- Nina Omotoso BSc(Hons) Dip ION – Revital Health Place
- Fix in Six- Getting results with advanced clinical massage – Rachel Fairweather – Jing Institute of Advanced Massage
- Pregnancy massage – an introduction – Amy Taylor MFHT Ad.VTCT(Diploma) – Purple Turtle
PROBIOTICS – their role in pregnancy and infancy
A recent trial reveals that probiotics of the correct strain and strength can reduce the incidence of development of allergy and eczema in children with a family history of allergy and atopic disease
The colonisation of our intestines and the establishment of a complex, ecosystem of beneficial and potentially harmful micro-organisms, is a dynamic enterprise which begins from birth. Different species are present at different stages, each releasing their own types of stimulating and modulating factors. One effect of exposure to this chemical cocktail is the adequate priming, balancing and development of the immune system – essential for future good health and resilience.
There are actually three stages of infant development when gut flora populations change significantly; at birth, when breast feeding, and at weaning. In effect, this means that variations in gut flora can arise between children born by caesarean or natural birth and bottle and breast fed babies; and due to their key role in the development of the immune system, it seems plausible that such micro-flora variations could impact on future health.
In fact, this seems to be the case, with bottle-fed infants having a significantly different micro-flora population and by the age of 6 months, having a persistently lower number of Bifidobacteria species1. Breast-fed babies, however, are exposed to prebiotics and other factors which encourage the development of Bifidobacteria species and a more typical balance of micro-flora.
As to the method of delivery, a recent study by Biasucci2 reveals that following caesarean, common Bifidobacteria species are absent and gut micro-flora generally less diverse. Apparent a few months after delivery and remaining until 7 years, the authors suggest that this long-term micro-flora imbalance might be a factor in the increased risk of atopic diseases, which are actually more common amongst caesarean-born infants.
Between 15 to 40% of children in the UK are affected by atopic diseases, such as asthma, eczema and allergy, and there seems to be a chain of progression, since children with atopic eczema are 50% more likely to develop asthma by the age of 12. A dysregulation and imbalance between the two branches of the innate immune system has been identified as a significant driving factor, so an obvious step would be to minimise such imbalance, and this is where immune-modulating probiotics come in.
Infants being weaned respond well. In a double-blind, randomised, placebo-controlled intervention trial, (the best kind), infants were fed cereal containing Lactobacillus F19 from age 4 months. By the age of 13 months just 1 in 10 of the probiotic-eating children suffered from eczema compared to 2 in 10 in the non-probiotic group3.
More recently, results from the Swansea Baby Study indicate that young babies can also benefit4. In this longitudinal trial, 227 mother/baby pairs took a probiotic blend that contained bifidobacterium bifidum (CUL-20);
bifidobacterium lactis (CUL-34); lactobacillus salivarius (CUL-61) and lactobacillus paracasei, as well as prebiotic GOS or FOS. Mum took a daily dose providing 10 billion of the probiotic during the last trimester and then gave the same probiotic to baby, each day, for a 6 month period after birth.
Significant differences were seen when compared to the control group – a comparable number of mothers and babies who didn’t take a probiotic. Not only were children in the probiotic group 57% less likely to develop allergic eczema but the likelihood of their developing reactions to common allergens such as egg, cow’s milk, dust mites and pollen was reduced by almost half.
In light of these trial results, lead author Professor S Allen stated: “Lactobacilli and Bifidobacteria administered to pregnant women and infants aged 0-6 months prevented atopic sensitisation and atopic eczema”. Exciting news indeed.
So what conclusions should we draw? Well, first of all I’d certainly recommend adding a probiotic to your supplement plan during your third trimester. This encourages the growth of beneficial bacteria and ‘sweetens’ the birth canal.
During delivery, baby is exposed to all these good bacteria, which have a fundamental role in encouraging a balanced and healthy immune system. Secondly, I’d also recommend considering a children’s probiotic for both caesarian born and bottle fed babies.
Finally, there’s a clear message on the positive impact of probiotics when taken by mother and baby, particularly when there’s a family history of allergy, eczema or asthma, and more importantly when taking the right strain and dose.
Nina Omotoso BSc(Hons) Dip ION
Nutritional Therapist at FLO health & nutrition (www.flo-life.com)
Revital Health Place
1. Fanaro S et al., (2003) Intestinal microflora in early infancy: composition and development. Acta Paediatric Supplement, 91:48-55
2. Biasucci G et al., (2010) Mode of delivery affects the bacterial community in the newborn gut. Early Human Development, 86:13-15.
3. West C et al., (2009) Probiotics during weaning reduce the incidence of eczema. Pediatric Allergy and Immunology, 20(5):430-7.
4. Allen SJ et al., (2012) Probiotics and atopic eczema: a double-blind randomised controlled trial. Archives of Disease in Childhood; 97:A2
This article has kindly been supplied by Revital.
Fix in Six- Getting results with advanced clinical massage – Rachel Fairweather – Jing Institute of Advanced Massage
Fix in Six- Getting results with advanced clinical massage
Before reading this article you may wish to pause and reflect for a moment as to how you feel when a new client walks through your door experiencing some kind of acute or chronic pain- for example; a herniated disc, persistent low back pain, frozen shoulder, carpal tunnel syndrome, whiplash, or a sports injury. Do you feel excited at this opportunity to help someone reduce their pain, gain a repeat client and enhance your word of mouth reputation? Or are you unconfident, unsure of how massage can help, hesitant in your treatment, or feel that you should be referring the client on to a osteopath or physiotherapist instead? If the answer is the latter then you may wish to read on – and don’t worry, you are not alone! Lack of training in the treatment of pain is one of the most common gaps in knowledge identified by British massage therapists today. Most qualifying courses enable us to do a great relaxation massage but leave students lacking when it comes to those clinical problems so common in the general public- bad backs, sore necks, shoulder or wrist problems. Even therapists gaining sports massage qualifications are often unsure about how to go about getting results with some of the techniques they have learned.
The great news for the massage profession is that skilfully applied massage using appropriate techniques and knowledge is highly effective in treating pain conditions. Using a proficient combination of the right techniques, many clients can experience a reduction in their pain levels within 6 weekly sessions and often as few as 1-3 treatments. This can do wonders for your enthusiasm for your work and of course your marketing – nothing enhances your word of mouth publicity more than a treatment resulting in relief from pain.
Principles of the Fix in Six approach to treating acute and chronic pain
Can you really make a lasting result in a maximum of 6 weekly sessions? Our experience suggests you can; most common musculo-skeletal injury and pain responds well to this approach; frequently achieving a pain free period by weeks 3 or 4. Once you have reached a pain free period, you can lengthen the time between treatments so you might next book your client in for 2 weeks time. Eventually most clients can be moved onto monthly maintenance sessions to keep them out of trouble on an ongoing basis.
We have found that the most successful approach involves using a combination of both assessment and treatment skills as outlined below – you will need more than one tool in your massage toolkit to achieve effective results with different conditions. The best practitioners get results because they use a dynamic combination of skills, adapting each session with every client to create a unique and specialised treatment.
The Seven Golden Steps in the “Fix in Six” Approach
Step one: Take an effective case history and assessment
Developing good assessment and evaluation tools enables your practice to move onto a truly professional level. Quite simply, a good assessment enables us to plan effective treatments that achieve the goals or outcomes that the client desires. From a business point of view, achieving good outcomes leads to satisfied customers, which leads to a thriving and interesting practice. A good assessment enables you to see whether your treatment is working and gives you measurable benchmarks so both you and your client are able to assess progress.
Whether you are doing relaxation massage, sports massage, energy work or pregnancy massage, some form of assessment is vital. You always need to know why your client has come to you, what they are expecting from the treatment and a baseline for any changes you make.
Assessment is usually divided into 4 components, which you can remember, by the acronym “HOPS”:
• H -Health history questions (usually known as your case history or medical intake)
• O– Observations (i.e.: of posture)
• P– Palpation (of soft tissues including muscles and fascia)
• S– Special Orthopaedic Tests (specific tests that help us to identify problems more precisely)
Assessing the data from all of the above helps us to determine what may be the cause of soft tissue pain – for example does the problem lie with the muscles, tendons, ligaments, or joint capsule? This can help us determine the most appropriate treatment plan and the correct combination of technique. A frozen shoulder may present with similar symptoms to trigger points in the rotator cuff muscles but will require a very different type of treatment. Assessment and orthopaedic testing helps us determine the type of soft tissue involved so our work can be more precise – as the great bodyworker Jean- Pierre Barrall, father of visceral manipulation says in his charming French accent ‘ if you are precise, ze results are lastable!”
Step two: Correct Application of Heat or cold
The results of your treatment can be greatly enhanced with the application of appropriate hydrotherapy. In general, chronic conditions respond best to heat whereas acute conditions should always be treated with cold (ice packs or direct moving ice application). Apply hot or cold to the painful area before your hands on techniques and you will find you get better results. You can also teach your client to apply hot or cold for themselves as a useful self help technique between treatments.
Step Three: Fascial Work
Myofascial work (MFR) is a powerful technique to add into the mix of your treatment plan for addressing musculo- skeletal problems. MFR techniques address the body’s fascial system, that is, the 3D fibrous connective tissue that holds the body together and gives it shape. Most commonly taught massage techniques fail to address the fascia, thus denying practitioners a large piece of the puzzle when treating pain conditions. MFR techniques aim to restore mobility in the fascia and soften connective tissue that has become rigid, with highly effective results. To be effective, fascial techniques should be performed without any oil therefore it is often most effective to do these at the beginning of your treatment.
Step Four: Release all the muscles around the affected joint using trigger point therapy
Thanks to the work of Dr Janet Travell, the doctor who pioneered trigger point work in the US, we have a growing body of evidence that many pain conditions are actually caused by trigger points or small contraction knots in the msucles. Studies suggest that trigger points are a component of up to 93% of the pain seen in pain clinics and the sole cause of such pain as much as 85% of the time. (Gershwin; Fishbain quoted in Travell and Simons: Myofascial Pain and Dysfunction: The trigger point manual Volume 1)
Trigger points are known to cause or contribute to low back pain, carpal tunnel symptoms, tennnis elbow, neck pain, migraines, jaw pain, and many kinds of joint pain mistakenly attributed to arthritis. They can cause sinus pain and congestion, nausea, chronic dry cough and are thought to contribute to fibromyalgia.
To gain truly efective results in the treatment of pain with trigger point techique, we recommend treating alll the muscles around the joint. This is a really important principle of treatment as most pain conditions will involve more than one muscle. So for example, if you have a client with a shoulder problem you will need to check the following muscles for trigger points: trapezius, rhomboids, supraspinatus, infraspinatus, teres minor, teres major, serratus anterior, subscapularis, latissimus dorsi, deltoid, pec major, pec minor, biceps, triceps and coracobrachialis.
Step Five: Use acupressure and meridian based techniques
Knowledge of relevant meridians and acupressure points can greatly enhance your treatment results. According to Traditional Chinese Medicine, meridians are the energy highways of the body and acupressure points are where this energy can be accessed and influenced. Recent research suggests strong connections between the meridians and the myofascia, with acupressure points being places where the fascia can be accessed at deeper levels. In my own clinic I have found a knowledge of acupressure points and meridians to be an excellent additional tool in the treatment of pain. So if you know relevant acupressure points, use them!
Step Six: Stretching Techniques
Once trigger points and myofascial restrictions have been removed, stretching will enable shortened muscles to return to their natural length, realign scar tissue to create a functional scar and promote energy flow in meridians to optimise healing. Stretching will enable your sporting clients to improve performance, prevent injury and treat it effectively when it occurs. You can use stretching with everyone from the athlete to the elderly and enable your clients to take greater control over their own health by teaching them to stretch between sessions. PNF stretching, Muscle Energy Technique and Active Isolated Stretching are all incredibly useful to get results in the effective treatment of pain.
Step Seven: Teach your client a self – help technique to use between sessions
Placing control over healing back in your client’s hands is an incredibly powerful psychological tool. There are many safe self help techniques that are within your remit as a massage therapist – for example instructing clients how to treat their own trigger points, showing self stretching, or teaching simple breathing and relaxation exercises to help deal with stress. Make sure you are only teaching your client techniques for which you are insured and knowledgeable (ie: don’t give nutritional advice if you are not a nutritionist)
Putting in all together
The above steps are like a tried and tested recipe – include all of these ingredients in your treatments and you will see an increase in your ability to get results. You will also need to use your own skill and creativity to determine which of the ingredients may be needed to a greater or lesser extent as the exact “recipe” will vary from client to client. So each treatment will be different, challenging and exciting for both you and the client!
Come see us at camexpo 2013
If you want to get great hands on training in all of the techniques described above then come see us at camexpo 2013 where we will be running several workshops in the treatment of pain including the ever popular Jing “Fix in Six” method. Be sure to book early as this is always one of the first workshops to sell out!
See you at the show!
Rachel Fairweather is co-founder and director of the Jing Institute of Advanced Massage. Based In Brighton, London and Edinburgh we run a variety of courses in advanced techniques to help you build the career you desire. Our short CPD courses include excellent hands on learning in all the techniques described above including trigger point therapy, myofascial release, stretching and orthopedic assessment. For the therapist who wants to be the best they can possibly be, we offer a BTEC level 6 (degree level) in advanced clinical and sports massage – the highest level of massage training in the UK.
The work we teach is serious but we do it with a lot of laughter. We use innovative teaching methods that ensure that you leave courses with the material in your hands, head and hearts. All work is taught practically so that you can use it right away in your clinic.
Want to find out more? Please contact The JING Institute!
To find out more, visit Jing’s website www.jingmassage.com, as well as its Twitter and Facebook pages (https://twitter.com/JingInstitute and www.facebook.com/pages/JING-Institute-of-Advanced-Massage-Training/133660816698821).
Copyright Jing Advanced Massage April 2013. Text: Rachel Fairweather. Photos Meghan Mari
Pregnancy massage – an introduction – Amy Taylor MFHT Ad.VTCT(Diploma) is a full time therapist, lecturer and director of the Purple Turtle
Pregnancy massage is a good addition to your skills set, especially in times of recession as women will always continue to have babies! But what is pregnancy massage and does it really differ that much to a normal client massage?
Every pregnancy is unique to that client and each time you treat a pregnant client it is important that she feels like an individual. As the pregnancy evolves the woman will experience changes in her physical and psychological well-being. The therapist must be ready to adapt their treatment to focus on the needs of the client so it is important that the therapist is competent and confident in dealing with pregnant clients.
The Federation of Holistic Therapists (FHT) does not state that practitioners avoid any trimester, but recommends that practitioners have consent from the client’s midwife or general practitioner (GP) before treating a client at any stage of pregnancy. Therapists are required to have adequate relevant training (i.e. completed a Pregnancy Massage course) and will need to review whether the treatment is advisable – check the client’s history for miscarriages or premature birth. Please check with your own insurance company to find out what you are insured for.
It all starts with a thorough consultation, as well as the usual massage contra-indications, health and lifestyle questions the therapist needs to ascertain if there are any pregnancy conditions presenting. If a woman has been a regular client before and becomes pregnant it is important to re-do the consultation to account for the changes happening to her body and lifestyle. Pregnancy conditions such as pre-eclampsia, symphysis pubis dysfunction and gestational diabetes may be contra-indicated. During consultation you would also discuss whether the client would like her bump massaged; you must gain permission for this as some women are very protective of their baby bump tummies. When you are pregnant you may feel more vulnerable and a lot of women state that it is annoying when people think they can touch their bumps without asking. We want to create a safe, positive and nurturing environment so they can relax and asking permission is a way of gaining trust.
The next stage is to get them on and off the couch. Pregnant clients may have to undergo medical examinations that can be intrusive, so maintaining the client’s dignity is paramount. This starts with good towel management, making sure your client feels safe and protected. You should help a pregnant client on and off the couch as the extra fluid held by the body during pregnancy can cause clumsiness and they may not be as agile as they were so make sure you instruct them as to the easiest way to do it. The onus is on making sure the client is comfortable but also that the therapist can work without any extra strain on their body. A variety of positions can be used, but the best position for both client and practitioner is to massage a client lying on her side. If you are doing a full body massage then from laying on their side you can access the legs, hips and the back. After you have done this you would ask them to lay semi-supine but with a wedge supporting their back, the best equipment for this is a couch with an adjustable back rest or you could use a foam wedge and cushions. From here you can access the anterior of the body including the baby bump and the breasts. Massage can be done with the client seated, if preferred, and a fitness ball can be good for this.
There are some excellent carrier oils to use for the massage; you do not need to be an aromatherapist to create a blend of carrier oils to suit your client’s skin type. Grapeseed and sunflower are good bases as these are commercially affordable and thinner oils so are absorbed easily. These oils can be blended with thicker, richer oils such as Rosehip which is thought to be good for stretch marks, and wheatgerm, which is calming for itchy dry skin. If you are a qualified aromatherapist you can add essential oils such as mandarin, frankincense, neroli and chamomile (N.B. some practitioners advise avoiding chamomile in the first trimester). The safest essential oil in pregnancy is Mandarin which has a gentle sweet smell. Mandarin is the least contra-indicated to pregnancy and is good for skin nourishment, mood lifting and oedema. As a woman’s sense of smell is heightened in pregnancy it is best to get the client to smell any blend of oils before you apply it to the body – whether it contains essential oil or just carrier oils – to make sure that she approves of the smell.
After pregnancy massage clients have said they felt rejuvenated and lighter, some have had improvements to the circulation system which reduces oedema and eases leg cramps or restless legs. On a physical level, pregnant clients have said massage helped the regulation of the digestive system, promoted relief from sciatica, gave pain relief in areas such as the pelvis and lower back, improved sleep, reduced itching on the skin and they have suffered from fewer headaches. On a psychological level women have said it helped reduce stress, depression and anxiety and made them feel positive about the changes to their bodies.
The benefits aren’t all anecdotal; research by the Touch Research Institute in Miami has shown that massage reduces pain in pregnancy and alleviates pre-natal depression in both parents and improves their relationships. The institute has also found through research that massage reduces the risk of premature birth and may help decrease complications in labour.
A therapist wanting to treat pregnant clients should undertake further training in pregnancy massage. When choosing a continued professional development course in pregnancy massage, you should look for an accredited course where you will gain a grounding knowledge of pregnancy massage both in theory and practical. This should include information on the three trimesters, anatomy and physiology during pregnancy, contra-indications, home care advice, contra-actions, massage techniques, pregnancy conditions, towel management and marketing advice as a minimum. It is best practice to be a member of a Professional Association to keep up-to-date with the latest information and legislation regarding the treatment of pregnant clients.
Pregnancy massage is a lovely treatment to give so the most important thing is to gain the confidence required, through further training to enjoy the treatment as a therapist.
Amy Taylor MFHT Ad.VTCT(Diploma) is a full time therapist, lecturer and director of the Purple Turtle Therapy Academy which has an accredited pregnancy massage course for therapists.
Tel: 01273 447891
This article has kindly been supplied by Federation of Holistic Therapist.