resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
In a previous column, I discussed the history and definition of evidence-based practice (EBP), and expressed concerns with how the concept has been narrowly construed by some academics and payers.
Let's face it – patient evaluation takes time. Unless you are really into the diagnostic evaluation game, you probably have found the formal exam protocol tedious if not downright annoying.
Economics of Complementary/Integrative Care
Although this column doesn't usually feature a book review, we're going outside of our usual public health format to discuss a new book written by Patricia Herman ND, PhD.
Wisconsin Exam in the Spotlight
You've passed your national boards with flying colors, including Part IV, the practical examination, at a combined cost of more than $3,000.
Energy is a hot commodity. Society pays dearly for it and for the expertise of those who know how to cultivate it.
Business Building: What's Your Strategy?
I know some in our profession love to debate about whether or not spinal curvatures change as a result of our chiropractic adjustment, but I have a question that hits a little more close to the belt than that: Are chiropractors capable of change?
Herbal Medicine: Go Mainstream
When it comes to practicing herbal medicine in a mainstream setting, there are a number of important points to understand when it comes to prescribing formulas. Some important questions to ask are - what method of prescribing and dispensing is most effective in this setting?
Helping Infertility Patients with the Spirit Essence
As many of you know, when it comes to treating infertility, we are dealing with a patient population that is, generally speaking, in emotional turmoil. These patients often experience fear, anxiety, despair, hopelessness, grief and anger.
Exercises for Back Pain: Low-Compression Training Program
This program is intended for two groups of people: 1) those who want to engage in resistance exercises for the major regions of their body without developing back pain in the process; and 2) those who already have back pain and want to do resistance exercises, but consistently re-irritate their back when trying to do so.
Calcium Supplements and Mortality
When the National Institutes of Health's AARP Diet and Health Study reported that men who took calcium supplements had a higher risk of dying from cardiovascular disease compared those who didn't, it was the third large cohort in six months with alarming findings regarding calcium supplements.
The Pallof Press for Core Stability Evaluation
Many people become injured because of instability, weakness and poor neural-sequencing patterns in the core. Lack of bracing and support from the inner core cylinder during coronal and transverse movements makes the body vulnerable to compensation injuries.
History Repeating Itself in Wisconsin?
Thirteen years ago, the Wisconsin Chiropractic Association (WCA) "agreed to settle Federal Trade Commission allegations that [the association] orchestrated a conspiracy among WCA members to increase prices for chiropractic services and to boycott third-party payers to obtain higher reimbursement rates."
Medical Payola (Part 2)
Not only has Medtronic made billions selling expensive screws and hardware for highly controversial spine fusions, but a Senate investigation also found Medtronic felt compelled to write and edit medical journal articles attributed to outside physicians that downplayed the risks of the company's best-selling bone graft, Infuse.
Peer Points: Stories of Practice Success
When patients go see Arizona-based acupuncturist Jing Liu, it is to get top care from an practitioner well versed in all aspects of Traditional Chinese Medicine.
News in Brief
Cancer Treatment Centers of America Continues Support of Chiropractic; ACBOH Announces 2013 Practical, Written Exam Dates; PCORI Approves Funding for Research on Spinal Stenosis; Macquarie University to Cease Offering Chiropractic Program.
There Are No Secrets: Treating Complicated Conditions with TCM
Including standardized extra points, there are just over 400 acupuncture points on the body. You get 400 and I get 400 - same. Yet, time and time again treatment protocols are coveted as if they were some secret formula only intended for the right and privileged.
Helping Patients Through Pregnancy Loss
There is a lot of focus in the acupuncture world on fertility and helping women get pregnant. It's exhilarating to hear the news that a patient is expecting a baby. The other side of that is pregnancy loss. That includes abortion, miscarriage or stillbirth.
Chiropractic Research: A Moral Issue
This year I've had the opportunity to go to three great chiropractic research conferences; the ACC-RAC, the Fédération Internationale de Chiropratique du Sport (FICS) Congress and the World Federation of Chiropractic Congress.
Telecommuting and Technology: Ergonomic and Worker's Comp Considerations
As our world becomes more and more reliant on technology, equipment becomes more dependable and we become increasingly more comfortable with e-mail, the fax machine, the Internet and the smartphone, it is becoming easier and easier to work away from the office.
Repeating Bone-Density Tests
The U.S. Preventive Services Task Force recommends that women older than age 65 undergo bone-density testing. However, organizations in general have not stated when repeat bone-density testing should be done.
Covering Chiropractic as a Profession, Not a Single Service
Recently Dynamic Chiropractic published a front-page article about various state essential health benefits and referred to Oregon and four other states not currently providing chiropractic as a covered benefit.
The Spirits of the Points: The Gall Bladder Official
The Gall Bladder is known as The Official of Decision Making and Judgment. In any given day, this Official makes countless decisions – conscious and unconscious, which influence every aspect of our being.
You are What You Eat Part II: Integrative Protocols
In the previous installment of this article I discussed important ideas concerning gastrointestinal health and foundational ideas from TCM, which can provide key insights into creating effective protocols for healing the gut.
Spinal-Cord Injuries: Saying No to Steroids
With steroids, epidural and otherwise, in the news lately for their overuse when treating back pain (and their danger when tainted by fungal meningitis), it was high time for a policy change, and we've got one, from the Congress of Neurological Surgeons and the American Association of Neurological Surgeons.
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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