resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Nutrition for Menopause: Front-Line Therapy for All Phases
Of all the changes women experience during their reproductive life, there is no doubt the most dreaded are the three phases of menopause. This is not surprising since all of the symptoms associated with menopause are replete with unpleasantness.
The winter season is upon us and offers unique challenges for the clinician and patient alike. To effectively navigate through the winter season there are two main TCM medicinals, Huang Qi and Gan Jiang, to consider, as well as two important formulas which feature these two TCM treasures.
The Case Report: A Valuable Tool
Case reports are a valuable form of descriptive research. The most basic form of practice-based research, a case report is a detailed account of the history, presenting symptoms, assessment, observations, treatment and follow-up of an individual patient, discussed in the context of prior and potential future research.
An Education in Gluten Sensitivity
A relatively new syndrome officially documented as non-celiac gluten sensitivity (NCGS) or gluten sensitivity (GS) was officially recognized and published in the new list of gluten-related disorders in 2012.
The Acupuncture Channel System (Part 1)
The earliest Chinese reference to channels is in the Mawangdui Medical Manuscripts,1 which are dated to the Warring States period of the Zhou Dynasty (475 BC-221 AD). The text presents 11 channels. There are no acupuncture points listed in those channels.
A Conversation With Dr. Betty Edmond
This month's column is an exclusive interview with Betty Edmond MD, newly elected CEO/President of the AOMA Graduate School of Integrative Medicine in Austin, Texas.
Low Back Pain in Running Athletes
After 7 million years of adapting to upright postures, the lumbar spine and pelvis have become remarkably adept at managing ground-reactive forces associated with running.
We Get Letters & Email
Our Country Needs Us Between Elections, Too; Continuing Care: We Aren't There Yet; Our Associations Need to Do More.
Five Branches University Has First Hospital TCM Residency
Established in 1984, Five Branches University (FBU) has campuses in Santa Cruz and San Jose, Calif., which serve the communities of Santa Cruz, the Monterey Bay, and Silicon Valley.
An Opportunity & a Responsibility
Nearly 80 Americans die from an opioid-related overdose every day, and spine-related pain is one of the principle drivers of opioid use. This unfortunate situation creates both an opportunity and a responsibility.
Shoulder Rehab: Start With the Scapula
The scapula is an incredible display of elegance and movement within the biomechanics of human motion. It's evolved for mobility and stability in the scapulo-thoracic region, giving us the ability to do things that are uniquely human, such as throwing with accuracy.
News in Brief
Updated Neck Pain & Whiplash Guideline; Attention, IHS DCs; New VP of Institutional Advancement At Palmer; N.J. DC Interns At U.S. Olympic Training Center; Chiropractic Society Of R.I. On The Front Lines.
A New Year and Vision for the ACA
Inadequate pain management coupled with the epidemic of prescription opioid overuse and abuse has taken a severe toll on the lives of millions of people in the United States. Every day, more than 1,000 people are treated in the ER for misusing prescription opioids.
Anti-Aging With Dr. Ping Zhang
Jennifer Waters, TCM practitioner and writer of the Acupuncture Today column, "Talking With the Masters" sat down with Dr. Ping Zhang to discuss aniti-aging with acupuncture.
True Practice Mobility for the Chiropractic Profession
When natural disasters occur, chiropractors can literally travel to the other side of the world to offer humanitarian relief in less than a day. The chiropractor's license to legally practice, however, can't make it past the state line.
Prepare for the End, From the Beginning: Wealth Building and Retirement with the Tao
Yin and yang flow into and out from one another continually. Beginnings become endings and endings become beginnings again. Wholeness and cycles are the nature of Tao.
Another Step Forward for Chiropractic
Chiropractic is now available to 86,000-plus Latter-Day Saints missionaries and you are invited to become a provider. LDS membership in not required; our only concern is that our missionaries get the best quality care available.
Scar Reduction With Acupuncture & Microneedling (Part 2)
Protocols and treatment Timing: A course of treatments should be performed over a period of 12 weeks if possible. Microneedling should be performed once every two weeks.
Let's Clear Up the Collection Confusion
This is an often-misunderstood practice swirling with misinformation. First, a few basics: Insurance is a contract between the patient and the insurance company. The insurance company is simply making a payment for services or care on behalf of the patient.
Acupuncture Points: Broadening Our Scope and Diagnostic Work
As every practitioner knows, the correct diagnosis is everything. Most healing disciplines rely on the use of symptomatology for their treatment implementation. Beyond symptomatology, we have clinical tests to provide more objective findings.
Flirting With Alternative Therapies
There are about as many adjunct therapies being marketed to acupuncturists as there are acupuncturists. While some may remain purist in their application of traditional Chinese medicine, others choose to explore new horizons of treatment.
Qigong for Substance Abuse
It is commonly believed that substance abuse, in addition to harming one’s physiological state, hurts the spirit. There is also a belief that one’s spirit does not weaken due to substance abuse, but rather, the person finds solace in addiction due to an already weak spirit.
Movement: A Valuable Technique
Oftentimes we are tasked with returning a client back to full function after they have become immobilized. This can be done by using the mechanoreceptors of the joint, however you should also consider the value of movement as a technique, and how gaining the knowledge that a personal trainer has can benefit you and your clients.
As therapists and business owners we are always looking for new and different skills that we can add to our practice tool box. What if you were to think about personal training knowledge as a technique rather than a different profession? Studying how the human body moves should be your first goal in rehabilitation, as studying movement has the same end goal— to relieve the client of pain and get them on the road to recovery. Getting them out of pain can be the easier part of massage therapy because we almost always make someone feel better in the first moments of treatment. However, helping a client return to either their regular sports activity or just the activities of daily living is different than just getting them out of pain.
Treatment for Immobilization
For example, what happens after someone has been immobilized for a period of time? When fascia is immobilized or injured microfibers form in between the adjacent layers of connective tissue and bind them together so the insult can heal. The tissue becomes plastic-like and loses its elastic properties; plus the immobilized body part has now lost valuable proprioception of the joint. The definition of proprioception, according to McGraw-Hill Concise Dictionary of Modern Medicine 2002 by the McGraw-Hill Companies, Inc., is the subconscious sensation of body and limb movement position, obtained from non-visual sensory input recevied from muscle spindles and joint capsules. The main goal of any rehabilitation specialist is to have the client regain mobility of the joint; flexibility of the tissues; lost proprioception; strength and to return to function, as well as integration of the central nervous system function. Gaining more insight through the practice and study of movement is one tool or technique that begins to give you those "aha moments".
"Motion is Life," said Hippocrates, Greek physician, 460-377 B.C. This simple statement helps to emphasize the point that we as holistic healers must have a system of evaluating, treating and most importantly returning the client back to function. A system is defined as a set of interacting or interdependent component parts forming a complex/intricate whole. Understanding movement through the eyes of a rehabilitation specialist gives you a complete system that has checks and balances, so that what we treat will not adapt back to the dysfunction in the coming months.
As a teaching professional, I often get students who have been in the profession for many years and over that time have taken numerous technique classes, however they still lack the valuable knowledge of how a human being's central nervous system works, with regard to movement. The first massage therapy book I read, Structure and Function did not teach me more than how the pieces and parts worked individually. The book didn't teach how, or even the importance of understanding the integration of those parts working together. It was through my personal training courses that I began to understand how a body would need to function after I finished a massage therapy treatment. Fundamentally we start off in this profession learning what range of motion a joint should have, but not how to rehabilitate it once it has been immobilized. I know this might sound like a job for a physical therapist and not a massage therapist, but we end up with these clients because they have so many other issues caused by the immobilization.
Recent Cases & Examples
I have had four cases recently of the ankle and foot being immobilized in a boot. The first one had to leave the boot on extra time because her fracture was not healing properly, so naturally when the boot came off she had complete loss of function and could hardly move the ankle joint at all and she was starting to experience pain up the chain to her quad and hip. The second after physical therapy still lacked balance and sadly was now suffering with opposite hip and groin pain. The third person had foot surgery and had to have pins after a calcium clean-up, and the foot was left in a very awkward everted position within the boot. So hers was compounded by an overly tight transverse arch and the usual loss of ankle joint motions of inversion, eversion, plantar flexion, and dorsiflexion. In addition, because of the walker her shoulders were now killing her. The fourth person (due to toe surgery) now faced the same issues as the client in the previous example, plus loss of dorsiflexion of the big toe, which is necessary for push off in gait.
All four of the ladies were left with having some back issues, even one with a stress fracture in her hip, pelvis, and pubis. She had radiation therapy approximately 30 years ago and the diagnosis of osteopenia which her doctor felt left her vulnerable for this kind of stress on the pelvis. As you can see, each person had an ankle boot, but none of them could be treated the same.
If Hippocrates can make a statement that long ago, which still lives on today, what do you think he would ask of us as healers today? I feel like he would ask you to gather around under the tree of life and watch and observe how the people are moving around the tree. He might say, "Students observe the tree and how it stands against the wind, but if we cut it in half it will lose its strength as a whole". Now think with me, when a human being is treated as a part and not a whole how long will your treatment results last?
How do we get the human being to stand like a tree again? Unfortunately, there isn't an ABC recipe because the factors are never quite the same. You must consider the physical condition of the person before the injury; the degree of injury or surgery; length of time of the immobilization; amount of disruption there has been to their central nervous system and the degree of proprioception before the incident occurred. But there is a system of checks and balances that you can go through to find out if you are achieving the desired result, or not.
Clearance from a medical professional to be a part of the client's rehabilitation process.
Regain elasticity to the tissue. Hands, heat, cupping, etc.
Regain range of motion. Use isometrics with an appropriate percentage of contraction depending on the person's condition followed by the client moving into their new range. This is assuming that they have been cleared for full weight bearing. Put the client in a safe environment and have them close their eyes for 10 seconds, then open for 10 seconds, rotating this up to at least one minute. This will take the righting reflex out of the equation and make them rely on their joint mechanoreceptors. This movement will progress to standing on a moderate unstable surface such as an airex blue foam pad performing the same round of 10 seconds. Progress this movement pattern from a bilateral stance to a unilateral stance. Your progression will then go back to solid ground and stand with eyes open on one leg working up to 30 seconds to one minute. In some clients you will want to progress this to eyes closed.
Use your checks and balances system— did your previous treatment strategy hold, or change the individual in the right direction? If not, go back to the beginning and look for other ways, in addition to what you have already found to work. Progression of movement is always easy. It is having the understanding on how to digress from the progressions or look for alternatives that makes a good rehabilitation specialist.
Now movement begins through the foot and ankle joint opposing gravity. Toe and ankle raises, walking lifting the knees higher, step up to balance, and there are so many more.
Again, I cannot emphasis enough that the client is not being helped if they are coming back repeatedly with the same chief complaint. Keep in mind that initial relief from pain does not resolve the issue as a whole. Understanding movement can certainly make you a better rehabilitation massage therapist, it can also make you an excellent referral source to someone who has studied this line of thinking and can help the client regain their health and vitality for good. Immobilization is a long road for the client. You can follow the steps outlined above and start to think of movement without compensation as the goal. We are not machines to be broken down into moveable parts, our brain recognizes sequences of movement.
In the book, Blink, Gladwell defines expertise as advanced pattern recognition, and explains that expertise and experience are not the same. Experience may only demonstrate high levels of technical skill, whereas expertise is defined by advanced problem-solving and innovation.