resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
Primary Spine Care: Addressing Concerns & Criticisms
The Dec. 1, 2013 issue of Dynamic Chiropractic included an article describing the implementation of a training program for primary spine practitioners (PSP) within a metropolitan region and supported by a large BC/BS plan.
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
Expanding Access, Branch by Branch
The big news coming from Capitol Hill isn't merely the recent introduction of a pair of bills designed to expand chiropractic services in the Veterans Affairs and military health care systems; after all, similar legislation has made its way through Congress before, never reaching the Oval Office for presidential signature.
Impacting Chiropractic's Future With Technology
When it comes to electronic health records (EHR), Robert Moberg and Dr. Steven Kraus are two of the leading industry experts on the topic.
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
Atypical Femoral Fractures and Bisphosphonate Use: What to Watch For
Bisphosphonates (BP) are popular drugs, with more than 8 billion in sales in 2008; however, profits have declined as patents began expiring. Nonetheless, BP remain the most commonly prescribed drugs for patients at risk of osteoporotic fractures, with several million prescriptions written every year.
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
B Vitamins Improve Memory, Prevent Brain Atrophy
The 2010 OPTIMA study showed that the accelerated rate of brain atrophy in elderly with mild cognitive impairment could be slowed via supplementation with homocysteine-lowering B vitamins, which included folic acid, vitamin B12 and vitamin B6.
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
Help Update the LBP Practice Guideline
The Council on Chiropractic Guidelines and Practice Parameters has announced the release of an updated Clinical Practice Guideline for Chiropractic Management of Low Back Pain for stakeholder review and comment.
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
A Reality Check – and a Chance to Educate
Imagine working in the public relations department of nutrition retailer General Nutrition Corporation (GNC) and reading the The New York Times announce...
Interpersonal Skills 101: Enhancing the Value of Our Patient Interactions
Recently, I read an interesting article in our local newspaper titled "The Value of Human Interaction." The article presented comments from a senior editor for Fortune magazine who discussed "Civility in the Business World."
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
Low Back Pain: Posture and Movement Analysis
When performing static and dynamic movement analysis of the lumbopelvic hip area, begin with standing visual posture analysis of the pelvis, and then perform lumbar range of motion and assess what you might see during normal versus abnormal lumbar flexion motion.
Avoid Random Treatment of Trigger Points (Part 2)
We must acknowledge that the fascia, which surrounds literally everything in our bodies, including every muscle fiber, is more than just a covering.
March, 2014, Vol. 14, Issue 03
Educate Yourself: Massaging a Client with ALS
By Sharon Puszko, PhD, LMT
In 1941, baseball legend Lou Gehrig died of a neurological disorder known as Amyotrophic Lateral Sclerosis. For the first time, people in cities across the country were discussing this rare and mysterious disease in their newspapers and on their radio stations.During the 70 years that have passed since then, advances in scientific research have provided us with a better understanding of the causes, symptoms, types and treatment of ALS. However, there is still no proven cure for the disease. Over the past 10 years, physicians have increasingly turned to massage therapy to help their patients manage the symptoms of the disease.
While this is fantastic news for practitioners of massage therapy, it also means we must educate ourselves about ALS. Do you know what the symptoms of ALS are? Are you aware of how the disease affects people emotionally? Would you treat an ALS client the same way you would treat an athlete? In order for massage therapy to be truly beneficial to PALS (People with ALS), massage therapists must do their best to learn appropriate techniques for ALS clients and do their best to understand what life is like for PALS.
What is ALS?
ALS is an incurable, degenerative, neurological disorder affecting the nerve cells of the brain and spinal chord that control voluntary muscle movement. These nerve cells deliver messages from the brain to the skeletal muscles of the body involved with voluntary movements such as walking, writing or playing an instrument. As these cells gradually deteriorate, the brain can no longer tell the body what to do. For instance, the brain of an ALS patient will tell its hand to pick up a pen and start to write, but the message will no longer be able to reach the hand. Muscles eventually waste away from disuse and this can lead to paralysis in the late stages of the disease.
The ALS Association says there are about 30,000 Americans living with ALS and about 5,600 people are diagnosed with the disease every year in the United States. ALS is more common among men than women and the majority of cases appear in people between the ages of 40 and 70. ALS has no economic, racial or ethnic boundaries and occurs in two out of every 100,000 people worldwide.
What Causes ALS?
There is no one definitive cause of ALS. There are several theories surrounding the causes of the two types of ALS occurring in the United States: sporadic and familial. Sporadic ALS is the most common type of the disease, accounting for 90% to 95% of all cases. Disturbances in the immune system, excess levels of the neurotransmitter glutamate and exposure to fertilizers, heavy metals or animal hides are all possible factors that may influence the likely hood of acquiring sporadic ALS. Familial ALS (FALS) accounts for the remaining 5% to 10% of ALS cases in the United States. About 40% of familial ALS cases are linked to a defective gene on chromosome 21 that does not produce a normal amount of the enzyme superoxide dismutase. It is unknown at this time what genetic defect is the cause for the remaining 60% of people with FALS.
Symptoms of ALS
Initially, patients with ALS usually experience a weakening of skeletal muscles in the arms and legs. They might also have frequent muscle spasms in these areas. People with ALS find it difficult to pick things up, walk, swallow and communicate effectively. As the disease progresses, the muscles of the arm and legs will begin to atrophy. During the final stages of the disease, the respiratory muscles that control breathing deteriorate and the patient must depend on a respirator for the rest of his/her life.
Some of the most common physical problems people with ALS encounter are: dysphagia and the need to meet nutritional requirements; the maintenance of blood gases within normal range; impaired verbal communication; weakness, impaired mobility and activity intolerance; constipation; and pain and discomfort due to muscle cramps. Depression is common among ALS patients and many experience an alteration in self-concept and body image.
Rilutex (riluzole) is one of the only drugs that has proven to prolong a patient's life and delay the progression of ALS. Most of the other medications (Baclofen, Zanaflex, Tramadol) prescribed by doctors are to help ease the patient's pain, not to treat the disease. Because many of the symptoms people with ALS suffer from are related to skeletal muscles, physical therapy and massage therapy are now being recommended as another form of pain management.
How Can Massage Help?
Massage therapy increases blood circulation, relaxes muscles, improves range of motion, reduces pain and swelling and promotes improved respiration: all of which can help treat symptoms ALS patients suffer from. People with advanced ALS are often threatened by decubitus ulcers from lack of activity. Massage therapy can help a patient maintain good circulation in order to avoid decubitus ulcers; at the same time, it can also help the patient overcome depressive feelings he/she might be having as a result of a recent loss of speech or the disease in general.
Dr. Robert Pascuzzi, a Professor of Neurology at the Indiana University School of Medicine, is of the opinion that massage therapy, "can be very beneficial to patients with ALS. Those who have been fortunate enough to receive such therapy all seem enthusiastic about the effects: relaxation... rest... feeling good. If their muscles are stiff and spastic it helps relax them and makes their skin feel better. Remember, these patients have intact sensation; they just have weak muscles. I have probably had 10 or 20 ALS patients receive massage therapy over the years. I think doctors should suggest ALS patients try massage therapy, as it would be well worth a try for everyone. I think it improves the quality of their day. They feel better."
Below are some techniques designed specifically for the needs of an ALS patient.
Passive and Assistive Range of Motion Exercises
Range of motion exercises will prevent or at least slow down the freezing of joints as the disease progresses and the body moves less often. As always, check with the doctor before doing any of these movements.
While people in advanced stages of ALS might not be able to give verbal feedback to a massage, often they can let you know what they are feeling by the movement of facial muscles or the blinking of eyes. By asking "yes" and "no" questions, it is possible to work successfully with an ALS patient.
Sharon Puszko is the owner/director/educator for Day-Break Geriatric Massage Institute. She may be contacted at
or through her Web site: www.daybreak-massage.com.
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