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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.
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.
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.
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.
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.
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.
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.
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.
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.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
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.
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.
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.
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.
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).
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.
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).
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
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.
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.
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.
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.
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%.
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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