resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
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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