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Massage Today
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

cloud heart - Copyright – Stock Photo / Register Mark 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.

  • Enhance the heart's ability to pump more blood by reducing the resistances to its expansion.
  • Restore the normal pressure differentials between the body's three great cavities.
  • Restore the mechanisms that naturally assist venous and lymphatic return by enhancing the inferior cylindrical movement of the diaphragm and the ease of dorsiflexion/plantar-flexion of the ankle/foot complex.
  • Lessen the tone of the sympathetic division and enhance the outflow of the parasympathetic division of the autonomic nervous system.
  • Reduce or remove common obstacles to the return of raw blood products.

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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