A couple of weeks ago, I was having coffee with another massage therapist and she made the comment, “You don’t have the tough tissue I feel in other diabetics.” I’ve heard this before, but never thought to blog about the issue. However, it is a good point regarding what massage therapists and other body work professionals feel when they touch the skin of someone with diabetes.
As a massage therapist, I can explain this comment: the muscle tissue of someone living with diabetes feels tough, fibrous and inelastic. There are many reasons why this can happen. Among the reasons: lack of hydration, high blood sugars for a prolonged period of time, and personal habits, for example lack of exercise and eating well. People living with diabetes have a tendency toward fibrous tissue and density caused by injection sites.
Does dense, fibrous tissue impede our health and longevity? What we know is that CAD studies are abundant for Type 1 diabetes. If hardening of the cardiovascular system is without question problematic for people with diabetes and knowing our propensity for coronary arterial hardening, wouldn’t the rest of the living tissue in the body be subject to the same "tough" problem?
My philosophy has been to work at keeping my body supple, flexible and fit. My staple for keeping my body supple, flexible and recovering from working out has been massage more than anything else.
My 20 years experience as a massage therapist, and someone who is type 1, I agree with my colleagues, there is a specific feel to the skin and tissue beneath in the diabetic body. I can also feel the difference between type 1 and type 2. Type 1 usually suffers thickening of the skin and underlying muscle hardness from injection sites, while a type 2 patient’s muscles feel congested and tightly wrapped in the skin, often the skin has a thickened feel over the whole body.
When my regulars who have diabetes are exercising and working at their control, there is a vast improvement in the thickness of the skin and their muscles feel more pliable and fluid, not fibrous or "woody". The mobility of the entire body, both muscle and joint, moves more freely.
Four years ago when my blood glucose numbers jumped into crazy, it was an almost immediate change in my muscle and skin texture My lean running muscles seemed to choke on runs, my calves often felt tight, as though they would pop out of the skin during a run or following exercise, massages were painful and I couldn’t relax. My massage therapist kept saying “You have that diabetic feel.” Ugh, I find that so insulting!
Ten days after my gallbladder was removed and my numbers came tumbling down, my post op recovery included yoga, massage and acupuncture weekly. The difference was amazing! My first massage after surgery was still tough tissue, but with each session my body responded with softer more flexible tissue. I believe the result was for many reasons: my blood glucose was in the normal range, my body was well hydrated and my stress level was down. I have maintained most of that recipe and my muscles, with the exception of my shoulder, remain fluid and flexible.
Regular massage is must for my health. But regular can be once a month or once every other month depending on my overall health, exercise and stress level. For me personally, I like many forms of massage, to give you a few options to think about:
Swedish/therapeutic- I often refer to this as the skin lube! But it has a very important place for those who suffer neuropathy and circulatory problems. It’s a lighter pressure, but helps stimulate circulation of blood and lymph, calms the nervous system and leaves you feeling relaxed.
Deep Tissue- this is a generic name, but deep tissue massage works on scar tissue, fibrous muscles and helps alleviate chronic muscle tension. Something many people living with diabetes experience! Some of the organized names are: Neuromuscular therapy, Phrimmer Deep Muscle therapy, Myofacial Release Technique, sports Massage.
Rolfing ® - is a specialized method of hands-on physical manipulation that straightens posture, improves range of motion, releases tense and tightened muscles. It increases general vitality by progressively stretching and lengthening the soft tissues of the body, the myofascia, that surrounds the muscles throughout the body.
I like what Rolfing can do for chronic conditions of the muscles and for the alignment of the body. Someone who has had diabetes for years and feels they have lost their flexibility should give Rolfing a try. Rolfing can be uncomfortable, especially when the body has been injured or misaligned for a long period of time. Skin lube it is NOT!!
The popularity of Thai Yoga Massage is taking off! Thai Yoga Massage is done on a futon and the therapist moves the body into a posture and applies pressure to help increase flexibility. It is not hands kneading tissue or using lotion, it is akin to assisted stretching. Still can be very beneficial to the diabetic body. A good option of skin to skin massage is not your thing!
How to pay for massage? Most often massage is not covered by insurance, but check with your doctor. The physical therapy clinic in my local hospital has a massage therapist working 2 days a week to help patients with neuropathy and it IS covered by insurance with a doctor’s prescription. You pay a higher out of pocket, but I think they cover 50%. If you have a company flex spending account most of the time, they will cover massage. If massage is something you find beneficial and none of the above options are available, start a budget. Because I’m self-employed massage is part of my out of pocket health care and it’s a deduction.
To look for a therapist of your choice:
Wellness Center Owner, living with type 1 diabetes