CE INSTITUTE LLC BLOG

In this article published at Massage Magazine, CE Institute LLC Instructors Selena Belisle and Wendy Langen help others understand what a medical error is with some real-life examples of massage industry errors: 

Providing MLD services to a client can be different, depending on the client's needs.  Are you attempting to performing a full detoxification, reduce unilateral extremity lymphedema or did the client show up for a full body massage with a severely swollen knee sprain?

Because there are so many different situations that can be treated with MLD, we recommend breaking MLD treatments down into 3 different categories:

1. LOCAL MLD: Only work on the affected area of swelling. This appointment could be as short as 10-minutes or as long 30-minutes or more. Practitioners can work as long as agreed and as long as you do no harm.

2. HYBRID MLD: Provide regular services (i.e., full body massage), and then provide MLD to only the affected area of swelling while the rest of the body receives its normal course of treatment. In full body massage, if the therapist spends 10-minutes massaging one leg, then the therapist would spend 10-minutes on the opposite leg with MLD.  The goal is to keep the appointment session fluid and even between the swollen and normal areas of the bodywork.

3. FULL BODY MLD: Full Body Lymphatic Drainage (i.e., detox treatment). Full body sessions on average take 90-minutes, but like almost any other bodywork, practitioners can modify the session to make it shorter or longer time.

To learn more about manual lymphatic drainage applications, please register for quality, affordable, professional training at: https://ceinstitute.com/

There is still some conflicting Information about the lymphatic system, and some unknowns as well.  We are still LEARNING more about the lymphatic system every year as science and research continues to advance.  For example, we still do not know why 75% of lymph is drained through the left side of the body to the cardiovascular system and 25% of lymph is drained through the right, as depicted in this infographic (pictured right).  There are many theories why there is such uneven distribution of lymph collection and redistribution to the cardiovascular system, but none of these theories have been scientifically proven to be factually correct.

New research studies are providing new information and updates about the lymphatic system every year.  In past MLD classes prior to 2015, it was regularly taught that there is no lymphatic tissue or intervention within the cranium or central nervous system.  We now know that theory was wrong. [i]   

One research study reported prior to 2015, that “The brain...has been thought to lack lymphatic vessels, as they’ve never been found….These vessels may have gone undiscovered until now due to their hidden location. The method the team used to prepare the meninges kept these layers intact. The researchers found similar structures in autopsy specimens of human meninges. Organization of the vessels in the human central nervous system will now need to be determined.” ^[ii]

Lymphatic vessels in the brains of mice were only recently discovered through use of new high-powered microscopes. Prior to 2015, we thought that the lymphatic system and central nervous system were two completely separate systems without intervention.

The cranial lymphatics (aka glymphatics) is a perfect example of a major discovery that was only made a few years ago.

Despite not having a total understanding of the lymphatic system, we have learned enough to know how to manipulate it to reduce swelling, with services such as manual lymphatic drainage.

To learn more about manual lymphatic drainage or the lymphatic system, please register for quality, affordable, professional training at: https://ceinstitute.com/

[i] Louveau A;Smirnov I;Keyes TJ;Eccles JD;Rouhani SJ;Peske JD;Derecki NC;Castle D;Mandell JW;Lee KS;Harris TH;Kipnis J; “Structural and Functional Features of Central Nervous System Lymphatic Vessels.” Nature, 16 July 2015, U.S. National Library of Medicine, https://pubmed.ncbi.nlm.nih.gov/26030524/.

[ii] “Lymphatic Vessels Discovered in Central Nervous System.” National Institutes of Health, U.S. Department of Health and Human Services, 14 Dec. 2021, https://www.nih.gov/news-events/nih-research-matters/lymphatic-vessels-discovered-central-nervous-system.

Different licenses have different scopes of practice, usually depending on the state you are licensed and practicing in.  Always check with your licensed scope of practice prior to administering a new service to a client.

There are may different products and ingredients that could be added to regular massage or bodywork service to give it a special touch.

To create an earth angel experience, think about using some of these specialized products:

1. Clary sage essential oil has an earthy aroma to it. It also provides euphoric, warming, balancing and relaxing therapeutic effects.
2. Jasmine essential oil has a floral aroma which is also euphoric, warming and uplifting. 
3. Dead sea salts have lots of different minerals that can boost hydration and reduce inflammation. You can use dead sea salts to create a full body scrub, or simply just a back, hand or foot scrub.
4. Similar to dead sea salts, dead sea mud also has a lot of different minerals with therapeutic effects, plus can be detoxifying when applied as a spa body wrap.
5. Using hot stones is a wonderful way to add mother earth to the appointment, plus the warmth is extremely comforting to most when properly applied and used. NEVER apply hot stones directly to the skin without 2 barriers as depicted in the picture above.

Adding specialized ingredients to regular appointment services can change the context and frame of mind for the appointment, to celebrate a special occasion or simply experience something different to break up a monotonous routine.

Be sure to train in aromatherapy plus body scrub, wrap, hot stone and massage applications and contraindications prior to administering any type of service to a client.

For full directions on how to create this treatment, or to learn more, please register for quality, affordable, professional training at: https://ceinstitute.com/

Different licenses have different scopes of practice, usually depending on the state you are licensed and practicing in.  Always check with your licensed scope of practice prior to administering a new service to a client.

The Safari Spa  service can have 2 to 4 separate steps.  Possible steps include:

1. a soak or shower
2. scrub
3. wrap
4. massage

Ingredients can vary based on the client, their individual needs and how many steps utilized in the safari spa appointment.  Here are some suggestions of what to use for ingredients to create a Safari Spa Experience:

• Ginger essential oil
• Any other essential oils you may find on safari
• Raw honey or spa grade powdered honey
• Unscented moor mud
• Shea butter
• Coconut butter
• Fine grit sand (spa grade)

The Safari Spa services would start with a scrub, which needs to be performed in a wet room or with a shower because the sand is non-water soluble. Do not perform more than one scrub per day and be sure to rinse your water drain with plenty of water to wash the sand away. Do not use sand as abrasive material in the scrub if there are already problems with your plumbing drainage.

Mix shea and/or coconut butter with a sparingly amount of sand, then apply directly by hand from the bowl for your exotic scrub. It is recommended to heat this body scrub concoction prior to applying on the body for comfort and warmth. The scrub will need to be washed away from the client either on a hydrotherapy table or in a shower or tub.

When performing the safari sand scrub, the 2nd step would be the hydrotherapy process to remove it.

To create an exotic safari body wrap. Mix moor mud, honey and a sparingly amount of ginger essential oil in a rubber mixing bowl and apply the wrap by hand or with a spa brush. The wrap can be removed with hot towels (be sure to be thorough), or a showers/bath/hydrotherapy table.

Last would be the safari massage, which would include shea butter and essential oil of your choice that would reflect a safari experience. This could include eucalyptus, ylang ylang and more.

Raw unprocessed shea butter is extremely rich, and could possibly stain clothing - so it would be recommended to tell the client to wear dark sweat type material given this fact. It feel incredibly smooth on the skin, but you wouldn't want to wear a white linen dress after having raw unprocessed shea butter applied to your skin.

Be sure to train in aromatherapy plus body scrub, wrap and massage applications and contraindications prior to administering any type of service to a client.

For full directions on how to create this treatment, or to learn more, please register for quality, affordable, professional training at: https://ceinstitute.com/

Some clients will want a scrub or day at the spa, but have sensitive skin.  Using coffee grounds is an excellent method to provide a scrub to a sensitive skin client. However, if their skin is overly sensitive - then no scrub may be appropriate including this one.  This would be an individual client test that would need to be administered prior to body scrubbing. And as always, never scrub skin that is overly dehydrated, or broken, as well as all other contraindications.

The coffee grounds will become softer and softer over time, especially when kept in a hot towel cabi, so the scrub should not be made more than a few minutes prior to the appointment so that there is SOME texture to the scrub.

There are other names you could call a Warm Java Scrub including: 

1. Brewed Awakenings
2. Java Express
3. Coffee Sunrise
4. Cafe Cleanse

Different licenses have different scopes of practice, usually depending on the state you are licensed and practicing in.  Always check with your licensed scope of practice prior to administering a new service to a client.

To make a warm java scrub, simply mix coconut butter with unused/new coffee grounds.  Mix to the consistency where the concoction has a slightly scrubby/abrasive texture.  

Warm java scrubs should only be provided with a wet room or shower given the coffee grounds are not water soluble. Body massage with coconut butter can be administered after the scrub, and the scrub is washed off the client.

Be sure to seek professional training in aromatherapy plus spa wrap applications and contraindications prior to administering any type of service to a client..

Individual clients will have their own sensitivities beyond this information. Adding essential oils and individual ingredients of each wrap and scrub will have their own peculiar contraindications and precautions as well.

Above and beyond regular and obvious precautions and contraindications, here's a small list of other medical issues that would be of concern or contraindicated for a body wrap or scrub:

1. pregnancy
2. high blood pressure (specifically with wraps or steamed scrubs)
3. menopause (for wraps)
4. open wounds/broken skin
5. telangiectasia
6. sunburn
7. diabetics (specifically neuropathies)
8. areas of lost sensitivity or nerve damage
9. geriatrics (specifically with thinner skin considerations)
10. fever, infection, inflammations, swelling, etc.
11. non-heat tolerant (for wraps or steamed scrubs)
12. sensitive skin
13. immediately after waxing or shaving
14. extremely dehydrated skin (specifically with scrubs)
15. allergies to ingredients (check all ingredients with clients)
16. clients who will be exposed to sun the same day of treatment for phototoxic essential oils

There are greater precautions and contraindications for body scrubs and body wraps beyond this short list. Many will depend on the ingredients being used and the individual client.

Be sure to seek professional training in aromatherapy plus paraffin use  body scrub, wrap and massage applications and contraindications prior to administering any type of service to a client.

For full directions on how to create this treatment, or to learn more, please register for quality, affordable, professional training at: https://ceinstitute.com/

Different licenses have different scopes of practice, usually depending on the state you are licensed and practicing in.  Always check with your licensed scope of practice prior to administering a new service to a client.

When we think of spa wraps, we often think of FULL BODY wraps.  However, a back wrap by itself can be an excellent add-on service, or a wonderful addition to a larger spa back.

In this Sea Breeze Back Masque, ingredients can vary based on the client and their individual needs.  Here are some suggestions of what to use for ingredients:

• Paraffin or marine fango
• Eucalyptus essential oil

Mix the ingredients in a rubber bowl and use a paraffin brush to apply directly on the back while the client is in pronated position. Cover the back (only) with plastic/body wrap and then wrap the back with draping. The client can be left in meditative silence, or practitioners can work on the legs, feet, etc. while the client is wrapped.  Remove the wrapping/masque prior to rolling over into supine position.

Be sure to seek professional training in aromatherapy plus spa wrap applications and contraindications prior to administering any type of service to a client.

For full directions on how to create this treatment, or to learn more, please register for quality, affordable, professional training at: https://ceinstitute.com/

Different licenses have different scopes of practice, usually depending on the state you are licensed and practicing in.  Always check with your licensed scope of practice prior to administering a new service to a client.

This Lavender Fields service has 4 separate steps - a soak or shower, scrub, wrap then massage. Lavender is known for it's healing, relaxation, soothing and calming properties.

Ingredients can vary based on the client and their individual needs.  Here are some suggestions of what to use for ingredients to create a Lavender experience:

• Lavender essential oil
• Lavender powder (spa or cosmetic grade available at spa supply stores or online at places like Universal Companies)
• Kaolin Clay (white)
• Grapeseed oil
• Epsom salts
• Ice cream rock salt
• Dried lavender flowers
• Unscented massage gel, cream, oil or lotion
• Unscented body wash if you prefer a lavender shower over a lavender soak

Your lavender services would start with a full body scrub. Mix epsom salts with grapeseed oil in a bowl and apply directly by hand from the bowl for your lavender scrub. It is recommended to heat this body scrub concoction prior to applying on the body for comfort and warmth. It is recommended to use warm water and hot towels to remove the scrubs prior to apply the lavender body wrap.

The 2nd step is a lavender body wrap. There are two different types of lavender wraps that could be performed with your Lavender Fields Getaway Experience. Both of these should be comfortably heated prior to applying to the body.

1. Mix lavender essential oil into massage oil and then paint onto the body with an estheticians brush. Massage the oil into the skin and then wrap.
2. Mix lavender essential oil or powder with kaolin clay, and paint onto the body with a brush or apply by hand.

Third, is a full body lavender soak or shower.  For a wonderful visual soak experience - mix some lavender essential oil into some massage oil and then shake in a clear glass container with some ice cream rock salt and dried lavender vegetation. This will make a stunning visual presentation for your customer which you can add to the warm bath in front of them, and/or provide as a take home gift with purchase, or use as a retail item for sale to continue their lavender experience at home.

For a lavender shower, mix some lavender essential oil into some unscented shower gel.

Fourth and last would be a lavender massage. Mix some lavender essential oil into grapeseed oil for a luxurious relaxation massage. Practitioners could also add hot stones to the lavender massage.

Be sure to train in aromatherapy plus body scrub, wrap and massage applications and contraindications prior to administering any type of service to a client.

For full directions on how to create this treatment, or to learn more, please register for quality, affordable, professional training at: https://ceinstitute.com/