resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. After two treatments for back pain, a patient presents for a third session complaining of rapid breathing and wheezing that is made worse during cold weather.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
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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