SET TALK
By Don McCann, MA, LMT, LMHC
MA3267 MH705 MM3717
ARTHRITIS
If I had a dime for every client who told me
they saw a physician because of joint pain, and, with only a cursory exam, were
told by the physician that they had arthritis, I would not have to work today!
Furthermore, they were given the explanation that they were getting older and
that almost everybody has arthritis.
Osteoarthritis is present in a large
percentage of the population over 40. As a massage therapist you will see
numerous clients with pain symptoms from osteoarthritis. It is important that
you know and understand the causes of osteoarthritis, referred to simply as
arthritis, and how to effectively treat the affected areas for pain relief.
The clinical definition of osteoarthritis
according to Taber’s Cyclopedic Medical Dictionary is: "a chronic disease
involving the joints, especially those bearing weight. Characterized by
destruction of articular cartilage, overgrowth of bone with lipping and spur
formation, and impaired function." Now, I find that the effected joints of
just about any client I have ever seen with osteoarthritis are stressed due to
one or more of the following conditions: structural misalignment, tension in the
soft tissue associated with the joints and muscles for movement, damage due to
old injuries or surgeries, or strain patterns in soft tissue that weaken the
strength of the joint. Each of these conditions involves irritation of the
tissues and an imbalance within the joint capsule that leads to a degeneration
of the joint itself, and ultimately arthritis.
Once we understand the conditions that weaken
joints, we can then consider how to apply massage techniques that will
strengthen the weakened arthritic joints, and prevent non-arthritic joints from
developing arthritis.
Structural imbalances cause uneven stresses on
the joints both internally (between cartilage and ligaments) and externally
(within the supporting tissues around the joints). Therefore, the ability of
massage therapists to rebalance the soft tissue responsible for the weight
bearing and movement of a joint becomes very important in the rehabilitation of
the joint, whether it is to prevent arthritis or to stop further degeneration
associated with arthritis that is already present. Many times when the joint is
realigned structurally, the pain and degeneration found with osteoarthritis
disappears.
Tension in the soft tissue, whether it is in
the connective tissue or the muscle tissue that effects joint movement, often
causes binding and undue pressure within the joint itself. It also limits the
overall range of motion of the joint allowing degeneration to occur and a build
up of calcium deposits. Either one of these directly feeds already existing
arthritic degeneration or, over a period of time, leads to arthritic
degeneration within the joint. Releasing the restrictions in the soft tissue
that bind the joint or limit its range of motion allows a healthy joint to
remain healthy, and stops the arthritic degeneration allowing an arthritic joint
to return to full range of motion and become healthy once again.
In the process of life many people injure
their joints or have damaging surgeries, and will later develop arthritis due to
the damage within the joint. Often these injuries and surgeries leave the joints
imbalanced and bound with tightened tissue that includes scar tissue and
splinting. If the injured joint had been treated to release the scar tissue in
the soft tissue and to restore balance and range of motion, the long-term
effects of the injury would have been minimized. Unfortunately, many of our
clients have not had the benefit of treatment in the initial stages of
rehabilitation from their injuries and surgeries. Once arthritis has developed
within the injured joint, the joint will degenerate rapidly due to the
aforementioned untreated conditions. To eliminate the further development of
arthritis, and to successfully rehabilitate the joint, proper soft tissue
releases must be applied which will reduce scar tissue and splinting and restore
full range of motion within the proper balance.
When the body is out of alignment, strain
patterns result in the muscles and soft tissue. These strain patterns reduce the
strength of the muscle function by at least 50%, and oftentimes 75%. When these
strain patterns exist around joints, the muscles have to tighten, bind, and
compensate for the resulting weakness of the joints. The result is a build up of
fibrous connective tissue that directly restricts range of motion and the
strength of the joint. This often results in injury to the joint capsule itself,
or to an ongoing irritation that can lead to arthritis. Since these strain
patterns are in the soft tissue, proper therapeutic releases by a massage
therapist can prevent arthritis, or rehabilitate an arthritic joint.
When a client comes to my office with concerns
about arthritis in their joints, these concerns are usually accompanied by pain
in the joint, inflammation, and swelling. Therefore, it is necessary for initial
soft tissue treatment to reduce the swelling and inflammation as these are a
direct cause of pain as well as restriction and tension in the joint. Therefore,
using strokes that will release the fluids and toxins with the venous flow is an
important first step. (Please refer to previous articles on three-step
approach).
After the inflammation and pain has been
reduced, it is now time to address the tension, adhesions, and restrictions
found in the myofascial holding patterns that can both bind and cause
misalignment to the affected joint. All of the musculature and soft tissue that
has any affect on the movement of the joint needs to be treated with strokes
that will release the myofascial holding pattern, the adhesions, and
restrictions so the joint can return to balance and full range of motion.
Special attention needs to be paid to the speed of these strokes to allow the
myofascial holding pattern to unwind and release the restrictions. Therefore, the
deeper you go the slower you go! This approach will also allow you to
work deeper in an area where the client is already experiencing pain. Clients
will communicate their relief as these holding patterns and restrictions
release.
When the myofascial holding patterns have been
released, very specific individual fiber strokes can be applied to soften the
resistant fibrous adhesions and scar tissue. Again, the deeper you go the
slower you go! This allows the joint to return a healthier state, usually
with pain greatly diminished or gone.
The wonderful secondary gain with these
releases is that they tend to structurally realign the joints since soft tissue
controls the alignment, range of motion and movement patterns much more so than
the cartilage and the effects of the arthritis inside the joint. It helps if the
massage therapist has a good understanding of the proper alignment and movement
of the joints. However, even without this knowledge, they will be able to reduce
the painful symptoms of arthritis and facilitate realignment if they release the
soft tissue in the three-step manner mentioned above. This is due to the fact
that the tightest tissues maintain the structural distortion, and their release
allows realignment.
I have used these techniques over the years
with great success treating clients who come in with osteoarthritis. Many times
I have not been sure that a proper diagnosis has been made, and have been
concerned that only a cursory examination was done in the physician’s office.
Still, the majority of my clients improve, and many become pain free with full
range of motion and return of strength to joints that were diagnosed as being
arthritic. One thing I can be sure of is that they are happy to have received
effective treatment and to be rid of their pain. They also refer their friends
and loved ones, which is a sign of their confidence in this therapy. Obviously,
there are extremely acute cases of arthritis that involve severe joint
degeneration. However, even the clients who could not become totally pain free
continue to come periodically because proper treatment does minimize the amount
of pain and slows down further arthritic degeneration to their joints.
If these techniques are new to you, or appear
complex, I urge you to seek further training. You will have clients who have
arthritic conditions and, with the proper training, you will have many chances
to make a difference!
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