Table Of ContentA Massage Therapist’s
Guide to Pathology
FIFTH EDITION
Ruth Werner,
LMP, NCTMB
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Library of Congress Cataloging-in-Publication Data
Werner, Ruth (Ruth A.)
A massage therapist’s guide to pathology / Ruth Werner.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-60831-910-7
I. Title.
[DNLM: 1. Massage. 2. Diagnosis, Diff erential. WB 537]
615.8¢22—dc23
2011040201
Care has been taken to confi rm the accuracy of the information presented and to describe generally
accepted practices. However, the author, editors, and publisher are not responsible for errors or
omissions or for any consequences from application of the information in this book and make no
warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents
of the publication. Application of this information in a particular situation remains the professional
responsibility of the practitioner; the clinical treatments described and recommended may not be
considered absolute and universal recommendations.
The author, editors, and publisher have exerted every eff ort to ensure that drug selection and dosage
set forth in this text are in accordance with the current recommendations and practice at the time of
publication. However, in view of ongoing research, changes in government regulations, and the constant
fl ow of information relating to drug therapy and drug reactions, the reader is urged to check the package
insert for each drug for any change in indications and dosage and for added warnings and precautions.
This is particularly important when the recommended agent is a new or infrequently employed drug.
Some drugs and medical devices presented in this publication have Food and Drug Administration
(FDA) clearance for limited use in restricted research settings. It is the responsibility of the health care
provider to ascertain the FDA status of each drug or device planned for use in his or her clinical practice.
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This book is and will forever be dedicated to
the memory of my grandmother, Dora Charak Beckhard,
who probably never got a massage in her life—
but she sure could have used one.
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Foreword
T
he massage therapy profession is not the same as what it was, even just a few short
years ago. Regardless of the work environment where a massage therapist practices,
he or she is likely to encounter a wide diversity in clientele who may present with all
kinds of different health complications. Consequently, the educational preparation a mas-
sage therapist needs is constantly evolving as well.
In the years since this book first appeared on the market, the explosion of accessible
information about medical pathologies has been enormous. While there is no question
that this increased access to valuable clinical information is a great benefit, there is also a
serious challenge for the consumer or student to evaluate high-quality information. The
hallmark of a great textbook is one that can both deliver a great quantity of content and
help the reader become a discerning evaluator of quality information at the same time.
That is no easy task, and with each edition, Ruth Werner has demonstrated an excellent
ability to accomplish this challenge.
An example of this improvement in accessibility comes in the new “At a Glance” sec-
tions where practitioners can rapidly and easily find concentrated information about special
topics of interest. In many cases, the topics presented in these sections are the key ques-
tions a practitioner needs immediate information about with a presenting client challenge.
With so many different and exceptional books available on the market today, it can be
difficult for the practitioner to determine what should reside in his or her clinical library.
Because most clinical books have new editions every few years, there is always the ques-
tion about what is brought forth in a new edition. However, pathology is one subject
where keeping current with the most recent research is a crucial aspect of relevance for
the text. Werner’s work leading the Massage Therapy Foundation gives her a particular
advantage in recognizing the crucial importance of staying current with research findings
and implementing them into her writings.
A great example in this text is a new section devoted specifically to conditions affecting
fascia. Worldwide interest in the role of fascia in musculoskeletal disorders has blossomed
in recent years, particularly as a result of the Fascia Research Congress held every two
years. Inclusion of this information in the new edition highlights the necessity of massage
practitioners knowing much more about the crucial role played by fascia in many pain
complaints.
One of the key challenges of teaching clinical practitioners in every field is helping
them move past information they learn in basic training as pure content. In professional
practice, the individual is often faced with gray areas that are not answered by simple con-
tent knowledge alone. Clinical reasoning and critical thinking skills are crucial to prepare
practitioners for the realities they face in clinical practice.
In this edition, discussions of massage are framed as risks and benefits. This is a key
issue of importance, as we must teach practitioners that decisions are not simply black-and-
white, but evidence must be weighed to make appropriate decisions. Spelling out the use
of massage in this fashion with risks and benefits discussed is a great way to encourage the
development of these key reasoning skills that are so critical.
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vi Foreword
When asked to write this foreword, there is another reason that I agreed without hesi-
tation. In the past two decades, I have spent a great deal of effort studying education and
how to teach well. There are a handful of educators in our field who clearly stand out
above others. From the first time I saw Ruth Werner present, I recognized her as having
that great gift that makes an outstanding educator.
Through each edition of her book, I see her infuse that same energy and skill of mak-
ing it easy, enjoyable, and stimulating to learn about pathology. The ability to take a chal-
lenging subject like pathology and make it fascinating for massage therapy students is a
clear sign of how skilled and valuable her contributions to our profession have been. This is
one book where I’ll always want the most recent edition so I can keep inspired and learn as
much as possible from what she so generously shares with us all.
Whitney Lowe
Sisters, OR
2011
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About the Author
R
uth Werner is a retired massage therapist and lifelong
educator with a passionate interest in the role of mas-
sage and bodywork for people who struggle with illness.
She began teaching while she was still a student of massage
and discovered she has a gift for taking complex topics and
breaking them down to easily assimilated pieces so that
learners can rebuild those ideas in their own framework.
Her love of teaching has been a center-point of her career,
and in 2005, Ruth was honored with the Jerome Perlinski
Council of Schools Teacher of the Year award.
Ruth wrote what became the framework for A Massage
Therapist’s Guide to Pathology as a resource for a massage
school in 1993. The first edition of this text was published
in 1998. Her second book, Disease Handbook for Massage Therapists, was published in 2010.
In addition to keeping A Massage Therapist’s Guide to Pathology up to date, Ruth is a
columnist for Massage and Bodywork magazine and is a frequent guest writer in other trade
journals.
Her success as a writer has allowed her to devote time and energy to many volunteer
efforts. Ruth has served on committees for the American Massage Therapy Association,
the National Committee for Therapeutic Massage and Bodywork, the Federation of State
Massage Therapy Boards, and the Department of Professional Licensing for the state of
Utah. Her most consuming volunteer passion has been to serve first as a Trustee and then
as President for the Massage Therapy Foundation: a 501 (c) 3 public charity dedicated to
advancing the knowledge and practice of massage therapy by supporting scientific research,
education, and community service.
In 2010, Ruth and her family fulfilled a lifelong dream of moving to the Oregon Coast.
Now she can see and hear and smell the ocean as she writes.
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