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Ruth Werner 1

By: Ruth Werner

I have been a pathology writer and educator for massage therapists for 30 years. When I share my vocation with some healthcare providers (my general practitioner, my OB-GYN, my dentist), they often ask, “why would massage therapists need to know anything about pathology?”

I have a one-word answer: diabetes.

They ponder that for a moment, and then say, “…. Ohhhh. Yeah, that makes sense.”

Why does it make sense? Because diabetes negatively impacts almost every major body system: the skin, the cardiovascular system, the nervous system, the reproductive system, digestive function, immune system effectiveness - it even affects the teeth. Diabetes is common, often expensive, potentially life-threatening, and extremely complicated.

And while certain massage therapy techniques may have some benefits to offer some people with diabetes, it also carries substantial risks.

Estimates of how many Canadians are affected by diabetes or prediabetes (fasting blood sugar that is higher than optimal, but below the diagnostic criteria for a diagnosis of diabetes) vary, but some suggest that up to 30% of Canadians have diabetes now or will have in the near future. Diabetes is the leading cause for lower limb amputations in Canadian adults, and a major cause of vision loss—up to 60% of all patients with type 2 diabetes have some form of damage to their retinas.

The most common types of diabetes, type 1 and type 2, arise from problems in the production and/or use of insulin: a hormone from the pancreas that helps to regulate blood sugar among other functions. If a person doesn’t create enough insulin, or if their receptor sites become less sensitive to insulin, or both, then their cells that need sugar to thrive lose access to this important fuel source. Meanwhile, sugar accumulates in the bloodstream, causing inflammation and tissue damage.

Complications from diabetes include peripheral neuropathy, degradation of the skin, renal failure with a need for dialysis and/or transplant, high blood pressure, cardiovascular disease, stroke, edema, suppressed digestive motility, complicated pregnancy with a high risk of birth defects, and much more. Each of these has implications for clinical decisions in massage therapy.

Given how common diabetes is, the chance of your working with someone who lives with this condition are excellent. And people with diabetes may seek out massage in non-clinical settings: they go on holiday, they visit spas, or they might want a massage as a special vacation treat. Consequently, massage therapists have an obligation to be well informed about this condition with the associated risks and benefits that various types of manual therapy may offer.

Research shows that massage therapy may have substantial benefits to offer patients who live with diabetes, if it is done with knowledge, skill, and care. We have seen consistent drops in blood sugar. Some changes in the intestinal microbiome with abdominal massage could influence insulin use. Foot massage might improve sensation and balance for people with peripheral neuropathy. And of course the stress and anxiety of living with a chronic condition can be eased with caring touch.

Are you fully prepared to work with patients who have diabetes? Would you like to refresh your knowledge and get the latest information on this serious condition? Join us for A Massage Therapist’s Guide to Diabetes Mellitus, a 90-minute webinar on June 20 from 12p.m. – 1:30p.m.. Click here for more information.

Selected resources:

1. Bullen, A. et al. (2018) ‘Effect of Acupuncture or Massage on Health-Related Quality of Life of Hemodialysis Patients’, Journal of Alternative and Complementary Medicine, 24(11), pp. 1069–1075. Available at: https://doi.org/10.1089/acm.2018.0030.
2. Canada, P.H.A. of (2022) Framework for diabetes in Canada. Available at: https://www.canada.ca/en/public-health/services/publications/diseases-conditions/framework-diabetes-canada.html .
3. Chatchawan, U. et al. (2015) ‘Effects of Thai Foot Massage on Balance Performance in Diabetic Patients with Peripheral Neuropathy: A Randomized Parallel-Controlled Trial’, Medical Science Monitor Basic Research, 21, pp. 68–75. Available at: https://doi.org/10.12659/MSMBR.894163.
4. Diabetes rates continue to climb in Canada (no date) DiabetesCanadaWebsite. Available at: https://www.diabetes.ca/media-room/press-releases/diabetes-rates-continue-to-climb-in-canada .
5. da Silva, N.C.M. et al. (2015) ‘Foot reflexology in feet impairment of people with type 2 diabetes mellitus: randomized trial’, Revista Latino-Americana de Enfermagem, 23(4), pp. 603–610. Available at: https://doi.org/10.1590/0104-1169.0036.2594.
6. Wang, G. et al. (2021) ‘Community intervention study of viscera massage in overweight/obese type 2 diabetes high-risk population’, Medicine, 100(48), p. e27932. Available at: https://doi.org/10.1097/MD.0000000000027932.
7. Xie, Y. et al. (2022) ‘Clinical Effect of Abdominal Massage Therapy on Blood Glucose and Intestinal Microbiota in Patients with Type 2 Diabetes’, Oxidative Medicine and Cellular Longevity, 2022, p. 2286598. Available at: https://doi.org/10.1155/2022/2286598.

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Ruth Werner is an award-winning educator, writer, and former massage therapist who loves to share her passion about the role of bodywork for people who live with health challenges. Her textbook, A Massage Therapist’s Guide to Pathology is now in its 7^th edition and used all over the world.

Tags: diabetes, benefits of massage therapy, education