly in massage we are not so much doing soft tissue manipulation (in spite of what most state laws say), instead we use manual suggestions to talk the nervous system into initiating the relaxation response. More repetitions do not do a better job of convincing the nervous system to relax – anymore than verbally telling the person to relax again and again and again.
Therapists are sometimes taught or get into the habit of always working at the same tempo, often doing all their strokes somewhat slowly. Frankly, if the massage is all slow, the client is often just put to sleep. When the client sleeps, there is no body-mind learning. The cure? Work that truly honors the nervous system, the mind and the body's needs – will vary in tempo. It is important to slow down in places of tension. It is equally important to speed up where things are relatively fine. I often think of Muhammed Ali's famous exhortation to "Float like a butterfly. Sting like a bee."
To repeat a stroke more than three or four times generally dishonors the client's nervous system. The nervous system GETS the message pretty quick! It doesn't need to be forced to relinquish its tension through brute force or excess repetitions. We need to remember that the client's awareness accompanies our touch and that a really good massage often will nonverbally impart important information to the client about their body and mind and emotions. I recently received a student session and I pointed out that the nervous system gets the message pretty quick and, if it's all slow, it's like assuming talking slow will improve communication.
Excess preoocupation with addressing the back, shoulders and neck and especially in the prone position. This often is a habit reinforced by frequent client requests to "just work on my back and shoulders." Clients do not realize that where their pain ends up is not necessarily where it's coming from. The most common example of this is back pain due to chronic forward flexion of the torso. As long as the front isn't lengthened, the back cannot let go. The cure?
Ida Rolf had an important saying, "Go where they're not." Explain to your clients, if they are willing listen, that you are happy to emphasize their backs and shoulders, but that often their back tension is related to posture and to stress elsewhere in the body. Therefore, in order to give them even more thorough and longer-lasting relief, in addition to giving the back, shoulders and neck lots of attention, your work will help them even more by addressing tension in the legs and feet which give critical support to the back; and addressing tension in abdomen and upper chest to help with the hunched over posture so many of us adopt at our desks and driving.
Boredom - the therapist just won't be bothered to individually plan the timing in the session. The cure? If you are bored in your work, you need to re-examine your attitudes and the environment you work in. Often in school, students say the subject they find most boring is business. But in graduate surveys, they often say if there was one subject they needed to pay more attention to it was business. If you are bored in your work, it is time re-examine your business plan; or, if you don't have one, it is high time create it. This can be fun and it certainly is necessary – look at Business Mastery by Cherie Sohnen-Moe or some other good business text written for massage therapists/health professionals.
Even more serious - lack of care. Sometimes one may be the sixth or seventh client of the day or the twenty-fifth of the week! The therapist, sadly enough, may just not care a whole lot at that point. The cure? Similar to boredom, lack of care may result from your attitudes or from being in an environment that is discouraging. Re-visit your business plan! Every business owner and/or employee needs to make sure that they keep on finding ways to activate their care for themselves and others in their work.
Not having the anatomical knowledge or technical skills to address the client's problems. The cure? Re-visit your anatomy and the most effective techniques you learned in school. Take continuing education that gives you efficient ways to address tension. Learn particularly how to pleasurably and effectively address the myofasical structures which keep the torso in chronic flexion – among them, especially rectus abdominis and pectoralis major.
Together we can overcome this pervasive problem. Let us free ourselves and our clients from the dreaded effects of Prone Position Syndrome!
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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