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A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
The Source-Luo Point Combination, Part 3
Dr. Nguyen Nghi (NVN) was born in Vietnam and is one of the most important scholars, writers, teachers and practitioners of modern time. Many of his theories and applications are the source of modern teachers from Europe and the United States.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
Medicine as Metaphor
The practice of medicine is both an art and a science. We study and learn the system so that when the time comes to apply it, there is a greater possibility of successfully helping others.
Abdominal Acupuncture for Eye Healing: The Sacred Turtle and Ba Gua Map
Our ideas about western medicine have shifted in recent decades, while the public is asking more from health care providers.
Can Acupuncture Treat Knee Pain?
Recently, an article in the Journal of the American Medical Association concluded that, "neither laser nor needle acupuncture conferred benefit over sham for pain or function" among older chronic knee pain patients.
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
Colon Health and TCM
I still remember many years ago, the loud "Yuck" from my wife at the time when we were together watching the Chinese movie "Last Emperor."
Melatonin: A Promising Natural Agent in the Prevention of ALS
A number of years ago, experimental studies suggested melatonin could block key steps in the development of Alzheimer's disease, primarily by acting as a brain antioxidant and inhibiting the build-up of beta-amyloid plaque in the brain.
Merger Creates New Model of Care
Two San Francisco powerhouses of holistic healing, the American College of Traditional Chinese Medicine (ACTCM) and California Institute of Integral Studies (CIIS), are merging. Together they are building a visionary approach to applied integral health.
Online Marketing Basics: Google Ranking, Part 1
We all know there is so much opportunity with online marketing. And, let's face it, if you don't have a presence online with a website and social media, you are probably not where you want to be.
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
The Integrative Medicine Puzzle: Putting the Pieces Together
The conversation is changing in the broader healthcare community with patients actually moving the discussion toward more integrative topics. Patients today want to know their options.
Adding Microneedling to Your Clinic for Results and Profit
Microneedling has taken the beauty world by storm over the last 10 years. Under the names dermaroller, microneedling or skin needling you will see these treatments listed in the services of nearly every fashionable beauty salon and day spa in the country.
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
The Roots of TCM in Depression Treatment
In traditional Chinese medicine, there is historical precedent for the treatment of so-called "Shen" (Heart-Mind) disorder, or disorder/dysregulation of the spirit, which is also considered as distinct but not separate from the cognitive function of the brain.
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
The Art of Creating a Healing Space
I always advise my graduates to examine their group practice or treatment rooms with fresh eyes after they leave my CE workshops. I tell them, "Ask yourselves - is your space qi filled, welcoming and healing? Or is it cold and clinical?"
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
Exploring and Learning from the Gift of Life
I'm grateful to have had the opportunity to teach cadaver dissection classes and workshops with Stephen Cina at the New England School of Acupuncture over the past seven years, first through the Sports Medicine Acupuncture Program and later as a NESA elective course.
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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