Massage Professionals Article Archive

by Nicole Cutler, L.Ac.

Often forgotten by bodyworkers, strain counterstrain (SCS) is a positional release technique that is invaluable when working with clients experiencing acute muscular pain. Several professions have embraced SCS, and it is one of the first applications therapists can try to help someone with an extremely tender location that has a limited range of motion.

In the January 26, 2009 edition of ADVANCE for Physical
Therapists and PT Assistants, Tom Dalonzo-Baker, PT describes how this positional release technique helped his client. According to Dalonzo-Baker, a patient scheduled for disc herniation surgery in four days entered his clinic bent over backward in agonizing back pain. He knelt down and allowed her body to relax, bent backward, over his knee. While thinking of how to best help her, he noticed that the woman’s posture relaxed. After several minutes, the woman stood erect for the first time in three weeks.

Dalonzo-Baker postulates that positioning her body further into the restriction allowed her to stand upright. Moving away from the restriction is thought to reduce aberrant afferent impulses sent to the spinal cord – and characterize the value of strain counterstrain technique.

About SCS
Strain counterstrain is a manual massage technique for relieving musculoskeletal spasms and pain. A positional release technique, SCS was developed in 1981 by the osteopathic physician Dr. Lawrence Jones. It is a gentle and safe technique that relieves spinal or other joint pain by passively shortening the affected muscle areas.

Repetitive or acute strains can lead to the development of painful tender spots. Dr. Jones identified the most common tender points that result from an abnormal reflex or unnatural movement. SCS focuses on correcting abnormal neuromuscular reflexes by finding the client’s position of comfort and determining at what point his/her tenderness diminishes. SCS involves:

· Having the client hold his/her position of comfort for approximately 90 seconds

· Then, the client is slowly brought out of this position, allowing the body to reset its muscles to a normal level of tension

· SCS is well-tolerated because it positions the recipient opposite his/her restricted barrier and towards the position of greatest comfort

An Explanation
Various scientists have offered explanations as to why SCS is so effective. Written in the 1970s, Irwin Korr’s work on muscle spindles and facilitated segments provides a solid rationalization for SCS. According to Korr, the counterstrain point is on the opposite side of a strained or suddenly stretched joint, otherwise known as the over-shortened side. The physiology that actually occurs on this side is a sudden shortening followed by a rapid return to normal length. On the strained side, the muscle spindles are recruited to protect the rapidly lengthening muscle from damage, creating an immediate reflex contraction. This muscle can then get stuck in a functionally shortened position.

During an SCS session, the practitioner palpates to identify active tender points related to hypertonic musculature. When the appropriate position is held during SCS, the muscles gain strength and diminish in tenderness. The proprioceptor nerves register the changes in the position of the muscle and enable it to remain in this neutral position even when the force applied by the practitioner has been removed.

Applications
In addition to restoring range of motion, strain counterstrain can help alleviate pain and discomfort in muscles and joints. Some examples of when to consider SCS for a client include:

· Post-injury pain
· Whiplash
· For a child or elderly person in pain
· Neck and back pain
· Fibromyalgia

Learning the strain counterstrain technique better equips massage therapists to help their clients overcome different kinds of pain. Designed to correct traumatically induced aberrant reflex changes that hold a dysfunctional muscular pattern, SCS is an excellent first choice for dealing with extreme discomfort. As witnessed in Dalonzo-Baker’s client with back pain, finding someone’s most comfortable position can bring them the breakthrough relief they are hoping to find.

Recommended Study:
Fibromyalgia and Massage
Myofascial Release
Sports Massage

References:

http://www.articlecity.com/articles/health/article_5788.shtml, Strain Counter-Strain, Sharon Hopkins, Retrieved February 1, 2009, Icthus.net, October 2006.

http://www.chiroweb.com/mpacms/dc/article.php?id=9223, “Strain-Counterstrain, Marc Heller, DC, Retrieved February 1, 2009, Dynamic Chiropractic, June 2003.

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B758B-4KHC39W-4&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=e10aabfe6b671d7c5482f91319879702, Immediate effects of the strain/counterstrain technique in local pain evoked by tender points in the upper trapezius muscle, Albert Atienza Meseguer, et al, Retrieved February 1, 2009, Clinical Chiropractic, September 2006.

http://www.spine-health.com/treatment/physical-therapy/specific-manual-physical-therapy-techniques, Specific manual physical therapy techniques, Robert J. Daul, MPT, Retrieved February 1, 2009, Spine-health.com, 2009.

http://www.massagetherapy101.com/massage-techniques/strain-and-counter-strain.aspx, Strain / Counter Strain, Retrieved February 1, 2009, massagetherapy101.com, 2009.

Mosher, Nathaniel, DPT, PT, CSCS, Empowered Patients, ADVANCE for Physical Therapists and PT Assistants, January 26, 2009; 32-33.

by Linda Fehrs, LMT

Whether plastic surgery is utilized for health purposes or cosmetic reasons, the aftereffects are the same for everyone – pain, swelling, scarring, heightened anxiety and, at times, depression. In some cases, medication may be prescribed for the pain and anxiety. But there are also other options – options that can help reduce the dosage or length of time of drugs are used, as well as aid in the healing process.

An increasing number of plastic surgeons are looking at the feasibility of using massage therapy in both pre and postoperative situations, and either hiring a massage therapist as part of the staff or partnering with trained massage therapists in private practice. Some surgeons are even promoting massage therapy services as a part of an overall offering.

Reducing Anxiety and Stress
Prior to getting plastic surgery, the client often has anxiety or stress about the procedure. One of the primary benefits of massage is a reduction of stress. A plastic surgeon recommending or providing massage before surgery may market it as a luxurious bonus in a spa type setting or simply refer a client to a licensed massage therapist. Numerous studies over the years have shown that massage therapy increases the levels of endorphins and serotonin in the body, thus reducing anxiety and promoting relaxation. Massage also reduces certain hormone levels such as cortisol, which is responsible for increased stress.

Postoperative Benefits of Massage
· Eases Pain – The anticipated pain after plastic surgery may cause anxiety in people having the procedure. For the most part, the doctor will prescribe anti-pain medication for the days immediately following the procedure. Started a few weeks after surgery, massage has been shown to interfere with the pain receptor signals to the brain. Also, the use of contrast therapy (using alternating cold and warm packs) can ease the pain caused by swelling and the muscle tightness caused by the surgery.

· Reduces Swelling – The benefits of lymphatic drainage massage (LDM) techniques have long been known to reduce the edema caused by the aftereffects of mastectomies, which often require the removal of adjacent lymph nodes and cause a reduction in the flow of lymph fluids. LDM mimics the pulse and flow within the lymph system. It helps to move stagnant fluids out of interstitial body tissue and into lymphatic vessels, thus both reducing the edema and stimulating the immune system.

· Softens Skin and Reduces Scarring – Part of the body’s own healing process is to protect an injured site from further harm. The physiological process involved does not recognize that the injury or intrusion is from a surgeon’s scalpel or a mugger’s knife. Though the mind understands the difference between cosmetic enhancement and assault, the body only feels pain and an interruption of its normal processes, and seeks to recover. This results in an increased production of collagen fibers which, if over produced, form highly visible hypertrophic or keloid scars. Massage therapy done locally on newly healed scar tissue can reduce and soften this buildup of tough fibrous tissue. Collagen will soften using warmth resulting from touch therapies such as Swedish massage or localized cross friction techniques.

· Speeds Up Healing – Massage speeds up the overall healing process by helping to eliminate the buildup of toxins that occur after plastic surgery and increasing the circulation of blood to the area that brings nutrients to both the skin and its underlying layers of tissue. The body, in an attempt to protect itself against further injury from intrusion will, after surgery, withdraw blood from the area, retaining the life sustaining fluid for internal organs. This can lead to a deterioration of the affected tissue and a temporary deadening of nerve endings. By encouraging a healthier blood flow, massage can help to return nourishment and flexibility to the affected area. Massage therapy also helps build up the immune system, thus helping to speed up the overall healing process.

· Lifts Spirits – Between the postoperative pain, swelling and high expectations people have of plastic surgery, it is likely they will experience some depression. Massage therapy has, time and time again, shown itself to be beneficial in making people feel better about themselves.

Working With a Plastic Surgeon
If you are interested in working in conjunction with a plastic surgeon, make sure you brush up on your anatomy, physiology and pathology. You should also know the effects of drugs used before and after surgery, and how they may be affected by massage. Be familiar with medical terms and procedures and be aware of what can go wrong after surgery. Furthermore, it is important to keep an open and professional three-way communication with the surgeon, the client and yourself, including maintaining accurate intake and SOAP notes.

Precautions
Massage should not be part of postoperative treatment until the client gets clearance from the surgeon or primary care physician. Depending on the procedure done, massage may begin as early as a few days after surgery, or may have to wait until 3 to 4 weeks later. If there are stitches, massage will have to wait until they are removed.

Reconstructive surgery is sometimes performed after surgery to remove cancerous tumors or in mastectomies. Massage, which historically has been advised against in these circumstances, is beginning to gain recognition as a viable adjunct therapy. However, it is still advised not to use massage on active tumors, recent incisions or on patients undergoing radiation.

Whether a person has undergone plastic surgery for personal image enhancement or because of medical necessity, the integration of massage therapy to pre and postoperative care offers both psychological and physical benefits. For some, this may be the first time they are experiencing massage in a therapeutic setting. And who knows, they may become long-term clients!

Recommended Study:
Advanced Anatomy and Pathology
Advanced Anatomy and Physiology
Lymphatic Drainage Massage
Medical Errors
Pharmacology for Massage
Swedish Massage

References:

Eppley, Barry, MD. "Massage and Plastic Surgery at Ology Sp." 06 January 2008. Explore Plastic Surgery. 5 Mar 2009 http://exploreplasticsurgery.com/category/massage-therapy/.

French, Ramona Moody. Milady's Guide to Lymph Drainage Massage. Clifton Park, New York: Milady Publishing, 2004

Press Release, "Plastic Surgery Procedures Maintain Steady Growth in 2007." 25 March 2008. American Society of Plastic Surgeoss. 5 Mar 2009 http://plasticsurgery.org/Media/Press_Releases/Plastic Surgery_Procedures_Maintain_Steady_Growth_in_2007.html.

Pruitt, Elana. "Treating Your Health to a Massage." PlasticSurgery.com. 5 Mar 2009 http://www.plasticsurgery.com/microdermabrasion.treating-your-health-
to-a147.aspx.

Staff Writers, "Massage After Cosmetic Surgery - Are You a Good Candiate?." 23 August 2008. LocateADoc.com. 5 Mar 2009 http://www.locateadoc.com/articles/massage-after-cosmetic-surgery-are-
you-a-good-candidate-1457.html.

Stevens, Grant, MD. "Hypertrophic Scars and Keloids." 08 October 2002. Breast Health Online. 5 Mar 2009 http://www.breasthealthonline.org/cgi-bin/mwf/topic_show.pl?tid=46478.

by Nicole Cutler, L.Ac.

Dealing with chronic digestive problems is frustrating, especially when medical intervention offers little help. Affecting up to 55 million Americans, one of the more common chronic digestive problems is irritable bowel syndrome (IBS). Because it is so common, most bodyworkers will have at least one client suffering from IBS. In and of itself, relaxation-based massage can help IBS sufferers. However, several additional strategies for supporting bowel health and relieving symptoms helps massage therapists empower their clients with IBS.

About Irritable Bowel Syndrome
Previously known as spastic colon, approximately one in five American adults has IBS. While its symptoms are usually not as severe as the more serious intestinal diseases such as ulcerative colitis and Crohn’s disease, IBS can dramatically interfere with someone’s quality of life. Despite its prevalence, many people suffer silently because of the embarrassing symptoms, the most common of which are:

· Abdominal cramping
· Bloating
· Flatulence
· Diarrhea
· Constipation
· Alternating diarrhea and constipation
· Mucus in the stool

Although IBS does not injure the intestines or increase colon cancer risk, its symptoms can mask or be concurrent with other more serious diseases. Therefore, chronic bowel problems are always best evaluated by a physician prior to being labeled as IBS.

Experts do not agree on the origin of irritable bowel syndrome. Three proposed physiological causes for IBS are:

1. Muscular – Normally, the intestine walls’ muscles contract and relax in a coordinated rhythm to move food from the stomach through the intestinal tract. However, the intestines of someone with IBS tend towards a longer and stronger contraction time, resulting in cramping pain, gas, bloating and diarrhea. When the relaxing action of the intestine’s muscles dominates, the passage of food slows down and results in constipation.

2. Neurological – Since the nervous system regulates muscular contraction and bowel sensation, a neurological imbalance may be behind IBS. A typical reason for IBS pain is an enhanced sensitivity to the normal stretching of the intestines as food or gas makes their way through.

3. Hormonal – Since women are twice as likely to have IBS as men, some believe that hormones are a causative factor. Additionally, the symptoms of IBS are often worse during or surrounding a woman’s menses.

Massage Therapy Intervention
For a majority of sufferers, IBS symptoms are aggravated by certain foods and stress. However, most experts agree that stress and food sensitivities do not cause irritable bowel syndrome. Despite its unidentified origins, IBS can be controlled largely with dietary adjustments and stress management.

For massage therapists, helping clients release stress typically has a dramatic effect on lessening unwanted intestinal symptoms. For this reason, a traditional relaxation-based Swedish massage lessens IBS severity in many people. Additional suggestions for improving intestinal health include:

· Deep Breathing – Deep breathing can be taught during a massage session and should be routinely practiced by the client. Instead of breathing from the chest only, diaphragmatic breathing allows the belly to expand and contract fully, which helps relax local muscles fostering more normal bowel activity.

· Probiotics – Those with IBS may be overrun with symptom-causing bacteria. Found in yogurt and dietary supplements, probiotics are the good bacteria that occupy the intestines. For many sufferers, supplementing with probiotics improves the intestine’s bacterial balance, which ultimately eases symptoms.

· Heat – Because heat expands and thus relaxes muscles, applying a hot pack over cramping intestines often provides immediate pain relief. Additionally, heat’s ability to induce relaxation makes it a wise choice for preventing the stress buildup that typically precipitates an IBS attack. In addition to beginning a massage session with a hot pack on the lower belly, encourage your client to use one at home.

Because stress aggravates IBS, receiving regular relaxation-based massages typically reduces the frequency and severity of irritable bowel syndrome’s symptoms. However, giving your clients the tools to help themselves proves invaluable. By instructing people with IBS to practice a regular deep breathing routine, supply their intestines with good bacteria and apply heat to their lower abdomen, you can help your client gain control over their own intestinal health.

Recommended Study:
Advanced Anatomy and Physiology
Swedish Massage for Professionals

References:

http://www.massagemag.com/ExtraEdit/133/IBS.php, Stress Makes People Prone To Irritable Bowel Syndrome, Retrieved September 3, 2008, medicalnewstoday.com, 2008.

http://www.mayoclinic.com/health/irritable-bowel-syndrome/DS00106, Irritable Bowel Syndrome, Retrieved September 2, 2008, Mayo Foundation for Medical Education and Research, 2008.

http://www.ultimatewatermassage.com/herbal-heat-therapy/big-pack-heating-IBS.htm, Therapeutic Heat for Irritable Bowel Syndrome, Retrieved September 3, 2008, Ultimate Water Massage, 2008.

http://www.webmd.com/ibs/, Irritable Bowel Syndrome (IBS) Health Center, Retrieved September 2, 2008, WebMD LLC, 2008.

by Linda Fehrs, LMT

As a licensed massage therapist you may have chosen to go into private practice, become an independent contractor, be an employee or do a little of each over the past year. No matter what it is you have chosen you must deal with paying taxes.

It is never too early to begin organizing your paperwork and financial records. Ideally, you should keep track of your income and expenses on an ongoing basis throughout the year. Then, when tax time arrives, all you need to do is gather the information together and present it to your tax specialist. Or, if you are brave, dig into it yourself.

Helpful Hint: Keep a Spreadsheet
One of the easiest ways to keep track of your income and expenses is to prepare a simple spreadsheet. You can do this by hand using a simple ledger, or you can do it electronically by using a basic database program on the computer. Yet another option is to use preset software, where there is little setup involved and you merely have to enter the data as you go along. There are several software programs available created specifically for massage therapists, including Massage Office Professional made by Island Software and Customer Pro File made by Land Software. A key benefit of using the computer is that many programs allow you to automatically transfer the information to tax forms.

5 Frequently Asked Questions About Tax Obligations
With few exceptions the Internal Revenue Service (IRS) requires almost everyone to report their income and pay taxes, as well as pay into the Social Security System and Medicare programs. If you are an employee, this is done automatically through payroll deductions and, once a year, sometime between January 1 and April 15, you file an income tax return along with your W-2 forms and reconcile, with the IRS, the amount under or overpaid.

If you are self-employed or work as an independent contractor, you must take care of estimating and paying your own tax obligations, file them quarterly and make a final reconciliation at the end of the tax year, sometime prior to April 15. For the self-employed practitioner there are some basic rules to be aware of. Here are answers to some most frequently asked questions.

1. Who must file taxes and when?
· A person who works solely as an employee must file taxes once a year, on or before April 15.
· If you are self-employed and receive payment directly from clients, or if you are an independent contractor and receive IRS form 1099 at the end of the year, you should file estimated taxes quarterly and a tax return for the year prior to April 15.

2. When do I pay my taxes if I am self-employed?
· You must pay your estimated taxes quarterly if you had a tax liability the previous tax year, or if you expect to owe $1,000 or more in taxes for the current year. Failure to do so may result in interest and penalty payments being added to your tax obligation.

3. What forms are required?
· At the end of the tax year everyone will file either a 1040 or 1040-EZ form, all other forms are either attachments or supplements.
· Each quarter, if you are self-employed you must file a 1040-ES, along with payment for your estimated quarterly taxes.
· If you are employed you will receive a W-2 form at the end of the year.
· If you work as an independent contractor, anyone paying you $600 or more for the year must issue you a 1099 form in January of the following year.
· If you participate in bartering you may receive a 1099B form and must report that as income.
· Schedule SE is filed along with your 1040 and is a worksheet used to calculate your net earnings.
· Schedule C is a worksheet used to calculate the profit or loss of your business and must be filed along with your 1040 form. This is where you would list deductions such as advertising, office supplies and professional dues.
· Depending on your personal circumstance there may be other forms required, especially if you have income from investments.

4. How much must I earn before paying taxes?
· Amounts will differ depending on your expenses and allowable deductions.
· If you earn more than $400 in a year you are required to report that income. If you are working as an independent contractor, the employer will issue a 1099 if they have paid you more than $600 for the year. This means you could work independently for four or five companies with each of them paying you $300 and not issuing you a 1099. You, though, will have earned $1,200 – $1,500 and must claim that income.

5. What is new* for 2008?
· The amount allowable for Earned Income Credit (EIC) has increased. Even if you are single with no children you may now qualify. Many people do not realize they are eligible and lose out on this benefit.
· Income limits have increased with regard to certain retirement savings plans.
· Standard mileage rates have increased. For business use it is now 50 ½ cents per mile. It is 19 cents per mile for medical use and 14 cents per mile for charitable use of your car. The IRS has very specific standards as to how this is determined with regard to proof of usage and how it is calculated.
· You may be able to exclude as income part or all of the mortgage debt on a principal residence.

*Note: There is more that is new for 2008 as well as some expiring benefits. Those listed here are just a few you may be eligible for.

Don’t Delay
It is important to keep track of both your income and your expenses for the year on an ongoing basis. Waiting until a few days before the deadline will only create chaos and stress. It will also take valuable time away from your clients if you need to take time off to get your financial records in order.

Forms and detailed instructions are available through the IRS in their regional offices and at their website, or can be requested by phone or mail.

References:

Internal Revenue Service - United States Department of the Treasury. 18 Nov 2008 . 1-800-829-1040 (individuals) or 1-800-829-4933 (businesses)

Small Business Association. 18 Nov 2008 . 1-800-827-5722

by Linda Fehrs, LMT

Studies have shown that the lack of touch can lead to severe psychiatric or physical problems, and even death in infants. Among the elder population it can lead to depression, anxiety, low self-esteem and lethargy. Lack of caring touch can result in a diminishing quality of life for anyone. Babies cry out to us for touch, but the touch-deprived senior often remains silent. It is important for those in the bodyworking professions to reach out to those who perhaps need them the most.

A frail elder would be defined as someone requiring assistance in taking care of every day needs such as dressing, bathing and eating. They may not be able to move around freely on their own, perhaps needing a walker or wheelchair to assist in mobility. Often they are living with family members or reside in some kind of assisted living facility.

For the very frail client, any vigorous or deep massage is generally contraindicated. But there are also many modalities with a lighter touch that provide similar health benefits, as well as offer comfort and compassion to the recipient. For many frail elders a typical Swedish massage may be too stimulating, and care needs to be taken regarding the use of techniques that might influence the effects of medication. They may be taking medication for blood pressure, a blood thinner, insulin for diabetes or undergoing a regimen of chemotherapy. A thorough intake and evaluation is important in determining what techniques will be most beneficial to your client.

Less Invasive, Yet Effective Techniques
1. Cranial Sacral Therapy – is a gentle, non-invasive technique that uses a light touch to encourage the healthy movement of cerebrospinal fluid. This method of bodywork is used to reduce the negative effects of stress, enhance overall health and improve resistance to disease. It has also been shown to reduce problems associated with pain as well as some neurological dysfunctions, because of its affect on the brain and spinal cord.

2. Lymphatic Drainage – is used to stimulate the movement of lymph, which in turn helps to rid the body of inflammatory and toxic material. This technique uses a rhythmic, light touch to enhance the body’s own gentle pumping action within the lymphatic system. Lymphatic drainage massage helps to enhance the immune system as well as to reduce pain.

3. Polarity Therapy – is a bodywork technique that is based on basic principles of energy. The body is gently manipulated to rebalance the negative and positive energies within the body. Polarity therapy also encourages living in harmony with nature and includes recommendations of improving ones diet and exercise.

4. Reflexology – is a modality originally based on an ancient Chinese therapy. It involves the application of pressure to specific areas in the foot, hands and ears, which correspond to various parts of the body. The applied pressure to these reflex zones in turn stimulates body organs and relieves areas of energetic congestion. Reflexology is used to reduce pain, increase relaxation and stimulate circulation of blood and lymphatic fluids, and has been found to be useful in stress related illness and emotional disorders. Reflexology can also be used in circumstances where areas of the body are traumatized or diseased to the extent that direct touch is contraindicated.

5. Shiatsu – a light compression technique, similar to acupressure, was developed in Japan and uses traditional acupuncture points which help to encourage the healthy flow of life energy as well as restore balance in the body. Shiatsu uses traditional five-element Chinese medicine, which shows a relationship between the earth’s natural rhythms and the human body. The technique produces a sense of relaxation while stimulating blood and lymphatic flow. In turn, this helps with pain relief and the strengthening of the body’s resistance to disease and discomfort.

6. Therapeutic Touch – is a non-invasive form of energy work based on ancient energy healing methods. Used mostly by nurses, it is also used by other bodywork professionals who are trained to feel or sense energy imbalances in the client. The therapist uses a light touch or holds the hand above the body, with the client generally seated. Therapeutic Touch has been used in a variety of medical situations, including the care of premature infants. It is known to induce a state of relaxation within minutes.

Five Precautions
1. Hot Stone Massage – it might seem gentle enough, but for those who are on certain pain medications, or who suffer from the effects of diabetes, they are less sensitive to heat and pain and may not be able to respond appropriately. Make sure you are well trained in this modality before using it on a frail or elderly client.

2. Accommodating Special Needs – whether the massage is conducted in your office, a client’s home, an assisted living facility, a hospital or hospice, care needs to be taken to accommodate the special needs of the individual. Preparation in the way of extra bolsters or pillows, a blanket for added warmth or lubricants for dry or fragile skin is very important.

3. Slower Mobility – depending on the modality or techniques used, you may want to limit the massage session to no more than a half hour, and allow extra time before and after the session to allow for slower mobility. Intake may take longer, your client may need more time to get undressed or there may be problems with mobility, getting on and off the table or in and out of the office.

4. Special Contraindications – would be to never work in an area that has received radiation therapy or that has a tumor.

5. The Usual Precautions Are Also Advices – such as avoiding black and blue areas, varicose or other distended veins, areas of recent surgery, rashes, etc. And if your client has a pacemaker or other implanted device, make sure you get an okay from his/her physician.

At any age massage therapy can be a benefit, but for the frail elderly it ameliorates some of the inevitable physical discomfort and pain that accompanies growing older. It helps us improve their mobility as well. Getting a regular massage helps in the emotional aspects of their lives as well. It has been shown to reduce the feelings of isolation, fear, anxiety and depression perhaps because it offers a gentle, nurturing touch to those who may live a life alone without close family or friends.

Consider providing your services as a massage therapist to nursing homes, assisted care facilities, hospitals and hospice programs. You will find it is rewarding in more ways than words can express.

Recommended Study:
Cranial Sacral Fundamentals
Healing Energy and Touch
Lymphatic Drainage Massage
Polarity Therapy
Reflexology
Shiatsu Anma Therapy

Resources:

Catlin, LMT, Ann. "Serving Older Adults." MJT Summer 2008: 111-121.

Finch, Mary Ann. Care Through Touch. New York: Continuum, 1999.

Nelson, MFA, CMT, Dawn. Compassionate Touch: Hands-On Caregiving for the Elderly, the Ill and the Dying. Barrytown, New York: Station Hill Press, Inc., 1994.

Nelson, Dawn. From the Heart Through the Hands: The Power of Touch in Caregiving. Forres, Scotland: Findhorn Press, 2001.

Rose, Mary Kathleen. "Comfort Touch: Nurturing Acupressure Massage for the Elderly and Ill." December/January 2004. Associated Bodywork and Massage Professionals. 14 Oct 2008 .

by Nicole Cutler, L.Ac.

Therapists can learn to use pure essential oils safely and successfully through a National Organization for Holistic Aromatherapy (NAHA) certified program of study. However, some aromatherapy information typically skimmed over and forgotten about is this: most pure essential oils don’t last forever. There are several things anyone purchasing, storing and using pure essential oils must know for aromatherapy to accomplish what it is capable of.

Luckily, pure essential oils do not go rancid. However, they do degrade through the process of oxidation. Heat, sunlight and air can all break down the chemical structure of essential oils. Additionally, the complex and varying chemistry of pure essential oils means that each oil has a different rate of degradation. Although there are too many variables to accurately predict how long an essential oil will be at its most potent, there are several tips that will help you determine your oil’s lifespan.

Buy Carefully
You can only control the environment of your oils after you purchase them. Thus, knowing what to look for when buying essential oils can help ensure their longevity.

1. Dark colored glass; no dropper – Dark colored glass helps protect the oils from the oxidative properties of ultraviolet light. Avoid purchasing essential oils that are stored in bottles with a rubber dropper incorporated into its cap. Pure essential oils can turn rubber into gum and quickly ruin the oil.

2. Evaluate your supplier – The closer to its distillation date, the more potent an essential oil will be. Suppliers specializing in aromatherapy typically have a high turnover of oils, ensuring a fresher purchase. When purchased from a store, they may have been sitting on the shelf for a long time. If you do buy from a store, make sure they are not displayed under hot lighting or in direct sunlight, and check that they don’t have a layer of dust on their caps.

Store Carefully
Once you have the essential oils, the steps you take to properly store them will either make them last long or render them useless.

3. Know their age – Although you are not likely to know the date an essential oil was first distilled, you can keep track of how long you have owned them. Devise a way to mark your oil with the date of purchase so that you can be alerted to when one might be approaching the end of its life.

4. Minimize oxidation – Since heat and light oxidize essential oils, always store essential oils inside dark glass bottles in a cool, dark place. In addition, keep your oils in the smallest possible sized bottles to reduce the amount of empty space in the container. Because the empty space in a bottle is occupied by air, more empty space hastens the rate of oxidation. For this reason, experts advise rebottling oils into smaller bottles as they are used.

Check your Stock
Again, based on the substantial number of variables in determining the viability of a pure essential oil, there are no guarantees of how long it will last. Some experts tout that well cared for oils will last for one to two years, while others claim this time frame is longer. However, terpene-rich oils such as citrus and some coniferous essential oils oxidize quicker than other oils, while the thicker viscosity essential oils, including Patchouli, Vetiver and Sandalwood mellow and improve with age. The only surefire way to know if your oil is still viable is to check it yourself.

5. Look and smell – Through a little bit of effort, you should be able to detect an essential oil that has passed its prime. Look carefully to see if your oil appears cloudy or thick, both of which indicate oxidation. Since drastic changes in odor also indicate oxidation, smell your oils to see if they have lost their characteristic odor or if they smell acidic. In either case, the therapeutic value has diminished, requiring its proper disposal.

Although the skilled application of essential oils can dramatically improve a person’s health, they must be suitably maintained to do so. Along with the knowledge gained through a NAHA certified course, careful purchasing, storage and inspection of pure essential oils allows bodyworkers to fully appreciate the therapeutic value of aromatherapy.

Recommended Study:
Aromatherapy Essentials

References:

http://www.aromaticsinternational.com/shelf-life.php, Shelf Life and Storage, Retrieved July 9, 2008, Aromatics International, 2008.

http://www.aromaweb.com/articles/essentialoilshelflife.asp, Essential Oil Shelf Life, Retrieved July 9, 2008, AromaWeb LLC, 2008.

http://www.aromaweb.com/articles/oldessentialoils.asp, How to Use up those Aging Essential Oils, Retrieved July 9, 2008, AromaWeb LLC, 2008.

http://www.aromaweb.com/articles/storing.asp, Storing Your Essential Oils, Retrieved July 9, 2008, AromaWeb LLC, 2008.

http://www.quinessence.com/essential_oil_storage_methods.htm, Storing your essential oils, Retrieved July 9, 2008, Quinessence Aromatherapy Ltd., 2008.

http://www.quinessence.com/shelf_life.htm, Shelf Life of Aromatherapy Oils, Retrieved July 9, 2008, Quinessence Aromatherapy Ltd., 2008.

by Nicole Cutler, L.Ac.

Most massage therapists are knowledgeable about the range of benefits possible from their work. While the ability to deliver pain relief, induce relaxation and assist with healing injuries are some of the well-known strengths of massage therapy, the internal organs and tissues can also benefit. Although most people assume massage primarily influences muscles, tendons and fascia, research from Japan proves yet another way massage therapy supports a healthy body. In addition to medications, dietary changes and regular exercise, Japanese researchers have shown that massage therapy also has a place among approaches to reduce cholesterol.

About Cholesterol
A natural component of the body’s cells and blood, cholesterol is a soft waxy fat. An essential part of a healthy body, excessive amounts of cholesterol in the blood increase a person’s risk for cardiovascular disease, which can lead to stroke or heart attack. With too much cholesterol circulating in the blood, sticky clumps of plaque can attach along the artery walls, eventually capable of obstructing or blocking the flow of blood to the brain, heart and other organs. Heredity appears to make some more susceptible to high blood cholesterol, but increasingly sedentary lifestyles combined with diets high in saturated fats appear to be the main culprits.

The ranges and corresponding risk levels for total blood cholesterol are:

· Normal = 140 – 200 mg/dL

· Moderate Risk = 200 – 240 mg/dL

· High Risk = over 240 mg/dL

In general, total cholesterol is composed of three types of lipids: low density lipoproteins (LDL), high density lipoproteins (HDL) and triglycerides (TRI). Often referred to as the protective kind of cholesterol, HDL differs from the other two types of lipids because high levels of HDL are desirable. These three types of fat have a complex relationship and the level of each one is important when determining a person’s state of health. In general, high cholesterol is characterized by elevated LDL, normal or low levels of HDL and normal or elevated TRI.

Keeping Cholesterol Levels Healthy
The causes of high cholesterol are so variable; there are few health conditions or poor lifestyle habits that could possibly be excluded. Physicians usually advise the following adjustments to help bring cholesterol levels back to a balanced state:

1. Weight Reduction – If overweight, even small amounts of weight loss can shift cholesterol ratios to reduce total cholesterol. Weight loss is typically accompanied by lowered triglycerides and increased HDL levels.

2. Exercise – Regular physical activity by itself both reduces the risk of death from heart disease and enhances the effects of diet on LDL cholesterol levels. Moderate exercise three to five times per week can help lower blood pressure, promote weight loss in overweight individuals, reduce LDL and triglyceride levels and produce favorable levels of HDL.

3. Diet – Instead of foods high in calories, saturated fat, trans fatty acids and cholesterol, eating foods high in fiber, rich in antioxidants and abundant in Omega-3 fatty acids help reduce total cholesterol.

4. Stop Smoking – In addition to increasing blood pressure, decreasing exercise tolerance and increasing the tendency for the blood to clot, tobacco use also lowers the favorable kind of cholesterol, HDL.

Besides these lifestyle changes, physicians commonly prescribe medications to those with high cholesterol to prevent the accompanying risks. However, research from Japan demonstrates massage may be another valuable addition to help reduce cholesterol.

The Study
In an effort to evaluate the effects of massage on anxiety, the immune system and blood cholesterol levels, Japanese researchers examined participants receiving Anma massage before and after a 25-minute session. Results of the study compared baseline measures to post-massage measures, and there were significant improvement in all areas. As determined by blood tests, participants had lower total cholesterol levels after receiving Anma massage.

By focusing on the entire body, the subjects received a fully clothed Anma massage that combined pressure, friction and touch with deep tissue bodywork. The practitioners used the following techniques: effleurage, kneading with whole hands and kneading with thumbs along the muscle. Each massage followed a specific order, beginning with the head and neck, then moving to the shoulders, back and hips, upper limbs and the lower limbs. Study participants were asked to let the massage therapist know the most comfortable level of pressure.

An Explanation
Although the researchers did not propose a mechanism by which massage reduces total cholesterol, there is a reasonable explanation. Massage therapy’s relaxation of the autonomic nervous system is likely behind the seemingly miraculous effect of massage over cholesterol.

When stressed, a person’s internal body chemistry changes. As part of the autonomic nervous system’s fight or flight mechanism, one of those changes involves a release of cholesterol into the bloodstream. Thus, repeated life stressors keep the autonomic system active and continually flood the blood with cholesterol. Through the relaxation effect, massage can actually end the fight or flight response. By stopping the autonomic nervous system from pumping cholesterol into circulation, a person’s cholesterol level and subsequent risk for heart disease drops.

According to the American Heart Association, an estimated 106.7 million adults in the United States have total blood cholesterol values of 200 mg/dL and higher. To help bring their cholesterol back to a healthy range, lifestyle changes and medications are typically combined. Likely a result of the autonomic nervous system’s reaction to massage, Japanese researchers have supplied proof that massage therapy is a viable option for reducing high cholesterol.

Recommended Study:
Shiatsu Anma Therapy

References:

http://www.americanheart.org/presenter.jhtml?identifier=4506, Cholesterol Statistics, Retrieved January 2, 2009, American Heart Association, 2009.

http://www.americanheart.org/presenter.jhtml?identifier=4545, Cigarette Smoking and Cardiovascular Disease, Retrieved January 2, 2009, American Heart Association, 2009.

http://www.innerworksmassage.com/cholesterol.html, Putting Cholesterol in its Proper Place, Jane Christ, Retrieved December 30, 2008, b.savvy magazine, February/March 2004.

http://www.jstage.jst.go.jp/article/jcam/2/1/59/_pdf, The Effects of Massage Therapy on the Immune, Hematological and Psychological State of Adult Subjects, Hiroko Kuriyama, et al, Retrieved December 31, 2008, Japanese Journal of Complementary and Alternative Medicine, 2005.

http://www.massagemag.com/News/massage-news.php?id=4909&catid=238&title=research-exclusive-massage-boosts-mood-immune-function-and-relaxation, Research Exclusive: Massage Boosts Mood, Immune Function and Relaxation, Retrieved December 29, 2008, Massage Magazine, December 2008.

http://www.umm.edu/altmed/articles/hypercholesterolemia-000084.htm, Hypercholesterolemia, Retrieved December 29, 2008, University of Maryland Medical Center, 2009.