resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
February, 2002, Vol. 02, Issue 02
CranioSacral Dissection Sheds New Light on Effects of Palpation
By John Upledger, DO, OMM
In early April 1999, a small group of us had the privilege of working with a human cadaver that had been neither embalmed nor frozen. It had only been kept in a cooler to inhibit the deteriorative processes.It was the body of an 80-year-old male who had died only 34 hours earlier. The cause of death was lung cancer.
This particular dissection echoed back to others I had participated. By studying unembalmed cadaveric skull samples - skulls that had not been calcified from the effects of chemical agents - we were able to demonstrate the potential for movement between cranial bones. That fact that would become the underlying basis for what I would later name CranioSacral Therapy. Now, some 20 years later, this new round of cadaver dissections would allow us to understand the effects of this therapy in ways we could only have imagined.
To preserve the intracranial membrane system, we performed a parietal window dissection. Carefully, we removed brain tissue with no instruments but our gloved fingers. We also fully exposed the spinal dura mater to explore the interrelationships of the intracranial and spinal dural membranes, as well as their effects upon each other.
Those interactions in such a fresh cadaver were remarkable. We could see and feel the tensions developed in the falx and tentorium as we gently tractioned the dural tube from points between the occiput and the sacrococcygeal complex. The reverse, we found, was also true. As we lifted the frontal, parietal or sphenoid bones, we could see and feel the effects upon the spinal dura mater. It was all very exciting.
Now I'd like to describe our findings as we explored the effects of various activities upon the palatine bones. As you may know, a "stuck" palatine bone can be very difficult to release. It can also cause major problems, from severe headaches to visual disturbances and even seizures.
First we evaluated the resistance of motions induced by our fingertips on the palatine bones. The resistance was quite high - it required a push of at least half an ounce (15 grams +/-) to move either palatine in a cephalad direction. Pressing on the eyeball did not cause any movement in an inferior direction. This wasn't surprising, considering there was no "life" in this body. (We questioned the concept of "life," however, when we noticed the dural membrane stretched at about five grams of traction, yet eemed to contract against us as we increased the traction.)
We then dissected the right eyeball and its surrounding fat pads, which were copious even though the cadaver was lean and muscular. The fat pads clearly occupied at least 40 to 50% of the volumetric space in the orbit. We exposed the superior aspect of the vertical pillar of the right palatine bone. We were careful not to disrupt the fascial lining of the orbit, so we couldn't be accused of liberating fascial restrictions attached to the intraorbital aspect of the palatine bone.
We proceeded to induce palatine bone motion, with one finger upon its orbital surface and another finger upon its horizontal contribution to the hard palate in the mouth. The vertical and transverse mobilities of the palatine bone were still quite restricted. That's when another therapist placed a finger in the mouth, contacting the internal aspect of the right zygoma. The zygoma was decompressed laterally. This technique broadened the floor of the orbit and dramatically freed the palatine bone so that its responses to even slight finger-induced motions were extremely smooth and easy.
I had been using this technique on my patients for some time, based on the theory that a stuck palatine bone might often result from abnormal medial compression of the zygoma. It seemed effective to move the zygoma laterally to release the bone. It was most gratifying to see and feel how well the technique worked from the inside. The principle is simply to widen the floor of the orbit using the zygoma as your "handle." As the floor widens transversely, the trapped palatine bone is released and can move vertically up or down. Usually it's caught in a cephalad (upward) position.
Having witnessed the amount of fat in this orbit and the small area the palatine bone contributes to the intraorbital surface, it would seem to take an inordinate amount of pressure upon the eyeball to significantly facilitate palatine motion in a caudad (downward) direction. I much prefer to use the zygoma bone as the recipient of my force. After all, the eyeball is a delicate and intricately designed bag of fluid with subcompartments that can be much more easily damaged than the zygomatic bone.
Even with my level of experience in dissection and treatment, I found this type of dissection both enlightening and confirming. Since then we have continued to conduct similar dissection classes on a regular basis through the Institute. These classes focus on fresh, unembalmed cadavers, highlighting functional explorations rather than static observations. After all, no matter what anyone teaches you, there's nothing like discovering it with your own hands.
Click here for previous articles by John Upledger, DO, OMM.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.