Massage is an ancient healing art that has been practiced in every culture. Captain Cook once described how his back pain was successfully treated with massage by the native people of Hawaii during his stay in the islands. Massage has evolved and taken many paths and continues to evolve during these modern times. With so many names and philosophies, how does a client know which is the right kind of massage for them? And how does the therapist know what is the right kind of massage for the client?
Sports massage, Swedish massage, Russian massage, accupressure, deep tissue massage . . . there are so many different kinds of massage. I'll discuss some general categories in another article but for now I want to talk specifically about what I mean when I say that the right kind of massage can be very effective, while the wrong kind of massage will, at the very least, be ineffective and, at worst, cause symptoms to worsen.
Let me give an example taken from my own practice. Years ago, when I was first beginning to learn Russian massage, a woman called and booked an hour appointment. Upon arrival, she told me she had Chronic Fatigue Syndrome. She'd had experience with massage before, liked it, and wanted a fairly vigorous one hour massage. I had recently begun to study with the renowned Russian Massage therapist Zhenya Kurashova Wine and knew from Zhenya that a vigorous one hour massage would not be the best choice for her and that, in fact, a gentle 20 - 30 minute treatment would be better. I explained this to the client. She was willing to consider it for a future visit but at that moment, she really had her heart set on a one hour vigorous massage. Against my better judgement, I complied. At the end of the appointment she said that she liked the massage very much and booked another appointment for the following week to try the alternative treatment I'd suggested.
When she came the following week, I asked how she felt after her first massage. She said she'd felt better for the rest of the day and then went home, crashed, and could barely get out of bed the following two days. I proceeded to do the very gentle 30 minute treatment that I do for CFS and fibromyalgia. The client came in the following week and, again, I asked how she felt after the last massage. She reported that she'd gone home, took a 20 minute nap, and then felt really good for the next three days.
Two different massage treatments, two entirely different reactions.
Zhenya would tell us that massage is like medicine. First, you have to have the correct diagnosis. If you don't know exactly what is the problem, you are not going to know what is the correct solution. Then, as with medicine, you have to know what is the right medicine and what is the right dose. How much? How often?
In Russian massage we study the specific effects that each stroke has on the physiological processes of the body. How is the treatment for nerve irritation different from treatment for muscle pain? How is treatment for an acute situation different for a chronic condition? How would one approach a systemic disorder? A client with congestive heart failure? Stroke?
As you can see with my client, the wrong kind of massage felt good at the time but really did not help her. The right kind of massage got much better results.
A good therapist will understand exactly how her touch affects the body at many levels. She will listen carefully to the client's needs and adjust accordingly. By understanding the client's condition at that point in time and understanding how we affect the body, we can deliver just the right kind of massage and achieve greater results.
Showing posts with label Fibromyalgia. Show all posts
Showing posts with label Fibromyalgia. Show all posts
Wednesday, May 12, 2010
Monday, October 27, 2008
Russian Massage Protocol for Fibromyalgia
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Russian Massage is unique in that it is a system of massage entirely based on physiology. Developed in the former Soviet Union as a medical massage, sports massage, and part of their physical therapy, it is supported by over 150 years of serious scientific research. What this means is that they have investigated the various strokes and examined exactly what physiological changes each of these strokes, when done in various ways, produces in the body.
In Russian Massage, the approach taken towards fibromyalgia is to calm the central nervous system (CNS). The idea is that when the central nervous system is normalized, everything in the body functions better. This systemic approach is also used for chronic fatigue syndrome; I have also used it successfully on a client with sarcoidosis.
Russian researchers have found that the central nervous system responds best to shorter and more frequent treatments. Too long of a treatment can backfire and too infrequent is ineffective. The more severe the symptoms of fibromylagia, the shorter and more frequent the treatments should be. They have also found that the CNS responds best to regularity and so, ideally, the treatments are best given at evenly spaced intervals, preferably at the same time of the day.
Since the goal is to soothe the CNS, Russian Massage for fibromyalgia uses only very soothing strokes. Continuous effleurage and vibration on the back and the back of the legs is done for twenty to thirty minutes. This gentle, rhythmic treatment is very relaxing and causes absolutely no pain to the client. The client enters a deep state of relaxation and, since the treatment is relatively short, rises relaxed but regains alertness quickly.
Treatment sessions are usually 20 to 30 minutes each, twice a week. If the client is particularly flared up, treatments are shortened to no more than 20 minutes and increased to three times a week. Treatments are repeated for 12 to 15 sessions and then interrupted for two weeks. This repetition followed by an interruption in treatment allows the body to become accustomed to being more relaxed but not dependent on the treatments. It also prevents the body from becoming so accustomed to the treatments that it no longer responds to them.
In many cases, if the client is taking sufficient care of themselves outside of the treatments, they will start to experience a reduction in the severity of their symptoms within four or five treatments. Significant reductions in symptoms are often experienced by the end of the 12 - 15 treatments. If further progress is desired, another cycle of treatments may resume after the two week break. This cycle of 12 to 15 treatments with a two week break may be repeated as often as necessary until the desired results are achieved. As symptoms are reduced and the client begins to feel better, treatments should be tapered off. Intervals between treatments may be increased. Eventually, treatments can be reduced to once a month to help maintain improvement. At the first sign of flare-up, the client should resume more frequent treatments. If this is done before symptoms have seriously increased, return to a more normal state is often achieved more quickly.
Outside of the massage treatments, it is imperative that the client do everything they can to support their physical and mental health. A relatively healthy diet is a must. Alcohol, cigarettes, and caffeine should be kept to a minimum. Clients must maintain regular sleep habits and get adequate sleep. Unnecessary stress needs to be reduced or eliminated. Exercise is important. It is often recommended that patients with fibromyalgia exercise three times a week. However, one doctor has found that his patients who exercise every day get the best results and if they miss even one day, they feel worse for the next two or three days. It is not necessary to exercise the painful muscles to benefit. The effects seem to come from the overall hormonal effects of the exercise.
Over the years, almost every one of my clients with fibromyalgia who has followed this protocol has reported good to excellent improvement. The exceptions have had complications from other conditions.
As with any medical condition, massage therapy is not a substitute for proper medical attention. Massage therapy, however, can support other therapies and be a powerful adjunct.
One client, whose symptoms had gotten severe enough that she did not think she could continue working, told me after two months of treatment, "This has allowed me to stay in my job."
I firmly believe, based on my own experience and validated by investigations at the Touch Research Institute at the University of Miami Medical School, that the right kind of massage therapy could provide safe, natural relief to many who suffer from fibromyalgia. It is certainly worth giving it a try.
You can follow us on Twitter at massagestl
Russian Massage is unique in that it is a system of massage entirely based on physiology. Developed in the former Soviet Union as a medical massage, sports massage, and part of their physical therapy, it is supported by over 150 years of serious scientific research. What this means is that they have investigated the various strokes and examined exactly what physiological changes each of these strokes, when done in various ways, produces in the body.
In Russian Massage, the approach taken towards fibromyalgia is to calm the central nervous system (CNS). The idea is that when the central nervous system is normalized, everything in the body functions better. This systemic approach is also used for chronic fatigue syndrome; I have also used it successfully on a client with sarcoidosis.
Russian researchers have found that the central nervous system responds best to shorter and more frequent treatments. Too long of a treatment can backfire and too infrequent is ineffective. The more severe the symptoms of fibromylagia, the shorter and more frequent the treatments should be. They have also found that the CNS responds best to regularity and so, ideally, the treatments are best given at evenly spaced intervals, preferably at the same time of the day.
Since the goal is to soothe the CNS, Russian Massage for fibromyalgia uses only very soothing strokes. Continuous effleurage and vibration on the back and the back of the legs is done for twenty to thirty minutes. This gentle, rhythmic treatment is very relaxing and causes absolutely no pain to the client. The client enters a deep state of relaxation and, since the treatment is relatively short, rises relaxed but regains alertness quickly.
Treatment sessions are usually 20 to 30 minutes each, twice a week. If the client is particularly flared up, treatments are shortened to no more than 20 minutes and increased to three times a week. Treatments are repeated for 12 to 15 sessions and then interrupted for two weeks. This repetition followed by an interruption in treatment allows the body to become accustomed to being more relaxed but not dependent on the treatments. It also prevents the body from becoming so accustomed to the treatments that it no longer responds to them.
In many cases, if the client is taking sufficient care of themselves outside of the treatments, they will start to experience a reduction in the severity of their symptoms within four or five treatments. Significant reductions in symptoms are often experienced by the end of the 12 - 15 treatments. If further progress is desired, another cycle of treatments may resume after the two week break. This cycle of 12 to 15 treatments with a two week break may be repeated as often as necessary until the desired results are achieved. As symptoms are reduced and the client begins to feel better, treatments should be tapered off. Intervals between treatments may be increased. Eventually, treatments can be reduced to once a month to help maintain improvement. At the first sign of flare-up, the client should resume more frequent treatments. If this is done before symptoms have seriously increased, return to a more normal state is often achieved more quickly.
Outside of the massage treatments, it is imperative that the client do everything they can to support their physical and mental health. A relatively healthy diet is a must. Alcohol, cigarettes, and caffeine should be kept to a minimum. Clients must maintain regular sleep habits and get adequate sleep. Unnecessary stress needs to be reduced or eliminated. Exercise is important. It is often recommended that patients with fibromyalgia exercise three times a week. However, one doctor has found that his patients who exercise every day get the best results and if they miss even one day, they feel worse for the next two or three days. It is not necessary to exercise the painful muscles to benefit. The effects seem to come from the overall hormonal effects of the exercise.
Over the years, almost every one of my clients with fibromyalgia who has followed this protocol has reported good to excellent improvement. The exceptions have had complications from other conditions.
As with any medical condition, massage therapy is not a substitute for proper medical attention. Massage therapy, however, can support other therapies and be a powerful adjunct.
One client, whose symptoms had gotten severe enough that she did not think she could continue working, told me after two months of treatment, "This has allowed me to stay in my job."
I firmly believe, based on my own experience and validated by investigations at the Touch Research Institute at the University of Miami Medical School, that the right kind of massage therapy could provide safe, natural relief to many who suffer from fibromyalgia. It is certainly worth giving it a try.
Sunday, October 26, 2008
Natural Relief for Fibromyalgia
Fibromyalgia (FM) is a poorly understood chronic pain condition that primarily afflicts women. Patients with fibromyalgia complain that they feel fatigued and ache all over as if they have the flu. They are generally otherwise healthy women and there seems no obvious reason for their pain. Many were very productive before they became afflicted. Symptoms can range from mild to severe but will persist for years. There is no known cause and there is no known cure. I once asked a pain management specialist what treatment conventional medicine had to offer fibromyalgia patients and his response was, "Not much." More recently, a new drug has been introduced that may offer relief to patients with fibromyalgia.
When I first began to practice massage seventeen years ago, it was difficult to find information about fibromyalgia. What information was available was often vague, confusing, and conflicting. At least half of all rheumatologists did not recognize fibromyalgia as a diagnosis and many sufferers went years before being diagnosed. Women often told me they hesitated to see a doctor because, as one put it, "I don't want them to tell me it's all in my head." When they were finally diagnosed, they were often told there was nothing to be done about it. What was a person with fibromyalgia to do? What was a massage therapist with fibromyalgia clients to do?
In my experience, the pendulum seems to have swung in the opposite direction. In recent years, a woman in pain is often told she has fibromyalgia whether she fits the profile for a diagnosis of fibromyalgia or not. I even had one healthy young woman, who had no pain, fatigue, or other symptoms, report that she was told by a doctor (who had never seen her before and was a sub for her regular doctor) that she had fibromyalgia. Two other female clients, who were later diagnosed with and treated successfully for frozen shoulder, were initially told that they had fibromyalgia. What's going on here?
Unfortunately, musculoskeletal pain is not well understood by many doctors. Overworked physicians who are under pressure to see too many patients in a day often do not feel they have the time to thoroughly investigate their patient's pains, pains which may be vague, not easily diagnosed, and do not seem life threatening. It's easy to dismiss them with a diagnosis of fibromyalgia. When these clients come to my office, I do what I can to relieve their muscular pain and help them to determine what perpetuating factors may exist in their daily lives. When it is clear that they need additional help, I direct them towards doctors, chiropractors, and physical therapists who I know will take the time to help them resolve their pain.
But what about the clients who truly have symptoms of fibromyalgia? Can massage therapy help? And, more importantly, what kind of massage therapy?
Fortunately, I met a Russian Massage teacher, the well known Zhenya Kurashova Wine. Russian massage, developed in the former Soviet Union, is supported by over 150 years of serious scientific research into the physiological effects of massage on the body. They can tell you, with evidence to support it, exactly how a particular stroke done in a particular manner will affect the physiology of the body.
I'd been taught to use deep tissue massage on clients with muscle pain but I quickly noticed this made clients with FM only worse. I'd started to lighten up but was afraid I wouldn't be effective. When I began to study with Zhenya, she taught me very specifically how to work with clients with fibromyalgia. As soon as I began to take her advice, I began to get much better results. And when my clients with fibromyalgia followed the suggested protocol, they reported a significant decrease in the severity of their symptoms and the frequency and intensity of flare-ups.
Tomorrow I'll describe the Russian Massage protocol for fibromyalgia and also mention some other conditions for which it has worked well.
When I first began to practice massage seventeen years ago, it was difficult to find information about fibromyalgia. What information was available was often vague, confusing, and conflicting. At least half of all rheumatologists did not recognize fibromyalgia as a diagnosis and many sufferers went years before being diagnosed. Women often told me they hesitated to see a doctor because, as one put it, "I don't want them to tell me it's all in my head." When they were finally diagnosed, they were often told there was nothing to be done about it. What was a person with fibromyalgia to do? What was a massage therapist with fibromyalgia clients to do?
In my experience, the pendulum seems to have swung in the opposite direction. In recent years, a woman in pain is often told she has fibromyalgia whether she fits the profile for a diagnosis of fibromyalgia or not. I even had one healthy young woman, who had no pain, fatigue, or other symptoms, report that she was told by a doctor (who had never seen her before and was a sub for her regular doctor) that she had fibromyalgia. Two other female clients, who were later diagnosed with and treated successfully for frozen shoulder, were initially told that they had fibromyalgia. What's going on here?
Unfortunately, musculoskeletal pain is not well understood by many doctors. Overworked physicians who are under pressure to see too many patients in a day often do not feel they have the time to thoroughly investigate their patient's pains, pains which may be vague, not easily diagnosed, and do not seem life threatening. It's easy to dismiss them with a diagnosis of fibromyalgia. When these clients come to my office, I do what I can to relieve their muscular pain and help them to determine what perpetuating factors may exist in their daily lives. When it is clear that they need additional help, I direct them towards doctors, chiropractors, and physical therapists who I know will take the time to help them resolve their pain.
But what about the clients who truly have symptoms of fibromyalgia? Can massage therapy help? And, more importantly, what kind of massage therapy?
Fortunately, I met a Russian Massage teacher, the well known Zhenya Kurashova Wine. Russian massage, developed in the former Soviet Union, is supported by over 150 years of serious scientific research into the physiological effects of massage on the body. They can tell you, with evidence to support it, exactly how a particular stroke done in a particular manner will affect the physiology of the body.
I'd been taught to use deep tissue massage on clients with muscle pain but I quickly noticed this made clients with FM only worse. I'd started to lighten up but was afraid I wouldn't be effective. When I began to study with Zhenya, she taught me very specifically how to work with clients with fibromyalgia. As soon as I began to take her advice, I began to get much better results. And when my clients with fibromyalgia followed the suggested protocol, they reported a significant decrease in the severity of their symptoms and the frequency and intensity of flare-ups.
Tomorrow I'll describe the Russian Massage protocol for fibromyalgia and also mention some other conditions for which it has worked well.
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