March 18, 2008
How Antibiotics May Impact Bodywork |
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Although frequently prescribed, many people do not realize the disturbing implications of antibiotic use. Discover several issues relating to antibiotics that all massage therapists should be aware of.
by Nicole Cutler, L.Ac.
People around the globe equate visiting their doctor with getting antibiotics. In today’s age of emerging superbugs, doctors are still writing prescriptions for antibiotics at an unprecedented rate. While antibiotics can be life-saving, many health authorities are beginning to admit that these medications are often over-prescribed, creating problems worse than the original condition. Although advising for or against the use of medications is beyond a bodyworker’s scope of practice, there are several issues relating to antibiotics that all massage therapists should be aware of.
Antibiotic Resistance
Resistance to antibiotics is a major public-health problem. Because antibiotic overuse contributes to the rise of superbugs, experts have been calling on doctors to curb the liberal prescribing of antibiotics in many types of patients, including children with earaches, adults with sore throats and those with terminal end-stage disease. Although the medical ethics involved in preferential antibiotic dispensation are hotly debated among physicians, bodyworkers must take extra precautions when working with people who take, or have taken, these commonly dispensed drugs. Experts are increasingly recognizing that the evolution of stronger pathogens has a global impact, affecting the patient, their environment and all the people that come into contact with that patient or with their environment.
Impact on Bodywork
Clients typically come to bodywork sessions reporting current antibiotic use. While this isn’t always a contraindication, it does present concern demanding more information prior to treatment. Some questions about the antibiotics needing clarification include:
· Why is your client taking antibiotics?
· How long have they been on them?
· Is there an infection?
· Is the infection systemic or localized?
· Is there a fever?
Before proceeding with massage therapy with a client on antibiotics, the bodyworker must evaluate the following:
1. Will our session risk spreading the infection?
2. Will this client put me or my environment at elevated risk for superbug exposure?
3. Can I help the additional health issues resulting from antibiotic use?
Spreading the Infection
While there are many reasons a doctor might put their patient on antibiotics, a current infection is the most common. Because most forms of bodywork involve enhancing circulation, a therapist must determine if their work could spread infection. Since there are so many variables in pathogen strength and location, antibiotic strength and human response, there is no exact formula to determine this risk. In favor of bodywork for an infection, circulatory massage can actually assist the lymph and immune systems move pathogens out of body tissue.
Taking both perspectives into account, a therapist must use their best judgment to ascertain any potential risk of spreading the infection. In general, bodywork is considered safe if the client has been taking antibiotics for at least three days, the infection is not systemic and none of the signs of current infection are present: heat, fever, swelling or pain.
Superbug Exposure
Aside from living in a bubble, all of us are exposed to potentially drug-resistant organisms every day. As members of the healthcare industry, bodyworkers and their environment are particularly prone to pathogen exposure. Understanding this vulnerability is one more reason for bodyworkers to practice Universal Precautions with each and every client.
The importance of frequent hand washing must not be underestimated in healthcare environments. Thoroughly washing your hands before and after each session is the number one way to prevent passing superbugs along to yourself or other clientele. In addition, providing fresh linens for each client, cleaning door handles and keeping your own immune system healthy all contribute to the prevention of spreading infection.
Results of Antibiotics
Hopefully, properly prescribed and utilized antibiotic use destroys a person’s potentially dangerous bacterial infection. Whether this is the case or not, a majority of those taking antibiotics suffer from the annihilation of all organisms in their digestive tract.
Like pesticides, antibiotics kill good bugs along with the bad ones, especially the wide-spectrum antibiotics. The non-discriminating nature of most antibiotics disrupts the delicate balance of organisms in the gastrointestinal system by destroying beneficial bowel flora. These beneficial flora help us digest food, produce certain vitamins and prevent harmful bacteria and yeast from multiplying. Unfortunately, antibiotic use can invite parasitic infection, vitamin deficiencies, mineral loss through diarrhea, gut inflammation, malabsorption syndromes and food allergy development.
When this pattern of antibiotics destroying good and bad bacteria is recognized, bodyworkers can offer their clients hope. The following strategies are used by alternative healthcare practitioners to restore healthy bowel flora:
1. Suggest taking a good quality probiotic to help restore balance in the gastrointestinal system. While several dairy products have started including probiotics in foods, higher, more therapeutic concentrations of probiotics are found in supplements such as Fatigue Relief Plus.
2. Tonifying certain acupressure points can stimulate a client’s immune and digestive systems. The most beneficial points for helping strengthen the gastrointestinal system include Large Intestine 11, Stomach 36 and Spleen 6.
3. Encouraging clients to rejuvenate their immune system with good nutrition and plenty of rest to help their body resist the consequences of antibiotic use. Getting adequate vitamins, minerals and other nutrients from their diet and giving their cells time to recharge with restful sleep helps the digestive system bounce back from being cleaned out by antibiotics.
Whether it stems from cold and flu season, a toothache or an open wound gone bad, nobody likes to be sidelined with an infection. In an attempt to eliminate infections, most physicians habitually prescribe antibiotics. Bodyworkers aware of the possible problems caused by antibiotics are best prepared to help their patients taking these drugs. In addition to making certain their clients on antibiotics are well enough to receive massage, bodyworkers must practice Universal Precautions to reduce the spread of infection. On an even further level, bodyworkers can employ the three previously described strategies to help their clients cope with the destructive aftermath of antibiotic use.
Recommended Study:
Advanced Anatomy and Physiology
Infectious Disease: Hepatitis
Pharmacology for Massage
Shiatsu Anma Therapy
References:
http://news.yahoo.com, Study Suggests Antibiotics are Overused, Carla K. Johnson, Yahoo Inc., 2008.
Versagi, Charlotte Michael, LMT, NCTMB, When Is It Safe to Treat a Patient Taking Antibiotics?, Massage Today, March 2008.
www.drwilson.com, Beyond Antibiotics, Lawrence Wilson, MD, 2008.
www.medicalnewstoday.com, Causal Link Between Antibiotic Prescription And Antibiotic Resistance, MediLexicon International, Ltd., February 2007.
Posted by Editors at 11:36 AM
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5 Tips for Combining Guided Imagery with Massage |
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While people meditate in many different ways, guided imagery is a type of meditation massage therapists can successfully incorporate into their sessions. Learn how you can lead clients in a guided imagery meditation, helping to deepen their state of relaxation and increase the session's therapeutic effectiveness.
by Nicole Cutler, L.Ac.
Even though many scenarios are appropriate for massage therapists guiding clients with imagery, therapists have a lot of leeway in personalizing each experience. While guided imagery is more than simply telling your client to relax, it doesn’t have to include a fully illustrated journey. The goal of combining the practices of meditation and massage is to bring the client’s mind into harmony with a relaxed and stress-free physical state.
Bodyworkers may choose a recording to guide clients into relaxation or use their own voice to lead the way. Two examples of useful journeys are described below:
· Imagine warm sunlight coming down from above. The warm, golden light beams down, touches the top of your head and relaxes the tension held in your scalp. The golden glow moves down your body slowly stopping to warm each muscle group, draining any tightness into the earth below you.
· As you feel your body relax and release tension it becomes lighter and lighter. As resistance is removed, your body becomes so light it begins to float. You lift off the earth and float like a cloud up to the sky. The warm sun envelops you and a gentle breeze carries you through the sky.
Imagery is an effective treatment for stress. Relaxation techniques can release neurochemicals that act as natural brain tranquilizers and lower blood pressure, heart rate and anxiety. Because imagery relaxes the body, doctors specializing in imagery often recommend it for stress-related conditions such as headaches, chronic neck and back pain, high blood pressure, spastic colon and cramping from premenstrual syndrome.
Several studies suggest that imagery boosts immunity. Danish researchers found increased natural killer cell activity among ten college students who imagined that their immune systems were becoming very effective. Natural killer cells are an important part of the immune system because they can recognize and destroy virus-infected cells, tumor cells and other invaders. In another small study, researchers at Pennsylvania State University and Case Western Reserve University School of Medicine found that seven people who suffered from recurrent canker sores in their mouths significantly reduced the frequency of their outbreaks after they began visualizing that the sores were bathed in a soothing coating of white blood cells.
Combining meditation with massage can elevate the recipient’s physical and spiritual well-being. As published in the October 2005 Journal of Palliative Medicine, Yale University researchers looked at the effect of meditation and massage on quality of life in people with AIDS. Study participants were allocated to either a massage group, a meditation group, a combined meditation and massage group or a standard care group. The researchers concluded the combination of meditation and massage demonstrated a significant favorable influence on overall and spiritual quality of life in late-stage disease relative to standard care, or either intervention component alone.
Leading your clients in a guided imagery meditation while you work requires practice. Below are five tips for getting started in guiding someone into a meditative state:
1. Listen to Guided Imagery – Make sure you are familiar with different ways of guiding a meditative state to help you develop your own style. Experiencing it yourself will help you recognize its benefits and choose what process suits you best to make you a better meditative leader. You can either listen to someone else’s guided imagery recording or be the recipient of a guided imagery session.
2. Practice on Friends First – Rehearse guided imagery with friends and family members and get their feedback before attempting to lead clients. It takes practice to guide a seamless opening, middle and closing meditation while simultaneously performing massage therapy.
3. Center Yourself – You can only lead a client into the relaxed state of meditation if you are grounded. Taking several deep, cleansing breaths, releasing accumulated tension and feeling connected to the earth below is one way to get centered.
4. Progress Slowly – When using imagery to guide someone towards relaxation, it is important to pause long enough for them to imagine each scenario you have set. Pace yourself so you don’t rush through the relaxation of a muscle group that may be carrying extra tension.
5. Voice Control – Maintain an even, calm voice tone throughout the meditation. Guided imagery works best when the practitioner’s voice is liquid, soothing and free of expression so the client doesn’t get distracted.
Incorporating guided imagery into your massage sessions may not be desirable for every situation. Clients who are not open to being led on a cognitive trip may find your guidance clashing with their attempts at relaxation. However, clients who are receptive to guided imagery have a unique opportunity to participate in their own healing process.
By working with the above five tips for beginning guiding meditations, you can learn to deliver a memorable physical and spiritual session. With research proving the advantages of combining meditation with massage, verbally guiding your clients into a deeply relaxed state will render your massage treatments even more effective than they were before.
Recommended Study:
Integrative Massage – Spirit
Recommended Recordings:
Ten Minutes to Relax
Your Present: A Half Hour of Peace
References:
Williams AL, Selwyn PA, Liberti L, Molde S, Njike VY, McCorkle R, Zelterman D, Katz DL, A randomized controlled trial of meditation and massage effects on quality of life in people with late-stage disease: a pilot study, Journal of Palliative Medicine, October 2005.
www.amcollege.edu, Guided Imagery, Dr. Richard Browne, Acupuncture Massage College, January 2007.
www.eupsychia.com, Guided Imagery, Eupsychia Institute, Inc., 2007.
www.holisticonline.com, Guided Imagery or Visualization, ICBS, Inc., 2007.
www.intelihealth.com, Guided Imagery, Natural Standard and Harvard Medical School, Aetna InteliHealth, Inc., 2007.
www.spas.about.com, Partnered Meditation and Massage, Margaret Doner, LMT, 2007.
Posted by Editors at 10:05 AM
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March 17, 2008
Solutions and Sports Massage Techniques for Achilles Tendonitis |
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Learn about ten commonly advised solutions you can discuss with clients suffering from acute or chronic Achilles tendonitis. Also, find out two specific sports massage techniques that can help repair this potentially crippling condition.
by Nicole Cutler, L.Ac.
As the largest and most vulnerable tendon in the body, the Achilles tendon joins the gastrocnemius and soleus muscles of the lower leg to the calcaneus. Accounting for 11 percent of all running injuries, inflammation of this tendon is appropriately named Achilles tendonitis. Although the slow healing time for Achilles tendonitis is due to scant localized vasculature, bodyworkers can play a key role in restoring this tendon to its pre-injured state.
Achilles Tendonitis
Providing the power in the push-off phase of the gait cycle, the Achilles tendon can become inflamed when the gastrocnemius is stressed. Although this tendon is strong, its lack of flexibility can easily lead to inflammation, tear or rupture. Achilles tendonitis can be acute or chronic. Signs of an inflamed Achilles tendon include:
· Tendon pain during exercise. Achilles pain gradually comes on with prolonged exercise and typically dissipates with rest.
· Swelling over the Achilles tendon.
· Redness over the skin.
· Sometimes, a creaking can be felt when pressing the fingers into the tendon while moving the foot.
Often more difficult to treat, chronic Achilles tendonitis may follow if the tendon is not treated properly or allowed to fully heal. When this problem becomes chronic, the pain typically disappears after a warm up, yet returns once the person stops training. If the Achilles is repeatedly stressed, the injury worsens until it is impossible to run. In addition to the symptoms of acute Achilles tendonitis, additional signs of a chronic problem include:
· Pain and stiffness in the Achilles tendon in the morning. This pain may be described as diffuse along the tendon rather than specific.
· There may nodules or lumps in the Achilles tendon, particularly 2 cm above the heel.
· Pain in the tendon when walking up a hill or up stairs.
Causes
An injury typically occurring from overuse, Achilles tendonitis usually comes on gradually. Ignoring the early warning signs of Achilles pain causes the symptoms to increase until activity is too painful to continue. In general, the more fatigued the calf muscles are, the more stressed the Achilles tendon, and the higher likelihood of tendonitis developing. The most commonly reported causes of Achilles tendonitis include:
1. Overuse – Excessive activity before adequate warm-up causes most overuse injuries.
2. Running Up Hills – Running up hills causes the Achilles tendon to stretch more than normal on every stride, which fatigues the tendon sooner than normal.
3. Overpronation – Overly pronating the foot increases the strain placed on the Achilles tendon. As the foot rolls in and flattens, the lower leg rotates inwards causing a twisting motion. This twist puts an additional strain on the Achilles.
4. Tight or Weak – A tightness or weakness in the calf musculature easily leads to fatigue. Once the gastrocnemius fatigues, it tightens and shortens, thus putting additional strain on the Achilles.
10 Solutions for Achilles Tendonitis
For best results, a sore or achy Achilles tendon responds best to immediate attention and rest. Left untreated, Achilles tendonitis could cause persistent pain or cause the tendon to rupture. A ruptured Achilles tendon may require surgery to correct the damage. Ten commonly advised solutions for treating Achilles tendonitis include:
1. Resting the calf muscles.
2. Applying cold therapy or ice to minimize inflammation.
3. Wearing a heel pad to raise the heel, thus taking some of the strain off the Achilles tendon.
4. Wearing arch support insoles or orthotics to prevent overpronation and improve foot biomechanics.
5. Taking anti-inflammatory medication.
6. Taping the back of the leg to support the Achilles.
7. Applying a plaster cast for more severe cases.
8. Applying ultrasound treatment to encourage the tendon to heal.
9. Administering sports massage to the lower extremities.
10. Strengthening the calf muscle to help reduce the stress on the Achilles tendon. Toe raises, balancing on the toes and wall stretching are useful exercises.
Whenever discussing approaches to Achilles tendonitis with clients, always emphasize avoiding excessive stretching. Taking this action has the potential to aggravate an already stressed Achilles.
Sports Massage
Two sports massage techniques put bodyworkers on the top of the list for Achilles tendonitis treatment: transverse friction massage and strain-counterstrain techniques.
Transverse friction massage is a massage technique that is often used for tendonitis. The massage strokes of transverse friction massage are deep and applied directly to the affected area, perpendicular to the direction of the tendon. When done properly, transverse friction massage can help reduce pain, improve blood flow to the surrounding area, and prevent or reduce the formation of scar tissue and adhesions in the connective tissue.
Another sports massage technique, applying strain-counterstrain on the calf muscles can unload the excessive stress these tightened or weakened muscles place on the Achilles. As published in the September 2006 edition of The Journal of the American Osteopathic Association, researchers found that applying strain-counterstrain techniques on the soleus of those with Achilles tendonitis produced a 23.1 percent decrease in localized stress. The investigators noted a similarly significant response when strain-counterstrain was applied to the lateral and medial heads of the gastrocnemius.
While early and persistent attention to this injury often results in a full recovery, making sure the original cause of the tendonitis is addressed is the only way to prevent its recurrence. In addition to tackling the reason for Achilles pain, most practitioners recommend some combination of the above ten solutions to help an inflamed Achilles heal. A massage therapist using strain-counterstrain and transverse friction massage techniques can play an important role in the timely healing of an inflamed Achilles tendon – and can even help prevent this injury from turning into a hard-to-treat chronic case of tendonitis.
Recommended Study:
Sports Massage
References:
Howell JN, et al., Stretch reflex and Hoffmann reflex responses to osteopathic manipulative treatment in subjects with Achilles tendonitis, The Journal of the American Osteopathic Association, September 2006.
http://altmedicine.about.com, Natural Remedies for Tendonitis, Cathy Wong, About, Inc., 2008.
http://sportsmedicine.about.com, Achilles Tendonitis, Elizabeth Quinn, About, Inc., 2008.
www.mayoclinic.com, Achilles Tendinitis, Mayo Foundation for Medical Education and Research, 2008.
www.sportsinjuryclinic.net, Achilles Tendonitis, Sports Injury Clinic, 2008.
Posted by Editors at 11:59 AM
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