Foreword
Orthopedic Massage: Theory and Technique, 2e [Paperback]
Whitney W. Lowe L
Leon Chaitow ND DO
What is Orthopedic Massage? At its’ simplest it can be said to be that form of massage that addresses orthopedic conditions, whether from the perspective of treatment, rehabilitation or, most importantly, prevention. Before considering the range and potential value of orthopedic massage it would be useful to acknowledge the foundations on which it has been built.
Abundant research shows that massage - in its most generic form, where its’ aim is to achieve relaxation, or wellness promotion - is non-invasive,almost totally safe, and with very few absolute contraindications. And when applied non-specifically, in this way, massage appears to produce consistently beneficial outcomes - involving individuals with a wide range of health problems – including autoimmune, pain and psychiatric conditions. (Field 2006)
However, when massage adopts therapeutic intervention strategies, by incorporating physical medicine modalities (such as the use of heat and cold - via hydrotherapy for example),as well as a variety ofactive and passive soft tissue manipulation methods (such as myofascial release, muscle energy technique),or when it undertakes specific therapeutic goals, for example deactivation of trigger points, reduction of fibrosis, enhancement of lymphatic and venous drainage, etc., caution is required – particularly in cases involving pathology, active inflammation, and/or severe pain.
When massage is involved in active treatment, or rehabilitation settings associated with trauma, overuse, chronic or acute pain, post-surgical care – as examples – a requirement emerges for a comprehensive, validated (as far as this is possible in manual therapy), and above all systematic approach to therapeutic intervention. This needs to cover both assessment and treatment – and needs to include as a primary feature – contraindications and cautions. Safety becomes paramount, over and above efficacy.
Orthopedic massage – including as it does a wide range of adjunctive soft tissue modalities - as comprehensively described by Whitney Lowe in this admirable book, achieves these requirements, thoroughly.
Within the enormous range of techniques, methods, procedures and options, used by the health care professions a general rule can be seen to apply to the objectives inherent in almost all therapeutic endeavors, whether these involve brain surgery, spinal manipulation, medication, acupuncture, massage – or anything else.
Apart from the obvious desire to ease symptoms, without adding to the distress already being experienced by the individual, this ‘rule’ can be stated simply as an aim to reduce the adaptive load (biochemical, biomechanical, psychosocial), that the body is coping with, and/or to enhance the self-regulatory mechanisms of the body, so that they can better handle current adaptive demands.
The wide range of variations ofmanual techniques, as used in orthopedic massage and described in this book, comprise anumber of basic generic elements, each of which carries inherentpotentials for physiological change.(Lederman 1997) Combinations of modes of manually applied loading – varied by thedegree of force employed, the directions of force and whether this is applied constantly or intermittently; as well as the amount of time involved (brief, lengthy, pulsating) and the rate atwhich loads are applied (rapidly, slowly, variably, harmonically);whether the method is passive or active, or involvesa combination of patient and practitioner effort, aswell as which tissues are involved (muscle, fascia, scartissue, joint, etc.), and their properties and stage of dysfunction (acute, chronic, subacute etc), along with the practitioner’s intent – create a huge range of variablesthat make up the potentially confusing variety of therapeuticoptions open to the practitioner, whether in active treatment or rehabilitation settings.
Orchestrating these variables into a systematic focus on named conditions, organised into the regions of the body, within a framework of orthopedic massage and associated modalities, in a logical and systematic manner, is one of the major achievements of this book.
Another is to place orthopedic massage, as described in the text, alongside established professional approaches to biomechanical problems, such as are used in physical medicine, osteopathy and chiropractic. The book should certainly form a resource for use in massage training, and should become an asset, from which to draw, for therapists and practitioners of all manual therapy professions.
Orthopedic Massage can be seen to be an evolving health care system, complementary to both mainstream medical, and CAM, approaches.
Field T 2006 Massage Therapy Research, Churchill Livingstone/Elsevier, Edinburgh.
Lederman E 1997 Fundamentals of Manual Therapy.Churchill Livingstone, Edinburgh.