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Treating Neuromuscular Facial Conditions-A Multifaceted Approach



Today I am going to be speaking to you about neuromuscular facial conditions and a multifaceted approach to treating them.

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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, my name’s Michelle Gellis and I am an acupuncture physician. Today I am going to be speaking to you about neuromuscular facial conditions and a multifaceted approach to treating them. So a lot of you know me for cosmetic acupuncture.

one of the lesser known things that is really important to have under your belt if you’re doing cosmetic. Acupuncture is a really good working knowledge of the muscles of the face and how they can be affected through different physical conditions. So will you go for the fir to to the first slide?

So I had, many years ago, about 15 years ago, I had started. Researching using some of the different techniques that I was using on my cosmetic patients to help patients with different neuromuscular facial conditions. And I wrote a journal article in the Journal of Chinese Medicine about the topic, so if you’re interested, you can look it up.

It is called a multifaceted approach to treating neuromuscular facial Conditions. And yes, I am outside. I don’t have a bird in my house. I live in Florida, so there are some birds tweeting. So what. Is a neuromuscular facial condition. That is the first thing that we are going to talk about, and then I am going to go through the whole theory of why using a multifaceted approach can be very beneficial.

I’m going to talk about submuscular needling, scalp acupuncture, facial motor points, and then a little bit about facial cupping and guas. So a neuromuscular facial condition is any sort of a disorder that affects the face and it can be muscular meaning it. Prevents you from being able to move any of the muscles of your mouth or your eyes or your cheeks or something that has to do with the neurological system of your face causing pain, twitches a lot of sensation like heat or cold or lack of sensation.

So there’s quite a few different diseases and I’ll touch on some of those that can cause these problems to happen. But the theory that I came up with, that I teach and I’ve been using for many years is that instead of just doing your typical constitutional treatment and maybe a few face points that if you use.

Several different modalities at once. It can really provide for the best results for your patients. So I do a combination of traditional TCM treatment. Then I use facial motor points, sub submuscular, needling, scalp, acupuncture, and , the person is not in too much pain. I can do facial cupping in Gua and even dermal can be incorporated in.

So what are some examples of neuromuscular facial conditions? The most common is Bell’s Palsy. Most of us throughout the course of our treatment career. Through our practice, we will come across at least one patient with Bell’s Palsy and some of them will be, it’ll be a new case and they want help so it doesn’t get any worse or so that it gets better faster.

And for some people they might have had Bell’s Palsy many years ago and they still have some of the residual. Signs and symptoms. Ramsey Hunt Syndrome, which is similar to Bell’s Palsy, but has some additional issues. Ptosis, which is a drooping of the eyelid synkanesis, which is where you try to move one part of your face and another part of your face moves.

Stroke, which can affect the face drooping in the face. Tmj. Any sort of temporal mandibular joint disorder trigeminal neuralgia, which is spatial pain, ms. And there are many others. Okay. . So the face is unique because the face is the only part of our body where the skin is directly connected to the muscle, and that is why we can move.

The skin on our face without having to move any bones. You can blink your eyes, you can smile, you can purse your lips, and you don’t have to move any bones anywhere else on your body if you want your skin to move. You have to actually move a bone in order for it to move. This is a cross section of the face and you can see this is the cheek here.

We have the mimetic muscle, which Goes out to the outer layer of the skin. We have some fat here. And the mimetic muscle is invested in this mass layer. It’s a superficial, muscular, epi neurotic system. And it is what allows the muscles to make our facial express. and the facial nerve is invested deep within the facial fascia.

So by using a submuscular or in some instances an intramuscular needling technique, you can increase the flow of blood and chi in the area. You can break up those fossil adhesions that might exist, and you can stimulate collagen production in the area. . So there are various places in the face where.

Submuscular needling is very beneficial. Not just the face and the scalp. So the auricular muscles, and I incorporate this as part of my cosmetic acupuncture treatments, the temporalis muscles, and this can help a lot with. Headaches and it also can help to get movement back in the face.

It’s very beneficial for T M J and trigeminal neuralgia, the maier. This is great doing submuscular needling underneath the maier for individuals who have tmj. The digastric muscle underneath the anterior digastric, underneath the chin. This can help to lift up underneath the chin area. The frontals can help both with cosmetically, with wrinkles, but can also help.

Lift the eyebrow, get movement going cuz your frontal is connected to your eyebrows. So for individuals who’ve had a stroke or a half bells palsy, by doing the submuscular needling, you can help to get that movement going back in the eyebrows and in turn in the eyelids, the procerus muscle, which. Is in between the eyebrows, the lader muscle, which is underneath the eyebrow, and oh, I missed the platysma.

The platysma, which runs from your jawbone down to your clavicle, and using submuscular needling can help more on a cosmetic level, but with the skin on the. So how this works is I showed you that cross section of the face. The nerves can get trapped, the facial nerve can get trapped and by using needles, let me see if I have it in my next slide.

I don’t using a needle to needle from the skin. Down through the fascia, you are actually helping to break up some of those fascial adhesions and to release any nerves that have been. Entrapped. So for example, let’s say you had a pet patient who had headaches, frontal headaches or ha who had some sort of muscular weakness through MS or Bell’s Palsy in their forehead.

You can take your needles and go right underneath the muscles and do some submuscular needle. . So here is a video, so I gotta get it here.

So when needling the frontals muscle, the,

so when needling the frontals muscle, the. Way that you isolate the muscle is you ask your patient to raise their eyebrows. Go ahead and raise your eyebrows, okay? And then relax and you can find the border of the frontals. Muscle and the way that you needle is you’re going to go from the origin to the insertion.

So the origin is up here and the insertion is here. And typically what I do is I will put in. , usually three needles on the lateral edge, and I will put in two needles. On the medial side, and when you’re needling, what’s important is that the angle of the tube is the angle that the needle’s gonna go in.

So if you go like this, it’s going to go too deep. If you go like this, it’s going to be too shallow. I use. My thumb or a finger to help to guide the needle. So you wanna keep your fingers out of the way when you’re actually inserting. That way you can get to the correct depth right underneath the muscle.

That’s the lateral side. Then you’re going to do the medial side and usually. Two needles will suffice and I do the one side and then I do the other side and I’m using half inch needles. You can use one inch needles depending on how big your patience forehead is.

So as you can see, needling underneath the muscle as I mentioned, will bring energy to the muscle and it can help if there’s any sort of tension in the headache. And on a more cosmetic level, it can help to stimulate collagen in the. Another thing that’s really beneficial to incorporate, and you can incorporate this at the same time you are doing some of your other treatments, is scalp acupuncture.

And scalp acupuncture is part of a class that I teach on treating neuromuscular facial conditions, but I only teach scalp acupuncture as it pertains to the. And neuromuscular conditions with the face. So here is a cross-section of scalp and there are one of the important things when you’re learning scalp acupuncture is how to measure the scalp.

And it is certainly beyond the scope of this short lecture to go through the whole thing. But essentially you when you’re measuring the. it is in different sections. You’re not working with acupuncture points, so you find the horizontal line, you find the vertical line, and then within the motor area or the sensory area, it’s broken up into three sections and the.

Two-fifths is the area that pertains to the face. So you could be needling this and at the same time, so in order to help the motor function, you could be needling this and at the same time doing some local points to help to get some of that movement going.

and this is a short video of what that needling technique looks like

when you’re needling the scalp. It’s important to angle the needle properly so that it goes into the loose connective tissue. I like using a tube. You can freehand if you’d like, but I find that the tube helps me to guide the needle. To the correct depth. I tap the needle in, remove the tube, and then I use my free hand to guide the needle.

If the needle is improperly, your patient should not feel any pain, so you’ll know that you’re into the loose connective tissue. If your patient doesn’t have any pain, when you. Once the needle is in, you stimulate it gently for 30 seconds just like this. Or you can use electricity.

So next up are facial motor points and essentially when. Muscle is not functioning properly. It is either over functioning or under functioning. So it’s either flacid and it’s not firing properly or. It’s over firing and causing too much tension. What the theory behind motor points are is you find the most.

Excitable part of the muscle. It’s essentially where the nerve goes into the muscle and you are gonna place a needle there. Fortunately, for us, many motor points, especially on the face, are actually acupuncture points. So you find the acupuncture point that correlates to the muscle. And in this case, I’ve chosen the frontal.

and the motor point for the frontals is gallbladder 14. So you would needle this, you can stimulate it, and it helps. It serves as a reset switch to get that muscle back into normal functioning.

So I had spoken about Fossil ad Hess. Before, and this is a picture of fascia and here is where the nerve would go. And as you can imagine if you had all of this fibrous fascia, adhesions going on and there was a nerve that was trapped in here, it would be very difficult for. Muscle to function properly for the nerve to do its job.

So one of the things that can really help is facial cupping and facial guha because when you’re moving these small, so these are very uniquely designed glass facial cups, and the rubber part is really easy to squeeze as opposed to. The ones that are more difficult to squeeze and they’re small, and they move around really nicely, they glide on the face and they can help to bring energy back into the muscles to break up the fossil adhesions.

And the same thing with these Jade Guha tools. The Guha tools. When you can use these edges here and you can stimulate different points and you can really get in there up against the bone and help to break up some of the fossil adhesions that might exist.

and I think I just have a picture. There’s no video here, but this would be an example if you were working and you were doing cupping on the face, starting at an acupuncture point, moving the cup up to another acupuncture point. And this has a very lifting effect on the face and. Then going and doing a suction and release down the neck.

You never wanna drag the cup up or down the neck. In my webinar about facial cupping in Guha, I really emphasize safety because it’s so important when you’re working around the neck and the face to be very safe. You don’t wanna cause any bruising. You don’t, you’re working along major vessels, you don’t.

Release any blood clots. So suctioning and releasing down the neck and then just working underneath the clavicle can really have a wonderful lifting, toning, and rejuvenating effect on the face, especially your patients that have some sort of Like degeneration. It’s a wonderful, it’s almost like a massage, and it gets that blood flowing.

It gets the blood up into the muscle and can really help getting that muscle function going again. and the same with Guha. Here’s a picture of me doing some guha along the jawline. This was for cosmetic reasons for sculpting, but can really help to get that movement going. And if a muscle hasn’t been used in a long time, they can get stiff and gua can be.

Now dermal rolling is something that is used on a very superficial, gentle level, but it can help to. Reeducate the nerves and the muscles and the skin, because the skin, if it, let’s say someone has had an injury to the face, maybe they had a facelift and now they have neuropathy and they can’t feel anything.

by doing some of your maybe scalp acupuncture, some body points. And then I sell my patients Dermer rollers and they bring them home and I teach them gently how to use it along some of the channels to stimulate the channel, the meridians, and just to stimulate the skin to reeducate the nervous.

These are some of the publications, my publications, and the one I was talking about was from 2016. It’s a multifaceted approach to treatment of neuromuscular facial conditions, which goes much more into depth about what I was just talking about and. I also teach classes on that and you can find my website, facial acupuncture classes.com if you wanna learn more.

Also on social with my first and last name. And that is it. Thank you for your time. And thank you to the American Acupuncture Council for this opportunity to share with all of you. I look forward to seeing you next time.