resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 2)
As mentioned in part 1, using a flexion-distraction table is a great way to unlock this particular fixation. You have found the stuck segment. You have determined whether it is unilateral, midline or bilateral.
Managing Patient Expectations About Acupuncture
Last year, I attended the Pacific Symposium in San Diego for the first time in six or seven years. It was the 25th anniversary of this event, and on one evening there was a panel discussion with the title; "What is Qi?."
Uncle Sam Needs You (Part 2)
Where chiropractic care has been used in the military health services, it has been deemed very successful.
Jingei Diagnosis: An Effective and Powerful Diagnostic
I graduated from the Kotatama Institute under the direction of Drs. Masahilo and Katsuharu Nakazono in 1984. As a student, I was exposed to the practice of most of the various theories and modalites of Oriental Medicine.
The Wonders of Light Therapy: An Interview with Wes Burwell
I first met Wes Burwell in 2011 when he was teaching a class on light. Since then, every time I hear him speak, his understanding of the benefits, function and capacity of light has evolved.
Lime Jello on Morphine
Taste is in the eyes... actually the mouth... of the beholder. My food preferences have changed, lightening from the food of my youth. My parents loved heavy eastern European cuisine and I loved it as a child. Now I enjoy leaner, healthier whole foods.
Chiropractic Research in Review
Predicting Pain With Disability in Office Workers; Traction Approaches for Discogenic Cervical Radiculopathy; Intra-Articular Gas Bubbles Following Manipulation; Nonresponsive Chronic Ankle Sprains: Think Tendon Rupture.
To The Finish Line With the Help of TCM
When acupuncturist Eddy De Smedt pursued a career in Traditional Chinese Medicine, he knew he wanted to make a difference.
The Case for Immunization
As long as I have been a chiropractor, I have seen many in this profession oppose vaccinations. Indeed, it has often been taken as a "given" that to be a principled chiropractor requires a curmudgeon's willingness to hold aloft that banner of opposition.
Communication 101: Please Explain Yourself!
Twice this past week, I overheard conversations about chiropractic. As you can imagine, it is a topic my ears naturally pick up. In both cases, a patient was talking to a friend about their experience with a chiropractor.
Healing With TCM at San Quentin State Prison
For the prisoners at San Quentin State Prison, life-sentences are the reality of every day life. It is not often that prisoners get the opportunity to use alternative medicine to deal with common ailments they encounter behind bars such as, depression, anxiety and pain.
Essential Orthopedic Testing: Tests That Involve Standing on One Leg
Since these tests have a common mechanism of performance (standing on one leg), there are differential diagnostic concerns during testing. The tests cannot be completely isolated from each other for performance.
The Heart Protector
On the physical level, the Pericardium is a double-layered sac of fibrous tissue that envelops the Heart. The space between the layers is filled with serous fluid that protects the Heart from external shock or trauma and lubricates to allow for normal Heart movement.
Sports Science: What's in That Drink?
Athletes frequently ask me what the best liquid is to drink during exercise – water or a sports drink? Water provides the necessary hydration, but unfortunately, it lacks the key nutrients to aid in performance and recovery.
Managing Today's Fertility Patient
I recently received an email from one of my fertility patients: "Got my lab results back. FSH is 11, AMH is 0.7. My doctor said these numbers aren't good. I guess I'm infertile. Just as a thought. Just set up an appointment to speak with an adoption agency."
Commingling Money: 12 Questions for the ACA About the CHAMP / NCLAF Merger
The American Chiropractic Association recently announced it was merging the National Chiropractic Legal Action Fund and the Chiropractic Health Advocacy and Mobilization Project into a single entity that will support both legal and legislative actions.
Correcting Pelvic Rotation Around the Long Axis: Adjustment Protocol
The pelvis can be considered a ring that can misalign on the sacrum rotating around the long axis. The following is a description of an adjustment that helps to correct sacroiliac rotation around the long axis.
Simple Ways To Find True Happiness
Patients in our clinics are always seeking happiness. As their health advocate, we need to ensure we inform them that in order to find happiness, they have to make sure to identify what makes them happy in the first place.
AOMA Strengthens Leadership Team
AOMA Graduate School of Integrative Medicine, a leading college of acupuncture & herbal medicine, announced the appointment of Donna LaPoint Hurta, MBA as the new VP of Finance & Operations this Fall.
Dr. George Goodman and His Legacy to Logan University
Those who knew him called him a revered leader, a visionary and one of chiropractic's biggest advocates. George A. Goodman, DC, Logan University's sixth and longest-serving president, passed away on Sept. 9. He was 70 years old.
CMT & Stroke Risk: Myth vs. Fact
By now, most of you have probably heard that the American Heart Association recently published a statement regarding the association between cervical dissection (CD) and cervical manipulative therapy (CMT).
Pulse Diagnosis: What We Know
I am still finding pearls of wisdom from the books and papers that I inherited from my pulse diagnosis mentor Jim Ramholz.
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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