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 TODAY
Following the Body’s Clues. How 29 minutes of massage therapy changed a life. Massage Today, July, 2014, Vol. 14, Issue 7
A great article! In contrast to many publications, the author shared with readers the actual protocol of the therapy. Unfortunately, many authors try to avoid that and use national publications as self-marketing tools without sharing any details of their methodology. This is why this author, who conducts her own seminars, deserves credit for good clinical work and a willingness to share it with readers.
Prone Position Syndrome. Massage Today, July, 2014, Vol. 14, Issue 7
Everyone who practices full body massage, especially new therapists, should read this article. We couldn’t agree more with the author, who in an easy-to-read form raised a very important professional subject. The Phenomenon of Adaptation (please see the Jan/Feb 2009 issue of JMS), also discussed in this article, is the main obstacle preventing stress-reducing massage therapists from building a successful practice.
Exploring the Anterior Pelvic Tilt. Massage Today, July, 2014, Vol. 14, Issue 7
The article is dedicated to the anterior pelvic tilt, its origin, testing and general treatment options. Overall, this is a well-written article. However, there are a couple of critically important pieces of clinical information the article missed.
The article correctly identified tension and spasm of the lumbar erectors and misalignment of the sacroiliac joint as causes of anterior pelvic tilt. Indeed, the trauma or chronic overuse (e.g., an incorrect sitting habit) will trigger the tension in the lumbar erectors, followed by an anterior pelvic tilt. However, this is a very partial and even mechanistic view of a much more complex issue, which the article completely missed.
In a very large number of cases, the tension in the lumbar erectors isn’t the cause but the consequence of other pathologies hidden deeper in the lumbar area. For example, a patient has a bulging intervertebral disk, and at this stage of degenerative spine disease, the patient won’t show any clinical signs of disk pathology. The only clinical manifestation of the degenerative process which has already happened in the disk is the protective spasm of the lumbar erectors.
As soon as the disk even slightly protrudes into the spinal canal, the brain will do whatever it takes to protect the spinal nerve roots, and it does so by increasing tension in the lumbar erectors. The same secondary protection in the lumbar erectors will form if tension builds up in the deeper anatomical structures of the lower back – the rotators and quadratus lumborum muscle.
Thus, blaming spasm in the lumbar erectors as the main cause of the anterior pelvic tilt is a completely incorrect assumption. In clinical reality, in many cases lumbar erector tension has a secondary, compensatory character.
Without understanding this, and by following the article’s recommendations, practitioners will never be able to help all patients with anterior tilt, because they will knock on the wrong door while the real trigger is located at a completely different level of the soft tissues. We would like to emphasize again that the article is correct in regard to original tension in the lumbar erectors and misalignment of the SI Joint. However, this is only part of the real problem.
The Evolution of Releasing the Core Distortion. Massage Today, July, 2014, Vol. 14, Issue 7
Unfortunately for practitioners, Mr. McCann continues to mislead. In the previous article, he accused the “entire medical field” [this author’s expression by JMS] of refusing to embrace his Structural Integration based on the kinesiology assessments he widely advocates. As we showed in the previous review of his article (see Issue #3, 2014 of JMS), the “medical field,” which has apparently conspired to undermine Structural Integration, in several double-blind studies with experienced kinesiologists proved that kinesiology isn’t a reliable diagnostic tool for evaluating various somatic pathologies.
Mr. McCann continues to be really upset about the short vision of the “medical field,” but at the same time he understands he needs data from the “field” to give at least some scientific validity to his claims. It is amazing to observe how the scientific data can be twisted to prove incorrect assumptions. Here are several examples from this article:
- Quote:
“It is understood in the medical establishment that 90% of musculoskeletal pain comes from distortions in the structure.”
Dear Mr. McCann,
We demand a medical reference for this misleading quote, which undermines all scientific data. If you can’t provide it in your next article, you are simply deceiving the readers using a national publication as your personal advertising platform.
JMS
- Quote:
“I have mentioned in previous articles that the core distortion is observable in 16-week-old fetuses. Unfortunately, there has not been a radiological study to either confirm or disprove this observation.”
If there are no radiological confirmations (from the “medical field”) of 16-week-old fetuses having observable core distortion, who actually observed that? Is it Mr. McCann personally? And what exactly did he use for the measurement? How can anyone make such ridiculous claims in a national publication and, more importantly, how can such nonsense get through the Editorial Board? There is supposed to be at least some professional responsibility!
- Quote:
“…if we look in Essentials of Skeletal Radiology, Vol. 1, 2nd ed. by Dr. Terry R.Yochum and Dr. Lindsay J. Rowe (the text book used in many medical, osteopathic and chiropractic schools), we find on pages 175-176 recorded measurements of normal acetabula angles of infants 0 to 3 months and 3 months to one year that show an average of 20 degrees difference between the right and left ilium with the left being anteriorly rotated and the right being posteriorly rotated. On page 176 in table 227, normal iliac angles are charted in babies from 0 to 3 months and 3 to 12 months, again absolutely verifying the difference in the angles of the iliums to be significant in normal children congruent with the core distortion. Thus, it is clear that normal children are born in the core distortion creating imbalances and weakness throughout the body.”
The last statement is clear only to one person, Mr. McCann. We already addressed this nonsense in previous reviews of the author’s articles. Before using data from the “medical field” or what he calls in this article the “medical establishment,” Mr. McCann should study the basics of neonatal orthopedy. If he did that before trying to fit scientifically correct data into his system of beliefs, he would find that in the time between birth and 12 months, a baby’s hip joints (unlike other joints) continue to develop and mature. This is why we do not stand or walk for almost an entire year, allowing the spine and hip joints to mature to be able to bear the weight of the body. This is why babies with congenital hip dysplasia are kept from standing and walking with special garments called Pavlik’s harness until X-rays confirm that both hip joints are structurally balanced (Bin et al., 2014).
As several studies (Dunn et al., 1985; Seringe et al., 2014) have shown, congenital hip dysplasia, which is a much more troubling condition compared to the situation invented by Mr. McCann, resolves spontaneously in a year in at least half the cases, even without using Pavlik’s harness. These newborns have normal hip biomechanics, which are confirmed by X-rays or MRIs, even though they have a real pathology rather than an invented one. Telling practitioners that we are somehow genetically predisposed to have torsion misbalance and that Structural Integration is the ultimate clinical solution reflects very low scientific standards, and it is a fiction invented by Mr. McCann.
REFERENCES
- Bin K, Laville JM, Salmeron F. Developmental dysplasia of the hip in neonates: evolution of acetabular dysplasia after hip stabilization by brief Pavlik harness treatment. Orthop Traumatol Surg Res. 2014;100(4):357-361. doi:10.1016/j.otsr.2014.03.017
- Dunn PM, Evans RE, Thearle MJ, Griffiths HE, Witherow PJ. Congenital dislocation of the hip: early and late diagnosis and management compared. Arch Dis Child. 1985;60(5):407-414. doi:10.1136/adc.60.5.407
- Seringe R, Bonnet JC, Katti E. Pathogeny and natural history of congenital dislocation of the hip. Orthop Traumatol Surg Res. 2014;100(1):59-67. doi:10.1016/j.otsr.2013.12.006
TDR Massage Protocol for Pain Relief. Massage Today, July, 2014, Vol. 14, Issue 7
Before we start to review this article, we have some questions for the Editorial Board of Massage Today. Here are two quotes which reflect ideas from two articles published one after another in the same July issue of Massage Today.
The first quote is from Mr. McCann’s article we reviewed above:
“It is understood in the medical establishment that 90% of musculoskeletal pain comes from distortions in the structure.”
The second quote is from this article by Mrs. LePelley:
“In my experience of actively looking for elevated TD [tissue density, by JMS], I’ve found it happens to everyone in pain. All musculoskeletal pain can be located and felt (in the tactile sense) by a second person, as palpable areas of indurations at the locus of pain. From the toes to the top of the head, elevated TD can be found at any physical location that hurts.”
Does the Editorial Board realize that in one issue of Massage Today, they published two pieces with completely contradicting views, while each author claims its universal value? It would be great to have at least some explanation of the Board’s professional position, since the publication of such materials does only one thing – it confuses practitioners.
Now, in regard to the article itself. The article is dedicated to the increased tissue density in patients with somatic pathology, something the author, to her great surprise, recently discovered. It is great that, after many of our reviews, the author has at least stopped using the most outrageous claims. For example, we didn’t notice for a while her explanation that increased tissue density is the result of the accumulation of cholesterol in the soft tissues.
Here is the most astonishing quote we’ve read so far:
“I am not a pathologist, biochemist or neurologist, nor do I have the time or inclination to acquire the additional education it would require to be able to investigate the physiology involved in the formation of elevated TD… I don’t have to fully understand the mechanism of the combustion engine to drive a car, but that doesn’t impair or hinder my ability to do so.”
Dear Mrs. LePelley,
Yes, you are completely correct when saying that you, as a driver, “…don’t have to fully understand the mechanism of the combustion engine to drive a car,” but we think that you will agree with us that the car mechanic is supposed to understand how the engine works. Otherwise, you will never trust him with your car.
If we continue with your car analogy, it seems to us that in the therapy room you are not a driver. You are a car mechanic who is supposed to do the appropriate repair; otherwise, you will ruin the car.
Also, if you “…don’t have the time or inclination to acquire the additional education,” you are not in a position to educate other practitioners on the very subject you are writing articles about, using the platform of a national publication.
JMS
In regard to the suggested protocol, the treatment described in the article in the form of TDR or Tissue Density Restoration has been part of the Medical Massage concept for decades. If the author were inclined to acquire even a basic Medical Massage education, she would find that these techniques were developed and used long ago by Dr. J. Cyriax, I. Rolf, etc. In such a case, she would have long ago discovered for herself increased tissue density and would have learned techniques to deal with it from the very beginning of her professional career. Then she wouldn’t have had to invent the bicycle and promote it as a new treatment method.
There is also a reasonable doubt that the author’s protocol is universally correct. Here is a quote from the article we will use to illustrate the author’s teaching:
“First, focus on the location of the pain and target the worst spots first.”
Such an initial approach to the treatment is fundamentally wrong. The pain is a ghost, and if the practitioner follows the author’s recommendations and chases the ghost, he or she dramatically decreases the clinical effectiveness. The pain is a consequence of something, and its origin and symptoms match each other mostly in cases of soft tissue trauma or overload. In all other cases, and they are the majority, the real cause is mimicked by the pain, and it misleads the therapist.
Using Massage to Ease Traumatic Brain Injury Symptoms. Massage Today, August, 2014, Vol. 14, Issue 8
The article is about using massage to ease traumatic brain injury (TBI), especially in children. The article touches on an important subject and generally describes the nature of TBI. However, when the article goes to the actual massage application, it becomes completely toothless. By reading this important part, readers are supposed to get some guidelines. Instead, they get several paragraphs of general information – that the therapist must take a health history, communicate with the physician and the parents and create an individual approach to each patient and session.
Unfortunately, this isn’t enough information to help therapists work efficiently on children who are suffering from TBI.
A Look at Compression, Congestion and Dis-Coordination. Massage Today, August, 2014, Vol. 14, Issue 8
This article describes the personal theory Mr. Alexander developed to explain how various abnormalities develop in the human body. He identifies three major causes: Compression, Congestion and Dis-Coordination. Of course, these aren’t all the mechanisms that are responsible for the complex puzzles of body dysfunctions, but they are definitely existing factors.
As usual, Mr. Alexander tries to inject into his articles some philosophical concepts he personally developed. Before, it was that our primate ancestors were falling from the trees and thus contributing to the development of our shoulder joints. Now it is a war raging in our bodies. Here is one of the quotes from the article. It is a fascinating read:
“Cringing, shortening, narrowing, and twisting of the structural elements related to the heart/lung complex, the diaphragm muscle, the liver, the uterus, the esophagus and the small and large intestines all activate “a war between the flexor and the extensor reflexes” to my sensibilities. The intrinsic visceral connections that activate this war between reflexes exist between the occiput and the anterior neck all the way to the sacrum.”
Mr. Alexander is using his sensibilities to present the human body as an arena where some kind of war between opposite forces rages. Yes, our body functions are managed by two opposite parts of the autonomic nervous system: sympathetic (fight or flight) and parasympathetic (rest and digest). Yes, we have muscles with opposite functions (flexors-extensors, adductors-abductors). However, in contrast to Mr. Alexander’s “sensibilities,” they are working together to maintain body functions. Even in a state of dysfunction, they are desperately trying to help each other to restore proper function. The somatic practitioner’s job is to help this process instead of participating in a war which rages only in the author’s imagination.
If our body operated on Mr. Alexander’s assumption about an imaginary war raging inside, we would have been swept from the face of the Earth at approximately the time of our primate ancestors the author already mentioned.
The most amazing part of the article is his list of references. Of seven references which are supposed to support the author’s theory, he quotes four of his own articles published in the previous issues of Massage Today. Aren’t there any other publications that agreed to publish this kind of information?
Searching for Trigger Points: Tips to Consistently Relieve Pain. Massage Today, August, 2014, Vol. 14, Issue 8
The article is dedicated to Trigger Point Therapy. The information discussed is partly correct. It guides practitioners to the basic ideas of how to find trigger points and treatment options. Unfortunately, the information in the article isn’t enough to achieve stable clinical results from Trigger Point Therapy. First of all, modern medicine sees trigger points as reflex zones formed in the skeletal muscles. We should abandon ideas of trigger points being simply local abnormalities. The clinical reality is much more complex and the involvement of the central and peripheral nervous systems in trigger point formation is a critically important factor for Trigger Point Therapy, and it isn’t mentioned in the article. Other important issues are also missing, like detection of the entrance into the trigger point before application of ischemic compression, etc.
Incorporating Energy Techniques into Massage Therapy Sessions. Massage Today, August, 2014, Vol. 14, Issue 8
The subject of this article is the application of Energy Techniques during a massage session. The article by itself provides very general and basic information, but the fact that this issue is discussed is very important. The application of Energy Techniques during a full-body therapeutic massage session is beneficial for clients, but it needs to be discussed before the session, since they are supposed to participate in the application of the technique.
However, for Medical Massage, the Muscle Energy Techniques are quintessential therapeutic tools. The only solution for the complete elimination of hypertonic muscular abnormalities is a combination of peripheral vasodilation achieved by ischemic compression and restoration of the muscles’ anatomic length, which is accomplished with Energy Techniques.
The Forgotten Rotator Cuff Muscle, PART IV. Massage Today, August, 2014, Vol. 14, Issue 8
A good article on homework exercises for the teres minor muscle.
Understand Shoulder Separation. Massage Today, September, 2014, Vol. 14, Issue 09
A very good and informative article!
Rehabilitation of the Breathing Process to Achieve Homeostasis. Massage Today, September, 2014, Vol. 14, Issue 9
Finally, the author correctly uses his Structural Integration. There is no doubt that such therapy will help patients with various pulmonary abnormalities, and Mr. McCann is correct in his treatment plan. We will only add that besides Structural Integration, local work on the respiratory muscles must be done in combination with Medical Massage in the areas of the pulmonary reflex zones.
MASSAGE & BODYWORK MAGAZINE
Validation Through Touch. Massage & Bodywork Magazine, Sept/Oct, 29-31
This article illustrates the desperate state some patients are in when they see a skilled somatic practitioner for the first time.
Postconcussion Syndrome. The Role of Massage. Massage & Bodywork Magazine, Sept/Oct, 40-43
A very good article. Even though Mrs. Werner’s articles are generally good, they frequently are missing teeth when the author addresses the massage treatment options associated with different abnormalities. This article is the most balanced piece so far, since it gives possible clinical choices for the massage treatment of Postconcussion Syndrome. The mention of face and head massage for these patients is an important piece of practical information.
Longissimus. Massage & Bodywork Magazine, Sept/Oct, 49-51
A good article on the anatomy, function and palpation of the longissimus muscle.
5 Short Stories About Muscle Tissue. Massage & Bodywork Magazine, Sept/Oct, 85-93
A funny and easy-to-read article about skeletal muscles with great illustrations.
Emily’s Nerve Traction Injury. Massage & Bodywork Magazine, Sept/Oct, 100-103
The article describes the complex case of shoulder and neck pathology developed as a result of trauma. The author correctly identifies that the clinical symptoms his client suffers from come from a combination of local trauma and peripheral nerve injury.
However, the treatment strategy discussed in the article doesn’t match the complexity of the described clinical picture. The only treatment option given to practitioners is different friction techniques. The successful treatment protocol should never be centered around friction techniques only. They are an important treatment option, but they are less effective when used alone. If, according to the described symptoms, there are signs of cutaneous reflex zones, why are they never even mentioned as a part of the treatment strategy? Why wasn’t the fascia targeted, since tension there will be one of the contributing factors to the overall clinical picture?
The Muscle Energy Technique must be used after the friction to help reset spindle receptors in the muscles which form such a complex biomechanical unit as the shoulder joint.
Another issue we would like to illustrate with this quote from the article:
“The traction injury Emily sustained to her brachial plexus and median nerve in her upper extremity is going to be more difficult to address. When a nerve has been overstretched, there is nothing that soft-tissue manipulation can do to the nerve to correct the stress.”
This is a completely incorrect assumption. Somatic rehabilitation has a variety of techniques to help inflamed nerves recover quicker and the therapist must use direct and reflex treatments to do that. Such a biased, bold statement as “there is nothing that soft tissue manipulation can do to the nerve” restricts the practitioner’s arsenal and discourages the therapist from using necessary treatments for desperate patients.
The Ankles and Feet. Massage & Bodywork Magazine, Sept/Oct, 104-105
A good article about anatomy and the biomechanics of the ankle joint and the foot.
Is the Knee a Dumb Joint? Massage & Bodywork Magazine, Sept/Oct, 107-108
This is a very good article if one evaluates the knee pain triggered by biomechanical dysfunctions of the hip joints or feet, especially in a physically active population. This is why the author and references used in the article examine knee pain in runners or physically active individuals. From this standpoint, the article puts everything in correct perspective.
Working With the Lumbars. Massage & Bodywork Magazine, Sept/Oct, 104-105
A good article about tension in the lumbar erectors, especially if the thoracolumbar fascia is affected. We think the discussed treatment options are helpful, but the article missed one critical point: to restore the elasticity of the thoracolumbar fascia, the lateral shift of the soft tissues at different levels must be applied. This is the only approach which allows the removal of even residual tension in the thoracolumbar fascia.
MASSAGE MAGAZINE
Fascial Stretch Therapy. Soft Tissue Technique Builds Flexibility. Massage Magazine, September (220): 48-53, 2014
A good article on stretching or what the author calls Fascial Stretch. It correctly emphasizes its benefits and body effects. The only problem we have with the article is that Fascial Stretch is discussed as only a treatment tool. As the author correctly mentions, the passive stretch is an important independent modality before and after training or competition. However, when the passive stretch is used as a clinical tool and applied alone, it doesn’t have enough clinical value to get to the bottom of the somatic abnormality and achieve stable results. It doesn’t matter what passive stretching is called. Overall, successful somatic rehabilitation is the result of an integrative approach rather than the application of one technique or method.
Also, what exact differences does the author see between Fascial Stretch’s illustrations in the article and the stretching part of Myofascial Release? They seem identical to us.
Medical Chair Massage. Massage Magazine, September (220): 54-58, 2014
Chair massage is an excellent type of bodywork, since it can be done in any environment. This article tries to explain how Medical Massage can be applied while the client sits in the massage chair.
Overall, it brings us to the core issue: what is Medical Massage to start with? The notion that Medical Massage is one specific technique or method is greatly erroneous. Medical Massage is a concept, and in such cases the practitioner must have full access to the body. Many key Medical Massage methods and techniques are simply impossible to conduct with the patient sitting in a massage chair. Yes, some limited treatment can be done in this position, but it simply isn’t enough. If the author just once saw a real Medical Massage session, he would never suggest using it in the sitting-on-the-massage-chair mode.
How Can I Incorporate Manual Muscle Testing Into My Practice? Massage Magazine, October (221): 34-35, 2014
The article is a response to the question posed, and the author correctly points out that manual muscle testing is a simple and informative test. It has to be part of every evaluation of every client before a proper treatment protocol is finalized.
With all due respect to Dr. George J. Goodheart, D.C., who is mentioned in the article, he doesn’t have anything to do with Manual Muscle Testing techniques. He used them in his work, but the testing itself is as old as manual medicine.
Vacuum Therapies. Mastectomy Recovery & Breast Reconstruction. Massage Magazine, October (221): 54-58, 2014
Vacuum therapy is a great treatment tool. Unfortunately, many educators sell it as the ultimate therapeutic modality, even though each somatic therapy has its own application niche. However, there are situations when vacuum therapy is simply an irreplaceable tool and nothing else can compete with it.
The article describes this exact situation, when after a radical mastectomy there wasn’t enough soft tissue left for breast reconstructive surgery. The successful vacuum therapy loosened the scar tissue, enhanced lymph drainage, stretched the remaining soft tissue and created the perfect condition for the reconstructive surgery. The article illustrates the power of somatic therapies. Thank you for the great article!
Myofascial Pain & Dysfunction. Understand the Role of Hypermobility Syndrome. Massage Magazine, October (221): 60-64, 2014
A very good article on Hypermobility Syndrome.
MASSAGE THERAPY JOURNAL
Body Mechanics. Overpronation. MTJ, 53(3):16-29, 2014
A very good, informative article with great illustrations.
Cold Stone Therapy for Migraine Headaches. MTJ, 53(3):62-67, 2014
A good article on treatment options for migraine sufferers. The aromatherapy part of the treatment protocol is the most questionable, because patients with a true migraine are very sensitive to any smell, even a healing one. Thus, this therapy must be used with extreme caution. The article suggests giving the client a vial with essential oil in it to find out if it is pleasant. It is much safer to use a piece of paper with a small drop of oil to test possible aromatherapy components first.
Massage Therapy for Osteoarthritis. MTJ, 53(3):76-89, 2014
This is a very large article which reviews causes, pathology and treatment options for patients with Osteoarthritis (OA). The general review of the subject is helpful for those who don’t know a lot about OA.
At the same time, this large piece is written for a professional audience, and when the article tries to address massage therapy as a treatment option, it falls flat. Besides general phrases, it doesn’t give the therapist any practical information he or she can use in the therapy room. There are two studies cited which showed that Swedish massage helps patients with OA. Massage therapy, especially in the earliest stages of OA, is a critical treatment tool which in combination with other modalities may save the patient from joint replacement and maintain quality of life.
For example, Periosteal Massage, which is specifically designed for the treatment of OA and other skeletal pathologies, wasn’t even mentioned in the article published by the main journal of the AMTA. The same goes for Cyriax’s friction applied at the insertion of the soft tissues into the periosteum around major joints.
Category: Good Apples, Bad Apples
Tags: JMS 2014 Issue #4
