Fingertips

Take The Bite Out Of TMJ Disorder

Temporal Muscular Joint (TMJ) Disorder can mimic migraine headaches, earaches, sinus infections and tooth abscesses. It can cause dizziness, ringing in the ears and muscle pain that radiates down the neck and shoulders. So how can you tell it's TMJ or something such as the conditions listed above?

It could be TMJD if you wake up with a sore jaw, or if you're wearing your teeth down. If your spouse or partner complains that you grind your teeth at night while you sleep, that could be a sign that stress is out of control. That and if you wake up with earachs, dizziness, sinus problems and/or pain in your temples, neck or shoulders, it may be time to get your nighttime bruxism addressed.

So what should you do about that? I like this article because it addressed both massage therapy and physical therapy options for treating TMJD. Massage can work the disorder from two perspectives: improve stress through general systemic relaxation and reduce myofascial trigger points in the jaw muscles. Physical therapy can use ultrasound or e-stim to ease muscle contraction and reduce pain, but also prescribe jaw exercises to cue muscles to relax and keep the jaws limber.

Medications include anti-inflammatories or muscle relaxants can be helpful. Studies at Tufts have shown that magnesium citrate can also help.

tags: massage massagetherapy wellness massage therapy bodywork health

New Licensing Exam

I found an article that North Carolina is adopting a new state licensing exam that can be used along side or instead of the National Certification Exam. Maybe some of you already know about this, and, if so, then I'm a bit behind the times. There is a new licensing board called the Federation of State Massage Therapy Boards (FSMTB) that was established in 2005 from a former alliance of the Associated Bodywork and Massage Professionals (ABMP).

The mission of the Federation is to support its Member Boards in their work to ensure that the practice of massage therapy is provided to the public in a safe and effective manner.

Interestingly, it wasn't long after this that the National Certification of Therapeutic Massage and Bodywork (NCTMB) revamped their entry level exam to test massage therapy alone, created another exam to certify bodyworkers, and had a third "advanced" exam, much like the original, that tested both.

So what is going on here? Was the revamp of NCTMB's exam a reaction to the formation of FSMTB? Is NCTMB seen as a tool of the AMTA that moved the bodywork community to formulate another national licensing exam? Is it ethical for an alliance that springs from a professional association to create a national licensure exam? What was wrong with NCTMB's exam that they felt the need to create a new exam with the intent to "protect the public?"

According to the FSMTB website, formation of the Federation addresses the following issues:
* the need for consistent scopes of practice and entry level standards across the country
* the need for a valid and reliable licensing exam that would be accepted by all jurisdictions
* the need for a common database with licensing and disciplinary information and the ability to store critical documents

The concerns of most significance were the need for the provision of a valid and reliable licensing exam and the desire to bring commonality in licensing requirements to assist with reciprocity and professional mobility.

Sigh. Call me naive, but why can't we all just get along? The continued fracturing of the profession into different camps only serves to weaken the industry as a whole and slow our forward advancement into a level of professionalism that other health care professionals expect. Not only that is confuses the very people who we seek to protect: our clients.

tags: massage massagetherapy wellness massage therapy bodywork health

The Importance Of Friendship

We just got back from an early Thanksgiving dinner that our downstairs neighbors hosted. We feel so lucky and blessed to have nice neighbors. We've taken a real shine to their little boy, as well, and enjoy playing with him.

But what our neighbors gave us, as far as our health, is more than a good meal. The health benefits of friendship are as important as controlling high blood pressure, weight and giving up smoking. And these benefits seem especially true for women.

"Feeling cared for and supported within a social network is particularly important for women in fostering self-care," says Todd Jackson, PhD, author of a 2006 study linking high levels of social support and community involvement with healthier diet, exercise and sleep habits, among other positive effects.

Friendship provides:
1) motivation -- exercising with a buddy prevents attrition and helps people trying to lose weight together to lose 10% more than if you try to go it alone.
2) support -- talking about problems helps ward off depression and insomnia.
3) accountability -- people who have friends are more likely to take care of their health and actually go to doctors appointments.

So get out there and connect with others. Even if it means leaving a comment on this blog. Let your voice be heard. Who knows, you might make a new friend.

tags: massage massagetherapy wellness massage therapy bodywork health

The Graston Technique

Imagine an extremely deep massage done with tools to break up scar tissue and you have an idea of what the Graston Technique of massage is like. Obviously, it is not for everyone. But for folks who have become debilitated due to repetitive use injuries, they consider it better than undergoing surgery.

The six treatments hurt so much it left bruises, Flach says. But it also was the first time something worked. "I'm as flexible now as I was when I was 15," she says of the treatments.

A kind of cross fiber friction technique, the Graston Technique uses stainless steel tools to deliver the therapy and break up scar tissue adhesions. Bruising is not uncommon, so consider populations of clients who may be contraindicated for this therapy before recommending or administering this type of therapy to them.

tags: massage massagetherapy wellness massage therapy bodywork health

7 Tips For Keeping Your Brain Young

More wellness advice comes from an an article in Reader's Digest. Before you shot the messenger, I must say that many of the sources pulled into this article are right in line with the brain plasticity literature that we've been reviewing this semester in my neuroscience class. And it's fascinating stuff.

1. Exercise -- The brain is an oxygen hog. Move your body and your brain gets the benefits because of increased blood flow that brings oxygen to your brain.
2. Food -- Diet is important. Food that is good for your body is also good for your brain. Think bright colors and high fiber.

The same weight that burdens your legs on the stairs also burdens your brain for the witty reply or quick problem solving.

3. Speed up processing -- Remember those Brain Age Games for the Nintendo DS I blogged about in the past. They work!
4. Stay calm -- stress is bad for your brain.

A part of the brain called the hippocampus, which is a primary locus of memory formation, but which can be seriously debilitated by chronic stress.

5. Get a good nights sleep -- sleep on a problem can help you come up with creative solutions.
6. Laugh.
7. Good news -- with age we have a larger pool of experience to draw from, so we are better at synthesizing and integrating information as we age.

tags: massage massagetherapy wellness massage therapy bodywork health

Fixing Cycling Woes

Lasers, cameras, data readouts, three-dimensional motion-capture technology, light-emitting diodes, computer imagery. Welcome to the new age of bicycling.

As recreational cycling continues to be a popular past-time for health, wellness, and sporting competition, riders are discovering the aches and pains that can go along with it. I can relate. I used be a cycling enthusiast. Then I rode a century and nearly ruined my knees. If felt as though I had worn all the cushion on the inside of my patellae off. I also had a problem with numbness in my hands and wrists while I rode, not to mention neck and shoulder pain. After about six weeks when it no longer hurt to walk down hills, I cautiously mounted my bicycle and swore I would no longer ride more than 3 or 4 hours at a time.

What I needed was a bike fitter. Called biomechanists or biodynamics specialists, there are approximately 12 to 15 "master" bike fitters in the U.S. who have elevated the craft to an art. Thousands more have taken certification courses from bicycle manufacturers, with varying levels of skill.

Bike fitters start with a series of body measurements, usually beginning at the feet and work their way up. They'll change out parts on a cycle such as the handlebars, seats, and even the bike stem. Some changes are simple, such as removing the visor from a helmet to alleviate neck pain.

I sure wish I had a bike fitter who could have sized me up for a bike. I always figured my knee problems were attributed to my Q factor being too wide. I figured fixing that would require I sell my bike (which I eventually did -- I bought a touring bike instead). And I figured my wrist numbness just went with the territory. After I moved away from a metropolitan area and bought a car, my cycling fell by the wayside. Maybe if I'd had a bike fitter, I'd still be on the road.

tags: massage massagetherapy wellness massage therapy bodywork health

Wound Care

I never thought it would be for me. I get queasy at the sight of blood and I'm terrified of hurting someone who is already in pain. One of the reasons I became a massage therapist was to help ease people's suffering.

But I realized that even as a massage therapist, some of the things I would have to do to help people may be perceived as uncomfortable or even painful to them. I would talk to them about a new technique that might be uncomfortable before I started. I put them in control of what they could tolerate by teaching them the pain scale: "Rank your discomfort from 1 to 10. One is no pain, 10 being unbearable. Five 'hurts so good.' If it's more than you can tolerate, I'll stop."

Other cues I would give my clients would be to breathe through the discomfort and try to relax. I reassured them that their discomfort would be temporary. If they could tolerate it, they would feel better when the muscle released its tension. Regular clients learned they could take me at my word; that I would stop when they said to; that a little discomfort in the short-term would give them more pain relief in the long-term.

So what about wound care? First, I've learned that many of my patients acquire wounds because they lack sensation in the area in the first place. Second, necrotic tissue is not living tissue -- it feels no pain. Third, wounds that are well cared for and kept moist heal faster. Seeing a wound heal is a very gratifying experience.

So, now that I don't pass out at the sight of a wound, and while unpleasant, the smell of a dressing doesn't make me nauseous, maybe wound care is the way to go. I still have two more years of school and clinical experience before I have to decide what kind of physical therapy I want to do. But wound care is no longer a big, scary, Christmas-gone-very-wrong kind of surprise under the wrapping of a dressing.

tags: massage massagetherapy wellness massage therapy bodywork health

The Buzz About Caffeine

There are all kinds of studies about caffeine and its effect on the body. Its use is discouraged among pregnant mother, and with good reason. Caffeine can affect fetal development may cause heart defects, low birth weight, or miscarriage.

Besides the precautions for pregnancy, over-consumption of caffeine constitutes a type of drug abuse. Like aspirin and many other over the counter medications, the availability of these substances lulls people into a false sense of safety because of their easy access. Caffeine especially, because of its availability in carbonated beverages, has no warning labels about excessive use.

If you do use caffeine, remember the old maxim: "Everything in moderation." One thoughtful essay has taken an interesting look at caffeine and the role it plays in the brain for enhancing attention.

Caffeine has a number of effects on the body, but the one that is relevant here is that it blocks adenosine receptors in the brain (by tricking your brain into thinking it is adenosine.) A decrease in the activity of adenosine (which is a sleep chemical) increases neuron firing rate and increases focus and concentration.

Some people say that caffeine actually has the reverse affect on them: shortly after consuming caffeine they get a short energy burst and then they fall asleep. I've trolled the internet for an answer to that paradox and have found some commentary about the use of stimulants to treat hyperactivity disorders. However, I found no explanation for how or why caffeine works this way in some people's bodies. If you have an answer, let me know.

tags: massage massagetherapy wellness massage therapy bodywork health

Are You Smarter Than A Fourth Grader?

We were visiting with family this past weekend. My 8-year-old niece is in a science class where they're teaching her a little bit about anatomy. So she wanted to test my knowledge. She'd say the bone and I'd point to it on her body.

We did great with the scapula, the clavicles, the cranium and the patella. She was a little unsure about the names of the femur, tibia, and fibula. Then she pointed to my fingers: I said phalanges. Then she asked about the carpals: okay, wrist bones. Got that one right. Then she said tarsal bones, and I pointed to her foot. She looked at her Mom.

Doh! I realized my mistake. Those are ankle bones! Not the bones to the foot. I must be having a mental block. We're studying gait analysis and the actions of the ankle joints and bones in all of the cardinal planes are a real challenge. This is especially true when you begin to factor those actions at different times in the gait cycle and what they do when they are weight bearing or not. Glad to see that physical therapy school is helping me with my knowledge of basic anatomy! I blaming stress. That's my story and I'm sticking to it!

tags: massage massagetherapy wellness massage therapy bodywork health

Making Fingertips Twitter

With so many people using Twitter these days, I decided to step into the fray and set up an account.

Twitter can be a great way to connect with people (clients, friends, family, or a combination of all three).

Follow me at Twitter, and receive updates when I post.

tags: massage massagetherapy wellness massage therapy bodywork twitter

Fat Message

No, that's not not a typo!

It's the message that your body is trying to tell you. Those love handle aren't so lovely. You can have a normal body mass index (BMI), but if you tend to carry extra girth around your middle, your risk for early death increases dramatically. For people with the same BMI, the ones with hip measurements that are larger are, on average, 15% more at risk for early death. And folks with high BMI are more likely to die of cardiac disease and cancer.

BODY MASS INDEX
Calculated by dividing weight in kilograms by height in meters squared
Normal: 18.5 - 24.9
Overweight: 25 - 29.9
Obese: Above 30

But here's an easier way to assess your risk. Measure your waist and divide by your hip measurement. This "hip-to-waist" ratio is a fast, economical way to assess your risk right away.
Good "hip-to-waist" ratios are 0.75 - 0.80 for women and 0.85 - 0.90 for men. Measurements for increased risk in women is 35 inches and for men, it's 40 inches.

Abdominal fat cells are much more metabolically and biologically active, Manson says. "They tend to be more active in producing hormones and chemical messengers that cause inflammation throughout the body," she notes.

On a more positive note, if you're trying to lose weight (ideally with exercise), that first 5 to 10 percent to go is likely that belly fat. This explains why there is so much improvement in people's blood pressure, blood sugar, cholesterol and metabolism.

tags: massage massagetherapy wellness massage therapy bodywork health

RTC On Massage And Parkinson's Disease

We have done a bucket load of reading about Parkinson's Disease this semester. All of the research papers that we have had to critique are about Parkinson's Disease. We'll be taking part in research related to gait dysfunctions in patient's with Parkinson's beginning next semester. So why all this focus on Parkinson's Disease?

Some background: Parkinson's Disease affects more than 1% of the US population over the age of 60. Five percent of people who develop Parkinson's disease have a first degree relative (parent or sibling) with the disease. Age seems to be the biggest factor, along with head trauma and exposure to pesticides or herbicides.

Production of dopamine, a neurotransmitter in the brain is deficient. The result is
* tremor, or trembling in hands, arms, legs, jaw, and face
* rigidity, or stiffness of limbs and trunk
* bradykinesia, or slowness of movement
* postural instability or impaired balance and coordination
Remember Tim Conway of the Carol Burnett show? He did a skit about a little old man who shuffled. He was mimicking classic walking associated with Parkinson's disease.

What can massage therapy do for someone with Parkinson's Disease? According to a report in the Journal of Bodywork and Movement Therapies, massage improved daily functioning, increased quality of sleep and decreased stress-hormone levels in people with Parkinson's disease.

"These data are consistent with previous research showing improvement on activities of daily living following massage therapy, for example, for patients with multiple sclerosis and spinal-cord injuries," state the study's authors. "Together these findings suggest that massage therapy enhances functioning in progressive or degenerative central nervous system disorders or conditions."

Locate this research article: Hernandez-Reif, M. Journal of Bodywork and Movement Therapies, July 2002, Vol. 6, No. 2, pp. 177-182.

tags: massage massagetherapy wellness massage therapy bodywork health

Taking Care Of Self

It's often the case that those who take care of everyone else, don't take care of themselves. Folks like that often see stress-reducing practices, such as massage, as indulgences. They couldn't be more wrong.

One of the things I used to ask my clients was, "How long do you think you can take care of everyone else if you don't take care of yourself?" Another great question regarded the example that people set for their children by abusing their own bodies. One therapist had a great way of posing the self-care question: "How would you want the person you loved the most to be cared for? Why don't you deserve that for yourself?"

And so, this line of thought brings up the trifecta of self-care and wellness activities:
1) get a massage
2) do some kind of exercise
3) take time for yourself preferably in some form of meditation

Not only will you reap the rewards, but so will the people around you, especially the ones you take care of.

tags: massage massagetherapy wellness massage therapy bodywork health

Cold Hands, Warm Heart

Somewhere in the marriage contract, there is a directive for men that they are required to warm their wife's hands and feet when they cold. So why is it that women usually feel colder that men?

I've read somewhere that it's due to hormones, but according to an article in the London Times online, women's bodies are supposed to be more efficient at holding in heat. It has to do with that subcutaneous fat layer we have that makes us soft and huggable.

They also talk about our tropical past:
“Man is a tropical animal. We evolved on the Equator and have since migrated to all parts of the planet. The only way we've kept warm is by modifying our behaviour: we've learnt to wear clothes, build buildings, make fire."

If that's the case, then why do men feel plenty warm? Women may have a more sensitive vasoconstriction threshold. Because of our tendency to hold our core temperature in our body less blood flows to our extremities. Cold hands and feet can make a person feel cold all over.

Female perceptions of cold also vary according to menstrual cycle, mood, food and beverage consumption, etc. I know that when I drink more water and less caffeinated beverages (which are mildly diuretic), not only do I feel more energetic, I also feel warmer. Increased blood volume likely makes circulation more efficient. More blood to the extremities means more efficient heating of those body parts.

tags: massage massagetherapy wellness massage therapy bodywork health

Stretching Does Not Warm Up Muscles

Here's something we learned in physiology: Don't stretch before a strenuous workout.

Stretching does nothing for warming up the body for physical exertion. In fact, it can make your muscles weaker for up to an hour before a workout, which is disastrous if you're competing. The reason that stretching makes your muscles weaker, is because the stretch actually unsticks the mechanisms inside your muscles (stuff that is sort of like velcro) that helps the muscle contract. It takes up to an hour for the myosin and actin heads inside muscle fibrils to recuperate and match up for ideal contractile power in the muscle.

To warm up before exercise, if your exercise is aerobic, then jog slowly for about 5 minutes. I walk before I jog, because jogging is my workout!. If your exercise is resistance training, lift light weights for 5 to 10 minutes before you work out. Warming up muscles, tendons and ligaments makes them more powerful with better range of motion, increases blood flow and enzyme activity for efficient metabolism, and raises heart rate in increments that don't stress the heart (think about the couch potato that shovels snow after a blizzard, only to have a heart attack).

Warming up actually helps to prevent exercise related injury. It refers back to that increased range of motion portion of the equation that I mentioned above. So, speaking of flexibility, where does stretching fit in a workout? You wouldn't want to stretch right before a competition, but stretching can go anywhere in your workout that you want. Putting stretching at the end of your exercises will not increase flexibility any more than having stretching anywhere else in your workout. And there is no evidence that stretching prevents injury or prevents delayed-onset muscle soreness.

Personally, I like stretching at the end of a run as a reward for a good workout because it just feels good.

tags: massage massagetherapy wellness massage therapy bodywork health