Massage therapy has been proven beneficial for health and wellness, and research has proven it is beneficial for improving flexibility, reducing pain, improving sleep, as well as reducing anxiety and depression in the general population. These benefits also apply to those with physical and developmental disabilities.

Massage and Physical Disabilities

Many physical disabilities, like Multiple Sclerosis (MS) and Parkinson’s disease, have symptoms such as tremors, spasticity, rigidity of muscles and uncoordinated movements. Loss of balance, slowness of movement and inability to walk, as well as pain and stiffness of muscles throughout the body are also symptoms of these conditions.

Similarly, those confined to a wheelchair for any reason may suffer from atrophied muscle tone, skin breakdown resulting from the constant pressure and reduced circulation that occurs, spasticity and spasms in muscle tissue, and reduced cardiovascular health. Many of these conditions, especially those that involve spasticity and chronic tension of muscle tissue, may result in significant pain over time. Massage can significantly improve the pliability of muscle tissue, which results in less spasticity and improved muscle function, as well as improved flexibility and range of motion. This can often be the difference between being able to walk or not for someone who is suffering with one of these debilitating conditions.

Spinal cord injuries, brain injuries, strokes and tumors often cause paralysis. Paralysis affects over 265,000 Americans and can produce symptoms such as joint and muscle pain, phantom pain, breathing difficulties and bedsores. For those with reduced circulation that is affecting the skin and causing bedsores, skin brushing has also been shown to improve circulation and stimulate the skin, keeping it supple and pliable.

The cardiovascular and lymphatic systems also suffer from the lack of movement, which reduces venous and lymph return significantly. Massage has been shown to increase circulation and improve lymphatic return, which is of great benefit for those who are unable to move all or part of the muscle tissue in their extremities. Those suffering from edema because of some condition or as a result of being wheelchair bound may see significant improvement after receiving lymphatic massage.

Massage and Developmental Disabilities

Many developmental disabilities also have physical symptoms, but are commonly accompanied by emotional and behavior problems. Those with Autism, Fetal Alcohol Syndrome, Attention-Deficit or ADHD, and other conditions that affect mental and intellectual development, often suffer from anxiety and depression as they struggle to deal with even the most basic social interactions and expectations placed on them. Massage therapy has been proven to reduce their anxiety and stress along with depression, often resulting in significant reduction in behavioral outbursts in those suffering from these types of developmental conditions.

Special Considerations

There can be many additional considerations and precautions when working with these special populations. Often there is a loss of feeling that accompanies the loss of function, especially in those with paralysis. It is especially important to be careful not to work too deeply, as they may be unable to feel the pressure and you may be bruising them. Also, many who suffer from muscle contracture may be hypersensitive, and require especially light, circulatory work.

Informed Consent

Another issue, especially when dealing with those who suffer from developmental disabilities, is that of informed consent. When dealing with those who are mentally or emotionally impaired, it is important to get consent from their guardian, but it is also important to make sure the client understands what is happening. Be sure to explain exactly what you will be doing before beginning the session, then explain each part as you are about to perform it. Most often, like children, those with developmental disabilities are curious and receptive to bodywork but they may not be able to decline the service verbally. If a non-verbal client is acting out and refusing to cooperate it should be taken as refusal, even if their guardian has given consent.

It may also be a good idea to remind them that it is okay to tell you if the pressure is too deep or it is hurting or that you will stop if they ask. It is an unfortunate fact that the disabled and those with developmental disabilities are often preyed upon in our society, and there is a high rate of abuse in these special populations. It is important to enable them to end the session if they are not comfortable.

As you work, explain the overall plan for the session before beginning. Then, explain again what they should do in preparation for getting on the table. This may involve them undressing to some extent or positioning with bolsters, pillows or wedges. Once they are on the table, as you begin each session, make a statement before beginning work on each area such as “I’m going to start working on your back now.” This allows them to be prepared and know what to expect.

Often, those with developmental disabilities may not be able to verbalize what is too deep or too light in pressure, so feel free to experiment a bit. Ask “which is better, this…(do a light stroke) …or this (do a deeper stroke)?” This will allow them to indicate their pressure preferences even if they are not able to verbalize them.

Accessibility

Finally, accessibility is usually an issue for these special populations. Massage therapy offices should have handicapped parking and accessibility, including ramps and bathroom accessibility for those clients who may be wheelchair bound or have difficulty walking. If a client indicates they need special accommodations, leave extra time for their appointment to allow them to access your office, complete the intake forms and discussion, and get on and off the table.

Tax Credit

It may be possible to get up to a 50% tax credit for purchases that allow for compliance with the Americans with Disabilities Act (ADA). Visit https://www.ada.gov/taxcred.htm for more information. This can sometimes be applied to the purchase of a hydraulic massage table, so long as it meets the height requirements for accessibility. Visit www.ADA.gov for further information on the requirements for this tax credit.

While there are certainly a few extra precautions and safety requirements for working with these special populations, it can also be immensely satisfying to help those who certainly need and appreciate bodywork.