resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
October, 2002, Vol. 02, Issue 10
Working with Patients Who Have Hypothyroidism
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
In my last article on cerebral palsy, I was happy to find lots of material not only on the condition itself, but on how massage can play a part in the life of a CP patient.I duly related this latter point in my article, expecting little controversy, since this is a well-researched and well-understood condition. Well, duck, because the fallout is still coming down.
I made a few errors in the CP article that I'd like to clear up. First, I misstated the locations in the brain where the damage takes place. Unable to find any specific information on this issue in my pathology resources, I pulled out my anatomy texts and listed the movement centers I know about: the basal ganglia, frontal lobe, and cerebellum.
Gary Bruce, LMT, NCTMB, who works extensively with special needs individuals, corrected me in an e-mail he sent me:
Second, I referred to the tight muscles of a CP patient as a "spasm"- this is quite incorrect: the proper term is spasticity, and the way it responds to massage is quite different. (For more information, please refer to my spinal cord injury article in the May edition of Massage Today.) These are technical errors, and I take full responsibility for not catching them.
At this point I'd like to restate (or state for the first time) what my job is: I am a translator. I read through scads and scads of material: some boring, some fascinating. Then I try to translate that material into accessible terms, so I can share it with anyone who is interested. Sometimes I get lucky and I find people who help me understand a topic, either because they themselves live with it, or they work with people who do. Sometimes, unfortunately, I don't get in contact with a valuable resource until it's too late. Such was the case with the CP article.
I want to voice my appreciation to everyone who wrote me with their own opinions about this issue, which proves that we are people who take our work and the well- being of our clients very seriously. It also proves that what the mainstream medical community promotes is not always the last word. To illustrate this fact, I'd like to quote from another response I got to the CP article, from Mary Green, LMT. Her comment relates to the statement that CP is non-progressive, but nontreatable. (Remember, I just report this stuff, I don't make it up!)
And that's all I'm going to say about CP for the time being.
In my last article, I asked what people would like to read about next, and thyroid disorders won the election in a landslide. I had planned to combine both hyper and hypothyroidism into one article, but it's just too much information, so I decided to limit this discussion to one of the most frustrating and controversial issues in chronic disorders: hypothyroidism.
What Is Hypothyroidism?
Hypothyroidism is a condition in which circulating levels of thyroid hormones are abnormally low, or in which levels of thyroid hormones may be normal, but target cells have become resistant to their action. This interferes with the body's ability to generate energy from fuel.
Demographics: Who Gets It?
Hypothyroidism may be a fairly common condition, affecting about one-tenth of one percent of the population overall. Women are five times more likely to develop hypothyroidism than men. Statistics rise with age; within women over 65 the incidence of this disorder may be as high as 10%. These numbers reflect reported cases; many people may experience hypothyroid symptoms without achieving a diagnosis.
Etiology: What Happens?
Before we get into the specifics of this disorder, we need to discuss some massage school anatomy. You may remember that the thyroid gland, that butterfly-shaped structure that wraps around the trachea, is an endocrine gland that secretes hormones related to metabolism: the use of fuel for energy or growth. It does this under orders from the pituitary gland, which secretes thyroid-stimulating hormone (TSH).
The primary hormone associated with the thyroid gland is called thyroxine. When thyroxine levels are high, metabolism is fast - hyperthyroid symptoms include weight loss, heart palpitations, minimal menstrual periods, and bulging eyes. When thyroxine levels are low, metabolism is slow. Weight gain, low energy, and hypersensitivity to cold may ensue. As with most things concerning hormones, this description is an oversimplification.
The thyroid actually secretes several different substances, including T4 (also called thyroxine, this is a molecule with four iodine atoms) and T3 (a molecule with three iodine atoms). T4 is generally secreted in greater amounts than T3, but T3 is more potent. Enzymes elsewhere in the body may help to convert T3 to T4, or vice-versa. In the etiology of hypothyroidism, it is the presence of T4 that is usually tested and treated with a synthetic version of thyroxine (Synthroid).
Beyond simple low levels of circulating hormones or cellular resistance, several other contributing factors to hypothyroidism have been identified:
Signs and Symptoms
Signs and symptoms of hypothyroidism are often subtle but steadily progressive. A person may not realize the extent of the problem until someone points it out. The result of not being able to convert fuel into energy means that a person gains weight, feels fatigued and depressed, and has a sluggish digestive system with chronic constipation. The person will have poor tolerance of cold, and the skin will be puffy, but dry. Hair will be flat and brittle, and may even fall out. In women, menstrual periods tend to be heavy and long-lasting. Some hypothyroidism patients will develop goiter: a painless enlargement of the thyroid.
It is common for hypothyroid patients to develop atherosclerosis, as liver function to produce the chemicals that expel cholesterol from the body is sluggish. High cholesterol levels from hypothyroidism do not respond to cholesterol-lowering medications. Fluid retention in the arms and wrists raises the risk of carpal tunnel syndrome; fluid retention in the neck along with goiter may cause chronic hoarseness. Very severe cases may cause patients to become so cold and drowsy that they becomes unconscious. This is called myxedema coma, and it is a significant cause of death among elderly hypothyroidism patients.
Many people who fit the profile for hypothyroidism also have symptoms of fibromyalgia syndrome, depression, candidiasis, or chronic fatigue syndrome. It can be a daunting and frustrating process to sort out which is which, since none of these conditions is well-understood or easy to treat.
Physical exams for hypothyroidism look for goiter, along with a significantly slowed heart rate. Reflexes are often slow in hypothyroid patients.
Blood tests may be conducted to look for elevated levels of antithyroid antibodies, which would point to a diagnosis of Hashimoto's disease. Levels of thyroid stimulating hormone (TSH) might also be evaluated. If the thyroid is underactive, the pituitary usually will pour more of this chemical into the bloodstream.
It is especially important for pregnant women to be tested for thyroid function. Pregnancy can hide some symptoms of hypothyroidism, which can create serious repercussions for the unborn child. Most newborns are tested for thyroid function as a matter of course; early intervention in the rare cases when thyroid function is subnormal can prevent stunted growth and mental retardation.
The most common treatment for hypothyroidism is to supplement thyroid hormone. In the early days of understanding this disease, desiccated thyroid glands of a variety of animals were prescribed to treat hypothyroidism. The doses were difficult to regulate, since potency could vary widely. Today, thyroxine is replaced with a synthetic version of the hormone, called Synthroid.
Some researchers, however, suggest that the symptoms of hypothyroidism may be related to other factors: general toxicity, for instance, or cellular resistance to thyroid hormones, or a need to supplement T3 instead of or in addition to T4. And of course the added challenge for treatment lies in the possibility of fibromyalgia syndrome, chronic fatigue syndrome, candidiasis, and any number of other chronic disorders that may mimic or accompany hypothyroidism. These factors, which are often neglected by some "mainstream" medical professionals, may account for why many people who have hypothyroid symptoms do not feel that taking synthetic thyroxine successfully treats their disorder.
Can Massage Help?
Outside of the risk of atherosclerosis (which is a risk for many mature clients regardless of thyroid function), massage is a perfectly appropriate choice for hypothyroidism clients. Although it is unlikely to restore the normal production of thyroid hormones or cellular sensitivity to them, massage can certainly improve the quality of life of people who feel chronically drained and lethargic.
In my next column, I'll examine hyperthyroidism. I'd love to hear from any readers who live with this disorder, or whose clients do. How has it impacted the quality of your life? What have you done, or what are you doing to treat it? What kind of impact has massage had on your situation? Share your experiences and wisdom - pathology readers want to know!
Ruth Werner, LMT, NCTMB
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
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