OrthopedicMassageTheoryTechnique.pdf

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vii

Foreword for Orthopedic Massage:

Theory & Technique

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 perspec-

tive of treatment, rehabilitation or, most impor-

tantly, 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 relax-

ation, or wellness promotion – is non-invasive,

almost totally safe, and with very few absolute con-

traindications. 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 autoim-

mune, 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 of active and passive soft tissue manipula-

tion methods (such as myofascial release, muscle

energy technique), or when it undertakes specific

therapeutic goals, for example deactivation of trig-

ger points, reduction of fibrosis, enhancement of

lymphatic and venous drainage, etc., caution is

required – particularly in cases involving pathol-

ogy, active inflammation, and/or severe pain.

When massage is involved in active treatment, or

rehabilitation settings associated with trauma, over-

use, chronic or acute pain, post-surgical care – as

examples – a requirement emerges for a compre-

hensive, validated (as far as this is possible in manual

therapy) and above all systematic approach to ther-

apeutic intervention. This needs to cover both

assessment and treatment – and needs to include

as a primary feature – contraindications and cau-

tions. Safety becomes paramount, over and above

efficacy.

Orthopedic massage – including as it does a wide

range of adjunctive soft tissue modalities – as com-

prehensively 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, acu-

puncture, massage – or anything else.

Apart from the obvious desire to ease symp-

toms, 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 of manual techni-

ques, as used in orthopedic massage and described

in this book, comprises a number of basic generic

elements, each of which carries inherent potentials

for physiological change ( Lederman 1997 ). Combi-

nations of modes of manually applied loading –

varied by the degree of force employed, the direc-

tions of force and whether this is applied constantly

viii

FOREWORD

or intermittently; as well as the amount of time

involved (brief, lengthy, pulsating) and the rate at

which loads are applied (rapidly, slowly, variably,

harmonically); whether the method is passive or

active, or involves a combination of patient and

practitioner effort, as well as which tissues are

involved (muscle, fascia, scar tissue, joint, etc.),

and their properties and stage of dysfunction (acute,

chronic, subacute etc.), along with the practi-

tioner’s intent – create a huge range of variables

that make up the potentially confusing variety of

therapeutic options open to the practitioner,

whether

regions of the body, within a framework of ortho-

pedic massage and associated modalities, in a logi-

cal 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 profes-

sional 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 evol-

ving health care system, complementary to both

mainstream medical, and CAM, approaches.

in active

treatment or

rehabilitation

settings.

Orchestrating these variables into a systematic

focus on named conditions, organised into the

Reference

Field T 2006 Massage Therapy Research, Churchill

Livingstone/Elsevier, Edinburgh.

Lederman E 1997 Fundamentals of Manual Therapy. Churchill

Livingstone, Edinburgh.

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