resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Case Studies and Answer Analysis for NCCAOM Exam in Foundation of Oriental Medicine
Case studies are very common for acupuncture school students, either in class exams or during taking the national board exam. Most test takers feel they have no idea where they should start and how they should start to analyze those complicated cases.
Treatment of Type 1 Diabetes Mellitus: The Latest Breakthroughs
There are now more than 29 million diabetics in the U.S. and 10% of them have Type 1. The incidence has been increasing in recent years at an epidemic rate.
Immunotherapy: Where Molecular Medicine Crosses Into Holistic Thinking
Immunotherapy, and its promise as a cancer treatment, has been in the news a lot in the last few years, and for good reason. Real shifts are happening in oncology and exciting researchers, clinicians, and patients.
The Good, the Bad and the Successful in Social Marketing
You might be thinking, "social marketing, don't you mean social media?" No, I mean social marketing. Every day, I keep reading, hearing and learning more and more about the changes happening in social media.
Time for World-Wide Growth
Acupuncture is the organically growing around the world. The legislative body in Quatar has said acupuncture is "okay." The United States has five states to go to have every state recognized and regulated.
We Get Letters & Email
Another Slap in the Face for DCs; I Know Where to Find the Missing Chiropractic Patients; Clarification on Vitamin D Study.
Five-Element Reaches Out to Serve the Community
In 2006, a student at the Institute of Taoist Education and Acupuncture (ITEA) approached the administration about an idea for his senior project.
Are Herbs Useful for Chronic Pain?
The human nervous system is what makes us special, but our greatest strength also makes us vulnerable: witness the growing incidence of chronic addictions, anxiety, depression, sleep disorders and chronic pain syndromes.
Acupuncture at a Pain Clinic
Introduction: Pain is the most comprehensive human experience. The experience of pain is associated with the somatic, emotional and social impact. Pain has not only somatic symptoms, but also psycho-social dimension, especially in case of chronic pain.
2016 Trudy McAlister Foundation AOM Scholars
This year, the Trudy McAlister Foundation (TMF) received a record number of excellent applications for the 2016 scholarship awards and has awarded five scholarships for $2000 each. More information is available on our website: AOMScholarship.org
Introducing the Dynamic Chiropractic Digital Edition
In response to the changing habits of our readers, Dynamic Chiropractic is proud to introduce a digital edition of the publication beginning with the July 2016 issue.
Diet, Nutrition and the Context of Risk (Part 2): Food Poisoning
Other than the morbidity and mortality linked to eating too much food, "all-natural" organisms that contaminate our food cause more illness, more hospitalizations and more death than food contaminated by heavy metals, plastics, preservatives, artificial colors, emulsifiers, artificial sweeteners and pesticides combined.
Bring on the Bitters
Out of all the possible flavor choices with foods, such as sweet, sour, salty, and umami (deliciousness), which would you choose first? Bitter, though not as enjoyable, is also a flavor.
Shoulder Rehab: The Gait Connection
Shoulder problems can be difficult to rehab completely for several reasons. The shoulder is made up of several joints that must function together smoothly to provide the extreme mobility that is possible and necessary for many activities.
Day in the Life of an Advanced- Practice DC (Pt. 2)
Let's continue our Q&A with Stephen Perlstein, DC, APC, chair of the New Mexico Chiropractic Association PAC and president of the American Academy of Chiropractic Physicians. Part 1 of this interview appeared in the May 1 issue.
How to Bill Evaluation and Management Codes
Q: I am in need for guidance on how to bill evaluation and management (E&M) codes in addition to acupuncture the same date of service, I have never been paid for an exam when done with acupuncture and I believe I am doing it wrong.
Does Anyone Know You're a Good Chiropractor?
If you had a chance to read the recent article in Time magazine (April 6), you know it provided some good information about the efficacy of chiropractic to the magazine's substantial consumer audience.
What Should You Call Your Patients (and What Should They Call You)?
When I walked into the exam room, the new patient looked uneasy, fumbling with his cellphone. He was a huge Polynesian man, probably in his 40s, with unrecognizable island tattoos.
The Effectiveness of Chinese Medicine in Treating Infertility in the Philippines
Infertility is defined as the inability to achieve a successful pregnancy after 12 months or more of regular unprotected intercourse.
The Eight Extraordinary Confluent Points
The eight extraordinary confluent points are a very popular set of acupuncture points in the modern practice of acupuncture. They are also called the intersection, meeting, command, opening, master, and the flowing and pooling points of the eight extraordinary vessels.
Who is Your Ideal Patient?
Being in a healthcare practice requires you to think critically about many things including your equipment, techniques, documentation, financial goals, and the retention of clients and staff.
Chiropractic Needs a Lesson in Education
The American Chiropractic Association has launched a campaign, The National Medicare Equality Petition, to enact federal legislation that would achieve full physician status for DCs in Medicare.
Herbal Medicine Continues to Evolve
Product manufacturers, industry partners, distributors and practitioners work as a collective Traditional Chinese Herbal Medicine (TCHM) community to produce high quality TCHM prescriptions that bring low-risk healthcare to thousands of patients everyday.
The Liver: The Official of Planning
The Liver, with its paired Official, the Gall Bladder, belongs to the Element Wood within us. Wood grants us the power of birth – new beginnings, growth, breaking through boundaries and surging forward. It is the vigorous, exuberant energy of the spring season.
F4CP Campaign Addresses Public Misperceptions of Chiropractic
In late 2015, results of the Gallup-Palmer College of Chiropractic Inaugural Report: Americans' Perceptions of Chiropractic were published. The report found that 33.6 million U.S. adults (14 percent) had utilized chiropractic care within the previous 12 months.
February, 2012, Vol. 12, Issue 02
Seeing Your Massage Clients Through a New Lens
By Ann Catlin, LMT, NCTMB, OTR
I've worked with people young and old with complex medical conditions since 1979 when I began my career as an occupational therapist. From rehabilitation centers, home health agencies, psychiatric hospitals, hospices and long-term care facilities, I've been around the block a time or two.But my work the past decade as a massage therapist has helped me see things through a new lens.
One such thing is the importance of distinguishing between a primary diagnosis and the secondary conditions resulting from the primary illness or injury. It's important to realize that secondary conditions can impact our clinical reasoning, leading to modifications in our approach or techniques, as well as our own feelings and emotional reaction to our client.
There are many diagnosis commonly found in older adults who require skilled nursing or home care. However, I'm focusing on only one — Parkinson's disease, a progressive neurological disorder. Nerve cells located in the area of the brain that controls movement degenerate causing symptoms associated with this disease. In spite of aggressive research, the exact cause is unknown; however there is speculation that genes and environmental toxins might play a role.
So, let me ask, is it necessary to be an expert about Parkinson's disease to have a safe and beneficial massage session for a person with the disease? I don't think so. It's not the diagnosis itself that drives our approach, but rather our observations of the secondary conditions or symptoms. Secondary conditions are those things we can see, feel, hear and sense during a session. They impact our decisions about how to carry out a session; how we position our client; how we communicate; what techniques to use.
What follows are three secondary conditions (symptoms) of Parkinson's disease and corresponding questions that influenced my own clinical reasoning when a woman was referred for massage therapy sessions to improve physical comfort and sleep. Mrs. P. was a woman with advanced Parkinson's disease being cared for in her home by family and a team of home care professionals.
Symptoms included tremor while at rest, involuntary shaking of an extremity, often the hands when the muscles are relaxed. For example, the hands shake when they are lying in the lap. But when the person reaches for something or performs other purposeful movement, the tremor is lessened. Clinical questions: Will her hands shake while I'm trying to massage them? If so, is it okay to massage them anyway? How much pressure should I use? Would compression be a good technique to use? Will massage help quiet the tremor?
When I started seeing Mrs. P., I noticed her right hand had a mild tremor that continued as we talked about how she wanted to receive her massage. I determined that gentle compression techniques to the arm and shoulder attachment sites would be a good technique to use since compression has an inhibitory effect on the nervous system. If compression did not ease the tremor, I understood there was still benefit to offering unconditional touch to sooth her.
Bradykinesia is when people have difficulty initiating movement and appear to move in slow-motion and walk with small, shuffling steps. Speech becomes slurred because the muscles of the mouth and tongue are affected and some people have a mask-like facial expression. It was clear that Mrs. P. was not able to get onto a massage table. Should I use a table-top massage device or have her get up on the bed? Is the area free of clutter or anything that might be a fall risk should she need to move from the chair? Should I have her remove clothing knowing that it takes her a long time to do so? She had a mask-like look on her face making it difficult to read her non-verbal expressions. How else might I determine her reactions and watch for signs of pain?
Mrs. P's speech was very hard to understand because she had difficulty forming the words and her voice was very soft. It took my full attention to understand. But she made it clear that she preferred to get onto her bed for our sessions. Her daughter helped her transfer from the chair to the bed. Mrs. P's movements were excruciatingly slow making the process difficult. It took several minutes for Mrs. P. to get settled in a supine position on the bed. She was dressed in loose fitting clothes and I decided it best to not ask her to remove anything. We would work around and through the clothing.
There was muscle rigidity and atrophy causing stiffness and sometimes painful contractures in the arms, legs and trunk. Is there pain? Does it hurt to move? How much range of motion is present? Should I try stretching it? Are there any positioning techniques I could use to increase her comfort and support during the massage?
As the disease progressed, Mrs. P's muscles became very tight and stiff especially in her arms, legs and neck. She now found it extremely difficult to speak and was now mostly silent. But she was alert and her eyes were bright. Now, when I arrived for our evening sessions she was already in bed. Her arms were usually bent at the elbow and held tightly to her chest. Muscle spasticity in her legs caused them to be clasped together and crossed at the ankles. Her daughter reported that Mrs. P. had difficulty sleeping because of pain. I discovered that effleurage strokes, gentle compression and focused touch, eased the spasticity that caused the stiff posture and she was able to relax her arms enough to be placed comfortably on pillows at her side. Her legs relaxed allowing them to uncross at the ankles. Within minutes of starting our session Mrs. P's eyes would close as she drifted into sleep. Her family reported that on nights she had massage she slept through the night, giving all of them much needed rest.
As our sessions continued, the fact that Mrs. P. had Parkinson's disease became less relevant in my mind. More important were my keen observation skills; meeting her in present time, responding to each moment of every session and allowing her to receive the gift of touch in any way that served her. Sometimes that meant having her cat sit on her stomach watching my every move. I'm not sure if that's a secondary condition or not, but I know I sure enjoyed it!
According to the Mayo Clinic, "Massage therapy can reduce muscle tension and promote relaxation, which may be especially helpful to people experiencing muscle rigidity associated with Parkinson's disease."
Click here for more information about Ann Catlin, LMT, NCTMB, OTR.
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.