August 24, 2007
How Massage Can Relieve Heartburn Symptoms |
Printer-friendly version |
Approximately one-third of Americans have heartburn at least once a month, with 10 percent experiencing it daily. In addition to seeking a physician’s guidance, massage therapy can also help a person with this uncomfortable condition. Learn what massage modalities can assist individuals suffering from heartburn.
by Nicole Cutler, L.Ac.
Heartburn is a burning discomfort in the chest or throat resulting from stomach acid contacting and irritating the lining of the esophagus. It is an expression of acid reflux or gastroesophageal reflux disease (GERD), a phenomenon caused when contents from the stomach rise into the esophagus, much like water bubbling up into a sink from a plugged drain. While occasional episodes are likely not indicative of GERD, frequent heartburn should always be evaluated by a doctor. The exact symptoms and sensations of heartburn vary from person to person, though the most prominent characteristics of heartburn are:
· a bitter, sour or acidic taste in the mouth
· feeling partially digested food or liquid rising from the stomach to the mouth
· burning chest pain, often behind the breastbone
· bloating, belching and nausea
· chronic cough
· stinging, hoarseness or sore throat
· an increase in severity of pain when lying down or bending over
Physiology
To break down food, the stomach secretes hydrochloric acid. While the stomach’s lining protects it from this potent acid, the esophagus does not share the same protection. Thus, heartburn is the burning sensation felt when hydrochloric acid enters the esophagus.
The lower esophageal sphincter (LES) is the muscular valve connecting the esophagus and stomach. The LES is a high-pressure zone that acts as a barrier to protect the esophagus against the backflow of gastric acid from the stomach. If the LES relaxes or malfunctions, it allows stomach acid to flow upward into the esophagus. Normally, the LES works like a dam, opening to allow food to pass into the stomach and closing to keep food and acidic stomach juices from flowing back up into the esophagus. Acid reflux occurs when the LES is weak or relaxes inappropriately, allowing contents of the stomach to reverse direction. While medical experts are uncertain why this happens, a loss of muscle tone in the LES results in the inability to close completely after food empties into the stomach. A complex segment of smooth muscle under the control of nerves and various hormones, dietary substances, drugs and nervous system factors can impair LES function.
Tips to Minimize Heartburn
Since many factors can affect stomach pressure and LES tone, there are a myriad of ways to minimize heartburn.
· Elevate – Lying down worsens the burning discomfort associated with indigestion and heartburn. By elevating one’s head when reclining, gravity promotes the downward flow of digestion for preventing regurgitation. During a massage session, massage therapists can place extra pillows under a client’s head for a similar effect.
· Dietary avoidances – Suggest clients abstain from food or drink that increases acid secretion, decreases LES pressure or slows the emptying of the stomach. Known offenders include alcohol, chocolate, carbonated beverages, fatty and fried foods, garlic, onions, spicy foods, mints, tomatoes, oranges and other acidic foods and drinks.
· Quit smoking – One more reason to kick the habit, nicotine stimulates stomach acid and impairs LES function.
· Relax – Massage and other relaxation methods prevent and relieve heartburn by reducing abdominal pressure. Additionally, stress can increase sensitivity to refluxed acid, reduce pain thresholds and increase the frequency and severity of heartburn symptoms.
Warnings
While heartburn is generally not considered dangerous, it can be mistaken for a more serious condition. If heartburn is persistent and severe, it could be a symptom of GERD. Untreated, GERD can cause or contribute to a wide range of problems, including peptic ulcers, hiatal hernia or even esophageal cancer. Fortunately, many of these complications can be avoided with proper monitoring from a health care professional.
The pain caused by heartburn and heart attack can be so severe that both patients and doctors have a difficult time distinguishing one from the other. In fact, sophisticated equipment is generally necessary to determine whether patients are suffering from a heart attack or not. Experts advise seeking immediate medical attention if chest pain, or other heart attack warning signs, lasts for more than a few minutes. The following details the differences between heartburn and heart attack:
Heartburn
· A sharp, burning sensation just below the breastbone or ribs
· Although it is possible, pain generally does not radiate to the shoulders, neck, or arms
· Pain usually comes after meals
· Rarely accompanied by a cold sweat, lightheadedness or dizziness
Angina or Heart Attack
· A feeling of fullness, tightness, dull pressure or pain generally in the center of the chest
· Pain may spread to the shoulders, neck or arms
· May be accompanied by a cold sweat
· Might experience lightheadedness, weakness or dizziness
· Shortness of breath
· Nausea and possible vomiting
Seek immediate medical attention if you or a client experiences any warning signs of a heart attack.
Shiatsu for Heartburn
By applying various pressure techniques to specific locations, shiatsu can quiet the nervous system, calm a churning stomach, slow increased acid production activated by stress and alleviate the burning symptoms of reflux. Practitioners of this specialized form of massage agree that the most useful points to ease heartburn, are:
· Stomach – Stomach 41, 42 and 43 are used to decrease stomach acidity.
· Pericardium – Pericardium 6 relaxes the chest, helps digestion flow downward and reduces nausea.
· Liver – Liver 3 reduces anxiety, decreases stomach acidity and minimizes pressure on the stomach from constricted abdominal muscles due to stress.
· Additional points – Conception Vessel 17 promotes the downward flow of energy in the chest. Spleen 4 is used for calming a rebellious stomach.
Odds are that a significant percentage of clients in any massage practice struggle with either occasional or frequent heartburn. While diagnosing and treating this condition is beyond the scope of practice for massage therapists, being familiar with its symptoms, physiology, tips to improve symptoms, warnings and beneficial massage locations will ensure your client receives the best care possible.
Recommended Study:
Shiatsu Anma
Advanced Anatomy and Physiology
References:
www.ehow.com, How to Use Shiatsu for Heartburn, eHow, Inc., 2006.
www.healingwell.com, Natural Remedies that Work: Irritable Bowel Syndrome, Jini Patel Thompson, HealingWell.com, 2006.
www.heartburnalliance.org, All Q & A, National Heartburn Alliance, 2006.
www.massagemag.com, Heartburn Solutions, University of California Wellness Letter, Massage Magazine, Inc., 2006.
www.mercksource.com, Gastroesophogeal Reflux Disease, Harvard Health Publications, 2006.
www.worldwidehealth.com, Heartburn, Rita Louise, PhD, WorldWideHealth.com, 2006.
Posted by Editors at 09:30 AM
Printer-friendly version
August 23, 2007
The Benefits of Exercise for Fibromyalgia: Tips to Share With Clients |
Printer-friendly version |
As one of the more common chronic pain syndromes, massage therapists are likely to encounter and counsel clients with fibromyalgia. Find out more about the value exercise has for those with this debilitating condition as well as information you can share with clients who have turned to you for treatment.
by Nicole Cutler, L.Ac.
Seeking ways to reduce pain, increase energy and enhance quality of life are common goals of those living with fibromyalgia. Ideal complements to massage therapy, certain types of exercise are proven to reduce the pain associated with this condition. When working with fibromyalgia clients, incorporating exercise into your treatment plan (through teaching, suggesting or referring to an expert) will increase the effectiveness of all therapies being received.
About Fibromyalgia
Fibromyalgia is a medically recognized, chronic condition characterized by fatigue, widespread pain, stiffness, muscular aching and burning. Because there isn't a specific diagnostic laboratory test for fibromyalgia, its diagnosis poses a challenge. Prior to receiving a diagnosis of fibromyalgia, many people endure several medical tests that are returned with normal results, such as blood tests and X-rays. Although these tests may rule out other conditions, such as rheumatoid arthritis, lupus and multiple sclerosis, they cannot confirm fibromyalgia.
The American College of Rheumatology has established general classification guidelines for fibromyalgia to help in the assessment of this condition. According to these guidelines, a diagnosis of fibromyalgia includes widespread aching pain for at least three months and a minimum of 11 out of 18 specified locations on the body that are abnormally tender under relatively mild, firm pressure.
Exercise
While the cause of fibromyalgia is hotly debated, researchers are making steady progress in uncovering its mysteries. One such discovery is that a regular exercise program is of tremendous therapeutic value to a person suffering with fibromyalgia. One of the many possible theories explaining fibromyalgia is a lack of oxygen in muscle tissue. Whether deficient oxygen is a cause or effect of fibromyalgia, exercise is an excellent way to increase circulation and supply oxygen to our body’s cells.
In the March 2005 edition of Current Opinion in Rheumatology, Swedish researchers reported:
“Previous studies indicate that aerobic exercise performed at adequate intensity for an individual can improve function, symptoms, and well-being. A recent study of aerobic exercise showed that training in sedentary women with fibromyalgia using short bouts of exercise produces improvements in health outcomes. A study of aerobic walking resulted in improvements in physical function, symptoms, and distress. Two studies of low-intensity pool exercise reported a positive impact on fibromyalgia symptoms and distress. Two studies of qigong movement therapy were reported, one indicating improvements in symptoms and the other in movement harmony.”
Clients suffering with fibromyalgia may be dubious about physical exercise. Understanding why a person whose muscles already hurt and is physically exhausted would be suspicious of the benefits of working out, will help you communicate compassionately with them. While exercise is probably the last thing a person with fibromyalgia feels like doing, it is crucial for muscular health and pain relief. By increasing oxygenation of muscle tissue, exercise improves flexibility, range of motion, strength, endurance and energy levels.
When clients complain that prior attempts at exercise have been disappointing, explain that this is likely due to the increased pain that can occur from unaccustomed muscle use. In those with fibromyalgia, the brain misinterprets signals from the muscles, causing your body to act protectively as if the muscles were injured. Instead of its well-meaning purpose, this misinterpreted signal feeds the cycle of fibromyalgia by perpetuating muscle weakness, pain and fatigue.
While helping your client begin or stick with an exercise program demonstrates invaluable support, make certain a physician has approved of their activities. Listed below are some helpful tips on exercising with fibromyalgia from industry experts:
1. Start slowly – Frustration for not being able to accomplish what used to be simple can easily result in giving up or doing too much. The rule for fibromyalgia is to start small, and only increase exercise gradually.
2. Progress sequentially – Always start the journey to fitness with a regular stretching program. Stretching will release some muscle tightness, decreasing the number of pain signals going to the brain. The next phase is muscle strengthening. After flexibility and strength are increased, aerobic and endurance activities can be added.
3. Minimize eccentric muscle loading – Simultaneous muscle contraction and lengthening is typically too demanding with fibromyalgia. When working with any muscle group, separate stretching the muscle from contracting the muscle into different exercises.
4. Focus on posture – Making sure to find one’s center of balance will correctly distribute the body’s weight and reduce how quickly the muscles fatigue. Proper posture can help reduce unnecessarily held muscle tension.
5. Limit muscle contraction time – Prolonged muscle contraction can perpetuate pain by fatiguing muscles too quickly. Make certain to take regular breaks from any activity. This can range from taking a break from swimming to do a two-minute stretch, or pausing for three seconds after every minute of vacuuming.
Working with fibromyalgia can be a terrifically rewarding niche for massage therapists. As one of the most encountered chronic pain syndromes in women, there is currently no medical cure for this mysterious condition. While massage therapy is one of the top-rated options for fibromyalgia, results are magnified when accompanied by a regular exercise program. The five tips listed above can help clients with fibromyalgia incorporate exercise into their health maintenance routine. By recruiting both massage and exercise into a treatment plan, fibromyalgia sufferers have a better chance of conquering this increasingly common syndrome.
Recommended Study:
Fibromyalgia and Massage
References:
Mannerkorpi, K, Exercise in Fibromyalgia, Current Opinion in Rheumatology, March 2005.
www.exercise.about.com, Exercising with Fibromyalgia, Paige Waehner, About, Inc., 2007.
www.fmaware.org, Starting an Exercise Program with Fibromyalgia, Lisa Lorden, National Fibromyalgia Association, 2007.
www.mayoclinic.com, Fibromyalgia, Mayo Foundation for Medical Education and Research, 2007.
www.myalgia.com, Everyday Flexibility Moves, Janice H. Hoffman, Fibromyalgia Information Foundation, 2007.
www.myalgia.com, A Fibromyalgia Patients Guide to Exercise, Sharon R. Clark, PhD, FNP, Fibromyalgia Information Foundation, 2007.
Posted by Editors at 11:28 AM
Printer-friendly version
August 22, 2007
Autistic Clients and the Value of Touch Therapy |
Printer-friendly version |
A neurological disorder affecting normal brain function, autism is a complex developmental disability that typically appears during the first three years of life. The safe and nurturing touch of therapeutic massage is being used more and more frequently as an accepted and innovative complementary treatment for children and adults with autism. Learn how you can help in treating this challenging disorder.
by Nicole Cutler, L.Ac.
Autism primarily impacts social interaction and communication skills. According to a 2004 report from the Centers for Disease Control Prevention, autism affects an estimated 1 in 166 births. Statistics from the U.S. Department of Education confirm that the number of children with autism is on the rise, with a growth rate of 10 to 17 percent more diagnosed cases each year.
Although there is no cure for autism, appropriate treatment and education can help many children with this disorder adequately learn and develop. Early detection is critical in order to reduce the developmental challenges autism poses. Treatment is tailored to the individual and typically includes a combination of behavioral modification, communication therapy, dietary modifications and medications. Proven effective in rigorous clinical trials, massage therapy has been shown to positively impact some of the more characteristic behaviors of autism.
Autism Traits
People with autism process and respond to information in several unique ways. Those with autism typically exhibit some of the following traits:
· Resistance to change, need for repetition
· Difficulty in expressing needs, use of gestures or pointing rather than words
· Repeating words or phrases in place of normal, responsive language
· Laughing/crying for no apparent reason
· Preference to being alone, aloof manner
· Tantrums
· Difficulty interacting with others
· Not wanting to cuddle or be cuddled
· Little or no eye contact
· Unresponsive to normal teaching methods
· Obsessive attachment to objects
· Seemingly over-sensitivity or under-sensitivity to pain
· No real fears of danger
· Noticeable physical over-activity or extreme under-activity
· Uneven gross/fine motor skills
· Non-responsive to verbal cues, acts as if deaf despite hearing tests in normal range
Sensory Integration
For most of us, the integration of all five senses helps us understand what we are experiencing. For example, our sense of touch, smell and taste work together in the experience of eating a ripe peach. The fuzz on the peach may be experienced by someone with autism as painful and the smell may make the child gag. Some children with autism are particularly sensitive to sound, finding even the most ordinary daily noises painful. A majority of professionals agree that some of the typical autistic behaviors, like the ones listed above, are actually a result of sensory integration difficulties.
Often described as a lack of attachment, failing to cuddle as an infant and disassociation from the environment, autism often involves a defensive reaction to touch. Withdrawing when touched, displaying aggressive behaviors or even refusing to eat certain foods due to their textures, all point to autism manifesting as a sensory integration dysfunction of the tactile system.
A properly functioning tactile system accurately transmits information from the skin’s receptors to the central nervous system. When the tactile system is immature and working improperly, neural signals sent to the brain’s cortex interfere with other brain processes. This interference causes over-stimulation of the brain, making it difficult to both organize behavior and concentrate and can cause a negative emotional response to touch.
Massage Therapy
Interestingly, the nervous system is formed from the same layer of embryonic tissue as skin. As such, excessive sensitivity to light touch is one of the most common symptoms of nervous system immaturity. The self-affliction of vigorous physical stimuli (such as striking one’s head against a wall) while avoiding tactile interactions with others (a light touch may cause the child to scream in pain) is typical of autism. Since light touch is over-stimulating to those with autism, deeper massage techniques and joint compression are better tolerated. Utilizing methods of sustained moderate pressure such as Swedish Massage and Neuromuscular Therapy, can help dampen the nervous system’s over-reactivity.
Michael Regina-Whiteley, LMT, who has been working with children and adults with special challenges for over 33 years, shares the following nine tips to enhance relaxation and reduce tactile defensiveness in autistic children:
1. Begin sessions with deep touch (as opposed to light strokes) for the client to accept nurturing touch.
2. Engage the child in music of their choice and a quiet atmosphere.
3. Place your hands on his/her upper back or back of the head for as long as they allow. If no resistance is met, proceed and do a back or head massage using deeper strokes. If there is resistance, remove your hand, wait a few seconds, and then return your hand to its original position.
4. Although some children will resist the touching of their hands, another approach for an apprehensive child is to use their own hand to do the massage on their arm or hand. Be sure to calmly explain to the child what you are going to do in a low voice.
5. Keep the sessions brief at first to acclimate your client to the touch.
6. While getting a client with autism to participate in a full-body massage is unlikely, work as much as the client will allow.
7. When the focus is to decrease distractibility or hyperactivity, your primary objective would be to provide the "relaxation effect." If the client has a high enough cognitive level, you can incorporate some tense-relax-tense exercises into the routine to teach relaxation skills.
8. Breathing exercises may be used to facilitate the client's participation in their treatment. Be sure to acknowledge the client's active involvement with verbal praise.
9. Many children with autism also experience hypertonicity of foot and leg muscles. Deep kneading and petrissage are helpful on the gastrocnemius and soleus; however, don't go too deep with the tibialis anterior and peroneus brevis. Be sure to spend time on the plantar muscle groups at all three layers.
In 1997, researchers at the Touch Research Institute published results of its first study involving autistic children. Building on the success of previous studies demonstrating anxiety reduction and increased attention span using massage therapy for children, the Institute surmised touch therapy may be beneficial in reducing the autistic behaviors of inattentiveness, touch aversion and withdrawal. The researchers found that autistic children receiving touch therapy exhibited significant beneficial effects for orienting to irrelevant sounds and reducing stereotypic behaviors. Additionally, participants received improved scores on the Autism Behavior Checklist and Early Social Communication Scales. These beneficial effects of massage on autistic children may be credited to its active physical contact, relaxation effect and recruitment of the central nervous system.
The dysfunction of the nervous system’s sensory integration typically seen with autism can be minimized with touch therapy. Massage therapists showing interest in this condition can be a child’s bridge between autism’s seclusion and normal, developmental socialization.
Recommended Study:
Swedish Massage
Neuromuscular Therapy
References:
Regina-Whiteley, Michael, LMT, Autism and Treatment With Therapeutic Massage, Massage Today, February 2005.
Vanderbilt, Shirley, Massage Therapy for Autistic Children, Massage and Bodywork, February/March 2003.
www.autism-society.org, About Autism, Autism Society of America, 2006.
www.neurologychannel.org, Autism, Healthcommunities.com, Inc., 2006.
www.nimh.nih.gov, Autism Spectrum Disorders, National Institute of Mental Health, 2006.
www.thechildrenscenteraz.org, Tactile System, The Children’s Center for Neurodevelopmental Studies, 2006.
Posted by Editors at 02:33 PM
Printer-friendly version
