resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Optimism = Compassion = Trust
A randomized clinical trial recently published online in JAMA Oncology examined how patients viewed their doctor based upon how the practitioner presented bad news to the patient.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
A House Divided?
The American Chiropractic Association's House of Delegates voted on 30 resolutions at its annual business meeting in Washington D.C., but two in particular took immediate center stage due to their controversial nature.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
Sleep, Less Sleep or No Sleep?
I had a dream I wasn't getting enough sleep. It was a very realistic dream, even though I was probably slightly awake and not really deep dreaming. Most likely I had been dozing, caught in that twilight of sleep and wakefulness.
Term Limits: What's in a Word?
It was the French historian and philosopher Voltaire who once declared the Holy Roman Empire was neither holy nor Roman nor an empire.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
Turning a Blind Eye to History – and Reality
The American Medical Association is taking the Supreme Court's Feb. 25, 2015 decision exactly as it always does – by turning a blind eye to history, legal precedent and reality.
Applying the Thin Skull Principle
The "thin skull" principle, also known as the "you take your victim as you find them" principle, is a legal principle that can be summed up by the following statement.
Functional Hip Impingement (Part 1)
Every time I sit down to write an article, I realize how much more there is to know about musculoskeletal pain. I also learn something new every time. (I want to give special thanks to Lucy Whyte Ferguson for assisting with this article.)
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
Low Back Pain in Professional Golf: A Common Muscular Relationship
Every sport creates its own unique demands on the body. Some sports require such a myriad of body positions that assessing pathology is often difficult and unpredictable.
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
A View From the ER
The University of Western States has inked an innovative agreement with local nonprofit health system Legacy Health whereby UWS sports-medicine fellows can experience observational clinical rotations in emergency-room settings within the Legacy system.
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
Talking to Patients About Lumbar Facet Denervation (Medial Branch Neurotomy)
Lumbar facet denervation, more appropriately termed medial branch neurotomy (MBN), is a procedure that may be considered when patients suffer from recalcitrant non-radicular axial back and/or leg pain.
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
August, 2014, Vol. 14, Issue 08
A Look at Compression, Congestion and Dis-Coordination
By Dale G. Alexander, LMT, MA, PhD
I want to propose that compression, congestion and dis-coordination are the cornerstones of the physiological processes which perpetuate chronic somatic dysfunction. Understanding this triad of dysfunction will allow you to describe the sources of the problems that many of your clients who are struggling to regain their function and quality of life are facing on a daily basis.
I have previously noted the importance of having clear and simple ways to describe the intentions of clinical massage therapy and bodywork to prospective clients, and to the public in general. Learning to describe this triad will greatly assist you in this pursuit. What prospective clients really want is an indication of the depth of your competence and your comprehensive understanding of how the human body really works.
Compression within our human structure, congestion of our bodily fluids and dis-coordination of our nervous system are inevitable outcomes of long-term, repetitious and intense periods of stress. These same variables are at play in response to trauma, extended illness, pathology and the aging process. Accompanying these variables, there may also be elements of scar tissue formation, derangement of joint structures and soft tissue compensations from impacts, falling or surgical interventions. Any of these may trigger the influence of the righting reflexes.1
In my January article, "The Sacs & Tubes Theory of Stress," I proposed that the sacs around organs, the menninges, pleurae, pericardium, peritoneum "cringe" in response to stress while the tubes within and between organs "shorten, narrow and twist." That old colloquial phrase of "feeling twisted up inside," has more reality to it than those who have used it realize.2
The very organization of the major internal viscera being slung "down and forward" from both the cranium and the anterior neck are suggestive to how and why so many clients present with posterior chronic symptoms related to their neck, upper, middle and lower back.2 As well as, how and why clients are challenged with postural dilemmas when faced with the progression of osteoporosis as they age.
Cringing, shortening, narrowing, and twisting of the structural elements related to the heart/lung complex, the diaphragm muscle, the liver, the uterus, the esophagus and the small and large intestines all activate "a war between the flexor and the extensor reflexes" to my sensibilities. The intrinsic visceral connections that activate this war between reflexes exist between the occiput and the anterior neck all the way to the sacrum.2
Consider that this resulting tension between the reflex systems is communicated down the length of the axial spine. Also, let us remember that these reflexes are governed by subcortical structures within the spinal cord and brain stem.1 As human beings, whether client or practitioner, we do not conceive of these reflexes, let alone are aware of their effects upon our moment to moment complex movement patterns. Most have never heard of them. We may notice the slump in our posture. And, we really notice when an involved joint goes "tweak" and the soft tissues dedicated to protect it reflexively spasm. That is the one positive function of pain, to get our attention. Understanding how this process happens so frequently is what this article is describing.
Congestion of the body's fluids is an inevitable result of compression within the human structure. The transverse diaphragm's at C0-C1(occipital /cranial base), C7-T1,T2 (thoracic inlet), T12-L1 (respiratory diaphragm), L5-S4-coccyx (pelvic diaphragm) are actually designed to distribute these strains yet, these same areas are where the flow of fluids and nerve transitions between body cavities and structures are most vulnerable.3
Using the C0-C1 junction as an example, consider the impact of compression upon the delivery of arterial blood to the brain, as well as its influence to slow the venting of venous blood and lymphatic fluids from the cranial vault. One theory of migraine headaches suggests just this juxtaposition of reduced arterial flow and inhibited venous return from the brain.3
Dis-coordination within the human nervous system may occur in many ways and places yet, the superior sympathetic ganglion located lateral to the uppermost cervical spine is easiest to reference as any downward and forward pull to the cranium and neck will add distortion to the occiput, atlas and axis resulting in many forms of autonomic confusion which usually results in disruption of blood supply.4 Dis-coordination within the sensory-motor systems usually relates to spinal cord compression, also known as stenosis.5
Stimulating blood toward a particular portion of anatomy is easily accomplished by all forms of touch therapies whereas stimulating the system as a whole to re-distribute blood and nerve flow within the entire body typically requires additional skill sets.
One such orientation to systemic re-distribution that has shown promise in my clinical experience was described in the last article of this column in which the body's central linkage was described from occiput to sacrum and the crucial role of the ankle/foot complex was emphasized in propelling blood and lymph back to the heart/lung complex.6 Many additional therapeutic perspectives are possible.
The crucial factor is that the body needs freshly oxygenated and nutritious blood containing the necessary hormones and effective nerve supply to all tissue structures to heal and to balance its healthy function. As the nerves hitch a ride on the arteries and arterioles, this therapeutic goal is one and the same though techniques differ in their orientation to stimulate circulation or neural expression.7
Compression relates to any structure which has a superior to inferior attachments. Compression eventually interferes with both blood and nerve supply to all body tissues.
Congestion infers that the body's fluids are impeded from flowing to their natural outlets, primarily back the the heart/lung complex. Congestion adds pressure to delicate peripheral nerves exiting the the spinal cord from the occiput to the sacrum.
Dis-coordination occurs both within the neuro-circulatory matrix of autonomic reflexes which direct blood supply and between the sensory-motor divisions of the central nervous system which coordinates gross and fine motor movements through its peripheral nerves to the extremities.
In summary for now, allow these ideas to distill through your own clinical experiences with clients. Consider the triad of compression, congestion and dis-coordination. Create your own synthesis for how the body heals. Create your own description of how it progresses into physiological difficulty and pathology. The ability to verbally articulate these processes is more important than any marketing tool. Re-emphasizing what was stated earlier in this article, "What prospective clients really want is an indication of the depth of your competence and your comprehensive understanding of how the human body really works."
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
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