Massage Professionals Article Archive

by Nicole Cutler, L.Ac.

For decades, athletes of all calibers and disciplines have been reaping the benefits of massage before, during and after sporting events. Up until now, the success of sports massage had been largely anecdotal, with a minimal amount of research conducted on this practice. However, a published trial from Japan demonstrates that petrissage has a valid place in the arena of sports medicine.

Sports enthusiasts wishing to improve performance and increase their competitive edge typically adopt a training regimen to enhance skill, strength, stamina, suppleness and speed. Regardless of which sport an athlete pursues, this goal always requires an increase in training levels, subjecting the body to gradual overuse. Without careful attention to cross training, this overuse almost always creates problems and imbalances in the body's soft tissues. If allowed to progress, these imbalances will hinder the athlete's performance and increase his/her susceptibility to serious injury.

Cycling
Often learning how to ride a bicycle when young, people enjoy bicycling for many reasons, namely transportation, recreation and competition. Competitive cycling began in the 1800s and has flourished into a favorite sport worldwide. With races spanning a few miles to thousands of miles, competitive cyclists must be very disciplined when training to succeed in their sport.

Requiring extended, high-power physiological demands on the body, cycling commands a relatively stationary trunk and highly active lower extremities - for potentially long periods of time. To prevent fatigue and improve performance, a great deal of oxygen is needed by the lower leg muscles during a cycling competition. For these reasons, the use of performance enhancing drugs is widespread in cycling, especially after the scandal that shook the Tour de France in 1998 and resulted in the expulsion of one of the leading teams. Cyclists desiring a legal and natural approach for enhancing the oxygenation of their limbs often turn to sports massage therapists for oxygenation of their leg muscles.

Petrissage
Belonging to any sports massage therapist's repertoire, petrissage is a powerful technique to mobilize circulation and stretch fibers deep within the targeted musculature. Often involving kneading, pressing, rolling and squeezing, petrissage moves muscles over bones and is reputed to increase the size and strength of the muscle.

The Study
Although the study published in the April 2008 edition of the British Journal of Sports Medicine focuses on cyclists, the results can be assumed for any other physically demanding sport. To determine if the sports massage technique of petrissage could be scientifically proven to influence localized circulation, Japanese researchers studied its effect between bouts of intensive cycling. Lactic acid in the blood, muscle stiffness and perceived lower limb fatigue was evaluated in cycling subjects who received a ten-minute petrissage massage and compared with cycling subjects who simply rested between intervals. The investigators concluded that petrissage improved pedaling performance, improved recovery from muscle stiffness and reduced perceived lower limb fatigue.

Any logical assessment of petrissage's effect on a fatigued muscle would condone its use. However, having the actual proof of its benefits to an athlete will bolster the widespread acceptance and use of this sports massage technique. By documenting that petrissage increases muscle strength and reduces fatigue under demanding circumstances, more and more athletic organizations will be looking to include this legal, substance-free approach into their training programs.

Recommended Study:
Sports Massage

References:

http://everythingbicycling.co.za, The Benefits of Sports Massage, Everything Bicycling, 2008.

Ogai R, et al., Effects of petrissage massage on fatigue and exercise performance following intensive cycle pedaling, British Journal of Sports Medicine, April 2008.

Wine, Kurashova Zhenya, Al Devereaux, Russian Sports Massage and Swimming Injuries, Part 2, Massage & Bodywork, February/March 2002.

www.brittanica.com, Cycling, Encyclopedia Britannica Inc., 2008.

www.enotalone.com, The Massage Techniques, Elaine Stillerman, eNotalone.com, 2008.

www.johnforester.com, The Physiology and Technique of Hard Riding, "Effective Cycling", John Forester, 2003.

www.positivehealth.com, Sports Massage - A Therapy for All, Wrio Russell, Positive Health Publications, Ltd., 2008.

by Nicole Cutler, L.Ac.

As just one of the many ways people express themselves and their individual sense of style, piercings have been popular for centuries. The trend continues today, with a significant percentage of young people adorning themselves with body piercings. Since massage therapists are likely to encounter clients with this kind of jewelry, they should know about the potential issues that could present while working with someone sporting a body piercing.

About Body Piercing
In general, piercings involve a hollow needle being passed through a body part followed by the insertion of jewelry into the newly formed hole. Although some pockets of society are slow to accept this practice, body piercings have historical traditions of identifying royalty, portraying courage and improving virility. In ancient Egypt, pharaohs pierced their navels as a rite of passage and Roman soldiers pierced their nipples to show their manhood.

The piercing heals when scar tissue forms a tunnel around the jewelry. Depending on the location of the piercing, the healing process can take anywhere from four weeks to a year. The following are average healing time estimates based on the area that is pierced:

· Cheek: 4 to 5 months
· Ear Cartilage: 4 months to 1 year
· Ear Lobe: 6 to 8 weeks
· Eyebrow: 6 to 8 weeks
· Genitalia: 4 weeks to 6 months
· Lip: 2 to 3 months
· Nasal Septum: 6 to 8 months
· Navel: 4 months to 1 year
· Nipple : 3 - 6 months
· Nostril: 2 to 4 months

This general guide can be helpful to massage therapists who have clients insisting that their relatively new piercing is fully healed. For example, a wound from a 2 month-old navel piercing is likely to still be open and susceptible to infection.

Piercing Problem Prevalence
Known as a time where someone can explore his/her freedom and experiment with image, many university students receive body piercings. According to a 2001 Pace University survey, 51 percent of undergraduates had a body piercing and, of those, 17 percent experienced medical complications from the piercing. With pierced navels outpacing other body parts as prone to infection, the complications most reported included:

· Bleeding
· Tissue trauma
· Bacterial infections

Despite the high rate of complications from piercings, this practice remains prevalent among undergraduate university students.

Relating to Massage Therapists
Piercings may appear to be a relatively innocuous body adornment. However, there are several reasons why massage therapists should know if their clients are pierced, where it is, how long ago the procedure was performed and if there are any problems with it.

According to Ruth Werner, LMP, NCTMB in the December 2008 edition of Massage Today, the guidelines for massage in the context of piercings are clear, "New piercings involve injured skin and must be locally avoided until the lesion has scarred over. On the other hand, older piercings pose no contraindications, and the jewelry can be removed to make massage more effective whenever necessary." In addition to performing massage in an area with an unhealed piercing, some additional cautions for bodyworkers include:

1. Navel piercing - Laying prone on the massage table can be uncomfortable for someone with a pierced navel that is not completely healed or is showing any degree of infection, inflammation, pain or redness.

2. Infection - If there are any signs of an infection at a piercing site, circulatory massage could spread the infection and is therefore contraindicated. Similar to any other type of skin infection, symptoms would include fever, pain, oozing greenish pus, swelling and redness. Additionally, Universal Precautions must be followed for any clients with these symptoms.

3. Sharp or protruding edges - Regardless of the piercing's location, jewelry that has a sharp or protruding edge could easily catch on the sheet or drape, or get stuck in the table when a client changes position. A piercing that gets caught on something has the potential of accidentally getting ripped out of the skin.

4. Know where it is - While no therapist would perform work directly on a pierced body part, therapists massaging a clothed client may not know what is underneath the material. Even if it is fully healed, many types of massage on a piercing are sure to cause irritation and possibly pain.

Especially prevalent in the young adult population, piercings are extremely common - and their location is not always obvious. By taking an extra moment to inquire about piercings - where they are, if there is any discomfort, how long they have been there and if there is any chance of it getting snagged on your linens or table - therapists are going the extra mile to assure their client's health, safety and comfort.

References:

http://media.www.jhunewsletter.com/media/storage/paper932/news/2004/02/27/Science/Teens.Require.Surgery.After.Piercing.Infections-2245500.shtml, Teens require surgery after piercing infections, Emily Nalven, Retrieved January 18, 2009, The Johns Hopkins News-Letter, February 2004.

http://www.drvenessa.com/wordpress/, Body Piercing: Hip or Health Risk?, Dr. Sally Byrd, Retrieved January 18, 2009, WhatSallySays.com, 2009.

http://www.bodyjewelleryshop.com/body_piercing_information/location_types/, Body Piercing Types, Retrieved January 18, 2009, BodyJerwelleryShop.com, 209.

http://www.healingtherapies.info/navel_piercing.htm, Navel Piercings & Multiple Sclerosis or Chronic Disease?, Laurance Johnston, PhD, Retrieved January 18, 2009, healingtherapies.info, 2009.

http://www.massagetherapy.com/articles/index.php/article_id/706, Piercings May Lead to Dentures, Lara Evans Bracciante, Retrieved January 17, 2009, Massage & Bodywork, April/May 2004.

http://www.massagetoday.com/mpacms/mt/article.php?id=13905, Body Art: Tattoos and Piercings, Ruth Werner, LMP, NCTMB, Retrieved January 17, 2009, Massage Today, December 2008.

http://www.nationalledger.com/cgi-bin/artman/exec/view.cgi?archive=26&num=21066, Body Piercings Warning: Sexual Studs and Health, Tina Johnson, Retrieved January 18, 2009, The National Ledger LLC, June 2008.

http://www.ncbi.nlm.nih.gov/pubmed/11794454, Prevalence of body art (body piercing and tattooing) in university undergraduates and incidence of medical complications, Mayers LB, et al, Retrieved January 18, 2009, Mayo Clinic Proceedings, January 2002.

http://www.ncbi.nlm.nih.gov/pubmed/18207100?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=1&log$=relatedarticles&logdbfrom=pubmed, Body art (body piercing and tattooing) among undergraduate university students: "then and now", Mayers LB, et al, Retrieved January 18, 2009, The Journal of Adolescent Health, February 2008.

http://www.pamf.org/teen/health/bodyart/piercing.html, Piercing, Irene Lin, MD, Retrieved January 18, 2009, Palo Alto Medical Foundation, 2009.

by Nicole Cutler, L.Ac.

A chronic disease of the airways that makes breathing difficult, people with asthma often have trouble getting sufficient amounts of oxygen into their lungs. While modern medicine has produced incredible improvements in asthma symptom treatments, its inadequacy is apparent in the numbers of people still struggling to breathe. By studying and administering bodywork based on Traditional Chinese Medicine (TCM), therapists have an additional tool for improving their asthmatic clients' respiratory health.

Asthma Prevalence
Affecting approximately 10 percent of children in the United States, 22 million Americans and causing nearly two million emergency room visits every year, asthma is a serious disease. As the most common chronic condition among children in the United States, massage therapists are highly likely to see clients who are living with asthma.

Asthma Characteristics
An involuntary and absolutely mandatory bodily function, many of us take breathing for granted. In contrast, people living with asthma are typically grateful for every step closer towards relaxed and easy breathing. The following are three prominent issues that asthmatics must contend with:

1. Obstruction - During normal breathing, the bands of muscle surrounding the airways are relaxed, allowing air to move freely. With asthma, allergy-causing substances and environmental triggers cause tightening of these bands, restricting the free flow of air. In addition to causing a person to feel short of breath, the air that moves through these tightened airways causes a whistling sound known as wheezing. Fortunately, this airway narrowing is reversible, a feature that distinguishes asthma from other lung diseases such as bronchitis or emphysema.

2. Inflammation - Contributing to the long-term damage that asthma can cause to the lungs, many people with asthma typically have inflamed, red and swollen bronchial tubes. This explains why physicians almost always address bronchial inflammation as part of an asthma management program.

3. Irritability - The airways of people with asthma are extremely sensitive and irritable. Asthmatics' airways tend to overreact and narrow due to even the slightest triggers such as pollen, animal dander, dust or fumes.

Allergies, chronic bronchiole infection and hyperirritability of the airway tubes are the most common causes of asthma.

Traditional Chinese Medicine
Originating in China, Traditional Chinese Medicine (TCM) is a holistic medical system combining acupuncture, Chinese herbs, nutrition, massage and movement exercises (known as Tai Chi or Qi Gong) to bring the body into balance. Although practitioners of TCM have been treating asthma for thousands of years, it only became globally recognized in the late 1970s. This recognition occurred in 1979 when the World Health Organization listed respiratory tract diseases, including asthma and bronchitis, as conditions benefited by acupuncture, one of the divisions of TCM. Although the majority of research touting the effectiveness of TCM focuses on acupuncture and Chinese herbs, TCM based-massage is steadily gaining ground.

Acupressure Study
A prospective, randomized study that involved eight weeks of treatment at Chang Gung Memorial Hospital in Taiwan included acupressure (a style of massage based on TCM) to evaluate ways for improving asthma symptoms. In this published study, adult patients with chronic asthma were given either:

· acupuncture with standard treatment
· acupressure with standard treatment
· standard treatment alone

By using several scales to evaluate respiratory symptoms, the researchers concluded that both acupressure and acupuncture significantly improved the quality of life in patients with chronic asthma on medical treatment.

Acupressure and Asthma Attacks
Similar to Western medicine's treatment of asthma, TCM theory differentiates between asthma attacks and the periods between attacks. During an attack, the situation is considered to be an acute or excessive condition. Between attacks, the body is considered to be in a chronic or deficient condition:

· Excessive - The objective of a TCM practitioner during an attack is to disperse the excess and stop the attack. Asthma attacks are characterized by wind, which combines with a cold or heat pathogen that lodges in the bronchi and causes bronchospasms. Since bronchospasms result from over-stimulation of the parasympathetic nervous system, acupressure points known to calm the spirit are used because they relax the parasympathetic nervous system.

While point suggestions for an excessive condition include Conception Vessel 17, Pericardium 6, Heart 7, Spleen 6, Liver 3, Lung 10 and Ear Sympathetic - prolonged attacks that don't respond to bronchodilators are a medical emergency! A bodyworker with a client having an asthma attack who is not relieved by his/her medications should only consider acupressure while en route to a hospital or while waiting for an ambulance.

· Deficient - Since TCM scholars claim that the lung and kidney energies combine forces to produce respiration, a weakness in either of these organ systems can contribute to asthma. Although difficulty upon inspiration is indicative of a kidney energy weakness and difficulty upon expiration is indicative of a lung energy weakness, tonifying both of these organ systems helps those with asthma.

Point suggestions for tonifying a deficient condition include Kidney 27, Lung 1, Lung 7, Bladder 13, Bladder 23, Stomach 36, Stomach 40, Kidney 3 and the extra point Ding Chuan. In addition, some of the points used during an attack are also beneficial in between attacks. These include Conception Vessel 17, Pericardium 6, Liver 3 and Lung 10.

As the number of people managing asthma continues to rise, practitioners who can help reduce symptom severity become increasingly in demand. When knowledgeable about the pathology of asthma and in possession of the skills that encourage relaxed and easy breathing, a massage therapist can be a major factor in improving the quality of their asthmatic clients' lives.

Recommended Study:
Advanced Anatomy and Pathology
Shiatsu Anma Therapy

References:

Field, T. et al., Children with asthma have improved pulmonary functions after massage therapy, The Journal of Pediatrics, May 1998.

Maa, SH, et al, Effect of acupuncture or acupressure on quality of life of patients with chronic obstructive asthma: a pilot study, Journal of Complementary and Alternative Medicine, October 2003.

www.acupuncture.com, Asthma and Chinese Medicine, Qineng Tan, L.Ac., PhD, OMD, Cyber Legend Ltd., 2008.

www.shiatsu.org, Shiatsu and Asthma, Nicola Pooley, Philip Harris, 2008.

www.tcmpage.com, Acupuncture for Asthma, Wei Liu, TCMD, MPH, L.Ac, Changzhen Gong, PhD, MS, 2008.

www.webmd.com, What is Asthma?, WebMD, LLC, 2008.

by Linda Fehrs, LMT

"Table linens" - For most people, the term conjures up images of an elegantly appointed dinner table. But for massage therapists, it refers to the collective term used when referring to sheets, face cradle covers, bolster covers and pillowcases used on massage tables. The table linens you choose will reflect who you are as a massage practitioner, and knowing more about what is available will help you to make wise choices.

Selecting Massage Linens: 5 Popular Choices
There are many considerations in choosing the fabric of massage linens. Not only is price important, but also the feel of the material and ease of care needs to be taken into consideration. Due to the high price and labor-intensive manufacturing involved with making linen (which is made from flax), the fabric is rarely, if ever, used in a massage practice. Though, it may still be used as a luxury sheeting material. Fortunately there are several other practical options.

1. Cotton - Cotton is perhaps the most popular and economical of fabrics available. It feels soft and cool to the skin. The downside is that it wears out relatively quickly and can be difficult to clean, requiring stronger detergents and bleach which can ultimately damage the fiber. Non-organic cotton also requires a lot of fertilization, pesticides and insecticides to grow.

2. Cotton/Synthetic Blend - The most well-known cotton blend is cotton/ polyester. While not quite as soft as pure cotton, they are more durable and tend to be easier to clean.

3. Bamboo - Although bamboo has been around for a very long time, bamboo sheets are relatively new. The fabric itself has a soft, silky feel. Bamboo is an environmentally friendly and sustainable crop, which grows faster and uses less space than cotton crops. Japanese studies on the fabric show that bamboo's mildly antibiotic qualities are still viable after 50 washes.

4. Hemp - Every industrialized country in the world grows hemp commercially, except the United States. This means that while the manufacturing of sheets may take place in the U.S., the raw hemp itself must be imported, thus increasing the price. It is similar to bamboo in that it needs no pesticides, insecticides or fertilizers to grow. It is much stronger than cotton and, for that reason, was once used almost exclusively in the ropes used for mooring ships.

5. Soy - Perhaps less known for its use in the making of linens, the fibers are derived from the discarded hulls of soybeans used for producing soybean oil. Unlike the other more well-known natural fabrics, items made from soy have a slight stretchy quality to them.

Bamboo, hemp and soy have natural antibiotic qualities and are highly absorbent. They are stronger and more resistant to insect infestation than cotton and can withstand the rigors of repeated washings. They can all be made into a smooth fabric, flannel or jersey knit and can be found in various colors and prints to match your office décor. As an alternative to cotton/polyester blend, some manufactures are now producing fabrics that offer the best of old and new options such as cotton and bamboo or hemp, and a bamboo/soy combination.

Caring for Massage Linens: 12 Tips
There is no getting around it. If you have a massage practice and you have clients every day, you will be washing sheets every day as well. Here are some tips to get you through the process:

1. Wash newly purchased linens before using them. Manufacturers often use toxic additives in the final process that need to be washed out.

2. Never use a sheet set for more than one client. Wash after each use.

3. Wash sheets and other linens within 24 hours of use. If you wait longer the oils and other substances will set in and be much harder to get out.

4. Using water dispersible oils and crèmes as massage lubricants will make stain removal easier.

5. Washing sheets in warm water and rinsing in cold water will not only save energy, it also helps sheets to last longer. Hot water and a hot dryer will set in oil stains and make them smell like a fast food restaurant.

6. Unless you work in a hospital setting, bleach is not needed to wash sheets. Warm water and detergent is enough to kill most common germs and bacteria. Bleach is ineffective in removing oil stains and shortens the lifespan of fabric. If you have a septic system, using excessive amounts of bleach will damage it. Try using a soap with tea tree oil added instead.

7. Use only unscented detergent that is free of chemical additives.

8. Rather than using fabric softener, which can cause allergic reactions, add ¼ cup of vinegar to the final rinse. Vinegar helps to eliminate odors, reduces lint, brightens colors and removes residual detergent. And, once dry, it leaves no vinegary smell.

9. Presoak heavily soiled linens before washing. You can use commercially available de-greasers, stain removers, borax or even baking soda.

10. To remove set-in oil from sheets, trying washing in automatic dishwasher detergent. It is slightly abrasive and made to dissolve grease. Do this only if it is a newly set stain and not often, as it greatly reduces the lifespan of sheets. (Note: Do not use the liquid soap you hand wash dishes with; they have additives that make an overabundance of suds.)

11. Reduce the load on your dryer and hang sheets outside in nice weather. The sun and air offer a natural solution to whitening and freshening sheets. If you must use the dryer, toss in three or four clean tennis balls, as this will reduce drying time and lessen wrinkling.

12. If you have a large number of clients or a busy multi-practitioner office, you may want to look into the feasibility of utilizing a reputable laundry service. The good thing is they usually supply the sheets. The bad thing is you may not have a wide selection of materials or colors to choose from. The sheets will most likely be a white cotton/poly blend.

If you are buying a new washing machine, go for a large capacity front loader. They use less water and clean more effectively than top loaders.

Depending on the fabric and quality, a sheet set can be as inexpensive as just under $20, or as costly as $100 or more. Look for sales and special offers for the best deals. It is generally advised that you have enough sheet sets on hand to last for two days' worth of clients. For example, if you intend to see four clients per day, then eight sets of sheets would be adequate. More sheets can be added as needed and older sets replaced as they wear out.

What type of fabric used and how it is cared for, in your clients' eyes, may be a reflection of how you also care for them. It indicates that you, the massage therapist, are concerned about both their comfort and health.

Resources:

Carter, Meghan. "10 Sheet Washing Tips Everyone Should Know." Washing Bed Sheets. AsktheDecorator.com. 17 Mar 2009 http://www.askthedecorator.com/Washing_Bed_Sheets.shtml.

Jones, Rebecca. "Choosing and Caring For Linens." Massage & Bodywork January/February 2009: 94-97.

"Laundry Cleaning Tips." StartACleaningBusiness.com. 17 Mar 2009 http://www.start-cleaning-business.com/laundry-cleaning-tips.html.

"Properties of Bamboo Fabric." Bamboo Fabric Store. 17 Mar 2009 http://www.bamboofabricstore.com.au/properties.html.

"Properties of Hemp." Hemp Traders. 17 Mar 2009 http://www.hemptraders.com/properties_of_hemp_washcare.php.

Walsh, Kelle. "Win Points With the Right Linens." Massage Magazine. 17 Mar 2009 http://massagemag.com/Magazine/2006/issue120/Linens/php.