Evidence Based Massage

Shifting away from nociception and mesodermalism and towards "yesciception," neurocentrism, and pain science.

Posted on: Mon, 04/28/2014 - 8:12pm By: Alice

Most of us were brought up, professionally, with an idea of "deep tissue" and the need to "break up adhesions," "stretch fascia," and generally "fix" the meat and bones. Along the way, some of us discovered pain science, neuromatrix theory, and the realization that it is the nervous system that creates tension, creates the sensation of pain, and it is through the nervous system that one corrects it. We came to understand that manual therapy works not by mechanically altering muscle, facia, posture, etc., but by influencing the nervous system.

Modern pain science has found that the more the nervous system is subjected to nociception, the more sensitive it becomes. Therefore, we avoid creating pain.

Pain Questionnaire Answers

Posted on: Mon, 04/21/2014 - 5:33pm By: Alice

About a week ago I put up a pain questionnaire.  


As promised, we're providing the answers, courtesy of Zac Cupples, PT.

Zac 
Cupples, a physical therapist in Plainfield, IL, had such great answers to these 
questions that I asked him if I could borrow them and he agreed. A few sentences were edited out for brevity and to keep it where we non-PT folks can understand. Read his unedited answers and the rest of his article on pain education here. Also highly recommended is his series on the book Explain Pain. If you haven't read it, this is a great chapter-by-chapter summary. If you have, it's a great review.

Thanks, Zac! 

And now for the answers:

“The best way to treat chronic pain is to prevent it.”

 

Pain receptors convey the pain message to your brain: FALSE

How Well Do You Know Pain Science?

Posted on: Thu, 04/10/2014 - 10:51am By: Alice

How well do you understand how pain works? Answer these questions and find out. We'll publish the answers after the pain education class this Saturday.

Pain Neuroscience Questionnaire

True or False?

1 When part of your body is injured, special pain receptors convey the pain message to your brain.

2 Pain only occurs when you are injured.

3 The timing and intensity of pain matches the timing and number of signals in danger messages.

4 Nerves have to connect a body part to the brain in order for that part to be in pain.

5 In chronic pain, the central nervous system becomes more sensitive to danger messages from tissues.

6 The body tells the brain when it is in pain.

7 The brain can send messages down your spinal cord that can increase the danger messages going up the spinal cord.

8 Nerves can adapt by increasing their resting level of excitement.

9 Chronic pain means an injury hasn’t healed properly.

10 Receptors on nerves work by opening ion channels (sensors) in the wall of the nerve

Confronting Confirmation Bias

Posted on: Tue, 01/07/2014 - 12:07am By: Alice

I had a couple of interesting conversations today that made me think about confirmation bias. Someone raised the question: 

How can you be certain you are not operating out of confirmation bias?

This is an excellent question and one that we should never stop asking ourselves. 

Confirmation bias is the tendency for us to see what we want to see and ignore what we don't want to see. As professional massage therapists who want to serve our clients well, it's important for us to be aware of confirmation bias and take steps to minimize it. The very first step is to recognize that it exists. 

A Reader Question About Craniosacral Therapy

Posted on: Mon, 01/06/2014 - 1:43am By: Alice

 A reader asked the following question:

How do you describe Craniosacral Therapy to a client who has never experienced it before and how do you promote it?

The simple, most straightforward answer is that I do not practice Craniosacral Therapy (CST) so I do not promote it. I've never had a client ask about it that I can recall. However, if a client were to ask about it, I'd probably answer something like this:

I had classes in Craniosacral Therapy many years ago from two different nationally known instructors. However, I never used it in my practice. I probably practiced some of the things learned in class shortly after I learned them, but abandoned it pretty quickly. 

Gentle Treatment for TMJ Dysfunction

Posted on: Sun, 09/15/2013 - 3:28pm By: Alice

When people say, “I have TMJ,” they usually mean that they have temporomandibular joint dysfunction, a condition that can cause jaw pain that can be difficult to treat. Chewing may be painful and it can lead to headaches and neck, shoulder, and upper back pain. They may experience popping, clicking, and shifting when they open and close their jaw and their mouth may even get stuck in an open position if they yawn or open their mouth too far.

Herniated Discs, MRIs, and Low Back Pain: Part 1

Posted on: Fri, 09/06/2013 - 1:55am By: Alice

 

"Did you hear about the study of the MRIs and herniated discs?" It was 1995, I was working at St. Mary's Hospital, and one of my fellow massage therapists had news about a surprising piece of research. In those days before the internet it was difficult for us to get information about studies of interest to us massage therapists. A juicy tidbit like this was cause for excitement.

Neurocentrism: A Unified Field Theory?

Posted on: Sun, 06/16/2013 - 4:00pm By: Alice

 If all you have is a hammer, everything looks like a nail.

There are many modalities in the field of manual therapy. All of them sometimes work yet many of their explanations contradict each other. 

A massage therapist is trained to treat trigger points. When a client comes to them seeking relief for a pain problem, the therapist will look for trigger points, will inevitably find them, and attempt to resolve them. The client often feels some relief after the treatment. Both client and therapist conclude that the pain was a result of trigger points and that the trigger points have been resolved, at least temporarily.

Another therapist is trained in myofascial release. A client comes seeking relief from pain. The therapist will look for and inevitably find fascial restrictions. The client may feel better at the end of the session, may even find long-lasting relief. Both assume that the pain was the result of fascial restrictions that have now been properly treated and resolved.

Let Us Now Praise Those Who Challenge Us

Posted on: Wed, 05/29/2013 - 3:25am By: Alice

A massage therapist recently asked the question, "Who was your mentor and what did you learn from them?" Immediately, a particular individual came to mind and I began to think of how I would answer that question. Then I thought of the first massage therapist I considered to be a mentor. And then the second one. Shortly after, I thought of two individuals who came into my life a couple of years ago. They challenged me in ways that changed and improved my thinking. I thought back to my science-minded father who did little experiments with me and bought an encyclopedia for me when I was five years old. The list kept growing longer. It seemed to have no end.

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