CE INSTITUTE LLC BLOG

Author: Selena Belisle, Founder/Instructor, CE Institute LLC, Miami FL

Use caution when working with cerebral palsy stiffness or contractures around the head or joints. Do not force a joint to a “straightened” position and be aware that moving a stiff head could cause “dizziness” to the client.

Cerebral palsy (CP) is a group of disorders that affect a person’s ability to move and maintain balance and posture. CP is the most common motor disability in childhood. Cerebral means having to do with the brain; palsy means weakness or problems with using the muscles. CP is caused by abnormal brain development or damage to the developing brain that affects a person’s ability to control his or her muscles. 

The symptoms of CP vary from person to person. A person with severe CP might need to use special equipment to be able to walk or might not be able to walk at all or require lifelong care. A person with mild CP, on the other hand, might walk a little awkwardly, but might not need any special help. CP does not get worse over time, though the exact symptoms can change over a person’s lifetime.

All people with CP have problems with movement and posture. Many also have related conditions such as intellectual disability; seizures; problems with vision, hearing, or speech; changes in the spine (such as scoliosis); or joint problems (such as contractures).  We need to be especially concerned with any client with a contracture.  Moving a body part too quickly or with too much range of motion could do damage to our massage, salon or spa client.

Doctors classify CP according to the main type of movement disorder involved. Depending on which areas of the brain are affected, one or more of the following movement disorders can occur:

• Stiff muscles (spasticity)
• Uncontrollable movements (dyskinesia)
• Poor balance and coordination (ataxia)

There are 4 Main Types of Cerebral Palsy:

• Spastic Cerebral Palsy: The most common type of CP is spastic CP. Spastic CP affects about 80% of people. They have increased muscle tone. This means their muscles are stiff and, as a result, their movements can be awkward. Spastic CP usually is described by what parts of the body are affected:
  • Spastic diplegia/diparesis: In this type of CP, muscle stiffness is mainly in the legs, with the arms less affected or not affected at all. People with spastic diplegia might have difficulty walking because tight hip and leg muscles cause their legs to pull together, turn inward, and cross at the knees (also known as scissoring).
  • Spastic hemiplegia/hemiparesis: This type of CP affects only one side of a person’s body; usually the arm is more affected than the leg.
  • Spastic quadriplegia/quadriparesis: Spastic quadriplegia is the most severe form of spastic CP and affects all four limbs, the trunk, and the face. People with spastic quadriparesis usually cannot walk and often have other developmental disabilities such as intellectual disability, seizures, or problems with vision, hearing, or speech.

• Dyskinetic Cerebral Palsy: Includes athetoid, choreoathetoid, and dystonic cerebral palsies.  People with dyskinetic CP have problems controlling the movement of their hands, arms, feet, and legs, making it difficult to sit and walk. The movements are uncontrollable and can be slow and writhing or rapid and jerky. Sometimes the face and tongue are affected, and the person has a hard time sucking, swallowing, and talking. A person with dyskinetic CP has muscle tone that can change (varying from too tight to too loose) not only from day to day, but even during a single day.

• Ataxic Cerebral Palsy: People with ataxic CP have problems with balance and coordination. They might be unsteady when they walk. They might have a hard time with quick movements or movements that need a lot of control, like writing. They might have a hard time controlling their hands or arms when they reach for something.

• Mixed Cerebral Palsy: Some people have symptoms of more than one type of CP. The most common type of mixed CP is spastic-dyskinetic CP.

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Author Selena Belisle is the Founder of CE Institute LLC in Miami FL. She is a retired professional athlete and has been practicing massage therapy for over 30 years. Selena is an approved CE Provider with NCBTMB & the Florida Board of Massage. She now teaches full time for the Complementary and Alternative Health Care Industries. You can learn more about Selena’s training and CE classes at www.CeInstitute.com

Author: Selena Belisle, Owner/Instructor, CE Institute LLC, Miami FL

Body lice are parasitic insects that live on clothing and bedding used by infested persons. Body lice frequently lay their eggs on or near the seams of clothing. Body lice must feed on blood and usually only move to the skin to feed. Body lice exist worldwide and infest people of all races. Body lice infestations can spread rapidly under crowded living conditions where hygiene is poor (the homeless, refugees, victims of war or natural disasters). Infestation is unlikely to persist on anyone who bathes regularly and who has at least weekly access to freshly laundered clothing and bedding.

Body lice eggs usually are seen in the seams of clothing or on bedding. Occasionally eggs are attached to body hair. Lice found on the head and scalp are not body lice; they are head lice.

Lice can spread epidemic typhus, trench fever, and louse-borne relapsing fever. Although louse-borne (epidemic) typhus is no longer widespread, outbreaks of this disease still occur during times of war, civil unrest, natural or man-made disasters, and in prisons where people live together in unsanitary conditions.

Lice are spread through direct physical contact with a person who has body lice or through contact with articles such as clothing, beds, bed linens, or towels that have been in contact with an infested person.[i]  As such, massage, spa or salon services should not be provided while an individual is infected with body lice.

To learn more, please register for quality, affordable, professional training at: https://ceinstitute.com/

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Author Selena Belisle is the Founder of CE Institute LLC in Miami FL. She is a retired professional athlete and has been practicing massage therapy for over 30 years. Selena is an approved CE Provider with NCBTMB & the Florida Board of Massage. She now teaches full time for the Complementary and Alternative Health Care Industries. You can learn more about Selena’s training and CE classes at www.CeInstitute.com

[i] Global Health – Division of Parasitic Diseases. Frequently Asked Questions (FAQs). (2013, September 24). Retrieved from https://www.cdc.gov/parasites/lice/body/gen_info/faqs.html

Author: Selena Belisle, Owner/Instructor, CE Institute LLC, Miami FL

Gout is a form of arthritis generally caused by a build-up of uric acid in the joint. It regularly starts in the big toe joint and joints furthest from the heart where our body’s temperature is coolest, and the uric acid can “crystalize”.  

• Considered one of the most painful kinds of arthritis
• Symptoms include:
  • Pain/tenderness
  • Tightening of the skin
  • Swelling
  • Redness or discoloration
  • Warm to the touch
• Is generally caused by consuming purine rich foods, such as alcohol, anchovies, dried beans, gravies, liver and peas

An area affected by gout may be red, hot to touch on the surface, swollen, and the client may have moderate to extreme pain.

Most people who have gout are house-bound, and are unable to stand or walk without extreme pain.  It is ill-advised to press on the affected area, and it is recommended to seek approval and/or direction for services from a medical physician regarding medical conditions.  This may include rescheduling any services that involves the affected area (i.e., a pedicure for someone who has gout in their big toe), so that they can receive their personal care service without extreme pain.  Manicures will also have similar contraindication if any of the joints of the fingers or hands are suffering from gout.  Pressing or providing traction to a tissue that is already swollen with gout could create greater tissue damage and swelling, regardless of location. 

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Author Selena Belisle is the Founder of CE Institute LLC in Miami FL. She is a retired professional athlete and has been practicing massage therapy for over 30 years. Selena is an approved CE Provider with NCBTMB & the Florida Board of Massage. She now teaches full time for the Complementary and Alternative Health Care Industries. You can learn more about Selena’s training and CE classes at www.CeInstitute.com

Author: Selena Belisle, Founder/Instructor, CE Institute LLC, Miami FL

Every client must be able to provide informed consent for each service they request or receive at the spa, salon or massage therapy practice. Informed consent includes telling the client of any possible consequences for the service, including known risks and benefits. The client can only provide consent for the service once this information is shared.

A person who is under the influence of alcohol or drugs is not of legal capacity to provide informed consent. This person may exhibit slurred speech, may be off-balance or is not able to make sense of their surroundings, etc.—and usually is not of “sound mind” to provide consent.

As massage therapists, spa & salon service providers, we are not able to make medical diagnoses.  Unfortunately, a person exhibiting imbalance, slurred speech, etc., may be having an acute medical episode that requires immediate medical attention.  Regardless of the situation, personal care services can only be provided when an individual can provide informed consent. Personal care services should not be provided to an individual who is under the influence of alcohol or drugs that reduces the client’s capability to provide informed consent for any reason.

To learn more, please register for quality, affordable, professional training at: https://ceinstitute.com/

Author Selena Belisle is the Founder of CE Institute LLC in Miami FL. She is a retired professional athlete and has been practicing massage therapy for over 30 years. Selena is an approved CE Provider with NCBTMB & the Florida Board of Massage. She now teaches full time for the Complementary and Alternative Health Care Industries. You can learn more about Selena’s training and CE classes at www.CeInstitute.com

Author: Selena Belisle, Founder/Instructor, CE Institute LLC, Miami FL

Acne is a noncontagious skin condition that occurs when your hair follicles become plugged with oil and dead skin cells. Blockages, inflammation, and infection can develop deep inside the skin and produce a cyst-like lump within the skin. 

Depending on its severity, acne can cause emotional distress and scar the skin.  In older adults, a sudden onset of severe acne may signal an underlying disease requiring medical attention.[i] 

It is important to note that some instructors teach different “grades” of acne (i.e. Grade I, Grade II, Grade III & Grade IV – or another system).  However, the American Academy of Dermatology states that “…there is no universally agreed upon grading system, and systems can differ greatly between studies…”[ii]

Massage therapists, salon & spa service providers should never work on or over broken skin.  That means that service or touch should be avoided over facial or body areas that have severe acne break-out.  Not only is the skin broken but there could be significant infection as well. 

If your client is concerned about severe acne, refer them to a dermatologist or physician for proper medical care.  For estheticians, facial specialists and those licensed to work with skin conditions, you may be able to help a client with acne with proper skin care acne treatment product(s) and regimen.

To learn more, please register for quality, affordable, professional training at: https://ceinstitute.com/

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Author Selena Belisle is the Founder of CE Institute LLC in Miami FL.  She is a retired professional athlete and has been practicing massage therapy for over 30 years.  Selena is an approved CE Provider with NCBTMB & the Florida Board of Massage.  She now teaches full time for the Complementary and Alternative Health Care Industries. You can learn more about Selena’s training and CE classes at www.CeInstitute.com

[i] Mayo Clinic Staff. “Acne.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 31 Oct. 2017, www.mayoclinic.org/diseases-conditions/acne/symptoms-causes/syc-20368047.

[ii] “Practice Management Center.” Systems for the Grading and Classification of Acne: Recommendations | American Academy of Dermatology, Retrieved on: 25 Apr. 2018, www.aad.org/practicecenter/quality/clinical-guidelines/acne/systems-for-the-grading-and-classification-of-acne.

By: Selena Belisle, Owner/Instructor CE Institute LLC, Miami FL

Knowing where skin is thinner or thicker in the body may help you determine a better service for your client.  For example, a hot stone during hot stone massage will be more tolerable over the thicker skin areas of the body.  And services such as cupping massage, body scrubs or waxing may require more attention in the thinner skin areas of the body, because the skin is thin and could easily rip or tear with too much force, etc.

Thin Skin:  Above is a diagram of thin skin in the axilla/underarm region.  Here, you can see that the outer layer of the epidermis (the stratum corneum) is much thinner than in the previous picture of thicker skin. 

You can also see there is no stratum lucidum, but there are apocrine glands (labeled #8 on the pictured diagram above) which can produce a scent or odor.  Most apocrine glands are found in the armpits, groin, and breast area.

Thick Skin:  Below is a diagram of the skin of the human palm.  Skin is regularly thicker on the palms of the hands and soles of the feet.  This thick skin on the soles of the feet are what can lead to excessive dead skin and calluses. 

In this image, you can also see the stratum lucidum layer of the epidermis (labeled letter B on the pictured diagram below).  This is an additional translucent layer of skin of the epidermis that is found in few select places such as the palms of hands and soles of the feet.

To learn more, please register for training at https://ceinstitute.com/

#massage #massagetherapy #massageprecautions #massagecontraindications

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Author Selena Belisle is the Founder of CE Institute LLC in Miami FL.  She is a retired professional athlete and has been practicing massage therapy for over 30 years.  Selena is an approved CE Provider with NCBTMB & the Florida Board of Massage.  She now teaches full time for the Complementary and Alternative Health Care Industries. You can learn more about Selena’s training and CE classes at www.CeInstitute.com

Author:  Selena Belisle, Founder/Instructor, CE Institute LLC, Miami FL 

Skin Facts & Basics plus its Vital Role to the Human Body[i]

Even at its thickest point, our skin is only a few millimeters thick. Yet it is still our heaviest and largest organ, making up about one seventh of our body weight: depending on your height and body mass, it weighs between 3.5 and 10 kilograms (7.5 and 22 pounds) and has a surface area of 1.5 to 2 square meters. This goes to show how important skin is for your body and metabolism.

Skin has a lot of different functions. It is a stable but flexible outer covering that acts as barrier, protecting the body from harmful things in the outside world such as moisture, the cold and sun rays, as well as germs and toxic substances.

Just looking at someone’s skin can already tell you a lot – for instance, about their age and health. Changes in skin color or structure can be a sign of a medical condition. For example, people with too few red blood cells in their blood may look pale, and people who have hepatitis have yellowish skin.

Skin also plays an important role in regulating your body temperature. It helps prevent dehydration and protects from the negative effects of too much heat or cold. It allows your body to feel sensations such as warmth, cold, pressure, itching and pain. Some of these sensations trigger a reflex, like automatically pulling your hand back if you accidentally touch a hot stove.

Skin also functions as a large storeroom for the body: the deepest layer of skin can store water, fat and metabolic products, and it produces hormones that are important for the whole body.

If skin is injured, the blood supply to the skin increases in order to deliver various substances to the wound so it is better protected from infections and can heal faster. Later on, new cells are produced to form new skin and blood vessels. Depending on how deep the wound is, the skin can heal with or without a scar. 

The skin consists of three very distinctive layers to be able to do perform its many required functions.  Those three layers are:

• the outer layer (epidermis)
• the middle layer (dermis)
• the deepest layer (subcutaneous tissue aka hypodermis)

Depending on where it is on your body and the demands made on it, your skin varies in thickness. The thickness of your skin depends on your age and sex too: older people generally have thinner skin than younger people, and men generally have thicker skin than women.

To learn more, please register for quality, affordable, professional training at: https://ceinstitute.com/

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By: Selena Belisle, Founder/Instructor CE Institute LLC, Miami FL

Sudoriferous Glands aka/are more commonly referred to as: Sweat Glands

Sweat glands produce and secrete substances onto the surface of the skin through a tubular passageway or “duct”.  They are found on the dermis and their passageways protrude through the epidermis.

There are two main types of sweat glands: apocrine and eccrine glands.  While they are commonly found around the same area of the dermis, these two glands can act quite differently.  They differ in their structure, function, secretory product, mechanism of excretion and anatomic distribution.

Eccrine Sweat Glands

A type of simple sweat gland that is found in almost all regions of the skin. These glands produce sweat that reaches the surface of the skin by way of coiled ducts (tubes). The body is cooled as sweat evaporates from the skin.[i] Eccrine sweat is a colorless, odorless, hypotonic solution. 

Humans are born with approximately 3 million eccrine sweat units, and no additional ones are formed thereafter.[ii]

Apocrine Sweat Glands

These glands are found mostly in the axilla (armpits) and perianal areas and are not significant for cooling for humans. The apocrine gland secretes an oily fluid with proteins, lipids, and steroids that is odorless before microbial activity. It appears on the skin surface mixed with sebum, as sebaceous glands open into the same hair follicle.[iii]

A foul or volatile odor is created when the apocrine gland secretions mix with bacteria on the skin.

Apocrine glands tend to excrete in “squirts” while eccrine glands excrete continuously. 

To learn more, please register for quality, affordable, professional training at: https://ceinstitute.com/

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This BLOG was written by Selena Belisle, the Founder of CE Institute LLC in Miami FL.  She is a retired professional athlete and has been practicing massage therapy for over 30 years.  Selena is an approved CE Provider with NCBTMB & the Florida Board of Massage.  She now teaches full time for the Complementary and Alternative Health Care Industries. You can learn more about Selena’s training and CE classes at www.CeInstitute.com

[i] “NCI Dictionary of Cancer Terms.” National Cancer Institute, Retrieved online: 20 May 2018, www.cancer.gov/publications/dictionaries/cancer-terms/def/eccrine-gland.

[ii] “Eccrine Units.” Derm101, 20 May 2018, www.derm101.com/inflammatory/embryologic-histologic-and-anatomic-aspects/eccrine-units/.

[iii] "sweat gland". Miller-Keane Encyclopedia & Dictionary of Medicine, Nursing, and Allied Health (7th ed.). Saunders. 2003. Retrieved 18 December 2012.

By: Selena Belisle, Founder/Instructor CE Institute LLC, Miami FL

In the obtuse angle between the root of a hair and the surface of the skin, a bundle of smooth muscle fibers, known as an arrector pili muscle, is usually found.

The arrector pili muscle extends from the deep part of the hair follicle to the papillary layer of the dermis.

Contraction of the arrector pili muscle makes the hair “stand” erect. The arrectores pilorum are innervated by sympathetic fibers and contract in response to such stimuli as emotion or cold. This results in an unevenness of the skin’s surface called "goose pimples."[i]

To learn more, please register for quality, affordable, professional training at: https://ceinstitute.com/

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