With a touch from the old school...
MASS0THERAPY AS A MEDICAL DISCIPLINE
Hippocrates wrote in 460 BC that
"The physician must be experienced in many things, but assuredly in rubbing".
Massage has been extensively used and advocated in both Occidental and Oriental health care practices in an almost unbroken line since the ancient times of the Greek Aesculapian Temples of Healing. Hippocrates, the "father of medicine," is considered part of the family line of the Aesculapians and asserted physicians must so trained. The dictionary definition of massotherapy is “medical treatment by massage” (Collins English Dictionary), yet public perception is that of massage – “the act or art of treating the body by rubbing, kneading, patting, or the like, to stimulate circulation, increase suppleness, relieve tension, etc.”
There are many types of disease, whether organic or functional, which in one stage or another can genuinely benefit by some form of massotherapeutics. It is also employed in maintaining health, recuperation from injury and disease, for its soothing or stimulating metabolic effects, but today its medical applications have waned from the medical profession. Unfortunately, as the health care system in the United States became more influenced by biochemistry and technology since the early 1900s, physicians began assigning massage duties to assistants, nurses, and physical therapists. By the 1970’s, massage by prescription was almost virtually abandoned.
In turn, in the 1930s and 1940s, nurses and physical therapists lost interest in massotherapy, virtually abandoning it as well. However, a small number of massage therapists, osteopaths, chiropractors and body workers carried on application and research until the 1970s, when a new surge of interest in massotherapy revitalized the field, albeit in the realm as a nearly ostracized domain of “alternative” health care. That disinterest has continued to the present day, ranking massotherapy as simply one form of alternative health care. We propose its dignity should be restored as a medical discipline, no different in rank or respect than traditional osteopathy or chiropractic.
Massage practices may remain as they are, but massotherapeutics is the scientific manipulation of the soft tissues of the body to normalize physiologic function. As defined by many dictionaries, massotherapy is “medical treatment by massage.” Massotherapeutics consists of a group of manual, mechanical, thermal, photonic, and electrical techniques that include applying fixed or movable pressure, holding, and/or causing movement of or to the body for restoration of homeostasis. These techniques affect the musculoskeletal, circulatory, lymphatic, nervous, glandular and other systems of the body just as powerfully as any drug or medicine when appropriately applied. The basic philosophy of massotherapy encompasses the naturopathic concept of vis medicatrix naturae --that is, aiding the ability of the body to heal itself-- and is aimed at achieving or increasing health and well-being. It is one form of nature cure in addition to nutrition, homeopathy, and herbalism; as well as a medical discipline when appropriately chosen and applied.
Massage, in its varied applications, has either direct or indirect relation to every structure and function of the body; but in its ordinary applications, this therapeutic measure directly and immediately affects especially the skin, muscles, nerves, tendons and ligaments. The systematic application of knowledge regarding the condition of nerves in health and disease, observation, study, experience and skill acquired by constant palpation, massage, manipulation and practice, has resulted in determining certain principles and facts which enable us to determine the conditions of the joints, bones (osteology/orthopedics) and muscles (rheumatology), which by their displacement and pain causing more or less nerve tensions, variation of internal functions, and conditions known as disease. Massotherapeutics can help regulate autonomic nerve function and thus reduce stress which enormously affects glandular dysfunctions and homeostasis.
The massotherapist traces sensitive, swollen, longitudinally contracted muscles, for the purpose of locating their impingement, contraction and tension; just as the osteopath or chiropractor traces bones for structure and function. By palpation the massotherapist determines the muscles which project induration and sore spots (trigger points) which are junctions of irritated nerves imbedded into muscle tissue and indirectly connected to internal organs. There is no better way to locate the cause of disease, or demonstrate to a prospective patient how bones and nerves are related to each other and why such relationship accounts for health and disease, than by palpation and nerve-tracing.
By palpation and nerve-tracing the therapist can often determine the ailing organ and the innervating subdermal nerves affected. Nerves in their normal condition are not sensitive to pressure just as those in the teeth are not affected by cold or hot, sweet or sour foods. By a unique movement or massage of the nerve and muscle which is unduly irritated, because of being impinged against, being imbedded by a toxic foci, or stretched by a displaced bone of the skeleton, is returned to its normal tension, normal vibration, normal temperature and normal function by therapeutic manipulation.
Chiropractors demonstrate the correctness of Dr. Dunglison’s statement in his dictionary, “Irritation is indicated by tenderness on pressure over the spinous process of one or more vertebrae or parts of the sides of the spine. Chiropractors are demonstrating upon living subjects, by no cadavers, no vivisection, that there are nerve fibers which have not been noticed by anatomists. Nerve tracing by palpation explains this unexplainable explanation of ‘vicarious commutation,’ or substitution by distal irritation.”
Osteopathy, chiropractic, naturopathic medicine, orthopedic medicine, Massotherapy, Applied Kinesiology, Acupuncture, and physiotherapy all pay attention to the diagnostic and therapeutic potential of the soft tissues of the body. These and other similar therapeutic systems have developed methods of identifying those aspects of soft tissue dysfunction which indicate disease or injury by reflex activity of some type, and advance treatment by counter-irritation in many, varied forms. Regardless of the terms used or the theories propounded, all the systems essentially refer to the same phenomenon: distinct, palpable, usually discrete sensitive areas of soft tissue aberration which are either directly or reflexively related to local or internal organ dysfunction.
Medics today are trained in how to use pharmaceutical agents to manipulate physiologic function. Surgeons are trained to manipulate physiologic function by mechanical and chemical means. Chiropractors are trained in how to manipulate physiologic function by spinal adjustments. Naturopaths are trained in how to manipulate physiologic function by nutrition, herbal medicines, and other natural agents. Massotherapists should be trained in how to palpate and modify the soft tissues and joints to manipulate physiologic function. All medical disciplines of therapeutics aim to restore homeostasis.
Homeostasis was defined by Claude Bernard and later by Walter Cannon in 1926, as the property of a system that regulates its internal environment and tends to maintain a stable, constant condition of health. Many diseases are a result of disturbance of homeostasis, a condition known as homeostatic imbalance, that therapeutics aims to correct or restore. As the body ages, everyone will lose efficiency in its control systems. The inefficiencies gradually result in an unstable internal environment that increases the risk for illness. In addition, homeostatic imbalance is also responsible for the physical changes associated with aging including change in posture, digestive upsets, loss of vitality, loss of skin tone and changes in complexion, loss of joint mobility, etc. Even more serious than illness and other characteristics of aging includes atherosclerosis, arteriosclerosis, and disturbances of nerve function. Heart failure has been seen where even nominal negative feedback mechanisms become overwhelmed, and destructive positive feedback mechanisms then take over as a result of loss of homeostasis.
Diseases that result from a homeostatic imbalance include diabetes, obesity, hypoglycemia, hyperglycemia, gout, arthritis, and any disease caused by a toxin present in the bloodstream or imbedded into the tissues. All of these conditions result from the presence of an increased amount of a pathological substance, undue stress and intoxication. In ideal circumstances, homeostatic control mechanisms should prevent this imbalance from occurring, but, in most all people, the mechanisms do not work efficiently enough or the quantity of the pathologic substance exceeds the levels at which it can be managed. In these cases, medical intervention is necessary to restore the balance, or permanent damage to the organs may result. Massotherapy ranks high in its drug-less applications and contribution to the restoration of homeostasis by stimulation of detoxification pathways, restoration of nerve function and thus vitality.
According to the following quote, every illness has aspects to it that are a result of lost homeostasis: "Just as we live in a constantly changing world, so do the cells and tissues survive in a constantly changing microenvironment. The 'normal' or 'physiologic' state then is achieved by adaptive responses to the ebb and flow of various stimuli permitting the cells and tissues to adapt and to live in harmony within their microenvironment. Thus, homeostasis is preserved. It is only when the stimuli become more severe, or the response of the organism breaks down, that disease results - a generalization as true for the whole organism as it is for the individual cell." (Pathologic Basis of Disease, third edition, S.L. Robbins MD, R.S. Cotran MD, V.K. Kumar MD. 1984, W.P. Saunders Company)
The systems of mechanical and manual therapeutics are most worthy of our consideration. The utility and necessity of palpation is extant among all the therapeutic arts and practices. Here enumerated, the order is not intended to indicate in any way their relative importance, are the principles of mechanical, electrical, and manual massotherapeutics.
1. The theory of the existence and importance of nerve centers, and the practice of localizing manipulation upon regions particularly adapted to affect these centers.
2. A belief in the importance of nervous reflexes. The entire body is governed by reflexes and feedback loops to maintain homeostasis. Reflexes normally protect the body from harm but when altered they may provide centers of irritation. They are evidenced by nervous tics, disturbed digestion, pain, morbid habits and addiction.
3. The observation that counter-irritation by mechanical, manual and electrical means, can reverse morbid reflexes. The internal disorders can alter sensations and function of the body’s soft tissues and reciprocally, mechanical irritation and manipulation of the soft tissues as a form of counter-irritation can modify the morbid functions of internal organs and restore homeostasis.
4. The theory that slightly displaced bones cause disease by interfering with nerve and blood vessel functions; and the practice of attempting to reduce displacements by manipulation restores homeostasis. All abnormal spinal curvatures, however slight, may cause dysfunction or other disease; and the practice of treating all classes of curvatures by manipulation helps restore homeostasis.
5. The theory that fascia and ligaments, thickened as a result of strain, toxic impregnation, or irritation as well as scar tissue may act as obstructions or entrapments to nerves or vessels. Massotherapy can relieve these entrapments.
6. The practice of giving attention to the feel of muscles, the theory that contracted muscles cause interference with nerves and with vessels and the practice of manipulation of these muscles in order to relax or tone them restores homeostasis and vitality.
7. The practice of giving particular attention to tender points, especially along the spine, muscles and soft tissues. Tender points represent toxic foci of irritated nerve centers and may be debrided (cleansed) by manual, mechanical, vibratory, or electrical means.
8. The practice of employing manipulations as mechanical stimulants to treat pain and foster recovery.
9. The practice of employing manipulations to lessen sensibility or hyperactivity in order to foster homeostasis.
10. The theory that the heart and brain’s actions can be altered by external manipulation.
11. The theory that the vasomotor mechanism and, through it, the distribution of the blood, can be altered by external manipulation.
12. The practice of employing manipulations in order to reduce congestion or accumulation of fluid to restore homeostasis.
13. The practice of manipulating the abdominal viscera, for example, the liver, the colon, the small bowel, or the gall bladder, for the purpose of moving forward their contents, or of increasing or decreasing their activity to restore homeostasis.
14. The fundamental theory that health is synonymous with normal circulation of fluids, diurnal digestive powers, normal elimination, and normal nervous innervation, and that disease is primarily an interference with any of these functions.
15. The fundamental theory that all life processes are fundamentally electrical. From atoms to molecules, and biochemical functions are ultimately electrical. From nutrition to digestion, from nerves to organs, from evacuation to micturation, the human body depends upon its electrical systems and ionic carriers to sustain life. The heart contains ‘pacemaker’ cells which send out the electrical pulses that cause it to maintain a regular beat. Similar cells also govern the action of the nerves and digestive tract functions. The very process of thought itelf and all body reflexes are a series of electrical pulses that speed across millions of synaptic connections within the brain. Our nervous system is a ‘hard-wired’ network designed to carry sensory information and instructions, all in the form of electrical pulses. Electrotherapy can assist manual manipulations to restore these functions.
16. The belief that a large domain of chronic illnesses are the result of toxic and morbid accumulations in both hard and soft tissue, that the method of detoxification by oral ingestion or abstinence alone is often insufficient to restore homeostasis. The belief that effective detoxification of the soft tissues require manual and mechanical stimulation in the forms of massage, counter-irritation, thermal agitation, sonic and vibratory agitation, iontotherapy, hydrotherapy, electrotherapy, and other means is most efficacious and hastens nature cure.
17. The belief that disease can be treated in accordance with these theories and by these practices of therapeutics is more safely and satisfactorily applied than by the use of drugs in a large majority of cases.
18. The belief that an intelligence that controls the functions of the body in health, it follows that it is the same power or energy that fails in case of disease. Failing intelligence, with plunder into chaos, the body requires assistance; and that is what all therapeutic agencies aim to accomplish. There is no life without mind, from the lowest unicellular organism up to man/woman. It is, therefore, a mental energy that actuates every cell and fiber of the body under all its conditions. It follows that the therapeutic value of all remedial agencies, material or mental, is proportioned to their respective powers to produce the effect of stimulating the subjective mind to a state of energized activity, and directing its energies into appropriate channels. We know that mental suggestion fills this requirement more directly and positively than any other known therapeutic agent; and this is all that needs to be done in many cases for the restoration of health outside of the domain of necessary surgery or trauma care. No power in the universe can do more to energize the mental organism than therapeutic suggestion which is the seat and source of restoring health within the body. It can be administered by voice, hands, presence or even human radiation. It is a psychological process by which an idea is induced in or adopted by another without argument, command, or coercion. This is a paramount duty of the therapeutician to cultivate and use this marvel of God.
19. The belief that man/woman are psychospiritual, sentient beings; that healing must and always accompany on the mental plane; that massage was historically rooted in religious practices, and that the religious beliefs of all practitioners and patrons alike must be respected.
That each one of the ideas and tenets mentioned enters into the platform of every practitioner at some time, and of some drug-less practitioners all the time, there can be no doubt. We may, then, take this group of practices and theories as a just representation of massotherapeutics as it is taught and practiced, and use it as a basis of comparison and complement with other medical systems. We shall take up in our courses, in turn, each of the items of the foregoing statements and inquire, in the case of each, to what extent it is new, and characteristic of massotherapy alone, and to what extent is to be found in the teaching and practices of the other systems considered.
Rheumastism as defined is ‘any disorder of the extremities or back, characterized by pain and stiffness.’ Rheumatism by extension is any of several pathological conditions of the muscles, tendons, joints, bones, or nerves, characterized by pain, stiffness, discomfort and even disability. Rheumatism often manifests as those individual aches and pains for which no definite physical cause can be found yet we know all humankind suffers from throughout their lives. Rheumatism is a large domain of massage and manipulative therapies.
The so-named syndromes of this group are classed as those of heredity; those caused by trauma and stress (physical and psychic); accentuated by autointoxication, poor hygiene and nutritional deficiencies; whose duration may or may not be self-limited, and are readily relieved by massage, acupressure, various manipulations and chiropractic and osteopathic adjustments; electrotherapy; thermotherapy; heliotherapy, balneotherapy, etc. The modern terms for accumulated rheumatic afflictions go by such terms as fibromyalgia, chronic fatigue, fibrositis, lumbago, arthritis, and rheumatoid arthritis. It goes without saying, all of humanity is at some time, some point, or by some measure, is affected by a rheumatic disorder. Thus massotherapeutics should constitute a distinct medical discipline as its own.
Today, the benefits of massage are far reaching and varied. It is an accepted part of physical therapy programs, has proven to be beneficial for many chronic, medical conditions, including arthritis, bursitis, depression, diabetes, fatigue, low back pain, smoking cessation, depression and much more. Massotherapy can help relieve the stress and tension of everyday living that can lead to disease and illness. The fact that the nerves in the skin, muscles and sinews are connected to the internal organs is widely recognized. Massotherapeutics offers a wide field of medical applications requiring extensive professional training and justly deserves its rank as a post-graduate terminal degree of education.
Graduates of the Panamerican School of Natural Medicine may enroll in the degree program: Doctor of Massotherapeutics (D.M.), and the right to use the name Massotherapeutician™ as part of their title.
