Wednesday, July 20, 2011

Pathology and Massage: ADD/ADHD


Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) when diagnosed in children, and known as Adult Attention Deficit Disorder (AADD) when diagnosed in adults, is typically defined as an inability to focus. However, the ADD characteristics an adult or child may display can be quite different from that of another person with ADD. Along with hyperactivity, one may be exhibit hyperfocus, impulsiveness, mood swings, forgetfulness, inattentiveness, restlessness and sluggishness. Children are often willingly disobedient, whereas adults find it difficult to complete plans or structure a routine for necessary daily tasks.
            
ADHD is diagnosed based on a symptoms checklist from the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders-IV (Text Revision) (DSM-IV-TR). Clinical interviews reviewing this checklist and computerized attention tests are psychological methods of ADD assessment. Neurometrics, PET scans, or SPECT scans of the brain can be used as well.
           
Possible causes of ADD include genetics, neuro-chemical imbalances of dopamine transporters, smoking during pregnancy, nutrition (specifically, lack of omega-3 fatty acids; the average American household is severely underprovided of its sources, which include fish), sleep apnea in infancy, and head injuries. Mainstream treatments of ADD include medication (most often methylphenidate, most commonly sold as Ritalin), behavior-changing therapies, and educational interventions. Alternative therapies have included the Feingold Diet, vitamin B6, Pycnogenol, neurofeedback, audio visual entrainment, and cerebellar stimulation.

ADD is most usually thought of as having negative effects on those with it and those who surround them. Children tend to have behavior or learning difficulties, including depression. Adults may be forgetful, easily distracted from their tasks at work, or easily irritated at home. ADD patients may not be mindful of their bodies’ natural rhythms, therefore creating eating disorders, chronic constipation, anxiety, or difficulties with sleep. An ADD patient may be calm and quiet, but is unable to pay attention as she is too focused on her own thoughts. ADD is thought to contribute to accidents on the road or at work. However, ADD patients are also intelligent and creative due the focus on their own thoughts and exploration of their imagination.

ADD is an indication for massage. Stimulation of the iliotibial tract through therapeutic massage can prompt bowel movements, relieving chronic constipation. Massage raises cortisol hormone levels, placing the body in a state of parasympathetic dominance, making sleep more restful and easy. In school-aged children, regular therapeutic massage was found to decrease anxiety and hyperactivity, including fidgeting, in the classroom. Students were able to focus more on tasks set before them. Adolescents in a Touch Research Institute study reported feeling happier after their massage sessions and were able to stay on task longer in the classroom as exhibited lower Conners Hyperactivity scores (10-item Conners Rating Scale). The study found that massage therapy “could become an important tool in the management of ADHD, in conjunction with currently used therapies. It may, for example, potentiate methylphenidate and other drugs” (Field, 1998). Massage has been known to alleviate problems associated with depression and anxiety, two secondary problems that can arise from ADD.
            
Massage should not be the only therapy, but it can help directly and indirectly to relieve some of the signs, symptoms, and secondary conditions associated with ADD.

For additional reading, check out this article about children, ADD and massage. It also references studies done on massage and adults with ADD and how it helps them. I have ADD and I know the regular massages I receive help keep me focused on the massages that I give.

Monday, July 11, 2011

Are You Dehydrated?

A trip to the loo is a clue! This is a great blog post on easy ways to determine if you are dehydrated, and how to get and stay hydrated if you are.

Be sure to check out the refreshing lime and cucumber spritzer recipe as well. It's super easy, actually: a bit of lime juice and club soda or seltzer over some ice with a few thin cucumber slices. I plan on drinking it all summer long!

Monday, June 27, 2011

Wednesday, June 22, 2011

Pathology and Massage: Anterior Shin Splints

What are shin splints?
Shin splints is a blanket term for a number of lower leg problems. It causes pain and sometimes swelling on the lower leg. Shin splints is an inflammation of the periosteum (the membrane that lines the outer surface of all bones) and the attached muscle fibers. The muscles attached to the tibia are tearing loose. Generally, when someone gets shin splits, it is due to excessive or repeated pounding, or “impact loading”, on hard surfaces during athletic activities, such as running or tennis. The condition worsens with the actions the affected muscles do. Other technical terms a doctor might use when diagnosing shin splints are idiopathic compartment syndrome, acute and chronic exertional compartment syndrome, periostitis, traction periostitis, tibial fractures, and medial tibial stress syndrome. These different titles account for location of pain and severity of the condition. Most commonly, shin splints are medial or lateral. Lateral shin splints are also called anterior shin splints, because the anterior muscle compartment is lateral to the tibia.

Which muscles or other structures are involved?
Principally, the tibialis anterior muscle and the tibia are involved in anterior shin splints. Tibialis anterior originates along the lateral  surface of the tibia. Tibialis anterior is responsible for dorsiflexion (flexing your foot toward your leg) of the ankle and sustains tears along the tibia when overused or constantly impacted. It’s possible the interosseous membrane could also be involved as tibialis anterior also originates there.


How are shin splints assessed?
Chances are, if a client had shin splints, I would know. For instance, if they stood up and grimaced and then proceeded to gingerly walk across the room. They may even limp or hobble a bit. Walking would be uncomfortable for anyone with shin splints. If you superficially massaged the anterior leg muscles, it would probably feel tender, but good; a deeper massage would most likely be uncomfortable or painful. Lesser muscle injuries would not be visible on the leg, nor would they be palpable, but more severe injuries would exhibit red, hot puffiness around the tibia. Pain along the tibia is an indication, and may be superficial or deep, mild or severe. The location of the pain would indicate the injured muscles. Someone with anterior shin splints may describe the pain as an ache that runs the length of the lateral tibia.

How are shin splints treated?
Shin splints require first and foremost, rest. Ice, stretching, strengthening and massage are also indicated.  Massage is only contraindicated if the condition is advanced: that is, if the leg looks and feels hot and swollen, or is extremely painful. Once the inflammation and pain begin to subside, massage is beneficial. If the condition does not improve within a couple of days, it could be a sign of a more serious condition and requires medical attention. Massage is an excellent treatment as it increases circulation and releases adhesions. Massage can also prevent shin splints from advancing into more serious complications, such as exertional compartment syndrome. Proper stretching is a necessary preventative measure. Plantarflexion (pointing the foot down) and eversion (pointing the foot in toward the mid-line of the body) will stretch the tibialis anterior muscle. Stretching the lower leg muscles can be difficult through exercise alone, but massage can work every inch. Regardless of where the injury is, all the lower leg muscles should be stretched and massaged. The feet should be worked as well, as the lower leg muscles insert into points throughout them. Myofascial Release is a desirable modality for shin splints, as it can release the fascia binding all four muscle compartments. Plus, as it works superficially, it would most likely be more comfortable than Deep Tissue techniques.


These pictures are from Trail Guide to the Body, Second Edition, by Andrew Biel, illustrated by Robin Dorn (both massage therapists) and published by Books of Discovery.

Thursday, June 2, 2011

One woman lost her voice, but she got it back, thanks to a massage

Check out this article on muscle tension dysphonia and myofasical release. MFR helped a woman who had thyroid surgery and had to give up singing - her inspiration and her life - as a result. It always makes me swell with pride when massage can help someone in such a significant way!

Wednesday, May 18, 2011

Seasonal produce

Peak-Season Map at Epicurious.com

Check out this seasonal produce map. I've been looking for a good one for what feels like forever, but was only ever able to come up with ones that are too area-specific or too general. This one lists what's in season by month and state. You can grab these things at the grocery store if you like to stick to seasonal eating. Chances are they'll be at their best flavor if you buy them in season, and your grocery store might even stock them from a locally grown source at that time. It's also a good indicator at what will be plentiful at local farmers' markets.

Right now in Maryland, asparagus, spinach and strawberries are where it's at. Enjoy!

Tuesday, May 17, 2011

Massage for Your “Manly Man”

Want to give a special father in your life the gift of massage? Is your man resistant to massage, though? Maybe he thinks it's 'for girls'. Maybe he thinks he's fine and doesn't need the bodywork. Lia Suzuki in Santa Barbara gives some excellent tips on how to make massage appealing to a 'manly man'.

One point she makes is to get a gift certificate that is fairly plain. My online gift certificates only have one simple graphic (my logo).