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Massage Today
October, 2004, Vol. 04, Issue 10

Healing From the Core: A New Paradigm, Part II

By Dale G. Alexander, LMT, MA, PhD

Editor's note: Part I of this article appeared in the September 2004 issue (

Consider the esophagus.

From the mouth to the anus, the human body is one long tube. That tube, the esophagus, is fascially suspended from the sphenobasilar junction of the cranium, which is directly behind the eyes. Hence, tension anywhere in the gut tube may be expressed by the esophagus pulling the head down upon the neck. Obviously, this can affect the craniosacral system's efficiency in circulating cerebrospinal fluid throughout the central nervous system.2

Less appreciated, too, is the anatomical fact that the esophagus is cradled behind the heart in front of the spine. When the esophagus shortens its resting length in response to highly emotional stresses or in response to whiplash-like biomechanical insults, the resulting contracture requires more effort from the heart.

In my clinical experience, the three most important intrinsic muscles are the esophagus, diaphragm and iliopsoas. This triad represents soft-tissue linking pins from the lower extremities through the trunk to the cranium. Thus, tensions overflowing from the viscera into these intrinsic muscles may exert an increasing amount of pull on the axial skeleton, activating and/or perpetuating the influence of the righting reflexes set in motion from traumatic incidents, winding the spring even more tightly. This entire process is layered and insidiously subtle for many.

The body endeavors to physiologically allocate its resources and to distribute the biomechanical strains until the "tipping point" of negative momentum is reached and an episode of dysfunction/pain or illness occurs, which allows the body to reset the resting length of these core muscles.

John-Pierre Barral, DO, developer of Visceral Manipulation, often referred to the diaphragm and iliopsoas as the body's "garbage muscles."3 It took a few years of study with him before I understood what he meant. In sum, the body builds charge in the form of tension, which eventually must be discharged. This notion was helpful in understanding how and why the body uses musculoskeletal episodes of pain and dysfunction to discharge this accretion of tension.

What this paradigm offers is this: There seems to be a logical order to this discharge process - one that offers each of us as massage therapists greater clarity of intention to our quality of touch. With your next client, allow your hands to relate to the basic physiological processes of the body. Seek to enhance your client's central circulation. Where do you sense the "kink" in the hose? Work from the inside-out.

The key question for us to consider is how one activates the homeostatic capacities inherent in the human body. The answer is to enhance the circulation of bodily fluids in all its forms. Consider these four aspects: how fluid is pumped; where its flow is resisted in the tissues; how it is filtered; and how it is re-constituted and/or excreted. The name of the healing game revolves around the central theme of "who gets the blood."

Many extraordinary teachers have influenced the evolution of the inside-out, including Lansing Barrett Gresham; Dr. John Upledger; Dr. Jean-Pierre Barral; Dr. Richard MacDonald; Frank Lowen, LMT; Jon Zahourek; Bill Williams, PhD; and Ellen Gregory, PhD. Read their works for more information.


2. Upledger J, Vredevoogd J. CranioSacral Therapy, Eastland, 1983.
3. Barral, JP. Visceral Manipulation I & II, and Trauma. Eastland, 1988.

Click here for more information about Dale G. Alexander, LMT, MA, PhD.


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