For several years, my entire practice has been strictly the application of MEDICAL MASSAGE PROTOCOLS for a variety of chronic somatic abnormalities, as well as post-trauma conditions. After trying various therapy methods, I concluded that the integrative approach Medical Massage offers for my patients is the optimal treatment option.
Our clinic in Torreon, Mexico, is overwhelmed with patients, but I have always wanted to expand the list of pathological conditions I am working with to help more patients. This recent clinical case is one example.
MEDICAL MASSAGE vs. PARKINSON’S DISEASE
A 69-year-old female came to our clinic with a diagnosis of Parkinson’s Disease that had been established 6 months earlier, after she visited three neurologists, who confirmed the initial diagnosis. The first symptoms had appeared 2 years earlier on the right side; 6 months earlier, they had become really bad, and by now the left side was affected even more.
At that time, she was taking a list of medications to cope with her symptoms, but there was no significant progress:
- Hipokinon 5mg;
- Cloisone: 250 mg of Levodopa and 25mg of Carbidopa;
- Alerdan 50mg;
- Inderaloce 40 mg
Visual Observation
The patient exhibited very expressive bradykinesia (i.e., slowness of movement), partial akinesia (i.e., loss of the ability to move muscles voluntarily) and poor movement control; she was unable to swing her arms while walking. She had a resting tremor in the right arm, hand and leg. There was also very strong spasticity in the left arm, forearm and hand.
The patient exhibited significant postural instability when she tried to turn. She got stuck in our doorway, unable to move, when she tried to turn to close the door. She suffered from severe anxiety.
Palpatory Examination
- Very strong rigidity in both lower extremities, no knee flexion.
- Rigidity in the forearm muscles, especially the extensors on the left.
- Adhesions between the skin and superficial fascia on both forearms and above the biceps femoris on the left.
- Soft tissues were very firm, and muscles were tight and spastic.
I have made it a routine to record all my patients before, during and after the application of MEDICAL MASSAGE PROTOCOLS. Video 1 below shows my patient walking into my clinic for the first time. The intensity of her symptoms is obvious. Since Parkinson’s Disease is a pathology of the CNS, my intention was to decrease the intensity of her symptoms and support her quality of life.
I had never worked on a patient with Parkinson’s Disease, and I had no clue how to approach her. I told my patient that I could try to help her, but I was not sure if it would work, and more likely it would assist her with the intensity of her symptoms. Her answer was, “I am ready to start whatever you want me to do. Nobody told me that there was any chance of improvement in the life I am living right now.”
After the evaluation, I consulted our clinic’s primary source – the Medical Massage textbook written by Dr. Ross Turchaninov and published by the Science of Massage Institute. In Volume I, the MEDICAL MASSAGE PROTOCOL for Parkinson’s Disease is discussed on pp. 374-376. I used that as the framework for my sessions, incorporating the evaluation results I had obtained during the initial examination. The first session was 45 minutes, and I performed Steps 1-10, customizing them to my patient’s clinical symptoms.
Step 1. Inhibitory regime of MT on the back according to the location of symptoms in the upper and lower extremities. Relaxation of the paravertebral muscles, intense Dr. Sherback’s Friction, especially around C7, to reduce tremor. Stimulation of the cutaneous branches of the spinal nerves (circular friction, vibration) responsible for the innervation of the affected muscles to decrease the excitability of lower motor centers in the spinal segments
Step 2. Elements of Vertebral Artery Syndrome protocol to increase brain perfusion in the pool of vertebrobasilar arteries
Step 3. Same as Step 1, but at the L1-S1 levels
Step 4. Layer-by-layer work on the posterior surface of the upper and lower extremities, addressing the skin, superficial and deep fascia and muscle bellies
Step 5. Kneading techniques according to Protocol #1
Step 6. Work at the muscle insertion into the periosteum and engage the H-reflex
Step 7. Felp’s technique
Step 8. Kneading techniques according to Protocol #1
Step 9. Passive stretching or very gentle PIR
Step 10. Steps 4-9 on the anterior surface of the upper and lower extremities
When my patient got up after the first 45-minute session of Medical Massage, I was stunned by its results. I expected some local improvement, since even a mild one would be a very big deal for her. What I witnessed well surpassed all my and my patient’s wildest expectations. It proved to me once more what an incredible clinical tool Medical Massage is and how much we can help patients when things are done right.
Video 2 illustrates my patient walking after her first Medical Massage session. For the first time in almost a year, she was walking like a completely healthy person! It was so incredible that I couldn’t believe my eyes!
Also, I want to demonstrate the effect Medical Massage had on the intensity of her resting tremor on the right side. Videos 3 and 4 illustrate the intensity of the tremor before and after the first treatment session.
Tremor before the first session
After the first session
In the 4 hours after the session, some tremor came back to a lesser degree, but the spasticity did not! While she continued to take medications, I saw her the next day for the second session. This time I added continuous, fixed electric vibration to the previously applied protocol. Results were becoming more stable after every session.
Video 5 illustrates her entering my clinic before the fourth session. As you can see, her walking is still dramatically improved, and the improvement holds between sessions! I continued to see her 3 times per week for two weeks and gave her a longer break before re-evaluation.
Now I am planning to extend my practice by offering Medical Massage treatment to patients with Parkinson’s Disease in my hometown. Please consider using SOMI’s MEDICAL MASSAGE PROTOCOLS to help patients. They are irreplaceable clinical tools, and this clinical case proved it to me once more.
LESSONS
- This clinical case is a great illustration of the clinical outcomes Medical Massage offers when it is practiced on a scientific basis rather than on personal opinions. From SOMI’s perspective, many therapists don’t fully understand what Medical Massage is, since partial, personal views and anecdotal experiences are frequently used to define Medical Massage.
- Working with the soft tissues in the affected extremities, Luis used correct activation and alteration of peripheral receptors to change:
- Plasticity of the parts of the motor cortex affected by disease.
- Restore and maintain soft tissue flexibility and elasticity, which are dramatically affected in patients with Parkinson’s Disease
- There is a better chance for the MEDICAL MASSAGE PROTOCOL to work on patients with Parkinson’s Disease if the disease was diagnosed relatively recently.
- Of course, Medical Massage is not the only solution for Parkinson’s Disease, since patients must take medication and exercise. However, clinical management of Parkinson’s Disease can’t be decisive without Medical Massage as a part of the overall treatment.
Category: Blog
Tags: JMS 2019 Issue #1
