Prevention: Stop Recurrent Urinary Tract Infections
The recurrent urinary tract infection (UTI) is one of those nuisance conditions that can play havoc with quality of life, and this particular infection is much more common than most people realize.
It's Time for a Functional Approach to Chronic Illness
It seems one of the more modern buzzwords is chronic, referring to diseases – that is to say, "ongoing and incurable." However, we can take a different perspective and recognize that, although the body may have been traumatized and injured, healing should always be viewed in the realm of possibility.
Official NCCAOM Practice Tests
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is excited to announce the launch of the new NCCAOM Exam Preparation Center.
Cyber Threat Checklist: Defend Your Business With These 10 Steps
Living in an internet connected society brings many conveniences and benefits. The power of the internet to connect us with customers, store data, and find information has opened the door for many small business owners to grow and flourish.
Paving the Way to Integrative Health & Wellness
Jared Polis (D-Colorado) and Mike Coffman (R-Colorado) launched the integrative health and wellness (IHW) caucus in October, 2018.
Better With Chiropractic
While chiropractic care is receiving high levels of exposure these days, most pain patients who consult with a health provider still do so with their primary-care MD. And of course, that means in most cases, they're receiving standard medical care, not chiropractic.
Bastyr University: On the Front Lines of the Pain Epidemic
At University of Washington's Harborview Medical Center, the Seattle region's only Level I Trauma and Burn Center, the demands for in-patient care are dramatically different from a private clinic environment.
Spring Allergies & The Spleen: Looking at Pattern Differentiation
As the season of Spring fades away and we shift into the warm summer months, many patients suffer from chronic allergies. This is by far one of the most common issues I see in the clinic as well as often mistreated and misdiagnosed.
Missed Causes of LBP: It's the Syndrome, Not the Subluxation
When I read the chart notes of other chiropractors, I am usually disappointed. They list what vertebrae are fixated or misaligned. They may describe the involved fascia and muscles.
Dropping Insurance: 4 Steps
My office manager just got off the phone with the secretary of a long-standing patient. I have treated this woman and 10 members of her family for more than a decade. She has, as have all of my patients, paid my fee at the time of service since I dropped insurance in 1997.
First World Spine Care Graduate: Hildah Molate
Hildah Molate, the first World Spine Care (WSC) scholarship student, graduated from Palmer College of Chiropractic earlier this year and is now working at the WSC community spine clinic in Shoshong, Botswana.
A Novel Way to Prevent Elderly Falls: Toe Strength
In any given year, nearly 40 percent of senior citizens ages 70 and older will fall at least once. Each fall significantly increases the risk of not only sprains, strains and contusions, but also fractures.
Multi-Dimensional Acupuncture: 3D, 4D & 5D
Maggie is an intuitive healer and workshop leader who I met on a recent hike. While we were talking she told me how she had to take it easy because of her knees. She said that her doctor told her that she has the early signs of arthritis.
The Acupuncturist and the Opioid Crisis: Conquering Pain & Addiction in the U.S.
The current opioid epidemic dominates the discussion among national health leaders, recovery advocates and families nationwide. Opioids include heroin as well as prescription pain relievers such as oxycodone, hydrocodone, codeine, morphine, fentanyl, and others.
State by State: Chiropractic Leads Changes in Health Care
Monumental legislative bills in support of the chiropractic profession were passed recently in Washington, West Virginia and Oregon. Here is a review of this important legislation, state by state...
New Opportunities for DCs
For decades, the model chiropractic practice has been the single-doctor practice. Recent surveys have found that approximately two-thirds of U.S. doctors of chiropractic still practice this way, with another 20 percent practicing in multiple-chiropractor practices.
NBCE to Reinstitute Computer-Based Exams
The National Board of Chiropractic Examiners (NBCE) has announced it will reinstate computer-based testing in January 2019 courtesy of a partnership with testing and assessment solutions provider Prometric.
Is Primary Spine Care the Answer for Chiropractic?
Recently, we sat down with Mark Studin, DC, FASBE(C), DAAPM, DAAMLP, to discuss the state of chiropractic and why primary spine care may hold the key to chiropractic's future. Read what he had to share in this exclusive interview.
News in Brief
Parker University Launches New Open-Access Research Journal for Chiropractic; Western States, Cleveland-KC Name New Deans of Chiropractic Colleges; Sherman College Goes Tobacco-Free; Life University Wins 11 Awards.
Transforming Exam Delivery
The NBCE Board of Directors has never wavered on its promise to deliver an excellent, on-campus computerized testing experience to students. Likewise, there has never been a compromise to the delivery of fair, valid and legally defensible exams.
TCM Codes for the World
I just received an email concerning the ICD-TM11 codes. The World Health Organization (WHO) will be presenting the new ICD-11 codes to World Health Assembly very soon.
Regenerative Medicine: How to Do It by the Books
The "lay of the land" for regenerative therapies, including but certainly not limited to adult stem-cell treatments, seems to change almost daily.
Old Trend, New Risks: Heavy Weight Training
With more opportunities to exercise than ever, a greater selection of exercise options, and the subsequent opinions supporting and challenging their merits, it's easy to be confused as to which approach is best.
Acupuncture's Standard of Care
Both a concern and critique of acupuncture, frequently espoused by the bio-medical community is, "there is no standard of care in acupuncture." The following is why I believe this statement is disingenuous at best.
Prompting Memory: How to Stimulate Cognition
Recently I gave a talk titled, The Art of Memoir – Tapping the Past to Sharpen the Present at a senior lunch event in Austin, Texas.
Practice Pearls: There's More to ROM Than Meets the Eye
As part of my neuromusculoskeletal examination, I perform range-of-motion (ROM) evaluations. I can "eyeball" the range and measure, I can use a goniometer and measure, I can use my phone app and measure, or I can use various other instruments to help determine degrees of motion.
Catch the Workplace Wellness Wave
Do you offer workplace wellness services to local businesses? If not, you might want to consider this lucrative channel for expanding your practice. Workplace wellness programs and wellness-related benefits have grown in popularity over the past several decades.
Diagnosing & Treating Aggressive Energy
Recently, there has been an article, and subsequent discussion, about the subject of Aggressive Energy (AKA "AE"), including ways to detect its presence and an alternative method of treating it.
Reducing Allostatic Load & Stress Through Heightened Awareness
Your contemporary mental health and psychotherapy colleagues may often approach the treatment of allostatic load as a mental health condition and use prescription psycho-pharmaceutical medicine to affect general and specific central nervous system (CNS) pathways and brain neuro-chemistry medicine to alleviate the associated symptoms.
June, 2004, Vol. 04, Issue 06
Defining Medical Massage
By James Waslaski
I disagree with the segment recently shown on national television claiming that massage can cause more harm than good ("Setting the Records Straight: Massage Gets a Bad Rap in National Report," www.massagetoday.com/archives/2004/06/02.html).Statements like these are usually based on turf wars in the health care profession. If there were substantial truth to these accusations, I would not be traveling 40 weekends a year teaching orthopedic massage!
My first article, "Medical Massage vs. Orthopedic Massage" (Feb. 2004, www.massagetoday.com/archives/2004/02/03.html), was intended to bring leaders of advanced massage disciplines together to create a unified definition of "medical" massage; now, it has become a mission to set a unified standard for medical massage "certification."
The best short definition I gathered from medical massage therapists is: "Medical massage is performed with the intent of improving conditions or pathologies that have been diagnosed by a physician; a wide variety of modalities or procedures are utilized to focus the treatment based on the diagnosed condition." I was determined to prove that advanced disciplines, such as neuromuscular therapy, CranioSacral Therapy (CST), myofascial release, lymphatic drainage, massage for cancer patients, orthopedic massage, etc., fall under medical massage disciplines, and certification in many of these disciplines usually requires a minimum of 100 hours of training.
Interestingly, when I teach orthopedic massage, it is a blend of many of these disciplines, and I believe that orthopedic massage is an advanced discipline of medical massage. It involves therapeutic assessment, manipulation, and movement of the locomotor soft tissues to reduce or eliminate pain or dysfunction. A unique multidisciplinary approach is utilized to restore structural balance throughout the body, which allows focus on prevention and rehabilitation of musculoskeletal dysfunctions, chronic pain and sports injuries. Primary modalities include functional assessment, myofascial release, neuromuscular therapy, scar tissue mobilization techniques, neuromuscular re-education, PNF stretching, strengthening, and specific client home-care protocols.
I encourage participants to be cross-trained in as many advanced disciplines as possible, and constantly research which discipline works best in each particular situation. I firmly believe that disciplines such as lymphatic drainage, CST, myoskeletal alignment, energy work,etc., may be better modalities than orthopedic massage for a percentage of patients; therefore, they are a critical part of the toolbox for elite-level medical massage practitioners.
Still, I question whether fewer than 100 hours of medical massage training without an internship and written and practical exam, can properly prepare therapists for the vast array of medical complications that could be made worse by improperly applied massage. For example, one massage instructor recently challenged my February article claiming that a patient with an aneurysm (like that of my mother) would be pale and too weak to get onto the massage table. My mother's aneurysm was leaking and ready to burst, but she did not have pale skin, diaphoresis or weakness. Other than slight kidney pain (often diagnosed as back pain) and small traces of blood in her urine, she had no other symptoms. Some therapists do not complete a thorough medical history, which is why an internship and direct medical training with a doctor is beneficial. In Canada, for example, many therapists spend two years in a hospital setting, following 2,000 hours of initial massage training to intern in neurology, cardiac physiology, etc.
I am blessed to be able to teach with some of the leading educators in the industry. Most recently, I taught with Dr. Erik Dalton (the founder of Myoskeletal Alignment Techniques) in Costa Rica, and was impressed with the emphasis he placed on assessing the cervical spine prior to beginning any treatments. He is highly concerned about the possibility of compromising the vertebral arteries during therapy and about pressing into the soft spot at the base of the skull when treating the suboccipital muscles. In another seminar, Dr. Dalton and I taught together with David Kent, a specialist in neuromuscular therapy and practice-building. He also emphasized the same precautions, as well as the importance of conducting a thorough assessment prior to treatment. He also stressed the need to refer some patients out to avoid complications from certain treatment protocols.
I am determined to point out those educators that mislead students into taking their courses, stating they will "certify" therapists in medical massage in as few as three days. One Texas chiropractor claims to grant a "certification" in medical massage if you take his six-hour continuing education course. Is it ethical to give a certification without a unified examination? Many of the therapists entering these courses have as few as 300 hours of massage training, with no medical background; most have only 500 hours of massage training. I think the word "certification" is misleading. I do not think a massage therapist with little medical background and training should be certified in medical massage without an intense clinical internship, or at least proof that the therapist can competently perform the skills he or she has learned.
I do not certify anyone in orthopedic massage for this exact reason; in fact, I am waiting for the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) to create "advanced certification" in massage before I set the standards to certify people in orthopedic massage. Then I will require a written and practical exam, and at least one year of experience in treating orthopedic conditions, prior to granting orthopedic massage certification.
Sure, I could probably sell more courses if I told people they would be "certified" after two weekends and a five-day intensive course. But we need to attest to the competency of the learned skills of our students to avoid complications when new therapists apply advanced skills. There are so many incredible advanced disciplines that we see as specialties of medical massage. I know many of those specialties usually require a minimum of 100 hours to be recognized as practitioners of that work. People excel much faster in seminars if they are already certified in other disciplines. But only a small percentage of our students come into the advanced courses with adequate prior training.
I look back on my many years in a hospital setting as a gift to what I now bring to orthopedic massage. It is also the reason I reference medical massage, but do not generically call my work "medical massage". Little did I know how valuable that type of hands-on learning would be in professional debates within the industry.
My intense medical background tells me we may be in a danger zone, unless we come together as a profession, clearly define medical massage and determine how it relates to the many advanced disciplines in our rapidly advancing profession. This will lead to a unified standard in our industry, and consistency among the true experts in the various advanced disciplines of massage. Then we can finally have a true certification in medical massage, and it will attest to the competency of those well-deserved advanced therapists.
Click here for previous articles by James Waslaski.
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