Tag Archives: American Acupuncture Council

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The Acupuncture Wow Factor – Lorne Brown

 

 

And so the Wow factor that I’m talking about is for your patients to have a shift on your table and experience a shift so that they are able to relax and therefore have the trust and confidence to follow your treatment plan.

Click here to download the transcript.

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.

Again, thanking the American Acupuncture Council for this opportunity to share with you my colleagues. My name’s Lorne Brown. I’m a doctor of traditional Chinese medicine. I’m a clinical hypnotherapist. I’m also a C P A. I’m a certified professional accountant, and I wanted to talk about the acupuncture Wow factor.

And I’m gonna set my intention that this will be simple and yet powerful and effective. That comes from the Einstein quote that make things as simple as possible but not simpler. Meaning let’s make it simple so we, it’s easier to implement, but we don’t make it so simple that it loses its effectiveness.

And also my intention is to do a small sound bite here. So you can just take one concept or one idea and run with this in your practice. I have found that sometimes the things that. Help practitioners be the most successful, are the most obvious, but yet they’re not obvious until somebody brings it to your attention, to your awareness that you’re like, oh yes, I want to intentionally do this.

And so the wow factor that I’m talking about is for your patients to have a shift on your table and experience a shift so that they are able to relax. and therefore have the trust and confidence to follow your treatment plan. Now I’m gonna unpack this for us, and I’m gonna talk about this from, I guess materialistic and quantum level here.

So when we have resistance, then we block flow and receptivity things that happen for us in life. And you’ve probably experienced this, where sometimes you just have flown receptivity, synchronicities are happening and things just seem. Easier. They just happen and flow for you as if there’s these invisible hands coming down from the heavens and opening up doors you did not know existed.

You’re probably also aware where you’re putting effort and more effort and the more effort you do, it just seems the higher things get and things just aren’t easy and there is no flow. And on a quantum or spiritual level, when we have resistance, we are blocking. This receptivity and flow, we have a beautiful term for this in Chinese medicine is called cheese stagnation.

In conscious work, I often hear it call as resistance or friction. And this ties into our patient’s ability to heal because the body has this beautiful, innate ability to heal. And I see my role as a practitioner, as a facilitator, I’m not healing, I. The person in front of me. We are learning more and more through really cool research.

Again, quantum physics level research, that it seems to be that it’s the patient’s need that determines the healing. And we as practitioners have to be that clean vessel. But we are the facilitator and even our nervous systems, our parasympathetic nervous systems, our subconsciouses. They’re syncing up.

They’re doing this through FMR, F M R studies where they can see that the nervous systems are syncing up beyond our conscious awareness, and there’s a healing, an exchange of information that happens. And we use our needles sometimes to do that exchange for information. So the wow factor for us now, I want to unpack this and go back into this patient’s innate ability to heal.

That if they have resistance, they’re not sure if you can help them. They’re not sure if it’s worth their money. There’s that trust issue. Do I really believe this? Does acupuncture work? Work? You know what the skeptics are saying, what conventional medicine’s saying? , all this can get into their psyche and disrupt their ability to receive and have flow.

So disrupt that innate ability to heal because that placebo impact, which has such a bad rap placebo, is not inert. We know this in 30% of Western trials, sorry, in Western. Random controlled trials. Sometimes it’s common that 30% and up to 90%, but it’s common 30% they attribute to placebo. From a Chinese medicine perspective, or at least from my perspective, what we are doing is engaging the individual’s capacity to heal.

They have this innate ability to heal. It’s amazing how we try to dismiss this, but I guess from our materialistic perspective, from conventional medicine, we have that ego that we’re doing the healing , but really it’s the individual. They take the medicine and through that medicine, they incorporate it in heal or through our needle or through our communication.

The healing process starts the acupuncture wow factor to allow the resistance to be lowered. So the patient is in that state of receptivity and flow to really accelerate and accentuate the innate ability, heal. That healing process comes from them feeling an a, an experience, a shift on the table. And so I’m gonna give you at least two examples here, and I’m thinking of recent lectures on healthy seminars.com, where I hosted in one week, both Pony Chung and David Uler.

It’s actually pronounced Oiler, but spelled Uler . David Uler, you probably know him if you read his name, but David Oiler and Pony Chung and their style of acupuncture gives the patient this incredible shift. On the table that even if they don’t have resolution on the table in that one treatment, which is, let’s be honest, it’s we don’t get that resolution for chronic conditions in one treatment.

But because they experience that shift, they now have that ability to have trust and confidence to follow your treatment plan. And it’s been my experience in my own clinical practice using their style of treatment and also call my colleagues that. Patients then leave the treatment room and book their 12 to 15 treatments in that two to three month period because of the experience they had on the table.

So when I talk about shift, let’s bring up David Jeweler first as a concept, and then I actually have a video demonstration that I have with Pony Chong that I’ll share with you with David Yuler. He does palpation based acupuncture. He study with Kiko, Matsumoto and her teacher, and it’s a really cool style of somatic acupuncture where you’re palpating tender spots on the body and based on those tender spots, those are called reflex zones, you needle other areas to release the tender spot.

And by doing so, that experience for the patient is an aha moment. So I’m gonna share a story with you, for example, and I’m gonna do the David Oiler idea of palpation, how this works in the treatment room. But here’s one of my. Own clinical stories and I’m gonna share one about Shen disturbance that David shared recently in his lecture.

This woman came to me after two, two months post C-section delivery of her baby, and she had poor quality of life because of the incredible lower abdominal pain that she had since the birth of her child. And she went to back to the surgeon, the gynecologist. They ruled out any infection they ruled out.

anything left inside and they just said, there’s nothing going on there. There’s nothing they can do. Obviously, she didn’t want to take high dose or pain meds because she’s breastfeeding. She had saw massage. They had referred her for some physio for post-surgical to help. Nothing had helped over those.

Two, two months. She came to my practice. She knew of me because I actually was the practitioner that helped her with her infertility, and I guess we have branded ourselves so well at fertility that because she wasn’t trying to get pregnant, she didn’t think to come back to my clinic until later say, do you think you can help me with this?

It didn’t even dawn on her that maybe this is something we can help. . And so she came into my practice with her lower abdominal pain and right away I thought about the tsu. And for those that are not familiar with that term, it’s basically a reflex zone for blood stasis. And when you have this, it can wreak havoc in the body.

Cause remember, it’s a system and we have a serious stagnation. It inf it interferes with the flow and receptivity. And I press down on her tsu and she’s oh. Like incredible pain. And so after pressing in on the tsu, I go to the distal points that are used to relieve that. It’s just two acupuncture points.

And I hold my little device, just the tube of the needle actually. And I try different angles on liver four and asking her as I palpate, does this reduce this pressure? Pain? And she goes, oh, you’re not pressing as hard. So she thought I was trying to fake her out because. She went from like a 10, outta 10 to two outta 10, and I said, I’m pressing the same.

How about you press so you take my hand and you push down? So she took my hand and pushed down while I used the handle of the tube. No pain. So I go ahead and I needle those points. I also noticed that her immune reflex was really sensitive, so I did the immune points and a week later I did follow up with her and she was immediately at that treatment.

90% relief. So she had 90% relief immediately after that treatment, and one week following, she still had 90% relief from that treatment. That’s where somebody like that now refers anybody and everybody to the practice and any plan that I would have for her. She is more relaxed, as in con, has the confidence trust in me.

One is she had relief in her symptoms, but I’ll share with you that even if the symptoms aren’t relieved, when they experience the fact that I can palpate an area, a reflex zone and then needles somewhere else, and then that zone is gone, they see that it’s doing something and it gives, it inspires them to now follow your plan.

In his course also, he talked about the reflex zone and the sternum for anxiety and shen disturbance. And there’s points that we do on the back for this. And there’s points that we do distally for firepoint on the pericardium and heart channel. We test the fire points to see if they’re tender as well.

And then we use metal and water points. To relieve that. And again, when patients come in and they’re really anxious, so the difficult trusting cuz they’re sympathetic. They’re sympathetic, is on high alert, that means can’t trust, right? They’re rarely cautious, paranoid, almost really feeling worried and anxious, palpating the sternum and it’s tender for them.

And then going and touching reflex zones on the back. And then if that relieves it, great. If not, then I go to the fire points on the palm and then I check the acupuncture points. And if that relieves it, you can just see the melt on the table. So that’s my example as a shift on the table. And so learning styles by like David Yuler is a way to really grow your practice.

Now, I was trained as what I call a barefoot doctor or Zg Fu acupuncturist, which I think many of you have been trained as well, meaning like if you have blood deficiency, it’s stomach 36, it’s red 12, it’s spleen six, bladder 17. Really? These are my herbalist, acupuncture herbalist from China teaching me acupuncture and.

Because I host healthy seminars. I’ve had the privilege and the opportunity to witness different styles of acupuncture and realizing that there is a really deep history and style of acupuncture more than how we were trained in TCM schools, where you can get really good results. and also there’s that impact on the table.

And so David Oiler is one of those examples of studying with him and being able to just palpate some points, relieve them right there, that first treatment in 20 to 30 minutes with that treatment, and then they continue on for their condition because they’ve seen such an experience of that. Plus, they also are getting resolution for what they’ve come in for.

Let’s talk about Pony Chong. Another style of acupuncture and where they’re in common is he shows a shift on the table. And in the video that we’re gonna bring up is from a lecture he did recently in our community library. And what he’s demonstrating is he’s doing a, an acupuncture point, spleen 12, and he talks about.

In the Canon and the classics, just where it travels on the Sinu channel and how it impacts what muscles, what ligaments went tendons basically in modern day. So he can treat certain conditions in the lower extremities and he’s going to needle the point. And then he tests the point with a pointer plus, and he does this because of two reasons.

One is when you. Test it. It lets you know you’re in the right place, cuz I’ll share that sometimes we always have the right intention. This is where I think SPLEEN 12 is on this individual based on landmarks. But Pony has shown through his style of acupuncture that it’s reproducible, that you can be really precise based on reading the description of what this acupuncture point does on a muscle skeletal level.

And seeing that muscle shift or move or fsic. When you touch it with a pointer Plus from the patient’s perspective, it is a wow factor because they know where their pain is in whatever their leg, and when you put a needle in and it co and they feel that sensation going down, that whole muscle, they now have the confidence that you are in the right spot.

The second reason it’s so important that I went on a quick tangent there about the patient’s experience is sometimes we have the right intention of where we think the point is, but points actually drift. They’re not. The same based on the book location on every individual, there’s a little bit of drifting and pony style of acupuncture.

Teaching shows you that you can actually get exact and know that you’re in the right spot by testing the needle. And I have to share when I use this in my practice, sometimes I have to reinsert the needle two or five times to get it. But now you get better results because originally my intention was this is the right spot for this point, but I can test and show whether I’m really in that spot or not.

This is also gonna be important for research to make research reproducible. Now we know we’ve given them the right acupuncture point for where it is in their body, and so this wow pa factor is crucial in having patients relax. So lowering the resistance, having confidence and trust to follow your treatment plan because they experience a shift, that first treatment, not let’s treat you for the next.

10 or 12 treatments and see if there’s a shift, and then we’ll reassess they believe after that first treatment. So let’s bring up the video. I’ll share with you the first five seconds, the volume’s low or 10 seconds, and then it kicks in. And this is just a discussion that I was having with Pony in one of his community lectures while he was demonstrating this idea of testing a point and how the patient experiences this.

So please bring up that video now.

And pony, this is what I mentioned in our introduction. If you could just go back to that video for a moment. Okay. That when patient experience a shift on the table and in this case when needle, when pony needles, the point and then he stimulates it with his pointer plus the structure of the leg. The muscles watch the leg move in the bottom left eyes, watch the leg move.

Confirming he’s in the right location cuz it wouldn’t move he was in, if he was in the correct. Two things happen. One is he has now accurate needle location because we have good intention and we say we’re putting it in SEN 12. We put the intention, but PONY is showing that there’s an actual real spleen 12 for each individual, and it can drift a bit from how it’s described in the book and based on the person.

And he’s confirming that he has reached spleen 12 based on what he’s seen in the leg. So a for effectiveness preciseness. Two is the patient is seeing what’s happening, she’s late leg and it just her leg gives them the confidence and trust to then pretends machine on the needle lake move. And that’s why I invite you to check out PONIES courses in the library and then really do a deep dive and he has those courses on demand so you can learn how to do this in your practice.

Thanks. No problem. Yeah. Thank you for Lorne. Thank you for mentioning the way intentioned to, that’s something I emphasize a lot when I teach the course is that we taught that, okay, you have to have good intention, right? And then, and your intent drives the cheat. Okay? And so drives the, your cheap, but also to the needle.

You drive the patients cheat. But that’s pretty much the end of the education. I got an intention, it just. But extreme attention’s the same. But the way I see it now, based on my experience in all my research, is that there’s a different intent for each specific point, and now you can predict and agree on that intention if you understand anatomy.

So for example, here, screen 12, the anatomy is the femoral neurovascular bundle. So the intention that we, when I have, when I come to Neil’s point, is that I want. This to activate the quadricep muscle, and if I apply electricity to that, it’ll activate all the quadrant muscle in the new extent. Okay? So it could be a sensory nerve in, in which case we know what that nerve travels, the duchess sensor should be felt to that area.

It’s not a guess word. You should know exactly what that intent for that specific point should be. and know if you got it or not, based on whether it moves what it should, ghost by sensation where it is. So then your intent is actually very clear and precise and it’s not just assuming that intents the same, it’s not just all heavy achy sensation e everywhere, anywhere.

Okay. But also coming back to, to like the buy-in the wow factor, patients are gonna remember. The times that you don’t succeed. But when you, if you tell them, okay, I’m needling this, I’m checking this. I’m, they don’t know what’s what they’re supposed to see, right? Only you know that. But you tell them that I’m, the reason I’m doing this, I’m checking to make sure I’m precise, but you stimulate it.

You tell them, you may feel a sensation going down the top of your quadricep. You might feel a little contraction in your muscles and quadricep. And if you say that and you try it, and if it’s one of those, one of those times that you succeed, they feel that’s instant. Because that’s pro, that’s in a way prophecy, prophesize what’s gonna happen.

And then it actually happened. More average mortal human beings don’t have the ability to prophesize. So that makes you different, that you can do something and make it happen. Exactly what you said, it’s gonna happen. They’re not gonna remember if it doesn’t happen, but they damn remember it when it does.

And that is the wow factor that Lorne is talking about before their. You’re even done treating them. It’s the first treatment. They haven’t solved the result yet. They’re already asking, do you treat this for my brother? Do you treat this with that? Okay, this is from my personal experience.

So I like his term, the prophecy. So you’re prophesizing for the patient and then they experience it. And that is a wow factor. And like he said, can you treat this? Can you treat this for my family members? Because you’re able to predict what they’re going to experience. And so from a practitioner with integrity intention, you’ve got the accurate point.

So you, you want the results, so you know you have the accurate location and then. From the patient’s perspective, they’ve experienced this prophecy on the table, which gives you that guru status and why some practitioners are constantly looking to fill their practice. And like others, like my practice, I usually have a two to three month wait list because of that Wow.

Factor on the table. And then when you learn from like a David Oiler, Or Red Yuler, but pronounce Oiler or Pony Chung. They give you language too to help with the prophecy. So going back to David’s talk where I mentioned he, for anxiety, he’ll palpate the typical area on the sternum. And when I go and palpate these reflex zones and they’re tender, and then I needle elsewhere, and then those reflex zones go away.

That’s the prophecy, cuz I’m telling them that if we can remove the blockages in the body that are preventing the innate ability to heal, if we can lower the resistance and bring back chief flowing, your body will start to heal regardless of the Western diagnosis. I just gotta remove some of these disturbances in your biofield and that is why I think.

To my colleagues that studying with Pony and David or having that wow factor where a patient experiences your prophecy in the treatment room cuz they experience the shift is important. And the last thing I wanna share for a wow factor, or just what I have found in my 20 plus years, sometimes complicated cases come in.

And I have to remind myself that it’s not my job to fix the patient, and if all I do is listen, really listen and let them know I hear them, then the healing process starts as well. Remember that there is something, and we’re this is being studied, that we know that there’s communication through our facial expression, our eyes, pheromones, and even biophotons light and packets of energy that are.

Transmitting between us that we now know that there’s information being exchanged. And what we’re noticing is that when somebody feels really seen and heard, that lowers their resistance as well. They start to relax, the flow starts to come back, and the healing response is engaged. And so really taking time to listen to your patients.

Let it Showing compassion that you understand and get what they’re going through with is really important as part of the healing process. So really making that time to hear them feel, understand, they feel understood. That lowers the resistance, and again, on a unconscious level, not something that you’re doing or they’re aware of, something is happening between the two of you.

Something has been triggered and there is an exchange of information. Add onto it when you do your treatment and you can prophesize that. When I palpate here. Anywhere there’s certain, there’s points all over the body and they’re tender. And I needle elsewhere, and that tenderness goes away. Then we have lowered the disturbance, the resistance in the body, which will support its healing.

I will share that when I was at the Society of Acupuncture Research Conference, one of the presenters there shared her research where they have. Shown a, what’s the word? They have shown that when there’s organ issues that down distally in the fascia that there’s disturbances. So tender points or even nodules or gunness happens.

So they’re sharing that this is happening. And when I heard this research, it made me think of David Oilers palpation based acupuncture style, because that’s their style is going along the channel and palpating these points. And if they’re. Tender. Then there’s other points to needle, to reli to relieve that tenderness.

And what I suspect is happening is we’re lowering the disturbance in the body, the resistance, and therefore the channel flow becomes free. And then the organs become healthy and the organism us become healthier, and so I just wanted to share that with you. Lectures by both Pony and David are available on healthy seminars in the community library.

They also have C E U proof courses on healthy seminars.com in that area as well. and a good way to just find out what I’m up to. If you like this Quantum idea and biophysics, do check out just my website, Lorne brown.com. Then you can see information about my practice management book. You can hear about my Conscious Fertility podcast, things that are doing at Healthy Seminars.

I created that website cuz I like to do a lot of things. And I decided to create that website so you can find everything in one place. So Lorne brown.com is to just go where everything is, aggravate is collected, and then healthy seminars.com is where the continued education, the community library, the mentorship, and the online learning is for healthy seminars.

So I hope what I shared with you is simple. For you and you’ll find it powerful and effective. It’s been my experience, my colleagues, and for the patients. They have found it powerful and effective. And I wish you the best of luck in your practice. I do believe we need more prosperous acupuncturists because we need more of people like you working in the C communities to help heal our community.

Cuz the world needs lots of healing and this starts with healing ourselves. Obviously. I want to thank the American Acupuncture Council again for this opportunity. To share some of my clinical and business pearls with you.

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Are You Practicing in a Vacuum? Nell Smircina

 

 

Click here to download the transcript.

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.

Hello, and welcome to another episode of To The Point. I am Dr. Nell with American Acupuncture Council. Thanks so much for having me, and let’s go to the slides.

Hey, we’re gonna be talking a little bit about this idea of practicing in a vacuum, and we pose this as a question, are you practicing in a vacuum? But I feel pretty confident with the experience that I’ve had in this industry to let you know. You might be. We are mostly sole proprietors. We’re thrust out of school and pushed into being small business owners.

A lot of times the mechanism of practice setup is, all right how do I figure out how to afford to rent one room and then scale to two rooms, and when do I get to a. Point where I could bring on an admin assistant or an office manager or another practitioner, and sometimes we don’t even have the time or the bandwidth to look at strategy around this.

And what often ends up happening with this mechanism of getting into practice. We forget about all of the resources around us. The resources that we could be leveraging outside of the four doors of our treat or the four walls of our treatment room, and really say to ourselves, all right, like, how do I leverage these resources around me to grow my business, to be more successful, to welcome more patience and.

To even have resources available that I don’t have to create on my own, whether it’s marketing collateral education resources for patients or for other providers. And so we’re gonna talk a little bit about those industry resources that we should be leveraging today. So first, we have to address the misconceptions here.

Again, we have our tunnel vision. , we’re focused on patient care. We’re trying to figure out how to afford everything and how to grow and how to scale. So a lot of times this mindset that there’s no infrastructure already set up, can creep in. Maybe we’re only familiar with our school. or the school alumni network, if your program even has a viable alumni network available to you.

And so we don’t think about what’s already there, what’s already set up that we can be leveraging. There’s also a lot of confusion around regulation versus advocacy. So what are these different players in the game and how do we fit into that equation? And this idea of limitations to involvement with that.

So we might see these big groups out there and think, oh, we’re divorced from them. They’re so far away. They’re a regulatory agency, or they deal with advocacy and that feels a little too far from. Me and my practice. And just to tell you that’s not true. There are definitely ways to be involved.

And we actually did another show specifically around leveraging advocacy for your business. And you can tune into that one as well and take a listen. Let’s look at first, who are these main players to get a little oriented to our industry and then we can talk about how we’re leveraging them. So the Council of Colleges actually was the creator of Clean Needle Techniques.

So we all had to do that in order to get into internship to then go ahead and get licensed or get our national board certification. And this is actually a collection of. School leadership. So schools join the Council of Colleges. And so in addition to issuing the Clean Needle Technique certification, they also gather multiple times a year, have different committees, and they’re looking at what are common issues that schools are experiencing.

We have had school closures just in the last few years. We’re probably gonna continue to see some consolidation. . So we wanna make sure we’re really tuned into what’s happening on an education level and what goes hand in hand with that is acom. So the Accreditation Commission for Acupuncture and herbal medicine, they’re actually linked up with the Department of Education who oversees what they do, and then they go and accredit the different schools, our education and.

Institutions. This allows for things like financial aid to happen so that we have an infrastructure set up where students can come in and get that federal financial aid support. If we didn’t have that accreditation, that wouldn’t be available to us, and that would really stall a lot of things in our industry.

There’s opportunities to be involved with them. You can be a site visitor. You can serve on their board of commissioners as well. Council of Colleges, if you’re involved with the schools, you can be a part of Council of Colleges and serve on one of their committees and help influence how the more minute details of education and school initiatives are happening.

And then everybody’s familiar with N C A O M. . Even in California, people are getting N C O M certified. So this is really those minimum standards. When we’re looking at getting into practice. For most states, they require these N C O M exams for licensure and a lot of states, Also require you to re-certify every four years.

Now, NCCM has a ton of resources. They have a provider directory. You can look on their website for different continuing education for your PDAs. You could be a PDA provider and be marketing yourself and your courses through them. So even though these are more Organizations that develop standards and are more regulatory in nature, there are still opportunities within them and still resources available to you even if you’re just in private practice.

And I wanna briefly note the difference between regulatory and advocacy or associations. . When I was the president of ciso, which is a state association in California we would get calls all the time for people thinking that we were the acupuncture board who issues licenses, who does the exam, who regulates the profession in California.

And so there are different agencies. We talked about standards and more the regulatory, but then you also have these advocacy organizations. And so a regulatory board who’s issuing your license. Their responsibility is to protect the public, not to advocate on behalf of the profession. So it’s important to be knowledgeable about where are our advocacy resources and how do we go ahead and leverage them.

So here are some really exciting big players in the advocacy, and I like to say advocacy slash. Fun stuff and awareness for the profession. Because some of these organizations, their primary initiative is advocacy and some of them, they’re just doing really good work that help elevate our profession.

And then they have great resources for us as well in private practice. The biggest one we wanna think about is American Society of Acupuncturists. That’s our National Trade Association. You have states like state associations like Selma, like the North Carolina Association, the DC Association, they are all members.

Of asa. So it’s a federation style organization. So states get voting rights and everybody’s an equal player, and that council of states is really powerful and they get to decide different initiatives that happen from a national level. I do have the pleasure of serving on the board for asa. We just had an awesome conference.

We were just on Capitol Hill talking about. Garnering support for our Medicare bill so that we can direct bill Medicare as providers. So there’s a lot of good work that’s being done at a federal level. And if you go on as a’s website, if you join a committee, if you are involved in your state association, who’s a member of asa, you get a ton of benefits.

There are one pagers that you can send to other medical providers explaining acupuncture. There are templates for advocacy in your state. So if you’re interested in going and speaking to your representatives, looking at a one pager and saying, Hey, how do I need to prepare? How do I find my representatives?

These types of things. These are resources that are available to you as well as like deals, discounts for different vendors in the industry. And then you have the Society for Acupuncture Research. I was also just at their conference last weekend, and this is an international organization, however really strong in the state.

So they had the conference in New York and they’re another organization that has. Tons of resources for you. You can go on their website, you can become a member. You can have access to different databases. See the incredible amount of research that our profession is involved in and how that works and the resources here for you and your practice.

You can easily have access to that research. Sometimes patients are gonna wanna know that information. Sometimes other providers wanna know that information. And seeing how this is done on a global level, it is a little bit different in the states than how other countries practice. And that global and cultural awareness is really important, especially today.

And I did throw on here e b a evidence-based acupuncture. I recently at the SAR conference met one of their board members and I was asking him, what’s the difference here? Because there seems to be a lot of overlap with the research and the good work that’s. Being done. Evidence-based acupuncture is like a little more a little more patient friendly, a little more lay person friendly.

So if you want like quick fact sheets that you can give to anyone, that’ll speak to people in a way that they can understand. Stand, even if they’re not familiar with research or acupuncture, they’re a great resource for you. And so a lot of these things are going to make your practice life easier because you’ll have resources to pull from so you’re not reinventing the wheel.

You don’t have to create a one pager for yourself about how acupuncture works for other medical providers. You get to download it from one of these organizations who’s already done it in a really easy and professional way. And I also like to put APA on here, American Herbal Products Association.

This is an organization that is a lot bigger than just our profession. They do have a Chinese medicine, like a Chinese herbs committee. But as a broader aspect, they’re really involved staying on top of what’s going on with F D A regulations how would this trickle down effect impact our profession?

And so even just getting on their mailing list and seeing what they’re up to, a lot of these quick updates will come out through them. When something around herbal medicine happens. So if there’s a press release that comes out or an adverse event they’ll probably have knowledge about it and be sharing that information in a really tangible way so that you get the entire story.

So let’s talk about, again, back to that vacuum effect. Is that what’s happening? Did. Maybe coming into this conversation you thought, oh no, I’m aware, , I’m not practicing in a vacuum. Were you aware of all these organizations? Are you aware of the resources available to you? Are you reinventing the wheel when you don’t need to be?

I hope that after this really brief 11 minutes that you’ve had a little bit more of an introduction to not only the resources available to you, but the ways that you can get involved. All of these organizations that I’ve mentioned have additional opportunities and some of them. Are revenue generating opportunities, ways that you could go and implement your skillset beyond private practice to help some of these organizations.

some of them are volunteer based, some of them are putting out resources for you. But regardless of that situation, please take the time to look into them, research them, see that they can help you with your marketing, with your collateral, with things that you would be spending your time and energy doing.

And also the networking that you get through this, going to these different conferences, hopping on their different. Portals, seeing the discounts and deals that are available to you. You’re not alone in practice. There are plenty of organizations here for you. We do have an infrastructure built in this industry that we need to strengthen and get more involved in.

And of course, I like to put AAC as this last resource for you. A lot of the opportunities that I’ve been introduced to were introduced to me through AAC. And so whether it’s your following on Facebook, Book you’re calling us up and saying, oh hey, like I have this issue. We’re always here to help. I’m always here to help and so please feel free to reach out with any additional questions.

Thank you all so much for being here, and do not forget to tune in next week for another episode of To The Point.

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Michelle Gellis’ Top 10 Facial Acupuncture Points

 

 

I am going to be talking to you about my top 10 facial acupuncture points.

Click here to download the transcript.

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 today I am going to be talking to you about my top 10 facial acupuncture points. I am a licensed board certified acupuncture physician, and I teach cosmetic and facial acupuncture classes internationally. Can you go to the first slide? Great.

So when I’m talking about my top 10 facial acupuncture points, these are both for cosmetic purposes, but some of them have spillover into treating neuromuscular facial conditions as well. So the first point I wanna talk about is and you might be wondering, what does this have to do with facial acupuncture?

When you needle shen men, it helps to calm your patient, which is. great when you’re going to be putting needles in their face, and it also relaxes the face itself when we think about our face and our face aging. We might think it’s a good thing to tighten up the facial muscles, when in reality the facial muscles when they’re tight and constricted, then the skin will wrinkle.

So you really want the face to be relaxed when you’re going to work on the face. So my first favorite facial acupuncture point is ear chan men.

My next favorite point when working on the face is gallbladder 41. And gallbladder 41, although it is on the feet, it helps when you are doing cosmetic and facial acupuncture in a couple of ways. Most importantly is it helps to keep your patient grounded because when you’re bringing a lot of energy up to the face and the neck and the head, you wanna make sure you counter that with some grounding points.

So this is always the first body point I put in when I’m doing cosmetic acupuncture. It also helps to relax the liver and spreads chi throughout the liver and the gall bladder channels. And this will help if your patient is very frustrated or angry because frustration and anger can cause a lot of constriction in the forehead and cause lines between the eyebrows.

My next favorite point when doing cosmetic and facial acupuncture is stomach 36 and stomach 36 is probably my most favorite acupuncture point of all of the points if I had to pick one. And the reason for this is, , it covers so many different things. It’s the chicken soup point for acupuncture, and it helps to infuse all of the gifts of the earth to all of the meridians.

It’s a sea of nourishment point, which is really important when you’re working with the skin. You wanna make certain that all of the. Food and drinks that you take in get digested properly, get into your bloodstream and are spread throughout the body. It also helps to tonify chi and blood, which can become deficient as we get older.

We can get blood deficient and chi deficient and by needling stomach 36, it helps tonify the chim blood. . It also helps to fortify the spleen, which is really important because as we get older and the spleen becomes weaker and not as efficient, we can have sagging. So the spleen holds things up and it also is very much integral with.

Creating nice, healthy blood. So holding things up and making sure that our blood is healthy are two of the spleen’s jobs. So by needling stomach 36, you’re fortifying the spleen and the next. Important thing about Stomach 36, which should have been its own bullet, but it calms the spirit. And when you’re doing cosmetic acupuncture, you want your patient to be nice and calm.

My next favorite facial acupuncture point, which is also on the body, is large intestine four, and this is a command point for the face. So I would never do cosmetic acupuncture without needling large intestine for, and it also allows us to get rid of impurities. Not just on a physical level, but also on a mental level.

So really clearing out all of the impurities on a body mind, and spirit level. I. Next is small Intestine six, and the name for small intestine six is nourishing the old. So if you think about where small Intestine channel runs, it runs right up the neck and then up. In front of the ear and it can help with sagging jowls and chin and neck.

It activates the entire channel because it is a sheet cleft point, and it also helps to nourish us in the face of old pain and allows us to. Taken all of life’s lessons from past traumas and it, it really calls on some of our ancestral chi as well. . Next is gallbladder 18. So gallbladder 18, in case you don’t know where it is.

So you go to the center of the brow, and that’s gallbladder I’m sorry, the center of the frontals muscle and. , which is in the middle of the brow and that’s gallbladder 14. Then you find gallbladder 15 and you’re going to go back along the gallbladder line until you are in alignment with do 20, so where the gallbladder meridian and do 20 intersect on the head.

This is where gallbladder 18 is, and you can see it here. And this is the occipital frontal. So the gallbladder 18 helps to benefit the eyes and the forehead, and it has a direct action on that super orbital nerve. So that’s this right here. and the super orbital nerve, which is C N six runs along the Galea epi erotica, which links the occipital and frontal bellies of the occipital frontalis muscle.

So when you needle that point, it helps to nourish the eyes, lift the brow, and lift. The forehead as well.

Next is stomach four, and the name of this point is receive nourishment. So stomach four is right at the corners of the mouth and it helps to treat the mouth area. Lip lines, naso, labial, folds that. Run right into this area. It’s also right on the Modis, which connects the lader muscles on the face. The depressor, anguli, ORs, the resources muscle, all of these muscles.

Calm together right here at Stomach four. So by needling this point it helps to relax the depressor, angular ORs, which can pull down on the corners of the mouth and Ma make us look unhappy when we are not

Next. Next is small intestine 18 and the name of this point. Is cheekbone and very appropriately named, and this helps to lift the cheek area. The way that I like to needle it is I come over the cheek and then I will needle straight up, so I’ll. Go over the cheek and I like to use tubes when I work on the face.

So I come over the cheek and then I will needle straight up right underneath the bone and this will help to lift up the cheek area.

Next is Yu and I do a combination of points in order to lift the brow and the eyelid. I’ll use Yu and Sano. 23 and Blood are two together, and I have a little video here for how I would needle.

Like really like this. What I’ll do is I’ll pull up, but for her I would just use the tube and push underneath the brow like that. So again, I’m not on the lid, I’m underneath the brow. And you know why they called us you? Yeah. Don’t you? . Ouch. Yeah. You. Yeah.

So you could see in the video, I like to pull the brow up above the orbital rim, and then I will just push the tube underneath the brow and then push the needle straight up. I use a half an inch needle. I usually put a little anika gel there because the orbit is very highly vascularized and you don’t wanna bruise your patient.

and then I will push it in almost up to the handle. And this really helps, works on the lader muscle and helps to treat you. Yeah. And then by using some supplemental points around the brow and the forehead, it really can help to lift this area because one of the biggest concerns that. My patients have had over the years is that their eyelids are starting to get droopy or their brows are getting droopy, like really like my last favorite acupuncture point for.

Facial and cosmetic acupuncture is Yong, and Yong is great for a lot of reasons, and it’s right there between the brows. This helps if your patient has any lines between like wrinkles, deep furrows between their brows. You can use Yong. and it also helps to relax your patient and spread the chi in this area.

It calms the mind. It calms the patient. So this is a great point. I use it on almost everyone, even if they’re not coming to me for facial and cosmetic acupuncture. So there you have it. My top 10 favorite acupuncture points for facial acupuncture, and you can follow me on social media. Michelle Gellis on Facebook, Instagram.

TikTok and on LinkedIn, and I also have a Facebook group called Facial Acupuncture, and my website is facial acupuncture classes.com. I hope you enjoyed this, and thank you to the American Acupuncture Council for providing me with this opportunity to share this with you.

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Worry and Fertility – Dr. Lucas

 

 

Today’s topic is worry and fertility, because. One of the main emotions that are fertility challenged patients, or some people call them infertility patients have is worry.

Click here to download the transcript.

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, it’s Dr. Martha Lucas here to talk with you today about fertility. I am very happy to be here and want to thank the American Acupuncture Council for sponsoring this webinar. My offices are located in Denver and Littleton, Colorado, but I teach everywhere. And my teaching website is lucas teachings.com.

So let’s go to the slides.

Today’s topic is worry and fertility, because. One of the main emotions that are fertility challenged patients, or some people call them infertility patients have is worry. And as you know from the history of Chinese medicine, emotional conditions can cause physical disease or physical symptoms, and we are the.

When we’re in utero, we are the vibration of our parents, especially of our mother. So there is a reason for an additional reason for the mother to try to get rid of that worry pulse, that worry, that anxious energy. At least when she’s pregnant. But as I will say later, most of the time it doesn’t go away.

Which is why we need to treat her throughout her pregnancy. Because even when the end is having a healthy baby, right? That’s the end goal. Healthy baby. Healthy mother. A long struggle to conceive can take a brutal toll on the couple, the both people involved, women and men who have lived with things like anxiety, worry, sadness, depression, and other emotions that are associated with fertility challenges, they c may even have those patterns.

After the healthy birth. So even seeing the couple or the mother after the birth is important. There is a quotation by Van Golf that says there may be a great fire in our soul, but no one ever comes to warm himself by it. All that pastors by can see is a little smoke. Now we know about the fire within, right?

How many people do we pass by every day that we just see the outside? We have no idea about the raging fire, the raging worry that’s inside of them. They may have a passion or a pain inside that is so great. They feel like they can barely contain it, but we don’t see it on the outside. Now, we as practitioners, Who specialize in treating fertility, know about that raging fire.

All of us know that cousin or aunt who loves kids or a friend of ours, and we see the sadness in her eyes at baby showers, but we don’t really know the depth of that person’s pain. We can see how coworkers light up whenever people talk about their children, but we don’t really know why.

He or she didn’t have any children. In fact, it becomes a little bit of a topic that you’re not really certain how to address or begin talking with people about it. We read something once in a while about. Recurrent miscarriages and we feel sorry for the person, or we felt sorry for the person, but we couldn’t picture anyone who we knew who had lost multiple consecutive pregnancies until, as I said, we are treating fertility challenges and then we know all of these people.

And the fire inside their passion, their desire fire can leave serious damage behind. And it’s hard unless you’re treating it to fully grasp what fertility challenges involved, unless you are dealing with it personally. As I said, the worry we’re gonna talk about doesn’t go away lots of the times when you get pregnant.

One of my fertility patients, Finally, got pregnant, had a healthy live birth, then she got pregnant again. In fact, she came to see me and she said, oh, I was coming to see you because we wanna get pregnant again, but guess what? I’m pregnant already, but I’m worried. And I said, are you worried about having a miscarriage?

Because she had miscarriages already. And she said yes. And again, I still had to deal with that worry, even though. She’d already had a baby, which does not necessarily mean you’re gonna get pregnant again or easily get pregnant or pregnant at all. And I needed to explain to her, are you having symptoms of a miscarriage?

No. Okay, then let’s work on that. Worry. Like I said, many people believe that the end game is have a baby, and if they can just get that prize, all their worries about infertility will go away. But that is not how it is in real life. It’s much, much bigger than that. It the. Experience they’re going through really affects their physical and mental health in insidious and sometimes long lasting ways.

Because struggling to have a biological child is a complicated emotional process and. , it’s an invisible loss, right? There aren’t any rituals for miscarriages. There aren’t any rituals for somebody who gets pregnant and at six weeks they realize, oh, there’s no heartbeat. Or genetically speaking, where this is not gonna be a viable pregnancy.

There aren’t any rituals for that. So these people are experiencing these losses without being able to go through. Hey, I’ve had this loss and I need to grieve, and I need people to grieve with me. Now we can grieve with them, right? And we get them through it. However, There aren’t any formal rituals for it.

And then they start to feel like there’s something wrong with them. I’ve had, and I’m sure you have to, women who had previously had an abortion who feel like, oh, that’s my punishment now my punishment is I’m never gonna get pregnant. That’s of course not true, but because of their.

Feelings about it because of this constant try and lose. Try and lose. Try and lose. What happens is they start to take it internally. They start to think of themselves as a bad person or lose some of their self-esteem. They may also experience shame. And part of shame is why can’t I be happy at my girlfriends?

Baby shower. Because you’re disappointed, because you’re sad, because you’re grieving your own loss, or the potential loss, or the idea that maybe you’re never going to have a biological child, but lots of people envy makes them feel shameful. So there’s that underlay of I can’t be happy for anybody else because I can’t be happy for myself.

And then that goes into worry that they’re going to lose friends. If I can’t show my happiness at my girlfriend’s baby shower, maybe she’s not gonna wanna be my friend anymore. So you can see that their worry about it, their constant thinking about it about. Whether or not they can get pregnant, how are they gonna have to go to a baby shower?

I think we have all heard the stories of, wow, I’m trying to get pregnant, and everybody around me is pregnant. It’s amazing how many patients tell us that, that, yep, am I Another coworker came in today. They weren’t even trying, and they’re pregnant. So it’s just all consuming sometimes. And they also have the worry that their relationship will suffer and relationships have been damaged by reproductive issues because there’s so much pressure to have that biological child.

And that affects intimacy. And this is partly why I always treat the man and the woman. That’s my protocol. I do not only treat the woman. I started doing that years and years ago, because we all know it takes young and it takes yin. And if the young part of the picture is. Over here and out of it.

Then how are we going to succeed? And remember, 40% of the time, reproductive challenges are on the male side. That’s a huge. Piece of percent you can. It would theoretically suggest that your success rate could go up. Success rate, helping people get pregnant by 40% if you treat the male. So find out about and treat the male.

And partly I can tell you in terms of the pressure I’ve had men be very grateful that I’m seeing them because they say they’re a nervous wreck. They’re on call all the time. Their wife is always checking her temperature and her phone app on when she’s gonna ovulate. And it’s just a lot of.

Tension for them. Plus remember the hormones that are involved in if a woman’s gonna get I V F or some fertility clinic treatment and getting hormones, boy oh boy, those can really intensify her emotions so everything can get worse. Anger, worry, depression, all of those can be escalated and. And sometimes your easiest target or your most available target is your partner who is really trying to help you, but can feel a little helpless.

So I’ve even ex, guided couples in how often to have intercourse. Studies show that if you have intercourse every three days, you are going to within three months, hit ovulation at the right time. I’ve had men. Thank me for giving their wife that information because again, they feel pressured to have intercourse.

Too often they are happy. It’s a pleasant experience, but it starts to become unpleasant when they’re on call, when it’s pressure, when it has to happen right now. So then even their intimacy gets in this negative cycle because of the woman’s worry. And men worry about it too, about being able to have that biological child.

And remember about their experience of loss too. Fathers to be, experience a loss of a miscarriage or having to end a pregnancy because of genetic problems and unsuccessful I V F treatment cycles. Remember, they are affected too. They would like to have a biological child. They get this thing done, they, it looks good.

The wife is. Pregnant, every, the woman is pregnant, everything’s looking good, and then it doesn’t work out that way. Remember, they are a part of it too. It is an emotional loss experience for the male of the partner also of the partnership also. So again, it’s, it can be very complex. Then there’s what is called unexplained secondary infertility.

Very nebulous term, right? It starts with the word unexplained, and this is when women have successfully given birth already. , but for some reason they are not able to easily get pregnant a second time. And there are timelines on this, it’s a shock, right? They feel like wait a minute. I got pregnant so easily the first time.

Why isn’t it happening now? Why shouldn’t I be able to have another baby? Why is this happening? Why won’t my body do what it’s supposed to do? So there’s not only the first time trying to get pregnant, but also. Future times can be affected by fertility challenges and you need to obviously look at everything, health conditions, surgeries what did they have, a previous C-section, and maybe there’s some scar tissue there.

Looking at all of that for the second time around. and research has also shown that women dealing with fertility challenges have depression and anxiety levels similar to those who are suffering with cancer, H I V and heart disease. And through our work, we can help resolve that worry. And also I consider it a trauma.

I consider these losses, this journey a part of trauma. The fertility struggle has. Traumatic. Traumatic impact. Now, some people don’t think it deserves the label trauma because it isn’t life threatening, but it is fulfilling, life threatening. It is having a happy life, living a life threatening. So I feel like there is no problem with.

Treating fertility challenges, especially when there are a lot of losses as though the person has been traumatized. In fact, there are research scientists and psychologists who feel like the word trauma or the idea of trauma should be expanded to include psychological and emotional responses, not only physical.

Threats or the physical threat of life. So these people are experiencing a Ma major shift in their life. They are planning a major shift in their life that sometimes isn’t working out for them. They are exposed to constant reminders of their condition or of the fact that they can’t seem to get pregnant from everyone, from family members, coworkers, friends, medical, the people that they go to for their medical treatments and other, and pregnant women.

I think that. We can truly believe that fertility challenges affect how you see yourself and the world along the way. A lot of women have so much worry and so much doubt that they just feel like they can’t even trust themselves, that this kind of doubt and experience is just a part of who they are.

They’re just always gonna leave live in a. State of worry, a constant state of worry. And as I said, this does not turn off when they become pregnant. It does not turn off when they hear that heartbeat. It’s a pattern in their body and they, we are gonna help them get past it. using acupuncture and sometimes herbs they’re always bracing themselves, right?

They’ve gone through fertility treatments that didn’t work. Some have failed adoption attempts. That’s also a traumatic experience for women. They’re bracing themselves all the way through their ivf, sometimes through a C-section, so they, you might think they’re invincible and a lot of people do. I think.

Feel like these women are invincible cuz look what they’ve been through. But that’s not true. They are extremely delicate inside and they are always thinking the other shoe is gonna drop. They are pregnant, but they are always waiting for something bad to happen with that pregnancy.

And even women who have a child after the child is born still feel like. Guilt over, oh, I have this baby finally. Or is something gonna happen to this baby because of that worry that they went through sometimes the years of their fertility treatments. So it’s that constant rollercoaster and unfortunately sometimes it’s off the rollercoaster and you’re still in defeat.

Plus, of course, these women, these worried women very often and something to pay attention to with your fertility patients, they very often deal with postpartum depression because again, even though it seems like the golden ring is that live healthy birth, It doesn’t take away the patterns of worry that they had while they were going through all of their treatments.

We need to be aware of that, a after our patient has their babies. So what has all this got to do with worry? In this picture of the right pulse side, so the right positions, you can see that worry earth is in that middle position there. And worry makes the energy go backward toward the kidneys.

Now, as you know for if you’ve heard me talk about pulse diagnosis, my system before the kidneys, and we know this, the kidneys fund everything, so we really don’t need a perverse movement going back toward the kidneys, but that’s what worry does to your digestion. So that’s one of the problems with worry is that it wrecks the Earth’s spleen stomach position and sends it back toward the kidneys.

The part that I talked about with trauma, the trauma can empty that earth sector. That’s what a trauma pulse feels like. These are, this is where unresolved, that continuous cascade of worry and other. Emotions that come with the experience. Leave the pulse, the earth, spleen, stomach, our digestive, our nurturing center can become empty.

In fact, it can be so empty that under your finger, it feels almost like that arrow, like it’s sucking down. This person is so needy and empty that their, literally, their earth is sinking. And then you’ll notice in the lung, large intestine position, I put a little arrow just to remind you that the positions flow through each other like those little sine waves on top of the line.

If earth is empty, Then there is no energy going to the large intestine in the lung. So you’re gonna have an out of balance lung, large intestine pulse. And as earth and metal make the immune system so that whole, those two whole sectors are liable to be empty and out way outta balance.

Now, as you can imagine from me showing you those, Pulse when Earth is not working, when earth is empty, when Earth is going back toward the kidneys, when digestion isn’t working, this person is not making good quality energy. They cannot make good quality blood, which. We’re trying to create a warm, fertile environment, a blood filled environment in the uterus, but they’re not making good quality blood.

Their ability to nurture themselves decreases because Earth is how we nurture ourselves. Digestion, working well is how we make our energy, make our blood, nurture ourselves, keep ourselves alive, and then their immune system can also suffer well. We don’t really need them catching frequent colds or that sort of thing.

Having bad allergies, having skin problems. We don’t need to add immune system problems onto their fertility challenge. And as I said, their skin might suffer. They might start to have hair loss. That is because partly that spleen, stomach sector, that earth sector is not moving into the lung large intestine.

So the immune system is suffering. The skin is suffering, the hair is suffering. And they basically just are losing their core, right? The where would be under my middle finger, the core, nothing is flowing from the kidneys into the earth, into the long, large intestine. So again, we, that’s a major part of treating fertility.

That’s why I always tell my students, treat digestion on every fertility patient because, They have to make good quality energy, make good quality blood, have enough blood to flow to the uterus, have a good solid immune system, and the only way they’re gonna do that is if we can keep their earth, their spleen, stomach, sector of the pulse strong.

Now the second pulse picture I showed you, which was the earth sector going down, that, as I said, is related to old trauma patterns. Now this could be. Worry from childhood sometimes I treat an awful lot of trauma. I treat an awful lot of people who today’s issues are because of what happened way back.

Because your pulses remember everything. They’re your Rosetta stone. So all that stuff is in there. Even if your conscious mind has blocked it out, your subconscious mind and your energetic body has those patterns in there. So I will ask them, do you feel like you worried as a child? and then you can say other things like, did you feel like your life was outta control?

Now, as kids, almost all of our lives are outta control. Let’s face it, we don’t have any control. Our parents control everything. But that’s different than worrying that your parents are gonna get a divorce or worrying that your dad who’s an alcoholic is gonna make it home alive without having an accident.

Worry like that, is going to. Create some sort of old trauma and it can lead these people to feel like their body’s outta control. So that again, would show up as a very deep, empty earth, spleen, stomach pulse, old trauma that is unresolved. Now the beauty of acupuncture is we can recycle that old trauma pattern into.

back into the digestion, back into nurturing the spirit, back into flowing through the kidneys. So like the infinity symbol here, that is the beauty of acupuncture for treating trauma. We can make that. Infinity symbol happened. The pulses from both sides connected to each other. That’s what good health is, that infinity symbol, all of the organ systems communicating with each other, flowing from side to side, everyone getting a continuous flow of energy rather than what I showed you with the spleen, stomach sector going back and forth, or just frankly being empty.

Now one way to accomplish getting the organ systems connected is using the low points. Now I know, I don’t do what I call prescription Chinese medicine. I follow the pulses and I do what the pulses tell me to do with the patient. However, sometimes you do need to connect things like the kidney low, if the, we use that kidney low.

If we s. We think the person is seeing an emotional vent as the worst possible thing that could ever happen to them, thereby leading to fear and sometimes paralyzing fear. All right, these women are afraid they’re never gonna have a baby. That’s their worry. Their worry is, this month is not gonna work.

Next month is not gonna work. I’m never going to have a biological child. So there is. A total acceptance in opening up kidney four to get the kidneys flowing into the other organ systems. Get them supporting the other organ systems.

Some other things are if the patient reacts quickly to everything, they’re, they’ve lost their ability to handle and manipulate their world. Then the stomach is associated with pensiveness and worry. So you can see you can do stomach 40. It’ll help regulate digestion. Spleen four also will help the gut and will help the blood, and it’s the master point of the chok, which is my.

Favorite. Favorite, I think extraordinary, or we’ll say one of my big favorite, extraordinary, I love, love, love the Chong Ma because as it starts in the fire, in the belly, comes up the body, and then encircles the spirit like a lollipop. That’s the vision I give my patients, and then recycles back down a perfect fertility channel.

So spleen four is a great low for you to try heart five. Remember? This person is having a hard time evaluating and articulating their feelings because their main feeling is worry and grief, worry and depression, worry, and anxiety. So this helps them the energetically to help them reevaluate the situation, help them speak to others about the situation.

Remember I said there aren’t any rituals for the losses that happen every month when you don’t get pregnant, however, We can help them with heart. Five. The small intestine low represents redefining. Emotional processes and getting feedback from others and being more accepting of that feedback. So it’s about reprocessing and integrating our emotions.

And the pericardium or heart protector, low, right? P six, PC six, that represents our defense mechanisms and. It can help us get out of those holding patterns and frankly, we might be tempted to go to heart seven when someone is suffering a lot from worry and pensiveness and we wanna nourish their spirit.

But remember, the pericardium might be protecting the heart. So we need to go through the pericardium some sometimes re, as I said, really tempted to go right to the heart, but honestly, sometimes we need to go through the pericardium to the heart, and PC six will help them with their coping mechanisms during these, what are very trying times for them.

Then there’s gallbladder 37 chance to let go of the stagnation of our feelings, illuminating brightness. Nice option for people going through this. And then the liver low. Remember, it’s gonna help when we’re feel like we’re controlled by something else than other ourselves. And they are. If they’re in an IVF clinic who’s controlling them, they feel totally outta control of their own body.

They’re, they might be having negative side effects. They have to do this on this day and this on this day, and this on this day. You can’t create good chi and blood when you’re stuck like that. So that combination is also very nice. Liver five. Gall bladder 37, they’re, they need blood for creation and that’s a part of liver five.

Blood moving for creation and them able to experience their passion, their desire in a positive way. So I wanna thank you very much for watching this. I wanna, again, thank the American Acupuncture Council. I am available to help you with any questions you have. You can go to lucasteachings.com and see course selections.

There’s a contact Dr. Lucas button there. Acupuncture woman is my. Private practice site. There’s a contact Dr. Martha button there, and my email address is dr. M Lucas acupuncture woman.com. Drmlucas@acupuncturewoman.com. If you need, have any questions or would like to talk with me about just anything, Chinese medicine, and next time we’re gonna talk about depression and fertility challenges.

Thank you.

 

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Improving Shoulder Mobility – Brian Lau

 

 

Today we’re gonna be presenting on some shoulder mobility. We’re gonna look right away from at a shoulder mobility drip drill with weighted clubs.

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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.

Hello I’m Brian Lau. I, first of all, I’d like to thank American Acupuncture Council for having me back. Today we’re gonna be presenting on some shoulder mobility. We’re gonna look right away from at a shoulder mobility drip drill with weighted clubs. So that’s why I’m standing here. We’re gonna go over some movement aspects with that.

These would be something you can do yourself, which are really great mobilization exercises to keep your own shoulders healthy. But also you could prescribe these to patients. We’ll look at some caveats for when you can do that, when you might not want to do that. It might be a little too much depending on the stage of shoulder injury.

This would also have implications for neck injuries. We can go over some of that in context. Let’s go over that right from the start. But let’s look at some movement aspects first. So I have a little bit of a bone model here. So this would be my left scapula. and left humerus. So I’m gonna put it in front of me.

Obviously this would be behind the ribcage, but just to give a little bit of context. So we’re gonna be looking at this shoulder mobility drill that’s gonna work on the glenohumeral joint, of course. So we have good movement in that, but we’re also challenging the strength so that we can do movement with stability and the joints not moving around excessively.

But with any shoulder movement, we wanna look at this sort of dance between the shoulder joint. and the shoulder girdle. For instance, you can look up something called the scapula humeral rhythm. So with that’s specifically in reference to abduction. As the body goes into abduction, as the arm goes into abduction, you wanna have this following of the scapula.

So it goes into upward rotation. The scapula’s not moving real well. It’s very possible, probable that the joint will hit the head of the humerus up against the acromion, and that can pinch and compress and impinge on the superspinatus tendon, biceps tendon. A lot of tendon type impingement problems can come from that.

So it’s a nice dance. You can look at it up online. You can find the exact ratio of movement of how they relate to each other. But it’s not just abduction. When the body does internal rotation in the shoulder joint, the scapula likes to follow into protraction. So it gives a little bit of room, a little bit of movement.

So that the joint doesn’t get compressed in the front of the joint. Same thing with external rotation. Sometimes it likes to combine itself with retraction of the scapula. Maybe even a little bit of a downward pull on the scapula. So there’s a nice dance of movement between the scapula on the ribcage glenohumeral joint.

I could add to that. the sternoclavicular joint so that this whole complex is moving in this nice unified movement. It’s not just the shoulder girdle though. When I’m doing any type of movement like overhead, my ribcage is gonna open and expand and move. So there’s a combined movement that happens in the ribcage all the way down to the diaphragm so that a lot of these movements take this whole range of motion of the upper body, thoracic spine ribcage.

Shoulder blade, sternoclavicular, joint glenohumeral joint, and a combined activity that’s organized and controlled, or at least we want it to be organized and controlled. There’s a lot of neurology that helps link that. The phrenic nerve going down to the diaphragm has a lot of relationships to the shoulder joint.

In the shoulder capsule, but also the rotator cuff muscles. If I go on the right side, there’s a little branch of the fren phrenic nerve called the nicco abdominal nerve that goes right into the liver into the capsule of the liver. So any liver mobility problems are also gonna potentially show up as especially right shoulder problems.

So that’s a lot to think about. We’re going to. Not necessarily try to dwell on all of those. As we’re doing the movement, we’re gonna look at one key aspect and allow all of those other things to happen. So I’m gonna put this down for a second and grab another tool.

So we’re gonna have a weighted club. If you don’t have a club, that’s fine. I’ll show you what you can do without one. It’s actually nice to start without a club. This is a five pound club. One or two pounds is really nice to start with. Or we can just have our thumb out. , my arm has a certain amount of weight in it, so this is fine.

All the movements we can do to get used to these movements, we can get we can do without a club or you can have a wooden spoon or something if you wanna have a little bit of something that gives you an idea of where you are in space. That’s one nice thing of the club. But the actual weight is useful too.

So if you were to do this on an ongoing basis, maybe start with a two pound weight, three pound weight, and you can go up from there. We’ll look at some options. So we’re gonna be holding the club at the base. I’m gonna have my arm out at 90 degrees in elbow flexion. I’m gonna start at about level with the opposite shoulder, so I’m in a little bit of internal rotation.

My chest can be relaxed. Again, if you don’t have a club, you can just stick your thumb up and that’ll give you an idea of the direction that you have. So the first thing I wanna do is just warm up the joint. We’re gonna build a movement here, piece by piece. So I’m gonna go into external and pull the shoulder blade back.

So I should get my arm lined up to the side, my elbow’s level with my hand. Chest is open. Then back into internal rotation. I can let my chest fold just a little bit. So right from the get-go, the driving force is the shoulder blade. I wanna pull my shoulder blade open, or I should say pull it back towards the spine to open the front.

Then I wanna let the shoulder blade come into protraction, my chest relaxes retraction, pull the shoulder blade towards the spine, open the chest. So right from the start, we’re working on the hearts in you channel as I go into internal rotation and the small intestines in you channel. As I go into external rotation and pull the shoulder blade, it’s fine.

So nice exercise for the in you channels. Alright, so this is stage one, but we’re going add a swing to this. So instead of me just turning my arm out, I’m gonna let the weight drop and find that position again. Let the weight drop swing. So it’s a swing and a catch. Down, turn the arm, open the chest, catch down, turn the arm, close the chest.

Catch. So swing you can go slow or you can start speeding it up if you feel comfortable with it. So we’re building a movement. This is a movement called Mills. Okay, next thing, swing. Catch now I’m gonna go overhead. I want my shoulder blade to be the driving force, so I want my shoulder blade to go into upward rotation, hand behind the neck, down, catch up,

down, up. I wanna keep a stable base down. Okay, now we’ll change one more time. Up

turn, throw, catch, swing, catch, cast it, overhead, turn, throw catch. So that’s the movement. It’s like a throwing motion like you’re throwing a baseball, but again, driven by the shoulder blade. Pull the shoulder blade back to open the chest. Upwardly rotate to point your scapula up towards the sky, protract and down.

Very nice. We can go the other way now. So over the shoulder, same shoulder. Pull the shoulder blade, open down, swing catch. Cast open, throw, swing, catch, cast open. Throw one more time. Swing and catch. Cast open. Pull the shoulder, blade back, throw. All right. Real quick, we’ll do it on the other side. Then we’ll look at some various options, when to do this, how to do it with patients or for yourself if you’re having shoulder issues.

So let’s go quickly through it again. Internal external rotation, external pull the shoulder blade open, chest opens, line the elbow up with the hand. So I don’t want my elbow facing back. I want it under level with the hand, chest in,

open the chest. Okay, we can do that with a swing. Let the weight drop up. Drop up 90 degrees. Drop up again, we’ll go overhead now. So up. Hide the hand behind the neck. Throw catch up. Throw catch. Okay, one more change up. I wanna turn my body in front of the other shoulder, swing, catch, cast, throw, swing, catch, cast, throw either direction over same shoulder.

Pull the shoulder blade open to pull the chest open down

over the shoulder. Retract the scapula, pull the chest open down.

So great movement to strengthen the shoulder blade the shoulder joint to strengthen and move the shoulder blade and to coordinate that activity with the chest and ribcage. This would be not a good idea to start with the five pound of somebody who’s having shoulder pain. Maybe that’s where it’s really nice to start with just the weight of the arm.

Maybe they have a painful arc. Oh, that’s causing a lot of sharp pain just to do that. They’re not stable. They don’t have strength to support that shoulder shoulder joint. They don’t have the strength for that shoulder blade to roll up and upward rotation so that they have a comfortable, nice movement and oh, it hurts to do that.

It’s probably not a good exercise for them. You need to build them up to that. You need to give them a simpler exercise, a floor exercise. We’ll look at some acupuncture techniques. There’s a lot that has to happen before they can comfortably do this. Once they can comfortably go up, maybe starting with no weight, one pound, two pounds would be a good idea.

Keep it small. Once they get coordinated movement then, and they’re feeling comfortable with that. Five pound,

five pounds pretty good. They get a little more comfortable, then they can go up more weight. So adding weight will create a little bit more challenge. So this is 10 pounds. So if I’m doing the same movement with this 10 pound weight, then that requires more force, obviously, but it’s not just the weight.

So 10 pounds

and 10 pounds. Now this 10 pounds weighs a lot more than the other 10 pounds because of where that weight is sitting farther away from my hand. And the torque that creates. when I’m going ahead, I don’t wanna swing it cuz my camera’s pretty close here, . But when I’m going ahead and if I were to swing that through, that’s gonna require a lot more strength on my part to be able to balance and manipulate this weight that’s farther from my hand if I were to move down even to the handle.

Even just holding that and stabilizing it is a lot more difficult because, oh, any little movement here, I have to do a lot more stability to support that. Since it’s so much farther away from my hand. So those are ways you can increase and build on this exercise. But you don’t wanna start with a shoulder.

A patient with shoulder pain, painful arc with that mace. You may not even be able to start with the weight of their own arm. You have to build them up to it. So just some ideas, some things you can work with go through step by step, maybe starting. with that, just internal external rotation, if that’s not excessively painful, just to be able to balance that weight in external rotation is gonna start to strengthen and stabilize that joint.

So that would be a good starting place. Then you can build until they get the full sort of movement of throwing. So that’s what I wanted to start off with was the mobilization. So we can start thinking about feeling, coordinating that activity of the shoulder blades with the movement of the glenohumeral joint and how that relates to the chest and all of the whole, really the whole body.

So what if they have limited range of motion? Let’s go over some potential techniques. We’re gonna focus mostly on the pectoralis major, cuz the pectoralis major has to lengthen to be able to get my arm back. It has to lengthen to be able to get my arm back in both positions, different fibers. But Peck major is gonna be one of the key structures that’s gonna limit mobility.

If this peck major’s held in a shortened position, I can only go so far. So I want to be able to have full range of motion, full elong full ability to elongate in that pack. Major in all different planes. So we’ll focus on that. I’ll tell you from the get-go, Sarus anterior would be another big one.

Another day we’ll just focus on P Major for today. So I’m gonna switch to PowerPoint and let’s go over a little bit of information, a little bit of the anatomy, and we can look at some techniques for acupuncture and manual therapy. So let’s get the slides up. I’m gonna come a little closer.

All right. All right. So here’s some netter images. If we look at the left image first, let’s look at the bottom left. We have Peck major. So Peck major’s a really intriguing muscle. It has the clavicular head that’s going up and attaching to the medial third of the clavicle. It has the sternal head attaching to the sternum.

Then as we go down a little bit, we see costal fibers attaching to the costal cartilage and that bottommost slip that you see attaching into the abdominal fascia. Is the abdominal head. So we have really four heads depending on how it’s divided. Some books look at it as three heads, but clavicular, sternal, costal and abdominal heads are the way I look at it.

So interesting thing about that is they play out with the yin channels of the arm. The clavicular head is part of the sinu channel, sternal head, part of the heart, Sinu channel Costal, and an abdominal head, part of the pericardium Sinu channel. Those fibers have to organize themselves with the muscles of the back, such as the rhomboids.

So we’re looking at the sternal fibers and we were going into that external rotation movement with the arm down. Peck major has to elongate, rhomboids pulls the shoulder blade back towards the spine. So it’s a balance between the hearts in you channel and the small intestines in you channel. , we start from internal rotation, Peck major’s in a shortened position as it goes into external rotation.

Infraspinatus, Terry’s minor part of the small intestine sy channeler firing while the peck major is lengthening. So they have this yin young relationship of one letting go, one shortening. So we don’t have time to go through all the channel relationships for each of them, but that’s one to start with.

We’ll look a few at a few of them though as we go into the PowerPoint. So lung sinu, channel clavicular, head of the Peck majors, part of that Peck miner’s, really the key muscle that’s also involved with this shoulder mobility exercise we were doing. Peck miner is gonna have a tendency to pull that shoulder forward into an anterior tilt when it’s shortened.

If you remembered from that exercise we were doing, we had a pretty neutral. Position the scapula is moving a lot, but we didn’t have this jutted out forward shoulder at any point when we were doing it. If that’s in a shortened position like that, we need to do a technique acupuncture’s great to be able to release the peck miner.

We can also use points along the channel, even muscles along the channel, like the flexor carpi. Radialis is a really great muscle to release the peck miner, so needling the motor point. If you’ve studied with sports medicine, acupuncture, we teach the motor point for flexor carpi radialis. Fantastic distal point, even though it’s not an official lung channel point, it’s kind of part of the lung inu channel.

So really a fantastic point to release Peck miner. But Peck miner needling is something to learn too with the caveat of being safe with it because it is close to the PLE cavity. That Peck miner is gonna have to be balanced by the large intestines Inu channel, lower traps, which is supporting it.

Those have that yin yang balance. Also upper fibers of Sarus anterior part of the long Sinu channel. Those are those upper two slips. They have a different fiber direction than the rest of the sarus anterior, and they have different action. Again, we can come back to Sarus anterior maybe another day. So here’s the movement of the lung sinu channel.

It’s gonna tend to pull that scapula, like that top arrow, which is pulling the scapula down into an anterior tilt, countered by the large intestines Sinu channel, which stabilizes the scapula against that force of the peck miner. So if you go back and review large intestine Sinu channel, you’ll see that it goes down into the thoracic spine.

It follows those lower trap fibers. So nice combination to work with. Har Sinu channel was the one we alluded to just before. The Har Sinu channel includes pretty much the Peck major, I think of the whole Peck major, but really the sternal head in particular is the big one for Hart Sinu channel.

This would be very important for that movement that we were doing, the mills that we were doing with the weighted clubs. We can also notice that the subscapularis is in there. Subscapularis is another big one, a really great muscle to learn how to needle. But it’s not something for a webinar.

That one’s much better for classroom setting because you’re going. Deep into heart. One with really a three inch needle, you have to be very mindful of where the ribcage is, so you can advance the needle towards subscapularis, but not towards the ribcage. So plenty of space if you do it properly. But too much room for error on a webinar.

So classroom setting. Another day we will look at some needling for tech major, though. So this relationship for the scapula is, again, we have protraction As the scapula pulls around, the ribcage moves away from the spine. P major is one of the big muscles that’s gonna contribute to that. And then that’s countered by the rhomboids, which are multiple channels.

But in this case, they’re acting along with other muscles as part of the small intestine sy you channel. But all of that’s happening with internal rotation, pag, external rotation, infraspinatus, Terry’s minor, also subscapularis, part of the small intestines in new channel. So those have to coordinate their activity as one shortens.

The other one has to let go as the, then it changes phases, and the other one shortens. They have to alternate. Elongate contract. Elongate contract. So very much of a yin yang relationship with those two. Peck major is usually the one that’s overactive, and we’ll be looking at a technique for that. Finally, the Pericardium Sinu channel.

Pericardium Sinu channel has a really interesting trajectory. . It involves the sarus anterior, also these lower fibers of the Peck major, all of those come down and blend in with this abdominal fascia. So it creates like a almost like a fascial belt around the ribcage that can get too tight. So we need to loosen up that belt.

Nice thing about that exercise we were doing is we had that in. an out aspect with the chest. So we’re starting to exercise and soften that sort of what can be a too tight of a belt around the ribcage for a lot of people. So the interesting thing about this one though is it wraps around the ribcage, which it’s discussed classically, but I take it a little beyond what you might think and into this Rambos sling.

So the sarus anterior attaches to the medial border of the scapula, and it links seamlessly with the sarus anterior. So much so that in recent dissection, and I’ve done this a few times, you can tease the fibers of the rhomboids and sarus anterior off the scapula and kind of layer, soft, slow approach and then bring the scapula away and you just have this seamless.

Sling of tissue that you don’t see really a break. All is where the scapula attached to it. But you have the sarus, anterior rhomboids is one continuous structure. You can pull the scapula off. It’s not something that if you were to take the scap off, you’d have to sew those back together.

They’re already united. They’re already part of a sling. That actually then combines over to the contralateral side and blends in with the SIA services and capitus. So this shoulder movement that we’re doing can have good implications for neck pain for a lot of reasons, but one of which is that those snia services and capitus muscles become problematic for a lot of neck pain patterns.

So we can needle splenius services, we can needle splenius capitus of their pain producers, but to be able to integrate them with the scapular movement so that there’s this nice sling expansion contraction on either side is a really great way to keep those changes. So this exercise we’re looking at, fantastic for shoulder problems, but neck problems, especially with plem and surfaces pain patterns, right?

So movement pattern with those and things you can look at. Somewhat protraction and retraction, but also that upward and downward rotation of the scapula. PS radius anterior in particular upwardly, rotates the scapula. So if you go back to this movement we were doing, there’s a lot of times where the scap is doing this circular movement of rotating up around ProTrac, protraction, rotating back down, rotating up.

Retraction rotating down. So that rotational aspect of the scapula is a very key movement of the pericardium sinu channel, moderated by the lower fibers of the peck, major sarus anterior, and then the rhomboids and also the upper part of the traps. So I put this pericardium Sinu channel in here, but again, this is an ebb and flow between Pericardium Sinu channel, San Joo channel.

So lots of scapular movement, lots of things to think about with just a small exercise. You’re really working all three of those in you channels. But I think the big one is pericardium and San Joo channel. That’s the one that’s the most prominent with the exercise we looked at. Got to twist my arm to say that cuz the other ones are.

All right, so tech major is what we’re focusing on for treatment. So you’re teaching this exercise to somebody or you’re doing it yourself. And oh, it’s hard to really get that arm back. It’s hard to pull that shoulder back and have this nice open chest because of that Peck major holding everything. So it’s like this too tight of a grip on the shoulder blade, and I can’t get that movement.

Or when I’m back here, I can’t get my arm back because that Peck major is pulling. So any of those positions that are difficult to get. Open in the chest. Peck major is gonna be a key player in that, and it’s one that we can look at on the webinar. There’s some concerns. We have to be careful. We have to know where the ribcage is.

There’s some cautions. I put this in the video and this is a video that’s up on my YouTube channel. You can reference later, or you can reference it directly from this webinar, which will be recorded. But it’s safe enough. I think we can look at it. In a webinar setting, I go through step by step.

This is a way to needle the Peck major for those who have taken sports medicine, acupuncture classes. Matt teaches it a little bit differently, which I think is great and maybe good for a class setting. I felt a little more comfortable with this one for a webinar setting because we’re holding the tissue up away from the ribcage.

So it’s it’s one that I use. I like it. Just for the reason that I like the technique, but it’s also, I think, a really useful one to have on the YouTube channel. And have on the webinar because I mitigates the risks by lifting the tissue away. So let’s look at it.

Okay.

We’re gonna look at palpation for to bands within the pectoralis major muscle, and we’ll look at a way of needling this muscle safely. First, let’s identify the fiber direction for the various portions of this muscle. The CLA head runs from the medial of the clavicle to the specifically the lateral lip of the, okay.

The sternal head runs from the sternum to the universe.

And the coastal and abdominal heads run from the coastal cartilage and the abdominal fascia, and then travel up to the s.

The arm down the clavicular fibers run superficial to the sternal fibers.

Which runs superficial to the coastal and abdominal fibers. The layered arrangement changes when the arm is overhead. The different layers unwrap and then wrap again as the arm is brought down. Palpating for top bands and the muscle can be helpful to gauge tension. Here I am palpating the clavicular head.

In assessing pretension, I can also push from inferior to superior or superior to inferior to feel which offers the most resistant.

And I can advance the needle across the fibers in that direction.

I have to take care that I place the needle in the same angle as the palpation and not change the angle deeper towards the.

Now I am palpating sternal head, starting from the sternum, and noting a local twitch with palpation.

This layer has a notable, palpable band, an easy way to needle the factor. Major is to grasp and lift the tissue away from the underlying rib cage

while grasping. You should feel the plane, the rib cage makes.

You then find the top band and place your two fingers around it.

Place the guide tube at an angle that allows the needle to penetrate the band and then advance the needle into the P major. Direct it toward your thumb into the needle, parallel to the rootage.

You can redirect the needle, but keep the needle parallel to the ribcage until you get the needle response.

The needle is always directed parallel to the ribcage, and you should never aim the needle towards the ribcage. The needle is parallel to the ribcage directed slowly towards the thumb and not downward towards the feral cap.

You should not perform this technique if you do not have an adequate sense of where the ribcage is the plaintiff makes, or where the needle tip is in relationship to your thumb. The advancing needle can be felt by the thumb, but you need to be sensitive to this. You should not perform this technique on women with breast implants.

Otherwise, working with women is essentially the same. Palpation will be the same, but you’ll not be palpating through breast tissue. You still have access to muscle around the breast tissue. Let’s go over this technique again on a female model, . So when I’m palpating, I want to feel for the clavicular fibers.

I can press into fibers going up. and that inferior to superior direction, or I can palpate into them from a superior to inferior direction. Feeling for resistance doesn’t feel particularly top. So I’m not gonna needle those fibers. I can palpate close to the stern looking for top bands.

Of one right there through that sternal fiber. Sometimes you’ll even see a local twitch response as you palpate through that. Interestingly, I can see a little bit of that local Twitch response respond up through the s SCM muscles. Those pec fibers do link with the scm, but I just feel able to top in there.

If I were to follow that’s gonna take me into that sternal portion of the muscle and. That’ll help me find and differentiate where there’s spot in the muscle for men. You have a little bit more territory you can palpate for women this sternal edge is a really useful area cause you can palpate feel without having even the ship.

The other area where you can palpate where it’s probably easiest to needle is that the excellent. So I have access to the bulk of the muscle through here. This is where knowing those fiber orientations can be very helpful. So I can come and feel for hotness within the muscle. Noticeable damage fibers.

And this is the easiest way to needle it. If you wanna be very cautious. I wouldn’t do this needle technique, breast implants cause you could puncture the breast implant, but faring that it’s not a problem. So I can grasp the muscle this way, heal the tension within the muscle hold. To guide you between my fingers, I’m gonna angle towards my thumb.

I can feel the edge of the top end, and maybe looking for trigger points you might need get a switch response with palpation, and I can hold and then advance the needle towards my thumb. I need to be really comfortable with the idea of kneeling towards my numb feeling that needle advance towards my thumb, bring it out, but it’s very safe situation there.

Do some general looking thrusting, different needle angles to listener response to tech nature.

All right, so I have a minute long myofascial release. This was longer technique, but this was YouTube short. This is on the Sports Medicine acupuncture YouTube channel. So you can reference it there. Again, it’ll be in the recording. This will be the last thing we have for today. And you can see a follow up technique to the needling.

Myofascial release for the HE major will take place with either the patient having their arm down by the side, especially useful for the clavicular head attachments, or having the arm up above the head and external rotation. Much better for the sternal and the costal fibers. And what you’re gonna have the patient do is start to turn their torso, start turning towards your same side.

So you wanna have the fibers shorten so that you can get in, get a good investment, get a good grab of the tissue, and relax there. Then have them turn away from the shoulder so they’re keeping the shoulder on the table. And trying a little slower, one slower turn the torso away, and they’re having to learn how to relax that als nature while you’re spreading through it.

All right. Very nice. Feel free to check these videos out. Like I said, those, the references along with this recording will be on the on my channel. It’ll be in multiple places, but it’ll be on my YouTube channel. The QR code is there, but also the webpage along with sports medicine, acupuncture had that myofascial release technique.

So I think I can take off the slides. And just to give a quick idea with that myofascial technique, in that exercise we were doing, we were moving the shoulder away from the ribcage. to get more space and buy that the front of the rib cage, I should say. So that ability for Peck major to move kinda like I’m throwing a ball, I have to be able to expand and move that shoulder away.

The myofascial technique, we did it slightly different, is we compressed and moved the rib, moved the sternum closer to the humerus and had the patient relax the shoulder on the table while they moved the sternum away from the arm. So same thing. The just different reference point is they were learning how to relax the Peck major so that they could turn the sternum away from the arm.

And in the exercise they were. Moving the arm away from the sternum. So same idea, just a different focus. Both of those are gonna require the peck major to lengthen. Both of those are gonna open the heart a little bit, or at least the heart channel, heart send you channel. Great exercise. If you have any questions feel free to comment on the webinar.

I’ll be checking those and maybe it’s something you can add to your routine, definitely with patience, but even yourself. I think that mobility exercise is a really fantastic exercise. So thanks again for American Acupuncture Council for having me. Dr. Martha Lucas will be here next week, so check check out next week and I will see you guys again another time.

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Acupuncture and Therapies Sam Collins

 

 

And we’re gonna talk a little bit about reimbursements today in the sense of, let’s talk about the acupuncture scope of practice and more specifically therapies.

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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. We’re back for another episode. Thank you for being with me. This is Sam Collins, your coding and billing expert for the American Acupuncture Council, specifically the network, your compliance, billing, coding, and most importantly, reimbursement expert. And we’re gonna talk a little bit about reimbursements today in the sense of, let’s talk about the acupuncture scope of practice and more specifically therapies.

Many of you are doing therapies, and I’m not saying you have to do therapies, but many of you do, and for the most part they are reimbursable. We wanna make sure when they are reimbursed that we don’t have any issues with that it wasn’t documented properly. Or some of these things some of you run into when you get denials because they look at your notes and go, wait, it wasn’t there.

I wanna make sure you know the quick and easy of how to do it, not complicated and whether or not who may provide them. As you’re familiar with physical therapists, chiropractors can use assistance. But can an acupuncturist. So let’s go to the slides. Let’s talk about what is the scope of practice for acupuncture.

So let’s look at the acupuncture scope of practice and look at what’s going on for us, what’s allowed, who may perform it, and all those things. I mentioned now generically, the scope of practice. Is one that it generally states this type of issue here, and I’ve just given an example. It means the stimulation of certain points or points on the surface of the body by the insertion of needles.

So in other words, inserting needles. That’s acupuncture. But beyond the acupuncture, of course, what else can you do for therapy? So you’ll see here it talks about, Generically perform the use of Asian massage, acupressure, breathing techniques, exercise, heat, cold magnets, nutrition, diet, nerves. In other words, much more than just.

Inserting needles. Now, this specifically is the California rule. Let’s look at another one here. Let’s take a look at Massachusetts, cuz sometimes these rules are somewhat vague or very specific. I’m gonna say, please know your state regulations because some states have more generous allowance, some have less.

So here’s Massachusetts. It talks about adjunctive therapy, so that means things beyond the acupuncture. But notice what it says shall include. But not be limited to. And whenever you say it shall include, it means these things. But of course, more. And I would say pretty much everything you learn or are taught in a standard acupuncture curriculum.

So this is gonna include lots of things in therapies, but also things like what they stayed here for Massachusetts, nutritional counseling, herbology. Recommendation of breathing techniques and exercises and lifestyle, behavioral supportive and educational, and even stress counseling. I wanna focus in on are those things billable?

That gives a pretty broad notion of could they do massage? Sure. That would be something that would be a. Not limited to. Then we’ve got someplace like Florida, which really lays out a ton of things, and I bolded it here. Notice Florida says manual stimulation, accument even goes so far to talk about massage, acupressure, shsu, even tuna.

Electric stem laser, and then even goes into the details of what type of Oriental massage you may have notice here it talks about acupressure, amma ammo, gua rah, reiki, and so forth. Again, given the details, so again, you can see this is a very broad scope. They can do many things. However, let’s take a look at New York.

Some states are more restrictive. It says, the profession of acupuncture is treating by means of mechanical, thermal, or electrical stimulation affected by the insertions of needles or by the application of heat pressure or stimulation at a point or combination of points on the surface of the body. Now you notice here the much more restriction, it doesn’t give adjunctive therapies.

It specifically says heat pressure and electric stem. It doesn’t talk about exercise. Massage or manual therapy. So you wanna be a little bit more careful now as restricted as you will as New York can be. New Jersey across the border, it’s gonna have the most generous, I’m just pointing out, please know what you can provide within your scope.

I’m gonna take the generic standpoint of, for the most part, acupuncturists can perform standard physical medicine services, physical therapy, and so that’s gonna be this listing here. If you’ve ever attended a seminar with me, you’ve seen this type of list where I give you the common C P T codes. You’ll notice that we include acupuncture, of course.

That’s something you can do by nature. Can an acupuncturist all do also do needling? Oh, of course, if you’d like to. Never the same time, but you could. I would recommend acupuncture, of course, but it includes also doing modalities such as heat or electric stem, but also constant attendance ones. What about electric stem?

That’s manual. How about even laser? Notice there’s two different codes for laser. And then of course we have the other things like exercise, massage, manual therapy, even therapeutic activities. And a lot of these, sometimes people are going what do these all mean? What are they? And so I like to think of it, not so much as trying to reinvent and trying to teach you something new, but let’s talk about the things that are commonly done in an acupuncture practice.

What are common therapies? Of course, heat, I would say majority of acupunctures I’ve ever met use some form of heat, whether it’s infrared. TVP lamp. I’ve seen hot stones, hot packs, but heat almost always in scene within scope everywhere, but would also include things like electric stem. Now, I’m not talking electric stem of the acupuncture.

I’m talking electric stem generically, like on the surface, like a TENS unit or the little pads people apply. That’s not uncommon. But it also includes all types of body work, meaning massage or manual therapy or just soft tissue manipulation. I put it generically, this could include twink. Even Gua to an extent, we have to look at word of those fit, but it also includes, and this is something that I think acupuncturists often forget, the active therapies like exercise.

These three codes are in fact covered under the VA program, which are gonna be just standard exercise, therapeutic activities, more functional, and then even balance or coordination training with neuromuscular education. I’m gonna say these are probably the four or five things that are pretty common now with, on that, I would say also cupping in moxa.

Outside of the va, though, we don’t find commonly cupping and moxa will be paid, though I’m not saying not to do it, not to bill a patient. And or the insurance. What I can only guarantee is it’s payment under the va. But nonetheless, these are the common ones. Now, you might say Sam, I’m doing a few more.

That’s okay. If it’s within scope, I’m all in, but I wanna talk about the common things to make sure, are we documenting it properly? So let’s talk modalities, things that you can apply to a patient. But you don’t have to be there. Like you can turn on an infrared heat lamp or a TDP lamp. Let the patient relax, let that heat do its work, but you don’t have to stand there while they’re doing it.

So we say those are unattended, which means there’s no time. So you either do it or you don’t, and you bill accordingly. But we still have to make sure how we’re documenting. And the same would apply. What if you’re doing a modality that is timed? So what does documentation need? Infrared heat. It’s as simple as saying you applied infrared heat to the lumbar spine or whatever, the body region.

Now you’ll notice here I put 15 minutes. Is 15 minutes required? No, because it’s a modality that’s unattended. I’m putting 15 minutes so that I know in my notes how much did I do last time. What I’m pointing out though is that the time that you do it is not going to change how much you can bill. It’s one unit only.

Nonetheless, the key factor here is indicating where I had a provider. And this is with United and a few others that got denied for infrared heat because when they reviewed their notes, it didn’t indicate where. Now the provider said Sam, I was diagnosing the patient’s low back, so obviously the heat had to go to the low back.

I don’t think that’s an illogical explanation, but it doesn’t fly. Always make sure to simply tell me what type of heat where’d you do it. In addition, what if you are doing electric stem? Tell me what type are you doing? Two pads, four pads. What’s the intensity? In fact, the easiest way to think of this should be documented in a way that any person reading it would know how to apply it.

If I told someone, put a hot lamp on their low back for 15 minutes, would you be able to repeat that? I don’t think too much trouble or if I said electric stim in this manner. So think of documenting as just a way of highlighting what you’ve done, not by checking a box. Checking a box that says I did heat would not be sufficient because where did I do it?

What type of heat and so forth. And that even gets more confusing when you look at some of the hands on stuff like massage versus manual therapy. What is the difference? They’re very similar. Generally manual therapy is more focal, I’m going to say probably I. Deep tissue, if you will, that’s focused on a trigger point is probably gonna fit more manual therapy, whereas the more generic stroking and relaxation would be massage.

The key factor is document what you’re doing with either one to differentiate between the two. So tell me what type of massage you’re doing, or trigger point or myofascial release. Lots of ways of describing it. Tell me how much time you spent, because this is a time code now you can put start and stop times.

You can say I started at 11, ended at 1135. Or you can say I did 35 minutes. Either way is acceptable, but it is absolutely required that you put how much time, like acupuncture, you have to have the time element. So simply document what you’re doing in a way that when someone looks at it, they can see what was done.

And then of course, always have a little bit of, why’d I do it? What was my purpose? What was the outcome or the goals? Give a little bit of how the patient felt after the visit. Did it accomplish what you’re looking for? Even exercise acupuncturist, if you think of probably, The most ancient form, if you will, probably stems back to acupuncture.

When you think of Chiang Tai Chi and those types, the enhancement of the physical culture of the body. Now, that doesn’t mean you’re turning your office into Gold’s Gym, but what if you are doing some exercises or you’re putting the patient through a series of stretches or other types of exercise, yoga.

Otherwise, absolutely. Just tell me what you’re doing. How many sets, how many reps, or whatever the amount of time that you’re spending. The key factor is when you’re documenting anything that’s time. Do remember the eight minute rule. This is the same. That’s true for of course, acupuncture. Remember, one unit can be as little as eight minutes.

That’s perfectly fine for one unit, but to get to two units, it has to equal 23. So let’s say by example, you did 10 minutes face to face for acupuncture and 10 minutes of exercise. Would that be acceptable to bill two units, meaning one of each? The answer is actually no, because if you think of it, if I did 10 minutes and 10 minutes, what’s the total number of minutes?

Only 20. Therefore, that’s not enough for two units. Notice two units takes 23, so it’s 15, if you will, plus eight to the next, so you gotta make sure it adds up. Now, by contrast, if you did 11 minutes of acupuncture face-to-face, and then 12 minutes of exercise. That actually would count. It’s that specific.

Tell me the time. Generally, when you write the time down and you really put from, and two, you’re gonna find, you probably have spent more time than you realized. If you just simply wrote, you spent 15 minutes, you may or may not have spent 15 minutes, often spent more. Keep in mind, look here on what is acceptable for documenting time, though don’t make this hard.

There’s two ways to do it. Tell me how many minutes I’m right here. Or just tell me from, and two, from nine 30 to 9 45. I’m okay with either, but get it in there. What’s unacceptable notice are the generic things like just putting down that I did a unit or telling me that I did an average time. I saw someone said I spent 25 to 35 minutes.

Huh? Either you spent 25 or some number up to 35, but not between that. So just be specific and then please don’t fall to where you just say, I did two sets or two units. It’s gotta be time. That’s not very hard at all. In fact, I think if we were taught that initially in school, probably be a lot easier for many of you.

But just think along those ways. Tell me how much time you spent. I am invariably fine when I help to audit and deal with these types of issues when I talk to the doctor. It turns out they often spend a lot more time than they’ve documented simply because they try to average. It’s what I call, if you tell someone, oh yeah, it takes five minutes to get there.

Does it ever actually take five minutes? Maybe not. That’s the idea. Once you get on the freeway, tell me how much real time it takes, and then let’s follow with, can I use an assistant to perform these? Now as an acupuncture, can you do these clearly part of scope, part of the services.

In fact, the VA encourages it, but may you use an assistant. The answer is no. There’s no laws that create acupuncture assistance in the way that can do therapies under your supervision, meaning that you bill for it. If you are billing for it, you have to provide it. Now by chance, if you had another acupuncturist working for you that did it, then I would say yes, but not someone that’s not licensed under you, if you will.

So keep in mind, we’re not there yet. I’m hearing rumors of some states and I’m hearing maybe Arizona’s gonna be the first one, but as of now, you would need to do all the services that you bill for. You cannot have. A staff person. Now, I know there’s some states that allow people to pull needles, things of that nature.

But again, keep in mind as far as the therapy, no assistance. Now, I’m hoping we get a change there. Obviously chiropractors use them, physical therapists use them. I would think acupuncture should also, but until we have the law, I’m going to say no. Let’s not make this hard. The main thing you do is acupuncture, but there may be therapies that are adjunctive.

Make sure they’re in your scope of practice. Make sure they’re documented. And your dog on you’re gonna bill for it. That is money you deserve and should be paid if you’re not billing for it. If someone’s willing to pay you an extra 50, but you don’t bill for it, they’re not gonna pay it. That’s what I do for you, is to make sure that we can help you get paid.

That’s why we do these programs. It’s what we’re doing for you. If you want some real day-to-day help some that can really make sure you understand what fees should I have, how do I document it properly? Can you help me office, Sam, make sure it’s okay. My job is to always make sure that you honestly just have a better business.

Meaning one that is compliant, but one that also makes sure that you’re getting maximum reimbursement. Give us a look at our website. Otherwise, I’m gonna say it all you. Thanks for being with me. I’ll see you next time. And until then, continue to take good care of your patients.

See you next time.

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