Massage as an Adjunct Treatment
Originally published in Massage & Bodywork magazine, February/March 2001.
By Mary Kathleen Rose, CMT
What is Diabetes?
Diabetes is a disease of impaired carbohydrate metabolism that results from inadequate production or utilization of the hormone insulin. This vital substance is necessary to convert food into energy by facilitating the transfer of glucose (sugar) from the bloodstream into the body's cells. Of the 16 million people in the United States with diabetes, most can be categorized into one of the following types:
Type 1 diabetes, also known as Insulin Dependent Diabetes Mellitus (IDDM), affects 10 percent-15 percent of the total number of diabetics. Because of damage to the insulin-producing islet cells of the pancreas, little or no insulin is produced. As with Type 2 diabetes, there is a genetic predisposition to the disease. Often the onset of the disease occurs following significant physical or emotional stress. These individuals must take regular injections of insulin. Type 1 diabetes tends to present itself in childhood or early adulthood.
Type 2 diabetes, also known as Non-Insulin Dependent Diabetes Mellitus (NIDDM), affects more than 85 percent of the total number of diabetics. In these people, the pancreas is producing insulin, but the cells that use insulin create resistance to it. Because of this insulin resistance, glucose levels are elevated in the bloodstream. Type 2 diabetics may take one or more oral medications designed either to decrease insulin resistance or enhance the cells' sensitivity to insulin. They may also need to take insulin by injection. Generally, Type 2 diabetes has a slower onset than Type 1 diabetes, and is more prevalent in the older population.
While the types have different pathologies, they have the same common symptom, that of elevated blood glucose which has many short- and long-term ramifications. If blood glucose is elevated, the cells are essentially starved for energy, so the person is fatigued. Excess sugar spills into the urine, causing frequent urination and excessive thirst. When these signs become tangible, the disease may be diagnosed with a simple blood test to determine glucose levels in the blood.
Massage Therapy and Diabetes
So how does massage therapy come into the picture of diabetes treatment? What are its benefits for the diabetic? What does the diabetic need to know about massage? What does the massage therapist need to know to successfully and safely treat the person with diabetes? Because of my personal experience as a diabetic (see sidebar) and as a massage therapist, I feel I am in a unique position to share my observations. My initial experience in the hospital taught me the value of the simplest touch. While in the emergency room and intensive care, I was so grateful when someone -- a friend or medical staff person -- would touch me. Unable to speak or communicate my fears, it was helpful to feel the comfort and assurance.
Even as a newly diagnosed diabetic, I felt tremendous changes in my body. In the short term, I began to feel increasing strength and the recovery from diabetic ketoacidosis. Insulin by injection is different than the body's own insulin. In some ways I felt as if I had a new body, running on a new and different fuel. It was as if the texture of my muscles and fascia had changed, becoming a little more dense. I had just completed a year-long training in massage therapy, and some of these changes were observable by friends whom I had met as fellow massage therapy students.
Over the years, I have benefited in many ways from receiving massage. I currently teach therapeutic massage in a number of massage schools and medical settings, and have been in a position to educate massage therapists and other health professionals about the benefits of massage for diabetics, as well as to inform them of special concerns when working with this population.
The Benefits of Massage for People with Diabetes
As with any population, massage is a beneficial complementary therapy -- diabetics, however, can find the results especially helpful.
Circulation -- There is no getting around the fact that massage can increase circulation, thereby encouraging the efficient transport of oxygen and nutrients throughout the body. Improved circulation, in turn, improves the cells' insulin uptake.
Relaxation -- The benefits of relaxation should not be underestimated, especially within the diabetic community. Consider the physical and psychological stresses of living with a debilitating disease and the need to self-medicate and monitor on a daily basis, as well as the burden diabetes puts on the body and its systems. That said, it's easy to see the therapeutic correlation between massage and diabetes. With the release of endorphins, the nervous system calms, there is a reduction of stress hormones and the diabetic client can find a homeostasis with their blood sugar levels.
Myofascial Effects -- For the client with diabetes, you may likely find a thickening of their connective tissue caused by increased blood sugars. Massage will help to increase mobility and tissue elasticity that has been hindered by that thickening effect. Of course, a good exercise program -- with an efficient stretching regimen -- will also benefit your client.