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People, who follow my articles and posts know that I am a big believer in professional discussions, and am not afraid of being challenged and support my opinion in a mutually respectful back and forth argument. Everyone can learn from this type of professional discussion: those who post, those who disagree, and those who are just following the discussion. Thus, I hope this post would also elicit a healthy discussion and become a source of mutual learning.
Recently, Dr.Ross Turchaninov invited me to join FB group Students of the Science of Massage Institute Medical Massage Program. Most of the members are recent students or graduates from that program. One of the members posted an overview of the article related to Coagulopathy of COVID-19. A special preview of Ruth Werner's Pathology Perspectives column scheduled to appear in the July/August 2020 issue of Massage & Bodywork.
This member asked Dr. Ross’ opinion on this very well written article. As always, Dr. Ross Turchaninov offered straight to the point summary and which was correct. I quote:
“There is a growing number of clinical and scientific articles that emphasized that COVID is not a lung problem, as we thought and treated accordingly, but it is rather a completely new virus within the coronavirus family. In the majority of fatal cases, death came as a result of inner organ failure due to the thrombosis of the small arteries. The virus damages inner lining, triggering the coagulation system and that it is the cause of death. Indeed patients are dying from lung failure more frequently, than the liver for example, but the cause of that is thrombosis not blockage of airways by inflammation or sputum as rest of coronaviruses do. It is because lungs have a large circulatory system and they are first to be affected. That recent discovery already makes a huge change in the therapy since the first line of defense now is anticoagulants (frequently the strongest ones) instead of IVL. Results of this therapy, before the vaccine is ready, are significantly better.”
I have replied.
Great commentary! Glad Ruth wrote this article. Probably later on when the time will permit I will write about extensive work by Dr. Chernich related to this issue. To summarize, massage significantly increases the fluidity and decreases the viscosity of blood. I believe that to the cases, presented in Ruth’s article, this is a very important factor. It's always important to maintain a good level of fluidity of blood but especially during this type of pandemic. BTW, I love the idea to have this site.
Best wishes.
Dr.Ross agreed.
Since then, already a few weeks I'm writing and rewriting my article. I am well familiar with the works of Dr. Chernich.Therefore I was positive, it won’t take me much time to write this article. Suddenly at the time of writing, I felt that all I am talking about, is very superficial, and I am not diving to the very bottom of the issue.
I obviously knew that the acceleration of the lymphatic drainage technique promotes a significant increase in the fluidity of the blood. Also while massaging in the inhibitory regime contributes to vasodilation and triggers a significant increase in the fluidity of blood. But I felt that I am missing a significant piece of pertinent information, preventing me from giving this topic a fair consideration.
The Soviet scientists and clinicians Dr. Chernich along with thousands of other Soviet scientists and clinicians was the part of the Soviet sports medicine machine placed with the sole purpose of propaganda to help the Soviet athletes to win the Olympian gold, to "rub it in" to the West in the frame reference of the Cold War. Thus scientists dedicated their entire careers to the developments of methods that prevented sports-related injuries, promoted rehabilitation from sports-related injuries, improved performance of Soviet Olympians, and increased their competitive longevity.
Yet, little or close to nothing of the Medical and Sports Massage protocols, that was improving sports performances, was known in the West. Although the large research institutions were involved in sports medicine including and not limited to Medical and Sports Massage studies, their developments were kept in strict secrecy. The secrecy was guaranteed by the mighty Soviet secret service organization KGB.
KGB or the Committee of Government Security, to some degree, was similar to the confluence of two American organizations FBI and CIA. Except for that American citizens rarely get involved with either of these organizations as it’s primary goal is to counteract internal and external foes of the United States. In the Soviet Union, one careless word or a risky joke could not only end one’s career but also make him or her a foreign spy – the enemy of the Soviet people and thus being tortured, sent to GULAG or killed. Therefore no one in the former Soviet Union, messed with KGB, which enabled it to keep any information as secret as the Communist Party wanted it to be. In this particular case, the secrecy was overseen by the influential member of the central Communist Committee comrade Suslov personally.
The reason for such secrecy was substantial. During the “Cold War,” Soviet propaganda always tried to portray the Soviet system and the Soviet way of life as superior to the one adopted by the West.
It even came up with the myth of a special new “Soviet Person”, the carrier of the advanced Soviet mentality, which allegedly was far superior to a mentality of a Western person.
To somehow substantiate this myth, the Soviet propaganda utilized any Olympic sports and the dominance of the Soviet bloc athletes, especially of the USSR and Eastern Germany during Olympic Games in the sixties, seventies, and eighties.
It would be essential to point out much greater longevity of the Soviet bloc athletes compared to their Western counterparts. The vast majority of the Soviet bloc athletes were competitive for ten to fifteen years.
The real secret of such longevity was the elaborate system of pre-event and post-event rehabilitative Sports massage and the proper warm-up procedure; a sequence of special exercises including neuromuscular re-education that ensured that all the muscles of the responsible regions work in assembly and the neurological sense. Such powerful scientifically based methods made verifies that joints are stable enough to withstand huge competitive loads and to perform to the maximum physiological potential of individual athletes.
All that changed during the time of Gorbachev’s “perestroika” – restructuring of the Soviet economy – and, subsequently, when the Soviet system has fallen apart. The scientific institutions that for decades were supported financially by the Soviet Government, regardless of their actual profitability, were suddenly left without any funding and, thus, quickly disintegrated.
The impressive body of knowledge accumulated by decades of arduous work by talented scientists was literally abandoned. That’s why, paradoxically, the only people who could carry the torch of knowledge in the Russian Medical and Sports Massage were those who have emigrated from the Soviet Union at the time and before “perestroika.”
Perhaps this sounds bizarre, but just to understand the significance of this loss, in 1963, a military faculty was organized, which claimed to prepare military sports instructors, thus making this faculty a military PO. Box ora top secret institution. These military instructors had nothing to do with sports medicine research, they couldn't even enter our facilities.The Soviet government used them as a decoy to declare our institution a military PO. Box.
The research was conducted under strict secrecy, and practitioners under training were obligated to keep this secrecy and knew that those protocols were a secret product of the Communist party. Perhaps, for those who lived in the free world, is difficult to comprehend the threat of KGB, but we all knew too well that messing around with KGB was a bad idea. It was too serious.
As you could understand, not much material, and research papers was and is available.For many years I'm practicing this protocols and this a lot but, at the time of writing this article, I knew I was missing some crucial information, that can help to understand more about the role of massage in increasing and maintaining level of blood fluidity.
It was just a pure intuition.I could remember it was more than this.Back during my student years in the Soviet Union, principal investigators used to give tasks to different groups of researchers, with all outcomes coming back to the principal investigator, so that only a very limited number of people could read the entire research paper.
When a particular massage protocol was developed, we learned in details its steps by step application, as well as its underlining theoretical concepts, to understand what we were doing.However, as a clinicians, when all was working well, time after time, and for a long time, sometimes, we weren’t on top of research findings, simply didn't remember details.
Yet for writing an article I need more details, I must have deeper and broader explanation.
This was my personal Eureka moment. Actually,the scientific data I rediscovered wouldn’t change the way I'm practicing sports massage, but it readjusted, enriched and broaden my understanding of power of massage, and,certainly, gave me the opportunity to share with you, extremely powerful details of massage procedure.
While studying, pre-event and post-event sports massage was a considerable part of the curriculum.I remember clearly, when I was trained to perform pre-event sports massage, our professors stressed the difficulties at the time of the research to adjust the existing Serazini’s pre-event sports massage protocol to a much more efficient, and more powerful one.
The regime, at which we perform pre-event sports massage, shouldn't suppress sympathetic activities to the level we strive to suppress it when performing stress management massage. Its purpose is to balance sympathetic and parasympathetic activities. At the same time, we must increase fresh arterial oxygenated blood supply aiming to increase the volume of the capillary network.
One could say that if you are not suppressing enough sympathetic activities then don't expect vasodilations to meet the desired expectation. Now I am about to discover the additional supportive pattern to the stimulation by massage and achieving vasodilation and to positively affect autonomic activities.
Unlike the USA where sports medicine experts are mostly orthopedic surgeons, in the Soviet sports medicine the leading sports medicine experts used to be neurologists. Certainly, orthopedic surgeons and traumatologists, physical rehabilitators, including medical and sports massage practitioners, as well as cardiologists, who specialized in biological rhythms also played an important role in the development of sports medicine.
Processes in our bodies exhibit rhythmicity, including blood fluidity rhythms. These highly qualified experts knew how to calculate biological rhythms, and then to adjust the regime of professional athletes practice accordingly. While conducting research, they always used to work with us, as many of them knew hands-on massage procedures quite well and used massage in controlled studies.
Olympian athletes used to practice twice a day three hours each practice. None of them could leave practice unless their heart rates would reach 220 beats per minute. Imagine what kind of physical load young Olympians had to undertake, if their resting heart rate was 40 beats per minute? That high of a heart rate did not result in overtraining as the biorhythms experts, knew how to adjust the personal training routine of each Olympian, incorporating rehabilitative efforts by use of sports massage.
For many years I have performed pre-event sports massage. Almost half of my long career I have dedicated working with professional athletes, performing equally important pre-event and post-event sports massage, as well as various medical massage protocols in cases of trauma. Very important technical components of pre-event sports massage are special techniques to release acetylcholine. I knew about the importance of correctly performed techniques in its relation to releasing acetylcholine. What I could remember is that by releasing acetylcholine volunteer muscles reacted much faster, and work better in assembly.
During the last six years of my career, I had the opportunity to manage two green jacket golfers and certainly implemented pre-event and post-event sports massage. Last year I decided to slow down my involvement with these athletes and spend more time with my grandkids.
The managers requested me to train two athletic trainers. These good people, had little interest in pre-event sports massage training as they were positive they knew what to do in pre-event and post-event case. Their main interest was a medical massage in cases of trauma, post-isometric relaxation techniques, as well as correction of biomechanics techniques.
Being in good relationship with these golfers, I periodically treated them in my office. Before coronavirus struck, while treating them both golfers complained:” when you used to perform pre-event sports massage, we could feel its effect; it boosted energy, allowed us to achieve greater focus, etc. These trainers are not achieving it.” I promised to talk to the trainers and, God willing, when all of us would get our normal life back, I will meet with the trainers and explain to them the importance of including the pre-event techniques in releasing acetylcholine.
Please don't get me wrong. The entire pre-event sports massage protocol is “must do” to achieve desirable results. All steps in the entire sequence compliments each other. But today we are talking about the role of massage in maintaining the fluidity of blood.
For some reason my intuition was screaming, I could remember that techniques to release acetylcholine, also contributing to the increased blood supply and the volume of small blood vessels network. Honestly, it was a kind of intellectuals suffering, to know, but not being able to remember details and theoretical explanation.
As you understood from the history of Soviet sports massage, I couldn't look up textbook, or Google the information.
Usually, when some question would arise, I immediately contacted my mentor. But he is not with us anymore, rest in peace, great man that he was. Suddenly, it crossed my mind that a long-ago retired sports medicine doctor for the last ten years lived in Israel. He used to work in sports medicine research, as well as he was a clinician and knew theory and practice of medical and sports massage. A few years ago, I talked to my mentor, this doctor was next to him, and I was introduced. I was flattered as he was one of the idols of young practitioners and I used to look up to him.
I called him and luckily he answered. Being 83 years old, he retained a perfect memory. I asked him to explain to me the process of releasing acetylcholine and its effect on the fluidity of blood. He said that in 1969, he worked, in the group with Dr. Chernich and Dr.Krasnova who was cardiologist and biorhythmologist. He further explained that it was their group that developed these techniques to release acetylcholine.
This was a WOW moment for me. Then he continued: “Boris this is not only a matter of fluidity. No doubt it is important to maintain fluidity, and various Chernich’s techniques, remarkably, achieving it.
The application of Chernich’s techniques combined with release of acetylcholine techniques, allowed us to constantly maintain the sufficiently high blood supply volume at the capillary network, suppress anticholinergic, and release acetylcholine, which measured level in blood was the evidence of suppressed anticholinergic.
Besides, releasing acetylcholine is extremely important for speed improvement, muscular assembly work, etc. By suppressing anticholinergic, we allow real and constant vasodilation of arteriole network. We found out that by constantly incorporating these techniques, we are establishing the reflex of normal dilation at the arterioles and capillaries network, and this reflex, sustained for days. An even the treatment extended for a limited time, immediately lead to desirable effects, as well as maintaining this acceptable normal sufficient blood volume in arteriole networks.
For these findings, he gave a lot of credit to Dr. Krasnova. She has carefully analyzed the daily rhythm of blood fluidity and came to the conclusion that this is not only about the fluidity of blood. They tried a controlled study, to use blood thinner medication.
According to Krasnova, some individuals who are even sustained higher than normal blood fluidity, it didn't change significant passage time.
Passage time is one of the measurements, scientists used to assess blood fluidity, the volume of the capillary network. The doctor explain to me that Krasnova used many more parameters of measurement. Discussing their entire gamut is well beyond the scope of this article. What she has proved and what I'm trying to stress in this article, that not only blood fluidity is extremely important, but also the capacity of the capillary network allowing to pass more blood.
When she proposed to control the study using anticholinergic medications, it made a big difference for some individuals compared to the group that received pre-event massage.
The Doctor continued: ”We understood there was no future in using anticholinergic medications, because of terrible side effects such as dementia, disorientation, decrees of mucus production, disturbances in bowel movement, increase the heart rates to name just a few. The biomarker of active dominating anticholinergic was blocked acetylcholine.
“By 1969, there was enough data and available techniques to elicit some effect of releasing acetylcholine. Using controlled studies based on biorhythms and the available data, they have developed scientifically and most importantly clinically proven, powerful massage techniques to release acetylcholine, as we know it today.
When I asked the doctor what in his opinion contributed to dominating anticholinergic, he responded that the main cause of it is the accumulation of toxic metabolic waste. He continued:” By performing manual acceleration of lymph drainage, you not only detoxifying the human body but also significantly increasing fluidity of blood, but also increasing passage through the capillary network “Then he joked: ”Not only ‘two birds with one stone,’ but many more”
I also asked him, if granted a person accumulated a lot of metabolic waste, I won't perform detoxification techniques, but only use techniques to release acetylcholine, would it positively affect blood supply volume at the capillary network. He said yes, for a short period of time. Then I inferred “In such a case as you describe, detoxification is must be done.” His answer was yes.
Then I asked him, why during the educational process we weren't required to do manual acceleration of lymph drainage along with pre-event sports massage? His answer was:” We didn't see the need. By constantly providing post-event rehabilitative massage, we stimulated accelerated drainage of lymphatic fluid and promoted disposal of metabolic waste.”
I have rephrased my question. If I will perform detoxification procedure only, without special techniques to release acetylcholine, would it affect the positive volume of the capillary network? He said:” We researched it. Regrettably performing detoxification procedures only didn’t have much effect on the release of acetylcholine. So in order to accomplish releasing acetylcholine we had to apply the pre-event techniques as well.”
Finally, I asked:” Why do we call this technique the “release of acetylcholine?” Shouldn't these techniques be called “suppressor of active dominating anticholinergic”? His answer was “yes, it is suppressing dominating anticholinergic. But because released acetylcholine, is a biomarker, we decided to call it as you were trained in school, the release of acetylcholine techniques.
The doctor asked me, why I got interested in this topic. I told him about Dr. Ross’ commentary on new findings of coronavirus. He said that in such a case scientists should look at individuals’ active dominating anticholinergics. He also said that during their research, it became absolutely obvious, that dominating anticholinergics, is very individual, and its level is different from person to person. But everyone and especially in competitive sports can greatly benefit from freed acetylcholine. Based on my clinical experience, I can say yes this is true.
1.We can speculate that a massage therapist possesses a powerful means in preventing the detrimental effects of the COVID-19 virus described in the Coagulopathy of COVID-19 article. It is the implementation of pre-event sports massage protocols that elicit the release of acetylcholine, which in turn increases the volume of the capillary network.
2. We must follow our intuition and not give up. This is got to be something in it.
3. As we all know, today coronavirus sparkled again. To prevent this infection we must boost the immune system, and increase blood fluidity, as I have described in my article Detoxification and immune systems sufficiency - Medical Massage
I talked to the doctors three times, each time for more than an hour. I took notes, and if I would try to present all of them, it would have to write many articles. Each sentence would have at least 10 extended interpretations. Should these additional avenues of discussion would ignite interest, we can manage these discussions on-line.
Twenty-three years ago, I have produced an instructional pre-event and post-event sports massage medical massage educational video, Presented hands-on step-by-step pre-event and post-event massage protocols, stressed the importance of each technique. At the same time, during performing hands-on techniques, the medical massage educational video stresses the importance of must do the release of acetylcholine techniques. Today even more clarity I realize how important it is to incorporate these techniques in pre-event sports massage, as well in other types of medical-massage. And knowing what I know today I appreciate this awesome massage protocol I was performing for forty-six years. The effect of this protocol is not releasing acetylcholine only, but the success of the massage procedure can be assessed by improvement and normalization of blood volume in the capillary network. By succeeding in it, we should expect improvement in the functioning of internal organs and the Muscular skeleton system.
I had this conversation with you, as a clinician to clinician. I didn't even try to search for references. Besides I am not that good at doing searches. Besides, I am against the practice of finding data produced by orthopedic surgeons for example and attempting to adjust it to massage protocols. We are in a different business; treating the same disorders, but using different techniques and approaches.
I believe very soon I will produce an educational video presenting hands-on techniques to release acetylcholine. In this video, I won’t discuss pre-event sports massage and demonstrate pre-event sports massage techniques only, but when treating internal organs disorders, stressing the importance of eliminating reflex zones abnormalities in soft tissues, developed due to visceral somatic reflex. Viewing the body in a holistic way, and I will explain the importance of performing each of the medical massage techniques to achieve sustainable results, including and not limited to extremely important techniques to release acetylcholine. The video will certainly include hands-on demonstration those that for many years are clinically proven as excellent.
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