resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Are You Ready for the 2016 Patient?
In October, Apple released its iOS 8 operating system for the iPhone and iPad. The new system includes Health, a new app that will interface with an ever-growing number of other apps.
Capturing the Essence of Tai Chi
Over the last 12 years, I have been working on one of the few documentaries about Tai Chi. It's called The Professor: Tai Chi's Journey West and it's about Cheng Man-Ching who moved to New York in the 1960s.
Make Low-Level Laser Therapy Part of Your Evidence-Based Practice
Low-level laser therapy (LLLT), also referred to as photobiomodulation, has been increasingly utilized in the clinical setting over the past decade.
Avoiding "Just a Pop Doc" Syndrome
Yes, it's harsh. Patients don't like to admit it. They have an unspoken plan when they first visit you: to come one time, get rid of their pain and then get rid of you. They know it's unrealistic, but they'd like to pay nothing for this service.
Treating Menopausal Women in Your Practice
I love what I do for a living. It's a great way to trade health for bread. And no topic of health, with the right bedside manner, is taboo.
Step by Step: Long-Term Treatment of Soft-Tissue Injuries Combines Skill and Care
Treating soft-tissue injuries with long-lasting results starts the moment an individual enters the office. When it comes to pain, the only thing that matters to the patient is relief.
The Death of the Travel Card
As long as I have been in practice, the travel card has stood as the primary style of documentation for chiropractic. It is quick, simple and direct. Unfortunately, the rules have changed.
Why Drugs and Supplements Can't Cure Disease
Chronic diseases are the outcome of disease-promoting, goal-oriented behaviors. So, the notion that diseases can be cured with drugs or supplements should be abandoned. Hypertension is the best example of this.
Introduce Your Patients to Collagen Induction Therapy
Cutaneous (skin) aging generally occurs from either intrinsic or extrinsic processes. Intrinsic aging results from natural skin tissue damage and degeneration.
DC App – The Next Generation
According to a survey by technology firm CDW, health care professionals gain approximately 1.2 hours per day in productivity simply by using a tablet computer in practice.
Micro-Needle Dermal Roller Use in the Treatment Room
Recently micro-needle dermal rollers have been getting a lot of media attention. As a practitioner who specializes in acupuncture facial rejuvenation, I know that skin needling with a dermal roller (also known as collagen induction therapy), promotes the natural reproduction of collagen and elastin, making the skin feel smoother and tighter.
Five Element Acupuncture Can Enhance Your Practice
For eight years I have been teaching and supervising TCM students at an acupuncture college in Colorado, in Five Element acupuncture.
Inspire Your Patients to Make Healthy Choices
Have you tried to get your patients to change their eating habits or their diet and couldn't get them to succeed? Were they confused and unsure of what the right thing was to eat? You are not alone!
The Power of Mu Xiang to Treat Irritable Bowel Disease
Bloating and gas pain is something that everyone has had to deal with at one point or another; however, that's usually reserved for holiday dinners and other large gatherings.
Chinese Medicine: The Natural Way to Children's Wellness
As a child, I did not like going to the doctor. For the most part, when I had to go I wasn't feeling good to begin with, and I was heading into a sterile environment to be awkwardly probed by a man in a white coat for a very short, impersonal period of time.
The Acupuncture Now Foundation: What Our Profession Needs
Although acupuncture is growing in popularity it continues to be underutilized due to misunderstandings about its true potential. Only a fraction of those who could be helped by acupuncture know enough to seek it out.
Meat in the Middle
Have you ever wondered what's the truth about meat? Is it really as bad as many people think?
Foundation for Chiropractic Progress Announces First Group Member
The Michigan Association of Chiropractors has joined the Foundation for Chiropractic Progress as its first group member.
It Pays to be a Foodie
If there is an inner foodie in you, just waiting to burst out—this article is for you! Do you want to know how I know? I'm that girl. My middle name might as well be "Foodie." I love food! And if my patients are any indication, many of them do as well.
Treating Acute and Chronic Neck Pain With Ischemic Compression and Exercise
There are many reasons not to manipulate the neck with cavitation: the patient is too old, their neck is too tight, etc. But the most common reason is that plenty of patients are afraid of "the crack," mostly because of the bad publicity about that procedure.
Treating Chronic Depression with Acupressure
In Traditional Chinese Medicine there already exists a comprehensive theory linking the body and mind.
We Get Letters & Email
Is It Time for a Popeye Moment? The Flaw in Recommending Chiropractic as a Career.
Following the Thinking of the Classics
I have heard about the "best time of day" to carry out certain examinations or therapies. For example, I remember making a note years ago that early morning is the best time to take someone's pulses.
Implications of Section 2706: The Non-Discrimination Provision Survey
In late April 2014, NCCAOM diplomates received an email survey with the subject line: "End discrimination against acupuncturists" polling CAM practitioners for a Request for Information from the Department of Health and Human Services, released in mid-March.
Peer Points: Promoting TCM Knowledge
When Elaine Wolf Komarow, LAc, received her first acupuncture treatment in 1989, she said it changed her life. "I felt more aware, calmer, and happier. I was so fascinated by the changes that I began to learn everything I could about the underlying philosophy of Chinese medicine," said Komarow.
Home Safety: Help Families Avoid Common Injury Hazards at Home
These days, many parents childproof their homes before a baby is even mobile. You will see an array of electrical outlet covers, bumpers on the corners of the coffee table and safety latches on the cupboards.
Chronic heightened emotional states create a perfect breeding ground for illness. Through my practice I noted the increasingly obvious relationship between one's mental focus on negative thinking, emotions, resistance to experiencing feelings and disease.
Are You Ignoring the 10,000-Hour Rule?
Having trained interns and mentored new practitioners, it has been my observation that their No. 1 clinical concern is adjusting skills. Their second clinical concern is their ability to read X-rays. Physical diagnostic skills are a distant third.
News in Brief
Life to Open Branch Campus in Italy; Northwestern Research Arm Benefits From Big Donation.
Solving the Pain Puzzle
Legendary former New York Yankees baseball player Yogi Berra once said, "You can observe a lot just by watching." He would have been a great chiropractor. We are trained to become experts with our hands: palpation, adjusting, soft-tissue release, etc.
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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