Guest guest Posted July 14, 2005 Report Share Posted July 14, 2005 FYI, from the latest North American Journal of Oriental Medicine (NAJOM), which is just out this week, here is a review i wrote of Alon Marcus' latest book. _____ Book Review: Foundations for Integrative Musculoskeletal Medicine, An East-West Approach, by Alon Marcus Reviewed by Robert Hayden On my clinic bookshelf, one of the most-used references for many years has been Alon Marcus' Musculoskeletal Disorders: Healing Methods from , Orthopaedic Medicine, and Osteopathy. I have found it a valuable resource particularly for understanding the biomedical perspective of many of the conditions which would present on a daily basis in my practice. It is well-organized, written in a very straightforward manner and presents a wide range of treatment options both Eastern and Western. It is not without its drawbacks, however, particularly in the illustrations and clarity of some of the material presented. So it was with great interest that I learned of Dr. Marcus' plans to write a new book. Foundations for Integrative Musculoskeletal Medicine is in many ways an expanded version of Musculoskeletal Disorders, with much new material and clearer illustrations and photographs. As in the earlier book, the many tables and charts that appear throughout clearly organize the copious information presented and add clinical utility, especially to the chapters on diagnosis. Overall, Foundations is more comprehensive in scope and professional in its appearance than its predecessor. The book is in large format and is a dense, extensively referenced 700 pages of text. It looks and feels like a medical textbook, and one gets the feeling that it will soon serve as the standard reference on musculoskeletal disorders in OM doctoral programs in the US. Just looking though it one can see the enormous amount of work that went into producing this volume. For those who are unfamiliar with Alon Marcus, he is a practitioner of Oriental Medicine in Oakland, California. He received his licensed acupuncturist degree in 1984, and his Doctor of Oriental Medicine degree in 1986. He also trained in Japan and China. He studied Orthopaedic and Osteopathic medicines and is a diplomate of the American Academy of Pain Management. Foundations for Integrative Musculoskeletal Medicine is his third published book. Because of the prevailing emphasis on TCM, which is based largely on Chinese herbal medicine, the scope of training in most US acupuncture schools has long been focused on general practice, often weighted toward internal conditions. Musculoskeletal disorders are frequently differentiated simply as Bi (obstruction) patterns and fairly basic TCM local-distal acupuncture point combinations are chosen with little thought given to integration of the structural understanding of the presenting complaint. Results in applying this methodology are often hit-or-miss, and the concept of prognosis is fuzzy at best. Even with the increasing number of English-language texts on OM treatment of pain, the profession in North America is in need of a book which presents the type of information necessary to a practice in which communication and cooperation with biomedicine is a fact of life. A pitfall of the move toward integration of biomedicine and complementary medicine is lack of balance between viewpoints. Too often, proponents of integrative medicine have a limited understanding of one side or the other (usually far stronger toward the biomedical side), but Marcus is notable in his breadth of knowledge not only of conventional physical medicine as well as osteopathic concepts but also OM styles ranging from TCM to Tong style acupuncture, French and Japanese styles. Though his standards of proof are high, he rejects nothing out of hand and acknowledges that most techniques may have at least some clinical utility. One very notable theme throughout the book which will be of interest to NAJOM readers is the great emphasis Marcus places on palpatory findings, not only palpation of channels and points, but also extended into various osteopathic concepts such as palpation of the craniosacral rhythm or global listening techniques pioneered by the French osteopath Barral. Along with such well-known proponents of palpation as Dan Bensky, I feel Marcus is entering a potentially vast and extremely fertile terrain rich in clinical possibilities. This is something which I personally find very exciting and represents an opportunity for a real contribution to the development of the field. The opening chapter of the book begins with an overview of the essentials of Oriental Medicine, including the basic principles of classical physiology and pathology with a special emphasis on their relationship to musculoskeletal pain. The channel system is detailed, particularly the channel sinews, divergent channels and extraordinary vessels. Correlations with biomedicine are made throughout: for example channel sinew theory is compared to Myers five fascial chains, which show some interesting similarities. Marcus also gives some clinical pearls, particularly in regard to setting diagnostic and treatment priorities. The second and third chapters contain a review of physical medicine, including pain mechanisms, psychological influences on pain and musculoskeletal anatomy and physiology; the latter portion with good discussions on OM and biomedical perspectives on soft tissues, the spine, sacral torsion, and thoracic outlet. The next section is devoted to integrative orthopedic and physical medicine assessments. The exposition of physical examination includes an excellent summary of palpation and orthopedic testing, where the tables of findings are well organized and very helpful. Acupuncture students commonly perceive a lack of applicability of the information gleaned from orthopedic exams to their OM diagnostic process. Marcus here makes some strides in meaningful integration of the data from West to East. For example in the section on gait patterns he includes OM interpretation along with the physical medicine findings: to quote one entry in the table from this section, " Gluteus Medius (Trendelenburg) often results in an increase of lateral shift, can be seen in the presence of L5 root lesions… associated often with Wei-atrophy, Kidney-essence, Gallbladder, Kidney and Urinary Bladder Sinew channels, and Pathogenic factors. " (page 241) Also included is an overview of lab test results and imaging which is necessarily brief but comprehensive and understandable. Chapter 5 delineates treatment principles for Integrative Musculoskeletal medicine. A broad array of acupuncture techniques, treatment strategies and point selection are presented. Many of these will be familiar to anyone who has completed a standard acupuncture program, but many may not. In addition to the classically-based methods, orthopedic-integrative concepts of needling (lesion or tissue specific treatments) and patient positioning based on orthopedic exam findings are also introduced. Marcus clearly does not rigidly advocate one approach over another; rather the individual case will dictate the appropriateness of the technique. The discourse on point location includes good information on palpation. Treatment methods for various channel levels are presented, including Marcus' favored channel sinew treatment, which involves a combination of motion testing, patient positioning, careful palpation and warm-needle or fire-needle treatment. The chapter concludes with the most complete point selection formulary for musculoskeletal conditions I have ever seen. An overview of various non-TCM acupuncture systems and related techniques are featured next, with detailed commentary and illustrations on abdominal diagnosis and Japanese Meridian Therapy, auricular, wrist/ankle, and Tong style acupuncture. Chinese herbal medicine as related to musculoskeletal disorders is given its own chapter, with thirty full pages of clinically useful tables. Electrotherapeutics, including electroacupuncture, TENS, magnetic therapy and laser therapy, are examined in another chapter, again in a broad yet thorough manner, including practical guidelines for each modality. The section on integrative manual therapies contains a wide-ranging overview of osteopathic methods of diagnosis and treatment such as functional technique, muscle energy, positional release, cranial technique and several more, and Marcus imparts ideas on integrating the various techniques into OM practice. This section is fascinating but represents an entire course of study outside the scope of the book and so would seem to be of limited utility without further training. It is valuable, however, if for no other reason than the fact that it introduces the OM practitioner to these methods (I for one was never introduced to McKenzie or MET in school) and provides information which could lead to appropriate referrals or further study on the part of the practitioner. Further entries cover rehabilitation exercises and orthotics. A brief chapter on trauma, primarily from an Oriental medicine perspective, follows. Finally, the book closes with a chapter on integrated treatment of various musculoskeletal disorders. Rather than a specific treatment formulary, Marcus emphasizes a systemic or holistic approach of principles rather than protocols. Explanations of inflammation, the three phase " degenerative cascade " model and their application to OM practice are given. Joint conditions, ligamentous, myofascial and nerve disorders are treated as a whole rather than specifically focusing on particular areas affected. The section on Fibromyalgia and Myofascial Pain Syndrome in particular is perhaps the best I've seen in the OM literature. This entire chapter is rich in clinical insight gleaned through decades of assiduous study and reflective practice. This book truly lives up to its title, as it provides a solid foundation for understanding and utilizing the entire spectrum of musculoskeletal medicine. The practitioner who studies it carefully and applies its principles to their own practice will no doubt reap great rewards. Alon Marcus has done English-speaking OM practitioners a great service by writing this book, and one hopes that his work will continue to inform the current as well as next generation of OM practitioners. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 14, 2005 Report Share Posted July 14, 2005 I have Dr. Alon Marcus' book and it is fantastic. The Master Tung points in it are also a great reference for those starting out with this effective system! Dr. Marcus derives from many sources and expands the modalities an acupuncturist can try for musculoskeletal disorders. The book is a concise refernce and a very professional presentation. My advice is everyone who deals with pain management, orthopedics, and sports medcine get it. It will be a standard reference for years to come. Robert Chu, L.Ac., QME, AHG, PhD chusauli See my webpages at: http://www.chusaulei.com > " kampo36 " <kampo36 >Chinese Medicine >Chinese Medicine > Book Review (long) >Wed, 13 Jul 2005 23:18:07 -0000 > >FYI, from the latest North American Journal of Oriental Medicine (NAJOM), >which is just out >this week, here is a review i wrote of Alon Marcus' latest book. > >_____ >Book Review: >Foundations for Integrative Musculoskeletal Medicine, >An East-West Approach, by Alon Marcus > >Reviewed by Robert Hayden > >On my clinic bookshelf, one of the most-used >references for many years has been Alon Marcus' >Musculoskeletal Disorders: Healing Methods from >, Orthopaedic Medicine, and >Osteopathy. I have found it a valuable resource >particularly for understanding the biomedical >perspective of many of the conditions which would >present on a daily basis in my practice. It is >well-organized, written in a very straightforward >manner and presents a wide range of treatment options >both Eastern and Western. It is not without its >drawbacks, however, particularly in the illustrations >and clarity of some of the material presented. > >So it was with great interest that I learned of Dr. >Marcus' plans to write a new book. Foundations for >Integrative Musculoskeletal Medicine is in many ways >an expanded version of Musculoskeletal Disorders, with >much new material and clearer illustrations and >photographs. As in the earlier book, the many tables >and charts that appear throughout clearly organize the >copious information presented and add clinical >utility, especially to the chapters on diagnosis. >Overall, Foundations is more comprehensive in scope >and professional in its appearance than its >predecessor. The book is in large format and is a >dense, extensively referenced 700 pages of text. It >looks and feels like a medical textbook, and one gets >the feeling that it will soon serve as the standard >reference on musculoskeletal disorders in OM doctoral >programs in the US. Just looking though it one can >see the enormous amount of work that went into >producing this volume. > >For those who are unfamiliar with Alon Marcus, he is a >practitioner of Oriental Medicine in Oakland, >California. He received his licensed acupuncturist >degree in 1984, and his Doctor of Oriental Medicine >degree in 1986. He also trained in Japan and China. He >studied Orthopaedic and Osteopathic medicines and is a >diplomate of the American Academy of Pain Management. >Foundations for Integrative Musculoskeletal Medicine >is his third published book. > >Because of the prevailing emphasis on TCM, which is >based largely on Chinese herbal medicine, the scope of >training in most US acupuncture schools has long been >focused on general practice, often weighted toward >internal conditions. Musculoskeletal disorders are >frequently differentiated simply as Bi (obstruction) >patterns and fairly basic TCM local-distal acupuncture >point combinations are chosen with little thought >given to integration of the structural understanding >of the presenting complaint. Results in applying this >methodology are often hit-or-miss, and the concept of >prognosis is fuzzy at best. Even with the increasing >number of English-language texts on OM treatment of >pain, the profession in North America is in need of a >book which presents the type of information necessary >to a practice in which communication and cooperation >with biomedicine is a fact of life. > >A pitfall of the move toward integration of >biomedicine and complementary medicine is lack of >balance between viewpoints. Too often, proponents of >integrative medicine have a limited understanding of >one side or the other (usually far stronger toward the >biomedical side), but Marcus is notable in his breadth >of knowledge not only of conventional physical >medicine as well as osteopathic concepts but also OM >styles ranging from TCM to Tong style acupuncture, >French and Japanese styles. Though his standards of >proof are high, he rejects nothing out of hand and >acknowledges that most techniques may have at least >some clinical utility. > >One very notable theme throughout the book which will >be of interest to NAJOM readers is the great emphasis >Marcus places on palpatory findings, not only >palpation of channels and points, but also extended >into various osteopathic concepts such as palpation of >the craniosacral rhythm or global listening techniques >pioneered by the French osteopath Barral. Along with >such well-known proponents of palpation as Dan Bensky, >I feel Marcus is entering a potentially vast and >extremely fertile terrain rich in clinical >possibilities. This is something which I personally >find very exciting and represents an opportunity for a >real contribution to the development of the field. > >The opening chapter of the book begins with an >overview of the essentials of Oriental Medicine, >including the basic principles of classical physiology >and pathology with a special emphasis on their >relationship to musculoskeletal pain. The channel >system is detailed, particularly the channel sinews, >divergent channels and extraordinary vessels. >Correlations with biomedicine are made throughout: for >example channel sinew theory is compared to Myers five >fascial chains, which show some interesting >similarities. Marcus also gives some clinical pearls, >particularly in regard to setting diagnostic and >treatment priorities. > >The second and third chapters contain a review of >physical medicine, including pain mechanisms, >psychological influences on pain and musculoskeletal >anatomy and physiology; the latter portion with good >discussions on OM and biomedical perspectives on soft >tissues, the spine, sacral torsion, and thoracic >outlet. > >The next section is devoted to integrative orthopedic >and physical medicine assessments. The exposition of >physical examination includes an excellent summary of >palpation and orthopedic testing, where the tables of >findings are well organized and very helpful. >Acupuncture students commonly perceive a lack of >applicability of the information gleaned from >orthopedic exams to their OM diagnostic process. >Marcus here makes some strides in meaningful >integration of the data from West to East. For >example in the section on gait patterns he includes OM >interpretation along with the physical medicine >findings: to quote one entry in the table from this >section, " Gluteus Medius (Trendelenburg) often results >in an increase of lateral shift, can be seen in the >presence of L5 root lesions… associated often with >Wei-atrophy, Kidney-essence, Gallbladder, Kidney and >Urinary Bladder Sinew channels, and Pathogenic >factors. " (page 241) Also included is an overview of >lab test results and imaging which is necessarily >brief but comprehensive and understandable. > >Chapter 5 delineates treatment principles for >Integrative Musculoskeletal medicine. A broad array of >acupuncture techniques, treatment strategies and point >selection are presented. Many of these will be >familiar to anyone who has completed a standard >acupuncture program, but many may not. In addition to >the classically-based methods, orthopedic-integrative >concepts of needling (lesion or tissue specific >treatments) and patient positioning based on >orthopedic exam findings are also introduced. Marcus >clearly does not rigidly advocate one approach over >another; rather the individual case will dictate the >appropriateness of the technique. > >The discourse on point location includes good >information on palpation. Treatment methods for >various channel levels are presented, including >Marcus' favored channel sinew treatment, which >involves a combination of motion testing, patient >positioning, careful palpation and warm-needle or >fire-needle treatment. The chapter concludes with the >most complete point selection formulary for >musculoskeletal conditions I have ever seen. > >An overview of various non-TCM acupuncture systems and >related techniques are featured next, with detailed >commentary and illustrations on abdominal diagnosis >and Japanese Meridian Therapy, auricular, wrist/ankle, >and Tong style acupuncture. Chinese herbal medicine >as related to musculoskeletal disorders is given its >own chapter, with thirty full pages of clinically >useful tables. Electrotherapeutics, including >electroacupuncture, TENS, magnetic therapy and laser >therapy, are examined in another chapter, again in a >broad yet thorough manner, including practical >guidelines for each modality. > >The section on integrative manual therapies contains a >wide-ranging overview of osteopathic methods of >diagnosis and treatment such as functional technique, >muscle energy, positional release, cranial technique >and several more, and Marcus imparts ideas on >integrating the various techniques into OM practice. >This section is fascinating but represents an entire >course of study outside the scope of the book and so >would seem to be of limited utility without further >training. It is valuable, however, if for no other >reason than the fact that it introduces the OM >practitioner to these methods (I for one was never >introduced to McKenzie or MET in school) and provides >information which could lead to appropriate referrals >or further study on the part of the practitioner. >Further entries cover rehabilitation exercises and >orthotics. A brief chapter on trauma, primarily from >an Oriental medicine perspective, follows. > >Finally, the book closes with a chapter on integrated >treatment of various musculoskeletal disorders. >Rather than a specific treatment formulary, Marcus >emphasizes a systemic or holistic approach of >principles rather than protocols. Explanations of >inflammation, the three phase " degenerative cascade " >model and their application to OM practice are given. >Joint conditions, ligamentous, myofascial and nerve >disorders are treated as a whole rather than >specifically focusing on particular areas affected. >The section on Fibromyalgia and Myofascial Pain >Syndrome in particular is perhaps the best I've seen >in the OM literature. This entire chapter is rich in >clinical insight gleaned through decades of assiduous >study and reflective practice. > >This book truly lives up to its title, as it provides >a solid foundation for understanding and utilizing the >entire spectrum of musculoskeletal medicine. The >practitioner who studies it carefully and applies its >principles to their own practice will no doubt reap >great rewards. Alon Marcus has done English-speaking >OM practitioners a great service by writing this book, >and one hopes that his work will continue to inform >the current as well as next generation of OM >practitioners. > > > > > >http://babel.altavista.com/ > > > and adjust >accordingly. > >Messages are the property of the author. Any duplication outside the group >requires prior permission from the author. > >If you are a TCM academic and wish to discuss TCM with other academics, > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 14, 2005 Report Share Posted July 14, 2005 Robert thanks Oakland, CA 94609 Quote Link to comment Share on other sites More sharing options...
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