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U.S. Olympians Have a DC in Their Corner
It's probably old news to you that doctors of chiropractic play an increasingly prominent role in treating athletes, from youth sports participants to weekend warriors, to elite / professional competitors.
First Annual ICD-10 Updates Take Effect
Yes, there was an update to ICD-10 codes on Oct. 1. It was a regular update to the diagnosis coding system and will take place every Oct. 1, just as it did when the ICD-9 system was in place.
Update from the International AIDS Conference
The 21st International AIDS Conference in Durban, South Africa, brought together more than 15,000 of the world's leading scientists, activists, funders, policy makers, and consumers from 153 countries.
Treating Peripheral Neuropathy: Multi-Faceted Approach Including Laser Therapy
Peripheral neuropathy affects at least 20 million people in the United States1 and nearly 60 percent of all people with diabetes suffer from diabetic neuropathy. Many suffer from the disorder without ever identifying the cause.
Going Beyond Just Feeling Good
We all know that most patients come to us for some pain complaint: neck pain, back pain, sciatica, carpal tunnel, etc. We also all know that acupuncture is a great first-line care for these issues, as well as supporting overall health and wellness.
Pediatric Asthma: A Case Study
I have had very good success with pediatric asthma, combining acupuncture with Chinese herbal products. Treatment is given over four to eight months, twice monthly, with herbal formulas rotated every month.
Upgrade to "Parker 2.0" in Las Vegas
Continuing your education and refining your practice: two key elements of a successful chiropractic career. Parker Seminars promises both as it celebrates its 65th anniversary in Las Vegas next February, according to Parker University President, Dr. William Morgan, and seminar consultant Dr. Mark Sanna.
Workers' Back Pain: Causes, Costs & Solution
You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.
Natural Cancer Prevention: Pomegranate for the Prostate
In recent years, the ingestion of pure pomegranate juice (8 ounces per day) has been shown in clinical studies with human subjects to slow, and to some degree, reverse, the progression of prostate cancer – the second leading cause of cancer death in North American men.
Decoding the Mystery of Medical Insurance Acceptance
In the constantly evolving profession of acupuncture, one of the least understood areas is medical insurance acceptance. The profession is filled with controversy surrounding this topic: Is it ethical?
Four Ways to Attract Patients
Acupuncturist A has been in practice for six years and has struggled since day one. She spends as much time and money on marketing as she can, but since her practice is slow, her budget isn't that big.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
Getting Paid by Medicare Is Getting a Major Adjustment
The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law to implement a new approach to clinician payments and replace the Sustainable Growth Rate formula.
Using the Lens of Chinese Medicine
One of the most common medications I see in clinical practice on a daily basis is fluoxetine or Prozac. Consequently, I hear many complaints concerning the side effects of this medication and am frequently asked by patients to help manage these side effects with acupuncture and Chinese medicine.
Integrative Cancer Care: Chiropractic for Chemotherapy-Induced Hiccups
Hiccups (singultus) are a frequent occurrence during cancer treatment. The cause of the hiccups may be the chemotherapy drug itself, such as Cisplatin; or the prophylactic use of corticosteroids such as Decadron, which is used to prevent nausea and/or vomiting.
Pediatric Footwear: Function Over Fashion
As practitioners, it is not uncommon for parents to bring us their children to treat or ask us questions related to the pediatric population. Children's feet tend to be a perplexing region for parents and practitioners alike.
Six Things Every DC Should Know About the Zika Virus
The Zika outbreak continues to spread across the continental United States and U.S. territories. We offer this brief overview on this important public health problem for the practicing doctor of chiropractic.
National Board Apologizes for Testing Issues
The National Board of Chiropractic Examiners (NBCE) has issued a formal apology following a series of computer-based testing malfunctions that impacted two separate examinations (March and June 2016) and caused "widespread confusion and frustration" to the nearly 1,500 examinees taking the tests.
Power to the Patient
Against a backdrop of splintered political parties, polarizations within nations, civil unrest, and distrust of established government (such as the growing anti-Washington, D.C. sentiment) comes the not-so-surprising finding that health care authorities and practitioners (with perhaps the exception of insurers) are turning over more and more powers to the individual patient.
ITB Syndrome: Treat the Tensor Fascia Latae
Iliotibial band syndrome is usually the result of repetitive knee flexion, such as in runners or cyclists. Pain may be experienced in the knee and/or the hip. The patient may express a sense of the hip dislocating, popping or snapping.
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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