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 present very questionable views in their writings. 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.
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 journals for the benefit of the entire profession.
Massage & Bodywork Magazine
Massage Therapy Journal
Massage & Bodywork Magazine
Anatomical Sleuthing. Finding Clues for Effective and Efficient Treatment. Massage & Bodywork Jan/Feb: 33-34, 2014, by Douglas Nelson
A concise and valuable article that discusses the practical experience of the author. We think that Mr. Nelson’s article offers genuine, professional insight, and the Editorial Board of Massage & Bodywork Magazine deserves credit for regularly publishing this column. On a personal note, we find Mr. Nelson’s column exhibits the author’s superior clinical thinking and reasoning compared to articles by other national educators.
In regard to the article’s topic, we maintain that scapular instability is not a diagnosis regardless of who establishes it. Unlike shoulder joint instability, scapular instability is a consequence rather than an original pathology.
As illustrated in Ellen et al., (2000):
“Scapular instability may be the result of a variety of causes of which the clinician should be made aware.”
Kibler and Sciascia (2010) commented that scapular dyskinesis is:
“…specific response to certain glenohumeral pathology.”
Thus, when a practitioner sees a patient with the diagnosis of scapular instability, we suggest the practitioner follow Mr. Nelson’s recommendations to diagnose the root cause of the problem rather than accepting it as an initial trigger.
Ellen MI, Gilhool JJ, Rogers DP. Scapular instability. The Scapulothoracic Joint. Physical Medicine and Rehabilitation Clinics of North America. 2000 Nov; 11(4):755-70. Review.
Kibler WB, Sciascia A. Current concepts: scapular dyskinesis. British Journal of Sports Medicine. 2010 Apr; 44(5):300-5.
When Massage Therapy Creates an Adverse Effect. Massage & BodyworkJan/Feb: 44-47, 2014, by Ruth Werner
The article addresses the side effects of massage therapy. We appreciate that Massage & Bodywork Magazine is among the few journals that have published material about this matter. The article analyzes anecdotal and medical sources of the possible side effects of massage therapy. We can summarize the main subject of the article in one word: PRESSURE. This is the main therapeutic tool of massage therapy, and it is the primary cause of almost all side effects. Another important and correct observation in the article is that more side effects are produced by therapists that use various massage tools instead of their hands.
We would like to add two more points. The first regards incorrectly applied Trigger Point Therapy (TPT). From publication to publication and from textbook to textbook, we read inaccurate presentations of the basic principles of TPT. In these sources it is obvious that TPT overpowers the patient’s pain analyzing system. Despite that practitioners achieve immediate, positive results with this approach, they are endangering the patient’s health by triggering processes that eventually cause trigger points to develop to the stage of irreversible degenerative changes in the muscle tissue called myogelosis.
The second point is there is no such modality in a clinical application of massage therapy as deep-tissue massage. Pressure is a vital tool that must be used carefully and judiciously instead of senselessly pushing on different parts of the body without realizing the consequences.
Gluteus Medius. Massage & Bodywork Jan/Feb: 51-52, 2014, by Christy Cael
An accurate article on the anatomy and palpation of the gluteus medius muscle.
The Fainting Mystery. A Phenomenon Unique to Chair Massage. Massage & Bodywork Jan/Feb: 58-67, 2014, by Eric Brown
Anyone who practices chair-massage MUST read this article. We greatly appreciate Mr. Brown’s contribution, his intelligence and professionalism. Thank you!
Creating Win-Win. How to Work With a Chiropractor. Massage & BodyworkJan/Feb: 68-73, 2014, by W. David Bond, DC
The author is a chiropractor and he offers a good review of the options massage therapists have when working with a chiropractor. The author is correct when he states that:
“Chiropractors and massage therapists can, and should, work together for the benefit of their patients/clients.”
Unfortunately, Dr. Bond is in the minority since the majority of chiropractors send patients to massage therapists after adjustments. We have received considerable feedback from our students who have lost their jobs in a chiropractic office after they started implementing medical massage that helped their patients but resulted in a decrease in the necessity for frequent chiropractic adjustments.
Breaking New Ground. Massage Can Reduce the Pain of Neuropathy.Massage & Bodywork Jan/Feb: 68-73, 2014, by Charlotte Michael Versagi
The article discusses the diabetic- and chemotherapy-induced peripheral neuropathy and the author’s protocol used for patients with these pathologies. The information in the article is correctly presented and useful for practitioners who treat patients with peripheral neuropathy.
The author states correctly that insufficient oxygenation of the tissue and sensory receptors is responsible for the peripheral neuropathy. However, this is only part of the pathophysiology of these conditions. For example the presence of glucose molecules as well as the metabolites of chemotherapy medications are equally damaging factors.
Mrs. Versagi’s protocol is helpful since she splits it to minutes and various techniques. Nevertheless, an important part of the treatment is missing. In addition to the author’s suggestions, practitioners MUST always utilize the large assortment of sensory stimulating techniques applied rapidly but superficially at the end of the session. Also, practitioners must teach the patient to do this daily as a self-treatment.
In addition to contributing to increased oxygenation, intense sensory stimulation prevents further deterioration of those receptors that are already compromised and to receptors that are still functioning. The efficacy of the treatment lies in a rapid switch from one stimulating technique to another to produce a variety of sensory input to the CNS. In a simple analogy, the practitioner simulates the actions of a powerful grader along the nervous pathway analogous to the grader that cleans snow from the highway. A rapid alternation of various percussion, shaking, manual and electric vibration in the interruptive, mobile mode, light pinching, short ice-cube application alternated with warm towel, etc., must be used superficially at the end of the session and by the patient at home.
Melvin’s Painful Shoulder. Massage & Bodywork Jan/Feb: 100-103, 2014, by Whitney Lowe
The article presents an extended case study on shoulder injury. Overall, this is a good example of the clinical approach to massage therapy but is lacking a couple of important points. First, the source of innervation of the affected shoulder was not evaluated or included in the treatment protocol, and changes in the periosteum were not examined either.
In addition, there are some treatment missteps. For example, the author correctly advocates friction as a treatment tool for the tendinitis of the biceps tendon but excluded cross-fiber friction from the treatment protocol and insisted on friction along the tendon only. Here is a quote:
“…when treating the biceps tendon, massage only in a longitudinal direction because it is possible, though uncommon, that deep and vigorous transverse friction could dislodge the tendon from the bicipital groove.”
This recommendation is the author’s personal opinion. It contradicts clinical reality, and is incorrect since it will decrease the effectiveness of the therapy. The author’s suggestion is never the case when cross-fiber friction is performed technically correct. To prevent dislodging the tendon, the practitioner must stabilize the tendon in the bicipital groove by pulling and anchoring the soft tissue on both sides of the tendon, and only after doing this can the practitioner safely use cross-fiber friction. Another tool is the application of small-range friction on the tendon itself rather than going back and forth with large-friction amplitude. It seems the author is not aware of this widely used technical approach, which was developed by the father of cross-fiber friction, Prof. J. Cyriax.
Another issue we have with the article is from this quote:
“…deep and vigorous transverse friction.”
The treatment MUST be within the patient’s comfort level but done longer to avoid excessive trauma to the synovial sheet and tendon since they are both located directly on the bone.
Finally, the suggested protocol does not provide any tools to reset muscle spindle receptors in the biceps brachii muscle to reduce pressure on the tendon. In such case, the patient mentioned in the article runs the risk of reoccurring clinical symptoms even if the protocol suggested in the article works in the short run.
Cyriax J. Theory and Practice of Massage. Textbook of Orthopedic Medicine, Vol. 2. 11th Edition, Bailleiere&Tindall, Toronto, 1985.
Scar Remodeling. Adhesion and Nerve Pain. Restoring Function to Inflexible Tissues. Massage & Bodywork Jan/Feb: 107-108, 2014, by Erik Dalton
This article addresses working on postsurgical scars even years after the initial surgery. There are several issues we would like to address. While the article is correct in stating that scar tissue formed after a Cesarean section may in some cases entrap hypogastric nerve, it is impossible for the same scar tissue to entrap pudendal nerve located in Alcock’s canal as is shown in the article.
Fig. 2 in the article presents the lateral view of the abdomen and pelvis with scar tissue propagated from the skin of the anterior abdominal wall, through the abdominal cavity all way to the anterior surface of the sacrum, and in this area, according to Fig. 2, the scar tissue entraps the pudendal nerve.
First, during a Cesarean section, the obstetrician opens the skin with subcutaneous tissue, anterior abdominal muscles and peritoneum to expose the anterior surface of the uterus. Thus, the surgeon does not go behind the uterus where the pudendal nerve is. The abdominal cavity is called a cavity for a reason, since there is no continuous soft tissue between the anterior and posterior abdominal walls which scar tissue can use as a framework to proliferate from the anterior abdominal wall to posterior abdominal wall.
Overall our extensive research of this subject revealed only one (!) medical source that reported adhesions had formed behind the uterus in the ileum after Cesarean section (Zahumensky et al., 2010).
Considering the number of C-sections performed in the world on a daily basis, the issue of adhesions behind the uterus is completely irrelevant. This why authors of this case study pointed that:
“We haven’t found a similar report of intestinal strangulation in adhesions after the Caesarean section.”
Some medical procedures may cause pudendal nerve entrapment. Below are iatrogenic or medical causes of Pudendal Nerve Entrapment Syndrome or Alcock’s Syndrome as documented by Passover and Forman, (2012):
1. Postpartal haematoma
2. Fibrosis of the ischiorectal fossa
3. Stretching of the nerve during delivery
4. Surgical damages during transvaginal sacrospinous colpopexy
5. Mesh material for sacrospinal fixation
6. Sacrocolpopexy or rectopexy
As readers can see, Cesarean section is not on the list, and all medical procedures listed above were performed posteriorly and inferiorly far below the C-section approach to the uterus. The stretching of the pudendal nerve during the delivery has no bearing on scar tissue formation.
Do adhesions form after a Caesarian section especially after repeated ones? Yes, but these adhesions are located anteriorly and inferiorly to the uterus and involve the skin, fascia, abdominal muscles, peritoneum and, in the worst case scenario, the greater omentum and uterus itself.
We found no medical sources that reported Pudendal Nerve Neuralgia may have developed as a result of a C-section. If the author has observed that in his practice, the only reasonable explanation for this unique fact is tension and shortening of the uterosacral ligament, which supports the uterus in the pelvic cavity. However, even in this case the scar tissue as a cause has nothing to do with entrapment of pudendal nerve.
The author provided the following explanation of possible pudendal nerve entrapment:
“…when a woman’s fingers press firmly on C-section scar, she may experience urethral burning, urgency, or frequency.”
The real explanation is simple and has nothing to do with the pudendal nerve. The post-Cesarean scar, which forms adhesions in the soft tissues of the anterior abdominal wall, will create secondary projectile tension all way down to the soft tissues of the external sex organs and urethra. In such case, the application of the pressure on the scar will trigger pain radiation and irritation-type sensations in the external genitalia and urethra.
So, why is so much time spent on what appears to be a purely anatomical issue? The information discussed in the article has great clinical value. If the practitioner follows the recommendations in this article on a female patient with a diagnosis of Pudendal Nerve Neuralgia and scarring from a Cesarean section, the therapist will make an incorrect clinical decision and initially treat the patient’s scar instead of addressing the lumbosacral area or entrance into the pudendal canal as a main initial triggers. In this case, the practitioner will be addressing the wrong cause of the problem.
The second issue not addressed by the article is the length of time for the scar treatment, suggested in Fig. 4 and 5. This issue must be addressed since practitioners, while working long and deep in the anterior abdomen, could easily bruise intestinal loops, which must be avoided at all cost. We have observed the painful results of incorrect deep-abdominal treatment of Iliopsoas Muscle Syndrome when prolonged and deep intra-abdominal pressure had been applied by a practitioner.
We certainly agree with the moral point of the article: “Don’t chase the pain.” In the majority of cases, the pain is a ghost, and it is the practitioner’s job to find its real cause.
Possover M, Forman A. Voiding Dysfunction Associated with Pudendal Nerve Entrapment. Cur Bladder Dysfunct Rep. Dec 2012; 7(4): 281-285.
Zahumensky J, Zmrhalova B, Sottner O, Maxova K, Brtnicka H, Horak J, Binder T, Halaska M. Adhesive Bowel Strangulation after Caesarean Section, the Rare Puerperal Complication. Prague Medical Report. Vol. 111 (2010) No. 1, p. 65-68.
Working With Hamstring Injuries. Massage & Bodywork Jan/Feb: 107-108, 2014, by Til Luchau
A good article on the anatomy and action of the hamstring muscles as well as the mechanism of their injuries. However, if the Hamstring Technique discussed in the article is the author’s only treatment option then his recommendations will fall short of being clinically effective. If the technique he discusses in the article is part of the bigger protocol that addresses tendinous parts, place of origin and insertion, etc., then the article offers helpful information.
The Point of It. Massage & Bodywork Mar/Apr: 33-35, 2014, by Douglas Nelson
A good article on a simple subject that illustrates the author’s ability to think clinically.
Understanding Stress. Massage & Bodywork Mar/Apr: 40-43, 2014, by Anne Williams
An excellent article that could increase a practitioner’s understanding of the impact of chronic stress on the human body. In concise and clear language, the author presents an important and complex subject.
Body Mechanics. Adjust and Thrive. Massage & Bodywork Mar/Apr: 40-43, 2014, by Barb Frye
The article is a general description of the measures used to correct body mechanics for practitioners. The basic ideas are correct but the article lacks substance.
Teres Major. Massage & Bodywork Mar/Apr: 51-52, 2014, by Christy Cael
The article presents the anatomy, action and the correct procedure for teres major muscle palpation.
Denise’s Shin Splints. Massage & Bodywork Mar/Apr: 100-103, 2014, by Whitney Lowe
The article is devoted to “shin splints.” Everything is correct until it describes the treatment. The article suggests starting with the superficial soft tissue and gradually move into the deeper layer. However, at this point, the article loses its clinical value. The only treatment option for the posterior leg compartment that is discussed in the article is an active-engagement technique.
In the majority of patients with shin splints, this treatment provides only short-term relief. We can guarantee that the patient receiving such a limited clinical approach will, sooner or later, suffer a reactivation of the same symptoms after returning to the same exercise routine. The author is a proponent of orthopedic massage, and we find it puzzling how he expects stable clinical results with the application of only one treatment option. It seems that the author is concerned only about the muscles of the posterior compartment and completely disregards other equally important muscle groups that make up the complex anatomical area of the leg compartments. The treatment presented in the article will only temporarily address the problem instead of achieving stable clinical results.
Here are the essential treatment components that are not covered by the article.
1. Why are superficial and deep fascia not addressed or even mentioned? They form the envelope that restricts muscle function and using only an active engagement technique will be insufficient to reduce tension in the fascia.
2. The active engagement technique is not a substitute for the correct application of trigger point therapy to eliminate active trigger points in the affected muscles.
3. The anatomical length of muscles in the posterior leg compartment MUST be restored by resetting muscle spindle receptors.
4. The periosteum of the tibia MUST be addressed. We think that the author does not fully understand the pathological changes in shin splints. Certainly, this is muscle pathology but it secondarily affects the tibia creating inflammation in the periosteum called periostitis (Detmer, 1986). This is why shin splints are so painful since tensed and shorten leg muscles additionally pull the periosteum of the tibia. As it was recently pointed out by Brewer and Gregory, (2012)
“…recent evidence points toward a spectrum of tibial stress injuries contributing to MTSS (medial tibial stress syndrome by JMS): periostitis, tendinopathy, and stress reaction of the tibia, as well as dysfunction of the tibialis posterior, tibialis anterior, and soleus muscles”
The pathological changes in the medial stress syndrome are identical to the changes the patients with anterior stress syndrome exhibit.
The periosteum is a richly innervated membrane. In fact, pain that patients feel from a bone fracture comes from damage to the periosteum rather than from the fracture of the bone itself. The bone does not have pain receptors. Thus, to eliminate shin splints, a practitioner must address the periosteal changes using periostal massage or at least Cyriax’s friction along the periosteum of the tibia.
As a final thought, the article misses the integrative approach to somatic rehabilitation, a frequent mistake we have observed from publication to publication in professional massage journals.
Brewer RB, Gregory AJ. Chronic lower leg pain in athletes: a guide for the differential diagnosis, evaluation, and treatment. Sports Health. 2012 Mar;4(2):121-7.
Detmer, D.E. Chronic shin splints. Classification and management of medial tibial stress syndrome. Sports Med. 1986 Nov-Dec;3(6):436-46.
Finding the Weak Key Link. Massage & Bodywork Mar/Apr: 100-103, 2014, by Erik Dalton
A short but good and important article we suggest to readers.
Working With the Vestibular System. Massage & Bodywork Mar/Apr: 114-117, 2014, by Til Luchau
Effective treatment of Benign Paroxysmal Positioning Vertigo (BBPV) cannot be achieved if the treatment protocol is insufficient or incorrect. However, when the treatment is correct, the results are astonishing in their effectiveness and stability.
This article is dedicated BBPV and its treatment. The theory portion of the article is good and the illustrations are helpful. Unfortunately, we consider the portion dedicated to treatment a disaster from the point of view of professional ethics and clinical effectiveness.
First, the ethical component: The author calls his treatment Vestibular Orienting Technique (VOT). Let us give readers a short history review. The commonly used protocol for treatment of BBPV is called Epley’s maneuver proposed by Dr. John Epley in 1980. So what is VOT? The author of this article omitted some critical elements of Epley’s maneuver to make it even more simplistic, if that is even possible, and now presents it to massage practitioners under a new name of VOT he invented with no mention of Dr. Epley’s work. While reading the article, practitioners may believe that VOT is a personal achievement of the author. This is such unprofessional and unethical behavior that it is disturbing to see it in an overall good educator.
We have already caught Mr. Luchau once on manipulating scientific sources and trying to adjust science to the system of his personal beliefs (see Good Apples/Bad Apples section of Nov/Dec 2010 Issue of JMS). This current article reinforces the appearance of an unfortunate pattern in his writing. We think that Mr. Luchau would receive more recognition and respect as an educator if he acknowledges the sources and original authors of the therapy, especially ones with the extensive education and credibility of Dr. Epley.
Now, we wish to address the treatment part itself. Despite that the author uses Epley’s maneuver, Mr. Luchau’s modifications nullify any clinical effectiveness of Epley’s treatment. Although Epley’s maneuver is widely used, it frequently produces limited clinical results especially in severe cases of BBPV.
In 1988, a group of French physicians under the leadership of Dr. A. Semont developed the Semont’s Protocol, which implements the same ideas but in a completely different clinical approach to the treatment of BBPV. We used Epley’s maneuver with mixed results in our Arizona and Los Angeles clinics until we were introduced to Semont’s protocol in 1999. Currently, we use this protocol several times per week and its clinical effectiveness still shocks us and our patients that in many cases had been through countless ineffective sessions by other practitioners that used Epley’s maneuver. Semont’s protocol has worked successfully for each of our patients with BBPV. Currently, many practitioners around the country use Semont’s protocol with effective results. The successful elimination of BBPV was also selected by our readers as Case of the Month Winner in 2010 (Mar/Apr Issue 2010 of JMS)
As exemplified by Haynes et al., (2002), in the majority of cases, the correct application of even one (1.49 maneuvers) of Semont’s protocol produced significant clinical improvements in 90% of the patients:
“Overall, 90% of all patients tested had significant improvement of their vertigo after 1.49 maneuvers on average.”
Mr. Luchau’s article also demonstrates a lack of the author’s understanding how manual therapy affects patients with BBPV. Here is one example:
“If your client suffers from vertigo……, ask him or her to keep her eyes open, and lift the head slowly…”
The only correct way to control BBPV during treatment is to require the patient keep his or her eyes closed. The vestibular system and visual analyzator work together to maintain balance, and every patient with chronic BBPV realizes that keeping the eyes closed helps reduce vertigo symptoms. If, while the practitioner works to reset otolithes in the inner ear, the patient’s eyes are open, hair cell receptors stay on the edge of firing in disarray and reduce any positive treatment outcomes.
Keeping the eyes closed is a critical component of successful therapy. The practitioner must insist that the patient’s eyes remain closed throughout the entire procedure and also before getting in or out of bed or during transition from the sitting to standing position. Patients must also avoid fast-moving images caused by activities such as driving or watching TV.
Epley, J.M. New dimensions of benign paroxysmal positional vertigo.Otolaryngology-Head and Neck Surgery (5): 599-605, 1980.
Haynes, D.S., Resser, J.R., Labadie, R.F., Girasole, C.R., Kovach, B.T., Scheker, L.E., Walker, D.C. Treatment of benign positional vertigo using the semont maneuver: efficacy in patients presenting without nystagmus.Laryngoscope May;112(5):796-801, 2002.
Semont A, Freyss G, Vitte E. Curing the BPPV with a liberatory maneuver. Adv Otorhinolaryngol. 42:290-3, 1988.
The Sacs and Tubes Theory of Stress. Massage Today January, 2014, Vol. 14, Issue 01, by Dale G. Alexander, L.M.T., MA, Ph.D
A very good article that discusses the clinical connection between chronic stress and various pathological conditions including visceral abnormalities. The theory of Prof. H. Selye as well as the work of Dr. J. P. Barral are correctly mentioned to support the information in the article.
Despite that Dr. Barral is referenced, a reader not familiar with his work may believe the article describes a personal theory developed by Mr. Alexander. However, this is not the case since the entire article is based on Barral’s work and it is Mr. Alexander’s interpretation of this work.
A Distorted View: How Massage Impacts Body Image Issues. Massage Today February, 2014, Vol. 14, Issue 02, by Tina Allen, L.M.T., CPMMT, CPMT, CIMT
The article describes the effect of massage therapy on stress levels in clients with various eating disorders. It reiterates the efficacy of massage therapy as a critical element in the prevention and/or management of behavioral changes resulting from chronic stress and anxiety.
The Integration of Cranial Structural and Soft Tissue. Massage TodayFebruary, 2014, Vol. 14, Issue 02, by Don McCann, MA, L.M.T., LMHC, CSETT
The article discusses cranial/structural core distortion and how it can be normalized. Mr. McCann has published several similar pieces in various massage publications that we have reviewed. However, this is first article in which he acknowledges the necessity of locating and treating the immediate pain first before considering the structural integration of the entire body. We agree with this following quote:
“Initially, spending extra time on these (more affected by JMS) areas and not trying to treat the whole body in the early sessions directly addresses and relieves the client’s pain for which the client is grateful. Once this is achieved, it is then necessary to release the soft tissue throughout the rest of the body to support the increased balance in the area that was the original presenting pain.”
We appreciate that the same point we have made in our previous reviews is finally being acknowledged.
What Does an MRI Tell the Therapist? A Closer Look at Cervical Pain.Massage Today February, 2014, Vol. 14, Issue 02, by Debbie Roberts, L.M.T.
This is an excellent article dedicated to the important subject of MRI reports. We highly recommend this article to readers. The author correctly states that MRI reports can be intimidating especially for those who have never experienced them. However, by investing a little time in study, it becomes apparent how much critical information is contained in an MRI report, and how much they may change and focus an entire treatment strategy.
The first step is simple, consisting of reading the descriptions of which segments of the spine are affected and correlating this information with a map of dermatomes (skin), myotomes (skeletal muscles) sclerotomes (periosteum) to discover which tissues are innervated by the affected segments. This is a foundation for a successful treatment protocol.
MRI reports also affect the entire course of future therapy. If words such as “severe herniation,” “fragmentation of the disk,” “severe spinal stenosis” are in the report, the practitioner must approach any treatment with caution. In addition, the practitioner should be prudent when discussing treatment outcomes with the patient since results cannot be guaranteed. Although the practitioner should offer all possible treatment options, the patient must be informed that there remains a significant chance that the therapy may not work if the spinal changes are profound.
The Forgotten Rotator Cuff Muscle, Part 1. Massage Today February, 2014, Vol. 14, Issue 02, by Ben Benjamin, Ph.D.
This is part one of an article about the teres minor muscle in which the author discusses the anatomy and function of the teres minor muscle.
The Tissue Density Grading Scale: A Communication Tool. Massage TodayMarch, 2014, Vol. 14, Issue 03, by Linda LePelley, RN, NMT
In this article, the author proposes a Tissue Density Grading Scale with matching colors. This visual presentation of information can be used by practitioners for their records and by patients to follow and estimate progress of their treatment.
Resolving Hip Flexor and Rotator with Rehabilitation of the Core.Massage Today March, 2014, Vol. 14, Issue 03, by Don McCann, MA, L.M.T., LMHC, CSETT
This article should never have been published in any respectable national publication. This is simply a promotional piece for enrollment into SET seminars conducted by the author. We were shocked by this quote from the article:
“…we have yet to find anyone who is not in the core distortion when evaluated. The only exceptions are clients who have been previously treated with the cranial/structural core distortion release combined with myofascial protocols.”
Learning How to Track Anterior Knee Pain. Massage Today March, 2014, Vol. 14, Issue 03, by Whitney Lowe, L.M.T.
A good article on anterior knee pain. Unfortunately, treatment options were not discussed.
Massage Therapy Journal
Tennis Elbow. Massage Therapy Journal Spring, V53 (1): 15-22, 2014, by Joseph E. Muscolino
An excellent article on Tennis Elbow and its treatment protocol.
Research Literacy. Can Massage Therapy Relieve the Symptoms of Carpal Tunnel Syndrome? Massage Therapy Journal Spring, V53 (1): 29-31, 2014, by Martha Brown Menard, Ph.D., L.M.T.
The article reviews the results of a study conducted in Australia in which a massage therapy protocol was used on patients with chronic Carpal Tunnel Syndrome. This information may be used by therapists to educate other health practitioners on the clinical benefits of massage therapy.
Work Smarter, Not Harder. Massage Therapy Journal Spring, V53 (1): 34-40, 2014, by AMTA
We are pleased that Massage Therapy Journal has placed the spotlight on such an important issue as correct body mechanics for practitioners. We also addressed this topic in the Nov/Dec Issue 2009, of JMS. The AMTA describes the body mechanics teachings of E. Mohr, and correctly presents some basics of body mechanics for therapists.
Massage & Carpal Tunnel. Massage Therapy Journal Spring, V53 (1): 50-56, 2014, by Michelle Vallet
The article is more of a journalistic piece than a serious, in-depth examination of Carpal Tunnel Syndrome. Readers can compare Dr. Muscolino’s article in the same issue of Massage Therapy Journal with this piece and see a clear difference. Overall, Mrs. Vallet’s article is a review of personal experiences and treatment options drawn from several practitioners. It appears that the author has limited personal experience with Carpal Tunnel Syndrome. For example, at the beginning of the article she states that:
“…carpal tunnel is inflammation or entrapment of nerves within carpal tunnel…”
There is only a single nerve in the carpal tunnel called median nerve not multiple nerves.
The author’s treatment options are confusing since they present a contradictory approach to the treatment protocol. Here are two quotes from the same paragraph:
“Garcia does a full body session with the concentration on the wrist..”
“Using detailed deep tissue (Bennett) work…. in the soft tissue of the shoulder, full arm and hand”
From simple curiosity, what would Massage Therapy Journal and the author of the article suggest practitioners do for patients with Carpal Tunnel Syndrome: Full body massage or limited treatment on the upper extremity along the affected peripheral nerve? Somehow, the author concludes that these two completely opposite treatment protocols are the completely same approach.
Mr. Garcia, mentioned in the article, appears to prefer the full-body session with concentration on the wrist. This is the strangest approach to the treatment of Carpal Tunnel we have heard about. Mr. Garcia justifies his full-body approach by saying that he is 100% (!) certain that patients suffer from Carpal Tunnel due to “…other muscles being out of balance.” Of course they are out of balance because the patient is experiencing pain, and his or her body is coping with that by rearranging new, pathological body mechanics in response. However, what is the reason for the other muscles “being out of balance?” Pain and other sensory abnormalities are the actual trigger of these changes.
Practitioners must treat the Carpal Tunnel first and, once the patient no longer feels pain, determine if muscle disbalance is still present. There is the reasonable question of why not do both treatments, Carpal Tunnel Syndrome and realignment of the disbalanced muscles during the same session? The answer is simple: When working on the somatic pathology, the practitioner needs to engage the patient’s nervous system as a major ally. To do this, the practitioner needs to “enter” the nervous system through the segments of the spinal cord that innervate only the affected area in combination with areas innervated by the same peripheral nerve(s). Thus, a healing motor response can be delivered specifically to the affected area, thus producing quicker and, what is even more important, stable clinical results.
This is exactly what Mrs. Bennett, also mentioned in the article, does while working on the wrist and upper extremity along the pathway of the affected nerve. Despite that Mr. Garcia and Mrs. Bennett have completely different (incorrect in the first case and correct in the second case) approaches to treatment, the author of the article asserts that both practitioners are applying the same treatment.
The article is correct when it emphasizes that Carpal Tunnel Syndrome is not always Carpal Tunnel and can be caused by other compression syndromes. The author again relies on Mr. Garcia’s opinion, who pointed out that Thoracic Outlet Syndrome is one of the main causes of Carpal Tunnel Syndrome. We would like to correct this statement by stating that the patient with Thoracic Outlet Syndrome is in such pain along the entire upper extremity that Carpal Tunnel Syndrome is going to be a lesser concern for the patient. Since a patient with Thoracic Outlet Syndrome suffers from the severe compression of the brachial plexus and subclavian artery, massage practitioners rarely see these patients. What Mr. Garcia referred to in the article is a condition called Anterior Scalene Muscle Syndrome, which precedes Thoracic Outlet Syndrome and is frequently missed as the actual cause for symptoms associated with Carpal Tunnel Syndrome.
Understanding a Patient’s Surgical Journey. Massage Magazine, Spring, V53 (1): 58-77, 2014, by Annie Morien
An excellent review of joint replacements. The popularity of these surgical procedures has grown in the last 20 years, and, every several years, the procedures have become simpler and more efficient. Many patients elect to have these surgeries to restore their quality of life. Practitioners need to understand the nature of joint-replacement surgery including the rehabilitation period as well as the effectiveness of massage therapy for these patients. The article gives an excellent and well-researched review of this subject.
Technique Spotlight: Rolfing Structural Integration. Massage Magazine, Feb, issue 213: 74-76, 2014, by Crole LaRochelle B.C.S.I.
The article is a short and simple description of Rolfing, and is helpful only for practitioners unfamiliar with this form of massage or its founder, Ida Rolf.
Hands-Free Massage. Save Your Body and Your Career. Massage Magazine, Feb, issue 213: 74-76, 2014, by Phyllis Hanlon
The title of the article explains its low rating. If practitioners do not use their hands, it should not be called massage, and anything else is a means of taking advantage of clients who are seeking professional help. If Oriental-bar therapy has its own niche of application, then Auth’s Method (which we have reviewed many times) is ineffective and detrimental to the profession. Instead of teaching and promoting correct body mechanics among practitioners, the author advocates saving the body by avoiding what massage is all about. This article illustrates a trend that is harming the profession of massage therapy.
Father-Baby Bonding. Massage Magazine, Feb, Issue 213: 42-46, 2014, by Tina Allen, L.M.T., C.P.M.M.T., C.P.M.T., C.I.M.T.
The article discusses infant massage in which treatment is performed by parents to enhance bonding with their healthy child. We agree with the article that the main role of the practitioner is to teach parents basic massage strokes and protocols so that treatment may be conducted within the comfort of the home.
Fibromyalgia. A Deeper Understanding. Massage Magazine, Mar, Issue 214: 54-57, 2014, by Sara Thomas Simpson, L.M.T.
The article is a basic introduction to a complex medical problem. However, it does not provide a deep understanding of the topic but only reiterates information already familiar to those in the massage profession.
Conscious Conception. Mercier Therapy Enhances Natural Function.Massage Magazine, Mar, Issue 214: 54-57, 2014, by Jennifer Mercier, N.D., Ph.D., L.M.T.
Manual therapy and medical massage branched into gynecology and fertility therapy since 1891 when Swedish therapist T. Brandt developed the concept of Gynecological Massage. Since then, various techniques and methods have been introduced.
We are not in the position to review Mercier Therapy. We are reviewing the article. There is a great possibility that Mercier Therapy is excellent clinical tool. However, it is impossible to discern this from the article since it provides only general information about therapy performed on the pelvic area through the abdomen to release pelvic organ restrictions.
By Massage Magazine‘s standards, this a long article. However, instead of offering a theoretical and practical description of Mercier Therapy, the author devotes 18 paragraphs to describe her personal story on the development of the therapy and how to get training, and only four paragraphs describing the therapy itself.
We think that Mrs. Mercier would attract far more interest if she shares some of her clinical techniques as well as theoretical foundations. Otherwise, the article is just like many other self-promotional pieces that we have frequently witnessed in professional publications.
Category: Good Apples, Bad Apples