External Applications in Anthroposophic Nursing

Leg Rhythmical Einreibung According to Wegman/Hauschka

Kind of substance

Lavender 10% oil

Guiding principle

Rhythmische Einreibung treatment of the legs and feet stimulates metabolic activity and clearance. It supports thrombosis prevention, stimulates the flow of blood and thereby facilitates warming in cases of cold extremities. Where there is pain from osteoarthritis or rheumatism the treatment has an enlivening effect on the joints and the entire leg.
Rhythmische Einreibung to the leg has four parts: lower leg, knee, thigh and foot.

Indications

  • Cold legs and feet (see example case)
  • Constipation
  • Pain in the lower leg and knee area from osteoarthritis and rheumatism
  • Heavy, tired legs
  • Hemiparesis: in cases of spasticity and loose paralysis
  • Circulatory disorders
  • Lymph congestion, edema
  • Supports the prophylaxis of decubitus
  • Supports the prophylaxis of thrombosis
  • Labor inducing

Instructions

Rhythmical Einreibung according to Wegman/Hauschka can only be learned in seminars from instructors. For more information see  Rhythmical Einreibung
But gently rubbing the legs with a little oil already supports warmth generation.

Evidence
Benefits many patients
Dosage
Ideally daily, or 1 to 2 times a week, a total of about 20 minutes
Onset of effect
Varies, from immediate to increasing after several treatments
Length of therapy
As needed

Case example

A small, delicate 59-year-old female patient is referred by her doctor. Her cancer is very advanced. Due to metastasis in the liver, this has also spread to the entire upper right quadrant, with accompanying ascites. The patient feels relatively well during chemotherapy, much better than her condition would lead to expect. Her biggest problem is lack of strength, which does not permit her to do very much. Emotionally she seems bright (medicated with lithium), open, friendly, approachable, but also somewhat hectic and not quite present. She is looking forward to the treatments, which she has never tried, and offers unsolicited information about her everyday life.

The treatment begins with a kidney figure-eight.
Due to the size of her liver she cannot lie on her stomach, even lying on her side presses too much against it, so I modify the treatment and do the figure-eight over the kidney area with Cuprum 0.4% ungt. (Weleda) while she is sitting on a chair. The region is initially cool, after the post-treatment rest it is well warmed. The patient does not react in any specific way during the treatment.
Rhythmical Einreibung of the legs:
The lower legs and feet are slightly congested. The legs are ice cold from toes to groin, they feel entirely lifeless. The aim is to induce lasting warmth development and more vitality, so my approach is "close". The gesture is one of enfolding and stimulating.

For her post-treatment rest the patient receives a heat pack with several warming elements on her legs. Her condition is quite poor, and she has little vitality, so that she requires vigorous outer support to develop good warmth. 

After the 3rd application the patient says, unasked (referring to her warm legs): "You feel somehow different in yourself. Before it was like walking around in a coating or something, and then it is like you are really there."
From the 3rd treatment onwards, the patient appears much calmer and more self-contained. She feels her forces returning and is very much looking forward to being able to cook for her son again and eat with him. That is her greatest joy! She had had a difficult marriage and feels liberated from it after the divorce. She makes no great demands on life, but being together with her son fulfils her deeply.

From the 7th treatment (end of April 2012) the general condition of the patient deteriorates, the tumor is progressive despite chemotherapy. Her legs are more congested, the development of warmth is less intensive and dynamic. After the 8th treatment (May 2012), she is admitted to hospital and I no longer see her in my practice.

In the palliative care unit the patient passes over the threshold in the presence of her son on December 24th that year.
ML

Author

Red., ML

Bibliography

  • Layer M, Grosse-Brauckmann E., in: Layer M (ed.). Praxishandbuch Rhythmische Einreibungen, 2nd ed. Bern: Verlag Hans Huber.
  • Batschko E-M. Einführung in die Rhythmischen Einreibungen nach Wegman/Hauschka. 2nd ed. Stuttgart: Mayer; 2011.
  • Film: Große-Brauckmann E, Glaser H. Rhythmische Einreibungen nach Wegman/Hauschka. DVD Filderstadt: Verband für Anthroposophische Pflege; 2012.

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