Massage Professionals Article Archive

by Linda Fehrs, LMT

It is easy to understand our love of the outdoors. After a long, cold winter, we want to plant flowers and vegetables; we want to get out to mow lawns, pull weeds and watch birds. After all, we are all connected, participating in the cycles of life, the ebb and flow of Mother Nature. And then there is poison ivy, that lovely but toxic three-leaved plant that seems to invade our little plot of beauty.

It is important, as massage therapists, to be aware of both the causes and treatment of being exposed to poison ivy, as well as poison oak and poison sumac. If a client has it, should they get a massage? If the massage therapist has it should he or she give a massage? Can getting a massage spread, or otherwise affect the rash?

How Does a Person Get Poison Ivy?
There is basically one way to get poison ivy. (This applies to poison oak and poison sumac as well.) It is to come in contact with the plant and ultimately have the plant oils get on the skin. Even if you don't physically touch the plant with bare skin, it may be that your pet, or some item of clothing brushes by one of the plants, and in turn you touch them - by putting on your gardening boots or petting your dog - and come in contact with the toxic oil.

The toxin responsible for the allergic reaction is urushiol and, while it seems to be most toxic in poison ivy, oak and sumac, it is also found in lesser concentrations in cashew nut shells, mangoes, ginkgo biloba seeds and in its namesake, the Japanese lacquer tree (kiurushi or urushi ki). The resinous oil can remain potent for years under the right conditions, and herbarium specimens have caused contact dermatitis after 100 years of storage.

Once the urushiol comes in contact with human skin, it "locks on" within just a few minutes. It then affixes itself to the underlying tissue, gets into the immune system and triggers a histamine reaction in the body resulting in allergic contact dermatitis.

The urushiol is difficult to remove, and using plain soaps and water can spread the substance rather than remove it. The reaction, the itchy rash, is not immediate. Depending on the person's sensitivity, the rash may not develop for 24 - 72 hours after exposure. This is when a massage therapist needs to be most aware and alert when questioning a client prior to the massage session.

Unknowingly Spreading Poison Ivy
Because the urushiol is oil soluble, it can bind to other oils. And, a very small amount - just two micrograms - of the urushiol can cause a fairly severe reaction. Combine this with the delay in reaction and you can have a potentially dangerous situation. While the situation might be rare, there could be a case of a client working in a garden the morning of, or even a day or two prior to coming for a massage. Unbeknownst to the client, the oil could still remain on the skin even after taking a shower.

As the massage therapist spreads the oil, the urushiol can easily be disbursed to other areas of the body and result in a very dangerous situation. The same holds true for a massage therapist who may have come in contact with the toxic plants. If you have touched the plant with your hands or forearms and not yet had a reaction, you could spread the oils and transfer them to your client's skin.

The Best Precaution is Prevention
The best way to avoid the rash caused by poison ivy is to avoid coming in contact with the plant, or anything that has come in contact with it that you might touch. If you do come in contact with it the best thing to do is to wash the area with warm water and a commercially available poison ivy soap. (Burt's Bees Poison Ivy Soap and Ivarest Poison Ivy Cleansing Foam are two that are easily available.) Many of them contain Jewelweed (impatiens capensis), a plant that is known to grow near poison ivy and has been used for centuries by native peoples and herbalists to counteract the affects of the toxic weed. Others contain topical antihistamines to counteract the allergic reaction.

There are also topical creams and gels (such as Ivy Block Lotion, Hylands' Ivy Block Lotion, Enviroderm Ivy Block) to apply if you expect to come in contact with poison ivy. Some contain bentoquatam, a type of bentonite clay. These topicals either serve as a barrier to the urushiol or prevent the urushiol from binding to the skin's natural oils.

Contrary to some urban myths, repeated exposure to small amounts of poison ivy does not enhance your immunity to the toxin; in many cases it actually intensifies future reactions. Another dangerous folk remedy for preventing poison ivy reactions is to ingest small amounts of the plant. This is not just dangerous, but can cause death. Equally toxic to the body is the inhaling of smoke from burning poison ivy/oak/sumac.

Despite Precautions, I Have Poison Ivy. What Can Be Done?
It is estimated that anywhere from 80 - 90 percent of human beings show an allergic reaction to exposure to poison ivy, poison oak and poison sumac. Some reactions are mild; others are quite severe, approaching anaphylaxis. In mild to moderate cases various topicals can be applied to reduce the characteristic itching, redness and blistering. Severe cases where the rash covers a major portion of the body, or when it appears to affect the moist tissue of the body such as the mouth, eyes, lungs, larynx, esophagus and/or digestive tract, an immediate trip to the emergency room is necessary or a call to 911.

10 Easy Remedies for Moderate Reactions
Sometimes the best remedies are those that are natural and have been found to be successful by our friends, neighbors, relatives and local herbalists. Here are some topical applications with ingredients you probably have in and around the house:

1. Banana skins, plantain juice or puree
2. Tea tree oil
3. A paste of goldenseal root powder and aloe vera gel
4. Jewelweed (If you have poison ivy in your yard, chances are jewelweed is growing nearby.)
5. Juice from fresh cut rhubarb
6. Baking soda mixed with water to form a paste
7. Distilled white vinegar
8. Epsom salt baths
9. Lemon juice
10. Honey suckle leaves, steeped in water

Calamine lotion is a standard tried and true treatment, and applying ice to the area will cool and numb the skin and at least temporarily reduce the symptoms.

Boost Your Immune System
Boosting your immune system may help to mitigate the symptoms as well.

· Taking extra Vitamin C can help to prevent infection and slow down the rapid spread of the rash.
· Calcium and Beta-Carotene help boost the immune response and speed healing.
· Zinc helps to repair damaged skin tissue.

Urusiol is said to be one of the most potent natural toxins on the planet, and it is found just about everywhere. Avoiding getting this plant oil on your skin is the only absolute way to prevent it and to keep it from transferring to and from your clients.

Recommended Study:
Advanced Anatomy And Pathology

References:

Armstrong, W.P., and W.L. Epstein, M.D. "Poison Oak: More Than Just Scratching the Surface." Herbalgram (American Botanical Council) 34:36-42, 1995. Web.7 Jul 2009. http://waynesword.palomar.edu/ww0802.htm.

"Home Remedies for Poison Ivy and Poison Oak." June 28 2009. Home Made Medicine. 7 Jul 2009 http://www.homemademedicine.com/home-remedies-poison-ivy.htm.

"Ivy Off: Poison Ivy Facts & Fiction." 2003. Ivy Off, Inc., 7 Jul 2009 http://www.ivyoff.com/factsandfiction.htm.

Martz, Eric. "Poison Ivy: An Exaggerated Immune Response to Nothing Much." Poison Ivy Immunology. March 31, 1997. 7 Jul 2009 http://wwwbio.mass.edu/micro/immunology/poisoniv.htm.

"Natural Remedies." Poison Ivy, Oak & Sumac Information Center. 7 Jul 2009 http://poisonivy.aesir.com/view/natural.html.

Werner, Ruth, LMP, NCTMB. "The Mysteries of Poison Ivy, Oak and Sumac." Massage Today 9.08August 2009 Web.7 Jul 2009. http://www.massagetoday.com/mpacms/mt/article.php?id=14045.

by Nicole Cutler, L.Ac.

Western medicine has made great strides in improving breast cancer detection and treatment. Despite these advances in diagnosis, surgery, radiation and chemotherapy, many managing this diagnosis do not fare as well as they possibly could. Evidenced by the frequency of breast cancer survivors reporting treatment side effects, isolation, depression, anxiety and anger, this illness requires support beyond the halls of traditional medicine.

Bodywork modalities such as massage therapy, acupuncture, reflexology and aromatherapy have demonstrated success in improving the quality of life measures that can make surviving cancer such a challenge. Unfortunately, a significant percentage of breast cancer survivors are unable to afford the supportive benefits associated with massage therapy and other holistic health practices.

Addressing this need, Luana Halpern had the vision and drive to found You Can Thrive!, a unique, integrative wellness center offering free or affordable educational, supportive and integrative medical modalities for breast cancer survivors. Located in New York City, Halpern is a pioneer in integrating patient advocacy, symptom reduction, mind-body cohesion and other educative tools to implement a breast cancer survivorship plan.

In an interview with Halpern, we learn more about her innovative and inspiring You Can Thrive! program:

Q: Can you share how and why you started You Can Thrive!?

LH: I was diagnosed with breast cancer at 35 years old, and was very aware of the discrepancy between the amount of funding and awareness for breast cancer vs. how hard it was for a survivor to find affordable services. Due to symptoms, treatment or side effects from treatment, breast cancer survivors often need to take a year off of work - and may consequently lose financial security. After doing research in the breast cancer community, I found that about 85 percent of breast cancer survivors were in some financial straits - with a large percentage in severe hardship. This translates to not having enough money for supportive services, especially when they are needed.

Q: What makes You Can Thrive! unique?

LH: You Can Thrive! is a multi-tiered program from a breast cancer survivor's perspective. Besides being available for low or no cost, each client receives five units of service to maximize results. After committing to coming in every week, clients first meet with a patient advocate, then receive massage or reflexology, then aromatherapy, then acupuncture and then nutritional counseling - all in one day. The effectiveness of one builds the effectiveness of another, thus maximizing each service's benefit. The overall goal is to help people not just survive breast cancer, but to see them thrive. This is accomplished by reducing symptoms with integrative health services, and providing support through nutrition, education and outreach to continue with healthy lifestyle practices.

Also, the volunteers are doing this because they want to help, not because they need to work and make money, so it strengthens the process.

Q: As a breast cancer survivor, what has been your personal experience with acupuncture, massage therapy and nutrition?

LH: I didn't have these services when diagnosed, and was angry - even with a moderate income - that I still couldn't afford it.

Q: How do clients at You Can Thrive! generally respond to your program?

LH: I see that people coming through our program have help dealing with anger and resentment and reconnecting their mind and body - which is as important as dealing with symptoms of breast cancer treatment. As determined by self-evaluation forms, clients have reported that within the first four visits, primary symptoms reduced around 50 percent. As a result, we are now starting research in collaboration with Columbia University to see how the You Can Thrive! program impacts quality of life from a breast cancer survivor's perspective.

Q: How is You Can Thrive! funded?

LH: We are expanding exponentially mostly without funding. While we have a few small grants, we primarily run on the generosity of our community.

Q: Have you found local healthcare practitioners eager to volunteer?

LH: Statistics show that one in three Americans want to volunteer, and it is the same with healers.

Q: How often do your practitioners typically offer their services?

LH: Most volunteers come in once a month for about four hour; this includes practitioners. We also have a core group of volunteers (about four people) who do administrative work and they donate their time up to four days a month.

Q: I see that the You Can Thrive! wellness center operates on Sundays. With this kind of weekly clinic, is it challenging to reschedule clients with the same bodyworker?

LH: We recognize that consistency in quality care is important. We maintain consistency within our multi-tiered program with a patient advocate, who is the same person for each client - and they communicate with the practitioners. Since there is not a lot of time to build relationships, communication is stressed.

Q: Is there anything you'd like to say to massage therapists who might be interested in volunteering?

LH: Giving back to the community has an intrinsic value that far outweighs the hours that you would give - and outweighs any fears or biases that anyone can try to place upon you. I am available to speak with massage therapists who are interested in volunteering or who simply have further questions.

After speaking with Luana, I was encouraged and inspired by her wellness center. Volunteering one Sunday a month in New York City is an ideal path for local massage therapists who want to give back to breast cancer survivors. If not, there may be other opportunities to participate in or create a system for gifting massage therapy to those especially in need. Regardless of where you stand, there is no doubt that the You Can Thrive! program is a giant step forward in the direction of true, integrative, compassionate healing.

More information regarding You Can Thrive! is available at www.youcanthrive.org.

References:

http://www.cancer.org/docroot/CRI/content/CRI_2_2_1X_How_many_people_get_breast_cancer_5.asp, How Many Women Get Breast Cancer?, Retrieved April 22, 2009, American Cancer Society, 2009.

http://www.massagemag.com/Magazine/2004/issue107/research107.php, Massage Benefits Women with Breast Cancer, Retrieved April 22, 2009, Massage Magazine, January/February 2004.

www.youcanthrive.org, Retrieved April 22, 2009, YouCanThrive.org, 2009.

by Nicole Cutler, L.Ac.

Why do some people have difficulty remembering things? Or, perhaps the question is, do we take our memory for granted? Although science seeks to explain forgetfulness in many ways, much of what enables memory is a mystery. However, we do know that aging, menopause and certain diseases are guilty of worsening our ability to remember. Regardless of how memory works or why it deteriorates, supporting the ability to retain and remember information has become a universal aspiration.

About Memory
The central nervous system's role in forming and recalling memories is a complex, poorly understood phenomena. When processing information, brain activity creates temporary, short-term memories. This fresh information is soon abandoned unless specific biological pathways are activated to change it into a long-term memory. Long-term memory generally involves three separate events:

1. Encoding - This is when we break new concepts into their composite parts to establish meaning. Furthermore, we include the context around us as we learn a new concept, or experience another episode in our life.

2. Storage - As we store a memory, we attach it to other related memories. This enables people to consolidate new concepts with older memories.

3. Retrieval - Retrieving a concept is accomplished by following pointers to trace a stored code, then accessing the memory to regain meaning.

Each memory related event involves an intricate series of reactions between nerve cells. Unimpeded circulation in the tissue surrounding the central nervous system fosters the ideal environment for these reactions to occur.

Improving Memory
Many approaches to memory improvement have been explored, with memorization techniques, brain exercises and supplements to increase cranial circulation taking the lead. Aside from pathological causes, the majority of experts concur that the old adage 'if you don't use it, you lose it' applies to memory. Analysis of this perspective enforces the concept of circulation as the primary constituent of good health. Just like all areas of the body, the brain needs free-flowing energy and blood flow to function optimally.

Once it is understood that cranial circulation plays a role in a person's cognitive abilities, a specific type of bodywork becomes a clear choice for supporting memory. By restoring the natural rhythmic movement found between the bones of the skull, cranial-sacral therapy (CST) can help improve the internal environment of the central nervous system. CST frees restrictions in the cranial tissue and cerebrospinal fluid, thus improving circulation within the central nervous system.

While CST supports the memory process from a physiological perspective, practicing specific mental tasks approaches memory enhancement from another angle. According to Harvard University researchers, normal age-related changes in the brain can slow some cognitive processes, making it harder to remember things. They suggest some of the following strategies to boost memory:

· Recruit all of your senses - The more senses you use when you learn something, the more your brain will be involved in retaining the memory.

· Expand the input to your brain - Widen the brain regions involved in learning by reading aloud, drawing a picture or writing down the information you want to learn. By forcing more details into a piece of information, these additional images help make it easier to understand a thought and remember it.

· Challenge yourself - Engaging in activities that require concentration and recruit your memory skills, helps maintain circulation in your brain - even as you age.

· Enroll in a memory course - Memory improvement courses run by health professionals or experts in psychology or cognitive rehabilitation help many people focus on practical ways to manage everyday challenges.

We can avoid taking our memory for granted by consciously striving to keep our cognition intact. Using the mind to strengthen our neural network increases the brain's resistance to forgetfulness. Cranial-sacral therapy supports a quick and accurate memory by releasing cranial restrictions that slow down nerve cell reactions. By keeping the brain active internally with memory strategies and externally with enhanced cranial circulation, it is possible to help prevent the breakdown of memory.

Recommended Study:
Advanced Anatomy and Physiology
Cranial-Sacral Fundamentals

References:

http://health.harvard.edu, 9 Strategies to Improve Memory, HealthBeat, Harvard University, 2008.

http://library.thinkquest.org, The Science of Memory, Think Quest, 2008.

www.sfn.org, How do Facts Stick in our Mind?, Society for Neuroscience, 2008.

www.upledger.com, Symptoms, Illnesses and Treatments, The Upledger Institute, Inc., 2008.

www.usatoday.com, How does Human Memory Work?, April Holladay, USA Today, 2008.

by Nicole Cutler, L.Ac.

When a client's body jerks on the massage table, it is natural to be a bit alarmed. According to the individual circumstances, such body jerks can be a normal part of relaxation or they can be indicative of a significant medical problem. Because clients often receive bodywork prior to being seen by their primary care provider, it is important for massage therapists to be able to distinguish between harmless involuntary muscle contractions and pathological spasmodic jerking.

Myoclonus
Myoclonus is the medical term describing the symptom of sudden, involuntary jerking of a muscle or group of muscles. Myoclonic twitches or jerks are usually defined as belonging to one of the following two types:

1. Positive myoclonus - sudden muscle contraction
2. Negative myoclonus - sudden muscle relaxation

The way myoclonus presents itself can vary widely. The jerking can occur:

· Alone
· In sequence
· Infrequently
· Many times a minute
· As a response to an external event
· Following an attempt at movement

Regardless of it being positive or negative, isolated or sequential, frequent or infrequent or what event precedes it, myoclonic spasms are always involuntary.

Myoclonus Origins
Being able to identify the cause of a muscle jerk helps practitioners decide if their client might require a physician referral. Such evaluation requires deliberation, because there are many possible causes of myoclonus and scientists are not entirely sure of why they occur. The basics of myoclonus dictate that it is simply a muscle twitch followed by relaxation. In general, the following types of myoclonic movements (without additional symptoms) are harmless:

· Hiccups - This spasm of the diaphragm is an example of positive myoclonus.

· Sleep starts - Jerks typical of falling asleep. Common in a relaxation-based massage session, this is an example of non-pathological, negative myoclonus.

However, regular muscle jerks that progressively intensify require attention by a physician. Severe cases of myoclonus can distort movement and severely limit a person's ability to eat, talk or walk.

Although some cases of myoclonus are caused by an injury to the peripheral nervous system, most are caused by a disturbance of the central nervous system. Even though the specific mechanisms are not yet fully understood, scientists believe that an over-excitability of the brain's motor pathways is responsible for myoclonic jerks.
Frequent and persistent myoclonus can indicate a wide variety of nervous system disorders including epilepsy, multiple sclerosis, Parkinson's disease, Alzheimer's disease or Creutzfeldt-Jakob disease. In addition, physicians evaluating persistent myoclonus must rule out:

· Head or spinal cord injury or infections
· Strokes
· Brain tumors
· Kidney or liver failure
· Chemical or drug poisoning
· Prolonged oxygen deprivation
· Metabolic problems

Not a Muscle Spasm
At first glance, involuntary muscular jerking may seem synonymous with a muscle spasm. However, these two events have different origins, with myoclonus being neurological and muscle spasms being muscular. While myoclonic jerks can be disturbing, they do not cause pain. On the other hand, muscle spasms are typically a result of soft tissue injury and are usually painful.

When massage therapists witness their client twitching, they may want to pay closer attention to this symptom. Upon ruling out muscle spasms and harmless myoclonic twitches, it may be appropriate for the therapist to inquire further about his/her client's spasmodic movements. A referral is definitely called for if the client has not been seen by his/her doctor for increasingly frequent and severe myoclonus. By advising clients in this situation to be evaluated for myoclonus, bodyworkers demonstrate their knowledge about this physiological phenomenon and their commitment to looking out for their clients' best interests.

Recommended Study:
Advanced Anatomy and Pathology
Advanced Anatomy and Physiology

References:

Chaitow, Leon, Peter Baldry, Jan Dommerholt, Fibromyalgia Syndrome: A Practitioner's Guide to Treatment, Elsevier Health Sciences, 2003: 280.

http://www.holistic-online.com/REMEDIES/Sleep/sleep_nocturnal-myoclonus.htm, Nocturnal Myoclonus, Retrieved September 15, 2008, ICBS, Inc., 2008.

http://www.mayoclinic.com/health/myoclonus/DS00754, Myoclonus, Retrieved September 15, 2008, Mayo Foundation for Medical Education and Research, 2008.

http://www.ninds.nih.gov/disorders/myoclonus/detail_myoclonus.htm, Myoclonus Fact Sheet, Retrieved September 15, 2008, National Institute of Neurological Disorders and Stroke, 2008.