Amyotrophic Lateral Sclerosis (ALS) is a horrible degenerative condition that involves the death of motor nerves (controlling skeletal muscle movement). It recently gained quite a lot of exposure thanks to the #icebucketchallenge that brought it to the forefront of the pop-culture sphere.
When it comes to working wth people who have ALS in the context of a massage treatment, there are a few things we need to consider.
The first thing we need to remember is that muscle strength and control is diminished (proportionally to the stage of the condition). This means that breathing is already a difficult process and the breathing apparatus as a whole is already strained for effort. Considering that Thai Massage involves a lot of static compressions, with longer holds, it is important to ensure that our techniques don’t add any additional stress on our patient’s breathing.
This might mean that we don’t use as many chest, and back massage techniques – at least not in the prone and supine positions. It is a good practice to substitute these positions and the pressure techniques we use here for side-lying massage techniques. Side-lying offers the unique ability of the bode to compensate and move in response to pressure (in a way that supine and prone do not).
Additionally, we will likely encounter tetanic muscular contractions. Similar to a cramp, tetany produces strong, uncontrolled contractions within the muscle.
When we come across this it’s a good idea to slow our touch down as much as possible. The reason for this is so that we can utilize the Golgi-Tendon Organ (GTO) reflex. The GTO reflex is described more fully here, but in essence it induces relaxation of a muscle when it detects higher load/strain on the tendon. Biologically, the GTO reflex is also a more powerful response than contraction signalling.
By maintaining static and sustained pressure on the muscle, we may find release in those structures that are constantly contracted.
Thai Massage is accessible to all populations – it’s just a matter of understanding what factors are at play and what modifications need to be made.
Here’s a video from our YouTube channel on this same topic – check it out: