resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Asking the Insurance Rep the Right Questions
One of the first or last questions a potential patient often asks is: "Do you take insurance?" An ill-informed or optimistic, "yes" can result in delayed or non-payment. Instead, just say: "Let me check if you are eligible first."
The Clinical Versatility of Milk Thistle (Part 2)
Evidence is growing that the silymarin complex of flavonolignans from milk thistle can impact serum ferritin and iron overload in various clinical circumstances.
Forgotten Options for Musculoskeletal Health
Challenges with musculoskeletal health are of tremendous concern for many people today.
Treating Pain: The Hypermobile Coccyx
When I write about the coccyx, I recognize that I am talking about a relatively small subset of patients. When I write for Dynamic Chiropractic, I am trying to reach 60,000 chiropractors.
The Roots of Insomnia
One of the most common clinical presentations is insomnia. Next to digestive disorders, sleep disorders are one of the most common complaints the clinician will encounter in daily practice.
Diet, Nutrition and the Context of Risk (Part 1)
Food and supplement safety is a topic that often comes up when I speak to chiropractors for CE relicensing, even when it is not the advertised subject.
Integrative Medicine Can Shape the Profession
As the AOM profession struggles to define the role of "integrative" medicine within their practices their schools and organizations, students, faculty, alumni and administrators at schools wrestle with discussions of how much, where, how, and what to "integrate."
RAND Study Recruiting DCs
Dr. Ian Coulter, RAND / Samueli chair for integrative medicine and senior health policy researcher for the RAND Corporation, has issued a call for participation, recruiting doctors of chiropractic for a practice-based research study that will examine "the impact of evidence, outcomes, costs and patient preferences on the choice of treatment for chronic low back pain and neck pain."
Billing and Coding for Moxibustion
Q: I am trying to locate a code for cupping and moxibustion, and have had various fellow acupuncturists indicate that they bill using the existing codes for heat, 97010 hot packs or 97026 infra-red for moxa and 97016 vasopneumatic device for cupping.
Enhancing Performance in Cross-Fit Athletes
Cross-fitness centers are expanding in number and increasing in popularity. To remain relevant to this growing portion of society, practitioners need to learn about the exercises and injuries common to this group.
East Meets West
Gung Hay Fat Choi. Welcome to the year of the Monkey. There will be fireworks for both January and February this year. What great celebrations.
Chiropractic Around the World: WFC Country Reports December 2015
The following country updates are reprinted with permission from the December 2015 World Federation of Chiropractic (WFC) Quarterly World Report. Information is excepted for space and edited to DC-specific style guidelines.
From Antiquity to Modernity: Huang Qin Tang at Yale Medical School, Part 1
Traditional Chinese medicine is a coherent medical system with several unique characteristics: it originated almost 3,000 years ago; in its area of origin, it has been practiced without interruption since its inception.
Is There a Neurological Basis and Correction for Macular Degeneration?
Macular degeneration, aka AMD (age-related macular degeneration), is a common eye disease and a leading cause of blindness in people age 50 years and older, according to the National Institutes of Health National Eye Institute.
Interprofessionalism: What it Means and Why You Should Care
Interprofessionalism in education and in practice is a growing trend across health care in the United States. The idea that team-based care and collaborative practice can improve health care has been around more than 50 years.
The MRI: What to Do With the Results
As I wrote in my previous article on this topic, it is my goal for you, the doctor, to be an expert in interpreting MRI images yourself; and to be able to independently make decisions based upon a combination of clinical presentations and findings, followed by the MRI images.
Do Doctors Lie to Patients? (Do You Lie to Yours?)
In a previous column ["When Patients Lie (Bribe or Flatter)," Oct. 1, 2015], I discussed the issue of patients lying to doctors, and the many reasons why this can occur.
Taking Another Step Toward a Secure Future
In 2008, the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) released a literature review on chiropractic care for low back disorders.
Lab Rats (Roaming the Streets)
The title of this article is an accurate description of American consumers (regardless of age) in the modern era.
How to Humanize Your Content to Create Stronger Relationships
Content marketing is about building relationships, whether that is through updates on social media, offers on your website, blog posts, email campaigns, or even printed material. Now days a business needs to make a human connection.
Ethics: The Glue That Holds Us Together
Kudos to the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) for creating a code of ethics for the nationwide profession and for deciding to make courses in ethics a requirement for certification renewal.
Percussion Therapy: An Experiment
My study of qi began more than 20 years ago — long before my study of TCM, points or pathways. It all started with an awareness in my hands and physical manifestations in the way of blockages while working on clients.
Yo San University Helps Make LA Communities Healthier
An element of healthcare training often overlooked is the residual benefit to communities served by Acupuncture and Oriental Medicine (AOM) schools nationwide.
Changing the Cultural View of Medicine
Many hospitals in the U.S. are incorporating integrative clinics that include Traditional Chinese Medicine. Cleveland Clinic has led the charge for adding a traditional Chinese herbal medicine clinic to their existing acupuncture program.
April, 2012, Vol. 12, Issue 04
Freeing the Heart Part IV: Reducing Resistance to the Heart's Expansion
By Dale G. Alexander, LMT, MA, PhD
Studying anatomy and reflecting upon what helps my clients to feel and function better are the foundation for what I am writing in this series. With that said, let's delve into the anatomy of the esophagus a bit further to set the stage for understanding the implications of its postulated tendency to re-set its resting length in response to physical injury or intense emotional experience.
The superior esophageal fascial mooring is anchored directly to the spheno-basilar junction to my perception through the buccopharyngeal fascia/pharyngeal raphe.1 This anatomical interpretation suggests that the entire length of the gastrointestinal tract (GI) is suspended downward and forward of the cranium. Consider this notion and its implications. My speculation is that a shortened esophagus with a superior strain being pulled on from below by any manner of GI disturbance will eventually contribute to the incompetence of the hiatal sphincter. It also makes sense to me that hiatal hernias might be the natural evolution in the progression of dysfunction to such opposing tensions over many decades. The maximal strain point of the esophagus is proposed to include the portion of the tube enfolded by the heart just before it pierces the diaphragm muscle.
The association of heart troubles and GI disturbance are considered a possibility by some2 yet, most often in the literature heart troubles and esophageal dysfunctions are described as if they are completely unrelated. This defies common sense to me. The intimacy of the anatomical enfolding of the heart around the esophageal tube is a related variable; structurally, if the esophageal fibers are contracted or go into spasm and, as a chemical irritant, when chronic gastric reflux is considered.3 Since no one pays attention to such variables, this might be one way that we may contribute to our clients' quality of life, as well as to possibly slowing the advance of cardiovascular disease.
Another implication of such strain along the length of the esophagus is that its tension can literally pull the head down upon the neck and is an influence contributing to the head being pulled forward which will inevitably activate the extensor reflexes of the spine.4 Might this be related to your clients chronic neck and upper back pain? Let's remember that the superior sympathetic ganglia and the vagus nerve have their most intimate communication between the occiput and the 1st cervical vertebra, the atlas.5 Compression of this autonomic interface can have far reaching influences on sympathetic and parasympathetic coordination of physiology, including that of the heart function to my sensibilities. Enhancing the ease within the space between the occiput and the atlas is one of my most reliable markers that a therapeutic effect has been achieved during a bodywork session.
With the head being pulled forward and the extensors of the upper back reflexively tightening, guess which segments of the spinal cord provide sympathetic supply to the heart, T1, T4 or 5? Could both of these compressions add to an over stimulation of the heart neurologically, a kind of structural squeeze play that begins with a functionally shortened esophagus. How many of your clients present to you with pain and muscle spasm between their shoulder blades? Loosening the tension of the pericardial sac is another contribution to "freeing the heart." My proposed definition of stress has been that in response to the intensity, repetition or duration of what is experienced by an individual as a stressor will result in the body sacs cringing and that the tubes within organs and between organs will shorten and narrow.6 This might happen either in response to a sudden occurrence or insidiously, over a long period of time which might include multiple events.
Many technique orientations might assist the pericardial sac to loosen. Those which I most commonly employ are unwinding and recoil techniques. The basics of unwinding were learned from Dr. John Upledger, developer of CranioSacral Therapy and the recoil techniques from Dr. Jean Pierre Barral the developer of Visceral Manipulation.7,8 Dr. Barral would want me to acknowledge the he learned recoil technique from, Dr. Paul Chauffour, the developer of the Mechanical Link approach to osteopathic manual therapy.9
A rather curious phenomena has occurred five times over the past 10 years where I actually felt the heart shift its position between my anterior-posterior placed palms when using a combination of unwinding and recoils techniques in a rhythmic fashion. The reason I mention it is the exceptionally positive response of the clients for whom this happened. All reported fewer somatic ailments and increased energy in their daily lives. Whether this was a shifting of position between the esophagus and the heart or a rotation, side shift or caudal or cranial slide of the heart as a whole, is unclear. Yet, it did happen and the clients felt much better. In this series, I am recounting what may be possible, not what can be predicted.
Another technique I have found to be helpful to lessening resistance within the thorax is the fascial stretching of the pleural sacs of the lungs. This is accomplished by softly anchoring the pleural dome of the lungs and caudally stretching the tissues adjacent to the sternum and just above and below the breast area. The intention here is to assist the sliding of the pleural sacs and to assist the ease of movement between the pericardial and pleural sacs.8 Reducing the resistance within the thoracic cage is the therapeutic goal. If the heart has less resistance to its expansion, it is my conjecture that it's coronary arteries are more likely to expand as well which may reduce the speed or quantity in the build-up of plaques within these crucial arteries. A river with a steady current has less sediment accumulation. Are our arteries really that different from other natural containers of moving fluid? To reprise, my clinical experience suggests that applying our palpation efforts to the structures "inside" the thoracic cavity is the most efficient way toward easing the tensions that the heart must overcome during its expansion phase. Such efforts positively contribute to "freeing the heart."
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
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