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Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. 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.
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
Code Connection: Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
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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