The purpose of this section of the Journal of Massage Science is to inform the practitioners about valuable articles that frequently go unnoticed, as well as to point to those authors and publications who exhibit low educational standards. We do not play politics, and we are not associated with any publishing company or professional association. We are a completely independent voice, and we promise you direct, unbiased reviews based strictly on the science.
If the author of the reviewed article does not agree with our opinion, we will be more than happy to publish his or her response and have a productive discussion over the article’s subject. Please contact us by sending e-mail.
At the end of the year, we will recognize and reward the author of the most important publication(s) and point to the authors of the most unscientific publication(s). We hope this will help to raise the bar of published materials in massage publications for the benefit of the entire profession.
Massage & Bodywork Magazine
Functional Anatomy. Piriformis. Massage & Bodywork Magazine, July/Aug. 2010, pp. 85-86
Correctly presented information about palpation of the piriformis muscle. The digital version has a very well presented visual demonstration of the anatomy of the muscles in the gluteal area and is definitely a great help for the readers.
Auth Method. Forearms for Feet. Massage & Bodywork Magazine, July/Aug. 2010, pp. 62
We have already reviewed an article on the Auth Method in the May/June issue of JMS. As usual, the author recommends conducting massage treatments or reflexology using forearms and elbows only, in this case on the legs and feet. There is nothing wrong with using forearms during a massage or reflexology session. This is a great technique which must be mastered by every practitioner. The real problem with this treatment is that it dismisses all other massage or reflexology techniques which require thumbs!
According to the author’s statement, she discovered during the application of her method that the usage of the forearm allowed her to conduct a reflexology session with the same effectiveness as these poor reflexologists who trained and practiced for years using and ruining their thumbs. Of course, the article didn’t specify how such a wide contact area as the forearm or elbow was able to specifically address reflex zones on the feet, which sometimes are the size of a nail. So we assume that the author works on the entire sole using forearm techniques, and it goes against the basic rules of reflexology where successful stimulation of reflex zones depends on very localized application of treatment.
The author also stated that the Auth Method is successful in the treatment of plantar fasciitis. Yes, the application of forearm massage techniques can, and should, be used as a part of the medical massage session to eliminate tension in the plantar aponeurosis. However, the practitioner will never be able to completely restore function of the plantar aponeurosis if he or she doesn’t work on each of its bands separately. Only thumbs or index fingers as well as massage tools with small contact areas can do this job, because each band of the plantar aponeurosis is only 4-5 millimeters wide. Application of the forearms or elbows for this purpose is a useless waste of time.
Despite the fact that we think that practitioners who don’t know how to use forearms (if they exist) will find the practical part of the article helpful, we encourage the use of forearm technique only as part of the treatment session. The practitioner will simply rob the client of the proper treatment if he or she uses elbows and forearms only during a massage or reflexology session.
In this article, the author again misinformed readers that forearms are as sensitive as fingers if the practitioners are able to train them, apparently with the help of the Auth Method’s DVDs. We specifically addressed this nonsense in the previous review (see Good Apples/Bad Apples May/Jun '10).
Benign Paroxysmal Positioning Vertigo. It will make your head spin! Massage & Bodywork Magazine, July/Aug. 2010, pp. 99-103
An excellent article on Benign Paroxysmal Positioning Vertigo (BPPV)! The author greatly illustrated the anatomy of the inner ear and pathophysiology of this frequently debilitating abnormality. The author mentioned Epley’s Maneuver as a main treatment option which, according to the scientific data she cited, is helpful in 70 percent of cases of BPPV. So what should the patients in the remaining 30% of cases do?
Epley’s Maneuver long has disappointed physicians who didn’t feel this treatment is able to deliver steady clinical results. There is a much more effective therapy existing which is effective in 100% of cases of BPPV. We are always skeptical when something in medicine is proclaimed 100% effective, but in the case of Semont’s protocol, this is an absolutely correct claim. This treatment is also very simple, but it is effective when everything else has failed. Unfortunately, Semont’s Protocol is much less known in the USA, but more and more practitioners are becoming familiar with this therapy and trained to perform it.
This protocol was developed in 1988 by French physician A. Semont and has been used successfully around the world. We used it in our clinics for years with 100% success. The clinical results of even one session are so dramatic for the patients that they frequently see it as a ‘miraculous’ procedure. In the May/June issue of JMS, our author O. Bouimer contributed the Case of the Month, where he described a case of BPPV treatment using Semont’s Protocol after the patient was unsuccessfully treated at Cedars-Sinai Hospital using Epley’s Maneuver.
REFERENCES
- Semont A, et al. Adv Otorhinolaryngol. 1988;42:290-293. doi:10.1159/000416126
Myofascial Techniques. Working With Headaches. Part I. Massage & Bodywork Magazine, July/Aug. 2010, pp. 110-115
A very good article which addresses the problem of headache as a result of musculoskeletal disorders and treatment options. There are several very good qualities in this article, especially the illustrations.
The author gives a very good overview of the problem. This is only Part I of the article, and the reader may expect more helpful information in the following issues of the magazine.
Massage
Myofascial Techniques For Medial and Lateral Pterygoids. Massage, 170, July 2010, 58-64
An excellent article which stresses the important subject of intra-oral work in cases of TMJ dysfunction. The article is a great practical source with very helpful illustrations. However, the practitioners must be sure that they follow local or state rules and regulations. Unfortunately, in the majority of cases, intra-oral massage as well as massage of other inner cavities is beyond the scope of the profession. Having a written prescription from the physician as well as the patient’s signature is a required component before treatment starts.
Medical Massage. Hands-on Therapies for Oncology Patients. Massage, 170, July 2010, 50-56
A good informative article which is helpful for those practitioners who consider the expansion of their practice into the medical massage field working with oncological patients.
Expert Advice: Can you explain the application of lymphatic techniques within a massage practice? Massage, 170, July 2010, 44-46
A very good short review of the possible incorporation of lymphatic techniques into everyday massage practice. These techniques are an important therapeutic tool which enhances the outcome of any type of massage treatment from stress reduction to medical massage sessions.
Guest Editorial: We are not Mindless Machines. Massage, 170, July 2010, 20-23
The author expresses his opinion about the current approach of traditional medicine to the treatment of cancer. We completely agree with the author’s position that we need to stop treating any form of cancer as simply an oncological problem and see and incorporate other important components into the treatment. The silver bullet of beating cancer will never come from one treatment option but rather from the integrative approach to pathology. In such cases, the disease is attacked from several directions at the same time, and massage and bodywork must be part of it.
Massage Today
Osteoporosis: Another Insidious Silent Progression. Massage Today, 10(7), July 2010
According to the author, this article is the first part of the discussion about osteoporosis which he researched for six months. The article raises an important subject but has provided little helpful information so far. However, it is impossible to analyze the entire project because this part looks like the introduction to the topic, and from this point of view, it accomplished its goal. We will wait for the following parts.
TMJ: Self-Care for Your Masseter. Massage Today, 10(7), July 2010
This article addresses the issue of self-treatment of TMJ dysfunction concentrating on the masseter muscle. Information from the article is practical and useful for those practitioners who suffer from TMJ dysfunction as well as for those who are able to conduct intra-oral treatment according to the local laws and regulations.
The only important information which is missing is the necessity of passive stretching of the masseter muscle after the local treatment presented in the article. These stretches are a crucial component of any self-care for TMJ dysfunction. They need to be conducted daily, especially before and after every big meal. The patients with TMJ dysfunction must repeat this simple self-stretching program daily to prevent further deterioration of the joint and have a pain-free life. Readers will find this simple set of self-care stretches in the next issue of JMS.
Research: Sport, Pelvic Pain and Associated Symptoms. Massage Today, 10(7), July 2010
An excellent article which addresses a very rarely mentioned issue even in medical literature: the correlation between different sports and pelvic pain and other associated symptoms. The clinical picture triggered by Pudendal Nerve Neuralgia or tension in the pelvic floor diaphragm can be very puzzling even for neurologists, and this issue is very rarely mentioned in massage publications.
At the same time, pudendal nerve decompression as well as releasing tension in the pelvic floor diaphragm should be done by trained massage practitioners. Unfortunately, these protocols are practiced by a small number of practitioners, which leaves the patients who suffer from these very uncomfortable clinical symptoms with very limited, in many cases ineffective, and costly treatments with a large percentage of side effects.
We described one of our clinical cases of Pudendal Nerve Neuralgia treated in our clinic in the previous issue of JMS in the MEDICAL MASSAGE vs. ERECTILE DYSFUNCTION section.
Referred Pain. Massage Today, 10(8): 8, July 2010
The author correctly answered the question from the reader: “If a client feels pain that radiates down the arm or leg, that usually indicates a disc injury. True or False?” The author gave the correct answer as False. However, during the explanation the author made several critical mistakes. It seems that the article puts into one basket completely different pathophysiological phenomena, and it makes such a complex issue as referred pain even more confusing for the readers. This article proclaims four basic guidelines of referred pain.
Guideline 1: “Pain refers distally…from midline to the periphery, not the other way around”.
The author confuses referred pain and radiating pain. Only radiating pain will always refer distally, while referred pain frequently refers to the ‘…other way around’. The radiating pain will always spread distally along the affected dermatomes. For example, pain radiates to the palm, and it can be caused by a bulged or herniated cervical disk as well as by tension in the anterior scalene and/or pectoralis minor muscles. Thus, “radiating pain is more commonly used in connection with pain perceived in somatic nerve and spinal nerve root distributions” (Woessner, 2003).
Meanwhile, the referred pain may perfectly spread in the opposite direction, and it can be triggered by somatic or visceral abnormalities which refer pain to various somatic structures. For example, for visceral abnormalities: pain from the gallbladder may refer to the right shoulder and mimic the presence of the active trigger points in the trapezius muscle; pain from the liver may refer to the right chest and mimic active trigger points in the pectoralis major muscle, etc. (Woessner, 2003).
For the somatic abnormalities: pain from the temporomandibular joint may refer to the temporal area triggering temporal and parietal headache; pain from the active trigger points in the sternocleidomastoid muscle may refer to the forehead and eye triggering cluster headaches, etc. (Travell and Simons, 1983).
In these cases: “Referred pain is pain perceived in a region that has a nerve supply different [by JMS] from that of source of pain” (Merskey and Bogduk, 1994). In other words, referred pain may very easily spread proximally, i.e., in the direction from the periphery to the center.
Guideline 3: “Pain is referred within a dermatome” and “… this pain [i.e., pain along dermatome, by JMS] is more commonly caused by an injury to a muscle, tendon, or ligament elsewhere in the dermatome”
This third guideline for referred pain, proposed in the article, is completely wrong. Dermatomal pain never ever can be caused by the local injury of muscles, tendons or ligaments in the area of pain. In these situations, the practitioner deals with myofascial pain. Why is this differentiation so important? The referred pain from, let’s say, an active trigger point uses completely different pathways of distribution (through sympathetic C-fibers) compared to the dermatomal pain distribution (through somatic sensory nerve). These two patterns of pain sometimes clinically overlap, but both types of pain, i.e., dermatomal and myofascial, require different evaluation and completely different treatment.
We are sure that articles in massage publications which are supposed to educate practitioners must be more rigorously reviewed before their publication. Even basic terminology in the article is incorrect. The muscles and tendons are associated with myotomes, and ligaments are associated with sclerotomes, and they do not have anything to do with dermatomes which are solely associated with the skin and subcutaneous tissue. These three are completely different pathophysiological concepts which can’t be mixed together.
Guideline 4: “Severity of an injury is directly proportional to the distance the pain refers. For instance, a severe cervical injury might refer pain to the hand, while a less severe injury refer pain only to the upper arm”
This incorrect and misleading statement, if implemented, will greatly cloud the practitioner’s evaluation and judgement. If pain is referred to the hand as a result of a cervical injury, it means only one thing: the spinal nerves which give origin to the radial, median and/or ulnar nerves are affected. This hypothetical patient doesn’t feel pain in the upper arm simply because this part of the upper extremity is innervated by completely different nerves: axillary and musculocutaneous.
Thus, it is not the intensity of the injury which defines where pain refers but rather which nerve is affected. The patient may have a minor injury and feel pain in the palm (i.e., median nerve distribution) or have an intense injury and feel pain in the upper arm (i.e., distribution of the axillary nerve).
REFERENCES
- Merskey H, Bogduk N, eds. Classification of Chronic Pain: Descriptions of Chronic Pain Syndromes and Definitions of Pain Terms. 2nd ed. IASP Press; 1994.
- Travell J, Simons DG. Myofascial Pain and Dysfunction: The Trigger Point Manual. Vol 1. Williams & Wilkins; 1983.
- Woessner J. Referred pain vs. origin of pain. Pract Pain Manag. 2003;(Nov/Dec):9-19.
Headaches: Trigger Points and Practice Building. Massage Today, 10(8): 10; 16, July 2010
Despite the fact that this article is dedicated to a very important subject, it has very little practical value and reads more like a sales pitch for purchasing laminated diagrams developed by the author. This article is of much lesser quality and value than the article on the same topic published in Massage & Bodywork by Til Luchau, which was reviewed above.
Category: Good Apples, Bad Apples
Tags: JMS 2010 Issue #5
