Ear & Sinus Manual Treatment for Children
Position the child on a bed face-up, with the crown of the head close to the edge. Do not use a pillow or cushion to support the head, unless it is a very thin. The parent/guardian should make themselves as comfortable as possible, so that both of you enjoy the treatment. The child's head should be level, straight and not rotated.
Place your open hands gently on the child's upper rib cage. Sense and feel the chest falling and rising ask the child to breathe in deeply and exhale. When the child appears to have expelled the air from the lungs, gently push down on the rib cage two or three times, and release, but at the same time keeping your hands in contact with the chest wall. Do this three or four time, and make sure that their clothing is loose around the neck. When this has been completed use the inside of your index finger, and massage/stroke the neck from the lobe of the ear downwards to the shoulders. Four or five times should be enough.
Using the middle three fingers or whatever you are happy with, commence the massage using circular motions beginning at the front of the lobe of the ears following the line of the Eustachian Tube to the nose. You will pass over the Maxillary Sinus in doing so. Be gentle, smooth, and use small circular motions, always stroking in a downward direction towards the heart. This can be done several times.
We now go on to the first articulation, where you take hold of the child's chin, with your thumb above and forefinger below. The other hand should be resting gently but firmly on the child's forehead. Ask the child to open their mouth normally to begin with, under resistance from your fingers. In other words you are making it difficult for them to open their mouths. Do this several times, and then ask them to open their mouth wider under the same resistance. When they close the mouth allow them to do so naturally.
The next step is to allow them to open the mouth naturally, and then use resistance when they try to close the mouth. Be firm but gentle. When you have completed this task, return to the massage from the lobe to the nose.
The second articulation is in respect of the external ear and meatus. Take hold of both ears. The 'flats' of the hand should be against the skull with the ear protruding between the middle and ring fingers. Now rotate them clock-wise two or three times, and anti-clock-wise. Do not pull the ears away from the head. Again, continue working the Eustachian Tube and stroking the neck.
The third articulation is when we cup the hands and cover the ears and press gently. You should sense a sucking feeling on your palms, but not in all cases. We call this the 'Ear pump'. Never do this when a child wakes up during the night with pain to the ear. (Do the rest of the treatment first time round, have a cup of tea, and then repeat the treatment, but this time including the 'Ear Pump'. The pump can be done three or four times. Again return to the Eustachian Tube and neck.
You must try at all times to keep your fingers in contact with the child.
Now leave the cheekbone area, and using the same motion work up through the temple region, and onto the forehead. When your hands meet work down onto the Ethmoid Sinus, and then back up onto the Frontal Sinus areas. Direct yourself towards the hairline, and then bring your thumbs into play. With circular motions work the forehead with your fingers and the crown with your thumbs. It is a bit like tapping your head, and rubbing your tummy at the same time.
Now the next part is tricky because we need to massage the back of the head without disturbing the child or the continuity of the treatment.
We do this by leaving the forehead, working down through the temple and onto the neck, where we slip our fingers under the neck. To enable us to work the hands back up the neck to the head we must rock the child's head slowly and gently side to side. At the same time and in tandem we rock our own body in the same direction, which makes it that much easier to move the hands backwards between the bed and the child's head. Once this is accomplished we can massage the back of the head for approximately thirty seconds. This is quite difficult to do, but practice makes perfect.
When this is done work back down to the base of the skull. (Occipital). There is a nice ledge for the tips of your fingers to get hold of. Gently clamp your thumbs against the temple region so that your hands are in full control of the head and neck. At this point we are going to traction and compress the spine and spinal cord. Do not use your hands to traction, but use your body instead. Do this by slightly lying backwards, and then compress forwards and repeat six times. It is a slow and gentle technique. Take your time.
When this task is completed gently massage the sides of the neck. Do not touch the cervical bones of the neck.
Your hands should be free now, and this is where we finish off the ear treatment by gently grasping the shoulders and pushing downwards towards the child's feet, three or four times, and then again back towards the bed.
When your hands are behind the child's head, make sure that the child is relaxed. Ask the child to think of your hands as the pillow. Look at the front of the neck at the musculature (Sterno Cleido Mastoid). If it is sticking up as in protruding, then they are not relaxed.
After a couple of weeks this treatment should only take about fifteen minutes. In the acute or when the child has a cold the treatment can be done once or twice a day. In the chronic three times a week will suffice.
As discussed at the time of consultation. Remember it is reverberation with a gently downward and forward thrust with the fingertips, across all the three main sinus areas. It should be done in conjunction with the ear treatment especially when the child has a cold. Remember – Three days of virus, and then weeks of congestion, that is the key.