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Targeting the Bad Apples in the Bunch
While everyone was focused on the conversion to ICD-10, the Office of Inspector General for Health and Human Services released a new report on chiropractic titled "CMS Should Use Targeted Tactics to Curb Questionable and Inappropriate Payments for Chiropractic Services."
F4CP Making a High-Impact Impression
The Foundation for Chiropractic Progress has released details of its 2016 strategy, certain elements of which are already in play. The strategy includes ads, posters and other resources available to all F4CP members.
Which Way is the Energy Going? Are You Burning Yourself Out?
One of the simple methods that I use to define Yin/Yang theory to patients is to ask the question, "Which way is your energy going?"
Footsteps of the Sages: An Apprenticeship with Dr. Kezhan Zhang
When I met Dr. Kezhen Zhang in May 2013, I was his translator and the integrity, creativity, and passion he demonstrated as a practitioner and advocate of the medicine convinced me to travel to Beijing to study with him.
The Concussion-Subluxation Complex
In the Aug. 1, 2014 issue of Dynamic Chiropractic, I reviewed some of the literature demonstrating the role of the chiropractic adjustment in post-concussive care.
Your Billing Questions Answered
I hear a lot of the following questions: I am afraid I may doing something illegal. I have heard I cannot have different fees for the same service.
Making Sense of an Increasingly Obvious Conclusion
Where's U.S. health care heading? Like it or not, the list of telltale signs is growing to a point that stands out to even the most myopic observer. Consider this list of facts as you look into the future of health care in the United States:
The Modern Application of Ancient Mei Rong
Chinese Medical Cosmetology (Mei Rong) has a well-documented and venerated history dating back to the Qin (221-206 BC) Dynasty.
One Size Does Not Fit All: Exercise and Nutrition According to Your Yin/Yang Body Type
There are countless new exercise and nutrition plans out there, emphasizing the latest ground-breaking research and claiming to revolutionize the way we view health.
Acupuncture and Oriental Medicine in the West
We know acupuncture and Oriental medicine as the indigenous medicine of East Asia; in particular China, Korea and Japan are the countries of origin of this wonderful healing system.
Pro-Con: Swaddling for Newborns
The practice of swaddling has been used for thousands of years and was popular until the 1700s, when it was slowly abandoned by many cultures that considered it old-fashioned or barbaric.
Designing a Fitness Plan (Part 1)
It doesn't matter if you come to my practice for pain relief, weight loss, healthy aging or something else. The formula I talk about for each patient's fitness strategy is pretty much the same.
It's Time to Review
It is amazing to see the changes that are occurring in the acupuncture profession. Let's look at some of the news and events that have contributed to this growth and awareness.
Born to Energize the Human Spirit: Recollections of Sig Miller
Sig Miller, longtime executive director of the Association of New Jersey Chiropractors (ANJC), passed away on Sept. 17 after a long battle with cancer.
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 2
Acupuncture's cultural and historical roots go back to the emergence of Chinese civilization. For more than 2,000 years, acupuncture needling has been continuously practiced on the largest population in the world.
Diagnose Sprain Injuries in MVA Cases With Dynamic X-Rays (Pt. 1)
Am I the only person to notice hospitals are doing a seemingly insufficient job lately in their initial radiological workup of motor vehicle accident (MVA) victims?
Mechanism: Experimental Approaches to Understanding Acupuncture, Part 1
The clinical benefits of acupuncture are difficult to ignore, but also can be difficult to explain to a Western audience. For nearly 50 years, relentlessly inquisitive scientists and physicians have been working toward a conceptual model to explain acupuncture.
Chinese Herbs and Pulmonary Fibrosis: A Case Study
"Mary M."* recently celebrated her 90th birthday. Even the former sheriff dropped by to kiss the hand of this diminutive retired teacher, to honor the years she interpreted for him during interviews with Latinas and Latinos.
Syncretism: Acupuncture and Public Health in Cuba
"Syncretism" is defined as a union of diverse tenets or practices. On a recent trip to Cuba designed to demonstrate the integration of Traditional Medicine and biomedicine, our group witnessed this union firsthand.
Dietary Fat and Prostate Cancer: An Important Update
K.M. Di Sebastiano and M. Mourtzakis published a review paper examining the role of dietary fat on prostate cancer development and progression late last year that does a stellar job of summarizing the available data on fat and prostate cancer.
Tailor-Made Knee Pain: The Sartorius Muscle
A patient was referred to my office after receiving treatment from various providers with no results. The patient was training for the Olympics as a marathon runner and was unable to run or walk without severe medial knee pain.
Too Many to Remember: Tips to Revive Your Ortho / Neuro Test Skills
When I was at Palmer in the mid-1980s, we were given a set of notes in one of our diagnostic courses. The notes covered approximately 70 orthopedic and neurological tests for various regions of the body.
Omega-3 Fish Oil: An Underappreciated Element of Men's Health
As a clinician with many male patients -- and as a man myself -- I am all too aware of the fact that we like to convince ourselves that we are doing great, when that may be the farthest thing from the truth.
North Carolina Acupuncture Board Files Dry Needling Lawsuit
In early September, the NCALB filed a complaint against the North Carolina Board of Physical Therapy Examiners over the issue of dry needling, a form of acupuncture that uses solid needles to puncture the skin and muscle tissue to relieve pain.
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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