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.
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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