By Gerald Y. Kinro
Originally published in Massage Bodywork magazine, April/May 2000.
Copyright 2003. Associated Bodywork and Massage Professionals. All rights reserved.
I had been a regular massage client of Katherine Kawana, a massage therapist and acupuncturist operating in Kaneohe, Hawaii. I was fairly active -- swimming, running in excess of 20 miles a week and playing other sports. Then came the case of sciatica that was severe enough to sideline me. Visits to various practitioners, including medical doctors, were futile. Back traction, adjustments and medication brought no relief.
During a massage session, Kawana detected tender spots on my body and suggested an acupuncture treatment. She also recommended Chinese herbs to augment the healing and "to balance my body." I had an aversion of needles and was apprehensive. I trusted my therapist, however, and desperate for a cure, I opted for the treatment she performed.
Kawana inserted needles at various points on my body and left them in for about 15 minutes. It was painless. More importantly, symptoms dramatically disappeared three days after treatment. To help prevent recurrence, she suggested posture analysis and balancing, as she noted possible physical imbalances in my carriage. Balancing included deep tissue massage and a shoe insert to correct a leg-length discrepancy of which I was unaware.
The shoe insert and periodic massage/acupuncture sessions have managed the ailment, and I have returned to my 20- to 30-mile per week running schedule. A serendipitous result of treatment has been the release of other chronic ailments, such as shoulder and neck problems and a nasty ilio-tibial band syndrome, all of which I had learned to live with and merely accept as permanent and normal for a 50-year-old. Kawana's treatments proved that wasn't so.
This integrative treatment can best be described as "fusion," combining sports massage and posture balancing from the West with acupuncture and herbology from the East. The Arrival of Eastern Medicine
Nearly 30 years ago, during President Richard Nixon's gate-opening visit to the People's Republic of China, we watched our television sets as a culture, although thousands of years old, unfolded before us as if new. We learned of Chinese physicians, without anesthesia, performing major surgery on a fully conscious patient -- the only painkillers being tiny needles inserted at various points throughout her body. Once denigrated by many as a form of sorcery, the credibility of acupuncture did an immediate about-face toward the positive. In the United States, its practice grew. Clinics established themselves and schools of Oriental medicine opened their doors. It is now a legitimate healing practice.
A few practitioners, like Kawana, use acupuncture effectively in combination with Western massage therapy. Trained in a variety of Western techniques, she had built a steady clientele for her business, Healthcare and Sports Massage Therapy. She entered this new field after practicing massage for about 10 years and subsequently feeling a need to acquire new tools to employ in her practice. "This is a common burnout point for many massage therapists," she said. "I had to do something else so that I could continue working, and I could not envision doing the physical aspect of massage indefinitely." Acupuncture seemed to fill that void, as age would not be a deterrent. "Knowledge of the points and the ability to control the needles are the keys to performance."
Kawana enrolled in acupuncture school while still maintaining her massage practice, taking courses not only in acupuncture, but in herbology and nutrition as well. She graduated, became certified by the national board, and received licensure from the state of Hawaii. Now she is able to practice, diagnose and treat accordingly.
What has evolved in Kawana's work is a blend of Eastern and Western treatments that have proven effective for many of the common ailments massage therapists see. She advocates continuous learning, growing and implementation of new knowledge; not just storing it away. "Every theory has exceptions," she said, "and you have to work with the reality of what's going on in marriage with the theory. It's knowing when to break away from one theory and look at another. When you have a repertoire, you can see which one works best in a situation and adjust accordingly." The Basics
Acupuncture is a discipline of Oriental medicine. Its basis is radically different from what we are used to in the West. While both Oriental and holistic Western medicine believe the human body is built in one piece -- that it is impossible to isolate a part of the anatomy without considering its effects on the whole being -- Oriental medicine takes this a little further.
In Oriental medicine, all diseases come from imbalance or interruption of energy (qi) flow throughout the body. Qi flows through various invisible channels, or meridians. These same meridians pass through many parts of the body and connect vital organs. Located along these meridians are points that correspond to various conditions and/or organs. The acupuncturist restores energy imbalances by stimulation -- by inserting needles into these points. In many cases, the proper insertion point is away from the site of the actual ailment.
The treatment may be assisted by using heat (moxabustion), acupressure, electrical stimulation, or by applying a suction cup to the points. In addition to point stimulation, the acupuncturist may suggest herbs to aid the healing process and to maintain general health. Oriental bodyworkers follow these principles and apply stimulation to these points manually. Can East Meet West?
East can meet West, according to Kawana, even if the philosophies are different. "Western massage therapy is effective for the acute conditions," she said, "while Oriental medicine, or alternative medicine in general, better addresses those chronic situations. They go together very well." Further, she said, because of its age, acupuncture has a system of diagnosis that is well-developed.
As a student, Kawana felt her training and experience as a massage therapist aided her learning process. Her sense of feel was advanced, enabling her to be a better diagnostician. Plus, there was the added benefit of not being afraid of making contact with a patient's body.
Acupuncture has also helped Kawana in her original intent. By allowing the needles to do the work, the practitioner need not expend physical energy on a client. Kawana still offers three options: acupuncture, massage therapy, and a combination -- a "fused" therapy of acupuncture and massage. Nevertheless, while doing a non-combined treatment, she is still able to introduce and "fuse" another discipline to benefit the client.
If a client comes in for an acupuncture treatment, there is always some bit of massage involved to assist the patient along. If one comes in for a Western massage treatment, Kawana will, during the course of therapy, introduce Eastern aspects. "It takes massage to a deeper level," she said. "There is more knowledge to pass on to the patient." If Kawana suspects something is wrong with the body, she feels and presses the various acupoints and meridians to detect potential problems. These are usually confirmed by the client who, at the same time, is developing trust in Kawana's skills. Some of these diagnoses have uncovered potentially life-threatening conditions. Kawana speaks of a client with tender points that intimated problems with her lungs. Kawana suggested further medical evaluation. A physician's diagnosis confirmed lung cancer.
This case is extreme. More typical are cases of chronic aches and pains with their genesis elsewhere. "In Oriental medicine, there is no state of perfection," Kawana said. What Is Fusion?
On a first visit to Kawana, the client can receive an Oriental diagnosis involving questioning, observation and touch; it's a time to learn about the client. Client answers are important, as no one knows their body as well as they do themselves. Kawana observes a client's emotions and posture during questioning, as she wants to know about reactions to temperatures, patterns of perspiration, the presence of headaches and nausea, pain, medical history, thirst, appetite and tastes, and sleep patterns.
Also important in the assessment is a tongue diagnosis, as Oriental medicine believes the tongue is an indicator of bodily disorders. Harmony and disharmony are being reflected in the tongue's color, moisture, size, coatings, and the location of abnormalities. Healthy systems will show a healthy tongue that is pinkish red, neither dry nor too wet, fits perfectly within the mouth, moves freely and has a thin white coating.
Anything otherwise, a "purple" tongue for example, may mean trouble. These signs reveal not only overall states of health, but correlate to specific organ functions and disharmonies, especially in the digestive system. Kawana then feels the patient's pulse to assess the condition of qi and fluids, organ system imbalances, the location of these imbalances, and the nature (heat or cold) of the disease, along with many other qualities.
After a review and the diagnosis, a treatment strategy is developed and followed. Kawana will then begin treatment. She will usually stimulate those points on the front side of the body (yang) with the patient lying on her back. During this course, the practitioner is continually feeling the acupoints to confirm diagnosis. Aside from needle stimulation, Kawana may use moxa (heat) or a suction cup as stimulators. How long the needles stay in depends on the nature of the ailment. When the needling phase is done, she will then apply Western massage, working both sides of the body. During the massage phase, she will suggest some dietary factors such as herbal treatments, Western vitamin supplements, or even the elimination of caffeine. Many feel better with one treatment; others by repeats.
Kawana enjoys great success with fusion therapy on a variety of ailments. "Knees and backs respond especially well to this treatment," she said, "and carpal tunnel syndrome is very well managed by a combination."
Yvette Miraflor, a regular client, agrees. Working at a computer left Miraflor with a severe case of repetitive stress syndrome in her arm. "It was a nagging ache that extended from my wrist up to the shoulder," she said. With treatment, the pain disappeared. Miraflor used to have this treatment every three months -- usually coinciding with the return of pain. The problem, however, may have been resolved. Miraflor last experienced the pains of carpal tunnel syndrome six months ago. Health Maintenance
Kawana advocates massage and acupuncture for maintaining health, as well as curing problems. She reported clients with chronic knee problems had reduced swelling by 90 percent with one weekly treatment. Now, with treatments every other week, the client is able to manage the knee problems and has prevented swelling from recurring. For maintenance, Kawana suggested at least a monthly massage. "People look at massage as a luxury instead of a maintenance program, like keeping a car oiled," she said. "They spend more money getting their hair and nails done, and to a visual degree it is important. In the long run, however, you'll look better if you are healthier." Not Really Separate
The combination of therapies has increased Kawana's healing success by 20 percent. Successes illustrate how two unrelated, often divergent, disciplines can work together for a client's benefit when employed by a skilled, creative professional. It seems only natural that different healing arts should come together. "After all," Kawana said, "all healing deals with energy."Gerald Y. Kinro is a freelance writer based in Hawaii.