Harm by “Massage” in Cases of Amyotrophic Lateral Sclerosis (ALS): Part 2

To read Part I ,click link below:

https://www.medicalmassage-edu.com/blog/harm-by-massage-in-cases-of-amyotrophic-lateral-sclerosis-als-part-1.htm

From the Author

Nearly 30 years ago, when I was working as a staff trainer at a physical therapy company, the owner introduced me to one of the referring physicians, who shared a remarkable case with me. His mother, then a 55-year-old woman, had reportedly developed psychiatric symptoms. She was experiencing widespread pain, fatigue, insomnia, and presented with severe clinical depression. Her pain threshold was extremely low; even light touch triggered sharp pain.

She had received conflicting psychiatric diagnoses—one psychiatrist diagnosed her with major depressive disorder, while another diagnosed her with psychotic depression. Radiological examinations as well as lab tests, revealed no abnormalities that could explain her widespread pain. She refused to take antidepressants or antipsychotic medications, insisting instead that she was suffering from ongoing physical pain.

I agreed to see her and explained that radiological tests cannot detect tension buildup in fascia and muscles. I told him if her condition was indeed fibromyositis/physical pain, my hands might detect these abnormalities, and I could potentially help her. The doctor seemed confused and asked, "What does fibromyositis have to do with psychiatric disorders?" I replied, "Everything. The development of fibromyositis can cause developments of mental disorders."

Please click this link to read more about the connection between fibromyositis and mental disorders, as well as the medical massage protocols used in such cases.

https://www.medicalmassage-edu.com/articles/files/articles/Fibromyalgia.pdf

I was surprised to learn that, in the United States, many fibromyalgia patients were being referred for psychiatric care and heavily medicated unnecessarily.

When I first met this woman, she had the classic presentation of a fibromyalgia patient. Somehow, she trusted me. During the initial session, I gently assessed her soft tissues. As her pain threshold increased slightly, I was able to perform a fairly normal introductory massage. That night, she was able to sleep. Over time, the treatment helped her regain her life. She returned to work as a senior administrator at Kaiser Permanente and went on to create the first fibromyalgia support group in Southern California. I was regularly invited to panel discussions alongside rheumatologists, psychiatrists, and clinical psychologists.

About 25 years ago, I was invited to present two-hour elective CE classes for physicians every Wednesday morning at a medical center where I was already on staff as an allied health professional. My class on fibromyalgia became very popular, drawing high enrollment. Many MDs were eager to understand the pathological developments associated with fibromyositis.

I always concluded my presentations with this statement: "As you can see, the chain of pathological developments, including clinical depression, starts at the muscular level and must be treated at the muscular level." I emphasized that after 5 to 6 initial treatments, once the pain threshold had increased, it was crucial to incorporate intensive techniques to release the neurotransmitter acetylcholine and spend 50% of the session on gradually increasing intensity kneading/petrissage techniques to stimulate mitochondrial activity in the muscles.

One day, the CE coordinator told me, "Boris, the director of the rheumatology residency program has attended your class for the second time and even asked questions." I noticed that most attendees were young physicians, but this senior doctor stood out.

After the class, he invited me for coffee and immediately referenced my concluding statement about the muscular origins of pathology. He said, "Although ALS not developing starting on level of muscles, that approach could also help patients developing Amyotrophic Lateral Sclerosis (ALS). Would you consider working with a few ALS patients?" I told him honestly that I had never been trained to treat ALS and doubted that massage could help. He presented several arguments, but I explained that working without a clear understanding would not only be unprofessional but potentially harmful to the patient. I also described my approach, emphasizing the importance of energy balance as I presented in part 1 of this article.

He asked how I could prove that my treatment stimulates mitochondrial activity. I replied, "Simple. Conduct a biopsy before and after my treatment sessions." He was intrigued . He shared that he was conducting research involving amino acid injections into muscles to help patients regain motor control. I asked if ALS was always genetic. He responded that only about 5% of cases are genetic. I then asked how ALS affects the neuromuscular junctions. He explained that these junctions are heavily impacted.

This piqued my interest because, in massage therapy, we often use ischemic compression to treat motor trigger points and restore energy balance. I explained how muscle/nerve junction dysfunction can lead to an energy imbalance within muscles and that specific techniques, including ischemic compression and post-isometric relaxation, could help address this.

Although I knew that treating ALS would be challenging, I felt that I was on the verge of a new discovery. I requested to work with newly diagnosed, non-genetic ALS patients. My first patient was a 45-year-old woman with significant walking difficulties, diagnosed five months earlier. She showed visible muscle atrophy.

Using intensive kneading, acetylcholine-releasing techniques, ischemic compression at neuromuscular junctions, and post-isometric relaxation, I observed improvements. After seven sessions, she could walk 15 steps. Her muscle mass began to return. After 18 treatments, she could walk for 25 minutes. During this time, the doctor was also administering amino acid injections. As the experimental treatment produced excellent results, the doctor suddenly told me, “Unfortunately, funding for the research has ended.” Honestly, I didn’t believe him. I asked to continue providing treatments for the patient, but he refused, saying, “I will continue with amino acid injections.”

It was a very unpleasant moment. I ended up telling him more than I originally intended to—I couldn’t hold back my thoughts.

Before agreeing to treat a patient with ALS, I asked him to educate me on various aspects of the disease. I had many questions, as I wanted to understand how medical massage could potentially be effective in such cases. For his own reasons, he needed my help at the time and provided all the specific information I requested.At the end of this article, I will summarize what I learned from him.

In my heart, I know that the medical massage protocol I used can be effective. It's a long, demanding process, but I believe in its potential.

The techniques I used are demonstrated in this video class. Click on program number 7: https://www.medicalmassage-edu.com/instructional-massage-programs/

Note: The course description of program number 7, for some reason mistakenly excludes description of pre-event sports massage, which includes techniques for releasing acetylcholine and more. I do teach it during this video lesson,

Summary.

Speaking generally, science of medical and sport massage —including but not limited to massage research—is entirely focused on the clinical application of massage for specific disorders and therapeutic goals. For example, the entire pre-event sports massage protocol was developed with a clear, targeted purpose: to be performed approximately one hour before athletic competition, with the goal of stimulating the body to perform at its maximum potential.

Researchers understood that if massage could help release acetylcholine, stimulate mitochondrial activity in muscles, and fully activate capillary reservoirs—particularly by dynamically regulating blood flow through capillaries—then athletes could indeed perform at their physical peak. As a result of this research, scientists developed a step-by-step, hands-on pre-event sports massage protocol, which has been repeatedly and reliably validated in clinical settings.

During my training, I was educated not only on the theoretical framework I’ve described above, but most importantly, I was taught how to properly perform this hands-on protocol in a precise, step-by-step manner.

Later, I discussed this knowledge with a doctor. I told him, “Yes, I can facilitate the release of acetylcholine, I can stimulate mitochondrial activity in muscles—but in this case, we’re dealing with patients who have a degenerative brain disease. Would it even be possible for their bodies to respond to such stimuli?”

His answer was unequivocal: “Absolutely. Even in the presence of degenerative or sclerotic changes in the brain, if your techniques can still trigger the physiological responses you described, it will work. ALS patients may respond positively, and some may even regain the ability to walk.”

I wasn’t entirely sure I understood him at the time from a neurological standpoint—but he made the statement clearly, and I went on to achieve results that supported his claim.

I’d like to take a moment to highlight Instructional Video Program #7, which runs for three hours nonstop. This program provides detailed demonstrations and explanations of:

• Pre-event sports massage
• Post-event sports massage
• Medical full-body stretching techniques

These hands-on techniques are shown in detail and applied to virtually every region of the body.

The full-body post-event sports massage is highly effective not only for athletic recovery but also in medical stress management massage. Furthermore, many pre-event sports massage techniques can be effectively applied in clinical cases such as bronchial asthma, digestive disorders, and other conditions linked to parasympathetic nervous system insufficiency.

When acetylcholine release is blocked, it causes dysfunction in the parasympathetic division of the autonomic nervous system—leading to significant impairments in digestion, respiration, and overall balance in the body. The medical full-body stretching techniques taught in Program #7 are designed to help normalize muscle tone, bringing it to a much-needed and clinically meaningful resting state.

If you have any questions, don’t hesitate to ask.

Best wishes, Boris