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Articles Of The Week February 13, 2022

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We all have patients that use them, and I’m sure we’ve all recommended them. However, what does the science say about their use? Well…the evidence is mixed.

Is foam rolling effective for muscle pain and flexibility? The science isn’t so sure – Ken Nosaka

It is really important for us to understand how a treatment affects the people we are helping. Equally important is taking into account contextual factors of treatment and the language we use, or the things we say are just as important to understand.

Nocebo Effect Vs. Placebo Effect: Language Can Affect Outcomes – Joe Camoratto

We know how much the brain influences pain and the perception of pain. Turns out some mindfulness work can influence your thoughts to modulate perceptions of pain which utilizes a completely separate brain pathway than the pathway used to send the physical pain signal to your brain.

Neuroscientists Identify How Mindset Alters Pain Perceptions – Christopher Bergland

Change is difficult, REALLY difficult. However, our profession needs change but we are not alone, every manual therapy profession needs change. The best way to cause change in the profession is to look within and be the change we wish to see, this will cause a ripple effect.

Our Toxic Massage Community Can Change When We Work Together – Stephanie Rodriguez

Science is REALLY cool. While it’s still early and only one person so far, it looks like scientists have found a cure for Type I Diabetes that hopefully will change the lives of so many.

First person cured of Type I Diabetes thanks to stem cells – David Zarley

Overcoming The Difficulties Of Being An Evidence Based Massage Therapist

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Often we see courses offered as the next new “technique” to have in our toolbox but we know when we look at evidence-based practice, the technique really doesn’t matter as much as things like communication, and therapeutic alliance, education, and movement.

As we strive to become more evidence-based a lot of what we see can get confusing as it sometimes seems like it’s telling us what not to do, rather than what to do, while many of the aforementioned courses seem like they’re giving us the “recipe” that will work for everything. 

So how do we know which direction to go?

Recognizing The Limitations

One of the limitations of evidence-based massage therapy are that the practitioner must have the ability to quickly implement this into practice, yet it can take years of practice and training.

Also, the literature fairly consistently talks about EBP in a multidisciplinary setting, which is typically referring to a hospital setting.

We quite often mistake this with a multi-disciplinary setting as we work in, but the two are quite different from each other. In those cases, people are paid hourly, have paid staff meetings, and have situations where collaboration is made easier because they are given the time to do so. 

In order for a team to take this approach in the hospital setting someone’s designated job is to take on the leadership role of implementing EBP throughout the team, however, this doesn’t really happen in most musculoskeletal clinics.

I don’t know about you but sometimes (even when you’re working in a multi-disciplinary setting) it can feel like you’re working in a silo. 

You go to work and spend the day working with your patients and kind of see your colleagues in passing while you’re focused on doing charting and cleanup between treatments. 

This can be even more of a challenge if you’re the only one in the clinic who is working on being evidence-based and others in the clinic are still sticking to the old narratives they’ve used for years, especially when the recommendations for success are for the entire organization to work as a team and adopt this approach.

Another issue we deal with is the arguments we often see on social media discussions where people are scared to even ask questions to help their practice for fear of the negative feedback they will receive. Yet because it sometimes feels like we’re working in a silo this may be our only way to reach out and ask for help or guidance if we need it.

And let’s be honest, implementing an evidence-based practice can just seem like a daunting task. When we look at reading research, dissecting, applying, and then collaborating with others to be truly effective, in addition to running our business, no wonder this is a huge difficulty for us. 

So what can we do?

Is There A Solution?

Truthfully speaking, Massage Therapy is the best-positioned profession to spearhead the application of evidence-informed and science-based practice.

When it comes to evidence-based practice, there are many ways to make this process easier. The first thing to do is to get familiar with the most recent research that has been done in the field. This will help you to become aware of what works and what doesn’t work. You should also find out if there is any further research that needs to be done. The second thing to do is to use the internet. You can find a lot of information on the internet using sites like google scholar, PubMed, or sci-hub to find research articles and you can check out various blogs (like this one) to find what you are looking for.

However, this does take a lot of time.

What if there was a place that could help you with all of these things, plus could give you:

  • a safe space to ask questions about your practice
  • regular presentations to help implement new research
  • research reviews
  • a community of like-minded practitioners willing to help and share their experience
  • people in leadership roles to help the team implement EBP

That’s what we have created with theMTDC Community.

We truly believe that Massage Therapists can be the leaders in MSK care because we have all the tools necessary to do so. We can educate, reassure, provide movement, and give one delicious feeling massage…which is exactly what evidence-based guidelines recommend! 

One of the biggest reasons we can be leaders in MSK care is also because of the time we get to spend with our patients. This extra time we get with people gives us more opportunities to connect, interact, and explore options that will work well for the people in front of us. This is a huge bonus for not only our success but for the success in helping the person in front of us.

However, in order to be a leader in MSK care, we still need to implement new research and keep up to date with the new information available to us. This is where we want to help. We want you to be able to focus on that extra time with your patients and not have to spend so much time seeking out the new research.

We’re going to do that for you with monthly presentations from industry experts and regular research reviews to not only make your practice better (and make you a leader) but also to save you time, money, and build a supportive community around you. 

You can continue working hard on your own but we want to help you take the next step and get on the right path to a successful practice! Join us and get involved in a community where you will have a place to get the guidance and support we all need in our practice. Click on the image below to join theMTDC community today.

 

 

Articles Of The Week February 6, 2022

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When we look at many of the things recommended as a major component of physical fitness flexibility is one of the topics that inevitably comes up. When we compare this to things like cardiovascular endurance, strength, or muscle endurance, is it really as important?

The Case Against Stretching – Alex Hutchinson

I sometimes wonder why others are able to accomplish more than me and honestly I get a little jealous about it. I’ve always thought maybe I just don’t have enough grit to get certain things done. However, it turns out this line of thinking can actually be detrimental.

How I Learned About the Perils of Grit – Todd B. Kashdan

We have always been big fans of movement as a tool to help patients who come in for help. Sometimes it can be a bit confusing on just how much movement to recommend (and this obviously depends on what the person is dealing with). So how much movement in general is beneficial for people? Well, here’s some guidelines!

24 Hour Movement Guidelines – Canadian Society For Exercise Physiology

At this time of year we may have people coming in with new years resolutions about health and fitness along with maybe a new gym membership. As it is with pain there may be a biopsychosocial influence behind why a person wants to do this, and it’s important we take it into account.

I Didn’t Start Weight Lifting Because I Wanted to Be Strong – Casey Johnston

It is often said that word of mouth is the best advertising. What if we took it a step further and took word of mouth online? As this article points out getting patient reviews can not only do great things for people who are booking in but also for the culture in your clinic.

Harnessing the power of patient reviews – Katie McBeth

Three Therapeutic Exercise Progressions For Lateral Movement Of The Hip

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Last week we posted some hip exercises called the “Monster Walks” which were some great exercises you can do

right in your treatment room with a simple exercise band to help with balance and general exercises for the hips.

 

This week we’re going to add to those movements with some extra focus on lateral movements to help with

abduction and adduction.

 

Let’s start with just some simple lateral movements that will work the hip really well for abduction/adduction.

 

Once those more static movements get easier for your patients we can ramp up the intensity a little

by providing some more variability to the movement.

Now we’re going to increase that variability by adding some forward and backward walking movements.

 

Takeaways

  • Make sure your patient is part of the decision-making process for when to progress the exercises.
  • Use the least amount of resistance to start and then add more when the person you’re helping is ready.
  • If you’re giving this as homecare make sure they can give you a good explanation of what they’re supposed to do.
  • Find ways to make this fun and incorporate it into things they already enjoy doing.

Articles Of The Week January 30, 2022

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We talk to our patients about taking care of themselves to prevent disability, but what about when it happens to us? We are in an interesting position as most of us are contractors so unless we pay into it ourselves, likely don’t have any kind of disability insurance. Many of us may push through injury, but how does this really affect us?

When Massage Quits You: The Tangible – Corey Rivera

Remember back in school when we used the pain scale of 1-10 as an assessment for pain? Well, times are changing. Instead, the focus is becoming more around the person’s ability to function. “The assessment of functionality is less subjective than the traditional numeric scale. But that’s not its only advantage. It’s also patient-centred.”

Tired of Rating Your Pain by Numbers or Smiley Faces? There’s A New Way to Communicate Coming – Avery Hurt

Sometimes when a person comes to see us they may have a condition we may know a lot, a little, or nothing about. In a case like Ehlers Danlos Syndrome, all of the above may apply. I did not know there are thirteen different types, nor did I know how it is diagnosed or many of the other things this informative post teaches us.

What Are The Ehlers-Danlos Syndromes? – Ehlers-Danlos Society

We talk a lot about the biopsychosocial aspects of pain. Usually, when we talk about this we’re looking at how these things influence pain. What about when an injury is influencing psychological factors and influencing things like anxiety? Concussions are one of those injuries that can cause anxiety so it’s important for us to understand the symptoms and how to influence better outcomes.

Concussion and Anxiety – Complete Concussion Management

I usually don’t include things I’m involved in with our articles of the week but I think this one is really important. RMT burnout is an important discussion (especially from the last two years) because while we work so hard to take care of the people who come to see us, it’s just as important to take care of ourselves and each other.

RMT Burnout – Jamie Johnston, Eric Purves, Stephania Johnson, Taylor Laviolette, Jocelyn Delorme

Three Therapeutic Exercise Progressions For The Hip

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I joined a great gym last year and quite often when we are doing lower body exercises, they take us through a great warm up.

I have to give them credit because I can’t help but think these would be a great therapeutic exercise progression for the hips that we can easily use in our clinical setting.

It doesn’t take much room and all you need is an exercise band (and maybe something to hold for balance) and you can easily take your patients through this.

 

Here is the first progression you can use.

 

Here is the second progression, a little bit tougher.

 

And the third progression, a little bit tougher again.

 

 

Takeaways: 

  • Make sure you start with the easiest exercise first.
  • Let your patient be part of the decision-making about when to progress and make it harder.
  • Start with the least resistance first.
  • It doesn’t have to be complicated, just get them started.

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