MASSAGE & BODYWORK MAGAZINE
Small Intestinal Bacterial Overgrowth. Massage & Bodywork Magazine. May/June 2019
It is a good-to-know educational piece.
Anterior Elbow and Forearm. Massage & Bodywork Magazine. May/June 2019
This article is about the anterior elbow. Previously, in her columns, the author concentrated on the anatomy of the muscles and joints and their palpation. The author has now added ‘Dysfunction’ and ‘Intervention’ sections to her usual format. That is where her information starts to lose clinical value. In these new sections, the author approaches elbow pathologies only from the position of structuralism and incorrect body mechanics.
Yes, there is a possibility of that, but mentioning these factors as the only cause of anterior elbow abnormalities is an incorrect and unfortunate position. The structural changes described in the article are, in the majority of cases, a protective reaction the CNS develops in response to the real triggers, which weren’t even mentioned as possible factors.
For example, shortening of the flexors with periosteal trigger point formation in the medial epicondyle, mild irritation of the ulnar nerve by a degenerated cervical disk or a tense pectoralis minor muscle, etc., will trigger secondary abnormalities in the anterior elbow. Thus, pure structuralism is the professional dead end of somatic rehabilitation. It should be considered, but never relied on completely despite visible structural changes. The identification and elimination of the initial trigger is the only ultimate clinical solution.
Foam Rolling Research Demonstrates Increased ROM Without Detriment to Strength and Performance. Massage & Bodywork Magazine. May/June 2019
This article reviews the results of a clinical study examining the effect of self-care in the form of foam rolling. Indeed, it can be a very helpful homework tool for clients and patients.
Stretching the Neck. Massage & Bodywork Magazine. May/June 2019
A very good article on stretching in general and neck stretching in particular. We may only add that stretching clients with cervical pain must be done strictly within their comfort level. The therapist must establish the threshold of tolerance first and build the clinical response to stretching from this level up.
Structural Integration 2.0. Massage & Bodywork Magazine. May/June 2019
A very good review of Rolfing and its basic principles.
Dissecting Disk Pathologies. Massage & Bodywork Magazine. May/June 2019
This article is very good until it gets to the evaluation and treatment options for people with disk abnormalities. There are several very questionable and even ridiculous statements in the article:
- “Various physical examination methods, such as the straight leg raise test or slump test, are used in conjunction with clinical signs to suggest the likelihood of disk pathology.”
No! The Straight Leg Test confirms Sciatica, but it is not fully informative in regard to disk pathology, since it will also be positive in cases of Piriformis Muscle Syndrome, for example. In the same way, a Slump Test may be positive in a patient with disk pathology AND in a severe strain of the lumbar erectors or rotators without any disk pathology.
Yes, physical identification of disk pathology is challenging, but it is possible to at least rule out severe ones. The therapist must gently and additionally stress each disk separately and observe the patient’s response. Any changes, even faint ones, down from the vertebral segment tested confirm possible disk pathology. If the author is not familiar with such testing, it doesn’t mean that it doesn’t exist.
- “The most common locations for nerve root compression are anterior to the transverse processes of the spine.”
No! Nerve root compression happens not anteriorly to the transverse process but between two neighboring transverse processes. That is an important point, because it defines the evaluation and treatment protocol. The suggestion in the article will send therapists in the wrong direction.
- “Massage therapy cannot change the amount of disk herniation”
That is simply a ridiculous statement, because a correctly formulated and individually designed MM protocol is the last line of defense before spinal surgery. Ironically, the author recognizes this fact while he continues to make incorrect clinical recommendations.
Here is another quote from the article: “…disk pathologies involving herniations can spontaneously regress.” Why are they spontaneously regressing? Because inside the disk is a vacuum, and if there is a herniation without full cracking of the disk’s annulus fibrosus, the decompression of the skeletal muscles and fascia in combination with gentle vertebral segment manipulations by a DC lets the gel of the nucleus pulposus be sucked back inside the disk. That is why disk pathologies spontaneously regress!
The author is correct that such spontaneous regressions are a clinical fact. If they happen spontaneously, the therapist must at least try to use the correct MM protocol to save the patient from spinal surgery by decompressing the vertebral segment and letting the material slide back.
Even if the disk herniation doesn’t get smaller as a result of therapy, there is a great possibility (which our students observe regularly in their clinics while practicing MM) to increase the size of the spinal opening and maintain it. With monthly supportive sessions to decompress the affected vertebral segment, the disk will eventually dry out and natural fusion will happen. We briefly discuss this topic in the S-SPINE vs. J-SPINE: IS THERE ANY MERIT IN THIS DISCUSSION? PART II article in this issue of JMS.
- “The best guideline [to deal with disk pathologies by JMS] is to use gentle and soothing techniques.”
No! If therapists follow such a primitive treatment option, they will never be able to help their patients avoid spinal surgery. Yes, the therapist must be trained properly to formulate the correct treatment strategy to decisively help patients, but it is possible. That is what clinical massage is all about! It seems that the author lacks any comprehensive clinical solution on this critical topic. Why then write an article with inaccurate suggestions which only serve to further confuse therapists?
Tale of a Falling Star. Hip Osteoarthrosis May Force Tennis Legend to Retire. Massage & Bodywork Magazine. May/June 2019
The article is about Hip Osteoarthrosis (OA) management using Musculoskeletal Alignment Techniques (MAT). Just to be sure that we are all on the same page: if advanced symptoms of OA have developed, MAT, as well as other equally effective somatic methods like Myofascial Release or Muscle Energy Techniques, is buying time, and this is a very important aspect. Currently, the life span of a hip endoprosthesis is expected to be 15-20 years if the surgery was done without any complications. Thus, the proper integrative OA management program mentioned in the article allows hip surgery to be postponed until later in life. In such a case, the patient won’t face the necessity of another surgery at an age when any surgical procedure is much more challenging.
The Myofascial Stretch. Giving Your Clients Fascial Freedom. Massage & Bodywork Magazine. May/June 2019
Another article on stretching, this time on myofascial stretch. It discusses how to incorporate myofascial stretching into a regular session of Swedish Massage. Indeed, it will increase the effectiveness of stress reduction and additionally promote relaxation.
Mycoses Abounding. Massage & Bodywork Magazine. July/August 2019
This article educates therapists about different fungal infections as well as saprophytic fungi. It widens the therapist’s professional horizons.
Gastrocnemius. Massage & Bodywork Magazine. July/August 2019
A good article about the anatomy of the gastrocnemius and its palpation.
Massage For Young People With Cystic Fibrosis. Massage & Bodywork Magazine. July/August 2019
A very good article which discusses the results of a pilot study that examined the impact of clinical MT on the quality of life of patients with Cystic Fibrosis.
Manual Lymph Drainage in Hospice Care. Massage & Bodywork Magazine. July/August 2019
This is an excellent article, and JMS considered itself lucky to publish a three-part article written by John Mramor, which was very well received by our readers. If you would like to study this clinical subject in more detail, please use these links to John’s three-part article published in JMS:
MANUAL LYMPH DRAINAGE AS A SUPPORTIVE THERAPY IN THE MANAGEMENT OF ASCITES
MLD FOR ASCITES SYMPTOM MANAGEMENT. PART II
MLD FOR ASCITES SYMPTOM MANAGEMENT. PART III: MANUAL LYMPH DRAINAGE PROTOCOL
The Many Meanings of Preparation. Massage & Bodywork Magazine. July/August 2019
This article discusses the psycho-emotional aspects of Rolfing. It would be of interest to Rolfers or therapists who consider that aspect of bodywork.
Uncricking the Neck. Massage & Bodywork Magazine. July/August 2019
This article is dedicated to tension in the levator scapulae muscle. There are some good points, but there are several mistakes in the article. It is complete nonsense to claim that 80-90% of cases of what the author labels a ‘crick’ in the neck, when the client is unable to turn the head without pain, are due to acute spasm in the levator scapulae muscle. This condition can be triggered by a variety of causes, from disk abnormalities to irritation of the cervical plexus by the anterior scalene muscle.
It is ironic, but the video and picture illustrations of the suggested treatment provided in the article don’t fully target the levator scapulae muscle, but rather the scalene and trapezius muscles. From a technical perspective, the best way to approach the levator scapulae muscle is with the patient/client positioned on the stomach. With the patient positioned on the back and the head turned to the opposite side (as suggested by the author), the therapist is able to address only very small parts of the levator muscle (at the insertions into the transverse processes), while the muscle belly, where the main tension is located, remains unreachable.
Another critical factor is that the levator muscle must also be treated at its insertion into the upper medial angle of the scapula through the fibers of the trapezius. This is why it is called levator to start with. That critical part of the therapy is not even mentioned and is impossible to conduct with the patient positioned on the back.
Bicipital Tendinopathy. Massage & Bodywork Magazine. July/August 2019
Everything is correct in this article about pathology and even possible treatment options. However, we have a real problem with the author’s description of cross-fiber friction application, which is indeed a very helpful tool to address tendinopathy in any location.
In the article, the author expressed concerns that the application of cross-fiber friction may dislodge the biceps tendon from the bicipital groove during intense cross-fiber frictions. To avoid damage to the transverse humeral ligament and prevent tendon dislodging by cross-fiber frictions, the author suggests using friction along the fibers.
However, the clinical productivity of longitudinal friction is much lower than that of cross-fiber friction, even though longitudinal friction is always used prior to cross-fiber friction application. Thus, it is complete nonsense to recommend the application of longitudinal friction instead of cross-fiber.
Also, it is obvious that the author is not familiar with how to apply cross-fiber friction correctly, and that causes his concerns about tendon dislodging. Before the application of cross-fiber friction on any tendon or ligament, these anatomical structures must be stabilized in the tissue by the other hand first. With such a simple but effective approach to cross-fiber friction, the therapist is never going to dislodge the bicipital tendon from the groove, and cross-fiber frictions can be easily implemented.
Enhancers in Action. Massage & Bodywork Magazine. July/August 2019
A very good article on cervical work.
MASSAGE TODAY
Tendon Damage: The Role of Massage Therapy in Recovery. Massage Today, 19(6), 2019
This article is about tendon damage and MT as a treatment option. The main clinical tool mentioned in the article is cross-fiber friction on the affected tendon. However, for a correct treatment strategy, it is not enough. Treatment of the tendon pathology is not clinically effective if the therapist doesn’t decompress the soft tissues (fascia, muscle) that are the engines of the pressure exerted on the tendon. Also, treatment of the tendon’s insertion into the periosteum is another critical component of the therapy, which wasn’t mentioned either. Suggesting cross-fiber friction as the only treatment tool greatly diminishes the clinical value of the article.
Exploring Torque and Rotary Motion. Massage Today, 19(8), 2019
This article presents soft tissue strain and overload from the viewpoint of pure structuralism. Of course, structuralism matters, but as we learn more and more about the complexity of relations between somatic tissues, such mechanistic views become very questionable. Based on the latest scientific data, we can say that it is obvious that structuralism no longer reflects the full clinical reality. We need to stop promoting this one-sided and narrow view of somatic pathologies. It is a grave mistake to continue to apply the rules of engineering, which are designed for inorganic matter and solid structures or machinery, to living tissues. Current scientific data paints a much more complex chain of events in the human body beyond torque, rotation or bipedal locomotion, and we need to adjust our views, practice and educational principles accordingly. We highly recommend that our readers pay attention to Dr. Sharkey’s article ‘Biotensegrity – Anatomy For The 21st Century’ in this issue of JMS. The author of this article and Dr. Sharkey are on opposite ends of the science of somatic medicine, with the author unfortunately lagging behind.
Integrative Approaches to the Hand’s Health. Massage Today, 19(8), 2019
This article covers some basic aspects of hand pathologies. However, it is technically impossible to discuss such a complex issue as hand abnormalities within a small format (2 pages). We think it would have been a much better piece if the author had dedicated the article to one topic instead of jumping between different pathologies. It made the article slightly chaotic.
MASSAGE MAGAZINE
Myofascial Trigger Point Therapy. Massage Magazine, July (278), 2019
A good article which reviews the basic principles of Trigger Point Therapy.
Elite Sports Therapy. Massage Magazine, July (278), 2019
It is a very helpful article for therapists who work on cyclists or who are cyclists themselves. It covers the most common areas of pressure and injuries associated with this sport.
Category: Good Apples, Bad Apples
Tags: JMS 2019 Issue #3
