resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Chronic heightened emotional states create a perfect breeding ground for illness. Through my practice I noted the increasingly obvious relationship between one's mental focus on negative thinking, emotions, resistance to experiencing feelings and disease.
Foundation for Chiropractic Progress Announces First Group Member
The Michigan Association of Chiropractors has joined the Foundation for Chiropractic Progress as its first group member.
Treating Menopausal Women in Your Practice
I love what I do for a living. It's a great way to trade health for bread. And no topic of health, with the right bedside manner, is taboo.
Are You Ready for the 2016 Patient?
In October, Apple released its iOS 8 operating system for the iPhone and iPad. The new system includes Health, a new app that will interface with an ever-growing number of other apps.
Are You Ignoring the 10,000-Hour Rule?
Having trained interns and mentored new practitioners, it has been my observation that their No. 1 clinical concern is adjusting skills. Their second clinical concern is their ability to read X-rays. Physical diagnostic skills are a distant third.
The Death of the Travel Card
As long as I have been in practice, the travel card has stood as the primary style of documentation for chiropractic. It is quick, simple and direct. Unfortunately, the rules have changed.
Micro-Needle Dermal Roller Use in the Treatment Room
Recently micro-needle dermal rollers have been getting a lot of media attention. As a practitioner who specializes in acupuncture facial rejuvenation, I know that skin needling with a dermal roller (also known as collagen induction therapy), promotes the natural reproduction of collagen and elastin, making the skin feel smoother and tighter.
Meat in the Middle
Have you ever wondered what's the truth about meat? Is it really as bad as many people think?
Peer Points: Promoting TCM Knowledge
When Elaine Wolf Komarow, LAc, received her first acupuncture treatment in 1989, she said it changed her life. "I felt more aware, calmer, and happier. I was so fascinated by the changes that I began to learn everything I could about the underlying philosophy of Chinese medicine," said Komarow.
It Pays to be a Foodie
If there is an inner foodie in you, just waiting to burst out—this article is for you! Do you want to know how I know? I'm that girl. My middle name might as well be "Foodie." I love food! And if my patients are any indication, many of them do as well.
Following the Thinking of the Classics
I have heard about the "best time of day" to carry out certain examinations or therapies. For example, I remember making a note years ago that early morning is the best time to take someone's pulses.
We Get Letters & Email
Is It Time for a Popeye Moment? The Flaw in Recommending Chiropractic as a Career.
Implications of Section 2706: The Non-Discrimination Provision Survey
In late April 2014, NCCAOM diplomates received an email survey with the subject line: "End discrimination against acupuncturists" polling CAM practitioners for a Request for Information from the Department of Health and Human Services, released in mid-March.
Solving the Pain Puzzle
Legendary former New York Yankees baseball player Yogi Berra once said, "You can observe a lot just by watching." He would have been a great chiropractor. We are trained to become experts with our hands: palpation, adjusting, soft-tissue release, etc.
The Acupuncture Now Foundation: What Our Profession Needs
Although acupuncture is growing in popularity it continues to be underutilized due to misunderstandings about its true potential. Only a fraction of those who could be helped by acupuncture know enough to seek it out.
Treating Chronic Depression with Acupressure
In Traditional Chinese Medicine there already exists a comprehensive theory linking the body and mind.
Avoiding "Just a Pop Doc" Syndrome
Yes, it's harsh. Patients don't like to admit it. They have an unspoken plan when they first visit you: to come one time, get rid of their pain and then get rid of you. They know it's unrealistic, but they'd like to pay nothing for this service.
Step by Step: Long-Term Treatment of Soft-Tissue Injuries Combines Skill and Care
Treating soft-tissue injuries with long-lasting results starts the moment an individual enters the office. When it comes to pain, the only thing that matters to the patient is relief.
Five Element Acupuncture Can Enhance Your Practice
For eight years I have been teaching and supervising TCM students at an acupuncture college in Colorado, in Five Element acupuncture.
Home Safety: Help Families Avoid Common Injury Hazards at Home
These days, many parents childproof their homes before a baby is even mobile. You will see an array of electrical outlet covers, bumpers on the corners of the coffee table and safety latches on the cupboards.
Acupuncture Detox as Part of Drug Rehabilitation
In the U.S., more than 2,000 alcohol and drug rehabilitation programs have added ear acupuncture to their practice. The development of the protocol was determined by Lincoln Hospital as it delivered 100 acupuncture treatments daily.
DC App – The Next Generation
According to a survey by technology firm CDW, health care professionals gain approximately 1.2 hours per day in productivity simply by using a tablet computer in practice.
Capturing the Essence of Tai Chi
Over the last 12 years, I have been working on one of the few documentaries about Tai Chi. It's called The Professor: Tai Chi's Journey West and it's about Cheng Man-Ching who moved to New York in the 1960s.
News in Brief
Life to Open Branch Campus in Italy; Northwestern Research Arm Benefits From Big Donation.
Why Drugs and Supplements Can't Cure Disease
Chronic diseases are the outcome of disease-promoting, goal-oriented behaviors. So, the notion that diseases can be cured with drugs or supplements should be abandoned. Hypertension is the best example of this.
Inspire Your Patients to Make Healthy Choices
Have you tried to get your patients to change their eating habits or their diet and couldn't get them to succeed? Were they confused and unsure of what the right thing was to eat? You are not alone!
Treating Acute and Chronic Neck Pain With Ischemic Compression and Exercise
There are many reasons not to manipulate the neck with cavitation: the patient is too old, their neck is too tight, etc. But the most common reason is that plenty of patients are afraid of "the crack," mostly because of the bad publicity about that procedure.
The Power of Mu Xiang to Treat Irritable Bowel Disease
Bloating and gas pain is something that everyone has had to deal with at one point or another; however, that's usually reserved for holiday dinners and other large gatherings.
Introduce Your Patients to Collagen Induction Therapy
Cutaneous (skin) aging generally occurs from either intrinsic or extrinsic processes. Intrinsic aging results from natural skin tissue damage and degeneration.
Chinese Medicine: The Natural Way to Children's Wellness
As a child, I did not like going to the doctor. For the most part, when I had to go I wasn't feeling good to begin with, and I was heading into a sterile environment to be awkwardly probed by a man in a white coat for a very short, impersonal period of time.
December, 2008, Vol. 08, Issue 12
The Progression of Cervical Stenosis Toward Cervical Spondylotic Myelopathy (CSM), Part 4
By Dale G. Alexander, LMT, MA, PhD
There is an assumption that the progression of CSM emerges in males more often than females, according to my Google searches of the literature.1 My own clinical experience with clients since beginning to recognize and research this progression eight years ago is fairly 50/50 in terms of gender occurrence.
Richard MacDonald, DO, explains an osteopathic distillation in his functional anatomy courses suggesting that, based on his profession's cadaver studies, males have a tendency toward lower back weakness because the iliolumbar ligament generally does not extend to L4 as it does more typically in women. The inferred evolutionary implication of this anatomic difference is that this extended stabilization represents a pragmatic genetic selection providing women with more low back, pelvic stability for birthing a child. Correspondingly, the first rib and sometimes the second rib of most women tend to be less stable in their unifacet mooring to the T1 and T2 spinal vertebrae.2
These anatomical gender-specific differences have been cited as a possible explanation as to why males experience more low back pain and dysfunction, while females tend to experience more craniofacial, neck and upper extremity pain and dysfunction. A further inference based on personal speculation is that these gender differences have functioned in our human evolution as sexual stimuli - the quality of power that is reflected in the strut of a male as he walks and the elevated positioning of the breasts in females. Nature is relentless in its drive for the genders to notice each other and to reproduce. In my opinion, both of these anatomic tendencies can feed into the eventual expression of CSM.3
The principle assertion in the orthopedic literature is that men have larger cervical vertebral bodies relative to the space for the spinal canal (canal/body ratio) that may encroach upon the circumference of the spinal canal more easily than for females; thus they have a greater tendency to exhibit the more acute symptoms of CSM. In numerous Google searches, I was unable to verify with recent studies that this gender difference in etiology is generally accepted. My speculation is that CSM is simply less often diagnosed in females because it is more often diagnosed in its acute expression in males. The orthopedic notion that a congenitally smaller spinal canal in either gender is highly correlated to the expression of CSM was verified.
Let's now add to the theories about how and why CSM begins and progresses, beginning with the obvious - the carriage of the head. Wherever the head goes, the rest of the body must follow.4 There exists within human neurology an exquisitely fine-tuned sense of tracking where the head is in relationship to the field of gravity. The subcortical flexor/extensor relationships are intimately linked to two of nature's most crucial imperatives - "don't fall" and "live long enough to reproduce." The writings of Thomas Hanna are one of the few places where you will find a comprehensive description of these righting reflexes.5 With gratitude, I had the opportunity to study and receive many treatments from him shortly before his too-youthful passing.
What I have found to be missing in the orthopedic theories of CSM are four principles of anatomy and physiology that have evolved from my trainings and my clinical experience with clients:
Based on my clinical experience, what is totally neglected is the capacity of the esophagus to pull the head down onto the neck and thus add direct compression to the cervical discs. The fascial mooring of the esophagus, the pharyngeal raphe, attaches to the basilar portion of the occipital bone just posterior to the sphenobasilar junction.9 The influence of a shortened esophagus is completely overlooked in most whiplash/impact injuries and as an influence in progressive anterior kyphosis of the spine. Additional soft-tissue structures that I find to be locked in a state of contracture or spasm include the CSMs, the longus colli muscles and the scalenes. Diaphragmatic and iliopsoas contracture or spasm adds strain to the extensor musculature.
The most commonly spoken somatoemotional statements of my clients over the years mirror this strain pattern. These include that someone or some situation is a prevailing "pain in the neck," that they feel an overwhelming sense of pressure within their body, or that they feel "all twisted up inside." Trace the pattern down and forward from the neck ... pressure strains the cervical vertebrae given its build-up within the thoracic and abdominal/pelvic cavities. The gut tube is suspended directly from the craniocervical junction. Both of these influences are speculated to directly contribute to the how and why cervical stenosis can progress toward spinal cord compression and CSM symptomatic expressions. I am admittedly postulating an interface between anatomy, physiology and consciousness, so please do consider these as theories.
In part 2 of this article series, I encouraged you to release the tension and lengthen the fascia of any muscular structures that have attachments to the back and the front of the body, to ease the tensions of these myofascial elements. The sternocleidomastoid muscle is a clear example of this.
Massage therapists who desire to become more comprehensive in their work with clients need to seek out training in how to therapeutically work with the visceral suspension of organs and also explore how consciousness can participate in escalating the tensions of visceral organs themselves, thus adding a significant strain to the musculoskeletal system. The educational resources that provided me with such training gave me dynamic insights, leading to my most significant leaps in comprehension of how the dance between psyche and soma expresses itself. (Contact me for information on educational resources.)
My intention has been to draw open the curtain of CSM neurological progression, which is highly correlated to diminishing the quality of life during the aging process and is often not considered, diagnosed or treated until it reaches an acute expression. Many clients will end up on your doorstep in the early and moderate phases of the progression.
In conclusion, the possibility that CSM may underlie many of the chronic somatic complaints of our clients ages 50 and older is what we want to anchor in our awareness. Do remember to inquire as to whether the client has or is currently experiencing any difficulty with urination, ranging from urgency to difficulty initiating a stream. Share with them that it is your understanding that an inability to interrupt the urinary stream is one possible clinical indication that warrants a visit to their physician.
The somatic complaints of CSM tend to come and go, sometimes being expressed in upper extremity problems and then switching to lower extremity difficulties commonly expressed as sciatic pain or the internal feeling of heaviness in the thigh or leg. Often they will bounce back and forth between the upper and lower extremities. As noted in earlier articles, when the complaints involve the same-sided upper and lower extremity, there is a high probability that the CSM progression is expressing itself. Another significant caveat is that in a study that followed patients who had undergone surgery for CSM, the degree and longevity of a successful outcome was based on the symptom profile being discovered earlier than later in its progression.10
Our job is to enhance both the functional capacity and coordinated mobility of our clients. This translates into quality of life. Allow your perception to become a therapeutic modality. Sense, feel and touch from the "inside-out." When I teach classes, I often draw upon an agrarian analogy that emerged early in my career - we plow the field, plant the seeds, weed the field and sometimes are there to assist in the reaping of a harvest of healing. May this continuum reflect your daily opportunity with clients.
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
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