A sick little boy in a hospital bed

The gift that massage therapists share with the world is an ability to help their fellow human beings feel soothed and restored. This is the case across the spectrum of massage work—and this is especially true of therapists who help medically frail children.

Massage Therapy for Children in Need

The Maryville Children’s Healthcare Center, located in Chicago, Illinois, is a facility that provides care for medically fragile and technology-dependent children. Maryville received a 2016 Community Service Grant from the Massage Therapy Foundation to help fund a massage program for the children in their charge. MASSAGE Magazine caught up with the folks at Maryville to ask about their work and learn more about how their massage program helps their young and vulnerable clients.

The Maryville Children’s Healthcare Center services an average of 30 to 35 children annually, with a population of 12 patients in their care at any given time.

According to Daniela Krivak, grants manager at Maryville, the medical conditions that afflict the children include brain injury, cerebral palsy, encephalopathy, gastroschisis, paraplegia, quadriplegia, respiratory failure, seizures, short gut syndrome, spinal cord injury, spinal muscular atrophy, tracheostomy, ventilator dependent, neurogenic bladder, neurogenic bowel, infantile spasms, developmental delay, chronic lung disease, bronchopulmonary dysplasia and gunshot wounds.

Child in intensive care unit after heart surgery. Shallow depth of field.Types of Care

The Children’s Healthcare Center provides both palliative and hospice care, depending on the specific needs of the patient.

“Palliative care improves the quality of life of the patient regardless of whether they have a terminal illness or whether they may live to be adults,” Kirvak explained. “It’s all about comfort, nurturing, reducing pain and improving all aspects of the life of the patient.

“Hospice care focuses on those same aspects of care, but with the understanding that the patient has a terminal illness,” she added. “The goal is to improve the quality of life for as long as the patient lives.”

Helping medically frail children brings with it a host of special challenges. For example, the children’s parents often need to be trained on how to utilize the life-saving equipment their children use. Sometimes they need to modify their home to install a hospital bed or a ramp for a wheelchair.

In some cases, children have been either abandoned by their families, or their families are unable to take care of them. In these cases, the caregivers are the ones who must now create a sense of comfort and security for their young charges.

“Whatever reason God has chosen to keep them here on Earth with us, we know we are privileged to provide for their needs and comfort, as they are life’s greatest teachers,” said charge nurse Mary Czerwinski.

“I feel they are angels with one foot on this side, and one foot on the other side of Heaven, even if they don’t know it, and even if they don’t want it, and even if they don’t always act like angels,” she added.

“We sometimes hold in our tears so they can’t see, because we need to let them know that despite all the answers we don’t have as to the why? of their situations, it is our mission to bring them hope, and love, and reassurance, and peace,” Czerwinski said.

medical massage therapy for childrenMedical Massage

Massage therapy for children plays an enormous role in the Children’s Healthcare Center’s noble mission.

“The massage therapy is just so critical,” Krivak said. “It helps improve the sleep of the children, reduces their pain and increases their comfort.”

Maryville’s massage program began in 2014 with funding from the Oberweiler Foundation. The Richard A. Perritt Charitable Foundation stepped in to help out shortly after that. The Massage Therapy Foundation supplied a generous grant in September 2016, which will allow the good work of the program to continue.

“We’re very excited that we’re going to be able to continue this service for at least another year,” Krivak said.

The latest grant from the Massage Therapy Foundation has a beneficial effect on the young patients, said Czerwinsk.

“The magic of intentional therapeutic massage creates the pathway of human touch, which relaxes the mind and soul, as well as the body,” said Czerwinsk. “All of our children have restrictions of movement, and shortened muscles from lack of mobility and weight bearing, and from paralysis. What better gift can there be for them than the soothing release of massage?”

Extra Care is Crucial

The massage therapists who have been a part of the Children’s Healthcare Center’s massage program have to approach their work with extra care. Massaging medically frail children is vastly different from working with athletes, or even with healthy adults. It requires understanding not only that the patients are much more delicate, but that they have a history of associating touch with intense discomfort.

“Some of [the children] have very brittle bones, so the massage therapist has to be very gentle,” said Krivak. “Some are very sensitive to touch. They have been hooked on machines, so anytime anyone touches them it’s been to take their blood or some other medical procedure. They don’t always associate touch with comfort—or with nurturing or soothing.”

Rashes, atrophy, and a lack of movement provide additional hurdles. According to Krivak, “some of [the children] have sensitive skin. Sometimes the massage therapists use lotions without any perfumes or any chemicals. It has to be a very gentle touch, because of the conditions of these children.

“Plus [the children] are attached in many cases to tubes and wires. Many of them can’t move or get out of bed,” she added. “So, the types of massage that are provided are different from what would be provided to normal children who are able to move much easier—and who have more flexibility or more range of motion.”

Child touching stethoscope of a doctor in hospital wardLife Changing Successes

For all the challenges that come with massaging medically frail children, the consensus among the massage therapists who work at Maryville is that their efforts are repaid tenfold. One massage therapist who is currently part of the massage program, Loredana Tomasello, documented in a recent case study a breakthrough with a 5-year-old client who has cerebral palsy, spastic quadriplegia, a history of hesitation, aversion to touch, and sporadic episodes of refusing to sleep or nap.

She said the child showed signs of withdrawal and aversion to touch by pulling away and groaning, and spastic motions would increase.

“Over the span of one month, the client began to let the therapist use comfort touch and light massage to hand,” Tomasello said. “After two months, the client slowly allowed the massage therapist to use light effleurage with lotion to hands, arms, and shoulders. By the end of the second month of treatment, the client smiled when approached by massage therapist.

During most treatments, the child’s breathing would slow and eyes would close, and often the client would fall asleep.

“Familiarity and positive comfort touch allowed the client to gain and regain trust in the massage therapist and with time the client was able to relax during the massage therapy sessions,” said Tomasello. “The nursing staff informed the therapist that the client was more willing to nap and had better sleep over time.”

The clients at Maryville vary widely in regards to age and ailment. Massage therapists at the Children’s Healthcare Center have also helped victims of gun violence, which has sharply increased in the Chicago area.

Always Happy to See the Massage Therapist

Massage therapist Karen Selph, in a recent case study, relates the impact of massage therapy on a 16-year-old young man who, as a result of multiple gunshot wounds, had limited use of his limbs.

“When I first met him … he complained of pain, stiffness, and decreasing ability to use his left arm,” said Selph. “He said that he had pain in his left shoulder and pain in his left side under his arm. Over the course of several weeks, he received massage two or three times a week to his left shoulder and side, specifically including his left subscapularis, latissimus dorsi, intercostalis, upper and middle trapezius, and some assisted stretching.”

The client told Selph that he felt better after the first massage, and he continued to improve consistently over the course of several weeks, she said. He gained increased range of motion with little or no pain in his shoulder, and increased ability to use his left arm to assist himself in his daily activities.

“He was always happy to see the massage therapist, and asked for [the therapist] until he was discharged,” Selph added.

Hard-won victories like these give the massage therapists who participate in Maryville’s massage program reason to celebrate. With a continued interest in providing massage to medically frail children, and the funding to see it through, successes such as these could be solidified.

About the Author

Phillip Weber is a San Diego-based writer and co-founder of The English Adept, a language-learning website where he blogs frequently. He writes news and features for MASSAGE Magazine, including “Massage Therapists Adopt the Food Truck Trend,” “Indy 500 Driver Gets Up to Speed with Massage” and “Massage Brings Peace to Torture Survivors’ Bodies & Minds.”

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