How Medical Massage For Physicians Integrates Soft Tissue & Structural Bodywork Therapy Into Their Practice, OR Managing Patients Referred To Outside Soft Tissue Practitioners
Acknowledgement of the value and effectiveness, as well as scientific foundations, of Soft Tissue Therapies such as Medical Massage; Clinically Oriented, Structural Bodywork; Therapeutic Stretching (Yoga Therapy); and other similar therapies is increasing almost by the day.
Medical Massage for Physicians offers opportunities to provide more comprehensive, neuromuscular, myofascial and musculoskeletal services for patients, as well as enhancing clinic profitability if employing soft tissue therapists in-house.
Such practices embracing medical massage for physicians are gradually moving from the “alternative” realm to the mainstream. And MANY patients feel that, properly administered, such therapies are among the most effective treatments available to them. That assumes, of course, their conditions and complaints are manifestations of problems of the neuromuscular & myofascial networks of the body, affecting, overall, the musculoskeletal system.
Yet muscle tension also affects, for example, the intestines. With walls made of muscle, they too are subject to accumulations of tension and stress, thereby interfering with their proper peristaltic function.
Patients with what felt like heart attack symptoms were found to have only spasms of the muscles of the chest wall. Spasm in the diaphragm can impair lung function considerably. Abdominal wall tension can inhibit a freely moving diaphragm, as well as cause acid reflux.
Though of course not accessible for direct treatment, the walls of the blood vessels are lined with muscle fibers as well. Assisting the patient or client in deep relaxation in more peripheral areas of the body can produce systemic decrease in tension and stress in the deeper structures and organs that cannot actually be touched.
When it comes to Anti-Aging and Elegant Aging, it is important to note that muscle cells chronically contracted into a state of more-or-less permanent tension have increased internal osmotic pressure within the sarcomeres containing the actin / myosin fibers. As long as the actin / myosin units are chronically tensed and shortened, the pressure inside the cell will force water out of the cells, and prevent the water from returning, no matter how much the patient hydrates, and no matter what supplements they take to enhance hydration.
The loss of that internal water has many implications for loss of efficiency of diameter, strength, and general function of the muscle unit.
… And so on.
And such soft tissue therapies are among the most non-invasive and safest treatment options available for many afflictions of patients. This is bolstered by the fact that insurance rates for massage, bodywork and yoga are among the lowest premiums in the health care industry.
Yet not all massage is created equal. … Studies are all over the board as to effectiveness due to the fact there are so few criteria that can be controlled for. There are so many variables. These include:
- a wide range of possible root causes of a pain or dysfunction presenting as (apparently) the same thing in the patient’s description.
- many therapists have wide variability in how they assess what areas of the body need treatment, and how much.
- a wide range of “styles” of massage therapy, even among therapies that have he same label.
- an even wider level of skill levels for every therapist.
- every patient’s body has widely varying tension & stress levels and metabolic function.
- every patient has a different psycho-emotional orientation to being touched.
Every drug dose can be nearly identical, so there is little to no variability from dose to dose. Yet large numbers of manual therapists have very different styles of massage and quality of training. The “natural manual sensitivity and ability” of therapists also varies widely. The level of mental acuity for evaluating and assessing clients, and the wide-ranging methods to do so, vary widely as well.
As a result, rarely is there an “identically” applied massage stroke or pressure even from the same therapist.
Therefore, two physicians administering the same drug has FAR less variability than two massage therapists performing “the same” style of massage. Controlling for the wide-ranging variability from “dose-to-dose” in hands-on therapy approaches impossibility. (The same is true for chiropractic, possibly explaining the disappointing results of many studies of spinal and joint manipulation.)
Regardless, highly skilled, top performing therapists regularly produce VERY significant results for their clients and patients, with, in many examples, a VERY high success rate. Many times, these successes are with afflictions unresponsive to medical, chiropractic or osteopathic methods.
Making sure these are the therapists chosen to administer treatment in a controlled study is difficult at best. This is especially because most of the great ones are very busy in their private practices, and have little time, nor interest, in participating in such studies. After all, they see the results in their own work, as do their clients or patients. They do not need to be “convinced” by more studies.
All of the above possibly explains why so many people receive so much value from their soft tissue therapist, yet controlled studies do not demonstrate such consistently remarkable results.
Because of the low overhead and liabilities, and the potential results for patients, a properly managed staff of well trained therapists can be very profitable for the physician(s) with an in-house staff. Otherwise, if referring out to therapists with known skills and knowledge, patient recovery from symptoms and conditions and improved well being is greatly enhanced, reflecting well on the physician providing the referral.
This section of this website will focus on how medical massage for physicians can be utilized to understand, apply, and manage soft tissue therapists.
Central for the application of medical massage for physicians is understanding of C.E.M.&.N.T. or Chronic, Excess Muscle & Nerve Tension & Stress.
The primary task of the physician is to recognize when a patient presents with C.E.M.&.N.T., then either instruct them in how to manage it, or refer the patient to a competent therapist who is qualified to work with reducing or eliminating C.E.M.&.N.T. After that, understanding the process of working therapeutically with C.E.M.&.N.T. allows the physician to properly mange the case and therapist performing the therapy.
It is OUR job to give you the insights you need to perform those steps, and provide therapists who can do perform the therapy.
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