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Massage Today
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."

References:

  1. Atlas of Human Anatomy 4th Edition, Frank H. Netter M.D., Plates 61 & 30, Saunders/Elsevier, 2006.
  2. Is there any association between myocardial infarction, gastro-oesophageal reflux disease and acid-suppressing drugs? Aliment Pharmacol Ther 2003; 18: 973–978.
  3. The Short Esophagus: Pathophysiology, Incidence, Presentation, and Treatment in the Era of Laparoscopic Antireflux Surgery, Karen D. Horvath, MD, Lee L. Swanstrom, MD, and Blair A. Jobe, MD Annals of Surgery, Nov. 2000, Lippincott, Williams, & Wilkens, Inc.©
  4. Somatics, Reawakening the Mind's Control of Movement, Flexibility, and Health, Thomas Hanna Ph.D., Addison-Wesley, 1988.
  5. Atlas of Human Anatomy 4th Edition, Frank H. Netter M.D., Plate 124, Saunders/Elsevier, 2006.
  6. "The Continuum of Progression, Dale G. Alexander Ph.D. L.M.T., Massage Today February 2007, Vol. 07, Issue 02, www.massagetoday.com.
  7. John Upledger D.O., Developer of CranioSacral Therapy, Course Notes, 1986 - 91, www.upledger.com.
  8. Jean-Pierre Barral D.O., Developer of Visceral Manipulation, Course Notes,1987 - 93, www.barralinstitute.com.
  9. Mechanical Link, Fundamental Principles, Theory, and Practice Following an Osteopathic Approach, Paul Chaffour. D.O., Eric Prat, D.O., translated by Monique Bureau, P.T., D.O., North Atlantic Books, Berkley. Ca., 2002.

Click here for more information about Dale G. Alexander, LMT, MA, PhD.

 

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