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A Simple Protocol for Holiday Stress
It's winter, a time when we should be deep in reflection, eating warming foods and sleeping long hours. Following nature's rhythms, we restore our bodies and minds in preparation for the renewal of spring.
Molecular Motors: Tiny Machines Behind the Rhythm of Life
In the clinic, we aim to restore healthy patterns of movement for qi that has gotten trapped or misdirected, or may have even collapsed. We may be focused on freeing stagnation, releasing heat or redirecting counterflow qi, but it often comes down to helping re-establish a flow of sorts.
Chiro School Reunion: Whatever Happened to...?
I opened the door to the closet slowly, carefully, since I knew it contained a large number of precariously stacked file boxes. It also held numerous outdated gizmos with electrical cords of various lengths that could trip or strangle a person.
Herbs for Digestion: The Power of Bitter
Many cultures (and indeed herbal clinicians) around the world have long respected the role of bitter herbs and foods for promoting digestion. For example, aperitifs – drinks consumed before a meal to stimulate appetite and digestion – were originally derived from bitter herbs.
Branding: Set Your Practice Apart
Dr. Brad started his practice seven years ago on a shoestring budget. He created his generic logo in five minutes using a website because he didn't have the time to figure out how to make something special.
What We Can Learn From Spine Surgery
Patients with lumbar stenosis presumably present for conservative care to improve their quality of life and avoid surgery. However, providing clear guidance to these patients can be difficult for a number of reasons.
Meshing TCM With Environmental Pediatrics: Where's the Overlap?
Pediatrics has a long history within Chinese medicine dating back to the late Han dynasty (i.e., the late 200s CE), with the two primary areas of emphasis being herbal medicine and xiao er tui na (pediatric massage).
Overuse Injuries in Young Athletes (Pt. 2)
Most overuse injuries are benign, but there are some high-risk injuries that, if unrecognized or inappropriately treated, can result in significant loss in time from the sport or even require leaving the sport.
A First for the Profession: CCE Accredits First Chiropractic Residencies
The Council on Chiropractic Education (CCE) has awarded accreditation to all five chiropractic residency programs currently administered at Veterans Administration facilities, "the first residency programs in the nation ever to be awarded this distinction, a significant advancement in the evolution of chiropractic education," according to a VA press release announcing the milestone.
End of an Era Looms at NYCC
New York Chiropractic College recently announced that Dr. Frank Nicchi will retire in August 2017 after 36 years with the college, the past 17 as president.
Little Sticker, Big Impact
It's the end of an election year. Hilary Clinton and Donald Trump were the subject of conversation for everyone, everywhere for the entire 2016 calendar year. I don't think any of us can deny that this election affected us all very deeply on a personal level.
All Fiber Is Not Created Equal
Sometimes the best place to start is at the end. So, the conclusion of this article is that all fiber is good ... but some fiber is better. Let's break it down. There are two main types of fiber: soluble fiber and insoluble fiber.
DVT: Know the Signs and You Could Save a Life
I lost a friend several months ago. He died from a pulmonary embolism (PE) secondary to a deep-vein thrombosis (DVT) that originated in his lower leg. Bobby was in his mid-60s, soft-spoken and had a big heart.
Can a Multivitamin Reduce Breast Cancer Recurrence?
There is a great deal of controversy regarding the value of multivitamin supplements in cancer prevention. However, with respect to preventing breast cancer recurrence, an important study was published in the Journal of Breast Cancer Research and Treatment in 2011 by Kwan ML, et al.
6 Steps to Make 2017 Your Best Year Yet
People often ask me what defines success. Success, for me, is simple: doing exactly what you want to do in life. Whether it's the kind of practice you run, your life at home, your hobbies or something else, it's achieving anything you put your mind to.
A Letter to the Profession from the New President at AAAOM
Volunteering for a national, nonprofit organization brings with it such highs, lows, and accomplishments, as well as a steep learning curve.
Southwest Acupuncture College Brings It to Division 1 Athletes
When Michael Phelps' photograph with the distinctive round marks left by cupping went viral, the Division 1 student athletes treated through the Dal Ward Athletic Center at the University of Colorado (CU) could relate.
A Q & A About Updated Codes
Yes, indeed there was an update to ICD-10 on Oct.1, 2016. This is a regular update to the diagnosis coding system and this type of update will occur every Oct. 1, just as it did when the ICD-9 system was in place.
Assessing Core Stability and ROM: 5 Basic Checks
One of the first steps in addressing core stability is assessing static posture, ranges of motion, and motion of the pelvic bones, sacrum, femurs, lumbar spine and thoracic spine.
News in Brief
New President / CEO Takes Office at Yo San University. Electroacupuncture for Constipation?
Dedicated to Defending Chiropractic
Whether you're a veteran DC or a first-trimester student, the name George McAndrews should be part and parcel of your professional vernacular, as familiar as the word chiropractic.
2016: A Year in the Life of Acupuncture
Happy Holidays, may you, your family and friends have peace, joy and blessings throughout this special time of year. As 2016 comes to a close, we can look back and celebrate the many events and accomplishments for the profession of acupuncture.
Another Chance to Make a Difference
Just a few months ago, "the worst natural disaster to strike the United States since Hurricane Sandy" hit Louisiana. During this storm, one area experienced 31 inches of rain in 15 hours as almost 7 trillion gallons of water rained down in just one week across the state.
May, 2009, Vol. 09, Issue 05
The Progression of Airway Obstruction
By Dale G. Alexander, LMT, MA, PhD and Thomas M. Walsh II, DDS
Subtle progressions that reduce the quality of our clients' lives and contribute to many of our clients' chronic somatic problems continues as a theme for this column. Thomas Walsh, DDS offers his 33 years of clinical experience as a general dentist and extensive orthodontics training to bring to light the progression of airway obstruction.
Air is one of our greatest needs for survival as human beings. The "airway is the tube" through which we breathe. It begins at the opening of the nostrils and continues all the way to the lungs. Visualize this tube as the snorkel through which we breathe. The diameter, shape and volume of this tube regulates the rate of exchange between oxygen entering the lungs and the exiting of carbon dioxide out of the lungs. A large diameter airway encourages an easy passage of air whereas a small diameter airway generates a greater resistance to airflow in both directions.
This essential airway tube is formed in utero and continues to develop from infancy until the teenage years. The airway is comprised of multiple spaces including the: nasal chamber; sinuses; and the upper, middle and lower pharynx. In normal growth, these chambers need to form in proportion to the size of the individual. That is to say that one needs a tube to breathe through that is large enough in diameter to support respiration during sleep and daily activity. The genetic design (preprogrammed in our DNA) mediates the enlargement of the bones, muscles, connective tissue etc., of our face and throat, to provide room for these spaces of the airway.1
Unfortunately, many times this airway tube does not form properly. A malformed airway can wreak havoc with muscle tone and head position. Research has clearly correlated head posture with mandibular position and temporomandibular joint disorders.2-7 Many of your clients will likely have these problems. They may complain of pain in the following muscles: masseters, sternocleidomastoid muscles (SCMs), trapezius, scalenes, splenius capitis and cervicis, medial and lateral pterygoids, temporalis and even the muscles of the low back. Simply put, if an airway is obstructed, a person will instinctively modify their muscle function to optimize or open the airway. This postulation reflects the essence of the Inside-Out Paradigm.
Clients rarely sense that they have a problem with their airway. (Dr. Walsh: "After 33 years of practicing dentistry, not one growing child or adult client has ever reported to me that they have a small airway.") The development of the airway is controlled by the autonomic nervous system of the growing child. Nature (your biologic engineer) detects this progressively developing constriction in the airway and makes alternate plans involving compensatory patterns of the musculoskeletal system.
For example, if the constriction is in the nasal cavity, the growing child will start to breathe through the mouth instead of the nose. The muscles of the face will pull open on the lower jaw, the mandible, and redirect the growth of this mandible to a more vertical or open position.8 If the airway obstruction occurs in the middle to lower oral pharynx (throat) the individual will likely extend their head forward to help open this airway tube.9-11 Again, this occurs without any conscious awareness within the individual. The head has now extended forward beyond the normal plane of vertical posture.
Forward head posture is very common and easily misunderstood. It is the opinion of these authors that many cases of forward head posture relate back to early childhood airway disorders, and improper muscle function of the oral cavity and have been clinically correlated to a congenitally short or an emotionally reactive esophagus.12
That being said, it is very difficult to separate the primary cause or etiology. We have the case of the proverbial chicken and the egg scenario, i.e., which came first? For some individuals the muscle function was altered first and in other children the airway obstruction occurred first.
There are many contributors to airway obstruction. Common influences include the following: improper swallowing habits developed from bottle nursing, air pollutants, food allergies, junk foods, broken nose, deviated septum, improper growth of the jaws (the maxilla and mandible), improper tooth position, imbalanced facial muscles, oral habits such as thumb sucking and many more. The thread that links all of these issues to you and your practice tends to be the compensatory forward head posture and associated muscle pain.
Feel this. Your head weighs about 12 pounds much like a bowling ball. Imagine if we placed a stick inside the hole of the bowling ball. Supporting this ball would not be difficult assuming the stick were directly under the bowling ball. Now, let's extend the bowling ball (your head) out beyond the stick (your spine) at a 45-degree angle. Suddenly the force on your spine from your head is dramatically increased. Forward head posture associated with airway obstructions places your neck and shoulders at a leverage disadvantage. It is reasonable to expect cervical bone remodeling and muscle pain to occur over time.
Airway obstructions and improper oral muscle balance commencing near infancy or in a growing individual have been linked to many systemic disorders later in life. These include the following: dental malocclusions, TMJ joint disorders, distorted faces, obstructive sleep apnea in children and adults, bed wetting, migraine like headaches, neck and back pain, lower IQ, stunted growth, criminal behavior tendencies, heart damage and increased risk of heart attack, arteriosclerosis and atherosclerosis, stroke, acid reflux and digestive disorders, anxiety and depression associated with lack of proper REM sleep, increased risk of occupational accidents and the list goes on.13-18
The following images graphically display the difference between normal and obstructed airways. These images have been acquired through cone beam imaging technology similar to CT scanning but with dramatically reduced radiation exposure as part of a comprehensive dental examination to evaluate patients for temporomandibular joint, orthodontic and sleep disorders. Figure 1 depicts the size and shape of a normal airway from a side view (coronal) and figure 2 from a cross-sectioned view looking downward (transverse). Notice the area identified by the pointer. Figures 3 and 4 demonstrate the reduced airway from both a coronal and transverse view. Note the constriction of the airway.
The diameter of the constricted airway is equivalent to the diameter of drinking through a straw. "Imagine the experience of breathing through a straw" all day. This client was completely unaware of any obstruction in the airway yet suffered from many clinical symptoms including lack of sleep, grinding of their teeth, pain and spasms in the neck and shoulders.
In summary, many of our clients suffer from airway obstructions that progress and worsen through life. As massage therapists we see many individuals with underlying problems as have been described here. Clients with head and neck pain including forward head posture are likely to have airway obstructions and are at risk for obstructive sleep apnea, a known contributor to decreased quality of life and reduced longevity. Your sharp observations can actually save lives.
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
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