resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
Musculoskeletal Disorders Take Center Stage
Looking for the latest on the musculoskeletal pain epidemic and the increasing premium placed on preventive strategies including chiropractic? Check out The Impact of Musculoskeletal Disorders on Americans – Opportunities for Action.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
Recording and Appropriate Billing of Timed Physical Medicine Services
There is a common misunderstanding about timed therapy services and although you do have some knowledge of timed service documentation, based on your comment on the 8-minute rule, your understanding is correct, but incomplete.
How to Find and Fix TL Nerve Impingements
The thoracolumbar junction (TLJ) and the peripheral sensory nerves that exit from it are frequent, important and rarely recognized sources of lower back, pelvic and hip pain. Let's outline a clear exam protocol for diagnosing the problem.
The Power of Eccentric Exercise: Hamstring Injury Prevention and Rehab
For almost 20 years, I've worked with professional athletes who make a living by running really fast. It goes without saying that hamstring injury (HSI) prevention and rehabilitation is a big part of what they expect from a sports chiropractor.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
Essentials of Assessment: The Squat
The squat is a simple, fast and functional tool to evaluate patient symmetry and function. As simple and easy as it is to implement, it can yield considerable amounts of valuable, clinically relevant information.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Business Lesson #1: Adapt or Else
My wife and I recently enjoyed an excellent meal at a restaurant recommended by some friends. We often have concerns about restaurant recommendations, as many have been disappointing.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
Vitamin D Fails to Help Knee OA? The Proper Perspective
The March 8, 2016 issue of JAMA includes a study about vitamin D supplementation for osteoarthritis of the knee. This is a really weird study.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
The IME System: A Current Public Health Risk and Solutions That Are Working
I strongly believe in the independent medical examination (IME) system. There are far too many doctors in every profession who are not following E&M protocols and never claim MMI (maximum medical improvement) has occurred for their patients, which has caused financial stress for many private and public carriers.
February, 2010, Vol. 10, Issue 02
Cancer, Treatment and Detoxification
By Tracy Walton, LMT, MS
Some time ago, a client going through intense chemotherapy treatment asked me if deep massage would help her cleanse the drugs from her system. She had read about a number of liver cleansing protocols that suggested very deep massage to facilitate the process of elimination.Her question touched on a number of issues in the oncology massage world and there were several layers to my response to her. I share my answers here, because the issues are relevant for our many clients in chemotherapy.
The Effects of Massage
In the massage profession, we have learned, read, taught and repeated the belief that massage helps move toxins out of the tissues and out of the body. However, we have not always been clear on which toxins, from which tissues, or through which routes of elimination. Almost any substance in the blood, even a nutrient, can be considered toxic if there is too much of it in the blood or tissues, so our use of the term is ambiguous. I once had a physician on my table that was a huge fan of massage therapy, but told me that the profession's liberal use of the word toxin always made him uncomfortable. Invariably, when he asked a massage therapist what the term meant, he received vague, unsatisfactory answers.
Our use of the word toxin seems to imply a waste product or poison that shouldn't be there. In the realm of chemotherapy, the reagents and products of breakdown are known to be toxic, so at least we are on more definitive ground there. But to my knowledge, there is no solid base of research to support the notion that massage moves toxins out of the tissues. By solid, I mean more than a single study. Instead, to be given serious consideration, we need multiple studies, from multiple investigators, in peer-reviewed publications, reporting similar results on this point.
That said, my client was talking about chemotherapy and wanting to eliminate chemotherapy drugs from her body. These medications and their metabolites do have toxic qualities which is why they are used to destroy tumors.
She was suffering greatly from the effects of these toxins she wanted them gone, period. I told her there wasn't much known about the effects of massage in the toxin department, so I couldn't say whether deep effleurage and petrissage would, in fact, speed it out of her system. I also told her I had other concerns about the detoxification approach, which I have described here.
The Intent of Massage
When we work with clients in chemotherapy, our intent is to ease symptoms and support our clients in integrating and managing the effects of treatment. For this reason, we do not impose additional challenges to the body by working it too hard (MacDonald, 2007). So I told my client that even if we knew for sure that deep massage strokes would chase the drugs out of her system more quickly, we wouldn't necessarily choose that approach.
Instead, it makes more sense to let the body set its own pace of detoxification. The organs of detoxification -- the liver, kidneys and skin -- are busy enough without the potential additional demand of a deep, draining, circulatory massage. I told my client that, even without research or clear understanding about massage and detoxification, this is our rationale for working gently.
Additional support for this gentle approach comes from our clinical observations: When clients in chemotherapy receive deep work, they feel worse, not better, afterward. Whatever the reason for that, deep massage is too much for them. These clinical observations inform our practice much more than any attempt to explain them.
A Good Referral
My client continued to press me about what I thought she should do after chemotherapy. She asked about a number of detoxification protocols involving ingesting large amounts of salt water and other substances. They had to do with cleansing the colon and liver. I listened, but stayed neutral. I told her I couldn't advise her either way, it was out of my scope of practice. I told her she had great questions, but that I thought such practices would be safest if done under the supervision of a naturopathic physician or another physician experienced in natural medicine after chemotherapy. And I urged her to raise her questions with her doctor and chemotherapy nurse.
These referrals gave her somewhere to go with her questions and her urge to detoxify. At the same time, I managed to stay within my scope of practice. This can be challenging when our clients ask us for our opinions and advice and these questions come up a lot when we have a whole hour available to our clients. It is important to navigate them in an unbiased way, with supportive listening and good referrals. In the end, this can be a great service to our clients.
Gloving for Chemotherapy
Whenever we talk about chemotherapy and massage, the question invariably comes up about chemotherapy eliminated through the skin: will the massage therapist, in continuous contact with the client's skin, unwittingly absorb some of these toxic substances? For our own safety, should we wear gloves when providing massage to clients in chemotherapy? Should we avoid contact with them altogether? Therapists are understandably concerned about the possibility of picking up chemotherapy by-products through their hands but, like any rumor, these fears have been overblown and somewhere along the line we came to believe it was dangerous to touch all patients in chemotherapy.
Space limits a full discussion of this issue here, but there is an excellent place to go for deeper understanding. The Society for Oncology Massage (www.s4om.org) provides detailed discussion for massage therapists, clients, caregivers and other health care providers. There is a Resource Link for massage therapists where the chemotherapy, toxicity and touch issues are well-addressed. Careful analysis of the risks is provided, bringing massage into alignment with nursing practices during chemotherapy. Conditions under which a therapist might wear gloves are identified, and the current understanding of the issues is made plain.
There clearly is room for more dialogue and research in the profession of massage about the precise effects of our work. There is growing energy devoted to these questions and more resources to turn to. We have the second Highlighting Massage in CIM Research conference to look forward to this May in Seattle (find out more at www.massagetherapyfoundation.org/researchconference2010.html) This conference follows closely on the heels of the second Oncology Massage Healing Summit in Minneapolis (find out more at www.nwhealth.edu/conted/seminars/oncology.html).
I attended both of these conferences the first time around, and they were some of my favorite experiences. In settings like these, the science and practice of massage are addressed by thoughtful people who bring their whole hearts and minds to their massage inquiry. Toxin or no toxin, movement or no movement; by holding massage therapy up to the light, we will come to more fully understand the work of our hands.
Click here for more information about Tracy Walton, LMT, MS.
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