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A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. After two treatments for back pain, a patient presents for a third session complaining of rapid breathing and wheezing that is made worse during cold weather.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
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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