resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. 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.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
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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