Arthritis

SET TALK
By Don McCann, MA, LMT, LMHC
MA3267 MH705 MM3717

If I had a dime for every client who told me they saw a physician because of joint pain, and, with only a cursory exam, were told by the physician that they had arthritis, I would not have to work today! Furthermore, they were given the explanation that they were getting older and that almost everybody has arthritis.

Osteoarthritis is present in a large percentage of the population over 40. As a massage therapist you will see numerous clients with pain symptoms from osteoarthritis. It is important that you know and understand the causes of osteoarthritis, referred to simply as arthritis, and how to effectively treat the affected areas for pain relief.

The clinical definition of osteoarthritis according to Taber’s Cyclopedic Medical Dictionary is: “a chronic disease involving the joints, especially those bearing weight. Characterized by destruction of articular cartilage, overgrowth of bone with lipping and spur formation, and impaired function.” Now, I find that the effected joints of just about any client I have ever seen with osteoarthritis are stressed due to one or more of the following conditions: structural misalignment, tension in the soft tissue associated with the joints and muscles for movement, damage due to old injuries or surgeries, or strain patterns in soft tissue that weaken the strength of the joint. Each of these conditions involves irritation of the tissues and an imbalance within the joint capsule that leads to a degeneration of the joint itself, and ultimately arthritis.

Once we understand the conditions that weaken joints, we can then consider how to apply massage techniques that will strengthen the weakened arthritic joints, and prevent non-arthritic joints from developing arthritis.

Structural imbalances cause uneven stresses on the joints both internally (between cartilage and ligaments) and externally (within the supporting tissues around the joints). Therefore, the ability of massage therapists to rebalance the soft tissue responsible for the weight bearing and movement of a joint becomes very important in the rehabilitation of the joint, whether it is to prevent arthritis or to stop further degeneration associated with arthritis that is already present. Many times when the joint is realigned structurally, the pain and degeneration found with osteoarthritis disappears.

Tension in the soft tissue, whether it is in the connective tissue or the muscle tissue that effects joint movement, often causes binding and undue pressure within the joint itself. It also limits the overall range of motion of the joint allowing degeneration to occur and a build up of calcium deposits. Either one of these directly feeds already existing arthritic degeneration or, over a period of time, leads to arthritic degeneration within the joint. Releasing the restrictions in the soft tissue that bind the joint or limit its range of motion allows a healthy joint to remain healthy, and stops the arthritic degeneration allowing an arthritic joint to return to full range of motion and become healthy once again.

In the process of life many people injure their joints or have damaging surgeries, and will later develop arthritis due to the damage within the joint. Often these injuries and surgeries leave the joints imbalanced and bound with tightened tissue that includes scar tissue and splinting. If the injured joint had been treated to release the scar tissue in the soft tissue and to restore balance and range of motion, the long-term effects of the injury would have been minimized. Unfortunately, many of our clients have not had the benefit of treatment in the initial stages of rehabilitation from their injuries and surgeries. Once arthritis has developed within the injured joint, the joint will degenerate rapidly due to the aforementioned untreated conditions. To eliminate the further development of arthritis, and to successfully rehabilitate the joint, proper soft tissue releases must be applied which will reduce scar tissue and splinting and restore full range of motion within the proper balance.

When the body is out of alignment, strain patterns result in the muscles and soft tissue. These strain patterns reduce the strength of the muscle function by at least 50%, and oftentimes 75%. When these strain patterns exist around joints, the muscles have to tighten, bind, and compensate for the resulting weakness of the joints. The result is a build up of fibrous connective tissue that directly restricts range of motion and the strength of the joint. This often results in injury to the joint capsule itself, or to an ongoing irritation that can lead to arthritis. Since these strain patterns are in the soft tissue, proper therapeutic releases by a massage therapist can prevent arthritis, or rehabilitate an arthritic joint.

When a client comes to my office with concerns about arthritis in their joints, these concerns are usually accompanied by pain in the joint, inflammation, and swelling. Therefore, it is necessary for initial soft tissue treatment to reduce the swelling and inflammation as these are a direct cause of pain as well as restriction and tension in the joint. Therefore, using strokes that will release the fluids and toxins with the venous flow is an important first step. (Please refer to previous articles on three-step approach).

After the inflammation and pain has been reduced, it is now time to address the tension, adhesions, and restrictions found in the myofascial holding patterns that can both bind and cause misalignment to the affected joint. All of the musculature and soft tissue that has any affect on the movement of the joint needs to be treated with strokes that will release the myofascial holding pattern, the adhesions, and restrictions so the joint can return to balance and full range of motion. Special attention needs to be paid to the speed of these strokes to allow the myofascial holding pattern to unwind and release the restrictions. Therefore, the deeper you go the slower you go! This approach will also allow you to work deeper in an area where the client is already experiencing pain. Clients will communicate their relief as these holding patterns and restrictions release.

When the myofascial holding patterns have been released, very specific individual fiber strokes can be applied to soften the resistant fibrous adhesions and scar tissue. Again, the deeper you go the slower you go! This allows the joint to return a healthier state, usually with pain greatly diminished or gone.

The wonderful secondary gain with these releases is that they tend to structurally realign the joints since soft tissue controls the alignment, range of motion and movement patterns much more so than the cartilage and the effects of the arthritis inside the joint. It helps if the massage therapist has a good understanding of the proper alignment and movement of the joints. However, even without this knowledge, they will be able to reduce the painful symptoms of arthritis and facilitate realignment if they release the soft tissue in the three-step manner mentioned above. This is due to the fact that the tightest tissues maintain the structural distortion, and their release allows realignment.

I have used these techniques over the years with great success treating clients who come in with osteoarthritis. Many times I have not been sure that a proper diagnosis has been made, and have been concerned that only a cursory examination was done in the physician’s office. Still, the majority of my clients improve, and many become pain free with full range of motion and return of strength to joints that were diagnosed as being arthritic. One thing I can be sure of is that they are happy to have received effective treatment and to be rid of their pain. They also refer their friends and loved ones, which is a sign of their confidence in this therapy. Obviously, there are extremely acute cases of arthritis that involve severe joint degeneration. However, even the clients who could not become totally pain free continue to come periodically because proper treatment does minimize the amount of pain and slows down further arthritic degeneration to their joints.