resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
It Is Time
This column is in two parts, one more political about education and the other about how to bring about inhibition (relaxation) easier and faster. Hopefully, there is something for every body.
Sadly, the movement toward energetic (subtle) forms of therapy within our profession lead to a significant percentage of instructors, and the therapists they trained, who discounted the need to study, learn and apply anatomy. This intellectual laziness still exists and handicaps our profession. The late, great Barbara Brennan, an RN who was a pioneer in energy healing, essentially told a group; you intuitive people with your great intentions really need to learn anatomy, because that growth you think you see on the liver is really a vital organ called the gall bladder.
We have severely limited ourselves, both in our abilities to help our patients and in our being accepted as creditable by other providers through our avoidance of learning anatomy, physiology, and kinesiology. We are addressing a physical body - a physical manifestation of a thought form maybe, but it is in the physical now - and to avoid learning the names and functions of its parts is negligence and incompetence. It is a disservice to those who come to us for help. It is arrogance and egotism. If you really want to help people, you should care enough to learn the language of the health professions and as much as you can about the human body. What is more fascinating than the study of the human body and mind? No one has ever learned all there is to know about them. Shouldn't your study be ongoing, as in regular continuing education activities, beyond the minimum required? For those who seek acceptance by the allopathic (medical) system, let me assure you, it will never be gained through ignorance.
Would you hire someone to fix your car that didn't know the names or location of the engine parts? I grew up around machinery mechanics, most of whom did not have an eighth grade education, but they knew the name of every part of every machine. They learned and spoke the language of their profession. We "work" on the most complicated "machine" known, the human body, and some don't think it important to know the names of the tissues that are being manipulated (touched).
It is high time our beloved "stakeholders" established standards and qualifications for entry level massage instructors and institute competency based requirements for graduation and licensing. We must ban the educational practice of "wheel"/"spoke"/"modular" massage education where students are plugged into a program at wherever the program is in its cycle. Students get dumped into the last two months of a program and then get the basics later. Or, some get a brief introductory class and then get dumped into the rotation, wherever it is at the time. That is no way to train competent, confident, professional massage therapists. Physicians are not taught surgery before they learn anatomy. Nothing is going to gain us acceptance as a profession until we have a consistent deliverable. We will not have that until we significantly change our entry-level educational practices. (Of course not all schools teach this way, but those that do must be required to change, and soon – for the sake of the public.)
Individual therapists who have learned their "stuff" are making good inroads into the "system." However, I talk with physicians regularly who tell me they would love to refer to massage therapists but they cannot find one who knows a fibula from a fender or will show up on schedule. Our average is way too low. It will take a long time to bring it up. The sooner we start the better. It is time.
If you have not already, it is time to come to the realization that one cannot drive pain out of the body with painful physical force. Therapeutically caused pain does not necessarily mean gain or bring about "healing." My good friend, colleague, and educator Mike McAleese recently posted, "Bodywork is a physical conversation with the body. Some people think that deep, painful pressure is helpful. This is akin to yelling at someone who is injured."
Our window to the body is not through the skin and muscles as much as it is through the nervous system. The results we achieve from massage are actually a stimulus-response loop. We apply a stimulus and the nervous system responds. If we apply the correct stimulus, we get the desired response, which is generally a relaxation (inhibition) response and a lessening of soft-tissue pain, often increasing range of motion. If we apply the wrong stimulus, we get a less than desired response.
Our touch triggers mechanoreceptors that are embedded in the soft-tissues. These receptors respond to mechanical stimulation such as massage. If properly stimulated, these mechanoreceptors elicit an inhibition (relaxation) response from the central nervous system (CNS) back to the local area of the stimulation. Different mechanical stimulus (massage strokes and techniques) stimulate different types of mechanoreceptors. The more mechanoreceptors stimulated, generally speaking, the more inhibition that is returned to the stimulated area.
However, if the stimulation is too intense and causes pain, a contractile response is sent by the CNS to the stimulated area. This is generally counterproductive to our goal of relaxation. Sadly, some patients seem to enjoy this pain and ask for it with the line "I can take it," or "I like it deep/hard, etc." They seem to equate the endorphin response elicited by the pain as relaxation, and the endorphins reduce the local pain, so they think they are receiving benefit. While such aggressive treatment may help some, even to a great degree, a more appropriate, non-painful stimulus would help them even more if they would let go of their association of pain equals healing.
Working hard and deep has destroyed many a therapist's body and thus their career. It is not necessary to "yell" at someone to get him or her to relax. In fact, deeper and more profound relaxation can be achieved by proper stimulation of mechanoreceptors that causes absolutely no pain to the patient, not even the hurts so good pain, and puts very little, if any, strain on the therapist's body. An elegant system has been developed by Lawrence Woods, a therapist from Indianapolis. Called Neural Reset Therapy (NRT) the system applies precise, gentle stimulus to mechanoreceptors in a way that almost instantly relaxes the muscle and relieves tickle, excess tension, and tenderness. Easy on the therapists, NRT can allow you to "reset" the tonus of 321 muscles in 45 minutes. It is time to learn a better way.