resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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?'
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.
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.
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.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
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.
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?
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.
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.
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.
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).
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.
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.
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.
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.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
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.
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.
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.
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.
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.
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.
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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