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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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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).
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.
DVT: Know the Signs and You Could Save a Life
I lost a friend several months ago. He died from a pulmonary embolism (PE) secondary to a deep-vein thrombosis (DVT) that originated in his lower leg. Bobby was in his mid-60s, soft-spoken and had a big heart.
The Effect of Massage Therapy Following DOMS
Contributed by April Neufeld, BS, LMT, BCTMB; Natalie Lorick, LMT; Derek R. Austin, PT, DPT, MS, BCTMB, CSCS, Massage Therapy Foundation Contributors
Delayed onset muscle soreness (DOMS) is a commonly expected muscle condition that affects people who engage in sudden or intense exercise that doesn't fit with the person's normal physical activity. Although DOMS frequently passes within 24-48 hours, most people experience pain, tenderness, stiffness, edema, muscle weakness, and discomfort in gait as part of the normal inflammatory reaction of aggressive activity.
The micro-damage caused to the primary muscles used in the exercise is thought to be caused by the most intense of exercises, but it can actually be experienced by people of all fitness levels.
Researchers have documented many different interventions to mitigate the DOMS effect including massage therapy. However, little is understood on how massage therapy relates to gait patterns following DOMS. This month, the Massage Therapy Foundation's research column reviews a study originally published in the Journal of Exercise Rehabilitation1 that investigated whether massage therapy affects gait and pain in participants with DOMS.
Participants & Methods
The researchers recruited 21 students attending Kyungnam University in Changwon, Korea, who did not usually perform lower-leg exercise and were otherwise healthy (age, height, weight, and gender were all documented). The participants were randomly selected into a control (n=10) and experimental groups (n=11). The researchers write that they had participants walk up and down a five-story building 20 times (isotonic exercise) to induce DOMS. Then, the individuals in the experimental group received 15 minutes of massage therapy.
The massage therapy techniques consisted of "light stroking, milking, friction, and skin rolling" for 15 minutes on the dominant gastrocnemius. As our readers know from reading other research studies, it is reasonable to expect a detailed description of each technique and the duration in which the technique was used. Unfortunately, a detailed description was not included, and no mention was made of the qualification of the person performing the massage.
While the experimental group received 15 minutes of massage, the control group received a sham TENS treatment for 15 minutes, where the TENS pads were attached to gastrocnemius, but not actually engaged.
Following treatment, the researchers measured the sensitivity of pain and performed a gait analysis. Using an algometer, they measured pain sensitivity at the middle bell of the medial and lateral gastrocnemius, and found there was a significant difference between the massage group and the control, indicating that massage may reduce pain after DOMS.
Analysis on the gait examined both the time and spatial variables. The authors wrote, "In the temporal variables, there [were] statistical differences in ambulation, heel on/off time, and stride velocity but no differences in step time, cycle time, swing time, stance time, single support time, [or] double support time."
The results of the spatial variables showed that massage therapy may have had positive influence on the gait pattern. No significant correlations were found between pain and gait.
The study authors referenced several other studies of massage therapy and its effectiveness on pain, including: massage therapy for pain treating patients with gout, massage therapy decreasing the intensity of muscle soreness at 48 hours following exercise, and a study of a sports massage program that showed effectiveness in treating DOMS. But they did not discuss if the massage techniques used in those studies matched the techniques used in their study.
The researchers also briefly discussed their reasons for not choosing to use a visual analogue scale (VAS) as a measure of pain, indicating that a previous study had outlined it as a poor tool. This was a limitation on their part, as VAS scales are commonly used in therapeutic settings and help medical providers compare the results of other studies and might be more applicable to a clinical setting.
Using a digital algometer, although perhaps more objective for measuring pain in a study, would not interfere with the standard VAS results, and are not commonly used in most clinics (at least in the U.S.).
The significant limitation of this study, not addressed by the authors, is the lack of detail on the massage techniques used. Later in the paper, the researchers discuss the effects of massage on blood and lymph circulation, elimination on lactate accumulation, and fatigue. And although there are studies that might show this, because the authors did not describe in detail the types of massage being performed, readers are limited when comparing this study to other studies where massage is the intervention.
The authors listed skin rolling as one of their massage techniques, but there is no research cited indicating that this specific technique, or this technique in combination with others, affects lymph, inflammation, or pain. The details of each massage technique could have vastly different outcomes on the condition being studied.
Without detailed definitions of each technique, readers are left to draw their own conclusions that stroking might mean effleurage, milking might mean petrissage, and friction could be multiple different types (linear or with the direction of the muscle; cross-fiber?). And without clearly understanding how much of each technique was used on each participant, other researchers have limited ability to duplicate this study.
Another limitation already mentioned is the absence of description of the person providing the massage therapy intervention. If an untrained student were performing the massage techniques, and the researchers did not define the techniques, how are readers to understand how the techniques are performed or if they were performing the technique the same as the researchers?
If studies are to be of benefit to multiple therapists across different countries, schools, and professions, then it is essential for researchers to provide the details of all aspects of the study, especially the details of the intervention. Otherwise, what a sports massage therapist in Portland, Ore., understands as "flush" will not be understood as "effleurage" to registered massage therapist in Canada, or "gliding" to a physical therapy student in Korea.
Are all these terms describing the same technique or are they just different words in different contexts? There could be fundamental differences in the way each technique is performed and indicated (or contraindicated), and the authors also did not mention why these four techniques and not others were chosen as the intervention.
Readers of this column who might be interested in writing and submitting a case report to the Massage Therapy Foundation's case report contest should remember the importance of detailing the type of massage therapy techniques used and being sure to provide sources for each technique definition. And if you would like to see how this study compares to other studies examining massage therapy's effect on pain, please visit the Massage Therapy Foundation's review archive section or search PubMed for "massage therapy."
This synopsis is authored by volunteers from the MTF's Writing Workgroup. To learn more visit their columnist page.