resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
January, 2008, Vol. 08, Issue 01
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
Happy New Year! I hope your holiday season has been peaceful, fulfilling, inspiring and rejuvenating to help get you through winter's months ahead.
After a prolonged departure from my usual "What's on Your Table?" fare, we return today to a discussion of a particular pathological condition - one that several practitioners have requested more information about - post-polio syndrome (PPS). Polio itself is almost an anachronism; but to understand PPS, we need to revisit a few key features of this infection.
Poliovirus is a pathogen spread most efficiently through oral-fecal contamination. When a person picks up some virus through contaminated water, it concentrates in the gastrointestinal tract and the feces. If any symptoms develop at this time they include high fever, aches, headache, nausea and diarrhea (which helps spread the virus), and then for most people the infection is completely over. Less than 1 percent of all people exposed to poliovirus in this way progress to develop a second-tier infection. The motor neurons begin in the ventral horn of the spinal cord and control muscle function. The resulting destruction to motor neurons leads to muscle atrophy and paralysis. This often occurs in the lower extremities, but a particularly serious form of the infection affects breathing muscles. (One interesting mystery about polio is that we have never figured out how the virus migrates from the intestines to the central nervous system.)
Even with such a low rate of serious infection, polio traditionally has been viewed as a significant public health threat. After all, if 1,000 children swim in a contaminated lake or drink from a contaminated well, this means 10 could become partially paralyzed. And because young children are especially vulnerable, this disease has also been called "infantile paralysis."
People familiar with the history of massage may remember that Sister Kinney, an Australian nurse, pioneered the use of hydrotherapy and intense rubbing to help her polio patients recover some muscle function in the 1930s before polio vaccines were available.
The good news for us is that wild polio (polio that is not connected to a vaccination series) is practically extinct. The last recorded case of wild polio in the Western hemisphere was in Peru in 1991; the last case in Europe was in 1998. As of 2003, wild polio was endemic to only India, Pakistan, Nigeria, Niger, Afghanistan and Egypt. One of the consequences of the extremely successful world-wide polio eradication program is that a bodywork practitioner working in the U.S. today is extremely unlikely to have a client with an acute polio infection. However, we estimate that some 440,000 people in the U.S. had polio infections during childhood and these people are vulnerable to a long-term complication related to the virus: post-polio syndrome.
Post-Polio Syndrome: No New infection!
When a person develops polio-related paralysis, some of his or her motor neurons have been destroyed and the muscle cells those neurons controlled are likewise prone to atrophy. However, remaining functioning nerve cells have a tendency to develop new axon tips to support some muscle fibers. In other words, the motor unit (a single functioning motor neuron and all the muscle fibers it supplies) becomes larger. Over the course of years, this can lead to cumulative fatigue, stress and wear-and-tear both on the overworked motor neurons and on the under-stimulated muscle cells. The result is that anywhere from 10 to 40 years after an initial polio infection, a person may experience a sudden onset of symptoms that include muscle weakness, pain, breathing and sleeping problems, and debilitating fatigue; this is PPS.
It's important to emphasize that while a polio survivor has new symptoms, often with a sudden or specific onset, PPS definitively is not a resurgence of the virus as a new polio infection. It's simply the result of decades of overuse of tissues that have limited capacity for growth and adjustment. The most typical pattern for PPS is that a middle-aged person who had polio as a child develops the symptoms listed above and the symptoms tend to run in cycles: During flares the person loses function, and during remission the person is stable, but may not regain lost function. People most at risk are those who followed their original polio infection with a rigorous and aggressive physical therapy program to rebuild strength in damaged muscles. We see now that the nervous system can't keep up with long-term demands in this way.
Massage for Post-Polio Syndrome
Polio itself involves motor paralysis but no sensory deficit. This makes it safe for bodywork, since the client can accurately report how intense or safe the pressure feels. Post-polio syndrome is the same: it involves pain and weakness related to neuromuscular dysfunction, but the pain is not related to any attack or inflammation of sensory neurons. Furthermore, numbness is not a reported symptom of PPS. Typically, people with this condition are counseled to adjust their posture and movement patterns to take advantage of their strongest muscle groups, rather than the ones that were damaged and then overworked after their infection. This may mean using or adapting tools like braces, crutches or canes. Massage certainly can help in this area to de-stress overworked areas and to support and refresh muscles that are newly being pressed into service. Massage won't eradicate the problems behind PPS, but by focusing on taking the workload off the weakest muscles and supporting the strongest ones, bodywork can be part of a helpful coping strategy for our population of polio survivors.
I've had some interest expressed in exploring polymyositis: an autoimmune disease that affects muscle function. If you have experience working with clients who have this condition, be sure to share. Until then, many thanks and many blessings.
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.