During the early days of fall, clients may often be complaining of severe muscle cramps. Discover the techniques that best aid clients in managing and preventing cramps as well as what tips you can share to help them alleviate their discomfort.

by Nicole Cutler, L.Ac.

Riding the heat waves of a long summer has likely taken a toll on many previously unaffected clients. While intense hot spells are often a concern for the young and elderly, just about anyone lingering in hot weather is prone to its ravages. Muscle cramps are most common for people who become dehydrated or participate in physical activity in high temperatures. Bodyworkers can directly help a client overcome a painful cramp or educate their clients on its prevention.

Electrolyte Imbalance
Suddenly emerging as a sharp pain, a muscle cramp is a sustained muscular contraction. While there are several possible triggers for muscle cramps, an electrolyte imbalance is often the cause when a person is overheated. The physiology of muscle contraction centers on the interplay between positive and negative charges activating muscle tissue. Charge-carrying electrolytes, namely potassium, sodium, calcium and magnesium, enter muscle cells, initiating either a state of contraction or relaxation.

Caused by hot temperature or excessive activity, perspiration is the loss of body fluid through the skin. Because sweat is laden with electrolytes, excessive perspiration can result in an electrolyte imbalance that can delay muscular relaxation, causing a sustained muscular contraction.

Cramp Locations
While different muscle groups can cramp, the calf and foot are most common affected. Abdominal cramps can accompany a gastrointestinal problem or a painful menses. To rule out a myocardial infarction, cramping in the chest or upper body should always be referred to a physician. Another client requiring referral to a physician is a person experiencing habitual muscle cramps. Habitual cramping may signify a more serious metabolic condition.

Hands-on Cramp Help
A client who is prone can easily experience muscle cramps during a bodywork session. A therapist can help its dissipation with the following methods:

· Massage – Massaging the cramped muscle increases circulation in the tissue, providing a rush of new fluid to bathe and relax the tense muscle. Swedish, neuromuscular and myofascial release techniques are particularly effective. However, a therapist must be aware that a client with a cramped muscle may be in too much pain for physical manipulation of the muscle.

· Reciprocal Inhibition – Commonly used in sports massage, reciprocal inhibition is the application of resisted tension to the opposing muscle group. By activating the opposing muscle group, reciprocal inhibition forces the contracted muscle to relax. For example, a cramp in the posterior, lower leg can be relieved by applying resisted tension to the anterior, lower leg muscles.

· Hot Pack Application – While not hot enough to cause perspiration, the radiance of a hot pack applied to a cramping muscle can enhance circulation. In addition to potentially alleviating the cramp, this technique is particularly soothing.

Cramp Prevention
If a client reveals a tendency towards muscle cramps, or experiences one during a session, suggested preventive care tips could be welcomed and of great benefit. As long as it is within your scope of practice to mention these tips, consider imparting the following information to clients:

· Hydration - In hot weather, stay hydrated. When overheated, carrying around and sipping from a water bottle is one way to cool off. For excessive perspiration, an electrolyte-containing beverage can not only re-hydrate, but also prevent the imbalance caused by electrolyte loss.

· Stay cool – During a heat wave, encourage clients to seek a cool location and refrain from strenuous activity outdoors during the hottest times of day.

· Eat a banana – Bananas are loaded with potassium, and can give the body enough potassium to counter what is lost during perspiration.

· Stretching – Stretching the legs and feet prior to, and after physical activity lengthens and bathes the muscles with oxygen-rich blood. This circulation enhancement method provides substantial fluids which can prevent cramping.

Another Consideration
In Traditional Chinese Medicine (TCM), those prone to recurrent muscle cramps may be experiencing an imbalance known as Liver Blood Deficiency. Other symptoms falling into a Liver Blood Deficiency pattern include fatigue, thirst, muscle spasms, dry eyes, headaches and insomnia. While only a qualified professional can diagnose this pattern, being aware of its existence could lead a massage therapist to offer a valuable referral. If liver blood deficiency is confirmed by a TCM practitioner, the following acupressure points can benefit this client:

· Gallbladder 34 – Located in the depression anterior and inferior to the head of the fibula.

· Stomach 36 - Located four finger breadths below the eye of the knee, one finger breadth lateral to the anterior crest of the tibia, in the tibialis anterior muscle.

· Liver 3 - Located in the web on the dorsum of the foot, in the depression distal to the junction of the first and second metatarsal bones.

· Spleen 6 – Located four finger breadths directly above the tip of the medial malleolus, on the posterior border of the medial aspect of the tibia.

· Spleen 10 – Located with the knee flexed, the point is two and a half finger breadths above the bulge of the medial portion of the quadriceps femoris muscle.

Through the direct application of bodywork methods or the sharing of information, massage therapists can take an active role in eliminating muscle cramps.

Recommended Study:
Myofascial Release, Neuromuscular Therapy, Sports Massage and Swedish Massage for Professionals

References:

Liangyue, Deng, et al., “Chinese Acupuncture and Moxibustion”, Foreign Languages Press, Beijuing, 1987.

www.mayoclinic.com, Muscle Cramp, Mayo Foundation for Medical Education and Research, July 2006.

www.sportsmedicine.about.com, Muscle Cramps, About Inc., 2006.

Posted by Editors at 02:52 PM

© 2009 Institute for Integrative HealthCare Studies. This work is reproduced with the permission of the Institute. www.Integrative-Healthcare.org

Fatigue is the most frequently seen symptom in clinical practice. Learn how to implement a therapeutic protocol to support clients suffering from fatigue while enhancing the value of your services.

Nicole Cutler, L.Ac.

The explosion of research centering on the benefits offered by massage therapy clearly demonstrates the modality’s ability to reduce fatigue:

• As published in Alternative Therapies for Health and Medicine, hospital nursing and physician staff members were provided massage therapy, relaxation therapy and music therapy. All of these therapies significantly reduced anxiety, depression and fatigue as well as increased vigor.

• As published in the Journal of Chronic Fatigue Syndrome, patients with chronic fatigue syndrome experienced a reduction in depressed mood, fatigue, anxiety and stress hormone (cortisol) levels immediately following massage therapy.

• As published in the Journal of Clinical Rheumatology, massage therapy (as compared to transcutaneous electrical stimulation) improved sleep patterns and decreased pain, fatigue, anxiety, depression and cortisol levels in adults with fibromyalgia.

• As published in the Journal of Nursing Research, acupressure followed by leg massage eases fatigue and depression in people with end-stage renal disease.

Acupressure for Fatigue
While there are just as many variations of fatigue as there are ways to help it, acupressure provides a solid theoretical basis and effective means for its treatment. Traditional Chinese Medicine thoroughly chronicles and seeks to balance energy flow within the body’s meridians. This intricate system of healing has been thoroughly studied and relied upon by acupuncturists, but massage therapists performing acupressure can also utilize this vast pool of therapeutic information.

Traditional Chinese Medicine discovered that when performed excessively, certain activities strain the energetic balance in specific meridians. This strain can result in weakened immunity and fatigue. Administering acupressure to specific points along these meridians can correct the offending imbalance and increase the client’s energy.

According to Michael Reed Gach, PhD’s book, Acupressure’s Potent Points, the following activities can result in fatigue:

• Excessive standing damages the bladder and kidney meridians, which can cause fatigue and low backaches. To restore these meridians, stimulate the following points:

Bladder 23 – located approximately two-finger widths lateral to the lower border of the spinous process of the second lumbar vertebrae, on the quadratus lumborum muscle.

Bladder 52 – located approximately four-finger widths lateral to the lower border of the spinous process of the second lumbar vertebrae, on the quadratus lumborum muscle.

Kidney 27 – located in the depression on the lower border of the clavicle, approximately three finger widths lateral to the sternum.

Kidney 3 – located in the depression between the medial malleolus and tendo-calcaneus, level with the tip of the medial malleolus.

• Excess sitting can damage the stomach and spleen meridians, contributing to fatigue, anemia and digestive disorders. To restore these meridians, stimulate the following points:

Stomach 36 - located four finger breadths below the eye of the knee, one finger breadth lateral to the anterior crest of the tibia, in the tibialis anterior muscle.

Spleen 6 – located four finger breadths directly above the tip of the medial malleolus, on the posterior border of the medial aspect of the tibia.

• Excess lying down can damage the large intestine and lung meridians, which can cause fatigue, respiration difficulties and elimination problems. To restore these meridians, stimulate the following points:

Large Intestine 4 – located in the web on the dorsum of the hand, between the first and second metacarpal bones, approximately in the middle of the second metacarpal bone on the radial side. Note: This point is contraindicated during pregnancy.

Large Intestine 11 – When the elbow is flexed, in the depression at the lateral end of the transverse cubital crease, midway between the lateral epicondyle of the humerus and the biceps brachii tendon.

• Excess use of your eyes (as in close desk work) or emotional stress can damage the small intestine and heart meridians, causing fatigue. Pressure or tapping on the following can restore balance in these meridians:

Conception Vessel 17 – located on the anterior midline, level with the fourth intercostal space, on the sternum.

Heart 3 to 7 – runs along the palmar aspect of the forearm, in a line from Heart 7 (the ulnar end of the transverse wrist crease, on the radial side of the tendon flexor carpi ulnaris), to Heart 3 (in the depression between the medial end of the transverse cubital crease and the medial epicondyle of the humerus).

• Excess physical exertion can damage the gallbladder and liver meridians, which can cause cramps, spasms and fatigue. To restore these meridians, stimulate the following points:

Liver 3 – located in the web on the dorsum of the foot, in the depression distal to the junction of the first and second metatarsal bones.

Gallbladder 34 – located in the depression anterior and inferior to the head of the fibula.

Asking the proper questions of a client during an intake interview can reveal excessive activities in their lifestyle that may be creating a fatigue-causing imbalance. For example, a client experiencing fatigue who sits at a computer all day likely has imbalances in the spleen, stomach, heart and small intestine meridians. Applying acupressure to the points most likely to balance these meridians could provide enormous therapeutic benefit. Massage therapists can take advantage of Traditional Chinese Medicine’s knowledge in a hands-on, healing manner to conquer the typical clinical struggle with fatigue.

References:

Field, T., Quintino, O., Henteleff, T., Wells-Keife, L., & Delvecchio-Feinberg, G., Job stress reduction therapies, Alternative Therapies in Health and Medicine, 1997.

Field, T, Sunshine, W., Hernandez-Reif, M., Quintino, O., Schanberg, S., Kuhn, C., & Burman, I. Chronic fatigue syndrome: Massage therapy effects on depression and somatic symptoms in chronic fatigue syndrome, Journal of Chronic Fatigue Syndrome, 1997.

Gach, Michael Reed, PhD, “Acupressure’s Potent Points”, Bantam Books, 1990.
Liangyue, Deng, et al., “Chinese Acupuncture and Moxibustion”, Foreign Languages Press, Beijuing, 1987.

Rho, Yi-Ching, RN, Shiow-Luan Tsay, RN, PhD, Acupressure for Fatigue and Depression in End-Stage Renal Disease, Journal of Nursing Research, 2004.

Sunshine, W., Field, T., Schanberg, S., Quintino, O., Fierro, K., Kuhn, C., Burman, I., and Schanberg, S., Fibromyalgia benefits from massage therapy and transcutaneous electrical stimulation, Journal of Clinical Rheumatology, 1996.

Posted by Editors at 11:51 AM

© 2009 Institute for Integrative HealthCare Studies. This work is reproduced with the permission of the Institute. www.Integrative-Healthcare.org

Stronger prescriptions and surgery are not the only options for improving eyesight. Learn how massage therapists with knowledge of Traditional Chinese Medicine can aid clients in their efforts to improve and support the health of their eyes.

Nicole Cutler, L.Ac.

While a significant percentage of our society experiences declining vision, there appears to be a limited understanding of what can be done about it. In addition to corrective lenses or surgical procedures, massage therapists with an understanding of Traditional Chinese Medicine (TCM) can make a substantial contribution to the maintenance of sight. Principles of TCM can guide bodyworkers in choosing acupressure locations to therapeutically support client eye health.

General TCM Theory for the Eyes
Although massage therapists are not intended to be TCM diagnosticians, the following principles will be of value to enhancing assessment and acupressure skills.
According to TCM, diseases involving the eye are closely related to a liver imbalance. Whenever studying TCM theory, it is important to recall that a reference to an organ may include the actual organ, but also takes into account the accompanying meridian and its energy. So while an eye disorder may correspond to a liver imbalance, the liver itself may actually be healthy.

In addition to the liver’s primary role in vision, the eye is nourished by all of the internal organs in the body. Specifically, the health of different parts of the eye reflects the health of the following organ systems:

• The pupil and lens of the eye reflect kidney health
• The sclera reflects lung health
• The arteries and veins, as well as the inner and outer canthus, reflect heart health
• The flesh around the eye reflects spleen health
• The cornea and iris reflect liver health

Because an imbalance in any of the internal organs can be witnessed in different parts of the eye, taking note of a person’s eyes can help in choosing a protocol. Abnormal eye coloration suggests a pathological cause. For example, a client with a discoloration of the sclera would benefit from bodywork on the lung (reflective of the sclera) and liver (applicable for all eye imbalances) meridians. If the sclera discoloring is due to an abundance of inflamed blood vessels, the therapist might want to also work with the heart meridian.

Abnormal eye color is also representative of a system out of balance. Before making this connection, a therapist must understand the colors associated with each major organ system:

• Heart is associated with the color red
• Kidney is associated with the colors blue or black
• Spleen is associated with the colors orange or yellow
• Liver is associated with the color green
• Lung is associated with the color white

These color indicators help a therapist decide what meridian system is most important to address. For example, a client with bags beneath the eyes would likely benefit from bodywork to balance the spleen (reflected in the flesh around the eyes). If those bags were blue or black, the spleen bodywork could be supported with kidney meridian acupressure.

Specific Eye Acupressure Points
Applying acupressure to points around the eyes can be a powerful adjunct to a massage session. Some of the major therapeutic points are:

Urinary Bladder 1 - Located where the inner corner of the eye meets the nose. This point is advised for all types of eye problems, especially early-stage cataracts, glaucoma, conjunctivitis and blurry vision.

Urinary Bladder 2 - Located in the depressions at the inner (close to midline) ends of the eyebrows. Similar to Urinary Bladder 1, this point is advised for all types of eye problems, especially early-stage cataracts, glaucoma, conjunctivitis and blurry vision.

Yuyao (extra point) – Located at the midpoint of the eyebrow in the hollow. This point is good for eye problems related to worry, excessive studying and mental strain.

Triple Warmer 23 - Located in the depression at the outside end of the eyebrow. This local point benefits many eye and facial problems, including eye tics, burning eyes, watery eyes and blurry vision.

Gallbladder 1 - Located in the cavities on the outside corners of the eye sockets. This point is good for conjunctivitis, red and sore eyes, photophobia, dry, itchy eyes, early-stage cataracts, blurred vision and temporal headaches (especially when related to vision problems).

Stomach 1 - Located directly below the pupil on the infraorbital ridge bone. This point is indicated for sinus congestion, itchy, burning, dry eyes (especially when related to colds or allergies).

Acupressure on points near the eyes must be done gently, slowly and with clean hands. Do not massage on an open wound, a scar, burn or infection.

Using TCM theory will help massage therapists better understand a client’s eye complaints, improve assessment skills and result in a more directed, therapeutic treatment. In addition to regular visits to eye doctors, clients can also turn to massage to help improve and support the health of their eyes.

Recommended Study:
Shiatsu Anma

References:

www.acufinder.com, Acupressure Points for Better Vision, Dr. Marc Grossman, OD, LAc, 2006.

www.acupuncturetoday.com, Natural Vision Improvement: An Alternative to Lasik Surgery, Deborah E. Banker, MD, December 2001.

Posted by Editors at 01:47 PM
© 2009 Institute for Integrative HealthCare Studies. This work is reproduced with the permission of the Institute. www.Integrative-Healthcare.org

Mastering the locations and indications of over 400 acupressure points on the body can be an overwhelming task. Our experts highlight 10 of the most effective points on the body, explain how to find them and describe the benefits of these points.

The human body is like a map with key points that, when pressed, can stimulate the body’s natural healing and self-curative abilities. Acupressure, the more than 5,000-year-old healing art of using the thumb and fingers to press on these key locations, is one of the most effective complementary modalities a massage therapist can employ. Acupressure can release muscular tension, promote circulation of both the blood and the body’s vital energy (Qi) and enable the body to relax deeply. By relieving stress, acupressure strengthens the body’s resistance to disease and promotes wellness.

The Qi of the body is produced in the internal organs and circulated through the body in the energy channel system known as meridians (pathways). The meridians are extensions of the 10 internal organs and contain specific acupressure points along each pathway. The points are sensitive to bioelectrical impulses in the body and conduct those impulses readily. Stimulation of these points with pressure releases endorphins. Endorphins are the neurochemicals that close the “gates” of the pain-signaling system. The closing of these gates prevents painful sensations from passing through the spinal cord to the brain.

Acupressure points can be located easily via anatomical landmarks that either lie underneath major muscle groups or near a bony structure. Points are located by proportional measurements called a “cun” — one cun is approximately equal to one thumb’s width. In order to assure accuracy, the width of the recipient’s thumb is the best determination of this measurement. After locating the point, the therapist stimulates it by pressing directly on the muscular knot of tension or directly into the hollow or indentation near the bone with the thumb or the fingers. Points that are painful when pressed are considered to be areas where excessive energy has accumulated. Points that welcome touch are considered to be areas of energy deficiency. Points are typically addressed bilaterally.

John Hickey, author of the Institute for Integrative Healthcare’s Shiatsu Anma Therapy program, gives the following instruction for applying specific pressing techniques to acupressure points:

“Ordinary pressure is considered tonifying to the point and can be used in excess or deficient energy conditions. Locate the point and with moderate pressure, gradually press directly into the point with the thumb at a 90-degree angle from the surface of the skin, hold for a few seconds and then release, gradually. To address points that feel painful or excessive, perform a stronger more dispersing technique using the tip of the thumb and applying a deeper, stronger pressure to break up the excessive and stagnant energy in the point. Hold the point until the excess energy is released. To address energy deficient points, and to encourage more Qi and blood to the area, use the flat part of the thumb, relax the hands, and use moderate pressure on the point to draw energy into the area.”

The Chinese names (translated into English) assigned to the acupressure points on the meridians can serve as a powerful meditation tool and can help establish the intention of your work. By pressing a point, silently repeating its name, breathing deeply and visualizing the point’s benefit, both you and your client can realize the full potential power held in each point.

There are hundreds of effective acupressure points that influence the functioning of the body. Ten of the most common and useful points to facilitate health are described below:

1. Lung 1, “Central Treasury”
Location: On the chest, 6 cun lateral from the midline, at the level of the first intercostal space, 1 cun below the lateral extremity of the clavicle.

• This is the collecting point for all the energy of the lungs.
• Helps the lung Qi to descend downward in the body to connect with the kidneys.
• Supports the lungs.
• Addresses acute coughs, asthma and a tight chest.
• Alleviates pain in the shoulder and upper back.

2. Large Intestine 4, “Union Valley”
Location: In the dorsal web space, between the first and second metacarpal bones, approximately level with the midpoint of the second metacarpal bone. Also – on the highest point of the bulge formed when the thumb is adducted.

• This is the command point for the face, mouth and head.
• Treats sinus congestion, allergies, headaches, sore throat, fever and toothaches.
• Strengthens the body’s defensive Qi and is helpful for colds, sneezing, runny nose and sore eyes.
• Alleviates pain in the shoulder and arm.
• Contraindicated during pregnancy.

3. Kidney 1, “Gushing Spring”
Location: On the sole of the foot, between the second and third metatarsal bones, one-third the distance from the webs of the toes to the heel.

• This is a very important point for grounding, connecting with the earth and rooting the energy downward.
• Helpful to calm someone who is in a disturbed state of restlessness or shock.
• Useful for headaches, anxiety, hypertension, diarrhea and insomnia.

4. Bladder 23, “Back Shu Point of the Kidney” or “Sea of Vitality”
Location: 1.5 cun lateral to the lower border of the spinous process of the second lumbar vertebrae, on the quadratus lumborum muscle.

• This point is a powerful place to strengthen both the yin and yang kidney energy.
• Helps strengthen the lower back and knees.
• Builds core energy.
• Helps the body replenish during times of personal transformation.
• Alleviates low back pain and fatigue.
• Fortifies the digestive organs and the immune system.

5. Liver 3, “Great Surge”Location: On the dorsum of the foot, between the first and second metatarsal bones, approximately 2 cun superior to the web margin.

• This point is the source point of the liver meridian.
• This is a thoroughfare for Qi activity.
• Releases pent up energy that causes anxiety, anger, irritability, tension headaches, depression and PMS.
• Liberates energy that is caged.
• Smoothes energy that is aggressive and edgy.
• Nourishes tendons and ligaments by alleviating tightness, tension and spasms.
• Particularly effective in conjunction with Large Intestine 4.

6. Gallbladder 30, “Jumping Circle” or “Jumping Round”
Location: In the gluteal region, 1/3 the way along a line drawn from the greater trochanter to the inferior end of the sacrum.

• Benefits the low back and all leg joints.
• Strengthens and comforts the low back and leg.
• Alleviates sciatic pain, hip pain and rheumatism.
• Relaxes tendons and restores joint mobility.

7. Heart 7, “Spirit Gate” or “Mind Door”
Location: On the transverse crease of the wrist, in the depression on the radial side of the insertion of the tendon of flexor carpi ulnaris into the pisiform bone.

• Calms the mind when overactive thinking is the culprit.
• Relieves insomnia due to overexcitement.
• Relaxes and eases anxiety.
• Reduces heart palpitations by regulating the heart and strengthening the spirit.

8. Small Intestine 11, “Celestial Gathering”Location: In the depression of the scapula half way between the left and right borders of the scapula and 1/3 the distance down from the spine of the scapula and the inferior angle of the scapula.

• Alleviates soreness of the shoulder and back.
• Reduces rigidity of the neck.
• Helps pain and numbness in the arm.
• Helps gather scattered or manic Qi in the body
• Sorts the real from the dream and the authentic from the inauthentic.

9. Spleen 6, “Three Yin Intersection”
Location: Three cun directly above the tip of the medial malleolus, less than a finger’s width posterior to the border of the tibia.

• This is the meeting point of the three yin channels (spleen, kidney and liver).
• Important for treatment of all gynecological, sexual, urinary, digestive and emotional imbalances.
• Nourishes and builds the blood.
• Use in the treatment of anxiety, insomnia, headaches, menstrual cramps, abdominal distention/pain and diabetes.
• Contraindicated during pregnancy.

10. Stomach 36, “Leg Three Miles”
Location: Three cun below the inferior border of the patella, one finger width lateral to the edge of the tibia. There is a small notch next to the tibia at this point.

• Ancient physicians said working on this point could treat all diseases.
• Chinese foot soldiers used to halt every three miles and massage Stomach 36 for renewed energy.
• Restores and builds energy in the stomach and spleen.
• Strengthens the stomach and improves digestion.
• Indicated for all digestive disturbances including gas, bloating, nausea, diarrhea and constipation.
• Alleviates abdominal pain, distention, coldness and numbness in the legs.

The best way to learn more about these points is to begin practicing on yourself. Daily practice will result in noticing a slight pulse at the point. This pulsation is a good sign that circulation has increased. Start adding some of these highly effective points in with your massage routine, explaining to your clients what you are doing and why. Take care to avoid those points that are contraindicated during pregnancy on an expectant mother. The body’s vital energies concentrate inward during a treatment, so to maximize healing, be sure to keep your clients warm and advise them to stay warm following a session.

The body has many more effective acupressure points that can address different imbalances. There are specific points along either side of the spine which reflexively influence every organ in the body. Watch for a follow up article addressing these powerful points on the bladder meridian.

Recommended Study
Shiatsu Anma Therapy

References:
1. Carey, Donna and de Muynck, Marjorie. Acutonics: There’s No Place Like Ohm, Sound Healing, Oriental Medicine and the Cosmic Mysteries, Devachan Press, 2002.
2. Gach, Michale Reed. Acupressure’s Potent Points, Bantam Books, 1990.
3. Hickey, John. Shiatsu Anma Therapy, Institute for Integrative Healthcare Studies, 2005.
4. Lundberg, Paul. The Book of Shiatsu, Simon and Schuster, 2003.
5. Tedeschi, Marc. Essential Anatomy for Healing and Martial Arts, Weatherhill, 2000.
6. Xu, Xiangcai. Chinese Tui Na Massage, YMAA Publication Center, 2002.

Posted by Nicole at 04:33 PM
© 2009 Institute for Integrative HealthCare Studies. This work is reproduced with the permission of the Institute. www.Integrative-Healthcare.org

Preparation for this seasonal change can maintain health and balance during the chilly months that lay ahead. This comprehensive approach to wellness includes six detailed methods (from acupressure to food choices) that will keep us in alignment with the cycle of nature.

The fall equinox, September 22, 2005, announces the first day of autumn, when day and night are of equal length. The cooler temperatures and shortened daylight hours following the fall equinox signal the growing predominance of yin. This time of year, both animals and plants become more yin, turning inward to build up the stores of nutrients they will need to get them through the long winter. Trees store nutrients as sap, which descends down the tree, and animals store nutrients as fat, converting everything they eat into that which will protect them from the cold and be converted into energy when food sources are scarce.

Autumn brings on a time when our vital energy also becomes more yin, moving downward and inward, to be replenished, nourished and refined. As in nature, we also must prepare for the oncoming winter months by strengthening our immune system, the body’s defense against colds and flu, which are often brought on by the change in seasons.

The Metal Element

According to Chinese Five Element theory, each season is represented by an element in nature. The metal element is associated with autumn and represents the mineral ores and salts in the earth. Metal is formed and contained deep inside the earth, where high temperatures and pressures cause molecules in molten magma to separate into homogenous layers. Some layers cool quickly into volcanic basalts, while others condense gradually into minerals and ores. Others stack themselves in precise lattice-like structures to form crystals. This process of separation pushes away impurities and molecules of dissimilar composition, forming metals that are pure and distinct.

In the body, metal manifests as the organs and meridians of the lung (yin) and large intestine (yang). The lungs and large intestine, when healthy and in balance, absorb and transform food and oxygen, utilize the food and oxygen’s essence and release what is not needed. An internal weakness in the metal element can result in problems associated with these organs, such as breathing or elimination difficulties. According to Chinese medical theory, the lung and large intestine perform the following functions:

The Lungs

• The lungs purify the air that we breathe. During inhalation, the lungs extract the purest essences from the air and distribute them throughout the body while eliminating impurities through exhalation. Impaired function of this aspect of the lungs can result in breathing difficulties like asthma and general fatigue.

• The lungs defend the body from pathogenic invasion by distributing protective or defensive energy to the body’s surface. This is primarily accomplished through the opening and closing pores to maintain thermal regulation of the body. Dysfunction of this aspect of the lungs can lower immunity, resulting in colds and flu.

• The lungs keep the body dry by dispersing fluids. Fluids that accumulate in the body are dispersed through the skin’s pores as perspiration and through the bladder as urine. When the lungs fail to disperse excess fluids, dampness can accumulate, causing the mucus and phlegm associated with colds and flu.

• The energy of the lungs can be evaluated in the quality of the skin and body hair, be they moist or dry, elastic or limp, shining or dull, soft or rough.

The Large Intestine

• The large intestine separates solid wastes and impure essences and eliminates them in the form of feces.

• Dysfunctions in the large intestine can result in constipation, diarrhea or an inability to “let go” of situations or attitudes. Poor intestinal elimination may affect the skin, another area of the body governed by the metal element.

Acupressure

Tonify and strengthen the metal element through the lungs and large intestine by performing acupressure on Lung 1 and Large Intestine 4. View the previous article Ten Highly Effective Acupressure Points for application and location information.

Emotions and Autumn

As the energy descends during autumn, the lungs and large intestine can be affected on an emotional level. Grief, sadness and depression are possible manifestations of this energetic shift. Just as high temperatures and pressure within the earth transform molten magma into gold and other minerals, the sadness and grief within our lives must be transformed into learning experiences from which we grow our courage and wisdom.

In the action of letting go we face our grief and mourn our losses. Through our losses and honoring our grief we derive strength and the courage to persevere. Although emotionally painful, this process can bring many gifts, crystallizing the essence of what is most important to us. Grief reminds us of how much love we can feel, and there is no greater strength than this deeply humanizing experience. Transforming grief by releasing it keeps our metal element in a healthy state of balance.

Resolve, the gift that comes after grief, is the recognition of what we still have; it is the pure gold that is transformed from the ashes, the distilled essence of what we have and what we can never lose.

Keeping ourselves emotionally healthy can positively impact our physical health. Understanding the connection between physical and emotional health can help us seek courage, strength and clarity to embrace the natural process contained in the energies of autumn.

Lymphatic Drainage Massage

As the daylight hours decrease and the weather becomes cooler, people generally spend more time indoors and at home, participating in more relaxed leisure activities. The lessening of physical activity has a profound effect on the lymphatic system and our immunity to colds and flu. Through inactivity, the immune system becomes sluggish and fails to adequately move stagnant fluid out of the tissues and into the lymphatic vessels and nodes where it can be purified by lymphocytes.

Lymphatic drainage massage (LDM) is an excellent means of assisting in this process. A massage therapist performing LDM moves his/her client’s skin in different directions: lengthwise, horizontally and diagonally. These movements, which stretch the microfilaments just below the skin that control the openings to the initial lymphatics, allow interstitial fluid to enter the lymphatic system while stimulating the lymph vessels to contract. Fluids are propelled forward through the lymph vessels and away from tissue areas where fluid has pooled from inactivity. LDM stimulates the lymphatic vessels to contract more frequently.

As the lymphatic fluid flow is enhanced, the body is put into a parasympathetic state, which slows the heart rate and breathing, relaxes muscles and allows organs to resume normal functioning. A deeper, more relaxed rhythm of breathing occurs during this massage and the therapist can work simultaneously with the client to perform specific breathing techniques that rejuvenate the lungs and increase the body’s defensive vital energy via the lungs.

Breathing Techniques

Inhalation nourishes every cell in our body, while the exhale eliminates byproducts and waste that no longer serve us. Every breath offers the opportunity to cleanse and purify the body. The two breathing techniques below can be done separately or combined to ensure maximum expansion of the lungs.

• Abdominal Breathing: Massage therapists can assist their clients with this exercise. Begin by breathing normally. Slowly direct the focus of breathing to the abdomen. Place your hand lightly on the client’s abdomen and ask them to inhale and expand the belly to push your hand upward. At this time, the diaphragm sinks downward, allowing the lungs to expand more fully. When exhaling, the shoulders drop, the chest sinks inward, the diaphragm rises and the belly should contract gently and easily. This action pushes the stale air out through the lungs. Do this exercise for at least three minutes.

• Yin/Yang Breathing: Make a loose fist with the index and middle fingers of the right hand, leaving the thumb and last two fingers extended. Using the ring and pinky fingers, gently close off the left nostril and breathe deeply in through the right. At the top of the inhalation, release the left nostril and close off the right one with your thumb. Exhale slowly and smoothly. At the inhalation, breathe in deeply through the uncovered left nostril. When complete, open the right nostril and close the left one again with the last two fingers, exhaling deeply and slowly through the right nostril. Do this exercise for two to four minutes.

Autumn Diet

Autumn offers an array of fruits and vegetables that can support the lungs and large intestine as well as our overall health. A week of juice cleansing in early autumn will provide a boost of energy and may eliminate any potential illnesses by flushing out excess toxins. Fresh fruit juices in the morning and vegetable juices in the afternoon or evening are ideal.

Since it is autumn, grapes are harvested and prove to be a fine cleanser, harmonizer and tonic for both the lungs and large intestine. Juice the dark grapes in a juicer with organic apples and pears or oranges, or eat them as a snack during the day. Balance the sweetness of the grapes by drinking a glass of lemon water.

Pungent foods penetrate the lung and large intestine, where they can be used in combination with other foods to affect various disorders in those organs. Eating warming pungent foods in moderate amounts such as garlic and onions, chili peppers, horseradish, fennel, anise, dill, mustard greens, cinnamon, nutmeg, basil, rosemary, scallions, cloves, ginger, black pepper and cayenne can disperse excess dampness in the lungs and large intestine. Cooling pungent foods like radishes, cabbage, marjoram, white pepper, parsnips and turnip roots can help balance excess heat in the lungs and large intestine.

Eating root vegetables in season can strengthen deficiencies and support the lungs and large intestine. Sweet potatoes, turnips, carrots, radishes, ginger, garlic and onions are plentiful in the autumn and help to consolidate the lower body energy so that it doesn’t become too dispersed. Baking and/or roasting foods like squash, pumpkin and meats help draw heat energy into the foods to keep our bodies warmer in the winter months.

Those foods that congest the large intestine are sweets (cookies, cakes, etc.), cheese, noodles and breads. To keep the large intestine healthy and balanced, eat ample foods that lubricate this organ such as nuts (pecans, brazil, walnuts), seeds (sunflower, pumpkin) and oils made from seeds (sunflower, sesame, olive). To support the large intestine, include soups that are made from the pungent food groups, roots and squash, which are also plentiful in the autumn.

Exercise and Meditation

Because the energies of nature are turning inward and becoming more yin, it is important to concentrate more on staying relaxed and loose. Stretching, calisthenics, yoga, tai chi and qigong all keep the body flexible and the energy moving during this season and can be done indoors during the cold months. Meditation is also valuable during the autumn to quiet the mind and regulate our breathing. Setting aside 15 to 30 minutes each morning to focus on abdominal and yin/yang breathing can contribute to strengthening of the body’s vital energy.

Change is a recurring process in nature and in our lives. Adapt to this change in season by taking advantage of lymphatic massage, acupressure, eating seasonal foods, exercising and meditating. These proactive lifestyle suggestions can support the immune system, the lungs and the large intestine helping to maintain our health and vitality during the autumn months.

Posted by Nicole at 05:48 PM |
© 2009 Institute for Integrative HealthCare Studies. This work is reproduced with the permission of the Institute. www.Integrative-Healthcare.org

Often a neglected part of the body, the ears hold a special place in bodywork. Discover why clients love their ears rubbed during a session, what ear massage is particularly effective for and how to use the ears to increase a session’s effectiveness.

by Nicole Cutler, L.Ac.

Auriculotherapy is reflexology of the ear. The auricle of the ear (the external, protruding portion), can be viewed as a microsystem representing the entire body. Microsystems are valuable in many disciplines, including neuroanatomy, foot and hand reflexology, face and scalp acupuncture, and iridology.

The first defined microsystem is a figurative representation of the human body mapped in the brain’s cortex. Called somatosensory mapping, a distorted human figure reflects the corresponding body parts in the sensory and motor cortex. Also known as the cortical homunculus, this figure has disproportionately large lips, hands, feet and genitals, reflecting the larger cortical area allocated for the innervation of these body parts.

Similar to the cortical homunculus, the ear has been mapped in detail to reflect associated areas with the entire human body. Due to its high level of accessibility, this auricular microsystem can be used to treat health conditions affecting all parts of the body. Stimulating points on the ear can alleviate problems associated with nearby regions of the face and head as well as relieve pathological disorders in the chest, abdomen, lower back, and feet. According to microsystem theory, there are no direct connections between the ear and specific distal body parts. Rather, nerves from the ear connect to reflex centers in the brain that send neurological reflex pathways to the spinal cord, which in turn, sends them on to the neurons reaching distal body parts.

While ear massage can be used to address a countless array of health issues, musculoskeletal pain and addiction have demonstrated some of the most dramatic responses to auriculotherapy.

Pain
Regardless of the mechanism, applying pressure to the ear in specific locations has been found to relieve distal body pain. Ear massage triggers the release of the body’s natural painkillers, endorphins. Studies have demonstrated that ear stimulation increases levels of endorphins in both the blood and cerebrospinal fluid.

Ear massage also aids in breaking the pain-spasm-pain cycle. Most chronic pain is due to the constriction of connective tissue surrounding muscles in spasm. Muscles remain in spasm when the brain instructs motor neurons to initiate and sustain their contraction. The stimulation of ear reflex points connected to the brain can reset the brain’s electrical prompts, stopping unwanted activation of spinal reflexes. According to Oleson, “Pain sensations that are due to irritated nerves can be relieved by the normalizing of pathological, hypersensitive reflex pathways that interconnect the ear microsystem and the somatotopic brain.”

Consult an auriculotherapy map to locate the correct reflex area to address a specific painful body part. Identification of a tender area on the ear typically corresponds with the most beneficial point to relieve the distally located pain.

Addiction
Auriculotherapy is used throughout the world to reduce substance cravings and assist in the detoxification of addictive substances. Explanations for the effectiveness of auriculotherapy in facilitating drug independence derive from both a Western neurological conceptualization and a Traditional Oriental Medicine perspective. The first evidence of auriculotherapy’s in reducing substance cravings of drug addicts came from Dr. Wen of Hong Kong in the 1970s, and was expanded upon by Dr. Michel Smith, a physician who practices Oriental Medicine in New York City.

A Western neurological basis for using auriculotherapy as part of drug detoxification focuses on the area of the ear primarily used in addiction treatment, the concha. The two concave or hollow areas of the outer ear, the concha correspond to the autonomic nervous system via the vagus nerve and the brain’s hypothalamus. Influencing these nervous system components enhances relaxation and maintains balance. Auriculotherapy’s release of endorphins has the additional benefit of improving mood without the aid of the addicted substance.

Traditionally, five points are stimulated on the outer ear to aid the addiction recovery process. Possession of an illustrated ear map will facilitate locating each of the five points: Sympathetic, Shen Men, Heart, Liver and Lung.

Don’t skip the ears
While the majority of research has focused on ear acupuncture, auriculotherapy works with any type of ear stimulation. Many massage therapists include a general, feel-good ear rub at the conclusion of a session. However, learning the anatomy and body map of the ear can add a new level of healing to a massage. Since the ears provide direct access to the central and peripheral nervous systems, spending some time to focus on specific ear locations will benefit your client by amplifying the bodywork performed.

References:

Netter, MD, Frank H., Atlas of Human Anatomy, Ciba-Geigy Corporation, 1989.

Oleson, PhD, Terry, Auriculotherapy Manual, Health Care Alternatives, 1998.

www.auriculotherapy.com, FAQs, Terry Oleson, PhD, 2006.

www.brainconnection.com, Motor Humunculus, Scientific Learning, 2006.

www.emedicine.com, Massage, Traction, and Manipulation, J Michael Wieting, DO, MEd, 7/18/05.

Posted by Editors at 02:26 PM

© 2009 Institute for Integrative HealthCare Studies. This work is reproduced with the permission of the Institute. www.Integrative-Healthcare.org

Traditionally known as a Traditional Chinese Medicine technique, cupping can be mastered by massage therapists to complement their professional repertoire. Discover several cupping variations, as well as the theory behind this traditional practice.

by Nicole Cutler, L.Ac.

One of the therapies employed by practitioners of Traditional Chinese Medicine (TCM), cupping is a powerful, manual technique for breaking up localized congestion. While it does require some additional training, cupping is within the scope of practice for most practicing massage therapists. Armed with expert guidance and a basic understanding of TCM theory, bodyworkers can deliver a deep, therapeutic cupping treatment while giving their hands a respite from the rigors of their profession.

What is Cupping?
Originally practiced to drain toxins from snakebites and skin lesions, cupping began by using hollowed out animal horns to suck poisons out of a recipient’s skin. As more was learned about human physiology, the therapeutic applications of cupping were applied to an increasing number of health conditions. Accompanying the progression of this therapy, the cups originally crafted from horns evolved to bamboo, then glass and sometimes plastic.

Records have proven that ancient cultures of China, Greece and Egypt regarded cupping as a medical practice as early as 28 A.D. Over the years, practitioners have relied on cupping’s strong suction to increase circulation for:

· Tightened or painful muscles
· Sprains or strains
· Pinched nerves
· Lung congestion
· Menstrual irregularities
· Inflamed breasts
· Lactation dysfunction
· Gastrointestinal disorders
· Cough
· Asthma

Cupping Variations
There are several cupping variations within a massage therapist’s scope of practice:

· Fire Twinkling Method – The practitioner clamps, then ignites a piece of alcohol-soaked cotton, places the flame into a glass cup, removes it quickly, and then inverts the cup onto the skin. Because the flame consumes the cup’s oxygen, a strong suction is created.

· Suction Pump Method – Usually composed of plastic, these cupping sets allow the practitioner to use a pump to remove oxygen from the cup, thus creating suction.

· Stationary Cupping – This is when a cup is applied to a specific, congested location and left there for up to 15 minutes.

· Running Cupping – This is when plenty of lubricant is applied to a broad area, a cup is adhered to the body, and then moved around without breaking the seal. Massage therapists can mimic several types of massage strokes by working with this technique.

Cupping Theory
Cupping is known for its ability to break up localized stagnation. Cupping is reputed to:

· Drain excess fluids and toxins
· Loosen adhesions
· Lift connective tissue
· Enhance circulation in stagnant musculature and fascia
· Stimulate the peripheral nervous system

In terms of TCM theory, the stagnation can be of just about any type: blood, toxins, qi or dampness. The suction created by cupping draws stagnant toxins, heat, energy or fluid out of where it has accumulated and brings it to the body’s surface. Once under the skin, the offending culprit can more easily be eliminated via the body’s waste removal systems.

Based on cupping’s most popular applications, the following conditions benefit from stagnation dispersal. For clarity, this is further broken down by stagnation type:

1. Blood Stagnation – Injuries, adhesions, menstrual irregularities

2. Stagnant Toxins – Gastrointestinal disorders, rigid muscles, breast inflammation

3. Qi Stagnation – Muscular pain, dysmenorrhea, pinched nerves

4. Fluid Stagnation – Lung congestion, asthma, lactation dysfunction

Once an adhesion or congestion is pulled away from its source, fresh blood, energy and fluids rush in to expedite healing. Besides sparing the practitioner’s hands from demanding physical labor, this dramatic increase in circulation makes cupping a valuable complement to bodywork. By learning about TCM stagnation theories and becoming practiced in the art of cupping, massage therapists have a unique and effective tool to bring their clients closer to their health goals.

For more information about cupping, look for the upcoming article, “Cupping for Massage Therapists: Part II.”

Recommended Study:
Shiatsu Anma Therapy

References:

http://www.massagecupping.com/, History of Cupping, Retrieved October 1, 2008, Massage Cupping Bodywork Therapy, 2008.

http://www.massagemag.com/spa/treatment/cupping.php, The Art of Massage Cupping, Anita J. Shannon, LBMT, Retrieved October 1, 2008, Massage Magazine Inc., 2008.

http://www.massagetoday.com/archives/2004/02/04.html, Massage Cupping Therapy for Health Care Professionals, Anita J. Shannon, LMBT, Retrieved October 1, 2008, Massage Today, February 2004.

Liangyue, Deng, et al, Chinese Acupuncture and Moxibustion, Foreign Languages Press, Beijing, 3rd printing, 1993: 346-347.

Posted by Editors at 02:00 PM
© 2009 Institute for Integrative HealthCare Studies. This work is reproduced with the permission of the Institute. www.Integrative-Healthcare.org

While most meridians of Chinese Medicine are associated with a familiar organ, one stands out as the source of much mystery. Discover the keys to stimulating the triple burner meridian to ensure a therapeutic session.

by Nicole Cutler, L.Ac.

Also referred to as the san jiao, triple warmer, triple energizer and triple heater, the triple burner metabolizes the fluids of our body. All of our body fluids (blood, sweat, tears, saliva, urine, etc.) originate from the food and drink we consume. Food and drink are transformed and separated by the spleen into “clean” and “dirty” parts. Clean fluids are directed to the lungs and skin, while the kidneys and small intestine process dirty fluids to be excreted as urine. According to Chinese Medicine, this process is a simplified version of how our body metabolizes fluids. The triple burner is responsible for the generation, transportation and removal of all body fluids.

Functions of the Three Burners
There are three portions that comprise the triple burner – the upper burner, middle burner and lower burner.

Upper burner – The main physiological process of the upper burner is distributing the body’s fluids via the action of the lungs. Often referred to as a mist, the upper burner is responsible for transforming the body’s energy into a vapor that maintains the lubrication necessary for healthful respiration. This vapor also assures the skin’s moisture, a necessary immunity guard to prohibit pathogens from invading the body. Our physical shield against viruses and bacteria, skin is our first line of defense against airborne illnesses.

Middle burner – The main physiological processes in the middle burner relate to digestion. In the process of digestion, the middle burner’s spleen and stomach break down food and drink by separating what is to be absorbed from what is to be excreted. Referred to as the maceration chamber, the middle burner is where nourishment is garnered and transported throughout the body.

Lower burner – The main physiological process in the lower burner is the separation of fluids for excretion in the form of urine. Referred to as the drainage ditch, the lower burner incorporates the functions of the small intestine, kidney and urinary bladder.

The Channel
The location of the triple burner is integral in understanding why its manipulation has such a significant impact.

Starting at the tip of the ring finger, the triple burner channel progresses dorsally between the fourth and fifth metacarpal bones and up the lateral aspect of the arm, between the radius and ulna. It then climbs up the posterior portion of the arm to the shoulder joint and the supraclavicular fossa, where an internal branch descends into the chest, through the diaphragm to the abdomen. From the supraclavicular fossa, the triple burner channel ascends along the lateral portion of the neck to just behind the ear (where a branch connects with the gallbladder) before it dips down to the cheek and ends in the infra-orbital region. Due to its course, bodyworkers address the triple burner meridian for issues involving the lateral aspect of the forearm and arm, the shoulder, neck, ear and eye conditions.

Triple Burner Pathology
Because the triple burner is not a distinct organ, its pathology can incorporate many different patterns. Recognizing a typical triple burner disharmony is the best indicator of when to include bodywork on this meridian. Since the applications are so broad, the pathologies will be discussed according to the location, namely, the upper, middle and lower burners.

Upper burner – When the misting function of the upper burner is impaired, it typically leads to a breakdown of our defenses. This can result in a cold, with symptoms such as sneezing, runny nose, temperature, sore throat, body aches, etc. Specific to the triple burner meridian are symptoms that correspond with the channel location, such as earache, pain behind the ears, cheek swelling, sore throat and pain in the outer canthus of the eye.

Middle burner – When the macerating function of the middle burner is impaired, there is an imbalance in the digestive process. Most typical of a triple burner imbalance are food retention issues, such as bloating, nausea, heartburn and excessive belching. Clients with these symptoms are likely too sensitive to endure abdominal massage. This scenario presents an ideal time to work with the triple burner meridian.

Lower burner – When the drainage ditch is not functioning properly, there are problems with water retention and urination. Imbalances involving the triple burner can include lower leg edema, burning urination, urinary retention, loss of bladder control and frequent urination. If a client shares any clues indicative of a lower burner imbalance, working on the triple burner meridian could positively benefit them.

With an understanding of the triple burner, massage therapists can take advantage of its easily accessible location to healthfully impact some very complex body imbalances. As our system for creating, processing and eliminating fluids, the triple burner is fascinating, and no longer mysterious.

Recommended Study:
Shiatsu Anma

References:

Maciocia, Giovanni, The Foundations of Chinese Medicine, Churchill Livingstone, New York, NY, 1989.

Posted by Editors at 02:26 PM
© 2009 Institute for Integrative HealthCare Studies. This work is reproduced with the permission of the Institute. www.Integrative-Healthcare.org

While massage therapists have many modalities to choose from to relieve pain, personalizing a treatment for a client’s pain is part of most forms of Asian bodywork. Discover what massage style is the best choice to incorporate into a customized pain treatment plan.

by Nicole Cutler, L.Ac.

A massage therapist’s practice is typically dominated by clients seeking to relieve some form of pain. Shiatsu is an effective, non-invasive massage style based on both Traditional Chinese Medicine (TCM) theory and Japanese massage techniques. The essence of this form of acupressure is the combination of diagnosis and therapy, allowing for a tailored treatment. While diagnosing a client’s condition in terms of Western medicine is beyond a massage therapist’s scope of practice, assessing a client’s imbalance in terms of TCM is well within a bodyworker’s realm.

Studying TCM theory is crucial for learning how to make an accurate diagnosis for shiatsu treatment. While this task looms large, a simplified guide in differentiating between excessive and deficient conditions can serve as solid starting point. In TCM, health is akin to balance. The energetic meridians traverse the entire body, and a balanced flow of energy within these meridians is analogous to a body free of pain. There is an old Chinese saying which roughly translates to:

“Where there is blockage, there is pain; where there is no blockage, there is no pain.”

A blocked meridian is an unbalanced meridian. While a majority of painful conditions are due to blockages within the meridian, there are many imbalances that can precipitate such a blockage. It is the Shiatsu practitioner’s job to uncover the primary imbalance causing the client’s pain. Once a proper assessment is made, a plan can easily be devised and applied to correct the imbalance. In the Institute’s Shiatsu Anma continuing education program, massage techniques to balance excess and deficient states are demonstrated. Choosing whether the primary causative imbalance is deficient or excessive in nature is the first step in choosing a treatment approach.

Blockages
A meridian blockage is considered to be an excessive imbalance. There are three main substances capable of congesting a meridian: qi (energy), blood or phlegm.

1. Qi Blockage: Although a blockage of qi can lead to blood congestion, qi congestion is associated more with distention rather than pain. If the pain is due to qi congestion, it moves around and will appear and then disappear. A pattern involving qi congestion typically involves depression, mood swings, frequent sighing and other emotional symptoms.

2. Blood Blockage: When it comes to painful conditions, blood congestion is almost always the culprit. Characteristics of pain due to blood congestion are pain that is fixed in one location, stabbing or piercing pain, pain aggravated by direct pressure, dark color in the area of pain and pain that worsens with inactivity.

3. Phlegm Blockage: Phlegm congestion is rarely responsible for pain, as it is mostly associated with internal organ disharmonies such as certain types of tumors, mucous congestion in the nose or lungs, obesity or gastrointestinal problems. An exception is headache, which can be due to phlegm congestion when the entire head feels heavy, the client is dizzy or nauseous, has low appetite and feels as if a vice is squeezing their head.

Differentiation
Although a majority of painful conditions are excessive cases of blood congestion, uncovering the reason for the congestion will give the practitioner a more accurate assessment of excess or deficiency. Because blood congestion can either be caused by an excessive condition or by a deficient condition, identifying the underlying imbalance is important for devising the best treatment plan. When aspects of both excess and deficiency are present, a practitioner must choose the most dominant pattern.

In general, a predominant presentation of excess is treated with dispersal and invigoration techniques, while a predominant presentation of deficiency is treated with warming and tonification techniques.

Blood Congestion Causes
While there are many causes of blood congestion causing pain, the ones most encountered in clinical practice include:

· Qi Congestion – An excessive condition, this is a common precursor to blood congestion. A basic premise within TCM is that qi moves blood, so if qi stagnates, eventually the blood will stagnate too. (See the above section for recognizing qi blockage.)

· Traumatic Injury – An excessive condition, the force of a local trauma causes a structural change that typically results in blood congestion. (See the above section for recognizing blood blockage.)

· Deficiency of Qi – A deficient condition, deficiency of qi that persists over an extended period of time may cause stasis of blood as the qi becomes too weak to move blood. Qi deficiency typically manifests with low energy, breathlessness, weak voice, loose stool, spontaneous sweating, and pain that worsens as the day progresses. This type of pain can improve with applied pressure.

· Blood Deficiency – A deficient condition, blood deficiency that persists over an extended period of time will cause qi deficiency. When the qi is too weak to move blood, blood congestion results. Blood deficiency typically manifests with pale complexion and lips, tightened and easily injured tendons, dizziness, poor memory, blurry vision, insomnia, amenorrhea and anxiety.

As taught in the Institute’s Shiatsu Anma course, Shiatsu techniques differ, with dispersal and invigoration methods used for excessive imbalances, while tonification and warming methods are used for deficient imbalances. Practitioners of Asian bodywork who master this differentiation can really utilize the strengths of TCM; by tailoring each treatment to their client, enhancing a massage’s therapeutic value and successfully ridding their clients of pain.

Recommended Study:
Shiatsu Anma

References:

Maciocia, Giovanni, The Foundations of Chinese Medicine, Churchill Livingstone, New York, NY, 1989.

www.altmedicine.about.com, Blood Stagnation, Cathy Wong, About, Inc., 2007.

www.davidbole.com, Sports Medicine: A Chinese Medical Perspective, David N. Bole, PhD, AP, 2007.

Posted by Editors at 01:03 PM

© 2009 Institute for Integrative HealthCare Studies. This work is reproduced with the permission of the Institute. www.Integrative-Healthcare.org

With just a few simple changes, discover more tips on how massage therapists can take better care of the earth and their clients.

by Linda Fehrs, LMT

As massage therapists, our clients often look to us for simple ways to improve and maintain their health. Massage therapy could be thought of as a collection of non-invasive, non-toxic techniques and tools that help to reduce blood pressure, increase circulation and improve muscle tone. Our needs as professionals are few. All that is required at the very basic level is a trained pair of hands and a body to work on. The next step up would perhaps include a good quality massage table, some clean sheets and safe, healthy lubricants. A good location, somewhere to set up, is of course also necessary. It doesn’t get much easier, or greener, than that.

As time goes on, though, we may develop some bad habits, or not look into newer, more environmentally friendly ways of doing things. Most, if not all, of us can do better. We can make our practices healthier for ourselves and for our clients and, in turn, help the earth.

Here are ten simple ways to make your home and your practice a place that is not only safe and healthy for you, but also has a positive effect on the environment.

1. Drive Less – If possible, use public transportation, or if your office is close enough, walk or ride a bicycle to your practice. You might want to consider the benefits of working out of your home and eliminate commuting all together. There are no motorized vehicles that are totally non-polluting. Even the newer hybrid cars use some gasoline, and a totally electric car still uses unhealthy materials to produce electricity and batteries.

2. Adjust Your Thermostat – By lowering your thermostat by a few degrees in the winter months and raising it in the summer, you will not only reduce the use of energy that is used to produce it, but could also see a savings of 25 to 30 percent on your heating and air-conditioning bills. Remember to lower your thermostat as well during times you are not using your office, such as overnight or while on vacation.

3. Switch to Compact Fluorescent Light Bulbs or LED’s (Light Emitting Diodes) – Consider using these instead of incandescent bulbs at your desk or in your waiting room. They last longer and are more efficient than incandescent bulbs, resulting in the use of between 30 and 75 percent less electricity. If you are concerned about the harshness of the light, soften it with warm colored lampshades. Also, remember to turn off any lights in unoccupied rooms.

4. Buy in Bulk – Purchasing often used items in larger containers will save on packaging as well as cost. Massage oils, lotions and creams can be bought in large quantity and your small bottles can be refilled.

5. Use Environmentally Friendly Cleaners – Massage offices need to be clean, but that doesn’t mean having to use harsh or toxic chemicals. Many stores now carry gentle but efficient cleaning products. Going back to basics is often the best and there are many books and websites offering easy recipes for creating your own cleaning materials.

6. Use Cloth Bags Instead of Paper or Plastic – Using and reusing cloth bags for shopping ends the debate on paper vs. plastic when it comes to groceries or other products you purchase. Cloth bags are stronger, usually hold more and nothing new is added to landfills.

7. Reduce, Reuse and Recycle – Reducing your consumption of one-use items such as disposable razors, plastic water bottles and overly packaged food, reusing what you already have on hand like glass containers, and recycling things made of paper, plastic and metal items helps to lighten the load on local landfills.

8. Visit Your Local Library – By taking advantage of the library you can reduce the number of magazines you buy or subscribe to and minimize the number of books you buy. This helps to save valuable trees, which in turn helps wildlife to survive.

9. Buy Organic – As much as possible eat organic food and use organic materials, such as oils and sheets in your practice. Crops grown using pesticides have been shown to have negative health effects including damage to the nervous system, cancer and birth defects. Growing crops organically decreases this risk not only for the consumer but also farmers and animals.

10. Support Local Vendors – By shopping locally, especially at farmer’s markets or small businesses, you help lower your own fuel consumption as well as reduce the amount of energy it takes to transport goods across the country. Shopping within your community also helps the local economy, providing jobs close to home and resulting in less gas consumption.

Every day, in both large and small ways, we can help to make our offices and homes more eco-friendly. Something as simple as using essential oils instead of commercial air fresheners can reduce allergic reactions and may even help to alleviate the symptoms of asthma or other respiratory problems. Walking short distances instead of driving not only reduces air pollution, but it also gives our body exercise, allows us to slow down and we may see the world around us in new ways.

Setting good examples and letting our clients know that we care about the environment shows we care about their health and safety as well.

Recommended Study:
Developing a Wellness Center

Resources:

Bond, Annie, Home Enlightenment: Practical, Earth-Friendly Advice for Creating a Nurturing, Healthy, Toxin Free Home and Lifestyle, Rodale Books, September 2005.

www.care2.com, Green Living, Care2, 2008.

www.earthshare.org, Workplace Campaigns, EarthShare, Spring 2007.

www.epa.gov, Pollution Prevention and Recycling, Environmental Protection Agency, 2008.

www.greenbiz.com, Small Business, GreenBiz.Com, 2008.

www.greenthislife.com, A Bright Idea: Eco Conscious Lighting, Blake Frino, Green This Life, December 2008.

www.massagemag.com, How Green is Your Massage Practice?, Karen Menehan, Massage Magazine, March 2008.

www.amtamassage.com/mtj, Going Green, Elizabeth Barker, Massage Therapy Journal, Fall 2007.

Posted by Editors at 12:27 PM
© 2009 Institute for Integrative HealthCare Studies. This work is reproduced with the permission of the Institute. www.Integrative-Healthcare.org