resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
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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