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Preventing Falls Using Technology

For gerontologists, physical therapists, techno geeks, and elderly everywhere, technology has lined up with medicine to help prevent falls. Some grim statistics about falling:

Falls are so harmful to the elderly and so costly to society that if falling were a disease, it would be deemed an epidemic. More than one-third of people ages 65 or older fall each year. About one fall in 10 results in a serious injury, like a hip fracture. Roughly 20 percent of older people who suffer a hip fracture die within a year.

All parties involved are interested in preventing falls before they happen. With the use of unobtrusive sensors in carpeting, clothing and rooms, medical personal can track movements that will give clues to an elder's fall risk.

In clinical settings, wearable sensors and wireless sensors embedded in carpets are used to measure precisely a person’s walking speed, stride length, step width and body sway — all variables in assessing the risk of falling.

The information gathered can then be used to determine whether a person's balance is deteriorating, and help clinicians decide what the best intervention would be. Would it be a specialized exercise program targeted at strengthening specific muscles, or would it be an adjustment in a person's medication to reduce dizziness or prevent them from getting up in the middle of the night to use the restroom?

The sensors track only motion, not what people are doing. The greatest benefit of this technology would be allowing older people to live independently in their homes longer.

tags: massage massagetherapy wellness massage therapy bodywork health

On The Nightstand

Jonathan Safran Foer has written a thought-provoking book titled Eating Animals. With the impending birth of his child, he decided to be more conscious about choices he made about food.

Like most people, I'd given some thought to what meat actually is, but until I became a father and faced the prospect of having to make food choices on someone else's behalf, there was no urgency to get to the bottom of things.

Filled with sweet anecdotes about culinary family traditions and the family dog, the book also examines deeper issues, sometimes uncomfortable examinations about why we eat the way we do. An essay by the author is available on CNN Opinion.

If you are interested in this genre of reading, I can also recommend The Ethical Gourmet by Jay Weinstein, In Defense of Food and Omnivore's Dilemma both by Michael Pollan, and the very first book I read on the politics of food back in the 1990s: Diet for a Small Planet by Frances Moore Lappe.

tags: massage massagetherapy wellness massage therapy bodywork health

Knee Hyper-extension Injuries

Nicole Cutler, L.Ac., of the Institute for Integrative Healthcare Studies, writes a thoughtful article about knee hyper-extension. I like that the focus of this article is on anatomy and what massage therapists can do to help this hyper-extension injuries.

This same condition is seen by physical therapists quite often, especially when working with people who have gait problems. Physical therapists take a different approach to correcting the problem by using exercise, stretches (when appropriate), and orthotic devices to correct improper biomechanics at the ankle.

Of course, some people naturally hyper-extend their knees. Children with cerebral palsy have spastic muscles which forces them to hyper-extend their knees when they walk. A great site to go to for discussion of gait deformities in children and orthotic correction is DAFO Cascade. Studying these videos taught me a lot about walking anomalies and how to select proper orthotics.

tags: massage massagetherapy wellness massage therapy bodywork health

The Link Between Alcohol And Cancer

Researchers have found a link between alcohol consumption and cancer. Researchers at Rush University Medical Center have identified a cellular pathway that may explain the link.

Alcohol stimulates what is called the epithelial-to-mesenchymal transition, in which run-of-the-mill cancer cells morph into a more aggressive form and begin to spread throughout the body.

This finding proves important because scientists may have found the cellular pathway to metastasis, the situation whereby cancer cells break away from their primary tumor and spread throughout the body. If scientists can interrupt this process, cancers may be able to be delayed at stage II where they are much more easy to cure.

Past studies show that some alcohol consumption has heart protective properties, but over-consumption is still a bad idea. Moderate alcohol consumption is one drink (12 ounces of beer, or 5 ounces of wine, or 1.5 ounces of 80-proof distilled spirits) for women per day and two drinks for men per day.

Don't drink if you are pregnant or trying to conceive, planning to drive or operate dangerous machinery, take medication (including OTCs), are a recovering alcoholic, or are under age 21.

tags: massage massagetherapy wellness massage therapy bodywork health

Managing Stress

Ah, today is the first day of my semester break. I have six whole days to stop twitching before the push is on again. And this was a particularly challenging final exam period because we had so many finals in such a short period of time. I must say that I'm proud of how I handled some of the more stressful aspects of this final exam season, remaining calm and collected during practicals. One thing I learned -- I don't like to be rushed.

Stress is present in all our lives, but certain situations really bring it out of us. When I started graduate school, student health came to speak to us and handed out information about how to handle stress. Apparently, academic stress is common. But at what point do we discern between stress responses that are normal to a given situation and stress that becomes pathological? Persistence of exaggerated emotion over a period of time (usually a couple of weeks up to six months or a year) that interrupts daily living and coping is considered a problem that requires outside intervention.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), anxiety falls into 5 basic categories:
Obsessive-compulsive disorder: consists of intrusive thoughts (obsessions) combined with repetitive behaviors (compulsions).

Panic disorder: recurring episodes of intense physical fear, without an obvious or immediate source of fear. Anxiety attacks: may manifest with heart palpitations, chest pains, difficulty breathing, or choking.

Posttraumatic stress disorder (PTSD): follows a severe traumatic event that threatens actual harm.

Social anxiety disorder: overwhelming anxiety when faced with everyday social interactions.

Generalized anxiety disorder: a catchall category that describes any chronic anxiety or exaggerated worry that lacks an obvious cause.

According to Experience Life magazine, if you have stress, there are ways to manage it without having to take prescription medication. Food also plays an important role in managing stress and they have a great article titled "Comfort Food." Of course, if your stress doesn't seem like the run-of-the-mill type and you find it disrupting your life, don't hesitate to contact your doctor -- there is help out there.

tags: massage massagetherapy wellness massage therapy bodywork health

Eat Curry

Do you like Indian food? How about Thai food? If your answer is yes, you may be naturally lowering your chances for certain cancers. According to BBC News, bright yellow turmeric, found in curries, has the ability to kill cancer cells in the lab.

The chemical - curcumin - has long been thought to have healing powers and is already being tested as a treatment for arthritis and even dementia.

I remember talking with a client about turmeric helping them with cystic fibrosis, also. But this newest benefit of turmeric is being viewed as a future treatment for esophageal cancer. So if you like curries, eat up -- colorful foods are good for you.

tags: massage massagetherapy wellness massage therapy bodywork health

Cat Massage

There are a plethora of books out there about cat massage. Some are serious and some are satirical, not for the faint of heart. But I stumbled upon a cat massage video. And while I personally find the lady in the video a little weird (she may be doing that on purpose to poke fun at herself), she does have some good massage moves.

One in particular is the chin massage. Many cats develop acne under their chins because it is just about the only place on their body that they cannot wash. My Siamese mix has this problem and gets black crusty patches on her chin (I know, eww gross!). But some chin massage and a damp paper towel helps alleviate this condition, and if I do it regularly, the skin under her chin clears up pretty quickly.

When I lived with my sister before I attended massage school, she had had the world's most aloof Himalayan. Anna was always out of reach until I began doing craniosacral therapy on my sister. The cat would come and position herself right at our sides as though she were waiting her turn. So one evening, much to her chagrin, I got my hands on her. She "whumped" right over on her side and let me work on her left hip. It turns out, years earlier, she came home with a big grease mark matting her fur and decided she wasn't going outside ever again. My sister suspects she had a run in with either a car or some farm equipment. Maybe it was just a coincidence, but it was peculiar that this cat was willing to let me work to release the the soft tissue of her hip.

But back to the video, another technique that I really like, and so does my male cat, is the chest massage. It doesn't hurt that my cat is really muscular (just like a typical Taurus), so I can really feel the meatiness of those chest muscles. I don't splay my cat's arms the way she shows in the video -- I think my cat likes to be in control of his contact with the ground -- but he sure will submit to a back rub and good combing.

tags: massage massagetherapy wellness massage therapy bodywork health

Best Careers of 2009

Okay, this is a little bit late, but my husband found a site for the best careers of 2009. US News and World Report picked the 30 best careers to have based upon 5 election criteria:

1. Job outlook
2. Average job satisfaction
3. Difficulty of the required training
4. Prestige
5. Pay

In a similar survey by the Wall Street Journal's Career Journal, physical therapy rated one of the eight best careers. Physical therapy was included in this year's list because 2 national surveys indicated a high rate of job satisfaction and prospects for employment are slated to improve as the baby boomers age.

If you're a science- and helping-oriented person, fascinated with the human body, and have an optimistic personality, a physical therapy career may heal your career pains.

Read about physical therapy from "a day in the life of . . . " perspective:

You might treat, for example, a brain-injured child, a football player who broke his arm, an Iraq War veteran amputee, and an aged stroke patient.

One of the main drawbacks noted was the level of training requiremented. It wasn't long ago that the minimum educational requirement was a bachelor's degree, but the minimum is now a master's degree. And in most places, in line with the APTA's Vision 2020, the minimum education requirements is a three-year doctor of physical therapy, which is what I have been describing in this blog for the past two years. After November 2, 2009 (assuming that I pass all of my finals), I will finally be a third year physical student.

tags: massage massagetherapy wellness massage therapy bodywork health

PC Posture

Have you been at the computer for a while today? As you read this blog, do me a favor. Check in with your body and assess how you're sitting. If you're like most of us, the longer you sit at the computer, the more you slump. PC Posture! (cue horror movie soundtrack).

Dumb Little Man: Tips for Life offers stretches you can do to help fight gravity and offset PC posture. With a little room on the floor and a theraband or theratube, all 6 of these stretches can be done right in your office.

Other handy tools from theraband (sorry, don't mean to sound like an ad here) is the flexbar which can help relieve or prevent medial or lateral epicondylitis, or plantar faciitis. Carpal tunnel syndrome encroaching on your keyboarding time? Try the HandMaster Plus. And if you like exercise balls, you can keep one in your office as a desk chair (helps with core stability) or as a handy decorative accessory for when you feel the need to take a break and get your blood moving with a few exercises.

Remember, if you want to exhibit good posture in front of the computer, it isn't about "just sit up straight." If your muscles have shortened because you've been giving into the gravitational pull for years, you'll need to stretch what is short and tight and strengthen what is loose and weak.

tags: massage massagetherapy wellness massage therapy bodywork health

Evidence For Craniosacral Therapy

Our last musculoskeletal lab covered Craniosacral Therapy. For the past year or two, our physical therapy curriculum has pounded evidence-based practice into our head. And so, shortly after class one of my classmates distributed a synopsis of three articles disputing the existence of the craniosacral rhythm, a critical palpation skill for the practice of craniosacral therapy. Also, they found literature about inconsistency between practitioners who claim they can palpate the rhythm -- this is called inter-rater reliability. (See extended entry section for citations to articles.)

I've been aware for years about the controversy surrounding craniosacral therapy and the source and existence of craniosacral rhythm, thanks to sites such as QuackWatch.com and several other sites. Controversies surround many alternative treatments such as acupuncture, reflexology, and even chiropractic.

I can only speak from my experience with craniosacral therapy. In October 1991, I was involved in a car accident and experienced whiplash. I had pain like someone was sticking an icepick in the back of my skull whenever I looked up at the sky (neck extension). In May 1992, I asked my physician for a prescription to physical therapy. Physical therapist, John Macy, PT, performed craniosacral therapy on me and I was free of pain. In fact, after six sessions of physical therapy, I was in better condition than I had been before the accident.

I was so impressed that I decided that I wanted to do bodywork. The course of my life changed from frivolous artist to a person on a mission to serve human kind and free them from pain. I took my first craniosacral class from the Upledger Institute in 1995, started massage school in 1997, and became a licensed massage therapist in 1999. After six years as a massage therapist, I decided I wanted to do more and have access more people in need. I was accepted to the graduate program for physical therapy at UAB in March 2007 and started their 3 year program in January 2008.

In a way, I've come full circle. I love craniosacral therapy. It's beautiful work. Nothing could induce relaxation faster in my clients than a cranial base release. But it was my classmate who circulated the synopsis about craniosacral research (all dated in the late 1990s) that put a fire under me to search for more current literature regarding craniosacral therapy. I'll admit, I had a heck of a time finding positive literature for craniosacral therapy. (See extended entry section for citations to articles.)

And that made me wonder: Why isn't there more current literature that discusses the discoveries that they teach us in CS continuing education seminars, such as the discovery of nerve endings and blood supply in the cranial sutures? Anatomy and physiology literature aside, I was able to find literature about how craniosacral therapy has a positive impact on urinary tract infections in MS patients, GERD and ear infections in children, fibromyalgia, and, also, a reliable measurement tool for craniosacral outcomes.

While we may not be able to fully describe the how and why of craniosacral therapy, but clearly there is some benefit to the treatment. Even in proven treatment protocols, some therapies do not work for some people. So before we throw the "craniosacral baby" out with the bathwater, we must acknowledge the efficacy of some treatments for some conditions some of the time. Our instructors tell us that evidence-based physical therapy practice is still in its infancy, and if we use only those tools found to be efficacious in the literature, our hands would be virtually tied with regard to patient care.

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Critics:
Rogers JS, Witt PL, Gross MT, Hacke JD, Genova PA. Simultaneous palpation of the craniosacral rate at the head and feet: intrarater and interrater reliability and rate comparisons. Phys Ther. 1998 Nov;78(11):1175-85.

Rogers JS, Witt PL. The controversy of cranial bone motion. J Orthop Sports Phys Ther. 1997 Aug;26(2):95-103.

Hanten WP, Dawson DD, Iwata M, Seiden M, Whitten FG, Zink T. Craniosacral rhythm: reliability and relationships with cardiac and respiratory rates. J Orthop Sports Phys Ther. 1998 Mar;27(3):213-8.

Downey PA, Barbano T, Kapur-Wadhwa R, Sciote JJ, Siegel MI, Mooney MP. Craniosacral therapy: the effects of cranial manipulation on intracranial pressure and cranial bone movement. J Orthop Sports Phys Ther. 2006 Nov;36(11):845-53.

Advocates:
Matarán-Peñarrocha GA, Castro-Sánchez AM, García GC, Moreno-Lorenzo C, Carreño TP, Zafra MD. Influence of Craniosacral Therapy on Anxiety, Depression and Quality of Life in Patients with Fibromyalgia. Evid Based Complement Alternat Med. 2009 Sep 3. [Epub ahead of print]

Raviv G, Shefi S, Nizani D, Achiron A. Effect of craniosacral therapy on lower urinary tract signs and symptoms in multiple sclerosis. Complementary Therapies in Clinical Practice. May 2009:15(2); pp 72-75.

Isbell B and Carroll S. The effectiveness of craniosacral treatment: Preliminary findings on clinical outcome research. The Fulcrum. 2006. 41: 1-5.

Masiello TL, Pace J. Influences of Craniosacral Therapy on the Health and Development of Infants and Young Children. Bridges. December 2005: 3(3); 1-11.

Joyce P, Clark C. The Use of CranioSacral Therapy To Treat Gastroesophageal Reflux in Infants. Infants & Young Children. 9(2):51-58, October 1996.

Eat Less, Feel Satisfied

I feel like I've been donning my "winter coat" for hibernation season. So I've been trolling the internet for some pain-free ways to drop a few pounds. So far, portion control seems to be the easiest way to lose weight (I have a bad tendency to double up on portions unintentionally).

In my search, I stumbled upon Dumb Little Man: Tips For Life, who blogs about eating less while feeling more satisfied. The concept: eating quality food will satiate you at the same time curbing the tendency to snack. Basic tips from their site:
1) Eat smart fats at every meal -- eggs, walnuts, oily fish (also great sources for Omega-3 fatty acids)
2) Protein is energy dense -- a little bit goes a long way because it takes your body longer to digest.
3) Choose organic when possible -- Food higher in vitamins, minerals, enzymes and antioxidants fills you up more.
4) Eggs are nature's wonder food -- eggs are one of nature's true whole foods. The cholesterol in the yolk is the good kind of cholesterol.
5) Eat healthy junk food -- choose dark chocolate with nuts, well – that’s almost healthy!
6) Drink water! -- those hunger pangs you're feeling may be your body's cry for water.
7) Nuts and seeds -- sign me up! Watch out, those little guys are addictive, so exhibit portion control before you start eating.
8) Eat rib-sticking sauces and gravies -- Many pre-bottled or pre-prepared sauces and gravies are little more than sugar, cheap oils and synthetic chemicals. I've heard enough.
9) Eat slower -- make food and event, but not "all you can eat" contest. It takes 20 minutes for the first bite to reach your hunger center and turn off the alarm. Shovel it in as fast as you can and you may be eating a lot more than you bargained for.
10) Choose food you crave -- hmmm. Sometimes I crave bananas, but this person says if you've been "jonesing" for a snicker bar for 3 weeks, go ahead and give in. Sometimes the build-up just doesn't live up to reality (this is the way I feel about most movies). If it does, remember, moderation.

Hope you find some of these tips useful. Sometimes I get out of the habit of choosing really good, cheap, and easy foods like eggs. Maybe it's time to work those back into my culinary rotation.

tags: massage massagetherapy wellness massage therapy bodywork health

PT Month and MT Week

Physical Therapists are celebrating national PT month in October and Massage Therapists are celebrating national MT week October 25-31. Massage therapists and physical therapists can join together to celebrate their respective professions.

An example is in Delaware, where PTs are collecting toiletries, twin sheets, blankets, clothing for men and women, and shoes to donate to a local charitable organization for low income families.

A celebration is scheduled from noon to 1 p.m., Wednesday, Oct. 28, that will include light refreshments and general education on the benefits of physical therapy. There will be a door prize and drawing for physical therapy-related merchandise and a chance to win a one-hour massage by a certified massage therapist.

What are your ideas for celebrating national massage therapy week? Event planning can be quite involved and time consuming. By sharing ideas, next year massage therapists can create more promotions to raise awareness of the profession in effective and positive ways.

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Bodywork Concepts

Today, we started out soft tissue mobilization unit in musculoskeletal class. I'm the only massage therapist in my PT class, but a handful of others knew about different soft tissue techniques that we discussed in class.

From our lecture notes, we were made aware of several different manual therapy techniques:
1) Rolfing -- philosophy of bodywork where structure governs function. Bones are held together by tensions within the muscles and connective tissue, and an imbalance in this tension alters structure.

2) Aston Patterning -- an integrated system of movement education, bodywork and environmental evaluation designed to increase the body's ability ot move more efficiently and effortlessly.

3) Feldenkrais -- structured movement lessons which introduce increased options for movement and integrate them into functional activities.

4) Hellerwork -- deep tissue bodywork and movement education designed to realign the body and release chronic tension and stress.

5) Trager therapy -- bodywork which facilitates integration of body and mind through multiple types of sensory inputs.

The hands-on lab offered some techniques I had not seen before in bodywork. Since I've not taken of John Barnes Myofascial therapy, I've not been aware of the impact of superficial restrictions on movement. While I was familiar with many of the hands-on techniques, it never hurts to learn something new.

tags: massage massagetherapy wellness massage therapy bodywork health

Health Gadget: Fitbit

If you're into gadgets, you may be interested in checking out the Fitbit health tracker. Wear it anywhere on your body and it will monitor how many steps you take in a day, how much sleep you're actually getting, and more. Get more information from Wired Magazine's product review.

WIRED: A true boon for data-loving geeks who want to track their workout progress. Nicely designed, minimalist hardware. Doesn't just focus on exercise: Diet and sleep are also tracked. Easily clips to just about anything. Nerd-tastic amounts of data can be had for a single C-note.

TIRED: More prone to loss than the Detroit Lions. May be a bit hard for non-native speakers of the tech language to immediately master. Other running trackers work a tad more accurately.

For the health conscious who have everything, this would be a great gift idea (67 shopping days until Christmas). Pre-orders are being taken and the product will start shipping October 31.

tags: wellness fitness health

Stress Can Take A Toll On Your Teeth

Dentists are seeing the effects of the economic downturn on their patient's teeth. And the battle over health care reform isn't helping much either. During tough economic times, people may be looking at ways to cut back on expenses by reducing their bi-annual dental check-ups to once per year. After all, most people don't have dental or eye insurance.

Something else dentists are seeing, along with a reduction in their extra services such as teeth whitenings, is an increase in signs that their patients are grinding their teeth. Bruxism can lead to musculoskeletal pain, headaches, teeth sensitivity and even cracking. Think about this, normal chewing exerts 20 to 30 pounds per square inch on the tooth surface, but grinding your teeth can exert as much as 200 pounds per square inch. That coupled with up to 45 minutes of sustained biting can wreak havoc on the tooth and enamel.

More patients who are seeing their dentists for this problem are opting for night guards rather than the more expensive fix, veneers. Medical interventions include botox injections into the masseter muscle of the jaw. Dentists and doctors alike recommend stress management techniques and good sleep hygiene. So don't cut that massage therapy appointment out of your budget just yet.

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