MORE MYTHS OF MASSAGE

Replies to This Discussion

Permalink Reply by Leigh Catlett on January 28, 2010 at 3:10pm

I often question and do use the internet as a sourse for research when presented with an issue that I either learned in school as fact or was told by a fellow massage therapist. Unfortunately there is never a clear answer in mythbusting as every question has 2 sides. Case in point: I was taught in school that you NEVER massage someone who is on kidney dialysis. My uncle Jimmy has been on dialysis 3 days each week for nearly 5 years. He's 80 years old and has the most positive outlook on life. He says the greatest pleasure (besides the love of his family) is his weekly massage. Unfortunately he lives about 4 hours away from me so it isn't me who gets to share his pleasure. I think the best rule is to follow your heart and the amazing power of touch.

lee kalpin said:

Thank you for your insightful comments. That is my point entirely - question what you read, question what you are told, try it in your own practice if it seems like a good and sensible technique and make careful observations as to whether it works.
My concern is with massage therapists, massage therapy student and teachers who do NOT question. A teacher tells them something and they do it forever,- or refuse to do it because they were told it is a contraindication. When I ask what is their reference source, I find that they have never even tried to research it.
It is not always easy to find the good reference sources, but today with internet it is easier than it has ever been in the past. Also, if a teacher or lecturer teaches you something, ask for THEIR reference source, and then check it out.
Rajam K Roose said:

As more research is done that isn't biased, we will continue to find there are things we were taught that aren't valid. Unfortunately, many of the things that were shown to be invalid many years ago are still being taught.

For example, I would take Paul Ingraham's site with a grain of salt. On his section about working the occiputs, he writes:

"The exact centre is the one spot where you might not get a positive reaction. There is a small hollow there, right at the top of the spine. To some people, pressure on this spot — which is not actually even muscular — will be sweet bliss."

He goes on to encourage the therapist to apply firm pressure directly in the soft region right in the middle of the occipital triangle.

This is taught to be an endangerment site as there is the vertebral artery runs horizontal in there from coming up the sides of the vertebrae and also spinal nerves. Digging around in that area is not a good idea. Looking at anatomy videos and through my anatomy books, I don't agree with that endorsement. (Although I will say that it is hard finding good breakdown of the anatomy of the occipital triangle!)

Tom Myers recently wrote an article about his experiences at the 2nd International Fascial Conference and I really liked something he said toward the end of his article, which was:
"..."Can you show me why I failed this patient" is a much more interesting question than "Can you confirm my prejudice about why I am succeeding with these patients."

Basically, as therapists we have to question a lot of what we hear, whether it be from someone we agree or disagree with. It's our responsibility to look into the work as we are able to discern for ourselves, and it's not easy especially if we don't have good resources or connections to find out about those resources.

e

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Permalink Reply by lee kalpin on January 28, 2010 at 4:06pm

I think what you have to do in this situation is look at the REASON why it is supposed to be a contraindication. In this one I believe the rationionale is that massage will increase kidney function, putting too much stress on the already overworked kidneys. In the case off your uncle, it seems that he has been able to live a pretty normal and a long life in spite of his kidney problems. Obviously the massage is not doing him any harm, and is doing a lot of good.

My massage reference books says that "advanced kidney failure" is a contraindication, and chronic kidney disease is a precaution. I think this is an excellent text. Outcome-Based Massage (2nd edition) by Andrade & Clifford (LLW). Evidence based and well referenced.

Leigh Catlett said:

I often question and do use the internet as a sourse for research when presented with an issue that I either learned in school as fact or was told by a fellow massage therapist. Unfortunately there is never a clear answer in mythbusting as every question has 2 sides. Case in point: I was taught in school that you NEVER massage someone who is on kidney dialysis. My uncle Jimmy has been on dialysis 3 days each week for nearly 5 years. He's 80 years old and has the most positive outlook on life. He says the greatest pleasure (besides the love of his family) is his weekly massage. Unfortunately he lives about 4 hours away from me so it isn't me who gets to share his pleasure. I think the best rule is to follow your heart and the amazing power of touch.

lee kalpin said:

Thank you for your insightful comments. That is my point entirely - question what you read, question what you are told, try it in your own practice if it seems like a good and sensible technique and make careful observations as to whether it works.
My concern is with massage therapists, massage therapy student and teachers who do NOT question. A teacher tells them something and they do it forever,- or refuse to do it because they were told it is a contraindication. When I ask what is their reference source, I find that they have never even tried to research it.
It is not always easy to find the good reference sources, but today with internet it is easier than it has ever been in the past. Also, if a teacher or lecturer teaches you something, ask for THEIR reference source, and then check it out.
Rajam K Roose said:

As more research is done that isn't biased, we will continue to find there are things we were taught that aren't valid. Unfortunately, many of the things that were shown to be invalid many years ago are still being taught.

For example, I would take Paul Ingraham's site with a grain of salt. On his section about working the occiputs, he writes:

"The exact centre is the one spot where you might not get a positive reaction. There is a small hollow there, right at the top of the spine. To some people, pressure on this spot — which is not actually even muscular — will be sweet bliss."

He goes on to encourage the therapist to apply firm pressure directly in the soft region right in the middle of the occipital triangle.

This is taught to be an endangerment site as there is the vertebral artery runs horizontal in there from coming up the sides of the vertebrae and also spinal nerves. Digging around in that area is not a good idea. Looking at anatomy videos and through my anatomy books, I don't agree with that endorsement. (Although I will say that it is hard finding good breakdown of the anatomy of the occipital triangle!)

Tom Myers recently wrote an article about his experiences at the 2nd International Fascial Conference and I really liked something he said toward the end of his article, which was:
"..."Can you show me why I failed this patient" is a much more interesting question than "Can you confirm my prejudice about why I am succeeding with these patients."

Basically, as therapists we have to question a lot of what we hear, whether it be from someone we agree or disagree with. It's our responsibility to look into the work as we are able to discern for ourselves, and it's not easy especially if we don't have good resources or connections to find out about those resources.

e

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Permalink Reply by lee kalpin on January 28, 2010 at 4:09pm

Pregnant women are a lot hardier than our massage teachers led us to believe. Most women athletes keep working out and pursuing their sports throughout most of the pregnancy. Women work throughout their pregnancies, and those who have other children are still caring for them, picking them up.
When I was pregnant I took a canoe trip, including portaging, and rode my horse until two weeks before delivery.
You are correct, that if a woman is prone to miscarriage, something, anything, or nothing at all may trigger that process.

I think the primary concern of many therapists is that if a miscarriage occurs, they will be blamed. People are afraid of being sued..


Leigh Catlett said:

My school taught that massage was contraindicated for women in their first trimester of pregnancy. I have to agree with Lee in that the few women I worked on were pregnant didn't know (or let me know) until they were easily into their 3rd month. From what I could garner from my "research" was that the same regarding not working around the medial malleolus as well as the area between the thumb and the index finger... all based on reflexology points. What I did find in my research was that working those areas during the first trimester would not cause a miscarriage, but only hasten the inevitable. In any event, I continue working on clients who are pregnant but avoid both the areas around the medial malleolus and the hands. If anyone knows anything different I would welcome the information.

Thanks!

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Permalink Reply by Rajam K Roose on January 28, 2010 at 5:40pm

Paul Ingraham wrote: "Fair point, but I don’t think it’s a major issue. Numerous listings of endangerment sites do not include this location. Also, concern about applying pressure to nerves and arteries is generally exaggerated. For instance, many listings of endangerment sites include the entire anterior cervical triangle, but obviously there’s plenty of good therapeutic work that can be done in this region. Endangerment sites are not necessarily off-limits, just areas where there’s a red flag.
That said, your point should be noted in the article. I’ll make an appropriate adjustment to the language. Thanks for pointing it out.

I hope that you won’t take my entire site “with a grain of salt” just because you disagreed with one thing that you found in an article I wrote about ten years ago. No writer can stand by everything they have ever written. Of course, you can certainly take SaveYourself.ca with a grain of salt in the sense that it’s always good to think critically! But I would encourage you to evaluate claims and statements individually and give SaveYourself.ca plenty of chances to be useful to you. It’s a really big site. ;-)"



Actually, I do like the saveyourself.ca site, I think it's obvious you've put a lot of hard work into it. I will let you know that I take everything with a grain of salt, and that has more to do with my life experiences than anything personal. But a client being dizzy from compression in the vetebral arteries when they get off the table, and they pass out and hurt themselves falling can be an issue, especially if they have had whiplash or are elderly. That being said, there are areas that are taught to be endangerment sites and maybe not so much, like behind the knee.

There are a lot of things we learned (well, I learned ten years ago) and aren't true and things I'm still being taught that aren't true and there are things that I pass on as information that isn't right either (but of course, I don't find out until later!)

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Permalink Reply by lee kalpin on January 28, 2010 at 9:21pm

I think Paul's site is excellent. Lots of good information explained clearly and in a manner that everyone can understand. Certainly there may be some errors. I have found errors in some of the most renowned text books. We are always learning and thereby upgrading our knowledge. It's an ongoing and never-ending process - or it should be.

I called this site the "Myths of Massage" and we often havie a little chuckle at the mis-information that was taught in the schools and passed on by word of mouth to generations of massage therapists. We should remember, however, that it was often the best information available at the time, or those who taught it thought they were sharing good knowledge.

We have a major focus on Evidence Based Treatment. It is important to realize that we have only the latest, most up to date information from research. New research projects will often disprove what we formerly thought to be the best, evidence based practice.

Think of the news we receive on the media. One year we are told that a particular food causes cancer and should be avoided. The next year we hear that a newer study disproves these findings and the newest research shows that this food is extremely good for us!!! And maybe next year it causes cancer again.

I think the lesson to be learned is that we need to be constantly reading and keeping informed so that we don't fall behind in our knowledge. It is so much easier to do in this internet age! .Sites like this one are excellent sources of information. I agree, take everything with a grain of salt - even the latest research findings, as they may be disproved next year

Rajam K Roose said:

Paul Ingraham wrote: "Fair point, but I don’t think it’s a major issue. Numerous listings of endangerment sites do not include this location. Also, concern about applying pressure to nerves and arteries is generally exaggerated. For instance, many listings of endangerment sites include the entire anterior cervical triangle, but obviously there’s plenty of good therapeutic work that can be done in this region. Endangerment sites are not necessarily off-limits, just areas where there’s a red flag.
That said, your point should be noted in the article. I’ll make an appropriate adjustment to the language. Thanks for pointing it out.

I hope that you won’t take my entire site “with a grain of salt” just because you disagreed with one thing that you found in an article I wrote about ten years ago. No writer can stand by everything they have ever written. Of course, you can certainly take SaveYourself.ca with a grain of salt in the sense that it’s always good to think critically! But I would encourage you to evaluate claims and statements individually and give SaveYourself.ca plenty of chances to be useful to you. It’s a really big site. ;-)"



Actually, I do like the saveyourself.ca site, I think it's obvious you've put a lot of hard work into it. I will let you know that I take everything with a grain of salt, and that has more to do with my life experiences than anything personal. But a client being dizzy from compression in the vetebral arteries when they get off the table, and they pass out and hurt themselves falling can be an issue, especially if they have had whiplash or are elderly. That being said, there are areas that are taught to be endangerment sites and maybe not so much, like behind the knee.

There are a lot of things we learned (well, I learned ten years ago) and aren't true and things I'm still being taught that aren't true and there are things that I pass on as information that isn't right either (but of course, I don't find out until later!)

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