Scar Erasure 101 Workbook

Scar Erasure 101 - Scar Remediation UNVEILING THE SECRETS OF SCAR REMEDIATION: A JOURNEY TOWARDS HEALING

Table of Contents TOPICS IN WORKBOOK

Table of Contents 

Introduction, Page 4

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Building a Healing Community, Page 22

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Patient Intake and Insurance Billing, Page 25

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Biomedicine Section, Page 38

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Patient Management and Assessment, Page 90

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Manual Medicine Section, Page 158

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Contraindications Section, Page 191

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Ancillary Techniques Section Page 198

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Therapeutic Oil Section, Page 270

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General Contraindications, Page 294

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Research and References, Page 300

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Conclusion, Page 311

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FastTrack Workshop Section, Page 316

Introduction

The Workshop OUR PRESENTATION AND WORKSHOP OBJECTIVES

Scar Erasure 101 - Scar Remediation

Unlock the healing potential of your hands in our specialized workshop, "Integrative Scar Remediation Techniques for Massage Therapists." This workshop is tailored for massage therapists who are looking to expand their expertise in scar treatment and help their clients achieve better skin health and mobility. Through a combination of evidence-based knowledge and hands-on practice, participants will learn advanced techniques to effectively manage and improve the appearance and functionality of scar tissue.

Scar Erasure 101 - Scar Remediation

About the Workshop

Massage scar remediation involves using specialized massage techniques to improve the appearance and functionality of scar tissue. This therapeutic approach aims to promote healing, increase flexibility, and reduce discomfort associated with scars.

Scar Erasure 101 Scar Remediation About the Workshop Patient information sheet on scar therapy.

Workshop Highlights:  Biology of Scar Formation: Understanding the phases of wound healing and how scars form.

Scar Remediation

 Types of Scars: Differentiating between hypertrophic, keloid, atrophic, and contracture scars.  Scar Assessment Techniques: Methods for evaluating scar tissue, assessing scar maturity, and identifying characteristics.  Scar and Fascial Release Techniques: How to apply gentle, sustained pressure to release and stretch the fascia around scars.

Workshop Highlights:  Cross-Fiber Friction: Techniques for breaking down adhesions and realigning collagen fibers in scar tissue.  Soft Tissue Mobilization:

Scar Remediation

Manual techniques to mobilize and improve the movement of scar tissue relative to surrounding tissues.  Lymphatic Drainage: Methods to reduce swelling and enhance lymphatic circulation around scars.  Integrative Treatment Approaches: Combining massage with other non-invasive treatments like silicone gel sheets, cupping, medicated oils, light therapy, and dry needling.

Workshop Highlights:  Topical Applications: Utilizing products and oils that support scar healing and improve tissue quality.

Scar Remediation

 Stretching and Exercise: Incorporating stretching and exercises to enhance scar mobility and flexibility.  Client Communication: Educating clients about the scar healing process and setting realistic expectations.  Home Care Recommendations: Teaching clients self-massage techniques and other at-home care practices to support professional treatments.

Workshop Highlights:  Practical Application: Hands-on practice with guided supervision to apply learned techniques.

Scar Remediation

 Case Study Analysis: Reviewing and discussing real-life case studies to understand various scar scenarios and treatment outcomes.  Interactive Q&A: Engaging in Q&A sessions to address specific challenges and refine skills.  Professional Development: Strategies for integrating scar remediation techniques into your massage therapy practice.

Workshop Highlights:  Ethical and Safety Considerations: Understanding when and how to apply techniques safely to avoid complications.

Scar Remediation

 Continuing Education Credits: Earning credits that contribute to professional licensure and certification requirements.  Resource Utilization: Accessing comprehensive guides and resource materials for future reference.  Networking Skills: Building connections with peers and industry experts to share knowledge and experiences.

Your Presenter GREGORY T. LAWTON, D.N., D.C., D.AC.

Dr. Lawton is national board certified in chiropractic, physiotherapy, radiology, and acupuncture.

Scar Remediation

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40+ years of research in the field of brain, spinal and peripheral neurology.

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Author of over 100 books and numerous health science articles.

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Licensed in 3 healthcare professions in 3 US states.

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50+ years as a health science educator.

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Former vice president of large medical psychology practice.

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Former vice president of large physical therapy group practice.

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Founder of the Blue Heron Academy.

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Founder of American Health Source.

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Over 50 years in private practice at Clinical Health Maintenance.

Functional Medicine Functional chiropractic medicine is a holistic approach to healthcare that combines traditional chiropractic techniques with principles of functional medicine. This approach aims to treat the root causes of health issues rather than just addressing symptoms. Functional chiropractic medicine seeks to create a balanced and healthy state within the body by addressing the interconnected systems and promoting overall wellness. This approach can be particularly beneficial for chronic conditions, complex health issues, and patients looking for a natural and integrative approach to their health.

Functional Medicine Holistic Assessment: Practitioners conduct a comprehensive evaluation of the patient, considering physical, biochemical, and emotional factors. This may include a detailed health history, physical examination, laboratory tests, and lifestyle assessments.

Spinal Adjustments: Traditional chiropractic adjustments are used to correct misalignments (subluxations) in the spine, which can improve nervous system function and overall health.

Functional Medicine Principles: This involves identifying and addressing underlying imbalances in the body. Functional medicine looks at aspects such as gut health, hormone levels, nutrition, and detoxification pathways to understand the root causes of disease.

Personalized Treatment Plans: Based on the holistic assessment, a customized treatment plan is developed. This plan may include dietary recommendations, nutritional supplements, exercise programs, stress management techniques, and lifestyle modifications in addition to chiropractic adjustments.

Functional Medicine Patient Education and Empowerment: Functional chiropractors place a strong emphasis on educating patients about their health and wellness.

They empower patients to take an active role in their healing process through lifestyle changes and preventive measures.

Integration with Other Healthcare Providers: Functional chiropractors often work collaboratively with other healthcare professionals, such as primary care physicians, nutritionists, and physical therapists, to provide comprehensive care.

Focus on Prevention: Preventive care is a key component, aiming to optimize health and prevent the onset of chronic diseases by maintaining proper alignment, reducing inflammation, and supporting the body’s natural healing processes.

This Training Guide PRESENTATION MANUAL

Scar Remediation: A Training Guide

Scar Remediation

This manual covers a series of treatment techniques and protocols for scar remediation. Scar remediation refers to the various procedures aimed at improving the appearance of scars.

These treatments can help reduce the visibility of scars, restore skin function, and improve overall skin texture. The scar remediation techniques covered in this workbook are non-invasive and non-toxic.

Scar Remediation: A Training Guide

Scar Remediation

Often medical, pharmaceutical, and surgical approaches to scar remediation are harmful and involve the use of toxic drugs or surgical revision which can create more scar tissue and harm to the highly delicate fascial, lymphatic, circulatory, and nervous systems within the human body. The approaches outlined in this workbook adhere to the fundamental principle of health care, “First do no harm”.

Building a Healing Community CONTRIBUTING TO THE GROWTH AND WELLBEING OF HUMANITY

Building a Healing Community

The Blue Heron Academy of Healing Arts and Sciences mission is to build a healing community founded on unity, diversity, and racial harmony.

Our mission is to cultivate a nurturing and inclusive community where every individual feels valued, respected, and empowered. We are dedicated to fostering unity and racial harmony by promoting understanding, compassion, and mutual support among all members of our diverse society. Through active engagement, individual and community service, education, and collaborative efforts, we strive to create an environment where healing and growth are possible for everyone. Together, we aim to break down barriers, celebrate our differences, and build a foundation of trust and solidarity, ensuring a brighter, more equitable future for all.

Building a Healing Community

Patient Intake and Insurance Billing

Patient Intake Forms PATIENT MANAGEMENT

Patient Intake Forms Patient Intake

Patient Intake Forms Patient Intake

Patient Intake Forms Patient Intake

Patient Intake Forms Patient Intake

Patient Intake Forms Patient Intake

Insurance Billing PATIENT MANAGEMENT

Insurance Billing

There are two main requirements for medical insurance billing:  A medical necessity for patient care (a diagnosis).  Documentation of ongoing improvement and clinical results.

If these two conditions are not met, medical insurance providers will not cover claims.

Insurance Billing

There are two codes that are needed for insurance billing, ICD 10 diagnostic code and a procedure CPT code.

Insurance Billing Manual Medicine CPT Codes (Procedures)  97124: Therapeutic procedure, one or more areas, each 15 minutes; massage, including effleurage, petrissage, and/or tapotement (stroking, compression, percussion).  97140: Manual therapy techniques (e.g., mobilization/manipulation, manual lymphatic drainage, manual traction), one or more regions, each 15 minutes.

Insurance Billing Remember to cite the exact treatment procedures in your claim to ensure coverage.

Additionally, avoid citing both CPT codes 97124 and 97140 without modifier code 59, which indicates distinct and different procedures performed on the same individual within a single day or across a few days.  CPT Code 97112: Neuromuscular Reeducation  CPT Codes 97010: Hot/Cold Packs  CPT Codes 97110: Therapeutic Exercise

Patient Intake Forms Medicare Billing Form

Biomedicine Section

The Science of Fascia What is it?

Anatomy, Physiology, and Pathology STRUCTURE, FUNCTION, AND DISEASE

An Introduction to Fascia Fascia, an often-overlooked component of our anatomy, is a remarkable and intricate network of connective tissue that permeates every aspect of the human body. Enveloping muscles, bones, nerves, and organs, fascia provides structural support, facilitates movement, and plays a critical role in maintaining overall bodily integrity. This dynamic tissue not only connects and separates different anatomical structures but also contributes to functions such as force transmission, proprioception, and the healing process. As scientific interest in fascia grows, its significance in health, disease, and therapeutic interventions becomes increasingly evident, unveiling a complex and vital system that underscores the interconnectedness of our bodily functions. This book delves into the fascinating world of fascia, exploring its anatomy, physiology, and the profound impact it has on our well-being.

An Introduction to Fascia

Fascia serves multiple vital functions in the human body, acting as an essential component of the connective tissue system. One of its primary roles is to provide structural support and stability. Fascia forms a continuous web that envelops muscles, bones, organs, and nerves, creating a cohesive unit that maintains the body's shape and structural integrity. This connective tissue not only holds individual components in place but also allows them to move and function in harmony. By compartmentalizing and separating different tissues, fascia ensures that each structure can operate without interference, yet still remain part of a unified system.

An Introduction to Fascia

In addition to structural support, fascia plays a crucial role in facilitating movement and force transmission. During physical activities, fascia helps distribute mechanical stress and strain throughout the body, reducing the risk of injury and enhancing efficiency. This is particularly evident in the myofascial system, where fascia interconnects muscles and transmits the force generated by muscle contractions across different parts of the body. This interconnectedness allows for coordinated movements and contributes to overall biomechanical function.

Fascia’s elasticity and ability to store and release energy also aid in smooth and efficient movements, making it a key player in athletic performance and everyday physical tasks.

An Introduction to Fascia

Fascia is also integral to proprioception and sensory functions. It contains numerous nerve endings and sensory receptors that provide the brain with critical information about the position and movement of different body parts. This sensory feedback is essential for maintaining balance, coordination, and spatial awareness. Furthermore, fascia’s role in proprioception extends to the detection of pain and changes in tension, which can influence how the body responds to injury or strain. By monitoring and adapting to these sensory inputs, fascia helps protect the body from harm and facilitates the healing process.

An Introduction to Fascia

Fascia contributes to overall health through its involvement in fluid dynamics and the immune response. It creates pathways for the circulation of blood, lymph, and interstitial fluids, ensuring that tissues receive adequate nutrition and waste products are efficiently removed.

This circulation is vital for maintaining cellular health and supporting immune function.

Additionally, fascia acts as a barrier and conduit for immune cells, playing a part in the body’s defense mechanisms against infections and inflammation. Understanding these diverse functions of fascia highlights its significance beyond mere structural support, emphasizing its role in maintaining the intricate balance of health and function in the human body.

An Introduction to Fascia

Fascia's relationship to the gut and the microbiome is a fascinating area of study that reveals the intricate connections between different systems in the body. The gut, encased in several layers of fascia, is supported and protected by this connective tissue, which ensures its proper positioning and function within the abdominal cavity. The fascial layers, such as the visceral fascia, envelop the digestive organs, including the stomach, intestines, and liver, helping to maintain their structural integrity and relative positioning. This support is crucial for the efficient functioning of the digestive system, allowing peristaltic movements and the passage of food and waste.

An Introduction to Fascia

Fascia also plays a role in the circulation of fluids within the gut. The mesentery, a double layer of peritoneal fascia, attaches the intestines to the abdominal wall and contains blood vessels, nerves, and lymphatics that supply the intestines. This vascular network within the fascia ensures that the gut receives necessary nutrients and oxygen while facilitating the removal of waste products. Additionally, the lymphatic vessels within the fascial layers play a crucial role in immune surveillance, transporting immune cells and supporting the body's defense mechanisms, which is vital given the gut's exposure to various pathogens.

An Introduction to Fascia

The relationship between fascia and the gut extends to the gut microbiome, the vast community of microorganisms residing in the digestive tract. The health and function of the gut microbiome are influenced by the state of the fascia. For example, fascial restrictions or adhesions can lead to compromised blood flow and lymphatic drainage in the gut, potentially affecting the microbiome's environment. Poor circulation can lead to an imbalance in the gut microbiome, known as dysbiosis, which is associated with various gastrointestinal disorders, such as irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD).

An Introduction to Fascia

Furthermore, the gut-brain axis, a bidirectional communication system between the gut and the brain, is also linked to fascia. The vagus nerve, a key component of this axis, traverses through fascial planes to innervate the gut. Fascial health can influence the function of the vagus nerve, thereby affecting gut motility, secretion, and the microbiome. For instance, vagus nerve stimulation has been shown to impact the composition of the gut microbiome, illustrating the interconnectedness of these systems.

An Introduction to Fascia

Fascia is intimately connected to the gut and the microbiome, providing structural support, facilitating fluid and immune circulation, and influencing gut-brain communication.

Understanding these relationships underscores the importance of maintaining fascial health for overall digestive well-being and highlights the complex interplay between connective tissue and microbial communities within the body.

An Introduction to Fascia

Fascia plays a significant role in the body's endocrine system, particularly in relation to the distribution and interaction of hormones, including female sex hormones. Fascia serves as a conduit for hormone distribution, influences hormone receptor activity, and plays a role in hormone metabolism and detoxification. Its interaction with female sex hormones, particularly estrogen, affects fascial health and function, highlighting the interconnectedness of fascia with the endocrine system and reproductive health. Understanding these relationships can provide insights into the role of fascia in hormonal balance and its implications for overall well-being.

An Introduction to Fascia Fascia and Female Sex Hormones Impact on Fascial Health: Female sex hormones, particularly estrogen, influence fascial health and function. Estrogen receptors are present in fascial tissues, affecting their structure and elasticity.

Changes in estrogen levels, such as during menstruation, pregnancy, or menopause, can impact fascial tone and flexibility. For instance, decreased estrogen levels in menopause may contribute to changes in fascial thickness and elasticity.

Fascia and Reproductive Health: The pelvis and abdominal fascia play a crucial role in supporting reproductive organs such as the uterus and ovaries. Fascial restrictions or adhesions in these areas can contribute to pelvic pain or dysfunction, which may be influenced by hormonal fluctuations.

Disorders such as endometriosis, characterized by abnormal growth of endometrial tissue outside the uterus, can involve fascial adhesions and may be influenced by estrogen levels.

An Introduction to Fascia

Fascia and Hormonal Therapy: Hormone replacement therapy (HRT) used to manage menopausal symptoms often involves the administration of estrogen and progesterone. The effects of these hormones on fascial tissues and their role in alleviating symptoms like joint pain and stiffness are areas of ongoing research.

An Introduction to Fascia The relationship between fascia and scar tissue involves complex interactions that can significantly impact tissue function and overall health. Scar tissue forms as a natural part of the body's healing process following injury, surgery, or inflammation. The interaction between fascia and scar tissue highlights the intricate relationship between tissue healing, structural integrity, and functional outcomes. Fascia provides a framework for scar formation and can be affected by the presence of scar tissue, leading to restrictions in movement, biomechanical dysfunction, and potential pain or discomfort. Understanding these interactions is crucial in managing conditions involving scar tissue to optimize tissue health and restore functional capacity. Therapeutic approaches that address both fascial health and scar tissue can help mitigate the impact of adhesions and promote better overall tissue function.

An Introduction to Fascia Interaction Between Fascia and Scar Tissue Fascial Restriction: Scar tissue can cause fascial restriction, where the normal elasticity and gliding ability of fascia are compromised.

Adhesions between fascial layers or between fascia and adjacent tissues can restrict movement and contribute to pain or discomfort.

Impact on Function: Fascial restrictions due to scar tissue can affect biomechanical function. For example, in musculoskeletal injuries, scar tissue may limit joint mobility, muscle flexibility, or range of motion.

In visceral structures (organs), adhesions between fascial layers can impair organ mobility and function, potentially leading to symptoms such as digestive issues or pelvic pain.

An Introduction to Fascia

Pain and Dysfunction: Scar tissue within fascial layers can be a source of chronic pain or discomfort. This is particularly evident in conditions like adhesive capsulitis (frozen shoulder), where scar tissue restricts shoulder movement and causes pain.

Myofascial pain syndrome can also result from trigger points within fascial tissues affected by scar tissue, leading to localized pain and muscle tension.

An Introduction to Fascia

Fascia plays a crucial role in scar tissue remediation by influencing the formation, organization, and functional integration of scar tissue within the body. Scar tissue forms as a result of tissue injury or surgical incisions, where collagen fibers are laid down in a haphazard manner to repair damaged tissue. This process can lead to the formation of dense, fibrous adhesions that may restrict movement, impair tissue elasticity, and contribute to pain or discomfort. Fascia's role in scar tissue remediation is essential for optimizing tissue healing, restoring mobility, and reducing pain. By understanding and addressing fascial contributions to scar formation, therapists can effectively facilitate rehabilitation and improve outcomes for individuals recovering from injury or surgery.

An Introduction to Fascia Role of Fascia in Scar Tissue Remediation Structural Framework: Fascia provides a structural framework for scar tissue formation. Surrounding and permeating muscles, organs, and other tissues, fascia guides the deposition and alignment of collagen fibers during the healing process.

By influencing the organization of collagen fibers, fascia helps to ensure that scar tissue forms in a way that supports tissue integrity and function.

Movement and Flexibility: Fascia plays a pivotal role in tissue mobility and flexibility. When scar tissue forms within fascial planes, it can lead to adhesions that restrict the normal gliding and sliding movements between fascial layers.

Techniques such as myofascial release and manual therapy target these adhesions, aiming to break down collagen cross-links and improve the elasticity of scar tissue. This can restore range of motion, enhance flexibility, and reduce stiffness associated with scar formation.

An Introduction to Fascia Biomechanical Integration: Scar tissue must integrate biomechanically with surrounding tissues to support functional movement and prevent compensatory patterns that could lead to further issues.

Fascia aids in the integration of scar tissue by promoting a balanced distribution of forces across tissues. This ensures that movement is coordinated and that excessive strain or tension is not placed on the scar tissue or adjacent structures.

Pain Management: Fascial restrictions caused by scar tissue can contribute to localized pain or discomfort.

Myofascial techniques help alleviate pain by releasing tension within the fascial network, reducing pressure on nerves and improving blood flow to the affected area.

By addressing fascial restrictions, therapists can often alleviate pain associated with scar tissue, improving overall quality of life and functional outcomes for individuals recovering from injuries or surgical procedures.

An Introduction to Fascia Therapeutic Approaches Therapeutic approaches to scar tissue remediation often involve a combination of techniques aimed at improving fascial health and mobility. These may include: 

Myofascial Release: Gentle sustained pressure applied to fascial restrictions to release adhesions and improve tissue mobility.

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Massage Therapy: Techniques such as effleurage and petrissage can help break down scar tissue and improve circulation.

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Stretching and Exercise: Specific exercises and stretches designed to lengthen and strengthen muscles while promoting healthy fascial movement.

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Manual Therapy: Hands-on techniques to manipulate fascial layers and release tension, promoting healing and restoring function.

Types of Fascia Fascia, the connective tissue that permeate all areas of the body, groups into several types based on its location and function: 

Superficial Fascia: Found just beneath the skin, this layer contains fat and allows movement of the skin over underlying tissues.

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Deep Fascia: Located deeper in the body, it surrounds muscles, bones, nerves, and blood vessels, providing support and structure.

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Visceral Fascia: Also known as the serosa, this type surrounds internal organs like the heart, lungs, and abdominal organs, providing them with support and allowing movement.

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Parietal Fascia: Forms the lining of body cavities and acts as a barrier between different layers of tissue.

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Subserous Fascia: Found between the serous membranes lining the body cavities and the deeper layer of fascia.

Each type of fascia plays a crucial role in maintaining the structure, support, and functionality of the body.

Anatomy and Physiology Structure and Function

Anatomy and Physiology of the Skin

The skin, also know as the integumentary system, the body's largest organ, serves as a crucial barrier and interface between the internal and external environments. It is composed of three primary layers: the epidermis, the dermis, and the hypodermis (also known as the subcutaneous layer). Overall, the skin's anatomy and physiology are intricately designed to maintain homeostasis, protect the body, and facilitate interaction with the environment.

Anatomy and Physiology of the Skin  Epidermis: The epidermis is the outermost layer, providing a protective barrier against environmental hazards such as pathogens, chemicals, and physical injuries. It consists primarily of keratinocytes, which are cells that produce keratin, a tough, protective protein. The epidermis is divided into five sub-layers, from deepest to superficial: the stratum basale, stratum spinosum, stratum granulosum, stratum lucidum (only in thick skin), and stratum corneum. The stratum basale, the deepest layer, contains proliferating keratinocytes and melanocytes, which produce the pigment melanin responsible for skin color and UV protection. As keratinocytes mature, they migrate upwards, undergo keratinization, and eventually form the outermost stratum corneum, which consists of dead, flattened cells that are continuously shed and replaced.

Anatomy and Physiology of the Skin

 Dermis: Beneath the epidermis lies the dermis, a robust and elastic layer that provides structural integrity and flexibility to the skin. The dermis is composed of dense irregular connective tissue, rich in collagen and elastin fibers, which give the skin its strength and elasticity. It houses blood vessels, nerves, hair follicles, and sweat and sebaceous glands. The dermis has two regions: the papillary dermis, which is the upper layer and consists of loose connective tissue with finger-like projections called dermal papillae, and the reticular dermis, which is thicker and made of dense connective tissue. The dermis plays a crucial role in thermoregulation, sensation, and nutrient delivery to the epidermis.

Anatomy and Physiology of the Skin

 Physiology of the Skin: The skin performs several vital physiological functions. It acts as a physical barrier, protecting against mechanical injuries, pathogens, and harmful substances. Through the process of perspiration, it regulates body temperature by dissipating heat. The skin also plays a role in sensory perception, housing a variety of receptors that detect touch, pressure, pain, and temperature changes. Additionally, it is involved in metabolic functions, such as the synthesis of vitamin D upon exposure to ultraviolet light. The skin’s immune function is supported by specialized cells, including Langerhans cells in the epidermis, which detect and respond to pathogens.

Anatomy and Physiology of the Skin

 Hypodermis: The hypodermis, or subcutaneous layer, lies beneath the dermis and serves as a key site for fat storage, providing insulation and cushioning for the body. It is composed primarily of adipose tissue and loose connective tissue, which helps anchor the skin to underlying structures such as muscles and bones. This layer also contains larger blood vessels and nerves that extend into the dermis.

Pathology Types of Scar Tissue

Types of Scars

Scar tissue forms as a part of the body's natural healing process after injury or surgery. There are several types of scar tissue, each with distinct characteristics and implications for the affected individual. These types include hypertrophic scars, keloid scars, atrophic scars, and contracture scars. Each type of scar tissue presents unique challenges and requires tailored approaches for management and treatment. Understanding the characteristics and formation of different scar types is crucial for developing effective therapeutic strategies and improving patient outcomes.

Types of Scars

 Hypertrophic Scars: Hypertrophic scars are raised, red scars that stay within the boundaries of the original wound.

They are often the result of excessive collagen deposition during the healing process. These scars are more common in areas of high tension or movement, such as the shoulders and knees. Although hypertrophic scars can be aesthetically displeasing and may cause itching or discomfort, they tend to improve over time and may flatten and fade with proper treatment.

Types of Scars

 Keloid Scars: Keloid scars are more severe than hypertrophic scars, extending beyond the original wound boundaries and forming large, raised areas of fibrous tissue. They occur due to an overproduction of collagen and are more common in individuals with darker skin tones.

Keloids can be itchy, painful, and cause significant cosmetic concerns. Unlike hypertrophic scars, keloids do not regress over time and can be challenging to treat. Treatment options include corticosteroid injections, pressure therapy, silicone sheets, cryotherapy, and in some cases, surgical removal combined with other therapies to prevent recurrence.

Types of Scars

 Atrophic Scars: Atrophic scars are characterized by a sunken or depressed appearance, often resulting from the loss of underlying structures that support the skin, such as fat or muscle. Common examples include acne scars and scars from chickenpox. These scars form when the body produces insufficient collagen during the healing process. Atrophic scars can be difficult to treat, but various options exist to improve their appearance, such as dermal fillers, microneedling, chemical peels, and laser resurfacing.

Types of Scars

 Contracture Scars: Contracture scars form when the skin "contracts" tightly during the healing process, often following burns or significant skin loss. These scars can restrict movement by pulling on the surrounding skin and underlying tissues, which can lead to functional impairments, especially if they occur over joints. Treatment for contracture scars often requires surgical intervention, such as skin grafts or tissue expansion, combined with physical therapy to restore function and improve the range of motion.

Types of Scars

 Stretch Marks: In addition to these main types, there are also stretch marks, a form of scar tissue that occurs due to rapid stretching of the skin, often from pregnancy, weight gain, or growth spurts. These scars appear as linear streaks and can vary in color from red or purple to white, depending on their age.

Types of Scars - Adhesions

Connective tissue adhesions refer to abnormal bands of fibrous tissue that form between tissues and organs, often as a result of injury, surgery, inflammation, or infection. These adhesions can develop within various connective tissues, including fascia, tendons, ligaments, and between organs, leading to restricted movement, pain, and dysfunction.

Preventive measures, such as early mobilization and physical therapy post-surgery or injury, can help reduce the risk of adhesion formation. Understanding and addressing connective tissue adhesions is crucial for restoring normal function and improving the quality of life for affected individuals.

Types of Scars - Adhesions

 Formation of Adhesions: Adhesions typically form as part of the body's healing response to trauma or inflammation.

When tissue is damaged, the body initiates a repair process that involves the deposition of collagen and other extracellular matrix components. In some cases, this process can lead to the formation of excess fibrous tissue, which can connect or bind adjacent tissues that are normally separate. This excessive fibrous tissue is what constitutes adhesions.

Types of Scars - Adhesions Types of Adhesions: 

Post-Surgical Adhesions: These are common after abdominal, pelvic, or cardiac surgeries. The formation of scar tissue can bind organs or tissues together, potentially leading to complications such as bowel obstruction, chronic pain, or impaired organ function.

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Fascial Adhesions: Fascial adhesions occur when the layers of fascia, a connective tissue that surrounds muscles, nerves, and organs, become stuck together. This can limit the glide between fascial layers, leading to restricted movement and pain. These adhesions are often seen in athletes or individuals with repetitive strain injuries.

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Joint and Tendon Adhesions: Adhesions can also form within joints or around tendons following injuries such as sprains, strains, or surgeries. These adhesions can restrict the normal range of motion and cause stiffness, pain, and reduced functionality.

Types of Scars - Adhesions Symptoms and Complications:  The symptoms and complications of connective tissue adhesions depend on their location and severity. Common symptoms include: 

Pain: Adhesions can cause chronic pain by restricting movement and irritating surrounding nerves.

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Limited Range of Motion: Adhesions can physically restrict the movement of muscles, joints, or organs, leading to stiffness and reduced flexibility.

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Functional Impairments: Depending on their location, adhesions can impair the function of organs (e.g., bowel obstructions due to abdominal adhesions) or joints (e.g., reduced shoulder mobility due to joint adhesions).

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Inflammation: Adhesions can cause or exacerbate inflammation, leading to a cycle of pain and restricted movement.

Types of Scars - Strictures

Strictures are abnormal narrowings or constrictions of a tubular structure within the body, such as blood vessels, ducts, or parts of the gastrointestinal tract. These narrowings can impede the normal flow of fluids or solids, leading to various symptoms and potential complications.

Strictures can occur due to a variety of underlying causes, including inflammation, injury, or chronic disease. Early diagnosis and appropriate management of strictures are crucial to prevent complications and improve patient outcomes.

Types of Scars - Strictures Types of Strictures: 

Esophageal Strictures: These occur in the esophagus, the tube that carries food from the mouth to the stomach. Causes include chronic gastroesophageal reflux disease (GERD), which leads to acid-induced damage and subsequent scar tissue formation. Symptoms often include difficulty swallowing (dysphagia), pain while swallowing, and regurgitation of food.

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Urethral Strictures: These affect the urethra, the tube that carries urine from the bladder to the outside of the body. Common causes include infections, trauma (such as from catheterization), or surgery. Symptoms can include difficulty urinating, decreased urine flow, frequent urinary tract infections, and urinary retention.

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Biliary Strictures: These occur in the bile ducts, which carry bile from the liver and gallbladder to the small intestine. They can result from gallstones, surgical injury, pancreatitis, or tumors. Symptoms may include jaundice (yellowing of the skin and eyes), itching, abdominal pain, and dark urine.

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Intestinal Strictures: These occur in the intestines, often due to chronic inflammatory conditions such as Crohn's disease, which leads to repeated cycles of inflammation and healing, resulting in scar tissue formation. Symptoms include abdominal pain, bloating, constipation, and bowel obstruction.

Types of Scars - Strictures Causes of Strictures: Strictures can result from various etiologies, including: 

Inflammation: Chronic inflammatory conditions, infections, or autoimmune diseases can lead to ongoing tissue damage and subsequent scarring.

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Trauma or Injury: Physical damage from accidents, surgical procedures, or medical interventions can cause scar tissue formation and strictures.

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Cancer: Tumors can grow within or press on tubular structures, causing narrowing.

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Congenital Conditions: Some individuals are born with narrow segments in their tubular structures.

Types of Scars - Strictures Symptoms and Complications:  The symptoms of strictures vary depending on their location and severity. Common symptoms include: 

Difficulty in Passage: For gastrointestinal strictures, this might mean difficulty swallowing or passing stool. For urethral strictures, difficulty urinating.

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Pain: Strictures can cause pain due to the obstruction and increased pressure in the affected area.

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Infections: Narrowed passages can lead to stagnation of contents, increasing the risk of infections like urinary tract infections or cholangitis (bile duct infection).

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Obstruction: Severe strictures can lead to complete blockage, causing acute symptoms like severe pain, vomiting, or inability to urinate, which may require emergency intervention.

Stricture Treatment:

Types of Scars Strictures

Castor oil packs.

Abdominal or pelvic manual therapy Dao yin breathwork and internal exercise Dietary management Anti inflammatory, anti spasmodic, and mucilaginous herbs Formulations such as TCM Cinnamon and Hoelen

Wound Healing Soft Tissue Healing

Soft Tissue Healing

Wound healing is a complex process that can be significantly impeded by a variety of factors. These factors can be broadly categorized into local factors, which directly affect the wound site, and systemic factors, which influence the overall health and healing capacity of the body. Understanding and mitigating these factors is crucial for promoting effective wound healing and preventing complications. Interventions such as proper wound care, infection control, nutritional support, and managing underlying health conditions are essential strategies in enhancing the wound healing process.

Local Factors:

Soft Tissue Healing

Local factors that impede wound healing include infection, poor blood supply, and the presence of foreign bodies. Infection is one of the most common complications in wound healing, as bacteria can invade the wound, causing inflammation, increased exudate, and tissue damage. This not only delays the healing process but can also lead to further complications like abscess formation or sepsis.

Poor blood supply to the wound area, often due to conditions like diabetes or peripheral arterial disease, can impede the delivery of essential nutrients and oxygen necessary for tissue repair.

Foreign bodies, such as dirt, debris, or sutures, can also disrupt the healing process by causing persistent inflammation and preventing proper tissue granulation.

Systemic Factors:

Soft Tissue Healing

Systemic factors include age, nutrition, underlying health conditions, and medications.

Age is a significant factor, as the body's regenerative capacity diminishes with time, leading to slower and less effective wound healing in older adults. Nutritional status plays a crucial role, with deficiencies in proteins, vitamins (especially vitamin C and A), and minerals (like zinc) impairing the body's ability to produce new tissue and repair damaged areas. Chronic health conditions, such as diabetes, cardiovascular diseases, and immune system disorders, can impede wound healing by affecting blood flow, immune response, and metabolic functions.

Medications such as corticosteroids and immunosuppressants can also delay healing by suppressing the immune system and inflammatory responses necessary for wound repair.

Lifestyle and Environmental Factors:

Soft Tissue Healing

Lifestyle choices and environmental factors can also influence wound healing. Smoking, for instance, has a detrimental effect due to nicotine-induced vasoconstriction, which reduces blood flow and oxygen delivery to the wound site. Alcohol consumption can impair immune function and protein synthesis, both essential for effective wound healing. Stress, both physical and psychological, can elevate levels of cortisol, a hormone that suppresses the inflammatory phase of wound healing.

Environmental factors such as temperature, humidity, and hygiene conditions can also play a role. For example, excessively dry or moist environments can hinder the healing process by affecting cell migration and proliferation.

Chronic Wounds:

Soft Tissue Healing

In some cases, wounds become chronic, failing to progress through the normal stages of healing.

Conditions such as venous ulcers, pressure sores, and diabetic foot ulcers are common examples.

These chronic wounds are often the result of a combination of the factors mentioned above, creating a vicious cycle of impaired healing.

Effective management of chronic wounds requires a comprehensive approach that addresses both local wound care and systemic health issues.

Examination and Assessment Hands on training section

Palpation

Examination

An examination is performed by locating the scar, determining the type of scar, measuring the scar, palpating the scar, and photographing the scar. When palpating the scar apply pressure to the scar and hold the pressure for several seconds and then release the pressure.

Observe blanching around the scar due to your pressure and then observe how quickly and to what degree blood moves back into the area around the scar.

Contraindications

Examination

If a wound is not healed over, the wound area is fragile, the area in and around the scar is unusually painful, or there are indicators of infection these are all contraindications for scar therapy.

MMT Patient Examination Assessment

When you are performing a patient interview and assessment you are determining and assessing the physical, mental/emotional, and when appropriate, the spiritual dimension of a patient. All these assessments are made, not from a viewpoint of diagnosing disease, but rather to determine and to assess what physical or behavioral changes may need to be recommended to the patient and made by the patient to enhance the patient’s wellbeing, or to prevent illness or disease.

Patient Management and Informed Consent LEGAL PROTECTION AND LIABILITY

In manual medicine, herbal medicine, naturopathy, or holistic health care we rarely use topical substances as a stand-alone treatment or therapy, rather they are utilized as one step in a comprehensive treatment protocol. A comprehensive treatment protocol may include the following steps and procedures:

Comprehensive Treatment Protocol

1.

Assessment of the problem.

2.

Identification of the cause of the problem.

3.

Determination of the best course of action and treatment for the problem.

4.

Delivery of manual therapy if determined to be appropriate.

5.

Utilization of a therapeutic modality such as a castor oil pack.

6.

The presentation of dietary and/or nutritional supplement recommendations.

7.

The presentation of herbal medicine recommendations and instructions.

8.

Instructions regarding therapeutic exercises

9.

Instructions regarding home care procedures.

10. Scheduling for reassessment and evaluation.

Treatment Plan

Informed Consent

Patient Assessment HOMEOSOMATIC EVALUATION

Evaluation and Assessment

I recommend a system-by-system approach to patient evaluation and assessment based upon observation, palpation, and questioning.

Dr. Lawton

Integumentary System

Integumentary System

The skin often reflects a person's overall health and well-being because it can manifest signs of internal issues, deficiencies, and systemic conditions. By observing changes in the skin, healthcare providers can often identify and diagnose underlying health issues, making the skin an important diagnostic tool for overall health and well-being.

Integumentary System Nutritional Status  

Deficiencies: Lack of essential nutrients like vitamins (A, C, D, E), minerals (zinc, iron), and fatty acids can lead to skin problems such as dryness, rashes, and poor wound healing.

Hydration: Dehydration can cause the skin to appear dry, flaky, and less elastic.

Hydration Levels 

Skin Turgor: Well-hydrated skin is firm and elastic, whereas dehydration can make it look wrinkled and saggy.

Hormonal Balance  

Acne and Breakouts: Hormonal imbalances, such as those seen in puberty, pregnancy, and conditions like polycystic ovary syndrome (PCOS), can lead to acne.

Changes in Texture and Color: Conditions like thyroid disorders can cause changes in skin texture and color.

Immune System Health 

Rashes and Infections: A compromised immune system can lead to frequent skin infections, rashes, and delayed healing.

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Autoimmune Disorders: Conditions like lupus and psoriasis often have skin manifestations.

Integumentary System Stress and Mental Health 

Stress-Related Conditions: Stress can exacerbate skin conditions such as eczema, psoriasis, and acne.

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Overall Appearance: Chronic stress can lead to dull, tired-looking skin and exacerbate the signs of aging.

Liver and Kidney Health 

Jaundice: Yellowing of the skin can indicate liver problems.

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Uremic Frost: In severe kidney disease, urea can crystallize on the skin.

Cardiovascular Health 

Cyanosis: A bluish tint to the skin can indicate poor oxygenation of the blood, often related to heart or lung problems.

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Redness and Swelling: Conditions like rosacea and chronic venous insufficiency can indicate underlying vascular issues.

Integumentary System Blood Sugar Levels 

Acanthosis Nigricans: Dark, velvety patches of skin, often in body folds, can indicate insulin resistance or diabetes.

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Delayed Healing: High blood sugar levels can impair wound healing and increase the risk of infections.

Allergic Reactions and Sensitivities  

Hives and Rashes: Allergic reactions to foods, medications, or environmental factors can manifest as skin rashes or hives.

Dermatitis: Contact with allergens or irritants can cause eczema or dermatitis.

Integumentary System Aging and Longevity 

Premature Aging: Lifestyle factors such as smoking, excessive alcohol consumption, and poor diet can accelerate skin aging, resulting in wrinkles, fine lines, and loss of elasticity.

Infections and Diseases 

Systemic Infections: Diseases like chickenpox, measles, and Lyme disease have characteristic skin manifestations.

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Cancer: Skin cancers, such as melanoma, can indicate exposure to harmful UV radiation and overall health risks.

Central Obesity

Central Obesity

Central obesity, also known as abdominal obesity or visceral obesity, refers to the accumulation of fat around the abdomen and internal organs. This type of obesity is often measured by waist circumference and waist-to-hip ratio. Addressing central obesity early can significantly reduce the associated health risks and improve overall well-being and longevity.

Central Obesity Association with Metabolic Syndrome 

Insulin Resistance: Central obesity is strongly associated with insulin resistance, a condition where cells in the body become resistant to the effects of insulin. This leads to elevated blood sugar levels and an increased risk of type 2 diabetes.

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Dyslipidemia: It often coincides with abnormal levels of lipids (cholesterol and triglycerides) in the blood, specifically low HDL ("good") cholesterol and high LDL ("bad") cholesterol, which are risk factors for cardiovascular disease.

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Hypertension: Central obesity is linked with hypertension (high blood pressure), which further increases the risk of heart disease and stroke.

Inflammatory and Immune Responses 

Release of Inflammatory Substances: Fat cells in the abdominal area (visceral fat) release inflammatory substances and hormones that contribute to chronic inflammation. This chronic inflammation is implicated in the development of various diseases, including cardiovascular disease, type 2 diabetes, and certain cancers.

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Immune System Dysfunction: Excess visceral fat can disrupt the normal functioning of the immune system, increasing susceptibility to infections and impairing wound healing.

Cardiovascular Disease 

Atherosclerosis: Central obesity contributes to the development of atherosclerosis, a condition where fatty deposits (plaques) build up inside the arteries, narrowing and hardening them. This increases the risk of heart attacks, strokes, and other cardiovascular complications.

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Heart Failure: Obesity, especially abdominal obesity, is a risk factor for heart failure, where the heart muscle becomes weakened and unable to pump blood efficiently.

Central Obesity Risk of Cancer 

Increased Cancer Risk: Central obesity is associated with an increased risk of several types of cancers, including colorectal cancer, breast cancer (in women), and prostate cancer (in men).

Liver and Kidney Disorders 

Non-alcoholic Fatty Liver Disease (NAFLD): Central obesity is a major risk factor for NAFLD, a condition where fat accumulates in the liver, potentially leading to liver inflammation and scarring (cirrhosis).

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Kidney Disease: Obesity, particularly abdominal obesity, is linked to an increased risk of chronic kidney disease.

Psychosocial and Quality of Life Impacts 

Psychological Well-being: Central obesity can impact self-esteem, body image, and mental health, leading to anxiety, depression, and social stigma.

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Reduced Quality of Life: Health complications associated with central obesity can impair physical mobility, limit daily activities, and reduce overall quality of life.

Central Obesity

Shortened Life Expectancy 

Overall Mortality Risk: Individuals with central obesity have a higher risk of premature death compared to those with a healthy waist circumference and body composition.

Spinal Posture

Spinal Posture

Poor spinal posture can significantly impact both quality of life and overall health in various ways. Misalignment of the spine can cause conditions such as scoliosis, kyphosis, lordosis, and arthritis leading to discomfort and potential long-term health issues.

Spinal Posture Chronic Pain: 

Poor posture often leads to chronic back, neck, and shoulder pain due to increased strain on muscles and ligaments.

Reduced Flexibility and Mobility: 

Poor posture can limit the range of motion and flexibility, making it difficult to perform daily activities and exercise.

Increased Risk of Injury: 

Misalignment and muscle imbalances increase the risk of injuries, particularly in the back and neck.

Respiratory Issues: 

Slouched posture can compress the lungs and diaphragm, leading to reduced lung capacity and breathing difficulties.

Digestive Problems: 

Poor posture can compress abdominal organs, affecting digestion and potentially causing issues like acid reflux and constipation.

Spinal Posture Decreased Energy Levels: 

Chronic pain and discomfort can lead to fatigue, reducing overall energy levels and enthusiasm for daily activities.

Mood and Mental Health: 

Persistent pain and physical limitations can contribute to stress, anxiety, and depression.

Self-Esteem and Confidence: 

Poor posture can affect body image and self-esteem, leading to decreased confidence in social and professional settings.

Spinal Posture Reduced Productivity: 

Physical discomfort and pain can reduce concentration and productivity at work or school.

Limited Physical Activity: 

Reduced flexibility and pain can hinder participation in physical activities and hobbies, impacting social interactions and overall enjoyment of life.

Sleep Disturbances: 

Discomfort from poor posture can interfere with sleep quality, leading to insomnia or restless sleep.

Gait

Gait

Poor gait, which refers to an abnormal walking pattern, can have wide-ranging effects on a person's health and well-being. Identify underlying causes of poor gait, such as neurological, muscular, or skeletal issues and develop an effective treatment plan.

Gait Musculoskeletal Issues: 

Joint Pain and Damage: Abnormal gait patterns can lead to uneven weight distribution, causing stress and wear on the joints, particularly in the knees, hips, and ankles.

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Muscle Strain: Compensatory movements due to poor gait can strain muscles, leading to pain and discomfort in the legs, lower back, and other areas.

Increased Risk of Falls and Injuries: 

Poor gait can reduce balance and coordination, significantly increasing the risk of falls, which can result in fractures, sprains, and other injuries.

Foot Problems: 

Abnormal gait can contribute to foot issues such as bunions, calluses, and plantar fasciitis, as well as exacerbate existing foot deformities.

Spinal Misalignment: 

Poor gait can cause or exacerbate spinal alignment issues, leading to back pain and other spinal problems.

Gait Reduced Physical Activity: 

Difficulty walking can lead to reduced physical activity, which in turn can negatively affect cardiovascular health, contributing to conditions such as obesity, hypertension, and cardiovascular disease.

Decreased Independence: 

Difficulty walking can limit a person’s ability to perform daily activities independently, leading to feelings of helplessness and decreased quality of life.

Mental Health Issues: 

Chronic pain and reduced mobility associated with poor gait can contribute to mental health issues such as depression and anxiety.

Social Isolation: 

Limited mobility can reduce social interactions and participation in community activities, leading to social isolation and loneliness.

Gait Reduced Mobility and Accessibility: 

Poor gait can limit a person’s ability to move around freely, affecting their ability to work, engage in hobbies, and participate in social activities.

Chronic Pain and Discomfort: 

Continuous pain and discomfort from poor gait can significantly impact daily life, reducing overall enjoyment and satisfaction.

Sleep Disturbances: 

Pain and discomfort associated with poor gait can interfere with sleep, leading to insomnia or poor sleep quality, which in turn affects overall health and well-being.

Foot Health

Foot Health

Foot health is crucial to overall health and well-being for several reasons including all of the reasons outlined under the Gait section of this workbook.

Foot Health Musculoskeletal Alignment: 

The feet serve as the foundation for the body. Problems with foot health can lead to issues in the ankles, knees, hips, and lower back due to misalignment and compensation for pain or discomfort.

Prevention of Chronic Conditions: 

Proper foot health can prevent chronic conditions such as plantar fasciitis, bunions, and arthritis, which can cause long-term pain and disability.

Circulatory Health: 

The feet are farthest from the heart, and good circulation is vital for delivering oxygen and nutrients. Poor foot health can be an indicator of circulatory problems, especially in individuals with diabetes or cardiovascular disease.

Hair, Skin, and Nails

Hair, Skin, and Nails

Hair, skin, and nails can serve as important indicators of a person’s overall health. Changes in these areas can sometimes be the first signs of underlying health issues. Regular monitoring of hair, skin, and nails can help detect early signs of potential health issues.

Hair, Skin, and Nails

Hair - Indicators of Health Issues: 

Hair Loss: Sudden or excessive hair loss can indicate hormonal imbalances (such as thyroid disorders), nutritional deficiencies (like iron or protein deficiency), stress, or certain medical conditions like alopecia areata or lupus.

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Dry, Brittle Hair: This can be a sign of nutritional deficiencies, overuse of hair styling products, or underlying health issues such as hypothyroidism.

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Thinning Hair: Could be a sign of aging, hormonal changes, or nutritional deficiencies.

Hair, Skin, and Nails Skin - Indicators of Health Issues: 

Rashes and Itchiness: Conditions such as eczema, psoriasis, allergies, or infections can cause these symptoms.

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Discoloration: Jaundice (yellowing of the skin) can indicate liver disease; cyanosis (bluish tint) can indicate respiratory or cardiovascular issues.

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Acne: While common and often related to hormonal changes, severe or sudden acne can indicate underlying hormonal disorders such as polycystic ovary syndrome (PCOS).

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Dry, Flaky Skin: Can be a sign of dehydration, hypothyroidism, or vitamin deficiencies.

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Wounds That Don’t Heal: Can indicate diabetes or circulatory issues.

Hair, Skin, and Nails Nails - Indicators of Health Issues: 

Brittle Nails: Can indicate nutritional deficiencies (like biotin), thyroid disease, or fungal infections.

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Discoloration: Yellow nails can indicate fungal infections, respiratory issues, or lymphedema; white nails can indicate liver disease.

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Spoon Nails (Koilonychia): This can be a sign of iron-deficiency anemia.

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Pitting or Grooving: Conditions such as psoriasis or alopecia areata can cause these changes.

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Clubbing: Enlarged, curved nails can indicate respiratory or cardiovascular diseases.

Oral Health, Breath, Teeth, and Gums

Oral Health, Breath, Teeth, and Gums

Poor oral health can be an indicator of broader health issues and can also contribute to various health risks. Maintaining good oral health is crucial not just for a healthy mouth but for overall health and well-being. Regular dental check-ups, proper oral hygiene, and a balanced diet are essential for preventing oral health problems and mitigating broader health risks.

Oral Health, Breath, Teeth, and Gums Indicators of Health Issues: Gum Disease (Periodontal Disease): 

Systemic Conditions: Severe gum disease has been linked to systemic conditions such as diabetes, cardiovascular disease, and rheumatoid arthritis.

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Diabetes: People with diabetes are more prone to infections, including periodontal disease, and uncontrolled gum disease can make it harder to manage blood sugar levels.

Oral Infections: 

Immune System Issues: Frequent oral infections can indicate a compromised immune system, possibly due to conditions such as HIV/AIDS or leukemia.

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Nutritional Deficiencies: Recurrent mouth sores or infections can be a sign of nutritional deficiencies, such as a lack of vitamin C (scurvy) or iron (anemia).

Oral Health, Breath, Teeth, and Gums Indicators of Health Issues: Cardiovascular Disease: 

Heart Disease and Stroke: Inflammation and infections caused by oral bacteria can lead to cardiovascular problems. Studies have found links between periodontal disease and an increased risk of heart disease and stroke.

Respiratory Infections: 

Pneumonia: Bacteria from the mouth can be aspirated into the lungs, leading to infections such as pneumonia, especially in vulnerable populations like the elderly or those with compromised immune systems.

Oral Health, Breath, Teeth, and Gums Indicators of Health Issues: Adverse Pregnancy Outcomes: 

Preterm Birth and Low Birth Weight: Pregnant women with periodontal disease are at a higher risk of delivering preterm or low birth weight babies.

Diabetes Complications: 

Poor Blood Sugar Control: Infections and inflammation from gum disease can make it more difficult to control blood sugar levels, worsening diabetes and its complications.

Endocarditis: 

Heart Infection: Bacteria from the mouth can enter the bloodstream and infect the inner lining of the heart, especially in people with damaged heart valves or other heart conditions.

Arthritis and Joint Disease

Arthritis and Joint Disease Indicators of Health Issues: Inflammatory Conditions: 

Rheumatoid Arthritis (RA): This autoimmune disease not only affects joints but can also indicate a systemic inflammatory condition that may affect organs such as the heart, lungs, and eyes. RA is associated with an increased risk of cardiovascular disease.

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Psoriatic Arthritis: Often linked with psoriasis, it indicates an underlying immune system disorder and can also involve the skin and other organs.

Metabolic Disorders: 

Gout: Characterized by the accumulation of uric acid crystals in the joints, gout indicates a problem with uric acid metabolism and can be associated with other conditions like kidney stones, obesity, hypertension, and cardiovascular disease.

Arthritis and Joint Disease Indicators of Health Issues: Inflammatory Conditions: Genetic Predispositions: 

Ankylosing Spondylitis: A type of arthritis that affects the spine, it often indicates a genetic predisposition and can also lead to inflammation in other parts of the body, such as the eyes (uveitis) and the intestines (inflammatory bowel disease).

Degenerative Conditions: 

Osteoarthritis: While primarily a degenerative joint disease, it can also indicate mechanical stress on the joints due to obesity, injury, or overuse. It may reflect broader issues like obesity, which is a risk factor for various other health conditions.

Arthritis and Joint Disease Indicators of Health Issues: Cardiovascular Disease: 

Inflammatory Arthritis: Conditions like RA and psoriatic arthritis are associated with an increased risk of cardiovascular diseases, including heart attack and stroke, due to chronic inflammation.

Obesity: 

Osteoarthritis and Gout: These conditions can be exacerbated by obesity, which also increases the risk of developing other health problems such as diabetes, hypertension, and cardiovascular disease.

Diabetes: 

RA and Osteoarthritis: These conditions are often associated with an increased risk of developing diabetes. The inflammation and physical inactivity caused by joint pain can contribute to insulin resistance.

Arthritis and Joint Disease Indicators of Health Issues: Reduced Mobility and Physical Activity: 

Joint Pain and Stiffness: Arthritis can lead to decreased mobility and physical activity, which can result in muscle weakness, weight gain, and a higher risk of cardiovascular disease, diabetes, and osteoporosis.

Mental Health Issues: 

Chronic Pain and Disability: Persistent pain and disability from arthritis can lead to mental health issues such as depression and anxiety, further impacting overall health and quality of life.

Respiratory Problems: 

RA and Ankylosing Spondylitis: These conditions can cause lung complications, including interstitial lung disease and reduced lung capacity, leading to respiratory problems.

Eye Health and Vision

Eye Health and Vision

Eye and vision health are integral to overall health, and poor eye health can be both an indicator of and a contributor to broader health issues and risks. Eye and vision health are closely linked to overall health. Regular eye care and attention to vision changes can help detect systemic health issues early and reduce the risk of complications.

Eye Health and Vision Indicators of Health Issues: Systemic Diseases: 

Diabetes: Diabetic retinopathy is a common complication of diabetes that affects the blood vessels in the retina. The presence of diabetic retinopathy can indicate poorly controlled blood sugar levels.

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Hypertension: High blood pressure can cause damage to the blood vessels in the retina, leading to hypertensive retinopathy, which can be detected during an eye exam.

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Autoimmune Diseases: Conditions such as lupus, multiple sclerosis, and rheumatoid arthritis can cause inflammation in the eyes, leading to symptoms like dry eyes, uveitis, or optic neuritis.

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Cardiovascular Disease: Changes in the blood vessels in the eyes can sometimes indicate broader cardiovascular issues, such as atherosclerosis.

Eye Health and Vision Indicators of Health Issues: Falls and Accidents: 

Impaired Vision: Poor vision increases the risk of falls and accidents, especially in older adults. This can lead to injuries, fractures, and a decrease in mobility and independence.

Quality of Life: 

Reduced Independence: Vision loss can lead to difficulties in performing daily activities, reducing the quality of life and increasing dependence on others.

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Mental Health Issues: Vision impairment is associated with an increased risk of depression and anxiety due to reduced independence and social isolation.

Eye Health and Vision Indicators of Health Issues: Cognitive Decline: 

Link with Dementia: There is evidence to suggest that vision impairment is associated with an increased risk of cognitive decline and dementia. This may be due to decreased sensory input and reduced engagement in stimulating activities.

Eye Strain and Headaches: 

Digital Eye Strain: Prolonged use of digital devices can cause eye strain, headaches, and neck pain. This can affect productivity and overall well-being.

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Uncorrected Vision Problems: Conditions such as astigmatism, hyperopia, and myopia, if uncorrected, can cause chronic headaches and fatigue.

Eye Health and Vision Indicators of Health Issues: Chronic Conditions: 

Glaucoma and Age-Related Macular Degeneration (AMD): These chronic eye conditions, if not properly managed, can lead to significant vision loss and are often associated with aging and other systemic health issues.

Potential for Infections: 

Contact Lens Use: Improper use and care of contact lenses can lead to eye infections, which, if severe, can result in vision loss and indicate poor hygiene practices.

Nutritional Deficiencies: 

Vitamin A Deficiency: This can lead to night blindness and, in severe cases, complete blindness. It can also indicate poor overall nutritional status.

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Other Nutrient Deficiencies: Deficiencies in vitamins C and E, zinc, and omega-3 fatty acids can affect eye health and may be indicative of poor dietary habits.

Hearing

Eye Health and Vision Indicators of Health Issues: Cardiovascular Disease: 

Reduced Blood Flow: Hearing loss can be an early indicator of cardiovascular disease.

The inner ear is sensitive to blood flow, and reduced circulation from cardiovascular problems can damage the tiny hair cells in the cochlea.

Diabetes: 

Nerve Damage: Diabetes can lead to nerve damage and poor circulation, affecting the ears and leading to hearing loss. Studies show that people with diabetes are more likely to experience hearing loss than those without the condition.

Eye Health and Vision Indicators of Health Issues: Hypertension: 

Blood Vessel Damage: High blood pressure can damage the blood vessels in the ear, leading to hearing loss. This can be an early sign of hypertension or poor blood pressure control.

Chronic Kidney Disease: 

Shared Risk Factors: Hearing loss is more common in people with chronic kidney disease due to shared risk factors such as diabetes and hypertension. The kidneys and the ears share similar structural and functional characteristics, making them both susceptible to damage from these conditions.

Eye Health and Vision Indicators of Health Issues: Infections: 

Viral and Bacterial Infections: Ear infections can be indicative of broader immune system issues. Chronic or recurrent ear infections can suggest underlying conditions that compromise the immune system.

Autoimmune Diseases: 

Inflammation: Autoimmune diseases such as lupus and rheumatoid arthritis can cause inflammation in the ear, leading to hearing loss. Sudden hearing loss can sometimes be a sign of an autoimmune inner ear disease.

Ototoxic Medications: 

Medication Side Effects: Certain medications, including some antibiotics, chemotherapy drugs, and diuretics, can be ototoxic (harmful to the ears) and cause hearing loss. This indicates the need for careful monitoring of medication use.

Eye Health and Vision Indicators of Health Issues: Cognitive Decline and Dementia: 

Reduced Stimulation: Hearing loss has been linked to cognitive decline and an increased risk of dementia. Reduced auditory input can lead to decreased brain stimulation, contributing to cognitive deterioration.

Mental Health Issues: 

Depression and Anxiety: Hearing loss can lead to social isolation, communication difficulties, and reduced quality of life, increasing the risk of depression and anxiety.

Safety Risks: 

Accidents and Injuries: Hearing loss can compromise the ability to detect environmental sounds, such as alarms, traffic noises, and warnings, leading to an increased risk of accidents and injuries.

Eye Health and Vision Indicators of Health Issues: Social Isolation: 

Communication Barriers: Difficulty hearing can lead to social withdrawal and isolation, impacting relationships and overall well-being.

Balance Problems: 

Vestibular System: The inner ear is also responsible for balance. Hearing loss, especially when related to inner ear issues, can lead to balance problems and an increased risk of falls.

Assessment

by Body System

Body System Indicators

Early indicators of dysfunction in the eleven major body systems can reveal underlying health problems and potential risks to overall health. Early indicators of dysfunction in these body systems can provide critical insights into overall health and potential risks. Recognizing and addressing these signs promptly through medical evaluation and intervention can prevent the progression of diseases and improve quality of life.

Major Body Systems Skeletal System: Composed of bones and cartilages, the skeletal system provides mechanical support, protects internal organs, and assists in movement. There are 206 bones in an adult human body.

Muscular System: This system enables movement by contracting and relaxing muscles. It includes both voluntary (skeletal) and involuntary (smooth and cardiac) muscles.

Cardiovascular System: Responsible for circulating blood throughout the body, the cardiovascular system includes the heart, blood vessels, and blood. It transports oxygen, nutrients, and hormones while eliminating waste products.

Respiratory System: Involved in gas exchange, the respiratory system allows us to breathe. It brings oxygen into the body and removes carbon dioxide. Additionally, it helps regulate acid-base balance and is essential for phonation (speech).

Nervous System: The nervous system collects and processes information from the senses, regulates vital functions, and coordinates body movements. It includes the central nervous system (brain and spinal cord) and peripheral nerves.

Digestive System: Responsible for breaking down food mechanically and chemically, the digestive system absorbs nutrients into the body for energy. It includes organs like the mouth, esophagus, stomach, and intestines.

Urinary System (Renal System): The urinary system filters blood through the kidneys, producing urine to eliminate waste products and maintain fluid balance.

Endocrine System: This system produces hormones that regulate various bodily functions, such as the menstrual cycle, blood sugar levels, and growth.

Lymphatic System (Immune System): The lymphatic system drains excess tissue fluid, transports immune cells, and defends the body against pathogens.

Reproductive System: Responsible for producing reproductive cells (sperm and eggs), this system contributes to the process of reproduction. It differs between males and females.

Integumentary System: Comprising the skin and its appendages (hair, nails, sweat glands, and oil glands), the integumentary system provides physical protection, sensory reception, and even synthesizes vitamin D.

Body System Indicators Cardiovascular System 

Indicators: Chest pain, shortness of breath, irregular heartbeats, high blood pressure, swelling in extremities.

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Health Risks: These symptoms can indicate heart disease, hypertension, or circulatory problems, increasing the risk of heart attacks, stroke, and other cardiovascular events.

Respiratory System  

Indicators: Chronic cough, wheezing, shortness of breath, frequent respiratory infections.

Health Risks: These signs can suggest asthma, chronic obstructive pulmonary disease (COPD), infections, or lung cancer, leading to decreased oxygenation and increased risk of respiratory failure.

Nervous System  

Indicators: Persistent headaches, dizziness, numbness, tingling, changes in vision, memory problems.

Health Risks: Such symptoms can indicate neurological conditions like multiple sclerosis, migraines, stroke, or neurodegenerative diseases, affecting cognitive and motor functions.

Body System Indicators Digestive System  

Indicators: Persistent abdominal pain, bloating, changes in bowel habits, heartburn, nausea.

Health Risks: These could be signs of gastrointestinal disorders like irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), gastroesophageal reflux disease (GERD), or even cancers of the digestive tract, leading to malnutrition and systemic effects.

Endocrine System 

Indicators: Unexplained weight changes, fatigue, excessive thirst or urination, changes in skin or hair.

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Health Risks: Such symptoms can indicate diabetes, thyroid disorders, adrenal dysfunction, or hormonal imbalances, which can impact metabolism, growth, and energy levels.

Immune System  

Indicators: Frequent infections, slow wound healing, fatigue, swollen lymph nodes.

Health Risks: These can suggest immunodeficiencies, autoimmune disorders, or chronic infections, leading to increased susceptibility to diseases and prolonged recovery times.

Body System Indicators Skeletal System  

Indicators: Joint pain, stiffness, frequent fractures, back pain.

Health Risks: These signs can indicate osteoporosis, arthritis, or other bone and joint disorders, increasing the risk of immobility and chronic pain.

Muscular System  

Indicators: Muscle weakness, cramps, tremors, muscle wasting.

Health Risks: Such symptoms can be signs of muscular dystrophies, neuromuscular disorders, or chronic conditions like fibromyalgia, impacting mobility and daily functioning.

Integumentary System (Skin, Hair, Nails) 

Indicators: Rashes, persistent itching, changes in skin color or texture, hair loss, nail changes.

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Health Risks: These can indicate skin conditions, infections, or underlying systemic issues like liver or kidney disease, affecting overall health and appearance.

Body System Indicators Reproductive System  

Indicators: Irregular menstrual cycles, pelvic pain, changes in libido, infertility.

Health Risks: Such symptoms can indicate hormonal imbalances, reproductive organ disorders, or sexually transmitted infections (STIs), impacting fertility and sexual health.

Urinary System 

Indicators: Changes in urine color or volume, frequent urination, pain during urination, lower back pain.



Health Risks: These signs can suggest urinary tract infections, kidney stones, or chronic kidney disease, leading to impaired kidney function and systemic effects.

Manual Medicine Section

Manual Medicine THE ROLE OF MANUAL THERAPY

Medical Massage Therapy

Massage therapy scar remediation involves using specialized massage techniques to improve the appearance and functionality of scar tissue. This therapeutic approach aims to promote healing, increase flexibility, and reduce discomfort associated with scars. Massage scar remediation is a valuable tool for helping individuals manage their scars more effectively, improving both their physical and psychological well-being.

Medical Massage Therapy Here are key aspects of massage scar remediation: Improving Tissue Quality: 

Massage can help break down scar tissue adhesions and realign collagen fibers, leading to softer and more pliable tissue.

Enhancing Mobility: 

Techniques such as fascial release and cross-fiber friction can increase the elasticity and flexibility of the scar, improving the range of motion and reducing stiffness.

Reducing Pain and Discomfort: 

Regular massage can alleviate pain and discomfort associated with scar tissue by increasing blood flow and reducing inflammation.

Medical Massage Therapy Improving Circulation: 

Massaging the scar area can enhance blood flow and lymphatic drainage, which can help reduce swelling and promote nutrient delivery to the tissue, aiding the healing process.

Esthetic Improvement: 

Over time, massage can help scars become less noticeable by evening out skin texture and reducing hyperpigmentation or redness.

Client Education and Care: 

Massage therapists often educate patients on how to perform self-massage techniques at home, which can be beneficial for ongoing scar care and maintenance.

Medical Massage Therapy Common Techniques Used: 

Fascial Release: A gentle, sustained pressure technique used to stretch and release the fascia.



Cross-Fiber Friction: A technique where the therapist uses their fingers to massage across the grain of the scar tissue, helping to break down adhesions and align collagen fibers.



Soft Tissue Mobilization: Involves various manual techniques to mobilize scar tissue and improve its movement relative to surrounding tissues.

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Lymphatic Drainage: A gentle technique aimed at reducing swelling and improving lymphatic circulation, which can be particularly useful for post-surgical scars.

Medical Massage Therapy Common Techniques Used: 

Dry Needling: A technique involving the insertion of sterile disposable needles around a problem scar.

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Cupping: A soft tissue vacuum decompression technique that lifts and opens space in and around the dermis.

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Therapeutic Kinesio tape: The application of a specialized form of sports tape that lifts the skin and encourages increased blood and lymphatic fluid flow.



Light Therapy: Light therapy is a form of photo biomodulation that promotes skin and soft tissue healing, eliminates inflammation, and reduces pain.

Medical Massage Therapy

Common Techniques Used: 

Exercise: Stretching and relaxation exercises especially those associated with Indian yoga, dao yin, chi kung, and tai chi chuan are most beneficial.



Breathwork and abdominal churning exercises: The exercise systems cited above contain highly effective breathing and movement exercises which are effective at treating internal scars and adhesions.

Manual Medicine TREATMENT PROTOCOL

Scar Needling Remediation Protocol Scar Needling Protocol - Surround the Dragon Identify Target Treatment Area: Locate areas with thickened, painful scar adhesions. Focus needling on these spots.

Preparation: Clean and stretch the area surrounding the scar tissue before beginning targeted treatment.

Internal Contraction: If the scar tissue is internal, encourage the patient to contract muscles internally through guided breathwork before needling.

Apply Scar Needling: Using the “Surround the Dragon” technique to needling the areas around the scar. Focus on the most restricted areas.

Scar Massage: Perform circling scar massage around and away from the scar tissue.

Scar Needling Remediation Protocol

Non - Needling Techniques Tenshin Method: Gently poke into the scar with tenshin and digitally pull away from the contracture.

Apply Small Vacuum Cups: Apply small suction cups around the scar using the sliding or lifting techniques and use infused and essential oils as recommended.

Precautions: Avoid scar irritation, provoking pain, or increasing hypertrophy of the scar tissue.

Additional Therapies: Utilize Bioptron light therapy and apply scar oil for enhanced healing.

Hyperesthesia Point Location Hands on training section

Trigger Points, Fascia or Nerve Dysfunction?

Homeosomatic Medical Massage

Trigger points are commonly associated with scars and connective tissue adhesions. While trigger points are traditionally viewed as a musculoskeletal issue, there is substantial evidence indicating that they have significant neurological components. These include peripheral sensitization, central sensitization, motor endplate dysfunction, and neurogenic inflammation. Understanding the neurological aspects of trigger points is crucial for developing effective treatment strategies that address both the muscle and nervous system components of this complex pain phenomenon.

Trigger Points, Fascia or Nerve Dysfunction?  Motor Endplate Dysfunction:

Homeosomatic Medical Massage

Some theories suggest that trigger points are associated with dysfunctional motor endplates, where nerves communicate with muscle fibers. This dysfunction can lead to abnormal muscle contraction and the formation of taut bands within the muscle.  Neurogenic Inflammation: Trigger points might also involve neurogenic inflammation, where the activation of nerves leads to the release of inflammatory substances that contribute to pain and muscle dysfunction.

Hyperesthesia Point Location:

Homeosomatic Medical Massage

When during examination and treatment you locate hyperesthesia points treat them with the appropriate MMT protocol. In MMT we use the term hyperesthesia points to describe “Trigger” points, pain points, ashi points, fibromyalgia points, neurolymphatic points, and the entire collection of vague and nonspecific point terminology used by various health disciplines.

Glides, Slides, and Tensioning Techniques Hands on training section

Glides, Slides, and Tensioning Techniques:

Nerve Entrapment and Compression

Nerve glides, also known as nerve slides, tensioning, flossing or stretching, are exercises used in manual therapy to improve nerve movement and reduce pain. These exercises are designed to mobilize the nerves, which can become restricted due to various conditions, such as muscle strains, sciatica, herniated discs, connective tissue adhesions, and various nerve entrapment syndromes.

Glides, Slides, and Tensioning Techniques:

Nerve Entrapment and Compression

Objective: The main goal is to enable smooth movement of peripheral nerves.

These are the nerves that extend from the brain and spinal cord to the rest of the body.

Technique: The exercises involve specific movements that stretch and mobilize the nerves without causing pain or discomfort. It’s like flossing the nerves through the tissues they pass through.

Conditions: Nerve glides can be beneficial for conditions that cause nerve tightness or compression, such as scars and adhesion entrapment, carpal tunnel syndrome, cubital tunnel syndrome, and thoracic outlet syndrome.

Nerve Entrapment and Compression Glides, Slides, and Tensioning Techniques: Upper Extremity Nerve Glides: For nerve pain in the arm or hands, exercises like the Median Nerve Glide can be prescribed. This involves movements that floss the median nerve, which helps in bending the wrist and fingers.

Lower Extremity Nerve Glides: Sciatic nerve glides, for example, can help relieve pain associated with sciatica, affecting the lower back and legs.

When employing nerve glides with a patient it is vitally important to know exactly how much tension and stretching can be safety applied.

Median Nerve Prayer Glide

Upper Extremity Glide – Median Nerve

 Begin by sitting with your head straight and your palms together in a "prayer position" in front of your face. Ensure that the entire surface of both palms is in contact.  Slowly and gently lower your hands while keeping the palms fully touching, until you feel some tension or muscle stretch.

If you experience pain or numbness, stop and return to the starting position.  Hold the "prayer position" for approximately 10 seconds, then slowly raise your hands back to your face.  Repeat this exercise for 5 cycles, performing it 3-4 times a day.

The Hitchhiker Fully extend the arm out to the side.

Upper Extremity Glide – Median Nerve

Extend the wrist, supinate the palm, stretch the fingers, and rotate the thumb posteriorly.

Turn the head and neck to the opposite direction and lift the chin.

If you experience pain or numbness, stop and return to the starting position.

Hold the “hitchhiker position" for approximately 10 seconds, then slowly lower your arm back to your side.

Repeat this exercise for 5 cycles, performing it 3-4 times a day.

Begin by standing with your shoulders relaxed and your hand at your side, with the back of your hand facing forward (Position 1).

Upper Extremity Glide – Radial Nerve

Drop or push your shoulder down towards the floor, keeping your back straight and avoiding any leaning (Position 2).

Bend your wrist towards your palm so that your palm faces up and behind you in the "waiter’s tip" position, as if receiving an object from behind (Position 3).

Move your arm back, reaching behind you and slightly to the side until you feel tension in the forearm. If needed, tilt your head and neck away from your arm to increase the tension (Position 4).

If you still do not feel the tension, further bend your wrist, hand, and fingers towards the ceiling, or tilt your head and neck further away from your arm (Position 5).

Hold the position where you feel tension for about 10 seconds, then slowly return to the starting position.

Repeat this exercise for 5 cycles, performing it 3-4 times a day.

Upper Extremity Glide – The Ulnar Nerve Reverse Single Whip Begin by sitting with your head straight and your arm extended in front of you. Slowly and gently move into Position 1 (described below), holding it for about 10 seconds before gradually moving to the next position.

Spend about 10 seconds in each position before gently transitioning to the next, completing all six positions to finish one cycle.

Repeat for 5 cycles. Perform this exercise 3-4 times a day.

Position Descriptions: Forearm in supination (palm up), wrist and knuckles in flexion, and elbow extended.

Elbow, wrist, thumb, and fingers all extended; palm of the hand up and out.

Same as Position 2, but with the elbow flexed less than 80 degrees.

Same as Position 1, but with the arm out and to the side.

Same as Position 4, but with the thumb and wrist turned back and down.

Same as Position 5, but with your head and neck tilted away from the arm.

Phalen's test is a diagnostic procedure used to evaluate for carpal tunnel syndrome, which is a condition caused by compression of the median nerve as it passes through the carpal tunnel in the wrist.

Procedure: Positioning:

Phalen’s Test – Median Nerve

The patient is asked to sit or stand comfortably.

Flexion: The patient is instructed to flex both wrists maximally (bring the backs of the hands together) and maintain this position.

Alternatively, the patient can place the backs of their hands together with fingers pointing downward, keeping the wrists in full flexion.

Duration: The patient should hold this position for 30 to 60 seconds.

Tinel's sign is a clinical test used to detect irritated nerves. It is commonly used in the diagnosis of carpal tunnel syndrome but can also be applied to other nerve compression or injury sites.

Procedure:

Tinel’s Sign

Positioning: The patient is asked to sit or stand comfortably with the wrist relaxed and supported.

Tapping: The examiner uses their fingers or a reflex hammer to tap gently over the median nerve at the carpal tunnel. The carpal tunnel is located on the palmar side of the wrist, just proximal to the wrist joint.

Medical Massage Therapy Hands on training section

John Harvey Kellogg, MD John Harvey Kellogg (February 26, 1852 – December 14, 1943) was an American businessman, inventor, physician, surgeon, and advocate of the Progressive Movement of the early to mid 1900’s. He was the director of the Battle Creek Sanitarium in Battle Creek, Michigan, founded by members of the Seventh-day Adventist Church. It combined aspects of a European spa, a hydrotherapy institution, a hospital and highclass hotel. Kellogg treated the rich and famous, as well as the poor who could not afford other hospitals.

According to Encyclopædia Britannica, his "development of dry breakfast cereals was largely responsible for the creation of the flaked-cereal industry."

John Harvey Kellogg, MD

Dr. Kellogg wrote one of the foremost books on medical massage therapy, a book that is still published and studied by massage therapists today. Here is a citation for that book -Kellogg, John Harvey. The Art of Massage: A Practical Manual for the Nurse, the Student and the Practitioner. Modern Medicine Publishing Co., 1895.

John Harvey Kellogg, MD In his book he begins by talking about the influence of the Chinese on the practice of massage. They were seen as one of the first people to use massage to help relieve illness and had particularly important contributions to the development of the field. One of the books produced from their studies was The Cong-Fou of the Tao-Tse. After the history of massage, he has a section discussing different parts of the body and how they should be manipulated.

The effects of massage on the participant's body are explored, and special attention is paid to particular benefits, such as fighting or holding off certain illnesses. This is an idea Kellogg advocated for in many different contexts besides just this book. The actual practice of massage is broken down into the specific movements that a therapist could use to achieve different effects, such as kneading or stroking. Joint movements are considered, and then the piece delves into how to massage separate parts of the body. There are special massages for each distinct body part he focuses on. Kellogg believes that the techniques are important for every part of the body, whether it is necessary to perform the practice on that area or by massaging other parts of the body that are connected to it.

Edgar Cayce Edgar Cayce was a well-known American psychic who wrote on various topics, including health and healing. Among these topics, Cayce frequently discussed massage therapy. His insights emphasized the holistic nature of health and the importance of balance within the body. Cayce often mentioned the importance of good circulation and the lymphatic system in maintaining health. He suggested that massage therapy could help improve circulation, remove toxins, and stimulate the lymphatic system.

Cayce pointed out the benefits of massage for the nervous system. He believed that it could help relax the nerves, reduce stress, and promote healing by restoring balance to the nervous system.

Edgar Cayce He believed in personalized treatments, tailored to the individual’s specific needs and conditions. Cayce’s readings often provided customized advice on the type, frequency, and duration of massage therapy. Edgar Cayce’s perspective on massage therapy highlights its importance as a holistic treatment that supports physical, mental, and spiritual health. His recommendations on techniques, oils, and the integration of massage with other therapies underscore his belief in the interconnectedness of bodily systems and the value of personalized, preventive care.

Edgar Cayce’s Recommendations for Treating Scar Tissue Castor Oil Packs: 

Application: Apply warm castor oil packs to the affected area. This involves soaking a cloth in castor oil, placing it on the scar, and covering it with plastic wrap and a heating pad.



Benefits: Castor oil packs are believed to enhance circulation, reduce inflammation, and promote tissue healing.

Massage and Manipulation: 

Technique: Gently massage the scar tissue with castor oil or olive oil to break down the fibrous tissue and improve flexibility.



Frequency: Regular massage was recommended to soften the tissue and improve the appearance of the scar.

Edgar Cayce’s Recommendations for Treating Scar Tissue Diet and Nutrition: 

Balanced Diet: Cayce emphasized the importance of a balanced diet rich in vitamins and minerals to support the body’s natural healing processes.



Specific Nutrients: He often recommended foods high in vitamins A, C, and E, as well as zinc, which are known for their roles in skin health and repair.

Electrical Stimulation: 

Violet Ray Device: Cayce suggested using a violet ray device, a type of high-frequency electrical device, to stimulate circulation and promote healing in the scar tissue.

Hydrotherapy: 

Alternating Hot and Cold Compresses: Applying alternating hot and cold compresses to the scar area to improve blood flow and encourage healing.

Contraindications Section

Contraindications FIRST DO NO HARM

Contraindications

Medical massage therapy is always indicated in conditions involving scarring, adhesions, strictures and nerve entrapment unless specifically contraindicated.



Contraindications: Situations in which medical massage therapy (MMT) should not be used). There may be exceptions, but only if ordered by a medical physician.

 Open Wounds: Do not perform MMT over broken skin or recent unhealed surgical incisions.

Contraindications

 Thinning Skin: Avoid performing MMT to thinning or fragile skin in the elderly or in any medical condition where the skin integrity is compromised.  Skin Ulcers: Do not use MMT on patients with skin ulceration and/or infection.  Acute Cellulitis: This condition involves inflammation of the skin caused by bacteria (usually staphylococcus or streptococcus). If a patient has acute cellulitis, characterized by redness, pain, swelling, and warmth in the infected area, MMT is not recommended.

 Deep Vein Thrombosis (DVT): Do not use MMT with patients with a history or who have DVT (a blood clot in a deep vein). It can increase blood flow and dislodge the clot, potentially causing a pulmonary embolism.

Contraindications, Continued

 Uncontrolled Diabetes: MMT can worsen pins-andneedles sensations (peripheral neuropathy) associated with uncontrolled diabetes.  Active Cancer: Do not use MMT with patients who are undergoing cancer treatment unless prescribed by a licensed physician.  Lymph Node Removal: Do not perform MMT directly over areas where lymph nodes have been surgically removed or damaged by trauma.  Varicose Veins: Tortuous varicose veins may be both and indication and contraindication for MMT.

 Fever: Not recommended for patients with a fever.  Broken or Damaged Skin: Do not perform MMT techniques over broken or damaged skin. (Risk of infection)

Contraindications, Continued

 Pregnancy: Care is required during pregnancy.  Certain Medications: Patients who are taking blood thinner medications may observe bruising under the skin due to the increased circulation effects.

Contraindications, Continued

Patients who present with signs and symptoms of nerve entrapment disorders related to scar tissue and adhesions should always be evaluated by a medical physician to determine the cause of the condition, appropriateness of manual care, and the possibility of combined medical care.

Ancillary Techniques Section

Ancillary Technique and Methods A COLLECTION OF EFFECTIVE THERAPEUTIC MODALITIES

In addition to the main manual therapy protocols employed in medical massage therapy scar remediation we also use many ancillary techniques.

The choice of which techniques, therapeutic modalities to use, is based upon the condition of the patient, the stage of the disease, and complicating factors. These ancillary techniques include:

Ancillary Methods

 Cupping  Red light or Bioptron Therapy  Castor Oil Packs  Infused Oil Treatment (IOT)  Dry Brushing  Gua Sha  Kinesio Tape (KinesioStretch Method)  Herbal Medicine and Supplementation

Ancillary Techniques Cupping

Ancillary Techniques Laser

Ancillary Techniques Bioptron

Ancillary Techniques Dry Brushing

Ancillary Techniques Micro Stim

Ancillary Techniques High Frequency Percussion

Ancillary Techniques Dry Needling

Ancillary Techniques Cupping

Ancillary Techniques Red Light Therapy

Ancillary Techniques Castor Oil Packs

Ancillary Techniques – Dry Brushing

Ancillary Techniques Gua Sha

Ancillary Technique and Methods HERBAL MEDICINE

Ancillary Techniques Herbal Medicine

Herbal Medicines

There is no justification, no rational or scientifically based reason, to think that herbs are less effective than synthetically manipulated petroleum by-products known as medical prescription drugs. The fact that many do hold this opinion is due largely to years of persecution, bias, and prejudice enacted against naturopathic, homeopathic, and chiropractic practitioners which is promoted by allopathic and osteopathic physicians, the medical profession, the Food and Drug Administration, the prescription drug companies, the drug company's lobbyists, and the politicians they pay as well as other health related state and federal government agencies.

Herbs can play a supportive role in scar remediation by reducing pain, inflammation, and promoting nerve health. Here are some of the best herbs commonly recommended for scar remediation:  Turmeric (Curcuma longa) (internal) Active Component: Curcumin

Herbal Medicine

Benefits: Anti-inflammatory and antioxidant properties that can help reduce pain and inflammation.  Ginger (Zingiber officinale) (External application) Benefits: Anti-inflammatory and analgesic properties that can help relieve pain and improve circulation.  St. John's Wort (Hypericum perforatum) (Internal and external application) Benefits: Traditionally used for nerve pain and has potential antidepressant effects, it can also has wound-healing properties and can help reduce the appearance of scars by promoting skin regeneration.

 Aloe Vera: Benefits: Known for its soothing and healing properties, aloe vera can help reduce scar appearance by promoting skin regeneration and providing moisture.

Herbal Medicine

 Calendula: Benefits: This herb has anti-inflammatory and wound-healing properties, making it effective in reducing scar tissue and promoting healthy skin regeneration.  Lavender: Benefits: Lavender oil is known for its skinregenerating properties. It can help reduce the appearance of scars and improve skin texture.

 Gotu Kola (Centella Asiatica): Benefits: This herb is known for its ability to enhance collagen production and improve skin healing, making it effective for scar reduction.

Herbal Medicine

 Chamomile: Benefits: Chamomile has anti-inflammatory and antioxidant properties that help soothe the skin and promote healing, which can reduce scarring.  Rosehip Seed Oil: Benefits: Rosehip seed oil is rich in essential fatty acids and antioxidants, which help repair and regenerate damaged skin, reducing the appearance of scars.

Calendula (Calendula officinalis): Is derived from the marigold flower, it is known for its antiinflammatory, antimicrobial, and skin-healing properties.

Anti-inflammatory Properties: Calendula oil helps reduce inflammation around the scar tissue, which can help improve the overall appearance of the scar.

Herbal Medicine



Wound Healing: Calendula promotes the healing of wounds by stimulating tissue regeneration and collagen production, which are essential for reducing scar formation.



Antimicrobial Action: The antimicrobial properties of calendula oil help prevent infections in wounds, ensuring that the healing process is not disrupted and minimizing the risk of developing scars.



Moisturizing: Calendula oil helps keep the skin hydrated, which is important for the healing process and can improve the elasticity and appearance of scarred skin.



Soothing Effect: Calendula oil has a soothing effect on the skin, which can help reduce any discomfort or itching associated with healing scars.

Master Scar Formula

Helichrysum, rose seed oil, and fractionated coconut oil blend:  Under normal circumstances a small amount of carrier oil and essential oil is mixed at the time of treatment. Larger amounts may be blended for daily use at home. Once the two carrier oils, rose seed oil and fractionated coconut oil are prepared, add helichrysum essential oil from between 1 to 5 percent.

Herbal Medicine

Aloe Butter is a rich blend of Aloe Vera and coconut oil. It is a soft, smooth, fragrance-free butter made from 100% natural and pure aloe Vera juice and refined Coconut oil. It is used for moisturizing, soothing, repairing, and protecting both hair and skin. Aloe Butter contains vitamin C, E, B, and B12, as well as antioxidants that hydrate and rejuvenate the skin.

Ancillary Technique and Methods ESSENTIAL OILS

Essential Oils for Scars

Essential oils can be highly effective for scar remediation due to their various healing properties. When using essential oils for scar remediation, it is important to dilute them with a carrier oil (such as coconut oil, jojoba oil, or almond oil) to avoid skin irritation. A typical dilution ratio is 2-3 drops of essential oil per teaspoon of carrier oil. Apply the mixture to the scarred area and massage gently. Regular application, combined with good skincare practices, can significantly improve the appearance of scars over time.

Essential Oils for Scars

 Lavender Oil: Known for its skin-regenerating properties, lavender oil helps in promoting the growth of new skin cells and reducing scar tissue.  Helichrysum Oil: This oil is renowned for its ability to heal wounds and reduce scarring. It has anti-inflammatory and regenerative properties that aid in skin healing.  Rosehip Seed Oil: Rich in essential fatty acids and antioxidants, rosehip seed oil helps in repairing and regenerating damaged skin, thus reducing the appearance of scars.

Essential Oils for Scars

 Frankincense Oil: Frankincense oil promotes cellular regeneration and reduces the appearance of scars and stretch marks.  Tea Tree Oil: Known for its antimicrobial properties, tea tree oil can help prevent infections in wounds and promote faster healing, which can minimize scarring.  Carrot Seed Oil: This oil is rich in antioxidants and is known for its ability to rejuvenate and regenerate skin cells, making it effective in scar treatment.

Essential Oils for Scars

 Chamomile Oil: With its anti-inflammatory and soothing properties, chamomile oil can help in reducing redness and promoting healing, thereby minimizing scarring.  Geranium Oil: Geranium oil has antibacterial and antiseptic properties, which can aid in wound healing and reducing the appearance of scars.  Myrrh Oil: Myrrh oil is known for its healing properties and can help in promoting tissue regeneration and reducing scar visibility.  Neroli Oil: This oil is effective in promoting skin cell regeneration and improving skin elasticity, which can help reduce the appearance of scars.

Ancillary Technique and Methods NUTRACEUTICALS

Ancillary Techniques Nutraceuticals

Nutraceuticals

Supplements can play a crucial role in promoting good wound healing by providing essential nutrients that support the body's natural repair processes.

Ensure that supplements do not interact with any existing medications or health conditions. Additionally, a balanced diet rich in these nutrients can often provide the necessary support for wound healing with out the need for additional supplementation.

Nutraceuticals

Vitamin D plays a significant role in wound healing, primarily through its effects on inflammation, immune function, and cellular processes that are crucial for tissue repair. Vitamin D is vital for multiple aspects of the wound healing process, from immune modulation and inflammation control to cellular proliferation and tissue remodeling. Adequate levels of vitamin D are essential to ensure efficient and effective wound healing. Individuals with low vitamin D levels or at risk of deficiency should consider increasing their intake through diet, supplements, or safe sun exposure.

Modulation of Immune Response: Vitamin D is essential for the proper functioning of the immune system. It helps modulate the immune response by:

Vitamin D and K2



Enhancing Innate Immunity: Vitamin D promotes the production of antimicrobial peptides, such as cathelicidins and defensins, which help to protect against infections by destroying pathogens at the wound site.



Regulating Inflammation: It helps to control the inflammatory response, ensuring it is sufficient to deal with pathogens and debris but not excessive, which can lead to chronic inflammation and delayed healing.

Promotion of Cell Proliferation and Differentiation: 

Vitamin D influences the proliferation and differentiation of keratinocytes, the primary cells in the epidermis. This process is crucial for:



Reepithelialization: The formation of new epithelial cells to cover the wound surface, an essential step in wound closure.



Collagen Production: Vitamin D receptors are present in fibroblasts, the cells responsible for producing collagen and other extracellular matrix components that provide structural integrity to the new tissue.

Angiogenesis: Vitamin D promotes angiogenesis, the formation of new blood vessels from existing ones. This is critical for:

Vitamin D and K2

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Nutrient Supply: Ensuring that the healing tissue receives adequate oxygen and nutrients necessary for cell metabolism and repair.

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Waste Removal: Facilitating the removal of metabolic waste products from the wound site, aiding in a clean and efficient healing environment.

Reduction of Fibrosis: By modulating the inflammatory response and promoting balanced immune function, vitamin D helps to: 

Minimize Excessive Scar Formation: Preventing overproduction of fibrous tissue that can lead to hypertrophic scars or keloids

Nutraceuticals Vitamin C (Ascorbic Acid): Role in Wound Healing: 

Essential for collagen synthesis, a protein crucial for the structure and strength of skin, blood vessels, and tissues.



Acts as an antioxidant, reducing inflammation and protecting cells from oxidative damage.

Vitamin A: Role in Wound Healing:  

Enhances epithelial (skin) cell growth and differentiation.

Supports immune function, which is vital for preventing wound infections.

Nutraceuticals Zinc: Role in Wound Healing: 

Plays a critical role in protein synthesis, cell growth, and immune function.



Supports the inflammatory response and epithelialization (formation of new skin cells).

Protein: Role in Wound Healing: 

Essential for the synthesis of collagen and other proteins involved in tissue repair.



Supports the immune response and overall energy needs during the healing process.

Nutraceuticals Vitamin E: Role in Wound Healing: 

Acts as an antioxidant, protecting cells from oxidative damage.



Supports immune function and helps in reducing scar formation.

Vitamin K: Role in Wound Healing: 

Essential for blood clotting, which is the first step in wound healing.



Supports bone health and the repair of damaged tissues.

Silicon Sheets SKIN HYDRATION, FIBROBLAST, FASCIABLAST COLLAGEN REGULATION

Silicon Sheets Silicone sheets create a moist healing environment by covering the scar and preventing water loss. This hydration helps soften and flatten the scar over time. The exact mechanisms aren't fully understood, but silicone sheets are thought to affect the fibroblast activity and reduce excessive collagen production, leading to smoother, less raised scars. A new type of cell in fascia has been discovered, the fasciablast, or a cell that manufactures fascia.

Clinical Cupping UNDERSTANDING HOMEOSOMATIC VACUUM DECOMPRESSION THERAPY

The Fundamentals of Cupping Therapy:

Who is it for?

With proper screening for contraindications, cupping therapy is suitable for anyone. Therapeutic cupping helps with various issues like sports injuries, scar tissue and adhesions, muscle pain, neuropathy, chronic pain, respiratory ailments, and lymphedema.

Understanding Homeosomatic Vacuum Decompression Cupping Therapy

Cupping therapy is a form of alternative medicine where glass, silicone, or plastic cups are placed on the skin to create vacuum suction to promote health and healing.

Cupping therapy has been used for centuries across various cultures for muscle relaxation, detoxification, and stress relief.

By creating a vacuum with cups on the skin, this alternative medicine technique promotes healing and overall well-being.

Cupping therapy aids in releasing tension in soft tissue to promote circulation and lymphatic flow.

Clinical Cupping PROCEDURES AND METHODS

Different Cupping Methods

When starting cupping therapy, choose the right cup size and method for your patient. Large cups cover more area while small cups are ideal for smaller areas or contour massage.

Different cupping techniques include static, flash, dynamic, shake, and rotational cupping. In our method of cupping, AcuMyoTherapy, we recommend the use of herbal infused oils to assist with the cupping process, benefits, and results.

Different Cupping Methods

Static Cupping Static cupping is the use of a cup, or several cups, with each cup left in one location on the skin and without moving or manipulating the cup. Apply a small amount of herbal infused oil before placing the cups on the skin. Gently press and release the cup to create suction or use a pump to remove the air from the cup. Start with a test site for one minute to access the patient’s response and then apply the therapy for three to five minutes per area treated. If a cup falls off, simply reposition it. Use this technique a few times a week for up to ten days before taking a break from the therapy.

Different Cupping Methods

Flash Cupping – Flash cupping involves placing and releasing cups on the skin to create vacuum suction, helping with blood and lymph stagnation and deep tissue release. Apply a small amount of herbal infused oil before placing the cups on the skin. Try flash cupping for up to five minutes per area for maximum benefits.

The benefits include deep tissue release and nerve stimulation.

Different Cupping Methods

Dynamic Cupping – (Gliding or Sliding Technique) Dynamic cupping is the gliding or sliding of cups across the skin. Apply an herbal infused oil to the skin. Compress the cup to create vacuum suction. Glide the cup in a zigzag, circular, or back and forth motion. When using dynamic cupping to provide a cupping massage limit the massage time period to twenty or thirty minutes.

Shake Cupping –

Different Cupping Methods

Shake cupping therapy is accomplished by shaking or vibrating cups in a static position. Apply a small amount of herbal infused oil before placing the cups on the skin. This technique is beneficial for softening scars, deep tissue work, and myofascial release.

Rotational Cupping –

Different Cupping Methods

Rotation cupping therapy is performed by placing a cup in a static position and rotating the cup over the treatment area.

Apply a small amount of herbal infused oil before placing the cups on the skin. This technique is beneficial for softening scars, deep tissue work, and myofascial release.

Different Cupping Methods All the techniques listed above may be combined to provide a “vacuum” massage therapy session. An expert cupping therapist will be able to demonstrate an adept flow of techniques, changing fluidly from one technique to another easily and efficiently.

To achieve this sense of proficiency first select the correct type and size of cups for the patient and your purposes. Having to switch between cup types or sizes breaks the cupping therapy routine and flow.

Also choose the correct lubricating herbal infused oil for your patient’s condition and in conformance with the patient's diagnosis.

Clinical Cupping THE EVIDENCE

The Evidence

The Evidence

Conclusion: The available evidence suggests that cupping therapy is effective in managing chronic pain, knee osteoarthritis, low back pain, neck pain, chronic back pain, and herpes zoster. Moreover, it represents a promising, safe, and effective nonpharmacological therapy that warrants wider application and promotion.

The Evidence Background: Myofascial decompression (MFD), or cupping, and self-myofascial release (SMR) are common techniques utilized to treat soft tissue injuries and increase flexibility. MFD is a negative pressure soft tissue treatment technique using suction to manipulate the skin and underlying soft tissues. One method of SMR is a foam roller, where a patient rolls his/her bodyweight over a dense foam cylinder in a self-massaging fashion to mobilize soft tissues for the body part treated.

Conclusion: The findings suggest that both treatments are beneficial in increasing hamstring length. Patients though felt an enhanced treatment effect using MFD over SMR for perceived benefits to hamstring flexibility.

The Evidence Vacuum Decompression Therapy increases blood circulation to the targeted area, which can help reduce muscle tension and promote healing. The negative pressure generated by the cups can also facilitate the removal of toxins and metabolic waste products from the tissues, thereby reducing inflammation and alleviating pain. Furthermore, cupping may stimulate the relaxation response in muscles, improving flexibility and reducing stiffness.

Overall, the combined effects of enhanced circulation, detoxification, and muscle relaxation contribute to the therapeutic benefits of cupping on muscle tissue.

The Evidence Lauche, R., Cramer, H., Hohmann, C., Choi, K. E., Rampp, T., Saha, F. J., ... & Dobos, G. (2012).

"The Effectiveness of Cupping Therapy on Chronic Neck and Shoulder Pain: A Randomized Controlled Trial." PLoS One, 7(9), e31793.

This study examined the effectiveness of cupping therapy on chronic neck and shoulder pain, showing significant pain reduction and improved quality of life for participants.

AlBedah, A. M. N., Elsubai, I. S., Qureshi, N. A., Aboushanab, T. S., Ali, G. I. M., El-Olemy, A. T., ... & Khalil, A. A. (2019). "The medical perspective of cupping therapy: Effects and mechanisms of action." Journal of Traditional and Complementary Medicine, 9(2), 90-97.

This review article discusses the various effects and proposed mechanisms of action of cupping therapy, including increased blood flow, reduced inflammation, and enhanced tissue repair.

The Evidence Huijuan Cao, Xun Li, and Jianping Liu. (2012). "An updated review of the efficacy of cupping therapy." PLoS One, 7(2), e31793.

This systematic review updated previous findings on the efficacy of cupping therapy, highlighting its benefits in treating a range of conditions, including pain and musculoskeletal disorders.

Kim, J. I., Lee, M. S., Lee, D. H., Boddy, K., & Ernst, E. (2011). "Cupping for treating pain: a systematic review." Evidence-Based Complementary and Alternative Medicine, 2011, 467014.

This systematic review evaluated the effectiveness of cupping therapy in treating various types of pain, concluding that it may be effective for pain management, especially in conditions like chronic pain.

The Evidence

Teut, M., Ullmann, A., Braun, V., Dornieden, K., & Irnich, D. (2012). "Cupping therapy in patients with carpal tunnel syndrome: a randomized controlled trial." The Journal of Pain, 13(3), 329337.

This randomized controlled trial assessed the effects of cupping therapy on carpal tunnel syndrome, showing improvements in pain and functionality among participants.

The studies cited offer insights into the physiological effects of cupping therapy, such as pain reduction, improved blood flow, and potential mechanisms underlying its therapeutic benefits.

Cupping and IOT THE USE OF INFUSED OIL THERAPY (IOT)

Infused Oil Therapy

In our homeosomatic method of treatment we utilize infused oils therapy along with cupping and gua sha. Later in this workbook these aspects will be covered in more detail along with the herbs and formulations that we use.

Cupping CONTRAINDICATIONS

Counterindications for Cupping



High Fever or Infection: Avoid cupping when a person has a high fever or an infection.



Convulsions or Cramps: Cupping should not be used in cases of convulsions or cramps.



Allergic Skin Conditions: If someone has allergic skin conditions, cupping is not recommended.



Ulcerated Sores: Avoid cupping over ulcerated sores.



Thin Muscle Layer: Cupping should only be done on soft muscle tissue and not where the muscle layer is thin or uneven due to bony projections or angles.



Severe Diseases: Cupping is contraindicated in severe diseases such as cardiac failure, renal failure, ascites due to hepato-cirrhosis, and severe edema.



Serious Illnesses: Individuals with serious conditions such as cancer, cardiovascular disease, or severe infections should consult with their primary healthcare provider before undergoing gua sha therapy.

 Hemorrhagic Diseases: Avoid cupping in cases of allergic purpura (a form of vasculitis), hemophilia, and leukemia.  Dermatosis and Disease of the Skin: Cupping should not be used on clients with dermatosis or destruction of the skin.

Counterindications for Cupping

 Blood Disorders: Individuals with anemia or similar blood disorders should avoid cupping.  Heart Disease and Pacemakers: Cupping is not recommended for people with heart failure, kidney failure, or those with pacemakers.  Blood Thinners: If someone is on blood thinners, cupping should be avoided.  Compromised Immune System: Patients with a compromised immune system, such as those undergoing chemotherapy or with autoimmune diseases, should use caution as the therapy could potentially trigger an adverse response.

 Varicose Veins: Avoid performing cupping directly over varicose veins, as the pressure may damage the veins further.

Counterindications for Cupping

 Pregnancy: While some practitioners may use gentle cupping techniques during pregnancy, it is generally advised to avoid it, especially on the abdomen and lower back, unless specifically recommended by a healthcare provider.

Cupping AFTERCARE

After a cupping therapy session, proper aftercare is essential to maximize benefits and ensure a comfortable recovery. Here are some key guidelines:  Hydrate: Drink plenty of water to help flush out toxins and stay hydrated.

Cupping Aftercare

 Rest: Allow the body time to rest and recover after the treatment.  Avoid Strenuous Activities: Take a break from vigorous exercise immediately after the session.  Stay Warm: Cover the treated areas to maintain warmth.  Avoid Caffeine, Alcohol, and Sugary Foods: These can delay the natural healing process.  Be Mindful of Diet and Drink: Chose nourishing foods and avoid extremes like hot showers or cold environments.

KinesioStretch Taping Technique THE CLINICAL APPLICATION OF KINESIOLOGY TAPE FOR SCARS

Kinesio Tape for Scars

Kinesio tape gently lifts the superficial layers of skin, creating a space between the skin, fascia, and underlying tissues. This lifting effect is thought to promote better circulation and lymphatic drainage, which can help reduce swelling and inflammation. In applying kinesio tape for the treatment of neurological conditions we generally follow the pathway of major nerves.

As an ancillary part of our Homeosomatic Medical Massage Therapy treatment protocol, and at the end of a treatment session, we often send patients home with kinesio tape applied to an area or region.

I Technique Anchor tape from the origin of the nerve pathway and follow the pathway of the nerve

Cross Technique With the cross-taping technique, we identify and cross over an area of localized pain

Theraband Kinesiotape Tension Chart

Theraband kinesiology tape is a product that supports muscles and joints and provides pain relief.

It is safe, effective, and easy to apply. The tape is latex-free, non-irritating, and allergy tested3. It lasts up to 5 days. The tape features stretch indicators for perfect application every time41. It has best in class adhesion and sticks and lasts like only the best tapes in the market.

Therapeutic Oil Section

Infused Oils and Medicated Oils TREATING AND HEALING INFLAMMATION AND SCARS

Herb Infused Oils

Herb infused oils are prepared by selecting an herb or herbal blend and then cutting or grinding the dried plant material to a size and consistency that allows the oil to permeate the herbal material and to draw out and dissolve the chemical constituents into solution. In the “long” method the mixture is allowed to sit in a cool dark place for up to 8 weeks. In the “fast” method or what is called the “alcohol intermediary method”, the dried plant material is cut or ground into an acceptable size and soaked in a very small amount of alcohol for 24 hours and then it is soaked in a carrier oil for 24 to 48 hours and finally strained. During the 24-to-48hour period the mixture is warmed to a temperature of 110-degrees Fahrenheit. When the appearance of the solution is appropriate for the herb or herbs being infused, the solution is strained. The remaining mixture of herbs may be used for other purposes.

Herb Infused Oils

An herb-infused oil, also known as a macerated oil, consists of a carrier oil that has been permeated (“infused” or “macerated”) with one or more herbs. The benefit of using an infused oil is that it combines the properties of both the carrier oil and the herbs. Unlike essential oils, which are highly concentrated extracts, infused oils are gentler and less concentrated. They capture the whole essence of the herb and can be used for various purposes, from skincare to cooking. For example, on average an essential oil only captures 4 or 5 percent of the chemical constituents in an herb, whereas an herb-infused oil will extract over 90 percent of the herbal constituents.

For the fast or alcohol intermediary method of extraction heat is used to speed up the process.

There are several ways in which heat is used:  Warm Infusion: Heat the oil and herbs gently on the stovetop.

Herb Infused Oils

 Solar Infusion: Place the herbs in a jar with oil and let it sit in a sunny window for 4-6 weeks.  Stovetop Infusion: Simmer the herbs and oil together.  Oven Infusion: Use low heat in the oven to infuse the oil.  Yogurt Maker: Place the mixture into jars and into a yogurt maker at 110 degrees Fahrenheit.  Double Boiler: Place the jars in a double boiler with water and set to simmer lightly.

Herb Infused Oils

Topical and Medicated Infused Oil Therapy Herbal blends and formulas include herbal infused oils using castor oil and flax seed oil as a carrier and adding essential oils such as poke root.  Castor Oil Packs  Infused Oil Treatment (IOT) (Poke Root)  Essential oils such as ginger and germanium  Mugwort infused oil

Mugwort is an effective ingredient for soothing even the most sensitive skin. It offers anti-inflammatory, antibacterial, and antioxidant benefits, and it could even help protect your skin against free radical damage.

Anti-Inflammatory Properties: 

Mugwort Infused Oil

Mugwort soothes irritated skin and reduces redness. It’s excellent for calming inflammation caused by external factors like sun damage or pollution.

Antibacterial and Antifungal Benefits: 

Mugwort has natural antibacterial and antifungal properties, making it effective against skin-damaging bacteria. It helps maintain healthy skin.

Antioxidant Protection: 

Rich in antioxidants, including vitamin E, mugwort protects the skin barrier from free radical damage. This contributes to preventing premature aging and other skin issues.

Softening, Moisturizing, and Toning:  Mugwort’s healing properties leave the skin soft and hydrated. Regular use can enhance overall skin health.

Mugwort Infused Oil

Ideal for Sensitive Skin:  It is well tolerated by most skin types. Its gentle nature makes it suitable for sensitive skin types.

Anti-Microbial Effects:  Mugwort’s compound called azulene has antimicrobial properties, helping maintain a healthy skin microbiome.

Herb Infused Oil Formulations Homeosomatic Topical Herbal Pharmacotherapy

Formulations

An herbal formulation refers to a dosage form that consists of one or more herbs or processed herbs in specific quantities. These formulations are designed to provide specific nutritional or therapeutic effects.

Arnica, Arnica montana (flowers) – Analgesic and Anti-inflammatory. Used topically or homeopathically.

Recommended Herbal Pharmacy

Boswellia, Boswellia serrata - Anti-inflammatory and Analgesic, Contains boswellic acids that can treat pain and inflammation.

Calendula Flowers, Calendula officinalis – Antiinflammatory, Anodyne, treatment of skin conditions and rashes.

Chamomile Flower, Matricaria chamomilla – Chamomile is known for its ability to promote wound healing. It can enhance the skin's natural healing processes, leading to improved scar appearance over time.

Lavender, Lavandula spp. (aerial parts) – Lavender oil promotes the regeneration of skin cells, which can help in the healing of scars and the improvement of skin texture.

Pain, Inflammation, Sedation, and Muscle Spasm

Licorice Root, Glycyrrhiza glabra – Antiinflammatory. Contains phyto sterols like hydrocortisone and estrogen which promote cell and tissue growth and repair.

Meadowsweet, Filipendula ulmaria (all parts but mainly flowers and leaves) – Anti-inflammatory and Analgesic. Contains salicin which can soften scar tissue.

Sage, Salvia officinalis (all aerial parts) – Antiinflammatory, encourages new blood vessel growth and circulation, encourages tissue healing and regeneration. Sage has strong antiinflammatory properties that can help reduce inflammation and redness around scar tissue, making the scar less noticeable.

Pain, Inflammation, Sedation, and Muscle Spasm

Mugwort, Artemisia vulgaris (Roots, leaves, stems, and flowers) – Mugwort has strong antiinflammatory effects, which can help reduce inflammation and redness around scar tissue.

Mullein Leaf and Flower, Verbascum Thapsus – Anti-inflammatory, can treat skin irritation and inflammation. Mullein contains compounds that support skin repair and regeneration, which can be beneficial for healing scars.

Rosemary, Rosmarinus officinalis (all aerial parts but mainly the flowers and leaves) – Antiinflammatory Rosemary oil can improve blood circulation, which helps deliver essential nutrients and oxygen to the skin, promoting faster healing and regeneration. Rosemary contains compounds that can stimulate collagen production, which is essential for skin repair and reducing the appearance of scars.

The following information provides a list of the various formulations and combinations I typically use for patient treatment:

Formulations



Castor oil and flaxseed oil 50/50 blend.



Castor oil and flaxseed oil 50/50 blend plus dried skullcap infusion.



Castor oil and flaxseed oil 50/50 blend plus dried sage infusion (increase circulation, edema, vascular insufficiency).



Castor oil and flaxseed oil 50/50 blend plus dried mugwort infusion.



Safflower oil and dried poke root (Phytolacca americana) infusion (for the treatment of lymphatic conditions, scars, immune response, and lymphedema).



Castor oil and poke root infusion.



Castor oil, flax seed oil, and rose seed oil with geranium essential oil.

The following formulation is recommended for general use.

The general formulation is blended by using flaxseed oil and adding castor oil, and mugwort infused oil.

Formulations – General Use

Formulation: (Equal parts of each oil)  Castor Oil – 1 Part  Flaxseed Oil – 1 Part  Mugwort Oil – 1 Part To this formulation you may also add an essential oil recommended for scars according to correct dilution procedures.

The following formulation is used for nerve conditions and neuropathy as well as to encourage blood circulation and lymphatic activity around nerve tracks.

Formulations – Nerve Detoxification

The nerve tonic is blended by using sweet almond oil and adding mugwort infused oil and skullcap infused oil.

Formulation: (Equal parts of each oil)  Sweet Almond Oil – 1 Parts  Mugwort Oil – 1 Parts  Skullcap Oil – 1 Parts To this formulation you may also add an essential oil according to correct dilution procedures.

The following formulation is used for the treatment and remediation of problem scars.

Formulations – Scar Remediation

The scar formulation is blended by using castor oil and flaxseed oil and adding mugwort infused oil and sage infused oil as well as rose essential oil.

Formulation:  Castor Oil – 1 Part  Flaxseed Oil – 2 Parts  Mugwort Oil – 1 Part  Sage Oil – 2 Parts  Rose Essential Oil – 18 drops per ounce

Formulations – Commonly Used Oils Sweet Almond Oil (Prunus amygdalus) Mugwort Oil (Artemisia vulgaris) Skullcap Oil (Scutellaria lateriflora) Castor Oil (Ricinus communis) Flaxseed Oil (Linum usitatissimum) Rosemary Oil (Salvia Rosmarinus) Sage Oil (Salvia officinalis) Rose Essential Oil (Rosa/Rosa damascene/Rosa centifolia)

Frankincense Essential Oil (Boswellia Serrata) Mullein Leaf and Flower (Verbascum thapsus) Clove Bud Essential Oil (Syzygium aromaticum) Lavender (Lavandula spp) Essential Oil Arnica (Arnica montana) Calendula (Calendula officinalis) Comfrey Oil (Symphytum officinale) Ginger Essential Oil (Zingiber officinale)

Helichrysum Skin Healing and Regeneration: Wound Healing: Promotes faster healing of minor cuts, wounds, and abrasions.

Medical Herbalism

Scar Reduction: Helps reduce the appearance of scars, including acne scars and stretch marks.

Anti-Aging: Reduces the appearance of fine lines and wrinkles due to its regenerative properties.

Anti-Inflammatory: Pain Relief: Alleviates muscle and joint pain, including conditions like arthritis.

Inflammatory Skin Conditions: Eases symptoms of inflammatory skin conditions such as eczema, psoriasis, and dermatitis.

Ginger Root Ginger oil can be beneficial for scars due to its antiinflammatory, antioxidant, and skin-rejuvenating properties.

Anti-inflammatory Effects:

Medical Herbalism

Ginger oil has potent anti-inflammatory properties that can help reduce swelling, redness, and inflammation around scar tissue.

Antioxidant Benefits: Ginger contains antioxidants that protect the skin from free radical damage, which can promote the healing of damaged tissues and improve the appearance of scars.

Skin Rejuvenation: Ginger oil can help improve blood circulation to the skin, which promotes collagen production and skin regeneration.

This can aid in reducing the appearance of scars over time.

Scar Healing: The warming and stimulating properties of ginger oil can enhance the skin's ability to heal, potentially speeding up the healing process of scars.

Geranium Anti-Inflammatory Properties: Geranium essential oil contains compounds that exhibit anti-inflammatory effects. A study suggested that geranium oil’s anti-inflammatory qualities may benefit leg and foot swelling caused by edema.

Medical Herbalism

Lymphatic Drainage and Circulation: Geranium oil can promote lymphatic drainage and improve circulation.

Geranium essential oil is derived by steam distillation of the leaves and stems of the Pelargonium graveolens plant species, which is native to South Africa. The oil has a pleasant floral fragrance and is widely used in perfumes, cosmetics, and aromatherapy. Its unique composition includes compounds like linalool, geraniol, citronellol, and limonene, which contribute to its therapeutic benefits.

Comfrey Wound Healing:

Medical Herbalism

Comfrey has long been used to promote the healing of wounds, cuts, and bruises. It contains allantoin, a compound that helps stimulate cell proliferation and tissue regeneration.

Anti-inflammatory: Comfrey has anti-inflammatory properties that can help reduce swelling and inflammation, making it useful for treating sprains, strains, and other inflammatory conditions.

Skin Conditions: It can be beneficial for various skin conditions, including eczema, psoriasis, and acne, due to its soothing and healing effects on the skin.

Poke Root Potential Benefits: Anti-Inflammatory: Poke root has antiinflammatory properties.

Medical Herbalism

Immune Support: Traditionally, poke root has been used to support the immune system.

Lymphatic Health: It’s used to promote lymphatic drainage and help with conditions like swollen lymph nodes.

Topical Applications: Infused oils or salves made from poke root have been applied to the skin for various skin conditions, including sore breasts or swollen lymph nodes.

General Contraindications

General Contraindications CONTRAINDICATIONS TO THE USE OF A CASTOR OIL PACK, INFUSED OILS, ESSENTIAL OILS, AND/OR MEDICATED OILS

Contraindications



Contraindications: Situations in which castor oil packs, infused oils, essential oils, and medicated oils combined with cupping, or gua sha should not be used). There may be exceptions, but only if ordered by a physician.



Open Wounds: Do not use over recent unhealed surgical incisions.



Thinning Skin: Avoid applying thinning or fragile skin in the elderly or in any medical condition where the skin integrity is compromised.



Skin Ulcers: Do not use on patients with skin ulceration and/or infection.



Acute Cellulitis: This condition involves inflammation of the skin caused by bacteria (usually staphylococcus or streptococcus). If a patient has acute cellulitis, characterized by redness, pain, swelling, and warmth in the infected area, oil therapy is not recommended.

 Deep Vein Thrombosis (DVT): Do not use with patients with a history or who have DVT (a blood clot in a deep vein). It can increase blood flow and dislodge the clot, potentially causing a pulmonary embolism.

Contraindications, Continued

 Uncontrolled Diabetes: May worsen pins-andneedles sensations (peripheral neuropathy) associated with uncontrolled diabetes.  Active Cancer: Do not use with patients who are undergoing cancer treatment unless prescribed by a licensed physician.  Lymph Node Removal: Do not use directly over areas where lymph nodes have been surgically removed or damaged by trauma.  Varicose Veins: Tortuous varicose veins may be both and indication and contraindication for use.

 Fever: Not recommended for patients with a fever.

Contraindications, Continued

 Broken or Damaged Skin: Do not use over broken or damaged skin. (Risk of infection)  Pregnancy: Care is required during pregnancy.  Certain Medications: Patients who are taking blood thinner medications may observe bruising under the skin due to the increased circulation effects.

Contraindications, Continued

Patients who present with signs and symptoms of nerve disorders should always be evaluated by a physician to determine the cause of the condition, appropriateness of manual care, and the possibility of combined medical care.

Research and References Section

Research SCAR REMEDIATION IS EVIDENCE BASED

Research Berrueta, L., Muskaj, I., Olenich, S., Butler, T., Badger, G. J., Colas, R. A., . . . Langevin, H. M. (2016). Stretching Impacts Inflammation Resolution in Connective Tissue. Journal of Cellular Physiology.

Best, T., Gharaibeh, B., & Huard, J. (2013). Stem cells, angiogenesis and muscle healing: A potential role in massage therapies?

British Journal of Sports Medicine.

Bove, G., & Chapelle, S. (2012). Visceral mobilization can lyse and prevent peritoneal adhesions in a rat model. Journal of Bodywork and Movement Therapies.

Bove, G., Harris, M., Zhao, H., & Barbe, M. (2016). Manual therapy as an effective treatment for fibrosis in a rat model of upper extremity overuse injury. Journal of the Neurological Sciences.

Lin T, Chou FH, Wang HH, Wang RH. “Effects of scar massage on burn scars: A systematic review and meta-analysis.” J Clin Nurs.

2023 Jul;32(13–14):3144–3154.

Lubczynska A, Garncarczyk A, Dziadecka D. “Effectives of various methods of manual scar therapy.” Skin Res Technol. 2023 Mar;29(3):e13272.

Shin, T. M., & Bordeaux, J. S. (2012). The Role of Massage in Scar Management: A Literature Review. Dermatologic Surgery.

Thompson, W. R., Scott, A., Loghmani, M. T., Ward, S. R., & Warden, S. J. (2016). Understanding Mechanobiology: Physical Therapists as a Force in Mechanotherapy and Musculoskeletal Regenerative Rehabilitation. Physical Therapy.

Research .

Shin, T. M., & Bordeaux, J. S. (2012). The Role of Massage in Scar Management: A Literature Review.

Dermatologic Surgery.

Thompson, W. R., Scott, A., Loghmani, M. T., Ward, S. R., & Warden, S. J. (2016). Understanding Mechanobiology: Physical Therapists as a Force in Mechanotherapy and Musculoskeletal Regenerative Rehabilitation. Physical Therapy.

Waters-Banker, C., Dupont-Versteegden, E. E., Kitzman, P. H., & Butterfield, T. A. (2014). Investigating the Mechanisms of Massage Efficacy: The Role of Mechanical Immunomodulation. Journal of Athletic Training. (Open Access) Wong, Y., Smith, R., & Koppenhaver, S. (2015). Soft Tissue Mobilization to Resolve Chronic Pain and Dysfunction Associated With Post-Operative Abdominal and Pelvic Adhesions: A Case Report.

Journal of Orthopaedic & Sports Physical Therapy.

Yelvington, M., Scoggins, M., White, L. (2017). A Child With a Burn-Related Foot and Ankle Contracture Treated With Multiple Modalities. Pediatr Phys Ther.

Research STUDY ON IMPACT OF SKIN REHABILITATION MASSAGE THERAPY ON IMMATURE SCAR IN BURN VICTIM

Research Massage Therapy: An Evidence Based Framework

Research Soft Tissue Mobilization to Resolve Chronic Pain and Dysfunction Associated with Postoperative Abdominal and Pelvic Adhesions

Research Traditional Chinese Medicine for Hypertrophic Scars – A review of the therapeutic methods and potential effects.

Research Use of tape for the management of hypertrophic scar development: A comprehensive review.

References SCAR MASSAGE THERAPY IS EVIDENCE BASED

Herbs and Natural Supplements in the Prevention and Treatment of Delayed-Type Hypersensitivity Reactions: This study discusses the potential benefits of herbal remedies, including their use in scar treatment.

Therapeutic Potential of Herbal Medicines for Wound Healing: This review article examines various herbs and their active compounds that promote wound healing and reduce scar formation. Link Plant Extracts and Natural Compounds Used against UVB-Induced Skin Damage: This research explores the protective effects of plant extracts, including their potential role in scar prevention and treatment. Link

References

The Effect of Herbal Medicines on Keloids: This study evaluates the efficacy of herbal medicines in managing keloids, which are a type of abnormal scar formation. Link Herbal Medicine in Wound Care: A Review: This comprehensive review discusses the use of herbal medicines in wound healing, including their effects on scar formation. Link A Systematic Review of the Efficacy of Herbal Therapy in the Management of Human Diseases: This systematic review summarizes the evidence on the efficacy of herbal therapies, including their application in scar management. Link These references provide scientific insights into the potential benefits of herbal medicine in scar remediation. They cover a range of herbs and natural compounds known for their wound healing, anti-inflammatory, and skin-regenerative properties.

Conclusion

Conclusion SUMMING UP OUR WORKSHOP

Conclusion Conclusion We hope our workshop on manual therapy and herbal medicine for scar remediation has provided valuable insights into holistic approaches for improving scar outcomes. Through the integration of manual techniques such as massage and stretching, coupled with the application of herbal remedies known for their anti-inflammatory, antioxidant, and regenerative properties, we have explored comprehensive methods to address scar tissue effectively.

Manual therapy techniques, including scar massage and fascial release, play crucial roles in breaking down adhesions, improving tissue mobility, and promoting collagen remodeling.

These techniques not only enhance the aesthetic appearance of scars but also contribute to the functional recovery of affected areas.

Conclusion

Herbal medicine, with its rich repertoire of botanical extracts and essential oils like lavender, rosemary, and calendula, offers promising avenues for scar treatment. These natural compounds exhibit anti-inflammatory actions, accelerate wound healing, and support tissue regeneration, thereby aiding in scar remodeling and minimizing scar visibility over time.

By combining manual therapy with evidence-based herbal interventions, we empower practitioners to provide personalized and effective scar remediation strategies tailored to individual patient needs. Moving forward, ongoing research and clinical practice will continue to refine and expand our understanding of these integrative approaches, ensuring optimal outcomes for patients seeking scar rehabilitation and aesthetic improvement.

Conclusion

Together, through continuous learning and application of integrative therapies, we strive to advance the field of scar remediation, promoting healing, restoring function, and enhancing the quality of life for our patients.

FastTrack Workshop Section

Other American Health Source FastTrack Certification Workshops NCBTMB APPROVED CONTINUING EDUCATION

American Health Source – FastTrack Workshop

American Health Source – FastTrack Workshop

American Health Source – FastTrack Workshop

American Health Source – FastTrack Workshop

American Health Source – FastTrack Workshop

American Health Source – FastTrack Workshop

American Health Source – FastTrack Workshop

American Health Source – FastTrack Workshop

No part of this proprietary material is to be used for any purpose, other than clinical therapy and treatment provided to patients, by schools or other organizations, without the express written approval of Dr. Lawton.

Scar Erasure 101 - Scar Remediation

Dr. Gregory T. Lawton 616 – 570 - 0790 drlawton@clinicalhealthmaintenance.com www.blueheronacademy.com

Scar Erasure 101 - Scar Remediation

Scar Erasure 101 - Scar Remediation UNVEILING THE SECRETS OF SCAR REMEDIATION: A JOURNEY TOWARDS HEALING