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TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
Expanding Access, Branch by Branch
The big news coming from Capitol Hill isn't merely the recent introduction of a pair of bills designed to expand chiropractic services in the Veterans Affairs and military health care systems; after all, similar legislation has made its way through Congress before, never reaching the Oval Office for presidential signature.
Impacting Chiropractic's Future With Technology
When it comes to electronic health records (EHR), Robert Moberg and Dr. Steven Kraus are two of the leading industry experts on the topic.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
Interpersonal Skills 101: Enhancing the Value of Our Patient Interactions
Recently, I read an interesting article in our local newspaper titled "The Value of Human Interaction." The article presented comments from a senior editor for Fortune magazine who discussed "Civility in the Business World."
Primary Spine Care: Addressing Concerns & Criticisms
The Dec. 1, 2013 issue of Dynamic Chiropractic included an article describing the implementation of a training program for primary spine practitioners (PSP) within a metropolitan region and supported by a large BC/BS plan.
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
A Reality Check – and a Chance to Educate
Imagine working in the public relations department of nutrition retailer General Nutrition Corporation (GNC) and reading the The New York Times announce...
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
Low Back Pain: Posture and Movement Analysis
When performing static and dynamic movement analysis of the lumbopelvic hip area, begin with standing visual posture analysis of the pelvis, and then perform lumbar range of motion and assess what you might see during normal versus abnormal lumbar flexion motion.
Avoid Random Treatment of Trigger Points (Part 2)
We must acknowledge that the fascia, which surrounds literally everything in our bodies, including every muscle fiber, is more than just a covering.
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
Atypical Femoral Fractures and Bisphosphonate Use: What to Watch For
Bisphosphonates (BP) are popular drugs, with more than 8 billion in sales in 2008; however, profits have declined as patents began expiring. Nonetheless, BP remain the most commonly prescribed drugs for patients at risk of osteoporotic fractures, with several million prescriptions written every year.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
B Vitamins Improve Memory, Prevent Brain Atrophy
The 2010 OPTIMA study showed that the accelerated rate of brain atrophy in elderly with mild cognitive impairment could be slowed via supplementation with homocysteine-lowering B vitamins, which included folic acid, vitamin B12 and vitamin B6.
Help Update the LBP Practice Guideline
The Council on Chiropractic Guidelines and Practice Parameters has announced the release of an updated Clinical Practice Guideline for Chiropractic Management of Low Back Pain for stakeholder review and comment.
June, 2006, Vol. 06, Issue 06
The Phrenic Circuit
By Dale G. Alexander, LMT, MA, PhD
Let's return to some basics in anatomy and physiology that support the notion that placing your awareness and working from the "inside-out" facilitates the healing process for our clients.Appreciating the influence of the phrenic nerves has assisted me to serve my clients with chronic problems. The very nature of chronic illness and pain requires that the body somehow distribute both the internal physiological pressures within it and the external musculoskeletal strain placed upon it.
My clinical experience has consistently demonstrated that the diaphragm muscle and its phrenic nerves together are one of the body's primary circuits for distributing strain. The phrenic nerves are the sole motor nerves of the diaphragm muscle; a direct efferent supply from the neck to the diaphragm. Its afferent system however is extensive as it receives sensory supply from all of the following sources; the peritoneal sac, the gall bladder, the capsule of the liver, the pancreas, the pericardial sac of the heart, the pleurae of the lungs and from the subclavius muscles1. Wow! That's a lot of current to handle.
Distribution of strain and allocation of resources are crucial components of physical healing. The notion of compensation within the musculoskeletal system when one has experienced an injury is a simple way to conceive of what is meant by distribution of strain. But it's only the tip of the iceberg. Allocation of resources refers to the body's remarkable genius to commandeer energetic and nutritional sources to support general physiology during times of increased demand. The body does all of this and more but, often at a price which lowers the quality of our lives.
What few have made sense of is that the pain in your client's neck actually might be emanating from their gut tube, heart or lungs, and might even be a major contributing source of their pain or the numbness in their shoulder, arms, elbow, wrist or fingers that just won't go away. How does that happen, you might ask? The phrenic nerves exit the spinal cord from C3, C4 and C5. This overlaps and shares the circuitry within the spinal cord of the brachial plexus C4 - T2, the origin of the neurocirculatory supply to the upper extremities.
Imagine water filling up within a sink, which, if not diverted back into the drain pipe, overflows the container. Thus, tensions within the organs of the "phrenic circuit" build to a tipping point and spill over into the relationships of the brachial plexus and are expressed as symptoms in the neck, upper back, and/or upper extremities. How many times have you used, or heard the phrase, "I've had it up to here" as an expression of feeling stressed, exasperated or overwhelmed? Often, people actually raise their hand to the level of their chin, which interestingly is approximately the level of the 4th cervical vertebra.
Let's remember, I previously have described the stereotypical effects of stress as the "cringing of the body's sacs and a shortening and narrowing of its tubes."2 Three of the four major sacs within the body feed direct sensory supply into this phrenic circuit.
Imagine what happens to body posture when the large sac within your abdomen cringes. Feel it within your own body. Next, add the cringing of the sacs of the heart and lungs, a shortening of the esophagus (the major tube between the head and the abdomen), and now, add the tightening of the diaphragm and a shortening of one or both of the iliopsoas muscles. Where do you feel the strain? Obviously, in the back and/or the neck. The head and neck literally are being pulled forward and down. The entire extensor reflex system is activated from the occiput to the sacrum. Little wonder our clients present so often with neck and upper, middle or lower back pain.
Make the connection within your own body. Tensions from within are distributed, expressed, and discharged into the musculoskeletal system from the "inside out." More specifically, these tensions are shared across as broad an area as possible for as long as possible until the pressure builds to where this distribution of strain affects the allocation of resources to the point that physical, energetic or psychological symptoms emerge and become chronic.
Psychologically, the physical symptoms you can now relate to the phrenic circuit are strongly correlated with anxiety and depression. The "mind" generates predictions which stimulate our emotions, which leads to the cringing of the sacs and the shortening of our tubes. Sadly, the mind is organized to predict negative outcomes under the guise of protecting us.3
Over time, we become tied up into knots, anxious about what might happen, then becoming depressed that we can't make any significant changes for ourselves. The cycle repeats itself over and over in so many of our clients' lives.
It is my consistent clinical experience that phrenic relationships are associated in most upper extremity dysfunction and pain syndromes. It's only a matter of degree. This includes cervical dysfunction and pain, frozen shoulder, encapsulitis, chronic rotator cuff problems and radicular symptoms (pain and numbness) into the arm, elbow, wrist, hand and fingers. These reflect the build-up of the tensions within the phrenic circuit and the body's attempt to distribute the strain.
What is the source of our stress?
Please refer to the articles co-authored with Lansing Gresham, "Move Your Mind and Engage Your Brain" (see the February 2006 issue of Massage Today, www.massagetoday.com/archives/2006/02/01.html) and "Your Mind Is the Source of Your Stress" (see the April 2006 issue of Massage Today, www.massagetoday.com/archives/2006/04/02.html). In this article, I have endeavored to introduce the anatomical relationships that consistently have assisted me to serve my clients. More in-depth anatomical descriptions of the relationships of the phrenic circuit will follow.
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
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