Massage & Bodywork

MAY | JUNE 2020

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Spinal Cord and Nerves What happened? Structure injured Who did the massage? Comments A 43-year-old man with no history of symptoms received a cervical massage. He felt weakness during the session, which progressed to full paralysis. He was diagnosed with acute spinal cord pressure. (Cheong et al. 2012) Spinal cord Massage therapist with a private certificate at a massage center It was found that this patient had ossification of his posterior longitudinal ligament and an acutely herniated nucleus pulposis between C5 and C6. He underwent extensive neck surgery to stabilize his vertebrae. Three years later he was still mildly impaired but able to live independently. From the authors: "In our case, compressive myelopathy occurred after massage therapy induced tetraplegia and neuropathic pain." A 40-year-old woman developed posterior interosseus nerve palsy following six sessions of friction massage for tennis elbow. (Wu, Hsu, and Wang 2010) Posterior interosseus nerve (PIN) Therapist at a clinic The PIN is an extension of the radial nerve, responsible for wrist and finger extension. Friction massage to the lateral epicondyle muscle attachments was seen to temporarily damage the PIN. The patient regained full function two months after the end of friction treatments. A 38-year-old woman received a single session of "deep-tissue massage." She had pain during the massage, which radiated down her left arm. (Aksoy et al. 2009) Spinal accessory nerve Massage therapist Client pain persisted after the massage, in spite of NSAID use. She lost strength and range of motion. Two weeks later she was diagnosed with spinal accessory neuropathy. The spinal accessory nerve is accessible near the brachial plexus at the lateral neck. It supplies the trapezius and sternocleidomastoid muscles, and loss of function leads to shoulder weakness and scapular winging. This person was treated with physical therapy that included exercise, heat, massage, and counseling on how to move without eliciting further injury. Two years after treatment, she had resolution of pain but strength and range of motion did not fully recover. Organs What happened? Structure injured Who did the massage? Comments A 77-year-old man was diagnosed with rupture of a renal cyst and internal bleeding after "two vigorous massage chair sessions." (Mufarrij and Hitti 2011) Kidney Someone doing chair massage This client had been diagnosed with polycystic kidney disease, which made his kidneys much larger than average. He also had coronary artery disease, hypertension, and pulmonary embolism. Among other medications, he was taking warfarin, a powerful anticoagulant—which probably contributed to his substantial retroperitoneal bleeding. A 39-year-old woman with no diagnosed illness received "deep body massage" that included the abdomen. Within 24 hours, she developed abdominal pain. At 72 hours, she went to the emergency department. She had a large hematoma (bruise) of her liver and a low blood count. (Trotter 1999) Liver Unclear but safe to assume person doing "deep body massage" in Denver in 1999 was a formally educated massage therapist This client had no history of liver dysfunction or abdominal problems. After this massage, she received two units of packed red blood cells to make up for bleeding in her liver. She recovered fully. Other findings on massage therapy and adverse events have been published, and a list of these articles are available online at https://bit.ly/2Jue8yJ. PATHOLOGY PERSPECTIVES Ruth Werner is a former massage therapist, a writer, and an NCBTMB- approved continuing education provider. She wrote A Massage Therapist's Guide to Pathology (available at BooksofDiscovery.com), now in its seventh edition, which is used in massage schools worldwide. Werner is available at www.ruthwerner.com or wernerworkshops@ruthwerner.com. N e w ! A B M P P o c k e t P a t h o l o g y a t w w w. a b m p . c o m / a b m p - p o c k e t - p a t h o l o g y - a p p . 33

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