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.
Keywords: range of motion, obesity, homecare, shoulder, cervical
Massage and Burn Scar Therapy for Burn Survivors in the New England Area
Brecken Chinn, PhD
East Falmoth, Massachussetts
HandReach is a network of compassionate professionals dedicated to improving quality of life for burn
and trauma survivors. HandReach works at the acute, reconstructive, and psychosocial levels to help
individuals debilitated by severe burns and amputations return to full function and a productive future.
The objective is to provide massage and burn scar therapy to underserved burn survivors in the New
England area who might otherwise not be able to afford treatment. Financial hardship may be due to being out of work during their recovery; not being able to return to work; or permanently disabled.
Massage Perceptions and Experiences for Individuals with Amputations
Niki Munk, PhD, LMT
School of Health and Rehabilitation Sciences
The 2016 Massage Therapy Foundation Research Grant award will support the completion of a developing amputation related therapeutic massage and bodywork (TMB) research program for early career TMB practitioner researcher, Dr. Niki Munk and will be conducted at the Indiana University’s School of Health and Rehabilitation Sciences.
Evidence informed practice is built from clinical experience, patient preferences, and the best research evidence available. Currently, little to no published research exists to elucidate TMB application, effect, or theoretical approach for individuals with amputations compromising the three-legged evidence based practice stool. Approximately 1.6 million people currently live with an amputation in the U.S. and this rate will double by 2050. Those with amputation face many chronic and/or reoccurring pain conditions and many with amputation related pain do not receive satisfactory relief through the typical opioid and anticonvulsant treatment regime. Massage therapy is a treatment self-reported by those with amputation as moderately-extremely effective, but no research has specifically examined efficacy or effectiveness in this regard. In order for meaningful and translatable TMB research to be conducted, an understanding of how and to what effect TMB is actually used for amputation related sequelae is needed. The overall aims for the developing research is to 1) explore and describe how, what, and why professional TMB care is sought by or applied to individuals with amputations and 2) explore and describe perceived treatment outcomes of professionally delivered TMB for individuals with amputations and to what and why perceived outcomes are attributed, from the perspectives of both TMB practitioners and the amputation population. Step I of the study, TMB practitioner perspective, has been completed with results currently in dissemination. Step II of the study (supported by the current award) will focus on the perspective of individuals with amputations and has three specific aims and one exploratory aim:
Specific Aim 1: Describe general perceptions of TMB and usage for individuals with amputations.
Specific Aim 2: Explore and describe the reasons or not adults with at least one amputation seek professional TMB care.
Specific Aim 3: Explore and describe perceived treatment outcomes of professionally delivered TMB for adults with at least one amputation.
Exploratory Aim: Generate potential relationship hypotheses between TMB usage and self-reported health for individuals with amputation.
To meet study aims, we are conducting a mixed methods study using a modified convergent parallel design in two amputation specific populations: those who have received TMB treatments (TMB Experienced) and those who have not received TMB treatments (TMB Naïve).
Stage III of the developing research program efforts will combine data from Stages I and II to identify alignment, divergent, and gaps between TMB practitioner and amputation population perspectives regarding TMB for amputation related sequelae. The whole of our efforts will be used to inform evidence based recommendations to TMB researchers, practitioners, and educators.
Massage Therapy as a Treatment for Rheumatoid Arthritis Affecting the Wrist and Hand: A Case Report
MacEwan University – 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.
Objective: To examine the effects of massage therapy on RA affecting the wrist and hand using
goniometry, grip strength measures, pinch strength measures, and subjective pain scales.
Methods: The study period included an initial and final assessment with the treatment being six
massage therapy sessions carried out by a student massage therapist over a seven-week timespan.
The subject, a 64-year-old female, presented with RA affecting the left wrist and hand. The
intent of the treatment was to increase grip strength, pinch strength, and range of motion (ROM),
and to decrease pain. In order to achieve these goals, a massage routine with specific techniques
was created. Longitudinal stroking (effleurage), petrissage, trigger point (TrP) therapy, frictions,
manual oscillations, and paraffin wax were the methods applied to the affected hand and wrist.
Results: Grip and pinch strength improved in both the affected and unaffected hands. ROM
increased in the affected hand. The unaffected hand’s ROM results varied, with a slight increase
in one motion and a decrease in another. The subject reported a decrease in pain in the affected
wrist and hand.
Conclusion: The results suggest that certain massage therapy techniques, when implemented
regularly, have a positive effect on RA in the form of increasing strength and ROM, and
Keywords: Rheumatoid arthritis, massage, manual oscillations
Massage Therapy for Immigrant Torture Survivors
Program for Torture Victims
Los Angeles, California
The Program for Torture Victims (PTV) is a 501c3 non profit organization that was founded in 1980 to address the complex psycho-social and health needs of survivors of political torture. For the past 35 years PTV has provided comprehensive services to immigrant survivors of political torture living in southern California. Torture survivors we see have mostly experienced complex trauma (sexual violence, physical assaults, prolonged periods of detention and/or isolation, psychological persecution/intimidation/threats, community/state violence, trafficking, domestic violence) and arrive from over 70 countries across the globe.
PTV will offer therapeutic massages services to help bring relief to the suffering of torture survivors. The provision of massage therapy will help to alleviate pain, reduce muscle tension, decrease stress and help survivors regain connection with their body.
Massage Therapy for Medically Fragile Children
Maryville, Children’s Healthcare
Des Plaines, IL
The Maryville Children’s Healthcare Center (CHC) treats medically fragile, technology-dependent infants and children who need hospital-to-home transitional care or palliative and hospice care. The CHC offers individualized care and crucial parental training of specialized child care in a homelike environment that combines traditional medical care with alternative medicine approaches to relieve pain, enhance comfort and facilitate healing. The Massage Therapy for Medically Fragile Children program is designed to improve the overall well-being of CHC pediatric patients as well as adjunct the traditional allopathic medical and nursing care. Specific objectives include employing massage therapy to relieve pain and reduce the need for pain medications; enhance physical comfort; facilitate healing/recovery from wounds and orthopedic surgery; increase tolerance to chronic therapies such as ventilator, gastric feedings and IV nutrition, and increase socio-emotional engagement through the positive sensations generated by human touch. These outcomes are documented in patient case notes, which include data on vitals, medication and other medical services delivered, and measurable data reflecting stress levels and other quality of life indicators.
The alternative therapy program was implemented in the spring of 2014 with an initial grant from the Oberweiler Foundation. The impact of stress and how it it’s addressed continues to be revealed in growing numbers of physiological and health and community health research. The use of alternative therapies to complement traditional western medicine has grown alongside the increase in the numbers of medically fragile children with special health care needs. According to the 2012 National Health Interview Survey (NHIS), 11.6 percent of the more than 10,000 children aged 4 to 17 included in the survey had used or been given some form of complementary alternative medicine (CAM) during the past year. More than half of children with chronic medical conditions use some form of CAM, usually along with conventional care. The National Center for Complementary and Integrative Health (NCCIH), one of the National Institutes of Health, reports the beneficial effects of massage therapy on pain and other symptoms associated with a number of different conditions. Much of the evidence suggests that these effects are short term and that people need to keep getting massages for the benefits to continue.
Monday Massage for Veterans
Clear Path for Veterans Wellness
Chittenango, New York
Recognizing the responsibility of communities to help those who serve, Clear Path for Veterans empowers service members, Veterans, and their families through supportive programs and services in a safe, respectful environment. Clear Path for Veterans is fully accessible for Veterans with mobility limitations.
The Massage Therapy Foundation funding will facilitate a demonstration project to help Veterans who have participated in programs at Clear Path for Veterans to take the next step, and access services in their home communities. Massage Monday for Veterans will offer a package of two one hour massage experiences to Veterans in Central New York to address issues of stress, pain, anxiety and/or difficulty sleeping. Massage Monday for Veterans participants will be identified through outreach efforts from the existing Clear Path Wingman, Peer Mentor and Dogs2Vets programs.
The Use of Massage to Increase the Performance of a Brazilian Jiu-Jitsu Athlete by Increasing Range
Center for Neurosomatic Studies – Clearwater, Florida
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.
Keywords: Brazilian Jiu-Jitsu, range of motion, shoulder, hips, elbow.