Massage & Bodywork

March | April 2014

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44 m a s s a g e & b o d y w o r k m a r c h / a p r i l 2 0 1 4 education Clients with Medical Implants Understanding Some Common Devices By Ruth Werner The array of devices that modern medicine can use to improve physical function is amazing to behold. There are now more than 1,700 different types of medical implants and devices, and that list continues to grow. While many are specifically for laboratory or surgical use, this discussion focuses on devices that are temporarily or permanently attached to the body—especially those that require caution during a massage. Implanted medical devices are not a new phenomenon. All carry some risk related to surgical mishaps, infection, or allergic reactions. In addition, an implant may require some accommodation in a client's daily activity, which may influence the choices a massage therapist makes. The following is by no means a comprehensive list, but it covers some of the most common implants likely to influence massage therapy sessions. PROSTHETIC JOINTS Replacement knees, hips, and shoulders are extremely common medical implants. They carry some cautions for massage therapy, mainly related to postsurgical complications and limited range of motion. The column "Baby Boomers and Joint Replacement Surgery," Massage & Bodywork, November/ December 2010 (www.massageandbodyworkdigital. com/i/70065/97), examines this topic thoroughly. CARDIOVASCULAR IMPLANTS Most implants that manage blood-flow issues or other cardiovascular problems pose few risks for a client who wants to receive massage. The therapist needs to know these implants are present, however, along with the involved underlying conditions. Several types of implants have to be adjusted or PATHOLOGY PERSPECTIVES replaced on a regular basis, so information about the client's current status is valuable as well. Arterial Stents Stents are small tubes inserted inside damaged arteries. They are usually used in branches of the aorta, coronary, or carotid arteries, but they can also be used in brain vessels. The presence of a stent may mean that the patient uses anti-clotting medications, which carry cautions for massage. Pacemakers A pacemaker is a small device that controls the heartbeat when the body's natural system to fulfill that function has been damaged. A pulse generator is housed just under the skin of the chest, and leads are implanted in the heart. Pacemakers that have been in place for more than a few months pose no specific cautions for massage, as long as the client is comfortable on the table. Practitioners who use magnets as part of therapy may need to gather more information about safety, however. Defibrillators A defibrillator is another device that controls the heartbeat, but unlike a pacemaker, it is designed to intervene only when needed. If the person goes into arrhythmia—tachycardia (rapid heartbeat) or fibrillation—the machine can deliver mild or extreme electric shocks to reset a healthy heart rhythm. People who have implanted defibrillators typically have tissue damage from a history of heart attacks, cardiomyopathy, or some rare inherited disorders. A person with an implanted defibrillator needs to keep cellphones a minimum of 6 inches away from the device, and avoid using headphones because of the magnets. Massage therapists who use magnets in their therapy should likewise avoid this with these patients. Vena Cava Filters A vena cava filter is a small wire device shaped like an octopus. It is inserted via a leg vein into the

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