resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
A Conversation With Dr. Betty Edmond
This month's column is an exclusive interview with Betty Edmond MD, newly elected CEO/President of the AOMA Graduate School of Integrative Medicine in Austin, Texas.
Qigong for Substance Abuse
It is commonly believed that substance abuse, in addition to harming one’s physiological state, hurts the spirit. There is also a belief that one’s spirit does not weaken due to substance abuse, but rather, the person finds solace in addiction due to an already weak spirit.
Low Back Pain in Running Athletes
After 7 million years of adapting to upright postures, the lumbar spine and pelvis have become remarkably adept at managing ground-reactive forces associated with running.
We Get Letters & Email
Our Country Needs Us Between Elections, Too; Continuing Care: We Aren't There Yet; Our Associations Need to Do More.
An Opportunity & a Responsibility
Nearly 80 Americans die from an opioid-related overdose every day, and spine-related pain is one of the principle drivers of opioid use. This unfortunate situation creates both an opportunity and a responsibility.
True Practice Mobility for the Chiropractic Profession
When natural disasters occur, chiropractors can literally travel to the other side of the world to offer humanitarian relief in less than a day. The chiropractor's license to legally practice, however, can't make it past the state line.
News in Brief
Updated Neck Pain & Whiplash Guideline; Attention, IHS DCs; New VP of Institutional Advancement At Palmer; N.J. DC Interns At U.S. Olympic Training Center; Chiropractic Society Of R.I. On The Front Lines.
Prepare for the End, From the Beginning: Wealth Building and Retirement with the Tao
Yin and yang flow into and out from one another continually. Beginnings become endings and endings become beginnings again. Wholeness and cycles are the nature of Tao.
Five Branches University Has First Hospital TCM Residency
Established in 1984, Five Branches University (FBU) has campuses in Santa Cruz and San Jose, Calif., which serve the communities of Santa Cruz, the Monterey Bay, and Silicon Valley.
Anti-Aging With Dr. Ping Zhang
Jennifer Waters, TCM practitioner and writer of the Acupuncture Today column, "Talking With the Masters" sat down with Dr. Ping Zhang to discuss aniti-aging with acupuncture.
Shoulder Rehab: Start With the Scapula
The scapula is an incredible display of elegance and movement within the biomechanics of human motion. It's evolved for mobility and stability in the scapulo-thoracic region, giving us the ability to do things that are uniquely human, such as throwing with accuracy.
Scar Reduction With Acupuncture & Microneedling (Part 2)
Protocols & treatment Timing
Flirting With Alternative Therapies
There are about as many adjunct therapies being marketed to acupuncturists as there are acupuncturists. While some may remain purist in their application of traditional Chinese medicine, others choose to explore new horizons of treatment.
The Acupuncture Channel System (Part 1)
The earliest Chinese reference to channels is in the Mawangdui Medical Manuscripts,1 which are dated to the Warring States period of the Zhou Dynasty (475 BC-221 AD). The text presents 11 channels. There are no acupuncture points listed in those channels.
The Case Report: A Valuable Tool
Case reports are a valuable form of descriptive research. The most basic form of practice-based research, a case report is a detailed account of the history, presenting symptoms, assessment, observations, treatment and follow-up of an individual patient, discussed in the context of prior and potential future research.
Another Step Forward for Chiropractic
Chiropractic is now available to 86,000-plus Latter-Day Saints missionaries and you are invited to become a provider. LDS membership in not required; our only concern is that our missionaries get the best quality care available.
Crow Like the Rooster
As we welcome in the Year of the Rooster, we look at some of its major characteristics: confidence and communication, which suits the image we have of the Rooster...strutting in the farmyard, crowing to the others that it's time to wake up.
Let's Clear Up the Collection Confusion
This is an often-misunderstood practice swirling with misinformation. First, a few basics: Insurance is a contract between the patient and the insurance company. The insurance company is simply making a payment for services or care on behalf of the patient.
A New Year and Vision for the ACA
Inadequate pain management coupled with the epidemic of prescription opioid overuse and abuse has taken a severe toll on the lives of millions of people in the United States. Every day, more than 1,000 people are treated in the ER for misusing prescription opioids.
The winter season is upon us and offers unique challenges for the clinician and patient alike. To effectively navigate through the winter season there are two main TCM medicinals, Huang Qi and Gan Jiang, to consider, as well as two important formulas which feature these two TCM treasures.
An Education in Gluten Sensitivity
A relatively new syndrome officially documented as non-celiac gluten sensitivity (NCGS) or gluten sensitivity (GS) was officially recognized and published in the new list of gluten-related disorders in 2012.
Nutrition for Menopause: Front-Line Therapy for All Phases
Of all the changes women experience during their reproductive life, there is no doubt the most dreaded are the three phases of menopause. This is not surprising since all of the symptoms associated with menopause are replete with unpleasantness.
March, 2012, Vol. 12, Issue 03
Freeing the Heart, Part III: Elongating the Esophagus
By Dale G. Alexander, LMT, MA, PhD
The premise asserted in the first two articles of this series is that physically freeing the space around the heart can make a significant contribution to the quality of life for your clients and may reduce the chronic component of their ongoing somatic difficulties.The last article described a technique for equalizing the pressure between the thoracic and abdominal-pelvic cavities. This same technique has also shown itself to assist mobilizing the posterior vertebral/rib articulations of the region.
It is proposed that reducing the pressure within the thorax both decreases the internal resistance to the heart's expansion resulting in greater cardiac output and enhances the efficiency of venous and lymphatic return back to the heart. Two additional steps were added to the initial screening assessment protocol. (A review of the assessment protocol and the suggested techniques can be accessed online at www.massagetoday.com).
This article proposes that elongating the esophageal tube can contribute to freeing the heart. The heart actually enfolds the muscular tube of the esophagus. Even less appreciated is that the upper 2/3's of esophageal fibers are striated fibers while the lower 1/3 -- the part that is juxtaposed to the heart as it pierces the diaphragm and becomes the stomach -- is comprised of smooth muscle fibers.1
There are many implications of this dual innervation and its potential participation in heart-related problems. Selecting the most obvious, consider how any type of cervical whiplash could re-set the resting length of the striated fibers of the esophagus toward varying degrees of chronic contraction or spasm. And, that this shortening of the esophagus may lie dormant for years going undetected yet, adding a posterior resistance to the heart's expansion, as well as influencing the onset of hiatal hernia symptoms and the reflux of stomach acid leading to chronic "heartburn." A shortened esophagus adds friction between itself and the sac of the heart, the pericardium. Friction begets irritation and irritation eventually incites inflammation. Chronic inflammation is increasingly considered the bridge between stress-related ailments and the onset of many pathological progressions during the aging process, including cardiovascular disease.2
Common sense suggests that the sac around the heart cringes in its attempt to prevent the acid from penetrating its protective sheathing. And, should the acid reach the fibers of the heart muscle, it creates an irritable reaction within them. Might this relate to a host of the different heart ailments that increasingly are described both in abnormalities of electrical transmission within the heart and the increasing frequency of atrial fibrillation?
Many years ago I had the unique opportunity to work with an exceptionally gifted physical therapist who was known for her success with helping infants and children. An infant was bought to her office with a diagnosis of non-epileptic brain seizures. As she was a graduate of Ohio State University, she called there and was referred to a Pediatric GI specialist. On the conference call, we both had a galvanizing learning moment as the specialist described that the infant may have been born with a congenitally short esophagus and that the seizures may stem from its central nervous system's attempts to elongate the tube.3 What a concept. He further noted that it was a fairly rare condition but that he had seen it enough times that his model for dealing with such unexplained seizure activity now included this as a possibility.
The epiphany for me was that along a continuum of genetic possibilities, not only could the esophagus be congenitally short, but that in many individuals, it is predisposed to contracting strongly and may re-set its resting length in response to intense emotional reactions and prolonged stress, in addition to the physical provocations described earlier. The most pertinent physical implication of the esophageal fibers bunching is its potential to limit the heart's expansion phase posteriorly. Thousands of clinical experiences with clients now validate this notion for me. The neurological implications of a shortened esophagus will be explored in the next article.
It has long been known that mid-sternal pain more likely relates to esophageal contraction or spasm, whereas pain associated with the left breast area is more likely to relate to some aspect of possible heart dysfunction or impending crisis.4 I carefully inquire with new clients to make sure that they have had a cardiology work-up if they present with either of these and insist that they see their physician if they haven't. It is prudent for us all to encourage clients to rule out any possible pathological or congenital predisposing scenarios.
The addition to the screening protocol I have found to be consistent with esophageal involvement is to palpate along the occipital ridge for the space and ease of distraction of the occiput from the atlas bone. The more close packed and resistant to distraction, the more the esophagus is a variable has become my clinical interpretation. Another primary myofascial structure that co-participates in the compaction of the head upon the neck are the SCM's (sternocleidomastoid muscles). It is my clinical experience that the SCM's function as the guard dogs of preserving the cranium's safety in the event of a sudden shift in position of the head as may happen in a fall, the body flung forward or backward (bicycle or motorcycle accident) or impact trauma of all kinds. So, the answer to the question of what can you do to help your clients is to use whatever techniques you have learned to reduce the tension of the SCM muscles.
A unilaterally contracted SCM or bilaterally so, compresses the jugular foramen through which both the vagus nerves and the accessory nerves exit from the brain. Old time anatomists suggested that the accessory nerve functions as an overflow valve for vagal tensions.1 And, let's remember that the accessory nerve innervates the trapezius muscles as well as the SCM's. Thus, tight traps are also a tip off that compression of the jugular foramen is a variable and that a contracted esophagus may be a crucial variable flying under the radar as a soft tissue structure that we need to treat.
Assisting the esophagus to elongate is accomplished by anchoring the occipital ridge and softly compressing the left side of the sternum along its length toward the left hip with an emphasis around ribs five and six and then into the soft tissue of the abdomen just beneath the left costal arch.5
In the next installment to this series, we will further explore the role of the esophagus along with those of the pericardial sac and explore the possibility that sometimes the heart may shift form its normal position in the thorax. It is my clinical experience that all of these variables can be positively influenced through bodywork, massage, movement and energetic therapies.6
To date, this series has endeavored to offer an assessment sequence and a couple of fairly specific techniques that have clinically shown themselves to assist an easing of thoracic rigidity. The clinical inference is that by doing so we are reducing the workload of the heart to deliver newly oxygenated and nutritious blood systemically.
Assessment Sequence for Freeing the Heart
The central theme is to assess the degree of pliability and distensibility of the thoracic cage. My experience suggests that when the left sternal border and the intercostal space associated with ribs five and six are rigid that the heart is definitely having to work harder to push out newly oxygenated and nutritious blood. Restriction to the lateral excursion of either or both hemi-diaphragms only adds to the workload of the heart.
Technique Review for Freeing the Heart
Let's review one "inside-out" technique that can jump-start the easing of thoracic pressure. Its effectiveness relies on the loosely organized areolar connective tissue along the posterior margin of the diaphragm muscle.
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
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