Inflammation is newly recognized as a leading factor in all types of diseases. Learn to differentiate between inflammation-reducing foods and inflammation-perpetuating foods. This insight just may put the pharmaceutical giants out of business.

Eating food is necessary to sustain life; however, eating the right foods will sustain your health. While many of us spend an enormous amount of time and expense on medical, pharmaceutical, herbal and alternative therapies for our ailments, the solution might be right at home in our kitchens.

The number of people looking for relief from their pain is staggering. According to a 2005 ABC News/USA Today/Stanford University Medical Center poll, 34 percent of Americans are in recurrent (on-again and off-again) pain and 19 percent are in chronic (lasting three months or more) pain. That’s a huge chunk of our population that is seeking every way possible to reduce their pain.

Inflammation is a significant component of the experience of pain. The body’s immune system initiates an inflammatory response when an injury occurs. In the case of an acute physical injury, this serves us well; by bringing the necessary cellular components to the injury so healing can occur. However, when it comes to chronic pain, inflammation perpetuates our experience of pain. Many pain relief modalities focus on reducing this chronic inflammation.

In addition to pain, inflammation is emerging in medical research as a predominant factor in a myriad of diseases from arthritis to heart disease to cancer. Measurable risk factors for disease-related inflammation includes elevated cholesterol, triglycerides and C reactive protein. Recent studies indicate that a measure of C reactive protein (which the body produces in response to inflammation) may be the strongest predictor of heart disease.

The foods that we eat have a direct connection to the functioning of our body. As our digestion breaks down what we eat, the building blocks of those foods are absorbed by different systems. When it comes to inflammation, certain foods aggravate it and others can prevent it. Jack Challem, author of The Inflammation Syndrome says, “…the body can become like a dry field of grass that is waiting for a match. Once the match lights, it’s hard to put out the fire.” In this context, Challem is referring to someone who eats a typical American diet, which is abundant in foods that aggravate inflammation.

According to Molly Siple, MS, RD, in the September 2005 magazine edition of Natural Health, foods that aggravate inflammation include:

1) Foods high in arachidonic acid. Examples include wheat, eggs, milk, yeast and meat.

2) Vegetable oils high in omega-6 fatty acids. Examples include sunflower oil, corn oil, peanut oil, soy oil, cottonseed oil and safflower oil.

3) Foods that cause spikes in blood sugar. Examples include sugar, refined white flour, fried potatoes and sugary beverages.

Foods that protect you from inflammation include:

1) Food that contains polyphenols, which dampen inflammation with phytochemicals. Examples include blueberries, blackberries, strawberries, raspberries, cranberries, cherries and green tea.

2) Quercetin containing foods. This flavanoid is also a natural anti-inflammatory. Examples include red grapes, red and yellow onions, garlic, broccoli and apples.

3) Antioxidants protect the body from free radicals, which can trigger inflammation. Examples of foods high in antioxidants are carrots, winter squash, bell peppers, tomatoes, spinach and kale.

4) Omega-3 fatty acids have significant anti-inflammatory properties. Omega-3’s can inhibit natural inflammatory chemicals such as prostaglandins and leukotrienes. According to Andrew Weil, MD, “Inflammation is regulated by a group of hormones called prostaglandins. Some prostaglandins intensify the inflammatory response while others reduce it. Aspirin, ibuprofen and other nonsteroidal anti-inflammatory drugs work on the prostaglandin system. The body makes prostaglandins from fatty acids. Omega-3 fatty acids tend to decrease inflammation while omega-6 fats and trans fats increase inflammation.” Examples of foods rich in omega-3’s are salmon, tuna, mackerel, anchovies, sardines, flaxseed oil, dark leafy greens and walnuts.

5) Oleic Acid contains omega-9 fatty acids, which supports the omega-3’s. Examples of foods rich in omega-9’s are almonds, macadamia nuts, canola oil and olive oil. Researchers at the Monell Chemical Senses Center in Philadelphia reported on olive oil in the September 1, 2005 issue of Nature. Their tests showed that a component of extra virgin olive oil, oleocanthal, inhibited cox-1 and cox-2 molecules associated with pain and inflammation, just as ibuprofen does.

6) Turmeric is an Indian spice that gives curry its color, and has a long history of use as an anti-inflammatory herb in many traditional medicines.

When choosing food, a general rule of thumb seems to be: the brighter the color the better. This is a broad statement, and doesn’t count fruits, vegetables or fish that have been artificially colored. Following the above dietary guidelines by avoiding foods that contribute to inflammation and including foods that prevent inflammation can make a dramatic impact on your health. Whether your concern is arthritis, diabetes, heart disease or cancer, you can reduce your reliance upon the medical community by eating for your health.

Posted by Nicole at 05:18 PM
© 2009 Institute for Integrative HealthCare Studies. This work is reproduced with the permission of the Institute. www.Integrative-Healthcare.org

Maximize positive energy and decrease negative energy in your practice by learning about feng shui, the ancient Asian art of design. Discover seven tips to improve the energetics of your massage space that you can apply right away.

Feng shui is the ancient Chinese art of arranging and placing objects in our environment. This thoughtful spatial layout facilitates optimal circulation of energy (Qi). Qi circulates throughout our body and imbalance occurs when that Qi becomes excessive, stagnant or deficient. The Asian worldview perceives our bodies as a microcosm of the universe, and thus, the same principles apply. It is this reasoning that forms the basis of feng shui, which acts to correct environmental imbalances due to overactive, stuck or insufficient Qi flow.

A majority of feng shui principles are extensions of common sense. Many people are sensitive to the flow of Qi outside of their bodies, and intuition guides them to favor areas with smooth and easy Qi flow. We have all experienced the difference between entering a room that feels awkward vs. entering a room that feels good. It is astonishing how some simple feng shui guidelines can transform the energy of a space, and result in positive implications for all of its occupants.

Following are seven feng shui tips to optimize the energetics of a massage practice:

1. Entrance Area: The space where someone first enters your practice is considered to be an auspicious place. Because one might pause here upon entering or leaving, they are affected by the Qi that flows through it. Entrance halls with no windows or doors, or enclosed in some way, can cause the Qi to stagnate. Strategically placed mirrors, a small water fountain or a ceiling fan can create the movement necessary to eliminate energetic stagnation.

2. Sharp Angles: According to Anne Mansfield, executive director of the International Feng Shui Guild based in Beaverton, Oregon, “In a wellness practice, you want to have soft edges, nothing sharp or pointed because you are dealing with people who are vulnerable and need to be treated gently.” Solutions to soften sharp or jutting angles include soft and comfortable seating, gentle lighting and plants or statues in front of those angles.

3. Water Fountain: This brings in the element of water and creates energetic movement. A water fountain in the actual treatment room may create too much activity to ensure a relaxing experience for the client. It can also influence activity in the bladder, and may interrupt a session with a trip or two to the restroom. Since the southeast corner is considered to be the “money area,” placement of a fountain here is said to bring in good luck and financial prosperity.

4. Ceiling Beams: Overhead beams generate negative energy that is directed downward. A beam over your massage recipient will place unseen pressure on that person. If a ceiling beam in the treatment room is unavoidable, properly hung bamboo flutes on the beam can lift that sense of oppression.

5. Massage Table Placement: Massage therapists typically work in small rooms. As such, there may not be many choices of how to position the massage table. Two standards of feng shui include preventing the feet or the head from being directly in front of the door. The client (when supine) should be able to see the door. If a person can’t see someone entering the room it may startle them, which interrupts relaxation. The worst position for a massage table is directly in front of the door with the client’s feet facing the door. This is called the “coffin position” because in ancient China the dead were laid with their feet toward the door for easier access to heaven. The “coffin position” drains away all of that individual’s good luck and energy.

6. Wall Color: While red is a desired color to bring fame and benefit a business’s reputation, avoid its use in the treatment room. The color red is energizing and can therefore prohibit a restful experience. Soft muted colors that appear in nature are the best bets to foster relaxation and healing.

7. Rocks: A bowl of smooth polished river rocks on the floor, under the massage table, is a simple way to encourage energetic grounding. Stones are yin in nature, and therefore connect us to the earth and bring us stability. When combined with the yang activity of massage, the rocks bring balance to a session and ground both the practitioner and the recipient.

If these seven tips don’t initiate the positive changes you may be seeking, think about hiring a professional feng shui consultant. These individuals have been trained in the complexities of environmental energy flow and are being increasingly commissioned to design buildings and remedy unsuccessful business locations. While bringing a feng shui expert into your practice may seem like a leap of faith, that leap can pay off both in your personal life and in your business life.

Posted by Nicole at 04:27 PM
© 2009 Institute for Integrative HealthCare Studies. This work is reproduced with the permission of the Institute. www.Integrative-Healthcare.org

Insomnia is associated with a lack of serotonin. Massage increases serotonin levels. Read about the neurochemistry of sleep and the logical connection indicating bodywork for the sleep deprived.

Insomnia means trouble either falling asleep or staying asleep. The prevalence of insomnia is staggering, with more than 30 percent of American adults suffering from occasional bouts of insomnia and 10 percent of Americans experiencing chronic insomnia. While insomnia may be a symptom on its own, it also can be connected to a long list of healthcare problems.

Chronic insomnia is poor sleep every night or most nights for more than six months. This endless cycle can cause extreme fatigue, problems with concentration and can adversely affect a person’s mood and well-being. Recurring insomnia should be evaluated by a healthcare professional or a sleep disorder specialist.

Methods of treating insomnia cover a wide span of lifestyle adjustments, psychological services, Western medical treatments and complementary/alternative medical choices. Under that last category, complementary/alternative medical choices, be certain to include massage therapy as a viable option to help the sleep deprived. While it may not be the first appointment that an insomniac thinks to make, looking at the neurochemistry of sleep, and the effect massage has on that neurochemistry, may provide a solid link between massage and insomnia treatment.

The neurochemistry of sleep is very complex. While there are many aspects of the brain and its chemicals that contribute to sleep, we will look at the serotonin component of sleep.

Serotonin is an extremely important neurotransmitter that is essential to our survival. Serotonin plays a role in mood, behavior, body temperature, physical coordination, appetite and sleep. Derived from the amino acid tryptophan, serotonin can also be converted by the brain into melatonin.

The involvement of serotonin in sleep has been repeatedly proven. However, the mechanism of that involvement remains unclear. A number of studies revolve around a specific area of the brain that mediates deep sleep. This area of the brain is called the raphe nuclei. The raphe nuclei contain nerve cells that use serotonin to communicate with each other. In laboratory experiments using cats as subjects, destruction of the cats’ raphe nuclei resulted in their inability to sleep. Another experiment consisted of blocking serotonin synthesis with a drug (p-chlorophenylalanine). Administration of this drug produced insomnia, an effect which was reversed by the subsequent administration of serotonin.(1) These studies all demonstrate the necessity of serotonin for healthy sleep.

Serotonin is a precursor to the body’s rendering of melatonin. Melatonin is a hormone released by the brain’s pineal gland to quiet and reset the part of the brain (the suprachiasmatic nucleus) that directs circadian cycles to prepare for sleep. According to Charles Czeisler, professor and chair of the Division of Sleep Medicine at Brigham and Women’s Hospital, Boston, MA, circadian cycles are internal periodic rhythms that profoundly affect sleep and wakefulness.(2)

The chemistry of sleep is relevant to massage therapists because massage can directly influence the body’s production of serotonin. A study on back pain, conducted in January 2000 by the Touch Research Institute in conjunction with the University of Miami School of Medicine and Iris Burman of Miami’s Educating Hands School of Massage demonstrated that in addition to a decrease in long-term pain, subjects receiving massage experienced improved sleep and an increase in serotonin levels.(3)

This massage study employed twice-weekly, 30 minute massages for five weeks. Starting in the prone position, the following techniques were used:
• Kneading and pressing the back muscles
• Stroking both sides of the spine and hips
• Gliding strokes to the legs
• Kneading and pressing the thighs

In the supine position, participants received:
• Gliding strokes to the neck and abdomen
• Kneading of the rectus and oblique muscles that help bend the trunk of the body forward
• Stroking of the legs
• Kneading of the anterior thighs
• Flexing of the thighs and knees
• Gentle pulling on both legs

In addition to other assessments, a sleep scale to measure quality of sleep and urine samples to measure levels of serotonin were used. The results of this study were originally published in the International Journal of Neuroscience in 2001.

Massage is an intelligent, healthy and substance free choice to help the scores of people that have insomnia. Because serotonin plays a role in sleep in multiple areas of the brain, it is logical to seek ways to increase serotonin levels for people that are sleep deprived. In addition, serotonin is needed for our bodies to produce melatonin. As melatonin influences the sleep stage of our circadian rhythm, a natural way of boosting serotonin is a positive sleep inducing option. This connection calls for further research showing the direct affects massage therapy has on serotonin and sleep. In the meantime, the existing evidence is certainly enough to condone regular massages for sleepless clients.

References:

1. Shepherd, Gordon M., MD, D.Phil., Neurobiology, Oxford University Press, 1988.
(pp 517-528).

2. Lambert, Craig, PhD. “Deep into Sleep,” Harvard Magazine, July/August 2005.

3. “Research: Massage Eases Lower Back Pain, Increases Range of Motion,” Massage Magazine, January/February 2002.

Posted by Nicole at 12:13 PM
© 2009 Institute for Integrative HealthCare Studies. This work is reproduced with the permission of the Institute. www.Integrative-Healthcare.org

There is more than one approach to help someone with plantar fasciitis. In this article, learn about this inflammation of the plantar fascia and find nine ways massage can be used to relieve this common type of foot pain.

Plantar fasciitis is a common painful inflammation of the plantar fascia, the fibrous band of tissue on the sole of the foot. This tissue is instrumental in helping to support the arch and in acting as one of the body’s shock absorbers. Plantar fasciitis occurs when this band of tissue is overloaded or overstretched. This tension produces small tears in the fibers of the fascia, especially where the fascia meets the anterior calcaneous.

Plantar fasciitis is common in many types of people. Those afflicted include, but are not limited to, obese people, pregnant women, diabetics, people who repeatedly walk or stand on a hard surface, athletes and weekend warriors. In a pronated (low arch) foot, the fascia is under a constant stretch. In a supinated (high arch) foot, the fascia is under constant tension. Both of these arch extremes can easily lead to plantar fasciitis. Worn or poorly constructed shoes can contribute to the problem if they do not provide enough arch support, heel cushion or sole flexibility. In athletes, plantar fasciitis may follow intense training, especially in runners who push themselves too quickly to run longer distances.

The physiology of plantar fasciitis is a debated topic. It is widely acknowledged that this condition is associated with small tears in the fascia. However, further analysis of the tissue’s integrity is unclear. While the term uses the suffix –itis, indicating an inflammatory condition, many believe otherwise. Whitney Lowe, in issue #105 of Massage Magazine, says “There is mounting evidence that many common tendonitis complaints are actually not inflammatory problems at all, but instead are caused by a degeneration of the collagen matrix within the tissue. It has been suggested that plantar fasciitis is similar to these tendon pathologies, and that the problem is collagen degeneration in the fascial tissue.”

Symptoms of plantar fasciitis extend beyond foot pain following activity. According to Janet G. Travell, MD, and David G. Simons, MD, symptoms of plantar fasciitis primarily revolve around pain in the region of the plantar aponeurosis and/or pain in the heel. A unique characteristic of plantar fasciitis is marked pain upon arising in the morning. The first 10-12 steps are severely painful until the plantar fascia and the muscles have been stretched. The pain worsens again in the evening and after weight bearing activities.

Bodywork is extremely effective in helping people overcome the pain and limitations of plantar fasciitis. According to Art Riggs, Certified Advanced Rolfer, CMT, in his Deep Tissue Massage book, “The pain [of plantar fasciitis] is caused by tight and inflexible plantar fascia and, also by tight calf muscles. Medication and rest may improve symptoms, but if the causes are not addressed, the likelihood of recurrence is increased.”

In helping your clients overcome this condition, a focus on the plantar surface of the foot must be combined with lower posterior leg work. The posterior leg muscles attach via the achilles tendon to the calcaneous. Tightness in these muscles, mostly the gastrocnemius and the soleus, will pull on the calcaneous and add tension to the plantar fascia. It is recommended to have training in the individual bodywork techniques discussed below before applying them to your clients.

Plantar Surface of the Foot

1. Glide on the plantar surface – Following some warm-up, glide your elbow, knuckles or thumbs from the foot pad to the heel. This will help the fascia migrate back up against the calcaneus. This can prevent heel spur development. Gliding on the lateral, medial and tranverse arches on the foot also contribute to relaxing of the plantar fascia.

2. Mobilize the calcaneous – This method is courtesy of Riggs’ video series Deep Tissue Massage and Myofascial Release. With the client supine, cup your bottom hand between the ankle and heel. Use your upper hand to hold the distal part of the foot, including the ball of the foot and toes. Use your lower hand to create movement in the heel by rocking it side to side (medial and lateral) and even up and down (superior and inferior). Because the plantar fascia attaches to the calcaneous, this mobilization can aid in freeing up restrictions of the plantar fascia.

3. Strip and stretch the plantar fascia – With the client supine, grasp the toes and ball of foot with one hand and dorsiflex the foot by stretching the plantar fascia. Use thumbs or knuckles to strip the plantar fascia from the ball of the foot to the heel. This may be very painful, but very helpful. Icing the foot afterward will speed the healing process.

4. Deep transverse friction – According to Lowe, “Deep transverse friction may be used directly on the plantar fascia to stimulate fibroblast activity and tissue healing from chronic overuse. However, caution should be used in applying friction massage near the attachment on the calcaneous because of the possibility of a bone spur.” This technique can be very painful. Use the maximum amount of pressure tolerable to your client. Icing the foot afterward will speed the healing process.

5. Wring the foot – The client is prone, with his/her knee at a 90-degree angle. Using a twisting motion, wring the foot as if you were wringing out a washcloth. This can be done for the entire foot, with one hand on the heel, and the other on the ball of the foot. This can also be done for the cuneiform joints, by having one hand on the ball of the foot, and the other on the center of the instep. As the muscles relax, you can increase the speed and intensity of the wringing to bring increased circulation and range of motion to the entire foot.

Posterior Lower Leg

1. Myofascial release of the lower posterior fascial line – This technique is described in the Institute for Integrative Healthcare Studies’ Myofascial Release manual. Position your client prone with the foot off the table to assess the leg’s fascia. Cross your arms and place one hand on the calf (proximal to the belly of the gastrocnemius muscle) and the other on the lower leg (just proximal to the ankle). Stretch and wait for a release. Allow the fascia to unwind in its own time.

2. Work the plantar flexors – With the client prone, put the Achilles tendon in a stretch by placing the client’s foot against your belly. Then use your thumbs to friction the sides of the Achilles tendon. Release the foot from your belly and use one thumb to push the tendon aside. Working at the level of the malleoli, rotate your other hand in order to cross fiber the anterior part of the Achilles tendon with your index finger. Follow with a forearm glide and/or stripping up the posterior leg being careful not to put pressure on the posterior knee.

3. Treat trigger points – Use ischemic compression on trigger points of the soleus, gastrocnemius and flexor digitorum longus. James Mally, ND, in the Institute for Integrative Healthcare Studies’ Sports Massage manual, suggests having the client prone, pressing the trigger point, flexing the client’s knee and dorsiflexing the ankle. Then, Mally says to find the position where the client does not feel any pain in the trigger point (except if the point is in the soleus). Hold the point for 30-90 seconds or until a release is felt. Then bring the client back to a neutral position while continuing to hold the trigger point.

4. Posterior fascial line stretch - Have your client stretch this line by performing a forward lunge, keeping the back leg straight and the feet flat on the floor. Hold for 20 seconds without any bouncing. Release for several seconds and repeat the stretch. This stretch can also be achieved by standing on the edge of a step. The balls of the feet are on the step while the heels hang off the step. Slowly, allow the body weight to shift into the heels, so that they drop below the step. This provides a great posterior lower leg stretch.

In addition to the above massage suggestions, here are some additional tips to offer your clients with plantar fasciitis:

• Rest is recommended for the acute stage.
• A physical therapist and/or athletic trainer can offer ultrasound, a stretching protocol, strengthening exercises and adequate taping.
• Supportive shoes or heel cups are helpful to many people.
• A podiatrist can fit your client for orthotics and/or a nighttime brace.
• Ice decreases inflammation and reduces the pain. Roll the foot over a firm cold object, such as frozen golf balls or a can of frozen juice concentrate.
• Surgery is available, hopefully as a last resort.

Plantar fasciitis is an increasingly common condition. An understanding of the anatomy and physiology of the foot and lower leg is very important in rendering appropriate care. Communication and collaboration with other healthcare professionals will provide your clients with the most comprehensive and effective treatment plan. Because massage therapists have such powerful tools to relieve plantar fasciitis, more bodyworkers will focus on and team up with professionals who treat this condition. Mastering the techniques described here, and making them your own, will give you a leg up on the pain of plantar fasciitis.

Recommended Study
Myofascial Release, Sports Massage

Posted by Nicole at 12:26 PM
© 2009 Institute for Integrative HealthCare Studies. This work is reproduced with the permission of the Institute. www.Integrative-Healthcare.org

Starting a massage practice is typically ushered by loads of enthusiasm and innovative ideas but a slump is easy to fall into. As eagerness fades to experience and routines are established, massage therapists may begin to relax into a false sense of security. Discover what steps you can take to assure your longevity as a bodyworker.

By Nicole Cutler, L.Ac.

Professionals from any fields must be able to recognize when their practice is declining in order to remain in business. While bodyworkers spend a great deal of energy studying preventative medicine, learning to prevent practitioner complacency is just as important. Settling too deeply into any routine typically leads to a reduction in business growth. Today’s competitive markets require even the most skilled professionals to regularly infuse their business plan with innovation and new tactics to reach new customers/clients. Below are seven common observations that can tip you off to an approaching slump:

1. Feeling relief when you only have two massages to perform in a day; your hands have been aching and you were hoping to tackle your personal to-do list.

2. Deciding to take a marketing hiatus and relying on word-of-mouth referrals as the only means of attracting new clients.

3. You panic when a handful of regular clients cease making appointments because its impact on your bottom line.

4. Your business costs are increasing with inflation, but your rates and income have not.

5. Whether it’s a chiropractor, physician, physical therapist or other medical professional, your primary referral source has just moved, retired or is simply no longer suggesting your services to prospects.

6. After each session, you feel more drained than before you began.

7. While the modality you’ve relied on for years used to benefit everyone, your clients no longer seem to be improving.

Onward and upward

Whether you reach the depths of a professional slump, are aware that one is approaching, or wish to completely avoid a dip in revenue and satisfaction, you are capable of reviving/sustaining your business’s longevity. While every one of the following suggestions could benefit a massage therapist with these concerns, do not attempt to adopt each one all at once. Focus on one or two strategies that resonate with you and once you feel good about your progress, implement the next tip that would offer you the most benefit. Some of the following suggestions may be a review of valuable information you already know, while others could be brand new career-boosting ideas:

1. Take care of your body – A bodyworker who ignores their hands, posture or emotions can quickly experience job dissatisfaction and fatigue - otherwise known as burnout.

* Reference the following articles Help for Overworked Hands, The Epitome of ‘Practice What You Preach’ for Massage Therapists and The 4 Steps of Energetic Separation for Bodyworkers for massage therapist self-care.

* If you find yourself struggling with the energy to complete your day, visit www.fatiguerelief.com for information on a proven supplement to reduce fatigue.

2. Expand your repertoire – Learning new techniques or information about specific conditions can infuse your practice with enhanced value. Clients will appreciate your commitment to improving your therapeutic skills while you will find new concepts to excite the healer within. For optimizing cost and convenience, consider enrolling in one of the Institute’s 35 distance learning programs to enhance your skill set.

3. Get business savvy – There are many ways to bolster the business side of your practice. Some suggestions include:

* Hire a consultant, business manager or marketing specialist to help you in areas you need the most help.

* Educate yourself by taking a course teaching business development. The Institute offers two such distance learning courses created specifically for massage therapists; Ethics: Practice Management and Developing a Wellness Center.

* If you prefer to read and reference books on the subject, consider Marketing Massage: How to Build Your Dream Practice or Hands Heal: Communication, Documentation and Insurance Billing.

* Visit your local community college and inquire about a small business development program.

Through renewed focus, any massage professional can experience the benefits of a successful practice. Recognizing professional burnout or a business slump is the best way to prevent it from happening. Experienced bodyworkers agree that mastering new therapeutic and business skills, combined with attention to physical and emotional health, is the formula to maintaining longevity in this constantly evolving field.

Recommended Study:
Ethics: Practice Management
Developing a Wellness Center

Posted by Editors at 12:11 PM

© 2009 Institute for Integrative HealthCare Studies. This work is reproduced with the permission of the Institute. www.Integrative-Healthcare.org <http://www.integrative-healthcare.org/>

To stave off the viruses that often accompany the arrival of the fall season, bodyworkers must be extra vigilant in order to protect themselves and their clients. Learn what else contributes to a healthy immune system and tips to maintain an optimal healing environment.

by Nicole Cutler, L.Ac.

Autumn brings back-to-school sales, a chill in the air and plenty of viruses to avoid. As a service professional with your door open to the public, viruses both mild and nasty can make their way into your healing space. Whether you provide bodywork to teachers or parents of runny-nosed children, receive a sneezing client on your treatment table or have someone under the weather waiting for a client in your reception area, autumn’s germs are everywhere. Keep yourself and clients healthy by learning to foster an optimal healing environment. Minimization of virus transmission and elimination of airborne germs will keep your massage practice from perpetuating the common cold.

Practitioner Resistance
Perhaps the most important component of a healthy environment is maintaining the bodyworker’s immune system. Someone who is ‘burning the candle at both ends’ will lack the strength necessary to fight off a communicable illness. Contributors include:

• Eating irregularly
• Consuming foods that lack nutritional value
• Drinking alcohol and smoking
• Working long hours
• Getting insufficient sleep
• Lacking movement or exercise
• Sacrificing fun and joy

Attention to general lifestyle factors will not only make a person feel better, but will also increase their immune system’s strength. Such factors include:

• Eating regular, healthy and nutritionally balanced meals.
• Supplementing diet with vitamins, minerals, antioxidants and essential fatty acids. Vitamin C, Zinc and Echinacea are all believed to strengthen one’s immunity to colds and the flu.
• Saving vices (alcohol and sugar consumption) as occasional treats.
• Quitting smoking. Tobacco smoking has been linked with the weakening of the immune system. Smokers on average take 25% more sick days a year than non-smokers.
• Setting limits on work. This will leave you more time for rest, relaxation, fun and sleep.
• Adhering to a regular exercise routine. Research proves that regular exercise strengthens the immune system.

The stronger a practitioner’s immune system, the less likely they are to act as a viral conduit from one client to the next.

Germ-free Environment
Excellent hygiene practices are crucial for minimizing contagion. This includes:

• Changing linens between every client
• Doorknob cleaning
• Scrupulous hand washing
• Air purification

Changing linens and cleaning doorknobs
While most practitioners understand the importance of linen changes, it is easy to become lax with this crucial practice. Even though a client appears to be perfectly healthy and may leave the massage table without any evidence of their previous session, the linens must be clean and fresh for each person. Since viral particles are undetectable to the naked eye, failure to provide fresh linens can easily result in viral transmission.

Doorknob germs are a prime suspect in the transmission of the common cold. An easy tip to minimize viral spread during cold and flu season is to keep some antimicrobial wipes handy, and wipe down doorknobs between clients.

Hand washing
To avoid catching a client’s cold; bodyworkers must wash their hands thoroughly and regularly, as well as refrain from touching their own face. If the therapist touches the client’s face (by performing any type of facial massage), be sure to follow immediately with thorough hand washing. Research has demonstrated that anti-bacterial soaps have no effect on the cold virus - it is the mechanical action of hand washing that removes the virus particles. In 2002, the Centers for Disease Control and Prevention recommended alcohol based hand gels as an effective method for reducing infectious viruses on the hands. However, subsequent research supports findings that the physical rubbing together of hands is the primary cleanser.

The following is a highly recommended hand washing protocol:

1. Turn on water to a moderate flow and wet hands.
2. Place liquid soap in hands. While plain soap is fine for routine hand washing, an antimicrobial soap is advised for use with an immune compromised client - or in the event of a blood or suspicious body fluid exposure.
3. Rub hands briskly for 30 seconds, including knuckles, between fingers and under nails. Wash up to forearms.
4. Rinse hands in a downward motion, from forearms to fingertips.
5. Dry hands completely with paper towel.

Disinfecting the air
Since viruses are primarily transmitted from person to person via cough or sneeze droplets, neutralizing airborne germs can prevent viral inhalation. While some practitioners may rely on aerosol spray disinfectants, many people (as well as the environment) are sensitive to these products. A natural, yet effective alternative is releasing an antimicrobial essential oil into the air.

When high quality essential oils are chosen, they can possess significant healing properties. Three essential oils typically relied on for their antimicrobial properties are:

1. Grapefruit
2. Orange
3. Tea tree

An easy method to disinfect the air is to use a spray bottle. Add 10 drops of a chosen essential oil to two ounces of water and spray the air in between clients. Another method to use in your healing space is an air diffuser. Use approximately six drops in a diffuser to maintain a continual dispersal of essential oil in the air.

Grapefruit and orange are more desirable for most healing spaces because the aroma of tea tree may be too strong for client appreciation. Tea tree essential oil dispersal into the air is best at the end of the day, to rid your office of any remaining airborne germs.

Maintaining your own immune system, practicing excellent professional hygiene and using aromatherapy to keep your environment germ-free are all ideal methods for making your healing space a retreat from autumn’s cold and flu season.

Recommended Study:
Aromatherapy Essentials

References:

www.en.wikipedia.org, Common Cold, Wikimedia Foundation, Inc. August 2006.

www.evb-aromatherapy.com, Using Essential Oils, Elizabeth Van Buren Essential Oil Therapy, 2006.

Posted by Editors at 02:18 PM

© 2009 Institute for Integrative HealthCare Studies. This work is reproduced with the permission of the Institute. www.Integrative-Healthcare.org <http://www.integrative-healthcare.org/>

Learn why massage is a proven, effective complement to traditional diabetes management, and discover what measures you should take to ensure sessions are both safe and beneficial for your diabetic clients.

by Nicole Cutler, L.Ac.

Approximately 17 million people in the United States currently have diabetes, and the number is growing. Odds are that most massage therapists either have a diabetic client, or will treat one soon. Diabetes is a complex disease, occurring when the body is unable to maintain the proper levels of blood sugar, or glucose, due to an inability to produce or properly use insulin. Studies have demonstrated the place bodywork has in diabetes maintenance, and an increasing number of sufferers are recognizing the value various alternative therapies can have on their health.

Below are three reasons massage therapy is beneficial to diabetics:

1. Relaxation - Duke Medical University researchers have confirmed that stress management can lower blood glucose levels. A Touch Research Institute study demonstrated that massage therapy lowers blood glucose levels in children with Diabetes Mellitus. A study at New Mexico University showed that a short stress-relief program including touch could lower blood sugar and improve health in diabetic patients.

When the body encounters stress, it prepares itself for a “fight or flight” reaction by raising blood glucose levels. Since raised blood glucose levels are detrimental to diabetics, methods of reducing stress, such as massage therapy, can have a profound effect on preventing blood sugar surges.

2. Circulation - There is no getting around the fact that massage can increase circulation, thereby encouraging the efficient transport of oxygen and nutrients throughout the body. Improved circulation, in turn, improves the cells’ insulin uptake.

3. Tissue Flexibility – A history of high blood sugar thickens connective tissue. Massage helps increase tissue mobility and elasticity, reversing the thickening effect of uncontrolled glucose levels. This tissue inflexibility can manifest as stiffness in muscles, tendons and ligaments, as well as decreased range of motion in the joints. Massage therapy can significantly counter this effect. Additional factors to encourage flexibility and support the myofascial system’s health include range of motion techniques, stretching and the inclusion of a regular exercise program.

While massage therapy presents many benefits to people with diabetes, there are some important safety measures requiring a caregiver’s attention.

Injection sites
Individuals with Type 1 diabetes typically must self-inject insulin to maintain insulin homeostasis. The increased circulation as a result of massage near the injection area can increase insulin absorption rates. Any increase in the bioavailability of insulin as a result of massage could have drastic consequences for a diabetic so a massage therapist must be sure to avoid the location of any recent injection sites. Prior to working with a diabetic, it is important to ask if and where they inject insulin, to prevent mistakenly working on such an area.

Neuropathy
Neuropathy is a common complication of diabetes, causing dulled or painful sensations on the extremities. As a result, a diabetic may be unable to provide adequate feedback regarding appropriate measures of tactile sensation or heat. Diabetic neuropathy can be extremely painful, requiring a sensitive technique, such as energy work, on affected areas.

Additionally, the chance of bruising, burning or any injury is increased with diabetic clients due to their delicate and easily damageable tissue. Instead of petrissage, deep effleurage or friction, which could potentially further damage delicate skin, the broad, direct pressure of Reflexology or the acupressure techniques of Shiatsu Anma Therapy are safer alternatives. When using any kind of heat therapy on diabetic clients, repeatedly check temperature settings, relying on your own sensitivity to temperature, not the clients’, to prevent burning.

Blood Sugar Changes
Primarily to confirm adequately controlled blood sugar, a diabetic must receive physician permission before receiving massage. Even with physician permission, wild fluctuation in blood sugar can occur. Because massage can lower blood sugar, both the client and practitioner must be armed to monitor any sudden changes. Due to the relaxing nature of massage, and the somewhat altered state of consciousness that can occur, a drop in blood sugar can be difficult to notice. Some diabetics can tell when their sugar levels are dropping, while others may not have any awareness. Hypoglycemia (low blood sugar) is a serious condition and can lead to unconsciousness and, rarely, death.

Due to the frequent unpredictability of a diabetic’s blood sugar fluctuation, it is important for the massage therapist to recognize the signs and symptoms of hypoglycemia. Any one or more of these symptoms may occur:

· Excessive sweating or clamminess
· Faintness or headache
· Inability to awaken
· Slowed or incoherent speech
· Slowed or delayed movements
· Sudden irritability
· Change in personality
· Rapid heartbeat

If the massage therapist notices any hypoglycemic symptoms, they must ask the client how they feel. A confirmation of a blood sugar reaction or a response that seems “off” requires immediate attention. A blood sugar drop can occur very quickly in diabetes, and is easily addressed with the administration of sugar. Make sure you have sugar available, either in the form of fruit juice, cookies, glucose tablets or some other sweet. Many diabetics carry sugar pills with them for such an event. The diabetic will typically experience an increase in blood sugar within minutes. Be certain that your client is feeling better befoe they get off of the table and again prior to their departure. It may be necessary to eat more sugar or test their blood glucose level to make certain of their safety.

Value Outweighs Risks
Massage can be a wonderful complement to diabetes management. Those affected will appreciate your understanding of their condition, willingness and compassion to avoid exacerbating damaged tissue and preparedness in handling a low blood sugar reaction.

Researching possible diabetes complications and any corresponding massage technique adjustments will further benefit clients suffering from this extremely common metabolic disease. It is critical to maintain open communication with your clients, instituting the exchange of client feedback and the awareness of possible hypoglycemia. Awareness of diabetes’s precautions will facilitate the safe enjoyment of massage by your affected clients.

Recommended Study:
Myofascial Release, Reflexology, Shiatsu Anma Therapy

References:
Rose, Mary Kathleen, The Benefits of Massage for People with Diabetes, Massage & Bodywork, Feb/Mar 2001.

Vanderbilt, Shirley, Returning to Native Tradition: An Integrative Approach to Diabetes, Massage and Bodywork, Dec/Jan 2005.

Vest, Gerald W., Acupressure, breath awareness helps diabetes patients, Health and Social Work, New Mexico State University of Social Work, 1997.

www.amtamassage.org, Therapeutic Massage and Diabetes, Mary Kathleen Rose, 2001.

www.dukemednews.com, Stress Management Can Help Control Glucose in Type 2 Diabetes, Duke University Medical Center, 2006.

www.miami.edu, Diabetes, Touch Research Institute, 2006.

Posted by Editors at 01:13 PM

© 2009 Institute for Integrative HealthCare Studies. This work is reproduced with the permission of the Institute. www.Integrative-Healthcare.org <http://www.integrative-healthcare.org/>

Any person receiving bodywork can experience what is known in the industry as a “healing crisis”. Such an occurrence can be frightening, both for the client and for the therapist. Learn how to identify the symptoms of a healing crisis and what steps for prevention you can suggest to clients.

By Nicole Cutler, L.Ac.

Any person receiving bodywork can experience what is known in the industry as a “healing crisis”. Such an occurrence can be frightening, both for the client and for the therapist. Learn how to identify the symptoms of a healing crisis and what steps for prevention you can suggest to clients.

Also known as the “Herxheimer Reaction”, a healing crisis occurs when the body tries to eliminate toxins at a faster rate than they can be disposed of. The more toxic one’s bodily systems are, the more severe the detoxification experience, or healing crisis. This reaction signifies that the bodywork received is working and that your client’s body is going through the process of cleaning itself of impurities, toxins and imbalances. While a healing crisis is temporary, it can occur immediately, within several days or several weeks after a bodywork session. Symptoms usually pass within several days, but can persist for several weeks. Often the crisis will come after a client feels their very best.

A healing crisis is a reaction to previously sequestered toxins being systemically released. Such poisons can be stored in all kinds of tissues, primarily muscle, fascia and adipose. During manipulation, whether it’s deep tissue massage, energy work or reflexology, these poisons are squeezed out of the holding body tissue into the bloodstream. This sudden increase in blood toxicity causes a toxicity reaction, until the body is able to effectively process and eliminate the poisons. While not a pleasant experience, a healing crisis signifies that a cleansing and purifying process is underway.

While cleansing can be physical, emotional or spiritual, a true healing crisis typically involves all three of these aspects. Due to the body’s fascinating ability to store memories and emotions in the tissues, their recollection or release can accompany the manipulation of those tissues. Most practitioners refer to the surfacing of memories or emotions without physical symptoms as an emotional release. An emotional release is a typical component of most healing crises.

Emotional Releases

Most people have some emotional issues or traumas occurring sometime in their life. Whenever an emotional trauma or situation happens it is stored in the nervous system. Though we may think we are over it and not even remember it, the mark or impression could still be there and negatively affect our health and psychology. During any form of bodywork it is possible to release these stored issues or traumas. An emotional release may give rise to feelings of anger, grief or another emotion. This release is indicative of a healthful body transformation, where the body clears itself of the negativity previously stored within.

Learning to suppress our feelings typically causes them to go into our physical bodies. The tensing of neck muscles will prohibit frowning, holding one’s breath can replace crying and jaw clenching may stifle yelling. When these patterns are repeated, emotional suppression becomes a habit, the unconscious mind takes over, and the body becomes a storehouse for unexpressed, unconscious feelings.

Suppressed emotions and traumas are a key factor in the development of muscular tension, high blood pressure, heart disease, immune weakness and other diseases. Most practitioners agree that real healing begins when this suppression is released, freeing the body to heal at the deepest level.

What are the symptoms of a healing crisis?

While each individual’s body is unique, there are some common symptoms typical of a healing crisis. Below is a list of Herxheimer Reaction symptoms most often experienced after receiving bodywork:

• Dizziness and light-headedness
• Fatigue
• Nausea and vomiting
• Low-grade fever
• Joint and muscle aches
• An odd or metallic taste in the mouth
• Muscle cramps
• Skin eruptions
• Intense emotional states
• Increased sweating, urination or defecation

Is this a healing crisis?
After a session, a client may experience a number of uncomfortable symptoms. In order to feel confident that this is a healing crisis, and not stemming from different etiology, the following causes should be ruled out:

• Low blood sugar – A hypoglycemic reaction can cause light-headedness, dizziness, nausea and fatigue.

• Pregnancy – A new pregnancy can cause dizziness, nausea, vomiting and fatigue.

• Starting to get sick – Catching a cold can cause dizziness, headache, feverishness, nausea, achiness and fatigue.

If the therapist is unsure of the reasoning behind a client’s maladies, and the client is concerned, refer them to their physician.

How do you prevent or minimize its course?
The best strategy to prevent or minimize a healing crisis is to support and facilitate the body’s toxin removal and encourage emotional health.

The best ways to facilitate toxin removal are:

• Hydration - Drinking extra water immediately following and sequentially after bodywork to aid the body in toxic elimination through urination and perspiration.

• Fiber – Increasing dietary fiber will support the gastrointestinal system’s swift removal of waste via the bowels.

• Sleep – Feelings of fatigue or sleepiness are best honored. Listening to one’s body by getting the rest it asks for will help the body in its recovery process.

During an emotional release, the most important item a therapist can lend is a safe environment while being supportive of the client’s process. Since bodyworkers are not trained as psychotherapists, below are some suggestions to best convey safety and support:

• Grounding - If appropriate, maintain a grounding touch with your client. This can take different forms, depending on the therapist’s level of education and comfort around grounding.

• Listening - Focus on listening, not counseling. Clients often need to verbalize their feelings to be able to move past them.

• It’s okay - Confirm to your client that an emotional release is not only okay, but it will amplify the effectiveness of your session. This can be prefaced by stating that when an emotion surfaces, the body is saying it’s time to let it go.

Most releases surface and resolve quickly. However, if a client exhibits frequent, strong emotional releases during sessions, or if the client’s anxiety or fear increases as a result of bodywork, it’s important they seek the help of a professional counselor.

A healing crisis may take both bodyworker and client by surprise, but being prepared for its possibility can be a freeing, learning experience. A therapist may wish to discuss this aspect of healing with their client prior to a session, or may find this information helpful during or following a client’s healing crisis. The release of the old and in with the new is what physical and emotional healing are all about, and the welcoming of this transformation opens the door to leading a healthier, more conscious, life.

Recommended Study:

Deep Tissue Massage
Reflexology
Healing Energy and Touch

References:

www.experts.about.com, Experts: Massage, Christopher Hall, About, Inc., 7/27/05.

www.falconblanco.com, The Healing Crisis, FalconBlanco, 2006.

www.massagetherapy.com, Freedom for Feelings, Cathy Ulrich, Body Sense Magazine, August/Winter 2005.

www.nihadc.com, Massage and Somatic Emotional Release, National Integrated Health Associates, 2006.

www.positivehealth.com, Reflexology – A Second Look, Ingrid Sahai, Positive Health Productions, Inc., 2006.

Posted by Editors at 01:48 PM
© 2009 Institute for Integrative HealthCare Studies. This work is reproduced with the permission of the Institute. www.Integrative-Healthcare.org

Chronic muscular pain is the number one complaint encountered by bodyworkers. Learn what two natural substances are considered to be superior pain-relievers by both the Western and complementary medical communities.

by Nicole Cutler, L.Ac.

Massage therapists typically rely on muscular relaxation, stretching, mobility and circulation enhancement to achieve pain relief. All kinds of healthcare practitioners - ranging from osteopathic physicians, to chiropractors, to acupuncturists, to massage therapists – include using topical applications as an adjunct to their primary modality of delivering pain relief. While many natural substances have been hailed for their pain relieving properties, two substances standout. That is why wintergreen and menthol are the star ingredients in a wide range of topical pain-relieving products.

Temperature
On a molecular level, American researchers have uncovered one of the reasons behind the success of gels using wintergreen and menthol in battling pain. Application of either compound to the skin causes a visceral temperature change. This is apparent when a product containing either substance, such as Ben-Gay or Icy Hot, is applied to the skin and causes a cold or hot sensation. According to Ardem Patapoutian, associate professor at Scripps Research and Genomics Institute, “Because our ability to sense temperature is closely linked to our ability to sense pain, it is not surprising that the misregulation of temperature-activated ion channels can result in chronic pain syndromes.”

Our experience of temperature is determined by long, specialized neurons connecting to the brain through the spinal column. These neurons have nerve endings embedded in our skin, where they detect temperature and communicate this information to the brain. The combination of pain and temperature sensation is well established. Try holding an ice cube where it’s so cold that it hurts. This is a logical protective mechanism where extreme freezing or scorching hot temperatures depend on our ability to sense pain and react accordingly. In the researchers’ identification of cold-sensing nerve receptors, it appears that those same receptors communicate pain. This could be the molecular basis for understanding how wintergreen and menthol ease pain. By stimulating temperature nerve receptors with a specific intensity, these topical ingredients may block or interrupt the pain signal.

Neuropathic Pain
The natural consequences of tissue injury, pain and tenderness typically abate as healing progresses. Unfortunately, some individuals experience pain without an obvious injury or suffer protracted pain that persists for months or years after the initial injury. This pain condition is typically considered to be neuropathic, accounting for a large number of people presenting to pain clinics with chronic, non–malignant pain. Rather than the nervous system functioning properly to sound an alarm regarding tissue injury, neuropathic pain occurs when the peripheral or central nervous systems malfunction and become the cause of the pain.

As a product of a constantly firing central nervous system, neuropathic pain is most likely to benefit from the activation of temperature nerve receptors. This is one way of understanding why topically applied menthol and oil of wintergreen relieve chronic pain.

Wintergreen
The main chemical constituent of wintergreen oil is a natural anti-inflammation compound, methyl salicylate. The body converts methyl salicylate to salicylic acid, otherwise known as aspirin. When applied topically, oil of wintergreen possesses two well-documented advantages over aspirin, with comparable anti-inflammatory results:

1. A topical application of methyl salicylate does not result in the stomach irritation or liver toxicity commonly associated with oral anti-inflammatory medication.

2. Methyl salicylate is better absorbed by muscle tissue than blood. Therefore, the active component is more effective when applied to the skin than where it can be filtered out by the blood supply.

Menthol
Menthol is a compound primarily derived from peppermint or other mint oils. It is a waxy, crystalline substance that is solid at room temperature. Similar to methyl salicylate, menthol is an anti-inflammatory and chemically triggers cold-sensitive receptors in the skin, causing the characteristic cooling sensation.

A study conducted on people with osteoarthritis showed improvement in the severity of joint pain when applying cetylated fatty acid cream topically. When menthol was added to this cream, pain and functional performance by people with knee, wrist and elbow osteoarthritis was even further reduced by a statistically significant margin.

Topical Application Cautions
There are several reasons why you should proceed with caution when using preparations with menthol or methyl salicylate, including skin irritation. First and foremost, thorough handwashing after application is essential to prevent contamination in unwanted areas. To avoid skin sensitivity and magnification of systemic absorption of menthol or wintergreen, do not cover the affected area with a tight bandage, use in conjunction with a heating pad or apply after strenuous exercise. Because methyl salicylate readily penetrates the skin after topical application, it should not be used on scraped, irritated or broken skin or near the eyes or mucous membranes. Due to the possibility of percutaneous absorption, methyl salicylate should be used with caution in individuals who are sensitive to aspirin or products containing aspirin.

Putting it to Use
Applying topical preparations, including the ingredients oil of wintergreen and/or menthol, can provide clients who experience chronic pain an additional layer of relief. While healthcare professionals have relied on these ingredients for years, understanding why they work may encourage their use by more therapists. Listed below are some tips for massage therapists looking to include topical applications in their treatments. Seek products with ingredients that:

· Come from a reputable supplier
· Are not greasy
· Will not stain clothing
· Have been recommended by other therapists/clients
· Have a liberal return policy

Try a few different formulations on clients with chronic pain, being sure to check for skin sensitivity, until you find one that works. By providing relief from every possible angle to yield the highest chance of success, it only makes sense to include topical pain relievers in conjunction with massage therapy.

Course Recommendations and Suggested Products:
Anatomy and Pathology
Herbal Heat
Herbal Ice

References:

Cross E. Sheree, et al., Topical Penetration of Commercial Salicylate Esters and Salts using Human Isolated Skin and Microdialysis Studies, British Journal of Clinical Pharmacology, Issue 46, 1998.

www.medicalnewstoday.com, Menthol Discovery Could Point Towards New Or Improved Pain Therapies, MediLexicon International Ltd, March 2006.

www.medicinenet.com, Methyl Salicylate and Menthol, MedicineNet, Inc., 2006.

www.research-innovation.ed.ac.uk, Topical treatment for chronic neuropathic pain, Edinburgh Research and Innovation Limited, 2006.

www.scripps.edu, Putting the Winter in Wintergreen, Jason Socrates Bardi, March 2004.

www.spineuniverse.com, Understanding Neuropathic Pain, Steven Richeimer, MD, Richeimer Pain Institute, 2006.

www.the-aps.org, Adding Menthol To Topical Creams For Osteoarthritis Provides Significant Pain Relief, Donna Krupa, The American Physiological Society, April 2004.

Posted by Editors at 09:40 AM

© 2009 Institute for Integrative HealthCare Studies. This work is reproduced with the permission of the Institute. www.Integrative-Healthcare.org <http://www.integrative-healthcare.org/>

Based on the work of Drs. Janet Travell and Raymond Nimmo, neuromuscular therapy, or trigger point myotherapy, is an appropriate and effective technique for medical and sports massage. Learn why neuromuscular therapy is recognized as one of the most effective types of bodywork for relieving lower back pain.

by Nicole Cutler, L.Ac.

Neuromuscular therapy (NMT) is the application of static pressure and applied stretching techniques to specific myofascial points for pain relief. Additionally, NMT employs soft tissue manipulation to balance the musculoskeletal and central nervous systems. To relieve pain, NMT directly addresses the following pain-causing elements:

1. Ischemia: The lack of oxygen due to reduced blood supply that can cause pain.

2. Nerve Compression or Entrapment: Pressure on a nerve by soft tissue, cartilage or bone.

3. Postural Distortion: Imbalance of the muscular system resulting from the movement of the body off the longitudinal and horizontal planes.

4. Biomechanical Dysfunction: Imbalance of the musculoskeletal system resulting in faulty movement patterns.

Lumbar Muscle Spasms
Lumbar muscle spasms are involuntary contractions typically occurring as a result of a muscle strain. Strains in the lumbar region are commonly due to exercising excessively or performing a movement beyond a muscle’s range of motion. Sudden movements that claim a majority of lumbar sprains, include:

• Unexpected jarring, such as an automobile accident
• Quick twisting, such as a vigorous tennis backhand stroke
• Excessive muscle loading, such as picking up a heavy object

The body’s response to a muscular strain is to protect the involved muscle from further injury. This protection is accomplished through contraction of its fatigued fibers to prevent any further stretching. Unfortunately, a chain of pain-causing events can follow a muscle sprain:

1. The contraction of strained muscles typically restricts adequate blood flow to the area, causing ischemia and lactic acid accumulation. Lactic acid accumulation itself can initiate muscle spasms.

2. Depending upon the muscle’s location, its contraction can put pressure on a nearby nerve. Termed nerve entrapment or compression, muscles squeezing a nerve can illicit intense radiating pain.

3. A muscle strain can disrupt the body’s musculoskeletal balance. Postural distortion is the body’s mechanical method of protecting and compensating for an injury. Unfortunately, this distortion off the body’s midpoint sets the individual up for a perpetuation of muscle strains, contractions and even more pain.

4. When an injury continues to disrupt body function, the individual may adapt their movement patterns in an effort to minimize pain. This adaptation solidifies a musculoskeletal imbalance and can transform a simple strain into whole body pain and dysfunction.

Muscle spasms can also occur as a reflex phenomenon caused by injured ligaments, infections, tumors or chronic disc problems.

Lumbar Disc Problems
Many disc abnormalities are actually a result of the aging process. Although pain from a herniated disc may come on suddenly, its cause generally occurs gradually, sometimes taking years to develop. Starting in young adulthood, discs naturally begin to dry up. The most likely location for changes to begin is the lower lumbar region, at the disc between the fourth and fifth lumbar vertebrae. Medical professionals speculate that this disc is most vulnerable due to the stress accentuated by the spine’s lumbar curve.

As a result of the degeneration associated with aging, the disc slowly loses its ability to bounce back. In the first stage of anatomic abnormality, the soft interior of the disc bulges outward. This bulging disc presses against the ligament holding it in place. The pressure on the involved ligaments can pull on and therefore strain nearby muscles, resulting in lumbar muscle spasms. Additional pain can ensue because the pressured ligament can impinge neighboring nerves. A worsening of this condition leads to disc herniation, where the inner core of the disc extrudes back into the spinal canal.

Breaking the Cycle
Fortunately, massage therapists practicing NMT have the tools to break the chain of events that can follow a lumbar sprain. NMT uses trigger points to identify and release pain referral patterns that are typical of lumbar sprains in the following ways:

• The application of static pressure on a trigger point disperses any built-up lactic acid, allowing the affected muscle to accept a clean supply of oxygen and blood flow. This circulation can release entrapped nerves and stop a muscle’s spasm.
• Because NMT involves postural evaluation, the practitioner can identify and treat the muscular source of a painful spasm pattern.
• Additionally, NMT involves muscle fiber stretching to correct the imbalances fostered by unintentional muscular contraction.

In our society, lumbar spasms are one of the most encountered conditions prompting healthcare visits. As endorsed by the American Academy of Pain Management, including NMT in a massage therapy session can save your clients from the intense and unremitting pain of lumbar muscle spasms.

Recommended Study:
Neuromuscular Therapy

References:

www.bucklandmassage.com, What is Neuromuscular Therapy?, Buckland Massage and Neuromuscular Center, May 2004.

www.findarticles.com, Muscle Spasms and Cramps, Richard Robinson, Gale Research, 1999.

www.massagetherapy101.com, Neuromuscular Therapy, massagetherapy101.com, 2006.

www.spine-health.com, Neuromuscular Massage Therapy, spine-health.com, 2006.

Posted by Editors at 02:03 PM
© 2009 Institute for Integrative HealthCare Studies. This work is reproduced with the permission of the Institute. www.Integrative-Healthcare.org