resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
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.
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.
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.
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.
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.
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.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
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.
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.
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.
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.
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.
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%.
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.
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.
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.
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).
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.
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.
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).
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.
January, 2013, Vol. 13, Issue 01
Freeing the Heart: The Role of the Autonomic Nervous System
By Dale G. Alexander, LMT, MA, PhD
This series of "Freeing the Heart" has evolved to offer our profession and other touch and movement therapies a conceptual framework for how we may collectively contribute to slowing the progression of cardiovascular disease.These ideas are extrapolations of my clinical experience that have assisted clients with cardiovascular problems and those that present with persistent chronic somatic problems. A descriptive summary of the concepts "Enhancing Central Circulation" is detailed at the end of this article.
From my point of view, the basic problem the human body faces in the aging process is that many variables combine to slow the "return of raw blood products to the heart" in the process of freshly oxygenated blood being reconstituted and delivered to all tissues and cells. Both the "quantity and the timely delivery" on both ends of the vascular system are key functional components of the heart's capacity to contract 100,000x's a day and to send blood efficiently over the estimated 60,000 miles of vessels.1 Obviously, the build up of fats inside the walls of these vessels is a primary component of the resistance to the efficient flow of blood, which I propose happens for most of us, not just some.2
Here is an anatomical interpretation of the progression of cardiovascular disease and I propose that the autonomic nervous system (ANS) has evolved three cards to play in its efforts to offset the inefficient flow of blood back to the heart.
I also propose that most progressions toward pathology will be accompanied by a decrease in the volume of freshly oxygenated blood. Whether it be a chronic somatic dysfunction, chronic illness, cancer or cardiovascular decline, such progressions reflect a compromised capacity for the body to manufacture in a timely manner and to deliver the nutrients, hormones and oxygen so desperately needed to maintain our health, contribute to our vitality and support our capacity to move, dance and sing.
In this theory, the autonomic nervous system has basically three cards to play at its reflexive disposal to keep up with the demands of producing and delivering freshly oxygenated blood. I am further proposing that these typically occur in sequence over the course of one's life. First, The heart works harder, and in some people, the left ventricular muscular wall may become thicker and stiffer and is most often identified as left ventricular hypertrophy. Second, the blood vessels narrow to push the blood through faster which, in many people, is identified as hypertension or high blood pressure. And third, the delivery of freshly oxygenated blood to "all body tissues" is decreased. My premise is that this latter progression is related to many chronic somatic conditions associated with the aging process, including most joint degradations, and might play a role in setting the stage for other illnesses including cancer.
Let's examine the concept of the heart working harder first. This happens when we exercise. It's normal, up to a point. However, if the resistance to the heart's expansion increases and, especially when this happens over a period of years, then the muscular wall of the heart's left ventricle thickens in its attempt to pump more blood. Many factors may contribute to the creation of this condition: internal tensions within the thoracic cage, atheromatous plaques made up of fat and cholesterol, scar tissue, extrinsic myofascial tension, reflexive righting reflexes and emotionally related identity and stress factors combine in my experience to provoke the dual innervation of the heart to strain in its efforts to provide enough push to send the blood throughout the vascular system and back to itself. Again, the time required to complete the loop and in sufficient quantity are the crucial variables that maintain circulatory efficiency.
At a certain point in the thickening of left ventricular wall, the additional effort of the heart actually decreases the amount of the blood being ejected. This is why left ventricular hypertrophy (LVH) is considered a very real risk factor in the progression of cardiovascular disease.3 In my view, increasing the force of the heart's contraction is the first card that the ANS plays as it spans both normal function and the possible progressive stages of dysfunction into pathology.
Considering hypertension and high blood pressure, what I sense has been overlooked is that the 60,000 miles of our human vasculature is principally innervated by the sympathetic division of the ANS as contrasted to the heart's innervation by both the vagus nerves from the brain and the sympathetic nerves from the spinal cord.4 This suggests to me that the narrowing of the vasculature system is the second card that the ANS plays in its reflexive efforts to push and rush blood back to the heart/lung complex in order to keep up with the process of producing freshly oxygenated blood. There appears to be no question that high blood pressure is a significant risk factor in potentially provoking plaque to break free and thereby triggering a heart attack or stroke.5
The third card that the ANS has to play is to prioritize moving the blood back to the heart as it's end goal and, by necessity, sacrificing the delivery of freshly oxygenated blood to some tissues along the way. Might this be reflected in the frequency of chronic somatic dysfunction that increases as we age? Further, this might contribute to the predominance of joint problems including the need for spinal surgeries, hip, knee and shoulder replacements as we age. I speculate that this is an under-recognized variable in the progression of many persistent chronic somatic dysfunctions. The consistent delivery of fresh blood containing its full constituents (oxygen, nutrients and hormones) is necessary to maintain vital human function and the health of all our various tissues.
Defining the problem more clearly often leads to targeting possible solutions. The following is an updated distillation from the previous article, "Enhancing Central Circulation" from the August 2012 issue of Massage Today.
The take away here is for us to turn our attention toward enhancing the central circulation of the human body. In the many and varied ways that touch and movement therapies have evolved and continue to improve their effectiveness, each may contribute their measure. Let us all commit to this direction and seek to assist as many clients as we can.
Author's Note: Many thanks to Annie Dundon, Glenn Gaffney, Katie Truax-Alexander and Dr. Ed Charlton for their editorial support and guidance.
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
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