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A Simple Protocol for Holiday Stress
It's winter, a time when we should be deep in reflection, eating warming foods and sleeping long hours. Following nature's rhythms, we restore our bodies and minds in preparation for the renewal of spring.
Assessing Core Stability and ROM: 5 Basic Checks
One of the first steps in addressing core stability is assessing static posture, ranges of motion, and motion of the pelvic bones, sacrum, femurs, lumbar spine and thoracic spine.
Overuse Injuries in Young Athletes (Pt. 2)
Most overuse injuries are benign, but there are some high-risk injuries that, if unrecognized or inappropriately treated, can result in significant loss in time from the sport or even require leaving the sport.
End of an Era Looms at NYCC
New York Chiropractic College recently announced that Dr. Frank Nicchi will retire in August 2017 after 36 years with the college, the past 17 as president.
All Fiber Is Not Created Equal
Sometimes the best place to start is at the end. So, the conclusion of this article is that all fiber is good ... but some fiber is better. Let's break it down. There are two main types of fiber: soluble fiber and insoluble fiber.
Little Sticker, Big Impact
It's the end of an election year. Hilary Clinton and Donald Trump were the subject of conversation for everyone, everywhere for the entire 2016 calendar year. I don't think any of us can deny that this election affected us all very deeply on a personal level.
Southwest Acupuncture College Brings It to Division 1 Athletes
When Michael Phelps' photograph with the distinctive round marks left by cupping went viral, the Division 1 student athletes treated through the Dal Ward Athletic Center at the University of Colorado (CU) could relate.
Herbs for Digestion: The Power of Bitter
Many cultures (and indeed herbal clinicians) around the world have long respected the role of bitter herbs and foods for promoting digestion. For example, aperitifs – drinks consumed before a meal to stimulate appetite and digestion – were originally derived from bitter herbs.
DVT: Know the Signs and You Could Save a Life
I lost a friend several months ago. He died from a pulmonary embolism (PE) secondary to a deep-vein thrombosis (DVT) that originated in his lower leg. Bobby was in his mid-60s, soft-spoken and had a big heart.
A Letter to the Profession from the New President at AAAOM
Volunteering for a national, nonprofit organization brings with it such highs, lows, and accomplishments, as well as a steep learning curve.
Chiro School Reunion: Whatever Happened to...?
I opened the door to the closet slowly, carefully, since I knew it contained a large number of precariously stacked file boxes. It also held numerous outdated gizmos with electrical cords of various lengths that could trip or strangle a person.
Can a Multivitamin Reduce Breast Cancer Recurrence?
There is a great deal of controversy regarding the value of multivitamin supplements in cancer prevention. However, with respect to preventing breast cancer recurrence, an important study was published in the Journal of Breast Cancer Research and Treatment in 2011 by Kwan ML, et al.
News in Brief
New President / CEO Takes Office at Yo San University. Electroacupuncture for Constipation?
Another Chance to Make a Difference
Just a few months ago, "the worst natural disaster to strike the United States since Hurricane Sandy" hit Louisiana. During this storm, one area experienced 31 inches of rain in 15 hours as almost 7 trillion gallons of water rained down in just one week across the state.
6 Steps to Make 2017 Your Best Year Yet
People often ask me what defines success. Success, for me, is simple: doing exactly what you want to do in life. Whether it's the kind of practice you run, your life at home, your hobbies or something else, it's achieving anything you put your mind to.
Meshing TCM With Environmental Pediatrics: Where's the Overlap?
Pediatrics has a long history within Chinese medicine dating back to the late Han dynasty (i.e., the late 200s CE), with the two primary areas of emphasis being herbal medicine and xiao er tui na (pediatric massage).
Branding: Set Your Practice Apart
Dr. Brad started his practice seven years ago on a shoestring budget. He created his generic logo in five minutes using a website because he didn't have the time to figure out how to make something special.
Molecular Motors: Tiny Machines Behind the Rhythm of Life
In the clinic, we aim to restore healthy patterns of movement for qi that has gotten trapped or misdirected, or may have even collapsed. We may be focused on freeing stagnation, releasing heat or redirecting counterflow qi, but it often comes down to helping re-establish a flow of sorts.
A Q & A About Updated Codes
Yes, indeed there was an update to ICD-10 on Oct.1, 2016. This is a regular update to the diagnosis coding system and this type of update will occur every Oct. 1, just as it did when the ICD-9 system was in place.
What We Can Learn From Spine Surgery
Patients with lumbar stenosis presumably present for conservative care to improve their quality of life and avoid surgery. However, providing clear guidance to these patients can be difficult for a number of reasons.
Dedicated to Defending Chiropractic
Whether you're a veteran DC or a first-trimester student, the name George McAndrews should be part and parcel of your professional vernacular, as familiar as the word chiropractic.
A First for the Profession: CCE Accredits First Chiropractic Residencies
The Council on Chiropractic Education (CCE) has awarded accreditation to all five chiropractic residency programs currently administered at Veterans Administration facilities, "the first residency programs in the nation ever to be awarded this distinction, a significant advancement in the evolution of chiropractic education," according to a VA press release announcing the milestone.
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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