resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Identify & Adjust the Apex Posterior Sacrum
Low back pain involving an apex posterior sacrum (+θX-axis misalignment) typically presents with signs of lumbosacral joint impingement or facet syndrome.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Let's Streamline Your Front Desk
Your front office can be your greatest source of efficiency or a constant bottleneck. Increasing the productivity of this area without sacrificing the quality of patient interaction can be a little tricky.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
News in Brief
Northwestern Student Honored for Addressing Concussions Head-On; Northwestern Announces New CFO; Life U. to Provide Unique Opportunity.
Specialized Pro-Resolving Mediators: 21st Century Inflammation Fighters
Specialized pro-resolving mediators, or SPMs, are a portion of the omega-3 fatty-acid spectrum that have been shown to have a powerful effect on reducing inflammation.
Designing a Fitness Plan (Part 4): Blending Pain Relief With Healthy Aging
Pain relief is still the No. 1 reason patients come to my office. However, most of my patients have other goals as well, such as: "I want to lose 10 to 20 pounds"; "I feel old and want to slow down the aging process"; "My doctor says I am becoming a diabetic and need to exercise"; or "I'm tired and want more energy."
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
Day in the Life of an Advanced-Practice DC
Can you tell us a little about your background in the profession? Why did you want to become a DC? I studied at Boston University from 1968-1972 as a pre-med student majoring in biology.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
An Alarming Lack of Accountability
Accountability seems to be a lost quality today. The simple act of taking responsibility and doing the right thing just doesn't happen as often as it should. Maybe it is the litigious nature of our society.
Excited to Share the Science of Chiropractic: An Interview With Dr. Heidi Haavik
Dr. Heidi Haavik has become known in the circle of chiropractic researchers as not only a rising star, but also one willing to do research that can have a major impact in the scientific world and how chiropractic is perceived.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
How Many of Your Patients Have Sarcopenia?
Figure 1 demonstrates the typical appearance of sarcopenia in the paravertebral muscles. Have you considered evaluating your patients for this problem? Sarcopenia is the progressive loss of skeletal muscle mass and function that affects the older population.
F4CP Launches New Social Media Campaign
The Foundation for Chiropractic Progress has launched a new service to help member doctors: a social media campaign called "Accelerator."
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
Misconceptions & Opportunities With Medicare
As I speak around the country on how to properly document Medicare patient encounters, I get questions regarding opting out of Medicare. There are many misconceptions about opting out of Medicare, including just what it means to opt out.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
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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