1. Complementary and Alternative Medicine Part II Manual Therapies
Candice Gorremans
Kaplan University

2. Outline Introduction Massage and Touch Therapies (General Massage)
Massage and Touch Therapies (Sports Massage)
Osteopathic Medicine
Chiropractic
Reflexology
Shiatsu
Resources

3. Introduction to Manual Therapies
Manual therapies are an essential component to CAM. They can be used in conjunction with other therapies or independently. Manual, alternative therapies have gained immense popularity in recent years because of their versatility, availability and therapeutic benefits. Massage and reflexology for example are conducted in clinics as well as spas. One of the main benefits of manual therapies is that CAM practitioners take a holistic approach. Healing of the mind and spirit are crucial components that are included in the therapy.

4. Massage and Touch Therapies
General Massage
Massage therapy is one of the oldest, well-known and most widely used types of manual therapy. The use of massage can be traced back to 15,000 BC which was before written records. Cave paintings in Europe depicted the use of therapeutic touch. Although massage is a physical therapy it is highly effective as a mind-body modality. It helps to reduce physical and mental stress.
The most fundamental theory of massage is that the body will function properly only when venous, arterial and lymphatic vessels flow are not impeded and the flow is in a balanced state.
There are five different techniques in massage therapy, effleurage, petrissage, friction, tapotement and vibration.
Effleurage- this is the most commonly used technique which involves gentle, gliding strokes with moderate pressure.
Petrissage- this technique is more aggressive and involves a “milking technique using the thumb and fingers

5. Massage and Touch Therapies
General Massage
Friction- the friction technique also requires the deepest pressure, while using fingers and thumbs in a back-and-forth or circular motion
Tapotement- this technique requires vigorous and rhythmic hits with the lateral aspect of the hand
Vibration- the therapist may choose to use an oscillator or vibrator for assistance when performing this technique because it can be difficult and tiring to perform over time. It requires a brief, light strumming or snapping over certain tissues.
Sports Massage
The primary goal of a sports massage is to reduce injury and to enhance performance. This type of massage is generally used by athletes and people who engage in a frequent, high level of exercise and physical activity.

6. Osteopathic Medicine
Osteopathic Medicine was first used by the Greek physician Hippocrates
It was introduced to the modern world by Dr. Andrew Still in the late 19th century. The goal of osteopathic medicine differs from contemporary, allopathic medicine. Osteopathic practitioners take on a more holistic approach. There is a greater focus on correcting an overall imbalance in the body and restoring homeostasis.
It was also the only form of medicine in the 19th century that addressed issues such as physical rehabilitation, joint pain and soft tissue injuries.
The principles of Contemporary Osteopathic Medicine
1. The human being is a dynamic unit of function
2. The body possesses self-regulatory mechanisms that are self-healing in nature
3. Structure and function are interrelated at all levels
4. Rational treatment is based on these principles

7. Chiropractic
Chiropractic medicine offers ways to relieve pain associated with the spine and nerves, without using surgery or pharmaceuticals.
The goal of chiropractic is not pain relief. Instead, the goal is to correct functional and structural imbalances that can cause pain.
Core Chiropractic Principles
1. “Structure and function exist in intimate relation with one another.”
2. “Structural distortions can cause functional abnormalities.”
3.Vertebral subluxation is a significant form of structural distortion and dysfunction and leads to a variety of functional abnormalities.

8. Chiropractic Core Chiropractic Principles cont.
4. “The nervous system occupies a preeminent role in the restoration and maintenance of proper bodily function.”
5. “Subluxation influences bodily function primarily through neurological means.”
6. “The chiropractic adjustment is a specific and definitive method for the reduction or correction of the vertebral subluxation.”

9. Reflexology
The practice of reflexology can be traced back to ancient Egypt in 2500 BC. This type of manual manipulation requires direct pressure to ten specific zones in the hands and feet. These zones are linked to various organs of the body.
The goal of reflexology is to remedy illness and/or strengthen different parts of the body by stimulating the hands and feet in these specific zones. Modern reflexology was founded by Dr. William Fitzgerald in the early 20th century.
In addition to correcting physical ailments of the body, reflexology can also be used as an alternative therapy for pain, anxiety, stress and cancer patients.

10. Shiatsu
Shiatsu, which literally means “finger pressure,” is an ancient massage technique from China. It has been described as acupuncture with fingers instead of needles. However, acupuncture is an invasive practice which requires the insertion of needles into the body. Acupuncture is also more specific and symptom-oriented while shiatsu focuses more broadly on the entire body.
The philosophy of shiatsu is that the natural state of the body is to be healthy
Case study- In a blind, randomized trial at a university-affiliated hospital, there was a documented decrease in overall blood pressures and heart rates when acupoints were stimulated by pressure. Ultimately, researchers determined that this type of therapy had a significantly positive influence on the cardiovascular system.”

11. Resources
National Center for Complementary and Alternative Health Manipulative and Body-Based Therapies medicine-cam/manipulative-and-body-based-therapies

12. Questions?