resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Lateral Femoral Cutaneous Nerve Entrapments
The lateral femoral cutaneous nerve arises from the 2nd and 3rd lumbar nerves. It is formed in the psoas muscle and emerges from its lateral border to cross the iliacus muscle and exit the pelvis.
Three Essential Herbal Products For Your First-Aid Kit
There are three Chinese patent medicines that belong in everyone's first aid kit. All three are for topical application, and all three provide extraordinary benefits unavailable from any domestic over-the-counter.
Becoming a Concussion Expert in Your Community: What You Need to Know (Part 2)
What makes an individual an expert in concussions? Obtaining education about concussions and treating concussed patients are two factors that lead to expertise.
Keeping Up With Western Medicine Advancements: The Amazing World of Imaging Studies
When patients with neuromuscular problems come to you for treatment there is usually a lot you can do for them to improve their mobility or reduce their pain, whether it is a middle age woman with a frozen shoulder.
If you visit the website of the JAMA and search on the word chiropractic, more than 200 results appear. If you sort that list chronologically and look at the oldest entry, you will find "Medical News" that includes the following.
Weaving Eastern & Western Medicine Together: Q&A with Beijing's Dr. Kezhen Zhang
Dr. Kezhen Zhang M.D., is currently the founder and president of Beijing Taijitang Traditional Chinese Medicine Hospital.
A Solution for the Primary Care Crisis?
A white paper generated by the ACCAHC Primary Care Project and UCLA Center for Health Policy Research Senior Research Scientist, Michael Goldstein, PhD, addresses a clear oversight noted in recent workforce analyses designed to assess the nation's primary care needs.
The Physiology of Anger
Most of us recognize and have felt anger at some point in our lives. Anger can be seen as a natural response to some kind of pain, whether emotional or physical.
Dry Needling is Acupuncture: But What of Education? What of Public Safety?
One of my patients told me recently, that their physical therapist used a "dry needle" and that it wasn't acupuncture. Apparently, physical therapists (PT) are taught to tell their patients that "only acupuncturists practice acupuncture."
We Get Letters & E-Mail
The "Great Opportunity" for Chiropractic: Expanded Scope of Practice; The SOAP Note: An Effective Tool for Documentation; Treating Patients Goes Beyond Following Established Protocol.
Pre-Conception Wellness: What Do Your Patients Need to Know?
Deciding to have a baby is one of the most important decisions a woman will ever make. But how many women are really prepared for a healthy pregnancy?
A Medication Primer for Alternative Health Care Practitioners (Part 2)
Morphine is arguably the greatest drug of all time, at least in the sense that it is so powerful in relieving pain.
The Monkey on Your Back
Many practitioners run their clinic without any extra help—at least initially. I've always been pretty good at multi-tasking. Having nine kids taught me how to wear multiple hats and juggle a lot of responsibilities. Running a clinic is similar.
News in Brief
In Remembrance: A Moment of Silence for Robin McKenzie (1931-2013); DC Re-Elected to Co-Chair AMA Code Review Board; WFC Celebrates 25 Years.
It's About the Word
The new patient was already a fan of chiropractic. "I liked the guy a lot," he said of the previous DC he had consulted. "But he is on the other side of town, and I just can't get there after work. So he sent me to you, since you're his buddy."
Obesity is a Shen Problem
The expressions "obese" and "obesity" are not pejorative terms. They are scientific terms, determined solely by the Body Mass Index scale, which combines a person's height and weight in a mathematical formula. A number of 30 and above denotes "obesity."
Healing the Qi: The Boston Marathon Bombing
On Monday, April 15 2013, locals and visitors from around the globe gathered for the world's largest marathon in the city of Boston. With 23,000 participating in the race and many more on the sidelines, the marathon represents a Boston institution.
Chiropractic Care for Veterans: Serving Those Who Served (Pt. 2)
To what extent do you think the role of chiropractors in the VA can serve as a model for greater chiropractic integration elsewhere in the American health care system? That's a very important question.
Study: Acupuncture for Acute Low Back Pain More Effective Than Drugs
New research by Korean doctors of Oriental Medicine suggested that an acupuncture method could reduce acute lower back pain faster and more effectively than conventional drug injections.
Treating Rib Joints to Protect Thoracic Stability
It is an exciting world that awaits us when we go to work every day. We deal with all types of people who present with varying health conditions we can (hopefully) help alleviate.
10 Life Lessons That Will Change the Way You Practice
"What would you do if you knew you couldn't fail?" I have posed this question for years to groups I've spoken to across the country and around the world.
Maintaining Professional Boundaries in a Facebook World: Social Media Guidelines for DCs
A few months ago, I received an unexpected message on my Facebook account: "Hi Doc, do you remember me? I'm so happy to find you here on Facebook. It's been years since I have seen you and I'm glad to reconnect with you.
Extraordinary Vessels and Emotional Healing
In addition to the 12 primary Organ-related meridians in the body, there are other energy circulation channels that have been mapped out by Traditional Chinese Medicine. Probably the most significant of these are called the Eight Extraordinary (or Extra) Vessels.
Weight Training: Are Cheat Reps Worth It?
While resting between exercises at the gym recently, a young lifter asked me for a spot on a set of barbell bench presses. The bar was loaded with a moderately heavy amount of weight that at first glance appeared to be too heavy for his frame.
Beauty is Averageness
After seeing Kim Kardashian's face all over the Internet -and my inbox- following her posting on getting facial acupuncture, I recalled the work of Michael Cunningham who was at the University of Louisville when I was doing my doctoral work.
July, 2012, Vol. 12, Issue 07
Do You Ever Wonder: What Technique Should I Use?
By Whitney Lowe, LMT
Open up any trade publication or listing of continuing education courses and you will see a vast array of different techniques you can learn. Many of these technique approaches claim to be new "inventions" and completely revolutionary.While there are clearly novel approaches to bodywork treatment, many of these techniques are simply variations on traditional massage techniques that have been around for a long time. With so many different techniques, it can be really difficult for the practitioner to know which techniques would be best in each unique client treatment. While the lure of advertising claims like "instant results" and "permanent pain relief" may seem attractive, can we really make those kinds of claims and be taken seriously as a health care field at the same time?
Like the carpenter or artist that uses tools to ply their trade, various techniques are at the root of our success in treating our clients. But what's the best technique to get the job done? The answer is clearly that it depends. Many years ago I grappled with this issue and recognized that other massage therapists do as well. To help understand and address this issue, I developed a four-part orthopedic massage system that could act as a framework for the clinical decision-making process of what techniques would be appropriate for different clients in each unique clinical situation. Two of these four component parts are directly related to helping the practitioner make an appropriate treatment decision about which techniques will be best for each unique client presentation.
As the saying goes, "If all you have is a hammer, then everything looks like a nail." This is quite applicable to what we do in massage as well. If you have narrowed your focus to one or two particular treatment techniques, then you may end up taking an ineffective approach and using them on a wide variety of conditions with only limited success. That saying could easily be changed to something like, "If all you have is neuromuscular therapy, everything looks like a trigger point." Very few people practice with that level of exclusivity on just one technique, but you can end up really narrowing your focus if it is not varied enough. Clients present with many types of soft-tissue disorders. In addition, one person's carpal tunnel syndrome can be very different from the next and the treatment approach for one person could be quite wrong for what is needed by someone else.
Another challenge for us if we focus too narrowly on just one or two techniques, is an over-emphasis on our lens of bias; and we all have one. The lens of bias is the way we look at client issues and the most effective way to address them. One of the best illustrations of the lens of bias concept came from an article written by Dan Cherkin and his colleagues in 1994. The article was titled, "Physician Variation in Diagnostic Testing for Low Back Pain. Who You See is What You Get."1 They found variation in the diagnosis of low back disorders depending on the practice and theoretical focus of the physicians; the lens of bias. We look at various pain complaints and treatment strategies differently depending on this lens of bias that is structured by what we have studied and practiced.
Match the Physiology
The second key component of this system is matching the physiology of the tissue injury with the physiological effects of the treatment technique. In order to choose the most appropriate treatment technique, we must understand the specific physiology of the pain or injury complaint. We must understand WHY we do the things we do. That means we also have to understand the physiological effects of our massage techniques. Over the years, I have heard some very interesting (and inaccurate) descriptions and explanations of what certain massage techniques were supposed to be doing (physiologically) to the client. If we base our treatment choices on inaccurate physiology, we may be far less effective. But we could also end up doing something that is detrimental and contraindicated, or even end up hurting the client as a result.
Take a look at how this might play out in a clinical situation. Suppose you have a client that comes in with lateral forearm pain and weakness. After going through an interview with the client, you decide to treat the client with deep friction massage to the proximal wrist extensor tendon attachments at the lateral epicondyle. After several weeks of treatment, the client reports that the condition appears to be getting worse.
You might wonder why the deep friction massage was not working in what seemed to be a classic case of lateral epicondylitis (tennis elbow). Further consideration of the physiology of the injury condition and the physiological effects of the treatment technique suggest what might be wrong. Suppose in your initial evaluation you didn't identify weakness in the wrist extensor muscles and note that the pain at the elbow was mild compared to the way it usually presents with lateral epicondylitis.
The client might actually be experiencing radial nerve entrapment in this region, which is a condition also known as "resistant tennis elbow" because of the way its symptoms mimic tennis elbow. You might be applying deep friction to a nerve entrapment disorder and making it worse. Instead, it would have been more appropriate to have identified the source of the client's disorder as a nerve entrapment problem and consequently your treatment choices would have changed and emphasized methods that would help reduce compression on the radial nerve.
Effective clinical massage is a comprehensive practice and having a systematic method for addressing assessment and treatment is at the root of clinical success. If you begin to pay much more attention to WHY you do the things you do and make sure there is a good physiological rationale for each treatment strategy, you are likely to see much greater success in your client treatments.
Click here for more information about Whitney Lowe, LMT.
comments powered by Disqus