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Inside-Out Paradigm

By Dale G. Alexander, LMT, MA, PhD

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A Look at Compression, Congestion and Dis-Coordination

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

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

body - Copyright – Stock Photo / Register Mark 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

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

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

Review

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."

References

  1. Somatics: Reawakening The Mind's Control Of Movement, Flexibility And Health, Thomas Hanna, PhD, Addison-Wesley, 1988.
  2. The "Sacs and Tubes Theory of Stress", Dale G. Alexander Ph.D. L.M.T., Massage Today, January, 2014 (Vol. 14, Issue 01).
  3. John E. Upledger, D.O., developer of CranioSacral Therapy, classnotes 1986 - 93.
  4. Freeing the Heart: The Importance of the Vagus Nerves/Cranial Nerve X, Dale G. Alexander Ph.D. L.M.T., Massage Today, July, 2013 (Vol. 13, Issue 07).
  5. The Progression of Cervical Stenosis Toward Cervical Spondylotic Myelopathy, Dale G. Alexander, Massage Today, April, 2008 (Vol. 08, Issue 04).
  6. The Body's Core Line and Central Linkage, Dale G. Alexander Ph.D. L.M.T., Massage Today, May, 2014 (Vol. 14, Issue 05).
  7. Richard MacDonald D.O., Functional Anatomy Courses, teaching assistant, 1989 -90.
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