resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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 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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.)
A House Divided?
The American Chiropractic Association's House of Delegates voted on 30 resolutions at its annual business meeting in Washington D.C., but two in particular took immediate center stage due to their controversial nature.
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.
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 Simple Steps to Create an Effective Marketing Calendar
In the educational experience of most healthcare practitioners, business and marketing are overlooked topics.
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.
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.
March, 2008, Vol. 08, Issue 03
When Is It Safe to Treat a Patient Taking Antibiotics?
By Charlotte Michael Versagi, LMT, NCTMB
Patients often arrive at a massage therapist's doorstep after a recent hospital release, recovering from bronchitis or another "bug." During intake, we discover they are taking some form of an antibiotic. Upon hearing these words from a client or patient, a red flag needs to pop into the therapist's consciousness. This isn't always a contraindication, but ingesting antibiotics presents certain precautions and demands certain questions are answered before proceeding with the massage treatment.
To clarify up front, in this article, massage treatment is defined as standard, full-body, Swedish-style massage consisting of effleurage, petrissage, some range of motion, perhaps some tapotement, etc. We are not referring to lymphatic drainage, energy work or other forms of bodywork. Those modalities are performed after advanced training and affect the body slightly or significantly different than normal Swedish massage.
First, what is an antibiotic? Antibacterial agents usually are called antibiotics. These medications cause irreversible and lethal damage to a bacterial pathogen or at least create bacteriostasis, inhibiting bacterial growth. You've heard of the common families of antibiotics: the penicillins, tetracyclines, sulfonamides and cephalosporins.
Here are some questions to ask when your client informs you they are on antibiotics. Why are they taking the medication? When did they start taking it? Are they suffering from an infection? Is the infection systemic or local? Do they presently have a fever? If so, is it spiking or is it low-grade? And at this point, you may be thinking to yourself, "What's the difference between inflammation and infection?" and "What effect will my massage have, based on the answers my client just gave me?" Our concern, as always, is safe treatment.
Let's clarify some definitions before discussing your treatment. An infection, according to Stedman's Medical Dictionary, 28th Edition, is an invasion of the body with organisms that have the potential to cause disease. Our own Ruth Werner tells us inflammation is a tissue response to the threat of bodily injury or invasion by antigens. The response is controlled by chemical, cellular and vascular functions. It's a chain of events; a reaction of injured tissue to defend and protect the body from invasion. The aim is to get rid of the pathogen, prevent the spread into the body (a massage therapist's primary concern) and prepare the injured area for healing.
Now prepare yourself for a generalization here, but it will help you with your treatment decision. Antibiotics most often are given to fight infection, something that is systemic or carries the threat of becoming systemic (although some infections can be quite local). Steroids and some other medications often are administered for inflammations; a problem we normally think of as local, yet sometimes is systemic.
You remember the cardinal signs of local inflammation, right? Redness, heat, swelling, pain and sometimes, lost function. The point is to help you intelligently understand what you are treating before you proceed. Does your client suffer from a local inflammation/infection (e.g. infected tooth socket after wisdom tooth removal) or are they taking antibiotics prophylactically before a procedure? Have they been diagnosed with bronchitis and started antibiotics three days ago? Do they have a fever of unknown origin and the doctor is simply experimenting with an antibiotic to try to allay symptoms?
Now let's put two and two together. You learned in massage school that one of the primary effects of massage is an increase in circulation, right? OK, if a one-hour massage is going to increase circulation, you must be as sure as you can about exactly what you are sending through that body. Are you potentially spreading infection or are you helping with waste removal and lymph flow to assist the body's fight toward health? The effects of massage are vast and wonderful; just keep reminding yourself that one of those effects is vascular. With infection and inflammation, you are dealing with the body's vascular (and immune) response.
As for the answer to the question of whether to treat a client, according to Werner, acute inflammation is a contraindication for circulatory massage. But massage may be appropriate for subacute conditions. (Think of a twisted and swollen ankle, for example. No massage therapist in their right mind would massage locally, but effleurage proximal to the injury, as well as massaging the rest of the body, would be completely appropriate.)
The mantra I learned in massage school was: "An antibiotic has to be taken for three full days for the patient to achieve a blood level (of antibiotic) before a massage can be safely given." Although this is generally sound advice, Jane Brown, director of the 1,000-hour massage program at Carnegie Institute in Troy, Mich., reminds us, "All antibiotics have different saturation levels in the blood; so although the three-day rule holds most of the time, you never really know which antibiotic has reached its height of effectiveness and when."
Jen Green, a naturopathic doctor and researcher practicing in Shelby Township, Mich., offers massage therapists a holistic view of treating patients who are taking antibiotics: "Antibiotics generally help control the bacterial population. But tell your massage therapists that the antibiotics are not doing the whole job - the immune system is still working. It needs a boost to work effectively and massage gives it that boost. I'd agree with waiting a couple of days (from the onset of taking the medication) to begin massage but after that, it would help the patients to stimulate the immune system by increasing circulation." Dr. Green continues, "Antibiotics, too, have a bacteriostatic effect; they can keep the bacteria from growing - but the body has to move. Increased blood and lymph flow helps get the problem out of the system."
It is probably safe to treat your patients after they have been taking antibiotics for two or three days and are manifesting none of the cardinal signs of heat, fever, swelling or pain. Remember, ask all the right questions, determine in your mind exactly what effect your increasing circulation will have on the body, and then proceed with intelligence and compassion.
Charlotte Michael Versagi is a medical journalist, national speaker and educational director of the School of Oncology/Hospital Massage in the Beaumont Hospital system in Michigan. Her private practice focuses on oncology patients.
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.