Obesity is defined by the American Obesity Association as a Body Mass Index (BMI) of 30 or greater. A BMI of 25 to 29 is considered overweight. Obesity affects at least 69 million Americans. Obesity is a chronic disease. Genetics and lifestyle both play a role in this disease. Obesity increases your patient's risk of developing conditions such as hypertension, diabetes, heart disease, stroke, gallbladder disease, and cancers of the breast, prostate and colon. Recent research has also shown that adipose (fat) tissue produces inflammation. This new research has implications for the massage therapist.
Fat or adipose tissue is a specialized form of connective tissue which serves to store fat in the body in the form of triglycerides. There are two types of fat tissue: white fat which is important for energy metabolism, heat insulation and cushioning, and brown fat which is found between the shoulders in adult persons and predominantly in newborn babies. Brown fat is important for making heat. Fat is found under your skin. This is referred to as subcutaneous fat. Fat is also located on top of each kidney. The body "shape" of a person helps to point out additional locations of fat. This is often determined by genetics. Adult males tend to carry body fat in the chest, abdomen and buttocks - known as the "apple" shape. Adult females tend to carry fat in the breasts, hips, waist, and buttocks - the "pear" shape. Upper body fat distribution is correlated with the development of cardiovascular disease, hypertension, and Type II diabetes. By measuring the circumference of the waist and dividing it by the circumference of the hips, you can determine if you or your client's are at risk. Ratios greater than 0.85 for women and more than 0.95 for men indicate increased risk.
Until recently, it was thought that the number of fat cells in the body remained constant once a person reached adulthood. Adipocytes (fat cells) are formed in the fetus during the third trimester of pregnancy as well as during puberty. Recent research has shown, however, that when fat cells become filled to capacity, precursor cells are told to differentiate producing even more fat cells. Once new fat cells are formed, they remain throughout a person's lifetime! Because adipose tissue produces inflammation, there are important implications in this research for massage therapists.
Inflammation is the response of the immune system to infection or irritation. It is characterized by redness, heat, swelling, pain and dysfunction of the involved organs. When an infection or irritation occurs to the body, the blood supply is increased to the affected area. The blood vessels become dilated and engorged which causes the blood plasma to leave them for the surrounding tissue spaces causing swelling. The tissue swells and compresses nerves. This causes pain. Without outside intervention, the body treats inflammation by sending white blood cells into the tissue spaces where they collect bacteria and other debris.
This action keeps infection from spreading. Once the inflammation has stopped, the body works to repair any damage by replacing damaged cells. Scar tissue forms where complete repair has not been possible. The mission of the massage therapist is to help heal the patient without causing further damage. Massage is contraindicated where it could further irritate the area or intensify the inflammation. However, massage can be used successfully on reflex areas related to the inflamed area and in areas proximal to the affected areas. Reflex areas are points that are not near the affected area but effect the area when stimulated. Reflexology is an example of a massage technique that uses reflex points. Acupuncture and acupressure also use reflex points. Proximal means "next to or nearest the point of attachment or origin" (Merriam-Webster Online Dictionary.) This means that the massaged area would be nearest the origin or attachment area of the muscles involved but not the inflamed area itself. This type of massage uses generally gentle but firm pressure.
Assisting patients with pain management can be an important part of a massage therapist's role in treating obese patients. Therapists may want to educate themselves on reflex techniques as well as review muscle origin and attachment points to best treat these patients.
No comments:
Post a Comment