resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
Using Massage to Address Pediatric Digestive Issues
Massage therapists practice hands-on therapeutic techniques to address a variety of medical and non-medical concerns for clients and patients. While teaching therapists of all backgrounds, it is very common that I discover at some point in their professional career, they have learned to use abdominal massage to address digestive concerns, such as constipation. But frequently, they stop using these techniques, or even offering massage for abdominal massage to clients. Many educators present to therapists that this is a very vulnerable body zone/region for clients, and abdominal massage should not be offered unless a client requests it. However, a client may not even know they can request this, so we are essentially performing a disservice by not addressing this very valuable region of the body.
An estimated 42 million people, or 15% of the population, suffers from constipation making it the most common gastrointestinal problem in the United States. In 2004, 6.3 million outpatient visits were due to constipation and 5.3 million prescriptions for constipation medications were written. The National Digestive Diseases Information Clearinghouse defines constipation as, "a condition in which a person has fewer than three bowel movements a week or has bowel movements with stools that are hard, dry and small, making them painful or difficult to pass." Essentially, constipation happens when stool spends too much time in the colon making it dry and compact. When the stool becomes hard, it is much more difficult for rectum muscles to push out of the body, thus creating constipation.
Constipation is often uncomfortable or even painful, based on the length of time and presentation of the person affected by this condition. Roughly 8.9% of the general pediatric population suffers from it on an ongoing basis. Although documentation supports that less than 10% of the pediatric population suffers from constipation, within pediatric cancer patients that rate inflates to nearly 50% to 60%. While direct cancer treatments can cause constipation, it is normally found that opioid use is the number one reason for constipation in this population. In the community of children labeled as having "special healthcare" needs, a study done of group homes found that out of 16 care homes between 29% and 36% of the residents were taking laxatives on a daily basis.
For children who have lower muscle tone, neurological conditions, poor posture, are non ambulatory, confined to bed rest or taking medications, they may be subject to frequent bouts of constipation and slow motility. Stress, anxiety and sense of control are also culprits for children suffering from constipation. Lack of adequate sleep, exercise and balanced diet often contribute to repeat incidents of abdominal upset.
Medical providers and parents use a variety of resources to address pediatric constipation and slow motility. Some treatment plans for addressing pediatric constipation call for the use of laxatives, enemas, suppositories and when the fecal matter is too impacted, surgical procedures are utilized.
One reported problem of using laxatives as an intervention for constipation are side-effects such as increased rate of constipation, fecal impaction, cramping, diarrhea, even more discomfort and electrolyte imbalance. While there are several options in dealing with constipation, one such approach which has been met with great success is the use of gentle, noninvasive abdominal massage.
Benefits of Abdominal Massage
Participants of a Swedish study felt that abdominal massage "influences the whole person" and while initially skeptical, felt comfortable by the end of the study. This study was done with 60 patients all regularly using laxatives to ease bowel symptoms. Significant improvement in bowel movement and reduction in laxative use after eight weeks of weekly 15-minute massages while the control group saw minor improvement but no reduction in laxative use.
A related study took these results but quantified how massage intervention related to financial savings. This study found that 40% of the massaged group felt massage had a good effect. Both self-massage and professional massage interventions showed abdominal massage as cost-effective in the long term and "relevant to consider ... when managing constipation."
A British study found that using abdominal massage as a holistic intervention of people with "special needs" found reduced rates of constipation, reduced use of laxatives and an unexpected finding, interpersonal contact between caregiver and clients who have profound disabilities. This same bond facilitation happens between parent and child, making it especially important for a hospitalized child. Hospital stays and hospital treatments are stressful especially for children, using massage can not only ease stress, help the child sleep better and longer, but can also aid in digestion.
In the healthcare setting, once providers see the benefits of abdominal massage, it has rapidly become one of the most common referrals for pediatric massage amongst hospitalized patients in my practice.
A Pediatric Protocol
As with any massage therapy provided for children, we should always ensure there are no precautions or contraindications to the hands-on therapy prior to begin. In many cases, asking the parents to administer techniques can be quite beneficial when led by a Certified Pediatric Massage Therapist. Children who may express they feel "ticklish" when touch therapy is applied to the abdomen may benefit from having their own hand placed first on the belly, with the therapist or parent's hand placed on top of the child's hand. This method may decrease heightened tactile sensitivities. For children who communicate in a non-verbal fashion, careful observation of non-verbal cues is even more imperative.
Wait approximately 30 minutes after the child has eaten to provide massage therapy techniques on the abdomen and do not perform massage on this region if there is medial equipment present in the body area. With the child relaxing in a safe, properly supported, supine position, you may wish to begin by gently applying a still, nurturing touch to the abdominal area. Be mindful to notice any discomfort or distention.
When making circular strokes on the abdominal area, they should always follow the direction of the child's digestive tract. For the vast majority, this is a clockwise direction moving from the child's right side to left side. Provide massage techniques on the soft areas of the child's abdomen, from the bottom of their rib cage down. Do not put any pressure on the Xyphoid process, the cartilaginous section at the lower end of the sternum, which is not attached to any ribs and gradually hardens during adult life. Practice care and caution to not press too firmly or deeply. If the child asks you to stop, or shows sign of discomfort, stop providing massage. Pediatric massage is always best applied with the child's express permission and with gentle relaxation in mind.
As evidence continues to support the use of non invasive therapies such as pediatric massage, children, families and healthcare providers gain greater access to an integrative approach that can best our clients and patients needs.