resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
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.
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.
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.
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.
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.
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?
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.
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.
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?'
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).
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.
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