resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Looking Back: Abstracts From Chiropractic History
D.D. Palmer's Technique for the Posterior Apical Prominence; An Early Attempt to Achieve Consensus on Subluxation; Chiropractic Subject Headings: Past, Present and Future; Mabel Palmer: A History of Chiropractic That Almost Wasn't.
Resolving Medial Arch Suspicions: The Navicular Drop Test
Healthy feet have three distinct arches: medial longitudinal, lateral longitudinal and anterior transverse.
Best Practices for Website Success
If one asked 10 years ago whether a website was relevant I was the first to suggest no. Yet as the world moves increasingly towards electronic information there is a dire need to have a website for your practice. Your website is actually your electronic calling card.
Post-Concussion Patient Care: Relevance of the Chiropractic Adjustment
There is a widespread understanding within the profession of the general guidelines for care of the concussion patient. These include guidelines for physical and cognitive rest, return to normal activities and so forth.
Hazards in the Environment Making Your Patients Sick
Working both separately and together, Western and Chinese medicine have many successes in the treatment of the myriad diseases that afflict human beings in modern times.
The Gluteal-Knee Connection
The underlying causes of knee pain and dysfunction are rarely isolated to the knee. The knee is a relatively stable joint with limited intrinsic ability to adapt to aberrant motion.
Healing With Simple, Healthy Food
When it comes to your health, there is no better way to take control and create positive outcomes than by focusing on diet and lifestyle. As chiropractors, you know the power that regular self-care has for your patients.
Inside Liver Failure, Cirrhosis and Cancer
The Liver belongs to Wood in Five Element Theory and is in charge of Dispersing and Expanding which means all the processing and detoxifying of harmful substances such as medications and chemicals require the efforts of the Liver.
Super Bowl Chiropractor
With opening night of the 2014 National Football League season only a month away, what better time to talk to Dr. Jim Kurtz, team chiropractor for the defending Super Bowl champion Seattle Seahawks?
Healing With Hope
Ella is a Gulf War veteran and a survivor of military sexual trauma. Like hundreds of veterans, Ella was on 11 different medications for depression, anxiety, insomnia, irritable bowel syndrome and chronic pain.
Deciphering The New CMS 1500 Claim Form
Q: I am confused on using the new 1500 form, particularly Block 14 and Block 15. What is required and how do I properly fill these out? And do I actually have to use this new form or may I continue using the old version?
Talking to Skeptical MDs: "Just the Facts, Ma'am"
The first lesson in public speaking is to know your audience. This is particularly applicable when talking to skeptical medical doctors about chiropractic. You have to understand where they are coming from and speak the language they understand.
Looking For Answers In Many Places
I am sure we have all heard the old adage: "When the only tool in your toolbox is a hammer, everything starts to look like a nail."
The Kidney Official
The Kidney is known as the Official Who Controls the Waterways. In Western medical terms, a major function of the Kidneys is to filter the blood. Every day, a person's kidneys process about 200 liters of blood to sift out about two liters of waste and excess water.
Not Another Typical Drug Company Lawsuit
It's becoming more common to see drug manufacturers negotiate "false claims" settlements for millions and billions of dollars.1-2 Most of these settlements have to do with violations in the marketing of the drugs they produce and sell.
Primary Lateral Sclerosis: A Condition With a Chiropractic Connection
Primary lateral sclerosis (PLS) is a slowly progressive, adult degenerative disease of the upper motor neurons characterized by progressive spasticity or stiffness. It is a clinical diagnosis that has been avoided because it is (largely) a diagnosis of exclusion.
Medical Qigong for the Heart: Part II
Chinese Medicine is rich in commentary regarding the emotions and how they affect our qi.
Advice for Young Doctors
When I began practice, I was just shy of my 25th birthday. I was young and I looked it. I had been told this would be a problem when starting a practice – and it was. Older patients often paused when they entered for care.
Getting Athletes Back in the Game: Low-Level Laser Therapy for Sports Injuries
Sports injury rehabilitation is all about getting back in the game quickly and with optimal health. A relatively new tool for the treatment of sports injuries is finding global success, and it is doing so in a fast, efficient way.
Spotlight on Acupuncture Research at IRCIMH
Acupuncture and Traditional Chinese Medicine were well-represented at the International Research Congress on Integrative Medicine and Health (IRCIMH)- 2014 which took place in Miami from May 13–16.
The Acupuncture Success Express
Time is passing very quickly these days. We are atoms half the way through the year of the horse. You could call it "horse racing season" for this profession. Perhaps it is time for reinvention during this time.
F4CP: New Campaign to Promote Chiropractic as a Career
The F4CP has announced a "targeted cooperative campaign" that will engage doctors of chiropractic and chiropractic students, as well as chiropractic colleges, chiropractic media, state associations and vendors, to encourage DCs to recommend a chiropractic career to patients, family and friends.
Offline Marketing Techniques: Opportunities to Help Grow Your Business
In a world becoming increasingly dominated by connected devices, when we think of marketing, we often think of online and social media marketing. Considerable attention is given to Facebook and Twitter, as well as CPC [cost-per-click] advertising.
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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