I met Karen Mooney years ago during one of the Medical Massage seminars in Las Vegas. She is an exceptional medical massage practitioner, teacher, and massage scientist. Her extensive resume ranges from working in a massage clinic to opening a successful massage therapy school.
Many therapists and educators practice MT and hold PhD credentials. However, most of these degrees are in other fields, such as psychology. Karen became the first massage therapist in the USA to earn a PhD focused on medical massage at Saybrook University. Her doctoral research examined the effects of medical massage on patients with fibromyalgia. We will republish the results of her PhD work next.
If you read any massage article or educational source on medical massage therapy, you will find a wide variety of protocols and techniques for treating different somatic abnormalities, from plantar fasciitis to headaches. Some are science-based; others are personal opinions with questionable claims. However, somatic abnormalities aren’t the limit of medical massage therapy. Can massage therapy also help patients with chronic visceral disorders, such as angina pectoris (cardiac pain) or urinary incontinence? You won’t find much educational material on this subject, even though modern medicine has accumulated a significant body of effective medical massage treatments for various visceral abnormalities.
Karen extensively studied medical massage for visceral disorders using various sources, including Medical Massage, Volumes I and II. As a result, she was able to help many clients with visceral abnormalities using this effective therapy. Below is an outstanding clinical case that illustrates the real boundaries of the massage therapy profession and how practitioners can help patients with visceral abnormalities using scientifically based MEDICAL MASSAGE PROTOCOLS.
Why was Karen’s treatment so effective when other modalities failed? A major mistake in the traditional management of any chronic abnormality is addressing only the abnormality itself or, even worse, only its symptoms. Traditional modalities failed because they treated congestive heart failure as an isolated cardiac pathology without considering its somatic component in the form of reflex zones. Karen successfully identified and treated the somatic component of the visceral abnormality and, as a result, normalized the patient’s cardiac function.
How did she accomplish that? First, she unloaded the heart by decreasing peripheral vascular resistance; second, she eliminated cardiac reflex zones developed in the soft tissue. This combination of therapeutic factors finally normalized cardiac function and restored cardiac output. Of course, medical massage is not a critical therapy in all cases of Congestive Heart Failure, but it must be included in the medical management of this frequently fatal cardiac pathology.
After reading this case, I would like readers to pause and appreciate the clinical power of medical massage and Karen’s expertise and dedication. Why? Because a 25% cardiac ejection fraction is almost a death sentence, and the patient, who is an RN, fully understood the gravity of the situation. All accepted treatment options were used without stable results until the patient came under Karen’s care. SOMI’s former and current students do this work; sometimes their results seem miraculous as they help patients in extremely difficult health situations through the clinical power of massage science.
We hope cases like this will spark greater professional curiosity among practitioners and motivate them to continue learning and practicing medical massage.
MEDICAL MASSAGE vs. CONGESTIVE HEART FAILURE COMPLICATED BY FIBROMYALGIA
The introduction of this case was written by my patient. She wanted to contribute to this article to express her gratitude for this modality and encourage the careful practice of medical massage.
INTRODUCTION
On a late December morning, I awoke with chest pressure, shortness of breath (SOB), moist rales, and abdominal edema. At the ER, my blood pressure was 180/100, my pulse was 130, and my breathing was very fast and shallow. After an IV infusion of Lasix, X-rays, an EKG, and several blood pressure medications, I was sent to the telemetry unit with a diagnosis of congestive heart failure (CHF). My heart rate constantly fluctuated. On admission, my ejection fraction was 25%, and over the next two days the heart condition further deteriorated.
I was then transferred to a hospital with a specialized cardiac unit for a heart catheterization. There were no blockages, no adrenal tumors, and the kidneys looked fine. The cardiologist prescribed Cardizem, 60 mg, and at the time of discharge my ejection fraction was around 15 to 20%.
As a hospice nurse, I admitted patients at 25% ejection fraction. The cause of my CHF at 56 years of age was unknown. The fibromyalgia I already had made the situation even more complicated. Now I had unmanageable pain and an overloaded heart. At home, I could manage a shower, but then I needed to rest. Daily activities were challenging. I felt they had sent me home without much hope of recovery. I was depressed, could not sleep, and had diffuse pain.
In the spring, I accidentally found the Medical Massage School and met Karen Mooney, an instructor and therapist there. We discussed the effects and useful protocols that would apply to my conditions. Previously, I had researched many options, but this approach gave me hope.
With treatment, my pain level decreased, and slowly my energy returned. My pulse remained at 100, and my BP dropped. When we added Connective Tissue Massage, the emotional and physical release was amazing. I felt in control of my body. But the greatest gift was my heart’s recovery. Within months, the ejection fraction rose considerably, and two years after CHF, the echocardiogram showed a normal 60% ejection fraction.
I am now 65 years old and working full-time as a medical clinical instructor. My Fibromyalgia symptoms are minimal, and I continue to have a weekly massage to maintain my good health.
Sincerely, KJ
MEDICAL MASSAGE PROTOCOL
Before starting medical massage treatment, the patient spoke with her physician and was monitored throughout the treatment course.
Since this patient had been diagnosed for several years with fibromyalgia and essential hypertension (EH), we decided to primarily address these issues. Volumes I and II of Medical Massage suggest that the progression of EH and circulatory dysfunction can result from irritation of the vertebral arteries caused by chronic tension in the cervical muscles. In this patient, we also found trigger points and a positive Wartenberg’s test for the left anterior scalene muscle. As an RN, she lifted patients and completed extensive repetitive paperwork, which contributed to chronic tension in her cervical muscles.
The protocol for Fibromyalgia (Medical Massage, Volume I) addressed many of the other symptoms such as tachycardia, insomnia, peripheral resistance, edema, and the psychological variants. Also, the treatment started slowly.
We followed the introductory Fibromyalgia protocol closely for 5 sessions, 3 days per week, to reduce pain and edema. We monitored her heart rate and blood pressure. (We did not use hot rocks as mentioned in the text or electrical vibration throughout the protocol because the patient was uncomfortable with that form of vibration.) The patient kept a record of her sessions for subjective observations of the treatment and changes. We used her notes with ours to reassess each session.
After the 5th session, we moved to Step 2 of the Main Part (Medical Massage, Volume I, p. 517), including the first steps of the protocol for essential hypertension (Medical Massage, Volume II, pp. 88–101) and the Anterior Scalene Muscle Syndrome – Video Library Protocol (Medical Massage, Volume I, pp. 203–209). We did not use Connective Tissue Massage during this first series of treatments. After 10 total sessions, the patient took a 2-week break before returning to the clinic.
When the patient returned, she reported a substantial decrease in pain and increased daily energy. She reported a “new interest in life.” Her blood pressure was stabilizing, and she had experienced no tachycardia for 4–5 weeks.
In the second set of sessions, as before, we monitored the heart rate and blood pressure, and we started with one introductory session to determine pain levels and reassess the reactions. We then moved to the Main Part of the protocol for the next 7 sessions, adding Connective Tissue Massage for Fibromyalgia and the Anterior Scalene Muscle Syndrome protocol.
Finally, I added the Connective Tissue Massage to eliminate active Connective Tissue Zones. I used the Glezer/Dalicho zones as guidance. This component greatly advanced the healing process, as the patient responded with further pain reduction, restored sleep, increased energy, and a return to part-time work.
After completing a second round of 8 sessions, we started a weekly therapeutic massage. The patient’s ejection fraction increased to 50% after 3 months of treatment. All parameters have been stable for 9 years since these initial treatments, and the patient now works full-time in her field.
If you’re serious about restoring the health of patients with somatic and visceral abnormalities and want to take your professional career well beyond stress-reduction massage, explore the Science of Massage Institute’s Medical Massage Courses & Certification.
ABOUT THE AUTHOR
Karen Mooney, PhD, MA, CMT, CMMP
Karen Mooney earned a BS in rehabilitation counseling from Penn State University and an MA in health psychology from Saybrook University. She later earned a PhD from Saybrook University, where her research focused on applied psychophysiology and the effects of medical massage on patients with fibromyalgia.
She received a massage certification from the Pittsburgh School of Massage in 1993. In 1994, she began studying medical massage and has used this modality exclusively in her practice since then.
She currently practices medical massage in Florida.
Category: Case Studies
Tags: JMS 2011 Issue #2
