resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Uncle Sam Needs You (Part 2)
Where chiropractic care has been used in the military health services, it has been deemed very successful.
Sports Science: What's in That Drink?
Athletes frequently ask me what the best liquid is to drink during exercise – water or a sports drink? Water provides the necessary hydration, but unfortunately, it lacks the key nutrients to aid in performance and recovery.
Communication 101: Please Explain Yourself!
Twice this past week, I overheard conversations about chiropractic. As you can imagine, it is a topic my ears naturally pick up. In both cases, a patient was talking to a friend about their experience with a chiropractor.
Chiropractic Research in Review
Predicting Pain With Disability in Office Workers; Traction Approaches for Discogenic Cervical Radiculopathy; Intra-Articular Gas Bubbles Following Manipulation; Nonresponsive Chronic Ankle Sprains: Think Tendon Rupture.
Essential Orthopedic Testing: Tests That Involve Standing on One Leg
Since these tests have a common mechanism of performance (standing on one leg), there are differential diagnostic concerns during testing. The tests cannot be completely isolated from each other for performance.
Commingling Money: 12 Questions for the ACA About the CHAMP / NCLAF Merger
The American Chiropractic Association recently announced it was merging the National Chiropractic Legal Action Fund and the Chiropractic Health Advocacy and Mobilization Project into a single entity that will support both legal and legislative actions.
Simple Ways To Find True Happiness
Patients in our clinics are always seeking happiness. As their health advocate, we need to ensure we inform them that in order to find happiness, they have to make sure to identify what makes them happy in the first place.
CMT & Stroke Risk: Myth vs. Fact
By now, most of you have probably heard that the American Heart Association recently published a statement regarding the association between cervical dissection (CD) and cervical manipulative therapy (CMT).
Correcting Pelvic Rotation Around the Long Axis: Adjustment Protocol
The pelvis can be considered a ring that can misalign on the sacrum rotating around the long axis. The following is a description of an adjustment that helps to correct sacroiliac rotation around the long axis.
Jingei Diagnosis: An Effective and Powerful Diagnostic
I graduated from the Kotatama Institute under the direction of Drs. Masahilo and Katsuharu Nakazono in 1984. As a student, I was exposed to the practice of most of the various theories and modalites of Oriental Medicine.
Pulse Diagnosis: What We Know
I am still finding pearls of wisdom from the books and papers that I inherited from my pulse diagnosis mentor Jim Ramholz.
Healing With TCM at San Quentin State Prison
For the prisoners at San Quentin State Prison, life-sentences are the reality of every day life. It is not often that prisoners get the opportunity to use alternative medicine to deal with common ailments they encounter behind bars such as, depression, anxiety and pain.
To The Finish Line With the Help of TCM
When acupuncturist Eddy De Smedt pursued a career in Traditional Chinese Medicine, he knew he wanted to make a difference.
Dr. George Goodman and His Legacy to Logan University
Those who knew him called him a revered leader, a visionary and one of chiropractic's biggest advocates. George A. Goodman, DC, Logan University's sixth and longest-serving president, passed away on Sept. 9. He was 70 years old.
Lime Jello on Morphine
Taste is in the eyes... actually the mouth... of the beholder. My food preferences have changed, lightening from the food of my youth. My parents loved heavy eastern European cuisine and I loved it as a child. Now I enjoy leaner, healthier whole foods.
The Heart Protector
On the physical level, the Pericardium is a double-layered sac of fibrous tissue that envelops the Heart. The space between the layers is filled with serous fluid that protects the Heart from external shock or trauma and lubricates to allow for normal Heart movement.
The Case for Immunization
As long as I have been a chiropractor, I have seen many in this profession oppose vaccinations. Indeed, it has often been taken as a "given" that to be a principled chiropractor requires a curmudgeon's willingness to hold aloft that banner of opposition.
The Tao of Gender
If you think gender is as simple as having a new client check off the "male" or "female" box on your intake form, we hope this article will expand your understanding and thus the reach of your health care.
The Wonders of Light Therapy: An Interview with Wes Burwell
I first met Wes Burwell in 2011 when he was teaching a class on light. Since then, every time I hear him speak, his understanding of the benefits, function and capacity of light has evolved.
Managing Today's Fertility Patient
I recently received an email from one of my fertility patients: "Got my lab results back. FSH is 11, AMH is 0.7. My doctor said these numbers aren't good. I guess I'm infertile. Just as a thought. Just set up an appointment to speak with an adoption agency."
AOMA Strengthens Leadership Team
AOMA Graduate School of Integrative Medicine, a leading college of acupuncture & herbal medicine, announced the appointment of Donna LaPoint Hurta, MBA as the new VP of Finance & Operations this Fall.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 2)
As mentioned in part 1, using a flexion-distraction table is a great way to unlock this particular fixation. You have found the stuck segment. You have determined whether it is unilateral, midline or bilateral.
Managing Patient Expectations About Acupuncture
Last year, I attended the Pacific Symposium in San Diego for the first time in six or seven years. It was the 25th anniversary of this event, and on one evening there was a panel discussion with the title; "What is Qi?."
October, 2005, Vol. 05, Issue 10
Breathing Patterns, Connective Tissue and Soft-Shelled Eggs
By Leon Chaitow, ND, DO
If the title of this article stirs your curiosity, hopefully by the end all should be clear, and you will be able to explain to a colleague just how increased levels of pain, soft-shelled eggs, and how you breathe are linked.
With implications ranging from increased fascial tone to colonic spasms, menstrual distress, pseudo-angina attacks, epileptic seizures, profound fatigue, muscle cramps, brain-fog, lowered pain thresholds, sympathetic arousal, increased sensitivity to light and sound, and feelings of extreme anxiety - I hope you will see I am not exaggerating when I say this is a topic worth understanding!22 This is a topic likely to be particularly relevant to your work with vulnerable, chronically painful and fatigued patients.
Before making these connections, though, I need to offer a brief summary of a personal health episode. I have shared this information with various audiences before (e.g., AMTA Conference, Nashville, October 2004), when attempting to highlight just how powerful and immediate the effects of respiratory alkalosis can be.
Back in 1998, I had flown from London to Edinburgh to make a video for my publishers to accompany my book on muscle energy techniques. It was a long day in a hot studio, accompanied by time pressures relating to the need to complete the shoot on time, and I had a plane to catch. I had skipped breakfast, consumed more coffee than usual, and had forgotten to drink enough water. These details are all relevant to what followed, as will become clear. Around mid-afternoon, I felt a strange sensation in my left leg. A mild tingle was passing down toward the foot, before fading away. This repeated itself a number of times over a period of an hour or so, but I paid little attention and focused on the details of the video shoot. The next day, safely back in London, the same mild symptom became more insistent and frequent, and then started to affect my left arm as well. Within an hour or so, it was accompanied by a strong spasm of the left leg and arm muscles, and finally of the whole left side of my body, including my face. This tetanic seizure convinced me I was having a stroke, and so I headed rapidly to the emergency room of my local hospital.
To cut a long story short, I was admitted to a neurological ward, spent a week being prodded, poked, observed and investigated - including a battery of neurological tests, cardiac investigations, blood tests and MRI scans. Nothing was found to be abnormal (not bad for a 60-year-old!). Finally, an enlightened neurologist had me wired up to an ECG machine, and asked me to breathe rapidly for two minutes. Within 30 seconds, all of my symptoms came back, with a severe contracture affecting my left side from face to foot.
"Ah," said this gifted physician (him, not me). "Your problem is hyperventilation. Go away and learn how to breathe." I did.
This life-changing experience turned out to be a turning point in my life and career focus. As a moderately successful osteopath and naturopath, I had long been aware of the importance of balanced breathing and had written about it in relation to stress management. But now, following this episode (which has never recurred), the topic became a virtual obsession. As mentioned in a previous article in Massage Today (April 2005), when I feel I need to study a subject deeply, I write a book about it. The end result of this experience was a text co-authored with physical therapist Dina Bradley and psychologist Chris Gilbert.6
I have spent the past seven or eight years with breathing pattern disorders as a top priority (for myself and my patients), and have studied as many aspects of breathing dysfunction and rehabilitation as I could. I am convinced this should be among the most important aspects of the work of all those engaged in health care, particularly manual and massage therapists.
So, what actually happens when we overbreathe? I will try to summarize a complicated sequence: As we exhale, we eliminate carbon-dioxide (CO2). This is recruited from carbonic acid that circulates in the blood. If breathing is more rapid than is ideal for the current needs of the body, we lose too much CO2 (and therefore carbonic acid), and the blood becomes more alkaline than normal.16 This creates a state of respiratory alkalosis: the blood's pH moves from a normal of around 7.4 to perhaps as much as 7.5.16 Not much change, you might say, but what a difference it makes! The effects are dramatic. Anxiety appears (and therefore, so does even faster breathing) - aggravating the feelings of anxiety or even panic.10,13 Smooth muscles constrict. And since these surround all of the "tubes" of the body, this creates a narrowing of blood vessels and interferes with normal digestion and bladder function.9 A process known as the Bohr effect starts, causing the red blood cells to bind more tightly to the oxygen molecules they carry. This means not only less blood gets to the brain and muscles, but also less oxygen is released by the blood that does get through, creating profound fatigue and a lack of mental clarity or "brain-fog."22 Sympathetic arousal occurs, creating altered neural function - more rapid reflex functions, lowered pain threshold, and sensitivity to all stimuli.23 Balance is disturbed.2 The kidneys try to rebalance the increased alkalinity by excreting bicarbonates, and a generalized imbalance occurs in the calcium and magnesium levels in the body, causing even more neurological mayhem, with cramps and spasms becoming more likely, accompanied by numbness, pins and needles and possibly pain.12 These changes provide a superb environment for the evolution of myofascial trigger points, as these are known to evolve in ischemic tissues where oxygen levels are low.18 All this is pretty terrifying, and does little to calm the breathing rate!
Chronic fatigue and chronic pain problems (such as fibromyalgia) are characterized by just such breathing patterns, as are a host of other health problems, most of which can at the very least be improved by better breathing, while many can be completely eliminated.4,20 All of these symptoms are more likely in deconditioned individuals, because of the way their cells produce ATP (energy) in an anaerobic environment, creating acid wastes that then further stimulate the breathing rate.16
How Widespread Are BPDs?
Breathing pattern disorders or BPDs (about which the notes above offer a description) are up to seven times more common in women and are more likely during the post-ovulation/premenstrual period because of increased progesterone levels.7 And they are much more likely to manifest when blood sugar levels are low. Recall my lack of breakfast, my coffee intake and dehydration.3 It has been estimated that the symptoms of at least 10 percent of all people seeking medical advice in the U.S. are the result of a BPD.13,15,16
Why do so many people breathe in an upper-chest, rapid pattern? There are many reasons for feeling anxious and stressed, or holding an "image" posture with a protruding chest and flat stomach, or of having mild asthmatic tendencies. But according to experts who have spent their professional lives studying breathing pattern disorders in general and hyperventilation in particular, whatever the background or original trigger, the main cause is pure habit.15
As a person becomes habituated to shallow breathing, the body learns to tolerate very low levels of CO2 in the blood and this becomes the "normal" for that person. In order to maintain this low CO2 level, rapid upper chest breathing is necessary. Relearning to tolerate higher levels of CO2 is a useful part of breathing retraining, achieved by focus on a slow exhalation and sometimes by specialized breath holding exercises based on the Russian Buteyko system.5,8
It's useful when thinking about the "habit" of upper chest breathing to think of another common habit: poor posture. The slouched, round-shouldered, chin-poked, belly-sagging posture of so many people is something of which we as bodyworkers are all too aware.22 How do you change poor posture into better posture? By retraining (such as the Alexander technique), combined with appropriate therapeutic interventions to stretch tight muscles and tone weakened ones, often aided by home-work such as Pilates-type exercises. Slowly, over a period of months, it often is possible to turn poor posture into better, or even good, posture.
Exactly the same applies to breathing pattern disorders. Manual therapy/massage methods are helpful in preparing the structures for better breathing and the person needs to do homework to re-establish a better pattern. This has, in many studies often involved severely anxious hyperventilators or people with severe balance disorders, taken up to six months to normalize, with some people improving within a few weeks.10,19
Mild forms of asthma and hyperventilation are almost identical, and the diagnosis given depends on the particular training of the doctor making the call. This can be pretty important because mild hyperventilation is curable, while a diagnosis of asthma often is a sentence to a lifetime of medication.
The Fascial Connection
As mentioned earlier, contractile smooth muscle cells have been found to be present in enormous numbers in most connective tissue. Their main function appears to be that, following injury, proliferation occurs allowing them to act as architectural supports to the damaged tissue as it heals.21 The cells in connective tissue, like other contractile smooth muscle cells, are affected by changes in pH21 (as in respiratory alkalosis), suggesting that a generalized increase in fascial tone occurs as pH rises, making all muscles feel more tense and impacting directly on musculoskeletal integrity. Just how much effect pH changes have on these cells remains a matter of ongoing research, and I hope to report to you on this when results emerge.1,11,24
A Fowl Story17
During the 1980s, a commercial egg farmer noticed his hens were laying soft-shelled eggs. The birds were being housed in very crowded and hot conditions, and the option of making them free range or installing air-conditioning was not economically possible. Veterinary experts decided that, as the birds were obviously hyperventilating, their calcium metabolism was disturbed, leading to the egg problem. They provided the hens with carbonated water (CO2 dissolved in water), and shortly after that, the egg quality returned to normal.
What we can learn from this is that the symptoms of hyperventilation (calcium disturbance in this instance) can be modified by biochemical interventions. The farmer's problem was solved, but the stress of the chickens was untouched. Other choices might have been tried - for example calming music, soothing aromas, massage, craniosacral therapy or even reflexology - any or all of which might well have had a calming effect, resulting in slower breathing. But what would have really helped the chickens was unavailable (free range life, air conditioning, etc).
Now consider your stressed, highly pressured patients, with multiple minor symptoms. Through massage and/or reflexology and/or aromatherapy you probably offer such complex, highly stressed individuals safe, symptomatic relief and moments of calm. This helps them cope with their own version of the hell the chickens were enduring. But what would help them most would probably be a cash infusion, a new job, a new hip, possibly a new relationship/spouse or some other life-changing event you are quite unable to provide. But you can teach them to respond to the stress/pain/fatigue differently; and you can efficiently and gently soften and mobilize their tense tissues. And above all, you can learn how to teach them to breathe differently.
Please let the editor of Massage Today and/or me know if you would like this particular article to be followed up with more detail on breathing rehabilitation from the perspective of a bodyworker.2,6,8
Click here for more information about Leon Chaitow, ND, DO.
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