resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Applying the Thin Skull Principle
The "thin skull" principle, also known as the "you take your victim as you find them" principle, is a legal principle that can be summed up by the following statement.
The Challenges of Integrating Eastern and Western Medicine
My Masters thesis was titled, "The Challenges of Integrating Eastern and Western Medicine," which highlighted several reasons why it is hard for these two worlds to mix.
5 Tips for Using Pinterest to Market Your Practice
Pinterest is a very popular, but often under-utilized, social media platform where people can bookmark, or "pin," fun and interesting things from all across the internet.
Marijuana, Apathy and Chinese Medicine, Part 1
This article was written in response to the unheeded acceptance of marijuana as a harmless substance that potentially does good when used for the medical relief of pain.
Turning a Blind Eye to History – and Reality
The American Medical Association is taking the Supreme Court's Feb. 25, 2015 decision exactly as it always does – by turning a blind eye to history, legal precedent and reality.
Functional Hip Impingement (Part 1)
Every time I sit down to write an article, I realize how much more there is to know about musculoskeletal pain. I also learn something new every time. (I want to give special thanks to Lucy Whyte Ferguson for assisting with this article.)
Animal Acupuncture: A Case Study in the Treatment of Traumatic Injury in the Equine
The rise of animal acupuncture in the U.S. began in the early 1970's as a result of the work by members of the National Acupuncture Association in Westwood, Calif.
The Acupuncturist's Problem
I want share with you some observations and insights into what seems to be the most common problem my colleagues in the acupuncture profession struggles with. If you also struggle with this problem, I hope you get a valuable "aha" moment from reading this.
How Much Do You Know About the Benefits of Birds Nest?
Edible bird's nest is the nest made by the Swiftlet bird of Southeast Asia that is usually prepared as a soup and prized in Chinese culture as a healthful delicacy.
Term Limits: What's in a Word?
It was the French historian and philosopher Voltaire who once declared the Holy Roman Empire was neither holy nor Roman nor an empire.
5 Simple Steps to Create an Effective Marketing Calendar
In the educational experience of most healthcare practitioners, business and marketing are overlooked topics.
The Tide is Rising in the Acupuncture Profession
Former President Ronald Regan said, "When the tide rises all boats float." The tide is rising for the acupuncture profession. Many forces outside the profession are helping the tides to rise.
Low Back Pain in Professional Golf: A Common Muscular Relationship
Every sport creates its own unique demands on the body. Some sports require such a myriad of body positions that assessing pathology is often difficult and unpredictable.
Medicine is Clumsy, Don't You Be
All medical systems have clumsiness in them. If the technique isn't, the practitioner is. Everyone in every form of medicine is striving to improve. That is why we call it practice.
Talking to Patients About Lumbar Facet Denervation (Medial Branch Neurotomy)
Lumbar facet denervation, more appropriately termed medial branch neurotomy (MBN), is a procedure that may be considered when patients suffer from recalcitrant non-radicular axial back and/or leg pain.
Sleep, Less Sleep or No Sleep?
I had a dream I wasn't getting enough sleep. It was a very realistic dream, even though I was probably slightly awake and not really deep dreaming. Most likely I had been dozing, caught in that twilight of sleep and wakefulness.
A View From the ER
The University of Western States has inked an innovative agreement with local nonprofit health system Legacy Health whereby UWS sports-medicine fellows can experience observational clinical rotations in emergency-room settings within the Legacy system.
PCOM Granted Regional Accreditation
Pacific College of Oriental Medicine (PCOM) recently announce it has received regional accreditation from the Western Association of Schools and Colleges (WASC). This achievement reflects five years of hard work on the part of faculty, staff, and students.
Integrating Art with Clinical Practice for Patients with PTSD: The Artemis Project
Are you restricted by those one-on-one clinic dynamics? Why not join colleagues and clients in experimental group settings? Three of us volunteered to do just that in Austin on behalf of women veteranss from all branches of the service.
Optimism = Compassion = Trust
A randomized clinical trial recently published online in JAMA Oncology examined how patients viewed their doctor based upon how the practitioner presented bad news to the patient.
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.
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