Treating a client with MS

[THiS iS TH3 Y3AR...]

I am interested in any and all suggestions or comments regarding working with clients who have MS. I have a 32 year old male I am treating weekly and I want to be as effective as I can be. I have treated clients with this malady before but it was usually in the later seforum.xxxes of the disease where they are wheelchair bound and I have to pick them up out of their chairs and put them on the table. This young man is still ambulatory but his legs are getting weak. He responds to what I do but I just want to know if anyone has found an effective way to address this in their own work.

I am currently using assisted stretching, various massage modalities and CST and he has success with this but it's usually short term success. I am eager to hear any other suggestions or experiences.

Thank you.

 

[STEVEN F]

I have not worked with someone with MS. Do you have the book Clinical Massage Therapy by Rattray & Ludwig? If not and you would like the information, PM me and I will fax it to you.

 

[Daniel John]

Thank you. Great recommendation!

Yowza!!! It ain't cheap though!

 

[irenaaneri1980]

Thank you. Great recommendation!

Yowza!!! It ain't cheap though!

lol, noooo, it ain't cheap ~ but it is a very valuable resource.

For those unfamiliar with the book, the subtitle is, "Understanding, assessing and treating over 70 conditions." I found it a blessing when I did my case study on a client with Spinal Cord Injury, and have referred to it often during my career.

 

[hey_uk2000]

Treating a client with MS

I am currently using assisted stretching, various massage modalities and CST and he has success with this but it's usually short term success. I am eager to hear any other suggestions or experiences.

Thank you.

From my reading on MS and fitness therapy it sounds like you are on the right course for this client. My source recommends "PNF techniques...as a primary means of restoration and function."

I know a woman with MS, I see her maybe once or twice a year when she visits the area, but she gets regular massage in her hometown. Along with her fabulous meds, she also does yoga three times a week and cardio. So I don't have anything experience wise to share. Except to say that she is doing great with her maintenance of massage, yoga, cardio and meds...and naps when she needs them.

So I wonder, is your client doing anything outside of massage to maintain the work?

 

[Ciao Bella is Love Drunk]

Treating a client with MS

So I wonder, is your client doing anything outside of massage to maintain the work?

Thanks for your question. He leads a very busy life with two young sons aged 1 and 3. He's a really good Dad but I don't think he has much time left for himself. I do have him swimming though and he says that is helping him. Yoga makes sense. I will mention it to him.

 

[Snarky]

I totally get the busy factor. If your client can learn some yoga poses that would be good to keep up strength and balance, I bet his kids would LOVE doing yoga with him at home. My son loves it when I start doing yoga. He does it with me. Your clients kids are perfect ages, my son is 3 as well and has been watching me do yoga for the past two years.

Swimming was another great recommendation for exercise. I think you are on the right track. It would be interesting to hear anyone else's experience with MS clients.

 

[jasmin2236]

Exercise is the only way for MS clients to retain the strength and motor control they need to avoid/delay being wheelchair-dependent. One of my personal training clients has had MS for over 20 years. It's been a serious battle for her for a long time, but she's still ambulatory. She wrote a short success story which can be read here: http://cstminnesota.com/5.html#susan

Since writing that story, Susan has returned to her writing and given some local readings - things she hadn't done for years. Though MS presents a number of challenges to remaining active, she continues to train with me, and is continuing to improve her balance, strength, and overall capabilities.

Since MS involves demyelinization of the nerves, the fatigue described by so many folks with MS is neurological rather than muscular in nature. Fine motor control and proprioception are early victims, while gross strength in simple movements can easily be maintained or even regained for many years. Balance is further challenged by increasingly poor posture.

I have found AIS stretching to be very safe and effective, and AIS has a wealth of strengthening exercises (see the book at http://www.stretchingusa.com) that work well. Occasionally, performing positional release techniques helps relax overactive muscles, enabling their aneforum.xxxonists to function more effectively by reducing reciprocal inhibition. PRT performed before stretching may make it easier to lengthen chronically tight tissues.

With advanced MS, it is also common to have a certain "mental fog" that impacts memory, cognition, etc. to some extent. Susan is a sharp lady, but she has found some mental tasks more challenging than they used to be. I don't know how much of this is due to neurological changes vs changes in level of daily mental and physical stimulation as personal activity levels and routines change. In any case, Susan has reviewed that her family and friends have commented on various perceived improvements in her memory, problem-solving, writing, comprehending, and other mental skills.

One thing I've found extraordinarily helpful for Susan: Intu-Flow (more info here: http://www.profcs.com/app/?Clk=2217683)

Intu-Flow is a simple follow-along program of light mobility exercises designed to help release excess tension and restore lost joint mobility from head to toe. It includes instruction in simple breathing drills and balance exercises that pretty much anyone can follow, and it's completely compatible with yoga, tai chi, and other mindful exercise practice. As Susan has worked with Intu-Flow, she has regained mobility throughout her body and become much more aware of her body. Though her proprioception is still impaired, she is developing improved sub-conscious awareness and control. At first, she was stumbling from one machine to another, and now she's becoming adept at using her mini-Clubbells to perform complex full-body exercises. It has been an amazing process!

MS clients need light, stimulating exercise that challenges their coordination. In working to master such exercises, they will see tremendous carryover to simpler tasks. Heavier, strength-oriented tasks should be simple and work a wide variety of muscle groups, with some light coordination drills practiced as well. Single sets of many reps tend to fatigue the CNS too quickly, while multiple sets of 5-8 reps (with short breaks between) permit greater CNS recovery and better endurance during an exercise session.

Since some MS clients have difficulty with sweating and may overheat easily, swimming and water aerobics are good options. It's important that trainers and clients be prepared to simply let things cool down now and then during a workout. This makes it very challenging to develop aerobic capacity, but it's possible.

Hope that helps!

 

[Tinkerbell XD]

Jason that was wonderful information. Thank you for taking the time to share it.

I remember reading about your client Susan on your website some time ago and was very impressed with the passion with which she dealt with her situation. You did an amazing job with her.

So far it sounds like as far as the body work goes I am pretty much on the same page with everyone. I'm combining techniques and adapting each week as he seems to have fluctuating symptoms. Thanks for the reminder about the fatigue being more nerve related than muscular. He responds really well to the stretching. My attempts to utilize AIS are mitigated by the fact that the only time I can see this guy is Sunday at 8 or 9 p.m. This is his request as he has a crazy schedule. He is usually so tired by the time I get him a lot of what I do has to be adjusted accordingly so it limits some of the techniques I can use.

I usually end the session doing about 40 minutes of un-windings (I work on him for 2 hours) which he responds to really well. He works out at Equinox Gym but I am not sure about his exercise routine but I do have him swimming for 3 weeks now. There is such good advice in your post I will probably just send it to him.

I have had MS clients before but much more advanced cases where I'd have to take them out of their wheelchair and gently lift onto the table. This guy is young, still ambulatory, a wonderful father and husband and one of those kind of people that you want to go above and beyond to the call of duty for.

So thanks everybody for your help. Even those that PM-ed me with great advice. Much appreciated.