In every issue of our journal you will find Case of the Month which we will select among submitted ones. Everyone who is using MEDICAL MASSAGE PROTOCOLs in their practice may submit their cases for the review and we will share with our readers the best one in every new issue.
If you would like to share with our readers your account of professional success and participate in Case of the Month program click here.
I met Karen Mooney several 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. She currently works on her PhD on the science of medical massage.
If one reads any massage article or educational source on medical massage therapy he or she will find a wide variety of protocols and techniques to treat different somatic abnormalities, from Plantar Fasciitis to Headache. Some of them work and are based on science, some are just personal opinion. However, the somatic abnormalities aren’t the end of medical massage therapy. Did massage therapy help patients with Angina Pectoris (cardiac pain) or patients with Urinary Incontinence? You won’t find a lot of educational materials on this subject, despite the fact that modern medicine accumulated a significant number of very effective MEDICAL MASSAGE PROTOCOLs for the various visceral abnormalities. One of our future projects is to include in our Video Library MEDICAL MASSAGE PROTOCOLs for the most common visceral disorders.
Karen extensively studied MEDICAL MASSAGE PROTOCOLs in cases of visceral disorders using various sources including both volumes of Medical Massage textbook and as a result she was able to help many clients with visceral abnormalities using this effective therapy. You will find below an outstanding clinical case, which illustrates real boundaries of the massage therapy profession and how the practitioners can help patients with visceral abnormalities using scientifically based MEDICAL MASSAGE PROTOCOLs.
Why was Karen’s treatment so effective where other modalities failed? The major mistake of traditional management of any chronic abnormality is to address the abnormality itself, or, in even worse cases, its symptoms. Traditional modalities failed because they addressed Congestive Heart Failure patient suffered as isolated cardiac pathology while Karen’s treatment successfully identified the cause, treated it and finally normalized cardiac function.
Her treatment was successful because first it unloaded heart by decreasing peripheral vascular resistance and secondly she eliminated cardiac reflex zones developed in the soft tissue. This combination of therapeutic factors finally normalized cardiac function. 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.
We hope that cases like this one will stir up more professional curiosity among practitioners and motivate them in further learning and practicing medical massage. We will save Karen’s original format of writing.
MEDICAL MASSAGE vs CONGESTIVE HEART FAILURE COMPLICATED BY FIBROMYALGIA
The introduction of this case was written by my client. 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 edema in the abdomen. At the ER my blood pressure was 180/100, pulse 130, and I had very fast and shallow breathing. After IV infusion of Lasix, X-Rays, EKG, and several blood pressure medications I was sent to the telemetry unit with a diagnosis of Congestive Heart Failure (CHF). My heart rate was constantly fluctuated. At 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 cardio 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. Fibromyalgia I suffered before made all of this situation even more complicated. Now I had unmanageable pain and an overloaded heart. At home I would manage to take a shower then I would need to rest. A daily routine was 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 felt this to be hopeful.
With treatment my pain level decreased, and slowly my energy returned. My pulse maintained at 100 and the 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 the recovery of my heart. 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.
TREATMENT PROTOCOL
Before starting treatment the patient talked with her physician and was monitored by the physician throughout the entire treatment course.
Since this patient had been diagnosed for several years with Fibromyalgia and Essential Hypertension (EH) we decided to primarily address these issues. Both Medical Massage Volume I and II suggested that the progression of EH and circulatory dysfunctions can be a result of irritation of the vertebral arteries from chronic tension in the cervical muscles. Also, in this patient we found trigger points and a positive Wartenberg’s test for the left anterior scalene muscle. As an RN she lifted patients and did much repetitive paper work contributing to hypertension in, at least, the 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 Main Part (Medical Massage, Volume I, p. 517) including the first steps of the protocol for the Essential Hypertension (Medical Massage, Vol. II, 88-101) and Anterior Scalene Muscle Syndrome (Medical Massage, Vol. I, p.203-09). 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 substantial decrease in pain with an increase in daily energy. She reported a “new interest in life.” The blood pressure was stabilizing and there was no tachycardia experienced in 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.
The treatment session with Connective Tissue Massage advanced the healing process as the patient responded with further decrease in pain, better sleep habits, increased energy, and returning to part time work. After completing a second round of 8 sessions we started a weekly therapeutic massage. The patient ejection fraction increased at 50% after 3 months of treatment. All parameters have been stabilized 9 years since these initial treatments and the patient now works full time in her field.
Karen Mooney completed her BS degree at Penn State University in Rehabilitation Counseling, MA at Saybrook University in Health Psychology, and is presently on a PhD track in Psychology with a focus on applied psychophysiology.
She received a certification in massage from the Pittsburgh School of Massage in 1993. In 1994 she began to study Medical Massage and uses this modality exclusively in her practice of 17 years. Karen teaches the introductory medical classes at a college in Northwestern PA and maintains a private practice in medical massage and health psychology there.
Category: Case Studies