resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Business Lesson #1: Adapt or Else
My wife and I recently enjoyed an excellent meal at a restaurant recommended by some friends. We often have concerns about restaurant recommendations, as many have been disappointing.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
Musculoskeletal Disorders Take Center Stage
Looking for the latest on the musculoskeletal pain epidemic and the increasing premium placed on preventive strategies including chiropractic? Check out The Impact of Musculoskeletal Disorders on Americans – Opportunities for Action.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
Vitamin D Fails to Help Knee OA? The Proper Perspective
The March 8, 2016 issue of JAMA includes a study about vitamin D supplementation for osteoarthritis of the knee. This is a really weird study.
The Power of Eccentric Exercise: Hamstring Injury Prevention and Rehab
For almost 20 years, I've worked with professional athletes who make a living by running really fast. It goes without saying that hamstring injury (HSI) prevention and rehabilitation is a big part of what they expect from a sports chiropractor.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
How to Find and Fix TL Nerve Impingements
The thoracolumbar junction (TLJ) and the peripheral sensory nerves that exit from it are frequent, important and rarely recognized sources of lower back, pelvic and hip pain. Let's outline a clear exam protocol for diagnosing the problem.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
Recording and Appropriate Billing of Timed Physical Medicine Services
There is a common misunderstanding about timed therapy services and although you do have some knowledge of timed service documentation, based on your comment on the 8-minute rule, your understanding is correct, but incomplete.
Essentials of Assessment: The Squat
The squat is a simple, fast and functional tool to evaluate patient symmetry and function. As simple and easy as it is to implement, it can yield considerable amounts of valuable, clinically relevant information.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
The IME System: A Current Public Health Risk and Solutions That Are Working
I strongly believe in the independent medical examination (IME) system. There are far too many doctors in every profession who are not following E&M protocols and never claim MMI (maximum medical improvement) has occurred for their patients, which has caused financial stress for many private and public carriers.
August, 2014, Vol. 14, Issue 08
How To Effectively Work with Wheelchair-Bound Clients
By Sharon Puszko, PhD, LMT
There are more than 1.7 million people in the U.S. who depend on wheelchairs and scooters to get around. Most of these people are currently over the age of 65, which means massaging them requires specific knowledge about how to work with geriatric clients, as well as clients with mobility issues.With the growing number of elderly in our country, as well as veterans of war, practitioners would benefit from learning how to properly work with wheelchair-bound clients.
Injuries to the elbow, wrist and hand are common among wheelchair users, but shoulder injuries are the most prevalent. Torn rotator cuffs and tendinitis are often the causes of shoulder pain. Muscle imbalance caused by overuse can lead to abnormal biomechanics and thus, injury. The most common disparity in strength associated with rotator cuff tear or tendinitis is an imbalance between the internal and the external rotators of the shoulder. Also, the prevalence of carpal tunnel syndrome among manual wheelchair users is between 49% and 73%.
Proper positioning in the wheelchair is probably most important for the prevention of repetitive strain for manual wheelchair users. A combination of manual mobility and powered mobility may be a workable compromise for some wheelchair users. Modern manual wheelchairs are easier to transport and easier to carry than powered wheelchairs. However they may not offer the same degree of independence for users with chronic arm or shoulder pain.
Many people who use wheelchairs suffer from foot pain as well. Walking and standing allows people to stretch the achilles tendon that runs up the back of the leg. Constantly sitting can cause the achilles tendon to shorten, placing the foot in a constant state of extension. Many people using wheelchairs develop plantar flexion, a condition in which the achilles tendon shortens as a result of sitting for most of the time. When the foot is being pulled into an extended position by the ever shortening Achilles tendon, it becomes very painful as it progresses. Plantar flexion also makes relearning to walk after a stroke even more difficult because it disrupts the normal heel to toe gait. An extended foot massage can help relieve some of this pain. Passively flexing the foot and stretching the calf muscles can also help with pain management of this condition.
"Massage therapy is seen as a positive method of pain management, but just treating the pain is not an end in itself," said James Laskin, MS, PT, adjunct professor for the division of rehabilitation services at the University of Oklahoma and the Health Services Center of Oklahoma City. He emphasizes the importance of treating the problem, not just the symptom.
Many people who spend their time in a wheelchair will develop pressure sores. These lesions are caused by unrelieved pressure over a period of time sufficient to cause the destruction of soft tissue cells. The pressure between bone and searing surface compresses the soft tissues of the buttocks and forces the blood out of the tissues. The longer one sits without movement to change the pressure areas, the greater the cellular damage. The same process occurs for those of us who can walk when we sit on a hard surface for too long. However, our subconscious nervous system causes us to move periodically, shifting the pressure points and allowing blood to re-enter the compressed tissues. Spinal cord injury causes a loss of the sensation that is vital to this process.
Most paraplegics and quadriplegics have no feeling in their soft tissues. They feel no distress, fail to move periodically and consequently develop pressure sores. Chair-bound individuals are advised by their physicians and therapists to change their position every 10 minutes or so by doing "pressure lifts" or other pressure point changing routines designed to stimulate the flow of blood to soft tissue. This allows the blood to re-nourish the tissues that have been under high pressure. The sad fact is that people forget to move, or may be unable to move themselves. The use of massage therapy on the coccyx, ischium (pelvic bone) and lower back can help prevent pressure sores on wheelchair users.
Even with the best passive cushion technology available, pressure sores are one of the greatest health risks a chair-bound person can have. They can cause a drastic decline in quality of life. Curing a sore may require weeks or months lying face down on the stomach or even skin grafts. Deep sores may very well develop into life-threatening bone infections, and can change a productive, self-sustaining individual into a bed-ridden patient dependent upon others for a long period of time.
Ultimately, the benefits of massage therapy for wheelchair-bound clients include improved range of motion, circulation and alleviated decubitus ulcers. This specific modality is also important for the massage therapists who are led to the rewarding practice of working in nursing homes and with assisted-living residents.
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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