resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
The Heart Protector
On the physical level, the Pericardium is a double-layered sac of fibrous tissue that envelops the Heart. The space between the layers is filled with serous fluid that protects the Heart from external shock or trauma and lubricates to allow for normal Heart movement.
To The Finish Line With the Help of TCM
When acupuncturist Eddy De Smedt pursued a career in Traditional Chinese Medicine, he knew he wanted to make a difference.
Blaming the Gluteus Medius, Overlooking the Deltoid
The gluteus medius (Gmed) is commonly written about, strengthened and blamed for many conditions, and rightfully so. After all, the Gmed plays a role in pelvic stability, hip motor control and lower-quarter dynamic movements.
5 Ways to Occupy Occupational Health
Despite the progress that has been made to better protect workers, occupational health and safety remains a priority area for many national governmental organizations due to the widespread problem of occupationally related morbidity and mortality.
The X Factor in Clinical Research: The Patient
It was the great baseball legend, former New York Yankees catcher Yogi Berra – he of countless aphorisms, each with a mind-bending twist – who once declared, "You can observe a lot by watching."
AOMA Strengthens Leadership Team
AOMA Graduate School of Integrative Medicine, a leading college of acupuncture & herbal medicine, announced the appointment of Donna LaPoint Hurta, MBA as the new VP of Finance & Operations this Fall.
Saying No to Medicine
An interesting article recently appeared in Men's Journal titled "When to Say No to Your Doctor." The article begins with the summary statement above and effectively arms readers with information that will help them "take more responsibility for your own health care, because you can't be sure anyone else is.
Managing Today's Fertility Patient
I recently received an email from one of my fertility patients: "Got my lab results back. FSH is 11, AMH is 0.7. My doctor said these numbers aren't good. I guess I'm infertile. Just as a thought. Just set up an appointment to speak with an adoption agency."
Calcium Helps Prevent Colorectal Cancer
Over the past 25 to 30 years, studies have suggested calcium may confer protection against colorectal cancer.
Transparency and Accountability: Q&A With the CCE
Every profession needs an organization dedicated to upholding the quality and integrity of its degree programs and educational institutions.
Talking to Patients About Healthy Aging
I've noticed that a particular category of patients seems to make up more and more of my practice – they work out, but still experience lots of degenerative joint disease (DJD) issues.
The Tao of Gender
If you think gender is as simple as having a new client check off the "male" or "female" box on your intake form, we hope this article will expand your understanding and thus the reach of your health care.
Pulse Diagnosis: What We Know
I am still finding pearls of wisdom from the books and papers that I inherited from my pulse diagnosis mentor Jim Ramholz.
Help Patients Achieve Optimal Vitamin D Levels
Much research has been done on vitamin D levels and their impact on health; optimal levels have been correlated with a reduced risk of developing numerous conditions.
Healing With TCM at San Quentin State Prison
For the prisoners at San Quentin State Prison, life-sentences are the reality of every day life. It is not often that prisoners get the opportunity to use alternative medicine to deal with common ailments they encounter behind bars such as, depression, anxiety and pain.
Managing Patient Expectations About Acupuncture
Last year, I attended the Pacific Symposium in San Diego for the first time in six or seven years. It was the 25th anniversary of this event, and on one evening there was a panel discussion with the title; "What is Qi?."
Web Marketing: Content Is King
Google's sweeping updates to its search algorithms over the past few years have brought a paradigm shift in how you can optimize your chiropractic website to gain maximum marketing leverage.
Understanding and Identifying Pediatric Growth-Plate Fractures
In general, fractures in children heal well with little intervention as long as the alignment is good. Fractures involving the growth plate, however, are a different issue. In fact, growth-plate injuries are the primary reason for the subspecialty of pediatric orthopedics.
The Wonders of Light Therapy: An Interview with Wes Burwell
I first met Wes Burwell in 2011 when he was teaching a class on light. Since then, every time I hear him speak, his understanding of the benefits, function and capacity of light has evolved.
Lime Jello on Morphine
Taste is in the eyes... actually the mouth... of the beholder. My food preferences have changed, lightening from the food of my youth. My parents loved heavy eastern European cuisine and I loved it as a child. Now I enjoy leaner, healthier whole foods.
Simple Ways To Find True Happiness
Patients in our clinics are always seeking happiness. As their health advocate, we need to ensure we inform them that in order to find happiness, they have to make sure to identify what makes them happy in the first place.
In Oncology Massage, Positioning Matters
A client with advanced cancer was looking forward to the massage session in his home. There had been so many medical appointments lately. So many scans and procedures and hard conversations. This soothing, gentle massage was exactly what he needed — touch without a medical procedure attached it and he couldn't wait to escape it all for an hour.
But there was a challenge ahead. Before the therapist even laid a hand on him, she was concerned that she couldn't get him comfortable on the massage table or even on the client's bed. Cancer had spread to his liver, causing his abdomen to become distended, a condition known as ascites. The added volume in his abdomen, plus this new challenge to his breathing, made the prone position impossible. Even lying supine would most likely cause shortness of breath.
A less-than-comfortable position detracts from the experience of the massage, no matter how lovely and skilled a therapist's hands may be. If someone is lying in discomfort, even minor, annoying discomfort, it may interfere with the potential benefits of the massage session, especially the ability to relax.
Now, imagine lying on the table in not just minor discomfort, but something decidedly more like pain. Pressure in the wrong areas, leads to guarding and tensing up. Compromised breathing leads to sudden changes in position in the search for air. Now, lying down has become work. This is where a skilled therapist can come in to save the session with some mindfulness, creativity and patience.
Most massage therapists are familiar with the two most popular positioning options: supine with a bolster or pillow under the knees and perhaps the head, and prone with a bolster or small pillow underneath the ankles, and sometimes, this is all we may need. But there are many less obvious choices, individualized ones tailored to each client's needs based on their responses to our intake interview questions and how things look on the table during the session.
In oncology massage, there are many reasons for possible position modifications. Anything going on in the abdomen, be it something as serious as liver swelling or abdominal masses to something like GERD, can make prone or supine positioning uncomfortable. In these cases, other options can ease breathing or alleviate pressure. Among these options are:
More Than Uncomfortable
There are cases where the wrong positioning can set the client up for risk. If a client has a history or risk of lymphedema, a chronic condition whereby an extremity or other area of the body fills up with protein-rich fluid, their arms should not hang off of the side of the massage table, as this can put pressure on axillary lymphatic structures and potentially cause damage or trigger an episode of swelling. Scrolls and wells made with rolled-up towels can gently support and tuck in extremities so that they stay safely on the table. Elevating an extremity with pillows or towels can help to ease that feeling of heaviness or fullness, even if only for a little while.
Clients undergoing cancer treatment may have a chemotherapy port in place. It can be positioned below their collarbone or on their abdomen, or sometimes in other areas of the body. For those clients who have a port placed in their chest, for example, and who really want to incorporate comfortable and safe back massage into their session, they can sometimes lie prone comfortably with the help of a "nest" made with a small hand towel that creates a soft, little depression that the port can fit into so that there isn't pressure being put on a sensitive area.
Good Positioning Supports Sleep
A good night's sleep is good for anyone. But for someone experiencing the symptoms of cancer and side effects of treatment, good sleep is essential. Properly bolstering and positioning someone who needs extra, individualized support may help clients relax more deeply during the massage itself. In addition, the work that you do as a therapist with lovingly supporting an arm, placing a pillow between the knees, or creating a "nest" around a sore spot can be carried into the client's daily life. They can use some of those positioning and bolstering strategies for themselves at home, to help get them more comfortable in bed when they are sleeping.
Perhaps these strategies can be passed along to the client's caregivers, who then get a chance to help by offering a well-placed pillow or towel at home. Good support with towels and pillows can help create a neutral spine for the client when they are on the table, and this position can help minimize pain in cases of bone involvement. Limbs can be gently supported, torsion on the spine can be eased and the neck can be cradled by rolls of soft towels. There is so much versatility and value available with such simple materials, aided by the creativity and caring intent of the therapist.
As hard as it may be, think of client positioning at a vital part of the massage session, not something to be hastily fussed with and glossed over in an effort to get to the "real" massage. Even though it can take longer with a client with a complicated medical history, it is worth the effort. Take time to communicate about it, so the client doesn't worry or feel pressured to rush the process.
"We're going to spend a few minutes of your session positioning you so you're comfortable. I'll ask you several different times about your comfort. Imagine the eye doctor asking, 'is this better, or worse?' In my experience, this time is well-spent. Once we've settled you into a well-supported position, you'll likely relax better during the massage."
When we take the time to make sure a client is positioned in the best way, when we take those moments to create a soft nest from a towel or to gently add another pillow under the head, and when we do so with 100% presence, our clients often express appreciation. More benefit is possible when the position is comfortable.
Worth the Effort
In the end, the massage therapist worked with the client with ascites in the semi-reclining and then sidelying positions, with five pillows and a few rolled-up towels that she was able to find in his home. The whole process took about 10 to 15 minutes, to get him lying comfortably and supported and bolstered well in each of several positions. Throughout, she worked in a mindful, caring way. She checked to make sure each area was well supported, sliding her hand underneath the support to check for space, then using more towels if the support was not bearing weight.
It didn't leave as much time for the hands-on work as the therapist was hoping for, but she knew her time was worth it when she heard him sigh happily and say, "It doesn't hurt anymore to lie this way. Thank you."