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The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
April, 2009, Vol. 09, Issue 04
Incorporating Lymphatic Drainage in Facelift Massage
By Rita Woods, LMT
More and more therapists are performing facial massage as a stand alone session such as a facelift massage. Women in their 60s, the typical age group treated in my practice, present with specific issues that should be taken into consideration. First, if they do not receive regular massage and do not have an active lifestyle, they may have sluggish circulatory/lymphatic systems. Second, they may have health and medication issues that impact how, and if, you can proceed with the session. In this column, I'll discuss what you need to know and how to approach the facial lymphatic system in a basic and uncomplicated session.
Areas of Caution
First, some words of caution. If your client suffers from an active infection such as sinusitis, strep throat, tooth abscess or any skin infection, do not proceed. Active head/face infection is your number one contraindication for this work. If, however, they have been taking antibiotics for at least three days, it is generally safe to proceed. Next, if your client has facial swelling of unknown origin, do not proceed. Remember this is for a typical session with a healthy client and no extenuating circumstances. While it is possible to use this work to address blunt force trauma and post-facial surgery, that requires advanced training. Standard massage contraindications also apply even when working on the face alone.
Facial Lymphatic System
Now, onto the treatment itself. You remember from your massage school curriculum that massage increases circulation; it also increases lymphatic flow. That is, massage also increases the release and flow of lymphatic waste. As with any "waste disposal," some form of clearing should be done before adding more waste to the system. (For example, if there is mud stuck in the end of a garden hose, the mud must be cleared out before the water can flow effectively. The same holds true in the body's waste removal systems.)
Unlike the blood circulation in the face which drains in a variety of directions before ending up back at the heart, the facial lymphatic system follows a very exacting drainage path. The right side of the face flows to the right and the left side to the left - with both sides ultimately flowing into submandibular lymph nodes. While there are other locations housing lymph nodes involved with head/face "cleaning," such as under the occiput, the main ones for facelift style work are the submandibular ones. Lymph nodes vary in size from small - about the size of a pin head - to large, about the size of an olive. The ones under the mandible are about the size of a pea.
During a regular full body massage, muscles are warmed and circulation increases. When performing a stand alone face session, muscles must also be "prewarmed" in order to gain the necessary effects. As importantly, submandibular lymph nodes must be stimulated (rubbed) in order to open and enhance circulatory and lymphatic flow. Failure to do so could result in edema and puffiness especially under the eyes, an area prone to sluggish lymph flow.
If your client suffers from bags under the eyes or obvious fluid retention in the face, you may choose to focus more time on lymphatic work until some of the fluid and puffiness has decreased, possibly in one or two sessions. Although it is not possible or practical to teach a facial lymphatic protocol in this format, we can follow some basic steps that will surely help your client. Do not mix muscle work and lymphatic work. The lymph vessels are just under the surface of the skin on the face and are easily flattened by pressing too deeply. While they recover quickly, they need time to do so. A muscle technique to break up adhesions should not immediately be followed by a lymphatic stroke.
Two Key Areas
Two key areas to focus your attention are the submandibular nodes and the terminus. The terminus is where the lymph vessels dump into the circulatory system just before entering the heart. Unlike the rest of the body, the lymph vessels of the face have a straight shot down the neck and into the heart. You want to stimulate this area to prepare it to receive more lymph. This stimulation, while gentle, is more aggressive than work on the actual vessels. The same is true of the submandibular nodes. You will exert a steady and firm pressure, almost in a milking/pumping action, to these nodes. Done correctly, your client will be able to breathe, swallow and speak while you affect the nodes. The tips of your fingers apply pumping pressure on the underside of mandible and your fingers must remain in constant contact with the inner edge of the jaw line. The nodes are tucked up under the inside edge and in some cases can be palpated. Keeping your fingers on the bone will also ensure that you are not encroaching on arteries or veins in the neck.
Steps of Treatment
A typical session would be as follows: 1)Warm the facial muscles using any gentle, non-invasive technique; 2)Gently stimulate the lymphatic terminus which is found below the clavicles and on either side of the manubrium; 3) Stimulate the submandibular lymph nodes by using digital pressure up underneath the mandible bone; then 4) Proceed with your facelift session protocol. Upon completion of the facelift protocol, allow 5-10 minutes for stimulating the lymph flow through the lymphatic vessels. These vessels respond well to light stroking that is almost featherlike. Starting with the region closest to the nodes, apply a light stretch to the skin then follow the movement with a featherlike trailing toward the nodes. Your stroke will look like a 7 or an L. Work your strokes up to the middle of the face with the featherlike trailing toward the nodes. You may encounter some drag if there is lubricant on the face. If so, you can use a cotton ball for the trailing stroke. Cotton balls work well on and around the eyelids.
The combination of the proper facial and/or facelift massage and lymphatic drainage of the face can multiply the effects of facial work. Some of my happiest clients are those who finally get rid of the bag-gage.
I want to thank Charlotte Versagi, lymphatic massage instructor extraordinaire for sharing her knowledge and experience in the writing of this article.
Click here for previous articles by Rita Woods, LMT.
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