Massage for Healthy Aging: Offering Comfort and Promoting Wellness

Global population aged 65 and older hit 49.2 million in 2016 and is projected to reach 98 million by 2060. As we age, muscles lose mass and forget how to restore their original position and function.  Tight muscles and related pain decrease range of motion, inhibiting activity and leading to a more sedentary lifestyle. The World Health Organization defines healthy aging as doing what it takes to be and do what you value throughout life. Massage therapy can be used to offer comfort and promote healthy mind, body and spirit.

As we age, our muscles are less able to supply blood to our tissue, inhibting natural recovery. Massage therapy can be used to manage symptoms of osteoarthritis and rheumatoid arthritis, improving function. Massage can be used to enhance muscle health, improve posture, and reduce tension causing distortion. Retraining muscles may increase range of motion and encourage healthy movement activities. 

Massage therapy is a viable option for pain management. Identifying the root cause of pain and addressing the underlying issue may relieve a problem long-term. Decreasing pain, increasing range of motion, and improving strength impacts how we feel, what we do, and how we interact with the world.

Traditional Chinese Medicine offers another perspective on healthy aging. Shen-Nong, of Integrated Chinese Medicine Holdings, LTD, in an article titled Views on the Natural Aging Process, describes aging as follows. "In TCM understanding, aging is mainly due to congenital essence being used up while the ability to supply acquired essence declines. The two essences are what make up human vitality."

Massage, in combination with self-care and appropriate exercise, can restore healthy muscles. In working with clients, massage therapists should ask questions and listen carefully to responses when determining a treatment plan. A therapist should research unfamiliar conditions and ask for guidance from mentors in areas of uncertainty.

In working with aging clients, massage therapists should be aware of changes that occur in the body as we age. For instance, muscle mass and muscle tone decreases at an observed rate of 3% - 5% per decade, according to a journal from Harvard Medical School. Deterioration of muscle impairs performance and physical function which causes instability and may lead to falls. Aging bones become brittle and prone to fracturing, and skin becomes thin and fragile. Considerations should also be made for increased incidence of disease, medication use, impairment and disability. Care and attention to patient needs should be offered by a massage therapist when working with aging clients.

Hashimoto's Thyroiditis: A Different Perspective

Hashimoto’s Thyroiditis is an autoimmune disease that affects the thyroid. With symptoms that can be debilitating such as anxiety and depression, individuals suffering from Hashimoto’s can find themselves wondering if it’s possible to continue to live a happy and productive life after diagnosis. Western medicine offers limited insight to people trying to manage Hashimoto’s symptoms, leading some to explore alternative methods. This paper will explore the Western and Traditional Chinese Medicine (TCM) points of view regarding Hashimoto’s.

From the Western medicine perspective, Hashimoto’s is a result of the body’s immune system mistaking the thyroid for a foreign invader that must be attacked and destroyed. Many patients of Western medicine are told that the body literally attacks itself when Hashimoto’s is present. In “Hashimoto’s Disease,” staff from the Mayo Clinic state, “Hashimoto’s disease is an autoimmune disorder in which your immune system creates antibodies that damage your thyroid gland. Doctors don’t know what causes your immune system to attack your thyroid gland. Some scientists think a virus or bacterium might trigger the response, while others believe genetic flaw may be involved” (www.mayoclinic.org). Western medicine doesn’t fully understand Hashimoto’s at this point in time. While experts agree that the immune system is malfunctioning, causes are unknown and treatments are not optimally effective in all cases.

Hashimoto’s symptoms include anxiety, depression, weight gain, hair loss, irregular menstruation in women, mood swings, fatigue, lack of circulation, heart issues, constipation, muscle weakness, brain fog, poor immune response, and feeling cold. Symptoms range in presentation and severity between individuals. Additionally, many people report “Hashimoto’s flares,” or a severe increase in symptoms, triggered by stress, diet, or environmental factors. Severe flares can leave some individuals unable to maintain normal levels of activity and functioning in day to day life. Therefore, preventing flares and managing symptoms can become a priority for some individuals with Hashimoto’s.

It is not uncommon for individuals with a Hashimoto’s diagnosis to present with seemingly unrelated or bizarre symptoms. Sometimes a patient may receive diagnosis of additional autoimmune disorders in conjunction with Hashimoto’s. On the National Institute of Diabetes and Digestive and Kidney Diseases’ (NIDDK) “Hashimoto’s Disease” webpage, the organization states, “You are more likely to develop Hashimoto’s disease if you have other autoimmune disorders.” The NIDDK goes on to list the following conditions as “linked” to Hashimoto’s: Addison’s disease; autoimmune hepatitis; celiac disease; lupus; pernicious anemia; rheumatoid arthritis; Sjogren’s syndrome; type 1 diabetes; and vitiligo (www.niddk.nih.gov). Individuals who have received a Hashimoto’s diagnoses can feel like they’ve jumped through the proverbial rabbit hole of health issues. A lack of concrete understanding surrounding Hashimoto’s and autoimmune disorders in general combined with no hope of curing these chronic conditions can make for a bleak prognosis from the Western medicine perspective.

Western medicine does offer some relief and management of Hashimoto’s symptoms through hormone therapy. By introducing either synthetic T3 and T4 thyroid hormones, or using a natural animal gland alternative, Hashimoto’s symptoms can be greatly reduced. In “A Massage Therapist’s Guide to Pathology: Fifth Edition,” Ruth Werner states, “The usual treatment for hypothyroidism is to supplement thyroid hormones, usually in the form of synthetic T4, which most people can metabolize into adequate amounts of T3. While many people find relief with this treatment, others must explore other options to find the right supplement for both T3 and T4. This can be in the form of synthetic versions of these hormones or as desiccated porcine or bovine glands. Using animal products for hormone replacement is challenging, though, because the potency from one batch to another can vary greatly” (p. 413). Thyroid hormones are the main form of treatment for Hashimoto’s from the Western medicine perspective.

Unfortunately, many people report that their Hashimoto’s symptoms persist even while receiving hormone therapy. In “Thyroid Healing: The Truth Behind Hashimoto’s, Graves, Insomnia, Hypothyroidism, Thyroid Nodules and Epstein-Barr,” Anthony William says, “You can still be gaining weight, losing hair, feeling fatigued, and generally suffering even after you’ve gone on medication for thyroid issues. It’s a common experience for millions of people: they’re diligently taking their medication every day, and even though that medication is causing thyroid test results to indicate normal hormone levels, their thyroids are getting worse over the years, because no one knew to look for the underlying issue and address the real cause” (p. 81). Because Western medicine views Hashimoto’s, the number one cause of hypothyroidism, as incurable the condition is managed but not healed. Furthermore, because Western medicine does not yet know the underlying causes of Hashimoto’s, treatment options are limited.

In Chinese medicine, Hashimoto’s is seen as an imbalance in the body. According to Cynthia McMullen, LMT and teacher at the Institute of Oriental Healing Arts Center (OHAC) in Anchorage, Alaska, autoimmune disorders are a “confusion” in the body. While teaching a course at OHAC that explores pathology from a TCM perspective, McMullen explains that, “The body never attacks itself.” McMullen says that, in Chinese medicine, every pathology in the body is an imbalance in energy that can be corrected or cured by restoring the body to balance.

TCM teaches that every person and every part of the natural world is comprised of five elemental energies: Earth, fire, water, wood, and metal. According to McMullen who, in addition to TCM pathology courses also teaches a class on the five elements of TCM at OHAC, it is essential to balance the energies within the self in order to experience health in the body. McMullen teaches that TCM practitioners can look for specific signs that indicate imbalances in particular energies. According to TCM, each element has its own characteristics and associations. For instance, the fire element is associated with the color red, the sound of laughter, a burnt smell, and emotions of joy and happiness. McMullen teaches students to observe the color, sound, smell, and emotions individuals present to better understand what energetic imbalances may exist.

Individuals who have received a Hashimoto’s diagnosis may find encouragement in TCM. Because TCM views all pathology as an energy imbalance within the body, every pathology is presumed treatable. Rather than a life sentence to depression, anxiety, fatigue, and the range of other varied and sometimes distressing symptoms that can result from an autoimmune disorder, TCM offers the perspective that Hashimoto’s is a confusion within the body that can be corrected through balancing the energies within the self. This perspective can offer hope in light of what is often a bleak prognosis from the Western medicine point of view.

According to the five elements theory of TCM, Hashimoto’s is related to the spleen. In “How Acupuncture Can Be Effective in Treating Hashimoto’s Thyroiditis,” River City Wellness states:

From the perspective of Chinese medical theory, the underlying potential of developing Hashimoto’s falls to the function of the spleen. Women are ruled by the concept of blood, which is either lost or consumed via menstruation, gestation and/or lactation. The spleen system creates and transforms the blood so through the natural functioning and aging of the body, by the mid-30’s the spleen can become deficient and weak. This may be an insight to why this condition effects more women than men. Other habits that can weaken the spleen system include overeating sugars and sweets, consuming too many chilled or uncooked foods, too much thinking, worry or anxiety, chronic fatigue, too little exercise or excessive use of antibiotics (www.rcwacupuncture.com).

In TCM, the spleen is associated with the earth element. In the “Five Elements” course offered through OHAC, McMullen teaches that an imbalanced earth element “Must use earth substances to replenish and rebuild.” What McMullen calls “earth foods,” or naturally grown, whole, organic foods, must be consumed in order to rebalance the earth element. Additionally, McMullen states that the earth element does not always heal “overnight.” She compares a fire ravaged area re-growing, replenishing, and thriving once again to the body rebuilding an earth element imbalance. The TCM approach to rebuilding the earth element agrees with the holistic approach to managing Hashimoto’s that many doctors and patients are finding to be true; managing Hashimoto’s has more to do with diet and lifestyle than any other factor.

In addition to diet and nutrition, TCM seeks to restore health by balancing the energy, called qi, of the self through various means. Massage, acupressure, acupuncture, physical activity that incorporates breath work such as qigong and tai chi, and herbal formulas are all possible tools for treatment. Massage can help reduce stress and assist in restoring energy balance in the body. Acupressure and acupuncture can help assess where there is a lack of or an excess of energy in the body. Acupressure and acupuncture are often used to get blocked energy flowing and to balance energy. Qigong and tai chi are traditional Chinese activities that incorporate energy meridians and breath work into physical routines. Herbal formulas, teas and tinctures are also used restore balance and health to the mind, body and spirit.

Massage can be beneficial to clients with a Hashimoto’s diagnoses. In “A Massage Therapist’s Guide to Pathology,” Werner does warn, “Persons with hypothyroidism are at risk for cardiovascular disease, and that informs some choices about massage” (p. 413).  However, Werner also points out the benefits of massage for common Hashimoto’s symptoms such as fatigue and depression (p. 413). Looking at Hashimoto’s from a holistic standpoint, it would stand to reason that massage could be beneficial in reducing the impacts of stress related triggers. For instance, in “Thyroid Healing: The Truth Behind Hashimoto’s, Graves, Insomnia, Hypothyroidism, Thyroid Nodules and Epstein-Barr,” William lists “Death in the family […]; Broken heart or betrayal […]; and taking care of sick loved one” as three of the most common triggers that can signal the onset of Hashimoto’s (p. 11-12). If stress is a factor in Hashimoto’s, as many professionals and Hashimoto’s patients report, then it would stand to reason that massage could aid in reducing stress and supporting patients’ health through high stress times. From a TCM point of view, massage can help balance excess or lack of energy within the self and assist blocked energy in flowing.

Hashimoto’s thyroiditis remains a bit of a medical mystery from the Western medical perspective. The root causes of the disease and its apparent link to other autoimmune disorders is not fully understood in the Western medical community, but generally the disease is seen as the immune system malfunctioning and causing the body to attack itself. The TCM point of view regarding Hashimoto’s, or any autoimmune issue for that matter, is that of confusion in the body. In TCM, Hashimoto’s is a result of the body being out of balance. By restoring balance through diet and nutrition, body work such as massage and acupuncture, herbs, and practices such as qigong or tai chi, it is believed that a person can heal Hashimoto’s. Regardless of a Western or Chinese medicine approach, massage can be helpful to individuals experiencing Hashimoto’s by reducing stress and easing symptoms of anxiety, depression and fatigue.

Works Cited

Mayo Clinic. “Hashimoto’s Disease” webpage. www.mayoclinic.org. 2018.

McMullen, Cynthia. “Pathology” and “Five Elements” courses. Oriental Healing Arts Center, Anchorage,

Alaska. 2019.

Werner, Ruth. “A Massage Therapist’s Guide to Pathology: Fifth Edition.” Wolters Kluwer Health;

Lippincott Williams & Wilkins. 2013.

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). “Hashimoto’s Disease”

webpage. www.niddk.nih.gov. 2017.      

William, Anthony. “Thyroid Healing: The Truth Behind Hashimoto’s, Graves, Insomnia, Hypothyroidism,

Thyroid Nodules and Epstein-Barr.” Hay House. 2017.

River City Wellness. “How Acupuncture Can Be Effective in Treating Hashimoto’s Thyroiditis.”

www.rcwacupuncture.com. 2018.

Implications of Massage Therapy and Acupoints for Generalized Anxiety Disorder

Acupuncture Chart: Midline of the Head

Chinese Woodcut 1591

Source: Wellcome Library, London, Wikimedia Commons

Credit: Wellcome Library, London. Wellcome Images images@wellcome.ac.uk 

Woodcut illustration from an edition of 1591 

(19th year of the Wanli reign period of the Ming dynasty).

Generalized anxiety disorder is a psychiatric condition that can literally cripple an individual with a range of symptoms such as constant worry and fear. Putting the individual in a constant state of agony, generalized anxiety disorder can manifest itself through physical symptoms such as nausea, light-headedness, irritable bowel syndrome, headaches, panic attacks, trembling, racing heart, and shortness of breath. According to the National Alliance on Mental Illness, approximately 18% of the population in the United States suffers from anxiety disorder. [1] According to Mayo clinic, the causes of anxiety disorders can be linked to life experiences, medications, health issues such as diabetes or thyroid problems, and heredity. [2]

American Massage Therapy Association reports that "massage can assist in reducing the symptoms of anxiety". [3] Nevertheless, research reveals conflicting results. For example, in a study conducted by researchers at Emory University, Swedish massage was found to be effective in relieving symptoms of anxiety. [4] In another study conducted by a group of researchers from Seattle, Washington, massage therapy was compared with additional treatments such as thermotherapy and relaxing rooms. Contrary to expectations, researchers did not find massage therapy to be "clinically or statistically superior to either thermotherapy or the relaxing room treatments at 12 and 26 weeks." [5]

From the Traditional Chinese Medicine (TCM) perspective, massage techniques applied on acupoints are established treatment modalities for anxiety. In TCM, anxiety is linked to Qi stagnation and is correlated with thought. For example, grand master Lu at the Traditional Chinese Medicine World Foundation points to the connection between anxiety and thought as follows:

"TCM sees anxiety as the mind creating the wrong thinking. Your mind receives the information from the outside and then you cook it, based on what you know from your past. You try to analyze what will happen in the future and your limited knowledge and narrowed vision cause you to see something you don't want to see. You create this anxiety because your vision of the future doesn't match your wish. That's the whole idea. There's a difference between how you want to see things and what actually is". [6]

Some of the methods in treating anxiety in Chinese Traditional Medicine are as follows:  

Applying pressure to Yin Tang/ Third Eye (area between the eyebrows on the forehead) in circular motions. [7] [8]

An additional approach in treating anxiety is to apply pressure for 60 to 90 minutes to the following acupoints in cycles: [9]

Yin Tang

Kidney 27

Heart 7 

Finally, working on Water meridians (kidney and bladder) is also recommended to treat anxiety in TCM. [10] Anxiety in TCM is associated with Water imbalance [10] and it is believed that the Water element helps combat anxiety.

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[1]  https://www.nami.org/Learn-More/Mental-Health-Conditions/Anxiety-Disorders

[2]  https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-20350961

[3] https://www.amtamassage.org/approved_position_statements/
Massage-Therapy-for-Anxiety.html

[4] Mark Hyman Rapaport et al. Acute Swedish Massage Monotherapy Successfully Remediates Symptoms of Generalized Anxiety Disorder, The Journal of Clinical Psychiatry (2016).

[5] Sherman KJ, Ludman EJ, Cook AJ, et al. Effectiveness of therapeutic massage for generalized anxiety disorder: a randomized controlled trial. Depress Anxiety. 2010; 27(5).

[6]  https://www.tcmworld.org/ask-grand-master-lu-anxiety/


[7] Reninger, Elizabeth. "Yin Tang: the "Hall of Impression" Acupressure Point." Learn Religions, Apr. 17, 2019, learnreligions.com/acupressure-treasures-yin-tang-3182283.


[8] https://www.mskcc.org/cancer-care/patient-education/acupressure-stress-and-anxiety


[9] https://www.mindbodygreen.com/articles/how-to-use-acupressure-for-panic-attacks-and-heart-palpitations


[10] https://innerworksacupuncture.com/five-element-acupuncture-fear-anxiety-water-winter/

Diabetes and Holistic Care

Diabetes and Holistic Care

Diabetes, a group of diseases characterized by an overproduction of sugar in the blood, affects 1 in 4 people over the age of 65. As of 2015, diabetes has affected over 30 million people in the U.S. alone. Over time, the high amounts of glucose in the blood lead to complications such as heart disease, stroke, kidney disease, and nerve damage.

The cause of diabetes depends on the type. Type 1 diabetes most commonly occurs in children and is thought to be genetic in nature. Type 2 affects those over 45 and is believed to be lifestyle-based, incurred by poor diet and lack of exercise.

In type 1 diabetes, no insulin is produced; the body destroys the glucose before it has a chance to absorb it. In type 2, the insulin is resisted.

Common symptoms among both include:

• Increased thirst and urination
• Blurred vision
• Increased hunger
• Numbness and/or tingling in the feet and hands
• Unexplained weight loss
• Lasting sores

For the purposes of this post, focus will be placed on Type-2 Diabetes.

The most common treatment for diabetes are insulin shots, able to be used at home to provide glucose that the body may not provide on its own, or may block significantly. Subsequent medications are prescribed as symptoms exacerbate and spread to affect other organs in the body.

Massage therapy, in conjunction with medical care, has been shown to normalize blood glucose. For those with high blood glucose, effleurage strokes moving blood up to the heart can work to lower the amount. It aids in treating numbness in the extremities; guiding circulation to fingers and toes. The emotional aspects of diabetes see great improvement- the stress, anxiety, and depression associated with having one’s life so drastically affected are soothed by the endorphins released during massage. It stimulates the lymph system, removes toxins from the body, and reduces the hardening of arteries due to diabetes. Blood circulation is improved, which delivers more oxygen and nutrients to the body which, in turn, improves the utilization of insulin by the cells. Massage therapy increased mobility and flexibility, which the hardening of tissues directly and adversely affects.

Traditional Chinese Medicine (“TCM”) looks at the body a little differently than western medicine. Called Xiao-Ke, it translates in English to “wasting and thirsting disease” (Flaws, Kuchinkski & Casanas, 2002)

According to TCM, the dryness and heat that are hallmarks of diabetes, lead to a deficiency in yin and chi. (Flaws, et al., 2002) Chi is known as the energy that keeps a person alive. As the disease progresses, it affects other organs and elements of the body.

In TCM, common symptoms created by the depletion of Chi and body fluids are:

• Lethargy
• Weight loss
• Excessive thirst
• Excessive hunger
• Excessive urination
• Poor wound healing
• Infections
• Blurry vision

As we can see, the symptoms characterizing Xiao-Ke and those of diabetes are almost exactly the same.

TCM  works with treatments of herbs, acupuncture, acupressure, and massage to stimulate the flow of Chi, and balance Yin and Yang inside the body. Scientific studies and clinical tests around the world for 10 years show that TCM assists in enhancing blood outflow, improving microcirculation, preventing the slowing of motor nerve conduction, and inducing secretions of endogenous beta-endorphin, known as β-Endorphin, which has a direct relation with insulin produced organically within the system.

Diabetes, in either healing modality, is not a life-sentence. It is a call to make a change, an opportunity to re-examine life patterns and decide for oneself if those patterns are for benefit, or detriment

Here at the Oriental Healing Arts Center, we firmly believe the human body, its mind and spirit, is capable of healing itself back to wholeness. We offer our hands to help.

Sources:

Heesen, Gayatri Chopra, L.Ac. “The Effects of Traditional Chinese Medicine on Type 2 Diabetes: A Literature Review Synthesis.” Yo San University of Traditional Chinese Medicine, 2019, www.yosan.edu/wp-content/uploads/2019/01/Gayatri-Heesen-Capstone-1.pdf.

Ezzo, Jeanette, et al. “Is Massage Useful in the Management of Diabetes? A Systematic Review.” Diabetes Spectrum, American Diabetes Association, 1 Oct. 2001, spectrum.diabetesjournals.org/content/14/4/218.

Covington, Maggie B. “Traditional Chinese Medicine in the Treatment of Diabetes.” Diabetes Spectrum, American Diabetes Association, 1 Aug. 2001, spectrum.diabetesjournals.org/content/14/3/154.

Wang, Zhijun, et al. “Treating Type 2 Diabetes Mellitus with Traditional Chinese and Indian Medicinal Herbs.” Evidence-Based Complementary and Alternative Medicine : ECAM, Hindawi Publishing Corporation, 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC3662109/.

“Symptoms & Causes of Diabetes.” National Institute of Diabetes and Digestive and Kidney Diseases, U.S. Department of Health and Human Services, 1 Nov. 2016, www.niddk.nih.gov/health-information/diabetes/overview/symptoms-causes.