Marvelous Massage

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http://www.mdausa.org/publications/Quest/q76massage.html What's not to like about a massage? What could be more inviting than a dimly lit, quiet room offering calm peace and privacy, your eyes closed, your body lying relaxed and comfortable under fresh cool sheets, your skin being touched by soothing oils and warm, caring hands?

For people with neuromuscular disease there's much to like -- everything from improved blood flow to relaxation of knotted muscles to nurturing touch. Massage has many immediate benefits, say practitioners, physicians and people who've discovered its pleasures. The downside is almost nonexistent.

Massage is the manipulation of soft tissue by stroking, kneading and pressure. It's been around for thousands of years, and it's good for babies, kids, adults of all ages, people with almost any medical condition or with none, and even for pets. Its general result is better blood circulation, overall relaxation, stress reduction and relief from muscle pain. Those effects in turn can -- depending on the individual -- yield better sleep, more flexibility of joints, improved bowel function, relief of mood symptoms such as depression and anxiety, and in some cases even prolonged muscle function. Though it can't stop or reverse the progress of a neuromuscular disease, massage can temporarily ease some symptoms and make a person feel more comfortable.

Most people who enjoy frequent massage wholeheartedly agree that it feels great, even if they aren't quite sure why. Doctors and physical therapists suggest it can ease neuromuscular pain, with no side effects to be concerned about. There's also a growing field of research aimed at scientifically measuring and explaining why and how massage produces its many benefits.

Bill Altaffer of Tucson, Ariz., has been getting massages twice a month for about 15 years. An attorney who has spinal muscular atrophy, Altaffer says massage has benefits "for circulation, relaxation, contractures, chest loosening up so you can breathe. I can't explain this to you scientifically, but when she works on me, my ribs all crack because things get loosened up, the cartilage sort of gets moved around."

Altaffer points to another significant benefit of massage. "People with disabilities who are skinny and shy about their bodies live in their heads more than they live in their bodies. So it's nice to celebrate your body, give your body a treat every once in a while."

Steve Pinczewski of Erie, Pa., worked as a massage therapist for several years and describes massage as "passive exercise." Pinczewski takes Mestinon for his myasthenia gravis, and finds massage relieves the cramps that sometimes occur with the drug.

Pinczewski can't say enough good about massage. "There's nothing better. It gets rid of all the toxins built up in the muscles. Anybody who can't get rid of their anxiety with a good massage, they've got a serious problem."

Pat Moeschen of Salem, N.H., teaches music in a middle school. He's been getting regular massages for over a year. "It helps relieve stress with the muscles, especially in my legs and my lower back. It has just been fabulous. I feel great every time I have one," he says.

"The next few mornings when I get up after having one I certainly feel better. By better I just mean more refreshed, my muscles are a little bit looser. It makes things easier to stretch."

Moeschen, who has Becker muscular dystrophy, also does regular physical and aquatic therapy. He finds massage a good addition to those treatments. "I push myself to the limits and when I have this treatment I feel that it will make me less prone to injury because things are just looser and easier to be used."

He asks his massage therapist to place particular emphasis on "my calves. It's probably the tightest muscle on my body at all times." Moeschen, who plays the drums, finds massage also helps alleviate fatigue and tightness in his lower back, shoulders, arms and hands.

L. Pittman, MDA clinic director at Baptist Hospital East in Louisville, Ky., considers massage "an untapped resource," especially for dealing with the pain that often accompanies weakening muscles.

"Typically we are always trying to find the least pharmacological means to deal with pain because we know that pain medicines don't generally work very well, at least in the long term. Any time you can come up with something that has nothing to do with medications is always a bonus," he says.

Pittman says massage can provide people with neuromuscular disease with needed physical activity. Family members can stretch the person's limbs and perform basic massage.

Foot massage can help restore circulation and reduce edema.

Another benefit is simple physical contact. "I wouldn't underestimate the fact that many of the patients have a serious problem with isolation," says Pittman. "People seem to be afraid to touch the disabled and that may even apply to their own family members. Yet I think that everyone has a certain need to feel physical contact from people."

Lee Archer, MDA clinic director at the University of Arkansas for Medical Sciences in Little Rock, also likes the symptomatic, palliative treatment massage can provide. "I think that in many people, if they're having a lot of problems with muscle spasms, or increased tone [tension] in their muscles, they may well feel better after a massage. Certainly it's not curative.

"I don't think there is any real good hard scientific data to support using it in any certain neuromuscular conditions," Archer adds. "At the same time almost all of us have a subjective impression that massage, when our muscles are tight, tense, seems to help them relax. I will talk to people who chronically have stiffness in their shoulders about having people in their family do massage, or rub their necks on a daily basis."

M. King, a physical therapist who works with MDA's clinic at Ohio State University Medical Center in Columbus, says, "Massage is one aspect of physical therapy. Personally, it's always been one of my favorites because, aside from all of the anatomical and physiological benefits you might get from massage, it's hands-on. I don't think you can deny the psychological aspect of just having a professional place their hands on you and attempt to help you."

King explains that in neuromuscular diseases, various muscles degenerate at different rates, leading to an imbalance between muscle groups. This can lead to development of nodules or trigger points, places in the muscles where tension builds up. Massage can relieve those trigger points.

Marla Kaplan, a licensed massage therapist in Commack, N.Y., works with many clients who have chronic diseases or disabilities. For those with neuromuscular disorders, she says, "We can increase circulation to the area, which has to improve the health of the tissue. We can keep the tissue to a certain degree from the natural atrophy that is going to happen, and that is going to aid in movement."

In addition, Kaplan says, "A massage will bring about an awareness to a muscular dystrophy patient on just how tight they are, just exactly what is happening from their body. So that when they are getting sore, when their legs are getting tired, they can do something about it whether it's moving, or calling an aide."

-Reif, director of research at the Touch Research Institute at the University of Miami School of Medicine, finds that massage before a physical or occupational therapy session can warm up and relax the muscles, thereby making the therapy session more comfortable and effective.