Past Student Case Report Contest
Massage Therapy for Paralytic Post-Polio Syndrome: A Case Report
by Erikka Opinio
Massage Therapy Treatment and Outcomes in a Patient with Charcot-Marie-Tooth Disease: A Case Report
by Galit Paz
Massage Treatment for Pain Due to Daily Chest Compression Practices in a Gender-Nonconforming Patient
by Alessandra Keener
Massage Therapy for Dystonia: A Case Report
Edmonton, Alberta, Canada
Effects of Massage Therapy on Pain, Sleep Quality, and Breathing Function in a Sciatica Patient
Center for Neurosomatic Studies
The purpose of my case study was to determine if massage, combined with inner unit stabilization exercises, could decrease pain, improve sleep quality, and increase breathing pattern functionality in a patient with sciatica. My research participant presented with low back pain classified as sciatica. She reported having issues with poor sleep quality, and had a history of recurrent pneumonia and chronic bronchitis. The patient’s goals were to have more energy, be free of pain, and get better sleep. Current research show a growing interest in the role breathing pattern disorders play in trunk stability, functional movement, and pain pathologies. I focused on treating muscle groups that would affect the patient’s back pain and breathing issues and worked with the patient to develop a home care plan that aimed to target trunk stability. The patient and I were very pleased with the results: her back pain was resolved, her sleep improved, and she was breathing better. I’m happy to report that she is still doing well.
Massage Therapy as a Treatment for Medial Epicondylitis in a Guitarist: A Case Report
Edmonton, Alberta, Canada
Background: Medial epicondylitis is an overuse injury characterized by micro-tears in the musculotendinous unit of the flexor-pronator musculature. Medial epicondylitis presents with pain, tenderness, stiffness, limited range of motion, loss of strength and reduced function. Pain syndromes of the musculotendinous unit are noted to be the most common of all upper extremity disorders in instrumentalists. Massage therapy can be of benefit to these presentations.
Objective: To examine the effects of massage therapy on pain, adhesions and scar tissue, hypertonicity, pinch and grip strength and performance in a guitarist with medial epicondylitis.
Methods: The study period included an initial and final assessment with treatment scheduled for five massage therapy sessions carried out by a second-year massage therapy student over a six-week period. The subject, a 54-year-old male guitarist, presented with medial epicondylitis on the left side. Assessment measures included pain scales, pinch and grip strength measures, and the Disabilities Arm, Shoulder and Hand (DASH) Questionnaire. The treatment plan was prepared with the intention of decreasing pain, reducing adhesions and scar tissue, reducing hypertonicity, increasing pinch and grip strength and increasing performance. This would be achieved through the application of moist heat, skin rolling, myofascial release, direct fascial techniques, wringing, muscle stripping, trigger point therapy, and frictions completed with ice.
Results: The subject reported a decrease in pain affecting the arm, wrist and hand. Pinch and grip strength improved in the left hand. DASH scores decreased.
Conclusion: The results suggest that a variety of therapeutic massage techniques have a positive effect on medial epicondylitis when received regularly. Massage therapy increased strength and decreased pain in subject, along with other symptoms commonly seen in medial epicondylitis.
Massage Therapy Treatment for Diabetic Peripheral Neuropathy: A Case Report
Edmonton, Alberta, Canada
Five massage therapy sessions were provided to a patient with long-standing diabetic peripheral neuropathy (DPN). The aim of the treatment was to increase circulation in the lower limbs and through that improve tissue health. Also it was suggested that massage therapy could help with pain management and thus help the patient with everyday tasks and work. Nerves and blood vessels get compromised with DPN leading to poor healing and thus development of ulcers on the legs. Though some limitations were present, five sessions still proved to be effective in providing relief to the patient and allowing the patient to work and maintain daily activities. The major suggestion is that with chronic issues such as DPN massage can be helpful if provided on the ongoing base, and not just for five session. Also it is very important to educate the patient about feet-care and self massage in order to get the maximum benefits in terms of tissue health and circulation in the lower limbs.
Massage and Atlanto-Occipital Mobilization to Improve Symptoms in a Boy with Autism
Center for Neurosomatic Studies
This project was a 5 week-long case study examining the potential therapeutic effects of massage and atlanto-occipital mobilization on a 3 year old boy with autism.
The hypothesis was that alleviation of distortions in the atlanto-occipital joint would improve circulation to and from the brain which might in turn help improve the client’s language and communication skills.
While the effects of general massage techniques were negligible, the effects of atlanto-occipital mobilization in particular were significant. After just one treatment involving atlanto-occipital mobilization the client’s ATEC scores improved by 20%. The client’s mother also noticed remarkable improvements in his behavior in the days and weeks following the treatment. This has profound implications for the potential benefit of targeted manual therapy for children with autism spectrum disorder.
The Use of Massage to Increase the Performance of a Brazilian Jiu-Jitsu Athlete by Increasing Range
Center for Neurosomatic Studies
Background: Brazilian Jiu-Jitsu is a modern combat martial art that utilizes joint locks to force an opponent into submission. It is a high intensity combat sport that places unique stresses on the body leading to atypical injuries and muscular imbalance, a possible predictor of injury. Athletes with a history of low back pain have significant reductions in hip range of motion, and maximum hip flexibility is necessary to perform optimally.
Participant: 40-year-old Caucasian male Jiu-Jitsu black belt presenting with restricted range of motion in the right shoulder and both hips as well as left SI joint and posterior gluteal pain.
Diagnosis: Herniated L4-5 disc with no other notable health issues
Purpose: To discover if the utilization of massage can increase the performance of a BJJ athlete by increasing range of motion and decreasing pain.
Intervention: The practitioner a 25 year old female within 3 months of the end of her third semester of a three-semester, 18-month program at the Center for Neurosomatic Studies (CNS). Biweekly targeted, deep-tissue massage treatments were performed for five weeks. The results were tracked using the Bournemouth MSK scale, PGIC, WOSI, active range of motion measurements measured with a goniometer, and routine Posturology assessments.
Results: There was significant improvement in range of motion in the shoulder, elbow, and both hips as well as eliminated SI joint pain and some diminished pain in the posterior gluteal area. The patient also claimed to have experienced improved performance in BJJ training. Discussion: The participant was training for a tournament throughout the duration of the study,
thus he was training more than normal (5-6 time weekly); this is likely why there was less improvement in pain than there was improvement in functionality.
Massage Therapy as a Treatment for Rheumatoid Arthritis Affecting the Wrist and Hand: A Case Report
Edmonton, Alberta, Canada
Background: Rheumatoid arthritis (RA) is a chronic autoimmune disease with a characteristic destructive nature, and is marked with periods of exacerbations and remissions. Affecting any joint in the body, RA presents with inflammation, pain, stiffness, edema, and a decrease in joint function over time. The cause of RA is unknown.
Effectiveness of Massage Therapy in Improving Range of Motion and Posture of Shoulder and Cervical Region in a Morbidly Obese Patient: A Case Report
Grant MacEwan University
Edmonton, Alberta, Canada
Background: Range of motion (ROM) is defined as the extent of movement of a joint for a certain inter-segmental rotational movement. Range of motion is primarily restricted by musculature and skeletal structures. It may also be affected by other factors such as age, gender, and obesity, which can have debilitating effects. Lack of physical activity, reduction in function, and fatty tissue surrounding the joints or adjacent structures may contribute to restrictions in range of motion in obese individuals. Lack of suitable equipment and protocols for treating morbidly obese individuals limits the effectiveness of the therapist and the desire of the patient to consider massage therapy as a viable treatment option.
Objective: To demonstrate the effectiveness of massage therapy on reduction of symptoms in a morbidly obese patient experiencing pain in the shoulder, restrictions in ROM during specific movements, and acquired postural alterations.
Methods: A 58-year-old disabled, morbidly obese male presented with pain and stiffness in his right shoulder. A student massage therapist conducted initial and final assessments and treated the patient over a six-week period. Techniques were chosen to help the patient reach his goals of reducing pain, and improving range of motion and posture. Techniques utilized were trigger point therapy (TrP), soft tissue frictions (STF) and direct fascial (DF) techniques. Stretches were chosen to help maintain results and promote active recovery.
Results: After five treatments, shoulder and cervical ROM increased and shoulder pain diminished. The patient was able to move through the entirety of range with minimal discomfort.
Conclusion: Results suggest that with modified positioning and techniques, massage therapy combined with therapeutic exercises can help reduce non-specific shoulder pain, increase range of motion, and improve posture in morbidly obese patients.
Effect of Massage Therapy on the Proprioceptive System of an Autistic Child – A Case Study
HACC, Central Pennsylvania Community College
Background: Children with Autism Spectrum Disorder (ASD) often have an underdeveloped or dysfunctional proprioceptive system, leading to significant motor skill delays and increased anxiety. There is not enough clinical research to
prove the efficacy of massage therapy on proprioceptive dysfunction in children with ASD, but if proven effective massage therapy could offer a new intervention for this issue.
Objective: The objective of this case report is to describe changes in the proprioceptive abilities of a child with ASD after the application of 8 massage therapy sessions over a four week period.
Participant: 5 year old female with mid to high functioning autism and proprioceptive dysfunction. The client’s proprioceptive dysfunction impairs gross motor planning and execution, creating gross motor developmental delays.
Intervention: Eight 40 minute massage therapy sessions, consisting of Swedish massage and foot reflexology, were administered twice a week over four weeks. Improvements in proprioceptive abilities were monitored through pre and postmassage testing activities that included single foot balancing, jumping rope, back- and- forth ball bouncing, and independent ball dribbling.
Results: The client displayed improvement in proprioceptive testing tasks at a much faster rate than her usual learning curve. Proprioceptive progress was demonstrated by gains in gross motor skills pertaining to postural control, overall body coordination, and use of force.
Conclusion: Although positive results were achieved within this case study, more extensive studies are needed to verify the efficacy of massage therapy on proprioceptive dysfunction in children with ASD.
The Effect of Massage Therapy on Postural Dysfunction Exacerbated by Parkinson’s Disease
Edmonton, Alberta, Canada
Background: The causes that lead to low back pain (LBP) vary, and include poor postural alignment, muscle fatigue, and chronic conditions. Deviations from balanced upright posture can result, leading to hypertonicity in compensatory muscles. With increased kyphosis and forward head posture, affected tissues include scapular retractors and anterior cervical muscles. With decreased lumbar lordosis, affected tissues include lumbar, trunk and hip muscles. Conditions such as Parkinson’s disease (PD), can exacerbate LBP, since a common sign of it is postural change.
Objective: To show that massage therapy is effective in reducing LBP by applying relaxation, myofascial release (MFR), mobilization, and stretching techniques, and hydrotherapy heat to postural misalignment resulting from PD.
Methods: A 55-year-old male diagnosed with PD in 2012, presented with shooting LBP in the left lumbar region after lifting a heavy gate. Clinical analysis suggested muscle strain exacerbated by postural changes related to PD. The treatment aim was to decrease LBP in the affected muscles. The treatment plan involved 50-minute sessions of massage, once a week, for five weeks. Techniques included hydrotherapy heat application, relaxation techniques, MFR techniques, passive stretches, and passive mobilizations. The treatment was provided by a second year massage therapy student.
Results: The patient reported an overall decrease in pain intensity, by rating pain descriptors. The patient also reported a general decrease in disability caused by
A Specific MFR Technique for Treatment of Non-Specific Upper Quadrant Mylagia and Paraesthesia – A Case Study
Atlantic College of Therapeutic Massage
Fredericton, New Brunswick, Canada
Objective: Investigate whether a case presenting with non-specific upper quadrant muscle pain and neurological dysfunction would benefit from an isolated myofascial release (MFR) technique, entitled herein as direct fascial glide with static unwinding (DFG- SU), in a multitude of related variables: degree of disability and pain, shoulder girdle kinematics and pectoralis minor length, unilateral upper-extremity strength, and neurological functioning.
Methods: The intervention consisted of six treatments over a period of five weeks with pre- and post-intervention examinations. Pain characteristics and degree of disability was monitored with the Revised Short-Form McGill Pain Questionnaire (SF-MPQ-2) as well as the Shoulder Pain and Disability Index (SPADI) and performance of Apley’s scratch test, respectively. Shoulder girdle kinematics was examined via the combination of an inclinometer and goniometer. Pectoralis minor length was assessed using a tape measure against a table and a wall in supine and standing positions, respectively. A handheld dynamometer allowed for the quantification of grip strength on the affected side. Finally, tactile sensation and Tinel’s sign was compared using a three-point ranking system from normal sensation to anaesthesia.
Results: Overall degree of pain, disability, and neurological pain ameliorated after the intervention, yet no notable change in pectoralis minor length or shoulder girdle kinematics was noted. Nonetheless, the restricted aspect of Apley’s scratch test and unilateral grip strength improved by 3.5cm and 2kg, respectively. Finally, tactile sensation and Tinel’s sign improved from presence of paraesthesia to normal sensation.
Conclusions: The results suggest that the MFR technique described herein improved overall well being and competence in daily tasks without significantly altering
Effects of Massage Therapy on Pain Associated with Partial Lumbarization of S1
Canadian College of Massage and Hydrotherapy
Halifax, Nova Scotia, Canada
Introduction: Lumbarization, known as a transitional vertebra or lumbrosacral transitional vertebra, is a congenital abnormality where the first segment of sacrum is not fused. The purpose of this study is to explore the effects of massage therapy on the management of chronic low back pain associated with right sided partial lumbarization of S1, by using General Swedish and non- Swedish massage techniques.
Methods: The patient was chosen based on her chronic back pain due to her right sided partial lumbarization of S1. A treatment plan was designed using General Swedish and non-Swedish technique and performed for ten, one hour treatments. The patient’s progress was monitored using a visual analogue scale for pain, energy, and quality of sleep, as well as assessment of range of motion.
Results: Results showed a three point decrease in day-to-day pain of the patient. Improved quality of sleep by two points and increased energy levels by three points in the morning and one point in the evening were reported as well.
Conclusion: The outcomes of this study therefore suggests that massage therapy is an effective treatment for managing chronic low back pain due to right sided partial lumbarization of S1.
Massage Therapy Treatment and Outcomes for a Patient with Parkinson’s Disease
Edmonton, AB, Canada
Background: Parkinson’s Disease (PD) is a complex neurological disorder. The root cause is unknown, and while treatment with pharmacotherapy is successful, eventually the effectiveness of the medications wears off. The disease is progressive and eventually results in severe disability. Symptoms are well-documented, with the most recognizable manifestations being resting tremor, bradykinesia, and rigidity.
Objective: To determine if massage therapy can produce favorable outcomes with respect to the severity of rigidity and tremor in a patient with PD. Methods A 63-year-old female patient with idiopathic, long-standing, Hoehn-Yahr Stage four PD was treated with massage therapy five times over the course of six weeks. A SPES/SCOPA Motor Impairments rating scale was used to measure rigidity and tremor pre- and post-treatment, to gauge treatment effectiveness. The massage treatments consisted of deep longitudinal stroking, muscle squeezing techniques, passive range of motion movements, and general relaxation techniques to encourage a soothing environment while promoting a decrease in muscular tone and hyperactivity.
Results: The results obtained indicated that massage therapy treatment had a positive effect on reducing resting and postural tremor in a patient with long-standing PD. The treatment was also effective to temporarily reduce rigidity during treatment, but did not produce a lasting effect.
MASSAGE TREATMENT & OUTCOMES FOR A PATIENT WITH PD 4
Further study is required; however, the results of this case were consistent with the limited research available on the subject of massage therapy and Parkinson’s Disease, in that positive change with respect to resting tremor – and to a lesser degree, rigidity – were achieved with focused, intentional treatment.
Touching Pain: Massage Therapy Techniques To Support Adaptive Body Awareness for Self-Management of Chronic Pain Related to Spondylosthesis
Background: Massage therapy techniques increase body awareness. Body awareness can be adaptive or maladaptive. Adaptive body awareness is shown to have a positive effect in the acceptance and management of chronic pain. Spondylolisthesis is a structural condition often accompanied with chronic pain.
Objective: The present report investigates the efficacy of massage therapy techniques in enhancing and sustaining adaptive body awareness for the self-management of chronic pain related to Spondylolisthesis.
Participant: A 57-year-old female initially diagnosed with congenital spinal abnormality by a physician and subsequently with both congenital and degenerative Spondylolisthesis by a chiropractor presents with chronic low and upper back pain and frequent episodes of intense pain in these same areas usually brought on by physical activity. Client is familiar with general massage and acupuncture treatments.
Intervention: Therapeutic massage with the clear goal of increasing adaptive body awareness was introduced during a 4-week period. Five treatment sessions, each 45 minutes in duration used a treatment protocol that included diaphragmatic 4 breathing, various massage techniques in a ‘massage flow’ to relieve muscle tension and recommended home care. Verbal instructions encouraging patient to experience body awareness and sensations of muscles relaxing during massage were integral to the protocol.
Results: Client recorded a decrease in intense pain episodes between treatments, decrease in use of pain medication, no perceptible change in intensity of pain episodes and a better understanding of how to manage her chronic pain.
Conclusion: Patient feedback and therapist observation suggest that therapeutic massage with the clear goal of enhancing and sustaining adaptive body awareness through a treatment protocol carried out as a touch based dialogue between client and therapist may decrease pain-related anxiety and avoidance and increase capacity to accept and manage pain. This in turn may improve functioning and overall sense of wellness.
Therapeutic Massage in Treatment of a Chronic Hyperventilator with Irritable Bowel Syndrome
Gold Award Winner
Utopia Academy, Vancouver, BC, Canada
The objective of this study was to determine whether a combination of therapeutic massage therapy modalities performed on major and accessory muscles of respiration would have a positive effect on a chronic hyperventilator who suffers from chronic unexplained digestive upset. The subject is a 55 year old female and prior to the study’s commencement, complained of frequent episodes of shortness of breath both with exercise and at rest as well as chronic digestive upset diagnosed as Irritable Bowel Syndrome (IBS). The subject’s costovertebral expansion, rib motion and breaths per minute were tested and she also kept a quality of life journal to determine the effects of regular therapeutic massage on her digestive upset. Treatments were first given at 5 to 7 and then 3 to 4 day intervals. Myofascial Release (MFR) and Swedish Petrissage techniques were used on the subject’s major and accessory muscles of respiration. Definite improvements in rib expansion and breaths per minute were recorded and the subject noted an improvement with comfort taking a deep breath and a lessening of her digestive symptoms. The digestive upset had not completely resolved by the end of the ten treatments but she reported that rather than noticing the digestive upset multiple times daily, it only appeared every two to three days. Although scientific documentation exists pointing out the connection between hyperventilation syndrome and digestive symptoms, this study is not specific or large enough to determine a definite link between improvement of breathing capability and resolution of unexplained indigestion.
Manual Lymphatic Drainage and Therapeutic Massage in Treatment of a Classical Violinist
Silver Award Winner
Vancouver College of Massage Therapy of Utopia Academy
Objective: The objective of this study was to determine whether a combination of therapeutic massage modalities and manual lymphatic drainage could ease symptoms of playing-related musculoskeletal disorder in a professional classical violinist. The patient, a 26-year-old Caucasian female, complained of stiffness, heaviness, and swelling in her overworked fingering (left) hand. She tested positive for several special tests for thoracic outlet syndrome and nerve entrapment pathologies, as consistent with existing literature regarding common injuries in professional musicians.
Methods: A strict treatment protocol was employed over the course of ten treatments in order to minimize variability. Therapeutic massage techniques such as myofascial release and neuromuscular therapy were applied first; each treatment closed with MLD to the neck and the left arm, following the protocol established by the Dr Vodder school. All treatment was applied bilaterally with the exception of MLD treatment of the arm, which was applied only to the left side.
Results: After 10 treatments the patient noted a complete resolution of her symptoms. These results were measured using a combination of special tests and the DASH (Disabilities of the Arm, Shoulder, and Hand) questionnaire.
Conclusion: For the purposes of this study, a combination of MLD and therapeutic massage was chosen in order to address the patient’s complaints of pain, tightness, and a sensation of overwork in her left, or fingering, hand. The choice to combine these techniques was based on the existing research, which indicated a gap to be filled between overwork due to sports injuries and overwork in a musician’s playing-related activities. To clearly determine what techniques had which effects on the patient, separate studies on these techniques need to be conducted.
The Effect of Massage Therapy on Piriformis Syndrome
Bronze Award Winner
Edmonton, AB, Canada
Background: Piriformis syndrome is a neuromuscular condition that primarily involves compression of the sciatic nerve by the piriformis muscle. The condition is caused by many different factors such as vigorous physical activity, associated trauma to the pelvic region, anatomical nerve or muscle abnormalities, postural imbalance, valgus knees, hyperlordosis, and hypertrophy. Signs and symptoms of the condition include pain and/or paresthesia that are first felt in the low back, hip, and/or gluteal region and then later on when the sciatic nerve is involved, the symptoms radiate to the posterior thigh and lower leg.
Objective: To evaluate the effects of a 45 minute massage treatment on piriformis syndrome by measuring hip rotation range of motion (ROM) and pain intensity levels each week for a consecutive seven weeks.
Methods: The treatment aim was designed primarily to decrease the pain and hypertonicity in the muscles of the affected right gluteal region, treat the compensatory muscles on the left side and to restore the length of the lateral rotators. Techniques included myofascial release (MFR), trigger point therapy (TrP), contract-relax proprioceptive neuromuscular facilitation (PNF) stretches for the lateral rotators and hydrotherapy heat applications.
Results: Range of motion for hip lateral and medial rotation of the affected side increased demonstrated through goniometer measurements. The client also reported a decrease in pain intensity which was documented throughout the seven weeks pre and post treatment.
Conclusion: The results suggest that massage therapy is an effective form of treatment for piriformis syndrome.
The Affects of Massage Therapy on Pain Associated with Spinal Cord Injury: A Full Body Approach
Canadian College of Massage and Hydrotherapy, Halifax
Objective: This study was performed to explore the effects of Massage Therapy for the purpose of improving pain associated with a spinal cord injury.
Methods: The candidate for this case study was chosen based on his diagnosis of an incomplete spinal cord lesion resulting in contracture formation, decreased range of motion, spasticity, and muscle imbalances’ ultimately resulting in chronic pain. A treatment plan was created using both General Swedish Massage techniques and non- Swedish Massage Techniques following a full body approach. One hour Massage Therapy treatments occurred biweekly for a five week period in which the Visual Analogue Pain scale was used to monitor the patient’s pain levels before, during, and after each Massage Therapy treatment.
Results: Within the first five treatments the candidate had begun to notice a decrease in pain, spasticity, shaking of the lower limbs at night and better sleep patterns. By the end of the tenth treatment the candidate had improved balance and gait, as well as decreased (almost eliminated) spasticity and shaking in the lower limbs at night. Final results using the Visual Analogue Pain Scale showed an average decrease in pain of 34% over the five weeks of treatment.
Conclusion: The outcome of this study suggests that the application of Massage Therapy is an effective modality in reducing pain associated with spinal cord injuries.
The Effects of Massage Therapy on Thoracic Outlet Syndrome
New Zealand College of Massage, Aukland, NZ
Background: Thoracic outlet syndrome (TOS) refers to a group of conditions resulting from compression of the neurovascular structures of the thoracic outlet. Traditional choice of treatment has been surgical intervention rather than physical therapy. Complementary treatment for TOS includes myofascial release, joint manipulation, trigger point therapy, muscle strengthening and stretching. This case study examined the effects of neuromuscular therapy (NMT), massage and other manual therapies in a subject with TOS.
Methods: Six sessions of therapy were performed over eight weeks. Following assessment an individualized treatment plan that included myofascial release, joint mobilization, trigger point therapy and breathing education was undertaken.Objective measurements included range of movement (ROM), Adson’s and Roos tests. Measure your own medical outcome profile (MYMOP2) a subjective patient generated measure of clinical outcome was used to measure clinical change.
Results: Clinically significant symptomatic improvement and increased cervical spine and shoulder range of movement resulted.
Conclusion: Massage was an effective choice of treatment in the management of a subject with thoracic outlet syndrome.
Investigating the Effect of Massage Therapy on Phantom Limb Sensation and Pain on a Double Amputee
Lambton College, Sarnia, Ontario
Objective: The purpose of this case report was to observe the effects of massage therapy on phantom limb pain. Massage therapy was provided to a client withdouble above-the-knee amputations as a way to relieve the constant phantom limb sensations she experienced, as well as to decrease the occurrence of her phantom limb pain.
Methods: Over a two week period, five treatments were administered using general Swedish massage techniques, as well as the implementation of rubbing a towel on the residual limbs bilaterally during each treatment to decrease sensitivity to the area. The client tracked her phantom limb pain and sensation, other pain, and mood three times a day, as well as how she slept the night before on the scales provided to her. The client also verbally commented during treatments as to when the sensation disappeared and how long it stayed away for.
Results: The case study for massage therapy as a treatment option for those experiencing phantom limb sensation was favorable. Over the five treatments the client noted that the phantom limb pain and sensations disappeared post-treatment and stayed away for up to 90 minutes.
Conclusion: This study shows that massage therapy is a valid and successful treatment option for individuals seeking relief from phantom limb pain and sensation.
Massage Therapy Treatment for Scar of Post Tibia/Fibula Reconstructive Surgery and Fasciotomy
Danielle Van Holst
Algonquin College, Ottawa, Ontario
Background: The purpose of this study was to determine the effectiveness of massage therapy in the rehabilitation of impairments that resulted from an open tibia and fibula fracture after reconstructive surgery and fasciotomy. The subjects most significant complications post-surgery included loss of sensation, fascial adhesions and decreased patellar joint range of motion.
Methods: Assessment of the condition included subjective reporting on any change in level of sensation and overall function. Orthopedic physical assessment was also used to measure changes in patellar range of motion and in palpable movement of the scar (adherence of the scar to underlying tissues). Treatment consisted of direct fascial and myofascial release, joint mobilizations, neuromuscular techniques (ex. trigger point treatment), dry brushing and hot hydrotherapy (paraffin wax, hydroculator).
Results: Results recorded include an increased level of sensation and overall function during daily activities, an increase in joint range of motion and a decrease in fascial restriction and scar adhesion.
Conclusion: Massage Therapy was an effective and efficient therapy for rehabilitation of impairments that resulted from an open tibia/fibula fracture, reconstructive surgery and fasciotomy.
Combination Structural and Swedish Massage on a Patient with Post-Operative Bunions
Heidie C. Furin
Cortiva Institute – Seattle
Bunions, also known as hallux valgus, are enlargements and eventually misalignments of the metatarsalphalangeal joint on the ball of the foot (Shiel,2011). The purpose of this study was to explore the effects of massage on a 65-year old female client suffering from pain associated with bunions and negative mood related to modification of activity levels. This study was designed toinclude a baseline assessment and five treatment sessions. Treatment sessions were 30 minutes of structural work on the right foot and the right tibialis anteriorto reduce physical pain. Treatment also included 60 minutes of full body relaxation massage to reduce depressive symptoms associated with reducedmobility and the effects of chronic pain. Two measures were used to assess quantitative outcomes: 1) the Brief Pain Inventory (Cleeland and Ryan, 1994), and 2) the Geriatric Depression Screening Scale (Yesavage et al., 1983). Results indicate that this treatment provides relief based on both measures of pain and mood. The subject also reports increased activity exceeding baseline goals. This study suggests that Swedish massage and structural work is a promising combination for decreasing pain and improving mood in an individual suffering with bunions.
Massage Therapy for Essential Tremor: Quieting the Mind
Grant MacEwan University, Alberta, Canada
Background: Essential tremor (ET) is a neurological disorder causing rhythmical shaking of part of the body. The condition is known to have an inheritable tendency and can present in more than one family member, known as familial tremor. ET is progressive and in its mildest form can be sensed and/or observed when performing simple motor skills or activities of daily living (ADL).
Objective: To evaluate the effects of massage therapy on the severity of essential tremor using an activity-based rating scale pre and post treatment.
Methods: The treatment aim was to reduce sympathetic nervous system firing; therefore the massage techniques implemented were relaxation-based. Methods included Swedish massage, hydrotherapy, myofascial release, diaphragmatic breathing, remedial exercise education and affirmative symptom management recommendations.
Results: Tremor intensity decreased after each session; demonstrated by improved fine motor skills. The client also reported an increased functionality in cervical range, which was documented during the first and last visits.
Conclusion: The results suggest that massage therapy is an effective alternative form of treatment for ET.
The Effects of Massage Therapy after Decompression and Fusion Surgery of the Lumbar Spine: A Case Study
Bronze Award Winner
Background: Spinal fusion and decompression surgery of the lumbar spine are common procedures for problems such as disc herniations. Various studies for postoperative interventions have been conducted however no massage therapy studies have been completed. The objective of this study is to determine if massage therapy is beneficial to treat pain and dysfunction associated with lumber spinal decompression and fusion surgery.
Methods: Client is a 47-year-old female who underwent spinal decompression and fusion surgery of L4/L5 due to chronic disc herniation symptoms. 7, 30 minute treatments were conducted over 8 weeks. Treatment was conducted on the back, shoulders, posterior hips and posterior legs. Techniques included rocking, shaking, gliding, wringing, stripping, kneading, compression, passive hip range of motion and myofascial release techniques including skin rolling, connective tissue cutting, fascial spreading, C-bowing, and S-bowing. VAS pain scale was recorded before and after every treatment. Hamstring Length Test, Oswestry Disability Index and the Roland-Morris Disability Questionnaire were recorded before and after 8 weeks of treatment.
Results: There was no significant changes in pain. Hamstring length improved (measured in degrees) at first treatment from pre 40 and post 60, left pre 65 and post 70. After the final visit the results were right pre 50 and post 65, left pre 70 and post 75. The Oswestry Disability Index improved 14% from 50% to 36% disability. Roland-Morris Disability decreased 1 point from 3/24 to 2/24.
Conclusions: Massage for pain had short term effects. Massage therapy seemed to lengthen the hamstrings bilaterally. Massage therapy does appear to have positive effects in the reduction of disability. This study is beneficial in beginning to understand the relationship between massage therapy and clients who have undergone spinal decompression and fusion. Further research is warranted.
Massage Therapy for Cervical Degenerative Disc Disease: Alleviating a Pain in the Neck?
Sir Sandford Fleming College, Ontario
Background/Objectives: A 66 year old female client with cervical degenerative disc disease at lateral left C6/C7 was experiencing symptoms of chronic neck pain accompanied by limited cervical range of motion, as well as radicular left shoulder and arm pain. The objective of this case report was to analyze the effect of therapeutic massage on the clients symptoms and impairments of cervical DDD.
Methods: Therapeutic massage interventions included; soft tissue manipulation using petrissage and neuromuscular techniques, fascial work, facilitated stretching, joint play, hydrotherapy, education on self stretching, and positive guidance about condition management. Markers of progress included pain free cervical ROM and a subjective verbal pain scale.
Results: After several treatment sessions, clients symptoms had decreased and cervical ROM had improved moderately. There was also a decrease in reported pain and an increase in functional daily activities. Client showed a greater understanding of the physiologic barriers which degenerative changes may present.
Conclusions: This client responded favourably to massage therapy as a treatment intervention for cervical DDD symptoms.
Decreasing Chronic Pain in a Patient with Adult Acquired Flat Foot due to Posterior Tibial Tendon Dysfunction
Kristin Louise Crymes
Cortiva Institute of Seattle
A patient with adult acquired flat foot due to posterior tibial tendon dysfunction was experiencing chronic pain and periods of intense spasm traveling proximally in her left leg from her medial longitudinal arch to her gluteals, exacerbated by her profession as a tae kwon do instructor. A 5 session massage treatment series targeted fascial stress and strain in the patients left foot, ankle, and lower leg and continued proximally to address systemic fascial restrictions and postural deviations. While the structural framework of the patient’s lower left leg did not measurably change, the patient gained a reduction in pain, improved range of motion, and increased fascial mobility. Massage therapy may be a viable non-surgical option for the reduction and maintenance of chronic pain associated with adult acquired flat foot and posterior tibial tendon dysfunction.
The Effect of Massage Therapy on Clinically Symptomatic Mortons Neuroma
Faith Davis Boulder
College of Massage Therapy
Morton’s neuroma is a common cause of pain radiating from between the 3rd and 4th metatarsals and creating symptoms of burning or sharp pain and numbness on the bottom of the foot. This case report will examine whether consistent treatment with massage therapy decreases pain symptoms associated with Morton’s neuroma. Treatment began with an extensive health history including questions specifically about activity level and foot health, as well as using a clinical test to determine presence of a Morton’s neuroma. The client received treatment once a week for 60-75 minutes over the course of six consecutive weeks. The treatment was composed equally of general postural realignment and specific foot and lower leg treatment therapy. Pain level was measured by the client on a questionnaire filled out at each session as well as by palpable findings. The massage treatment resulted in progressive change in the character of the pain from burning and stabbing pre-massage to a dull, pulsing sensation post third session.The client also experienced a continuous decrease in the duration of pain after physical exercise. In this case report, massage treatment of Morton’s neuroma resulted in significant pain reduction, both during activity and at rest.
Manual Therapy for Osteoarthritis of the Hip
New Zealand College of Massage
Background/Objectives: Osteoarthritis is a common musculoskeletal disorder. Conventional treatments for mild to moderate osteoarthritis include medications, exercise, hot and cold therapy, and corticosteroid injections. Treatment is limited by poor effectiveness and significant side effects. Massage therapy has been reported to improve symptomatic control in mild to moderate osteoarthritis. This case study examined the effect of massage therapy in a subject with right hip osteoarthritis.
Methods: Six sessions of massage therapy were performed over a six week period. Following assessment, a tailored programme including hip joint mobilization, myofascial release, trigger point therapy, and hip strengthening exercise was carried out. A holistic approach that included psychological needs was taken. Subjective and objective outcome measures evaluated included measurement of pain scale, level of activity, range of motion, trendelenberg test, hip abduction strength and straight leg raise.
Result: At completion, range of movement of the right hip, hip abduction strength and the trendelenberg test showed improvement. Subjective perception of pain 3 had improved and level of activity increased. Improvement in mood and attitude was observed.
Conclusion: Holistic massage therapy is beneficial to both physical symptoms and psychological status of subjects with mild to moderate osteoarthritis of the hip.
The Effects of Massage Therapy on Vascular, Nervous and Muscular Impingement in the Upper Limb
CCMH Foothills College of Massage Therapy
Objective: Determine the effectiveness of massage therapy in treating symptoms of carpal tunnel syndrome, thoracic outlet syndrome, and supraspinatus impingement.
Methods: A 30 year old female reported pain and weakness in the right wrist, forearm and shoulder as well as numbness in right hand. An objective assessment confirmed carpal tunnel syndrome, thoracic outlet syndrome and supraspinatus impingement syndrome. A total of ten, sixty minute Massage Therapy treatments were received by the subject over the course of ten weeks. Each treatment consisted of fifteen minutes of interviewing to gather any pertinent updates regarding the subject’s symptoms and forty-five minutes of hands on treatment time, consisting of various soft tissue mobilizing and lengthening techniques. Additionally, the subject was presented with homecare exercises to complement treatment. A full assessment was performed prior to, halfway through, and upon completion of the treatment plan.
Results: By the end of the study, elimination of shoulder, wrist and forearm pain and weakness, along with numbness in the hands was achieved.
Conclusion: Massage Therapy is an effective means for reducing the symptoms of carpal tunnel syndrome, thoracic outlet syndrome, and supraspinatus impingement syndrome.
Myofascial Techniques along the Acupunture Meridians: a new possibility for treating internal organ dysfunction
Atlantic College of Therapeutic Massage
Research suggests connective tissue planes are the biological basis for the acupuncture meridians. Although acupuncture needles are inserted through the skin into the superficial fascia, they are meant to treat internal organ dysfunction. This case report’s hypothesis is that myofascial techniques applied to engage the connective tissue along these meridians may in turn affect function or dysfunction related to the corresponding internal organs.
Two participants with diagnosed gastrointestinal disorders were treated using myofascial techniques along meridians typically treated in acupuncture for these conditions. Diaries of bowel function and symptoms were kept before and during treatments. Results were mixed; one participant experienced a change in her usual bowel movement pattern, the other had unusual bowel responses never experienced before and unexplained by other factors. There were no dramatic improvements in their conditions. The results suggest it may be possible to affect the internal organs via the acupuncture meridians using myofascial techniques. Further research is needed to explore the possible effectiveness, and the best means to elicit therapeutic responses.
Does Massage Therapy Affect Temporomandibular Joint Dysfunction?
Silver Award Winner
Melissa Pierson, MT
CCMH Ð Foothills College of Massage Therapy
A 26-year-old female was selected for participation in a study on temporomandibular joint dysfunction (TMD). Her primary symptoms included pain, decreased range of motion, clicking and crepitus. Her symptoms were related to emotional stress and bruxism (grinding of the teeth). The objective of the study was to determine if massage therapy has any affect on TMD. Ten 45 minute massage therapy treatments were administered over a five week period, and the subject’s progress was monitored by an initial, midway, and final assessment using range of motion testing, personal interview, special tests, and postural analysis. Progress was also evaluated by the use of a daily journal. The subject partcipated in a home-care routine consisting of stretches, self massage, proprioception exercises, and hydrotherapy. Results of treatment included an increase in maximal opening from 3.1 cm to 3.8 cm, an overall increase in neck range of motion, a decrease in muscle hypertonicity using the Wendy Nickel’s Scale, a decrease in pain from 7/10 to 3/10 on a numerical pain scale, and a decline in stress. Although the results of ths study were positive, more extensive studies must be done to reach a conclusion on the effects of massage on TMD.
The Effects of Massage Therapy on Lumbar Spondylolisthesis
Gold Award Winner
Cortiva Institute of Seattle
Objective: To investigate the effectiveness of myofascial massage and muscle energy techniques on reducing low back pain and hyperlordosis related spondylolisthesis.
Methods: A 30-year old female was diagnosed with spondylolisthesis at age 12, has chronic mild to moderate back pain during prolonged walking/standing, hyperlordosis and anterior rotation of the pelvis. A 7-session treatment series of muscle energy techniques and structural myofascial massage was carried out measuring ilium rotational change and length of standing/walking time before low back pain onset.
Results: The onset of low back pain was delayed during walking/standing over the course of treatment, and hyperlordosis and bilateral anterior rotation of the ilia reduced.
Conclusion: Massage treatment combining neuromuscular and myofascial massage was effective in reducing pain during activities of daily living, minimizing chronically tight muscles, and altering skeletal structure associated with spondylolisthesis. Massage therapy should be considered as a non-invasive healthcare strategy to improving soft-tissue dysfunction in cases of spondylolisthesis.
Improving Mobility in a Client with Hypochondroplasia (Dwarfism): A Case Report
Gold Award Winner
Amy Axt Hanson
Cortiva Institute, Seattle School of Massage Therapy
A client with hypochondroplasia dwarfism and a medical diagnosis of spinal stenosis had found that her ability to walk had decreased the past seven years from easily walking six miles to now needing to rest every half block due to muscle fatigue. Such weakness is consistent with nerve impingement due to spinal stenosis, which is not expected to be improved by massage. However, it was found that both lower legs had severe fascial adhesions, possibly compressing her tibial artery and other blood vessels and nerves. Relieving such adhesions was expected to improve her mobility, and indeed, myofascial techniques showed positive results in reducing adhesions, improving circulation, and significantly increasing the distance she could walk before resting. It was also found that LMPs need only make a few alterations in setup to better serve their dwarf clients.
Impact of Massage Therapy on treatment of Adhesive Capsulitis
Silver Award Winner
Cortiva Institute, Seattle School of Massage Therapy
This intent of this report is to investigate the effectiveness of massage as an adjunct to physical therapy in treating adhesive capsulitis. A 45 year-old female subject was diagnosed with adhesive capsulitis 1 month prior to the beginning of the study and was undergoing standard physical therapy protocol. Six weekly manual therapy sessions were administered. Each 120 min session consisted of 15-20 minutes of intake and assessment during which ROM (Range of Motion) was measured and pain levels, sleep patterns and energy levels (after the last massage) were recorded. Manual therapy was applied for 90 minutes consisting of deep tissue, muscle energy, myofascial release and neuromuscular therapy (NMT). The remaining time was used to assess ROM and pain levels at the conclusion of the session. Reported ROM, pain levels, activity levels and sense of wellbeing all showed improvements over the course of the treatment. Massage is an appropriate tool for treating adhesive capsulitis and further research should focus on the ability of massage to address orthopedic as well as somato-emotional aspects of this pathology.
Massage Effectiveness for Client with Post-Polio Syndrome
Brian D. F. Richmond, MPH
Potomac Massage Therapy Institute
A student massage therapist worked with a client experiencing post-polio syndrome (PPS) over a period of nine sessions. The series began with a medical history intake and interview to determine the clientÕs needs, expectations, and common symptoms. Based on post-polio syndrome conditions cited during this initial intake, a multi-variable scale was created for the client to track the frequency and extent of his PPS symptoms prior to each session, and to afterwards record his assessment of the therapy. Eight sessions were tracked using this instrument. The application of extremely slow, gentle glides over the body of the atrophied muscles was a key intervention used to help the client sense some degree of muscular fullness and length. PPS conditions of muscle tension and overall stress were tracked using pre-/post-massage measurements and suggest a correlation between the therapy and a decrease in the client’s tension and stress. Qualitative feedback from the sessions indicated “a marked increase in energy, and a decrease in muscle spasm, joint and muscle pain, and overall fatigue.”
Intuitive Listening and Body Reading: are they viable tools in Massage and Bodywork?
Cortiva Institute, Seattle School of Massage Therapy
Body reading and intuitive listening are often consciously and unconsciously employed by massage practitioners, in conjunction with verbal communication, in an effort to better understand the body’s needs. It is often times not openly recognized and/or discussed as a tool; the purpose of this study is to try to determine if the practitioner can utilize these skills, in the absence of any other communication with the client, to listen to the body and discern what it needs.
Before each of the five 1-hour sessions, the client noted and diagrammed their area of concern which is not shared in any way with the practitioner. The practitioner then does body reading/intuitive listening and determines where the body is indicating work needed. The session work is focused based on the practitioner’s findings. The client completes a follow up questionnaire for each session. The practitioner does not review any questionnaires until the study is completed. Results showed that, in four out of the five sessions, the client and practitioner were generally in-sync. The results indicate that body reading/intuitive listening can be a useful tool in better understanding the body’s needs and providing more precise and effective treatment.
Management of Lower Body Pain in a Client with a Chronic Lumbar Disk Herniation
Algonquin College, Ottawa, Canada
Background/Objectives: Peripheral pain is a prevalent symptom of a lumbar disc herniation. Pain may radiate from the affected nerve root causing local pain in the low back and gluteal region as well as pain radiating down the lower leg. This study was designed to decrease the prevalence of these associated symptoms through massage intervention in conjunction with client homecare.
Subject: The client was a 55 year old woman with a previous herniation of L5/S1 as well as history of degenerative disc disease. She had complaints of low back pain and calf cramping with extreme sensitivity to pressure in the calves.
Method: The study was completed over a six week period consisting of five one hour treatments and home care assigned weekly. The outcomes were measured by range of motion of hip flexion, length of the gastrocnemius and soleus, algometer readings on various points of the calves as well as client journaling of pain occurrences using a pain analog scale.
Results: Over the course of five weeks straight leg hip flexion increased an average of 48 degrees with the client experiencing a complete absence of low back pain during the course of a work week. Pressure sensitivity lowered in the calf with tolerance to pressure increasing an average of seven pounds bilaterally. Massage therapy can be a beneficial treatment to decrease pain, lessen sensitivity and increase range of motion in the lower body of a client with chronic lumbar disc herniation.
Effects of massage in sustaining performance and limiting soreness in a multi-performance sporting event
Mary Jane Calvert
Cortiva Institute, Colorado
Summary: For athletes participating in a sporting event, maintaining performance and limiting soreness are often key concerns. Study Aim: This study aims to evaluate the efficacy of sports massage in limiting soreness and maintaining performance during a multi-performance sporting event. Methods: Two male hockey players participated in this study over the course of a 3-day recreational ice hockey tournament. Performance, muscle strength, soreness and range of motion data were gathered prior to and after each skating event. The participants received a 10-minute sports massage protocol targeting major muscles of the upper leg (hamstrings, quadriceps, and adductors) approximately 30-60 minutes following each skating event. Results: The data gathered showed active range of motion, muscle strength and performance levels were maintained over the course of the study despite a limited increase in soreness for Subject A and more significant increase in soreness for Subject B. These results support the conclusion that sports massage is effective for sustaining performance and limiting soreness in a multi-performance sporting event.
Bulimia Nervosa and Massage: A Case Report Examining Body Awareness with Co-morbidities Anxiety and Depression
Silver Award Winner
Cortiva Institute Ð Brian Utting School of Massage
Objectives: The study investigates the ability of Massage Therapy modalities to have a positive effect upon anxiety, depression, body image in a subject diagnosed with Bulimia. Methods: The subject is a 25-year-old female, presenting with chronic bulimia nervosa diagnosed 8 years ago. Massage treatments were administered once a week for 5 weeks, 90 minutes per session. Techniques employed included Swedish, Deep Tissue, Reflexology, Neuromuscular Technique, Sports Massage Compressions, Passive Stretching and range-of-motion (ROM).
The intention of the work was to provide a nurturing full-body experience with an emphasis on body awareness. Measurement of anxiety, depression, and body image was accomplished with 5 selfreport assessments, administered one month prior, before, and after the treatment series.
Results: A reduction in anxiety, depressive symptoms, and body image anxiety were reported, as well as an increase in body awareness.
Conclusions: This study suggests that massage therapy is a useful adjunct to traditional psychotherapy and an effective treatment choice for the comorbid symptomatology of bulimia nervosa.
Massage Therapy as a Method to Decrease Forward Head Posture, Internal Shoulder Rotation and Anxiety: A Case Study
Bronze Award Winner
Kiné-Concept Institute, Ottawa
Introduction: Study investigated the ability of massage therapy to decrease pain and limitation associated with postural dysfunction, Forward Head Posture (FHP) and Internal Shoulder Rotation, and to decrease symptoms of Anxiety.
Methods: Client diagnosed with Anxiety Disorder and Obsessive-Compulsive Disorder also presented with postural dysfunction complained of right shoulder pain and limitation with Activities of Daily Living persisting for 3 years. A massage therapy intervention, using Swedish techniques, Myofascial Release, Neuromuscular Therapy, stretching, diaphragmatic breathing hydrotherapy, and homecare was implemented for five one-hour treatments over the course of three weeks. Treatments focused on the back, anterior and posterior neck, chest, Intercostals and Diaphragm. The measures of interest were those of Active Free Range of Motion (ROM) of the shoulders and cervical spine, Pain, changes in FHP and Internal shoulder rotation, and selfrated anxiety.
Results: ROM of the shoulders and the cervical spine increased to normal ranges, and associated pain decreased. Measures of FHP and internal rotation of the shoulders also decreased. The measure of self-rated anxiety indicated a decrease during treatment.
Discussion: Results suggest that massage therapy may decrease postural dysfunction and associated pain and limitations. Massage may also be an appropriate complementary treatment for Anxiety and Mental Health disorders
The Effects of Massage Therapy on Mild Structural Scoliosis in the Thoracic Spine Resulting in Postural Changes, Muscle Fatigue, Sleep Disturbances and Chronic Headaches
Kiné-Concept Institute, Ottawa
A case report promoting massage therapy as an alternative healthcare treatment option for scoliosis in maintaining tissue health, reducing myofascial pain, frequent headaches and sleep disturbances. An additional goal is to provide a comfortable environment lending emotional support for physical insecurities experienced by those affected by scoliosis.
Methods: A 28-year old government worker presents with mild structural scoliosis of the thoracic spine. A log was kept to document frequency of headaches and number of times waking in the night. Treatment consisted of Neuromuscular Techniques (NMT), Myofascial Release (MFR), Trigger Point Therapy (TrP), and General Swedish Massage (GSM) targeting the torso and cervical region twice weekly for 60-minute sessions for 4 weeks.
Results: Client reached sufficient decrease in complaints of chronic headaches, frequency of sleep disturbances and pain at the end of the third week of treatment. Rapid onset of muscle fatigue remained unchanged.
Conclusion: Treatment results suggest that massage therapy techniques can improve management of musculoskeletal discomfort and quality of life for those suffering from mild structural scoliosis.
Treating Fatigue in Multiple Sclerosis with Massage Therapy
Gold Award Winner
Introduction: Fatigue is recognized as one of the most disabling and common symptoms of multiple sclerosis (MS). No universal consensus has been reached regarding effective treatments for fatigue and the causes are not well understood.14 This study was designed to investigate the effectiveness of massage therapy, an alternative modality, on fatigue symptoms with multiple sclerosis.
Methods: Using two fatigue scales, the Fatigue Severity Scale (FSS) and the Multidimensional Assessment of Fatigue (MAF), one female adult, with MS for 20 years, self-assessed her fatigue levels post massage therapy intervention. Over a five-week treatment period, 45 minute massage treatments were administered in the early evening.
Results: There was no evidence to indicate that perceived fatigue levels were decreased over time with the massage intervention. Self reports did imply that an overall endurance improvement in both treadmill walking duration and speed from Week 1 to Week 5. Sleep patterns were self-reported to have improved over the duration of the 5 week intervention period.
Discussion: Current findings suggest that there may be no direct correlation between improved fatigue levels and weekly massage therapy intervention on an ongoing or long-term basis. Yet, there is opportunity to further research the short-term benefits of massage therapy intervention and fatigue for the people managing life with multiple sclerosis.
Investigating the Effectiveness of Myofascial Release Techniques in the Treatment of Primary Raynaud’s Syndrome
Gold Award Winner
Objective: To investigate the efficacy of a non-pharmacological approach such as Myofascial Release massage in the treatment of Primary Raynaud’s Phenomenon. This study assessed the impact of specific myofascial techniques on connective tissue of the arm and hands to determine if fascial work can affect frequency or symptoms of vasospastic episodes.
Methods: A 35-year old female reported experiencing symptoms of Primary Raynaud’s Phenomenon for the past 12 years. Five treatments of specific myofascial release massage techniques were administered over a 3-week treatment period. The focus of the work centered on the upper back, neck and arms according to specific fascial lines.
Results: After the first treatment, the duration of the subject’s vasospastic episodes was reduced by almost half and continued to decrease throughout the 3 weeks of treatments. Neither the frequency, severity of the episodes, or number of affected digits varied significantly from the pre-treatment weeks.
Conclusion: Overall findings suggest that Myofascial Release techniques have the potential to relieve the duration of vasospastic episodes in a client with Primary Raynaud’s Phenomenon.
Massage Therapy’s Effects on Low Back Pain with Sciatica Symptoms
Silver Award Winner
Carteret Community College
Objective: This study evaluated the effectiveness of massage therapy as a component in increasing range-of-motion (ROM), decreasing pain and assisting in healing of a client with low back pain (LBP) and sciatica symptoms.
Methods: The client presents with an insidious onset of LBP and pain that radiates into the right lower extremity (sciatica). The client has been experiencing this pain daily for the past 9 months. Frequency, duration, and intensity of symptoms were recorded in a daily diary beginning the day after the client’s first visit with the massage therapist. Manual therapy was administered once a week; each session lasted 45 minutes and consisted of a structured protocol directed mainly toward muscles of the lumbar spine, pelvis, thigh, and leg regions.
Positive Systemic Effects Using Therapeutic Massage as a Conjunctive Treatment for Rheumatoid Arthritis
Bronze Award Winner
Community College of Baltimore County
Objective: This study considered the efficacy of causing positive systemic effects translating into sustained periods of symptomatic remission in the management of rheumatoid arthritis (RA) for a recently diagnosed patient.
Methods: The study subject reported RA complications with pain related symptoms in the right shoulder, forearm and index finger. Over a 10 week period, the subject received 8 therapeutic massage sessions; 7 were weekly and one was at a 3 week interval. Each session lasted for 1 to 1 1/2 hours and was mainly comprised of Swedish and myofascial techniques to the musculature surrounding the right glenohumeral joint with an additional specific hand massage protocol and light friction strokes in the right antecubital region to encourage lymph flow.
Results: At the third weekly session, the client reported experiencing no pain or discomfort. This period of non-flare up and absence of pain continued through the remainder of the study period, even with a longer 3 week duration between sessions at the end of 10 weeks. The client also noted that no pain medication other than her weekly Methotrexate dosage was taken throughout the duration of the study and that she was obtained a better quality of sleep and daily activity.
Conclusion: Therapeutic massage treatments while able to achieve qualitative muscle release in an affected joint region, can also positively affect the physiological systems of a patient with RA and help to alleviate and prolong the deteriorating effects of the disease.
The Effects of Massage Therapy in Pain Management for Patients Undergoing Chemotherapy for Cancer
Atlantic College of Therapeutic Massage, Fredericton, New Brunswick
The author designed and implemented a treatment plan to investigate the effects of massage therapy (MT) on pain reduction in patients undergoing chemotherapy for cancer. It was expected that a 50% reduction in pain scores would result. The subject was a 68 year-old female with a history of non-progressive, non-metastatic breast cancer who was undergoing chemotherapy following a complete mastectomy of her right breast, including removal of all axillary lymph nodes. Intense, intermittent pain was reported, along with moderate levels of anxiety and depression. Low levels of fatigue and depression were also reported. Five MT treatments were applied over a six-week period. All symptoms were assessed before, during, and after the study using a visual analog scale (VAS) and the Memorial Pain Assessment Card (MPAC).
Data from the subject’s daily journal showed a 45.1% improvement in pain scores during the first five weeks of therapy. From beginning to end of the treatment series, scores for pain at its worst improved by 51%, despite the aggravation of all symptoms due to a stressful travel period during Week 4. Marked reductions in anxiety and depression were documented, as well as strong trends towards a decline in fatigue and sleeplessness. These data clearly indicate that MT is an appropriate tool for the management of pain and associated symptoms in patients undergoing chemotherapy for the treatment of cancer.
This case report was published in Massage Therapy Practice Magazine.
Massage Therapy Reduces Frequency and Intensity of Symptoms from Lumbar Disk Herniations
Fleming College, Ontario
Objective: To determine whether the use of massage therapy, specifically connective tissue and neuromuscular techniques, helps to reduce the frequency and intensity symptoms related to lumbar disk herniations with radiculopathy.
Clinical Features: A 36 year old female experienced a dull ache in low back and left gluteal that began to radiate into the left posterior thigh 6 weeks after initial injury subsequently producing spasms in left hamstrings and gluteal with pain referral and paraesthesia into the left foot. Diagnostic studies revealed two lumbar disk herniations; one occurring at L4-L5 5mm in size and the other at L5-S1 8mm in size.
Intervention and Outcomes: Massage treatments consisted of neuromuscular and connective tissue techniques focusing on the posterior aspect on the body from cranium to plantar fascia. At the end of 5 treatments the subject no longer had any pain and could perform activities of daily living pain free.
Conclusion: There are many reports published on the use of massage therapy and low back pain, as well as the use of manual traction and exercise for the rehabilitation of lumbar disk herniations. This case study combines elements from many professions and carries over the main principles in order to effectively treat lumber disk herniations.