Trending: CBD / Hemp Oil
A recent survey of DCs regarding cannabidiol (CBD) / hemp oil provides food for thought as to the viability of CBD-based products as a component of chiropractic patient care. Here are some observations from the executive summary of the survey:
Confessions of a Former Drug Rep: Statins Are Endangering Your Overweight Patients
As I sit at my desk on the sixth anniversary of my successful liver transplant, I can't help but reflect on what caused that life-threatening ordeal. Looking back on my personal situation, I want to offer my insight into what is happening routinely to many patients.
NCCAOM: A Route to National Certification
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is offering a route to achieve national certification—without having to take any of the NCCAOM exams. This is specifically for California licensed acupuncturists that meet the eligibility requirements.
A Resting of the Soul
In my pursuit of being a skilled health care provider, I focus on reading journals, attending classes, staying current on medicinal research, and choosing the correct billing codes. However, most of us would never have started down this career path if there wasn't something more.
Autoimmunity, Gut Health and Diet: Connect the Dots
According to the National Institute of Health (NIH), autoimmune disease is recognized in approximately 24 million individuals in the U.S., consisting of more than 80 various disorders that contribute to the top 10 causes of death in female children and women of all age groups.
Facebook Marketing 101
Many of the health care practitioners we work with have smaller practices. The provider tends to wear many hats – office manager, salesperson and healer.
The Secondary Insurance Plan
I have a patient that has Medicare, but also has a secondary insurance plan that does cover acupuncture. How do I bill Medicare to get a denial so that I may bill this secondary payer?
News in Brief
WFC Among Founding Members of Global Rehab Alliance; HealthSource Selects GoChiroTV as Exclusive Digital Signage Partner; Western States' Online Degree Programs Among Best in the Nation; Logan University, University of Missouri-St. Louis Forge Partnership.
Vaccines & Autism (Part 1)
It turns out chronic inflammation is the driver of autism expression. Unfortunately, those who emotionally embrace the vaccine issue rarely, if ever, consider this relationship, which hinders a rational view of the vaccine issue.
Art of the Associateship: It's OK to Trust, But Verify
Trust is a valuable part of any business relationship. It serves as the foundation for all business operations and ultimately long-term success for owners, employees and customers. This is especially true in the world of health care.
#TechPain: Causes, Solutions
For the past several decades, the science of ergonomics has blossomed. The workplace is much safer and life is generally more pleasant thanks to the application of ergonomic principles.
The Certified Practitioner
Certified Chinese herb practitioners often identify themselves with the credentials "LAc" (Licensed acupuncturist).
Why the Automatic Denials for Modifiers 25 and 59?
Your experience is one shared by many chiropractic providers who bill through those plans. It appears to be the national trend, but by far is more prominent in Texas and Illinois.
A Bold Strategy to Take Chiropractic to New Heights
Building public awareness of an entire profession requires strategic planning – especially when it pertains to the exploration of ground-breaking marketing tactics that target new audiences with key messaging about the value of chiropractic care.
Reducing Hip, Knee & Shoulder Replacements (Part 2)
In the first article in this series, "Early Detection Reduces Hip, Knee, & Shoulder Replacements," I described time tested screening procedures and perspectives as indicators of when to encourage your patients to seek further medical evaluation.
UnitedHealthcare Can't Seem to Keep Chiropractic Down
AA decade ago, UnitedHealthcare announced changes to its chiropractic services policy that declared manipulative therapy for headache unproven.
The Classical Texts & Integrative Medicine
The acupuncture profession has been undergoing many changes in the past years. There has been a shift towards a more integrative approach to medicine as more hospitals include integrative departments.
The Hidden Hip in LBP: Critical Screening Tests
In 1998, Harvey used this test on 117 elite athletes and found excellent interrater reliability to differentially assess iliopsoas, quadriceps or TFL/ITB tightness.
Blockchain Health Records?
Keeping data secure has become a nightmare for the average consumer. Just consider general user account hacks on Yahoo (3 billion records compromised), eBay (145 million records compromised) and Facebook (87 million records compromised), to health record breaches involving Anthem Blue Cross (78 million records compromised) and TRICARE (almost 5 million records compromised).
It's All About That Ki
As an industry are we shifting too much toward a Western mind set? We strive to understand how acupuncture works using imaging and extensive studies. We spend numerous hours of our training learning Western medicine and learning to speak their language. What happened to our core though?
Does Dairy Cause Dampness?
The topic of dairy consumption was brought up at a scalp acupuncture seminar I recently attended.
Treating Pain With Nutrition
Back in 1910, when D.D. Palmer published The Chiropractor's Adjuster and introduced the world to what he called the "triad of health" – thoughts, trauma and toxins – he explained that the body can only be made optimally healthy if all three aspects of health are addressed.
Why Take X-Rays When You Already Have an MRI?
Let's clear up the issue regarding the efficacy of plain-film studies when an MRI study has already been performed. I review imaging studies primarily for chiropractors, and often their patients have been to other health care providers before finding their way to a DC.
Help Shape the New Neck Pain Best Practices Guideline
The Clinical Compass (originally the Council on Guidelines and Practice Parameters – CCGPP) has issued a call for interested chiropractic clinicians to help shape a new best practices guideline for chiropractic care of neck pain.
Doc, Are You a Social Media Holdout? Your Future Is Now
Whether you like it or not, to compete in any business, even chiropractic, you really should know and consider using social media. It is no longer a small, sleepy, local world we live in; it has become a far-reaching community.
Valuable Adjunctive Therapies
Based on the latest CDC statistics, more than 795,000 Americans have strokes per year, 140,000 of which are lethal. Approximately 87 percent of all strokes are ischemic with an estimated health care and missed work cost of $34 billion annually.1
CBD for Athletes: The Advantages of Cannibidiol
For athletes, pain is often part of their sport or activity. And to a certain extent, it is to be expected. However, after pushing themselves to the limit, soreness and fatigue set in, hampering their ability to perform and recover.
End of Life Treatment
TCM looks death in the face. We do not camouflage it as if it were poisonous. "We must allow our patients to die but we cannot allow them to perish," was my first lesson the day I met my teacher as a teenager.
September, 2014, Vol. 14, Issue 09
Study Shows Massage Therapy Improves Blood Flow in Aching Muscles
By Massage Therapy Foundation Contributor
Contributed by Jolie Haun, PhD EdS LMT, Pualani Gillespie, MS RN LMT, Beth Barberree, BA RMT
It is a natural tendency to rub the injured area when someone has overexerted a muscle. This stress on the muscle tissue and related injuries is known as "exertion induced muscle injury." Individuals often seek massage therapy to relieve the soreness in these muscles. For example, this is a basic concept of sports massage, as athletes have a tendency to over exert themselves and often experience much relief from receiving massage therapy.
The Massage Therapy Foundation and the massage therapy profession have a great deal of interest in understanding the mechanisms of muscular injury phenomena, and the role of massage therapy in improving function and recovery. In fact, the Foundation recently supported the work of a group of researchers, Franklin and colleagues, to examine the role of vascular endothelial function in exercise-induced muscle injury and recovery supported by massage therapy. The purpose of this study was to: investigate the mechanisms of systemic endothelial dysfunction of the brachial artery, which develops after exercise-induced muscle injury of the lower extremities; and determine if treatment of the lower extremities with massage therapy reduces endothelial dysfunction. The authors hypothesized that a massage therapy treatment performed after exposure to exercise-induced muscle injury would protect against impaired endothelial function.
Franklin and colleagues conducted a randomized, blinded trial with 36 sedentary young adults in a clinical research setting at an academic medical center and laboratory. Each participant was randomly assigned to one of three groups: treatment following exposure to 75 exercise-induced muscle injury (exercise-induced muscle injury + massage therapy); a control intervention of exercise-induced muscle injury without MT treatment (exercise-induced muscle injury only); or a 76 control intervention of massage therapy treatment without exercise-induced muscle injury (massage therapy only). The exercise-induced muscle injury was induced by a single bout of bi-lateral leg press exercise.
The massage therapy protocol was provided by one licensed and certified massage therapist. The treatment included a 30-minute bilateral lower extremity (legs) massage using Swedish techniques varying in depth from superficial to deep.
Participants were screened in an initial visit. Approximately one week following the initial screening, participants who met all inclusion criteria returned for baseline assessment of endothelial function. Participants provided data at five time points before (baseline) and after (90 minutes, 24 hours, 48 hours and 72 hours) the intervention. Several measures were taken, all after a 12-hour fast. The primary measures, determined by ultrasound, were brachial artery flow-mediated dilation and Nitroglycerin-induced dilation.
Findings indicate brachial (upper extremity) flow-mediated dilation increased from baseline in the exercise-induced muscle injury + massage therapy group and the massage therapy only group at 90 minutes remaining elevated until 72 hours post treatment. In the exercise-induced muscle injury only group, flow-mediated dilation was reduced from baseline at 24 and 48 hours returning to baseline after 72 hours.
Interpreting the Findings
Results indicate that massage therapy has systemic effects on endothelial function; such that massage therapy lessens impairment of upper extremity endothelial function resulting from lower extremity exercise-induced muscle injury in sedentary young adults. Dilations due to Nitroglycerin were similar over time. Authors suggest this is the first study to determine that massage therapy protects against reduced upper extremity endothelial function following lower extremity exertion.
The primary finding of this study is that massage therapy reduces impairment of brachial artery flow-mediated dilation resulting from exercise-induced muscle injury. The authors also reported the unexpected finding that lower extremity massage enhances brachial artery flow-mediated dilation even in the absence of exercise-induced muscle injury.
Franklin and colleagues mentioned several study limitations including the possible confounding of results by the absence of a true control group; the inability to test endothelium independent dilation to nitroglycerin before exercise-induced muscle injury and/or massage therapy because of the residual vasodilator effects of this compound on blood pressure; due to the small sample size this study was also unable to assess gender or racial/ethnic-specific effects; and differences in BMI may confound the effects of massage on flow-mediated dilation.
The authors indicated future research would benefit from a no intervention control group and larger sample sizes to validate these findings, as well as allow for sub-group analyses.
The results of this research suggest that exercise-induced muscle injury impairs systemic endothelial function; and massage therapy enhances endothelial function in both the presence and absence of muscle injury. These study results contribute to understanding how massage therapy promotes faster recovery from exercise-induced muscle injury and may have broader implications for the clinical use of massage therapy, especially in the context of endothelial dysfunction.
From a clinical perspective, massage therapy is a widely used. Annually, millions of Americans receive massage therapy for health reasons such as pain relief, injury recovery and rehabilitation, yet to date research provides little evidence for the effects of massage on blood flow. Findings in the current study indicate that a single massage treatment improves brachial artery endothelium-dependent flow-mediated dilation for up to 48 hours.
How do these findings apply to clinical practice? Franklin and colleagues suggest that since flow-mediated dilation correlates with cardiovascular risk, their study findings may support the use of massage therapy for reducing exercise-induced muscle injury and post-exercise hypo-perfusion in at risk populations, such as individuals with heart disease who are engaged in intense exercise regimens. As the field of massage continues to expand its application to the medical field, Franklin and colleagues also suggest massage-induced improvements in endothelial function may help to protect against vascular responses to other physical stressors such as acute hypertension, hypoxemia and wound healing.
Massage therapists commonly observe and state that part of the benefit of massage therapy is increased circulation, which promotes healing and wellness. The work of Franklin and colleagues make an empirical contribution to the growing body of evidence that supports these clinical observations and claims.
If you would like to learn more about the evidence based research that supports the benefits and mechanisms of massage therapy, you can review the Massage Therapy Foundation article archives, read accepted MTF Research Grant abstracts or search Pub Med. Also, take the opportunity to boost your research knowledge by registering for an MTF Basics of Literacy course. You can explore the basics of incorporating principles of research literacy into your practice or school curriculum at your own pace.
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