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Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
9 Common Causes of Thyroid Imbalance and How You Can Help
How you sleep, how easily you wake up, and how much energy and stamina you have during the day are directly related to levels of the thyroid hormones.
Chiropractic Research in Review
Chiropractic Treatment of Lateral Epicondylitis; Cost / Benefit Analysis: Different Doses of SMT for Low Back Pain; Imaging for Occult Rib and Costal Cartilage Fractures; Treating Neck Pain: Thoracic Thrust Manipulation vs. Non-Thrust Mobilization.
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
MPA Media Wins 7 Publishing Awards
MPA Media, publisher of Dynamic Chiropractic and DC Practice Insights, among other titles, has been recognized for editorial and design excellence with an unprecedented seven publishing awards by the American Society of Business Publication Editors (ASBPE), the nation's largest organization for business-to-business publications.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
A Vibrating Capsule for Constipation? Relevance to Your Chiropractic Practice
The relationship between gastrointestinal (GI) complaints and back pain is not typically written about or discussed.
CCE Finally Takes a "Baby Step" Toward Reform
During a 16-month period from October 2010 to February 2012, I devoted four separate columns to the heavy-handed attempt by the Council on Chiropractic Education to radically change the chiropractic profession through the accreditation process.
Waking Up the Gluteus Maximus
In previous articles in this series, we expounded on the importance of the gluteus maximus (GM) in athletic performance and protecting the knee from injury. We also know there is a link between iliotibial band syndrome and GM weakness.
Don't Turn a 2 Into a 10
The Wong-Baker FACES Pain Rating Scale1 is so useful because it can be used by almost anyone. Patients can use the numbers associated with the faces depicted on the scale or select the face that demonstrates their current level of pain from 0-10.
News in Brief
National Chiropractic Health Month: Be Proactive; Collegiate Roundup: Academic Appointments at Parker, Logan.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
Why Young People Need Chiropractic Now More Than Ever
According to a recent study published in BMC Musculoskeletal Disorders, "It is now widely acknowledged that neck pain (NP), mid back pain (MBP), and low back pain (LBP) (spinal pain) start early in life and that the lifetime prevalence increases rapidly during adolescence to reach adult levels at the age of 18."
Pain Underfoot: Metatarsalgia
Foot pain can interfere significantly with normal activities and severely limit participation in sports. Metatarsalgia is foot pain involving the metatarsal bones in the forefoot – the complaint of pain on the bottom of the ball of the foot.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
October, 2011, Vol. 11, Issue 10
Massage and Diabetic Peripheral Neuropathy
By Rita Woods, LMT
You can use your massage skills and talents to work on clients with diabetic and chemotherapy induced peripheral neuropathies. The degree of success is dependent upon the stage/severity of the neuropathy, client compliance with their own medical care and the "homework" you give them, and your understanding and use of the correct massage therapy protocol.
Neuropathies are characterized by a progressive loss of nerve fiber function. Diabetic peripheral neuropathy or (DPN) can be defined as "the presence of symptoms and or signs of peripheral nerve dysfunction in people with diabetes after exclusion of other causes." This is by far the most common form of neuropathy and one that you are likely to see in your massage practice. Symptoms include pain, tingling, a burning sensation, numbness or loss of feeling, pins and needles feeling and even muscle weakness. This neuropathy usually starts in the toes (in the most distal peripheral nerves) then progresses to the foot, then up the ankle and so on. The hands can be affected in the same way. This condition is almost always bilateral, involving both feet and or both hands. While DPN can involve organs and other body systems, our goal here, staying within our scope of practice, is to normalize function in the feet and hands using appropriate massage therapy techniques. It's important to understand some processes to help hone your skills and to help educate your clients about why it is important to follow their doctors orders. Understanding the why of something often encourages participation and compliance.
First, let's look at the condition itself. The feet of a person with long-term or poorly treated diabetes will often look discolored in a mottled pattern, bluish, shiny/tight or swollen. The client may or may not have been diagnosed with diabetes. Often, it's the neuropathy that causes them to go see their doctor. Early stages usually show no outward physical signs but more advanced stages may show blue toes. This can (and usually does) eventually turn to gangrene where the tissue dies and turns black. The first sign of gangrene can look like a small poppy seed sized black spot. This tissue cannot be regenerated and amputation is the end result of this progression. Naturally, the goal is to begin working on these feet before the condition gets to that point. Following is a case study provided by Charlotte Versagi, LMT, using the massage protocol. This was her first and most dramatic case that eventually led to the saving of hundreds of toes and feet.
The client was a 55-year-old male construction worker with severe diabetes and bilateral cold/blue feet with numbness and tingling. He could barely stand to have his feet touched and his feet were so painful from neuropathy that he could barely get his feet into his work boots in the morning and almost cried when he pried his boots off at night. When he went to the doctor, he was told, "you should plan on an amputation sometime in the near future." There was no mention of any treatment option, no additional medication proposed, just "plan on amputation."
He came to Charlotte asking what she could do. She started the protocol, very slowly, very lightly and called in his wife to teach her. After a few weeks, they were going in "to the bone" as the protocol suggests. He came once per week. His wife was performing the protocol twice a day. He rubbed his own feet whenever he could. In four months, he had almost no pain, had full function and his feet were warm to the touch and normally colored. The doctor retracted his statement about amputation. It should be noted that the client was following a strict diet and taking his medication as directed and was compliant with all aspects of his diabetes care.
Glucose in the body undergoes a series of chemical reactions. If you consume normal amounts of sugars (fructose, sucrose, any form of "sugar" including honey) the early stages of the chemical reactions form an equilibrium reaction. This is called a reversible reaction and allows the body to function optimally. On the other hand, if too much sugar is consumed, these reactions are not reversible and a cascade of events take place by joining the glucose molecule with a protein or fat in an abnormal process which is pathological in nature. This process is called glycation and involves every fundamental process of cellular metabolism. Eventually, through a series of reactions, you wind up with advanced glycation end products or AGEs. These are bad things and cause nothing but harm and damage.
Glycation has been implicated in many diseases and inflammatory processes. It affects the cardiovascular system in a very big way. Tissues that have a slow turnover (more permanent) in the body are most affected by glycation. So the cardiovascular system, connective tissue and skin, nerve tissue and renal tissue are major targets. Inside a blood vessel are elastin fibers to which AGE molecules will attach, thus decreasing the diameter (or caliber) of the blood vessel. There is also a lot of collagen in the arterial walls that can cross-link with the AGE molecules further compromising the blood vessels ability to function properly. Each time there is a glucose spike and AGE molecules are formed, distal circulation is compromised and the blood vessels themselves become occluded beginning with the small capillaries. Unable to supply the surrounding tissue and nerves with nutrients and oxygen the resulting oxidative debt turns toes blue and causes nerves to malfunction sending signals to the brain of pain, tingling, burning and numbness. In addition to the mechanical damage, it is believed these toxic AGE molecules (and other toxins) also trigger the release of substances that further damage the adjacent nerves.
The most important factor to getting DPN under control is to first stop the sugar spikes. Clients must maintain their glucose at a balanced level. No great highs or lows. (They know what level their doctor wants them to maintain.) With diet and medication under control, the massage therapy protocol (coming next article) can truly help save toes and feet from amputation and relieve some or all of the pain and misery of the neuropathy. The next article will discuss chemotherapy induced peripheral neuropathy and give the detailed step-by-step massage therapy protocol for peripheral neuropathy as developed by Charlotte Michael Versagi who has graciously allowed me to share it, in its entirety, with Massage Today readers.
Editor's Note: For additional information, see Step-By-Step Massage Therapy Protocols for Common Conditions by Charlotte Michael Versagi with contributions by Rita D. Woods. Published by Lippincott Williams & Wilkins, 2011. To find this book and more on medical protocols, visit www.charlottemichaelversagi.com or www.darienlourde.com.
Click here for more information about Rita Woods, LMT.
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