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Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
After two treatments for back pain, a patient presents for a third
session complaining of rapid breathing and wheezing that is made worse
during cold weather.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
June, 2003, Vol. 03, Issue 06
Applications of CranioSacral Therapy in Newborns and Infants, Part II
By John Upledger, DO, OMM
Editor's Note: Part one of this two-part series appeared in the May 2003 issue.
Forceps and Vacuum Extraction
Once an infant's head is delivered and free from the pressure of the birth canal, we can focus on what occurs as the rest of the child's body is delivered.The trip through the birth canal involves a brilliantly orchestrated series of twists and turns for the child's torso and pelvis, which essentially mobilizes each joint in the spine and pelvis and stretches all the related musculature and soft tissue. Nature intended this to be a process that relies more on pushing from uterine contraction than pulling from externally applied forces.
When those assisting the delivery process apply excessive traction to the child's head to "assist" the body through the birth canal, significant strains of muscles, ligaments, fasciae and joints may occur. The body's response to a strain is tissue contracture. There also may be small amounts of blood extravasated, which act as irritating stimuli that may later induce fibrotic changes in soft tissues. These phenomena may occur within the craniosacral system and in the paraspinal and pelvic tissues.
Wherever strains and extravasations occur, they can interfere directly or indirectly with proper functioning of the craniosacral system. Strains should be released; contracted tissues should be relaxed; fluid exchanges in tissues where extravasated blood has spilled should be encouraged; and all joints should be mobilized as soon as possible after delivery.
If these issues are not addressed, they can cause a wide variety of craniosacral system problems, spinal problems (that I believe can manifest as scoliosis in later life) and pelvic imbalances (that could easily interfere with the proper functioning of pelvic organs). It is easy to correct the majority of these problems immediately following delivery, and it is essentially risk-free when the work is done by a competent CranioSacral therapist. It requires only minutes to carry out the evaluation and treatment early in the child's life; it seems a shame not to do so as soon as possible.
Other causes of craniosacral system dysfunction that relate to delivery include abnormal presentations, such as eith the face, arm, leg and breech. Each of these presents abnormal stresses, strains and pressures upon the child's body, which may manifest as unique craniosacral system problems. The system must be evaluated to determine the dysfunction, and the natural self-corrective mechanisms must be supported to attain full function and efficient craniosacral system function.
Forceps and vacuum-assisted deliveries often impose the excessive "pulling" forces that induce strain patterns in body tissues. Forceps, which are applied asymmetrically, often result in a misshapen head that is beyond the child's self-corrective abilities. These problems can be resolved by a skilled CranioSacral therapist as soon as possible after delivery.
My own experience with children delivered by vacuum extraction has firmly molded my opinion in opposition to this practice. The vacuum or suction on the child's head creates a negative force inside the head that can result in the suction of abnormal quantities of intracranial fluids into the top of the skull vault. This "edema" may result in long-lasting craniosacral system dysfunctions relating to loss of flexibility of the meningeal membranes, and probably some fibrous changes in tissues that are meant to be pliable and compliant.
The "vacuum-extracted" children we have worked on at our clinic require a great deal of CranioSacral Therapy (CST), even when therapy begins during the first year of life. The problems are correctable, but if another choice of delivery is available, it would be better to avoid the risk imposed by applying such strong vacuum forces to the top of the delicate fetal head.
I was surprised during my early work to see the strong positive correlation between the presence of significant craniosacral system dysfunctions and delivery by Cesarean section. It was quite puzzling, until I remembered occasions during C-sections when I saw amniotic fluid spout up into the air a few inches as the incision was made into the uterus. This suggests the sudden reduction of pressure inside the uterus where the child has been living for the past nine months. Fetal physiology could be severely challenged by this sudden change in pressure. It seems comparable to a scuba diver surfacing too rapidly and suffering the "bends."
From a craniosacral point of view, this sudden reduction in external pressure might result in a rapid expansion of the fetal head. This, in turn, could easily result in intracranial membranous strain; micro tears in the meningeal membranes; and tiny capillary bleeds. As these extravasated red blood cells degrade, they undergo biochemical changes in which they become bile salts, which are irritants to brain tissue and membranes. This tissue irritation results in fibrous change in the form of gliosis in the brain loss of compliance in membranes; and small but significant intermembranous adhesions. These conditions may cause craniosacral system dysfunctions that could require extensive therapy.
Postpartum Events That May Relate to Craniosacral System Dysfunction
The most common postpartum event we have seen relating causally to dysfunctions of the craniosacral system is the suctioning of the mouth and nose. The newborn's hard and soft palate, and nasal structures are extremely delicate at the time of birth. The suction bulb or tube easily insults the soft tissues, causing them to contract. When it persists, this contracture compromises hard-palate and nasal-bone mobility that, in turn, causes craniosacral system dysfunction.
Hard palate problems usually result in sphenoid and/or temporal-bone dysfunction. These problems can easily lead to eye-motor system dysfunction and severe irritability of the child. Other symptoms are often sensory and very difficult to evaluate since a newborn cannot provide verbal reports of sensation. Therefore, it is up to the astute CranioSacral therapist to locate the system dysfunctions without much feedback besides crying and other signs of discomfort. Occasionally, the suctioning is done rather roughly, and actual bony dysfunction of the hard palate, zygomata and/or mandible can occur. These problems are more flagrant, and therefore more easily discovered during the evaluative process. What is discovered must then be addressed.
Other postpartum craniosacral problems are usually seen as they relate to injuries, like dropping the newborn. These are all individual and unique problems for which each child must be evaluated. The CranioSacral therapist must address what he or she finds.
Craniosacral System Evaluation and Protocol
I have spoken a lot about CST and its uses in the delivery room and during the early stages of the newborn child's life. In closing, I would like to describe the initial evaluation and protocol as I do it in the delivery room or the nursery.
First, I simply hold the skull vault of the child's head in one hand and evaluate for tightness and/or asymmetry over the whole skull-vault surface. Then I insert one finger of the other hand into the child's mouth and try to induce the sucking response. If it occurs, I enhance it in synchrony with the child's own rhythm. This enhancement is done in the form of gentle finger pressure on the roof of the mouth with each suck. If no sucking occurs, I will gently and rhythmically press on the roof of the mouth. As this rhythmical hard-palate pressure is continued, I can feel the skull vault expanding slowly. In this way, and by gently sculpting with the skull-vault hand, skull asymmetries and overriding can usually be corrected.
Next, I release the occipital base by laying one or two fingers under the back of the neck. These fingers support the upper cervical vertebrae in an anterior position while, with the other hand, I very gently urge the occiput to "back off" of the atlas. Once this is accomplished - and it seldom takes a full minute - I keep my occiput hand where it is. I move the other hand down to the pelvis and gently traction between the occiput and pelvis. This technique is used to release strains induced by "pulling" the newborn through the birth canal.
Frequently, I feel a sort of unraveling process along the spine as I do this technique. I believe many cases of scoliosis are headed off right here, just as many cases of hyperactivity and learning disabilities are avoided by the occipital-base release and the skull-vault molding.
I move both hands to the pelvis and, holding one half of the pelvis in each hand, I release and balance this region. I release the shoulders and rib cage by holding one half of the upper torso in each hand and releasing and balancing, just as I did with the pelvis. This total evaluation and protocol should not take more than five to 10 minutes. If specific problem areas do not resolve, the child should be seen again for re-evaluation and therapy within 24 hours.
This rather innocuous session with a newborn may head off problems later in life. It is a worthwhile, minimal-risk investment in a child's future.
Click here for previous articles by John Upledger, DO, OMM.
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