Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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Should You Change an Athlete's Natural Running Form?
Once past the ankle, impact forces travel at about 200 mph into the knee. In addition to allowing the quad to absorb force, bending the knee (E) prevents the hip and pelvis from moving up and down too much (F), which is important for injury prevention and efficiency.
Integrative Medicine for the Underserved: A Seat at the Table
Numerous organizations have risen to the challenge of providing care to medically-underserved populations and here we feature one such group.
Q&A With the First VA Chiropractic Residents
As you may have read previously, a major step forward for the profession occurred in July 2014 when the Department of Veterans Affairs began piloting a chiropractic residency program at five locations.
Treatment of PTSD: An Opportunity for the Practice of Integrated Medicine
PTSD is widespread across America today. Not only do many of our honored men and women in uniform bring it home with them from the war zones they have been active in, but it often follows any life-threatening event people go through when their lives have been in danger.
Desert: A Metaphor from the Study of Genetics
In most of the human lives I know about, there are stretches of time which feel stagnant, or worse. We can feel adrift, or wounded and sidelined, and these times don't seem to carry much usefulness while they are unfolding.
The Source-Luo Point Combination, Part 2
The Da Cheng includes symptoms for the source-luo points that indicate when to use them for treatment. Yang defines the method as the guest-host (it is one of a variety of acupuncture point combinations called guest-host).
Creating Relationships at Southwest Symposium
The month of May brought many interesting activities. As I have said in many previous columns this year, this profession is moving in a very exciting direction. Make sure you are getting involved. If you're not, you just might get left behind.
The Risks I Took
We all take risks when we choose this profession. For some, it is not knowing if you can make a living practicing TCM. For others, it is parental or cultural disapproval.
News in Brief
Investigating the Cellular Impact of Mechanical Force; National Board Seats (Not-So) New Officers at Annual Meeting.
Free Yourself From the Pocketbook Practice
Let's take a journey together; there's an important lesson to be learned. Imagine a town or city just like yours.
Marketing with a Microphone
When given an option, it stands to reason that people prefer to do business with those they know, like, and trust.
Nomenclature and Classification of Lumbar Disc Pathology: Version 2.0
The Nomenclature and Classification of Lumbar Disc Pathology consensus, published in 2001 by the collaborative efforts of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology, has guided radiologists, clinicians and the public for more than a decade.
An International Life: An Interview with Mary Elizabeth Wakefield
I met Mary Elizabeth Wakefield during her class last summer in Seneca Falls, New York at the Finger Lakes School of Chinese Medicine.
Meet Cheyenne: Your Future Colleague
Allow me to introduce you to Cheyenne (Chey), the daughter of some of our family's closest friends. We attend and serve at the same church together, and have known each other for many years.
Going On-Site With Chiropractic Care
The Foundation for Chiropractic Progress has released a position paper highlighting the financial, clinical and patient-satisfaction benefits of providing chiropractic care at on-site corporate health clinics.
The Three Heater Official
This Official, belonging to the element Fire, is responsible for maintaining and regulating the heating system of the body, mind, and spirit. It is named for its function. The trunk is divided into three "burning spaces" or "jiaos."
Chinese Doctors Poke Holes in Australian Study
A recent Australian clinical trial, published in the Journal of the American Medical Association (JAMA) in 2014 by Rana Hinman, et el., evaluating the effectiveness of both needle and laser acupuncture for chronic knee pain.
I was sitting in a Pizza Hut in Peoria, Ill., with my friend Reggie, sometime in the spring of my senior year in college, when he started doodling on his paper placemat. In those days, the company had a picture of U.S. on the mats, showing all the locations of the "Huts" in the country.
Key Changes and Updates to the 7th Edition CNT Manual
Acupuncture Today recently interviewed Jennifer Brett, ND, L.Ac. regarding the updates to the CNT manaul.
Leg-Length Inequality and Pelvic Fixation: A New Approach to the Negative Derifield (Part 3)
A patient with sacroiliac fixation and dysfunction ordinarily demonstrates a noticeable leg-length inequality when placed in the prone position on the adjusting table.
NCCAOM Video Contest
The NCCAOM is excited to announce the launch of the second annual video contest "Because it Works!" 2015.
Sports Medicine 101: Surgery or No Surgery?
In the world of sports medicine, many careers are saved by surgeries that correct traumatic damage to the body. Muscle tears, ligament damage, fractures, spinal disc herniations, and joint instabilities are a few of the issues frequently addressed with surgical intervention.
May, 2001, Vol. 01, Issue 05
What about Varicose Veins?
By Kate Jordan, NCTMB
As I travel throughout the United States teaching pregnancy massage programs, I hear a myriad of conflicting opinions about the appropriate way to address varicose veins in our clients.Some therapists have been taught to avoid the legs entirely in the presence of varicose veins; others to work "above" them, "below" them, or "once over lightly." Can we safely massage clients with varicose veins, and is there any benefit to them in doing so?
Varicose veins are quite common in the general population; in fact, they are estimated to affect as many as 50% of middle-aged adults living in the United States. You are far more likely to develop varicose veins if you are a woman, if you've been pregnant, and if your occupation requires constant standing (like massage therapy!) Other factors that can predispose an individual to varicose veins are heredity and structural weakness of vein walls, obesity, and a sedentary lifestyle. Still another contributor is our low-fiber diet -- varicose veins are rarely seen in parts of the world where high-fiber unrefined foods are eaten.
Besides the legs, varicose veins can be found in the perineum, rectum (hemorrhoids), vulva and esophagus. I'll be discussing the suitability of massage to the legs when varicose veins are present.
Varicose veins can develop in superficial or deep veins. Superficial varicose veins can be seen through the skin -- they are dilated, lengthened and tortuous or "ropy."
Why do such veins develop? We know that in normal vascular mechanics the muscles of the calves (especially the soleus) act as powerful auxiliary hearts to pump returning blood through the deep leg veins, This pressure is not transmitted to the superficial veins, because of valves in the communicating veins. If these deep vein walls become dilated (from mechanical stress, inherent weakness or hormonal influence), the valves stop functioning effectively. When these valves become incompetent, the pressure pushes the blood into superficial veins, causing them to dilate and lengthen. This condition progresses, further lengthening and dilating the superficial veins. Continued constriction of upward blood flow caused by constant standing or sitting, or tight garments, causes blood to pool in the legs, further aggravating the varicose veins and contributing to poor health in the surrounding tissues. The veins gradually lose their elasticity and the condition worsens.
Some clients with varicose veins may consider them to be only a cosmetic issue. For others, there can be considerable pain, aching and fatigue in the legs, particularly when walking. Their calf muscles may cramp especially at night. The soleus/gastrocnemius complex may lose muscle strength, further decreasing pumping action and muscular support for the veins.
In severe cases, areas of a client's legs may become pigmented, hardened, or ulcerated. It is common to develop congestion and edema in the ankles as a result of the dilated veins and the abnormally high pressure in the capillaries, leading to increased exudation of lymph.
Blood clots are more likely to develop in varicose veins, and veins may rupture, leading to hemorrhage. One of my clients, a 50-year-old woman, experienced such a rupture one night as she stood in front of the developing tray in the lab of her photography class. In such severe situations, your clients may need to wear compression stockings at all times to increase venous flow to the heart.
Bodywork can be an effective supportive modality for clients with varicose veins, applied judiciously in relation to the severity of the condition. In addition to hands on work, clients will benefit from lifestyle changes, exercise, support stockings and nutritional and herbal remedies.
As a result of venous stasis, venous blood has a low level of oxygen and a high level of carbon dioxide, and other metabolic products, impairing the nutrition of venous tissue and the surrounding skin and subcutaneous tissue. If bruising or ulceration occur around the area, healing may be impeded. Massage techniques such as lymphatic drainage and circulatory massage that increase general circulation and improve tissue nutrition are especially beneficial in addressing varicose veins. Circulatory technique should include short (three-inch-long) effleurage strokes to move the blood from valve to valve in the vein, and longer strokes to increase flow throughout the length of the vein. Lymphatic drainage strokes are superficial strokes that effect lymphatic circulation by moving lymph from areas of pooling and congestion in the intercellular spaces into lymph vessels and eventually general circulation. These very light strokes are directed to the subdermal area and the superficial fascia. All massage techniques that address venous insufficiency should proceed toward the heart. Use gentle full-palm pressure or flat fingertip pressure when massaging over varicose veins and avoid digital pressure, cross-fiber friction, stripping, wringing, and percussion movements. To aid in venous return, the legs can be optimally elevated to 45 degrees during the session. They may also be treated in sidelying position with the uppermost leg massaged.
Only the presence of broken skin, ulceration, or phlebitis precludes the therapist from stroking directly over varicose veins. In the case of ulceration, lymphatic drainage and circulatory strokes can be initiated proximal to the lesion. Myofascial release techniques applied at the margin of venous ulceration can help to soften and release areas of hardening, leading to free movement of the skin and underlying tissue.
Connective tissue massage (Bindegewebsmassage ) is utilized in Europe to increase peripheral circulation and speed healing of tissue affected by venous stasis. Bindegebsmassage is especially suited for safe treatment of varicose veins because its application is focused primarily on the lower margins of the latissimus dorsi, pelvis, sacrum, greater trochanter and iliotibial tract, and not at the site of the varicose veins.
Since it is better to limit friction when massaging varicose veins, lubricants are essential. Oils rather than creams or lotions are recommended. I most often use a 50/50 mixture of heated olive oil and tincture of myrrh over varicose veins, as recommended in the Edgar Cayce readings. In sessions in which the client's varicose veins are not an area of primary concern, I use peanut oil. Cold witch hazel can be rubbed gently on the legs to relieve itching and irritation.
All clients who have developed varicose veins should be encouraged to move! Standing for long periods should be discouraged. If you're a massage therapist, consider using a footstool to shift your weight during a session from one leg to the other, and changing your position from standing to sitting throughout the session to minimize continued static stress on your legs. Clients who are sedentary should be encouraged to dorsiflex/plantar flex the ankles at least twenty times per hour in a seated or supine position, and, if able, to walk or ride an exercise bicycle 1-2 miles daily. Anyone with symptomatic varicose veins will benefit from resting for 15-20 minutes after work while elevating the ankles at least 45 degrees, and sleeping with the foot of the bed elevated 5-10 degrees. Moderate compression stockings are now available commercially and can contribute significantly to limiting the progression of varicose veins if worn regularly.
Many herbal remedies are recommended for varicose veins. Horse chestnut seed extract taken in a dosage of 100-150 mg daily appears in a number of double-blind studies to be among the most effective. This herbal treatment is contraindicated in pregnancy.
When we work on a client who has varicose veins, her legs should not be avoided, but addressed with appropriate techniques intended to support venous return to the heart, improve the condition of surrounding tissue, and reduce contributory restrictions in other parts of the body.
Click here for previous articles by Kate Jordan, NCTMB.
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