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TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
Low Back Pain: Posture and Movement Analysis
When performing static and dynamic movement analysis of the lumbopelvic hip area, begin with standing visual posture analysis of the pelvis, and then perform lumbar range of motion and assess what you might see during normal versus abnormal lumbar flexion motion.
Avoid Random Treatment of Trigger Points (Part 2)
We must acknowledge that the fascia, which surrounds literally everything in our bodies, including every muscle fiber, is more than just a covering.
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
Interpersonal Skills 101: Enhancing the Value of Our Patient Interactions
Recently, I read an interesting article in our local newspaper titled "The Value of Human Interaction." The article presented comments from a senior editor for Fortune magazine who discussed "Civility in the Business World."
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
Atypical Femoral Fractures and Bisphosphonate Use: What to Watch For
Bisphosphonates (BP) are popular drugs, with more than 8 billion in sales in 2008; however, profits have declined as patents began expiring. Nonetheless, BP remain the most commonly prescribed drugs for patients at risk of osteoporotic fractures, with several million prescriptions written every year.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
Primary Spine Care: Addressing Concerns & Criticisms
The Dec. 1, 2013 issue of Dynamic Chiropractic included an article describing the implementation of a training program for primary spine practitioners (PSP) within a metropolitan region and supported by a large BC/BS plan.
A Reality Check – and a Chance to Educate
Imagine working in the public relations department of nutrition retailer General Nutrition Corporation (GNC) and reading the The New York Times announce...
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
Help Update the LBP Practice Guideline
The Council on Chiropractic Guidelines and Practice Parameters has announced the release of an updated Clinical Practice Guideline for Chiropractic Management of Low Back Pain for stakeholder review and comment.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
Impacting Chiropractic's Future With Technology
When it comes to electronic health records (EHR), Robert Moberg and Dr. Steven Kraus are two of the leading industry experts on the topic.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
Expanding Access, Branch by Branch
The big news coming from Capitol Hill isn't merely the recent introduction of a pair of bills designed to expand chiropractic services in the Veterans Affairs and military health care systems; after all, similar legislation has made its way through Congress before, never reaching the Oval Office for presidential signature.
May, 2003, Vol. 03, Issue 05
Applications of CranioSacral Therapy in Newborns and Infants, Part I
By John Upledger, DO, OMM
CranioSacral Therapy has proven effective in identifying a number of disorders affecting children, including dyslexia, hyperkinetic behavior and motor-control problems.It's also good at alleviating such conditions when they're caused by restrictions in the dura mater membranes of the craniosacral system. I believe the few minutes necessary to conduct a craniosacral system evaluation in the delivery room, or shortly after birth, is a worthwhile investment in any child's future health and well-being.
In 1977, we did a great deal of clinical work at Michigan State University (MSU) to discover how the newly discovered craniosacral system affected patients. For research purposes, I had to develop a standardized evaluation tool. By that time, I had done enough hands-on work that it was fairly simple to come up with the 19-step protocol, which was used by four different examiners to see whether or not the findings were in agreement. The examiners were unaware of each other's findings until each statistician had completed his work. Using this protocol, we examined 25 nursery-school children and found an 85- percent agreement among the four examiners, which took their individual subjective findings out of the realm of chance. Clearly, we were dealing with a craniosacral system that could be evaluated reliably using only the hands of a trained examiner. Based on this study, I considered the evaluation protocol a valid research tool.
I went on to use this protocol on 203 grade-school children. An independent statistician-psychologist correlated my results with the childrens' academic and behavioral performances, and with the medical/obstetrical history of each mother and child. Statistical data analysis revealed that the process was capable of identifying children suffering from dyslexia, hyperkinetic behavior, seizures and motor-control problems. It also could identify babies delivered by Caesarean section or forceps, and those who had suffered oxygen deprivation at the time of delivery.
Based on those results, we opened a clinic at MSU for brain-dysfunctional children. We also received funding to research relationships between autism and craniosacral system dysfunction. The clinic opened in late 1977, and the autistic research was carried out from September 1978 through June 1981. All of this work led to the following impressions and conclusions regarding the effects of craniosacral system dysfunctions on central nervous system (CNS) function.
Maternal Illness or Toxicity During Pregnancy
Maternal illness or toxicity during pregnancy usually results in a generalized tightness of the fetal dura mater, which makes the membrane less able to comply with the rhythmic volume changes of cerebrospinal fluid flowing within the craniosacral system. Frequently, this is a consequence of a maternal viral infection during the last six months of pregnancy. (Maternal bacterial infection is a less likely cause.) We've also seen cases in which tight membranes seemed related to the mother's respiratory difficulties, such as asthma, or to toxin problems, whether from a single experience or ongoing exposure. The toxins could be taken in as food, drink, medicines or street drugs, or inhaled as air pollutants or airborne allergies.
Usually, such a generalized tight-membrane syndrome manifests as gross dysfunction of the child's central nervous system: Sensory and motor deficits, while extremely variable, are obvious. Most often, CranioSacral Therapy greatly affects or completely corrects these problems. The treatment is particularly effective when applied during the first few weeks of an infant's life. If allowed to persist, the noncompliant-membrane syndrome may be severe enough to become a strong contributing factor to the development of autism. Other problems, such as maternal injury, emotional upset or fetal malposition in the pelvis over a prolonged period, are more likely to produce specific clinical symptoms related to craniosacral system dysfunctions that can be discovered quite easily. Proper application of CranioSacral Therapy - the earlier the better - usually is quite effective.
Craniosacral System Dysfunctions Related to the Delivery Process
Delivery of the newborn involves passage of the child through a convoluted birth canal. I believe vaginal delivery represents a child's first CranioSacral treatment, spinal mobilization, myoneural system treatment and sensory-stimulation session. In my opinion, all of these serve to prepare the infant for the rapid transition from life inside the womb to the outside world. Nature seldom makes design errors, and I certainly don't believe the birth canal is one of them.
The bones of the vault of the fetal/newborn skull are hard places in the membrane. There is ample room between their edges for overriding and changing of the head's shape so it can pass through the birth canal. This passage represents a "manipulation" of the skull bones by the birth-canal walls; it ensures their proper mobility, so that after delivery, the bones are able to comply with the motion of the craniosacral system.
Cases of skull-bone overriding usually self-correct as the child's head expands and reshapes after exiting the birth canal. Should this not occur within minutes, a CranioSacral therapist can correct these situations easily. Left uncorrected, override problems can contribute to seizure tendencies. We often find a persistent override between the parietal and frontal bones in spastic conditions such as cerebral palsy. When corrected, these conditions usually improve or disappear entirely.
The squeezing of the child's head during delivery also may act as a circular wringer that encourages the permeation of cerebrospinal fluid into and throughout the brain tissue, down the spinal canal and throughout the subdural spaces. This squeezing motion helps the venous blood drain from the skull vault, so that as soon as the head is delivered from the birth canal, fresh arterial blood can enter the vault and further activate the circulatory systems of the brain. It also offers the first scalp massage.
Most infants are delivered face-down, with the mother in the supine position and the child's occiput coming out under her pubic bones. Many well-meaning delivery attendants feel a need to speed up the process. Obstetrical lore contends that when the head comes out, we must hasten to complete the delivery, since the birth canal may be squeezing the umbilical cord against the infant's body. This cord compression is thought to potentially occlude blood flow to the infant, which may result in brain damage due to hypoxia. In other words, the attendant's good intention translates into grasping the child's head and pulling; in doing so, the head can be hyperextended, which may create a "jamming" of the skull's occipital bone forward into the V-shaped receiving-joint surfaces, located on the superior surface of the 1st cervical vertebra (atlas).
When there is danger of injury, the soft tissues of the body contract or splint. If splinting occurs with the child's occiput jammed in this forward position, it will stay that way. In that case, the contracture of soft tissues at the juncture of the skull base and the top of the neck may compromise areas of the jugular foramena on the right side, the left side or both. If the jamming is more severe, it may compromise the foramen magnum.
The jugular foramena allow several important structures to pass out of the skull, including the jugular veins that drain most of the venous blood from the head into the neck. The foramena also afford passage to the IXth, Xth and XIth cranial nerves. The glossopharyngeal (IXth) and vagus (Xth) cranial nerves work jointly to help control swallowing, airway function, and the larynx, pharynx and esophagus. The glossopharyngeal nerve also works along with the hypoglossal (XIIth) cranial nerve to control the tongue and oropharynx. Additionally, the vagus nerve helps maintain a normal heart rate and is involved in stomach and bowel function. When dysfunctional, the vagus nerve can contribute to a sense of dizziness.
The hypoglossal (XIIth) nerve exits from the skull through the hypoglossal canals, located beside and beneath the joint surfaces of the occiput as it articulates with the atlas. Consequently, jamming can easily result in tongue control problems, such as tongue thrust. The spinal accessory (XIth) cranial nerve innervates some of the major muscles of the neck; when dysfunctional, it may create spasm of the sternocleidomastoideus and/or the portion of the trapezius muscle in the neck. This may continue after birth due to ongoing compression/irritation of the nerve as it exits the jugular foramen, which may then produce a torticollis.
We call this type of craniosacral system dysfunction "occipital base compression." If both sides of the occipital base are severely compressed, it's common to see colic; food regurgitation; esophageal reflux; respiratory difficulties; rapid heart rate; and compromised bowel function (constipation or diarrhea). There also may be spasm of the neck muscles. If left uncorrected, the situation may result in hyperactive child syndrome and attention deficit disorder. When the occipital base jamming is less severe, or only on the right or left side, any combination of these symptoms may be present.
Fortunately, occipital base compression can usually be corrected by a skilled CranioSacral therapist in a matter of minutes, if the child is treated during the first weeks of life. Treatment is most effective when performed during the first few days of life - or even in the delivery room, after the umbilical cord has been cut and the child has been suctioned and wiped clean. The sooner the child is seen, the less treatment normally is required.
If neck-muscle spasm is allowed to persist, it can cause temporal bone dysfunction in the craniosacral system. This has been shown to be a strong contributing factor in children with dyslexia and other reading problems. Interestingly, correcting these dysfunctions in school-age children often allows them to catch up to normal reading levels in a matter of weeks, unless psychological and/or emotional scars are in the way. If they are, psychoemotional therapeutic modalities must be incorporated into the treatment program.
Click here for previous articles by John Upledger, DO, OMM.
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