“Active Engagement Techniques” with Whitney Lowe

Yesterday I had an opportunity to attend the presentation “Active Engagement Techniques” with Whitney Lowe at AMTA-CA Annual Education Conference.

I thought it was an interesting concept to engage painful regions. We talked a bit and both have agreed that 1000s names to massage therapy procedures/modalities, is not sustainable, not ethical and very confusing for all, clients, healthcare professionals, as well as for us as a community. It was nice to learn that, for a change, somebody agrees with me. LOL.

Another issue. I always used to say: “If one vigorously presses, or performs other dangerous “no pain no gain” manipulations, and cannot explain why this is done, one simply don’t know what she/he is doing; and ultimately shouldn’t do it.

Interestingly enough, Whitney used the expression ”Clinical reasoning.” Now I will use “you are not using clinical reasoning” instead of ”you don’t know what you are doing.” Sounds much gentler. Clinical reasoning, is a part of clinical thinking, and should be applied whenever we treat our clients.

Participants have asked very intelligent questions, including such as “if Active Engagement Techniques should be applied in cases of fresh/recent significant injuries.” Whitney replied that clinical reasoning doesn’t not suggest in such stage to apply Active Engagement Techniques. Clinical reasoning suggests to apply different massage techniques, to warm-up area, and then with condition improvement to incorporate Active Engagement Techniques.

Whoever follows my writings and teachings, not once heard me say: ”There are different technical approaches, including massage methodologies, to reach rapid and sustainable results.” I was trained first to provide techniques to reduce size of lymphedema, following by introductory massage in inhibitory regime in order to increase threshold of pain, following by connective tissue massage/fascia release, muscles mobilization, trigger point therapy, post-isometric relaxation techniques.

Listening to Whitney, it became obvious that he approaches orthopedic status disturbances utilizing the same concept as I do, but applying different techniques.

There is no silver bullet in our occupation, and everyone can contribute and share knowledge that will lead to better clinical results. In no case we shell deny medical physiology treasure, as well as remember that conventional Western massage is 150 years old. By attempting to reinvent the wheel, we are ending up with 1000s different names, our colleagues leave our field massively and after being only a few years in business. This is painful, and shouldn’t be this way. Massage therapy is very powerful methodology of treatment. Millions of people, if not all, are in desperate need of treatment.

By working together, confronting educators, who propose unsustainable claims, deny the treasure of medical physiology, declare “new revolutions,” claim that only ”this” particular methodology is the only right approach, we will improve the field of massage therapy. I believe that massage therapy field is in decline, and, God forbid, can be totally destroyed. Together we can reverse it in its direction to destruction.

Best wishes.

Boris

Is it necessary to cross the line?

Massage therapy is a very powerful therapeutic tool. Did I say something new?

Most of us who practices soft tissue mobilization by means of massage, know that massage therapy is extremely powerful in stress management, as well as in cases of painful orthopedic disorders. Also most would agree that there is no silver bullet in our occupation. There are many different types of massage that allows a practitioner to achieve desirable results, such as less pain, improved functional activities, improved sleep qualities, fewer anxieties, normalization of blood pressure and many more positive outcomes.

In my view, we are first door treatment providers. At the time I strongly believe that we have to work with chiropractors, physical therapists, medical doctors. Each of mentioned above healthcare providers, can contribute to well-being of the patients.

In many cases integrations of methods leads to solutions in cases of most difficult diseases/disorders.

Many times I wrote about negativity of creating 1000s alternative names, to massage therapy.  Individuals obtain massage therapy license, professional liability coverage for massage therapy and are members of massage therapy trade associations. Yet instead of calling themselves massage therapist they assume titles any of other 1000 alternative names. If one performs soft tissue mobilization using hands, then one is a massage therapist, and we have no need to cross lines to different scopes of practice. This is wrong, illegal and not necessary.

A few years ago, this was a massive phenomenon… instead to calling themselves massage therapists; many called themselves manual therapist. I am in very good relationships with many physical therapists in Southern California. One of them is very powerful member of Physical Therapy Association. She saw my article Manual Therapy vs. Massage Thrapy and laughingly said: ”Boris, you’ve made my day” She explained that many members of her professional associations, lately started complaining that’s more and more massage therapists use title ”Manual therapist” crossing the scope of practice line. Manual therapy CPT code can be used only, by PTs DCs and MDs. She added that many chiropractors also complained on the same line crossings.  Finally she said: ”…if your colleagues continue crossing the lines, we’ve got to stop this legally. In her assessment massage therapists have to work under PT supervision. That would guarantee no violation of scope of practice boundary lines.”

I strongly disagreed, but couldn’t answer the question: ”Why do massage therapists have tendencies to call themselves other than massage therapist?” I agreed that such trend exists however stating that overwhelming number of massage therapists practices therapy by means of massage in the frame of our scope of practice, and are very proud to call themselves massage therapists. She commented that even if a small percentage of massage therapists continues to present themselves as manual therapists it will be enough, to make all massage therapists to work under PT supervision. Thank God, the practice of calling themselves “manual therapists” is almost gone.

But creations of “new theories” and concepts continue. For many reasons I view this practice as negative and again somehow leading to crossing the lines.

Recently I have been involved in a discussion where my opponent claimed that according to Neuromatrix theory (I copied and pasted statements below).

There are four things that every therapist should know:

* There is no such thing as a pain receptor.
* The brain does not receive pain signals.
* Pain is created by the brain as a protective response to perceived threat.
* Pain science is a sub-discipline of neuroscience that has its own peer-reviewed journal(s), its own international association and conferences, and a massive amount of ongoing research and clinical work being done.

I was really shocked reading this statement and have replied.

Of course, there is such a thing as a pain receptor. It’s a sensory nerve and it’s called a nociceptor. The brain certainly receives pain signals. In most cases we address pain that is not created by the brain. In most cases pain sensation is generated on the peripheral level and is interpreted by the central nervous system. Neurophysiology is a most complicated discipline in entire medical physiology. I’m not neuroscientists, and as much I know, you also not a neuroscientists. At the time you are trying to interpret   the data and make such claims that a real clinical neuroscientists/MDs neurologist would be hesitant to do.

Pain is a complicated matter as there are many different types of pain. In some cases pain is indeed created by the brain as a protective response to perceived threat. However, if this were a general rule, then how can we explain the following phenomenon?  The brain of people who undergo brain surgery, exposed to and stimulated by electrodes during the surgery. Yet they experience no pain, even though they are NOT under general anesthesia. They can even talk and share their sensations.

As massage therapists we should focus on our work and what we know are clinically proven facts. This “neurorevolution” is unnecessary; massage therapy is not methodology under developments, but the working methodology clinically proven for long time. Surely there is always a room for improvement, but what you’ve proposed in your post, in my views is diametrically opposite from “improvement.” I am not saying this out of spite or any other negative emotion but as the one witnessing the total destructions of Eastern European Beautiful massage therapy fields, and only because of “new revolutionary ideas.”

This destruction happened at the time when massage was recognized and proven as an extremely powerful therapeutic methodology. MDs used to stay in line to study it. “If it ain’t broke, don’t fix it.” Let’s work together and to find healthy proportion.
Best wishes.
Boris

sorry to say it didn’t work. I got reply.

:”the mislabeling of nociceptors as “pain receptors” is not my opinion. It’s what the pain scientists say. You’ll have to take it up with them.

Patrick Wall is one of the leading pain scientists in the world. Patrick Wall and Ronald Melzack were the authors of the “Gate Theory of Pain.”

Fellow massage therapist, please pay attention at denying existence of pain receptors/ Nociceptors

* There is no such thing as a pain receptor.
* The brain does not receive pain signals

The same person continues writing:

”Nociceptors are high-threshold receptors. Low levels of pressure, for example, on normal tissue will not usually cause them to respond. However, high levels of pressure can make them fire, sending impulses to the brain. The brain processes this information and if it deems the pressure threatening may generate the sensation of pain as a protective mechanism. If the brain does not deem the situation threatening, it may not.“

It didn’t end up there. My opponent continued

“Pain researcher Patrick Wall stated, “The labeling of nociceptors as pain fibers was not an admirable simplification, but an unfortunate trivialization under the guise of simplification.”

I personally never labeled nociceptors as pain fibers, I calling them pain receptors, which is a free nerve ending , afferent nerve ending,  it brings information of pain/ pain impulse from the periphery toward the brain.

Dear colleagues, I wouldn’t bring up this discussion, if not for the fact that this new “neurorevolution” became a massive trend.  In my opinion it disseminates disinformation as well as misguides many massage therapists toward crossing the line. In the discussed case, and in many other cases, a massage therapist pretending to be a scientist capable to interpret scientific data would lead to statements “There is no such thing as a pain receptor.”
* The brain does not receive pain signals.

There were a number of people who participated in this discussion.  If all stated by my opponents would spread, our entire professional community would experience ill effect of this disinformation.  In an attempt to make this discussion a real educational experience I have asked a medical doctor, double board certified in: Clinical Neurology and Clinical Neurophysiology to reply to these statements.  FYI, there aren’t too many neurologists possessing double certifications. Clinical Neurology and Clinical Neurophysiology, is a bit different then theoretical neuroscience.

The doctor kindly agreed to help us out and this is what he wrote.

Boris,

This could not be further from factual science that is highly documented. There ARE multiple pain receptors, from somatic, cutaneous, visceral receptors. OF COURSE the brain receives the pain signals! How else would we perceive pain. Pain is simply an electrical impulse (the “pain impulse”) from the receptors that is activated (by heat, mechanically/ trauma etc., cold, hyperstimulation) through the spinothalamic tract in the anterior spinal cord, iplilaterally to the thalamus. The thalamus is commonly referred to as the “pain relay station,” because it seperates out the various sensations to communicate with the cortex and limbic system. The cortex perceives the pain, and the limbic system is the emotional center to “feel the pains effect.” In addition, there are multiple modulating centers in the spinal cord, brainstem, pons, and “peri-aqueductal grey” that is collectively known GATING THEORY OF PAIN. Some evidence of brains role in pain is that a stroke in the thalamus produces a famous syndrome in Neurology known as the Dejerine-Roussey syndrome of hemibody excruciating pain, even without an actual cause of pain in the body.
Pain is not exclusively “created by the brain.” Not sure who wrote this to you Boris, but this is highly amateurish and wouldn’t take much stock in it. The human body spends a great deal of energy, brain power, and a significant portion of the spinal cord, in order to monitor pain for protection. These pain signals are DESIGNED to be produced at or near the site of pain. AGAIN, the brain CAN produce pain on its own, but the design is meant to sense pain in the body for protection. An example of this is phantom limb pain. When a limb is cut off, the brain is unsure how to handle this and pain of the stump is perceived by the brain as in the phantom limb. This is because the brain WANTS to continue to receive SIGNAL FROM THE LIMB.
E. B. MD, FABPN
Board Certified in: Clinical Neurology and Clinical Neurophysiology.

This, however, wasn’t enough for this group of people who pretended to be a neuroscientists and the following rebuttal was posted:

”Boris, if you think you can fix broken tissue with your bare hands, through a thick layer of cutis/subcutis, full of neural array, there to protect the brain’s thermoregulatory organ and everything beneath it from external deformation, without engaging the brain itself, especially since epidermis, sensory receptors, nerves and brain all come from ectoderm, then, my friend, you are well and truly self-deluded and are going about blithely deluding others.
If you admit you are treating a person’s pain with your hands, then join the club – that’s all anyone else does, either. Via the perfectly scientifically acceptable mechanism of stress reduction.
I.e., you don’t have magic hands and you are no better “healer” than anyone else on this thread. So no one should have to look at your links or have your stuff presented in the context of a discussion.
It’s also possible you are just being a deliberately obtuse salesperson.”

First of all I never consider myself to be a healer, but a massage therapist. Secondly, to me all this post was a bunch of words, without meaning.  I requested to explain me the meaning of “broken tissue” and never got the answer.
Also this person repeatedly stated that there was no such thing as “pain receptors” at the same time mentioning “sensory receptors.” Again this is an example of confusion and misunderstanding of scientific terminology.

By the way, there is no shame in trying to become a good salesperson. In my case, however, I have miles to learn.  Otherwise why would I offer so many free educational materials?

”If you admit you are treating a person’s pain with your hands, then join the club – that’s all anyone else does, either.”

My answer was:

”When it comes to treating a person’s pain with my hands, applying massage techniques I can reduce size of lymphedema, stimulate muscles to normal resting tone, release tension within fascia, apply techniques of trigger point therapy/ischemic compression. Of course in case of successful massage therapy application, I have mentioned above, my client will experience less pain. I clearly communicated the definition of Physiological effect that massage has on the human body. That explanation included the main power/ “engaging the brain itself.”  However, not only brain, spinal cords are part of CNS. You are welcome to read it again if you miss it. Meantime don’t forget to explain what you meant by saying: ”Boris, if you think you can fix broken tissue with your bare hands…”
Two factors define the physiological effect of massage on humans:

1. The local or mechanical factor is expressed by mechanical acceleration of venous blood drainage, some degree of lymph drainage acceleration, passive exercise for soft tissues, breaking down deposits of calcium in soft tissue and stimulation of its removal from the body.
2. The main power of massage therapy is in reflexive therapy. By mobilizing skin, connective and muscular tissue, we deform the mechano receptors, which in turn release action potentials/impulses. Through neurological pathways these electrical impulses stimulate motor and vasomotor centers. As a reflex, or involuntary reaction of organs and systems to original stimuli, the body responds by expressing positive changes such as: muscular relaxation, vasadilation, reduction of blood pressure, reduction of stress hormones production, etc.

My fellow colleagues, I have decided to extend my blog and to exhaust this subject.

And knowing that not everyone likes reading long blogs, I apologize.

I will try to explain my views why all this  NEW, NEW often happening with in our community .I mean wrong interpretation of data. For example ,findings of constricting fibers within fascia, almost led to “Revolution” of massage therapy approach. When I asked is fascia containing nerves/fascia junctions, like muscles containing? It was a silence. Even when Dr. Schleip , was just talking on front of the camera, shared his excitement about ongoing research, immediately “pretending to be scientist” Lady interpretated this interview, as an scientific data presentation, and came  to conclusion, that fascia is not stretchable. I would ignore some statements and data interpretation like this, if she wouldn’t have  a lot of followers, to repeat this nonsense.BTW. Using the opportunity, and in case if some of you believes that fascia is not stretchable, then you’ll have to claim that fascia is not composed by collagen and reticular fibers.  I mean if fascia is not composed by collagen and reticular fibers, then fascia is not stretchable, as well as ligaments not stretchable, in case  if ligaments wouldn’t composed by collagen and reticular fibers.

Dear friends,

Biomedical field contains specialists of three equally important types: intellectuals, intellectuals/clinicians, and just clinicians. The “intellectuals” are mainly academicians who teach theoretical concepts of a particular science. Some of them possess great skills and academic backgrounds, in doing meta-analysis, and or performing medical statistics. They contribute to design  of research protocols ,research coordination, collecting medical statistics, and contributing to writing research papers, etc.

Intellectuals/clinicians are mainly people in clinical practice, scholars of science, professors of medicine, mainly principal investigators in clinical trials, as well as professionals practicing different medicine and or different methods of treatments.

These people serve as a bridge between intellectuals and clinicians.
Intellectuals and Intellectuals/clinicians practically work for clinicians. This two departments develop protocols/methods of treatment while clinicians learn techniques and theoretical concept well, and then applying on patients.

Intellectuals and clinicians live in different realities. When they communicate and discuss issues almost always many misunderstandings arise. In most cases there is no understanding. At the time intellectuals/ clinicians perfectly communicate with clinicians as well as with intellectuals.

In general intellectuals/ clinicians represent a very small percentage in the entire biomedical fields. Mainly these are scientist intellectuals, and clinicians. These structures are applicable to fields of medicine, physical therapy fields, and chiropractors, as well as to massage therapy fields. Lately many from our community have tendency to pretend to be scientists intellectuals, with no academic backgrounds, skills and capability to do interpretation of scientific data.

Most of us, including myself, are simple, hard-working massage therapists, who use massage therapy techniques in order to achieve results. Some of us possess skills in orthopedic massage, some in full body stress management massage. In principle, massage therapy is very simple but a very powerful methodology of treatment. For us it is crucial to understand physiological effect of massage as well as not to confuse deep tissue massage, with vigorous pressure.

Back to the Neuromatrix theory.

This is not a new theory, and it is the one that never really had clinical use in massage therapy. When asking my opponents on how Neuromatrix theory changed the way they practice massage therapy, I didn’t receive a clear answer but was referred to Neuro orthopedic Institute page, and other similar forums. In order to understand clinical applications based on Neuromatrix theory I also was recommended, to read the book “The neurodynamic techniques” by David Butler.

First of all, Neuro orthopedic Institute and other similar organizations are dedicated to educate about understanding pain and treating pain not massage therapists but physiotherapists and physical therapists. From what I could understand, there is no real emphasis on different variations of pain, and I really cannot understand meaning of the term “The neurodynamic techniques.”

Having said that, I carefully reviewed the book, just to see how it can be incorporated within massage therapy procedure without crossing lines of our scope of practice. The book is 96 pages long and is well illustrated.  From the page number 1 to 4, 10 to 13, 18 to 19, 22 to 24, 30 to 31, 35 to 43, 51 to 54, 61 to 65 and 71 to 86 the book presented techniques that, in my view, massage therapist legally cannot be perform. On the rest pages author proposing self stretching, and kind of exercise. Most likely it wouldn’t be legal to teach our clients this type of home programs, especially using the proposed concept.

There techniques reminded of osteopathic manipulations allowed performing to physical therapists and chiropractors. I couldn’t understand what does, mentioned in book, “nerves palpation” mean? By no means, I assert that the book is not good; it just discusses techniques that we, as massage therapists, cannot perform.

Which brings me back to the question stated in the title of this blog: ”Is it necessary to cross the lines?”

For the last 41 years I practice massage therapy with the great deal of success. I’m positive that many of my colleagues reach great results, by applying appropriate massage techniques. Lately, more and more, members of medical organizations such as doctors from Mayo Clinic, praise massage therapy outcomes. We practicing as a first door practitioners, as well as part of integrative medicine approach. Why crossing the lines? Just focus on perfecting massage performances. It is powerful enough.

Dear friends,

It is possible that Neuromatrix theory is important for clinical psychologists/ neuroscientists, psychiatrists, who deal with psychosomatic pains and other similar types of pains. But it isn’t really useful for massage therapy fields.

I am not a neuroscientist and wouldn’t take on myself the burden of presenting my own interpretation of the Neuromatrix theory.

I share with you my understanding of this theory.

1.Prof.Melzack  never proposed any clinical approach for pain management based on Neuromatrix theory.

2. Reading his works, it was my understanding that he proposed a variety of theoretical aspects. Yet never concluded Neuromatrix theory.
3. Neuromatrix is some kind of network connecting: ”spinothalamic tract in the anterior spinal cord and iplilaterally to the thalamus. The thalamus is commonly referred to as the “pain relay station,” because it seperates out the various sensations to communicate with the cortex and limbic system. The cortex perceives the pain, and the limbic system is the emotional center to “feel the pains effect.” In addition, there are multiple modulating centers in the spinal cord, brainstem, pons, and “peri-aqueductal grey” that is collectively known GATING THEORY OF PAIN.Dr.E.B” As you can see it is a very complicated network.

If you follow my presentation on physiological effect of massage on human body, massive release of action potentials/electrical impulses causes multiple positive changes in functions of organs and systems. All this positive changes in functions of organs and system, is a reaction of CNS to the original stimuli by massage, including stimulation of neuromatrix network. This is why in many cases of no tissue injury pains, we also achieving results. But if pain is a result of lymphedema, higher resting muscular tone, decreased blood supply to the tissues, etc. than until therapists address the mentioned above causes for pain – causes that activating neuromatrix network – client will continue to experience pain. During my career I knew about Neuromatrix  theory but never had necessity to study it deeply. Possessing the knowledge of physiological effect of massage and massage technical approaches that I was trained to perform, was quite enough to deliver results such as less pain, greater range of motion, improved functional activities,  experiencing less anxieties, control of blood pressure etc.

Perhaps the day will come when scientists will know more on neuromatrix theory, and will develop side effects free treatments, to deal with unknown origins of pain. Yet massage therapy is already known, clinically proven great methodology allowing treating people suffering from painful orthopedic disorders, muscular aches and pains related to stress and clinical depressions, etc. Let’s scientists, intellectuals and intellectuals/ clinicians, to develop methods, but meantime we shell talk less, not to pretend to be scientists. We shall continue practicing clinically proven, beloved massage therapy. Our methods of treatment work. Let’s continue helping people to get read of pain and, in general, to feel better.

The last few weeks I spent a great deal of time learning details of neuromatrix theory. It didn’t change the way I practice massage, simply because this theory has nothing to do with what I am doing.

Best wishes.

Boris

Do you speak your professional mind?

Approximately 18 years ago, when I have started producing my medical and sports massage instructional DVD series, my friend’s wife told me: ”Boris don’t do this. You guys should just teach live classes.”  On my question “why not?” she replied: ”the other practitioners will learn your methodology, repackage and rename your product, and will try to discredit and demonize you, including criticizing your accent, your pronunciation, sentence structure, semantic pattern, etc.”

This wonderful woman is an American, while my friend is like myself is an immigrant from the former Soviet Union. She branded us as naïve immigrants who don’t understand American reality.

I had many valid reasons to disagree with her…

1. I teach methodology that wasn’t researched and developed by me and I never claimed or will claim it as mine. I just was trained in and practiced more than 60 protocols of medical and sports massage.
2. At this time two my instructional VHS were out. I didn’t feel like keeping secrets. What for?
3. The whole idea behind production of these educational DVDs was to educate practitioners how to perform Russian medical and sports massage protocols. In order to teach others, one have to acquire many years of clinical experience. This is the only condition when one is able to teach this methodology. It is different business to be a good clinician and to be instructor. Of course one cannot be good instructor and at the same time not be a good clinician. It was absolutely okay with me if people will learn from me, will develop skills to such degree that they will be able to teach others, and will teach details from treatment room.

So, at the time, the idea that someone who would study from me, would demonize, mock and discredit me afterward, seemed nonsensical.

My argument was that I am teaching hands on massage therapy, and rather that English language. At the time I was involved with medical schools in Los Angeles and knew a few professors of medicine, who said to me that my English is good enough to teach hands-on massage because in our faculties many professors of medicine spoke English that was no better than mine.

This gave me some comfort.

Just to entertain you I am offering very funny clips, where accents are discussed. Please be aware, that some F-words are included in this clips. If you are F- word intolerant, than please do not click. Thank you. Voice Recognition Elevator – ELEVEN! (Preview)

In this video The English Language In 24 Accents (Preview) the F-word used even more frequently and its usage is more elaborate. Just warning you.

Al this time I was very happy teaching my classes and being involved in preparing professional career for thousands of American practitioners.  Many of them already possess 20 years of clinical experiences and nowadays teach medical massage, in the same way as trained them.

However, it turned out that to some degree this lady was right.  It wasn’t a pleasant experience and somehow influenced me just to be a clinician and much less being involved in different professional events. The most striking for me, was her statement: ”…don’t confuse freedom of speech in our country, with “freedom” to speak up your professional mind.  Better sit quiet, otherwise you’ll be demonize”

Honestly when she said this to me, I started laughing. I said to her: ”my dear friend, if I had no problem speaking my professional mind in the dictatorship system of the Soviet Union, I will speak my mind here in the US. Surely professionals will disagree with my opinions. So what? We will discuss and ,maybe agree to disagree, but to be afraid to speak our minds??????”

I told her that I was planning to share my knowledge by offering instructional video material for free as well. If someone would disagree on my hands on performance approach, or on presented concepts, then in our times of great technological advancements they could easily shoot their own video and demonstrate their hands-on techniques.  So everybody would be able to learn, including myself.  The less demagoguery is involved the better. Instead our capability to deliver faster, better and sustained results will flourish.

So I did what I planned.  You are welcome to click and to review my free lessons.

Free Lessons Educational Page

Certainly, I wasn’t afraid to speak my mind. But in most discussions I couldn’t even get to the point of agreeing to disagreeing. This it didn’t stop me from continuing to share my knowledge with others. To write my articles, blogs, and to produce video materials.

What was an unpleasant discovery, is that many practitioners afraid to speak their mind, because they would be attacked by the group of (for the lack of a better term) “purists” or “sticklers” who demand to provide references. Even though many of these references make no sense at all and often carry false statements in regards to the huge benefits that the use of massage causes to a human body.

How do I know that many practitioners are afraid to speak their mind? While being involved in arguments with these “purists,” many practitioners used to write me supportive private messages. When I ask why they do not post it their opinions openly, I wasn’t given clear answers. It was obvious, massage therapists are afraid to speak their minds, which is despicable.

This year I had a great opportunity to participate in the World Massage Festival. This was great experience and a very positive energy. All was about massage, including educational programs. The organizers arranged the events in the way that people could use this time as a combination of vacation and educational programs. It is no secret – our community is divided.  But at WMF, it was a really professional mutually respectful atmosphere. I am attributing all this positive respectful atmosphere to WMF mission statement which is:

“To honor those who built the bridges for our profession, to educate the general public about massage, to educate therapists about different types of massage and to have fun. Experts in different types of massage could freely discuss professional aspects, to exchange knowledge, etc.”

I was just copying and pasting from WMF so the statement above is verbatim.

Anyhow, it was a great atmosphere and enjoyed every moment of it. Never again I will miss the future WMF. Many massage therapy schools brought students to this wonderful convention. This future massage therapists felt as a part of our professional family. I personally had an opportunity to present to students at Bon Vital’s booth. Please click this link and you’ll see a big crowd of students who was very enthusiastic to learn.

At this first shift, I presented to students from China who are studying Chinese methods of massage. They were very eager to learn as much as possible on methods of Western massage.https://www.facebook.com/photo.php?fbid=10200767493762768&set=a.2087032368481.2117156.1025316598&type=1&comment_id=3313200

What a huge interest have they expressed viewing my hands on performance and listening to my explanations.  Students asked me many very intelligent questions.  It was a pleasant experience.

I’ve met many wonderful people in person.  Laura Allen looks much, much younger than on her Facebook picture. Fun lady. We laughed a lot.  Cindy and Mike Hinkle are very good people, sincerely passionate to built much-needed bridges for our profession. Darcy Neibaur is simply a very warm and a pleasant person. She is finding much pleasure in welcoming people, to make everybody feel very good.

I had an opportunity to meet James Waslaski. We didn’t have enough time to talk but the conversation was of substance. We talked like a old friends and colleagues.

It was a great deal of pleasure to meet in person Donno Sarvello, NCBTMB VP of educational support.  Practically during a few minutes she explained to me the NCBTMB future educational plans as well as how easy it would be to upgrade the status to the “board certified.” She is very fun young lady – we have laughed a lot.

I was witnessing hard work of Michael Robertson who is a president of AMTA state of California chapter. Honestly I wouldn’t be able to stay, all day long, and to explain students how important it is to join professional Association. I know Michael for a long time, but honestly after witnessing his enthusiasm at WMF I gain even greater respect for him.

I also met Brian Holterman ABMP education program coordinator. He was very busy explaining students and massage therapists the benefits and importance of advanced career by taking continued education, and belonging to trade associations.

These guys are amazing and really inspired me to contribute even more. I also had an opportunity to meet Mr.Thomas P. Haidenberger, owner of BONVITAL – great enthusiastic person. For years I know Bruce Baltz, who is  VP of Education & Business Development at Bon Vital. So I was happy to join  Bon Vital educational team, when few years ago Bruce have invited me. It felt good, but after meeting Mr.Thomas P. Haidenberger, somehow it gave additional great feeling to work with these wonderful people at Bon Vital.

It was great to see Judy Calvert. It’s always a pleasure to talk to Judy, to share with her love and passion for massage therapy. She knows a lot of massage history. It was very interesting to listen to her. Needless to say how generous where every vendor at the exhibit hall. They provided gifts to everyone. I would say pretty costly gifts and a lots of them.

I really regret that missed meeting in person Taya Countryman, Vivian Madison- Mahoney, Ralph Stephens, Walt Fritz, who also took a part at WMF. I hope next time I will have this opportunity to meet them as well.

My dear friends, when reading my blog, you probably felt my excitements. I realized that this is like a mini report from WMF.  I just felt like providing these details. I mean personally for me WMF event changed a lot of perceptions of who are people in my professional community. Most likely I was for a long time involved in arguments with some particular group of peoples who are not sharing my beliefs. I met huge amount of people who are very supportive and encouraging to each other; sharing the knowledge, the knowledge that will help people to deliver better results. I have discovered a different world. Hope to see you all next year at WMF. God willing I will be there for sure.

Best wishes,

Boris

 

The role of medical massage in fighting pandemics of hypertension.

Hypertension is a very dangerous disorder.  It literally endangers  life.  This disorder could lead to strokes, heart attacks, peripheral arteries diseases and to many other diseases.

Hypertension has some known causes such as kidney disorders, tumor on adrenalin gland, narrowing of aorta and some others. All the mentioned above causes of blood pressure are not difficult to diagnose with various blood tests and radiological means. Yet they represent only 8%-10% of all the people suffering from hypertension. Cases of unknown causes fall into the category called Essential Hypertension.

As any other disease the hypertensive disease, once diagnosed, can be treated with medications.  If a patient responds to a medication than doctors can control such condition.  In other word blood pressure, although higher than normal, could be held within a not dangerous range such as under 140 systolic and under 85 diastolic.  Needless to say these medications have side effects, which initiate other health problems, but of course prevents hypertension from causing instant death.

People who don’t respond to medications well have to look for some other means to control hypertension.  Very often people could suffer from high blood pressure/essential hypertension tremendously.  At times it could be as high as 220 to 120, people could be hospitalized for hypertonic crises and yet medications could not make a decisive difference.

In 1973 the professor I studied from, Alexander Dembo MD PhD, paid attention that people who suffer from non-responsive to medication high blood pressure also suffered from neck disorders, tension, discomfort in the neck area, etc.  As a result he came to the conclusion that hypertension in this case is a secondary to the vertebral artery syndrome.http://medicalmassage-edu.com/articles/46-article30

The answer to why people, suffering from Vertebral Artery Syndrome, secondary develop high blood pressure, is pretty simple.  The moment when the Vertebral Artery is compressed and the blood supply to the brain is obstructed, the blood pressure is raised to compensate for its deficiency. http://medicalmassage-edu.com/articles/46-article30

Recently, the second time in the US, I was involved in the hypertension related clinical experiment. Ten patients where privately referred to me to perform massage protocols for Vertebral artery syndrome. All the ten subjects didn’t respond well to medications. i.e. taking hypertensive medications didn’t affect them at all. As well all 10 of them suffered from some neck pain and dysfunctions.

Usually an application of Dembo’s protocol delivers 80 percent success rate.  In this case all ten of the subjects sustained the successful outcome, controlled hypertension.  Forty five days ago I had completed providing 15 treatments for each of them. Being in touch with these patients, I know that it is already been more than 45 days and their blood pressure is under control. To all of them I recommended self massage home programs.

It is important to mention that, in average, most of the patients couldn’t control hypertension using medications for 3+ years. Some of them suffered heart attacks, as well as according to MRI, minor strokes.

Interestingly enough, the doctors who referred these patients for treatment, said that although clinical proof was undisputable, it was not enough to claim that massage protocols work.  Something like this was said: ”We need to understand this process on a much deeper level before making claims.”

I can understand and appreciate their drive. I love to have scientific explanation for everything.  For example in my 10 years old article, I have provided detailed explanation in regards to hypertension secondary to Vertebral artery syndrome.

In general, however, I am more clinically oriented.  To me it is much more important to help a real person in the field than to be able to explain in a scientific paper ”on a much deeper level” why what I do works.

When I put my hands on a person, who has a neck problem, accompanied by high blood pressure and who is not responding to medications, I do the step by step massage protocol designed by professor Dembo and I reach results, such as less pain, tensions and discomfort within the neck area, as well as normalization of blood pressure.

I understand scientist’s curiosity, but it is somewhat irritating to hear “yes, but” all the time.

Once I asked the group of doctors the question regarding “can anyone of you explain the reason why walls of vertebral arteries have their own sympathetic plexus innervation, regulating their constriction and dilation?”

There was silence.

“When we will find the answer to why the Vertebral Artery have their own sympathetic plexus innervation, then we will find the answers to why Dembo’s protocol reduces the blood pressure.”

To me as a clinician the issue of publishing well supported scientific paper and that explain the phenomenon ”on a much deeper level” carries much lesser weight than saving lives.

Hypertension is a terrible disease, a very dangerous when a person is not responsive to hypertensive medication.  In such a case it’s the question of “when” rather than “if” the hypertonic crisis will strike.

One of the patients, a fairly wealthy man whom I helped to control his blood pressure, will privately sponsor large-scale studies. I will work hard at this studies and, of course, will be delighted if scientists will find more explanation why Prof. Dembo’s protocol since 1973 is clinically proven as working.

As far as I know, an appropriately applied protocol of medical massage in the case of the Vertebral Artery syndrome is the most powerful clinically and scientifically proven methodology of treatment and this is the privilege of massage therapist to possibly save people’s life in this case.

I suspect that the desire of ”being able to explain on a much deeper level,” aims at the development of medications that will work in cases of nonresponsive to medication hypertension, secondary to Vertebral Artery syndrome. This is my private opinion, of course.

Don’t take me wrong.  It’s ok with me if doctors want “to understand on a much deeper levels.” In my opinion, though, we don’t have enough massage therapists prepared to confront this hypertensive pandemics right now. Therefore, in the meantime, I’m encouraging everyone to study this protocols, and to implement it.

On my DVD#2 I explain the full protocol for vertebral artery in detail.  The explanation given is similar to my article but more directed to hands on detailed performance. Much other material and individual protocols are also presented on this DVD. To learn more on multiple protocols presented on the DVD#2 please click follow this link http://medicalmassage-edu.com/dvds-only/66

You’re welcome to ask any questions, as well as to post comments.

Best wishes.

Boris

2. As you will understand from my article, that other type of essential hypertension that is not secondary to Vertebral  artery syndrome, can also be successfully managed by full body medical stress management massage, as I am presenting step-by-step protocol on DVD#2.

 

Are trigger points real, or this is false claim that has no clinical value?

Lately much discussion transpires on trigger points. Something like

Are trigger points real?

What are trigger points?

What is the mechanism of trigger points therapy; how it work?

Is it necessary to include trigger point therapy when providing medical /orthopedic massage?

In the end of my commentary you’ll find a brief scientific review on the subject, but prior to reading it, I would like to offer some additional layman considerations.

From our own experiences we know that sometime when we experience pain at any reachable part of our body, by instinct we try finding pinpoint localization of pain, as well as by instinct compressing it and experiencing somewhat good feeling or so-called healing pain.

These facts are supported by real life experiences. Would like to ask the opponents of this notion, whoever claims that there is no such a thing as trigger points.  Is it real pinpoint localization of pain we people find and compress them by instinct? How would you then call pinpoint localization of pain?

Now talking from research and clinical points of view. Medical/orthopedic massage is not a new methodology of treatment.

Medical massage was initially researched and proposed in 1936 by the Russian physician Anatoli Sherbak, M.D., Ph.D. About 20 years later, two German physicians, Dr. Glezer and Dr. Dalicho, developed maps of reflex zones abnormalities in the skin, fascia, muscles, and periosteum. Their work was based on the database of Dr. Sherbak. The first edition of the textbook by Drs. Glezer and Dalicho was published in 1955. Reflex zones maps of Drs. Glezer and Dalicho help tremendously to detect/to locate and to address the above-mentioned abnormalities in cases of support and movement system as well as in cases of inner organs diseases. Since then this methodology was massively applied clinically, including hospital-based programs, outpatient clinics, the matter of fact , utilization of medical and sports massage, contributed tremendously to win most of the Olympian gold medals, from the period of 1960s-1980s. Mention above reflex zones abnormalities in the skin, fascia, muscles, and periosteum, is actually painful local areas, containing tension within fascia, muscles etc. all these painful areas, containing pinpoint pain localizations/trigger points. at article link I am proposing, you will find explanation on morphology of trigger points and more. No need to repeat all. Also in my two weeks ago published blog click here to read Simplicity and extreme healing power of massage therapy

I have explained why injections into the trigger points provide only temporary relief of symptoms. For better understanding of the treatment concept, I would recommend to read it again. It is impossible to reach results in cases of painful orthopedic disorders, if we will not provide adequate treatment including trigger point therapy.

Any scientifically and not scientifically developed protocols must be clinically proven as an working concept for a long time. Otherwise all can be scientifically sounds but will not work. You can have lots of references, but it will be only theoretical concepts, if clinically it will be not proven working.  I am claiming the necessity to provide adequate treatment as was explained in Simplicity and extreme healing power of massage therapy  based on clinically proven necessities to address abnormalities in the skin, fascia, muscles, and periosteum, as well as to provide trigger point therapy.

Those practitioners who deny the existence of trigger points and/or not addressing myofascial dysfunctions and trigger points, only inhibite trigger points, converting them to sleeping trigger points. What I have stated in this commentary, in my blogs, presented on my DVDs and other materials, is a longtime clinically and/or scientifically proven fact.

Below is the link to, I would call trigger points and trigger point therapy scientific review.

http://medicalmassage-edu.com/articles/45-article29

Please feel free to post any questions. Also please find link to medical massage books page by Dr. Ross Turchanonov. They are great texts. Books also including all Dr. Glezer and Dr. Dalicho, maps of reflex zones abnormalities in the skin, fascia, muscles, and periosteum. http://medicalmassage-edu.com/massage-books/223

You all are also welcome to visit medical and sports massage DVDs page http://medicalmassage-edu.com/dvds-only

as well as CEs programs http://medicalmassage-edu.com/ceu-programs

Please be advised that as a member of this group, you will be able to purchase any DVD including CEs programs at 30% discount. This is inclusive benefits for group members only. If you will decide to purchase any program using discounted prices please write to us [email protected]  and you’ll provided the link to discounted pages.

https://www.facebook.com/FreeInstructionalandSelfMassageLessons/app_103822229704881