FirstHealth practitioners educate and empower patients by using Massage Therapy and Personal Training techniques in the clinical setting and home care. In addition to direct tissue manipulation, emphasis is given to patient teaching. This is divided into the areas of pre-operative and post-operative phases with focus on patients acquiring and return-demonstrating skills and knowledge necessary to optimize outcome. Evaluation is ongoing as patients are continually encouraged to verbalize understanding of the concepts and techniques.

Practitioners work together with primary doctors, surgeons, and health care specialists. Treatment course and progress are monitored and adjusted as needed. While a prescription is not required, it is recommended. In some cases, a physician release is necessary.

Example:

• Diagnosis: Breast Cancer
• Procedure: Mastectomy, Breast Reconstruction
• Treatment: Pre-operative phase

Preparation of soft tissue for surgery utilizes massage, myofascial release, stretching, and range of motion techniques. Swedish massage serves to relieve pre-op stress and to prepare the patient mentally. The patient is encouraged to take an active role in preparation for surgery using a variety of self-care techniques including self-massage, meditation, and relaxation.

Possible benefits of massage for people having surgery:

• Relieving anxiety pre-operatively.

Post-operative phase-office care (includes instruction in home self-care techniques):

• Massage, myofascial release, scar tissue management – for incision sites and surrounding tissue.
• Active isolated stretch, range of motion – to reorganize flexibility and minimize further scarring.
• Strength training exercise techniques – to reintegrate into active lifestyle. In cases of tram surgeries, core training techniques are used to re-educate the use of the trunk musculature.

Possible benefits of massage for people who have had surgery:

• Postsurgically, clearance of anesthetic and other medications may be expedited by reflexology or other reflex work or energy work on kidney and liver points;
• Appropriate massage techniques may ease pain after surgery(1);
• Massage therapist’s approach to, and acceptance of the client’s body without judgment may help client dealing with difficult body issues(2).

Post-operative phase home self-care:

• Self massage techniques for scar tissue management.
• Active isolated stretch for increased range of motion.
• Strength training program for re-integration to active lifestyle
• Body gloving, dry brushing for increased lymphatic flow, circulation, and energy during radiation and chemotherapy treatments.

Possible benefits for clients in Radiation Therapy:

• In general, off-the-body energy techniques, foot and hand reflexology techniques may support healing.
• Very light contact or strokes may be possible directly on the affected areas as the patient heals, but working with medical staff and following proper precautions is required(3).

Possible benefits of massage for people in chemotherapy:

• Fatigue can lead to characteristic tension patterns from resting in uncomfortable positions, so neck and shoulder tension are often present, low back pain from resting on couches or sitting in uncomfortable chairs. Massage of these areas, reducing excess muscle tension, may be indicated.
• Hair loss can be devastating to body image. Touch by a caring, accepting professional can be corrective in this case.
• Massage therapy-induced relaxation may reduce nausea and vomiting. (4)
• Reflexology points or Shiatsu/Acupressure points could provide relief from nausea and vomiting. (5)

Possible benefits of massage for people undergoing Bone Marrow/Stem Cell Transplant:

• Some bodywork techniques, where contact is possible, may benefit people with nausea;
• Where possible, patients in isolation may benefit from touch – this depends upon medical guidelines;
• Touch techniques that are oriented to comfort may provide pain relief, following appropriate precautions; (6)
• Massage therapy can provide emotional support to patients undergoing bone marrow transplant. (7)

Resources

1. Nixon, M., J. Teschendorff, J. Finney, W. Kamilowicz. "Expanding the Nursing Repertoire: The Effect of Massage on Post-Operative Pain," Austrialian Journal of Advanced Nursing 14(3): 21-26, March, 1997.
2. Bredin, M. "Mastectomy, Body Image and Therapeutic Massage: a Qualitative Study of Women’s Experience," Journal of Advanced Nursing 29(5) 1113-1120, 199.
3. Tracy Walton, "Cancer and Massage." Massage Therapy Journal; 71-72, Fall, 2000.
4. King, C.R. "Nonpharmacologic Management of Chemotherapy-Induced Nausea and Vomiting," Oncology Mursing Forum, 1997 Supplement 24(7): 41-48, 1997.
5. A pilot study performed in 1983 suggested that the relaxation brought about by massage could reduce vomiting. Scott, D., D. Donahue, R. Mastrovito, T. Hakes, "The Antiemetic Effect of Clinical Relaxation: Report of an Exploratory Pilot Study, "Journal of Psycholosocial Oncology, 1(1): 71-83, 1983. Another pilot study suggests that stimulation of specific acupressure points may help control nausea. See "Acupressure for nausea: results of a pilot study," Oncology Nursing Forum 27(1) 41-47, Jan-Feb 2000.
6. Tracy Walton, "Cancer and Massage." Massage Therapy Journal; 77-78, Fall, 2000.
7. Ahles, T.A., D.M. Tope, B. Pinkson, S. Walsh, D. Hann, M. Whedon, B. Dain, J.E. Weiss, L. Mills, P.M. Silberfarb, "Massage Therapy for Patients Undergoing Autologous Bone Marrow Transplantation," Journal of Pain and Symptom Management 18(3): 157-63, September, 1999.