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

Approximately one-third of Americans have heartburn at least once a month, with 10 percent experiencing it daily. In addition to seeking a physician’s guidance, massage therapy can also help a person with this uncomfortable condition. Learn what massage modalities can assist individuals suffering from heartburn.

by Nicole Cutler, L.Ac.

Heartburn is a burning discomfort in the chest or throat resulting from stomach acid contacting and irritating the lining of the esophagus. It is an expression of acid reflux or gastroesophageal reflux disease (GERD), a phenomenon caused when contents from the stomach rise into the esophagus, much like water bubbling up into a sink from a plugged drain. While occasional episodes are likely not indicative of GERD, frequent heartburn should always be evaluated by a doctor. The exact symptoms and sensations of heartburn vary from person to person, though the most prominent characteristics of heartburn are:

· a bitter, sour or acidic taste in the mouth
· feeling partially digested food or liquid rising from the stomach to the mouth
· burning chest pain, often behind the breastbone
· bloating, belching and nausea
· chronic cough
· stinging, hoarseness or sore throat
· an increase in severity of pain when lying down or bending over

Physiology
To break down food, the stomach secretes hydrochloric acid. While the stomach’s lining protects it from this potent acid, the esophagus does not share the same protection. Thus, heartburn is the burning sensation felt when hydrochloric acid enters the esophagus.

The lower esophageal sphincter (LES) is the muscular valve connecting the esophagus and stomach. The LES is a high-pressure zone that acts as a barrier to protect the esophagus against the backflow of gastric acid from the stomach. If the LES relaxes or malfunctions, it allows stomach acid to flow upward into the esophagus. Normally, the LES works like a dam, opening to allow food to pass into the stomach and closing to keep food and acidic stomach juices from flowing back up into the esophagus. Acid reflux occurs when the LES is weak or relaxes inappropriately, allowing contents of the stomach to reverse direction. While medical experts are uncertain why this happens, a loss of muscle tone in the LES results in the inability to close completely after food empties into the stomach. A complex segment of smooth muscle under the control of nerves and various hormones, dietary substances, drugs and nervous system factors can impair LES function.

Tips to Minimize Heartburn
Since many factors can affect stomach pressure and LES tone, there are a myriad of ways to minimize heartburn.

· Elevate – Lying down worsens the burning discomfort associated with indigestion and heartburn. By elevating one’s head when reclining, gravity promotes the downward flow of digestion for preventing regurgitation. During a massage session, massage therapists can place extra pillows under a client’s head for a similar effect.

· Dietary avoidances – Suggest clients abstain from food or drink that increases acid secretion, decreases LES pressure or slows the emptying of the stomach. Known offenders include alcohol, chocolate, carbonated beverages, fatty and fried foods, garlic, onions, spicy foods, mints, tomatoes, oranges and other acidic foods and drinks.

· Quit smoking – One more reason to kick the habit, nicotine stimulates stomach acid and impairs LES function.

· Relax – Massage and other relaxation methods prevent and relieve heartburn by reducing abdominal pressure. Additionally, stress can increase sensitivity to refluxed acid, reduce pain thresholds and increase the frequency and severity of heartburn symptoms.

Warnings
While heartburn is generally not considered dangerous, it can be mistaken for a more serious condition. If heartburn is persistent and severe, it could be a symptom of GERD. Untreated, GERD can cause or contribute to a wide range of problems, including peptic ulcers, hiatal hernia or even esophageal cancer. Fortunately, many of these complications can be avoided with proper monitoring from a health care professional.

The pain caused by heartburn and heart attack can be so severe that both patients and doctors have a difficult time distinguishing one from the other. In fact, sophisticated equipment is generally necessary to determine whether patients are suffering from a heart attack or not. Experts advise seeking immediate medical attention if chest pain, or other heart attack warning signs, lasts for more than a few minutes. The following details the differences between heartburn and heart attack:

Heartburn
· A sharp, burning sensation just below the breastbone or ribs
· Although it is possible, pain generally does not radiate to the shoulders, neck, or arms
· Pain usually comes after meals
· Rarely accompanied by a cold sweat, lightheadedness or dizziness

Angina or Heart Attack
· A feeling of fullness, tightness, dull pressure or pain generally in the center of the chest
· Pain may spread to the shoulders, neck or arms
· May be accompanied by a cold sweat
· Might experience lightheadedness, weakness or dizziness
· Shortness of breath
· Nausea and possible vomiting

Seek immediate medical attention if you or a client experiences any warning signs of a heart attack.

Shiatsu for Heartburn
By applying various pressure techniques to specific locations, shiatsu can quiet the nervous system, calm a churning stomach, slow increased acid production activated by stress and alleviate the burning symptoms of reflux. Practitioners of this specialized form of massage agree that the most useful points to ease heartburn, are:

· Stomach – Stomach 41, 42 and 43 are used to decrease stomach acidity.

· Pericardium – Pericardium 6 relaxes the chest, helps digestion flow downward and reduces nausea.

· Liver – Liver 3 reduces anxiety, decreases stomach acidity and minimizes pressure on the stomach from constricted abdominal muscles due to stress.

· Additional points – Conception Vessel 17 promotes the downward flow of energy in the chest. Spleen 4 is used for calming a rebellious stomach.

Odds are that a significant percentage of clients in any massage practice struggle with either occasional or frequent heartburn. While diagnosing and treating this condition is beyond the scope of practice for massage therapists, being familiar with its symptoms, physiology, tips to improve symptoms, warnings and beneficial massage locations will ensure your client receives the best care possible.

Recommended Study:
Shiatsu Anma
Advanced Anatomy and Physiology

References:

www.ehow.com, How to Use Shiatsu for Heartburn, eHow, Inc., 2006.

www.healingwell.com, Natural Remedies that Work: Irritable Bowel Syndrome, Jini Patel Thompson, HealingWell.com, 2006.

www.heartburnalliance.org, All Q & A, National Heartburn Alliance, 2006.

www.massagemag.com, Heartburn Solutions, University of California Wellness Letter, Massage Magazine, Inc., 2006.

www.mercksource.com, Gastroesophogeal Reflux Disease, Harvard Health Publications, 2006.

www.worldwidehealth.com, Heartburn, Rita Louise, PhD, WorldWideHealth.com, 2006.

Posted by Editors at 09:30 AM
© 2009 Institute for Integrative HealthCare Studies. This work is reproduced with the permission of the Institute. www.Integrative-Healthcare.org

May is Stroke Awareness Month. This is a good time to learn how bodywork can play a valuable role in helping to prevent stroke in those who are most vulnerable, and help victims recover with dignity. Of the five million stroke survivors in the United States, more than three million have some resulting disability or degree of impairment. Discover three complementary therapies that have been shown to help in stroke recovery and rehabilitation.

by Linda Fehrs, LMT

Every 45 seconds someone in the U.S. has a stroke. It is the third leading cause of death behind heart disease and cancer and the number one cause of adult disability. Eighty percent of strokes are preventable, according to the American Stroke Association.

Depending on the severity, recovery can be long and difficult. A major stroke can result in a person being unable to walk or speak; a mild stroke makes recovery easier and resulting disabilities are barely noticeable. Quick intervention, within 48 hours, is most effective in reducing the negative impact of damage to the brain. Unless you work in a hospital setting this is difficult but, as doctors become aware of how massage helps, this may change.

Causes
The causes of stroke, or cerebrovascular accident (CVA), include:

· Cerebral thrombosis, which is caused by a clot lodged in a cerebral artery and accounts for about 88% of strokes.
· An embolism, similar to cerebral thrombosis, differs in origin. Inefficient pumping of the heart allows blood to thicken, forming clots in the left atrium, which then enter the bloodstream and, ultimately, the brain.
· Cerebral and subarachnoid hemorrhages are caused by ruptured blood vessels as a result of uncontrolled chronic hypertension, head trauma or malformed blood vessels, which produce tissue death in the brain.

The extent of damage depends on the part of the brain affected, how much of it and for how long. Motor damage can be seen in either partial or full paralysis on one side of the body (hemiplegia), a loss of language (aphasia), personality changes and/or loss of memory.

Symptoms
Massage therapists offer a first line of defense in helping to recognize the symptoms of stroke and later, during recovery, to reduce its effects.

If a client appears to have a sudden onset of numbness in one arm, speech is slurred or difficult to understand, if they cannot repeat a simple phrase, or their face appears to droop on one side, it is time to call 911.

Prompt intervention is the best treatment, including administration of anticoagulants for blood clot reduction, except in strokes caused by a hemorrhage. Massage would typically not be introduced into the recovery regimen for several weeks or months and requires approval from the attending physician.

Massage Reduces Anxiety and Pain
In a 2004 study, Hong Kong Polytechnic University, Department of Nursing and Wong Chuk Hang Hospital in Hung Hom, Lowloon, Hong Kong, found that slow-stroke massage on elderly stroke patients treated for anxiety and shoulder pain resulted in significantly lower pain, anxiety, blood pressure and heart rate. The subjects had an average age of 73 and received no other pain relief measures. They received ten minutes of slow-stroke massage prior to bedtime for seven days and an evaluation before receiving massage on the first day, again on the last day of the study, and three days after the sessions ended.

The authors, Esther Mok and Chin Pang Woo, wrote “the results of this study support the view that [slow-stroke back massage], as an alternative adjunct to pharmacological treatment, is a clinically effective nursing intervention for reducing anxiety and shoulder pain in elderly stroke patients.”

As the study indicates, slow-stroke massage reduces two of what may be the most important factors in stroke recovery – pain and anxiety. Deep or vigorous strokes are counterproductive and may cause more harm than good. Slow, soothing techniques and gentle stretching help with flexibility and proprioception.

3 Complementary Therapies for Stroke Rehabilitation
In addition to slow-stroke massage techniques, a client’s recovery may also be helped by the use of familiar complementary therapies such as reflexology, aromatherapy or shiatsu.

1. Reflexology might be used if Swedish massage is inappropriate. It gently helps the body recover from a stroke. Clients are helped without using techniques that increase blood flow, and contraindicated in someone with blood vessel weaknesses.

2. Aromatherapy is also helpful. Using an essential oil such as lavender helps relieve stress, while oils of rosemary and lemon may help circulation.

3. Another option is shiatsu. In Chinese medicine, chronic weakness of Qi blocks the blood flow to the brain, causing strokes. Shiatsu helps restore this flow, offering a session that is both rehabilitative and relaxing. Using points known as Four Gates (LI4 and LV3) relaxes tension in the head, reduces pain and calms the mind. GB20 improves circulation to the head, thus bringing much needed oxygen to the brain.

Documentation
Documentation through accurate and thorough SOAP notes is an important factor in the treatment of stroke victims. You will most likely be working in conjunction with other health care professionals, and sharing the outcomes of your sessions provide important evidence of a client’s progress. While initial intake is important in determining the type of massage treatment, ongoing notes will record the client’s improvement, help to update the primary care physician and demonstrate how massage can be an effective and valuable tool in the rehabilitation of stroke survivors.

While there may be no definitive studies proving the efficacy of massage in preventing or reducing strokes, it has been shown to positively affect predictors such as improving circulation and lowering stress and blood pressure. The effects of stroke continue to be one of the most debilitating disability issues. Massage therapists may help prevent stroke in those who are most vulnerable, and help victims recover with dignity.

Recommended Study:
Aromatherapy Essentials
Ethical Case Management
Reflexology
Shiatsu Anma Therapy

Resources:
www.haleclinic.com, Ailments/Stroke, Hale Clinic, London, UK, 2008.

http://holistic-online.com, Jacob, Dr. George, Alternative and Complementary Medicine for Stroke, 2008.

Massage Benefits Stroke Patients Study: Originally published in Complementary Therapies in Nursing & Midwifery, 2004, Vol. 10, pp. 209-216.

www.massagetherapy.com, Stroke Rehab – Part I, An Overview, April/May 2000, and Stroke Rehab – Part II, Coming Back, June/July 2000, Massage and Bodywork Magazine, Miesler, Dietrich, M.A., C.M.T.

www.stroke.org, May is Stroke Awareness Month, National Stroke Association, 2008

www.pacificviewpress.com, The Practical Application of Meridian Style Acupuncture, Pirog, John E., Pacific View Press, Berkeley, C, 1996.

www.americanheart.org, Stroke Statistics, American Heart Association, 2008.

Posted by Editors at 09:29 AM

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

Spring has finally rolled around, and the first thing that may come to mind is cleaning your home from top to bottom. Spring also happens to be the best time of year to get rid of the toxins in your body - learn which three massage techniques are especially suited for this task.

by Nicole Cutler, L.Ac.

As the cobwebs of winter dissipate with spring’s rainfall, the human body has its own way of adjusting to longer hours of daylight and increases in the outside temperature. By getting rid of the dirt that has accrued over the colder months, the tradition of spring cleaning promotes clean homes across the continents. Similarly, many realize spring as the ideal season to rid their body of the toxins accumulated over winter. Known specifically for their internal cleansing properties, certain bodywork techniques have the ability to support this ritualistic detoxification.

Chinese medical theory teaches its students that the energy in the liver organ system is most active in the spring. As the first line of defense against accumulated poisons, the liver’s role in cleansing the blood makes it one of the most important targets for detoxification. According to Denver naturopath and yoga instructor Brenna Hatami, “Spring represents the best time of year for cleansing the body for many reasons.” Hatami cites the availability of lighter foods, milder weather enticing more people outdoors and the enhanced regenerative properties of the liver as contributing to spring’s history as the season where people return to health.

Today, with more toxins in the environment than ever, “it’s critical to detox,” says Linda Page, N.D., Ph.D., the author of Detoxification (Healthy Healing Publications). Page recommends detoxifying for symptoms such as unexplained fatigue, sluggish elimination, irritated skin, allergies or low-grade infections, bags under the eyes, a distended stomach even if the rest of your body is thin, menstrual difficulties or mental confusion.

Among advocates of detoxification, there is dissension about what constitutes the ideal detoxification regimen. However, any program that augments the removal of toxins will improve health. Depending on who is consulted, a plan for detoxification may involve many factors, including:

· A highly specialized diet – often organic, vegetarian and low-fat
· Fasting
· Herbal supplements
· Bodywork
· Colonics
· Perspiration practices
· Increased water consumption
· Physical activity

While no one method is sufficient for a complete system overhaul, combining several detoxification approaches always enhances toxin removal quantity.

Bodywork to Detoxify
There are a number of different massage therapy techniques that encourage detoxification. While a case for impurity elimination can be constructed for many of these approaches, three kinds of bodywork are known to be especially supportive of detoxification:

1. Shiatsu for the Liver – Based on the meridian network mapped by Traditional Chinese Medicine, stimulating points along the liver channel help stimulate this organ to be a more efficient blood purifier. Performing shiatsu on Liver 3, the source point of the liver, is especially effective in increasing the blood circulation and thus purification capacity of this organ.

2. Lymphatic Drainage Massage – Integral to detoxification, the lymphatic system sequesters circulating threats in the body and aids in their elimination. Thus, draining the lymph nodes of accumulated toxins with lymphatic drainage massage removes blockages and improves their cleansing function.

3. Swedish Massage – Because the circulation resulting from Swedish massage enhances oxygen exchange among local tissues and improves colon drainage capability, this is a good addition for helping escort impurities out of the body.

Bodywork Caution
Massage therapists working with clients undergoing an intense detoxification program must be aware of the potential for a Herxheimer reaction. The Herxheimer reaction occurs when the body is detoxifying too rapidly, causing toxins to be released faster than the body can eliminate them. When this occurs, symptoms such as headaches, nausea, vomiting and malaise typically ensue. Although a Herxheimer reaction is short-lived, it can be severe enough for a client to stop detoxification.

To minimize this problem, advise clients undergoing detoxification to:

· proceed with their detox program slowly
· drink lots of pure water
· avoid exposure to environmental toxins
· avoid eating refined, processed foods
· abstain from alcohol
· perspire through exercise or taking a sauna/steam bath

Encourage established or potential clients to take advantage of spring’s momentum by cleansing themselves of the toxins residing within. As long as bodyworkers are careful to circumvent a Herxheimer reaction, shiatsu for the liver, lymphatic drainage massage and Swedish massage are the perfect accompaniments to someone’s internal spring cleaning.

Recommended Study:
Shiatsu Anma Therapy
Lymphatic Drainage Massage
Swedish Massage

References:

http://chetday.com , Detoxification Details, Ted H. Spence, DDS, ND, PhD/DSc, MPH, chetday.com, 2008.

http://life.gaiam.com, 10 Ways to Detoxify Your Body, Deborahann Smith, Gaiam Inc., 2008.

Marty, Diane M., Detox Days, Body Sense, Spring/Summer 2004.

www.healthydetoxtips.com, Detox - Why You Need To Start Now, How to Detox, 2008.

www.integrative-healthcare.com/mt, Emotional Spring Cleaning, Nicole Cutler, L.Ac., Natural Wellness, 2008.

www.massagemag.com, Massage Eases Alcohol Withdrawal Syndrome, Massage Magazine, March/April 2005.

www.talkmince.com, Detox Massage for Body Cleansing, Sandra Kim Leong, 2008.

Posted by Editors at 12:54 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

Although frequently prescribed, many people do not realize the disturbing implications of antibiotic use. Discover several issues relating to antibiotics that all massage therapists should be aware of.

by Nicole Cutler, L.Ac.

People around the globe equate visiting their doctor with getting antibiotics. In today’s age of emerging superbugs, doctors are still writing prescriptions for antibiotics at an unprecedented rate. While antibiotics can be life-saving, many health authorities are beginning to admit that these medications are often over-prescribed, creating problems worse than the original condition. Although advising for or against the use of medications is beyond a bodyworker’s scope of practice, there are several issues relating to antibiotics that all massage therapists should be aware of.

Antibiotic Resistance
Resistance to antibiotics is a major public-health problem. Because antibiotic overuse contributes to the rise of superbugs, experts have been calling on doctors to curb the liberal prescribing of antibiotics in many types of patients, including children with earaches, adults with sore throats and those with terminal end-stage disease. Although the medical ethics involved in preferential antibiotic dispensation are hotly debated among physicians, bodyworkers must take extra precautions when working with people who take, or have taken, these commonly dispensed drugs. Experts are increasingly recognizing that the evolution of stronger pathogens has a global impact, affecting the patient, their environment and all the people that come into contact with that patient or with their environment.

Impact on Bodywork
Clients typically come to bodywork sessions reporting current antibiotic use. While this isn’t always a contraindication, it does present concern demanding more information prior to treatment. Some questions about the antibiotics needing clarification include:

· Why is your client taking antibiotics?
· How long have they been on them?
· Is there an infection?
· Is the infection systemic or localized?
· Is there a fever?

Before proceeding with massage therapy with a client on antibiotics, the bodyworker must evaluate the following:

1. Will our session risk spreading the infection?

2. Will this client put me or my environment at elevated risk for superbug exposure?

3. Can I help the additional health issues resulting from antibiotic use?

Spreading the Infection
While there are many reasons a doctor might put their patient on antibiotics, a current infection is the most common. Because most forms of bodywork involve enhancing circulation, a therapist must determine if their work could spread infection. Since there are so many variables in pathogen strength and location, antibiotic strength and human response, there is no exact formula to determine this risk. In favor of bodywork for an infection, circulatory massage can actually assist the lymph and immune systems move pathogens out of body tissue.

Taking both perspectives into account, a therapist must use their best judgment to ascertain any potential risk of spreading the infection. In general, bodywork is considered safe if the client has been taking antibiotics for at least three days, the infection is not systemic and none of the signs of current infection are present: heat, fever, swelling or pain.

Superbug Exposure
Aside from living in a bubble, all of us are exposed to potentially drug-resistant organisms every day. As members of the healthcare industry, bodyworkers and their environment are particularly prone to pathogen exposure. Understanding this vulnerability is one more reason for bodyworkers to practice Universal Precautions with each and every client.

The importance of frequent hand washing must not be underestimated in healthcare environments. Thoroughly washing your hands before and after each session is the number one way to prevent passing superbugs along to yourself or other clientele. In addition, providing fresh linens for each client, cleaning door handles and keeping your own immune system healthy all contribute to the prevention of spreading infection.

Results of Antibiotics
Hopefully, properly prescribed and utilized antibiotic use destroys a person’s potentially dangerous bacterial infection. Whether this is the case or not, a majority of those taking antibiotics suffer from the annihilation of all organisms in their digestive tract.

Like pesticides, antibiotics kill good bugs along with the bad ones, especially the wide-spectrum antibiotics. The non-discriminating nature of most antibiotics disrupts the delicate balance of organisms in the gastrointestinal system by destroying beneficial bowel flora. These beneficial flora help us digest food, produce certain vitamins and prevent harmful bacteria and yeast from multiplying. Unfortunately, antibiotic use can invite parasitic infection, vitamin deficiencies, mineral loss through diarrhea, gut inflammation, malabsorption syndromes and food allergy development.

When this pattern of antibiotics destroying good and bad bacteria is recognized, bodyworkers can offer their clients hope. The following strategies are used by alternative healthcare practitioners to restore healthy bowel flora:

1. Suggest taking a good quality probiotic to help restore balance in the gastrointestinal system. While several dairy products have started including probiotics in foods, higher, more therapeutic concentrations of probiotics are found in supplements such as Fatigue Relief Plus.

2. Tonifying certain acupressure points can stimulate a client’s immune and digestive systems. The most beneficial points for helping strengthen the gastrointestinal system include Large Intestine 11, Stomach 36 and Spleen 6.

3. Encouraging clients to rejuvenate their immune system with good nutrition and plenty of rest to help their body resist the consequences of antibiotic use. Getting adequate vitamins, minerals and other nutrients from their diet and giving their cells time to recharge with restful sleep helps the digestive system bounce back from being cleaned out by antibiotics.

Whether it stems from cold and flu season, a toothache or an open wound gone bad, nobody likes to be sidelined with an infection. In an attempt to eliminate infections, most physicians habitually prescribe antibiotics. Bodyworkers aware of the possible problems caused by antibiotics are best prepared to help their patients taking these drugs. In addition to making certain their clients on antibiotics are well enough to receive massage, bodyworkers must practice Universal Precautions to reduce the spread of infection. On an even further level, bodyworkers can employ the three previously described strategies to help their clients cope with the destructive aftermath of antibiotic use.

Recommended Study:
Advanced Anatomy and Physiology
Infectious Disease: Hepatitis
Pharmacology for Massage
Shiatsu Anma Therapy

References:

http://news.yahoo.com, Study Suggests Antibiotics are Overused, Carla K. Johnson, Yahoo Inc., 2008.

Versagi, Charlotte Michael, LMT, NCTMB, When Is It Safe to Treat a Patient Taking Antibiotics?, Massage Today, March 2008.

www.drwilson.com, Beyond Antibiotics, Lawrence Wilson, MD, 2008.

www.medicalnewstoday.com, Causal Link Between Antibiotic Prescription And Antibiotic Resistance, MediLexicon International, Ltd., February 2007.

Posted by Editors at 11:36 AM

© 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