Archive for the 'shiatsu' Category

Nov 26 2009

Geriatric Massage – Part II: Modalities for Frail Elders

Discover six techniques that can safely be used on those who are experiencing the discomforts of aging, and find out five special precautions and contraindications to be aware of regarding this growing population.

by Linda Fehrs, LMT

Studies have shown that the lack of touch can lead to severe psychiatric or physical problems, and even death in infants. Among the elder population it can lead to depression, anxiety, low self-esteem and lethargy. Lack of caring touch can result in a diminishing quality of life for anyone. Babies cry out to us for touch, but the touch-deprived senior often remains silent. It is important for those in the bodyworking professions to reach out to those who perhaps need them the most.

A frail elder would be defined as someone requiring assistance in taking care of every day needs such as dressing, bathing and eating. They may not be able to move around freely on their own, perhaps needing a walker or wheelchair to assist in mobility. Often they are living with family members or reside in some kind of assisted living facility.

For the very frail client, any vigorous or deep massage is generally contraindicated. But there are also many modalities with a lighter touch that provide similar health benefits, as well as offer comfort and compassion to the recipient. For many frail elders a typical Swedish massage may be too stimulating, and care needs to be taken regarding the use of techniques that might influence the effects of medication. They may be taking medication for blood pressure, a blood thinner, insulin for diabetes or undergoing a regimen of chemotherapy. A thorough intake and evaluation is important in determining what techniques will be most beneficial to your client.

Less Invasive, Yet Effective Techniques
1. Cranial Sacral Therapy – is a gentle, non-invasive technique that uses a light touch to encourage the healthy movement of cerebrospinal fluid. This method of bodywork is used to reduce the negative effects of stress, enhance overall health and improve resistance to disease. It has also been shown to reduce problems associated with pain as well as some neurological dysfunctions, because of its affect on the brain and spinal cord.

2. Lymphatic Drainage – is used to stimulate the movement of lymph, which in turn helps to rid the body of inflammatory and toxic material. This technique uses a rhythmic, light touch to enhance the body’s own gentle pumping action within the lymphatic system. Lymphatic drainage massage helps to enhance the immune system as well as to reduce pain.

3. Polarity Therapy – is a bodywork technique that is based on basic principles of energy. The body is gently manipulated to rebalance the negative and positive energies within the body. Polarity therapy also encourages living in harmony with nature and includes recommendations of improving ones diet and exercise.

4. Reflexology – is a modality originally based on an ancient Chinese therapy. It involves the application of pressure to specific areas in the foot, hands and ears, which correspond to various parts of the body. The applied pressure to these reflex zones in turn stimulates body organs and relieves areas of energetic congestion. Reflexology is used to reduce pain, increase relaxation and stimulate circulation of blood and lymphatic fluids, and has been found to be useful in stress related illness and emotional disorders. Reflexology can also be used in circumstances where areas of the body are traumatized or diseased to the extent that direct touch is contraindicated.

5. Shiatsu – a light compression technique, similar to acupressure, was developed in Japan and uses traditional acupuncture points which help to encourage the healthy flow of life energy as well as restore balance in the body. Shiatsu uses traditional five-element Chinese medicine, which shows a relationship between the earth’s natural rhythms and the human body. The technique produces a sense of relaxation while stimulating blood and lymphatic flow. In turn, this helps with pain relief and the strengthening of the body’s resistance to disease and discomfort.

6. Therapeutic Touch – is a non-invasive form of energy work based on ancient energy healing methods. Used mostly by nurses, it is also used by other bodywork professionals who are trained to feel or sense energy imbalances in the client. The therapist uses a light touch or holds the hand above the body, with the client generally seated. Therapeutic Touch has been used in a variety of medical situations, including the care of premature infants. It is known to induce a state of relaxation within minutes.

Five Precautions
1. Hot Stone Massage – it might seem gentle enough, but for those who are on certain pain medications, or who suffer from the effects of diabetes, they are less sensitive to heat and pain and may not be able to respond appropriately. Make sure you are well trained in this modality before using it on a frail or elderly client.

2. Accommodating Special Needs – whether the massage is conducted in your office, a client’s home, an assisted living facility, a hospital or hospice, care needs to be taken to accommodate the special needs of the individual. Preparation in the way of extra bolsters or pillows, a blanket for added warmth or lubricants for dry or fragile skin is very important.

3. Slower Mobility – depending on the modality or techniques used, you may want to limit the massage session to no more than a half hour, and allow extra time before and after the session to allow for slower mobility. Intake may take longer, your client may need more time to get undressed or there may be problems with mobility, getting on and off the table or in and out of the office.

4. Special Contraindications – would be to never work in an area that has received radiation therapy or that has a tumor.

5. The Usual Precautions Are Also Advices – such as avoiding black and blue areas, varicose or other distended veins, areas of recent surgery, rashes, etc. And if your client has a pacemaker or other implanted device, make sure you get an okay from his/her physician.

At any age massage therapy can be a benefit, but for the frail elderly it ameliorates some of the inevitable physical discomfort and pain that accompanies growing older. It helps us improve their mobility as well. Getting a regular massage helps in the emotional aspects of their lives as well. It has been shown to reduce the feelings of isolation, fear, anxiety and depression perhaps because it offers a gentle, nurturing touch to those who may live a life alone without close family or friends.

Consider providing your services as a massage therapist to nursing homes, assisted care facilities, hospitals and hospice programs. You will find it is rewarding in more ways than words can express.

Recommended Study:
Cranial Sacral Fundamentals
Healing Energy and Touch
Lymphatic Drainage Massage
Polarity Therapy
Shiatsu Anma Therapy


Catlin, LMT, Ann. “Serving Older Adults.” MJT Summer 2008: 111-121.

Finch, Mary Ann. Care Through Touch. New York: Continuum, 1999.

Nelson, MFA, CMT, Dawn. Compassionate Touch: Hands-On Caregiving for the Elderly, the Ill and the Dying. Barrytown, New York: Station Hill Press, Inc., 1994.

Nelson, Dawn. From the Heart Through the Hands: The Power of Touch in Caregiving. Forres, Scotland: Findhorn Press, 2001.

Rose, Mary Kathleen. “Comfort Touch: Nurturing Acupressure Massage for the Elderly and Ill.” December/January 2004. Associated Bodywork and Massage Professionals. 14 Oct 2008 .

Posted by Editors at 02:06 PM
© 2009 Institute for Integrative HealthCare Studies. This work is reproduced with the permission of the Institute.

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Oct 14 2009

Significance of a Shiatsu Massage

Published by under shiatsu

A massage is responsible for providing a healthy mind along with a chaste soul to its recipient. It also provides a robust physique to the person. Realizing its benefits, most of the people tend to incorporate it into their daily time table. Massage can be of many types, such as the Swedish massage, Deep tissue massage, Trigger point massage and many others. With the application of pressure using the thumb, fingers and the palm and making either circular, horizontal or vertical strokes a massage therapist provides relief to the client. The muscles and the tissues of the receiver’s body are well rubbed and squeezed by the massage therapist for a quick relief. As a result of the massage, its beneficiary acquires mental relaxation, relief from stress, physical strength and an improved circulation of blood in the body.

Shiatsu massage is another popular form of massage but is a slightly different from the others and is the most effective and result oriented as well. This massage originated in Japan and derives its name from a Japanese word that means “finger pressure”. Shiatsu believes that the human body is composed of energy which is termed as “ki”. This energy flows through the body via specific energy channels or meridians. It is believed that when the flow of this energy becomes inappropriate in the body or some obstructions are observed in its path, then it is an indication of ill health or some disorder.

Our body has two energy levels at the extremes, namely Yin which is the negative energy of the body and Yang which is the positive energy. When the energy level of the body reaches either of the above two positions then it is detrimental to the person possessing it. The accurate energy level lies somewhere between these two points which is well known as “ki”. The massage practitioner strives to achieve this energy stage for you.

The massage practitioner detects a point in the body of the receiver of the massage along one of the meridians of his body. He then applies pressure slightly with some part of his body which ever is required at that point. He can make use of his arms, fingers, elbows, knees, legs, feet or toes for the application of pressure. This is done to refurbish the actual energy level of the body and to remove any obstacles present in its path. If the obstruction in the path of the flow of energy is stern, then the pressure applied by the practitioner may be hard so as to invoke proper body function. At times the experience may be painful, but is extremely profitable.

A Shiatsu massage endows its receiver with emotional contentment, physical assistance, spiritual sagacity and mental tranquility. A Shiatsu massage can help you to attain a balanced state of mind and body.
By Jan H Schiphorst

A massage that carries so many benefits with it should definitely be your ideal choice whenever you visit a massage parlor or a spa.

Provided by: Jan H Schiphorst ProMassageTable.

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

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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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Jun 01 2009

Effective Pain Management Techniques

Pain management techniques are as diverse and far ranging as the areas of the body pain impacts. Massage represents the safest, most effective component of a multi-disciplinary approach to pain management. Discover the options available to your clients in addition to your valued services.

by Nicole Cutler, L.Ac.

Dealing with chronic pain is big business for healthcare practitioners in the 21st century. An April 2005 nationwide poll conducted by Stanford University Medical Center, ABC News and USA Today found that more than half of Americans suffer from chronic or recurrent pain, and of those surveyed, 25 percent reported back pain as a significant disability. This translates into more than 11 million Americans being significantly impaired by chronic and recurring pain, and more than 2.6 million being permanently disabled by back pain alone.

Time is repeatedly proving that chronic pain has the best outcome when a multi-disciplinary program is followed. This indicates that pain relief finds clients seeking treatment from a variety of sources. The installment of pain management centers across the country have tapped into this success by combining a facility with physicians, pharmacists, rheumatologists, physical therapists, acupuncturists, nutritionists, fitness trainers, chiropractors and of course, massage therapists. Massage therapists can further expound upon the multiple modality approach by utilizing an array of techniques to shift clients out of their pattern of chronic pain.

There are three primary categories in which pain management focuses:
· Non-invasive, non-drug pain management
· Non-invasive, pharmacologic pain management
· Invasive pain management

Non-invasive, non-drug pain management
There is a wide variety of noninvasive non-drug pain management techniques available for treating chronic pain. A few of the most widely accepted in comprehensive pain management programs are the following:

· Exercise—physical exertion with the aim of training or improvement. This can include strength training, water therapy, flexion exercises and aerobic routines involving active, passive and resistive elements. Exercise is necessary for proper cardiovascular health, disc nutrition and musculoskeletal health.

· Manual techniques—manipulation of affected areas by means of chiropractic adjustments, osteopathy, massage therapy and other tactile applications. Manual techniques use physical touch to alter tissue morphology, structure and function. The primary goal is increasing local circulation through muscle/ joint elongation and oxygenation.

· Behavioral modification—use of behavioral methods to optimize patient responses to pain and painful stimuli. Cognitive therapy involves teaching the patient to alleviate pain with relaxation and coping techniques. Biofeedback involves the gradual alteration of neuromuscular signals for symptomatic improvement.

· Cutaneous stimulation —superficial heating or cooling of skin. These pain management methods include cold packs and hot packs, and yield the best results when used in conjunction with exercise and other circulatory methods.

· Electrotherapy —the most commonly known form of electrotherapy is transcutaneous electrical nerve stimulation (TENS). TENS therapy attempts to reduce pain by means of low-voltage electric stimulation that interacts with the sensory nervous system.

Non-invasive pharmacologic pain management

Pain relievers and related drugs are used at every stage of western medicine’s treatment for chronic pain. The most common noninvasive pharmacologic treatments for chronic back pain are:

· Analgesics—includes acetaminophen. Long-term use involves risk of kidney damage.

· Nonsteroidal anti-inflammatory agents (NSAIDs)—includes aspirin, ibuprofen, naproxen, and the controversial COX-2 inhibitors.

· Muscle relaxants—used to treat muscle spasms due to pain and protective mechanisms.

· Narcotic medications—most appropriate for acute or post-operative pain. Since the use of narcotics entails risk of habituation or addiction if not properly supervised, they are seldom used for chronic conditions.

· Antidepressants and anticonvulsants— primarily used to treat nerve pain. However, an increasing number of physicians are experimenting with their use for all kinds of chronic pain syndromes.

Determine how client medications influence massage with a comprehensive, easy to use reference chart.

Invasive pain management techniques

Invasive techniques in pain management involve invasion of instruments and devices into the body. In general, surgery is not included in pain management, so invasive pain management techniques typically are less traumatic to the body than surgery. Some of the most popular invasive pain management therapies include:

· Injections—direct delivery of steroids or anesthetic to nerve, joint or epidural space. Injections into the facet, peripheral nerve, trigger point and other locations are also known as “blocks”. These may provide relief of pain (often temporary) and can be used to confirm diagnosis.

· Prolotherapy—injection of a solution to stimulate blood circulation and ligament repair at the affected site.

· Surgically implanted electrotherapy devices—implantable spinal cord stimulators (SCS) and implantable peripheral nerve stimulators. This is essentially an internal TENS device.

· Implantable opioid infusion pumps—surgically implanted pumps that deliver opioid agents directly to an affected nerve. Typically a last resort, this technique carries a high risk of addiction.

· Radiofrequency radioablation—deadening of painful nerve via heat produced by a specialized device.

Massage Therapy’s Role

Massage therapy’s role in pain management can be substantial. Fitting into the safest category with the best long-term outcome, massage is an excellent, non-invasive, non-drug, pain management, manual technique. Analogous to the overall pain management approach of inter-disciplinary healing, the reliance on a variety of massage techniques will give your client the greatest chance for pain relief. In order to visualize this approach, begin by imagining a stream filled with debris that prevents water from flowing downstream. With the goal of increasing water flow, one could choose from the following strategies:

· Physically removing the debris
· Digging a trench around the debris to encourage flow
· Opening an upstream dam to naturally force the debris through
· Pulverizing the debris

A comprehensive approach to increase your success rate would be combining all of the above. A massage therapist can take advantage of this comprehensive approach by relying on a variety of massage techniques, such as Swedish massage, Reflexology, Neuromuscular Therapy, Myofascial Release, reiki, or acupressure. In addition to collaborating with other healthcare professionals, diversifying within one’s own field will amplify your effectiveness. When choosing to enter the ever-growing market of pain management, keep all of these integrative concepts in mind for the ultimate benefit to your clients and your practice.

Recommended Study:
Myofascial Release, Neuromuscular Therapy, Pharmacology for Massage, Reflexology, Shiatsu Anma Massage, and Swedish Massage for Professionals.

References:, Poll: Americans Searching for Pain Relief, Gary Langer, ABC News Internet Ventures, May 2005., Pain Management Techniques,, 2006.

Posted by Editors at 01:35 PM

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

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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 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
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Apr 29 2009

Massage and Bodywork to Reduce Fatigue and Build Your Practice

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

Nicole Cutler, L.Ac.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


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

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

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

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

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

Posted by Editors at 11:51 AM

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

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Apr 27 2009

Massage for Eye Health

Published by under accupuncture,shiatsu

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

Nicole Cutler, L.Ac.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Recommended Study:
Shiatsu Anma

References:, Acupressure Points for Better Vision, Dr. Marc Grossman, OD, LAc, 2006., Natural Vision Improvement: An Alternative to Lasik Surgery, Deborah E. Banker, MD, December 2001.

Posted by Editors at 01:47 PM
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