The purpose of this section of the Journal of Massage Science 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.
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
Treating Headaches with a Cranial/Structural Solution. Massage Today. October, 2015, Vol. 15, Issue 10
By Don McCann, MA, LMT, LMHC, CSETT
It’s time for a celebration! Finally Mr. McCann gets it after years of criticism. For the first time in his normally purely promotional articles we see clinical sense. The therapist should find and target the immediate trigger for the pain and other uncomfortable sensations before addressing any postural and structural changes.
The Sub-Scap Attack. Massage Today. October, 2015, Vol. 15, Issue 10
By Debbie Roberts, LMT
A very good case study which shows the author as a thinking clinician.
Lymph Balancing and the Body’s Internal Water Environment. Massage Today. October, 2015, Vol. 15, Issue 10
By Bethllen Zang, LMT, AHE, CNC
A good introductory article on Lymph Drainage. It is helpful for those who are not familiar with the subject.
TDR Massage: A Case Study of Facial Fasciculations. Massage Today. October, 2015, Vol. 15, Issue 10
By Linda LePelley, RN, NMT
Great news for therapists since the author finally stopped her proliferation of para-scientific theo-ries about the origin of increased tension in the soft tissues. It made our life significantly easier. The current article correctly identifies tension built up in the area of the mental foramen on the lower jaw and indeed it may irritate the mandibular division of the trigeminal nerve. Despite that the function of the mimic muscle is under the control of the facial nerve, the chronic irritation of the trigeminal nerve, which is a sensory nerve by its nature, may trigger muscle secondary fasciculation of the mimic muscles.
However, there is no need for TDR as a new and separate modality. What the author sells to therapists as a new treatment option is simply re-packaging old ideas and therapies in a simplified form, which is unfortunate from an ethical point of view.
No Pain, No Gain and Its Effects on Our Clients. Massage Today, November, 2015, Vol. 15, Issue 11
By Marie-Christine Lochot, LMT
This article itself is very simple but the author deserves credit for raising the question of unnecessary activation of the pain analyzing system, which some therapists provoke and sometimes even rave about it.
Maybe That’s Not Tennis Elbow. Massage Today, November, 2015, Vol. 15, Issue 11
By Whitney Lowe, LMT
What’s good about Mr. Lowe is that he learns from friendly critique. We’ve observed definite improvements in the quality of his articles. This article about the clinical picture of Tennis Elbow mimicked by Radial Tunnel Syndrome is a great example of this tendency. The author uses correct references and in his articles he finally starts to sound like a clinician.
Pain Chasers vs. Pain Solvers. Massage Today. December, 2015, Vol. 15, Issue 12
By Debbie Roberts, LMT
We think every massage therapist owes his or her patients/clients the answer to a very simple question raised in the article: Am I a Pain Chaser or Pain Solver? Thanks for the very informative article and its great title!
TDR to Facilitate Venipuncture. Massage Today. December, 2015, Vol. 15, Issue 12
By Linda LePelley, RN, NMT
Every attempt by the author to inject theory in her articles usually ends up in disaster. Unfortunately, this piece follows the same pattern. If the author stayed with massage therapy as a way to ease venipuncture she would be fine. However, she decides to weigh in on pain theory under the modest subtitle, “My Perspective on Pain.” Here is her main, “profound” thought:
“…I have consistently and repeatedly found that tissues which are in a state of pain are associated with a palpable elevation in their density, referred to as Elevated Tissue Density (ETD).”
This quote is such nonsense that it is not even worth discussing, but Mrs. Le Pelley’s para-scientific inventions must be challenged otherwise she will use a national publication to mislead therapists.
We would like to ask the author about phantom pain which she should know about if she is an RN. How can phantom pains be explained by her statement? Another example is radiation of pain along the irritated or compressed nerve. How can someone with a medical education explain such a complex psycho-somatic phenomenon as pain by the simple fact of increased soft tissue density? By the way, there is no such thing as “Personal Perspective of Pain” since there is only one correct perspective and this perspective must be based on science, which the author is lacking.
Pediatric Massage: A Collaborative Approach with Occupational, Physical and Speech Therapy. Massage Today. December, 2015, Vol. 15, Issue 12
By Tina Allen, LMT, CPMMT, CPMT, CIMT
The integrative approach to any somatic abnormality is the only correct clinical solution. This article emphasizes that and the author deserves credit for building bridges between different professions. However, from a massage therapy perspective the information in the article is very basic and doesn’t give readers a lot to work with.
MASSAGE&BODYWORK MAGAZINE
Finding “Normal” – A Moving Target. Massage&Bodywork Magazine, Sept/Oct: 28-29, 2015
By Douglas Nelson
As usual, a very good piece in a reader friendly form that delivers important theoretical and clinical concepts of what is “normal.”
Popliteus. Massage&Bodywork Magazine, Sept/Oct: 45-46, 2015
By Christy Cael
A good article on anatomy, function and palpation of the popliteus muscle.
Massage Therapy for Cardiac Surgery Pain. Massage&Bodywork Magazine, Sept/Oct: 48-51, 2015
By Jerrilyn Cambron
A good review of recent studies that have examined the effect of stress reduction massage for the patient after cardiac surgery. It can be used by therapists as a reference source. All studies cited used basic massage as a clinical protocol. Even these basic soft tissue manipulations showed positive clinical outcomes.
It is sad, but no one is using MEDICAL MASSAGE PROTOCOLs developed for cardiac rehabilitation. These protocols, for example Pericardic Massage, use local and reflex mechanisms of massage therapy to speed up the patient’s recovery after cardiac surgery or heart attack.
Miserable Malalignment Syndrome. Part 1. Massage&Bodywork Magazine, Sept/Oct: 96-99, 2015
By Whitney Lowe
This article explains the nature and mechanisms behind Miserable Malalignment Syndrome (MMS). From reading the article one will get impression that MMS is a common medical condition which therapists should be aware of. Let’s move from Internet posts to the medical science.
If one types “Miserable Malalignment Syndrome” into the world medical database of medical articles (pubmed) he or she will get 1 (!!!) reference. In contrast, typing “Carpal Tunnel Syndrome” into the same database will give 9112 medical references from all around the world. Thus it is even questionable if MMS is an actual disorder rather than several abnormalities linked together by the pathological changes in the biomechanical pattern due to the initial trigger. While readers should keep MMS in the back of their minds, they may disregard it as an issue they need to be aware of.
Race Walking and Shin Splints. Massage&Bodywork Magazine, Sept/Oct: 100-101, 2015
By Erik Dalton
A good article on shin splints and their connection with repetitive exercise (race walking, elliptical machines, etc.).
Vertebral Mobility. Massage&Bodywork Magazine, Sept/Oct: 106-109, 2015
By Til Luchau
Overall this is a very good article with the correct presentation of the theoretical concept and its clinical applications. The only thing we have a problem with is taking decades-old existing treatment techniques and renaming them for marketing purposes.
The Master Volume Switch. Massage&Bodywork Magazine, Nov/Dec: 26-27, 2015
By Douglas Nelson
A very good article which uses simple examples to illustrate the role the brain plays in somatic pathologies.
Iliocostalis. Massage&Bodywork Magazine, Nov/Dec: 41-42, 2015
By Chisty Cael
A good article on the anatomy, function and palpation of the iliocostalis muscle.
The Painful Truth. Helping Clients Manage Chronic Pain. Massage&Bodywork Magazine, Nov/Dec: 90-95, 2015
By Mark Liskey
The article presents five types of pain behavioral models patients may use to cope with chronic pain. Readers may find it a little boring but in reality this is first time we’ve seen this information available in any massage therapy source. It makes its publication a precious gift to therapists.
Why it is so important? For the practitioner to be clinically effective he or she must employ all possible tools. One may take all the necessary classes, do everything correctly and still have limited effectiveness. To get as much as possible from the therapy session the therapist must engage the patient’s brain. However, its activity is greatly affected by chronic pain and this is why the therapist must understand with what type of patient he or she works.
The article fills this gap. The brain of every patient reacts differently to chronic pain. Each model discussed in the article is a protective reaction of the brain to the chronic pain and understanding each of the models is the first step in introducing the so called ‘placebo’ effect into the treatment routine for the patient’s benefit.
To do that the therapist must adjust HIS or HER behavior to the type of psychological reaction the patient’s brain developed as a response to the chronic pain. For example, in the fear avoidance type of behavior the patient focuses on chronic pain and the brain develops a fear of pain and especially, any additional pain. Let’s imagine a hypothetical therapist who correctly identifies the cause of the pain and is ready to move in to try to help the patient. However, he or she doesn’t realize that the patient has fear avoidance type of behavior and during the first session the therapist starts to apply Ischemic Compression in the areas of active trigger points or use deep tissue massage. At this moment the therapist is done. The patient will never trust him or her and all efforts will go to waste since the fear of any additional pain will block any treatment. This is why identifying the type of behavior associated with chronic pain in each new patient is such an important first step in the successful somatic rehabilitation.
We would like to emphasize this article discusses the patient’s reaction to chronic pain. It means that the therapist shouldn’t chase the pain but find its initial trigger first. However, while doing that, the patient’s behavior pattern must be considered. Thank you for an exceptionally important piece!
Miserable Malalignment Syndrome Part 2. Massage&Bodywork Magazine, Nov/Dec: 98-101, 2015
By Whitney Lowe
In this article the author acknowledges that “MMS is a complex biomechanical pattern with numerous challenging components.” This is an exactly correct statement since MMS is a pattern rather than a separate pathological condition. Having said that, let’s get back to the article itself.
Since MMS is a pattern rather than a specific pathological condition, the author tries to fix the pattern with what looks like a random set of techniques. These techniques can be used as a part of therapy but the author presents them as the ultimate solution for this or that issue associated with MMS. This is a completely incorrect vision of somatic rehabilitation and the entire treatment strategy discussed in the article looks childish. The pattern can be fixed only with an integrative approach to the somatic rehabilitation which finds and addresses the initial trigger while randomly assigned techniques won’t help.
Stomach-Sleepers’ Headache. Massage&Bodywork Magazine, Nov/Dec: 98-101, 2015
By Erik Dalton
This article explains how those who sleep on the stomach can get a headache, especially in the distribution of the trigeminal nerve. However, the article explains the headache mechanism only in this limited group of patients. In clinical reality, the majority of patients with occipital headache eventually develop so called ‘cluster’ headaches around the eye which is again within distribution of the trigeminal nerve.
Headache in these patients is triggered by occipital-trigeminal convergence. In such cases the headache therapy requires complete elimination of the tension in the suboccipital muscles including not only the obliquus capitis inferior muscle mentioned in the article but even more importantly, the obliquus capitis superior muscle. This muscle needs to be worked directly and it holds the key to the occipital-trigeminal convergence.
In regard to the therapy option discussed in the article, the therapist who uses only the so called indirect techniques shown flies with one wing since the direct therapy on suboccipital muscles is an equally important component, a detail completely missed in the article.
Working With the Sacrum. Massage&Bodywork Magazine, Nov/Dec: 108-109, 2015
By Til Luchau
At the beginning of this article the author discusses how to work with scrum and he describes ‘The Pelvic Lift Technique” developed by I. Rolf. This is an excellent treatment tool which has proved its clinical effectiveness for decades now. However, it seems the author would like to improve the technique, offering to the therapist his own treatment option under a very poetic name – “Floating Sacrum Technique.” According to the author the advantage is that it is a “… less directive, listening-based version.” However the description of Mr. Luchau’s floating sacrum shows that what Ida Rolf wanted to achieve clinically, he successfully eliminated.
This article is great example of Mr. Luchau’s overall educational strategy. Instead of saying, “This is the result of my pure imagination but I guarantee that floating sacrum will solve your clients’ problems,” he needs validation. So, he takes an existing technique or modality and twists or changes it, without any data that it actually works. Then he attaches the technique back to the author whose name Mr. Luchau used to give his questionable recommendations some validity. So in the minds of some therapists Mr. Luchau has further developed and improved Rolf’s technique, while in the real world he has taken out all its clinical essence.
MASSAGE MAGAZINE
Active Isolated Stretching. Massage Magazine, October, 223:40-45, 2015
By James Graffenberg LMT, CPT
This article gives a very good overview of Active Isolative Stretching. There is no doubt this modality is a helpful clinical tool. Our concern is that therapists who practice it see it as the ultimate solution, which is an incorrect vision of somatic rehabilitation.
In the article the author claims that AIS promotes full range of motion in muscles and fascia. Unquestionably, AIS will stretch the short muscle but by its nature this method has very limited impact on the fascia. Considering that for full somatic rehabilitation, superficial and deep fascia must be worked on separately using unique technical approaches (e.g. Connective Tissue Massage, Myofascial Release, etc.), the application of AIS alone has much more restricted clinical potential.
In conclusion: learn and practice AIS but combine it with other modalities which target skin, fascia, periosteum and reinforce somatic rehabilitation using reflex mechanisms along with reciprocal inhibition which AIS actively uses.
Orthopedic Massage, Massage Magazine, October, 223:40-45, 2015
By Boris Prilutsky
This article is a good introductory overview of post-event sports rehabilitation using Orthopedic Massage.
MASSAGE THERAPY JOURNAL
Table Mechanics. MTJ, 54(4): 21-32
By Joe Muscolino
We agree with the majority of information in this article. It reviews correct body mechanics and it is well illustrated. However, we strongly disagree with one of the key points – the height of the massage table the therapist should use. Here is a quote:
“The general guideline when using thumb/fingers/palm is to have the top of the table at or just below the level of our knees. For elbow/forearm contacts, it can be mid-thigh.”
This “general guideline” works great for chiropractors, but it will kill the massage therapist’s back. Yes, the therapist needs to use body weight. Yes, he or she must lean against the patient’s body. Yes, the therapist needs to lean on the table and so on, but a table so low can be used only for the compression type strokes. We would like the author to try the application of kneading or even simple lymph drainage strokes from the table height recommended in the article. It’s simply impossible to do productive work without fear of injury.
In the article the need for a higher table is recognized but the author suggests its usage “…when light work is being done.” Since there is also a statement that there is
“…increased popularity and recognized effectiveness of deep tissue/deep pressure work among therapists who choose to do clinical orthopedic work…”
it sounds like “light” work is not clinical or less effective than “deep” work. We would like to address this issue separately.
Deep tissue work isn’t a separate modality. It is a small part of the medical/clinical massage session which targets proper rehabilitation of the soft tissues. In such case the “clinical orthopedic work” must include light, medium and deep pressure depending in what level of the soft tissues pathological changes are located. Here are two everyday clinical situations we face in our clinics:
1. The patient has a tingling sensation on the leg and top of the foot. The Medical Massage therapy requires work on the origin (lower back) and at the leg/foot using local therapy. To address the area of tingling with local therapy, the main therapeutic tool that must be used is superficial friction. Considering superficial friction targets only the skin, how is it possible to apply it safely with table knee high?
2. Another scenario is tension in the superficial fascia which requires the application of Connective Tissue Massage or Myofascial Release. Again the therapist won’t be able to use both of these critically important methods of somatic rehabilitation with the recommended height of the table.
While a knee or thigh height table is ideal for chiropractors, it is completely unusable for massage therapists by the nature of their profession, since it makes application of many of their unique tools impossible.
The author is completely correct when he suggests electric tables since they are the best professional investment. Yes, indeed the platform recommended in the article can be used for the application of vertical compression, but this is only a small part of Medical/clinical massage.
If massage therapists want to continue practicing the unique aspects of the massage therapy profession, they have to keep the table height at the level of a straight arm with the fist slightly touching the table
The Right Touch. MTJ, 54(4): 41-44
By Ian McCafferty
This article correctly explains and recommends treatment options using massage therapy for patients with Fibromyalgia. We have an issue only with the theoretical part of the article where it is stated:
“recent research suggesting fibromyalgia may be a central nervous system disorder..”
First of all, this is very old research. Based on these early findings entire treatment protocols with various medications which addressed the brain function were developed and continue to be currently implemented. The references in the article just illustrated the same school of thought and nothing new was said there.
Let’s think logically. If Fibromyalgia is a pathology of the central nervous system we should have defeated it long ago with modern medications that correct brain function. Unfortunately, Fibromyalgia continues to spread like wildfire. Considering the failure of the concept that Fibromyalgia is a CNS disorder, scientists in the most respected medical institutions started to examine other potential triggers and at this point we have undoubted proof that one of the major initial causes of Fibromyalgia is in the skeletal muscles.
As several clinical trials confirmed, the fragmentation and diminishing number of mitochondria in the skeletal muscles is the initial trigger of Fibromyalgia (Sprott et al. 2004) with changes in the concentration of neurotransmitters and their interaction as a secondary outcome of the “energy crisis” which develops in the muscles affected by Fibromyalgia.
REFERENCES
Sprott H., Salemi S., Gay R. E., Bradley L. A., Alarco ́n G. S., Oh S. J., Michel B. A., Gay S . Increased DNA fragmentation and ultrastructural changes in fibromyalgic muscle fibers. Ann Rheum Dis. 2004 Mar; 63(3): 245–251.
Treating Fibromyalgia: What The Research Tells Us. MTJ, 54(4): 46-47
By Martha Brown Menard, PhD, LMT
This article reviews the results of a study where Swedish Massage was tested as a treatment tool for patients with Fibromyalgia. The article and results of the study may be used by therapists to support their therapy
MS – Fighting Back With Massage. MTJ, 54(4): 54-69
By Marcella Durand
A great review article which touches the issue of Multiple Sclerosis from many aspects, including massage therapy. We highly recommend it to therapists.
Category: Good Apples, Bad Apples
Tags: Issue #1 2016