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Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
Vitamin D Fails to Help Knee OA? The Proper Perspective
The March 8, 2016 issue of JAMA includes a study about vitamin D supplementation for osteoarthritis of the knee. This is a really weird study.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
Business Lesson #1: Adapt or Else
My wife and I recently enjoyed an excellent meal at a restaurant recommended by some friends. We often have concerns about restaurant recommendations, as many have been disappointing.
Musculoskeletal Disorders Take Center Stage
Looking for the latest on the musculoskeletal pain epidemic and the increasing premium placed on preventive strategies including chiropractic? Check out The Impact of Musculoskeletal Disorders on Americans – Opportunities for Action.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
The IME System: A Current Public Health Risk and Solutions That Are Working
I strongly believe in the independent medical examination (IME) system. There are far too many doctors in every profession who are not following E&M protocols and never claim MMI (maximum medical improvement) has occurred for their patients, which has caused financial stress for many private and public carriers.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
The Power of Eccentric Exercise: Hamstring Injury Prevention and Rehab
For almost 20 years, I've worked with professional athletes who make a living by running really fast. It goes without saying that hamstring injury (HSI) prevention and rehabilitation is a big part of what they expect from a sports chiropractor.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
How to Find and Fix TL Nerve Impingements
The thoracolumbar junction (TLJ) and the peripheral sensory nerves that exit from it are frequent, important and rarely recognized sources of lower back, pelvic and hip pain. Let's outline a clear exam protocol for diagnosing the problem.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
Recording and Appropriate Billing of Timed Physical Medicine Services
There is a common misunderstanding about timed therapy services and although you do have some knowledge of timed service documentation, based on your comment on the 8-minute rule, your understanding is correct, but incomplete.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
Essentials of Assessment: The Squat
The squat is a simple, fast and functional tool to evaluate patient symmetry and function. As simple and easy as it is to implement, it can yield considerable amounts of valuable, clinically relevant information.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
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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