Shiatsu and Parkinson’s Disease: some experiences and thoughts by Catherine Scanlon PhD MRSS1

intended readership: this article may be of interest to people who have Parkinson’s Disease as they consider how they can support themselves; friends and relatives; practitioners (orthodox, integrative, complementary and alternative) who work with people who have this condition; and students of shiatsu and other therapies. Abstract A reflection on how shiatsu treatment may support people who have Parkinson’s Disease. A case study is reported. Links are made to relevant academic research literature. There would seem to be some promise for using shiatsu as part of an integrative raft of treatment in care of people who have Parkinson’s Disease and their management of this condition. Key points for service users • • •

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Shiatsu treatment may be helpful in your management of Parkinson’s Disease. The shiatsu practitioner may help you move in a way that your body most needs at that time. Be aware that shiatsu practice may mean different things if an orthodox e.g. physiotherapist says they do shiatsu (which is likely to mean they work on particular acupressure points), as opposed to a shiatsu practitioner, who is likely to have undergone a much fuller training, including fuller study of acupressure points and meridians (energy lines), as well as holding and mobilising techniques. People supporting those with Parkinson’s Disease, such as carers, may well benefit from shiatsu treatment as well.

Key points for practitioners • • •

Many shiatsu techniques may be helpful for someone with Parkinson’s Disease. Cranio-base hold and release may be a good technique to use, among others. It would be good to have a central place to share information and experience on treatment of people with Parkinson’s Disease with shiatsu treatment. This is something shiatsu practitioner Catherine Scanlon is keen to facilitate ([email protected]).

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(Catherine Scanlon has a degree in anthropology, and a doctorate in biology; experience in academic research in biology, education and sociology; and is a qualified, registered shiatsu practitioner.) (contact: [email protected]; www.shiatsuhealth.com)

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Shiatsu as part of semi-integrated treatment for someone with Parkinson’s Disease information collated by Catherine Scanlon PhD MRSS (Catherine Scanlon is an experienced academic researcher in biology and sociology. She qualified as a practitioner from the British School of Shiatsu-do in 1996, and joined the register of the Shiatsu Society (UK) in 1997. She runs a practice based in Milton Keynes, and is an Associate Lecturer in Health and Social Care at The Open University). What is Parkinson’s Disease? In this condition, the production of dopamine is reduced and the level of acetylcholine is increased. The basal ganglia in the brain then do not modify nerve pathways controlling contraction as they should. Muscles then become overly tense. This results in trembling, lack of control of movement, a slowness, and a typical stooping posture. It may be somewhat linked genetically. It tends to occur more in men than women, and to people in middle age on. Bibliography: The British Medical Association (1990) ‘Complete Family Health Encyclopaedia’ Dorling Kindersley, London. Parkinson’s Disease Society This organisation has information about Parkinson’s, provides training about this disease, and serves as a network for people with the condition. Information elsewhere on shiatsu and Parkinson’s A Google search using keywords ‘shiatsu and Parkinson’s’ resulted in two main results: a) a forum discussion between a shiatsu student and another about their client with Parkinson’s (Healthy pages discussion forum, 2011). They indicated that Stomach meridian could be indicated for treatment, and that a shiatsu teacher had recommended treatment by drawing energy down from the head. In TCM terms, they suggested that Liver Wind was a common reason. Points suggested included GB20, Liv 3, Sp6 and TH5. b) The other result picked up was from the Long (2009) study, where one client participant reported finding shiatsu helpful for managing and even reducing Parkinson symptoms and progression. ‘Having Parkinson's disease the shiatsu treatment helps slow down the progress of the disease, a positive attitude.’ There is no mention of the treatment of Parkinson’s disease within the systematic review of evidence for shiatsu and acupressure conducted by Professor Nicola Robinson and colleagues (Robinson et al, 2011). Healthy Pages discussion forum ‘Shiatsu for Parkinson’s’, http://www.healthypages.co.uk/forum/shiatsu/74421-shiatsu-parkinsons.html [accessed on 13th August 2011]. Long, A F (2009) ‘The potential of complementary and alternative medicine in promoting well-being and critical health literacy: a prospective, observational study of shiatsu.’ BMC Complementary and Alternative Medicine, 9 (19).

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Robinson, N, Lorenc, A, Liao, X, and Donaldson, J (2011) ‘Shiatsu and Acupressure: a review of the effectiveness of the evidence’ London South Bank University. Commissioned by the Shiatsu Society (UK). Treatment of someone with Parkinson’s disease using Japanese shiatsu treatment and/ or Traditional Chinese Medicine. Maciocia (1994, pp. 657-663) discusses treatment of Parkinson’s disease, following theory and using illustrative case studies. Maciocia says that Parkinson’s disease is always under the category of ‘convulsions’ and related to Liver-Wind. Maciocia indicates Qi and Blood Deficiency, Phlegm Heat agitating Wind, and Liver and Kidney-Yin Deficiency as needing treatment in the case studies he describes. These case studies indicate some positive results in managing and diminishing symptoms of Parkinson’s disease. Maciocia, G (1994) ‘The Practice of Chinese Medicine: the treatment of diseases with acupuncture and Chinese herbs’ Churchill Livingstone, London. A case study: The client A 66-year-old man, J, had Parkinson’s diagnosed two years ago. His work, from which he is now retired, involved carrying quite heavy equipment on his shoulder sometimes. He suffers from pain emanating from the middle of his back (c. diaphragm Yu point), and in the shoulders. He has feelings of nerves giving contradictory signals, which results in ongoing discomfort. His right side is most affected, with a tendency to tremble. His wife noticed my publicity, and wondered if shiatsu might be helpful to him. She checked by Googling and finding the information reported above. She organised the first treatment, and accompanied him to it. Session 1: The first appointment: 12th July 2011 A case history was taken, and shiatsu treatment given on a futon on the floor. Treatment included cranio-base hold and release. At the end of the treatment J’s wife said that she had noticed J’s trembling right forefinger stop moving at some point during the cranio-base work. J seemed to feel somewhat better, and keen to have more treatment. His wife suggested he might be better to have shiatsu than have a gym membership. (J has been following an exercise programme prescribed by the medical doctor, but which has left him feeling exhausted.) treatment: supine + shoulders/side A programme of treatment (6 treatments weekly). Session 2: 1st of 6: 19th July 2011 At the end, J said he could write better (as he wrote the cheque for the programme of treatments). We used the body cushion to enable a straight neck. treatment: prone on body cushion, and side/ shoulders. Water element – Bladder and Kidney.

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Session 3: 2nd of 6 – 26th July 2011 J takes medicine just before he comes at 4 pm We went through the Mymop form. This takes some time, so worth bearing in mind in terms of balance of treatment content. However, the Mymop form does give a useful baseline of issues. During this treatment, I noticed J’s finger stopped going at one point (in notes). However, J did not seem to think his finger does in fact go all the time. We discussed stopping drugs, and I undertook to find out more, and he undertook to discuss with his Parkinson’s Disease Specialist Nurse (PDSN). treatment: supine throughout. Cranio base focus on dural tube. ‘It’s good to be doing something positive for myself’ I email Parkinson’s soc regarding stopping drugs – them unkeen! They mentioned that a serious condition (neuroleptic malignant syndrome) could result by stopping taking medication. session 4 3rd of 6 Tuesday 2nd August. ‘My sleeping seems to be better following shiatsu’ and this had been indicated as a problem in an earlier session – waking up approximately every hour through night, possibly with the need to urinate. treatment: Dural tube and Water. session 5 4th of 6 Tuesday 9th August 2011 Sleeping improvement has not been maintained. We discussed the diaphragm (Yu point) level pain – his pain radiates out from there. People with Parkinson’s may get short of breath. treatment: Wood and Fire session 6 5th of 6 Tuesday 16th August 2011 We went through Mymop follow-up questionnaire – same as first time, no new symptoms. We discussed issue of pain and Parkinson’s. J said pain is not mentioned much. I checked this out with Google later on, and found an article (Ford, 2011) which concurred with this view, but said that over 50% of people with Parkinson’s do feel pain as a major symptom. session 7 6th of 6 Tuesday 23rd August His wife said after the last session, as they were standing in the garden, that he was standing straighter. J said shiatsu was always relaxing. It is also noteworthy that at the beginning they agreed that shiatsu would be better than the exercise, but J has maintained doing the exercise most of the period, especially the Monday morning exercises. We went through some chi kung exercises – sitting and standing, and Beginning Movement from 18 stance chi kung. He found Opening the Chest (stance 3) uncomfortable on arms, so I recommended just the initial still and breathing, followed by Beginning Movement six times each for a week, and then review. We also looked at Water Makkaho, which was difficult because J’s knees don’t lie flat, and the orientation of the pelvis makes sitting on ischial tuberosities difficult. We also touched on the Fire Makkaho stretch, because J found it easier to rock from side to side for the Water compensation of buttock walking.

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I gave a brief treatment, J chose to lie in supine, and I worked primarily on Metal (which came out kyo in the 5 element hara diagnosis) with some Water. Low back (knees to chest) Water/Kidney stretch was really quite flexible, though right side was more awkward than left (unsurprisingly, since this is the worse side). J has now decided to book on a monthly basis, on a time by time booking. Conclusion after (1 + 6) 7 treatments: The treatments have been somewhat helpful, but not a ‘miracle’ cure. They seem to always be relaxing. Additionally, it provides a space to discuss the treatment situation, and to consider supporting exercises. On the basis of this case study, shiatsu would seem to provide some useful support to this individual who has had Parkinson’s disease diagnosed two years ago.

Ford, B (2011) Pain in Parkinson’s Disease, Parkinson’s Disease Foundation Inc. http://www.pdf.org/en/winter04_05_Pain_in_Parkinsons_Disease [accessed online on 23rd August 2011].

Catherine Scanlon August 2011.

update September 2011 discussion in Shiatsu Society regional forum at Malvern Altair de Almeida (who has trained in holistic medicine since 1975, and in full-time practice since 1988) is a long-term practitioner of shiatsu, acupuncture and chi kung (more information at www.wellbeingvibes.com). He suggested that he had been told that ‘shaking’ chi kung might help with working through the characteristic Parkinson’s disease trembling. This is apparently drawn from Dr Shen Hong-Xun, who is quite well known amongst shiatsu practitioner and /acupuncturists. Altair explained this as fitting in with Maciocia’s Liver Wind diagnosis, and why Shaking would work. The Liver gets stagnant/ blocked through stress etc, and shaking would help to release pent up stress. He also felt that the Parkinson’s Disease Society would be likely to be sponsored by Big Pharma, and therefore with investment in retaining drug treatment. Altair says that he believes patients should be given homework to help themselves, having done that for 23 years. ‘Where our intention goes, our qi flows!’

Pat Homewood (shiatsu practitioner and educator) emphasised that it was important that carers would need shiatsu as well since it is very stressful for them. ‘Parkinsons is a relentless disease and acts as a black hole for the whole family because it is so long-winded I suppose. But my point about carers is a strong one. If

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carers can remain positive and active in inspiring the patient, then the quality of life for everyone is better. Shiatsu practitioners can make a real difference on this emotional and energetic level I feel, and the Parkinson's Society could perhaps bear this in mind when making recommendations. Probably a separate paper on shiatsu for carers generally needs to be written! ‘

Almeida, A de (2011) ‘re: shiatsu and parkinson's - altair, chi kung shaking point’ email 21st September 2011. Homewood, P (2011) ‘re: shiatsu and parkinson's - pat, carers support point’ email 21st September 2011.

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