resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Inspire Your Patients to Make Healthy Choices
Have you tried to get your patients to change their eating habits or their diet and couldn't get them to succeed? Were they confused and unsure of what the right thing was to eat? You are not alone!
Are You Ready for the 2016 Patient?
In October, Apple released its iOS 8 operating system for the iPhone and iPad. The new system includes Health, a new app that will interface with an ever-growing number of other apps.
Home Safety: Help Families Avoid Common Injury Hazards at Home
These days, many parents childproof their homes before a baby is even mobile. You will see an array of electrical outlet covers, bumpers on the corners of the coffee table and safety latches on the cupboards.
Micro-Needle Dermal Roller Use in the Treatment Room
Recently micro-needle dermal rollers have been getting a lot of media attention. As a practitioner who specializes in acupuncture facial rejuvenation, I know that skin needling with a dermal roller (also known as collagen induction therapy), promotes the natural reproduction of collagen and elastin, making the skin feel smoother and tighter.
Why Drugs and Supplements Can't Cure Disease
Chronic diseases are the outcome of disease-promoting, goal-oriented behaviors. So, the notion that diseases can be cured with drugs or supplements should be abandoned. Hypertension is the best example of this.
Introduce Your Patients to Collagen Induction Therapy
Cutaneous (skin) aging generally occurs from either intrinsic or extrinsic processes. Intrinsic aging results from natural skin tissue damage and degeneration.
Peer Points: Promoting TCM Knowledge
When Elaine Wolf Komarow, LAc, received her first acupuncture treatment in 1989, she said it changed her life. "I felt more aware, calmer, and happier. I was so fascinated by the changes that I began to learn everything I could about the underlying philosophy of Chinese medicine," said Komarow.
Treating Chronic Depression with Acupressure
In Traditional Chinese Medicine there already exists a comprehensive theory linking the body and mind.
We Get Letters & Email
Is It Time for a Popeye Moment? The Flaw in Recommending Chiropractic as a Career.
Treating Acute and Chronic Neck Pain With Ischemic Compression and Exercise
There are many reasons not to manipulate the neck with cavitation: the patient is too old, their neck is too tight, etc. But the most common reason is that plenty of patients are afraid of "the crack," mostly because of the bad publicity about that procedure.
Acupuncture Detox as Part of Drug Rehabilitation
In the U.S., more than 2,000 alcohol and drug rehabilitation programs have added ear acupuncture to their practice. The development of the protocol was determined by Lincoln Hospital as it delivered 100 acupuncture treatments daily.
Five Element Acupuncture Can Enhance Your Practice
For eight years I have been teaching and supervising TCM students at an acupuncture college in Colorado, in Five Element acupuncture.
Treating Menopausal Women in Your Practice
I love what I do for a living. It's a great way to trade health for bread. And no topic of health, with the right bedside manner, is taboo.
Following the Thinking of the Classics
I have heard about the "best time of day" to carry out certain examinations or therapies. For example, I remember making a note years ago that early morning is the best time to take someone's pulses.
Chronic heightened emotional states create a perfect breeding ground for illness. Through my practice I noted the increasingly obvious relationship between one's mental focus on negative thinking, emotions, resistance to experiencing feelings and disease.
Solving the Pain Puzzle
Legendary former New York Yankees baseball player Yogi Berra once said, "You can observe a lot just by watching." He would have been a great chiropractor. We are trained to become experts with our hands: palpation, adjusting, soft-tissue release, etc.
Implications of Section 2706: The Non-Discrimination Provision Survey
In late April 2014, NCCAOM diplomates received an email survey with the subject line: "End discrimination against acupuncturists" polling CAM practitioners for a Request for Information from the Department of Health and Human Services, released in mid-March.
News in Brief
Life to Open Branch Campus in Italy; Northwestern Research Arm Benefits From Big Donation.
The Power of Mu Xiang to Treat Irritable Bowel Disease
Bloating and gas pain is something that everyone has had to deal with at one point or another; however, that's usually reserved for holiday dinners and other large gatherings.
Are You Ignoring the 10,000-Hour Rule?
Having trained interns and mentored new practitioners, it has been my observation that their No. 1 clinical concern is adjusting skills. Their second clinical concern is their ability to read X-rays. Physical diagnostic skills are a distant third.
It Pays to be a Foodie
If there is an inner foodie in you, just waiting to burst out—this article is for you! Do you want to know how I know? I'm that girl. My middle name might as well be "Foodie." I love food! And if my patients are any indication, many of them do as well.
Avoiding "Just a Pop Doc" Syndrome
Yes, it's harsh. Patients don't like to admit it. They have an unspoken plan when they first visit you: to come one time, get rid of their pain and then get rid of you. They know it's unrealistic, but they'd like to pay nothing for this service.
Make Low-Level Laser Therapy Part of Your Evidence-Based Practice
Low-level laser therapy (LLLT), also referred to as photobiomodulation, has been increasingly utilized in the clinical setting over the past decade.
DC App – The Next Generation
According to a survey by technology firm CDW, health care professionals gain approximately 1.2 hours per day in productivity simply by using a tablet computer in practice.
Chinese Medicine: The Natural Way to Children's Wellness
As a child, I did not like going to the doctor. For the most part, when I had to go I wasn't feeling good to begin with, and I was heading into a sterile environment to be awkwardly probed by a man in a white coat for a very short, impersonal period of time.
The Acupuncture Now Foundation: What Our Profession Needs
Although acupuncture is growing in popularity it continues to be underutilized due to misunderstandings about its true potential. Only a fraction of those who could be helped by acupuncture know enough to seek it out.
Capturing the Essence of Tai Chi
Over the last 12 years, I have been working on one of the few documentaries about Tai Chi. It's called The Professor: Tai Chi's Journey West and it's about Cheng Man-Ching who moved to New York in the 1960s.
Step by Step: Long-Term Treatment of Soft-Tissue Injuries Combines Skill and Care
Treating soft-tissue injuries with long-lasting results starts the moment an individual enters the office. When it comes to pain, the only thing that matters to the patient is relief.
The Death of the Travel Card
As long as I have been in practice, the travel card has stood as the primary style of documentation for chiropractic. It is quick, simple and direct. Unfortunately, the rules have changed.
Foundation for Chiropractic Progress Announces First Group Member
The Michigan Association of Chiropractors has joined the Foundation for Chiropractic Progress as its first group member.
May, 2002, Vol. 02, Issue 05
Working with Clients Who Have Spinal Cord Injuries
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
In my last article I provided some information on multiple sclerosis - a topic that many readers had requested. I hope that information was helpful and provided some insight into fruitful ways to work with these clients.At the end of the article, I promised to devote my next column (this one) to working with clients who have spinal cord injuries - another frequently requested topic. Then I put out a request for those of you who work with that type of client to share what you do, what works, and what to avoid, so that we all might benefit from your experiences.
Guess how many responses I got? Goose egg. Zilch. Bupkis. To me, this means one of two things: either no one is doing any work at all with spinal cord injury survivors, or no one feels confident enough about what they're doing to share it with others. I know the first can't be true, since somewhere between 183 and 230 thousand people in this country currently live with permanent spinal cord injuries. Surely some of them receive massage!
After considerable research, I finally found a few therapists with experience in this area. In addition, I just finished being a support person for the 2002 Winter Sports Massage Team for the Paralympic Games, so I do have some things to share. I'll proceed on the premise that many of us do have some of these clients, but we feel that we're working in the dark. I'll do my best to shine a little light on this subject.
First, let's look at what exactly happens when the spinal cord is injured.
Spinal Cord Injury: What Happens?
Spinal cord injury (SCI) is a situation in which some or all of the fibers in the spinal cord are damaged, usually by trauma, but occasionally from other problems such as tumors or bony growths in the spinal canal. They fall into one of three categories: concussions, in which tissue is jarred and irritated but not structurally damaged; incomplete injuries, in which only some of the neuron tracts in the spinal cord have been damaged; and complete injuries, in which all the ascending and descending tracts have been interrupted at a specific level or levels.
As long as at least part of the spinal cord is intact, some motor or sensory function may remain in the affected tissues. This factor will determine what kind of recovery a person can expect to achieve. Obviously, the higher the damage, the more of the body is affected. Injuries to the anterior part of the cord affect motor function, while damage to the posterior aspect affects the senses of touch, proprioception, and vibration. Damage to the lateral parts of the cord interrupts sensations of pain and temperature.
An injury that affects the lower abdomen and extremities, but leaves the chest and arms intact, is called paraplegia. An injury that impacts the body from the neck down is called tetraplegia or quadriplegia. Among the SCI patients alive today, quadriplegics slightly outnumber paraplegics.
A person with a newly injured spinal cord goes through a period called "spinal cord shock." During this time, blood pressure is dangerously low, the heart beats slowly, peripheral blood vessels dilate, and the patient is susceptible to hypothermia. A number of secondary reactions may occur in the CNS at this time, including excessive bleeding; edema; free radical activity; scar tissue formation; white blood cell attacks on healthy tissue; and demyelination of healthy cells. These secondary responses can interrupt function up to two full levels above the primary injury, but they can be controlled with medical intervention, so it is vital that the patient receive aggressive care during this window of opportunity. With a new spinal cord injury, the affected muscles may be either flaccid or hypotonic. When the inflammatory process begins to subside (and this can take days or weeks after the initial injury), the muscles supplied by damaged axons begin to tighten, and their reflexes become hyperreactive. Spasticity along with hyperreflexia is a hallmark of spinal cord injury. If muscles stay flaccid and reflexes are dull or nonexistent, the damage is probably to the nerve roots rather than to the spinal cord itself. Injuries to the low back often show this pattern, as the spinal canal is occupied by the cauda equina nerve root extensions from T12 down to the sacrum. Depending on the nature of the trauma, it is perfectly possible to sustain injury to both the spinal cord and the nerve roots simultaneously.
Spinal Cord Injury Complications
Spinal cord injuries can lead to many serious long-term complications, several of which have important implications for massage therapy. SCI patients invest a lot of time and energy in working to prevent, minimize, or recover from these secondary problems.
Spinal Cord Injury Treatment Options
New treatment options for SCI patients are being developed daily. Some SCI patients may have electrodes implanted in muscles that are controlled from an external computer. These implants can provide pinching and gripping capabilities for people who otherwise would not have the use of their hands. Surgical transfer of healthy tendons can also be helpful. For some people, the triceps muscle may be paralyzed, while the deltoid is not. Surgically extending the posterior deltoid tendon and attaching it to the olecranon can provide these people with the power it takes to use a wheelchair.
Treatment for SCI survivors is targeted at providing them with the skills to live as fully as possible. Physical and occupational therapists specialize in helping these patients gain the skills they need to function; mental/emotional therapists are also critical, especially for those who are adapting to their paralysis as a new way of life. Ultimately about 90% of all SCI patients are able to live independently with these new skills.
Spinal Cord Injuries and Massage
With all these complicated processes going on, and all these potentially dangerous problems that may develop, could it ever be appropriate for an SCI survivor to receive massage? Absolutely. In fact, the range of massage therapy modalities that can be successfully used with SCI patients is exactly the same as that for any other clients. As long as threatening complications like blood clots, pressure sores, and infections are not present, massage therapists can apply their skills with compassion and imagination to the great benefit of their clients.
Some bodyworkers specialize in energy and light-touch work with their SCI clients: this approach, which could include therapeutic touch, craniosacral therapy, and any number of other modalities, can be especially powerful in achieving "incorporation"- that weaving together of the whole body that many SCI patients lose.
Other approaches address the mechanical challenges of being confined to a wheelchair. The spasticity that SCI patients live with is a chronically progressive situation. This progress can be slowed or even halted with a carefully applied program of exercise and stretching-massage is certainly appropriate in this setting. Further, some of the spasticity and contractures that SCI patients experience seem to be a function of myofascial binding as much as loss of enervation. One therapist I spoke to described how exciting it was to work with an elderly patient's gnarled and claw-like hand, and see her gradually relax and be able to regain some control.
As SCI patients' muscle tone changes, they are likely to experience postural distortions that can be quite painful. Massage can help to limit this process and reduce the pain associated with it. As long as sensation is present so the client can give accurate feedback about how the bodywork feels, massage can be a powerful tool in keeping these changes at bay.
Finally, many SCI patients have to cope with chronic tendinitis and overuse syndromes in their hands, wrists, elbows and shoulders. In these cases it's not only appropriate, but essential to receive bodywork that can help to restore function as quickly as possible.
Practical questions such as how to position clients on a table, or whether to use a table at all, can only be answered on a case-by-case basis. At this year's Paralympics, the 2002 Winter Sports Massage Team had hydraulic tables that could be raised and lowered to make getting in and out of a chair as easy as possible. This is a good investment for therapists who work with any clients who might have movement difficulties. Plan on using bolters extensively, and be sure to accommodate for urinary catheters and/or colostomy bags. Ultimately, the best service we can offer is simply to ask, "How can I make you most comfortable?"
I'd like to conclude this article with excerpts of a reflection written by Jan Fields, a member of the 2002 Winter Sports Massage Team, after he had worked with a Paralympic alpine skier with spina bifida:
So, readers, what's next? Give me some ideas of topics you'd like to see discussed in "Dealing with Pathologies: What's on Your Table?" Otherwise, I'll just make some up of my own!
Ruth Werner, LMT, NCTMB
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
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