Summer 2011

S u m m e r 2 0 1 1

A J o u r n a l f o r R e g i s t e r e d M a s s a g e T h e r a p i s t s

Massage MattersC A N A D A

Higher Education

Non-Vascular Edema Affecting the Bones: Three Case Reports

2 • b c m a s s a g e t h e r a p i s t s ’ j o u r n a l • S u m m e r 2 0 1 1

The Third International Fascia Research CongressMarch 28-30, Vancouver, Canada 2012www.fasciacongress.org

Hosted by tHe Massage tHerapists’ association of b.c.

Theme: What Do We KnoW? What Do We notice? continuing the ScientiSt-clinician Dialogue

for More inforMation: www.fasciacongress.org

organizations interested in becoMing financial sponsors contact: [email protected]

Program at a glance

abstract subMissions now open

graduate student scHolarsHips availableHttp://www.rolfresearcHfoundation.org/about

Wednesday, March 28

Keynote: Mary Francis Barbe, PhD Temple University, Philadelphia Changes in Fascia Related to Repetitive Motion Disorders

Keynote: Michael Kjaer, MD, DMsc University of Copenhagen, Denmark. Adaptations of Tendinous Connective Tissues to Exercise

Parallel Breakout Sessions: Selected Authors Panel: Scars and Adhesion Panel Geoffrey Bove, DC, PhD — Moderator

Keynote: Albert J. Banes, PhD University of North Carolina School of Medicine. Mechanical Loading & Fascial Changes: Tendon Focus

Thursday, March 29

Keynote: Rolf K. Reed, PhD University of Bergen, Norway. Fluid Dynamics

Panel: Fluid Dynamics: Clinical Implications Michael L. Kuchera, DO, FAAO — Moderator

Keynote: Gerald H. Pollack, PhD University of Washington, USA Interfacial Fluid: The Secret Life of Water

Parallel Breakout Sessions: Selected Authors

Keynote: Karen J. Sherman, PhD, MPH Group Health Research Institute, Seattle. Developing Clinical Trials for Bodywork and Massage: A Guide for the Perplexed

Friday, March 30

Keynote: Carla Stecco, MD University of Padova, Italy Fascial Anatomy Overview

Panel: Fascial Imaging Techniques Leon Chaitow ND, DO — Moderator

Keynote: Jay P. Shah, MD National Institutes of Health in Bethesda, Maryland Ultrasound & Microanalytical Techniques to Identify Objective Abnormalities in Hard, Painful Myofascial Trigger Points

Parallel Breakout Sessions: Selected Authors Panel: Art and Science / Research and Practice: Mechanisms to Improve Communicaton to Promote Translation Brian F. Degenhardt, DO — Moderator

Hear f rom the Foremost Exper ts on Fascia Research!

Pre-ConferenCe DisseCtion WorkshoP, Mar. 26-27

Post-ConferenCe WorkshoPs, saturDay, MarCh 31

b c m a s s a g e t h e r a p i s t s ’ j o u r n a l • S u m m e r 2 0 1 1 • 3

R ecently, I was reflecting on how the massage therapy profession in British Columbia has evolved over the years.

This past year, I had the privilege of travelling throughout the province and meeting many members at our area road shows, as well as at this year’s AGM conference in the Okanagan. The passion that Registered Massage Therapists have for their work, and the care they have for patients, is evident.

With all of the conversations I’ve had with RMTs, I began to question, Does the name Registered “Massage” Therapist truly reflect the profession? For me the answer is clear: the word “Massage” no longer adequately describes the work we do, nor does it reflect the public expectations of RMTs’ services in BC.

Certainly the work that RMTs do every day in their clinic is not reflected in the government’s current Scope of Practice (SOP) definition for the profession:

“…'massage therapy' means the kneading, rubbing or massaging of the human body, whether with or without steam baths, vapour baths, fume baths, electric light baths or other appliances, and hydrotherapy or any similar method taught in schools of massage approved under the former Physiotherapists Act, but does not include any form of medical electricity.”

Kneading, rubbing, and steam, vapour or fume baths – all terms that seem rather archaic to a modern day RMT – are perhaps more in line with the days of physicians doing

“lobotomies” as a cure for almost everything. I have been a practicing RMT since 1997 (almost 14 years), and I didn’t relate to that SOP

then, and it seems even more out of date now. Today, RMTs and their patients are much more sophisticated about health and wellness

care. RMTs regularly work in multi-disciplinary settings in which each practitioner is a respected member of the clinical or health care team.

A key part of this evolution is education. RMTs are at the top of their field in terms of their knowledge-base and applicable techniques. Additionally, the MTABC research department has made the provincial Electronic Health Library (eHLBC) available to members. The eHLBC is an effective tool in assisting RMTs to treat their patients, often with complex care. RMTs today are embracing research and utilizing best practices in their day-to-day work.

Continuing educational opportunities have also raised the bar in the profession. This past year the MTABC has brought in international instructors such as Willem Fourie, Dr. Antonio Stecco and Dr. Robert Schleip to run workshops for RMTs. And of course, the 2012 Third International Fascia Research Congress will be an exciting and highly educational event, hosted by the MTABC.

As BC RMTs reach for higher education, their patients are also doing their part to understand the issues affecting their health. Patients are becoming more informed and conscientious about their own health needs.

The future holds expansive opportunities for RMTs. The MTABC along with interested stakeholders is working towards a clearer identity of what we do so that our work can be better reflected. In the meantime, we look forward to the profession continuing to deliver high quality health care for British Columbians.

Damon Marchand, President

President’s Message

Please direct your comments to [email protected], subject heading “Letters,” where they will be forwarded to the MTABC Board for review.

Editor in ChiefDavid DeWitt

EditorLori Henry

Published by: BIV Media Group102 East 4th Avenue, Vancouver, British Columbia V5T 1G2Tel: 604-688-2328

SalesVictoria Chapman 604-741-4189 [email protected]

DesignSoraya Romao

Editorial BoardSandra ColdwellBodhi HaraldssonAnita WilsonBrenda LockeJennifer YipDee WillockDamon Marchand

Mission StatementThis publication is intended to provide a voice to BC’s Registered Massage Therapists, a source for the latest research and a vehicle for the general population to understand and respect the valuable work of our RMTs.

Massage Matters is published three times a year for Registered Massage Therapists. Funding is provided from the MTABC and advertising revenues.

Massage Therapists’ Association – MTABC180 - 1200 West 73rd Avenue Vancouver, British Columbia V6P 6G5Tel: 604-873-4467 Fax: 604-873-6211Toll Free: 1-888-413-4467 Email: [email protected]

www.massagetherapy.bc.ca

Massage Therapists’ Associationof British Columbia

Massage MattersA J o u r n a l f o r R e g i s t e r e d M a s s a g e T h e r a p i s t s


contents

in this issue:Cover 5

People 8

Science 10

Lymph Drainage 18

Classified 20

Cover photo credit: DTDeWitt

Therapist easing their Lymphedema pain

by erin mcphee 18

After Nearly 50 Years, RMT Gibson Brown “Wouldn’t Change it for Anything”by karilyn kempton 5

Non-Vascular Edema Affecting the Bones: Three Case Reportsby dr. david de camillis 9

Higher Education

by kari walker, rmt 14


After Nearly 50 Years, RMT Gibson Brown “Wouldn’t change it for anything”

Cover

felt that you could never be too strong in life,” he says. “The stronger you are, the easier it is,” he admits, so he still strength trains three times per week and cycles regularly. “When I come from the gym, massage feels easy,” he laughs. He was told early on that if a massage therapist relies on their knuckles or elbows, they should choose a new profession and it is advice he has taken to heart.

By the end of his RMT career, Gibson massaged triathletes almost exclusively. The Canadian National Triathlon Centre is very close to his Victoria office, and about seven years ago he began enticing athletes into his office by offering the first massage free and then handing out a gift certificate for the patient to give to another athlete. He called the transition from serving the general public to serving triathletes a real turning point in his business and career, and he advises RMTs to go after a niche market if it interests them.

He loves treating elite athletes because “you can follow their success on Google and feel like a little bit of you has gone with them.” He sponsors Canadian triathlete Brent McMahon simply because “I get enough of a kick out of helping him.” Gibson also believes that athletes may be more amenable to exercise suggestions, whereas

photo: DTDeWitt

by karylin kempton

The first thing you notice about Gibson Brown is his easy laugh. A massage therapist since 1964 and a BC RMT since 1969, Gibson recently officially retired but has not given up his passions for massage therapy and helping people.

A former marine engineer, Gibson decided to go to massage school in Durban, South Africa after emigrating from Scotland. Working off and on as a marine engineer and a massage therapist, he moved to British Columbia in 1969. “The first day I looked for a job I was hired by BC Ferries,” says Gibson, “but after chatting up a co-worker I couldn’t believe that every person in BC got 12 free massages per year at that time.” Gibson wrote and passed his BC RMT exams and “went from diesel oil to massage oil!”

Gibson has always found massage therapy gratifying: “When you’ve got confidence in what you do, and you know that it helps people, you keep plugging away at what you do.” Gibson loves the diversity of massage. “It’s one of the modalities you can take for pleasure or treatment,” he says, and he loves giving both. He has kept fit, healthy and happy for more than four decades in the profession, and “I wouldn’t change it for anything,” he smiles.

Gibson’s early years were not particularly easy. He worked out of a health club in Nanaimo for a short time before moving to Victoria, where he worked out of a hotel, and managed the pool and gym. The biggest hurdle Gibson faced, as Vancouver Island’s second RMT, was the stigma associated with massage. “Massage wasn’t yet part of our culture,” he says, and people associated massage with erotic services. “They expected a Swedish massage with Russian hands and Roman fingers,” laughs Gibson.

It took Gibson three years to get established. “I used the facilities of the hotel I worked at to help promote massage,” he says; “I’d let them use the pool to entice them in.” He remembers being happy with one client per day in the early months, but “now people can come out of school today and start making a living, depending on where they go.” Gibson has never worked out of or run a clinic. He runs his practice out of his re-furbished garage, and believes that “if you’ve got a quiet spot, you’re fine,”

He calls the general acceptance of massage therapy “tremendous” now, noting, “it’s becoming a part of our culture, which is great for the association.” He remembers his first MTABC AGM in Vancouver in the early 1970s, when the whole group sat around one big table. Then there were well under one hundred RMTs in the province.

Even after nearly fifty years, Gibson is still going strong. “I’ve always Continued on page 6


the general public “wants you to cure them in one visit, and when you tell them to exercise they can look at you like you’re crazy.” A former 100-yard racer, Gibson also admits that he lives vicariously through endurance athletes because he has only been a sprinter. “My idea of a long run was 200 yards,” he chuckles.

His modalities have not changed a great deal since his early days as an RMT, but “the proof of the pudding is in the doing,” he says. “People come back year after year, month after month, or week after week, so they must like what I am doing,” smiles Gibson. His Swedish massage modality is “very basic compared to training today,” he notes, but feels that since he treats faster, “you’re getting more massage for the money.” His massage training in South Africa only took six months, so there was no time for “all the teeny weenie muscles here and there, and little nerves all over,” he laughs.

Massaging PM Pierre Trudeau several times during a Federal Liberal Party convention in 1969 was particularly memorable for Gibson, and he still laughs about their conversations. “On the table he was just a regular guy,” Gibson grins, “and he puts his pants on one leg at a time, just like I do.” Both single gentlemen at the time, they shared a few laughs about bachelor life.

Gibson points to the fact that patients often start to feel quite free and open “when they’re lying there in their jockey shorts,” and so he has heard a lot of confessions, and personal and interesting information from patients. “They start telling you things they might not tell you otherwise,” he grins.

Gibson warns RMTs, and folks in general, to be light-hearted. “Try not to take life too seriously,” he advises. “It’s just temporary, so approach it with a lot of humour.” An early mentor in Victoria taught him to approach massage with a combination of detachment and compassion. “If they get better, that’s fine, and if they don’t get better, that’s fine too,” says Gibson; “[i]f they don’t get better then it’s

probably beyond what I can do for them. Give it your best shot.” His other pithy advice includes the following: “Eat sensibly, don’t get too carried away with anything, clean your teeth twice a day and take your vitamins.”

Family has always been important to Gibson. He has been married to wife LaRay for 40 years this year, and he still gives her a massage each week. She recently retired from cosmetology, and they were able to offer a combination of skin care and massage services out of their home. Their two daughters both live on Vancouver Island as well, and one took over the skin care business upon LaRay’s retirement. They also have a granddaughter who just became a Registered Nurse after graduation from the University of Victoria. Now that he and his wife are retired, they are happy to spend more time bicycling and gardening, but he still treats patients several days a week. •

Cover

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In the Spring 2011 issue an article we published “Chronic Fatigue Syndrome and Massage Therapy” by Alison Marshall-Rath was printed without references. Massage Therapy Canada regrets this omission and you can find the references below.

Science

Alison Marshall-Rath photo: DT DeWitt

REFERENCES: ME/CFS1. Carruthers BM, JainAK, DeMeirleir KL, et al. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols. A Consensus Document. Journal of Chronic Fatigue Syndrome 11 (1): 7-115, 2003.2. Carruthers BM, and van de Sande MI, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Clinical Case Definition and Guidelines for Medical Practitioners. An Overview of the Canadian Consensus Document. Copyright 2005/2006.3. Okada T, Tanaka M, Kuratsune H, et al. Mechanisms Underlying Fatigue: A voxel-based morphometric study of chronic fatigue syndrome. BMC Neurology 4:14 2004.4. Komaroff AL. The biology of chronic fatigue syndrome. Am J Med. 2000; 108:169-71.5. Jason LA, Richman JA, Rademaker AW, et al. A community-based study of Chronic Fatigue Syndrome. Arch Intern Med 159:2129-2137, Oct. 1999.6. www.me-cfs Community.com Feb. 2009, Dr. Nancy Klimas, President, IACFS/ME.7. Doidge N. The Brain That Changes Itself, Penguin Books, 2007.8. Bolte J. My Stroke of Insight, Amazon.com/books, 2007.9. O’Connor T. New Discovery Could Rejuvenate the Brain, The EMBO Journal, Dec. 2008.10. Sieverling C Dr. Cheney’s Basic Treatment Plan for Chronic Fatigue Syndrome, 2001.11. Sheperd C. Pacing and Exercise in Chronic Fatigue Syndrome, Physiother. 87(8) Aug 2001. 12. Ament, Walter RMT: Safe, Smart & Effective Health Care.13. MEFM Myalgic Encephalomyelitis and Fibromyalgia Society of BC, Box 462 916 West Broadway Ave., Vancouver,BC. V5Z 1K7. E-Mail: [email protected], www,mefm.bc.ca14. Posted by National ME/FM Action Network: www.mefmaction.net


Non-Vascular Edema Affecting the Bones: Three Case Reports

Science

Anatomy of a typical bone.

by Dr. David De Camillis

This is my third article written for this publication. In the summer 2010 edition of Massage Matters, I explained in some detail the phenomenon of non-vascular edema and resulting tissue degeneration. Please refer to this edition. Briefly, this condition is characterized by an expanded extracellular matrix with a paucity of blood elements and a high concentration of proteoglycans in the tissue. In this paper I’ll be discussing three cases involving the long bones. The reason for writing this manuscript is to demonstrate that the nerves and the general physiology within the bones are really no different from other tissues of the body. The underlying pathology is the same. Only the symptoms are different.

To quickly summarize, if the affected body areas are stretched at their end-range then hypothetically the excess fluid will be drained from the area and a more

normal blood flow will return. Tissues can be stretched because they are viscoelastic. Relatively speaking, one would think bones are rigid and therefore couldn’t really undergo end range loading procedures.

This is not the case. Bones do deform under mechanical loading and an internal fluid shift within does take place. (1-9) I believe the periosteum will also be affected in a similar manner.

We think of the peripheral nervous system as being flexible and loose. For example, the median nerve has to adapt to various positions of the upper limb. It has to ‘uncoil’ and ‘coil’ itself depending if the subject is reaching or conversely flexing his elbow and wrist. In order to end range load and stretch this nerve the arm has to be taken into an extreme position. Since there is very little movement in the periosteum and in the bone in general, there is no need to have the same ‘looseness’ of the nerves within. That being the case, only a little flexion of the bone and

Continued on page 10

“Many conditions involve bones.

A lack of blood supply within

would be an obvious cause

to many chronic conditions.

Consider for example

degenerative arthritis of the

hip. “

1 0 • b c m a s s a g e t h e r a p i s t s ’ j o u r n a l • S u m m e r 2 0 1 1

“Pain Relief That Lasts!COLDER LONGER ”™

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Science

Mechanical loading of the upper radius and ulna.

periosteum may be enough to stretch and so drain edema from those nerves.

In November 2010, a fifty-six year old female presented with upper right radial forearm numbness, pain and stiffness. The problem began four years prior, about the time she was diagnosed with osteopenia. The condition was slowly becoming worse. Examination showed restricted excursion of the elbow in extension, swelling and tenderness to deep palpation in the common extensor area and motor weakness in dorsiflexion and radial deviation of the wrist. In her history she described a fall in 1964 where she fractured her upper radial aspect of the right forearm in three places. This fracture had to be surgically reduced at the time of injury. This lady was treated twice in November 2010. Therapy included bending the upper radius and ulna in such a direction

From page 9


Notice the upper humerus is being loaded differently in these diagrams. Reproducing the pain during the procedure will target the tissues we want to affect.

b c m a s s a g e t h e r a p i s t s ’ j o u r n a l • S u m m e r 2 0 1 1 • 1 1

E-mail : [email protected]

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as to reproduce the symptoms. On December 1, 2010 she reported a 98% abatement of symptoms and disability. She had no pain on deep palpation, no swelling, exhibited a full range of motion, and exhibited full strength in her right wrist. Her diagnosis is non-vascular edema in the proximal radius and ulna resulting in her disability and caused by the fall in 1964.

In November 2010 a sixty-year-old female presented with right hip symptoms. She suffered from constant pain, stiffness and numbness from the lateral aspect of her hip down along the anterior thigh and into the knee. She also complained of right lower back and buttock pain and stiffness. She couldn’t lie on her right side, at times the right leg would give out while she was walking, and the right leg would usually feel weak while she was walking. This started in 1978 when she skied into a snowdrift. It took half an hour for her to wriggle free. Afterwards she experienced moderate to severe hip pain along with bruising in the area. I treated her on two occasions in November and checked her once in early December 2010. Therapy included bending the femur in such a manner as to reproduce the symptoms. In December she reported a 75% decrease in symptoms. She can now lie on her right side, has no more sense of weakness or the leg giving out while

Loading the superior aspect of the lateral femur

she is walking, and feels she is more active now. Her diagnosis is non-vascular edema in the right proximal femur. The treatment was end range loading of the femur.

A seventy-seven year old lady presented January 12, 2011 with right upper arm and shoulder pain and stiffness. She had fallen and fractured her right upper humerus and shoulder joint in two places. This occurred in December 2007. Her arm was in an immobilizer for four and a half months. For the past three years her symptoms have plateaued. She couldn’t sleep on her right side, had difficulty in reaching up, felt a constant tightness in her biceps area and experienced constant low-grade pain. The treatment consisted of end range loading her upper right humerus. As of January 18, 2011 she had noticed the following improvements: She could now sleep on her right side. She could reach behind with her right arm and undo her bra. Her range of motion had improved markedly. She had no pain or achiness.

Many conditions involve bones. A lack of blood supply within would be an obvious cause to many chronic conditions. Consider for example degenerative arthritis of the hip. We know that a function of articular cartilage of the femoral head is the protection of the underlying bone. With degeneration, the cartilage disappears and the bone of the

femoral head is susceptible to mechanical stress. This stress causes the nerves and associated connective tissue within to secrete proteoglycans and so the edema/avascularity scenario develops. Perhaps end range loading the upper aspects of the femur will alleviate the pain and disability brought on from osteoarthritis of the hip.

On a personal note, my right hip has advanced OA. Loading the femur in my case dramatically eased the pain. I underwent one treatment six months ago and today still have no pain while lying down at night. Other conditions may include tendinopathies at the bone junction, medial tibial stress syndrome, old boney injuries, and so forth.

End range loading of bones fits well within the massage therapists’ scope of practice. I encourage you to learn and practice these procedures.

References: 1) Gardinier JD, Townend CW, Jen KP, Wu Q, Duncan RL, Wang L. In situ permeability measurement of the mammalian lacunar-canalicular system. Bone. 2010 Apr;46(4):1075-81. Epub 2010 Jan 18. 2) Goulet GC, Coombe D, Martinuzzi RJ, Zernicke RF. Poroelastic evaluation of fluid movement through lacunocanalicular system. Ann Biomed Eng. 2009

“The reason for writing this

manuscript is to demonstrate

that the nerves and the general

physiology within the bones are

really no different from other

tissues of the body. “

Science

From page 10



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Jul;37(7):1390-402. Epub 2009 May 5. 3) Gururaja S, Kim HJ, Swan CC, Brand RA, Lakes RS. Modeling deformation-induced fluid flow in cortical bone’s Canalicular-lacunar system. Bone. 2010 Apr;46(4):1075-81. Epub 2010 Jan 18. Ann Biomed Eng. 2005 Jan;33(1):7-25. 4) Knothe Tate ML, Knothe U. An ex vivo model to study transport processes and fluid flow in loaded bone. J Biomech. 2000 Feb;33(2):247-54. 5) Knothe Tate ML, Steck R, Forwood MR, Niederer P. In vivo demonstration of load-induced fluid flow in the rat tibia and its potential implications for processes associated with functional adaptation. J Exp Biol. 2000 Sep;203(Pt 18):2737-45. 6) Rogala P, Uklejewski R, Stry a W. Modern poro-elastic biomechanical model of bone tissue. I. Biomechanical function of fluids in bone. Chir Narzadow Ruchu Ortop Pol. 2002;67(3):309-16. 7) Srinivasan S, Gross TS. Canalicular fluid flow induced by bending of a long bone. Med Eng Phys 2000 Mar;22(2):127-33. 8) Steck R, Niederer P, Knothe Tate ML . A finite difference model of load-induced fluid displacements within bone under mechanical loading. Med Eng Phys. 2000 Mar;22(2):117-25. 9) Swan CC, Lakes RS, Brand RA, Stewart KJ. Micromechanically based poroelastic modeling of fluid flow in Haversian bone. J Biomech Eng. 2003 Feb;125(1):25-37. •

From page 12

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Massage Matters


by kari walker, rmt

After completing the gruelling massage therapy program and board exams, I think most BC RMTs would agree that our education, training and certification process is amongst the best (and toughest) in our field. That said, our education entitles us to a Diploma of Massage Therapy only, and those wanting to pursue a full degree either have to take an additional upgrade program, or choose another field of study to pursue. Which begs the question: Is pursuing higher education worthwhile for RMTs?

For those that have done so, has higher education helped their careers as RMTs, or their lives in general? What, if any, are the benefits to our profession for having more education than the standard massage therapy diploma? To get a better sense of this, I talked to a few of our members with university degrees about their experiences with higher education.

Christophe Lacour is an RMT with a background in mechanical engineering (Institut National des Sciences Appliques, 1991) and naturopathy. He completed the 3,000-hour massage therapy program in 2003, and while he felt the education was of good quality, to him it felt somewhat

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disjointed and incomplete. He wanted a better understanding of how all the body systems interrelated, and how they all worked together to allow for homeostasis.

“Higher education gave me more tools to start understanding and assessing these interrelationships,” he says. “As a massage therapist, until I got further assessment tools, I mostly treated where the pain was because I did not have enough tools to really assess where the dysfunction was. Too often I treated symptoms. Higher education for me is a lot about getting more assessment tools to understand some of the wonders of the human body. I do not believe it is useful to have more techniques without understanding who we are treating.”

Another question to consider is whether a degree helps earn an RMT more respect from patients and from the medical community itself, including doctors, surgeons, and other specialists. Possibly, but Christophe suggests that perhaps the real issue is a lack of communication among health practitioners. Maybe it’s as simple as other medical professionals not understanding exactly what our training consists of, and how good it really is.

Shelley Would, RMT, also has a BSc in kinesiology (Simon Fraser University, 1994). Like Christophe, she feels that having a university degree may help earn an RMT more respect from others within the medical community. “I feel like our profession is still


Education

Christophe Lacour photo: DT DeWitt


working on credibility, and bringing more education into our realm can only boost that credibility.”

Shelley says that higher education taught her how to think critically, how to organize and disseminate information better. To her, higher education can only benefit our membership in terms of broadening experience and insight, and does help lend more credibility to our profession from outsiders.

“There are many excellent therapists out there who

don’t have a secondary higher education,” she points out. “The really good ones, in my experience, may not have a formal degree or certificate but have in some way sought more education in a specific area of massage therapy, such as mentoring another professional. I believe broadening one’s education does make one a better therapist even if it’s not on a specific technique. More education helps in processing information, communication, using and acquiring information, decision making, etc.”

“The unfortunate part is that most in the medical community still don’t realize how great the Massage

Therapy program is, and how much the depth of knowledge that the graduating therapists have.”

And perhaps what degree you wind up with isn’t as important as the life experience you gain along the way. “I believe, in general, that we can never have too much education (no matter what the topic). We should always be seeking to learn because learning never stops. We become stagnant if we stop learning. This can be in anything: how to play an instrument or how to use a computer program. I think going to school or college or university gives us that drive to learn and continue learning.”

Shelley also believes her degree has given her the tools necessary to perform research, something else our profession can only benefit from. “Higher education in my case increased my ability to perform research. I did a degree in applied science in kinesiology and I did countless scientific papers as reviews and as experiments, and the attention to detail was critical—especially in the

Brenda Beattiephoto: DT DeWitt

From page 15

scientific domain.” And Shelley is not the only one that feels confident in that area because of her background.

Brenda Beattie, RMT, has a BSc in biology (University College of Cape Breton, 1992). Like Shelley, Brenda also feels that her foundation in sciences has given her the necessary means to perform research. She believes that her university experience has helped her learn how to communicate more clearly and precisely—a benefit that translates into increased trust in the client/therapist relationship. Brenda agrees that her university degree has helped her gain credibility with both patients and the medical community, but not because she thinks it makes her superior to other RMTs. Not at all.

“The unfortunate part is that most in the medical community still don’t realize how great the Massage Therapy program is,


Justin Madderphoto: DT DeWitt


and how much the depth of knowledge that the graduating therapists have,” she says. “There are many, many great therapists in the field who don’t have a degree. I do think that the perception from the medical community is changing, though; it’s much different now than it was when I graduated in 1993. At that time, in order to have coverage by MSP or an Extended Medical plan, the client had to have a referral from their doctor. If a Doctor did not believe that Massage Therapy had any benefits, they would refuse to give a referral. Now we have Primary Practitioner status and in most cases clients do not require a Doctor’s referral to get reimbursement for their sessions. That was a big step for the Massage Therapy profession.”

And right now there are even more opportunities for RMTs wanting to further their education. “The fabulous thing about becoming an RMT now,” Brenda says, “is that there is the Bachelor of Health Science degree at Thompson Rivers University (TRU) towards which a therapist can apply credits from their Massage Therapy training. It’s difficult to know what you really want to do for a long-term career coming out of high school, but if a student finds that they really love learning about the human body and how it works, there is a great option of continuing that learning by obtaining a TRU degree, which then opens up even more opportunities.”

RMT Justin Madder recently completed the TRU program, consisting of three mandatory online classes of approximately five months each in duration. From TRU’s website, this unique program “provides health care diploma graduates from recognized

programs and institutions with the opportunity to obtain a bachelor’s degree.”

TRU applicants require a minimum of a two-year Diploma in health care or a related area of study from a recognized program/institution. Justin reported that each class requires a great deal of work and the necessary time commitments for researching current health care issues.

“Each course emphasized and illustrated the significance of understanding the processes involved in conducting or interpreting research,” he says. “This particular skill is something I believe all RMTs need and should be provided with throughout their formal education. A health care provider’s ability to conduct, or yet, understand research regardless of their health care field, supports not only their professional practice but establishes professional creditability within the medical community.”

The required weekly discussions were time-consuming, but Justin found them very beneficial. Different health care backgrounds from respiratory therapist, dental hygienist to laboratory techs would give examples of personal care management conflicts or policies from different health facilities. “These genuine in-depth conversations of an individual’s personal and professional challenges within their health care setting, provided insight for each one of us on the day-to-day operations of hospitals, multi-disciplinary clinics and private clinics.” (For more information about the program, go to: http://www.tru.ca/distance/programs/health-science/bachelor-health-science.html)

Having just finished his degree within the past two

months, it is too soon for Justin to gauge how other individuals within the medical community have perceived his degree. But he strongly believes that any advancement of education can create a high level of respect from peers and clients. “The Bachelor of Health Science Degree has undeniably enhanced my career as a Registered Massage Therapist. Not only do I have a greater regard for client care management, but also an appreciation for legislative and political processes of health care in Canada. There is no doubt that the degree program is worthwhile, as I strongly believe in higher education and personal development. This program not only enhances an individual’s knowledge of health care, but it connects and strengthens our relationships

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with other health care providers and further solidifies our deserved place within the medical community.”

I think most would agree with these four RMTs in saying that advancement of our education is always beneficial, whether it be in the form of continuing education courses or a full degree program. What we learn in any course and the life experience we gain along the way gives us potential tools for us to draw upon later. Higher education can help shape us, give us a career path and help guide us along our way. In whatever form it takes, education is never wasted. At the very least it provides a stepping-stone, a solid base that can never be taken from you. And you never know what doors it will open for you in the future. •

For those that have done so, has higher education

helped their careers as RMTs, or their lives in

general?


Therapist easing their Lymphedema pain

Specialist

by erin mcphee north shore news sunday

She’s seen it all.Patients with legs so swollen they’re

unable to walk a few blocks to the corner store without pain. Others who’ve beat breast cancer, but are now constantly reminded of that fact by a swollen arm they’re forced to carry around.

Grace Dedinsky-Rutherford is a registered massage therapist and certified Vodder lymph drainage therapist. Maintaining a busy North Vancouver practice, she has dedicated herself to the treatment of individuals diagnosed with lymphedema, a malfunction of the lymphatic system resulting in the accumulation of tissue fluid. Major symptoms include painful swelling of the limbs.

Grace has been a therapist since 1992. Prior to that, she acted as a caregiver for her father who had been diagnosed with cancer. “In the later stages near his death he developed quite a bit of swelling, which I learned in school was lymphedema,” she says.

After undergoing her training and establishing her practice, Grace felt emotionally ready to begin helping others dealing with what her father had. “I was able to help my dad,” she says. “I know that there’s a lot of people that suffer from this and a lot of people don’t know that they have this condition . . . (so) I thought . . . I could help these people.”

Becoming certified, she currently treats 350 patients out of the North Shore Lymphedema Clinic, housed in a chiropractor’s office at 1372 Marine Dr., in North Vancouver. Grace says that the majority of her patients, who range in age from 25-99, are cancer survivors. For those who’ve had breast cancer, their lymphedema develops in the thorax or arms and for those who’ve had cancers below the waist, in the abdomen and legs. This type of lymphedema,

occurring post-cancer or as a result of some other trauma to the body, is referred to as secondary lymphedema.

Primary lymphedema affects individuals born without a well-working lymphatic system. Grace estimates that 20-30 per cent of her patients are affected by primary whereas the rest are affected by secondary lymphedema.

To treat lymphedema, Grace employs a manual lymph drainage system, a non-invasive procedure that works to reduce the swelling and fluid accumulation naturally in the body.

“You’re manually moving it,” she says. “Everything drains up to the terminus of our body which is up by the clavicle, by your collarbone. It gets absorbed back into the capillaries and either gets returned back to the heart or we pee out the extra fluid. So what I do is I manually stimulate all the areas that I want it to go to.”

The amount of pressure required is quite light as the lymph vessels are located right beneath the skin’s surface, she says. Following the massage, she bandages the affected limb to prevent the fluid from returning.

One of her patients, Joan Kowalewich, has been coming to her for the last 10 years. The 69-year-old Burnaby resident had a modified radical mastectomy in 1983 and two years later developed lymphedema in her right arm. “The lymphedema became a larger problem in my life after I had a heart attack four years ago and heart surgery two years ago,” she says.

Kowalewich sees Grace once a week for a manual lymph drainage treatment.

“Besides keeping the arm soft and keeping some drainage movement alive, muscle pain has been relieved and a wider range of

motion has been achieved,” Kowalewich says.Based on the success, either in the

reduction of fluid and pain and discomfort or increased mobility and energy, there is a huge demand for Grace’s services. Currently, her wait list is three months long. She works 12-hour days, rarely taking a day off, in order

Grace Dedinsky-Rutherford, a registered massage therapist and certified Vodder lymph drainage therapist, works at the North Shore Lymphedema Clinic. photo: DTDeWitt



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to work around patients’ chemotherapy schedules as well as to accommodate her palliative care patients.

While the work is difficult and the days long, she says she’s extremely proud to be able to offer this treatment. “I am thankful that I decided to follow this path that sometimes isn’t all rosy. On the other hand, I have a ton of active, happy, swollen or less swollen people after my treatments come in and out of my life,” she says.

Unlike other conditions, lymphedema tends to exist under the radar, leaving patients out in the cold.

“They just don’t have the networking that they probably could really benefit from emotionally,” she says.

Another problem with this is that patients can go untreated for years.

Grace will also be piloting an exercise program designed for lymphedema patients that she has just become trained and certified to offer. She plans to begin offering the class on a regular basis in the fall at the Delbrook Community Centre in North Vancouver. Nothing like this is currently offered in the Lower Mainland, she says. •

From page 18

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A Fascial Approach, CEC's TBA MEMBRANES & DIAPHRAGMS

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Mexico Workshop Retreatwith Natale Rao, RMT & Heather Inglis RMT

Contact Natale Rao, RMT at [email protected] for full workshop information*Please note participants are responsible for booking their own flights and food.

FEBRUARY 26 - MARCH 4, 2012

Pre-requisites: Introductory Fascial Release course &a working knowledge of Craniosacral Therapy

Includes course fees, hotelcharges & HST when$400 DEPOSIT paid bySEPT. 30, 2011

EARLY BIRD!$850 REGULAR FEE: REGULAR FEE: $400 deposit due by $400 deposit due by

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INSTRUCTOR: NATALE RAO RMTLOCATION: BUCERIAS, MEXICO (fly into Puerto Vallarta )DATE: FEB. 19TH - 25TH 2012FEE: $850.00 early-bird rate – register by Oct. 1st, 2011; includes shared accommodation ($400.00 deposit fee due by Sept. 01, 2011; balance due by Oct.15, 2011) 21 hours – 21 Continuing Education Credits.

The workshop will take place over 6 days – with one full day off mid week!!!

The workshop is designed for the RMT wishing to improve their knowledge and skill level through the application of Myofascial Release and its principles. Its specific intention is to help the RMT identify “densified fascia” and myofascial restrictions. Visual and Manual assessment techniques will be used.

Some examples of structures that will be examined include:In the Lumbo-Sacral area: abdominals, gluteals, thoracolumbar fascia, iliopsoas, latissimus dorsi and lower trapezius. Some ligaments; sacrotuberous, inguinal and iliolumbar.In the Shoulder complex region: biceps, pectoralis major & minor, subscapu-laris, lats & teres major, corocobrachalis, middle trapezius; the corococlavicular ligaments.Within the Cervical complex: the deep fascial layer of the cervical region, SCM, upper trapezius; levator scapula; scalenes. Lower extremity complex: adductors, quadriceps, hamstrings: influencing I.T.B. presentation.For more information, email: [email protected] OR call: 250.838.9884

Myofascial Mobilization and Release

Natale brings 31 years of clinical practice and 21 years of instructional

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Touch for Health in Vancouver, with Janice Golub

Level 1-4: 14 CECs for each level Level 1: Sat. & Sun., Oct. 22 & 23Level 2: Sat. & Sun., Nov. 19 & 20

Workshops focus on self-testing, as well as muscle-testing patients. To register or for more information:

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Applied SomAticS clinicAl SomAtic educAtionThis client stood 3 inches taller in 4 weeks and felt like he was “walking on air”. These types of results consistently happen with Applied Somatics.

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Instructor: Andrew teufel, rMt cHsE, rYt 500to rEGIstEr: call Applied somatics 250-748-6600 email: [email protected] to attend the upcoming courses. Begin training for certification.september 23 - 25: Applied Somatics for the Tilting Body TMJ 18 CEU, Level I, Vernonoctober 14 - 16: Applied Somatics for the Stooping Body TMJ 18 CEU, Level I, Vancouvernovember 25 - 26: Applied Somatics for the Extremities and TMJ 18 CEU, Level II, Duncan

Applied somatics for tilting Bodies (18 hrs) (3 days)- 18 cEusThis course looks at the somatic (voluntary) retraining of the muscles involved with tilting. People tilt because of trauma/injury and hand/leg/eye/ear dominance e.g., if an individual has a sore foot they tilt their weight onto the other foot or if a person does not hear well with one ear they tilt and rotate the better ear to hear. Titling is a major functional component to leg length differences, chronic hip/low back pain, frozen shoulder and many other traumas. Learn how the Somatic Nervous system is the connection to a functional model to the myofascial & kinetics systems. Learn a systems approach with manual techniques and therapeutic exercises to reduce pain.

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Combine Yoga and Anatomy for an education vacation. Travel, relax, learn and earn credit while studying the anatomy of the yoga body; apply what you learn in your massage therapy or yoga practice. Limited to 16, apply now to reserve your place.Leigh Milne RMT, E-RYT500 is an experienced RMT, yoga teacher and educator. For course and instructor details and registration information visit www.thesadhanacentre.com [email protected] 902-273-9642

Dr. VODDEr MLD COUrSESBasic, Therapy I, Therapy II & III

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Banyan Thai Massage CMTBC CeU approved CoursesA teaching affiliate with the famous

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ITM Chiang Mai Level 1, 24 CEU’s~ Traditional Thai Massage:

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Please visit our website to view our 2011 Course Schedule. On-line registration available at www.BanyanThaiMassage.com or contact: sharon Brown-horton, Instructor at 604.773.2645COMing sOOn – sUMMeR 2012! Retreat courses, yoga, Meditation & hiking expeditions at the “gambier island Retreat & study Centre”.

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The Function of the Ankle and the Foot as seen in the Muscles, Their dysfunction from Myofascial Trigger Points and their treatment,

One day Seminars in Toronto, Montreal and Vancouver. Seminar in Vancouver 1st of April 2012

For full information, contact Brian S. Joseph, DO.FHEA, The Joseph System of Foot Mobilisation • [email protected]

A Yogic ApproachTo Visceral Manipulation

YVM 1 (12 CEC’s)

Prince George September 2011 Nelson February 2012 Courtenay May 2012

YVM Refresher (6 CEC’s)

Vancouver October 2012

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Advanced Cranial TherapyWith Robert Hackwood, RMT

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Ann Sleeper is offering private courses for 2-5 people in her home in central Vancouver. Review sessions are also available to improve your techniques. In these small groups, you can take any of the muscle energy or osteopathic technique courses listed in this journal or at www.annsleeper.comE-mail Ann at [email protected] or leave message at 604-872-1818

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MTABC CEC Courses 2011Registration at MTABC 604.873.4467 or [email protected]. Or mail to MTABC 180-1200, West 73rd Ave, Vancouver, BC, V6P 6G5. Provide name, phone and email. Cancellation within 3 weeks of a course results in 20% penalty; within 2 weeks, 40%; and within 5 days or “no shows”, no refund. All prices in Can. dollarsFascia: Its Structure and Function - The Pelvic Girdle with Mark Finch 14 Credits Holiday Inn 711 West Broadway VancouverOctober 22-23, 2011 Sat and Sun - 9am to 5 pmPrices:MTA One Month Early $322 Regular $350 Non-MTA One Month Early $450 Regular $495End-Range Loading - BONES AND JOINTS - NEW - 14 Credits with Dr. David DeCamillis D.C., F.C.C.R.S.(c) WCCMT New Westminster Nov 5-6, 2011 Sat. 10:00 - 4:30 and Sunday 9:00 - 3:30Prices:MTA One Month Early $280 Regular $310 Non-MTA One Month Early $390 Regular $430Ann Sleeper’s CoursesAlso see Ann’s web page www.annsleeper.comOsteopathic Concepts for Treating Legs, Arms and Back Pain 12 Credits(formerly called Intro to Osteopathic Techniques, Part Two) Victoria - Pacific Rim CollegeOct 1-2, 2011 Sat and Sun - 10am to 5 pmPrices:MTA One Month Early $340 Regular $375 Non-MTA One Month Early $445 Regular $485Muscle Energy Technique for the Low Back, Part 2 - Sacrum 14 CreditsVancouver – Holiday InnOct 22-23, 2011 Sat and Sun - 9 am to 5 pmPrices:MTA One Month Early $322 Regular $350 Non-MTA One Month Early $450 Regular $495Mike Dixon, RMT - TMJ 14 CreditsNew Westminster - WCCMT New Westminster- WCCMT Oct 22-23, 2011 Sat and Sun - 9 am - 5 pmPrices:MTA One Month Early $322 Regular $350 Non-MTA One Month Early $450 Regular $495For more course details, see MTABC web site www.massagetherapy.bc.ca and the MTABC newsletter “Massage is the Message”


Massage MattersIf you have a product,

service or course to advertise call Victoria Chapman at:

[email protected]

Systemic Deep Tissue Therapy® Workshops(also known as SDTT)

(Systemic Deep Tissue Therapy® should not be confused with high pressure treatments)

Originated and developed by Armand Ayaltin DNM, RHT, RMT, and taught by him since the late 1980’s.It consists of its own scientifically-based philosophy, therapist-friendly assessment and treatment.

To reduce burn-out, body and hand postures are ergonomically designed. Therapy takes its cue directly from the assessment. This innovative procedure is designed to minimize the mental and physical stress of the Tx room.

In these Workshops we will teach:• Philosophy and background• How to treat the underlying cause of pain, often realizing quick and lasting results• How to Structurally Realign the body by collapsing the compensatory-matrix, using specific SDTT

techniques at the physical and energetic levels which are: • recognizing the compensatory-matrix • engaging the SNS • manipulating the Fascial-muscle-joint systems • therapeutic intent • treating the relevant meridians • stimulating the patient’s quantum field of healing

If as a Therapist, gaining self-confidence, self-sufficiency and effectiveness with reduced chances of self-injury is important, taking these workshops and adopting the Systemic Deep Tissue Therapy® is for you.

Testimonials:“Thank you so much for this amazing workshop. It will change my life!” W.M. RMT.“This course surpassed my expectations...” B.C. RMT.“ Thank goodness there is a way to read the body and respond to its core needs.” J.W. RMT.“ Great coverage of biomechanics and application. I like these instructors, cool guys” J.L. RMT.

Fall 2011 – Introductory: September 10-11; Intermediate: October 15-16, (CEC 28 for both courses combined), Cost: $399 each.Spring 2012 – Introductory: February 25-26; Intermediate: March 24-25, Cost: $399. For more info and to register, phone: 604.984.2611 • web: systemicdeeptissuetherapycenter.com

CYAN

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PMS

Die

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Vernis

Client : CEO

Projet : 1426-Publicité CEO_Massage Matters

Contact : Marie-Chantal

Format : 8.375 x 11.063

Date : 25 janvier 2011

Note :

70, des JonquillesSaint-Mathieu-de-BeloeilQuébec, J3G 0G7

Téléphone : 514 225-4157

[email protected]

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Osteopathy, a discipline in demandOsteopathic education emphasizes the transmission of the art of osteopathic palpation. This ability, to treat the humanbody at a highly sophisticated manual level, is what distinguishes Osteopathy from all other forms of medicine and

therapy. Given the increasing need for qualified health professionals,osteopaths benefit from interesting career perspectives. Osteopathycould be the career you are looking for.

This 5 year program (6 seminars/year) is designed for health-careprofessionals to gain experience and evolve their practices whilestudying.

The College of Osteopathic Studies offers- A program tailored to professionals already in clinical practice- A low instructor/student ratio- Experienced faculty with many years of clinical practice

The practice of traditional manual osteopathy requires a fine touch,a gentle heart, and a desire to learn. The emphasis at the Collegeis to ensure that the hand-to-hand transmission of traditionalosteopathy is preserved. Our lead instructors hold a specializationin certain aspects of the program to ensure that the knowledgepassed on is of the highest quality.

Successful graduates of the CEO receive a Diploma in Osteopathic Manual Practice (DOMP) and are automatically eligibleto become a member of Society for the Promotion of Manual Practice Osteopathy (SPMPO).

“Osteopathy is a natural medicine which restoresfunction to the organism by treating the causes of pain and imbalance…”

Philippe Druelle, D.O.

efficient solutionpatients

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for your

6 Canadian campuses: Montréal | Halifax | Vancouver | Québec | Toronto | Winnipeg

For information: 1-800-263-2816 | [email protected] | www.ceo.qc.com

College of Osteopathic StudiesCEO (Osteopathic Studies) Inc.

30 years of experience in the Traditional Manual Practice of Osteopathy

Manual Practice Osteopathic studies

Summer 2011

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