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Everyone has learned about endangerment sites, right? These are areas containing structures that lie near the body’s surface and, because of their location, heavy and/or sustained downward pressure is avoided.
Well, this idea deserves a little examination…
I’m in the process of working on my next book. I’m a big believer in an extensive review process because “two heads are better than one.” This book project has over 90 reviewers (so far). I also insist on scholarly reviewers, so the cardiovascular chapter was reviewed by a cardiologist (who also happens to gets weekly massages).
Her comment about endangerment sites was “With the exception of the carotid artery, I don't think this and following arteries should be called something that invokes fear. Unless one puts sustained, unrelenting pressure on these arteries for more than several minutes, no damage will result. As an example, you can massage my temples for 10 minutes and I'll roll over like a dog and kick my legs. You're not consistently occluding the artery for those 10 minutes.”
When she read about avoiding sustained pressure on the abdominal aorta while address for the psoas through the abdominal wall, she writes “Unless there is an abdominal aortic aneurysm, not a problem.”
Is what we know about endangerment sites fact or myth?
What does the research say?Share your thoughts…..
Carotid artery endangerment is also about vagal stimulation as well as the risk of helping dislodge clots. The carotid has baro-receptors that when massaged trick the brain into thinking the Blood Pressure is too high and the vagus nerve is stimulated resulting in decreased HR and force of contraction which can lead to a severe drop in BP. This is an intervention that medical professionals use to help with tachycardia. Also not good if people have underlying arrhythmia issues. The carotid is also very susceptible to plaque buildup and pressure or striping of the artery can dislodge an emboli.
I don't know of any reason for striping of anything even in healthty people. However when people have specific health issues special precautions are needed. I was speaking of healthy people only.
One of the TAs pushed so hard into my psoas that I fainted. hmmm.
Tracy Walton once said in a class that most of what is taught in massage school has not been proven.
I'm enjoying catching up on everyone's comments and always like to hear what you're thinking about and working on. I just read the attachment Julie posted, by Batavia, who brought up a point about relative vs absolute contraindications. As as become experienced MTs we realize most are relative, but for a student or someone just starting out......
Information is changing and disseminates quickly, as you said. I'm learning to preface my research with "to the best of my knowledge." We do the best with what we know at the time (in practice and in research), and as long as we're willing to hear what others have experienced (which might be something we hadn't considered) our intentions are good. Intention is what I remember emphasized in school. Intention was used recently in the MTBOK to decribe our work to the public.
We all know research isn't the "end all be all" for massage therapy, either. It is, however, one way to answer questions, evolve our field, and gain respect from the public. Practicing ethically, improving curriculum, writing and publizing, addressing policy, lobbying for insurance reimbursement, and applying public health applications to the disadvantaged are other ways we gain positive support and promote our industry.
Whew... can you tell I haven't posted for some time?