Treating Neuromuscular Facial Conditions




So today’s presentation is an overview of a multifaceted approach to treating neuromuscular facial conditions.

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Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.  Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Hi, everyone. I want to thank you. And the American Acupuncture Council for hosting me. Thank you for coming today. And if we can go to the first slide, I’m going to go ahead and hop. So today’s presentation is an overview of a multifaceted approach to treating neuromuscular facial conditions. My name’s Michelle Gellis and I teach facial and cosmetic acupuncture classes internationally.

And one of the. Things that I do in addition to just the cosmetic is I treat individuals that have various neuromuscular facial conditions that are affecting them in some way. So what exactly is a neuromuscular facial condition? Essentially a neuromuscular facial condition is any condition that affects the face, either the facial movements or any sort of sensory issues such as if someone has neuropathy or pain and some examples of neuromuscular facial conditions.

And certainly some of these are not. Just, they don’t just affect the face, but for many of these conditions, the most noticeable or troublesome part of the condition can be the part that affects the face. So Bell’s palsy, Ramsay hunt syndrome. Synkinesis stroke, Tam J trigeminal neuralgia. My esteem, gravitas, ptosis, Ms.

Shingles, and hemifacial spasm.

When I approach treating and the, of these conditions, the part that affects the Fest. I, what I have learned over the years in practice is that using a multi-faceted approach. Which I will describe is the best way to really take care of the issues and especially issues that have been around for a long time and to make your treatment long lasting.

These conditions such as Bell’s palsy and. TMJ can have a major impact on the face. And so there are again conditions that have to do with more muscular movement. And then there are ones like trigeminal neuralgia, which have pain. So the modalities that I use in order to. Treat. When I say a multi-faceted approach, I will use scalp acupuncture, facial motor points, submuscular and intramuscular, needling, facial cupping, and Derma rolling.

And some of these modalities can be used in conjunction and some are better for certain conditions and some are better for other condition. Scalp acupuncture is a fairly new series of techniques that we use in our practice. It’s only been around since the 1950s and it became popular in the 1970s and essentially you’re stimulating areas of the brain that correspond to.

Functions, whether they’re sensory functions or motor functions and it’s based, it’s not based on acupuncture points, it’s based on neuroanatomy. And it is really fabulous for treating any sort of neuromuscular condition, but specifically for neuromuscular facial conditions. And if you look at the homonculus if this is a cross section of the brain and you look at the homonculus, you can see the area for the face takes up the bottom two fifths.

If you were to break it up into two feds, two fifths, and one fifth, the face takes up a huge area of. The brain and the way scalp acupuncture works is you take a needle and you insert it into the loose connective tissue and you thread it into the new loose connective tissue corresponding to the area of the scalp that you would be working on.

So here is a map. Of a couple of the different areas. So we have the motor and sensory area of the scalp on one side of the head. And then this bottom two fifths here is where you would be needling in order to affect the face.

And I’m just going to talk through this video. Let me get it going. So this is me demonstrating how to put the needle into the scalp. First, you have to measure the scalp and the bottom two fifths is what you’re going to be needling until.

So this so the motor areas in front, the sensory area is behind it. And this part of the scalp can be sensitive. So you have to be careful when you’re needling and it’s helpful if your patient is sitting up and then you want to work very quickly. You don’t want to be too tentative when you’re going in.

And I’ll, you can either use a one handed method or a two handed method. I use a one hand for the insertion in the beginning, and then sometimes I’ll use two hands to push it down. And then once the needles and you’re going to stimulate it and For that, there are a lot of contraindications and precautions and scalp acupuncture is a very wide field.

It requires specialized training, but it went, especially when combined with some of these other modalities can really affect a tremendous change for some of these neuromuscular facial cues. So the next is our official motor points. So motor points are something that have been used. Actually I found some information back in the late 18 hundreds in a medical book.

A medical doctor had mapped out some of the motor points, but most recently people like Matt Callison and other researchers have really. Built on this foundation and have used motor points on the body, especially to restore muscle from.

So what exactly is a motor point? A motor point is essentially in a nutshell, the most electrically excitable, part of the muscle where the motor nerve bundle is attached, but it’s not a trigger point trigger points or something different, but it’s And frequently, many of the motor points that we’ll use on the face are also acupuncture points.

So it makes it easy for us to feel. And if a facial muscle is in spasm, if it isn’t moving properly, if it’s overly tense or overly relaxed, then by needling the motor point, it will cause it’s like a reset switch and it will cause it to get back into its normal functioning. As I mentioned, motor points are not trigger points, or.

Typically areas along the muscle that can be sensitive when you push on them. But motor points are something entirely different. And as I said many motor points are also acupuncture points, which is great for us. So here’s an example of a motor point, and this is the motor point for the frontalis muscle.

And. Coincidentally. It is also gallbladder 14. And by putting a needle into gallbladder 14 and stimulating it, it can help. If someone has ptosis, if they can’t raise their eyebrows, it can also help if they’re having some eyelid drooping. And another motor point. This is a quick video of a motor point for the mentality, and this was I’m going to play it and talk at the same time.

So this was a student of mine in. Class I was teaching, she had Bell’s palsy many years ago and she still was missing some muscle movement in her chin. So I went ahead and I needle the motor point for the mentality muscle. And try it one more time. You can see the needle. It when I stimulated.

The her chin started to move and Twitch, and I have a lot of these videos. You can see it moving right there. I have a lot of these videos. On my Facebook group, it’s called facial acupuncture. And on my Instagram page, I have a lot of, I do a facial acupuncture tip of the week and some of them are cosmetic and some of them are neuro.

That’s a good place if you want to see a bunch more of this stuff. So some examples of motor points. For example, if a person cannot smile, there are four main muscles that are affected the zygomaticus major, which draws the angle of the mouth upward and outward. This Acumatic is minor, which elevates the upper lip.

The LaVey levator labii superioris, which elevates the upper corner of the mouth and the resource, which retracts the angle of the mouth laterally. So by knowing which motor points to use, you can help someone who has lost their ability to smile.

The next thing is submuscular needling and. This is something that is uniquely suited to help with a lot of different disharmonies of facial and neck muscles. And essentially if a muscle, much like motor points, if a muscle is not functioning properly, that. You can needle either underneath the muscle or through the muscle and it will help to bring blood and she back to the muscle.

And it’s great for people who have had long-term paralysis. And when I teach my class, I go through all the different facial muscles. The big few are the corrugators, the frontallis, the temporalities and the massive tier. And you would needle from the origin to the insertion. So for example, this is the frontallis muscle.

You would thread needles on either side, just like this. Underneath the edges of the frontallis muscle. And you just put them in, you can stimulate them a little if you want, but you want to try to get underneath the muscle. It is a lot less painful if you do, if you’re working with a bigger muscle, like the massive tear, you might not be able to get underneath it.

So you would be needling through. But the, this is how you would needle. So underneath the muscle on either side, and this is what this would look like. And again, I’m going to talk through this. The first thing you have to do is measure the muscle. And the best way to do that is Asher patient to raise their eyebrows because the muscle is on either side of the eyebrow and when they raise their eyebrows, you can see the skin right over the muscle will wrinkle, and then you are just going to needle, right?

Underneath the edge of the muscle

are you usually use to. And that helps get my angle of insertion. Correct. And then I will press down on the skin to get it way underneath the muscle. Again, I’m not treating wrinkles. This is not cosmetic. This is a way of bringing muscle function back into the muscle.

And then I’m going to. Once I’ve done one side. So here I’m showing if you angle to date, you’re not going to be able to get underneath the muscle. If you go to superficially, you won’t be able, you’ll just be hitting this.

So once you’ve done the lateral side, then you’re going to come in and you would do the medial side

and I’ll do, depending on their forehead, I’ll either do two or three on each.

This is just for one, our brow or one side of the frontallis. If you were treating Bell’s palsy, then you would just treat the effected side.

And if you were needling the temporary Ellis, this is what that would look like.

The next thing is facial cupping and guash Shaw and facial cupping and gua SHA is designed to bring blood and treat cheese circulation to the skin and the muscles. It helps to relax tight facial muscles. And facial tissue, it can move out stagnant, lymph and toxins. It helps the lymphatic system to function better and that the lymphatic system is functioning better than the whole face will function better.

It helps with inflammation and it will help to strengthen the vascular integrity of the face. And it can help with any sort of nerve entrapment, especially if facial fascia has trapped some facial nerves. So here’s a cross-section of the face and the face is the only part of our body where our skin is attached to muscle.

And so the functioning of the muscles and the nerves that. Make the muscles work is very important because if the muscles not functioning properly because of nervous and trapped, then the skin is not going to move and you won’t be able to fully smile. So here’s a picture of that bone, muscle skin on the face.

And this is a picture of fascial adhesions. So the fascia is this stuff it’s like when you have chicken. Pull the scan off that stuff that looks like spiderwebs. So it really helps to release a lot of that in the face. And facial cupping is not like cupping on the body. You don’t leave the cups. You Stimulate different acupuncture points on the face and the cups are meant to move.

And this is just a slide from one of my classes where I’m showing gliding and then suction and releasing down the neck into the lymphatic drainage area. And. Also Derma rolling is something that can help to stimulate the channels. Like our channel rollers that we might use on the body. Derma rollers have these tiny little needles on them and.

You can stimulate the channels on the face, stimulate the cheap and your patients can buy a Derma roller from you and you can teach them how to use it. And then it will stimulate they can do this at home in between treatments. So what are some of the. Neuromuscular facial conditions that that we’ve, we can work with that I’ve worked with.

I mentioned in the beginning Bell’s palsy, stroke, TMJ, trigeminal neuralgia, Ms. Ptosis hemifacial spasm. And I have enough time to just talk about one and I’m just going to talk about Bell’s policy, which is the most common form of facial paralysis. And typically it just affects one side of the face.

Usually it’s temporary, but. The people that come to see me have had Bell’s palsy frequently. It’s been years. They still don’t have complete movement of their face. They’ve tried everything and then they come for acupuncture. It can affect blinking opening and closing the eyes, facial expressions, hearing taste, the salivary glands.

And that I say hearing it can affect their hearing. So I use a multifaceted approach. I’m going to do my body points. I’m going to do face points and depending on their underlying conditions, what’s going on with them, of course, I’ll treat them constitutionally and then bringing the multi-faceted approach in I’m going to do.

Motor points on the scalp. So the lower two fifths on the opposite side, I might use your Shan, men and face points just to calm the patient, treat their face, and then have them do some exercises. Look at their face, have them try to move different parts of their face, figure out where the paralysis is.

And then do facial motor point. And possibly some submuscular needling to get these parts of the face, moving cupping and wash eyes. Great. Derma rolling is gray. And you’re going to want to see the person two to three times a week until they get the movement back in their face. So I. Teach a cosmetic and neuromuscular.

Acupuncture facial acupuncture classes. My website is facial acupuncture, classes.com and some of the products that I was showing the cups, the washout tools at Derma rollers microneedling devices are@akeelaskincare.com. And these are my social media links. I do have a bunch of live classes coming up and all of my classes are also recorded.

That is the end of my slides. And I, again, I want to thank the American acupuncture council for giving me this opportunity. Next time is Sam Collins. And I believe he’s next Wednesday. I can’t see that right there, but it is next week. So you want to check in with that he’ll be streaming live and do we have time for Q and a or.

People on that we can open it up to where there any questions,

crickets. Okay. I’m not seeing any questions in that chat box, so I am.

Not now, I guess there’s no questions now. Okay. Thanks again to the American Acupuncture Council. And if you need to reach me, you can just drop me a line at visual acupuncture classes.