Archive for the 'accupuncture' Category

Jun 16 2009

TCM, Cupping and Massage: Part I

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:, History of Cupping, Retrieved October 1, 2008, Massage Cupping Bodywork Therapy, 2008., The Art of Massage Cupping, Anita J. Shannon, LBMT, Retrieved October 1, 2008, Massage Magazine Inc., 2008., 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 on October 8, 2008 02:00 PM
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Jun 16 2009

TCM, Cupping and Massage: Part II

Discover 10 massage cupping tips, and review the clinical support for this ancient healing art. This is the second installment of this invaluable 3-part article.

by Nicole Cutler, L.Ac.

More massage therapists than ever are embracing additional complementary approaches for healing. Likely a result of the increasing popularity of massage therapy and, thus, the greater demand for highly trained practitioners, cupping has sparked interest in many massage therapy practices. While there isn’t an abundance of scientific evidence proving cupping’s effectiveness, its ability to promote circulation is well-known to practitioners of Traditional Chinese Medicine (TCM). Bodyworkers wanting to learn more about the tradition of cupping can experiment with the massage cupping techniques described below.

For a basic understanding of what cupping is, its general variations and the theories supporting its use, read TCM Cupping and Massage: Part I.

Cupping Massage Techniques
Being familiar with several massage cupping techniques can help a bodyworker confidently include cupping in his/her range of services. Below are ten suggestions for effective massage cupping:

1. The level of suction for running cupping should be gentler than that used for stationary cupping.

2. Prior to applying cups for running cupping, administer plenty of oil to the area being cupped to facilitate smooth cup movement.

3. When moving the cups, the movement should be smooth without the practitioner applying downward pressure, because that would inhibit the suction effect.

4. The broad area of the back is one of the best surfaces for running cupping. The back can generally accommodate the larger cups.

5. Imitating a long stroke with the cups can help drain fluid accumulation.

6. Circular movements with a cup over a specific area can help release stubborn knots, adhesions and other types of rigid tissue.

7. Applying a diluted essential oil to the skin immediately following running cupping will facilitate its absorption into the tissue.

8. Long strokes along the ribs can improve ribcage expansion and benefit deep breathing.

9. Vigorous circling with the cups on the gluteus maximus can help ease certain types of sciatica.

10. Strong stationary cupping on the Lung Back Shu points can help relieve chest congestion, coughing and asthma.

Although the clinical support endorsing massage cupping is sparse, centuries of successful case studies have perpetuated its use. Since cupping falls under the umbrella of Traditional Chinese Medicine, most of the research on this modality has been conducted within a TCM setting.

The variation known as wet-cupping has dominated a majority of cupping’s research, and wet-cupping does not fall under a massage therapist’s scope of practice. Wet-cupping is when the skin is pricked with a lancet, then covered with a cup to draw out the stagnant blood. Bypassing the research on wet-cupping, a couple of clinical trials evaluated massage or stationary cupping in isolation:

1. Chronic Fatigue Syndrome – Chinese researchers observed the therapeutic effect of multiple, stationary cupping at the back-shu points on participants with chronic fatigue syndrome. By comparing their clinical symptoms before and after treatment with either cupping or acupuncture, the researchers found that cupping’s ability to reduce chronic fatigue symptoms far surpassed acupuncture’s effectiveness.

2. Senile Dementia – Researchers evaluated the effect of running cupping (massage cupping) on participants with senile dementia. Running cupping was performed over the spine (the Governing Vessel channel) and along the sides of the spine (the Urinary Bladder channel). The investigators determined that running cupping improved dementia’s symptoms as evidenced by increased measures of bodily strength, memories, feelings and movement.

While these two studies represent just a small percentage of a bodyworker’s clientele, the empirical evidence supporting massage cupping has preserved its practice for centuries.

Using cups to massage the body can be incorporated into most bodywork sessions. By learning about this modality and practicing different running cupping techniques, practitioners can add another layer of therapeutic effectiveness to their treatments.

For information about cupping’s cautions and contraindications, look for the upcoming article, TCM Cupping and Massage: Part III.

Recommended Study:
Aromatherapy Essentials
Shiatsu Anma Therapy

References:, The Art of Massage Cupping, Anita J. Shannon, LBMT, Retrieved October 1, 2008, Massage Magazine Inc., 2008., Massage Cupping Therapy for Health Care Professionals, Anita J. Shannon, LMBT, Retrieved October 1, 2008, Massage Today, February 2004., The efficacy of wet-cupping in the treatment of tension and migraine headache, Ahmadi A, et al, Retrieved October 1, 2008, American Journal of Chinese Medicine, 2008;36(1):37-44., Observation on therapeutic effect of multiple cupping at back-shu points on chronic fatigue syndrome, Chen GL, et al, Retrieved October 1, 2008, Zhongguo Zhen Jiu (Chinese Acupuncture and Moxibustion), June 2008., Treatment of Senile Dementia with Running Cupping Along Back Shu Points: 18 Cases, Translated by Jennifer Lynn Brown, Retrieved October 1, 2008, New Journal of Traditional Chinese Medicine, December 1996.

Posted by Editors on November 6, 2008 11:59 AM
© 2009 Institute for Integrative HealthCare Studies. This work is reproduced with the permission of the Institute. <>

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Jun 15 2009

TCM, Cupping and Massage: Part III

Before massage therapists add cupping to their menu of services, they must have a firm grasp of cupping’s cautions and contraindications. This is the final installment of this important 3-part article.

by Nicole Cutler, L.Ac.

Because cupping gives massage therapists a break from deep tissue work while delivering a powerful therapeutic benefit, it is an ideal supplement to a massage therapy practice. While cupping is a relatively simple practice, there is a lot to learn about this method before mastering it. In addition to the flawless application and manipulation of cups, knowing what conditions it helps most and why cupping works, practicing therapists must know about cupping’s cautions and contraindications.

For background information on cupping, read TCM, Cupping and Massage: Part I and TCM, Cupping and Massage: Part II.

The therapeutic benefits to massage cupping are far-reaching. However, practitioners who include cupping in their repertoire must log in a significant amount of practice before performing it on clients. In order to assure its effectiveness and maintain cupping’s safety, massage therapists must be extra careful to prevent burns, apply the right level of suction and be familiar with all of the associated contraindications.

Fire Cautions
Because it can provide a strong suction without causing tissue damage, the fire twinkling method is the traditionally preferred method of cupping by many practitioners. Nonetheless, when using the fire twinkling method, therapists must be attentive, quick and agile to prevent burning their clients. The following tips help prevent burns or fire hazards:

· Protect – Since the practitioners must place the flame into the cup in close proximity to their clients for quick adherence, the client’s skin, hair, clothing and anything flammable (hair product, oils, linens) must be protected from catching fire. Being alert is crucial to providing such protection.

· Plan – Logistical planning prior to cupping is essential to minimize any fire hazards. Once the flame is withdrawn from the cup, the cup is applied and the flame is blown-out, place the hot, alcohol-soaked cotton ball on a stable, non-flammable surface. Because the flame may not be 100 percent extinguished, practitioners must make sure it cannot re-ignite what it is resting on, or roll off onto something flammable. A wide porcelain bowl on a firm surface (not the massage table) is a good choice.

· Timing – Choosing the amount of time the flame is held inside the cup can be a fine line between too short and too long. If the lit cotton is in the cup for too short a time, it will not create sufficient negative pressure for suction. If the lit cotton is in the cup for too long, the lip of the cup will become very hot and could burn the client. Until mastery over cupping is achieved, practitioners should always err on the flame occupying the cup for a shorter period of time. If insufficient suction occurs, the process can always be repeated.

Suction Cautions and Contraindications
Whether you choose the fire twinkling or suction pump method to apply the cups, the therapist must avoid cupping’s contraindications and be careful with the degree of suction used.

· Bruising – While stationary cupping typically causes more bruising than massage cupping, either technique can leave large, unsightly bruises in the cups’ wake. (To review the difference between these cupping variations, read TCM, Cupping and Massage: Part I.) To prevent surprised and angry recipients, make sure to discuss this possibility with your client prior to using this modality.

· Degree of Suction – Getting strong enough suction is key to cupping’s effectiveness. Although, too strong of a suction could damage the tissue or even create a blister. Cupping’s intensity depends upon the following: the speed the cup is placed on the skin after the flame has been removed, the strength of the flame (certain alcohol burns hotter than others) and the size of the cup. Therefore, practicing the balance between these variables will help the therapist determine a safe cupping routine. Practitioners will find that it is very challenging to obtain suction over irregular angles, thin muscles or on areas with lots of body hair.

· Contraindications – Just like any modality that strongly invigorates the circulation, there are some situations where cupping should be avoided. Cupping should not be done on a client with a fever, convulsions or cramps, over allergic skin conditions, ulcerated sores or large blood vessels. In addition, cupping is contraindicated on the abdomen or lower back of pregnant women or on those with a bleeding disorder.

Cupping is a relatively simple application that, when done correctly, can relieve many types of congestion in the body. Despite its simplicity, there is a great deal to learn about cupping before it can be safely administered. By reducing fire hazards, preventing burns, practicing timing, informing your client about the potential for bruising, refining your degree of suction and memorizing cupping’s contraindications, therapists are better prepared to add this valuable technique to their massage practice.

References:, The Art of Massage Cupping, Anita J. Shannon, LBMT, Retrieved October 1, 2008, Massage Magazine Inc., 2008., Massage Cupping Therapy for Health Care Professionals, Anita J. Shannon, LMBT, Retrieved October 1, 2008, Massage Today, February 2004., Ancient Chinese technique of cupping offers pain relief without drugs or surgery, Alexis Black, Retrieved October 9, 2008, Natural News Network, August 2006.

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

Tierra, Lesley, L.Ac., The Herbs of Life, The Crossing Press, Freedom, CA, 1992, 148-149.

Posted by Editors on November 25, 2008 04:17 PM
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May 27 2009

Beat the Heat: 7 Tips for Cool Summer Sessions

Are your client sessions already starting to heat up to an uncomfortable level this summer? Here’s how to support the body’s cooling mechanisms without losing the assistance heat lends to therapeutic massage.

by Nicole Cutler, L.Ac.

As summer sends the mercury rising, intolerance to excessive heat grows. When it comes to massage administration, this intolerance poses a contradiction. The nature of bodywork is enhanced with warmth, as higher temperatures encourage tissue relaxation and fluid circulation. However, when a person is overheated, adding even more heat is anything but therapeutic.

At first thought, a cooling technique, such as ice massage, appears to be a logical technique to balance the fiery heat of summer. While valuable for reducing inflammation in acute sports injury work, ice massage will not increase local circulation or relax tense muscles. The solution to providing a balanced therapeutic massage this season is to find ways to support body cooling without sacrificing the aid of warmth in the healing process. Try incorporating some of the following suggestions, or use them to jumpstart your own ideas into your summer client sessions:

1. Cool moonstones – Consider learning how to do a cool moonstone facial. While hot stone massage is a popular choice in colder months, the heat translated by hot stones can be too warming for many individuals already heated by summer’s temperature. The Institute offers the continuing education course, Stone Massage, which includes cool moonstone facial instruction. In addition to the moonstone facial, cool stones can be held in the palm or placed behind the neck to comfortably reduce body temperature.

2. Aloe Vera – A massage medium containing aloe vera creates a cooling sensation, and is particularly effective on sunburned skin. When applied to the lower legs and feet, aloe vera can bring the body’s temperature down a few degrees without inhibiting circulation or relaxation.

3. Room Temperature – The temperature in your massage setting is always a crucial factor, particularly during summertime. Especially if a client is already perspiring and feeling warm, stepping into a hot, stuffy room will only perpetuate their experience of heat. A ceiling fan’s slow setting is an ideal choice to make certain there is air circulation in the treatment space. However, finding the right semblance of cool can be a fine line, as an air conditioner blowing directly on a client can initiate muscular tension and contraction from its chill.

4. Hydrosol Misting – Hydrosols are the pure, water-based solutions created when essential oils are steam distilled. Take advantage of the cooling properties of peppermint or wintergreen to cool and refresh your client. When spraying a hydrosol mist, be aware of and refrain from its use if there are any contraindications present. Additionally, avoid irritation with any essential oil derivative by preventing any eye or mucus membrane contact.

5. Cucumber eye pats – Often used in spa settings, a disc of fresh cucumber placed over the eyes can cool down a flushed face quickly. The cooling and moisturizing properties of cucumber are ideal for a supine client struggling with a hot perspiring body. Always seek permission before placing fresh veggies on your client’s face.

6. Water consumption – Staying hydrated in the heat is crucial, especially when combined with bodywork’s characteristic release of toxins. To reduce overheating, offer your client a bottle of water to sip during, as well as after, your session.

7. Cooling Acupressure – According to Oriental Medical Theory, working the following two locations can reduce internal body heat:

Large Intestine 11 – Located at the lateral end of the transverse cubital crease, midway between the radial side of the biceps brachii tendon and the lateral epicondyle of the humerus. This is a traditional point to reduce fever, revive from heatstroke and reduce all kinds of internal heat conditions.

Governing Vessel 14 – Located just below the spinous process of cervical vertebrae 7. The main point for reducing summer heat, all of the yang (heat containing) meridians intersect here, and is therefore an extremely accessible location to release interior body heat. When this intersection of yang energy is opened, it reduces the accumulation of body heat.

Being aware of your client’s body temperature translates into your awareness of their comfort. The differences in body constitutions will lead some individuals to extreme discomfort in the heat while others will feel their best. When a therapist pays attention to temperature variations and then institutes methods to balance those variations, the client’s experience will be that much more beneficial and therapeutic.

Recommended Study:

Stone Massage


McCampbell, Harvest, Light Summer Massage Lotion Recipe, Massage Magazine, January/February 2001., The Five Element Theory, Stefan Karlsson, Dipl. Ac., 2006., Summer, Fire, Spirit, Tofinotime Magazine, June 2004., Acupuncture Points Database, Yin Yang House, 2006.

Posted by Editors at 01:01 PM

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May 27 2009

3 Imbalance-Specific Bladder Point Combinations

Understanding Oriental Medical theory to appropriately choose the best acupressure points typically requires years of post-graduate education. Our experts have provided a quick and easy summary of three common health imbalances and recommended point combinations most supportive of their healing.

by Nicole Cutler, L.Ac.

Most bodyworkers now perform a substantial intake evaluation prior to conducting their respective sessions. The interview process has become a requirement for conscious care, arising out of the profession’s increased presence in the healthcare industry. Once a therapist has the informative details of their client’s health, it is easier to create a customized treatment plan from the many possible massage therapy applications.

Acupressure practitioners are familiar with the meridians of the body, accessing the energy within these meridians to influence health. Out of the 12 primary meridians, the Urinary Bladder (UB) meridian is unique. With the most number of accessible points along its path, the UB meridian begins just medial to the inner canthus of the eye, ascends up the forehead, around the cranium, runs all the way down the dorsal surface of the body and finally ends at the lateral edge of the little toe. When this meridian descends along each side of the spine, UB points provide access to toning every organ system in the body.

Although not diagnosticians, bodyworkers can use the principles of Traditional Chinese Medicine (TCM) to offer particularly beneficial treatments to their clients. In TCM, an imbalance of health is characterized by a symptomatic pattern. Discover the most beneficial points to work on the UB meridian for the following three commonly encountered imbalances:

Heart Blood Insufficiency
The symptoms of this pattern are characterized by anxiety and insomnia. Additional symptoms may include memory and concentration problems, heart palpitations, pale complexion, dizzy spells, vertigo and blurry vision. This pattern can manifest after blood loss (examples include: giving birth, surgery, trauma or heavy menses), or can be a result of chronic disease.

Working with Urinary Bladder points 15, 17 and 20 can be useful in bringing about balance to heart blood insufficiency.

UB 15 is located approximately two finger widths lateral to the lower border of the spinous process of the fifth thoracic vertebrae, at the height of the paraspinal muscle. This is the Associated Point of the Heart, and is indicated for its calming properties and ability to strengthen heart insufficiency.

UB 17 is located approximately two finger widths lateral to the lower border of the seventh thoracic vertebrae, at the height of the paraspinal muscle. This is the Influential Point of Blood, and is useful to build and nourish the blood.

UB 20 is located approximately two finger widths lateral to the lower border of the spinous process of the eleventh thoracic vertebrae, at the height of the paraspinal muscle. This is the Associated Point of the Spleen, and is indicated because the spleen is the primary source of nourishment for making blood.

Liver Invading the Spleen
The symptoms of this pattern are characterized by abdominal distention and pain aggravated by emotional upset. Additional symptoms typically include alternating constipation and loose bowel movements, flank pain, decreased appetite, dysmennorhea, irritability, depression and fatigue. In TCM, unreleased emotions create stagnation in the liver, which in turn, disturbs the spleen’s digestive functions.

Working with Urinary Bladder points 18, 20 and 25 can be useful in bringing about balance to a liver invading the spleen.

UB 18 is located approximately two finger widths lateral to the lower border of the ninth thoracic vertebrae, at the height of the paraspinal muscle. This is the Associated Point of the Liver, and is used to relieve stagnation in the liver.

UB 20 is located approximately two finger widths lateral to the lower border of the spinous process of the eleventh thoracic vertebrae, at the height of the paraspinal muscle. This is the Associated Point of the Spleen, and is indicated to strengthen the spleen’s digestive functions.

UB 25 is located approximately two finger widths lateral to the lower border of the spinous process of the fourth lumbar vertebrae. This is the associated point of the Large Intestine, and can help regulate the intestines.

Lung and Kidney Yang Deficiency
The symptoms of this pattern are characterized by asthma and coughing with watery sputum. Additional symptoms typically include a sensation of cold throughout the body, lower limb edema, low back cold and pain, fatigue, desire for warm beverages and breathlessness. In TCM, when the kidneys are lacking their life-giving fire and lung energy is weak, the body fails to transform fluids and warm itself. This pattern is commonly seen in chronic disease and the elderly.

Working with Urinary Bladder points 13, 23 and 43 can be useful in bringing about balance to lung and kidney yang deficiency.

UB 13 is located approximately two finger widths lateral to the lower border of the spinous process of the third thoracic vertebrae. This is the Associated Point of the Lung, and is useful in strengthening the lung.

UB 23 is located approximately two finger widths lateral to the lower border of the spinous process of the second lumbar vertebrae, on the quadratus lumborum muscle. This is the Associated Point of the Kidney, and tonifies kidney yang.

UB 43 is located approximately four finger widths lateral to the lower border of the spinous process of the fourth thoracic vertebra, on the spinal border of the scapula. This point is commonly used in chronic conditions where the lung and kidney need strengthening.

While arriving at the correct TCM diagnosis is complex, the key to this analytical process is looking at the pattern from an overarching perspective. There are at least five or six possible imbalances each for anxiety, stomach pain and asthma, so investigate further to see if a client’s additional symptoms fit the rest of the pattern as described. If the imbalance seems to fit the presented case, working with the UB points listed abovie will aim your client in the direction of healing and recovery.

Do not press on disintegrating discs or fractured or broken bones. If your client has a weak back, use caution with a stationary, light touch. If you have any questions or need medical advice, seek permission to discuss your client’s health with their physician.

Editor’s Note
For more information on acupressure, read the article, Ten Highly Effective Acupressure Points

Flaws, B., Finney, D., A Compendium of TCM Patterns and Treatments, Blue Poppy Press, 1996.

Lade, A., Acupuncture Points: Images and Functions, Eastland Press, 1989.

Liangyue, D., Chinese Acupuncture and Moxibustion, Foreign Languages Press, Beijing, 1993.

Maciocia, G., The Foundations of Chinese Medicine, Churchill Livingstone, 1995.

Posted by Editors at 10:39 AM
© 2009 Institute for Integrative HealthCare Studies. This work is reproduced with the permission of the Institute.

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May 23 2009

Emotional Spring Cleaning

Published by under accupuncture,yin yang TCM

Just as the environment adjusts to each seasonal change, so does the human body. The shift into spring prompts our release of stored emotions in preparation for increased activity and productivity. Learn how bodyworkers can assist in spring’s healthful transformation of winter’s stored emotional tension.

by Nicole Cutler, L.Ac.

During the winter, we draw our energy inward to reflect, rejuvenate and rest. As the season shifts into spring, energy bursts forth, like bulbs lying dormant throughout the colder months. As daylight lengthens, contained energy begins to flow instead of being stored. Nature’s activity during early spring can be witnessed everywhere, from newly composed avian harmonies to animal mating rituals. Projects sitting on hold jump to life and bodies that have been curled up on the couch itch to move. Spring is representative of transformation and growth, bringing renewed optimism, hope and life.

According to Chinese culture, humans are microcosms of the environment, and are equally affected by the change in season. The cyclical character of energy flow creates a predominance of energy in a paired organ system during a specified time of year. According to Chinese medical theory, the energy in the liver and gallbladder systems are most active in the spring.

In addition to viewing humans as mirrors of nature, Chinese medical theory also emphasizes the interplay of physical, emotional and spiritual aspects governed by each bodily system. Encompassing much more than the western medical model’s understanding of organ structure and function, each body system also governs emotion, cognition and spirit.

The cognitive responsibility of the liver is planning while the gallbladder oversees decision-making. When the energy in these two organ systems mounts, as it naturally does each spring, there can be two possible outcomes:

1. The desired outcome is an active outpouring of creativity, productivity and release of negative patterns.
2. The undesired outcome is energetic stagnation, or resistance to allowing this energy to flow.

Restricted liver energy manifests itself as anger, frustration, depression and irritability. Disease occurs when this energy is not expressed or freed. When energy remains stuck, it coagulates, becoming thick and heavy, hampering optimal body functioning. The inability to express spring’s active energy can lead to all sorts of illnesses including migraines, PMS, heart disease and even cancer.

Because the energy in the liver and gallbladder systems increase during the spring, people often experience an increase in stress, anger and anxiety during this season. When an outlet for this energy is found, these emotions can be transformed into creativity, opportunity and change. Springtime is ideal to convert these difficult emotions by focusing on their movement and release. Nature provides us this time of year to spring clean our stored emotions. Feeling these intense emotions is a healthy first step, and indicates readiness for the second spring cleaning step: release.

Emotional release can be achieved in many different ways, and each person must find the method that works best for them. Some methods that may be useful include:

· Engaging in physical activity
· Receiving bodywork
· Verbalizing emotions to a friend or professional
· Journaling or writing about one’s feelings
· Crying and/or laughing
· Meditation and/or visualization
· Using creativity as an emotional outlet

Bodyworkers can assist in this process by understanding the need for and paying extra attention to modalities encouraging emotional release. In general, relaxing massage strokes help clients shed tension and drop resistance. Techniques to invigorate the Liver and Gallbladder meridians are especially useful in facilitating the desired free and easy flow of energy. A specific acupressure combination to address this is called The Four Gates. While The Four Gates is typically used to reduce pain, its overarching purpose benefits both physical and emotional pain by invigorating and moving stagnation. For more specific information on The Four Gates, please see the previous article, Differentiating Back Pain from Kidney Pain, under bodywork techniques for Kidney stones.

Regardless of the method used, finding the path to emotional release keeps the body, mind and spirit healthy. The natural instinct to spring clean our homes and environment answers our spiritual yearning to clear away the cobwebs (stagnation) left over from winter. When spring cleaning is applied to emotional health, our ability to plan and make decisions blossoms, and we experience renewed optimism, creativity, hope and transformation. From the Chinese perspective, the free flow of liver and gallbladder energy is the number one disease preventative, and best way to guarantee a healthy and happy year.

Posted by Editors at 04:19 PM

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May 22 2009

Be Prepared: What to do When a Client Faints

Regardless of the training received in massage school, the fainting of a client is a stressful situation for any bodywork professional. Review the causes and warning signs of fainting, preventive measures, as well as the necessary steps to safely and confidently handle this unpredictable occurrence like a pro.

by Nicole Cutler, L.Ac.

Realizing clients may faint during massage therapy does not mean you possess the confidence to handle the real, live situation. A formal massage education does not include an emergency room internship, where challenging experiences take place under the watch of a professional. Often, the first time a client faints during massage, the practitioner is on their own.

Why do Clients Faint?
Fainting, or syncope, is a sudden, brief loss of consciousness. Someone who faints may only pass out for several seconds or for as long as an hour. There are hundreds of possible causes of syncope, most of which are due to the vasovagal reflex, where blood vessels relax and dilate, causing a sudden drop in blood pressure.

Some of the most common reasons clients faint include:

· Low blood sugar (hypoglycemia), common in early pregnancy and diabetes
· Anemia
· Heat stroke or heat exhaustion
· Dehydration
· Eating disorders such as anorexia, bulimia
· A sudden change in body position like standing up too quickly (postural hypotension)
· Extreme pain
· Sudden emotional stress or fright
· Anxiety
· Taking some form of prescription medication. Examples include medicines that lower high blood pressure, tranquilizers, antidepressants, or excessive use of some over-the-counter medicines.
· Being in a hot, stuffy room or hot, humid surroundings
· Alcohol consumption

Fainting Prevention
The number one way to prevent client syncope is through being prepared and communication with clients.

· Be familiar with the medications clients are taking, including new medications and anything that may lower blood pressure.
· If your client has just come from physical activity and is overheated, allow them to cool down and re-hydrate.
· Know if your client has a history of orthostatic hypotension, fainting or dizzy spells.
· Be aware if your clients are diabetic and make certain they have checked their blood sugar or have sugar pills, juice or cookies available if necessary.
· If your client is hypoglycemic, or hasn’t eaten within the past five hours, provide them with a light snack or refuse treatment.

Even if you have no reason to suspect that a client may faint, there are a few signs that may precede a temporary loss of consciousness. If any of these signs appear, verbally check with your client to see if they are okay prior to continuing a session.

· The skin becomes hot and sweaty or cold and clammy.
· A client suddenly becomes fidgety.
· Complaints of dizziness or light-headedness.
· The person lifts their head out of the face cradle to yawn or take a breath. According to David Palmer, this is an involuntary reaction to not getting enough oxygen to the brain.

What to do
Although a client becoming fully unconsciousness is rare, it is best to be prepared. The following is the preferred order of steps to address syncope:

1. Be Calm – The number one thing to remember if a client loses consciousness is to remain calm.

2. Proper positioning – If the client is not lying down, assist them into a position where they can’t fall, their head is below their heart and the legs are elevated. This position promotes blood flow to the brain. If a victim who is about to faint can lie down right away, he or she may not lose consciousness. Call for assistance if you need help in accomplishing this, but do not leave the client’s side.

3. Check breath and pulse – If there are no sounds of breathing, make sure the airway is open and begin rescue breathing. If there is no pulse, begin CPR. Look for a medical identification bracelet, necklace or card that identifies a medical problem, such as epilepsy or diabetes. In either case, have someone call 911 for emergency help.

If the client has a pulse and is breathing, it is not necessary to call 911 unless the client does not regain consciousness in a few minutes or if the person is diabetic. A diabetic may be in insulin shock, requiring additional support.

4. Comfort measures – Make sure there is no tight-fitting clothing around the client’s neck, that there is adequate air circulation, and keep the client from getting chilled.

5. Acupressure – Only after the first four steps have been taken, consider this age-old technique for fainting. Oriental meridian theory suggests applying firm pressure to the following locations to revive someone from syncope:

· Governing Vessel 26 – Located in the philtrum, about 1/3 the distance from the bottom of the nose to the top of the lip.
· 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.

Additional Tips
Upon fainting, a common mistake is to try to give the person something to eat or drink, including water. This gesture must wait until the client is fully conscious. Additionally, don’t allow the person who’s fainted to get up until the sense of physical weakness passes. Then be watchful for a few minutes to be sure he or she doesn’t faint again. Once again, don’t leave your client’s side until they have fully recovered.

Other Reasons to call 911
If your client also has signs of a heart attack, call for emergency help. Such symptoms include:
· Chest pain or pressure.
· Pain that spreads to the arm, neck or jaw.
· Shortness of breath or difficulty breathing.
· Nausea and/or vomiting.
· Sweating.
· Rapid, slow or irregular heartbeat.

If your client also shows signs of a stroke, call for emergency help. Such symptoms include:
· Numbness or weakness in the face, arm or leg.
· Temporary loss of vision or speech, double vision.
· Sudden, severe headache.

While episodes of syncope in the massage setting don’t occur every day, most massage therapists may encounter a few in their career. A thorough intake will provide the therapist with the information to prevent such an episode by alerting them to a fainting possibility, discovering if the client hasn’t had anything to eat or drink prior to a session, or by prompting modification of the session. Such modifications include avoiding strokes or techniques that further lower blood pressure or those drawing energy away from the head. Reviewing the causes of syncope, including these warnings and procedures, will build your confidence so if you do encounter syncope, you are both calm and prepared.

Massage professionals interested in enhancing their knowledge on this subject would benefit from the Institute’s Pharmacology for Massage distance learning program. This 13-credit course covers different medications that may render clients more susceptible to fainting and also suggests massage strokes to use to counter this tendency.

Editor’s Note: This information is for education purposes only, and is not intended to replace professional medical care. If not completely sure of your client’s well being, seek emergency medical help.

Recommended Study:

Pharmacology for Massage


Palmer, David, Fainting and Chair Massage, Massage & Bodywork, June/July 2000.

Shanghai College of Traditional Medicine, Acupuncture: A Comprehensive Text, Eastland Press, 1995: 572-3., First Aid for Fainting, American Institute for Preventive Medicine, 1996.

Posted by Editors at 09:28 AM

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May 21 2009

Lighting Up Your Massage Practice

Light intensity plays a significant role in creating a relaxing environment. Illuminate yourself on the principles of Feng Shui, the ancient art of design and learn what lighting works best for your massage space.

by Nicole Cutler, L.Ac.

The ancient Chinese art of design, Feng Shui, extends well beyond home decorating. Based on the premise that our environment can profoundly affect our physical, emotional and spiritual well being, many factors contribute to this style of design. First used to help farmers decide where to plant their rice fields and build their houses, Feng Shui’s principles today are used to design both interior and exterior spaces where people feel comfortable interacting with one another. Creating a space that makes you feel good includes its directional orientation, arrangement of items, spatial layout of furniture and placement of objects, as well as the source, intensity, location and direction of the room’s lighting.

Well-known to Feng Shui practitioners, lighting can dramatically transform any space. Dependant upon how it is lit, a room can be perceived as cool and sterile, small and cramped, or warm and cozy. “How a space feels,” says Feng Shui consultant and lecturer Linda Varone, RN, MA, CFS, “affects how people respond at a conscious and unconscious level. While some spaces just don’t feel right and people want to leave right away, other spaces invite people to relax and talk comfortably about personal concerns.”

Yin and Yang
Feng Shui is based on the principle of yin interplaying with yang. In Chinese philosophy, yin and yang represent the two cosmic, opposing forces of the universe. Yin is the receptive, passive, solid and cold force, while yang is the aggressive, energizing, moving and warm force. As such, light is perceived as a yang element. Using bright light within a space or shining it on an object increases the active energy of that location.

To encourage the restfulness and inactivity typically desired as part of a massage session, reducing the amount of light is favored. However, this concept does not encourage complete darkness, as achieving balance always remains the goal in Chinese-driven philosophies. The well-known yin-yang symbol represents such equilibrium, illustrating darkness following light, while each retains a small component of the other.

Effective Feng Shui occurs when yin and yang are harmoniously balanced. For example, a room with no windows, very little light and dark walls is exceedingly yin in nature, and needs a yang force to balance it. In this example, bringing in yang with appropriate lighting will stimulate the energy and transform this room into a pleasant space.

In the physical realm, light is radiant, electromagnetic energy. When light strikes the retina, it creates visual sensations, stimulating a neurological response in the brain. Revealing shape, size, texture, color, depth and location, light encourages brain activity. Desired during a massage session, a hiatus from conscious brain activity leads to increased relaxation. On the other hand, an overly darkened room can transmit feelings of depression and suffocation. Once again, finding a balance between light and dark is conducive to healing.

Most institutionalized healthcare settings use florescent lights that function by flickering on and off up to 60 times per second. While this is too rapid for the eye to see, this flicker is noticed on a subliminal level and can cause fatigue. To counter this effect, lamps using incandescent bulbs or windows bringing in natural sunlight reduce the impact of a flicker. Although relaxation is desired in bodywork, causing fatigue from over-stimulation of the eye runs contrary to a healer’s purpose.

Hard and Soft
When choosing lighting for a massage space, it is important to consider the difference between hard and soft lighting.

Hard lighting equates to a brightly lit area, and is best suited for areas requiring attention or concentration. Hard lighting makes hallways, landings and porches safe and can help spaces seem wider. For vulnerable individuals, prolonged exposure to hard lighting creates feelings of stress. Hard lighting includes:

· Direct light (ex: spotlight)
· Fluorescent light
· High wattage bulbs

Soft lighting reduces brightness, encouraging relaxation. Also called ambient lighting, this illumination is ideal in the actual room where massage therapy is administered. Ambient lighting comes from an indirect light source that throws light against a wall or ceiling, creating soft illumination through reflection. Ambient lighting creates a relaxing, inviting atmosphere with:

· Indirect light (ex: sconces)
· Floor torchieres or uplights
· Lamp shades
· Yellow or pink lighting
· Dimmed lighting or low wattage bulbs

Diffuse, indirect, soft and low lighting are a bodyworker’s best bet in creating a relaxing, comforting and healing environment. By using the principles of Feng Shui in lighting up your massage space, you are adding another dimension to your services. Careful consideration of the type of illumination you use and how it will affect your clients is a relatively small detail that can make a big difference in your practice.

References:, Yin Yang, Jennifer Emick, About Inc., 2006., Feng Shui Balancing Tools Including Color and Light, Kathy Browning, Associated Content, Inc., 2006., Feng Shui Cures, About, Inc., 2006.,au, Lighting, Gayle Atherton, 2002., Fantastic Fixtures, Sally Fretwell, 2006., In Other Words…Using Feng Shui to Improve Healthcare Communication, Helen Osborne, MEd, OTR/L, Boston Globe’s On Call Magazine, May 2001., Feng Shui: Light and Lighting, Sally Fretwell, Qi Journal 2006., Integrated Lighting Design Boosts Performance, Strang, 2006.

Posted by Editors at 09:51 AM
© 2009 Institute for Integrative HealthCare Studies. This work is reproduced with the permission of the Institute. <>

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May 20 2009

An Ideal Combination of Bodywork Techniques

Combining therapeutic approaches is the cornerstone of integrative medicine. Learn how to combine two popular massage techniques to improve client sessions, and help stand out from others in your field.

by Nicole Cutler, L.Ac.

Two leading massage modalities cover an even broader range of applicability when fused together. At its very essence, integrative medicine consists of combining therapeutic approaches to yield a more effective outcome. Integrating hot stone massage with the meridian principles of Traditional Chinese Medicine (TCM) exemplifies how the sum can be greater than its parts.

Massage therapists are becoming increasingly adept at fusing different bodywork styles. Using different techniques from various schools is how therapists can create a signature massage. While there seems to be no end to the combinations, some provide more benefits than others. Even while working simultaneously with stones and meridians, massage professionals can imprint their own unique flair. However, a comprehensive grasp of both modalities is required before uniting stone massage with meridian work.

Hot Stone Massage
Hot stone massage is a form of thermal hydro-therapy. Using smooth, warmed, heat-retaining stones as extensions of the hands, clients receiving a well-administered hot stone massage will seek it again and again. For some, stone therapy brings unrivaled deep tissue release and alignment. For others, the heat of the stones gently softens muscular tension and melts away emotional stress. On a spiritual plane, the stones are from the earth and have an extremely grounding quality adored by many. Grounding can be very helpful to individuals struggling with issues related to sleep, headaches, dizziness, anxiety or feeling overwhelmed or scattered.

The heat of the stones, combined with the soothing gliding massage movements, warms and relaxes the muscles to a much greater extent than what can be achieved by massage alone. Proponents claim the following benefits of warmed stone bodywork:

· Increased circulation, lymph and vitality
· Release of excessive toxins
· Relief from tight muscles
· The weight and material of the stones function to ground the body
· Reduced ticklishness for many vulnerable clients
· Relaxed central nervous system (when stones are laid upon the spinal column)
· Added energetic quality to massage when incorporated with vibration (clicking or tapping of stones)

From active placement to active stone massage, there are many different ways to manipulate the stones on a person’s body. Using the heated stones to apply pressure to acupressure points, trace or rub meridians is one way to amplify the therapeutic efficacy of a treatment.

Meridian Bodywork
A part of TCM, massage along the body’s energy-containing meridians can have many therapeutic uses. According to the 3,000 year-old practice of TCM, energy that is deficient, excessive or stagnant within the body’s meridians results in imbalance and eventually, disease. By breaking up blockages and promoting energy’s free and easy flow, acupuncture and acupressure are common modalities used to influence the health of energy flow throughout these meridians. Because meridians connect every part of the body to every other part, bodyworkers are able to address all types of pain and illness at easily accessible body locations. Once the affected meridian is properly assessed, bodywork on that meridian can have seemingly miraculous results – including restoring vitality, stopping pain and restoring blood sugar levels.

TCM understands the human body as a microcosm of its surrounding environment. As such, factors affecting the environment also affect the body. Forces such as heat, cold, dryness, dampness and wind have specific implications to a person’s health. A host of common TCM pathologies evolve when excessive amounts of cold influence the urinary bladder, lung and kidney meridians. These are the meridians most easily affected by cold temperatures. A practitioner can recognize whether cold is cause of an imbalance when the following symptomatic patterns emerge:

· a preference for warm beverages
· frequent sensations of cold or being chilled
· a worsening of painful symptoms in cold conditions
· pale facial complexion
· profuse and watery urination

Once it is understood that cold is a culprit, using heat becomes a logical therapeutic choice. A common TCM technique, moxibustion is the burning of an herb over an acupressure point or meridian to impart warmth. While admittedly beyond the scope of practice of most massage therapists, there are other methods of warming a chilled meridian. Using hot stone massage is an alternate technique to warm and invigorate the energy within a meridian.

The Union
Continued education fuels creativity. Knowing how to give a skilled hot stone massage and combining it with meridian massage will enhance your sessions. Once you are aware that a client could use some energetic warming, the treatment you can capably provide will rival any of the most respected therapies available.

Recommended Study:
Stone Massage
Shiatsu Anma Therapy


Alexandra, Sonia, LMT, Stone Massage Therapy: A Catalyst for Health, Massage Today, November 2003.

Baltz, Bruce, Deep Tissue Healing: The Art of Stone Massage, Massage Today, January 2005., Hot Stone Massage Guide eBook, Kareen Fellows,, 2006., A Stone Massage Description – Useful Knowledge for Self-Maintenance,, March 2006., The Breath in the Stone, Karyn Chabot, D.Ay., LMT, The North East Directory of Holistic Resources, 2006., Hot Stone Massage: An Ancient Tradition That Still Rocks! Upasana Titterington, National Holistic Institute, 2006.

Posted by Editors at 11:24 AM

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

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May 16 2009

News Report on Massage for Pain

Published by under accupuncture,Massage Therapy

A new, national survey conducted by an independent research firm, spotlights massage’s popular opinion rise in therapeutic effectiveness. These poll results are valuable additions to a massage therapist’s promotional material for consumer marketing and education.

Massage Scores For Pain Relief

CBS News
Daniel J. DeNoon (WebMD)
© 2005, WebMD Inc. All rights reserved.

Oct. 26, 2005 – For the treatment of pain, Americans rate massage as highly as medications, a new survey shows.

Conducted by an independent research firm, the annual survey is the ninth commissioned by the American Massage Therapy Association (AMTA).

It shows that one in five U.S. adults got a therapeutic massage in the last year. Three-fourths of them would recommend it to others — one reason for the body therapy’s growing popularity.

Among those who actually had a massage in the past year, 28 percent say massage therapy gives them “the greatest relief from pain.” Another 28 percent say medication gives them the greatest relief. Chiropractic comes in third at 11 percent, followed by 8 percent who got the most pain relief from physical therapy, 3 percent who said acupuncture was best for their pain, and 1 percent whose pain best responded to biofeedback.

Survey Findings

The survey, conducted by Opinion Research Corp. International in Princeton, N.J., surveyed a national sample of 1,014 U.S. adults. The poll has a margin of error of plus or minus 3 percent. It found that:

• 90 percent of Americans feel massage is good for a person’s health.
• 93 percent agree with the statement that massage can be effective for pain relief.
• Use of massage in people age 65 and older has tripled from 4 percent in 1997 to 15 percent in 2005.
• 22 percent of Americans had a massage in the past year; 34 percent had a massage in the last five years.
• 73 percent of those who had a massage would recommend it to a person they know.
• 46 percent of respondents at some time had a massage to relieve pain.
• Among respondents who discussed massage with their health care provider, 57 percent said this health professional strongly recommended massage or encouraged them to get a massage.

Whole-Body Approach To Pain

Massaging sore muscles obviously reduces pain. But massage is really meant as a whole-body approach, says AMTA vice president and licensed massage therapist M.K. Brennan, RN, LMBT.

“One of the things about massage that helps pain is that it goes down to the heart of where people feel their pain,” Brennan tells WebMD. “There is the overall sense of well-being one can get from the massage approach. And the stress responses in the body associated with pain, such as elevated cortisol, are reduced through massage.”

For these reasons, massage can be used to treat many different kinds of pain, says Tiffany Field, PhD, director of the Touch Research Institute at the University of Miami School of Medicine.

“Basically we have found massage to be effective in chronic pain syndromes in arthritis and diabetes; in depressive disorders such as ones that involve addiction like eating disorders; in chronic fatigue and fibromyalgia and other autoimmune disorders — HIV-associated diseases, too,” Field told WebMD in a June 29 interview. “We have looked at the A-to-Z of medical conditions, and we have not found a single condition massage has not been effective for.”

Brennan says all trained massage therapists learn the same basic techniques. As they go on to advanced training, massage therapists may specialize in one or more specific kinds of massage. There are more than 200 of these techniques, according to the web site.

Qualifications For Therapists

Brennan recommends that a person seeking therapeutic massage look for a well-trained professional. Most states, she says, require that massage therapists be licensed or registered. And the AMTA web site maintains a referral list of massage therapists who meet certain standards:

• Graduate from a minimum 500 in-class-hour massage therapy training program, or
• Pass the National Certification Examination in therapeutic massage and bodywork, or
• Possess a current AMTA-accepted license to practice, and
• Earn continuing education credit, and
• Uphold the AMTA Code of Ethics.

“If you are looking for someone dealing with chronic or acute pain issues, you may want to look for someone who does sports massage, neuromuscular massage therapy, orthopedic massage, or someone who does craniosacral work or uses strain/counterstrain techniques,” Brennan says. “But any list like this leaves out some qualified professionals. The best thing to do is to find a qualified massage therapist and talk with him or her about what you want massage for, be it relaxation or pain relief. Then ask what is their experience in addressing that issue.”

Brennan says weekly massage is most effective but admits that not everyone has the time or money to get massage therapy that often.

Field, however, has a solution. Though there’s no replacement for a qualified massage professional, she recommends that families learn basic massage techniques.

“In our studies, we try with adults to get them two 20-minute massages a week,” she says. “With kids, we use parents as therapists so they can give their children massages every night, 10 minutes before bedtime. We say this because most of the children in our studies have chronic illnesses and can really benefit from a daily dose of massage.”

Sources: 2005 Massage Therapy Consumer Survey, Opinion Research Corp. International, Princeton, N.J., conducted Aug. 11-14, 2005. M.K. Brennan, RN, LMBT, vice president, American Massage Therapy Association. Tiffany Field, PhD, director, Touch Research Institute, University of Miami School of Medicine.

Reviewed by Louise Chang, MD

Posted by Nicole at 10:42 AM

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

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