Massage & Bodywork

November/December 2012

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MULTIPLE SCLEROSIS clients can't tolerate any form of sympathetic nerve firing, which might cause a spasm. 2) They might have an inadequate physiologic reporting mechanism to sense how far they can stretch. 3) If they have contractures, you can cause harm with even mildly overzealous passive ROM. • When treating or assigning homework to a client with MS, remember: ROM work must be performed only to the point of slight resistance, and then stopped. Consider scope of practice. Any further stretching or strengthening exercises should be performed by a physical therapist. Resources Bar-Or, A. "The Immunology of Multiple Sclerosis." Accessed October 2012. www.medscape.com/viewarticle/572284. Cassels, C. "Multiple Sclerosis Gene Discovery First Major Genetic Advance in 30 Years." Accessed October 2012. www.medscape.com/viewarticle/560661. Cohen, B.J. Memmler's The Human Body in Health and Disease. 11th ed. Baltimore: Lippincott Williams & Wilkins, 2008. Jeffrey, D.R. Medscape.com. "Managing Clinically Definite Multiple Sclerosis. A CME course." Accessed October 2012. www.medscape.com/viewprogram/8268. Jeffrey, S. Medscape.com. "BEYOND and PRECISE Results Suggest Equivalence for Multiple Sclerosis Treatments." Accessed October 2012. www.medscape.com/viewarticle/573185. May, T.S. "Most Cases of 'Benign' MS Progress After 20 Years, But Survival is Longer." Accessed October 2012. www.medscape.com/viewarticle/564612. Rattray, F, and L. Ludwig. Clinical Massage Therapy: Understanding, Assessing and Treating over 80 Conditions. Toronto: Talus Incorporated, 2000. Werner, R. A Massage Therapist's Guide to Pathology. 4th Edition. Philadelphia: Lippincott Williams & Wilkins, 2009. • Never work deeply or vigorously enough to overheat a muscle complex or raise the client's core temperature. MS patients react poorly to heat, and you could initiate a flare. • Do not apply hot packs; even a table warmer could produce too much heat and cause a flare. • Do not use mechanical muscle vibrators to quiet a spasm, which can stimulate the sympathetic nervous system; use only your hands. • Be aware of the day, location, and time of the client's last injection, and avoid working around puncture sites within 24 hours of the injection. • Since many MS patients experience vertigo, ask permission before using any rocking techniques. • Watch for red, inflamed, hot, or swollen areas over bony prominences. The client may not be able to feel these signs and symptoms of skin infection or breakdown. If symptoms exist, refer the client to a physician immediately. PROTOCOLS FOR MS MS is a complicated medical condition, and those afflicted endure it for their entire lives. As a result, you have an opportunity to make a significant difference in your clients' quality of life and help them manage their level of pain. Remember, you will never accomplish 64 massage & bodywork november/december 2012

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