resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. After two treatments for back pain, a patient presents for a third session complaining of rapid breathing and wheezing that is made worse during cold weather.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
Code Connection: Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
April, 2011, Vol. 11, Issue 04
How to Help People With Parkinson's
By Ben Benjamin, PhD
Those readers familiar with my column will know that my articles typically deal with pain and injury conditions. This month, I'm excited to address a very different type of ailment, Parkinson's disease (PD), and a type of exercise therapy that can dramatically reduce the symptoms of this disorder.Seeing the effectiveness of this work with clients has been a wonderful surprise and a great learning experience, as well as being deeply gratifying.
What is Parkinson's Disease?
Nearly one million people in the United States are living with PD, a chronic, progressive, neurological disorder with no known cure. Most PD is idiopathic (of unknown cause), but some cases are thought to be caused by genetic factors or exposure to environmental toxins.
PD affects the brainstem, the lowest part of the brain, which connects directly with the spinal cord. Specifically, it affects the neurons (nerve cells) in an area called the substantia nigra. When they are functioning properly, these neurons produce dopamine, a chemical responsible for transmitting movement-related messages. In a person with PD, 60 to 80 percent of those cells become damaged and no longer produce enough dopamine. As a result, the person begins losing the ability to initiate and control their movements.
While brain scans can reveal whether a person's substantia nigra is damaged, there is still no single test or exam that proves the presence of PD. The primary indicators of the disease are four characteristic symptoms: tremor, rigidity, bradykinesia (slowness of movement), and postural instability. As the disease progresses, these movement conditions ultimately result in paralysis. Additional symptoms often associated with PD include fatigue, sleep disorders, cognitive impairment, depression, speech problems, gastrointestinal issues, impulsive behaviors and pain. The development and advancement of PD is somewhat of a mystery and varies by person. For instance, although tremors are commonly a primary symptom, some individuals experience no tremors but instead have problems with balance. While some people quickly become severely physically disabled, others live with a much slower disease progression over 20 to 30 years.
Treatments for PD vary depending on the stage of the disease and the symptoms the individual is experiencing. The medications currently prescribed do not reverse symptoms but can slow their progression. Unfortunately, some drugs may lose their effectiveness over time, cause an allergic reaction, or cause disconcerting side effects, such as dsykinesia (sudden involuntary movement). However, in many cases, finding the right combination of medications can dramatically improve a person's quality of life.
In cases where medication is not sufficient, PD is sometimes treated with deep brain stimulation (DBS). This is a surgical procedure in which a neurostimulator (essentially a "brain pacemaker") is implanted in the brain. The device sends electrical impulses to the specific areas of the brain that control movement, while also blocking the abnormal nerve impulses that people with PD often experience. It can sometimes take up to three months for this treatment to significantly reduce symptoms, but the success rates are high.
In addition to pharmaceutical and surgical treatments, speech and physical therapy are usually helpful. Physical exercise in particular appears to help some of the movement symptoms by improving balance and flexibility and reducing joint stiffness.
As an experienced therapist, I concluded long ago that there was little that hands-on practitioners could do for people with degenerative neurological conditions such as PD. I'm happy to say that over the past few years, I've been proven wrong. As increasing numbers of massage therapists and bodyworkers are discovering, active isolated stretching (AIS), can be enormously helpful in reducing PD symptoms and restoring normal motor function.
Several aspects of AIS help to explain its unique ability to provide neuromuscular benefits. First, every AIS stretch includes a gentle assist. At the end of the client's active range of motion, the practitioner provides just enough assistance to push slightly beyond what the person could do on his or her own, typically adding two or three degrees with each repetition. This means that the muscles are continually moving into new territory. The brain-muscle connection keeps learning to do something new and different, which means new neural pathways are always being created.1
In addition, the stretches in AIS are active, rather than passive. Although the practitioner supports and assists the stretch, each movement is initiated by the client. This further reinforces the connections between the brain and the muscles.2 Repetition of the stretches also promotes nerve development. Instead of a single stretch held for a prolonged period of time, AIS involves six to 12 repetitions of each movement, performed for just two seconds.
Another relevant factor is the reduction of muscle spasticity, which is excessive tone in a muscle that leads it to involuntarily contract when it is stretched or lengthened. It can vary in severity from mild muscle stiffness to severe, painful spasms. In many cases, AIS can effectively resolve spasms and lessen spasticity.
Beyond these specific neuromuscular effects, some of the more general benefits of AIS are very helpful for individuals with degenerative neuromuscular diseases. AIS helps restore the supply of oxygen and nutrients to chronically contracted, blood-starved tissue. Some of the most affected tissues in Parkinson's patients are the "two joint" muscles that act across more than one joint. These include the hamstrings and rectus femoris (hip and knee joints); gastrocnemius (knee and ankle joints); and the psoas (hip joint and multiple joints in the low back). AIS allows for focused stretching on each of these muscles, working toward restoring normal posture and gait. After flexibility has been restored, the focus shifts to building strength through Active Isolated Strengthening.
My First Client With Parkinson's Disease
It's one thing to have a theoretical understanding of how AIS can reduce neuromuscular symptoms; it's quite another to see this in action, with real people who are suffering from progressive degenerative disorders. When I first heard that AIS could help clients with PD, multiple sclerosis, and other neuromuscular conditions, I was extremely skeptical. Only after seeing dramatic improvements in my own clients did I fully accept that this was possible.
My first client with PD, whom I'll call Mary, was a college professor whose symptoms had begun four-and-a-half years earlier. After receiving a critical evaluation from one of her advisees that she thought was unfair, she became distressed and started shaking. This is common; while life stresses do not cause PD, the first signs of the disease often occur during a stressful event. Although she had no problems with balance, she experienced both tremor and rigidity, which interfered with her daily life.
I began treating Mary with hour-long AIS sessions, twice a week. She began to feel increasingly looser, stronger, more flexible, and less rigid. Within about three months, there was a drastic reduction in her symptoms. Previously, her right foot had dragged, and now she could lift it up, even on days when she was under stress. For several years, she hadn't been able to brush her hair with her right hand; now she could do that regularly. She also credits AIS with eliminating an extreme, acute pain in her arm and an annoying pain in her fingers and toe joints, as well as with improving her ability to write. As the years went by, her writing had become smaller and smaller, and she had lost the capacity to write "N"s and "M"s. After several sessions, she could write an "M". Currently, she can write almost as well as she could five years ago.
The AIS work also seems to have affected Mary's sleep. For four years, she had experienced severe sleep troubles that would cause her to get up in the middle of the night, even with the help of medicine. A month and a half after starting AIS treatment, she began sleeping through the night. After about three months, she told me that for the first time in years, she had woken up feeling truly rested and refreshed. Both she and her doctor (a neurologist who specializes in movement disorders) believe that this improvement is due to AIS. Another benefit was being able to halve the dosage of a medication she was taking, which made her sleepy. Before Mary started with AIS, her doctor wanted to put her on the strongest possible medication. After seeing the progress she was making, he decided to postpone this measure.
One of the most inspiring changes to witness was that as Mary's symptoms decreased, she regained her self-confidence. Because her tremors have diminished significantly, to the point where they are usually unnoticeable by others, she is less self-conscious in stressful meetings or other public interactions. (Mary was impressed when her neurologist told her that her PD could be noticed only during a physical exam performed by a specialist.) She also feels much more comfortable eating with her right hand in public than she had in many years.
Mary has participated very actively in her own recovery. I taught her AIS stretches and strength-building exercises for her neck, arms, hands, fingers, legs, feet and toes, and she has continued to do these regularly at home. When she feels any pain coming back in her arm, she does the arm exercises right at that moment, and it goes away again.
In this way, I have found AIS work to be empowering for Mary and for other individuals with neurological conditions (including multiple sclerosis and muscular dystrophy). It is also empowering for me. It has given me the ability to help an entirely new set of clients who don't respond to the other forms of treatment I offer. I find it exciting to see more and more massage therapists and other health practitioners learning these valuable skills.
Click here for more information about Ben Benjamin, PhD.
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