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Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
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.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
August, 2012, Vol. 12, Issue 08
Freeing the Heart: Enhancing Central Circulation
By Dale G. Alexander, LMT, MA, PhD
Enhancing central circulation is a notion that has emerged over many years from my work with clients who typically present with exceptionally difficult chronic somatic difficulties. It's combined therapeutic intentions have been to:
Here, we seek to identify the what and where of these therapeutic intentions. Many possible "how to's" are possible when one's treatment goals are clear.
It is postulated that this orientation of enhancing central circulation can serve to reduce the workload required of the heart and may slow the build-up of plaques within the coronary arteries. Further, it is postulated that a dedication to assisting cardiac output, neurological balancing and venous and lymphatic return in each bodywork session will assist the autonomic nervous system to more equitably deliver fresh blood to ischemic tissues associated with stubbornly chronic problems.
From our common training base in Swedish massage, we were taught stroking patterns and a general sequential protocol that was intended to assist systemic venous and lymphatic return. Little attention, however, was given to restoring the underlying mechanism(s) by which the body can reset its efficiency of facilitating the flow of these fluids within itself nor, to balancing the functioning of the two divisions of the autonomic nervous system or to enhancing diaphragmatic and ankle/foot range of motion. Absolutely no attention was given to reducing the resistances to the heart's expansion. That is what makes this construct of enhancing central circulation both useful and unique.
To my sensibilities, there are three great pumps which are designed to move the fluids of the body (arterial, venous, lymphatic and interstitial). These include:
Now, add the notion of equalizing the pressure between the body's three great cavities which is proposed to allow for the natural flow of fluids back to the heart based on restoring normal pressure gradients.2,3 Full credit is given to Dr. Jean-Pierre Barral, DO, for introducing me to this golden anatomical nugget in 1987.
Consider the importance of enhancing the movements of these mechanisms which are the prime pumps of fluids and the importance of restoring the appropriate pressure differentials which assist these fluids to more efficiently move back toward the heart. Consider how therapeutic attention to these factors may together "reduce the need" for the heart to work harder or for the arterial system to narrow. Consider how these intentions might be a contribution our profession could make toward the prevention of high blood pressure.
The notion of reducing sympathetic tone and enhancing parasympathetic outflow is a core construct of craniosacral therapy as was taught by Dr. John Upledger, DO. I was first introduced to this foundational premise in 1986 and my years of clinical practice since vivify the effectiveness of this treatment goal. This relates to all aspects of activating the body's self-corrective capacities and especially to the regulation of a normal heart rhythm as it is the sole duty of the vagus nerve to slow the heart.4,5
Let us now consider the equally important therapeutic intention of reducing or removing obstacles to the flow of fluids back to the heart from below the diaphragm. Obstacles may be many and varied in their presentation but in distillation, they slow the return of raw blood products either by making the fluids take alternate routings, by adding resistance to the speed of normal drainage or by building congestion as the fluids are held back from moving. Similar to being stopped by a traffic snarl, we either seek another route around the tie-up, crawl our way along hoping the problem will clear itself, or when traffic is completely stopped, we wait in frustration for the road to open ahead of us.
My clinical experience suggests that congestion around or inflammation within the liver, gall bladder and pancreas complex is one of the most common obstacles to blood return. Let us appreciate that the liver is suspended from the inferior surface of the diaphragm muscle and its portal vein is the main tributary for venous blood returning to the heart through the inferior vena cava. Together with the gall bladder, its common bile duct and the sphincter of Oddi which is shared with the pancreas, any inflammation in these organs or their tubes can impair venous and lymphatic return. This is why learning to mobilize and gently stretch these organs and tubes, along with others, is such an important skill for touch practitioners to add to their therapeutic tool boxes.3,6,7
Above the diaphragm, another common area where blood seems to become congested is at the cranio-cervical junction. This is a crucial area to evaluate and treat with whatever therapeutic tools you possess. My experience supports another notion that Dr. John Upledger postulated some 26 years ago: that the brain sometimes holds onto blood. And that the bilateral jugular foramen openings in the cranium serve to drain 85% of the fluids leaving the cranium.4 It is through these same openings that the vagus nerves, who have the task of helping to regulate the heart, exit the cranium.8 A simple way to evaluate this notion of vascular congestion is to lift your client's head and feel for its weight in your initial evaluation. Later, if your bodywork has successfully normalized the flow of fluids leaving the cranium, their head will kinesthetically weigh less.
The Inside-Out Paradigm continues to explore the inner workings of how we may assist our clients to both maintain or to regain their functional capacity and quality of life. Enhancing central circulation is proposed to not only to assist the heart itself but may be a key component toward facilitating the autonomic nervous system to increase its delivery of fresh blood to stubbornly chronic somatic tissues as well.
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
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