resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
February, 2010, Vol. 10, Issue 02
Cancer, Treatment and Detoxification
By Tracy Walton, LMT, MS
Some time ago, a client going through intense chemotherapy treatment asked me if deep massage would help her cleanse the drugs from her system. She had read about a number of liver cleansing protocols that suggested very deep massage to facilitate the process of elimination.Her question touched on a number of issues in the oncology massage world and there were several layers to my response to her. I share my answers here, because the issues are relevant for our many clients in chemotherapy.
The Effects of Massage
In the massage profession, we have learned, read, taught and repeated the belief that massage helps move toxins out of the tissues and out of the body. However, we have not always been clear on which toxins, from which tissues, or through which routes of elimination. Almost any substance in the blood, even a nutrient, can be considered toxic if there is too much of it in the blood or tissues, so our use of the term is ambiguous. I once had a physician on my table that was a huge fan of massage therapy, but told me that the profession's liberal use of the word toxin always made him uncomfortable. Invariably, when he asked a massage therapist what the term meant, he received vague, unsatisfactory answers.
Our use of the word toxin seems to imply a waste product or poison that shouldn't be there. In the realm of chemotherapy, the reagents and products of breakdown are known to be toxic, so at least we are on more definitive ground there. But to my knowledge, there is no solid base of research to support the notion that massage moves toxins out of the tissues. By solid, I mean more than a single study. Instead, to be given serious consideration, we need multiple studies, from multiple investigators, in peer-reviewed publications, reporting similar results on this point.
That said, my client was talking about chemotherapy and wanting to eliminate chemotherapy drugs from her body. These medications and their metabolites do have toxic qualities which is why they are used to destroy tumors.
She was suffering greatly from the effects of these toxins she wanted them gone, period. I told her there wasn't much known about the effects of massage in the toxin department, so I couldn't say whether deep effleurage and petrissage would, in fact, speed it out of her system. I also told her I had other concerns about the detoxification approach, which I have described here.
The Intent of Massage
When we work with clients in chemotherapy, our intent is to ease symptoms and support our clients in integrating and managing the effects of treatment. For this reason, we do not impose additional challenges to the body by working it too hard (MacDonald, 2007). So I told my client that even if we knew for sure that deep massage strokes would chase the drugs out of her system more quickly, we wouldn't necessarily choose that approach.
Instead, it makes more sense to let the body set its own pace of detoxification. The organs of detoxification -- the liver, kidneys and skin -- are busy enough without the potential additional demand of a deep, draining, circulatory massage. I told my client that, even without research or clear understanding about massage and detoxification, this is our rationale for working gently.
Additional support for this gentle approach comes from our clinical observations: When clients in chemotherapy receive deep work, they feel worse, not better, afterward. Whatever the reason for that, deep massage is too much for them. These clinical observations inform our practice much more than any attempt to explain them.
A Good Referral
My client continued to press me about what I thought she should do after chemotherapy. She asked about a number of detoxification protocols involving ingesting large amounts of salt water and other substances. They had to do with cleansing the colon and liver. I listened, but stayed neutral. I told her I couldn't advise her either way, it was out of my scope of practice. I told her she had great questions, but that I thought such practices would be safest if done under the supervision of a naturopathic physician or another physician experienced in natural medicine after chemotherapy. And I urged her to raise her questions with her doctor and chemotherapy nurse.
These referrals gave her somewhere to go with her questions and her urge to detoxify. At the same time, I managed to stay within my scope of practice. This can be challenging when our clients ask us for our opinions and advice and these questions come up a lot when we have a whole hour available to our clients. It is important to navigate them in an unbiased way, with supportive listening and good referrals. In the end, this can be a great service to our clients.
Gloving for Chemotherapy
Whenever we talk about chemotherapy and massage, the question invariably comes up about chemotherapy eliminated through the skin: will the massage therapist, in continuous contact with the client's skin, unwittingly absorb some of these toxic substances? For our own safety, should we wear gloves when providing massage to clients in chemotherapy? Should we avoid contact with them altogether? Therapists are understandably concerned about the possibility of picking up chemotherapy by-products through their hands but, like any rumor, these fears have been overblown and somewhere along the line we came to believe it was dangerous to touch all patients in chemotherapy.
Space limits a full discussion of this issue here, but there is an excellent place to go for deeper understanding. The Society for Oncology Massage (www.s4om.org) provides detailed discussion for massage therapists, clients, caregivers and other health care providers. There is a Resource Link for massage therapists where the chemotherapy, toxicity and touch issues are well-addressed. Careful analysis of the risks is provided, bringing massage into alignment with nursing practices during chemotherapy. Conditions under which a therapist might wear gloves are identified, and the current understanding of the issues is made plain.
There clearly is room for more dialogue and research in the profession of massage about the precise effects of our work. There is growing energy devoted to these questions and more resources to turn to. We have the second Highlighting Massage in CIM Research conference to look forward to this May in Seattle (find out more at www.massagetherapyfoundation.org/researchconference2010.html) This conference follows closely on the heels of the second Oncology Massage Healing Summit in Minneapolis (find out more at www.nwhealth.edu/conted/seminars/oncology.html).
I attended both of these conferences the first time around, and they were some of my favorite experiences. In settings like these, the science and practice of massage are addressed by thoughtful people who bring their whole hearts and minds to their massage inquiry. Toxin or no toxin, movement or no movement; by holding massage therapy up to the light, we will come to more fully understand the work of our hands.
Click here for more information about Tracy Walton, LMT, MS.
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