resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
The Easy Way to Learn How to Document ICD-10
The 2015 Work Plan for the Office of the Inspector General (OIG) includes a focus on chiropractic services. This means chiropractors can expect to see more audits and reviews in the coming year because private payers pay attention to the OIG's focus as well.
Online Efforts That Convert Traffic Into Patients
Most chiropractors are using "dinner with the doc," "refer a friend," customer appreciation days, grand openings, health fairs, chamber of commerce meetings, and other networking events to get new patients.
Neuroscience: Where Western Medicine and Chinese Medicine Can Come Together
The recent advances in neuroscience are truly incredible. With this expansion of scientific knowledge, I would like to see even more research into the neuroscientific basic of acupuncture and Chinese Medicine.
It's Time to Create a Strong Acupuncture Footprint
Footprints in the sand. Footprints in the snow. Where do these footprints go? Some are big, some are small, but footprints are made by all.
The Top Seven Website Mistakes Clinics Make
The majority of acupuncture clinics finally have a website for their business. Having a website is crucial for being found online through Google, Facebook and review sites like Yelp.
Acupuncture and Homeopathy: Bioenergetic Brothers
Acupuncture and homeopathy share an important healing principle: bioenergetics. "Bio" means "life," so bioenergetics is literally "life energy."
Finding Balance in the Clinic
This past December, I celebrated 11 years in practice. I seriously don't know where the time went. I feel beyond blessed and grateful to be practicing our profound and beautiful medicine and to be helping guide my patients restore a state of optimal health.
Connections Worth Making
"If most doctors are like me, [they are] isolated physically and professionally. I do not make the time to connect with other doctors and also a lot of doctors do not want to be connected for a lot of reasons. Dynamic Chiropractic keeps me grounded and connected.
A New Era of Injury Awareness Means a New Focus on Prevention
Despite a dramatic Super Bowl last month, the National Football League has taken quite a few hits lately concerning player injuries, particularly concussions.
Are You Really a Healthy Eater?
I always giggle a little bit (to myself) when someone comes into my office and informs me that they are a healthy eater. What exactly does that mean? Does that mean they eat sugar in moderation? And what's that, exactly?
Old TCM Sayings: Treat the Front to Treat the Back
Chinese medicine college was, and always will be, a memorable time. It was a time of massive personal and professional growth.
Reflections: The Art of Teaching Asian Medicine
Over the past three decades, my global workshops have been translated into German, Swiss German, French, Romansch, Spanish, Lithuanian and Xhosa. Time to offer you new teachers a few tips!
Leg Length and Pelvic Fixations
A common component of low back pain is sacroiliac joint dysfunction. Signs of SIJ dysfunction can include fixation with reduced range of motion, and localized pain or joint laxity and inflammation.
We Get Letters & E-Mail
We Have Come a Long Way – But There's a Long Way to Go; Grounded and Connected.
Put the Social Back Into Social Media
Social media is more than a passing fad, it is definitely here to stay. Social media apps and channels of distribution may evolve, but the concept of social media is now big business and a part of all our lives.
Adjusting the Occiput on the Atlas
You may never see a particular set of patients in your office – the ones who are either afraid of neck adjustments or have had a bad experience. A vast majority of those who had a bad experience did not have a life-threatening vascular event.
It might have been a miserable start to the day in the heart of downtown San Diego. A heavy rain had soaked the large homeless population congregating near the intersection of Third Avenue and Ash Street as they waited for a free breakfast to be served at the First Lutheran Church on the corner.
The Conscious Evolution of Healing, Part 2
The idea of transmission is very important in the Chinese medical classics. According to author Claude Larre, the ancient Chinese were highly interested in the connection between things. Nothing was looked at as an isolated entity.
What's Triggering That Point?
An orthopedic friend recently saw a patient of mine. He felt an injection of a trigger point (TP) at the upper trapezius and surrounding areas was necessary, since that was the patient's area of chief complaint and there was a tender, radiating nodule.
Joint Supplements for Athletes (Part 1)
Maintaining joint health should be a daily focus for athletes. Joint health is a complex issue for everyone, but for athletes it poses a greater concern.
March, 2001, Vol. 01, Issue 03
A Comparison of the Somatosensory Effects of Therapeutic and Medical Massage, Part I
By Gregory T. Lawton, DN, DC
There are many different kinds of massage therapy and massage therapy techniques. This article reviews two systems of massage therapy: therapeutic massage and medical massage, as they relate to their clinical effects on the somatosensory system, specifically, mechanoreceptors, nociceptors and the joint complex.
Medical massage is composed of a strictly delineated clinical protocol, and therapeutic massage is commonly practiced as recreational, relaxation; energy; fringe or spa massage, and is most often based on the system developed by Per Henrik Ling.Massage therapy is a form of manual therapy and may be considered to have two categories of physiological considered to have two categories of physiological effect: generalized effects and specific effects. All modes and methods of manual therapy have some degree of generalized physiological effect, whether the massage therapy is employed for medical or relaxation purposes.
However, it is in the area of specific clinical effect that systems of massage separate into different categories: medical and non-medical. Medical massage claims to be a specific system of manual therapy that facilitates connective healing relative to the pathophysiology of the condition to which it is applied and is therefore a system of medical treatment. Therapeutic massage, which is most commonly practiced as relaxation or spa massage, has numerous documented clinical effects. To date, most studies on massage therapy have employed the general techniques of therapeutic massage. Perhaps the greatest strength of therapeutic massage is its effect on the stress cycle.
Therapeutic massage may be broken down into two categories of techniques: those techniques originally developed by Ling and represented by the "Swedish massage" system, and ancillary techniques added to the Ling system by various therapists and utilized by therapeutic massage practitioners as adjunctive techniques. Examples of this latter category would include trigger point therapy, skin rolling, proprioceptive neuromuscular facilitation (PNF), and neuromuscular and muscle energy technique.
To make the issue of definition between medical and non-medical technique even more confusing, some practitioners of medical massage, and authors of medical massage articles and books, utilize therapeutic massage (Swedish massage) technique and simply label it medical massage. Some therapeutic massage therapists do this because they do not practice therapeutic massage for relaxation massage purposes, but rather general clinical objectives. Some practitioners of therapeutic massage consider themselves to be medical massage therapists if they use therapeutic massage in a hospital or medical environment, or if they add muscle testing and range of motion techniques to their therapy.
Medical massage therapy contends that any system of manual therapy that claims a specific clinical effect must demonstrate that its techniques can achieve clinical outcomes identical to those measured in other clinical systems, or techniques that have been scrutinized in research studies and clinical settings. One example would be the ability of a series of techniques or a massage treatment protocol to effectively address chronic pain through stimulation of mechanoreceptors and inhibition of nociceptor activity, while also reducing acute and chronic inflammation and restoring normal joint range of motion. Any system of massage therapy that systematically obtains these clinical objectives is a form of medical massage. Currently, any clinical claims made by the medical massage therapist are based on "borrowing" the observations and findings of studies from other disciplines, such as histiology, chiropractic, orthopedics, physical therapy, and biomechanics. It should be noted, however, that a review of the current research in these areas offers the medical massage therapist a wealth of information. This information at least suggests the effectiveness of certain techniques, and further defines the application of certain techniques. Missing are specific studies that measure the outcome of medical massage techniques and protocols.
The massage profession at large has not seriously engaged in the labor of defining many of the issues addressed in this article because of a lack of general consensus within the massage community of the definition of medical massage; because of a lack of standardized educational curriculums in massage schools; and because of an historic rejection, by the massage community, of research-based technique and medical methodology. In addition, many schools of massage therapy teach very elementary and introductory massage therapy technique, basic anatomy, almost no pathology, and no clinically based internship programs. Indeed, the level of education in most massage schools is currently at a low level as compared to other allied medicine and professional training programs in health care.
This article does not propose to define medical massage for all practicing massage therapists, but rather to offer some insights into possible future directions and development for medical massage. Certainly, there is a wide diversity of massage therapy practice that ranges from esoteric forms of fringe massage to clinically focused manual therapy.
Studies on massage to date have been performed utilizing generalized therapeutic massage, not the controlled clinical techniques used by some medical massage therapists. As this article emphasizes, technique should not determine studies, but studies should indicate or suggest technique, or even lead to the development of new treatment approaches. When research, technique, and outcome-based clinical rehabilitation collide, medical massage is born.
One of the problems in the general practice of massage therapy is the use of theories, techniques and concepts that are not based on valid scientific knowledge or accepted clinical practice. Within the fields of histology, pathology and biomechanics, there already exists a vast body of scientific research on connective tissue that validates massage and manual therapy techniques. Rather than waiting for future studies, massage therapy can adapt current research to clinical practice. Significant current examples are the research that exists on the physiology of ligaments, the joint complex and mechanoreceptors and nociceptors.
An example of a universally accepted misconception within the massage community involves the concepts regarding the "proprioceptor." Currently, within the general massage culture, the term proprioceptor is used to describe a type of neural receptor that transmits biological impulses related to a sense of position of a body part or area. Various massage techniques and exercises have been developed by different massage therapists that claim to "reprogram" or "normalize" proprioceptor function. In medical research and scientific circles, the term "proprioceptor" is and has been recognized as an inaccurate and non-scientific term. Although first entered into use by Sherrington (1906), the term was used to describe a specific type of biological sensor, and was not accepted by the legitimate scientific community since 1926. The term is listed in Gray's Anatomy, 37th edition, as "arbitrary." Scientific literature related to the use of the word proprioceptor dismisses the term for the following reasons:
Most, if not all massage textbooks, refer to and teach treatment and technique based on the concept of the proprioceptor. Almost all massage schools and their instructors teach the concept of the proprioceptor. Several methods of manual technique and therapeutic exercise are based on the erroneous concept of a proprioceptor. If this is not a physiological term, then what terms are physiologically and scientifically correct?
References and suggested reading:
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