Fingertips

Living with Cancer

Scientific American has an insightful and tremendously useful article online about living with cancer. Eight topics are covered in detail:

1.You Have Cancer: Now What?
2. Questions to Ask
3. Your Odds of Beating Cancer
4. Getting Support: Tips, Tools and Tenderness
5. Medical Resources
6. The 411 on Health Insurance
7. How to Stay Healthy
8. Looking Ahead: Start a Family?

Each point is explored in easy to follow language, and plenty of useful links are included. This article is a great resource for people with cancer and their families.

One of the tips under "You Have Cancer: Now What" recommends massage therapy:

Focus on lifestyle changes: “The only thing that you can control is what you eat, what you drink and how you move,” Carr says. She recommends exploring healthy diets, exercise and alternative therapies such as massage, yoga and meditation to boost and maintain your physical and emotional well-being.

tags: massage massagetherapy wellness massage therapy bodywork health cancer

Great Physical Therapy Blog

Orthopedic Physical Therapy is a blog after my own heart (or shoud I say, my future profession). Written by a board-certified orthopedic physical therapist and strength and conditioning specialist, the blog is aimed at health care providers and is a valuable resource for physical therapists and massage therapists.

tags: massage massagetherapy wellness massage therapy bodywork health

Tennis Ball as Pressure Point Accessory

laurensfitness.com is a blog by a personal trainer that offers tips on exercise, nutrition and training. I have only been reading the site for a couple of days, but I am already a huge fan.

I discovered laurensfitness.com when my husband sent me a link to her series on using a tennis ball as a pressure point tool. Since I am all in favor of using everyday objects to make exercise and pain relief more accessible, I wanted to share this link with my readers.

Part 1 explains about pressure points in the body

Part 2 demonstrates lower body exercises

Part 3 demonstrates upper body exercises

One of the most interesting (and helpful) things Lauren does is illustrate her exercises with photographs.

tags: massage massagetherapy wellness massage therapy bodywork health

"Wii Hab"

The videogame Wii Fit is showing up in physical therapy clinics as a new way to get patients to do the same old exercises. Because of it's interactive design, patient actually get up and participate physically in the game.

Users must literally get into the game to participate in any of the Wii sports that include baseball, tennis, golf, bowling and even boxing. The Wii also boasts many other games users can enjoy with direct interaction through the wireless remote.

Therapists are using the interactive games to help patients improve balance. The Wii Fit is especially useful with children who are sometimes difficult to convince why they need to do their exercises. But don't be fooled, this is not just child's play, the elderly and athletes are benefiting from "Wii Hab."

One of the students in my class has seen the Wii Fit in action at her clinical internship. It's exciting to hear that the latest technology in use for the rehabilitation of patient function.

tags: massage massagetherapy wellness massage therapy bodywork health wii wiifit

My Sister's Feet (A continuation of the conversation)

I was visiting with my eldest sister over the 4th of July holiday. She's been having trouble with her feet and thought it may be plantar faciitis.

Following is more of our correspondence after her visit:
She writes: I started doing a "joggy, bouncy" walk today up and down my sidewalk and could make only one round. That was very discouraging. Could definitely feel it in my legs and could also feel my ankles weakening/fatiguing. Of course, I haven't been able to walk much at all, and not normally when I do walk, for 18 MONTHS now.

I think a fall might (might) have precipitated the whole mess (fell on sidewalk in March and hit knee, fascitis started in April with ultra-swollen feet - could there be a link?) Anyway, am certainly NOT interested in degenerating any further. But since fascitis is tendons, will working and exercising them rather than resting them, cause further stress. I think the bouncy walk, where each foot/ankle lifted my weight was too much....

My reply: Yes, bouncy may have been too much--doesn't give the velcro-like quality of the muscles time to "unrip" from each other--causes damage and swelling--this is why they discourage athletes from the ballistic stretching that was so popular in the 1980s--progress. And since the ankles aren't terribly vascular, they tend to remove fluid build-up slower than other areas of the body. Whether a fall precipitated this cascade of events is uncertain, though not out of the question. Seems like an awfully long delayed onset, though. It's probably a combination of things.

Start out with the ankle pumps and hold off on the heel raises for now. Ice the ankles and elevate them ~15 minutes. (Icing consists of a bag of frozen peas or corn with a damp face cloth between you and the bag if you don't want to make a bag of crushed ice)--might be nice for the hot flashes too. And if you can, get walking, keep walking. For health and weight-loss (surprisingly) it really doesn't take much. Just 20-30 minutes a day--you can even break it up into 10 minute bouts.

tags: massage massagetherapy wellness massage therapy bodywork health

My Sister's Feet

I was visiting with my eldest sister over the 4th of July holiday. She's been having trouble with her feet and thought it may be plantar faciitis.

Following is our correspondence after her visit:
You asked about whether your plantar fasciitis can affect your balance.
Yes it can, so here's what you can do to prevent yourself from getting weak in your lower legs:
1) ankle pumps--every night before bed and every morning before you get out of bed, do 10 ankle pumps -- toes toward your nose, then point. Don't just wiggle your feet around for 30 seconds, do these slowly, really feel your calf muscles working but don't make your feet cramp.
As these get easier to do and tolerate (in that they don't make your feet cramp) begin to increase the amount to 15, then 20 (should take you about a week to week and a half at most). Then begin to do them in sets (from one set of 20 back off to 2 sets of 12 with 15-30 seconds of rest between sets). Then begin to increase the reps back up toward 20 (12, 16, 20), then increase to 3 sets 3 times per day (you can do them under your desk at school).

Benefits of this simple exercise helps to improve circulation (will help with that pesky ankle swelling) and prevent blood clots from forming in your legs. That doesn't include the flexibility benefit and strengthening that this exercise will do for you (not to mention sexy, sculpted calf muscles).

2) heel lifts--hang on to something: while standing, raise up on your tippy toes--SLOWLY--we're not playing beat the clock here. You can do this in the morning while you're brushing your teeth, in the grocery store line while you're waiting to check out, in the kitchen while you're washing dishes or waiting for your coffee to brew (but don't lean over and support yourself--takes too much weight off). Same frequency as above--start with one set of 10 and work your way up to 3 sets of 12.

Benefits are that they strengthen the calf muscles and help with balance.

tags: massage massagetherapy wellness massage therapy bodywork health

Taking Care Of Our Arthritis Clients

As practitioners of the manual healing arts, we see lots of people with arthritis. Arthritis is also called degenerative joint disease or osteoarthritis.

Massage therapy can help people with arthritis have a drug-free alternative for coping with arthritis pain. This general overview of massage and arthritis can direct patients to practitioners.
Proponents claim that massage therapy, done correctly, can help improve joint movement, relax tense muscles, and stimulate the flow of blood and nutrients to the skin and underlying tissues.

Other alternatives to arthritis treatment will help clients cope or cut down on pain medications. Not only that, a value added way for massage therapists to take care of our clients is to coach them about ways they can change their lifestyle and daily activities to help them take care of themselves between visits.

tags: massage massagetherapy wellness massage therapy bodywork health

Hip Replacement Precautions

I saw several people who had hip replacements in my massage practice. If you've been in practice for a couple of years, or if you work in rehabilitation massage therapy, you will see clients who have undergone hip replacement surgery.

It's important to be aware that there are practical precautions for patients to follow after hip replacement surgery (this also goes for folks who've had pins and plates put in).
1) Avoid bending the hip beyond 90 degrees. This means don't bend from the hip to reach or pick something up off the floor. Avoid sitting in sofas and couches that would cause excessive hip bending.
3) Avoid crossing the surgical leg over the non-surgical leg.
The reasons for these precautions is because the patient could cause the hip to dislocate.
4) Avoid turning the operated leg inward (pigeon-toed).

If your clients decide to get massage within the first 6 to 8 weeks following their surgery, these precautions are important to keep in mind. The client may need help getting up and down from the table. Be aware of any chairs in the practice room or waiting room that may put them at risk of violating the 90 degree rule and direct them to a suitable chair.

As far as activities or treatments with these clients, forewarned is forearmed. Don't do any range of motion or stretches with the leg until their doctor has cleared them for that activity. Don't assign them any exercises that will put the hip into contraindicated positions.

tags: massage massagetherapy wellness massage therapy bodywork health

HIPAA Laws

I have pulled my posts concerning my PT clinicals at a local hospital because of privacy issues surrounding HIPAA laws. My university has contracts with the clinics where the clinics do internships. If I want to blog about any of the patient's that I see there, I need to get permission from that hospital and the hospital then needs to get permission from the patients that I see.

Not getting that permission means that I, the hospital and the school could incur huge fines and/or legal arbitration. Not only that, it could mean delays or prevention of me getting my physical therapy license once I finish school. Rather than take the risk of hurting myself or those institutions, I will not be blogging about patient cases.

Even though I have taken out all personal information, even concerning the gender of the patient, that may not be enough to protect that individual's privacy. Someone may be able to read, put together the pieces of the puzzle, and identified someone that I mentioned by chance, and I'm not willing to take that risk.

However, I do plan to continue to compare the things I'm learning in PT school to the practice of massage and the care of clients. I also plan to identify health conditions that I'm learning about in school that massage therapists may encounter in their practice. I plan to continue comparing and contrasting types of care that physical therapists and massage therapists can perform with patient/clients. And finally, I will continue to share any health related news or tips for general good health and wellness.

tags: massage massagetherapy wellness massage therapy bodywork health

How To Do A Pelvic Tilt Correctly

Following my physical therapy appointment, one of the exercises I was assigned was pelvic tilts. I'd been assigned pelvic tilts before and was unimpressed with the results. Usually, most people believe that pelvic tilts involve rocking the hips back and forth, moving the pelvic crest first toward your feet (arching your back) and then toward your chin (flattening your back on the floor). The cycle of the exercise is usually performed about one per second.

This is the wrong way to do a pelvic tilt.

A true pelvic tilt requires contraction of the muscles around the pelvis. It was explained to me this way:
Tilt the pelvis toward the chin (flatten the curve of the low back to the floor). Suck your belly muscles toward your spine. Tighten the gluteal muscles as though you want to stop or prevent a bowel movement (gluteal squeezes)

We're not done yet.

My physical therapist wanted me to take the exercise one step further into the bridge position by lifting my hips up off the floor and straightening my torso like a plank. I am required to hold this pose for a slow count of five. This is the hardest exercise I have to do for strengthening my low back. It's quite a trick to stay in position and keep both the gluteal and abdominal muscles contracted throughout. After a count of five, I am to lower to the floor in a controlled way before I can relax.

tags: massage massagetherapy wellness massage therapy bodywork health

My Physical Therapy Experience

I finally made it to physical therapy for my low back pain. The PT took my history, assessed my posture, bony alignment of my spine and hips, and watched me walk back and forth barefoot several times.

During the spinal examination they noted a slight curvature in my upper spine at T5--that must be that touch of scoliosis I developed in adolescence. Every once in a while that flares up when I carry my book bag over one shoulder. Since I got an ergonomic book bag that fits me and is comfortable, I'm much better about putting it over both shoulders. If I'm stooped over my studies for long periods of time, my upper back gets tired and achy, but I usually alleviate this by side bending and my spine usually adjusts a bit.

For my back pain, they asked a lot of questions about pain: where, when, how much, what I do to alleviate it. Unfortunately for therapy, but fortunately for me, I was having a good day, so I did not hurt much. It doesn't help that my back pain has been a part of my life for so long, because it makes it hard to recall exactly when it started or what precipitated it. I do know what has aggravated it over the years, though.

The therapist did manual muscle testing by having me lie on my side, elevate my leg away from the table in abduction, and then hold against resistance. This tested gluteus medius and gluteus minimus. It was a pathetic performance--minimum to moderate resistance against gravity (3+ or 4), worse on the right side. Then they muscle tested me on my stomach, with a hand on my low back, they had me lift my leg off the table and hold against resistance. This tested gluteus maximus and the hamstrings. Even though this is a yoga exercise I had been doing for years, I had clearly been compensating with muscles from my torso, because in this instance, I could hardly clear the mat. As for resistance, I had almost nothing--how embarrassing. I have no idea how this happened. They assigned me pelvic tilts and side-lying leg raises.

While I was there, I figured they could help me with my running injury from May 7. The therapist assessed the ankle using using range of motion, palpation and muscle testing. They assigned me exercises to strengthen my tibialis posterior. Using a theraband wrapped around my foot, I am to point my toes and pull my foot medially to the inside while using my other foot (crossed over my lower leg) to regulate tension on the theraband. I've also been assigned heel raises which will strengthen my calf muscles.

Incidentally, the physical therapist told me to lay off of my stretching routine. They believe that I'm a little too flexible and this may be why I got injured in the first place.

tags: massage massagetherapy wellness massage therapy bodywork health

Lowering Your Textbook Bills

When I started school again, I was astounded by the high prices of the required textbooks we were assigned. I am picky about my books, I plan to keep these texts as I start my new career as a physical therapist, so I require books with no markings or highlighting and in great shape, so I usually pick up new books.

Today we were handed our list of required and recommended textbooks for the third semester of the Physical Therapy program, and as soon as I got home, I handed the list to my husband (our in-house bargain hunter). As in the past, he compared prices from several online bookstores, my campus bookstore, and other online vendors, and we ended up saving a bundle (to put toward tuition).

After about thirty minutes of price comparisons, he picked up all the books brand new at Amazon.com, three books directly from Amazon.com and four from companies selling through Amazon.com (all with at least a 95% customer approval rating). Remember to check out the prices for the "new and used" books, many times you can get a great deal even when you factor in the $3.99 a book shipping fees when dealing with a third-party Amazon.com vendor.

Total savings including shipping fees (versus the college bookstore prices with 10% sales tax included) added up to an amazing 25% savings of $80.26 ($324.34 - 245.08)!!!

Here are the book I bought, with the price comparison:

Motor Control: Translating Research into Clinical Practice
bookstore price (with tax): $66.00
Amazon price (with shipping): $44.98

Handbook of Pediatric Physical Therapy
bookstore price (with tax): $42.84
Amazon price (with shipping): $36.96

Muscles: Testing and Function, with Posture and Pain
bookstore price (with tax): $35.18
Amazon price (with shipping): $31.99

Therapeutic Exercise: Foundations and Techniques
bookstore price (with tax): $71.44
Amazon price (with shipping): $44.82

Physical Therapy for Children
bookstore price (with tax): $87.94
Amazon price (with shipping): $72.76

Strength Training Anatomy
bookstore price (with tax): $21.94
Amazon price (with shipping): $13.57

Drug Delivery And Massage

One of my classes this semester is an introduction to Pharmacology. We are required to read several chapters and answer questions that the instructors think is pertinent to our learning. One of the questions we had was:

Describe the potential impact of either exercise or physical agents on pharmacokinetics. Pharmacokinetics deals with drug adminstration, absorption, distribution, tissue binding, metabolism and excretion.

In my research to answer this question, I found articles that address both of these impacts. The links are below:
exercise and pharmacokinetics
physical agents and pharmacokinetics

What I found among my reading was the effect that massage therapy may have on pharmacokinetics as well. Mostly what they have to say refers to insulin injections.
Massage can increase drug absorption from local subcutaneous injections sites. Massage has been shown to increase the disappearance of insulin from the injection site and thus increase plasma insulin concentration.

If massage increases insulin absorption, the impact this has on the client is a risk for hypoglycemia. If this is true for insulin, consider what this may do in the case of steroid injections for conditions such as bursitis or plantar fasciitis.

As far as systemic drugs are concerned, the authors say the following:
Massage could conceivably increase drug delivery to the massage tissues by increasing local blood flow or by some type of mechanical "milking" effect.

If the systemic drug is taken for the same reason a client comes in for massage, then the dosage of medicine needed for the condition may need to be lowered. It is important for massage therapists to know why a client is taking a given drug and know what impact massage could have on drug delivery. For the same reason, it is important for your clients to let their doctors know they get massage therapy so the doctor can adjust their medications accordingly.

tags: massage massagetherapy wellness massage therapy bodywork health

Minnesota's Alternative Medicine Controversy

In Minnesota, a law has just passed that allows recognition of naturopathic doctors. What appears to be a victory after 99 years of proponents trying to get the law passed, is coming under assault. Interestingly, it is creating a bitter fight among the alternative health community!

"What they're trying to do is become the gatekeeper for natural health, so nobody else can practice," said Greg Schmidt, who runs the Minnesota Natural Health Legal Reform Project, which led a pitched battle to sink the law. Despite assurances to the contrary, the fissure remains.

Maybe Minnesota can look to other states such as Oregon and Arizona to see how the practice lines are drawn among alternative health care practitioners.

tags: massage massagetherapy wellness massage therapy bodywork health

Experiencing Thai Massage

This reporter shares his experience of receiving Thai massage in Dallas, TX. Matt Chapman, Thailand-trained therapist, discusses how Thai massage is different from "regular" massage:

"We work toward achieving emotional balance by balancing things physically," Chapman explains, directing me to a padded cotton floor mat. "We combine yoga-type stretches with energy work. Energy work is movement of the emotions. Everything is energy work, because everything is energy."

Following the session, the author describes feeling electric and his therapist promises him that the results are longer lasting than a traditional massage. As a yoga practitioner myself, I've always wanted to try Thai massage, but we had no practitioners in my community. After reading how great it makes you feel, sign me up!!

tags: massage massagetherapy wellness massage therapy bodywork health