Summer 2018 AMTA Iowa newsletter
Summer 2018 AMTA-IA newsletter
A note from the new president of AMTA-IA chapter
Hello Chapter Members,
I am humbled and honored to serve as your AMTA-IA President for the next two years. I look forward to what the next two years has to offer and can’t wait meet as many of you at conventions as possible. One of the top priorities once again will be to keep the members informed about not only what is going on at the state level but trying to keep ahead of the ordinance problem we are having at the city level. One of the things that I would really like to work on is getting you the therapist involved. Whether it be by going to city council meeting and keeping the board and the membership informed about what is happening in your area or just simply listening to your ideas or concerns.
I have been on this board for almost 8 years now and have a new appreciation of what it means to volunteer. I have meet some of the best people I know being on this board and enjoy meeting members at the conventions. I have been a massage therapist since 2003 and have a private practice and have had the honor of being a massage therapy educator in Johnston, IA. My main area of focus is on therapeutic massage specializing in trigger point therapy and stretching. I look forward to meeting as many of you as I can, and please feel free to discuss any ideas or concerns you might have. I have been an AMTA member ever since I became a massage therapist and enjoy working for our members.
Thank you for being a member of the most trusted and respected name in the profession – AMTA.
Yours in service,
Greetings. I’m Karen Sindelar, a newly elected board member to the Iowa Chapter of the AMTA. I am honored to be a part of this thriving organization. I am the new Education Committee Chair, so I will help you with your continuing education questions for license renewal. I look forward to meeting you at our conventions, and am willing to visit massage schools around the state to share all the benefits that AMTA has to offer with our newest members. (Please feel free to contact me to set up a time to visit your school.)
I love the many continuing education choices our state convention offers. As an avid reader, you may catch me studying the materials from our past convention instructors. When I’m not an LMT, I enjoy being outdoors – traveling, camping, canoeing or just grilling with friends in our backyard. I also coordinate healing touch and aromatherapy certification courses in Eastern Iowa that provide continuing education for nurses and LMTs.
AMTA-IA Board Member
Happy Summer everyone!
I have been working on future convention and speakers. The following is the dates and location we have booked. Please watch our facebook page for the announcements of the speakers as contracts are approved by Nationals.
The fall 2018 convention will be on September 8-9, 2018 at the Grand Harbor in Dubuque.
Our Speaker will be the one and only LEE STANG!!
Lee Stang, owner of Bridges To Health Seminars has been teaching massage since 1996. She taught in the massage school environment for 17 years at the CT Center for Massage Therapy specializing in anatomy and physiology, orthopedic and sports massage. She is certified in orthopedic massage and teaches within the OMERI program. As well she has been bringing her Bridges To Health Seminars to a national audience since 2006, most recently the AMTA National Convention in Pasadena.
Lee currently travels with the Women’s Tennis Association bringing massage to elite professional tennis players throughout the world as a member of the Sports Science and Medicine Team. She has been on the numerous Sports Massage Teams at the Olympics and Paralymics and traveled with the US National Powerlifting Team.
A NCBTMB approved provider Lee’s focus is to provide theory and techniques that can be immediately incorporated into ones practice. Orthopedic massage and movement technique, passive and active, are the foundation of all Bridges To Health Seminars. Feedback from seminar goers is that these seminars are informative, dynamic and provide tools today that can be used tomorrow to make a massage practice more dynamic.
Spring 2019- March 16-17th 2019 at Prairie Meadows in Altoona IA
I encourage everyone who is coming to either convention to make your hotel reservations as soon as you receive the brochures as rooms fill very fast!!!
Have a great Spring
AMTA-IA Board Member
Hi! My name is Cynthia Haack (aka: Cindy) I am your Awards Chair on the AMTA – Iowa Chapter. Our spring convention at the Doubletree Inn, in Cedar Rapids, turned out to be a success even though “Mother Nature” tried to through a wrench in our plans!
I’d like to congratulate the following people for their contribution to making our Iowa Chapter one of the Best Chapters of our profession…..
Subbu Varanosi – Good Humor Award
Robert Campbell – Involvement Award
Ken Swenson – Beacon of Light
Pam Burnikel – Financial Planner
I would like to give a special “Thanks” to Sandy Anderson, Sandra Black, Pam Burnikel, Kathy Lutz, Robin Markus, Bill McCarter, Ken Swenson, Jeanna Tellin, & Soraya Wagner for participating in our 2017 Veterans Day Appreciation.
If you would like to find out more about how you or another active massage therapist can receive an award please contact me.
I’d be happy to help in any way I can! When I’m not working as a LMT, in Waverly, I love spending time with my family and furry kids! Camping, boating and any outdoor activity keeps us busy and connected! I am looking forward to seeing you at our fall convention in Dubuque. Have a great spring and summer!
AMTA-IA awards chair
Hello everyone!!! My name is Soraya and I hold the membership chair for our Iowa AMTA state chapter. I hope this bubble of warmer weather is treating everyone well. I know I can hardly wait to play in the dirt and get some flowers potted and soak up some much needed vitamin D!
Our numbers are on the rise again and continuing to grow. We now have a total of 912 AMTA members in the state of Iowa. Ya! I’m hoping that if we all help spread the word we will hit 1,000 a year from now. If you have any questions please feel free to visit our new website or contact me directly at email@example.com.
Another reminder to make sure you all mark your calendars for fall convention held in September in Dubuque. Help spread the word to all massage therapists both members and non members. Can’t wait to see you there!
Soraya Wagner LMT LNT
AMTA-IA Membership chair
Hello my name is Pam Burnikel.
I’am currently the financial administrator for the Iowa AMTA Chapter. I help plan the budget for the up coming year. I am responsible for paying all bill of the chapters bills. If you ever have any questions, or need any help in anyway, please feel free to contact me at firstname.lastname@example.org.
In my down time love to spend time with my family and friends. With a family our size things get a little crazy. I have four children, I have 11 grandchildren and 2 great grandchildren.
See you all in the at the September convention.
AMTA-IA Financial Administrator
AMTA IOWA CHAPTER
Double Tree by Hilton
Cedar Rapids, IA
March 24, 2018
1. Call to order:
President, Ken Swenson called the meeting to order at 1:10 PM. He welcomed everyone to our Spring Convention. He then went on with the approval of the agenda. With no additions or corrections the addenda was approved as written.
President – Ken Swenson, Board member – Holly Rasmusson, Financial Administrator–Pam Burnikel, Secretary – Jeanna Tellin, Membership Chair- Soraya Wagner, CSMT Team Chair-Robert Campbell, Awards Chair- Cindy Haack, Convention Events Chair/ Delegate -Robin Markus. Delegate- Keith Kowal, Alternate Delegate- Karen Sindelar.
3. Absent: Board Member – Zachary Flick.
4. Approval of Minutes:
Secretary, Jeanna Tellin submitted the minutes from the September 9, 2017 Business Meeting for approval.
President, Ken Swenson asked the membership for the approval of the minutes. Melissa Cantele MADE A-MOTION to approve and Emily Pirkl SECONDED-MOTION- CARRIED. The minutes were approved as written.
5. Commission on Candidacy/Officer Delegate Election:
Ken explained the election of officer’s process to the membership as it had changed. He then explained the Commission on Candidacy. This helps us to explore the candidates further. There are 3 chosen people, Soraya Wagner, Robin Markus and Alex Collins reviewed. They are all in good standing with the AMTA. Ken talked about their resume’s that need to be submitted 14 days before our business meeting. The resumes can be found in the AMTA IA Chapter Newsletter.
The people running for this year’s election, with no one running against are: President- Robert Campbell, Board member-Karen Sindelar. Secretary-Jeanna Tellin and Delegate- Keith Kowal. He went on to ask someone to make a motion to have this election by acclimation. Jolene Melver MADE –A- MOTION and Erika Dorher Smith SECONDED-MOTION –CARRIED.
6. Reports of Officers:
6A. President – Ken Swenson:
Ken thanked everyone for their support the past 4 years. He said it’s been a pleasure serving as your president. Ken thanked all the volunteers for making the Iowa Chapter great and for being known nationally for helping over the years.
He thanked everyone again for the chapter and for himself.
6B. Board Member – Holly Rasmusson:
Holly thanked everyone for coming. She wanted to acknowledge all the first timers with us for the weekend.
Holly announced upcoming conventions;
September 8-9, 2018 at Grand Harbor Hotel and Waterpark – Dubuque IA.
March 16-17, 2019 at Prairie Meadows- Altoona IA.
Presenters TBA. Watch our Facebook Page and the Newsletter for announcements on Presenters.
Due to the weather Cassie Sampson could not be here today. Holly then directed the membership to check out our Facebook page with a Cassie Sampson video explaining a pamphlet in our bags at registration. Answering questions about the Iowa Massage therapy board can and can’t do.
Holly went on to talk about the pizza social and give aways tonight.
6C. Financial Administrator – Pam Burnikel:
Pam shared that Nationals says we are once again a very stable Chapter.
The balance as of February 28, 2018 is $122,089.20.
Pam then went on to explain the budget. In January the Board approved it and then National approved the budget. We do not have to have the membership approve the budget. If anyone has any questions Pam would be available to answer them.
Pam announced we have several attendee’s that have reached 25 years with AMTA. These members will receive $1000 help to go to National convention in Washington D.C this year if they chose to go. Those people need to see her.
7. Reports of Committee Chairs:
7A. Membership Chair- Soraya Wagner:
Soraya announced as of March 2018 we have a total of 908 members. That is up from January 2017 with a number totaling 872.
She went on to talk about honoring people having 25 years with AMTA.
7B. IA-CSMT Team Chair – Robert Campbell:
Robert shared on February 7th the CSMT sponsored an event at the State capitol to help promote Massage Therapy to the legislation of the Iowa Congress. Thirteen therapists met at the capitol to provide chair massages and educate the legislators and the general public how beneficial massage is and why regulation for our industry is needed. They massaged 7 legislators and 33 people who were not legislators for a total of 40 people. They had at least 2 legislators that didn’t have time to stop and get a massage or who came after the event and asked questions about our pressing legislative concerns and goals as an industry.
Bob said the day was a great success and he would personally like to thank:
Advocacy Strategies, Mindy Ceaser, Emily Bauler, Rachel Regenold, Rachel Brown, Tami Linn, Becky White, Kevin Peterson, Tisha Knight, Subbu Varanan and Jill Ellsworth. A special thanks to Cassie Sampson who organized this event for us. Bob encouraged everyone to speak up in your own community about illicit businesses, prostitution and human trafficking. Pay attention to your city council meetings. Education is the key.
Another event Bob talked about was the November 11th Veterans Day Event at the Centre in Waverly. This event is done nothing but grow in the 7 years that the CSMT Event has been sponsoring the event. He would like to personally thank Cindy Haack for her setting up this event each year and the volunteers who make this event exceptional each year. Giving your time at events like these are what make this industry truly remarkable. He say’s our job is never done. There will always be groups that need our help and organizations who need our efforts. He looks forward to working with everyone in future events that the team decides to participate in.
Bob then told everyone we will be doing a nonperishable item collection at every fall convention now. Receiving $10 vendor bucks in return.
7C. Awards Chair- Cindy Haack:
Cindy mention the awards box at the awards booth and how to nominate someone who needs appreciation for going above and beyond.
Veterans Day Appreciation will be held on Sunday, November 11, 2018 at The Centre from 8a.m. – 2 p.m. Cindy thanked Sandy Anderson, Sandra Black, Ken Swenson, Pam Burnikel, Jeanna Tellin, Robin Markus, Soraya Wagner, Kathy Lutz, Bill McCarter for helping at this event November 11, 2017. Cindy awarded key chains for their great help.
This year HyVee will be serving breakfast at The Centre as well so that it won’t interfere with their Sunday breakfast crowd. They will be in the back half of the building and we will have our event in the front half.
Cindy and Soraya handed out to Geri Chamberlin and Pebble Doss for their 25 years. Cindy then gave out awards.
Beacon Of Light – An active AMTA Chapter member who is a leading role model of giving back to the massage profession, helping new members feel welcome and chapter events and goes above and beyond expectations.
This person is an extraordinary leader, fantastic camera man in capturing the new skills that our presenters are showing us, and represents our Iowa Chapter with great Integrity and Moral Stature. He truly is OUR Beacon of Light! She presented this award to Ken Swenson OR as he puts it “Son of Swen”
Financial Planner with Calculator:
Our Financial Administrator is a huge part of making our chapter run smoothly. Pam is in charge of our yearly budget, keeping track of expenses, mileage, reimbursements, and all convention costs. So to help keep her job running smoothly Cindy presented Pam with a Financial Administrator Planner with built in calculator.
An active AMTA Chapter member who always attends board meetings, conventions and continually stays involved with the massage profession and always gives a helping hand. This person also contributes to his community by teaching others the importance of massage therapy and has taken a group of massage therapists to our state house to work on legislators to drive home the importance of our profession. This award goes to Robert “BOB” Campbell!
7D. Convention Events Chair/ Delegate- Robin Markus:
Robin told everyone we will be using the Vendor BUCKS again this weekend. James Mally, Rapid Fire Relief, Real Time Pain Relief, Healing Hands and More, Mother Earth Pillows/Pillowsage. LuLaRoe, Natural Options Aromatherapy, Scentsy.
The following businesses contributed; Ralph Stevens, Sacred Earth Botanicals, NCBTMB, Sombra, Clinic Sence, Free up massage Cream, Oak Works, Carlson College, Sounding of the Planet, Elements Massage, Grand Harbor Resort and Water Park, Massage Warehouse, China Gel (Dawn DiNardo), The Hygenic Corp. Performance Health.
7E. Digital Media Committee- Alex Collins
Alex asked everyone to get their phones out and like us on Facebook.
NEW WEBSITE ADDRESS IS http://ia.wp.amtamassage.org
The current numbers for as of march 23 2018 11:45am
Facebook 598 like/following us
Twitter 52 following us
Instagram 96 following us
Compared to last year numbers were:
Facebook had as of March 15 2017 ((429 ))
Twitter “followers” (( 2 )) first post on March 16, 2017.
Instagram “followers” (( 9 )) First post on March 15, 2017
That is 169 new likes on Facebook, 50 new likes in twitter and 87 new likes on Instagram in the past year.
e-mail question to : email@example.com
8. Alternate Delegate Election- Ken:
Ken went over what an alternate delegate’s position would be. This is a 1 year commitment. He then asked for nominations from the floor. Alex Collins was nominated from the floor. With no other nominations, nominations ceased. The nominee will be elected by acclimation. Brianne Goetzinger MADE-A- MOTION LaHoma Simmonds SECONED-MOTION- CARRIED.
9. Swearing in of Officers-Ken
Ken swore in Robert Campbell, Karen Sindelar, Jeanna Tellin, Kieth Kowal and Alex Collins for their elected positions.
10. Adjournment: Brianne Goetzinger MADE-A-MOTION to adjourn. Kathy Lutz SECOND- MOTION- CARRIED. The meeting was adjourned at 2:05.
Jeanna Tellin LMT
Can Breast Augmentation Exacerbate Thoracic Outlet Syndrome?
Breast augmentation can exacerbate Thoracic Outlet Syndrome. Understanding How Breast Augmentation Can Affect Recovery from Thoracic Outlet Syndrome.This information is provided for educational purposes only and is not meant as a substitute for the advice provided by your own physician or other medical professional.
From the Desk of Robert B. Haase, LMT:
I would like to offer some insight to my fellow therapists and physicians regarding my clinical observations regarding the complications of Thoracic Outlet Syndrome from large submuscular (subpecular) breast augmentation. This a common dynamic I have observed over my 26-years in the massage profession and it can be successfully treated with deep tissue treatment.
As you may know, I have been teaching deep tissue and injury treatment seminars over the past two decades. My experience includes a two-year tenure as an autopsy assistant for the country coroner, working in tandem with medical doctors in clinical and hospital settings, as well as providing tens of thousands of treatments over the span of my career.
Like I tell my students, “Just because you see two things happen at the same time doesn’t mean they are related”. If you see it consistently, however, there certainly might be a correlation.
What I have seen, on a consistent basis, is an occasional complication when treating Thoracic Outlet Syndrome which adds to its complexity, ultimately delaying and potentially preventing recovery.
This past month I met a woman who told me how she had been the victim of an assault. For the past two years, she has suffered from numbness in her arms and hands and nothing was working to alleviate her symptoms. She had been treated by the best doctors in the country at some of the best hospitals but was still suffering.
Without sounding inappropriate, I will just say it was visually apparent that she likely had breast augmentation. Our conversation went something like this…
Me: “Did your symptoms of numbness follow the assault?”
Woman: “Yes. It’s frustrating because I can’t go back to work or even drive when I can’t really feel my arms and hands. It isn’t safe.”
Me: “Forgive me for asking, but have you had breast augmentation?”
Woman: “Yes” (She raised an eyebrow from my question.)
Me: “Was the augmentation prior to the assault?”
Woman: “Yes” (The leery look continued)
Me: “Are your implants over 350cc in size and are they under the ‘chest’ muscle?”
Woman: “These are seriously weird questions for a ‘massage therapist’ to be asking, don’t you think? But yes, they are over 350cc in size and they are under the muscle.”
Me: “Well… let me explain…”
What I told the woman was the same thing I have been teaching the students in my seminars in recent years. The common issue is found in women who have had breast augmentation with large implants, usually over 350cc in size, and the implants were inserted under the pectoralis major. With “subpecular” implants, the pectoralis major muscle is used as somewhat of a “sling”. Although the implant isn’t entirely covered by the muscle on the lower aspect, the adhesions which form around the bag’s rough surface tend to complete the sling effect.
With larger implants, the weight ultimately ends up pulling down or depressing the clavicle. Meanwhile, the “whiplash muscles” (anterior and middle Scalenes) shorten and end tend to elevate and rotate the first rib, causing it to press into the clavicle. The problem is the nerve (Brachial Plexus) that passes between the first rib and clavicle “feeds” the arm and ultimately gets pinched (Thoracic Outlet Syndrome). Exacerbating the issue is the Pectoralis Minor which often gets injured in motor vehicle accidents, adding to the compression of the Brachial Plexus.
When you have:
The injured anterior and middle Scalenes are spasmed and shortened
The large implant adds weight, pulling down on the clavicle (the Pectoralis Major’s attachment)
A spasmed Pectoralis Minor muscle pinches down again on the nerve…
…Trifecta! You have what is often referred to as “triple crush syndrome.”
Back to the conversation…
Me: “I can fix that.”
Woman: “That’s pretty arrogant considering all of the treatment I’ve had from exceptional doctors.”
Me: “I’ve been accused of arrogance on more than one occasion. It’s actually confidence, not arrogance. All I need to do is release and lengthen the Pectoralis Major’s fibers, release the spasms and lengthen your Pectoralis Minor and Scalene muscles, and then help the first rib to return to where it wants to be, with steady and direct pressure, taking it through its ‘range of motion.'”
[Note: The pressure on the rib is not an adjustment, but simply taking the rib through its range of motion without interference from muscular tension.]
Me: “One treatment and you’ll see. Plus, I won’t charge you if it doesn’t work.”
It is an even longer story, but the short version is this: (1) 15-minute treatment resulted in the return of her normal sensations in her arm, increased circulation and warmth, and the full use of her hands. The woman was in tears – more than grateful – and extremely upset at the money and time she had “wasted” when something so simple could restore her quality of life much sooner.
So, the next time a woman says she had some sort of MVA or other physical trauma around her neck and shoulders, has numb arms and hands and the appearance of augmentation, perhaps you can be more tactful than I was. Life is short, so I tend to get to the point.
Until next time, keep Changing the World, One Massage at a Time.
Robert B. Haase, LMT
Haase Seminars & Consulting
The Changing Face of Myofascial Release
by WALT FRITZ, PT on MARCH 22, 2018
“My work is called Myofascial Release due to the style of engagement that most resembles traditional gentle, sustained myofascial release treatment. While a popular belief, I no longer believe that I am able to singularly and selectively target fascia (connective tissue) beneath the skin to the exclusion of all other tissues, as many in the myofascial release field believe. Having a broader, more scientifically plausible explanation allows the consideration of many more factors to influence our interventions.” Walt Fritz, PT
That has been my “disclaimer” for a while now, though it is frequently modified and updated. Since 1992 I have been integrating myofascial release (MFR) into my treatment and have found it exceedingly effective in dealing with issues of pain and a very wide range of movement disorders. Success tends to reinforce the thought that we know what we are doing, as well as the stories about what we are impacting that were taught as a part of the training in MFR, which may be one of the biggest mistakes a therapist can make. Even though this last sentence may seem absurd, my ability to help you does not mean that I knew what was wrong with you or what, if any, tissues were impacted/changed to cause your distress. The more that I’ve learned, the more I realize how little I know.
Myofascial release is not unlike most forms of manual therapy and massage, in that each modality claims that dysfunction is caused by problems within its target tissue, whether fascia, muscle, joints, viscera, or dozens of other anatomical structures or pathologies (real or metaphoric), and that practitioners of that modality are able to singularly and selectively target those problems to relieve or eliminate the issue. Positive outcomes are used as proof of claims, though little credible evidence has been published to validate the claims, both in terms of dysfunction residing only in that tissue or that that tissue alone was impacted with the therapy.
The average consumer is seldom exposed to these truths, as once they get involved with a health professional or therapist who is either recommending or specializing in a particular modality or belief, the compelling narrative often takes over. The therapist, experienced as they are, often does provide significant relief from whatever the patient was seeking care for, providing further apparent validation to the stories told. Many patients never make it to a point where they start asking questions about the science and evidence behind the stories, as they were simply seeking relief. They then tell their friends or doctor about this therapist and how that therapist found the problem within the (fill in the blank with whatever tissue or pathology the therapist believed).
MFR is no different from others in that therapists claim to be able to identify problems based on patterns that resulted from so-called fascia restrictions within the body and to be able to selectively reduce or eliminate the restrictions. Evidence tends to be outcome-based rather than based on actual scientific research. While outcomes do matter, it does little to validate the beliefs of the therapist. MFR has dozens of published papers to show that is an effective modality in treatment, but nearly all of the papers use the near-century old narrative to validate its effect. Open up a paper that speaks to MFR as being an effective modality and read the introduction. It may make sense to you, as that is how most of us are taught. But does the so-called science hold up to the scrutiny of outside critique?
Skilled manual therapy can provide tremendous relief of pain and improve the ability to move, sleep, breathe, swallow, play, dance, and much more. But why does every modality carry such different names and explanations? If one had the ability to observe dozens of sessions with dozens of health practitioners using as many different forms of manual therapy/massage, but used earplugs to block out the sound during these sessions, you might be struck by the similarity in the overall type of engagement throughout all of these practitioners. The earplugs would prevent you from hearing the stories told by the therapist, allowing you to be a simple visual observer of how a session progresses; seeing how the therapist’s method of interaction unfolds.
While some sessions are done on dry skin or over clothing and others use a lubricant, such as massage lotion, and some methods move across the skin in a more traditional massage/like fashion while others stay stationary, there is a remarkable quality of similarity throughout all of these interactions. Still others may use what appear to be light pressures while others probe or push deeply into the body. If you were not wearing the earplugs you’d be witness to stories of how light pressure accomplishes outcomes and effects that deeper pressures cannot, and vice versa, or that certain kinds of evaluation/treatment pressures are able to selectively impact certain tissues/pathologies. You would also hear stories of how postural or asymmetry is a major causes of problems, while other therapists/modalities never mention these topics. But without sound, the visuals may be a bit confusing as most manual therapy is not that different from the next. So what gives? If all of those therapists are using similar actions, can the widely varied science-sounding stories be true? Might there be simpler explanations that apply to all forms of manual therapy/massage?
Occam’s razor is a principle used in the scientific method that states, “(W)hen presented with competing hypothetical answers to a problem, one should select the one that makes the fewest assumptions.” (1) In essence, the simplest explanation is typically the best one. All of the wildly different explanations of MFR, deep tissue work, craniosacral therapy, Swedish Massage, Rolfing, and the dozens of other named modalities may be true, but are there simpler explanations that apply to all of them, instead of each one having its own science, known only to skilled practitioners of that form of therapy?
Explaining pain/problems based on muscular anatomy and pathology, such as spasms, strains, tears, remains a popular one, both with the public as well as those with in the medical and health professions, but is it the whole story; the entire reason why pain exists? Patients frequently come to me blaming their pain on their posture, their weakness, their job/computer/cell phone use, or other issues, but are these true? Each tissue belief system and pathology-blaming has its followers, but each tends to practice within a rabbit hole; a hole that does not allow one to see what others are doing, thinking, or putting into practice. Instead of each modality being unique, able to singularly and selectively able to influence one tissue, pathology, or disorder, might they all be quite similar, with only the difference being the explanation? Might they possibly be different roads to the same destination?
So if I do not believe all of the stories told by therapists and educators, what do I believe? Looking at manual therapy and massage from a plausibility perspective, one might best start with the skin. Being the only tissue that we can be certain we are impacting, does the skin possess sufficient action potential to contribute sufficiently to the gains seen as a result of therapy? Without going into great detail in this shorter paper, many feel that it may.
The published work of Michael Shacklock (2) and Nee/Butler (3) speak to the probability of pain and related dysfunction being a result of tunnel syndromes within the nerves of the body, with outcomes improved by specific nerve tunnel glides/stretches. While these originated as precise and patterned movements, the latest research puts forth the possibility of simpler therapeutic engagements of the nerves, which may be an aspect of even general manual therapy/massage. Another aspect of the skin is the richness of receptors whose sole purpose is to provide feedback to the brain for processing. Diane Jacobs, PT (4) speaks at-length of these receptors and how simple and gentle engagement of the skin may be sufficient to cause the brain to change outcome to the periphery. Can the brain alone change pain in the body? With ultimate control over all bodily processes, I think it would be safe to say, “yes”. Skin contact and probable impact is an unavoidable consequence of ALL manual therapy.
There is far greater to be said about indirect and contextual factors involved when receiving myofascial release, manual therapy, or massage from a dedicated therapist. There is a great deal of evidence that points to these factors as potentially playing more of a role than many therapists wish to believe. We (therapists) like to think that it is our skill and experience that improve our outcomes and it may, at last to some extent, but not for the all of the reasons we think. Brian Fulton, RMT, in his book, “The Placebo Effect in Manual Therapy” (5) speaks at length to these factors and how the science story the therapist tells has impact on potential outcomes, with the better told the story, the greater the potential for increased indirect (placebo) effects. This makes sense, as if we sound like we know what we are talking about and about to do, trust is increased. With trust often come greater outcomes. One problem with this research is that there are no provisions for the accuracy of the story. As long as it sounds plausible and is told in believable ways, potential outcomes improve.
These aspects of neuroscience and brain/pain science do not eliminate the possibility that tissue-specific results, such as releasing fascial restriction, from occurring. But the deeper we dive into the body the more speculation that must take place in order to rationalize the actions of our manual therapy. Fascia may be releasing, trigger points may be disappearing, muscles may be lengthening/reducing tone, and all of those other promises that your therapist made to you may be happening…but there is a decided lack of irrefutable evidence that these are indeed happening. I’m not suggesting that you have an argument with every therapist or patient who makes claims such as these, as it is sometimes not an argument worth undertaking.
There are many instances when I seek help from another health professional who provides me relief from or help with an issue, but have issues with their explanation. It would be egocentric to believe I have all of the answers and, as such, I remain open to the new and emerging science that points to potential changes in our target tissues as we treat. But the stories told do not always match the outcomes achieved. Neurological explanations for why manual therapy, myofascial release, and massage feel so helpful may not be completely correct and universally accepted, but these explanations might well be less wrong that many of the other stories. Every day, I am trying to be less wrong.
Walt Fritz, PT
Occam’s razor: https://en.wikipedia.org/wiki/Occam%27s_razor
Michael Shacklock: Cinical Neurodynamics (2005).
Nee, R.J., Butler, D: Management of peripheral neuropathic pain: Integrating neurobiology, neurodynamics, and clinical evidence. Physical Therapy in Sport 7 (2006) 36–49. doi:10.1016/j.ptsp.2005.10.002
Diane Jacobs, PT: http://humanantigravitysuit.blogspot.com/
The Placebo Effect in Manual Therapy, by Brian Fulton, 2015
What CE hours do we need?
This seems to be the million-dollar question among massage
therapists. It’s not as complicated as it seems. Let’s break it down. click the link to get the break down.
CE Requirements-2 page spread (1)
My name is Alexander L. Collins. I’m the digital media and newletter editor.
IF you can DREAM IT you can DO IT.
I’m looking for some help with the social media aspect of the AMTA-IA chapter. If you are interested in volunteering email at firstname.lastname@example.org
Alexander L.Collins LMT
AMTA-IA Digital Media