Welcome to The Cafe 

The cafe is a place where students, massage therapists, and physical and occupational therapists and assistants can hang out!

Note: This page is designated as a place for students but everyone is welcome.

Come in, sit down with a cappuccino or espresso, or your beverage of choice and read some of the students published work, and chat, on one of the discussion groups!

We are always happy to hear from everyone!

Discussion Groups/Bulletin Boards

    (click above to go to the discussion pages)
    

Student Reports: (here you will find some exceptional reports and papers)

Anyone wishing to comment on the content of these articles can do so by going to the Discussion Groups/Bulletin Board.

Note: Students wishing to get articles published here MUST:
                1. Submit articles on a floppy disc or via e-mail for review.

                2. To be approved for publication, articles will be approved for correct scientific content only. It is the authors responsibility to scrutinize their papers for correct grammar and spelling.

                3. For more information contact John Struck via e-mail.

Article List :

(Below is a list and a brief explanation of the articles that you will find here.)
(Click on the article Title to read it.)

QUESTIONS? Send e-mail to info@orthopedicmassage.net

      Breast Cancer: submitted by: Jacki Weber, a Massage Therapy Student, Virginia Academy of Massage Therapy (VAMT): an excellent, informative article dealing with the statistics, the testing and some of the procedures  now being used in the fight to treat breast cancer.

     Cerebral Palsy (Its effects on muscles): submitted by: Margo Schaffer, a Massage Therapy Student, Virginia Academy of Massage Therapy (VAMT): a must read article for any one interested in the effects of cerebral palsy on muscles.

    Kyphosis - Can Massage Help?: submitted by Anne Alden, a Massage Therapy Student, Virginia Academy of Massage Therapy (VAMT): this article explains the benefits of massage therapy on kyphosis (curvature of the mid back).

    Electromagnetic Radiation in the Home: submitted by: Anne Alden, a Massage Therapy Student, Virginia Academy of Massage Therapy (VAMT): this great paper helps to explain the affects of electricity on the body.

    Practice Test Questions for Bones: submitted by: Margo Schaffer, a Massage Therapy Student, Virginia Academy of Massage Therapy (VAMT): this is not an article but an excellent study guide for the review of the information covered in the skeletal system. 

    Qigong: submitted by: Gilbert John on Aug. 4, 00 - Massage Therapy Student, Virginia Academy of Massage Therapy (VAMT): this paper will give the beginner a step by step procedure of the oriental art and practice of Qigong.

Raynaud's Disease: submitted by: Jennifer Roberts - Massage Therapy Student, Virginia Academy of Massage Therapy (VAMT): this is a concise article about the conditions and complications of Raynaud's disease.

Student Article:

QIGONG
AUGUST 4, 2000.
PRESENTER: GILBERT JOHN

QIGONG is a combination of movement, meditation and breath regulation. It can be used by both the healthy and severely ill. Because of this it is one of the most widely used self-care system in the world. Qigong also called chi-kung is an ancient Chinese exercise that stimulates and balances the flow of qi or vital life energy, along the acupuncture meridians. Qigong cultivates inner strength, calms the mind and restores the body to its natural state of health by maintaining the optimum functioning of the body’s self-regulating systems.

How Qigong Works

Qigong practice can range from simple calisthenic-type movements with breath co-ordination, to complex exercises where brain wave frequency, heart rate and other organ functions are altered intentionally by the practitioner.

When practiced regularly, qigong’s combination of movement, deep relaxation and breathing can improve strength and flexibility, reverse damage caused by prior injury and disease, promote relaxation, awareness and healing. By circulating qi, qigong stimulates and nourishes the body’s internal organs. Energy blocks are broken down which allows free flow of energy throughout the body. This promotes blood and lymph flow and the even flow of nerve impulses necessary for proper health maintenance. The human body has the ability to conduct an electrical charge, which affects the entire body and is responsible for maintaining the functions of the organs and tissues. Qigong activates the electrical currents that flow along the meridian pathways of the body. It stimulates human bioelectrical conductability.

Qigong has been shown to be effective in helping resolve digestive problems, asthma, arthritis, insomnia, pain, depression and anxiety. It also helps with cancer, coronary heart disease and cases of HIV/Aids. It lowers blood pressure, pulse rates, metabolic rates and oxygen demand. It also reduces the level of dopamine which controls neurological activity.

Qigong is often found to be more effective than chemotherapy, surgery and even acupuncture for the prevention and treatment of disease. The most incredible thing about qigong is that people can actually feel the operation of the physiological mechanisms of healing in their bodies. The increase in blood and lymph flow and a shift in neurotransmitters create an actual sensation that is clearly perceptible to the individual. This is referred to as the "Q1 SENSATION"

A series of qigong practices are designed for maximum result along with maximum ease. They can be done by almost anyone regardless of health, age or physical condition. For these to be beneficial and accessible to the person just starting out the person should:

Take it easy, don’t rush. Excess effort goes against the natural benefits of qigong. Remember qigong is intended to help you heal.

Results come over time, don’t overdo it or expect too much too soon.

It can be practiced as often as possible.

You can also make up your own routine or change the practices to suit your needs, likes and limitations.

Approach each practice with an intention to relax, direct the mind to quiet indifference.

Regulate the breath so that both inhalation and exhalation are slow and deep but not urgent or exaggerated.

The Actual Practices

The goal is to move qi along the meridians. Rub your hands together to build up heat. As if washing your face, stroke the palms upward across the cheeks, eyes and forehead. Continue over the top and side of the head, down the back of the neck and along the shoulders to the joint. Continue under the arm and down the sides of the rib cage. Move the palms around to the back, across the buttocks, down the back and sides of the legs and out the sides of the feet.  Trace up inside the feet and the inner surface of the legs, up the front side of the torso and onto the face again. Here begin the second round. You may rub your palms together before each round.

Directing Life Energy to Internal Organs

Rub hands together to build up heat. Apply the right hand to the area over the liver at the lower right edge of the rib cage. Visualize the liver – the largest most complex organ in the whole body, receiving the qi and benefiting.

Apply the left hand to the area over the spleen and pancreas at the lower left side of the ribs. The spleen – an immense lymph organ, is a producer of white blood cells and the pancreas is a critical link in energy metabolism and digestion. Move the hands circularly continuing to create heat, breathing full breaths and relax. Feel the heat, or qi passing in through the surface of the skin and penetrating to the organs, as the entire metabolic process becomes more efficient.

Still holding the hands over the organs, continue to feel the heat penetrate. On exhalation, visualize the qi circulating from the center of the body out the arms, into the hands and penetrating from the hands into the organs. 

Now move the palms to cover the navel and breastbone. The navel is the original connection to life and nourishment; the Chinese believe that in adulthood it still connects the whole body. The breastbone protects several vital organs, the heart and the thymus. The heart pumps blood, but the Chinese believe it is also the resting-place of one’s emotional and spiritual self. The thymus is the source of T-cells some of the most powerful agents. Visualize them benefiting from the warmth, the qi pouring into the navel, heart and thymus, making them more efficient.

- Move the palms around to cover the lower back. In traditional Chinese Medicine, this area is thought to be directly connected to the kidneys which remove toxins from the blood and stores vital life energies, again according to the Chinese. The adrenal glands rest on top of the kidneys and control the regulation of those energies, again according to the Chinese. Rub these areas, penetrating the qi deep into the body to allow the kidney and adrenals to do their work more efficiently. Visualize the kidneys and adrenals getting the qi and getting more power to help eliminate waste products, produce energy and activate healing throughout the whole body.

Massaging The Acupuncture Microsystems

In modern Chinese medical terminology, the hands, feet and ears are called reflex microsystems. Pressure applied to these areas, usually with the thumbs, stimulates qi throughout the body.  With thumbs vigorously press all areas of the palms and soles of the feet. Find sore points and concentrate pressure on them several times. Press out along each segment of the fingers and toes. At the tips-press on the lateral sides of the base of the finger or toenail, (feel for an indentation). Continue to press, roll the receiving finger or toe under the pressure of the thumb and forefinger of the working hand. 

Return to the points that were most tender and give additional pressure. Using thumbs and forefingers massage the ears simultaneously. Start with moderate pressure; work over the entire ear on both sides, until the ears begin to feel hot. Notice any areas of discomfort and rub the uncomfortable areas vigorously.

Building up Vital Energy with Breathing 

Sit or stand, keep eyes lightly closed or slightly open – attention focused inward. Relax shoulders and rest the head directly on top of the shoulders and spine Hold palms facing upward, point fingertips to each other, two inches below the navel. Slowly inhaling – bring hands upward to the lower edge of the breastbone. Then, take three additional puffs of breath to maximally fill the lungs, raising the hands a bit with each puff to the level of the armpits. Hold for a bit. Slowly turn the palms downward – exhale slowly while lowering the hands slowly to the navel. Exhale three additional puffs of air to maximally empty the lungs. Lower the hands a bit to the beginning level. Hold for a moment, repeat. On exhalations you may feel a warm tingling sensation spreading outward from the center of your body toward your hands.

On inhaling visualize the qi accumulating deep inside the pelvic and abdominal cavities, (known as "the sea of energy"). Continue visualizing with exhalation.

Contracting and Relaxing with Breathing  

In this exercise, on exhalation, the whole body’s musculature contracts. On inhalation it deeply relaxes.

The breath and the contraction together help to cleanse the tissues of the body. 

While sitting or standing, bring the hands in front of the heart/breastbone, inhale and relax. Begin to exhale, pressing the hands forward as if pushing something heavy. Contract as many of the body’s muscle as possible. Grip the floor or ground with the toes and while the hands slowly push forward, contract the perineal muscles, (located on the pelvic floor between the genital and anal area). When the hands are extended, all muscles contracted, breath is completely exhaled, relax.

Release tensions from all muscles and float the hands back toward the heart with deep inhalation. Release the toes the perineum and the abdomen. Repeat the same cycle pressing the hands upward as high as possible, as if lifting a great weight off yourself exhaling and contracting. Then relax completely, inhale slowly and return the hands to the position before the heart. Next repeat pushing out to the sides, pressing downward. Contraction and release of muscles pump large volumes of lymphatic fluid away from the tissues, carrying away metabolic by-products and pollutants through the bloodstream.

Twisting the Waist

Stand with your feet at shoulder width, rotate your torso. This can be done seated. Upper body movement should come from moving the waist. Shoulders follow the waist and the arms follow the shoulders, they just dangle and swing. Turn the head completely as far as it will comfortably go, to look behind you. Breathe fully and note a dynamic relationship between action and relaxation. Bring as much relaxation to the movement as possible. Notice that the arms and hands hit the body. This hitting and thumping can become purposeful when aimed at the reflexes of the kidneys, spleen and liver around the lower torso.

Spontaneous Movement

Very common in China. Instead of following a prescribed set of instructions each individual is guided to move about or not move at all by an internal sense of body’s needs, a sense of the qi. Some people seem to be doing nothing or almost nothing. Others may be sitting and moving their arms about in co-ordination with the breath. Still others may be dancing about in a deeply energized state. 

Stand with feet at shoulder width or sit in an armless chair. Begin to wiggle the fingers and shake or rock the body, deepen the breath. Increase the body’s activity and allow hands and arms to shake. Add shaking of the head and shoulders. Relax the jaw, allowing some sound to be generated on the exhalation, like a giant sigh of relief. 

This is one of the best exercises to bring about an immediate sensation of the energy or qi. Exaggerate the movement, prolong it, shift weight from foot to foot, make sounds. Find your own best way to use this exercise.

Qigong Meditation

This practice can be done standing, sitting or lying down. In the severely ill, it can mobilize important healing resources. If the person is healthy, it can help maintain health and co-ordinate body, mind and spirit. In this practice natural forces accelerate through breath, relaxation, intention and visualization.

On inhalation, visualize a concentration of qi in the abdominal area. On exhalation, visualize these resources circulating out from the center to all parts of the body, extremities, organs, tissues and glands. Continue through thought and visualization to circulate healing energy with deep breathing and deep relaxation.

CONCLUSION

Although widely practiced in America, Qigong is not accepted for use in a medical context. Yet, with qigong, individuals learn to heal themselves and maintain health which is quite cost-effective.

In time, with its proven ability to enhance health and prevent disease, qigong can serve as an effective system of self-care, thus saving thousands of dollars in long-term health costs.

SOURCE: 

Alternative Medicine, The Definite Guide, Compiled by: The Burton Goldberg Group, Published by: Future Medicine Publishing Inc. 5009 Pacific Highway, E, Suite 6, Fife, Washington 98424

Student Article:

Submitted by: Jacki Weber - Massage Therapy Student, Virginia Academy of Massage Therapy
Date: 03/2000

Breast Cancer

Anatomy Report One

Jacki Weber

One in nine women will develop breast cancer in their lifetime. Breast cancer kills more women than any other cancer except lung cancer. It behaves differently in each woman. It may stay in the breast for years or it may spread to the lymph nodes or other body parts even before a lump is felt.

There are many theories, but as of yet, no one knows for sure what causes breast cancer. Many experts agree that there are factors that increase a woman’s risk of developing this cancer. Family history is a contributor, if a woman has a mother or sister that has or has had breast cancer her chance of developing it is as high as one in two; in fact 5 – 10 % of all breast cancer cases have a family history of the disease. In 1997 researchers found two genes linked to higher risks of inherited forms of breast cancer. They are P53 which suppresses the growth of abnormal cells and the RB gene which may undergo mutations. Tests are now available to identify these genes, the jury is still out as to whether these tests help detect the cancer earlier or just alarm patients.

As a woman ages, her risk increases, it is also said that a woman under 40 with a family history of breast cancer has a risk factor five times greater than that of a woman with no family history, however, if a woman has not contracted the disease by age 60 her risk of development is the same as any other woman.

Estrogen is another risk factor, if a woman starts her period before age 13 or goes into menopause after age 51 or takes estrogen replacement her risk increases. A woman taking birth control pills has a 50% greater chance of contracting the disease, however, once usage stops so does her risk, past pill use does not pose a risk. If a woman doesn’t have children or has her first child after age 30 she is in a higher risk category, estrogen is the factor here also.

The highest incidences of breast cancer develop in women born in North America, Europe and Latin America; the lowest incidences occur in Asia and South America. Socioeconomic status and race are believed to put women at a slightly higher risk. Experts have recently added toxic chemicals and high voltage power lines to their list of risks. Keeping all of that in mind, it is also reported that 75% of breast cancer occurs in women with no known risk factors. There are a few things a woman can control to lower her risks, diet and not smoking are numbers one and two. If a woman controls her intake of fat, especially animal fat, eats plenty of fruits, vegetables, and whole grains, limits alcohol and maintains a healthy weight she is said to lower her risk.

The most common sign of breast cancer is a lump or thickening in the breast; it may or may not be painful or tender and many times are found during a self examine; when doing an exam, note lumps or hard areas but also look for abnormalities such as discharge from the nipple that is clear or bloody or a retracted nipple should alert a woman to be examined by a doctor. Any changes in the breast should be looked into especially a change in size, shape, the contours or the skin itself for example if the breast begins to flatten, if it has redness or pitting (like a golf ball) or indentations, it would be wise to see a doctor. All the experts agree that early detection is the key – if in doubt check it out!

It is recommended that a woman begin breast self-exams once a month beginning at age twenty. The self-exam should be done at the same time each month after menopause or seven to ten days after the start of her period, before menopause. From ages 20 – 39 she should be examined by a doctor once every three years; when she reaches 40 this should be once a year and after age 50 she should add mammograms to her physical exams.

Currently, a number of diagnostic tests are being used to detect breast cancer. A mammography is a x-ray of the breast both vertically and horizontally. A mammogram can detect abnormalities and cancer as early as two years before a lump is felt. 25% of diagnosed breast cancer found from a mammogram is smaller than 1/3 of an inch and it usually hasn’t spread beyond the breast. Sometimes ultra sound is used to detect lumps. If a lump is detected, further examination called a biopsy will be done to determine if it is a solid mass or a cyst which is fluid filled. One of the ways this is done is by needle aspiration. A small hollow needle is inserted into the lump, if it is found to be solid, cells are retrieved, if it is a cyst, or liquid filled it can be drained. A surgical biopsy may also be used; with this procedure, the entire lump is removed for examination. If the lump is very small, a procedure called stereotactic is used. With this procedure, a radiologist uses a mammogram from different angels to find the exact suspicious area, a computer then aligns a needle to the area and the radiologist removes a small amount of the tissue. This takes about 30 – 40 minutes under local anesthesia, doesn’t leave a scar, costs 1/3 less than a surgical biopsy and is just as accurate. More than 70% of breast lumps biopsied are found to be benign or non-cancerous.

The pathologist will document the type of breast cancer and the size of the tumor measured in centimeters or millimeters. After surgery an extensive pathology report will reveal if the tumor cells are estrogen receptor positive or negative. The estrogen receptors are like locks on the cells that have to be stimulated by estrogen to survive. Post-menopausal woman are commonly estrogen-receptor positive while pre-menopausal women tend to be estrogen-receptor negative. Generally, estrogen-receptor positive breast cancer is less aggressive than negative. Based on the cancer cells being estrogen-receptor positive or negative a treatment plan will be implemented.

The biopsy will also show other results such as Nuclear grade or how fast the nuclei of the cells divide. They’re rated from one to three the higher the score the more aggressive the cancer. Flow cytometry, which is a measure of DNA in the cancer cells, almost 70% of breast cancer cells have abnormal DNA. S phase fraction is an assessment of how many cancer cells are dividing at any given time. The last is Cathepsie D6, which is an enzyme, if there is a high level of D6 the cancer may have spread.

There are a number of categories of breast cancer and their treatment depends mainly on when it is found. The most common breast cancer is early; it begins in the cells lining the ducts that connect to the milk producing glands that connect to the nipple. If detected while confined to the ducts or lobules it is more than 95% curable. The tumor and possibly some surrounding tissue is removed in what is called a mastectomy or lumpectomy; with this procedure most of the breast is left intact. Removal of the tumor by surgery cures 1/3 of all breast cancer when detected early, however, there may be a small chance that the cancer had spread.

The next stage is invasive where the cancer has spread beyond the ducts or lobules to the surrounding breast tissue. By this stage a hard lump may be the first palpable sign but the cancer has probably been present for years. At this stage a simple mastectomy may be performed where the effected breast is removed. Radiation therapy is often recommended after the surgery as part of the treatment plan if the cancer has not spread beyond the breast. A radical mastectomy where the breast and surrounding tissue is removed is rarely used because it has not been shown to improve a woman’s survival rate and it changes her appearance dramatically.

The final or most serious stage is metastatic where the cancer has spread to other body parts. The most common metastasis in breast cancer patients is into the lymph glands in the armpit. Presence or absence of cancer cells in the lymph glands help doctors know how far the cancer has advanced and if the patient can be cured with a mastectomy, use of radiation, chemotherapy, drugs or any combination of treatments.

The prognosis for breast cancer patients has improved greatly. The five-year survival rate of American women with localized breast cancer was 78% in the 1940’s. The survival rate was 97% in the 1990’s. If the cancer has spread to adjacent tissue the five-year survival rate falls to 76%. Since the cause of breast cancer is unknown you can’t eliminate your risk but you can take steps to lower your risk! The key is early detection!! Ladies be sure to do monthly self-breast exams, encourage your friends, sisters, aunts and mothers to do the same. Be sure to have a physical once a year, get a mammogram from 50 years old on, watch your diet and exercise and hopefully you’ll live breast cancer free.

Encyclopedia Encarta 99

IntelHealth.com – home to Johns Hopkins Health Info

AolHealth.com

Mayo Health Clinic.com

Student Article:

Submitted by: Margo Schaffer - Massage Therapy Student, Virginia Academy of Massage Therapy
Date: 03/2000

Cerebral Palsy (CP) is a term used for a group of disorders that result from damage to the brain before or during childbirth, or in early childhood years. Abnormalities in the brain cause a lack of muscle control in just about every type of cerebral palsy. The disorders can be very mild to very severe. I will briefly address the types of cerebral palsy, its symptoms, causes, diagnosis, and treatment.

There are four types of cerebral palsy: ataxic, athetoid, hypothoid, and spastic. In the first type, ataxic, the victim’s voluntary muscle movements are jerky and they have a loss of balance or equilibrium. The second type, athetoid, or athetosic, causes the muscles to move continually. This may interfere with any voluntary muscle movement attempted by the victim. The third type, hyptonic, is the inability of the muscles to contract. The limbs, in this case, are limp. The fourth type is spastic. In this type, the muscles are stiff and therefore the person cannot move that body part. A person may have more than one of these disorders.

Symptoms of cerebral palsy are varied. A person can have several of these symptoms. They include a clumsy walk, lack of balance, shaking, jerky movements, unclear speech, mental retardation, learning disability, and seizures. Symptoms are usually difficult to diagnose in infants before they are six months old, and sometimes not until they are two to three years old. An early symptom could be difficulty sucking on a breast or bottle, difficulty swallowing, and seemingly limp limbs. But not all babies with cerebral palsy have limp limbs or muscles. At about six months you may notice a stiffening of the muscles. Or if the baby is seen in unusual positions or postures, or appears to have muscle spasms, you may want to have them checked for possible cerebral palsy. Sometimes the affected limbs will be curled up under the body or settled in unusual positions, the legs may be crossed like scissors, or the feet may be pointed downward at the ankles. The baby may move very little or its movement may be very clumsy. All these are due to the normal muscle balance being disrupted. Normal infant development may be delayed considerably due to these conditions. And there is the possibility that impaired hearing and vision, also due to the brain abnormalities, may cause even further delays in the infant’s development. Children with the spastic type of CP may also have epileptic seizures in the part of the body that is paralyzed.

Some victims of cerebral palsy also suffer a degree of mental retardation. However, some grow up to mentally competent adults. Sometimes the affects of cerebral palsy make it difficult for the victim to communicate. This can lead to a belief that the person is mentally retarded when, in fact, they are very intelligent. Mental retardation is more frequent in the spastic type of CP. It is less frequent in the athetosic type, but because of muscle dysfunction in the face, the victim may appear mentally retarded due to speech impairment.

All of these symptoms are the result of damage or abnormalities in the brain. The exact causes are unknown, but it is know that one cause is faulty growth of the brain during fetal development. It is much more common in premature babies or ones whose mother was ill during pregnancy with German measles or other illnesses. Also the use of drugs or excessive use of alcohol by the mother during pregnancy can cause the infant to have CP. Incompatibility of the parents’ blood types may cause severe jaundice at birth thus resulting in CP. It is not believed to be hereditary. So the birth of one baby with cerebral palsy does not increase a mother’s chances of having another baby with the same condition.

The brain can also be damaged during birth. Sometimes the use of forceps has caused brain damage. Hypoxia, or lack of oxygen, (even in normal term babies) causes brain cells to die, possibly resulting in cerebral palsy. After birth, accidental injury to the head, or infections such as meningitis, can cause damage to the brain. Severe convulsions in the infant or very young child can also cause damage to the brain resulting in CP. Child abuse is another cause of head injuries that could result in damage to the brain that causes cerebral palsy. As you can see, there are many causes of CP. How is it diagnosed?

We said that it is difficult to diagnose during the first year of life. In fact, the child may be two or three years old before diagnosed with CP. The diagnosis includes blood tests, an electroencephalogram, and a CAT scan or MRI. After the child is diagnosed with CP, how can we treat it?

There is no curative treatment or any that will alleviate the abnormal motor functions. A disease like CP cannot get better, but fortunately, neither does it worsen. The symptoms may be treated. Stiff muscles can be treated with muscle relaxants, or if the muscle becomes immobile, surgery may return some movement to the limbs. Medicines may also be prescribed to reduce frequency and severity of seizures. Therapy can also be prescribed. It may include physical therapy, occupational therapy, speech therapy, braces, corrective glasses, and hearing aids. Most therapy is designed to help the child develop to his or her greatest ability, to prevent additional deformity, and to develop posture that may be beneficial to them.

Many children with mild CP have normal intelligence and can attend regular schools, while those with more severe CP may require special schooling. Children should be examined by their physician on a regular basis to evaluate their mental and physical abilities.

There are a few things women can do to prevent CP. Before pregnancy, get vaccinated against diseases like Rubella. Expectant mothers should take only those drugs prescribed by their physician. After birth, use careful handling and take proper care of your infant and young child, to include getting their vaccinations.

Cerebral Palsy is probably the most crippling childhood disease. Almost one percent of the population has some form of CP. But through teamwork, parents, physicians, therapists and teachers can help these children develop to the best of their ability. And many more of these victims should be able to lead better lives.

BIBLIOGRAPHY

1. Encyclopedia Brittanica, Vol 3, 1987 ed.

2. The Lenox Hill Book of Symptoms and Solutions, ed. By Diana Benzaia, random House, 1994, pp 46, 58-60

Grolier Wellness Encyclopedia: Pregnancy, Childbirth and Parenting, Vole 11, by Robert E. Kime, c. 1992, (Figure of Developmental signs, p. 92-3)

The American Medical Association Family Medical Guide, third edition .c. 1994, Random House, pp716-717.

.Going Places: Children Living with Cerebral Palsy, by Thomas Bergman, c. 1991

World Book Encyclopedia, Vol. 3, 1993 edition, pp. 361-2.

Student Article:

Submitted By Jennifer Roberts - Massage Therapy Student, Virginia Academy of Massage Therapy
Date: 03/2000

Raynaud's Disease
by:
Jennifer Roberts

Raynaud’s Disease is a circulatory system disorder marked by recurrent vasospasm of the superficial blood vessels, especially in the fingers and toes. It was originally documented in 1862 by French physician Maurice Raynaud, hence the name, Raynaud’s Disease. When this condition is present with no known cause, it is called Raynaud’s Disease, or sometimes Raynaud’s Syndrome. However, when this condition is secondary to another disorder, it is known as Raynaud’s Phenomenon.

The most common regions to be affected by Raynaud’s Disease are the fingers and toes. Less frequently, the disease affects the nose, cheeks, ears, and tongue. Recent studies suggest that Raynaud’s Disease may even have an effect on major organs, such as the heart, lungs, and kidneys.

When the symptoms of Raynaud’s Disease occur, the blood vessels of the affected areas contract and blood circulation is restricted. The loss of oxygenated blood to the area results in an extremely pale, often white, appearance. A blue-purple color may also be present. A typical presentation of symptoms might include numbness of the fingers and toes, followed by loss of color in those digits, particularly in the first and second phalanges of each finger or toe affected. When the tissue is warmed, a bluish or purple color is often noted, known as cyanosis, and finally, when the blood returns to the digits a flush, or exaggerated redness known as rubor may appear. The return of blood to the tissues is often accompanied by a tingling sensation or even pain. A Raynaud’s attack may last from a few minutes to several hours.

When a Raynaud’s attack does occur, it is important to restore blood flow as soon as possible. Swinging the arms in 360-degree circles (as if to release an underhanded pitch) helps to bring blood back to the affected tissues. Running the affected area under warm (not hot) water is very effective as well. Any physical activity that elevates the body’s temperature usually helps to restore circulation to the extremities after a few minutes.

The long term effects of Raynaud’s Disease from inadequate blood supply to muscles, nerves, and tissues may include weakness in the fingers, diminished sense of touch, and ulceration of the tissues in the affected areas due to prolonged oxygen debt. Cuts and scrapes may heal more slowly. In rare cases, lack of adequate oxygen supply to the tissues can lead to gangrene.

The acute symptoms of Raynaud’s Disease are intermittent, and are generally brought on by external conditions, primarily cold. For some people the vasospasms of the blood vessels are brought on by emotional upset or excitement, but in the majority of cases cold temperatures cause the symptoms. Although cold is the major culprit, some patients with Raynaud’s Disease may have an increased sensitivity to heat as well, and in hot, humid weather they may experience swelling of the extremities, a red tone to the skin, and a decreased ability of the body to cool itself. Although visible symptoms are not always present and only appear under certain conditions, people with Raynaud’s Disease generally exhibit poor overall circulation.

Primary Raynaud’s Disease has no known cause. It occurs spontaneously without any underlying condition being present. Raynaud’s Disease may also occur as a disorder secondary to another disease. People who have diseases such as Systemic Lupus Erythematosis, Multiple Sclerosis, Scleroderma, Rheumatoid Arthritis, and Fibromyalgia frequently exhibit Raynaud’s Phenomenon. Another group of people who often develop this disease are those who work with vibrating machinery such as chain saws, jackhammers, or pneumatic drills. They may develop this disease as a result of handling this equipment. Typists, pianists, and others whose fingers are subject to repeated physical stress are also susceptible. .

Raynaud’s Disease affects both men and women, but women make up the majority of cases. Although the figures vary widely, recent surveys indicate that Raynaud’s Disease affects between 5 and 10 percent of the general population, with women accounting for seventy-five percent of reported cases. Onset usually occurs during young adulthood and worsens throughout a person’s adult life.

There is no cure for Raynaud’s Disease. However, there are precautions people with Raynaud’s Disease can take to minimize the occurrence of symptoms and the associated discomfort. First, common sense is the key. It is important for the patient to stay warm; this includes the entire body, not just the affected areas. Keeping the entire body warm is vital because the circulatory system is less likely to divert blood away from the extremities if the body’s core temperature is not threatened. Hands and feet should be kept warm and dry in cold temperatures. Mittens work better than gloves, as this allows the fingers to warm each other. Battery operated socks and mittens are helpful, as are chemical warmers. When going outside in the cold, a person with this disease should stay active. Once the core body temperature is elevated, the extremities usually warm up as well. When handling cold objects, Raynaud’s sufferers should protect their hands with an insulating layer. A significant contributing factor to the severity of Raynaud’s Disease is smoking. Smoking can cause considerable restriction of blood flow to the extremities, so smokers who have Raynaud’s Disease should quit. Even second-hand smoke has an effect, so patients should minimize their exposure to any cigarette smoke.

Under a physician’s care there are many therapies available, with varying degrees of effectiveness. Certain vasodilators may be prescribed, especially calcium channel blockers. There has been some success with the use of the drug Procardia, typically used to control hypertension. Topical application of Nitroglycerin ointment helps to dilate blood vessels of the extremities, and has provided many people relief from their symptoms. A radical, and somewhat last-resort procedure is a surgery called a Sympathectomy, in which nerves that control contraction of the arteries are cut. This is a risky operation, and not always successful. It is usually more effective for controlling Raynaud’s symptoms in the feet.

Other recommended therapies for Raynaud’s Disease include acupuncture, massage therapy, chiropractic therapy, regular exercise, and alterations in the diet to include iron-rich foods and vitamin E. Another treatment, which has gained some recognition, is biofeedback, which is based on the premise that a person can learn to control their skin temperature. The patient is taught to focus mentally on warming the fingers and toes with the help of temperature sensors.

Raynaud’s Disease is a distressing condition and does require some care to avoid tissue damage. Most people with this illness can continue with their usual activities. It does not have to interfere with a person’s quality of life. With the right combination of therapy and care it is manageable. This circulatory system disorder is steadily becoming more understood within the medical community, and an increasing amount of research is being performed in search of treatments and a cure.

SOURCES:

1) Encyclopedia of Healing Therapies, by Anne Woodham and Dr. David Peters, c.1997, pg. 249.

2) The American Medical Association: Family Medical Guide, Third Edition.

Medical editor: Charles B Clayman, MD, c.1994, pgs. 440-441.

Internet Resources:

    1)  http://www.atlantic.edu

    2) http://www.healthgate.com

    3) http://www.health.excite.com

    4) http://www.medicinenet.com

Student Article:

Submitted By Margo Schaffer - Massage Therapy Student, Virginia Academy of Massage Therapy
Date: 03/2000

1. There are five areas that make up the vertebral column. They are cervical, _____________, lumbar, _________________ and coccyx.

Match the following:

2. _____medullary canal                                    a. shaft of the long bone

3. _____periosteum                                            b. connective tissue at end of bone to reduce friction

4. _____endosteum                                            c. ends of bones

5. _____articular cartilage                                d. thin connective tissus on outside of bone

6. _____diaphysis                                               e. where epiphysis and diaphysis meet

7. _____epiphysis                                               f. central, hollowed area containing yellow marrow

8. _____metaphysis                                           g. thin layer that surrounds medullary canal

9. Name the three types of bone cells.

10. _____________ are responsible for breaking down and reabsorbing bone tissue?

11. ____________ are responsible for building bone tissue?

12. There are two types of bone. What are they?

Match the following Projections and definitions:

13. _____ Condyle                                      a. Knob-like end

14. _____ Tuberosity                                  b. very large, blunt, irregular process

15. _____ Tubercle                                     c. a large, rounded articular prominence

16. _____ Trochanter                                 d. sharp, slender process

17. _____ Facet                                           e. any prominent projection

18. _____ Head                                           f. large, rounded projection

19. _____ Process                                       g. smooth, flat surface

20. _____ Crest                                           h. less prominent than a crest

21. _____ Spine                                           i. Narrow ridge of bone, usually prominent

22. _____ Line                                             j. small, rounded process

Match the following bone Depressions with their definitions:

23. _____ Foramen                       a. cavity in a bone

24. _____ Sinus                             b. depression in a bone

25. _____ Fossa                            c. furrow or depression, usually accomodates tendons,  blood vessels,or nerves

26. _____ Meatus                         d. opening through a bone, through which blood vessels,nerves and ligaments pass.

27. _____ Sulcus                           e. tube-like passage running within a bone

28. Name the 3 types of joints.

29. ____________________ joints are held together by cartilage (e.g. pubic symphasis and vertebral discs).

30. ___________________ are held together by fibrous connective tissue (e.g. sutures of skull).

Match the synovial joints with their definitions:

31. _____ Gliding joint          a. allows for greatest range of motion

32. _____ Pivot joint             b. spool-like surface fits into concave surface

33. _____ Hinge joint            c. flat surfaces that articulate with each other

34. _____ Ellipsoidal joint     d. oval-shaped

35. _____ Saddle joint           e. similar to hinge joint – goes two directions

36. _____ Ball and Socket    f. rounded, pointed or concave surface fits into a ring formed by      bone or lig.

37. Give an example of a gliding joint?

38. Give an example of a Saddle joint?

39. Give an example of a hinge joint?

Match the following movements with these names:

a. flexion     b. extension     c. abduction     d. adduction     e. pronation
f. supination     g. internal rotation     h. external rotation     i. Protraction    
 j. retraction

40. ____ Neck - chin to chest                                        

41. ____ Elbow – bent

42. ____ Knee – leg straight

43. ____ Thumb – curled in to fist

44. ____ Radio-ulnar – palm up

45. ____ Shoulder girdle – shoulders back

46. ____ Hips – raise leg to front

47. ____ Wrist – bent down

48. ____ Trunk – back bend

49. ____ Shoulder – straight arm to front/overhead

50. ____ Shoulder – arm away from body

51. ____ Neck – turn head

52. ____ Fingers – spread out

53. ____ Hips – leg out to side

54. ____ Hips – foot in, knee out

55. Raising the shoulders is called ______________________.

56. Wrist bent toward ulnar is ___________ ____________.

Match the following articulations with their bones

57. _____ Shoulder joint                    a. femur articulates with tibia

58. _____ Shoulder girdle                  b. scapula and clavicle

59. _____ Elbow                                 c. ulna articulates with humerus

60. _____ Radio-ulnar                       d. tibial and fibula articulate with talus

61. _____ Radio-carpal                     e. articulation - head of humerus with glenoid fossa

62. _____ Sacro-iliac                          f. sacrum articulates with ilium of pelvis

63. _____ Hip                                     g. articulation between radius and carpals

64. _____ Knee                                  h. radius articulates with ulna

65. _____ Ankle                                 i. Articulation – head of femur with acetabulum

66. Name the three joints that make up the shoulder girdle.

True or False. 

67. _____ The Gleno-humeral joint is a very unstable ball & socket joint whose stability is determined by the musculature.

68. Ankle bones are called the ________________ and ________________ malleoli.

69. The most important ligament in the ankle is the _____________________.

70. Name the rotator cuff muscles (SITS).

71. Name the two ligaments in the elbow.

True or False. 

          72. _____ The acetabulum and head of the femur are covered with hyaline cartilage.

73. Define resorption as it applies to bone.

74. Name the bones of the upper appendicular skeleton

75. Name the bones of the lower appendicular skeleton.

76. Name the six functions of bones.

Student Article:

Submitted By Anne Alden - MT Student VAMT
Date: 02/2000

Can Massage Help? by: Anne Alden

February 2000

    Kyphosis is the term used to describe the exaggerated forward curvature of the Cervical/Upper Thoracic area of the spine. This condition may be a congenital abnormality, a result of disease, such as Polio or Pott’s Disease, a form of tuberculosis, osteoporosis, arthritis, or from spinal trauma such as accidental injury, burst fractures or other soft tissue trauma. Less severe forms are the result of poor postural habits.

    A congenital form of Kyphosis, called Scheuermann’s Disease, primarily affects tall, thin individuals. The skeletal vertebra form into wedge shapes instead of rectangular shapes during early growth, so the spine’s normally gentle curvature is exaggerated forward into a more rounded shape. The cause of this inherited abnormality nor why it specifically affects tall, thin individuals has yet to be determined. It may or may not cause pain in an individual and may only be an issue of appearance. This type of Kyphosis may possibly be improved with the use of a back brace prescribed by their physician, but the individual must literally wear it 24 hours a day to see any results. If caught early enough in the development cycle, the vertebrae may grow closer to the correct rectangular shape. Massage may provide some relief and assist the muscles to accept the changes a brace would promote. Ask them to confer with their Physician first, and get permission localized work.

    Kyphosis as a result of disease cannot be reversed. It may be helped somewhat by surgery, but the damage is done. The Polio-related Kyphosis is generally combined with severe scoliosis and the result is the exaggerated "hunchback" appearance. Affected individuals have severe pain as a result of fused vertebra and the inability to support their upper bodies, but also due to their internal organs being cramped together in a much smaller space. They generally need oxygen support and are very limited to what activities they may undertake. Massage is only indicated for relaxation and absolutely not on the affected areas. You must obtain permission from their Physician for any massage that is to be performed near the spine.

    Traumatic injury resulting in Kyphosis is generally also very difficult to repair. A burst fracture is when a vertebra actually caves in on itself and flattens, as a result of injury or weakening of the bone structure itself, as in osteoporosis. A surgical procedure may be used to replace the vertebra or fuse it in place, but the trauma may only be slightly reduced. Soft tissue injury may encompass torn ligaments, spinal cord damage and muscle damage that results in the inability to properly hold the vertebra in its correct position. The body may then try to compensate for this change and may actually enhance the Kyphotic condition. As with disease related Kyphosis, massage is only indicated for relaxation and away from the affected area. Ask the individual to check with their physician first, obtain permission if they want any work performed near the site.

    Poor posture is the main cause of a less severe, but more common, form of Kyphosis. This postural distortion may be the result of physiological, emotional, psychological, and even technological factors. In each of these cases, what basically happens is that an individual repeatedly slumps over and the body conforms to the encouraged shape. It may be physiological because the individual just doesn’t know any better and naturally slumps over. It may have emotional and psychological roots in such cases as a taller person not wanting to seem as tall as they really are, or even self esteem issues where a person does not want to be noticed or presents a natural ‘protective’ posture towards a perceived threat. The technological factors include sitting in front of a computer/television monitor for hours at a time. Postural Kyphosis can prevented and improved.

    Can massage help individuals suffering from Kyphosis? It cannot specifically help those that have irreversible forms except to relax the individual and soothe sore, overworked muscles elsewhere on their body. Once again, you must obtain permission from their physician before performing any massage near the spine. A soothing massage may certainly help the individual deal with pain and discomfort. The Massage Therapist must be acutely aware of how the spine is positioned and take great care to not harm the individual further. Gentle, caring massage is in order in these situations, avoiding the spine altogether.

    Massage CAN help those individuals suffering from Kyphosis as a result of poor posture. First, we must understand what Kyphosis does to the soft tissues of the body in order to formulate a treatment plan. Refer to figure 1. As you can see the individual is slumped forward. This would mean that the muscles in the upper back are stretched and their antagonists in the chest area are shortened. The tendons and attachment points of the stretched muscles may also be under stress. Peripheral muscles may also be affected due to the body’s constant attempt to compensate. These would most likely be the muscles used to keep the back stable and upright, the lower back muscles - Lattisimus Dorsi, Quadratus Lumborum, Eerecto Spinae - and their antagonists, the lower abdominals – Rectus Abdominous, and External and Internal Obliques.

    Your plan should be to work the attachment points and bellies of the upper back muscles, -Upper and Middle Trapezius, Rhomboids, Levator Scapula, and Paraspinals - to help ease the strain at the tendon/bone connections and to help the muscles remember their original shorter shape. Effluerage, petrissage and friction are all indicated. The Rhomboids, Erector Spinae, Levator Scapula, and Upper Trapezius will also most likely need trigger point therapy to help release severely contracted tissue. The antagonists –Pectoralis Major and Minor, Subclavius, and even the Serratus Anterior - would then need to be warmed and stretched, their attachment points also worked to help them accept the increased tension placed upon them by the stretching. Effluerage, petrissage, and friction are also indicated for this task.

    You should also show your client a few stretches that they can do at home that will help to stretch the chest muscles. They should be made aware that this is a process that requires their participation if they truly want to prevent and/or improve their posture. Please see Figure 2. These exercises will also help them become aware of their posture as they go about their daily activities.

    As a Massage Therapist, you must also be aware of the psychological and emotional factors that may be involved and be empathetic to any emotions that may arise during a massage session. Just being there and listening may be all that it takes. You have the ability to help your client feel better and to also encourage them to be a partner in their healing process.

    In closing, Kyphosis from poor posture, and to a lesser degree, more severe forms of Kyphosis, may be helped through massage. Your knowledgeable and caring touch can help an individual not only feel better physically and emotionally, but also give them the sense that they can help themselves and can be successful as they strive towards better health and its benefits.

Bibliography/ Other Source Material

Spine Care Foundation
110 Princess St.
Ryde NSW, 2112
Australia

Funk & Wagnalls Encyclopedia

National Scoliosis Foundation
Scoliosis@aol.com

www.healthfinder.gov

Ask Dr. Weil
www.pathfinder.com/drweil.com

Student Article:

Submitted By Anne Alden - MT Student VAMT
Date: 11/11/99

By Anne Alden

Technological advances have greatly improved our lives. We can flip a switch to shut out darkness, cook dinner, heat our beds, and watch news taking place across the world. We take for granted the Internet, space travel, and even robots. Technology has enabled us to work smarter, play harder, live longer. All of these things would be out of our reach if we didn’t have the one thing they all must have in order to exist. Electricity. Without electricity, we would still be using gaslights and fireplaces to light and heat our homes, cook our meals, and communication would be slow, smoke signals would be our best bet for long distance.

We are very busy each day, or perhaps not so busy sitting in front of Satellite driven reruns on our 35 inch color television, using all of this wonderful technology that we may not consider that all of this convenience may have some inconvenience, too. Inconveniences that may be dangerous. There are harmful properties of electricity that we should all be familiar with, specifically shock and fire, but you may be totally unaware of the hidden danger called Electromagnetic Radiation (EMR). EMR may also be referred to as Electromagnetic Field (EMFs) and Electromagnetic Waves. EMR, EMF and E-waves may refer to any frequency of radiation. This discussion is limited to the EMR byproduct of the flow of electricity through an electrical conductor i.e., wires, switches, tubes, transistors, etc.

When electricity is turned on, it excites the electrons in the conductor, which in turn excites the next electrons and so forth, eventually creating a "flow" of current through the conductor. This electron excitement not only affects the conductor’s electrons, but all of the electrons that surround the conductor. This excitement of the surrounding electrons is EMR. The strength of the EMR is dependent upon the strength (amperage) of the internal "flow" (current). It may be insubstantial or radiate huge potential. On exposed conductors (those that you can physically touch) there is a type of nonconductive – resistant to electrical flow - material that surrounds the electrical conductor to prohibit this action, but its usefulness is dependent upon the strength of the amperage. Other conductors are not covered on purpose so that we can take advantage of this byproduct.

This EMR byproduct is actually very useful. One of these uses is in transformers, which enable us to change the electricity from one form to another depending on what our end device needs. Without transformers, we would be extremely limited to how we could use electricity. Almost every household appliance uses a transformer. A simple analogy is wheat. Wheat in its original grain shape is useful in animal feed, cereals, and rough breads, but unless we change the shape of wheat by grinding it into different textures, we can’t make doughs and pastries and use it to thicken soups and gravies, etc. Its use would be extremely limited.

Another property of EMR is that if we use electricity, it occurs whether we need it or not. It is acting upon surrounding electrons as long as the current flows within the conductor. If our bodies are in close proximity to the conductor, our electrons can also become excited which means changes may happen within us. Changes that are not intended and that interrupt the normal activity of our cells. This unusual activity may cause the cell to grow irregularly, change its function, mutate, or even die. Many studies have been and continue to be conducted by private and government agencies to determine what affects exposure to EMR may have upon us. Some studies were instigated due to increased cancer rates among electrical workers and others exposed to higher than normal levels of EMRs.

You are probably thinking that you have used electricity all of your lives and nothing bad has happened to you yet. I am not implying that it has, but that it may, and you should be aware of this potential so that you can make an informed decision based upon the information disseminated in this report. After receiving this information, you may want to limit your present exposure to EMRs as a safety precaution. This discussion is limited to the EMRs found in a standard household.

Appliances that use transformers, have motors, or otherwise require a lot of current are of most concern because of what we discussed earlier about increased amperage. Motors require substantial amperage to drive their mechanical parts. Potential offending appliances include, but are not limited to, your hair dryer, curling iron, electric alarm clock, electric blanket, cordless phone, television, stereo, and computer.

You may think right away that the TV, stereo, and computer are the biggest emitters of EMRs, but unless you are using one manufactured before 1980, it normally isn’t the case. Their dangers were addressed early on and shielding and preventive measures were taken and set into law through the Federal Communications Commission.

Personal appliances may be the biggest offenders. They must also conform to safety guidelines, such as shock and fire prevention, but EMR protection is limited. Their EMRs are particularly risky because we keep them close to our bodies, sometimes for long periods of time. Some of them also require increased amperage in order to work, and as I said before, the greater the current flow, the greater the EMR. The handheld hairdryer is an excellent example. It is held close to the head and it requires lots of current to power the blower and heater units. The blower is a motor and the heater is a coiled wire assembly, looking a lot like a transformer. Two big EMR emitters.

Electric blankets are a concern. Here we are keeping a continual current flow on top of our bodies for extended periods of time. Depending on how warm you like it, the EMRs vary from minimal to meaningful. There are conflicting reports on the effects of electric blankets on the human body. The EPA is reluctant to release any negative findings without much more investigation. It has been generally reported that electric blankets should not be used on babies, pregnant women, and senior citizens. Make your own conclusion.

So what can you do about EMR in your home? Limit your usage of high current appliances. Keep your appliances in good shape, throw away those that may be worn out, heat your bed with the electric blanket then turn it off after your get in, use one of the new gel packs instead of a heating pad. Be aware of how long you use electrical appliances and how close you hold them to your body. Turn off items that are not in immediate use. Buy low wattage products (low wattage means low current).

In closing, technology has enabled us to accomplish many wonderful things, but always keep in mind that in order to do something faster or smarter or better, there may be a price to pay. Be aware of your surroundings and know what is happening to your body, it is the only one you get.

(select the above pictures for a larger view)

Amperage The strength of a current of electricity expressed in Amperes (Amps)

Current A flow of electric charge; also the rate of such flow.

Electromagnetic Field The area of electromagnetic radiation that surrounds a magnetic or current carrying device.

Electromagnetic Radiation A series of electromagnetic waves

Electromagnetic Wave One of the waves that are propagated by simultaneous periodic variations of electric and magnetic field intensity and that include radio waves, infrared, visible light, ultraviolet, x-rays, and gamma rays.

Electromagnetism Magnetism developed by a current of electricity.

Frequency The number of periodic oscillations, vibrations, or waves that occur in a period of time, measured in Cycles (Hertz)

Magnetic Field The portion of space near a magnetic body or a current carrying body in which the forces due to the body or current can be detected.

Voltage The electric potential or potential difference expressed in Volts.

Bibliography/ Other Source Material

"The Electrical Sensitivity Handbook: How Electromagnetic Fields (EMFs) Are Making People Sick" – Lucinda Grant

"Currents of Death" – Paul Broder

Newsletters/Organizations

EMR Alliance Newsletter

Human Ecology Action League

Websites

Ask Dr. Weil
www.pathfinder.com/drweil.com

EMFacts Consultancy
www.tassie.net.au/emfacts

Environmental Protection Agency
www.epa.gov

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