Russian Medical Massage: Massage for Diabetes

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Russian Medical Massage: Massage for Diabetes

Along with standard medical care, massage can create a difference for many diabetic sufferers by preventing some complications of the disease and improving the patient's daily life.

This article addresses massage protocol for patients suffering with diabetes mellitus, the most common form of diabetes. Some of the symptoms seen in diabetes mellitus might occur in other forms of diabetes, and massage treatment protocol could be applicable to that patient. I will advise you, however, at all times for all cases of diabetes (including diabetes mellitus) to consult with the patient's physician and explain your proposed treatment, reasons for it and the results you expect.

About five percent of the United States' population suffers from this disorder. It is the fifth leading cause of death and the leading cause of blindness. Twenty-five percent of diabetes mellitus sufferers die from renal failure, and 50 percent have their lower extremities amputated due to the complications associated with diabetes mellitus.

Development of diabetes mellitus

Diabetes mellitus, which falls into a group of carbohydrate metabolism disorders, develops for two reasons: 1) The beta cells in the pancreas, which are responsible for insulin production, are not supplying the needed insulin due to low regeneration rate, viral destruction or even simple genetic malfunction; 2) An increase in glucose production and decrease in pherepheral glucose use -- meaning the body has created its own "fasting" situation -- that is most likely to occur in pregnant women and is known as gestation diabetes.

Whatever the reason for developing this type of diabetes, all patients will see hyperglycemia, or excess glucose in blood, which is commonly referred to as "high blood sugar." In a person not suffering with diabetes mellitus the normal fasting glucose level in blood is between 80-120 mg./100 ml., whereas in a patient suffering with diabetes mellitus the fasting glucose volumes will be 200-300 rag./100 ml. When the body does not utilize all of the sugar it produces -- regardless of the reason (not enough insulin to metabolize the glucose or too high glucose/insulin ratio) -- it wastes the glucose and thus subjects the renals to more work.

The two types of diabetes mellitus

Type I -- Insulin Dependent Diabetes Mellitus (IDDM), which affects five to 10 percent of diabetics. IDDM, sometimes referred to as Juvenile Diabetes, is most likely to occur early in life. IDDM patients have to receive daily injections of insulin and suffer more severe consequences of this disorder (such as ketoacidosis).

Type II -- Non Insulin Dependent Diabetes Mellitus (NIDDM), which affects 90 to 95 percent of the diabetic population. NIDDM is most often developed after the age of 40 and happens due to lessened production of insulin and resistance to insulin use.

Causes of diabetes mellitus

Etiology, or cause, of diabetes mellitus is based on four factors: genetic, metabolic, microbiologic and immunologic. Diabetes mellitus is an inherited disease and occurs most often if both parents are diabetes mellitus sufferers. Stress (both emotional and physical) can unmask hidden diabetes mellitus. The most common metabolic factor, however, is obesity -80 percent of Type II diabetes sufferers are obese. Some viruses seem to cause destruction of beta cells, especially in patients with Type I diabetes who are predisposed to diabetes mellitus due to their genetic makeup. Finally, some research suggests that Type I diabetes mellitus can be classified as an autoimmune disease.

Whatever the cause, the number of patients with diabetes mellitus has grown steadily in the last few decades. Complications that follow diabetes can be life-threatening and do result in serious disability. Atherosclerosis (thickening, hardening and loss of elasticity of the walls of the arteries) is more common in diabetic persons than in a non-diabetic person, and correction in glucose levels in blood does not seem to decrease the chance of cardiovascular complications. Besides ocular problems, diabetes mellitus patients develop abnormalities in the peripheral nerves of the lower extremities. After 10 years of diabetes mellitus present, the patient experiences the feeling of progressive "anesthesia," which can lead to tissue damage without the patient's knowledge.

Standard medical treatment

Standard medical treatment consists mainly of promoting healthy eating and exercise habits in diabetic patients. By reducing weight -- through decreased calorie intake, increased fiber intake and maintaining an adequate level of exercise -- patients with Type Il diabetes can maintain normal glucose levels without having to take insulin injections. Insulin therapy is prescribed for both Types I and II diabetes mellitus patients (although Type I is absolutely insulin dependent) and there are some oral medications that are used instead of insulin.

Although massage has not been one of the recommended forms of diabetes treatment in this country, it can be used to aid in management of diabetes mellitus.

Massage treatment

First, consult with the patient's physician. State your goals and objectives as clearly as you can and ask for any comments the physician or patient may have. If for any reason the patient's physician believes your treatment will result in harm to the patient and massage should be avoided, follow the physician's orders.

The goals and objectives of the massage treatment will concentrate on both diabetes complications and its causes. Both types of diabetes mellitus patients are good candidates for massage, and insulin therapy has no bearing on appropriate indicated massage.

As we know that both emotional and physical stress can lead to diabetes mellitus, general stress-reduction massage is recommended for patients who have a genetic predisposition to diabetes. This massage should concentrate on relaxing the central nervous system, and will consist of rhythmical continuous effleurage and gentle medium/slow continuous vibration. This full-body massage should last 30 minutes at the most, and can be done once or twice a week. By reducing stress, this massage treatment may postpone the onset of diabetes mellitus.

Massage will not cure diabetes, but it will help with some of the complications of the disease. Diabetes patients have cardiovascular conditions associated with diabetes mellitus, and massage could help with their circulation problems. Most patients suffer from severe swelling, especially in the lower extremities. Draining massage will reduce this swelling as well as aid the body's cardiovascular system.

For this massage you will use continuous effleurage, beginning your massage with the back. Make sure your effleurage moves only toward the heart (for example, when massaging the neck and shoulders move toward the arms). Do not press down into the tissues, but rather glide in the direction of the heart. After the back is effleuraged for five to seven minutes, proceed to the thigh and effleurage it toward the buttocks. Follow with effleurage of the calf in the same fashion.

Length of treatment

You will probably spend about 20 to 30 minutes effleuraging the posterior side of the body and only l0 to 15 minutes effleuraging the front of the legs and the arms. This whole-body massage can last 25 to 35 minutes and should be done at least twice a week for 10 to 12 treatments. At the end of the treatment set the patient can be placed on a maintenance program with massage done once every 10 to 14 days, or a break of two to three months can be taken with the same treatment set resuming after the break.

If the patient is suffering from peripheral nerve damage you can add some gentle friction of the lower extremities after a sufficient amount of effleurage has been completed. Please remember that friction cannot be done on areas that are swollen, as direct pressure down -- characteristic of friction -- will further close the dysfunctioning vessels.

Sometimes you might find yourselves finishing a set of seven to 10 treatments of effleurage massage before you can add friction of the lower extremities into your routine. As the tissue of the diabetic person is very fragile due to vascular dysfunction, inappropriately done friction will cause more vascular damage and bruising. Your massage should create no pain. If pain is present you should lighten your pressure. This treatment can be done two to three times a week for 12 to 15 times. The same guidelines for maintenance or set of treatments after the break as in previously described massage should be followed.

Additional massage treatments: petrissage and vibration

If the patient has an inactive lifestyle but needs to increase his or her amount of exercise, your massage can act as a passive exercise for this patient. Begin with effleurage massage as described above and add some gentle strokes of petrissage of the extremities after adequate amount of effleurage is completed. Be aware that your petrissage is in fact exercise for the muscles, so add the number of strokes gradually as you can cause tissue overuse -- especially in an inactive person. You can gradually increase petrissage amount (decreasing amount of effleurage) in your massage with petrissage being used up to 50 percent of the time. I will stress that petrissage by no means will replace active exercise, but it will add to the patient's exercise.

Vibration

Vibration has been proven to improve some visceral reflexes, including the function of the adrenal glands. Adrenal glands play an important role in the body's autoimmune function -- so by stimulating the suprarenal glands you will aid in the body's own restoration process. To perform this vibration place one hand on top of the other on the area just below the ribs and pump gently in and out. This vibration can be done for 30 seconds up to three minutes, with some rest in between, and should be done at the end of the back massage.

Massage Magazine, Inc.

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By Zhenya Kurashova Wine

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