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VA Recoupment & SEOC Updates – Sam Collins

That they’re not paying for exams and they’re also still recouping. We’re gonna talk a little bit about that, but we have to update from what we did in April.

Click here to download the transcript.

Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors. Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Greetings, friends and colleagues. It’s Sam Collins, the coding and billing expert for acupuncture, the profession, of course, the American Acupuncture Council. Of course, I’ve got a little update coming up because obviously many of you have been contacting me, network members, and even others have contacted me.

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Say, Hey, Sam, what’s going on? I notice. That they’re not paying for exams and they’re also still recouping. We’re gonna talk a little bit about that, but we have to update from what we did in April. So let’s go to the slides. Let’s talk about what’s going on with recoupment and standard episode of care specific to acupuncture and frankly non-physician providers.

So you’ll see here is a letter dated June 23rd from Tri West and it says, we received the above claim. Let me bring it so I can blow it up. And it says. Try West. Receive the above-mentioned claim for your offer. And notice I highlighted and yes says evaluation and management procedure codes are not paid for this rendering provider specialty.

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This is the latest thing we’re seeing. It appears, and I’ve seen it absolutely published way that to me would make it more, but it appears they have taken the ability for acupuncturists to be paid. Separate exams when it comes to the va. That of course is very frustrating because of course is an exam necessary thing.

Of course, I to determine the need for care, to determine the continuation of care. So what’s recurring I think is maybe a Leo GE cut here at they’re eliminating the payment for exams. That doesn’t mean you don’t need one, they’re just not. Pay for it. I think it’s probably worth seeing the patient for the overall payments, but they’re not covering it.

We’ll see directly. Now the word that they did this in April, what I’ve seen when their newsletter is not quite clear enough for me. So I’m waiting to see the full publishing standard episode of care, but I’m sure many of you have met. Now. Here’s gonna be the pushback if the exam after April when they published it.

They’re gonna be am behind it because published, however, then I want you all to think of standard episode of Care for Acup Occupy. Whenever you notice the standard episode of care, you’ll notice whether it’s going to be initial chronic follow ups. They include e and M codes. You’ll see really, 9 9 0 2 to 2 0 5 9 9 2 1 to 2 1 5, and I bet pro your authorization has so my argument’s gonna be, they’re saying they’re not gonna cut well, if it’s after April, send an updated authorization, not listed, I’m waiting to see that, then I would say, okay, but if it’s prior dispute’s gonna be, how did you send me an authorization?

Clearly indicates exams and they’re, now, I’m not gonna pay for it. Now, it appears April. This is gonna true. But prior to, it’s gonna be a pushback. Now, is that very frustrating? Of course it is. But I’m gonna ask you, is it worth it to still be part of it? I do, because think of the overall payment on a VA patient.

You’re getting 12 visits to start, probably eight and eight to follow up. Assuming you’re doing three sets of acupuncture and a therapy or two, that’s maybe 110 to $150 of reimbursement. Am I going to take away potentially, three to $4,000 a payment? Because they’re not gonna pay for a couple of exams.

I prefer they do, but I’m gonna say I’m not gonna go that far. It’s something I think though we’re gonna be fighting. I shouldn’t say think. I know we’re gonna be fighting as a profession on a national level along with chiropractors and physical therapists, because this affects them too. Because this goes against the equality provision.

Equality says that if it’s within scope and you pay, other providers have to pay you because this is not Medicare. Now that’s gonna be a little bit of a fight, and that’s not gonna happen in short term. So when you get this, I do think we should dispute it. I would certainly push back if it were pre-AP April, that they should, if it’s after April, not so much.

Of course, if you’re a network member with me, reach out. We’ve got some letters for that as well. But I do wanna highlight also beyond that, just a couple of quick updates. Let’s talk about what’s happening and what’s gone on with doing. Things with 9 7 0 3 9 or 1 3 9, and that’s of course what a lot of offices have used for cupping.

Remember that was removed more than a year ago, so please do not use that code for cupping. It is not appropriate. I. Do not list it. They may pay it, but they’re gonna recoup it. So do not, if you’re gonna do cupping, use 9 7 0 1 6, which is a vaso pneumatic device. It’s not a high payer. It’s about 11 to $15, but at least you are being paid for it.

But again, do not use 9 7 0 3 9 and if they are recouping that, if it’s pre 2024. I would argue they can’t, but if it’s after 2024, they can. Now some people have argued. What about statute of limitations? Statute of limitations, I would argue certainly does apply. Unfortunately, you know what I’ve realized or what I’ve learned, the statute of limitations for the VA is actually six years, so we’re not gonna win on that one as far as this goes.

The other thing here is, and this has come up recently because obviously a lot of you are using pain indexes or similar. To verify how the patient’s improving. I recently had an office, or actually a few that they were denied few further care because they weren’t showing at least a seven point difference on the general pain index.

I really like the general pain index. It’s certainly the similar to the pain interference. Make sure though, if you’re using it. If you’re doing it once a month, there’s gotta be at least a seven point change to be considered significant. Now, most of you, I hope, are getting bigger than seven point changes, frankly, but if you’re not realize it’s going to be a problem ’cause they’re gonna push back, which means you also have to focus in what if I’m using the pain scale?

That also has a limitation, which means it’s gotta be three points or more. Obviously if I say I’m a seven, I go to a six. That means I’m better, but it’s not considered significant. So if they start at seven, the next time you do it to really be considered significant, say on re-exam, it’s gotta be four.

So a three point difference, I would say. Then obviously those two factors are important. If you’re not getting at least one three, you better focus in on something about activity, particularly a home or work activity that couldn’t do before. What they care about is the getting better. Because remember, once they’re stabilized, they have to be on a continua care with flareups.

So keep in mind, acupuncture works well. We need to demonstrate it. Show me on this general PEX pain scale or function, how much improvement there is. Now, this brings me to, for some of you, and I’ve had this question a lot, is being part of the VA worth it? Does it cost anything to join? No. Do the patients sometimes have some hassles getting authorization?

Yes, that’s true. But when you’re paid. Let’s go over it. If you’re getting a standard episode of care for 12 and eight visits, just say the first two 20 visits in a year, considering just the treatment, that’s probably 2000 to $2,500 now, even with taking out exams. Is that worth it to me? Absolutely.

However, am I frustrated with the exam part not being paid? I am. But at the same token, that’s not gonna stop me, but this is where if you’re not part of your state and national association, this is where we need to belong. ’cause this is where we need to push back because how are they treating us differently?

Now the downside is they are doing it to chiropractors. I. To physical therapists as well as massage therapists. So it’s not just you. But at the same token, I think it’s valid to say that it should be covered. ’cause how are you supposed to determine care without an exam because they’re doing this based on a Medicare rule?

Medicare only sets the fees for the va. It’s not the protocol. ’cause if that were true, they shouldn’t pay for acupuncture at all unless it were chronic low back pain and under supervision. So we know that they’re just. Choosing and picking certain ones. So I think we’re gonna have a pretty good pushback, but I do still, it is worth it if you’re thinking, I’m not so sure we are doing next month in August, a whole seminar on the va, what to do, how to make it work for you, make sure you tune into that.

Otherwise, I’m gonna say to everyone, we always want to be resource. If you’re having issues, reach out to American Acupuncture Council. The next specifically, we highlight updates right on our website. And if you’re a member, it allows you to have direct interaction with me via calls and zooms. And otherwise, until next time to my friend, be well.

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IBS

Acupuncture and Irritable Bowel Syndrome (IBS)

Acupuncture and Irritable Bowel Syndrome (IBS)

Can acupuncture reduce the symptoms of irritable bowel syndrome (IBS)?

IBS affects between 25 and 45 million people in the United States and is a major women’s health issue, with 2 in 3 IBS sufferers being female.

A 2021 review and analysis of 24 studies in 3,220 people with IBS found that in studies comparing acupuncture to various medications, acupuncture was more effective in relieving IBS symptoms.

When used in combination with other treatments, including medicines or herbs, acupuncture helps to improve their effectiveness in treating IBS symptoms.

Healthcare continues to evolve toward less-invasive, natural, and drug-free methods, with acupuncture now becoming a first-line complementary healthcare choice.

Remember, the American Acupuncture Council (AAC) offers an unparalleled track record in acupuncture risk management.

There is a reason acupuncturists have trusted AAC with their business for 50 years

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Treating The Face, Healing the Whole Part 2 – Michelle Gellis

So there are quite a few neuromuscular conditions that affect the face, such as Bell’s Palsy, Ramsey Hunt Syndrome, synchronic cys, stroke, TMJ, trigeminal Neuralgia,…

Click here to download the transcript.

Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.  Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Hi, my name’s Michelle Gellis. I am an acupuncture physician, and I would like to thank the American Acupuncture Council for this opportunity for me to present to you today on treating the face a multidimensional approach. So today we’re going to do part two. And you can go ahead and go.

So a little bit about me. I’m currently on the doctoral faculty at Jossane University. Before that, I was a faculty member and clinic supervisor at the Maryland University of Integrative Health from 2003 until 2021. I am a published author and contributor to the Journal of Chinese Medicine and I’m a regular columnist for acupuncture today.

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And I’ve been treated teaching facial acupuncture classes internationally since 2005. My book Treating the Face was released in November of 2024. It is a 500 page 15 chapter, hard cover book, and it covers all aspects of treating the face. I’m going to talk mostly about the information that’s in chapter six, and that is neuromuscular facial conditions.

So when we think about facial acupuncture, we tend to think about cosmetic facial acupuncture. But facial acupuncture is really about a holistic approach to not just treating the face. Cosmetically, but also all different aspects of treating the face. So there are quite a few neuromuscular conditions that affect the face, such as Bell’s Palsy, Ramsey Hunt Syndrome, synchronic cys, stroke, TMJ, trigeminal Neuralgia, Ms.

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Whoops. Ms. Ptosis, HEFA spasm, myasthenia gravis, shingles, and facial ticks, just to name a few. And many of these are very unique to the face itself. And. Since I specialize in treating the face, after a few years of doing cosmetic acupuncture, I started getting people calling me, asking me if I could help them with a lot of these neuro conditions.

And through studying and doing a lot of research. I and some trial and error. I learned that the best way to really manage these conditions is through a multifaceted approach using scalp, acupuncture, submuscular needling, facial motor points, facial cupping. And so I’m gonna touch on these, the.

And so Scalp acupuncture is based on neuroanatomy. It is not based on acupuncture points. And you have to measure the scalp appropriately. And there’s a motor area and there’s a sensory area, and the bottom two fifths of each one of these lines, the sensory area is not shown on this picture. The. The bottom two fifths corresponds to the face, and so you would needle this area and stimulate it either with electro acupuncture or with manual stimulation in order to help with either motor conditions such as Bell’s palsy or with sensory conditions such as trigeminal neuralgia.

Facial motor points. This is from an old medical textbook. These are the motor points that have been discovered on the face, head and neck. And in part one of this talk I talked about using motor points for cosmetic concerns, but facial motor points are wonderful for neuromuscular concerns because what a motor point is the most electrically acceptable part.

The muscle where the motor neuron goes into the muscle, and by stimulating it, you can cause the muscle to get back into normal functioning. And the reason why this is important for the face, besides the functioning of opening the lid or closing the lid, the. Skin on the face is directly attached to the muscle.

So if someone’s face is paralyzed and is drooping in one area by getting the muscle back into normal functioning, by stimulating the motor point, the skin itself will. Snap back and be working in a more normal fashion with the muscle. So I do have examples of a couple of motor points. This was a student of mine in class and she had.

Had Bell’s Palsy many years ago and was still having trouble cursing her lips, whistling spitting like when she’d brush her teeth. And so I did the Mentalis Motorpoint and as soon as I put the needle in. Her chin started to twitch and then when I stimulated the point, it really started to jump.

And then after the treatment, she reported that she was able to make a lot of facial expressions that she hadn’t been able to make in the past.

Next example I have is a student in a class I was teaching in London and he had been in a bike accident and he had some neuropathy and a little ptosis on his left eyebrows and. I put this needle and stimulated it. So this is the motor point for the frontals. It’s gallbladder 14.

Sorry, that was so loud. But you could see the needle moving back and forth when, once it was put in the muscle, which meant it was starting to wake up. Submuscular needling is another technique that I use, which involves needling underneath and in some instances through a muscle in order to.

Blood and cheese circulation into the muscle itself. And I have a little demo here, which I.

Facial cupping and GU can also be very beneficial. For neuromuscular facial conditions, as long as your patient can tolerate it. These techniques are very gentle if done properly, and can help with blood and cheese circulation into the face. It can help with any sort of fascial adhesions. That is because over time.

If a muscle in the face isn’t used, the fascia can become stiff, and by using the cups it can help with lymphatic, the lymphatic system of the face, and it’s also very relaxing and very enjoyable for your patients. I am gonna talk really quickly about Bell’s Palsy. Bell’s Palsy is the most common cause of facial paralysis, usually temporary, and it’s caused by a disruption of the facial nerve, which causes either weakened or paralyzed facial muscles.

So here’s one patient you can see. This entire when asked to smile, they can only, she can only smile on one side of her face and the other side is completely paralyzed. This was a patient of mine. I only focused on her eyes, but I asked her to close her eyes. You can see one eye closed and the other one.

She could not close it at all. And then I did some submuscular needling and some acupuncture points and used gallbladder 14 as a motor point, did some scalp acupuncture for the face, and, after one month,

you can see she can close her eyes. Still a little difficult, but she had complete recovery.

So I do offer many different classes on. Facial and cosmetic acupuncture, you might wanna check those out. You can scan the QR code or go to my website, facial acupuncture classes.com and you can find me on social under my name, Michelle Gellis, or I have a Facebook group called Facial Acupuncture.

Very active group. Thank you so much.

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Acupuncture and Urinary Incontinence

Can acupuncture reduce the symptoms of urinary incontinence?

Urinary incontinence (the loss of bladder control) affects an estimated 25 million adults in the United States, and is more prevalent in women.

Stress incontinence is a type of urinary incontinence that occurs when movement (coughing, laughing, running, etc) puts pressure on the bladder, causing urine to leak.

A study of approximately 500 women with stress incontinence received electroacupuncture treatment (18 sessions over 6 weeks) and had reduced urine leakage.

Approximately two-thirds of the women experienced a 50 percent or greater decrease in urine leakage.

Healthcare continues to evolve toward less-invasive, natural, and drug-free methods, with acupuncture now becoming a first-line complementary healthcare choice.

Remember, the American Acupuncture Council (AAC) offers an unparalleled track record in acupuncture risk management.

There is a reason acupuncturists have trusted AAC with their business for 50 years.

Not an American Acupuncture Council member? Get a Quick Quote and find out how much you will save! Click here!

Chronic Prostatitis/Chronic Pelvic Pain

Acupuncture and Chronic Prostatitis/Chronic Pelvic Pain Syndrome

Can acupuncture reduce the symptoms of chronic prostatitis?

Chronic prostatitis or chronic pelvic pain syndrome is long-term pelvic pain and lower urinary tract symptoms without evidence of a bacterial infection, and its cause is uncertain.

The National Institutes of Health and other sources estimate that 2-10% of men experience symptoms compatible with chronic prostatitis at some point in their lives.

A review of 3 studies (204 total participants) suggested that acupuncture may reduce prostatitis symptoms, compared with a sham procedure.

Healthcare continues to evolve toward less-invasive, natural, and drug-free methods, with acupuncture now becoming a first-line complementary healthcare choice.

Remember, the American Acupuncture Council (AAC) offers an unparalleled track record in acupuncture risk management.

There is a reason acupuncturists have trusted AAC with their business for 50 years.

Not an American Acupuncture Council member? Get a Quick Quote and find out how much you will save! Click here!

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Qigong and the Internal Branch of the Kidney Channel – Brain Lau

 

One of the things we were doing is evisceration and kind of exploring those internal branches of the channel. So this is gonna be a very anatomical perspective of that internal branch of the kidney channel. We’ll go over the anatomy.

Click here to download the transcript.

Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.  Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Hello, thanks for joining and thanks to the American Acupuncture Council for having me again. My name’s Brian Lau and I teach with the Sports Medicine Acupuncture Certification Program. I also have a YouTube channel, Jingjin Movement Training, where I go over a lot of channel oriented approaches to movement, especially for the Jing J or channel Send You Perspective.

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So check out my YouTube channel if you get a chance. You’ll see some very similar ideas that I’m gonna be presenting today. So what we’re gonna be looking at today is we’re gonna dive into the internal branch, or at least a portion of the internal branch of the kidney channel. In sports medicine, acupuncture.

We have some three day cadaver dissection classes, and I just finished one. I. One of the things we were doing is evisceration and kind of exploring those internal branches of the channel. So this is gonna be a very anatomical perspective of that internal branch of the kidney channel. We’ll go over the anatomy.

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We’re gonna look at some netter slides. We’re not gonna look at cadaver images, but they’re drawn from, or they’re illustrated from cadaver dissection. Very good illustration, so we should get a somewhat of a clear idea. What those internal branches look like. There’s really no substitute to doing it in person though, but this will be pretty good.

We’ll get a little bit of a window into that internal branch of the kidney channel and then we’re gonna look at a very simple movement exercise that will kinda stretch, move some of those fossil planes engage that internal branch of the kidney channel. This is something you can do for your own cultivation and development.

It’s also a very easy exercise to give to patients. So I’ll give some thoughts on prescribing it to patients. So a lot to look at, but it’ll be a fairly easy and straightforward exercise that we can we can extrapolate from that to be able to put movement into that portion of the channel to really be specific in our thought process for the movement through that plane.

So let’s start with looking at the channels. We’ll go to the presentation. And start right away from one that you’re very common and familiar with is this Deadman image from a manual of acupuncture. We know the kidney channel, so you know, the kidney channel coming up, the medial portion posterior or medial portion of the thigh up into the abdomen.

I would say at the level of the transverse abdominis when you’re needling, that, that would be deep to the rectus abdominis and getting the deepest abdominal layer. Then it goes up into the chest and terminates, but. We’re gonna look at this internal branch, especially in the abdomen area. So let’s zoom into this area that goes from the urinary bladder and to the kidneys.

Many people think this follows the ureters that makes sense, but we’re gonna be looking at a whole fascial plane. First off, let me say from this Deadman illustration that from an illustrative standpoint, he draws or not whoever the illustrator is, they draw this much bigger. The kidneys are very large and it looks like this.

Whole internal branch is very anterior, but that’s not particularly it’s useful for the illustration to see the structures, but it’s not very informative of where this actually lives. It would be just posterior to the midline. So if you think about this internal core, this portion of the internal branch is gonna be on the back portion of the core.

And by core I don’t mean core musculature, I’m talking about the central. The the peritoneal cavity, this is in the back. This is retroperitoneal, so it’s closer to the front of the spine, closer to the back, but it’s pretty center back center. So keep that in mind from this illustration. When you come back and use this as a guide, understand that this is not forward as we’re seeing in the illustration.

So let’s look at some netter images and get a little clarity. So first thing, this is the anterior, the ventral portion of the peritoneal cavity. This isn’t the target we’re looking for today. I just wanna walk you in. This would be pretty much the approach we do when we do eviscera evisceration, where we’re taking the ventral cavity.

We’re taking the contents of the peritoneal cavity out of the body, putting them on a table to study. They’re still connected through their peritoneal connections. They’re still all, it’s all one piece. It’s still organized. You just have to put it on a table and you can study it out of the table instead of trying to look in the ventral cavity.

But when we first start, everything’s intact. So we’ve, reflected back the abdominal muscles. We’ve cut open the peritoneum. This would be the first thing and what is the stomach. You might see a little portion of the liver, but it’s a little more buried under the ribcage, the stomach, and the greater omentum hanging off of the stomach.

It’s not the subject of this of this presentation, but I can note that this, in my opinion is what’s being described by the internal branch of the lung channel because this greater momentum hangs off the stomach much like it’s described as connecting with the stomach. It hangs off the stomach if you lift the greater momentum up, which you can do very easily unless there’s been a lot of peritonitis and scar tissue.

You’ll see that the transverse colon is attached intimately right to the back surface of that greater momentum. And when you look back at the lung channel, it comes off the stomach and links with a large intestine. I think they’re not describing a channel per se, but a plane they’re describing anatomy with this particular internal branch.

We could go more into that another day, but just to highlight the start of what we’re looking at, because once we have that ventral cavity open. We’re gonna start to come in and gently cut away the abdominal contents from the parietal peritoneum from the peritoneal wall. So that’s gonna be our first access.

And over time it’s gonna maybe look something like this. I’ll tell you when we do evisceration, we’re cutting the intestines out also. But we’re gonna come around the intestines and go behind them to the posterior abdominal wall and eventually. You’re gonna see the strong connection of the small intestines to the root of the mesentery that goes basically from the jejunum all the way to the ileum.

So I put this slide in here just to highlight how stronger bound the abdominal contents are to the back of the abdominal wall compared to the front of the abdominal wall. But it also gives us a window in how we would do the evisceration would be coming around the intestines. Maybe this image doesn’t quite show that as well as this image.

This image is showing a cross section so I can see where I might bring that scalpel around the intestines and cut it away from the abdominal wall. I’m gonna follow in front of the kidneys and in front of the perren fat, which is generally much thicker than what in this in this image.

I’m gonna come around the inferior vena cava. Generally, when we do evisceration, we go behind the pancreas. The pancreas, at least a majority of it is retroperitoneal. So you could go in front of the pancreas. We usually go behind the pancreas, take the spleen out, and take the whole abdominal contents out.

So you know, you have one person lifting up. Pulling everything to the right while there’s gentle cutting, maybe move, pull to the left. Gentle cutting. Eventually we bring the whole abdominal contents up, bring the liver away from the diaphragm, clamp the bowels, cut those so we can eventually lift everything and remove the abdominal contents.

And once that happens, this is what something like this. This is a pretty good illustration that doesn’t quite. Look like it would be in, in a a real body. It’s simplified a little bit to make it a little bit easier for, for study for med students and such. But we’ll see that the intestines were removed.

Some things were kept in this case, the pancreas was kept in this netter image. Like I said, I usually go behind the pancreas and bring that out. The kidneys are left in though there’s a lot of perren fat around them. You don’t actually see the kidneys until you remove that fat. The adrenal glands are left in.

A lot of the vasculature is left in so we can study. In dissection, we can study this posterior retroperitoneal space, which is basically what we’re looking at. Especially if the peritoneum was cut off in this illustration, it’s left on. So imagine this film of the peritoneum off, the pancreas out.

That’s what we really end up with, is that retroperitoneal space. And this, in my opinion, is that internal branch of the kidney channel. It could follow the ureters. There’s the ureter. To the kidney from the urinary bladder. So urinary bladder to kidney. So the ureters are in there, but I don’t think of it as necessarily like a line or a space.

I think of it as a plane. I think they’re talking about this retroperitoneal space. And when you’re doing this dissection, it’s amazing how loosely held all of this is. You’re using a scalpel, but sometimes you can just tease it apart with your hands. You have gloved hands of course, but you can tease it apart with the hands and break up.

Some of those little cross links that are connecting the peritoneum to the retroperitoneal space. It’s very loosely held. Now. It’s a large space, so collectively there’s some integrity there, but individual spots of that are pretty loosely held, or at least we want ’em to be fairly loosely held. We want a little bit of movement in that plane.

And this is what I wanna explore with the exercises I’m gonna show is not to think of the movement exclusively as musculoskeletal movement. Yes, the muscles are gonna be active. Yes, the spine’s gonna be moving. But can we sense, can we bring our attention and our awareness to that space that’s in front of the spine and let that sort of elongate and come back up and move.

Can there be some movement there to increase circulation in this internal branch of the kidney channel? So what is in this retroperitoneal space? We have the kidneys. That’s gonna be a big part. The SOAs, you can see a little shadow of the SOAs. Right in here. It’s covered by a lot of the fascia in this retroperitoneal space.

So to view the SOAs, you’d have to remove that fascia, but you can see the outline of it there. The kidneys are intimately tied to the SOAs. So the SOAs would be a big part of it. The ureters going down to the bladder. A lot of the blood vessels. So if we can get movement in this plane what’s gonna happen with the aorta and the inferior vena cavas, those can create a little bit of a stretching and elongation to help for their suppleness because that’s very important that they have a certain amount of suppleness in those vascular structures.

There’s lymph nodes, pancreas is in there, but I’m not sure if that’s relevant for the internal kidney. Channel as much as it is, maybe other aspects. But the pancreas would be in that retroperitoneal space. A lot of nerves coming through there. The perren fat that covers the kidneys, but there’s a lot of other fat back here that has a lot of implications for health.

It’s a very metabolic tissue. So there’s some hormone production from that. I don’t know if movement would help that, but I think that just getting circulation and free movement in that area can’t hurt. I think it has a lot of implications for health, not in an area that’s been explored much in terms of how we understand movement, but I think there could be a lot of implications for improved health, and maybe that’s one of the mechanisms of Qigong and those types of practices is to introduce movement into these internal cavities of the body.

And this one, the kidney channel in particular. All right, so just some, quick sample of some distortion of those. Internal branch of the kidney channels. I could have picked a whole lot of other types of images. But overweight is people who are obese a big portion because that abdominal wall is less tightly held in the front than it is in the back.

So oftentimes that extra weight pulls everything forward. And you can picture how compressed that internal branch of the kidney channel that retroperitoneal space was. How. Close that area is, and how little movement is gonna occur in that retroperitoneal space. Not somebody who’s heavy, but this is not an uncommon posture.

It’s a kidney deficient posture where the pelvis moves forward. We look at this in sports medicine, acupuncture. See a lot of correlations with various types of kidney deficiency, kidney in deficiency. Commonly with this, you see this with older people. This person’s not particularly older, but you see it a lot with elderly too, where the body starts collapsing, where the pelvis shifts anterior and the rib cage collapses down onto the pelvis.

And again, you can imagine that region of that retroperitoneal space. Just posterior to the midline, how compressed that area is, how compressed that area is, and how potentially little movement there is. So we wanna introduce movement, build core strength for this person, which is also involved with the kidney network, but also to start to introduce movement into that retroperitoneal space.

So that’s the last slide. Why don’t we look at the movement. It’s very much a squatting exercise. It’s a Qigong exercise, a type of spinal wave. Very simply, it’s a squat, but I’m focusing on getting an expansion and compression throughout the spine, particularly in the space we’re talking about.

You’ll still be an arm motion, it could be interpreted as a macrocosmic orbit. You know that circulation up and down the spine is the microcosmic orbit. That’ll be inherent in this movement, but then that expresses out into the arms. So you’ll see that there’s an arm component. I wanna start though, on parallel bars and just show this dropping.

You can see it a little bit better when I’m off the ground. You can see the pelvis in that area drop a little bit more than you’ll see in the squatting exercise. That’s not the exercise I’m showing. That’s just for demonstration. So we’ll show a static hold on parallel bars so I can let the pelvis drop and you can visualize that area elongating and softly, gently stretching a little bit.

Then I’ll show it in the squat activity. So let’s move to that position and we’ll look at the exercise today and keep in mind that that kidney channel internal branch. So I wanna start off with an exercise that’ll let you see what I was talking about in the slides with the anatomy.

This isn’t the exercise I wanna show, but it’s a little bit more visible. The next exercise is a little bit more subtle. So this is gonna show just that ability for the lower pelvis to drop and that internal branch of the kidney channel just elongate and stretch and have a little bit of movement and just coming up.

Into a hold on the parallel bars. I wanna initially pull the pelvis up, so I’m engaging my core to pull them, pull the pelvis towards the shoulders, and then let everything relax. So just letting gravity take the pelvis down. So it’s that initial drop sinking of the pelvis. Elongation of the pelvis and the spine, especially the lumbar spine, but that internal branch of the kidney channel will stretch.

So one more time just to see that I’m gonna do this while I’m sitting in just a moment. I just wanna let gravity take the pelvis down so I can get that stretch on the internal branch of the kidney channel. All right. I’m gonna move these.

Move that out the way. Do you want me to move it all the way outta the way, Alan? I guess it’s fine. Fine there. As long as it’s a little more.

So let’s look at the full exercise. So maybe I’ll start with a little bit of a spinal wave motion to warm the spine up. I’ll show this from the side in a moment. I’m just getting things moving. This will start to engage that internal branch of the kidney channel, but a little bit more of the musculature of the front and back is engaged.

I’m just warming up. So just a little bit of spinal wave activity. Let me show that from the side. So if you’re working on these exercises and following along with this, I just wanna initiate that from the pelvis tuck. The pelvis under chest comes down, so rectus abdominis is engaged back, muscles are engaged, front muscles are engaged.

I’m creating a circulation up and down the spine.

Exhale, if I wanna bring my breathing into it. Inhale, exhale, and inhale. I could do other variations of that to get the chest involved, but I’m gonna go into the main exercise now, so I’ll show it first from the side. I wanna get about a pelvic width stance outside of my pelvis could fit on the inside of my feet.

And elongate the spine, chest relaxes, and here’s that part. Whereas on the parallel bars, I want to drop the pelvis down. A little less visible, but it has a feeling of that elongation that you got on the parallel bars. So chest softens, pelvis sinks. Drop the pelvis down. Gauge that internal branch of the kidney channel by letting it just relax and stretch.

Sink. Let it go. I’ll do a few more from the side, and then we’ll look at it from the front.

All right, so chest softens, everything comes slightly in. I have a very slight hollow shape to the spine. Then the next part is I wanna let the pelvis sink. Let the pelvis sink. Let the pelvis sink. Everything’s getting longer inside. Eventually the whole body’s gonna start coming down, but there’s a moment where my pelvis is moving away from my head as I push up, everything’s coming together as I fully stand up, everything’s spreading apart.

Chest is coming higher than the pelvis. Chest sinks down towards the pelvis. Pelvis sits away. Pelvis comes up, chest expands away, chest softens down, pelvis sits away. So I return length to the body. There’s like a compression, a lengthening. I don’t wanna go down all compressed. I don’t wanna lean forward.

I wanna let everything drop, stretch, elongate, relax, soften inside, and just let it go. Okay, so a couple times from the front. So again, the setup is hips can fit between my two feet. So about the inside of my feet are about as wide as my hips. I’m going to open the chest, press up, relax the chest, sit down,

press up, get taller, soften the chest, sit the pelvis away.

Sink down, push up.

And up.

All right, that shows the main exercise, very subtle, quiet exercise. You can show it for patients quite easily. Easy to work with, easy to work with for yourself. But a couple highlights is that you can watch out for is sometimes people don’t have enough strength on the adductors, or excuse me, the abductors, so when they go down, the knees collapse in.

So that might be something to work with. Of course flexibility in the spine. You don’t want ’em to be like you saw from the side, very rigid or sticking their behind out. A lot of that can be strength and flexibility. So I’m gonna take just a quick step forward and note that I might use something to hold onto.

Especially if I’m giving this to patients and they’re new, I have a TRX in my room, so TRX might even be better if there’s a slight angle where they’re holding onto. But even just kitchen sink, parallel bars, a door, something like that, just so they can go down in a controlled manner, let the pelvis sink down and just having something to hold onto can make it a little easier so they can concentrate on not letting the knees pull in.

They keep the shape open, they can. Work on just letting everything soften and just having that extra little support can be very helpful for ’em pushing up. The other thing is they don’t have to go super low, right? If it starts getting distorted, going farther than that, maybe that’s where they stop for now, push up, et cetera, so they build the leg strength, build the flexibility.

Build the relaxation to let the spine go and holding on is a perfectly acceptable way to do it.

So simple exercise, but it offers a ton for patients and even just for your own self practice. All right, so I hope you found that informative. It’s one exercise. I particularly like that exercise and I use it a lot in my own practice, and I do show variations of that to patients. But I think the bigger thing is to start thinking about therapeutic functional type movement patterns and considering that visceral component.

How does that move the inside? How does that move and engage these internal branches of our channel network? It gives you a different perspective on movement instead of just thinking about the muscles that are involved. And I think there’s a ton of implications for health and development and wellness from that.

So play with the ideas. You can use this exercise for this particular internal branch, but it’s not tied to one exercise. It’s a. It’s a thought process that, a change in paradigm, a paradigm shift for movement. So give it a thought, put it into your own practice and see see how it goes.

So thanks again to the American Acupuncture Council. I always appreciate having the opportunity to come on and present. Hope you found this informative. Again, if you wanted some more information, you could look at my YouTube channel, Jingjin Movement Training. I cover a lot of these types of exercises, and again, from a channel perspective but there will be other times we’ll be here with the American Acupuncture Council.

We’ll look at some other ideas with it at that time. So thanks again.

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