Ep 442 – Episataxis: “I Have a Client Who . . .” Pathology Conversations with Ruth Werner

Image of a person with tissue in their nose trying to stop a nose bleed.

A client with frequent nosebleeds works with a massage therapist on TMJ pain, and something unexpected happens: she goes from 3-4 bleeds a week, to about one. The therapist has referred her to get more information about her sinus health, which is a good idea. But is there anything else they can be doing?


Pocket Pathology: https://www.abmp.com/abmp-pocket-pathology-app

Association of Hypertension With the Risk and Severity of Epistaxis | Bleeding and Transfusion | JAMA Otolaryngology–Head & Neck Surgery | JAMA Network (no date). Available at: https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/2770570 (Accessed: 28 May 2024).

Durham, J. and Wassell, R. (2011) ‘Recent Advancements in Temporomandibular Disorders (TMDs)’, Reviews in Pain, 5(1), pp. 18–25. Available at: https://doi.org/10.1177/204946371100500104.

Epistaxis and Hypertension: Reviewing a Complex Relationship (no date) Medscape. Available at: https://www.medscape.com/viewarticle/epistaxis-and-hypertension-reviewing-complex-relationship-2023a1000i7t (Accessed: 28 May 2024).

‘Epistaxis: Practice Essentials, Anatomy, Pathophysiology’ (2024). Available at: https://emedicine.medscape.com/article/863220-overview?&icd=login_success_email_match_fpf (Accessed: 28 May 2024).

Karegeannes, M. (2018) Red Flags, Treating TMJ. Available at: https://www.treatingtmj.com/symptoms/red-flags/ (Accessed: 28 May 2024).

Nose Bleeds at Night: 5 Causes (2017) Healthline. Available at: https://www.healthline.com/health/nose-bleeds-at-night (Accessed: 28 May 2024).

Nosebleeds (Epistaxis): Causes, Treatment & Prevention (no date) Cleveland Clinic. Available at: https://my.clevelandclinic.org/health/diseases/13464-nosebleed-epistaxis (Accessed: 29 May 2024).

Nosebleeds: When It’s Time to Get Medical Attention (2021) Columbia University Irving Medical Center. Available at: https://www.cuimc.columbia.edu/news/nosebleeds-when-its-time-get-medical-attention (Accessed: 28 May 2024).

Image of Kiesselbach Plexus

Credit: FirstAdmiral, CC-SA-3.0

Author Images: 
Author Bio: 

Ruth Werner is a former massage therapist, a writer, and an NCBTMB-approved continuing education provider. She wrote A Massage Therapist’s Guide to Pathology, now in its seventh edition, which is used in massage schools worldwide. Werner is also a long-time Massage & Bodywork columnist, most notably of the Pathology Perspectives column. Werner is also ABMP’s partner on Pocket Pathology, a web-based app and quick reference program that puts key information for nearly 200 common pathologies at your fingertips. Werner’s books are available at www.booksofdiscovery.com. And more information about her is available at www.ruthwerner.com.   



Anatomy Trains is a global leader in online anatomy education and also provides in-classroom certification programs for structural integration in the US, Canada, Australia, Europe, Japan, and China, as well as fresh-tissue cadaver dissection labs and weekend courses. The work of Anatomy Trains originated with founder Tom Myers, who mapped the human body into 13 myofascial meridians in his original book, currently in its fourth edition and translated into 12 languages. The principles of Anatomy Trains are used by osteopaths, physical therapists, bodyworkers, massage therapists, personal trainers, yoga, Pilates, Gyrotonics, and other body-minded manual therapists and movement professionals. Anatomy Trains inspires these practitioners to work with holistic anatomy in treating system-wide patterns to provide improved client outcomes in terms of structure and function.    

Website: anatomytrains.com    

Email: info@anatomytrains.com          

Facebook: facebook.com/AnatomyTrains

Instagram: www.instagram.com/anatomytrainsofficial

YouTube: https://www.youtube.com/channel/UC2g6TOEFrX4b-CigknssKHA  


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EmbodyU helps you find out what you're made of - from online anatomical embodiment and movement courses to in-depth Dissection + Embodiment labs, founders Ann Teachworth & Alison Wesley are passionate about helping therapists improve their skills through better anatomical education. Their 6-day fresh tissue cadaver dissections are approved by the NCBTMB for 45 CEs.

Ann Teachworth: co-founder of Trunamics, offering advanced massage education, including for ABMP and AMTA. She is a Franklin Method Educator, yoga teacher, and Director of Education at the Inspirit School of Healing Arts in Orlando, FL. 

Alison Wesley: Franklin Method Faculty, yoga teacher, author of Understanding the Pelvis: A Functional Approach to Yoga and Faculty at Oregon School of Massage. She shares embodied anatomical study and movement classes online and in-person in Portland, Oregon. 

Website: embodyu.net/dissection

Dissection Promo Code: EMBODYABMP

Instagram: instagram.com/embody_u


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