Pain Is Not an Inevitable Part of Aging

Weakened muscles, stiff joints, and pain are not an inevitable part of aging and I have the research to prove it.

I started to experience arthritis, bursitis, low back pain, and knee aches in my early 40s and considered it to be a normal part of aging. Likewise, many of my clients come to me having accepted a certain amount of pain that comes with getting older. 

Recently, I learned of two studies that contradict this bit of common wisdom, suggesting that we can maintain our vitality into our 70s and beyond.  Both studies show that not only can we prevent pain from weakened muscles and stiff joints, but that we can reverse these conditions in our older years.

In one study, active men in their 70s had better muscle function and energy production than inactive men in their 30s. The differences showed up in how far they could walk, their strength, and their general mobility.  The active participants weren’t extreme athletes either--they put in around 150 minutes of moderate activity per week.

Most exciting of all, even participants who began regular exercise later in life showed significant protection against further decline.  Our bodies remain responsive to activity at any age!

What about people who struggle to become active because of pain and immobility? The second study showed that stiffened tissues can be rejuvenated with the application of stretching and massage therapy.

Pain develops when we first become inactive for whatever reason—injury, surgery, or a prolonged period of immobility—and the connective tissue that surrounds and holds our muscles and organs in place (called fascia) conforms to these positions and movements becoming more stiff and fibrous.

Moving against the stiffened fascia is difficult and painful which causes us to stick with the dysfunctional positions or movements. This leads to the fascia becoming stiffer, which causes more pain when we move.

Researchers demonstrated that massage and stretching interrupted the pain cycle by remodeling the fascia and retraining muscles where fibrous connective tissue had developed.

That’s great news for those of us who are already “set” in our ways.  We don’t have to sit around bemoaning our fate, but can start to explore gentle stretching, possibly with the help of a physical therapist depending on the severity of the immobility. A nice massage would also help soften tissues! 

I see many clients who have resigned themselves to a “bad back”, achey hands, or weak knees because they know of no solution. The good news is that there are ways we can all start to feel better and start on the path to being free of pain.

Sources

1 “Impact of Physical Activity on Physical Function, Mitochondrial Energetics, ROS Production, and Calcium Handling Across the Adult Lifespan in Men”, https://Cell.com/cell-reports-medicine

2 “Manual therapy prevents onset of nociceptor activity, sensorimotor dysfunction, and neural fibrosis induced by a volitional repetitive task”, https://Pubmed.ncbi.nlm.nih.gov

3 “Downward Facing Rat? How Rat Yoga is unraveling the Mystery of Back Pain”, https://bwhclinicalandresearchnews.org/2017/09/08/downward-facing-rat-how-rat-yoga-is-unraveling-the-mystery-of-back-pain/

Massage Therapy for Clients with Dementia

Recently I was interviewed for an article in the American Massage Therapy Association journal about the benefits of providing massage therapy to clients with dementia. I think it would be beneficial to share my answers in this month’s blog.

Can massage therapy improve the quality of life for those with dementia?

Massage therapy provides a nurturing touch that conveys caring in a more powerful way than words. It can improve feelings of security and calm anxiety by invoking the relaxation response provided the client enjoys the touch and trusts the therapist. They may not remember the therapist by name or face, but they will remember how the therapist made them feel.

What are some special considerations to make when massaging someone with dementia?

I ask for permission from the client, even if a caregiver has arranged for the massage. It’s important that the client have some understanding of what I am going to do.  If a client shows hesitation or doubt, I would ask to simply massage their hands until they are comfortable with something else.  Maybe the session is just the hands or, if the client doesn’t want me to touch them at all, we just sit together, allowing them a space to be.

How do you ensure safety and avoid distress during the session?

Most importantly, I perform the massage at the client’s location with a caregiver nearby. It is important that a caregiver stay present and not leave the premises, even if the client is in the early stages of dementia.  Simply because dementia is an unpredictable condition and I don’t know the client’s situation well enough to reassure them if they become distressed.

I ascertain as well as I can the client’s preferences for music, aroma, and lighting to make them as comfortable as possible. In advanced stages of dementia, I will have to rely more heavily on caregiver input in terms of client preferences.

How might a session differ from a typical massage?

 I do not ask the client to undress because consent is tricky with a person who has dementia. I do not want them to become confused about why they are undressed, who I am, and what I am doing to them. If the client is accustomed to massage and chooses to undress, then that is their choice.

Especially at first, I am prepared to perform the massage off the massage table.  Lying down on the table puts the client in a vulnerable position that might cause the client distress unless they are accustomed to massage. I tell the client that they can tell me to stop if they don’t like what I am doing and I check in frequently.

In short, I am ready to adapt the session each time I visit.

What is the typical session duration for someone with dementia?

For a first session, I schedule a 20-minute seated session to determine if a client is open to massage.  If a client wants to continue and go further, I will suggest a 30- to 45-minute session on the table, depending on their level of awareness.  I assess the client’s openness and enjoyment level at each session, ready to pivot to a seated massage and shorter session if need be.

You can read the full article on the Massage Therapy Journal website.