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Adjusting the Occiput on the Atlas
You may never see a particular set of patients in your office – the ones who are either afraid of neck adjustments or have had a bad experience. A vast majority of those who had a bad experience did not have a life-threatening vascular event.
We Get Letters & E-Mail
We Have Come a Long Way – But There's a Long Way to Go; Grounded and Connected.
Online Efforts That Convert Traffic Into Patients
Most chiropractors are using "dinner with the doc," "refer a friend," customer appreciation days, grand openings, health fairs, chamber of commerce meetings, and other networking events to get new patients.
Are You Really a Healthy Eater?
I always giggle a little bit (to myself) when someone comes into my office and informs me that they are a healthy eater. What exactly does that mean? Does that mean they eat sugar in moderation? And what's that, exactly?
The Top Seven Website Mistakes Clinics Make
The majority of acupuncture clinics finally have a website for their business. Having a website is crucial for being found online through Google, Facebook and review sites like Yelp.
Neuroscience: Where Western Medicine and Chinese Medicine Can Come Together
The recent advances in neuroscience are truly incredible. With this expansion of scientific knowledge, I would like to see even more research into the neuroscientific basic of acupuncture and Chinese Medicine.
Put the Social Back Into Social Media
Social media is more than a passing fad, it is definitely here to stay. Social media apps and channels of distribution may evolve, but the concept of social media is now big business and a part of all our lives.
Acupuncture and Homeopathy: Bioenergetic Brothers
Acupuncture and homeopathy share an important healing principle: bioenergetics. "Bio" means "life," so bioenergetics is literally "life energy."
It might have been a miserable start to the day in the heart of downtown San Diego. A heavy rain had soaked the large homeless population congregating near the intersection of Third Avenue and Ash Street as they waited for a free breakfast to be served at the First Lutheran Church on the corner.
The Conscious Evolution of Healing, Part 2
The idea of transmission is very important in the Chinese medical classics. According to author Claude Larre, the ancient Chinese were highly interested in the connection between things. Nothing was looked at as an isolated entity.
Joint Supplements for Athletes (Part 1)
Maintaining joint health should be a daily focus for athletes. Joint health is a complex issue for everyone, but for athletes it poses a greater concern.
Old TCM Sayings: Treat the Front to Treat the Back
Chinese medicine college was, and always will be, a memorable time. It was a time of massive personal and professional growth.
Reflections: The Art of Teaching Asian Medicine
Over the past three decades, my global workshops have been translated into German, Swiss German, French, Romansch, Spanish, Lithuanian and Xhosa. Time to offer you new teachers a few tips!
The Easy Way to Learn How to Document ICD-10
The 2015 Work Plan for the Office of the Inspector General (OIG) includes a focus on chiropractic services. This means chiropractors can expect to see more audits and reviews in the coming year because private payers pay attention to the OIG's focus as well.
Leg Length and Pelvic Fixations
A common component of low back pain is sacroiliac joint dysfunction. Signs of SIJ dysfunction can include fixation with reduced range of motion, and localized pain or joint laxity and inflammation.
A New Era of Injury Awareness Means a New Focus on Prevention
Despite a dramatic Super Bowl last month, the National Football League has taken quite a few hits lately concerning player injuries, particularly concussions.
Finding Balance in the Clinic
This past December, I celebrated 11 years in practice. I seriously don't know where the time went. I feel beyond blessed and grateful to be practicing our profound and beautiful medicine and to be helping guide my patients restore a state of optimal health.
What's Triggering That Point?
An orthopedic friend recently saw a patient of mine. He felt an injection of a trigger point (TP) at the upper trapezius and surrounding areas was necessary, since that was the patient's area of chief complaint and there was a tender, radiating nodule.
Connections Worth Making
"If most doctors are like me, [they are] isolated physically and professionally. I do not make the time to connect with other doctors and also a lot of doctors do not want to be connected for a lot of reasons. Dynamic Chiropractic keeps me grounded and connected.
It's Time to Create a Strong Acupuncture Footprint
Footprints in the sand. Footprints in the snow. Where do these footprints go? Some are big, some are small, but footprints are made by all.
November, 2001, Vol. 01, Issue 11
Reflex Mechanisms of Massage Therapy, Part II
By Ross Turchaninov, MD
Editor's note: Part I of this article appeared in the October 2001 issue of Massage Today, available on line at www.massagetoday.com/archives/2001/10/05.html.
Why do stimuli from the stomach that are delivered to the central nervous system (CNS) radiate to somatic structures, and why in turn are the stimuli from reflex zones activated by the flow of motor impulses to the stomach? The phenomenon of convergence is responsible for this effect. The number of afferent sensory neurons delivering information from peripheral receptors to the spinal cord is greater than the amount of spinal neurons in the posterior horns of the spinal cord. The posterior horns accept and primarily process this information (see figure 2).
In other words, there is more than one sensory neuron in contact with each spinal neuron in the posterior horns of the spinal cord. In this instance, the information brought to CNS by sensory neurons from the stomach excites the entire neural plate of the spinal neuron. The sensory information delivered by sensory neurons from the peripheral receptors in the skin or skeletal muscles also excites the entire neural plate of the same spinal neuron. This stimulation by sensory stimuli from the stomach or reflex zones activates the lower motor cells in the anterior horns of the spinal cord. They generate motor input not only to the location of the original abnormality (the stomach, in our example), but also to the somatic structures innervated by the same segment of the spinal cord.
Simpler mechanisms of reflex zone formation are applied in cases of somatic abnormalities. This mechanism is responsible for the reflex zones' formation along the pathway of irritated or compressed peripheral nerves. For example, the chronic irritation of the sciatic nerve by overtensed piriformis muscle will produce pathological symptoms through the entire lower limbs. In this manner, irritation of peripheral nerves in the upper part of the body will cause the formation of reflex zones in the lower extremities, supported by the affected peripheral nerve.
Finally, reflex zone formation can be caused by direct compression of the spinal nerve by a herniated disc. As a result of irritation or compression of the spinal nerve, various areas of pathological excitement develop in the spinal cord, especially in the lower motor centers in the anterior horns. Abnormal impulses flow from the spinal cord to the inner organs, and to other parts of the body that are innervated by the affected spinal nerve. Further development follows the same pattern of relation between reflex zones and inner organs or parts of the body as mentioned previously.
Let's now look at another important issue, and ask another important question: "What local events lead to the formation of reflex zones?" First, let's briefly review the physiology of excitation and the conduction of nerve impulses. A nerve impulse or "action potential" is a propagated electrical disturbance originating in the peripheral receptors or in the upper nervous centers; it is conducted through afferent, ascending sensory or efferent, descending motor neurons. Both ascending information to the central nervous system about any kind of peripheral receptors activation, and descending motor commands from the central nervous system, are delivered as a series of action potentials. Any single action potential is the result of changes in the conductance of sodium and potassium through the membrane of the nervous cells. Every action potential has a threshold. A threshold is the firing level of the action potential. This means that if applied stimuli are weak, they are unable to evoke an action potential. In this case, full action potential is replaced by a local response.
A local response is a weak electric excitement that stays within the stimulated receptor, rather than propagating along the neuron. As soon as the stimuli are strong enough, the action potential is generated and conducted through the neuron. This mechanism protects the nervous system from overflow with useless information. Normally, the threshold activation of peripheral receptors has stable electrical magnitude. The continuous radiation of motor impulses to the reflex zones in skin, connective tissue, muscles, or periosteum evokes unusual phenomena in these tissues. The magnitude of the threshold is reduced in all receptors located in these areas. As a result, receptors start to generate action potentials as a response to even the weakest stimulus, even those that normally had subthreshold levels and have never produced action potentials. (Korr, 1947). This phenomenon is called hyperirritability. The affected soft tissues respond by building up tension, especially in contractile elements. Vasoconstriction and local edema are formed, further diminishing blood circulation and decreasing tissue metabolism.
The decrease of the threshold of peripheral receptors, i.e. the condition of hyperirritability, is the starting point of reflex zone formation (Korr, 1947; Glezer, Dalicho, 1955; Kunichev, 1985; Shterngertz, Belaya, 1994; Loginova, 2000). Figure 3 shows how the action potentials are generated, both in the receptors of the normal parts of the body and in the areas of reflex zones.
In 1947, in a series of brilliant clinical experiments, Prof. I. Korr showed that hyperirritability is a key to understanding reflex zone formation. In his experiments, Korr inserted microelectrodes in muscles with clinical symptoms of hypertonic abnormalities, then exposed his subjects to different types of stimulation: physical activity, decreased and increased temperature, loud sounds, bright light, etc. When subjects were exposed to each of these stimuli (even visual and auditory) the skeletal muscles in the area of reflex zones reacted with increased tension, which was detected by electromyography. This caused the additional decrease of peripheral circulation in already-affected areas. Thus, as Prof. I. Korr showed, any type of sensory stimulation of the CNS causes the further development of reflex zones in the tissue which are no longer protected from theactivation of peripheral receptors by subthreshold stimuli.
A number of clinical abnormalities can be found found in the areas of reflex zones in the skin, connective tissue, skeletal muscles and periosteum. During diagnostic examination, the practitioner should detect all abnormalities and record them on prepared diagrams of the body. At the end of the diagnostic examination, the practitioner will have a complete picture of somatic abnormalities for the patient. Such an approach to diagnostic examination allows the practitioner to formulate the optimal treatment protocol.
I. Cutaneous Reflex Zones
II. Connective Tissue Zones (CTZ)
Connective tissue zones are also examined by palpation. Several diagnostic techniques target the CTZ in the each level. In general, the practitoner is looking for following abnormalities in the areas of CTZ:
III. Reflex Zones in Skeletal Muscles
Reflex zones in the skeletal muscles are examined by palpation and direct compression. The moderate compression of muscular tissue elicits sharp pain in the area of hypertonic muscular abnormalities. Patients show the so-called "jump symptom." Sharp pain elicited during moderate compression is another example of hyperalgesia.
IV. Periostal Reflex Zones
The periosteum is the thin connective tissue membrane covering all bones. It supports bone metabolism and remodeling. The periostal reflex zones are available for diagnostic examination only in the areas at which bone structures are covered by skin only. Examination of periostal reflex zones is conducted by palpation and direct compression.
Following diagnostic examination, the practitioner will able to formulate the proper protocol of medical massage therapy. The formulation of a correct protocol is of course key to successful treatment. As mentioned, this protocol is a combination of different methods and techniques. For example, connective tissue massage is the best way to work on the connective tissue zones, but it is useless in the areas of periostal reflex zones, where periostal massage is the most effective therapy. The practitioner must utilize the particular methods and techniques created for the treatment of particular type of reflex zones. For example, if the patient does not have abnormalities in the periosteum, periostal massage techniques must be excluded from the protocol. However, if one measures the clinical validity of different methods of medical massage, I believe that segment-reflex massage is as appropriate as all known methods of Western medical massage therapy. The major advantage of segment-reflex massage is its integrative approach to treatment.The modern protocol of segment-reflex massage includes therapeutic massage, connective tissue massage and periostal massage, as well as its own therapeutic techniques and approaches. This unique combination allows the practitioner to target the reflex zones precisely and deliver an effective therapeutic impact to the affected areas of the body. In any case, the protocol of medical massage therapy must be individually adjusted to each new patient, because there are no two identical cases.
In conclusion, I want to emphasize that reflex mechanisms of massage therapy allow the massage practitioner reach a completely new level of professional expertise. At first, the clinical application of reflex mechanisms of massage therapy is a challenge. However, the professional benefits are far more rewarding than the time spent by the practitioner to achieve this level of expertise.
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