THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE

Volume 17, Number 3, 2011, pp. 185186

Mary Ann Liebert, Inc.
DOI: 10.1089/acm.2010.0880

Editorial

Advances in Manual Therapy for Children

Daniel Redwood, DC

ince the first time one of our ancient ancestors reached

out to touch an injured child, comforting the young one
and seeking to convey healing through the hands, manual
therapy for newborns, infants, and children has been part of
human culture. In the river of passing time, physical medicine
traditions derived from these manual approaches developed
among various peoples and were passed down through the
generations. As these healing lineages evolved into health
professions, practitioners have sought greater consistency
(and in some cases standardization) while striving to sustain
the heart-driven impulse that inspired our first ancestor to use
her or his hands for a healing purpose.
Manual Therapies, East and West
Manual healing traditions exist in all nations. With the
advent of scientific medicine in the West, they were viewed
with disdain by the medical establishment and in many cases
forced underground. But something so primordial and
valuable can never be fully suppressed. Western manual
healing artsosteopathy, chiropractic, and massage therapy,
along with lesser known offshoots such as naprapathy and
Rolfingemerged to fill the gap left by conventional medicines willful turning away from these healing methods and
their nonbiochemical focus. In the East, this dichotomy never
took root to the same extent. In Asia and other non-Western
settings, manual treatments evolved side-by-side with herbal
and, later, pharmaceutical therapies.
In our era, East and West have met in an emergent global
culture. As long as relations are based on mutuality rather than
hegemony, both will be immeasurably enriched through the
interchange. One significant aspect of this global phenomenon
is the exchange of health insights on a worldwide basis. Since
our founding 17 years ago, The Journal of Alternative and Complementary Medicine, based in North America and Europe, has
sought out and published excellent articles from researchers
and practitioners on all continentsfrom China, India, Korea,
Japan, Iran, Israel, and nations in Latin America and Africa.
We all have much to learn from each other. At the deepest
level, our purpose is one and the same.
Artful Scrutiny of a New Approach
In this issue (pp. 231237), we are pleased to publish a
noteworthy article, Primary Massage Using One-Finger
Twining Manipulation for Treatment of Infantile Muscular
Torticollis, by Yixin Kang and colleagues in the Department

of Rehabilitation Medicine at the Linzi District Peoples Hospital, in Shandong Province, Peoples Republic of China. Kang
et al. report on a condition that, left untreated, can result in
long-lasting disfigurement, with all the physical and emotional consequences that can arise in its wake. These investigators compared their alternative manual method to
conventional tuina manipulation, which in China constitutes
first-line usual care for this condition. They explain that
twining manipulation involves a smaller contact area, provides faster frequency and stronger penetrating force, and
produces better effects in promoting blood flow, removing
blood stasis, promoting tissue regeneration, subduing swelling, and alleviating pain. The twining method, which in this
hospital-based study is delivered by a medical physician
working in the Department of Massage, involves a pendular
movement delivered to the sternocleidomastoid muscle
(SCM) at a frequency of 250250 times per minute, for a total of
20 minutes in most cases. In addition, adjacent muscles and
key acupuncture points are manually stimulated.
Because failure of manual intervention is often followed
by glucocorticoid injections or surgery, both of which entail
significantly heightened risks, the stakes are high. Kangs
team found that one-finger twining and tuina were both
helpful to a large majority of patients, with the twining approach yielding significantly superior results.
This large study, with over 200 patients in each group, was
a randomized trial in which outcomes were judged not only
by headneck deflection and range of motion but also with
measurements of the morphology and size of the SCM using two-dimensional ultrasonography, and measurement of
blood flow in the SCM with color Doppler ultrasonography.
Thus, as with other examples of the highest quality research in
complementary and alternative medicine (e.g., Ornish et als.1
use of quantitative coronary angiography to demonstrate reversal of atherosclerosis with diet and lifestyle changes, or
Streeter et als.2 use of magnetic resonance spectroscopy to
measure changes in brain g-aminobutyric acid levels after
yoga, corresponding with improvements in mood and anxiety), Kang et al. employed high-tech methods to validate a
low-tech intervention. In more ways than one, the work by
Kangs team truly embodies the best of both worlds.
Sharing Knowledge, Finding Common Ground
Western practitioners of manual healing arts can clearly
benefit from advances such as those described by Kang and

Cleveland Chiropractic CollegeKansas City, Overland Park, KS.

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colleagues, though it should also be noted that in the West,
manual approaches for infantile torticollis already exist
within both chiropractic and medicine. I recall being told by
the late J.F. McAndrews, a chiropractor, of a conversation he
had with Irving Dardik, a medical doctor, when the two
served together on the group planning medical services for
U.S. Olympic athletes in 1980, the first year that chiropractors
treated American Olympic athletes in an official capacity.
In a wide-ranging discussion on spinal adjustment and
manipulation, Dardik related that on more than one occasion
in his medical practice, he had delivered a baby with severe
torticollis. To remedy the condition, he would lay the newborn on its back, hold its head and neck in his two hands,
and deliver an adjustive thrust, which elicited a sound like
the breaking of a dry twig and was followed by full resolution of the torticollis. When McAndrews told me this story
a few months later, he noted that he, too, had used precisely
this method in some cases of pediatric torticollis.
It is worth noting that in 1980, the official position of the
American medical establishment was that spinal manipulation for any purpose was useless at best and frequently
harmful. It is further worth noting that even today, efforts by
some medical practitioners and their allies to ban chiropractic care for persons under the age of 18 are underway in
more than one nation. The struggle goes on.
Despite opposition from such retrograde forces, manual
therapies continue to develop and mature worldwide. In

EDITORIAL
November 2008, in Beijing, China, the World Health Organization convened its first Symposium on Manual Methods
of Health Care, delegating to the World Federation of
Chiropractic the responsibility for organizing this landmark
event. With the expanding range of manual practice, the
increasingly broad and deep research foundation that underlies it, and the continuing integration of chiropractors,
massage therapists, and other manual practitioners into the
mainstream of health care delivery in many nations, manual
therapies are truly coming of age.
References
1. Ornish D, Brown SE, Scherwitz LW, et al. Can lifestyle
changes reverse coronary heart disease? The Lifestyle Heart
Trial. Lancet 1990;336:129133.
2. Streeter CC, Whitfield TH, Owen L, et al. Effects of yoga
versus walking on mood, anxiety, and brain GABA levels: A
randomized controlled MRS study. J Altern Complement
Med 2010;16:11451152.

Address correspondence to:

Daniel Redwood, DC
Cleveland Chiropractic CollegeKansas City
10850 Lowell Avenue
Overland Park, KS 66213
E-mail: dan.redwood@cleveland.edu

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