resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
The Science of Stretching
In 1986, Rob DeCastella set a course record by running the Boston Marathon in 2:07:51, just 39 seconds off the world record.
Vaccines and Chiropractic: Evidence-Based Medicine or Medical Dogma?
Right or wrong, the chiropractic profession has historically been against vaccinations. However, a growing trend within the profession is seeking to reverse this position.
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
Curbing Label Overwhelm
For the average consumer, reading a food package can be overwhelming: natural, organic, non-GMO, gluten free, free range ... you get the picture.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
Fibromyalgia: Put the Pain in Its Place
While some fibromyalgia patients respond favorably to regular chiropractic care, others experience minimal relief. Unfortunately, many of these patients must rely on pharmacological management to relieve their constant pain.
Physical Exam 101: The Hands
I am sure you are familiar with the old adage: "When the only tool in your toolbox is a hammer, everything starts to look like a nail."
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
Coding for the Subluxation: ICD-9 vs. ICD-10
When I attended chiropractic school, I was taught that chiropractors approach health care differently than the traditional medical establishment.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
Are You a Bad Chiropractic Patient?
My father was a great DC. In fact, as you might expect, he was the doctor of chiropractic I measured all other doctors against. Sadly, he died at age 61 when I was in my early 30s.
Why You Should Include the Single-Leg Stance Test in Every Patient Assessment
The single-leg stance (SLS) test, also known as the single-limb stance test, unipedal stance test or one-legged stance / balance test, is often used in the geriatric population to assess static postural and balance control.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
Immunizations by Colorado DCs: Really?
You probably didn't hear about it, but back on Nov. 21, 2013, the Board of Directors of the Colorado Chiropractic Association (CCA) adopted "immunization authority" for Colorado DCs as its No. 2 legislative goal.
By the Numbers: 3 Common Financial Mistakes With Major Consequences
Warren Buffett is on record for sharing the hidden art of becoming wealthy and making it simple enough for anyone to grasp.
Knee Pain From the Kinetic Chain
As practitioners of manual medicine, chiropractors often treat patients suffering from knee pain.
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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