Massage & Bodywork

November/December 2012

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PATHOLOGY PERSPECTIVES into the adult community. The number of massage therapists who count themselves comfortable with working with adults who have CP is low indeed. This is a frustrating situation. Right now, 400,000 adults with CP are living in this country. Many of them can't walk, and the ones who can are at risk for losing that ability. Their most common problems— acute and chronic pain, fatigue, balance problems, and weakness—can be successfully addressed by massage therapy. This short video demonstrates how just a few minutes of massage, even in subfreezing weather and through multiple layers of clothing, can make an immediate and discernible change in ease of walking of an adult with CP: http://bit.ly/NmS4ot. Massage therapy carries some risk for CP in adults, as it does in children. Patients may use medications that impact our choices: Botox injections, muscle relaxants, pain relievers, and other substances require some adaptation for bodywork. CP patients may undergo surgery, and this also requires some adjustments. And of course, numbness and difficulty with communication always call for special sensitivity from a massage therapist. However, the benefits of massage therapy for adults with CP far outweigh the risks. We can work with proprioceptors to reeducate functioning muscles and improve balance (an important factor in prolonging the ability to walk); we can help improve efficiency of movement for better stamina; we can help reduce pain and fatigue; we can become part of an important network of supporters for people who tend to live in social isolation. But perhaps the most precious benefit we can offer is the experience of being touched, rather than handled—this can be a rare gift for anyone who lives with a chronic, serious condition. "People with CP really know their bodies," Erica says. "They can give absolutely phenomenal feedback. Trust them." If working with adults who have CP is of interest to you, I encourage you to pursue this specialty. Check with your local resources. Alert your network of primary care providers that you would be happy to make yourself available to their patients. Unfortunately, not many educators teach workshops on working with neurological disorders, but if one comes your way, don't miss it. Above all, make yourself available. See if your town hosts a CP support group, and visit them. This is an extremely underserved group, and it would be great to see massage therapists step up to this challenge. Notes 1. A. Opheim A et al., "Walking Function, Pain, and Fatigue in Adults with Cerebral Palsy: A 7-year Follow-Up Study," Developmental Medicine & Child Neurology 51 (2009): 381–8. 2. C. Andersson and E. Mattsson, "Adults with Cerebral Palsy: A Survey Describing Problems, Needs, and Resources, with Special Emphasis on Locomotion," Developmental Medicine & Child Neurology 43 (2001): 76–82. 3. A. Opheim, "Walking Function, Pain, and Fatigue," 381–8. 4. A. Hirsh et al., "Symptom Burden in Individuals with Cerebral Palsy," Journal of Rehabilitation Research and Development 47, no. 9 (2010): 863–76. 5. M. Bottos et al., "Functional Status of Adults with Cerebral Palsy and Implications of Treatment for Children," Developmental Medicine & Child Neurology 43 (2001): 516–28. 6. K. Schroeder et al., "Long-Term Results of Hip Arthroplasty in Ambulatory Patients with Cerebral Palsy," International Orthopaedics 34, no. 3 (2010): 335–9. 7. G. Glew et al., "Survey of the Use of Massage for Children with Cerebral Palsy," International Journal of Therapeutic Massage & Bodywork 3, no. 4 (2010): 10–15. Author's note: The author wishes to extend a special thanks to Erica, who generously shared her experience of being an adult with CP who is also a massage therapist, and to Pam Fitch and Matt O'Meara whose video is so inspiring. Ruth Werner is a writer and educator approved by the National Certification Board for Therapeutic Massage & Bodywork as a provider of continuing education. She wrote A Massage Therapist's Guide to Pathology (Lippincott Williams & Wilkins, 2012), now in its fifth edition, which is used in massage schools worldwide. Contact her at www.ruthwerner.com or wernerworkshops@ruthwerner.com. www.abmp.com. See what benefits await you. 45

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