Remembering about the uniqueness of massage therapy

Hello friends!

I am of the opinion that massage therapists must remember about the great uniqueness of massage therapy when treating any disorders or dysfunctions.
Recently, a person from our fields, a friend of mine, posted this article on his site. Effect of the Suboccipital Musculature on Symptom Severity and Recovery After Mild Traumatic Brain Injury.

To me, the information presented in the article was a borderline distortion if not disinformation and I posted my considerations about it on his site.

Below I would like to share with you this what I have written there.

In my opinion, the aforementioned article was not written for massage therapists. In fact, it isn’t written for physical therapists or anybody who is applying physical methods of treatments.

As a massage therapist, I possess considerable clinical expertise and rich clinical experience in rehabilitation of post-concussions. The main goal of this rehabilitation is not the elimination of symptoms but the prevention of post-trauma brain dysfunction/encephalopathies. I would like to repeat not the elimination of symptoms only.

1. “Neck musculature mass has been suggested as a biomechanical contributor to injury severity.” I hope we all agree that muscle mass cannot contribute to the severity. At least, this is not our professional language and approach.
2. In my opinion, the sentence below represents the claim of health care professionals, who are radiologists, and who have never managed post-concussion rehabilitation: “Overall and individual muscle cross-sectional areas were correlated with symptom severity, neuropsychological testing, recovery time, and headache.”
3. Can MRI cross-sectional examination determine the high resting tone (tension) in all suboccipital muscles? No, this examination cannot. When treating painful skeletal muscular disorders, because of pain sensation, neighboring muscles immediately elevate the muscular tone even those that do not share the same innervations. When treating muscular syndromes such as piriformis muscles/sciatica, all gluteal muscles increase muscular tone. In the case of the head trauma/concussions, all neck muscles, including suboccipital muscles, are in the state of a protective muscular spasm.
4. As massage therapists, we must address all of the surrounding muscles, in order to reduce tension, and achieve results. In the case of the buildup of tension in the fascia, massage therapists must address it too. We can release this tension. At the same time, because of this article, one might address rectus capitis posterior only, and thus never will be able to achieve real results. Unlike painkillers that only block pain impulse to reach the brain, one of the greatest unique features of massage therapy is in addressing the real causes that produce pain and disorders/dysfunctions. The same is true to say in cases of post-concussion rehabilitation.

Below is my article Rehabilitation VS inhibition of symptoms 

If you won’t have much patience to read it in its entirety, then please read at least the summary and conclusion. It will give you a quick overview of how and why we as massage therapists can prevent encephalopathies/brain dysfunction.

You’re welcome to challenge all that I stated in this post. Professional discussion can advance our level of professionalism.

Conclusions

1. I am of the opinion that massage therapists must remember about the great uniqueness of massage therapy when treating any disorders/dysfunctions. Our methods are not similar to painkillers that block pain impulses from reaching the brain but address the real causes that producing pain, and other dysfunctions.

2. Just because the article is published at PubMED.gov, it doesn’t mean that this article is written for massage therapists and/or this is good and scientifically valid material. Some time ago PubMED.gov published this article 

Massage Impairs Postexercise Muscle Blood Flow and “Lactic Acid” Removal

Please Google:” Massage Impairs Post-exercise Muscle Blood Flow and ‘‘Lactic Acid’’ Removal” and you will find many other “scientific publications” repeating the same nonsense, Massage Impairs Post-exercise Muscle Blood flow”??????

In truth, the mere fact of something being published in PubMED.gov doesn’t guarantee it is a reliable material and could, in fact, be absolute nonsense.

This is my principle approach to a discussion.  When in a discussion, someone disagrees or categories a statement as “nonsensical”, they must explain why it's nonsensical or must explain the base of the disagreement.  In this post, I said: ”Please Google:” Massage Impairs Post-exercise Muscle Blood Flow and Lactic Acid Removal” and you will find many other “scientific publications” repeating the same nonsense, like "Massage Impairs Post-exercise Muscle Blood flow”

Here is a detailed explanation of why all these “research” “findings”, are nonsense big-time.

https://www.scienceofmassage.com/.../response-to-new.../

Summary

Even today, doctors practice suboccipital injections, be it Botox/toxin injection, or corticosteroids hormones injections. Can it inhibit pain? In some cases, it can. Does it address causes that lead to encephalopathies? Positively not.

”In mild traumatic brain injury, the rectus capitis posterior minor is the only suboccipital muscle whose cross-sectional area is associated with symptom severity and worse outcome. Given the unique connection of this muscle to the dura, this finding may suggest that pathology of the myodural bridge contributes to symptomatology and prognosis in mild traumatic brain injury.”

To make the aforementioned claim, by all scientific standards, the researchers should first assess autonomic activities, and only then administrate these injections.

One cannot do Botox/toxin or corticosteroid injections nonstop and then, after a minimum of four months of observation, do a test of autonomic activities again. The test must be run much more frequently especially in view of the fact that test equipment can assess the irregularity or normalizations of the autonomic system rather quickly. Only when the test would establish normalization of the autonomic activities, anyone can claim what they claimed in this article.

Besides, why use the injections? Injections that have side effects. When it comes to muscular tone,  by means of massage, we can achieve sustainable results without side effects, and in a relatively short time.

Having said that, practically my entire career I’m participating in an integrative medicine approach, which is a diagnosis by MDs, and then many different health care disciplines and methods, including injections, but only in certain cases when needed. Sometimes, but not often, it is very difficult to inhibit sharp pains by means of massage only. Many factors contribute to the pain, including but not limited to the central sensitization of pain.

One of the conditions to sustain results in post-concussions rehabilitation/prevention of encephalopathies, during numerous treatment is an immediate decrease of intracranial pressure, which reduces the intensity of headache, etc.

Remember, it’s very difficult to positively contribute to the balance of autonomic activities when intense sharp pains present. In certain cases, suboccipital injections can be very helpful, but in no case, as you could understand from my article Rehabilitation VS inhibition of symptoms, should be viewed as the main effort to prevent brain dysfunction developments. Prevention of encephalopathies demanding much more.   

Best wishes,

Boris.