Clinical Massage
ONCOLOGY MASSAGE
The modification and customization of existing massage techniques in order to safely work with patients experiencing complications of cancer and its treatment. Anyone who has ever received cancer treatment, from those in active treatment, to those in recovery or survivorship, as well as those at the end of life, are best served by a therapist who has received training in Oncology Massage. Clinical assessment and adaptations to the massage session for someone experiencing cancer or with a history of cancer treatment, are critical to providing a safe massage. Many people believe that cancer patients are not recommended to receive massage, when just the opposite is true. There is always a modified style of bodywork that can be safely applied to the patient with effective and pleasant results usually achieved.
Standard oncology massage intake questions include those pertaining to:
Cancer treatment history
Tumor site or metastasis
Compromised blood cell count
Lymph node involvement
Blood clots or DVT (deep vein thrombosis)risk
Fragile or unstable tissue
Medications (short and long term)
Medical devices
Fatigue, neuropathy, and pain
Changes in sensation
Late effects of cancer treatment
SCAR TISSUE RELEASE
While the bodies formation of scar tissue is a demonstration of self-preservation, the resulting fibrous mass can set the stage for problems down the road. Composed primarily of collagen, scar tissues fibrosis prohibits adequate circulation. In addition to the physical limitations of collagenous tissue, the lack of blood flow and lymph drainage occurring in scar tissue makes it vulnerable to dysfunction. The resulting abnormal stress on surrounding tissues may include:
Nerve impingement
Pain
Numbness
Tightness
Pulling sensation in surrounding area
Limited range of motion
Postural misalignment
Muscle atrophy
Tissue hypoxia
Increased potential for future injury
In fact, some health professionals believe that scar tissue is the root of a majority of physical imbalances. Body workers addressing scar tissue early in its development can help minimize any of the preceding list of secondary scar tissue problems.
Scar tissue is not a permanent fixture in the body. After scar tissue forms and healing has taken place, the scar needs to be remodeled so that it can tolerate the stress and forces that the body may encounter throughout each day. The remodeling process is essential to ensure that normal range of motion, strength, and mobility are restored to the injured tissue.
Scar tissue release work in this case is done through disrupting the realigning the fibers of the scar. This work can be done dry, without a lubricant, as in facial reconstruction work. Another way is to use sesame seed oil, which softens the scar, as well as lightens the discoloration that is generally associated with scar tissue. I gently massage the oil into the damaged area to promote circulation, encouraging the release of tension on the surrounding tissues, and start restoring proper range of motion.
MANUAL LYMPH DRAINAGE
A type of gentle massage intended to encourage the natural drainage of the lymph from the tissue spaces in the body. MLD uses a specific amount of pressure (less than 9 ounces per square inch), and rhythmic circular movements to stimulate lymph flow. Following the known existing pathways of vessels and “dump sites” for lymph, and manually pumping the areas by hand where lymph nodes are concentrated, we look to stimulate circulation and elimination of excess fluid in the region. This is beneficial for relieving lymph edema, which can occur during or after surgery, accidents/trauma, or cancer treatment.
Lymph edema is an abnormal collection of high-protein fluid just beneath the skin. This swelling, or edema, most commonly occurs in the arm or the leg, but it may also occur in other parts of the body including breast or torso, head and neck. Lymph edema usually develops when lymph vessels are damaged or lymph nodes are removed as in cancer treatment. Lymphatic swelling can also occur post-op when a patient undergoes breast augmentation or reduction, or has a plastic surgery procedure done. MLD is very effective to reduce bruising and swelling, and speed recovery time considerably from having undergone these procedures.
Lymph edema can be painful and cause inflammation, rashes, and pressure on the internal organs. Fluid is usually transported out of a region of the body by an extensive network of tiny vessels. When the protein-rich fluid persists in a specific area, it can attract even more fluid thus worsening the swelling. In addition to increased fluid in the area, the body experiences an inflammatory response resulting in scar tissue called fibrosis in the affected area. The presence of fibrosis makes it even more difficult for the excess fluid to be eliminated from the area. As a result, the increased fluid and fibrosis prevents the delivery of oxygen and essential nutrients to the area, which in turn can delay wound healing.
CUPPING
Traditional Chinese medicine brings to mind acupuncture and the use of natural herbs as healing remedies. Cupping is a lesser-known treatment that is also part of Oriental medicine, one that can provide an especially pleasant experience.
One of the earliest documentations of cupping can be found in the work titled A Handbook of Prescriptions for Emergencies, which was written by a Taoist herbalist by the name of Ge Hong and which dates all the way back to 300 AD.
Cupping is the term applied to a technique that uses small cups as suction devices that are placed on the skin. Once the suction has occurred, the cups can be gently moved across the skin (often referred to as “gliding cupping”). The suction in the cups causes the skin and superficial muscle layer to be lightly drawn into the cup.
Cupping is much like the opposite of massage - rather than applying pressure to muscles, it uses gentle pressure to pull them upward. For most patients, this is a particularly relaxing and relieving sensation. Once suctioned, the cups are generally left in place for about ten minutes while the patient relaxes.
The suction and negative pressure provided by cupping can loosen muscles, encourage blood flow, and sedate the nervous system (which makes it an excellent treatment for high blood pressure). Cupping is used to relieve back and neck pain, stiff muscles, anxiety, fatigue, migraines, rheumatism, and even cellulite. For weight loss and cellulite treatments, oil is first applied to the skin, and then the cups are moved up and down the surrounding area.
Like acupuncture, cupping follows the lines of the meridians. There are five meridian lines on the back, and these are where the cups are usually placed. Using these points, cupping can help to align and relax qi, as well as target more specific maladies. By targeting the meridian channels, cupping strives to ‘open' these channels - the paths through which life energy flows freely throughout the body, through all tissues and organs, thus providing a smoother and more free-flowing qi (life force).
Cupping is one of the best deep-tissue therapies available. It is thought to affect tissues up to four inches deep from the external skin. Toxins can be released, blockages can be cleared, and veins and arteries can be refreshed within these four inches of affected materials. Even hands, wrists, legs, and ankles can be ‘cupped,' thus applying the healing to specific organs that correlate with these points.
This treatment is also valuable for the lungs, and can clear congestion from a common cold or help to control a person's asthma. In fact, respiratory conditions are one of the most common maladies that cupping is used to relieve. Three thousand years ago, in the earliest Chinese documentation of cupping, it was recommended for the treatment of pulmonary tuberculosis.
ELECTRICAL STIMULATION
Although they come in many shapes and sizes, essentially, an E-stim, (or TENS), unit is an electrical device that sends currents through unbroken skin via small electrodes that target muscles. This device has a wide variety of uses within the medical field including muscle toning, muscle spasm relaxation, and pain prevention. Within the field of massage therapy, E-stim is important for rehabilitative purposes and enhancement of the healing process. E-stim units induce muscle contractions by excitation(current) produced directly at the motor nerve. Current acts just like signals sent from the brain to cause muscle contraction. Electrodes are placed on the target muscle group area. The electrodes are then plugged into a power supply. The power supply emits current that in turn stimulates the muscle group.
This passive muscle stimulation is important in rehabilitation therapy, as it is a simple, easy way to rebuild muscle. This is important for re-education of muscles after immobilization due to injury.
Electrical stimulation units use an electrical current to simulate the same electrical impulses that are activated during normal exercise. By passively activating the muscle, the body responds in much the same way as during normal exercise. By placing a pair of electrodes on the target muscle or muscle group, the unit can send electrical impulses muscle in a rhythm similar to daily exercise.