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Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
April, 2011, Vol. 11, Issue 04
Putting Insomnia to Sleep: Using Cranial Techniques
By Sharon Desjarlais, CC
Have you ever been home alone late at night when a tiny creak in a floorboard suddenly becomes a gunman breaking in? That's your reticular activating system (RAS) triggering an adrenal response that's preparing you to fight or flee.
The RAS helps the body instinctively deal with issues of fear and survival. Unfortunately, it can't always distinguish between real and imagined threats. And according to Amy Lewis, LMT, an Upledger-trained CranioSacral Therapist, that dynamic is at the heart of much of the insomnia she's seeing now in her clients.
Insomnia, which means "no sleep" in Latin, is one of the most common sleep complaints among Americans. According to the National Center on Sleep Disorders Research at the National Institutes of Health, some 30 percent to 40 percent of adults report symptoms of insomnia within a given year, while about 10 percent to 15 percent report chronic insomnia lasting months or years.
"Insomnia comes in cycles that line up with our stress levels," Amy says. "I see it a lot in clients who present with complex pain patterns. But look at the stress that's happening worldwide. Then take that down to the level of the state, the county, the city, the neighborhood, the family and the individual. Add all that up and you've got recurring cycles of insomnia."
While individual cycles and sources of insomnia may vary, Amy believes it ultimately comes down to the RAS, which Dr. John Upledger referred to as the "reticular alarm system." Located in the ventricular area of the brain responsible for regulating arousal and sleep-wake transitions, the RAS is the filter for everything in our lives that's "coming at us," she says. That's why, with her insomnia clients, she focuses on cranial techniques that are known to affect the RAS.
Three Cranial Techniques That Relax the RAS
One of Amy's favorite techniques for relaxing the RAS is the "CV4." Named for its ability to compress the fourth ventricle, the CV4 is performed at the occiput to subtly stifle the expansion of the craniosacral system as it cycles through the phases of filling and emptying cerebrospinal fluid, which therapists can palpate as the cranial rhythm.
When you bring this rhythm to a "still point," fluid pressure builds in the membranes that surround the brain and spinal cord. By stretching these membranes ever so slightly, the fluid gently flushes the craniosacral system and moves the autonomic nervous system from a highly aroused sympathetic-dominant state to a relaxed parasympathetic-dominant state.
"What's different about using cranial work this way is its gentle, non-invasive nature," Amy says. "If I don't plow in there with my hands, I don't create a backlash or a rebound effect in the tissues, muscles or brain. I'm simply amplifying the parasympathetic nervous system. So we're moving from the adrenal fight-or-flight response to a parasympathetic response. We're just slightly moving that little diode on the scale."
Another technique Amy uses to address insomnia symptoms is called "cranial pumping." To perform this technique, you find a place on the client's body where you're comfortable feeling the cranial rhythm. The rhythm reflects the motion of flexion and extension, which signals the filling and emptying of cerebrospinal fluid as it cycles through the craniosacral system.
Amy likes to palpate at all the cranial listening stations, which are areas of the body that can quickly give you a general evaluation of the cranial motion: the heels, dorsa of the feet, anterior thighs, ASIS, ribs, shoulders and several holds at the cranium.
After feeling the rhythm for about three to five cycles, you begin to gently "nudge" the rhythm a bit further. "But you do it so subtly," Amy says. "There's not even any physical movement. You're really doing it with your thoughts and intention to create what feels like a ripple of Saran wrap over water."
By then tuning into changes in the symmetry, quality, amplitude and rate of the craniosacral rhythm, you can bring the body into greater balance. And that helps expand the internal stress threshold so the RAS is less likely to leap into hyper vigilance.
The Rock and Glide
The third cranial technique Amy recommends for insomnia is called the "Rock and Glide." With the client lying supine, place one hand under the sacrum and one under the occiput. Then tune into the rocking motion the dural tube makes to see how it feels. "I'll follow it for a few cycles and then give it a very gentle nudge, about 1 to 5 grams, with my intention again. This helps release the transverse fascial rings of the dural fascia."
For the "gliding" aspect, place your hands in the same position and focus on the longitudinal glide of the occiput and sacrum as it moves in flexion toward the feet and then back toward the head. "As I tune into the gliding motion and it reaches the sacrum, I begin to nudge with 1 to 5 grams of traction toward the feet while I hold the occiput in neutral. Then as the motion glides toward the occiput, I give another little nudge toward the occiput with slight traction while I hold the sacrum in neutral." You may do this for several cycles.
"The glide helps with nerve roots and lengthening of the dural tube, but I think of it as a relaxing cosmic cradle," Amy says. What a soothing way to help your clients get a good night's sleep!
Click here for more information about Sharon Desjarlais, CC.
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