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Assessing Core Stability and ROM: 5 Basic Checks
One of the first steps in addressing core stability is assessing static posture, ranges of motion, and motion of the pelvic bones, sacrum, femurs, lumbar spine and thoracic spine.
Southwest Acupuncture College Brings It to Division 1 Athletes
When Michael Phelps' photograph with the distinctive round marks left by cupping went viral, the Division 1 student athletes treated through the Dal Ward Athletic Center at the University of Colorado (CU) could relate.
All Fiber Is Not Created Equal
Sometimes the best place to start is at the end. So, the conclusion of this article is that all fiber is good ... but some fiber is better. Let's break it down. There are two main types of fiber: soluble fiber and insoluble fiber.
What We Can Learn From Spine Surgery
Patients with lumbar stenosis presumably present for conservative care to improve their quality of life and avoid surgery. However, providing clear guidance to these patients can be difficult for a number of reasons.
News in Brief
New President / CEO Takes Office at Yo San University. Electroacupuncture for Constipation?
Overuse Injuries in Young Athletes (Pt. 2)
Most overuse injuries are benign, but there are some high-risk injuries that, if unrecognized or inappropriately treated, can result in significant loss in time from the sport or even require leaving the sport.
End of an Era Looms at NYCC
New York Chiropractic College recently announced that Dr. Frank Nicchi will retire in August 2017 after 36 years with the college, the past 17 as president.
Another Chance to Make a Difference
Just a few months ago, "the worst natural disaster to strike the United States since Hurricane Sandy" hit Louisiana. During this storm, one area experienced 31 inches of rain in 15 hours as almost 7 trillion gallons of water rained down in just one week across the state.
A First for the Profession: CCE Accredits First Chiropractic Residencies
The Council on Chiropractic Education (CCE) has awarded accreditation to all five chiropractic residency programs currently administered at Veterans Administration facilities, "the first residency programs in the nation ever to be awarded this distinction, a significant advancement in the evolution of chiropractic education," according to a VA press release announcing the milestone.
A Letter to the Profession from the New President at AAAOM
Volunteering for a national, nonprofit organization brings with it such highs, lows, and accomplishments, as well as a steep learning curve.
6 Steps to Make 2017 Your Best Year Yet
People often ask me what defines success. Success, for me, is simple: doing exactly what you want to do in life. Whether it's the kind of practice you run, your life at home, your hobbies or something else, it's achieving anything you put your mind to.
Molecular Motors: Tiny Machines Behind the Rhythm of Life
In the clinic, we aim to restore healthy patterns of movement for qi that has gotten trapped or misdirected, or may have even collapsed. We may be focused on freeing stagnation, releasing heat or redirecting counterflow qi, but it often comes down to helping re-establish a flow of sorts.
A Q & A About Updated Codes
Yes, indeed there was an update to ICD-10 on Oct.1, 2016. This is a regular update to the diagnosis coding system and this type of update will occur every Oct. 1, just as it did when the ICD-9 system was in place.
Little Sticker, Big Impact
It's the end of an election year. Hilary Clinton and Donald Trump were the subject of conversation for everyone, everywhere for the entire 2016 calendar year. I don't think any of us can deny that this election affected us all very deeply on a personal level.
Branding: Set Your Practice Apart
Dr. Brad started his practice seven years ago on a shoestring budget. He created his generic logo in five minutes using a website because he didn't have the time to figure out how to make something special.
2016: A Year in the Life of Acupuncture
Happy Holidays, may you, your family and friends have peace, joy and blessings throughout this special time of year. As 2016 comes to a close, we can look back and celebrate the many events and accomplishments for the profession of acupuncture.
Herbs for Digestion: The Power of Bitter
Many cultures (and indeed herbal clinicians) around the world have long respected the role of bitter herbs and foods for promoting digestion. For example, aperitifs – drinks consumed before a meal to stimulate appetite and digestion – were originally derived from bitter herbs.
Dedicated to Defending Chiropractic
Whether you're a veteran DC or a first-trimester student, the name George McAndrews should be part and parcel of your professional vernacular, as familiar as the word chiropractic.
Can a Multivitamin Reduce Breast Cancer Recurrence?
There is a great deal of controversy regarding the value of multivitamin supplements in cancer prevention. However, with respect to preventing breast cancer recurrence, an important study was published in the Journal of Breast Cancer Research and Treatment in 2011 by Kwan ML, et al.
Meshing TCM With Environmental Pediatrics: Where's the Overlap?
Pediatrics has a long history within Chinese medicine dating back to the late Han dynasty (i.e., the late 200s CE), with the two primary areas of emphasis being herbal medicine and xiao er tui na (pediatric massage).
A Simple Protocol for Holiday Stress
It's winter, a time when we should be deep in reflection, eating warming foods and sleeping long hours. Following nature's rhythms, we restore our bodies and minds in preparation for the renewal of spring.
Chiro School Reunion: Whatever Happened to...?
I opened the door to the closet slowly, carefully, since I knew it contained a large number of precariously stacked file boxes. It also held numerous outdated gizmos with electrical cords of various lengths that could trip or strangle a person.
January, 2016, Vol. 16, Issue 01
Does Massage Affect the Immune System Following Exercise?
By Massage Therapy Foundation Contributor
Contributed by April Neufeld, BS, LMT; Beth Barberree, BA, RMT; Derek R. Austin, PT, DPT, MS, BCTMB, CSCS
Massage therapy increasingly is integrated into the healthcare plan for individuals suffering from a multitude of conditions.In particular, athletes, and those people supporting the athletes, believe that massage therapy can yield many benefits that could aid the athlete biomechanically, physiologically, neurologically, and psychologically. However, when research articles were reviewed to examine the effects of massage therapy on the immune system, researchers found that the benefits were unclear. This month, the Massage Therapy Foundation's research column reports on a literature review published in Physical Therapy in Sport (2014): Immunological effects of massage after exercise. "The purpose of this [literature review]," wrote the authors, "was to describe and review the current literature on massage and its role in modulating immune parameters when applied after intense physical activity."
The authors searched databases (Pubmed Medline, PEDro, and Cochran) for controlled studies conducted between 1970 and 2012 using specific keywords: massage, myofascial release, acupressure, recovery, warm up, exercise-induced muscle damage, exercise, sport, immunology, and lymphocytes. And they only included studies where "massage was the main intervention, control subjects received a placebo treatment, immunological variables were measured, and all study participants were healthy people. Studies were excluded when subjects had a history of systemic disease, had less than 5 hours of physical activity each week, smoked, had been involved in intense exercise during the previous 4-months, or had a contraindication of training." While the literature search appears thorough, the authors did not clarify why they excluded articles where participants had been involved in intense exercise.
Of the original 739 studies initially identified that examined some aspect of immunology, massage therapy, or randomized controlled trials (RTC) relating to post-exercise recovery massage, all but five studies were excluded for final review because they did not meet at least one of the inclusion criteria. "The inclusion criteria were as follows: massage is the main intervention; control subjects receive a placebo treatment; immunological variables are measured, and all study participants are healthy individuals." This last inclusion, that study participants must be healthy, is of particular interest because often research is performed on populations with health problems and yet many massage therapists report their clients are mostly healthy individuals.
"The results of this review suggest that massage may exert an influence on immune parameters, especially when applied after high-intensity exercise," wrote the researchers. Some evidence suggested that massage helps support immune system response by impacting the levels of proinflammatory cytokines (important in the anti-inflammatory response). For example, in a study where massage was performed on Quadriceps, cytonkine levels s were found to be higher in the non-massaged Qquadriceps than in the treatedmassaged legQuadriceps. Since exercise can cause a potentially damaging inflammatory response, decreasing the levels of proinflammatory cytokines could be beneficial. The authors also wrote of the speculation that massage therapy induces a parasympathetic response and so "improvements in local circulation may indirectly reduce the proinflammatory cytokines." However, since much of this research is performed on only a single body part (e.g. one leg), it is difficult to assess the overall role of massage therapy on the parasympathetic system.
Two studies were compared that described the movement of neutrophils towards the focus of post exercise inflammation. But since each study examined different sized muscles, and each had different intensities and duration of exercise prior to the intervention, the researchers concluded that it is difficult to make generalizations about the effects of massage on neutrophil count without further research.
Despite the impact on a variety of immune system constituents, it was noted that only a reduced IgA level is associated with increased risk of infection. The review yielded only one study on the impact of post exercise massage on IgA levels, and that study found that significant recovery of IgA levels occurs following massage, especially in females.
Also notable to readers, may be that three of the five studies in the review found "no robust evidence of an immunological improvement after massage" (Hilbert, Sforzo, Swensen, 2003; Smith et al., 1994; Stock, Baum, Rosskopf, Schober, Weiss, Liesen, 1996). In contrast, only two studies supported the immunological benefits (Arroyo-Morales et al., 2009; Crane et al., 2012).
Systematic reviews can be useful for readers to get a broader understanding of a particular topic, but can raise more questions than they answer. Readers will recognize that there are many factors that can influence the results of a study: sample size, type of massage therapy performed, timing of the intervention, type of exercise the subjects were engaged in, and duration and intensity of the exercise. Of the five studies examined, all had different sample sizes. All studies used healthy and active subjects but not all studies examined the same kind of exercise or frequency of the physical activity. Each study had the massage therapy application applied to different body parts. Additionally, the review examined four studies that indicated there were greater immunological effects when the massage therapy was applied following a 2-hour delay post exercise. "The differences in training mode and intensity may have produced corresponding variations in the immunosuppressive effects obtained, influencing evaluations of the recovery achieved by massage," wrote the researchers. "The data in this review suggest that massage may have a more relevant effect on the immune response after exercise with a higher cardiovascular demand. However, further research is required to confirm this possibility."
The researchers report there were several weaknesses in the studies selected for the review. One was that there was no information on any adverse effects that could have indicated complications with massage therapy as an intervention. Sports massage therapists might be tempted to read the information about the 2-hour delay and think that they should use that model on the athletes they work with. However, it is important to remember that while the subjects studied were young and healthy, none of them participated in professional sports or were elite athletes who practiced at moderate/high-intensity levels of physical activity.
The authors of this review clearly pointed out that a main limitation of the studies was that although some reported cell count changes, further research is needed to understand if these cells are simply relocating in the body as part of an immune response or actually proliferating.
Systematic reviews are excellent ways for readers to get a broad view of various studies examining a single topic. And as researchers explore topics before beginning new studies, a review is especially helpful to inform new projects by seeing what studies could be improved upon.
For more information on other reviews that have been done on massage therapy, please read the Massage Therapy Foundation review article archives, read accepted MTF Research Grant abstracts, or search PubMed for massage therapy studies.
The Massage Therapy Foundation continues to support and promote research as seen in this month's review. Registration is now open for the 2016 International Massage Therapy Research Conference (IMTRC) that will be held in Seattle, Washington, May 12-15. Registration information as well as conference updates are now available on the website at www.massagetherapyfoundation.org.
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