F r e e m u s i c d o w n l o a d s f o r C e r t i f i e d m e m b e r s : w w w. a b m p . c o m / g o / c e r t i f i e d c e n t r a l 43
stroke, trigeminal neuralgia, and other intractable pain
problems. Conceivably, massage therapy could have
application here, too; look for a future article on this topic.
The takeaway message is that massage therapy has a
lot to offer clients who have had amputations. Story #3
is a great synopsis of what massage therapy can do:
What do you need to know to work safely with this
special population? Find out what led to the surgery:
circulatory dysfunction, congenital problem, or trauma.
Find out what drugs your clients are taking, especially pain
management drugs. To gauge clients' adaptability, you need
to know their level of general activity, and whether they
have experienced contractures, cramps, or other limitations
at the affected limb. And most of all, you need to fi nd out
what your client's highest priorities are for the time you
spend together. Massage therapy is unique among healthcare
options with its ability to decrease pain and promote a sense
of well-being. Let's use that capacity to improve the life of
all our clients, especially those who are amputees.
Note
1. Tony Fitzsimons et al., "Physiotherapy Following Lower Limb Amputation:
Protocols and Reference Material," Sydney West Area Health Service,
Western Cluster hospitals, physiotherapy departments. Accessed September
2014, www.austpar.com/portals/admin_protocols/docs-and-presentations/
AmputationManual1.pdf.
Bodywork Story #3
I worked with a man whose arm had been torn off at the
elbow in a log-rolling machine. We had two huge issues:
severe nerve pain at the amputation site, and phantom
nerve pain in the missing limb.
I found it very helpful to work on his arm as if it were
intact. Using pillows, I made an "arm" and continued my
long strokes as if the arm were there, while he watched.
That helped dramatically with the phantom pain.
For the actual nerve pain associated with the
amputation surgery, we found that light massage over
the stump, although somewhat painful, was especially
soothing. He felt that it calmed the nerves after a few
minutes.
After he received a prosthetic, we had to spend
a lot of time on the muscle soreness he developed
from the use of the new device.
The client reported that in every way possible,
massage helped him. He especially appreciated
being touched by someone who did not fi nd the
amputation to be offensive.
Ruth Werner is a former massage therapist, a writer, and
an NCTMB-approved continuing education provider. She wrote
A Massage Therapist's Guide to Pathology (Lippincott Williams &
Wilkins, 2013), now in its fi fth edition, which is used in massage
schools worldwide. Werner is available at www.ruthwerner.com or
wernerworkshops@ruthwerner.com.
Resources
Amputee Coalition. "Limb Loss Statistics." 2014. Accessed
September 2014. www.amputee-coalition.org/limb-loss-
resource-center/resources-by-topic/limb-loss-statistics/limb-
loss-statistics/index.html.
Bloomquist, T. "Amputation and Phantom Limb Pain: A
Pain Prevention Model." AANA Journal 69, no. 3 (June,
2001). Accessed September 2014. www.aana.com/
newsandjournal/Documents/amputation_phantom0601_
p211-217.pdf.
Brigham and Women's Hospital Department of Rehabilitation
Services. "Standard of Care: Lower Extremity Amputation."
2011. Accessed September 2014. http://bit.ly/Whutvp.
Ertl, J. P., and J. H. Calhoun. "Amputations of the Lower
Extremity." WebMD, 2011. Accessed September 2014.
http://emedicine.medscape.com/article/1232102-overview.
Foell, J. et al. "Mirror Therapy for Phantom Limb Pain: Brain
Changes and the Role of Body Representation." European
Journal of Pain 18, no. 5 (May, 2014): 729–39. Accessed
September 2014. www.ncbi.nlm.nih.gov/pubmed/24327313.
Kania, A. "Integration of Massage Therapy into Amputee
Rehabilitation and Care." inMotion 14, no. 4 (July/August,
2004). Accessed September 2014. www.amputee-coalition.
org/inmotion/jul_aug_04/massagetherapy.html.
Ramachandran, V. S., and E. L. Altschuler. "The Use of Visual
Feedback, in Particular Mirror Visual Feedback, in Restoring
Brain Function." Brain 132 (2009): 1,693–1,710. Accessed
September 2014. http://gnowledge.org/~sanjay/Advanced_
Cogsci_Course/Week6/Extra/rama_brain.pdf.
Sydney West Area Health Service, Western Cluster
hospitals, physiotherapy departments. "Physiotherapy
Following Lower Limb Amputation: Protocols and
Reference Material." 2006. Accessed September
2014. www.austpar.com/portals/admin_protocols/
docs-and-presentations/AmputationManual1.pdf.
What do you need to know to work safely with this
special population? Find out what led to the surgery:
circulatory dysfunction, congenital problem, or trauma.
Find out what drugs your clients are taking, especially pain
management drugs. To gauge clients' adaptability, you need
to know their level of general activity, and whether they
have experienced contractures, cramps, or other limitations
at the affected limb. And most of all, you need to fi nd out
what your client's highest priorities are for the time you
spend together. Massage therapy is unique among healthcare
options with its ability to decrease pain and promote a sense
of well-being. Let's use that capacity to improve the life of
all our clients, especially those who are amputees.
1. Tony Fitzsimons et al., "Physiotherapy Following Lower Limb Amputation:
Protocols and Reference Material," Sydney West Area Health Service,
Western Cluster hospitals, physiotherapy departments. Accessed September
2014, www.austpar.com/portals/admin_protocols/docs-and-presentations/
AmputationManual1.pdf.
long strokes as if the arm were there, while he watched.
That helped dramatically with the phantom pain.
For the actual nerve pain associated with the
amputation surgery, we found that light massage over
the stump, although somewhat painful, was especially
soothing. He felt that it calmed the nerves after a few
After he received a prosthetic, we had to spend
a lot of time on the muscle soreness he developed
from the use of the new device.
The client reported that in every way possible,
massage helped him. He especially appreciated
being touched by someone who did not fi nd the
amputation to be offensive.
I found it very helpful to work on his arm as if it were
intact. Using pillows, I made an "arm" and continued my
long strokes as if the arm were there, while he watched.
What do you need to know to work safely with this
special population? Find out what led to the surgery:
circulatory dysfunction, congenital problem, or trauma.
Find out what drugs your clients are taking, especially pain
management drugs. To gauge clients' adaptability, you need
to know their level of general activity, and whether they
have experienced contractures, cramps, or other limitations
at the affected limb. And most of all, you need to fi nd out
what your client's highest priorities are for the time you
spend together. Massage therapy is unique among healthcare
options with its ability to decrease pain and promote a sense
of well-being. Let's use that capacity to improve the life of
all our clients, especially those who are amputees.
Note
1. Tony Fitzsimons et al., "Physiotherapy Following Lower Limb Amputation:
Protocols and Reference Material," Sydney West Area Health Service,
Western Cluster hospitals, physiotherapy departments. Accessed September
2014, www.austpar.com/portals/admin_protocols/docs-and-presentations/
AmputationManual1.pdf.
long strokes as if the arm were there, while he watched.
That helped dramatically with the phantom pain.
For the actual nerve pain associated with the
amputation surgery, we found that light massage over
the stump, although somewhat painful, was especially
soothing. He felt that it calmed the nerves after a few
minutes.
After he received a prosthetic, we had to spend
a lot of time on the muscle soreness he developed
from the use of the new device.
The client reported that in every way possible,
massage helped him. He especially appreciated
being touched by someone who did not fi nd the
amputation to be offensive.
PATHOLOGY PERSPECTIVES
