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Treatment of PTSD: An Opportunity for the Practice of Integrated Medicine
PTSD is widespread across America today. Not only do many of our honored men and women in uniform bring it home with them from the war zones they have been active in, but it often follows any life-threatening event people go through when their lives have been in danger.
Creating Relationships at Southwest Symposium
The month of May brought many interesting activities. As I have said in many previous columns this year, this profession is moving in a very exciting direction. Make sure you are getting involved. If you're not, you just might get left behind.
Desert: A Metaphor from the Study of Genetics
In most of the human lives I know about, there are stretches of time which feel stagnant, or worse. We can feel adrift, or wounded and sidelined, and these times don't seem to carry much usefulness while they are unfolding.
I was sitting in a Pizza Hut in Peoria, Ill., with my friend Reggie, sometime in the spring of my senior year in college, when he started doodling on his paper placemat. In those days, the company had a picture of U.S. on the mats, showing all the locations of the "Huts" in the country.
The Three Heater Official
This Official, belonging to the element Fire, is responsible for maintaining and regulating the heating system of the body, mind, and spirit. It is named for its function. The trunk is divided into three "burning spaces" or "jiaos."
Should You Change an Athlete's Natural Running Form?
Once past the ankle, impact forces travel at about 200 mph into the knee. In addition to allowing the quad to absorb force, bending the knee (E) prevents the hip and pelvis from moving up and down too much (F), which is important for injury prevention and efficiency.
Chinese Doctors Poke Holes in Australian Study
A recent Australian clinical trial, published in the Journal of the American Medical Association (JAMA) in 2014 by Rana Hinman, et el., evaluating the effectiveness of both needle and laser acupuncture for chronic knee pain.
Leg-Length Inequality and Pelvic Fixation: A New Approach to the Negative Derifield (Part 3)
A patient with sacroiliac fixation and dysfunction ordinarily demonstrates a noticeable leg-length inequality when placed in the prone position on the adjusting table.
Meet Cheyenne: Your Future Colleague
Allow me to introduce you to Cheyenne (Chey), the daughter of some of our family's closest friends. We attend and serve at the same church together, and have known each other for many years.
NCCAOM Video Contest
The NCCAOM is excited to announce the launch of the second annual video contest "Because it Works!" 2015.
Integrative Medicine for the Underserved: A Seat at the Table
Numerous organizations have risen to the challenge of providing care to medically-underserved populations and here we feature one such group.
Free Yourself From the Pocketbook Practice
Let's take a journey together; there's an important lesson to be learned. Imagine a town or city just like yours.
The Source-Luo Point Combination, Part 2
The Da Cheng includes symptoms for the source-luo points that indicate when to use them for treatment. Yang defines the method as the guest-host (it is one of a variety of acupuncture point combinations called guest-host).
Going On-Site With Chiropractic Care
The Foundation for Chiropractic Progress has released a position paper highlighting the financial, clinical and patient-satisfaction benefits of providing chiropractic care at on-site corporate health clinics.
Nomenclature and Classification of Lumbar Disc Pathology: Version 2.0
The Nomenclature and Classification of Lumbar Disc Pathology consensus, published in 2001 by the collaborative efforts of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology, has guided radiologists, clinicians and the public for more than a decade.
An International Life: An Interview with Mary Elizabeth Wakefield
I met Mary Elizabeth Wakefield during her class last summer in Seneca Falls, New York at the Finger Lakes School of Chinese Medicine.
Q&A With the First VA Chiropractic Residents
As you may have read previously, a major step forward for the profession occurred in July 2014 when the Department of Veterans Affairs began piloting a chiropractic residency program at five locations.
Sports Medicine 101: Surgery or No Surgery?
In the world of sports medicine, many careers are saved by surgeries that correct traumatic damage to the body. Muscle tears, ligament damage, fractures, spinal disc herniations, and joint instabilities are a few of the issues frequently addressed with surgical intervention.
Marketing with a Microphone
When given an option, it stands to reason that people prefer to do business with those they know, like, and trust.
News in Brief
Investigating the Cellular Impact of Mechanical Force; National Board Seats (Not-So) New Officers at Annual Meeting.
Key Changes and Updates to the 7th Edition CNT Manual
Acupuncture Today recently interviewed Jennifer Brett, ND, L.Ac. regarding the updates to the CNT manaul.
June, 2013, Vol. 13, Issue 06
Freeing the Heart: Protection of the Hip and Shoulder Joints
By Dale G. Alexander, LMT, MA, PhD
As we continue with this current series of articles on Freeing The Heart, if we consider the basic physiology of the human circulatory system, it seems evident that when the heart and lungs reach full expansion with a minimum of resistance, the heart will eject more blood and at a greater velocity.When more blood exits the heart with greater speed, these variables increase the probability that freshly oxygenated and nutritious blood will reach all body tissues. Thus, as massage therapists, focusing our attention on reducing resistances to the expansion of the heart and lungs is one clear way that we may assist our clients with chronic somatic dysfunction; including those with either identified or unidentified cardiovascular disease.
In previous articles of this series, the major "intrinsic resistances" to the heart's expansion have been described. However, there are three additional "extrinsic" variables that reflexively contribute to the chronic tension of the thoracic cage. The first two are hip and shoulder subluxations, while the third is known as a Lateral Trauma Reflex.1,2
Typically, massage therapists do not use the word subluxation, yet this is what I consistently find in the hips and shoulders of most clients with chronic somatic dysfunction. To my perception, the generic definition of a subluxation in this regard is when the head of the femur or the humerus has moved far enough to the edge of its joint capsule so that the potentially unstable position stimulates the reflexive protection of the surrounding myofascial elements whose job it is to prevent dislocation. These subluxations may be mild, moderate or severe in my experience. Since first identifying and tracking these dysfunctions as significant variables to therapeutic progress some 25 years ago, more than 70% of my clients have presented with one or the other or both of these dysfunctions.
I have a theory about the reason why these subluxations occur as often as they do. My speculation is that our primate ancestors developed a more flexible anterior shoulder capsule and a more flexible posterior hip capsule as a functional adaptation to their day to day reality. Should they fall from a height, say from a tree, these joint capsule adaptations would assist their ability to tuck and roll suddenly (anterior shoulder going forward while the opposing posterior hip moves backward), creating a spin of their bodies such that upon impact their chances of survival would be enhanced and therefore their genes passed on.
When either femoral head slides posterior, then the job of weight bearing shifts to the sacroiliac joints and the lower three lumbar vertebrae with attendant splinting of the deep lateral rotator and gluteal myofascial structures of the pelvic girdle. Weight bearing also continues to shift up the kinetic chain to the deeper paraspinal structures which are designed to guide normal vertebral motions. This shift in weight bearing distribution has implications for the high incidences of low back dysfunction, sciatic syndromes, hip or knee degeneration and may also influence the internal function of the bowel, bladder or reproductive organs. These implications will be addressed in future articles.
My premise is that when a hip subluxation occurs, a subcortical reflex is set off that subtly stimulates the person to pull their arms against the sides of their chest. This, of course, becomes yet another resistance to the heart and lungs to reach their respective full expansions.
I owe a debt of gratitude to Thomas Hanna, PhD, for introducing me to the power of our subcortical human righting reflexes.1,2 And, what I have briefly described acknowledges the wisdom of Ida Rolf's famous statement that, "when the body is not supported from below, it will attempt to hang from above."3 Andrew Still, the father of osteopathic medicine, placed great value on the integrity of the hip joints inferring that all physiological processes worked better when their function was efficient and proper.4
In the shoulder joint, if the head of the humerus slips forward enough to stimulate the protective reflexes of either or both of these joints, then the result is the same. The body will pull the arm against the lateral chest and usually the same sided scapula will lose its ability to slide freely. The loss of ability of the scapulae to move freely has many implications for respiratory efficiency, as well as thoracic inlet inflexibility, cervical dysfunction and other upper extremity difficulties. Any or all of these symptoms contribute to an extrinsic resistance to heart/lung expansion.
The 3rd subcortical reflexive protection that I have clinically observed and treated repeatedly since 1988, is what Dr. Hanna called the Lateral Trauma Reflex. It is hypothesized that this reflex is most often stimulated by sudden movements like a severe fall or the act of being thrown through the air such as snow skiing, or being ejected from a car in an accident, being thrown off a motorcycle, bicycle, water skiing or jet-skiing.1,2 Certainly, other events may trigger this reflex as well.
One can easily assess whether this reflex is lingering in your clients by requesting that they out-stretch their arms over their head while grasping their wrists and gently pulling superiorly. If this reflex is present, then one side will resist normal elongation not only at the shoulder, but down along the full side of their body.
Dr. Hanna's explanation was when stimulated by sudden movements such as the ones described above, the subcortical elements within the brain stem reflexively contract tissues such as the latissimus and the abdominal oblique myofascial structures to create a generalized state of contraction.1,2 My clinical experience suggests that this reflex participates in the perpetuation of recurring hip and shoulder subluxations.
As it relates to the full expansion of the heart and lungs, the internal result is the same. The reflexive protection of the shoulder(s) or of an entire side of the body increases the resistance that these organs must overcome to reach toward full expansion and ultimately requires the heart to work harder.
I would speculate that as "successful adaptation" is the hallmark of our species, both the good news and the bad news is that the heart alone can only work harder for so long before the autonomic nervous system activates its back-up plan which is to systemically narrow the blood vessels (known as hypertension and high blood pressure) and finally resorts to racing the blood back to the heart. This final adaptation progressively is proposed to decrease the delivery of freshly oxygenated blood to various tissue sites usually the larger joints and various organ structures in a fashion that perhaps only genetic predisposition, psycho-emotional possibilities and a client's trauma or illness history might help us to understand.
The irony here is that the innate righting reflexes which evolution provided in order to survive long enough to reproduce may also "reduce our quality of life" as we age far beyond our childbearing years. The intention of this series has been to unravel the "mystic of cardiovascular disease progression" and empower us in our profession to realize and understand how we may positively contribute to our clients' quality of life.
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
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