{"id":1503,"date":"2019-04-03T09:00:58","date_gmt":"2019-04-02T22:00:58","guid":{"rendered":"http:\/\/blog.amt.org.au\/?p=1503"},"modified":"2019-07-04T17:37:16","modified_gmt":"2019-07-04T07:37:16","slug":"multiple-sclerosis-massage-and-me","status":"publish","type":"post","link":"https:\/\/blog.amt.org.au\/index.php\/2019\/04\/03\/multiple-sclerosis-massage-and-me\/","title":{"rendered":"Multiple Sclerosis, Massage and Me"},"content":{"rendered":"\n<h2 class=\"wp-block-heading\"><strong>By Sharon Livingstone<\/strong><\/h2>\n\n\n\n<p>At the 2018 AMT Annual Conference, Derek Zorzit took to the stage to present a session and placed his walking stick against the lectern. It promptly fell to the floor.<\/p>\n\n\n\n<p>\u201cI have MS,\u201d Derek shrugged. \u201cAnd it\u2019s playing up a bit at the moment.\u201d<\/p>\n\n\n\n<p>Multiple Sclerosis (MS) has stepped into the spotlight with Australian comedian<a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"https:\/\/www.youtube.com\/watch?v=Ixq-PUfqyiQ\" target=\"_blank\"> Tim Ferguson<\/a>, US actor<a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"https:\/\/www.today.com\/popculture\/selma-blair-describes-early-multiple-sclerosis-symptoms-throwback-photo-t149973\" target=\"_blank\"> Selma Blair<\/a>, and QLD cricketer<a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"https:\/\/www.theage.com.au\/national\/queensland\/the-brisbane-heat-star-hitting-ms-for-six-20190109-p50qg0.html?fbclid=IwAR3tNl3Rg6EyXzXGS6f_QpgBxZEJSGSsArja5ywqYy0uzq8SUSkO42stHaI\" target=\"_blank\"> Jemma Barsby<\/a> all making their MS public knowledge. But what do massage therapists know about MS? And how can we help?<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>What is Multiple Sclerosis?<\/strong><\/h4>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\"><p><em>\u201cMultiple Sclerosis (MS) is the most common acquired chronic neurological disease affecting young adults, often diagnosed between the ages of 20 to 40 and, in Australia, <\/em><strong><em>affects three times more women than men<\/em><\/strong><em>. As yet, there is no cure.<\/em><\/p><p><em>There is no known single cause of MS, but many genetic and environmental factors have been shown to contribute to its development.<\/em><\/p><p><em>In MS, the body\u2019s own immune system mistakenly attacks and damages the fatty material \u2013 called myelin \u2013 around the nerves. Myelin is important for protecting and insulating nerves so that the electrical messages that the brain sends to the rest of the body, travel quickly and efficiently.<\/em><\/p><p><em>As the myelin breaks down during a MS attack \u2013 a process called demyelination \u2013 patches of nerves become exposed and then scarred, which render the nerves unable to communicate messages properly and at risk of subsequent degeneration. This means that the brain cannot talk to other parts of the body, resulting in a range of symptoms that can include a loss of motor function (e.g. walking and hand and arm function, loss of sensation, pain, vision changes and changes to thinking and memory).\u201d<\/em><\/p><p><\/p><cite><br>&#8211; Multiple Sclerosis Research Australia <\/cite><\/blockquote>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Types of MS<\/strong><strong><sup>1<\/sup><\/strong><\/h4>\n\n\n\n<p><strong>Relapsing remitting MS<\/strong> \u2013 is the most common form of MS; it is characterised by flare-ups of the neurological symptoms of MS, also known as relapses or attacks, followed by periods of recovery or remission.<\/p>\n\n\n\n<p><strong>Secondary progressive MS<\/strong> \u2013 (SPMS) is a secondary phase of relapsing remitting MS that can develop years, to decades following the initial onset of relapsing symptoms. SPMS is characterised by a progressive worsening of symptoms (accumulation of disability) over time, with no obvious signs of remission.<\/p>\n\n\n\n<p><strong>Primary progressive MS \u2013 <\/strong>(PPMS) is diagnosed in approximately 10-15% of people with MS. PPMS is characterised by a progressive worsening of symptoms and disability right from the beginning, without periods of recovery or remission.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Symptoms<\/strong><\/h4>\n\n\n\n<p>Symptoms vary from person to person and can be any combination of the five major health problems, including:<sup>2<\/sup> <br><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Motor control&nbsp;<\/strong>&#8211;&nbsp;muscular spasms&nbsp;and problems with weakness,&nbsp;coordination, balance and functioning&nbsp;of the arms and&nbsp;legs<\/li><li><strong>Fatigue&nbsp;<\/strong>&#8211; including&nbsp;heat sensitivity<\/li><li><strong>Other neurological symptoms<\/strong>&nbsp;&#8211; including vertigo, pins and needles, neuralgia and&nbsp;visual disturbances<\/li><li><strong>Continence problems<\/strong>&nbsp;&#8211; including&nbsp;bladder incontinence and constipation<\/li><li><strong>Neuropsychological symptoms<\/strong> &#8211; including depression, cognitive difficulties and memory loss.<\/li><\/ul>\n\n\n\n<p>Further information on common symptoms can be<a href=\"https:\/\/www.ms.org.au\/what-is-multiple-sclerosis\/symptoms\/common-symptoms.aspx\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\"> found here<\/a>.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>MS and Massage \u2013 The Research<\/strong><\/h4>\n\n\n\n<p>The available research shows that massage on people with MS may be beneficial, and while this is positive news, the sample size in the studies undertaken to date is small\/tiny. Until larger and longer term studies are available, we\u2019ll have to keep our celebrations low-key.<\/p>\n\n\n\n<p>In terms of participation, a<a href=\"https:\/\/journals.sagepub.com\/doi\/abs\/10.1191\/0269215503cr604oa\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\"> survey in the US<\/a>, with over 3000 respondents, indicated that nearly one quarter seek massage to help with their MS symptoms, so massage is a popular treatment choice for people with MS.<\/p>\n\n\n\n<p>While<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/27502797\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\"> this review of massage therapy research<\/a> found evidence that massage can be beneficial for conditions including MS, more specific research includes:<\/p>\n\n\n\n<p><a href=\"https:\/\/www.bodyworkmovementtherapies.com\/article\/S1360-8592(98)80009-0\/abstract\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">This study<\/a> found that people with MS had \u201c<em>lower anxiety and less depressed mood immediately following the massage sessions and, by the end of the study, they had improved self-esteem, better body image and image of disease progression, and enhanced social functional status<\/em>\u201d.<\/p>\n\n\n\n<p><a href=\"https:\/\/journals.sagepub.com\/doi\/abs\/10.1177\/1352458510384899\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">This study<\/a> looked at the positive affect of abdominal massage on constipation for people with MS.<\/p>\n\n\n\n<p><a href=\"https:\/\/journals.sagepub.com\/doi\/abs\/10.1177\/0269215513491586\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">This study<\/a> found that massage therapy was slightly better than exercise therapy for people with MS (but not as good as a combination of both massage AND exercise therapy).<\/p>\n\n\n\n<p><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/27974947\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">Impact of Massage Therapy on Fatigue, Pain, and Spasticity in People with Multiple Sclerosis: a Pilot Study<\/a>. Massage was found to be safe and effective.<\/p>\n\n\n\n<p><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/24949078\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">The effects of massage therapy on multiple sclerosis patients&#8217; quality of life and leg function<\/a>. Massage was found to be safe and may assist in managing stress for people with MS.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Training for Massage Therapists<\/strong><\/h4>\n\n\n\n<p>There are no additional training requirements for remedial massage therapists to treat people living with MS. A good understanding of the symptoms of MS, how the client is impacted by their MS, and a few guidelines will help the client get the most benefit out of their treatment. As Derek says, \u201c<em>even if two people have the same type (of MS), that does not mean that they will present the same<\/em>\u201d, so that old adage of treating each client as an individual still applies.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Considerations for Massage<\/strong><\/h4>\n\n\n\n<p>Symptoms of MS vary between people, and change over time and between treatments. Communication between massage therapist and client is the key to a good massage experience, especially where the client has MS. This is a non-exhaustive list of considerations:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Deep massage or strong pressure is often counterproductive.<\/li><li>Avoid torsion techniques.<\/li><li>Avoid over-stretching. When stretching soft tissue, get feedback from the client.<\/li><li>Limit quick, jerky movements.<\/li><li>Body temperature regulation is often affected by heat \u2013 avoid anything that raises body temperatures such as hot stones, heat packs, cupping that involves heat, moxibustion. Also consider the temperature of the treatment table, the amount of draping and the treatment room temperature.<\/li><li>If the client had steroid treatment or intravenous treatment in the last 24-72 hours, treatment is contraindicated.<\/li><\/ul>\n\n\n\n<p>Merimbula based Massage Therapist, Melanie King says, \u201c<em>Each time I treat my MS clients, I keep in mind the previous sessions but do not think that today is a follow up from three days or a week ago. I start from the beginning every time. Their condition is changing<\/em>.\u201d<\/p>\n\n\n\n<p>Melanie adds, \u201c<em>I have to really listen\/feel my clients\u2019 bodies and take cues from verbal and non-verbal communication. Limbs and muscles do not respond (in the same way as those in people without MS). Keeping that in mind is critical.\u201d<\/em><\/p>\n\n\n\n<p>Because the client knows their body better than their massage therapist does, Melanie suggests speaking with the client about what does and doesn\u2019t feel good. Derek echoes this advice. \u201c<em>With any client you would be asking for feedback on pressure and what feels good\/bad. It shouldn\u2019t be any different.<\/em>\u201d<\/p>\n\n\n\n<p>From her experience, Melanie says that MS clients have disliked light touch, so recommends massage therapists be \u201c<em>purposeful in touch<\/em>\u201d.<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter is-resized\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" src=\"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/03\/No-two-cases-are-the-same.-MS-complicates-things-but-doesnt-make-massage-impossible.-300x300.png?resize=351%2C351\" alt=\"\" class=\"wp-image-1538\" width=\"351\" height=\"351\" srcset=\"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/03\/No-two-cases-are-the-same.-MS-complicates-things-but-doesnt-make-massage-impossible..png?resize=300%2C300&amp;ssl=1 300w, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/03\/No-two-cases-are-the-same.-MS-complicates-things-but-doesnt-make-massage-impossible..png?resize=150%2C150&amp;ssl=1 150w, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/03\/No-two-cases-are-the-same.-MS-complicates-things-but-doesnt-make-massage-impossible..png?resize=768%2C768&amp;ssl=1 768w, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/03\/No-two-cases-are-the-same.-MS-complicates-things-but-doesnt-make-massage-impossible..png?resize=750%2C750&amp;ssl=1 750w, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/03\/No-two-cases-are-the-same.-MS-complicates-things-but-doesnt-make-massage-impossible..png?w=800&amp;ssl=1 800w\" sizes=\"auto, (max-width: 351px) 100vw, 351px\" \/><\/figure><\/div>\n\n\n\n<p>Derek shares an example of why communication between massage therapist and MS client is important:<\/p>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\"><p><em>\u201cThere are times when a MT is treating my leg and it just jerks. It\u2019s a reaction that I can\u2019t control. I have learnt to laugh at this now because I expect it. If I am getting a treatment from someone I normally warn them that might happen.\u201d<\/em><\/p><\/blockquote>\n\n\n\n<p>While Derek hasn\u2019t experienced any negative effects from receiving massages, one of Melanie\u2019s MS clients was bedridden and one of my MS clients had to make a hospital trip. In both cases, the massage too closely followed an intravenous treatment.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>I have MS<\/strong><\/h4>\n\n\n\n<p>Derek was 27, fit and strong, and working with the Wallabies (Australian national rugby team) when he was diagnosed with Relapsing Remitting MS. After a particularly busy period, Derek developed \u201c<em>an electrical-like buzzing feeling down my neck into my groin. The best way to describe it would be like the feeling of holding an iridescent light bulb and the buzzing feel that would have. My GP sent me to a neurologist who then referred me for an MRI. I had 7 lesions on my brain. All the size of a tic tac.<\/em>\u201d<\/p>\n\n\n\n<p>2014 was a big year for Eliza: she got married, the Rabbitohs won the NRL premiership, and she was diagnosed with Relapsing Remitting MS. She was 32.<\/p>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\"><p><em>\u201cMy first MS attack came on over one weekend. I eventually lost feeling in my left leg, left arm and right foot \u2013 (I had) numbness, and pins and needles. It started on the Friday and slowly crept up until I couldn&#8217;t run on the beach with my friend on the Sunday afternoon. I went to work the next day and couldn&#8217;t walk back to work from a meeting. I decided to see my GP \u2013 hoping it was sciatica \u2013 and he sent me to the Emergency Room. The Registrar told me that night it was (either) sciatica, MS or Motor Neurone Disease \u2013 I just needed a few scans and tests to confirm. I said I thought \u2013 and I was hoping \u2013 that it was the first option but my Dr Google searches suggested MS. A few days later, after MRIs and a lumbar puncture, that was it.\u201d<\/em><\/p><\/blockquote>\n\n\n\n<p>Derek described the shock of his diagnosis and denial of his MS. \u201c<em>The strangest thing was I had several clients at the time with MS and I was not at all like them.<\/em>\u201d<\/p>\n\n\n\n<p>Ever the pragmatist, Eliza\u2019s focus was on building her medical team, \u201c<em>I was suddenly looking into who was the best neurologist in Sydney \u2013 lucky I had some contacts in the medical industry who were able to send me in the right direction. I wanted someone excellent, actively involved in research, someone who was young and enthusiastic and in it for the long haul, and personable.\u201d<\/em><\/p>\n\n\n\n<p>Eliza\u2019s main symptoms are extreme fatigue, \u201c<em>like permanent jetlag tired<\/em>\u201d, pain, pins &amp; needles, numbness, paraesthesia, insomnia, stiffness, and some mobility issues (e.g. limp) from time to time.<\/p>\n\n\n\n<p>Apart from the buzzing, Derek initially had no other symptoms, \u201c<em>I was functioning in every way and it would have been impossible to tell I had MS. My Expanded Disability Status Scale (EDSS) score was 0 out of 10, so I had no disability to speak of.\u201d <\/em>Now his main symptoms are imbalance, weakness in his right leg and tiredness.<\/p>\n\n\n\n<p>Heat and humidity exacerbate Eliza\u2019s symptoms, making a Sydney summer a challenge. Also overdoing it, sitting at a desk for too many hours, and \u201c<em>being a busy working mum! Wouldn&#8217;t change it for the world though.<\/em>\u201d<\/p>\n\n\n\n<p>Derek agrees. \u201c<em>Stress. Stress is a killer for me. Plus heat. I have had 4 MS attacks in my life. Each one was caused by severe stress.<\/em> <em>&#8230; The fourth is ongoing, and has lasted now for 3 years and the most debilitating I\u2019ve ever had with 3 of my 7 lesions becoming active, causing multiple symptoms.\u201d <\/em>And necessitating that walking stick.<\/p>\n\n\n\n<p>Eliza has a busy, demanding job and a toddler, so how does she manage her MS?<\/p>\n\n\n\n<p>\u201c<em>6 monthly Ocrevus by injection. Daily oral pain, fatigue and sleep medications, Vitamin D and magnesium (supplements)<\/em>.\u201d And \u201c<em>reduced work days, outsourcing daily activities like cleaning, food prep, and reduced social activities and sports.\u201d<\/em><\/p>\n\n\n\n<p>Derek takes Gilenya daily. <em>\u201cThe<a href=\"https:\/\/www.gilenya.com\/c\/multiple-sclerosis\/safety\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\"> side effects are not great<\/a>, but it helps my MS from progressing.\u201d<\/em> In addition, Derek stays fit (<em>I\u2019m not doing a very good job of it at the moment<\/em>). Daily stretching and mobility exercises for his back and hips are part of Derek\u2019s routine. \u201c<em>I have also been introduced to a device which stimulates my muscles helping with both my stability and muscle activation. This has made a huge change for me. I\u2019m a very social person* and this has not changed at all. The stress things that I can control have been using a mindfulness app called \u201cCalm\u201d which helps a lot before going to bed.\u201d<\/em><\/p>\n\n\n\n<p>*Anyone who has met Derek can attest to this.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>I Have MS, and I Get Massage<\/strong><\/h4>\n\n\n\n<p>Famously,<a href=\"https:\/\/www.youtube.com\/watch?v=mFHdKIT7LE4\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\"> Derek does swap massages with other massage therapists<\/a> (currently 3), \u201c<em>In a perfect month, I will get 3 treatments. Massage helps me relax. I get great relief from massage plus it helps with my muscles<\/em>.\u201d<\/p>\n\n\n\n<p>Eliza also receives massage \u201c<em>each month roughly. I\u2019d love to do it more often but can&#8217;t fit it in<\/em>\u201d. These massages \u201c<em>probably make me more tired but I usually sleep better that night so it helps with my insomnia<\/em>\u201d but they do make a difference.<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter is-resized\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/i2.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/03\/MS-2-1.png?fit=1024%2C1024\" alt=\"\" class=\"wp-image-1506\" width=\"456\" height=\"456\" srcset=\"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/03\/MS-2-1.png?w=1080&amp;ssl=1 1080w, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/03\/MS-2-1.png?resize=150%2C150&amp;ssl=1 150w, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/03\/MS-2-1.png?resize=300%2C300&amp;ssl=1 300w, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/03\/MS-2-1.png?resize=768%2C768&amp;ssl=1 768w, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/03\/MS-2-1.png?resize=1024%2C1024&amp;ssl=1 1024w, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/03\/MS-2-1.png?resize=750%2C750&amp;ssl=1 750w\" sizes=\"auto, (max-width: 456px) 100vw, 456px\" \/><\/figure><\/div>\n\n\n\n<p>But things haven\u2019t always gone well after receiving a massage. Eliza offers this advice for others with MS: \u201c<em>Talk to your neurologist or MS nurse about what the massage therapist should\/should not do with you. Don&#8217;t get a massage the day after steroids or IV treatment! Make sure you give your body the chance to rest. Trust me \u2013 led to pretty extreme pain for me as I didn&#8217;t warn my massage therapist<\/em>\u201d.<\/p>\n\n\n\n<p>Echoing Melanie and Derek, Eliza has some advice for massage therapists:<\/p>\n\n\n\n<p><em>\u201cEvery person with MS has different symptoms so always ask about their personal experience and don&#8217;t make any assumptions. Talk to your client about what they can and can&#8217;t tolerate and what they want to achieve.\u201d<\/em><\/p>\n\n\n\n<p>Eliza continued with massage for the entirety of her pregnancy when she had stopped her MS treatments. Eliza consulted her neurologist and obstetrician about this. Massage took on a dual role in assisting her to manage her MS symptoms and the pregnancy during this time. <\/p>\n\n\n\n<p>Derek has advice for anyone with MS who might be thinking about having massage:<\/p>\n\n\n\n<p><em>\u201cIt\u2019ll help you dummy!!! Stop thinking about it and just do it *slaps palm to forehead*\u201d<\/em><\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>I\u2019m a Massage Therapist and I have MS<\/strong><\/h4>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"alignright\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"225\" height=\"300\" src=\"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/03\/20181013_110521-225x300.jpg?resize=225%2C300\" alt=\"\" class=\"wp-image-1509\" srcset=\"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/03\/20181013_110521.jpg?resize=225%2C300&amp;ssl=1 225w, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/03\/20181013_110521.jpg?resize=768%2C1024&amp;ssl=1 768w, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/03\/20181013_110521.jpg?resize=750%2C1000&amp;ssl=1 750w, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/03\/20181013_110521.jpg?resize=300%2C400&amp;ssl=1 300w, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/03\/20181013_110521.jpg?w=2000&amp;ssl=1 2000w, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/03\/20181013_110521.jpg?w=3000&amp;ssl=1 3000w\" sizes=\"auto, (max-width: 225px) 100vw, 225px\" \/><figcaption>Derek on stage at the 2018 AMT Annual Conference, walking stick upright again. (Photo credit: Sharon Livingstone)<\/figcaption><\/figure><\/div>\n\n\n\n<p>Derek manages his symptoms at work. The most important way he does this is \u201c<em>Time in between appointments! The worst thing I could do, or any other Massage Therapist for that matter, would be to do back-to-back appointments. I personally need 15-30 mins between appointments to function efficiently<\/em>.\u201d<\/p>\n\n\n\n<p>During a relapse, where his symptoms get worse, Derek is determined to keep helping his clients.<\/p>\n\n\n\n<p><em>\u201cI push through and suffer. I tend to sit down a little bit more during these times as I find it easier. It\u2019s a fine line between needing to work to make money and taking care of my health. Normally I can feel my symptoms changing, but that has only come through trial and error. I have also been very up front with my clients and most understand.<\/em><\/p>\n\n\n\n<p>One of Derek\u2019s current symptoms is a loss of balance. \u201c<em>Strangely enough, I find this the most embarrassing of my symptoms. I have had to explain to several clients that I\u2019m actually NOT drunk, just having issues with balance. I have also stumbled whilst walking a few times which is highly embarrassing, but I just get over it. It is what it is!<\/em>\u201d<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>The Final Word<\/strong><\/h4>\n\n\n\n<p>MS can be an invisible illness. It\u2019s not possible to look at someone and know that they have MS. Symptoms can change on a daily basis \u2013 or on the same day. Even though a person with MS looks well, they may be struggling with their symptoms.<\/p>\n\n\n\n<p>Derek sums up his experience with MS.<\/p>\n\n\n\n<p><em>\u201cI guess one of the biggest things that I have struggled with is looking back at what I used to be able to do and what I can, or more to the point, what I can\u2019t, do now. For example, I have been to Nepal trekking in the mountains 6 times now. I have been the equivalent of \u00be of the way up Mt Everest. And now I need a walking stick to help with walking. I cannot run. Literally can\u2019t do it. If I try, my right leg goes weird and I fall over. That\u2019s a hard pill to swallow. And ALL of this has been in the last 3 years.<\/em><\/p>\n\n\n\n<p><em>I have had to look abroad for treatment as Australia doesn\u2019t offer it. The cost of this is immense, but highly successful. In December 2018 the Australian Government announced a stem cell trial in Sydney for 2019 and I have applied for this. If I get in to this trial, there is a 95% chance that my MS will be halted or even reversed. I am currently waiting on a call any day! Fingers crossed.\u201d<\/em><\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Learn More<\/strong><\/h4>\n\n\n\n<p>The University of Tasmania is running a Massive Open Online Course (MOOC) on \u201cUnderstanding MS\u201d. It commences on 29 April 2019 and runs for 6 weeks (2 hours\/week). It\u2019s all online and FREE. AMT members can earn <strong>60 CEU<\/strong>s for completion of the course. All the details, and to enrol, are<a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"https:\/\/ms.mooc.utas.edu.au\/index.php\" target=\"_blank\"> here<\/a>.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Further Reading<\/strong><\/h4>\n\n\n\n<p><a href=\"https:\/\/www.healthline.com\/health\/ms-massage#benefits\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">Can Massage Help with MS Symptoms?<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/secure.rmtao.com\/Massage_Therapy\/the_benefits_of_mt\/margaret.htm\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">Margaret\u2019s story on the benefits of massage therapy on her MS<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/www.medicalnewstoday.com\/articles\/324177.php?fbclid=IwAR0KFyXTyKjLG9USSFfRHYKM759oH7JJue3uIv49NCopT_6dXCy_O5Thchk\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">How to relieve nerve pain in MS<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/msra.org.au\/news\/treating-ms-in-pregnancy\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">Treating MS in pregnancy<\/a><\/p>\n\n\n\n<p><a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"https:\/\/themighty.com\/2019\/03\/what-is-multiple-sclerosis-really-like\/\" target=\"_blank\">14 Things People With MS Wish Others Understood<\/a><\/p>\n\n\n\n<p><a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5142712\/\" target=\"_blank\">Impact of Massage Therapy on Fatigue, Pain, and Spasticity in People with Multiple Sclerosis: a Pilot Study<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>References<\/strong><\/h4>\n\n\n\n<p>1. Source: <a href=\"https:\/\/msra.org.au\/what-is-multiple-sclerosis-ms\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"Multiple Sclerosis Research Australia (opens in a new tab)\">Multiple Sclerosis Research Australia<\/a><\/p>\n\n\n\n<p>2. Source: <a href=\"https:\/\/www.msaustralia.org.au\/about-ms\/symptoms\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"Multiple Sclerosis Australia (opens in a new tab)\">Multiple Sclerosis Australia<\/a><\/p>\n\n\n\n<p><strong>The author acknowledges the time, generosity and honesty of Eliza and Derek in sharing their experience of MS (and massage), and the assistance of MS Australia and MS Research Australia.<\/strong><\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>About the Author<\/strong><\/h4>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"alignleft is-resized\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" src=\"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2017\/11\/Sharon-150x150.jpg?resize=175%2C175\" alt=\"\" class=\"wp-image-286\" width=\"175\" height=\"175\" srcset=\"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2017\/11\/Sharon.jpg?resize=150%2C150&amp;ssl=1 150w, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2017\/11\/Sharon.jpg?zoom=2&amp;resize=175%2C175&amp;ssl=1 350w, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2017\/11\/Sharon.jpg?zoom=3&amp;resize=175%2C175&amp;ssl=1 525w\" sizes=\"auto, (max-width: 175px) 100vw, 175px\" \/><\/figure><\/div>\n\n\n\n<p><em>Sharon Livingstone is a massage therapist in Sydney, NSW. A love of sport drew her to the industry but discovering job satisfaction came from helping people live with less pain keeps her in it. Sharon is a writer, keen bushwalker and frustrated traveller who is also a coffee snob.<\/em><br><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Research continues to show that massage may help with symptoms of Multiple Sclerosis but what does massaging someone with MS look like? We speak to a couple of people with MS about their experience of massage.<\/p>\n","protected":false},"author":1,"featured_media":1514,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[110,164],"tags":[238,104,10,379,380,381,378,62],"class_list":["post-1503","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-clinical-practice","category-continuing-education","tag-derek-zorzit","tag-massage","tag-massage-therapy","tag-melanie-king","tag-ms","tag-ms-research","tag-multiple-sclerosis","tag-sharon-livingstone"],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/03\/MS3.png?fit=1200%2C628&ssl=1","jetpack_likes_enabled":true,"jetpack_sharing_enabled":true,"jetpack-related-posts":[{"id":2213,"url":"https:\/\/blog.amt.org.au\/index.php\/2019\/12\/05\/top-7-articles-of-2019\/","url_meta":{"origin":1503,"position":0},"title":"TOP 7 ARTICLES OF 2019","author":"admin","date":"05\/12\/2019","format":false,"excerpt":"Revisit 7 of the best articles we've featured on AMT's blog in 2019. Which was your favourite?","rel":"","context":"In &quot;AMT&quot;","block_context":{"text":"AMT","link":"https:\/\/blog.amt.org.au\/index.php\/category\/amt\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/12\/top.jpg?fit=953%2C454&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/12\/top.jpg?fit=953%2C454&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/12\/top.jpg?fit=953%2C454&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/12\/top.jpg?fit=953%2C454&ssl=1&resize=700%2C400 2x"},"classes":[]},{"id":845,"url":"https:\/\/blog.amt.org.au\/index.php\/2018\/06\/06\/join-us-for-the-29th-annual-amt-conference\/","url_meta":{"origin":1503,"position":1},"title":"Join Us for the 29th Annual AMT Conference","author":"admin","date":"06\/06\/2018","format":false,"excerpt":"Earlybird registration is open for the 2018 AMT Conference, to be held in Sydney. With a phenomenal lineup and a great location, there's plenty to get excited about, not least of which is the opportunity to spend time with other massage therapists.","rel":"","context":"In &quot;AMT&quot;","block_context":{"text":"AMT","link":"https:\/\/blog.amt.org.au\/index.php\/category\/amt\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2018\/06\/crowd-2457732_1920.jpg?fit=1200%2C800&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2018\/06\/crowd-2457732_1920.jpg?fit=1200%2C800&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2018\/06\/crowd-2457732_1920.jpg?fit=1200%2C800&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2018\/06\/crowd-2457732_1920.jpg?fit=1200%2C800&ssl=1&resize=700%2C400 2x, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2018\/06\/crowd-2457732_1920.jpg?fit=1200%2C800&ssl=1&resize=1050%2C600 3x"},"classes":[]},{"id":1169,"url":"https:\/\/blog.amt.org.au\/index.php\/2018\/10\/18\/finding-your-village\/","url_meta":{"origin":1503,"position":2},"title":"Finding Your Village","author":"admin","date":"18\/10\/2018","format":false,"excerpt":"Massage Therapists work alone but there's no reason why Massage Therapists should feel lonely. How do you connect with your massage therapy \"village\"?","rel":"","context":"In &quot;Massage&quot;","block_context":{"text":"Massage","link":"https:\/\/blog.amt.org.au\/index.php\/category\/massage\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2018\/10\/doodle-1792253.png?fit=1200%2C600&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2018\/10\/doodle-1792253.png?fit=1200%2C600&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2018\/10\/doodle-1792253.png?fit=1200%2C600&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2018\/10\/doodle-1792253.png?fit=1200%2C600&ssl=1&resize=700%2C400 2x, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2018\/10\/doodle-1792253.png?fit=1200%2C600&ssl=1&resize=1050%2C600 3x"},"classes":[]},{"id":692,"url":"https:\/\/blog.amt.org.au\/index.php\/2018\/04\/05\/10-pregnancy-massage-mythconceptions\/","url_meta":{"origin":1503,"position":3},"title":"10 Pregnancy Massage Mythconceptions","author":"admin","date":"05\/04\/2018","format":false,"excerpt":"We've all heard them and we've probably repeated quite a few but research doesn't support any of them. Is it time we changed the dialogue around Pregnancy Massage and tossed these myths in the bin?","rel":"","context":"In &quot;Clinical Practice&quot;","block_context":{"text":"Clinical Practice","link":"https:\/\/blog.amt.org.au\/index.php\/category\/clinical-practice\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2018\/04\/Pregnancy-Massage-Mythbusting.png?fit=560%2C315&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2018\/04\/Pregnancy-Massage-Mythbusting.png?fit=560%2C315&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2018\/04\/Pregnancy-Massage-Mythbusting.png?fit=560%2C315&ssl=1&resize=525%2C300 1.5x"},"classes":[]},{"id":3504,"url":"https:\/\/blog.amt.org.au\/index.php\/2021\/12\/22\/amt-not-the-chairperson-summer-2021-message\/","url_meta":{"origin":1503,"position":4},"title":"AMT (not the) Chairperson Summer 2021 Message","author":"admin","date":"22\/12\/2021","format":false,"excerpt":"A reflection on the year that was.","rel":"","context":"In &quot;AMT&quot;","block_context":{"text":"AMT","link":"https:\/\/blog.amt.org.au\/index.php\/category\/amt\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2021\/12\/2021-xmas-scaled.jpg?fit=1200%2C800&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2021\/12\/2021-xmas-scaled.jpg?fit=1200%2C800&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2021\/12\/2021-xmas-scaled.jpg?fit=1200%2C800&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2021\/12\/2021-xmas-scaled.jpg?fit=1200%2C800&ssl=1&resize=700%2C400 2x, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2021\/12\/2021-xmas-scaled.jpg?fit=1200%2C800&ssl=1&resize=1050%2C600 3x"},"classes":[]},{"id":515,"url":"https:\/\/blog.amt.org.au\/index.php\/2018\/02\/07\/a-massage-therapists-journey-through-a-career-crisis\/","url_meta":{"origin":1503,"position":5},"title":"A Massage Therapist\u2019s Journey Through A Career Crisis","author":"admin","date":"07\/02\/2018","format":false,"excerpt":"What happens when all your long-held beliefs about massage and your place within the massage industry get blown out of the water? Do you quit? Do you continue spreading outdated info? Or do you dust yourself off, open your mind to new theories and science? Sharon Livingstone explains her journey\u2026","rel":"","context":"In &quot;AMT&quot;","block_context":{"text":"AMT","link":"https:\/\/blog.amt.org.au\/index.php\/category\/amt\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2018\/02\/Career-crisis-1-Header.jpg?fit=1200%2C819&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2018\/02\/Career-crisis-1-Header.jpg?fit=1200%2C819&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2018\/02\/Career-crisis-1-Header.jpg?fit=1200%2C819&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2018\/02\/Career-crisis-1-Header.jpg?fit=1200%2C819&ssl=1&resize=700%2C400 2x, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2018\/02\/Career-crisis-1-Header.jpg?fit=1200%2C819&ssl=1&resize=1050%2C600 3x"},"classes":[]}],"_links":{"self":[{"href":"https:\/\/blog.amt.org.au\/index.php\/wp-json\/wp\/v2\/posts\/1503","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blog.amt.org.au\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blog.amt.org.au\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blog.amt.org.au\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/blog.amt.org.au\/index.php\/wp-json\/wp\/v2\/comments?post=1503"}],"version-history":[{"count":20,"href":"https:\/\/blog.amt.org.au\/index.php\/wp-json\/wp\/v2\/posts\/1503\/revisions"}],"predecessor-version":[{"id":1839,"href":"https:\/\/blog.amt.org.au\/index.php\/wp-json\/wp\/v2\/posts\/1503\/revisions\/1839"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/blog.amt.org.au\/index.php\/wp-json\/wp\/v2\/media\/1514"}],"wp:attachment":[{"href":"https:\/\/blog.amt.org.au\/index.php\/wp-json\/wp\/v2\/media?parent=1503"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blog.amt.org.au\/index.php\/wp-json\/wp\/v2\/categories?post=1503"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blog.amt.org.au\/index.php\/wp-json\/wp\/v2\/tags?post=1503"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}