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Acupuncture Malpractice Insurance – Is it the Fascia?

I am obsessed with fascia these days. Fascia is the glue that’s holding us all together.

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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 everyone, my name is Dr. Shellie Goldstein. I’m here in Florida. Today’s lecture is called Fascia. So thank you so much to the American Acupuncture Council for allowing me to be here today and presenting this topic to you. So let’s go to the slides.

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One of the things that has become very obvious to me these days is the synergy of Eastern and western medicine. And I do firmly believe that integrating eastern and western medicine in today’s healthcare system is both multifaceted effort. It’s on both of our parts, Eastern and western practitioners.

It requires collaboration, education, research, and certainly cultural sensitivity. And when we are able to perform these responsibilities the potential is enormous for both patients, but also . For us as well for the patients. It provides a broader range of treatment options and more personalized care.

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And then when we as eastern medicine practitioners begin to understand Western medical concepts we find that not only do the patients benefit, but we do as well because recognizing and understanding these parallels of each of those systems can . Absolutely lead to an enhanced professional collaboration and improved patient care, which is so important today because as Eastern medicine practitioners, this is our time.

This is our time to join Western medical practitioners in an integrative care modality to Bri be to improve the quality of healthcare and to bring forward. A much broader range of treatment options for both the patients and the practitioners as well. That is what brings me to this topic of fascia.

I am obsessed with fascia these days. Fascia is the glue that’s holding us all together. It’s the, from a modern anatomical and physiological. peRspective we see it both as fascia from a Western medical perspective, and in our world as Eastern medicine practitioners, we see it as the concept of Jji or the Sinu channels.

And when we talk about Jji, what we’re talking about is the network of pathways related to both . Muscles, tendons, and all of the other connective tissue that keeps us connected in the body. One is fascia. From a Western medical perspective, it’s a form of connective tissue. It contains collagen fibers, Alaskan fibers, and what we call ground substance.

And so ground substance is what keeps it all together, keeps it nice and moist. So you think about . Fascia is this tactile network of tissue that both surrounds every muscle organ, vessel bone and nerve fiber. But it also connects the horizontal planes from bone to the surface of the skin. So it surrounds and protects, but it also connects and it’s three dimensional.

As you can see of this image, it moves back and forth. It provides the structural integrity, the stability, and the flexibility of our body to move and be fluid in its movement. And it also allows us to move in a multi-directional and multi-dimensional plane so that we, our fluids are, our movements are nice and fluid.

One muscle doesn’t move and then mu another independently find the movement of another muscle so that there’s this schism of muscle contraction. But it’s that fluid movement that allows us to move through the different multi-dimensional planes upward, downward, inside outward, and then running through these planes.

Of fascia are nerves, and in that sense, not only do we have movement, but we have sensation. There are so many nerve endings or nerves that run through the fascial planes that it is almost as sensitive as touch on the surface of our skin. That’s how sensitive and acute our fascial system is. It is both affected by internal muscle activity and external, say, gravity and movement.

And so as these systems come into play, both our muscle contractions and the weight of external bearing systems, uh, it allows that transmission and that dispersion. Of that through the neck fascial network and then also through its visel properties. It helps to move us in one direction or another. So for example, if someone holds onto your arm and pulls, it’s not just your arm muscle that’s gonna pull, but your whole body is going move along with that.

With that pull or with that movement to compensate both movement in one direction and stabilize that movement in ano in another direction. And when we have our body moving in ni in a nice fluid system such as the fascial system, it actually helps to minimize the amount of energy that’s utilized throughout each singular or connected movement.

Fascia protects the integrity of the body and helps prevent or minimize local stress within a specific muscle joint or a bone. For example, if you have tightness in say, one area, it the ability for the fascial network to move and to break through that tightness allows the body to minimize that local stress.

Also to absorb that localized stress and move it through the body to release that, that tension or that stress. Think of it as the Terminator, right? Think of the Terminator Revisited. I. Think of what if the Terminator was just an individual subset of parts and there was this gap filler, this structure that was stayed in, in, in the, in those empty spaces and it just

Filled the space. That’s not what fascia is. Fascia is actually what we’ve been talking about. That ability for this entire elastic contractual signaling, whole body signaling network to move the body in a very fluid dynamic and structure so we can run faster, jump higher, and be more efficient in our movements.

There are multiple types of fascia. There’s superficial fascia. That’s what’s on the surface of our body, and it’s a very loose layer. It’s very wet, and it is made up of fat. Adipose tissue collagen and elastin fibers, and that ground substance or hyaluronic acid keeps that superficial fascia nice and loose and sticky so that its job is to actually attach the superficial and horizontal planes so that you get this smooth.

Flow between the different horizontal layers so that there’s no friction or tension. Its job is more to stabilize and connect these structures, whereas deeper fascia, I. Has much more fibrous and its job is to cover the different structures, bones, muscles, nerves, and vessels, and protect ’em. So it’s job is to actually absorb contraction.

There. If the body, say for example, if you start to fall, the fascia that surrounds the different muscles and tissues will contract right before you, you fall. In order to support the muscles and contain those muscles. So the difference being that the deeper fascia is protective, it’s contracting and it holds everything together, whereas the superficial is more of a connection, so it connects the different layers together.

aLso deep fascia has receptors that signal the sensation of pain, right? You land hard when you fall, and the body absorbs that shock. Feels that sensation sends it to the brain to signal the brain that something is occurring in that particular area, and then the brain can respond accordingly. And then deep deep into the pockets or the cavities of our body.

We have the visceral and the parietal fascia, and again, these are more loose, connective air, irregular tissue. That’s sub, that has that fat and that liquid hyaluronic acid in it and its job is to surround and protect the internal organs. The visceral fascia surrounds the organs and the AAL cavity, the lungs and the heart, whereas the parietal fascia lines the wall area of the pelvis.

Now what’s interesting and what’s most relevant for the conversation that we’re having today is the relationship between what we’re calling myofascial slings. So the myofascial slings are different planes that work together to create mobility and stability. So they are dense bands, as you can see, the superficial front sling, the superficial back sling, the lateral swing, the.

Spiral and the deep front swing. They’re bands that run from the back to the front of the body, shoulder to the contralateral hip, and their job is to play an int integral role in coordinating con control, coordination and control movement sequencing, and the integration or the kinetic movement that involves the transfer of force.

From the upper to the lower aspects of the body and extremities. So think of them as the slings that support and allow movement of the body. What’s interesting for us is these slings are ve are directly related to what we call our gene gen or sinu channels. These are not the Jing low. These are the sinu or muscle channels that are described separately from the jingo.

So the Jing gin channels incorporate the Sinu channels, the channel sinus, the muscle meridians, and the muscle conduits, or tender muscular meridians. They’re found in Theen. In Theen Chapter 43. It says that whey or defensive chi is formed from food or drink. It cannot travel within the vessels, but flows between the skin and the muscles.

It circulates through the chest and remains outside of the channels and vessels. Now Ma, Chicha then takes this information and combines it with the information that’s found in chapter 13 of the Ling Shoe. He says that the connective tissue of the limbs is either muscle or sinew in Chinese medicine.

Fascia in limbs, sinus, or muscles are both called gin. Therefore, muscle gin is the muscle channels inclusive of fascia, cartilage, tendon, and ligaments. And then he says that they’re discussed in chapter 13 of the Ling Shoe called Jin Gin Channel like muscles or muscles of the channels. And then in the link shoe in chapter 13.

The reference that he’s referring to is the statement that the pathology of sinus cause pain, tightness, and fla, acidity, and even impairs movement. So again, there’s this correlation of this band that we call Jji that is specific to movement and the coordination of muscle and tendon movement within the body.

And also founded by the research of Helen l Langevin at the University of Vermont. She suggests an overlap between fascia and the traditional Chinese medicine concept of channels or collaterals. Now she combines Jing Jin and Jing Lo. But ’cause what she’s saying is that she and her colleagues notice that the insertion and the attachments of the muscles and fascia create cleavages or lines that pull like the grain of in wood.

And then she says that the, there are many acupuncture points that lie directly over that area in these fascial cleavages, where the sheets of fascia diverge to separate, surround and support the muscle bundle, similar to the deeper fascia that we’ve been referring to. And then according to Langerman, the yang chi is said to flow in those spaces between the organs, the bones, and the flesh.

Now what’s fascinating is we, as our, and when we think of our Jji channels, we have CH 12 channels, six paired channels, the Ang Sinu, the Young M Sinu, the Young Chao tie in Cha Andan Sin Channels. If you look at the trajectory of those channels, they’re very similar to the fascial slings. So you can see them in, in this image is the similarities be between them.

But then if you look at this image, you can actually see the direct correlation between the specifics of the slings and the superficial lines of the sinu channels. So you see the superficial back and the urinary bladder channels are very similar. The frontline and the stomach channel are, have overlapping similarities.

And then the deep back arm line, the small is correlates with the small intestines in new channel and the hearts in new channel. The superficial back arm line corresponds with the. Triple burner sinu and the large intestine senu channel. And then if you look in the similarities between the lateral line and the gallbladder senu channel, they’re almost identical.

And then again, through the deep front line. We see overlapping correspondences between the liver sinu channel, the kidney sinu channel, the spleen sinu, and the spleen sinu channel. And then again, lastly, the deep front arm line corresponds to the lung sinu channel and the heart sinu channel. And the superficial front arm line is very similar to the pericardium Sinu channels.

So you can see that the planes of these channels very much o overlap with one another. So when we compare the similarities between Jing, Jin, and Fascia, we see that from a conceptual and anatomical and functional perspective, there are certain parallels between the Jji and Chinese medicine and Western medicine.

And that the myofascial system can be observed in their roles as connective tissue networks that support connect and influence body movement. And even though they’re described differently in our medical frameworks, they both recognize the importance of these pathways in maintaining health, um, both in terms of structural support.

In Chinese medicine, we see them in terms of our . Our support, movement and stability of the skeletal system we see in Chinese medicine, the concept of pain and dysfunction are attributed to our blockages or imbalances in the flow of Q and blood. And we know that from our Jing Jinen meridians, they’re thought to be responsible for the smooth circulation of vital energies.

And when there’s an obstruction in the sinew channels, it can lead to musculoskeletal problems, pain, and a decreased s ability to provide support to the body. And then we see the very similarities in Western medicine and western an anatomy. Same recognition of connective tissue that envelops impacts the muscles, the organs, the blood vessels, the nerves and other structures, and that same three dimensional network or support system throughout the body.

And similarly, I. When there are obstructions or disturbances in the myofascial slings in the fascial system, it leads to musculoskeletal problems, pain, and a decreased ability to provide structural support. We also see that similarity in the ability of the Jing gin and fass that. To movement and mechanical transmission.

So the gene gin acts as a conduit for smooth flow of chi and blood throughout the body and supporting that movement. Where is in western medicine, it’s the fascia that facilitates that smooth mood and colliding action. Between the adjacent structures we see there’s this interconnection. So we see in Chinese medicine, we understand that connection between everything, that continuous flow of chi and blood through the meridians and the vessels that are believed to nourish and support the organs and the tissues.

And we also understand that blockages or imbalances in this flow lead to health problems. And then we also correlate that interconnection integration by understanding the com, the emotional component of both pain, but also trauma into those jji affecting the specific organ system separately. Although the JJI does not necessarily refer to the organ systems, we know.

That there is an interconnection and integration in all the body parts with the deeper senses of emotion in our being. And then in Western medicine they think of this interconnection and integration more in terms of movement. But again, we all recognize the emotional component of it. . And then there’s the understanding of the parallel between gin and fascia in terms of pain and the perception of pain.

So we know from our functional MRI studies in that acupuncture’s ability to influence the brain’s activity in regions associated with pain perception, motor control and mood regulation. And we know . That acupuncture has been shown to activate the release of pain relieving endorphins. By modulating these pain perceptions we can, with acupuncture, we can reduce pain, improve mobility, and ease emotional related discomfort.

The same with in Western medicine, they may not use acupuncture, but there is that innate understanding that fascia contains sensory receptors, propria receptors, and neuro. No e receptors at which contribute to the somatic sensation appropriate adoption. In our Chinese medicine, we see pain in terms of B syndrome and we, and from our understanding of the gene gym, they’re not, although they’re not related to individual organs we do know that they.

Pain itself is what flows through the concept of pain or what we call B or painful obstruction syndrome. Pain, soreness, numbness of the muscles and tend tendons and joints. Rose runs through our Jing gym and we know that acupuncture improves and accelerates that flow of QE and blood within the Jing Gen to alleviate B syndrome, ands, restore proper function.

Now, although the a Jing Jin does not have acupuncture points, those acupuncture points lie along the Jing low. But we know that the Jing Jin and the Jing Low run in parallel. So we use the Jing low points. In order to affect the Jing, Jin Meridians and classical treatment strategies will include primarily we think of the Jing well points.

We also know that there are those four meeting points that are organized, the channels, and regardless of there being an arm, a leg or re or upper or lower uh, we know that CV three. Is for the three Li in channels small intestine. 18 for the three young channels. . Stomach eight or GB 13, depending upon the source for the three young channels of the arm and gallbladder 22 for the three yin channels of the arm.

And we also have realized that those anatomical locations of these specific points are similar to the histological nodes and convergent points of different myofascial planes. So there’s a another correlation there. In terms of treatment, we generally use the ASHI points, or those are the points when you palpate someone and they go, ah, , those are our Ashi points.

trIgger points. Those are those discreet local, hyper irritable spots along a band. So although the pain may be felt in a different area, it’s the, that one trigger point is the referral pain that accompanies this musculoskeletal discomfort. Or we use motor points. And motor points are the site where the motor nerve first pierces the muscle belly.

It’s also known as the MEP of the motor nerve point. And so those are those are the points that are very, a little bit larger in diameter. They carry a greater quantity of motor and sensory sensations and so those are great points for treatment as well. Other forms of treatment include cupping, are guhan.

So let me give you an example of what I’m talking about. Here’s a case study, and this is a hypothetical case study of a 47-year-old male patient presenting with a three-year history of plantar fascitis. He complains of excruciating sharp burning pain on the soles of his feet that would come and go.

The right foot was worse than the left and the right hamstringing. Lower back sous and medial head of the gastric Venus were very tight, and then that pain and upon palpation extended to the medial head of the area of the kidney. Now the patient said that he was not aware of any other physical or digestive disturbances, but upon palpation what we find is that, or are looking at his tongue and pulse, that his pulse was wiring and deep in the both proximal positions and tongue pale with red tips.

So what does that tell us? It tells us that although we are treating. The pain it through the jji. And in our situation, given this case study, this is the T Young Sinu channel or what we call the superficial backline from a Western medical perspective. But we also can tell that from his tongue and from his pulse that he has a little bit of underlying kidney deficiency.

So we’re gonna treat the stagnation in the bladder meridian of the TA Yang Sinu channel. That’s our primary treatment. We may support the kidney treat deficiency because as Chinese medicine practitioners, we’re always looking for that under root cause, but the primary treatment. Is the stagnation and the taang sinu channel.

The treatment is to resolve that stagnation in the bladder meridian of the taang channel and then all, and then to the secondarily, we’re gonna nourish kidney chii and chi and blood of the kidneys. So these are points that we might use that would support both the Tay Young Sinu channel treatment and then supporting the underlying kidney deficiency.

And from a Western perspective, what they were gonna do is a very similar thing. So Mo you see a lot of these points. Bladder 40, 60, 56, 57. 67, 37 all are along the bladder meridian, and then we are supporting . The underlying systems with kidney six, liver three, and spleen six. But as a western medical practitioner treating the back line, what I would do is use trigger points or different types of treatments to pressure with pressure to release the that medial gastric muscle so the patient gets treated, he comes back.

A week later are reporting that a significant reduction and there’s a significant reduction in his pain along the under sole area. But he still has some tight calves and a little bit of tightness in the right hip, which would make sense by looking at both the back sling and the CNU channel. So the next two treatments.

We’re going to incorporate the following points, gallbladder 29 34, and these are designed to release the tights around the hips. Again, we’re treating that sling or that’s sin new channel. And then after three treatments, his musculoskeletal problems significantly improved and he was able to mean. Remain pain-free by regular home care treatment.

And then if he were to go for physical therapy or western treatment, they would do a similar thing. They would treat, continue to treat that medial gastric ne emus area with including the antola lateral zone of the leg and the pelvis. So you see the similarity there. With us treating the channels and then in western medical treatments, the slings.

So there’s a lot of overlap here. And again, going back to the similarities of who we are, both from Eastern West and the importance of understanding. Both the Eastern and Western I do believe that we’re in the right time right now to be able to bring the eastern western medicine together and to make a huge difference and improve the health of our patients by offering a lot more opportunity and options.

So thank you so much for today’s presentation. Thank you to the American Acupuncture Council for allowing me to be here. It’s always a pleasure. And have a wonderful day and take care of those slings. All righty, take care. Bye. .

of Eastern and western medicine. And I do firmly believe that integrating eastern and western medicine in today’s healthcare system is both multifaceted effort. It’s on both of our parts, Eastern and western practitioners.

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Acupuncture Malpractice Insurance – Hyaluronic Acid: The Key to Hydrated Youthful Skin

Hyaluronic acid is a natural. Substance found in the body. It’s present in large concentrations in the skin where it helps keep complexion hydrated. And plumped, we hear about hyaluronic acid a lot in our social media and regular world today.

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Hi, my name is Dr. Shellie Goldstein. I am here today from Florida. We are going to talk about hyaluronic acid and I wanna thank the American Acupuncture Council for allowing me to give this very exciting presentation today. So let’s go to the slides. Hyaluronic acid, the KE to hydrated youthful skin.

And for those of us in Florida, this is very important, but it’s also important for everybody as you’re about to see, what is hyaluronic acid? Hyaluronic acid is a natural. Substance found in the body. It’s present in large concentrations in the skin where it helps keep complexion hydrated. And plumped, we hear about hyaluronic acid a lot in our social media and regular world today.

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What you may or may not know about hyaluronic acid is it’s a humectant. And what is a humectant hum? A humectant is a protein or a substance that actually draws moisture from the environment, whether it’s from the air or from the water or wherever you are. So it takes it in from the environment and through the skin into the deeper layers of the tissue, what we call the dermal layer and below.

And a , like I said, is a substance that has the ability to attract and retain moisture. Similar to a sponge. Just you put a sponge in water, it just soaks it up and it holds onto it, and that’s what hyaluronic acid does. As we age our body, like other substances in our body, we begin to produce less and less of it.

So what happens? We start to dry out. Our skin looks dry, our tissues get dry. We get fine lines and we can get skin wrinkles. When we think of the body, let’s start with the anatomy of the face. You have the bone, which is your solid core structure of your face, layered and horizontally. On top of that is our layer of muscles.

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Then we have fat and we have skin, and what keeps everything together, it both separates, but it also joins all of the horizontal tissues of the face and the rest of the body is connective tissue or fascia. It’s like a web, as you can see in, in the image. It’s just this woven web that holds everything together in place, but it also holds the individual tissues in place as well.

The primary components of fascia are collagen. So collagen is the integrity and the support system of this tissue. It’s like the mattress. It’s gives you the support, gives you the volume of that you need and see in your skin tissue. Whereas the next in protein is elastin. Elastin isn’t so much volume, but.

It allows that snapback. So if you take your skin and you lift it, and you drop it, elastin is what you need in order like that rubber to snap back into place once you lift and let it go. And then there are fibroblast cells, or small protein. That when stimulated is what produces collagen or what stimulates the production of collagen in the fascia.

It also affects many immune and inflammatory responses, and it’s very important for wound healing as we’re gonna learn in a few minutes. And then there’s hyaluronic acid. It’s the moisture this . Substance that bathes all of the other proteins, the collagen, the elastin, the fibroblasts, and other cells that are in this area, what we call the extracellular matrix.

Hyaluronic acid is in the image, is this a little red line and it has a surrounding it, what we call protio glycans and protio gly cancer. What attracted those water molecules to the hyaluronic acid? It is so effective that hyaluronic acid molecule can hold up to 10 a thousand times of its molecular weight and water, which makes it responsible for th up to 30% of the skin’s national natural moisture retaining ability it has.

So here’s . Hyaluronic acid strand and then attached to what are bound to the hyaluronic acid are protio, glycans, and protio. Glycans are what the water molecules attach to, and you can see it in this area. In the lower image, you can see the hyaluronic acid and green, the protio glycans are those little

Feathers that stick out from the hyaluronic acid. In red, elastin and collagen that woven matrix of different colors of blue. So all of these are in fascia and in the what we call the extra cellular. Matrix in the face, hyaluronic acid is primarily located in the dermal layer of the skin, which is the second layer of the skin.

And we’ll look at this for a minute, and it’s found throughout. This matrix is found throughout loose connective tissue of the superficial layer of the skin. Below the deep layer of fascia, and it’s generally found in places aside from the skin, in places that are moist, like the oral cavity, the cartilage of the nasal structure and blood vessels, and in the mucosa membranes of the face here, although the structure of fascia layers varies across different areas of the phase.

Here we see it where the stars are. So the very top layer of skin is the epidermis. It’s what we see when we look at someone else, when we look in the mirror. And then just below the epidermis is the derma layer, and this is the true health of the skin. So the surface is the surface layer, the epidermis, and just below it is what we call the dermis.

And this is where we see most of the hyaluronic acid, the extracellular matrix, and all of the nutrients and proteins that keep cells nice and healthy. And then underneath that we have the superficial Retin Macular Cuts fibrous. And those are not horizontal. They’re vertical structures like ligaments that hold those horizontal structures in place.

I. Below that, we have a fat layer, which gives our skin plumpness. And then below that we have the superficial fascial membrane. And this membrane actually attaches the above layers to the below layers, another layer of ligaments. And then we have another layer of fascial membranes, which don’t have as much hyaluronic acid, but because of that, underneath it as an entire layer of hyaluronic acid or extracellular matrix.

And then we have the lining of the muscles epimysium and then the muscles themselves. So this is lining, you can see multiple layers of hyaluronic acid, which keeps this entire tissue layering nice and hydrated, nice and wet, so that things slip around and slide more effectively. So in acids, the benefits of hyaluronic acid are that keeps skin nice and plump.

When skin is nice and plump and hydrated, it minimizes wrinkles and fine lines. There are many different types of wrinkles. I’m talking about wrinkles at this. Moment that are related to skin dehydration, it increases skin elasticity and slide remembering that the elasticity is the elastin or the snap back in our skin tissue, and that all of those, that proteins need to stay wet.

In order to work effectively. And then also remembering that wetness allows those horizontal planes to slide back and forth. When we don’t have enough hyaluronic acid in our skin, we get dry. It gets irritated and then you start to see facial redness, irritation, even to the point where you have skin breakouts and dryness.

Like eczema and psoriasis. And then also remembering that we have fibroblasts in that extracellular matrix. And so without that wetness or moisture we have difficulty having our wounds heal. So hyaluronic acid and providing that moist environment helps the fibroblasts development and assisting assist in wound healing.

And here’s an example of this. So in terms of the integrity of hyaluronic acid, you see the image on top. You have tissues that need hyaluronic acid to lubricate and enhance the movement of those adjacent cells. That slide that we were talking about and then without. Hyaluronic acids are changes in that production from either age or other trauma, that type of thing.

We start to lose the production of hyaluronic acid, which leads to skin dehydration, loss of firmness and elasticity, wrinkling, and then again those horizontal planes. What happens if . You don’t have moisture. They get sticky and tight and so things, the lows, layers just can’t move independently of one another.

And that’s when you start to get fascial binding. And there are many ways to improve hyaluronic acid. One is acupuncture. When we are needling to improve the skin layer, so it’s very superficial layers of the tissue we’re not gonna place the needle perpendicular. Why? Because then you go towards the bone area.

We need to go into that superficial tissue. So we’re gonna angle the needles at a 15 to 20 degrees. Relative to the surface of the skin. So for us as facial acupuncturists, we tend to use intramurals more because you can slide them at an angle as opposed to going deeper in, into the tissue and missing it heading into the muscle layers.

So we will use very superficial needling to stimulate the skin to produce more collagen, in which case the, and the hyaluronic acid elastin all of the proteins that are found in that extracellular matrix in order to improve skin elasticity, plumpness, and texture. And then also we use needling.

Anytime you roll or create a, an, and a little channel by puncturing the skin. It allows product or whatever it is on top of the skin to move into those deeper layers of the skin. So we use it. Same microneedling is a very popular treatment that we use. And facial acupuncture. So it’s a number, like a plum blossom, a lot of superficial needles in one small area, and then you rub product into the surface of the skin.

So by superficial needling, we’re creating tiny little channels in the skin that make it easier for topical products, including hyaluronic acid, serums, or creams. To penetrate into the deeper layers through the epidermis, into the germal layer and below, and this will enhance the absorption and the effectiveness of whatever product we’re using.

And then that combination of superficial needling and hyaluronic acid, whether it’s in the form of a serum or a cream, can enhance the skin, make nice and plumb, make it smoother, more even toned with reduced fine lines, wrinkles, and even scarring it at ate layers. When we think about hyaluronic acid and topical products we think of it either as a serum or a cream or a mask. Another conversation, at another time, which I promise I will deliver here. And so we’ll use these products that contain dosages of hyaluronic acid and they go into the surface of the skin and directly moisturize the, those deeper layers and superficial layers.

Their job is to retain water. So again, the protio glycans on the hyaluronic acid proteins bring water into the tissue or wherever the hyaluronic acid sits to improve the skin plumpness and reduce the appearance of fine line and wrinkles. So it’s immediate hydration. You put the product on the moisture, it attracts the moisture and plumps the surface of the skin.

Depending upon the product and depending upon the depth of penetration, if it’s sitting on the surface of the skin, this product, then it’s gonna bring moisture to the surface of the skin, and if you can press it through the deeper layers. Say with the addition of superficial needling, then it actually goes into the tissue below the germal layer, and then it has longer lasting results.

Hyaluronic acid, because it’s naturally produced in the body, in its pure form, it’s very safe to use. Sometimes people will get a reaction to a product and any product which could result in irritation or redness or itching. In most cases, it’s not the hyaluronic acid that’s actually causing the irritation.

I. But it’s other ingredients in the product. Products are made of multiple ingredients. Sometimes an ingredient doesn’t agree with your skin, particularly if you have very sensitive or sensitized skin, and so you may develop some redness. It’s usually not the hyaluronic acid, although if you discontinue it and try a different product with a different formation, it may or not.

When we think of derivatives of hyaluronic acid, we think of them in terms of molecular weight. So all proteins, all ingredients, particularly in the skincare world, are have a certain weight and that’s measured in dass. So a compound. So in its raw form, say hyaluronic acid in its raw form, because it’s raw, it has a very high molecular weight.

Which means that it has difficulty pressing into the surface of the skin. So it remains on the surface to pre and remembering that the hyaluronic acid is, and the proteoglycans are actually gonna pull the water to the place of the hyaluronic acid. So if it’s a high molecular weight, it’s just gonna sit on top of the skin.

It can’t get through the skin, so it’s gonna remain on the surface. And where does the water go on the surface? So it’s going to create a protective film that prevents water from actually evaporating. So it’s gonna keep the moisture that’s in the skin in, and it’s going to put water on the top. So it’s actually going to give you a tightening effect because it’s a locking moisture in.

So it’s gonna look plump, but it’s gonna feel a little tight. For deeper penetration, particularly in skincare world, we look at different forms, say the hydrolyzed, which actually breaks it down a little bit and allows the hyaluronic acid to split into smaller fragments, and that’s usually less than a thousand to 1800.

Das. And so this allows that product to penetrate a little bit deeper into the surface of the skin. So again, drawing that water a little deeper through those tissues. There’s another form, sodium hyaluronic, and this is the salt of the hyaluronic acid that’s used and it’s good for stability when you think of cells.

And molecules that penetrate through the cell wall. Salt is one that actually go, is small enough to go back and forth and back and forth through the cell walls, which is where you want the moisture. And so another form the form of the alkaline foreign sodium hyaluronate is oftentimes used in cosmetic formulas, allowing it to penetrate a little bit deeper into and through the epidermis into this.

Skin area, the deeper layers. And this is actually a, gives you a visible effect of plumpness from underneath the skin surface as opposed to on top of the surface. There are two new forms of hyaluronic acid that are being used right now, sodium hyaluronic cross polymer, and this is even a lower molecular weight than the salt version, and it’s crosslinked to form.

A molecule that is a little bit higher molecular weight, but passes through that barrier quickly. And it’s it’s very interesting because it’s gives you the stability of a hyaluronic salt acid but also the humectant properties of a more superficial, so it’s covering both the surface and a little bit deeper and then to go most deeply or the deepest into the skin.

Is the the new sodium ated Hyaluronate and acetyl hyaluronate is it’s new. And what’s fascinating about this form is that this ingredient or this formulation of hyaluronic acid actually can penetrate into the skin three times. Much deeper, which allows for three times more water and absorption than ordinary hyaluronic acid.

And it keeps it in, it locks it in so that it stays longer. So it’s great for aging skin, dehydrated skin, or people say who live in the desert or in dry climates or even in the winter when you tend to lose a lot of moisture on the surface over your skin from cold. It also inhibits the release of MMP one, which is a degradation of collagen, immature skin.

Skin and it’s also used to help protect the skin from the UV rays and environmental pollution. So it’s lookout for that one. It’s new. It’s coming up and I think it’s gonna. Be really popular. It’s used to reduce crows free and the nasal labial fold of the skin, the wrinkles that run from the corner of the nose to the corner of the mouth.

And keep an eye out. I think it’s gonna be very popular in upcoming formulations of skincare. What’s interesting is this research study, it’s a randomized control trial of the efficacy of cream-based hyaluronic acid at different molecular weights. And this. They’re using water bound hyaluronic acid at a weight, a molecular weight.

So three different weights, 51, 3300, 802,000. That’s more than three, isn’t it? It’s five. And so they applied it around the eyes. 76 female patients between the ages of 30 and 60 years for 60 days. So they measured at 30 and 60 days. And what they, so one eye, they used this cream and then the other at different molecular weights.

And they used placebo on the other side. And then they were taking objective measurements. So they used a semi-automatic morph photometry meter in order to demonstrate the changes, the objective changes. What they did is the measurements were wrinkled depth. They, and then they also compared the size or the amount of change that occurred at 360 days.

And the 60 day measurement, what they concluded was the application of a 0.1% hyaluronic formulation was made significant changes in both skin hydration and elasticity, but they also found that the lower the molecular weight. The more effective it was. So again, going back to those cross pollinations or breakdowns of combined hyaluronic acid products that are coming up, they’re designed to both break down the acid, the hyaluronic acid, into very small, low molecular weights in order for it to penetrate through the skin more effect effectively and efficiently.

The other, another very important way to get hyaluronic acid into your skin is through your diet. So a diet rich in nutrients that support hyaluronic acid production can help improve the health and appearance of your skin. Key factors related to improving hyaluronic acid or getting hyaluronic acid through your food and diet.

A water. Drink as much water as you can. And that will help keep hyaluronic acid functioning properly. And then nutrients to consume are foods high in vitamin c, e, and magnesium to help produce and support the synthesis of hyaluronic acid. So these vitamins help synthesize it, water helps to keep it functioning.

And then antioxidants, such as fruits and vegetables. They actually protect that hyaluronic acid from breaking down. And then collagen rich foods and supplements can support hyaluronic acid by promoting skin elasticity and hydration. So you will need to have nutrients like vitamins C and magnesium to build or synthesize it.

You need antioxidants to help it from breaking down. And then drink plenty of water in order to support or maintain the functioning properties of hyaluronic acid. And then you want to promote, help, promote and support that hyaluronic acid by promoting skin elasticity and hydration by taking collagen rich foods or supplements.

And then here’s a research study. This is a 12 week double blinded placebo study, and 12 weeks is about right because when we talked about the epidermis and the dermis, skin cells start at the base of the dermis and make their way up to the epidermis so that you, what you visibly see. It takes about 30 days to, to migrate up from the cells, from the base of the dermis all the way up to the surface.

So 12 weeks is three rounds of improved production of hyaluronic acid in that germal layer in order to visibly see a difference in the epidermis. After 12. So in this study, this double-blind placebo controlled study, they were using daily hyaluronic acid, 120 milligrams, and it was from High Best.

It’s a company in Tokyo. Taken daily for 12 weeks in 40 healthy Asian men and women ranging in the age of 35 to 64, and they evaluated objective measurements of wrinkles and the stratum cornea water content. That’s the surface of the skin. The amount of transepidermal water loss, that’s through the tissues.

Elasticity and they looked at imaging analysis so that they were objective measurements rather than just asking the people. How do you feel? So this was actually a measurable controlled study. I. After 12 weeks, they noted that skin condition was significantly improved in terms of wrinkle assessment, stratum, cornium, water contact, transepidermal, water loss, and elasticity.

So they concluded that. It makes a difference. What’s very interesting is remembering that when you were applying hyaluronic acid to the surface of the skin, you wanted a low molecular weight. In this one, what’s interesting is another 12 week period they were looking at the benefits of hyaluronic acid.

Applied orally. They did a similar study, 60 Japanese male and females aging, 22 to 59 years old, presenting with crows free and wrinkles. And then they were assigned hyaluronic acid at a me molecular weight of two 300 and 300. Again, 120 milligrams of hyaluronic acid. Now what was so interesting about this.

Is again measuring the skin wrinkling by imaging analysis and skin condition, and that was from a questionnaire survey. Here’s what they found is during that study period, what they found is that the higher molecular weight at 300 K group showed significant, a higher significant. Change in terms of diminishing wrinkles and compared with the placebo group.

So both worked at two and at 300, but the conclusion is that the 300, the higher molecular weight. Worked better. Why? Now? This is a good question. So think about this. If you are applying it to your skin, then those molecular, then the hyaluronic acid molecules have to get through the skin. However, if you’re eating them or ingesting them orally, it has to get through the digestive tract and get absorbed in the digestive.

To track. So when you break them down, a higher molecular weight has more of it. So you actually get a higher delivery of the product as opposed to topically when you can’t a higher molecular weight, it’s not gonna get through. So it’s just gonna sit on the top. So situation, you want a lower one. So I hyaluronic acid is great and.

It just depends how you do it. Whether you stimulate it with acupuncture, you ingest it, or you apply it topically. And so the benefits are really not just the hyaluronic acid but the delivery system. Low molecular weight for application on the surface of the skin topical application, and a higher molecular weight.

When you ingest it, so read your ingredients, read the package you want around a 300 molecular weight of 300 k if you’re gonna consume it, and you’re gonna want a smaller, safe five to 50 if you are going to apply it topically. So if you want more information about hyaluronic acid, I actually will be giving a presentation about tissue and DA fascia at the upcoming Pacific Symposium.

Here’s more information about it, and that’s it. So thank you very much. I appreciate your time here, and I hope you enjoyed this and learned a lot. Again. Thank you American Acupuncture Council for allowing me to present today. .

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Facial Acupressure for Health and Wellness

…when we think about health and we think about wellness and Chinese medicine, we think about yin and yang, cheap blood fluids, the meridian system and the organ systems.

Click here to download the transcript.

Hi, my name is Shellie Goldstein, Dr. Shellie Goldstein. Welcome to the American Acupuncture Council. Today’s presentation is Facial Acupuncture for health and Wellness. I am specialist in cosmetic facial acupuncture, but today we’re gonna talk about health and wellness because they are com overlap and they interlink.

So let’s get started. Let’s start with the PowerPoint presentation.

Most of us know who are acupuncturists, that when we think about health and we think about wellness and Chinese medicine, we think about yin and yang, cheap blood fluids, the meridian system and the organ systems. As a specialist in cosmetic facial acupuncture, what I love about treating

The body and treating the face is the correlation between the face and the rest of the body. We know that we have meridians running up and down the body. We know that we are affected by the state of health of our organ systems. We also know that all of the young meridians. Either start or end on the face.

What we may or may not remember is when you think about the organ systems, each of those systems has a sense system. Now, whether it be the eyes, the nose, the ears, the mouth, meaning, What we see, what we smell, what we hear, what we taste, and they affect and are affected by the state of health of each of the organ systems and the meridians, because remembering that the meridians run through the different organs, assume their name and pick up the characteristics of that.

System, that organ system. But then again, the meridians affect the organs as well. So we know it’s that yin y balance, that the complimentary dynamics between the meridians and the organ systems and the health of our body. But also remember that when you see things, when you hear things, when you smell things, when you taste things, it creates a sensory stimulation, some type of proprioception where we are in the world, but also.

Not just on a physical level, but on an emotional and energetic level as well. So when we surround ourselves with beautiful things visually, we feel relaxed, we feel at peace. As opposed to when we see something that’s awful or horrifying or frightening, then those emotions get reflected in the body as well.

The same with our, or with our sense of hearing. If we hear soft music, like we heard as we were starting the live stream of this presentation, it’s very soothing music. It’s very lovely and it brings peace and harmony within as opposed to seeing, hearing something loud, abrasive, shocking. Disturbing. It sets up that a different dynamic within the body as well.

Same with smell, same with taste. So the emotional activity that gets triggered when we experience something is very much a part of the reflection of what’s going on inside and reflects in terms of affecting how we are. Feelings, feeling both on a physical and emotional and a spiritual level. So in that sense, the face is a very important part of the diagnostic and treatment of health and wellness.

So we can diagnose what’s going on in the body by looking at the face, because remembering that our muscles are tissue. Interstitial tissue, the connective tissue, all of the different aspects of the layering from skin to bone holds that memory, particularly the connective tissue holds the memory of that experience.

If we process that experience and let it go, then it let’s go in the connective tissue of the di of the face. When we hold onto that experience, that also gets reflected in the face. And so we can look at the face as an big organ, one big facial organ map. And when we look at different parts of the face, each of those organ systems are reflected.

For example the forehead and the eye. Browse is related to the liver and the gallbladder system. The spleen and the pancreas is the eyelids and across the bridge of the nose the kidneys run underneath the eyes and on the chin and the ears. The lungs are the cheeks. The heart is the tip of the nose and the stomach and the intestines is, and the reproductive organs are around.

The mouth and what that means is that disharmony in those organ systems is reflected in the face, whether it be in terms of wrinkles tissue sagging skin disharmonies, acne, rosacea, breakouts, or just red pitted skin rosacea. Any disharmony on the surface of the skin or in the deeper layers of the skin is reflected by the organ systems and a reflection of the organ systems in turn of their health and wellbeing.

And then when there’s a disharmony in the organ systems, it is reflected and pass through. The different meridians. So what’s nice about treating the face is that it’s a wonderful tool and an opportunity to both diagnose what’s going on in the body, but also to treat, because as we treat the face, we have an effect on the state of the lungs, the state of the liver, the state of the spleen, the state of the heart, the state of the kidneys.

And we can harmonize both from a meridian’s perspective, but also from an organ. System, we can make a difference just by treating the face. Now, we know from our cosmetic acupuncture world that we’re not when we treat wrinkles, when we treat sagging skin, when we treat different skin conditions, we’re not just treating the surface of the skin, but we’re treating from within as well.

And that means that when we treat. For cosmetic facial acupuncture or for health and healing. We don’t just put points in the face, of course not. What we’re gonna do is we are going to do our diagnostics, tongue pulse pattern of is harmony, and then we’re gonna treat accordingly and we’re going to use the face as a treatment, as a diagnostic tool and a validation of what we find when we do our tongue pulled and questions.

So what I would like to do today is help you to understand how to treat the face by going through a very simple facial exercise. It’s an acupressure exercise, so it’s something that you can do at home. It’s something that you can . Do on yourself. It’s something that you can do with your patient and acupressure.

We know that acupuncture and acupressure are both ancient healing techniques that have been acknowledged for their effectiveness by both Western medicine and eastern medicine, and supported by thousands of scientific studies around the world. We know that acupressure and acupuncture are based on the same fundamental principles of acupuncture point activation across all of the meridians.

We know that acupressure is basically pressure applied with the hand fingers or an instrument assisted device at specific acupuncture points to adjust and balance the flow of energy. And the National Institute of Health Database offers hundreds of studies on the use of acupressure in the treatment of dozens of conditions, including a allergies, chronic fatigue, constipation, insomnia, musculoskeletal disorders, heart disease, pain, and stroke.

And we know as acupuncturist, there are many more health issues that acupuncture and acupressure treat. I wrote a book in 2016 called Your Best Face. Now look Younger in 20 Days with a Do It Yourself Acupressure facelift. And I also created the Touch and Glow Acupuncture assisted. It’s an acupressure assisted tool.

In my book, I outline a number of different techniques for facial harmony. But also for health and body. And the acupressure technique that we’re gonna learn now is based on some of the systems or some of the parts of the book that, that I wrote and the photographs that I took for the book.

So let’s get started. Let’s just have you sit back, relax, take breath. And relax, blow out. Exhale. Let’s lift your shoulders up. Drop them. Lift your shoulders up, drop them. Rotate your neck.

And stretch it out. And I’m actually gonna lift my glasses up so you can see my face, because I’m going to walk you through an acupressure technique that is going to improve health and wellness of not just your face, but your body as well. It’s very relaxing and I think that you’ll enjoy it. So let’s start by opening the neck.

I’m going to. Place my fingers at the top of the Ss c m. So if you go to the jaw area and slide your fingers up to the top of the neck to where the cervical, where the skull meets the cervical vertebra. And slide forward to the top of the Ss c m, the sternum Plato mastoid muscle. And then we’re just gonna massage down the Ss c m to the clavicle.

I just massage. Now I’m gonna do it five to 10 times. And in doing so, what we’re doing is not only we’re relaxing the neck, but we’re also helping to reduce tissue inflammation by improving lymphatic drainage, which means that if you have allergies or if you have any type of congestion in this area, what you’re gonna do is you’re gonna feel that coming down in the form of kind of a saliva on your throat, you may need to swallow good.

Okay, now take your fingers, go behind your neck, and you’re just, you’re gonna take these four fingers and you are going to place them starting at Bladder 12 T, nsu, and Gallbladder 20 Thank Chi and Andon. If you don’t exactly know where they are, it’s okay. Just place your fingers at the base of your oput on the outer, outside of the spine.

And feel for areas that are tight and just gently massage these points with the pressure that feels comfortable for you. And it doesn’t matter if you go clockwise or counterclockwise. Just massage those points five to 10 times good. Make sure that you breathe good, right? Excellent. And now slide your finger to what we call triple heater 17 or yen.

Yen is where the star is on the image. So you you have the corner of the jaw and the lower aspect of the ear lobe. It’s in between the corner of the jaw, directly under the ear lobe. We’re gonna massage this area. This point is the access point to the facial nerve. So the facial nerve is the nerve, the motor nerve that innervates the entire face and controls all the muscle activity on the face.

So by massaging this point, not only does it improve lymph drainage, but it also helps just to relax all of the muscles of the face. Okay. And now with this point we’re going to take our fingers and keep your finger on this point on Triple eight 17. And then just massage up and down the front of the ear.

So we’re covering Teen Quo, teen Gong and Erman Gall butter two small Intestine 19 and heater.

And then slide your fingers around the back of your ear, back to triple heat 17. Massage triple heater 17 again, and continue to massage up and down the ear in front of the ear

about five times, 10 times, and slide your fingers behind your ears again. Let’s do that one more time. Massaging triple leader 17, and then up and down the front of the ear

and behind the ear. Great, and now let’s slide up to T Young T. Is located in the temples at the end of the eye area. You massage that area. So this is great for any type of stress around the eyes and the face.

And then we’re gonna treat The three points on top of the eyebrow, , and sanju. So again, you can do it with your three fingers. 1, 2, 3, and just place them at the end of the eyebrow, the center of the eyebrow and the middle of the eyebrow at the inner campus of the eyebrow sort a massage.

Good.

And big relaxing breath. And now we’re gonna go to our favorite point. It’s yin tongue and we know that yang is the main point for relaxing the body, mind, and the spirit. We don’t do this for about five to 10 times.

And move into the inner aspect of the inside of the corner of the eye to bladder one. And again, this point is used for any type of eye disorder, which we know affects the liver system, and it’s used to relax and open and brighten the eyes. And then we can stomach one and stomach two, or right on top of each other, above and below the orbital bone.

So use the flat part of your finger to capture both of them

and just massage ching cheese. See by feel relaxing.

And then back to

and let’s repeat that sequence again. Oops, sorry. We’re gonna go back up to the eyebrows, the top of the eyebrows.

End tone.

Water one.

Stomach one and stomach two.

Cool. And this time we’re gonna slide down the nose. To lateral to the side. Yeah. Lateral to the side of the nose, and we’re going to type. Stomach. Three is underneath the eyes, lateral to the side of the nose, small intestine. 18 is at the outer canthus of the eye, lateral to stomach three. And then stomach seven is lateral to that in front of the ear, and we’re just gonna massage his points.

Three fingers, just massage his points.

Good. Don’t forget to breathe.

And then slide down to stomach four. Deep tongue. It’s at the corner of the mouth.

We use this point a lot in facial acupuncture. It is the connection to all of the muscles of the face that connect from the mouth to the eyes and to the collar. Very important point. And then take your thumb. Place your thumb underneath your jaw. And then the top and the fingers, the first four fingers, and then just slide out to stomach six stomach sixes.

I use it the corner of the jaw. The angle of the jaw. We’re gonna slide, slide,

slide. And then come back. Come back to the S C M

and slide down to the clavicle.

Now let’s repeat that again. I won’t talk this much. So again, ing your fingers. See on Zoom,

Andon

circling around feeling for those tight areas

and then slide to offense directly into the.

And then massaging

ting gong air mine, and slide behind your ears. Come back to triple heat. 17.

Slide up and down in front of the ears. At this point, you should start feeling new, smooth, relaxed. It’s a great, this combination around the ear is really good. If you can’t sleep at night, great. Insomnia. It’s really relaxing, super smoothing,

and up to nne, massaging, nne.

It carries so much stress in our eyes

and then coming back.

Nice. Get that little extra massage.

Let’s do that one more time. Slide up.

Under the. I wanna use a little lighter pressure under the eyes

tie.

Now to get there, we’re gonna come down. Slide around the corner. Angle of the nose, fingers. Inner canus of the eye. Center of the eye. Center of the eye, outer campus of the eye. And in front of the ear massage

do come.

And thumb under the chin fingers slide out to stomach six, which I g.

And then back down the.

Feel better. I do. So this, again, this is a great short treatment that you can give yourself, you can, and help your patients by showing this to them. It’s very simple, very effective. And I hope you have a nice day. So thank you very much. If you want to learn more about me, you can visit me@hamptonsacupuncture.com or follow me on Instagram.

Again, my name is Shellie Goldstein. I also teach a number of classes through the Pacific College of Health. And we have a symposium coming up. So thank you very much, and again, thank you to the American Acupuncture Council. For having me here today, and I hope you have a lovely, relaxing, peaceful, healthy day.

Thank you. .

The Lymphatic System and Aging – Shellie Goldstein

Today we’re gonna talk about the lymphatic system and aging. Is your lymphatic system working?

Click here to download the transcript.

Hi everyone. How are you? My name is Dr. Shellie Goldstein and I am delighted to be here. Thank you to the American Acupuncture Council for hosting today’s presentation. I am a cosmetic facial acupuncturist. I’ve been practicing for over 30 years. In addition to lecturing internationally, I work with the Pacific College of Health and Science.

We run the facial applications for cosmetic enhancement of the face program, and at the end you’ll see my links to obtaining more information about me and other programs. I’m the author of Your Best Face Now and created the Touch and Glow facelift kit. So there’s a lot out there. Today we’re gonna talk about the lymphatic system and aging.

Is your lymphatic system working? Let’s go through these questions. How do you feel physically? Are you feeling tired or stiff or swollen? Do you feel, does your body feel inflamed? Um, are your muscles fatigued? Is your body contained fatigued? Do you have allergies? How do you feel mentally? Are you experiencing brain fog?

Do you feel depressed, stressed, anxious for no reason? Reason? Maybe you have headaches, you can’t remember, things can’t concentrate, or just simply not motivated? Uh, how does your skin look and feel? Does it look dry? Are you having acne or blemishes? Rashes, some type of irritations or itchy, tingling skin, maybe thi thick, leathery.

And then how does your body look? Do you look puffy? Do you look different than you would normally think that you look? Or how does your metabolism work? Uh, how is your bowel movements you, are they regular? Do you have stomach aches? Gas, bloating, any type of abdominal bloating, difficulty losing weight even though you’ve made dietary changes and you’re working out, all of these can be symptoms of poor lymphatic drainage.

So it’s not your fault that you feel these ways if your lymphatic system isn’t working. So let’s take a look at the lymphatic system. What does the lymphatic system do? It maintains fluids, so all of the fluids that, this is the lymphatic system, the image on the right, so all of the fluids in the skin and in the tissue that drain from the cells.

And circle in this kind of bathing interstitial tissue. So the. The fluid goes through the circulatory system, comes out into the interstitial tissue if it doesn’t continue in through the venous system, and then it gets reabsorbed back into the lymphatic system, and then the lymphatic system takes that.

Fluid in and circulates it through the body and puts it back into the bloodstream. It also filters through the digestive tract, so fats, proteins, anything that falls out or comes out of the digestive tract, the lymphatic system takes it, puts it back in, circulates it through, cleans it out, puts it back into the bloodstream.

It also helps to protect ab against foreign substances. Lymphocytes, it’s gonna produce them. It’s gonna release them, and we know that lymphocytes, white blood cells are responsible for maintaining proper immunity to help destroy bacteria viruses. Parasites, fungus, and it also is a purifier. So the lymphatic system takes all of the waste, all the impurities from our system filters.

It gets rid of it, breaks it down, gets rid of it. So it’s kinda the clean. Part of our body that cleans things, purifies things, keeps the fluid moving. So imagine if it’s not working, what happens? You get backup, you get swelling, you get breakdown of the entire body. And this is why you feel bad without even understanding your realizing why.

The lymphatic system is part of the circulatory system, and it’s also part of the immune system. So as part of the circulatory system rather than blood, the lymph system carries that clear fluid, we call it lymph throughout the body. It’s in a unilateral direction, which means it takes it from the capillaries, from the interstitial tube.

Tissue moves it through the lymph, the vessels, through the lymph nodes into the thoracic duct, and back into the circulatory cy system. It’s a one-way track here. The extracellular fluid, what is this fluid? So we think of the the arteries and the heart pumps, the arteries, and then that this blood moves, th and fluids runs through the arteries and then back through the venous system where it goes into the lungs and it gets oxygenated and then back to the arterial system.

When this pressure, there’s a gradient ion, the heart is pumping. It creates a pressure when the pressure reaches what we call the capillaries or this little area. In here it starts to shift and it moves into the venous system. There’s not the pressure in the venous system to keep moving things, so there’s a pressure gradient, which means it’s coming faster in through the arterials.

As it going out through the venous system, so some of the fluid gets lost, it goes through that interstitial tissue, and then this, the green, this is the lymphatic system. It’s gonna suck it up and transport it and push it back into the system through the nodes. Here are the vessels. So this is the surface of the skin that’s picking.

The circulatory system runs parallel to the circulatory system, and the lymphatic system right here starts to grab all of the fluid that gets pushed out of the. The vessels, picks it up, cleans it through these ducks, and then sends it back. So these ducks are, no, they’re called lymphatic nodes and they look like bean shaped glands.

They look like this. And they store, they have a number of different properties and this is where. The lymphatic system interfaces with the immune system, the lymphatic system stores lymphocytes and other immune system cells that are designed to attack and destroy and filter bacteria and other harmful fluids.

Substances in the fluid. There are about 600 lymphatic nodes scattered throughout the body. Some of them are single nodes. And if you look at this image, you can see some that are single. Others are closely collected. And this is a chain. So a few of the most familiar locations of the lymph nodes are in the armpits along the clavicular area, right below the clavicle in the groin.

Area and behind the knee. So we’re gonna look at a massage later to help move that lymphatic system. And then as the fluid moves through, the vessels gets cleaned and filtered through the nodes, it comes back right at the clavicle and empties into the right lymphatic duct and the left lymphatic duct.

And these ducts, what they do is they connect to the subclavial vein, which returns the limb to the bloodstream. And then helping to do this not only helps to maintain normal blood vessel. Blood volume and pressure, but it also helps to prevent the excess of buildup of fluids and tissues, which we call edema or puffiness or swelling in the body throughout the body.

What’s interesting for us as acupuncturists is along the face, these lymph nodes gather along the jaw area. The neck and the clavicle area. And if you look at the acupuncture points, it’s around stomach five, stomach six triple warmer, 17 down the S scm triple warmer, 16 small intestine 1716 large intestine 18 large intestine 17 through stomach 12, and here it empties into.

Kidney 27. So right below kidney 27 is the primary area of drainage back into the circulatory system on the body. These lymph nodes gather again at the armpits in the elbow area, the abdominal region, the groin, and the knees. So once again, what we’re doing is we’re looking at the vessels, the flow from the venous to, from the arterial system into the venous system.

We lose a lot of the fluid here and the capillaries, and this is the interstitial tissue. So this is the blood flow, this is the loss of tissue of fluid coming out into the interstitial tissue and then gets absorbed into lymphatic capillaries. The lymphatic capillaries are more like the venous system in that they don’t have a pump, like the heart to pump the fluid.

So it really relies on an external manual manipulation to move that fluid through the vessels. There are similar to the the venous system, there are little valves. So this is the lymph, it’s the lymph gathers through the interstitial. Tissue. The fluid comes in through the limb system. There are some little nodules or valves that help to prevent back flow, but if it’s not flowing properly, what happens is you just get a buildup.

So there’s no place to go. So they, it starts to swell. The flu can’t get in, and that’s how you get swelling. And when that happens, we start to see. Decreased lympho tissue swelling, it results in pain and it feels like physical and mental fatigue, and then all sorts of illnesses related to the inability for our immune system to function properly.

It looks like this. Think of it as a fishbowl. Here’s a bowl with fish in it. And all of these fish are our cells. And when the system is working cleanly, the water is nice and clear and pure. But what happens when the lymphatic system isn’t working problem? Then you properly, then you get this, it looks like that gray, yucky, murky stuff.

So which do you want in your system? Do you want nice, healthy, clean lymphatic system or this yucky, dull, putrid lymphatic system? And it’s amazing how easy it is. To make that transition. And also how easy it is to not have poor lymphatic drainage. And so there are things that you can do on a daily basis to help have this instead of that.

So let’s take a look at some information with regard to aging, because it’s a two double-edged sword. If you have a good lymphatic system and your flow is nice and healthy and effective, then aging slows down. If you don’t, then you actually age more on the other end of that sword. As we age, our lymphatic system does slow down a little bit, and so it’s even more important as we are aging to maintain the integrity of the lymphatic system.

In this research by Shang and Capron and others what are they saying in terms of the lymphatic system aging, the diverse etiologies of age related disease from osteoarthritis to Alzheimer’s disease, all share an impairment or slow loss of tissue functioning. Aging tissue homeostasis shifts toward progressive low grade inflammation and a dampen immune system.

So this is saying that as we age organically, things start to slow down. The lymphatic vascular is the key regulator of tissue homeostasis and health and disease. So in order to maintain health, you need to have a healthy lymphatic system. Lymphatics, transports, antigens, and other macromolecules excess.

Interstitial fluid in activated immune cells during inflammation. We know this. This is what its job is according to she and colleagues. Detrimental molecular changes occur in lymphatics with age and reduced lymphatic function is a key component regulating numerous age related diseases. Interesting. Because when we look from our T C M perspective, our team perspective, traditional Eastern Asian medicine, when we look at some of these illnesses, what we’re calling this is phlegm and blood stasis.

So you think of the lymphatic system, it’s job is to clear infection and keep the fluids in balance. And when it’s not working properly, those fluids build up in tissues and cause swelling or lymphedema. And then what happens is it starts to back up. This is what we’re calling our phlegm. It’s that inability of fluid to move that gathers and gets stuck.

It’s also when things don’t move. Think of the yin and yang chiam blood, the blood moving with cheek. She blocks can’t move. The blood starts to stagnate and then you get blood stasis. And when you look at some of the top aging conditions in Chinese medicine, hearing loss, cataracts, macular degeneration, dry eyes, Alzheimer’s, poor memory, brain fogginess, dizziness, maculas, dry skin, itching, numbness, and hair loss.

These are all from both a Chinese medicine perspective, but also an Western medical. Perspective Western medicine being portly, drainage, Chinese medicine, phlegm and blood stasis. They’re all the same. And so one backs up the other here there are a number of different techniques for making a difference for moving lymphatic drainage.

Remembering that it needs some type of manual manipulation, either acupressure. Massage or manual lymphatic drainage. And when you look at the manual lymphatic drainage research, because that seems to be the most prevalent there’s a great literature search of 30 years starting from 1989 to 2019, so 20 years.

Of study 20 studies that met inclusion criteria of identifying different effects of manual lymphatic drainage. What research has found was that the manual lymphatic drainage has been shown to help with symptoms and conditions beyond edema and lymphedema. Mainly fatigue and pain tolerance. So isn’t that interesting that a lot of our idiopathic pain symptoms could actually be related to the lymphatic system and a number of brain fog and fatigue could also be related to poor drainage.

And according to the authors, this study suggests that mld or manual lymphatic drainage can be used INSYS symptomatic treatment of various diseases like. Multiple sclerosis, Parkinson’s disease, and a number of other various systems. 2022 study explored the integrative therapies for managing fatigue associated with long covid.

So here we go. Here’s another one. Long Covid found that the student that study participants who had face-to-face treatment sessions with parent technique practitioners, along with daily self massage and gentle mobility exercises. An approximate 50% reduction in subscale scores of fatigue. The parent technique is based on the theory that different stress factors, whether they’re physical or allergies or emotional.

Or infections lead to an over strain in the sympathetic nervous system. So their job is to as manual lymphatic drainage with this particular system. They use, they look at the nervous system. And the overload of the nervous system and the buildup of toxins and fluids around the brain and the spinal cord.

So a lot of their techniques work on massage in the brain area and also along the spinal cord, as well as opening up the lymph nodes. So again, here we go again. Look at the symptoms related to long covid fatigue, palpitations, dizziness, sleep disturbances, fever. Pain, joint and muscle pain, chest pain or tightness, stomach pain, nausea, diarrhea, loss of type, brain fog again, headaches, numbness and tingling delirium.

We look at that in terms of dizziness, not dementia. Depression or anxiety, sore throat, loss of taste or smell earaches are tend, so all of this information is leading to the same thing that whether it’s on a physical level, a mental level, or an emotional level or pain related on all of these levels.

Are all affected and affect the lymphatic system. There are, we are gonna go through a small lymphatic drainage technique. So just to general safety, although it’s generally safe, if you have a high risk of blood clots, congestive heart failure, kidney disease, any type of active lymphatic infection or swelling of a night cause.

You may just wanna watch, not participate. And again, I would check this out with your physician to see if these would be precautions or contraindications or actually helpful for some of these conditions. So when we look at supporting the lymphatic system with massage, let’s just do this. We’re gonna start with the points right below kidney 27 and stomach 10.

So if you place your fingers on the chest bone right at these right below the clavicular head, We’re gonna find this area and we’re just gonna massage it with our hands. So medium pressure. Just massage this area. So what are we doing? We’re opening up the flow in the Subclavial area. The big filtering system because if this is clogged, you’re not gonna be able to move things through.

Interestingly enough, when you’re massaging this area and keep massaging ’em, I notice that because I get spring allergies and here we are is, I’m starting to swallow a little, I feel like a little fluid building up in my throat, which is good. That’s a good sign. And then just give this little tap.

Okay. Tap and then we’re gonna move to the jaw line. So I’m actually gonna take my fingers and just massage around the jaw area like this, moving from CV 23 and four, and then five, stomach, five and six. So along the jaw, just give it a little bit of massage with medium pressure so that we can stimulate that fluid so you can go from back to front.

Front to back, let’s go from front to back and then you can just slide down the SM back to that clavicular head area. And then we’re gonna try the neck area. So let’s just put our fingers at the back of our neck from reaching from bladder 10, gallbladder 20, amnion triple heater, 17, and just massage.

Along the neck area. Good. Great. Good massage. See if we can get that fluid to move and then I always slide back, bring it back to that area below, kidney 27. Okay. And then armpits. So we’re gonna lift our arms. You can do it at the same time or under, or one at a time. Just take your thumb and put it in the lung one, lung two area, and then reach under the armpit like this and just give it a little massage.

Good. And do one side

and the other. Lung one, lung, two, heart, one, spleen, twenties, stomach, small intestine. 19, this whole area. Great. Good job everybody. And little tap. Now we’re gonna go to the elbow so you can bend your elbow and a 90 degree angle. And we’re just gonna give it a little bit of a massage. At the large intestine.

11 part three, lung five, pericardium six.

I’m gonna do both sides.

There you go,

Okay, now you’re not gonna be able to see this, but in the inguinal groove, in the groin area, same place. So the large intestine, 11 lung five heart sorry. Spleen 12, stomach 30 to 31. Liver, 10 to 11 area. Just gonna give it a little bit of a massage.

Great. And then behind the knee bladder 54.

Good job. All right, so you can do this several times a day. I know that I come from Florida and drive to New York and imagine you think of these point, these areas where the joints are. So yeah, I’m sitting in a car with my knees bent in a 90 degree angle. So bladder 54 is locked. My in green groove area is locked, and I have my hands on the steering wheel and I’m clenching my.

Neck area because I’m constantly paying attention to driving and you’re just sitting there. But after three days of driving, I’m exhausted. And then I remember, oh gosh, my lymphatic system didn’t really flow because you don’t really. Drink too much in case you have to pee. You don’t wanna have to keep stopping.

This is just a really quick for me, A reminder was, oh, lymphatic drainage. Or if you’re sitting at the desk and you are worse studying or doing a lot of computer work, guess what? You’re in the same position. You’re in, Guino area is locked, your knees are bent, your arms are up. You probably, are hyper focused.

So your jaw area might be a little tighter. Again, this is such a simple thing. It took us less than five minutes, and it makes a huge difference on your physical health, your mental health, your emotional health, and just remembering that when you feel good, you look good. And. When you feel good, you’re also nicer person.

And so I think, just a five minutes of lymphatic drainage a day makes a better you and a better world. I hope this helps and thank you very much for being a part for paying. Listening to this, thank you again to the American Acupuncture Council. If you want more information about me, Instagram at Shellie Goldstein, and then my website is hampton acupuncture.com.

You can learn about me more, things that I do, classes that I teach, and programs that I’m involved with. So have a wonderful day. Don’t forget to do your, I’ll do your little lymphatic drainage massage, and we will see you again. All righty. Bye-bye.

Building Practice Revenue With Retail

Today’s topic is building business revenue with retail as a cosmetic facial acupuncturist for over 30 years.

Click here to download the transcript.

Hi everyone. My name is Dr. Shellie Goldstein. It’s always a pleasure to be here with the American Acupuncture Council. Thank you so much for having me. Today’s topic is building business revenue with retail as a cosmetic facial acupuncturist for over 30 years. . But I realized in my practice that it was one thing to work and to see people with hands on, but also building a revenue through retail actually was a very, not only lucrative part of my practice, but it was also beneficial for the patients as well.

So here’s what I’ve learned over my past 30 years, and this is for people who both have a retail. Or would like to start one. So to begin with, think about this. Do you offer retail products in your practice? Yes or no? Are you already offering products? Would you like to, it’s a yes or no question, but it applies to everyone.

And then what percentage of your income is generated from these retail sales? Is it five to 10%, 15 to 30%, 35 to 50, or more than 50%? If you can up your retail sales to hit, say, the 50% mark, what does that mean? It means that you have to work half the amount of time to earn the same amount of money. . So working efficiently is always a great thing to do, particularly when it’s a win-win situation for everybody, both for you but also for your patients as well.

And when we talk about your patients, this is really important or has been important for me is really understanding who my patients were as a practitioner. For me personally, I tend to my primary. Patients were baby boomers in Generation X, but thinking about our practices today, whether it’s facial acupuncture, whether it’s any type of acupuncture, you tend to pull in or target a certain generation of people primarily.

So what and depending upon who you bring in, it’s gonna adjust or have to, it’s gonna affect what retail items you offer and a number of other things too. So do you treat mainly, Baby boomers. So as of now, these baby boomers are in the late, early sixties and seventies, generation X in the forties and the 50 year old range millennials now in their late twenties to early forties.

Huge generation of people that have a major influence in the retail world nation and international. Generation Z, they’re a little bit younger, they’re coming up. But again, all of these generations think differently. And when we think differently, what we’re talking about in terms of retail is what they look for and how they choose to spend their money.

So according to HubSpot when you look at the most important factors in terms of consumers and their purchasing decisions, it’s different. It’s different across the board. So looking at these, we have quality of the product, the price of the product, the features or the functionality, whether the brand has an active community around.

What type of reviews these products get, whether a percentage of the products that are the proceeds from the products will be donated to charity. A brand social media presence, Caesar across the board, the most common factors. But if you look within those parameters, then each of these generations thinks differently.

For example, that most people across the board are gonna look at the quality of the product relative to the price. If the price, if the quality of product is a very high quality, they may be willing to pay. But then there are the other things that are, that people think about. So for example look at the brand social media, present.

Social media. Guess what? The baby boomers really do not consider that as a primary. Topic or primary influencer in terms of whether they’re gonna purchase a pro product or not. They don’t really care about whether somewhat, but not as much as say, a ge, generation Z, whether it’s there’s a proceeds or donated to charity.

But what they are more interested is both in terms of baby boom. is the features of the product, the functionality of the product, how easy it is to use, what it does, and that type of thing. Whereas Generation X, they’re gonna look at what they’re, what’s the community around it? Are they donating to different charities?

So again, taking a look at each of the generations, what’s important to them, what’s going to make them stop and say, Hey, I want this product. So when you think about them also people in general, a lot of people say 68% say they prefer finding new products in the store as opposed to finding in the online.

So that’s good for us. 83% of the millennials say it’s important for the companies to buy it from, that they buy from, to align with their own beliefs and values. I think that’s pretty much across the board, both in terms of millennials and other generations as well. and 82% of millennials will purchase an item if they first see it, and they like it enough the first time.

But across the board, everyone wants that optimal gratification. Getting a lot of use out of the purchase makes me feel like I made a good decision. If you buy it and it sits on the shelf, they likely will not buy it again. But if they buy it, they like it, then they’re gonna come back for. . And what’s particularly interesting about this is the benefits for the patient.

When you think about a product, what you need to remember. And for those of you who have a strong retail product, I’m sure you see this as being true too. It has to be convenient for them. They have to be able to use it. And be able to use it easily. So if it’s a product, say a skincare product, then you have to refrigerate it each time.

I know me, I’m gonna forget. I’m gonna be putting on my things at night, putting on my creams or whatever. And then there’s this one that’s in the refrigerator. The chances of me remembering are not very the same with other things as well. If you’re using, say, a tool or a derma roller or something like that and you have to go find it, Chances are using it are not as high as, say, if it’s conveniently located.

Also, pricing. I know that, and I know for my patients that if it’s a higher price item, it has to come with a higher quality. It has to be relative. The price has to be relative to the quality of the product. And the re, the quality of the product is designated by the results. If it’s a topical ointment for say, pain, it has to work.

It has to slow down the pain or minimize the pain. If it’s for hydrating skin, it has to work. Your skin has to look better. So again, price. Convenience and the results. And when you have all three of these together and the patient actually uses the product and they get the results from the product, there’s a certain underlying sense of empowerment.

They feel like they are contributing to the healthcare of themselves. And we know from the perspective of a practitioner that when we can empower our patients and when our patients feel like they are contributing, it levels the playing field. It’s a win-win for every. , your treatments are better, the results are better.

They, and they are participating in their treatment plan. And so they feel at like they’re a part of it as opposed to you doing it for them. And we know that psychologically that’s always beneficial and it actually leads to better results and. For the practitioner what we know is that when patients are participating in their healthcare, when they are using their home care regime appropriately, your treatment results are better.

So when they, you can encourage them to participate. When they actually participate, your treatment plan, your treatment results are better. They like you, they trust you more. They will talk about you more. They will refer people to you, and at the end of the day, it enhances your income potential. So not only are you are retailing products, but the products are working for themselves and actually bringing in more patients for you.

When we are starting our retail practice or if we are enhancing our retail practice, there’s always business logistics. There are always things that you need to look out for. First one isn’t your inventory. How much does your product cost? Can you afford it? How much inventory can you afford to maintain if a product costs $10?

That amount of inventory is much different than a product that costs say, a hundred or even a thousand dollars. So that’s one of the logistics that you have to figure out. And then based on that, what is your return on investment? If you have a product that costs $10, And you charge 20, you’re gonna need to make, in order to make a hundred dollars, you have to sell 10 of them.

If you have a product that costs you a hundred dollars and you sell it for $200 it’s a larger investment, but the in the return on your investment is a lot higher too. So there’s a balance and every balance, every person. Balance is a little bit different and it’s based on your your product sales, what you think you can sell, and it’s also based on realistically what you can afford to invest in and have sitting on your shelves.

But then there are other things too. For example, what are your state regulations? Can you carry as an acupuncturist or whatever your license is? Can you, are you legally allowed to carry that? I know in the state of New York there are certain regulations about skincare products and the therapeutics of it, and then what’s appropriate and what’s legal within our scope of practice?

CBD is a big issue right now. A lot of states allow you as a licensed practitioner to carry products with cbd. Some do not. You need to know that because a lot of products right now have C B D oil in them. And then for those of us who in most states, you have to collect sales and local tax, who’s gonna do that?

And how are you gonna do that? So you need to get a business license, right? And then who’s gonna file the paperwork for it? It takes time, honestly. It takes some, if it’s, if you’re selling items that are only getting, making a couple of dollars a profit and you aren’t making that much, is it worth your time to actually do it?

I don’t know. It’s up to you. It’s a judgment call. And then also, if you are not a solo practitioner and you have staff, what did they think about it? Are they interested in it? Or because they’re gonna need to learn about the product. So are they interested in taking that extra step for you and for the business?

And again, so you’ve done your work. It’s okay. Ready to go. You’re gonna, who are you gonna target? Your brand. Your brand actually needs to, the products actually need to reflect your brand. So who are you? Who are you both in terms of the clientele that you bring in. Who are you in terms of the cost? What, how much do you think that you can charge for, and that your patients will be willing to pay for based on the effectiveness of the product?

Based on how easy it is to use. If you see a older generation of people and your product is a high tech product, they’re not gonna be able to use it that easily. That’s, and a consumer friendliness too. Do you have to keep the product in the refrigerator? Is it easy to reach? . And then what are the quality of ingredients?

Some, a lot of people these days want more natural ingredients that are organically sourced, that are chemical free or perfume free. That’s important. And then for some people too, what is the efficacy of that product? Based on scientific research, so that some of your products may need to have some scientific research behind it, if that’s important to you, if that’s important to your client, and then also your personal relationship to your product.

So I know that for me, in order to sell something, I need to have tried it. I need to know that I like it. I know that I need. to have it work for me, and then if it’s a product that I as a practitioner stand behind. And maybe work with a company at the manufacturers. I’m gonna need to disclose that.

I’m gonna need to disclose my relationship to that product from both the fiduciary responsibility, but also as a personal one as well. And then for me too, and for retail in general you need to really know if you can sell it and while your patients buy it, because there’s nothing more frustrat. Then investing in retail and just having it sit on your shelf.

If it has an expiration date, you have to throw it out. Or if it’s just sitting your shelf, you’re losing money because you’re not able to turn that. And part of this in terms of maximizing that return on investment is how you display it, how you store it, how you display it. Do you keep it behind your desk or in the closet, in which case you, as the practitioner or the staff are responsible for bringing that product out and saying here’s to your patient, here’s a product I recommend this, or is it in the waiting area?

Where the patients themselves actually are their own salespeople. They can look at it, they can play with it while they’re waiting for their appointment, and then if it’s an awaiting area, you probably need to make it look presentable, clean space, needs space, and really making the appearance of it appealing.

this is common sense, but sometimes we forget . In addition to the appearance of the product, and the display is really knowing everything about your product from the story of the product and a unique story. So for example a chemist, a mother is a chemist and she has a daughter, and the daughter is hyperallergic to so many different things.

And so in her quest, in her whatever topical things the mother puts on, so in her quest for fighting. The perfect product for her daughter. That’s hypoallergenic. She created this product line. Now that’s a good story. That’s a really good story because the personal experience with it is, I can use this too because I have sensitive skin and I use this product and it works for me.

That’s the benefit for the consumer because then the consumer goes, oh, I like this product. I can benefit for this. So there mean most products have a story behind it. What’s the story? How do you respond to that story? What’s your personal experience with that story and what’s the benefit to the consumer about it?

And then how does that compare to other products? So if it is a skincare product, then the, you would want to say the product is all natural, unique ingredient. I know that it works. I tried it and the story, so that would be one way of doing it. If it’s a say, a tool, then we’re gonna talk about guha tools later.

What’s the story behind it? Naturally? Stores, no, no heavy metals in it. So there are many different stories, and the stories count, believe it or not, the stories count a lot. And then how are you gonna promote this? You have your inventory, you have your story, you know the line, your staff knows the line.

You believe in the product, you know that it’s gonna help the patient. You know that it’s gonna be a win-win for all. So how are you gonna promote that product? Because again, you don’t, just on the shelf, sitting on the shelf is losing money. So do you just, do you have enough turnover? In your patient load to just keep it in the office.

Do you want to move it out of the office and say events? Do you have a website or a social media blog, an Instagram account where you can talk about your products, Facebook whatever you have. How are you gonna market it? Are you going to market it through them? And if you are marketing through a blog site, through a website, through social media, There’s that 80 20 rule, 80% educational, 20% promotional, which means that if you have a blog site, so every fourth or fifth blog post, you can talk about your retail product.

Otherwise, what happens, people get bored and they feel like you’re pushing a product on them. So mean, my kind of rule of thumb is let the product sell itself and you help.

and then you can sell. What I love about this part is you can sell a product individually, but you can also gift box ’em, and this is the perfect time. We’re coming into the holidays. The holidays is a really good time to come up with gift box bundles. But again, when you bundle these products, you have to know your patient.

You have to know your patient, and you also have to put it together, put the box together so that it makes sense. With skincare there’s so many different types of skincare products out there, wide range based on the practitioner preferences and consumer desires. So let’s, in this limited time, let’s hold onto that one.

We’ll come back in another presentation. But now let’s think about this. Let’s think about a bundle. Let’s think about our patients. What do our patients want? Do they wanna be educated? Do they wanna read about it first? In that case, you might add a BU book or something into our pamphlet or a booklet into your bundle.

There are some really good, very simple, no brainer products that you can retail that are low cost to you. Low cost to your patients and extraordinarily effective. And for the, these right now are guha, face cupping, derma rolling, and instrument assisted acupuncture tools. So look at this bundle. First of all, when you think about Guha tools, we know that guha tools are palace gemstones.

They’re organic materials, they have unique qualities. Each one of them have different vibrations, different colors, different meanings. So for example In facial acupuncture the gush eye tools of the gemstones that we use Amethyst. What I like about amethyst is it’s very calming, so it’s used, it opens up the crown and the third eye chakra, so it calms the mind.

When you calm the mine, you can calm the skin. So it’s really good for minimizing skin inflammation from a calming perspective, whereas something like. Is more opening of the heart chakra. So cooling versus calming. This is gonna be more cooling. Jade has a cooling reflection to it, so it’s gonna reduce inflammation and tissue irritation by cooling it as opposed to say, calming it.

So when you’re choosing between these different stones, you have to consider is my patient irritated because it’s. Or is my patient stressed, in which case you might choose, say an amethyst or a rose quartz. Rose quartz also is very calming. And so this product is going to calm tissue swelling, relieve stress, enhance circulation, and calm from an emotional perspective.

Whereas something like Jade or citrine is interesting because it’s more related to the solar praxis, your digestion. For the face, a lot of irritation on the face comes from, say the stomach meridian. The stomach meridian runs from the center of the eye, stomach one and two all the way down, straight down to the jawline, across the jawline and up.

So it’s the entire cheek area and lower face area. Breakouts, acne, rosacea, that type of thing are often related to heat in the stomach. So something like a siting would improve applied topically, would minimize facial redness and irritation by improving digestions through the stomach. And so each of the different gemstone personalities are slightly different.

and as well as their shapes. So when you are looking at a guas eye tool, if you wanna do some type of a sweeping motion, you’re going to use something like the teardrop or the dolphin, where it has a really long edge. The left hand side is a long edge or the rectangular square, whereas something like a pointed edge say the top of the waves are the fish.

Those are the wand, those are gonna have pointed edges, and those are really good for pressing into acupressure points as say, an assisted acupressure tool. Whereas something like the rounded paddle, the wand or the spoon, they’re really good for under eye area for very gentle lymphatic drainage and generally different puffiness and limb training.

So the shape of the tool is gonna make a difference as. And then in general, what are we using the for improving circulation, stimulating lymph drainage, harmonizing facial imbalances, improving wrinkles, softening or improving skin thickness. So again, this is the story, right? . This is why it’s different.

This is what’s good about this tool, this shape, this different gemstone. These are all important when you’re selling this particular item. And then when you bundle it, you wanna bundle it with something that makes sense. So maybe a face cut. Whereas the difference between, say, a Guha tool is more improving circulation, stimulating limb drainage, harmonizing and balancing.

And I think of face cups also as. Stronger and more in terms of strong lymph drain and strong, my fascial moving blood in cheek. The risk is that you need to be a little bit careful because if you’re, when you’re teaching your patients what to do you don’t wanna get a bruise on your face, so you need to explain it a little bit better.

In some ways, squash eye tools are a little bit easier to use, but fish cups are effective too. And then also using the appropriate oil to go with it. . And then the third type of product that you might bundle into a roll would be, say a derma roller. In this bundle you’re going, you might have the guha tool, the cup, and then say a derma roller.

So the, whereas the cups and the guha tools are more lymph drainage, myofascial drainage, moving blood and chewing where it’s an application and you can teach them how to do that. This is more for. Skin would be more like building collagen, that type of thing. And so you would educate your patient.

Here’s a derma roller. You write, roll this every other day and you can do your wash off daily. So the story, you need to have the story, the directions, and why you would be using each of these. And I say on this, be careful about serums at, with essential oil, CBD bonds, hydrosols for the same. Essential oils, they may be allergic to the perfume.

C, b, D are you, can you use that? Bombs and hydrosols bombs are too olian. So you don’t get that great slip and hydrosols aren’t enough, so you need a serum. That’s a good thing. So look at this. That’s swine bundle and I’ll, we’ll price these out for you. Another one might be, do they want education?

A book? Give them a book. True confession. This is a, this is, where I need to say, this is my book. I wrote this book, this is my tool. I made this tool. Disclaimer, there are many out there. This is just one, it’s a book and a tool. You read the book, you use the tool, you apply it, and you get the results.

So that, that’s another type of bundle. You can bundle these and make a lot of money. So a beauty box under a hundred dollars. It’s a tool, a tool, a derma roller, some serum, and it’s costs you, and these are, I’m just sourcing lasa, oms. There are many other places, but you would pay between 30 and 30, 37 and $39.

Package it nicely. You can sell it for a hundred eighty two ninety $5. Where is a beauty box? That’s say a. and the tool it would cost you $88. Package it, you can sell it for almost 200. Very simple, very clean, easy to do, easy to instruct, and you have the opportunity to make money. So whether you are doing single products are a bundle.

Again, it’s the holiday season. It’s a really good time to offer beauty boxes, holiday bundles have fun with. Get really creative. The more creative you are, the more excited your patients get. Make it easy, and it’s a wonderful way to earn income. And your patients will appreciate it. They’re gonna buy things anyway.

They’re gonna buy things for themselves. They’re gonna buy gifts for. If they trust you and they know that you have their best intention and they know you and what’s good for you and you, they can explain to you about the people they’re buying from. They know that they’re fulfilling all of those priorities.

They’re getting a good quality. It comes from a reliable source, there’ll be results. The price will be compatible with the results of the product. And so it really becomes a win-win for everybody. So it’s not a selfish thing about making money, it’s about empowering your patients. It’s about helping your patients.

They’re going to buy things anyway, and it helps you too. So why not? And that’s all I have to say for today. So thank you so much for listening to this lecture. If you have additional questions, you can reach out to me on my website, learn more about what I do. In terms of facial acupuncture and teaching facial acupuncture, or reach out with your questions to info hamptons acupuncture.com, or you can follow me at Instagram Goldstein.

So have a great day. Have a wonderful holiday, everybody. We’ll see you next year.

Micro-current For Enhancing Facial Appearance

Today’s presentation will be microcurrent for enhancing facial appearance. For those of you who practice cosmetic facial, acupuncture, you’re gonna love this

Click here to download the transcript.

Hello everyone. My name is Shelly Goldstein. I’m the doctor of acupuncture and Chinese medicine and licensed in Florida and in New York. Today’s presentation will be microcurrent for enhancing facial appearance. For those of you who practice cosmetic facial, acupuncture, you’re gonna love this. And it’s actually, and then for those of you who practice facial acupuncture of any sort, this is right up your alley.

Today, microcurrent is one of the most rapidly growing ancillary services for facial acupuncturists, but a lot of people don’t really know what it’s about. So here we go. Let’s begin now.

Patterns Microcurrent is what I call low level electrical current for skin and muscle re education. And this is what’s important because many of the ancillary services that we offer, Address the skin level or address the tissue level, but they don’t go down to the muscle level. So this type of service is addressing both skin and muscle.

When we think about the history of Microcurrent, it’s been used for decades. It was been used by acupuncturist, physicians, physical therapists, and chiropractors, and it’s primarily used for. Muscle education and tissue healing. So if you’ve ever damaged muscle damage or muscle strain or pulled a muscle and you go to physical therapy and they put these pads on you, it’s a form of microcurrent.

It’s a little stronger. And the intention of it is to actually heal the tissue, the trauma in the tissue, and reeducate the muscles on that level. What we’re talking about here is just a little bit different. And because we’ve been looking at it for so many years, particularly with patients with Bell’s policy, it started with people being treated with Bell’s Palsy, with low level micro.

And what happened was after they were treated and after the Bell’s Palsy had resolved, they noticed that their fine lines were softer, their face was more lifted, their eyelids were a little bit drier. And this really started the impetus to start exploring various forms of microcurrent for cosmetic treatments and appearance enhancements to lip facial appearance.

Just to give you a little bit of perspective about how this works, when we analyze the face from our perspective, You wanna look at the face in thirds. So the top third is the forehead to the eye to right underneath the eyes. The middle third is from right underneath the eyes to the corner of the nose, and then the lower third is the corner of nose to the chin area.

And in our younger years, when we look at someone, the height of the face or the widest part of the face is at the top of the middle. Third, it’s right below the eyes. You can see it in this image if you look at the triangle. So the base of that triangle is where the height of the, of your appearances.

So when you. At someone what is the upper portion of the face what happens as we age, whether it’s due to gravity, whether it’s due to tissue change, or bone resorption, or bone changes. The tissue begins to drop and the weight of the face moves to the jo area as opposed to the height of the face.

So what happens is when you look at someone with the, who’s older, with that drop, it looks as though the face is heavy, it’s saggy. And oftentimes this is when our patients come in and they say, I look old. I feel old. I, my jaw line is lost in. My cheeks feel flat. I just look old. And that’s what you’re looking at is this organic movement of the weight of the face shifting from the upper aspect to the lower aspect of the faces.

And not only does it move from top to bottom, it moves from the lateral aspect, the corner of the zygomatic area where the cheek bone is. To the middle area. So you would get a deepening of what we call the nasal labial fold, which is that full between the corner of the nose and the corner of the mouth, and the corner of the mouth and the jaw area.

So the weight of the face moves from outer to inner. And then also the forehead starts to shorten, in which case you start to see putting of the eyelid, puffiness underneath the eye. Some of it is organic. It changes within the tissue itself, but some of it is just the redistribution of weight in the face.

And many of those changes occur on multiple levels of the face. So we have the bone changes and starts to change the tissue layer on top of bone on the face. We have muscles. We have two different groups of muscles. On top of the muscle, we have what known as the subcutaneous of the hypodermic layer.

It’s where our adipose tissue is the fat in the face that fills out and gives you volume. So muscles gives your movement to all of the the math, the cheeks, the eyes, and all of the expressions that we make. The hypodermic. So the subcutaneous layer gives you the fat or the plumpness of your. And then the health of the tissue or the health of your skin is really determined by the dermal and dermis and the epidemics cells start at the base of that dermal the orange layer, and float up to the surface of the skin as it reaches the surface.

And in that dermis dermal layer. It’s bathed in hyaluronic acid and nutrients so that they grow healthy and strong and plum. And then as they move to the epidermal layer up to the surface, then they start to slough off and then new cells move their way up. And then all of these layers are surrounded by what is known as connective tissue.

Connective tissue looks like this. It’s sticky. It’s afl. It’s like a sticky film or sarn wrap, and it’s designed to either encapsulate, say the muscles and keep them protected. Or it’s also used to connect, so it can either connect, it can either protect the muscles and surround them and isolate them.

Or it can be used to connect, say the muscles to the more superficial layers of the tissue and then and top the skin, which is why we can see when the deeper, when the muscles of expression move, we talk, we blink our eyes. We smile, we frown. These are all the ability, the muscle’s ability to express themselves on the surface of the skin by virtue of that connective tissue, holding everything together and connecting them.

And collagen, we’ve heard this word a lot. Collagen is the primary component of connective tissue. And what’s unique about. Is that collagen has a mechanical and an electrical property, and it’s that property, the electrical and the mechanical property. That’s the basis for being able to interact with other tissue.

So in the presence of external influences, they can be pressure, they can be vibration, they can be an acupuncture needle going into the surface of the skin when the collagen is altered by any type of external influence that current or that electronic electrical current permeates from the connective tissue throughout.

The other areas of the body and migrates into neighboring structures. And this is how a lot of our ancillary services work. Works in this way, cupping face, cupping works in this way. A number of different services that we use, even acupuncture work by activating the elec, the Paso Electrical effect of collagen.

To create that electrical charge, which then vibrates through the connective tissue into migrating structures. And Microcurrent is another example of how this works. When you. Microcurrent is a vibration. You turn it on, it has a vibratory effect. And in that vibratory effect, it has a number of wonderful functions.

It a, it improves skin tissue circulation. When that happens, skin tone and texture start to change and improve also by going a. Deeper, we talked about the epidermis, the dermis, and then into the deeper fat layers, and then into the muscle. So it starts to move through all of those different layers so it can soften the appearance of fine lines and wrinkles.

And then also it’s used to re-educate muscle activity and interpreting. And this is what you, my current is unique for because a lot of the other service. Like cupping, wash out are primarily for more surface skin, for removing limp from the tissue and for sculpting the tissue, but not necessarily.

Integrating and educating the muscles. So in doing so, by changing the muscle integrity, you can lift and into the cheeks, the lower and the midface muscles. Now, microcurrent is different than tens, the tens that we use. You have needles, you have the little prongs that you put to the needles, and then you turn it on and it causes the muscles to twitch.

This is not what we’re talking. So TENS devices is delivers milli amps of current. This current is designed to blocking messages from the spine to the brain, and that’s why it’s very effective for say, back brain damage. It’s going to help mitigate the pain messages that move from the spine into the brain and help to heal the tissue.

Microcurrent on the other hand, delivers a sub censory micro amperage as opposed to milli amperage. So this current micro amperage is 1000 times less than that of milli amperage current. And when you use this type of current, first of all, the muscles are not gonna twitch. It’s gonna be, and it’s gonna be sub sensory, which means you don’t feel it.

So the current is actually moving into the tissue at a very low cellular intensity. And. Activates or it aligns with that collagen, Paso Electrical current and all of the other currents that we have in our body. So our body is always vibrating. There’s a current that runs through, we may call it Archie, that’s constantly running through our body.

This low level microcurrent actually. And its sub sensory format mimics the body’s own low intensity and this at the cellular level to do a number of things. So here’s what I’m talking about. Here’s the top image is the microcurrent. It’s that low level current. So it’s a very small current that’s moving through the mechanism and into the tissue versus the lower, more charged microcurrent.

Tense machine. Now, when the current moves through this tissue, it goes into the cells and it moves into the mitochondria to activate the Creb cycle. How many of us remember in high school learning about the Creb cycle? The most important aspect of the Creb cycle is to produce at. Triphosphate. Now, Atine Tri Phosphate is like Archie.

It’s what charges the body, keeps it activated, keeps it moving, and keeps us alive. So without atp, we do not exist according to the Western world. When ATP is activated, a number of things happen. It enhances the healthy synthesis of number of proteins. It stimulates the proliferation of fiberblast, or needed to collagen.

And it does it at such a high volume that it actually can increase ATP up to 500%. It can improve the cell wall permeability, and we’ll go into this in just a minute. By 30 to 40%, it increases protein synthesis up to 73% and increases collagen activity up to 60%. These are huge numbers. How does it do it?

First of all, when we produce ATP one, one of the things happens. It creates a the mi, the crib cycle begins. You get the production of atp, and then another couple of things happen. One is it stimulates the activity of the electric transport chain. The electric transport chain is very important for producing the healthy wall of the cell.

But it also helps to boost healthy skin dermal protein development, including collagen and safe development. When we have a cell and when we have the cell wall, there’s a kind of a, some gateway. Which means that there’s a charge that goes back and forth through the cell wall, and you need that fluidity within this cell membrane, not just to pass ions like sodium, potassium, and chloride, but in a bioelectrical potential at this charge as well.

As we age that the tissue of the wall gets heard, it gets damaged, and then we get an imbalance within that bioelectrical potential, which means the cell’s not activating and it’s not doing its job. The body naturally follows the path of least resistance. So in the effort to get that bioelectrical charge into the wall, it’s gonna pass the damage areas and it’s gonna try and get in other places.

And in doing so, it actually damages the cell even more. Microcurrent starts to reverse that process by healing the wall of the cell in order to create and boost that and restore that electrical transport. Also within that Creb cycle and when the activity of the mitochondria, we are also creating an antioxidant effect.

So what do we know about antioxidants? Antioxidants stop cells from oxidizing. If too many cells oxidize, they start to die. So it’s a way of rejuvenating cells and keep them. When we do that, we can heal the tissue. So microcurrent is beneficial for enhancing tissue repair and when tissue repair, when we get a wound a or some type of a physical wound microcurrent is actually beneficial for healing that wound and for our purposes for cosmetic acupuncture, it’s going to improve and reeducate muscle.

I. And this is what we need in order to lift those muscles that we talked about. Start to bring the weight from the base of the chin area all the way up to the top of the chin. It’s not good. Here’s an example. Oops, I’m gonna go back. Sorry about this. I think I’m gone the wrong direction. Oh no.

I don’t wanna do that. Sorry. What you’re gonna need to do is you’re gonna need to reshare that if you can, and then I think we’ll be okay. Okay. Yeah, so just make sure that you have that slide open. Then do share and it’ll be back. Everyone will be very patient. It’ll only take a minute. are did it work while you’re sharing the whole screen rather than just the slide?

So you wanna stop sharing. I’ll help you with. What I’m going to do is help by doing this for a second. So now they can’t see us . And let’s go back to.

Hi, welcome back. Okay, so here’s what happens. Take a look here. You see the microcurrent coming in. It’s. Moving its current into the tissue, and you can actually see the multiple layers, including the orange one. The orange one is the tissue, is the muscle itself. You can actually see the change that occurs.

Now there are some side effects although this is a very low risk treatment. Sometimes let me just say with the side effects are dizziness, headaches, tissue, swelling, pain, discover, redness, bruising, tingling. I have not found these in my practice. But that doesn’t mean that they don’t exist.

Every once in a while, someone may be red, but you can actually just turn the volume down and it’s not in my personal experience, I haven’t. These side effects. There are a few contraindications and precautions. So a contraindication is when not to use it. A precaution is to be aware.

Pregnancy is a precaution. If someone is cleared by their physician, no problem. You, if you are under the age of 18, that’s just because they’re a minor. So that would be a precaution. Active cancer, for me, that’s a contraindication because you wanna deal with the problem first. And then epilepsy seizures, it is current and it’s, but it’s very mild current.

So things like epilepsy, seizures, muscle nerve disorders. You just wanna make sure that’s not something that they’ve had recently or under, or is under control and it should be fine. Reach some facial surgery, filler implants and injections. You just need to wait a couple of weeks after their surgeries, fillers, implants and injections to begin pacemaker or electrical implant device.

Now we’re on the face and it’s a very mild current. So again, that’s not something that. Experience, but it’s in the literature. And then severe acne or inflamed skin as usual, you want, it is current. You are stimulating the face, and so you want to manage that situation or avoid the area.

So again, it’s very space, but you just need to be wise and be a little cautious. It’s a very mild current that you’re buying on someone’s. But the advantages of using it are just tremendous. So if you look at this image, in the remembering the weight of the face, moving from the upper face to the lower face.

If you look on the left where it says baseline, you can see where there’s puffiness and jowling on this image and this woman’s jaw area. And then after 60 days of five minutes of use. So this would be as like retailed as a home treatment, but also you can use it in the office. You will see the jawline begin to lift.

You can see the weight of the face starting to change, moving upwards. It’s actually a little more clear in the sculpted jawline area. You can actually see not just the weight of the face dragging in the jaw area, but you can also see the skin is starting to be creepy and drooping as well. So in this situation, The microcurrent is not only addressing the muscle level, but the tissue level as well.

So this is a really good indication. If you look at the 60 day of all of tightening of the muscles lifting the jaw area, but you can also see the collagen area that has been. Built and building collagen is tightening and lifting skin as well. And then the bottom one is smoother wrinkles, and this is the far ahead area.

And you can actually see the visible changes that occur from forehead, creasing, and lack and diminished creasing after. Microcurrent. So it’s a great treatment to use both in your office, but it’s also really good to use at home too. And there are many different devices that you can use. So the one that it, for those of you who are just starting, you’re interested in microcurrent and you don’t wanna put out a lot of money for it.

New face is a really good way to start. It’s very lightweight. It’s very easy to use. You can use it at home. You can use it in your treatment. You, it has an auto, a charging station that you put it on. I can help you get those. I give you a discount for being a part of the American Acupuncture Council.

For those of you who know you wanna do this, you’re investing in it. There are programs like Biotherapeutics, they’re a wonderful company from was. They have that Suzuki sequencing, which we talked about. It’s microcurrent going into. And to the body and matching the electrical vibration of our body. And this is the key to it.

If your system doesn’t do that, it’s just throwing current at you instead of working with you. This particular instrument is about five to $6,000. And then for those of you who really wanna jump in and know this is what you wanna do, and this is only what you wanna do, or a huge part of what. To do you can spend, 15 to 25,000 pounds.

And then this Casey is the workhorse or the gold standard of microcurrent. But honestly, if you’re just starting, either the new face or the biotherapeutics are really good. Microcurrent machines. And again, if you need help, I can help you do that. So if you have any questions or need additional information about Microcurrent or this lecture, you can contact me at hampton’s acupuncture gmail or at info hampton’s acupuncture.com, or you can watch.

On Instagram as well. So this is a, just an abbreviated lecture about Microcurrent. There are many more out there. And again, I just wanna thank the American Acupuncture Council for allowing me to be here today. And thank you for joining me as well.