So I wanted to present the technique of using Shawnee Shoni Shen for the treatment of pediatric patients, but actually what I want to also, point out today is that this, that we can actually use sh hin for adults.
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 is Moshe Heller from Jingshen pediatrics.com. I want to thank the American Acupuncture Council for letting me do this show today. And today I will be talking about Shoni Shen. So let’s move to the. Slide. So I wanted to present the technique of using Shawnee Shoni Shen for the treatment of pediatric patients, but actually what I want to also, point out today is that this, that we can actually use sh hin for adults. And it all depends on how we use this technique. Generally speaking, sh hin is a technique for stimulating the channels and acupuncture points instead of using needles. And it was developed in Japan in a long time ago, and it is very effective if it’s used correctly for the treatment of both pediatrics and adult patients.
And there, although we use this, the name shone and it seems like it’s one style, but there’s actually many styles of sh and many tools. And each tools, each tool is actually a different. Used for a different style. Generally speaking, when we are using SHO Shoni Shen, we always hide the sensation from the tool.
We really should be looking at our own chi and how we are positioning ourselves and being aware of our own QI so that things are really loose and flowing well. We also should always be clear on our intention on what we’re trying to achieve when we’re using these techniques. Generally there are many techniques.
I’m going to be mentioning five techniques. And I will also show you the different tools that are appropriate for each one of them. The first. Technique is a tapping technique when we use a tool that for specific points or along a channel and we tap on the skin with the tool to bring the chi up to the surface.
We also try to tap in different angles to produce a different effect so that it’s not constantly using the same angle. The second technique is called scraping, where we use the tool to scrape along the channel. So both tapping and scraping follow the flow of the channel and usually done within the flow of the challenge.
So we’re following the flow. Of the channel, we we use both tapping and scraping. So the idea is first we tap, we call the chia up to the surface, and then we scrape in order to make the chief flow within the channel. The tool that I use or is commonly used for tapping and scraping is called the Y Yama.
I’ll have pictures in a second, but this is the tool. Where you can, it has an edge that we can use for tapping, and it has an edge that we can use for scraping. And as I mentioned, hiding the sensation is very important. So we use our, both, our finger and thumb to hide the sensation from or distract the sensation from the patient.
The other technique I wanted to present here is called a stroking technique. And for that it, we use a different type of tool. That tool is called a dashi tool, which looks like this. And a dashi tool is made for stroking, stroking. Again, as I said, in all shown hin techniques. We need to hide the sensation so it’s not so blunt, and we will stroke the patient in a certain direction.
And that’s called stroking technique. And we use the dashi tool and, and that’s a special tool for this technique. Also with the dashi, we can use either pressing or vibrating. So we use the other side of the tool and we can press on a point and vibrate it to create pressure and vibration And, so this is the use of the dashi, and the last one is called scra scratching sounds. We call it scratching, but it doesn’t, we are not scratching with anything sharp or anything like that. Scratching just means that we are not, it’s like we’re scratching our skin. We are not following the direction of the channel.
And usually we use a tool that has a wider. Or a rounder or bigger kind of edge, and we scratch along the channel, meaning going backwards and forward creating more of a dispersing effect. So these are examples of these five techniques. There are many more techniques and the idea is that we can definitely affect the points and create a very strong treatment for without using any insertion of the needles.
And this is comes from the idea of sh Shoni Shen here. I have a few pictures of for you to to look at. This is a, which is also used for more specific points. And usually comes in a very more fine, form. And then there’s engines which are wider, which I mentioned before to use for scratching.
There’s also a teardrop engine, which enables us to either vibrate or pass press specific points. And this is the Y Yama that I mentioned before. This is pictures of the dashi tool that I mentioned that I showed you, which enables us to do stroking. And and these are some other different tools that are available for different techniques.
I just want to finalize the idea that in Shoni Shen there are usually, two phases in treatment. The first phase is usually a generalized treatment, especially when we’re UU using s sh for babies. The first thing I do is do a generalized treatment where we go over most of the channels.
Or we call it a basic treatment. We go over most of the, or all of the channels, and we create a harmonious flow by tapping, scraping, or stroking or vibrating on certain points to create a harmonious flow. And then. After we do that, we usually can focus more on the basic pattern of disharmony that the patient presents and choose point and use them accordingly to create the effect that we’re, wanting. If you, sh machine is a process a technique that you study and you continuously study and get better with as you practice it, as you perform it therefore it. Something if you are interested to explore, it’s something you need to develop or find ways to learn it and develop the technique.
There are different institutions that do that. I, i, myself come from the Jingshen Pediatrics course and we also teach Shian over there. If you are interested please look into Jingshen pediatrics.com. So I hope this really helped you be interested in, Shoni Shen technique, which is a very gentle but powerful technique to add to your tools in the clinic.
And I want to thank the acu, the American Acupuncture. Counsel for letting me present this amazing technique to you all. Thank you very much for your time.
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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 is Moshe Heller. I am from Moshen Herbs, and I wanted to thank the American Acupuncture Council for letting me speak today about Bones and Hormones in Chinese medicine. And so let’s go to the slides. So I wanted to speak about this subject because I actually had three cases that I had in the my office lately.
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And. Those three cases all had to do with bone and they were different. And we’ll talk about that in a second. But there were also some similarities that I wanted to bring out. So the first case was this 14-year-old little. Guy who came to me with this, with an a genetic issue where his mandibular condyle and the Corona process of the left side were underdeveloped and did not fully grow as much as the other side.
So there was an imbalance, and when he was chewing, it caused him a lot of pain. Actually on the opposite side, on the right side ’cause there was a little more pressure on that aspect. He also felt that he was smaller than his peers. He really had a lack of appetite. And although he and although he gets tired easily.
He does not really complain of being fatigued or having low energy. He has regular bowels, although he may miss a day here and there and he has some seasonal allergies, but hardly gets sick. So that was the presentation and it clearly shows an. Points toward a weakness in the spleen.
And that is something that we might address in this case as a main sort of issue. In the, in, in the case. The second case was a 6-year-old woman with a fracture. She fell and broke her wrist. Wrist and wanted came in to promote the healing and help in the healing process of her bone.
Although she had hot flashes and reported having gluten sensitivity and therefore bowels tend to be soft and and frequent, she was otherwise healthy. In that case although we might want to address this hot flashes, meaning that somehow points toward some yin vacuity and.
Issues of reg yin regulation and yin and yang regulation. The main point thrust in this case would be probably to promote the movement of qian blood to the area to promote healing. So we’ll see. Some more focus on moving qian blood. And the last case was this 45-year-old woman with osteopenia which means that the bones are becoming more.
Brittle and having less calcium in them. And she did experience early menopause. She was 45 and already had not been menstruating for a couple of years. Having hot flashes, sleep issues, low back pain, and tended to be constipated. So in general, what we see in her in this case is that we would.
Might focus on strengthening the kidney and and and yin in her case. So we see three cases here. All related to, bone structure and in all three cases we might use a different focus focal point to address them. And so I. I wanted to point out the similarities or the ideas similar ideas that we’re addressing in all three cases.
And for that I wanted to review the relationship of the bone to the organ organs and ubstance and substances in our body in Chinese medicine. And I, created these seven idea seven concepts that we need to maintain when we are working on. On Bones. The first one is Jing. We have, and we’ll talk a little bit about Jing in a second and what that means.
Jing and kidneys work together. The spleen is a, is energy needs to be evaluated and making sure that it is strong and effective because in order to build yin. Or Jing, the spleen needs to be strong. Then we also need to work on liver and heart. That also relates to circulation of Q and blood respectively.
So making sure the liver chi is flowing harmoniously and the heart chi is not blocked and therefore chi and blood. Are flowing and harmoniously in our body. That’s really super important to, to support bone growth and also of course, evaluating the chi and blood is sufficient and not deficient in any way, shape or form.
And also the last point. Is the triple burner, which ties everything together. The triple burner function should be very also in in balanced and uninhibited in order for it for the triple burner to control or support the formation of Yin and bone and Jing. And that is also through the relationship of the triple burner.
To the Yuan Chi. So it is the distributor of Yuan Chi throughout the body, and that’s an important concept to remember. I also wanted to make sure that we are remembering that their, the cycles of Jing are really especially significant in the beginning and at the end of our cycles. We have in the females a seven year Jing cycle and and for males of course, eight year cycles, and we can see that we’re the idea, the concept is we’re born with a hundred percent Jing and then we’re at, when we at the end of life, we end with. Zero Jing. So we are expending Jing throughout our life. And by the way, there’s an opposite curve where sheen on the other hand, we are born with zero sheen and end up when we end up our life with a hundred percent.
She. So it’s an opposite curve, but the most important thing I want to say is that. Especially at the beginning and at the end of this Jing Cycles, when we when we have issues with those aspects, we should be thinking of. So when there are issues with a Jing cycle, especially beginning and end whether there’s a somebody born with a weakness of Jing or.
The Jing has not been or has been expanded and there’s not enough jing at the end of life. Always the herb of choice or my thinking is always because it deals, it is addresses these imbalances in the be begin, beginning and end of life. When we’re thinking of building jing, usually it requires a multifaceted approach.
So Jing is very deep. Therefore we cannot just, put a few points and expect an increase in the gene. And although we believe that we are born with a certain amount of prenatal gene, there is a concept of postnatal gene. And postnatal gene is is influenced by or can be created when our life is balanced in all aspects.
Whether it’s diet, rest, activity, emotional, everything is balanced, then we have surpluses usually in production, and therefore we can keep them or make postnatal jing that supports and reduces the amount of the. Prenatal gene that we use on a daily basis. So when we’re thinking about this multi faceted approach, we should think of both acupuncture, herbs, diet and exercise, and emotional balance in life and how we can support that.
Acupuncture wise, we always think of. UB 11 as the point we, it’s influential point of bones and essence. So when we’re trying to bring more essence to the body, UB 11 is a point to we might think of and of for of course also. The influential point of essence is gallbladder 39, and of course we need to think of kidney points.
Kidney three as more of a yin point. Kidney seven is both yin and young. That’s why I always think of her as a supported support that it supports. Jing Postnatal, Jing Production and Kidney Nine helps to also support postnatal kidney Jing production. Herbs. We look at herbs that are usually black and dark.
And because then that points towards this kind of ability to support the Jing. As I said, Sudi Huang is one, but also HW. And Huang Jing. Huang Jing is a very important because it’s actually a chee to, and it allows the spleen chi to produce more jing. It’s a very powerful herb that we should always remember when we.
When we’re addressing Jing, Ruon, GR is another one, and Gu, both are Jing tonics and strengthen the kidney and the Jing. And are very important to, to include also from a dietary point of view, bone broth is extremely important and balancing this activity and rest and emotional state are all part of this process.
If the spleen is weak, nothing happens. Meaning we cannot transform our food and our tea and our thought and our anything. It creates a stagnation. And therefore, when we are addressing Jing, we cannot forget the spleen, especially when we’re talking to kids. Especially in this first case, although he’s 14-year-old, he’s in his moving him to his.
Second, he’s in the end of the second cycle of life. Still his spleen is showing weakness and therefore we need to fortify the spleen and work on, on strengthening his spleen so he can actually, I. Transform the Gucci and make actual excess high quality, separating the pure from the impure and creating high quality product that can be also transformed into postnatal jing.
So we think of points like spleen three, stomach 36, CV 12, and new B 20 to strengthen. The spleen as well as formulas example, formulas like Ong Ichi, tongue to uplift the spleen, qi or ling ba tongue if there’s a dampness hindering the function of the spleen. I. So these are just example. We always need to support diet and make sure that they’re not that they’re eating spleen strengthening food and supportive lifestyle for that.
So we also need to make sure that chi and blood are not deficient and are flowing freely. Chi and blood is something that we should have abundance of, and if there’s anything hindering in the production or the circulation, we need to address it. Making sure that the liver and heart functions are ble balanced and that’s something you need to check.
And we also, in terms of herbs, we might include things in a formula that we are addressing in each one of those cases. For example we could use a thing orb call, herb example is Git, which moves the blood and also can be used for cases in cases of va vacuity or Hui, which is another very important blood mover that helps with bone repair and building.
Woo. Yao is another QI regulator that I wanted to also point out ’cause it helps to move the qi, but it also warms the kidney. And if we want the kidney to be able to support bone building, that’s another herb we might be thinking of. And to conclude all this what we covered the triple burner ties, everything together makes everything possible.
So the it ta it, it plays an important part in the process of regulation, distribution, especially when we’re talking about kidney function. We can use herbs that affect the triple burner open or regulate herbs like WWE Zoo. We can include that in a formula that builds bone to help that things move freely.
Or a point like bladder 22, which is the black shoe of the triple burner. That to help that. Triple burner function and to regulate all three burners and making sure the kidney is gene is distributed where it needs to go. So the relationship between bones and hormones, that’s that’s another link between in the triple burner and from a Chinese medical perspective, there’s a close relationship between those two concepts.
I always think that essence and Jing. Has a relationship to the hormonal balance in our body. And a lot of times when we see hormonal shifts, we’ll see temperature fluctuations. And so it’s really important to understand that the manifestation of imbalances of hormones will. Manifest with heat, usually whether it’s deficient or excess somewhere in the body.
And we see that very clearly in, beginning in adolescence. There’s, we are seeing it in the beginning of life. We’re seeing it clearly in adolescence when there’s hormonal changes in heat, comes up. And we have acne and and a lot of smelly sweating as examples. And then in menopause, again, hot flashes of feeling imbalances in temperature.
So balancing in and yang in the end is what is important for all these things. I would like to again thank the acupuncture council for letting me present this. And I have the information here in the slide if anybody wants to connect with us with more information. And thank you again for the time.
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And today I’m going to go over the definition, the etiology, and using facial motor points to treat TMJ. And then in part two, I will go over using scalp acupuncture and submuscular needling to treat TMJ.
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 is Michelle Gellis. I’m an acupuncture physician and I teach cosmetic and neuromuscular facial acupuncture classes internationally. I just completed my first book. It is called Treating the Face and it is a comprehensive guide. It’s a hardcover book. It’s a comprehensive guide to treating the face, both for cosmetic and neuromuscular Conditions.
I’m currently on the faculty at Yosan University on the doctoral faculty. And prior to that, I worked at, I was on faculty at the Maryland University of integrative health from 2003 until 2021.
Sorry, I having trouble getting going to the next slide. There we go. So these are the different chapters in my. book and it’s a full color book and some of the images that will be in today’s presentation are from my book. So today we’re going to talk about this is part one of a two part lecture on treating TMJ.
And today I’m going to go over the definition, the etiology, and using facial motor points to treat TMJ. And then in part two, I will go over using scalp acupuncture and submuscular needling to treat TMJ. So what is TMJ? TMJ is short for temporomandibular joint pain. It is also kind of part of TMD is another way of referring to it for temporomandibular disorders, and these are any issues that arise from any jaw pain, jaw problems that come from the muscles surrounding the jaw and can cause problems opening and closing the jaw.
And the temporomandibular joint, or TMJ. for short, is the actual hinge joint that connects the mandible to the temporal bone of the skull. So we’re going to go through, as I mentioned, the definition, and then we’re going to talk about motor points. is the temporal bone right here, and this is the mandible.
And here is the joint that we were discussing. And here’s a blow up of that. So you can see where this condyle goes into the temporal bone and there’s a disc here and there’s various nerves that are attached to it. What can happen through grinding the teeth? or injury or stress, which can cause tension.
People can develop temporomandibular joint pain or TMJ for short.
TMJ can manifest as many different things, not just in the jaw area. People can have pain behind their eyes, different issues with their eyes. They can have limited ability to open their mouth, clenching, grinding. They can have sore teeth. They can get headaches because of the location of the temporal muscle.
They can have issues with their ears, vertigo, dizziness, ear pain neck pain, and of course pain in the jaw and clicking and popping of the jaw. So as acupuncturists, we can do some local treatments with acupuncture and treat the channels that are involved. And so some local points might be stomach five, stomach six, you might treat gallbladder four, SI 19, Sangio 17, Tai Yang.
And then using some distal points, like large intestine 4, which is a command point for the face and jaw. Sand jaw 5, gallbladder 41, which are the master couple point of the young way my. And if they have constrained liver qi and they’re grinding their teeth, you could do liver three and liver four and you can combine some other points such as gallbladder 34, which can help to supplement liver three.
But one of the things that I have found in my practice to be really beneficial when treating TMJ are facial motor points. Facial motor, what facial motor points are, they are the most elect, they’re located in the muscle. They’re the most electrically excitable part of the muscle where the motor nerve bundle is attached.
And specifically, it’s the skin region where the muscle is most accessible to electrical activity. excitement at the lowest intensity. So you can actually measure them. Motor points are not trigger points, trigger points, or tender points, or ashi points, that when you press on them the person is tender.
And fortunately for us, when we’re looking at the face, many motor points are also acupuncture points. When you’re trying to figure out what motor point to use when treating the face, you have to determine what muscles are affected, and then you would look at the motor point on the face. That muscle.
When needling motor points on the face, it’s a good idea to use some ornicogel and a very thin needle. You don’t want to be using a really heavy gauge needle because stimulating the needle could possibly cause some bruising.
Here is an image I took from an old this is an old medical text and they actually outlined all the different motor points on the face and neck. This is from the late 1800s, which I thought was very interesting. Motor points have been used for quite some time. Here is a picture of a nerve and going into the muscles.
So we have the sensory nerve and then we have the motor nerve and the motor point. is, as I mentioned, the most electrically excitable part of that muscle.
There are many motor points on the face. We’re not going to talk about all of them. We’ll just be focusing on a couple, because when we’re thinking about TMJ, the muscles that are involved are going to be the masseter. and the temporalis.
So here’s the temporalis muscle as you can see, and here is the acupuncture point gallbladder A. The motor point for the temporalis is just anterior, it’s one cun anterior to gallbladder A, and you would use a perpendicular insertion. The goal is to go into the muscle, but not through the muscle. The temporalis works with the massetere.
Here’s the massetere to move the mandible up and down and by when a person has TMJ, the temporalis can get very tight and by releasing this motor point, it can relax the entire side of the head and face. and jaw.
Another muscle with motor points that we would use for TMJ is the masseter and here is an image from my book of the masseter and then the it has two motor points and one of them is small intestine, six. And the other one is just below stomach seven, it’s just inferior to stomach seven, and it is level with the earlobe, and you would needle this about a half to one soon deep, because you’re going through the flesh and the fatty area of the face right here.
And this is really wonderful for jaw pain as well. Now this is demonstration of what can happen when you needle a motor point properly. This is not the masseteer or the temporalis, but it was a good display of what happens when you needle a motor point. So, I wanted to show this. Where’s my Ah, there we go.
So this person had had Bell’s palsy and they had a lot of trouble pursing their lips and so this is actually muscle on the chin and you can see when I stimulate the needle, see if I can get that to go again, when I stimulate the needle This is in the mentalis. When I stimulate the needle, how it really jumps, it’s already moving on its own.
And then once I stimulate it, it really causes the muscle to jump.
So next time we are going to talk about other ways of treating TMJ using scalp acupuncture and submuscular needling. And I want to thank the American Acupuncture Council for this opportunity. You can go to facialacupunctureclasses. com and let’s see, I have a slide here. Sorry. You can go to facialacupunctureclasses.
com and you can learn more about some of the classes. That I teach. Thank you so much.
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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.
Dr. Martha Lucas, today we are going to talk about amygdalizing, and I want to thank the American Acupuncture Council for giving me the opportunity to share this information with you. You can also find information on LucasTeachings. com, my teaching website. So my practice is located in Denver, Colorado, but I love to teach.
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Teaching all over and having opportunities like this to spread the word about how wonderful Chinese medicine is. So today’s topic is something that I have called amygdalizing. And so I’m going to talk to you about telling your patients to amygdalize. Now, the amygdala is a part of our brain. It’s involved in our stress response, and a friend of mine and I have been studying the amygdala for quite a while in terms of how it is related, especially to anxiety, but anxiety and depression in our patients.
Kathleen is one of my Pulse diagnosis students from years and years ago, and we’ve kept in touch all these years about how important the proper diagnosis is to help our patients find the cause or help us find the cause of their condition, because that’s what Chinese medicine is about, right?
It’s essentially a preventive medicine, so we want to see our patients to prevent. Conditions, in other words, keep them healthy. You all know the old story about the ancient medical doctors and how you went to see them all the time to stay healthy and you paid them, but if you turned up sick, they didn’t get paid because they’re supposed to keep you healthy.
Now, in our culture, we only we might go see our doctor once a year for our annual exam, but we usually only go when we’re sick. So it is an educational thing to get your patients to understand. You need to come see me. Let’s say they start with a symptom. Come see me. We get you quote unquote cured.
We get your symptoms to go away. We get you healthy again, and then see you in a month. That’s what I tell all my patients. I need to see you twice a week for a couple of weeks, and once a week, then every 10 days, and two weeks, and then see you in a month when you’re healthy. Because I’m getting them back to the time where I can prevent their conditions.
So I love to treat emotions. Emotions are, I, in my pulse diagnosis system, we can feel the emotions in the pulse. Like worry makes the earth, spleen, stomach, pulse go backward toward the kidneys. Part of the problem with that is, number one, it’s taking away from the kidney energy in a perverse way. And number two, it’s not connecting with the lung, large intestine, metal, and earth and metal are our immune system, right?
So people are going to show up with some sort of immune or skin or hair condition, along with their worry causing this to happen. Terms of anxiety and depression, we feel depression, chronic depression, current depression in the liver pulse, the liver gallbladder pulse. And then anxiety is felt mostly in the heart, but that combination of the liver and the heart.
So I have for years been telling my patients when I feel their anxiety to what I call amygdalize. Now, why choose the amygdala as the choice of organs for them to calm down? And remember, the master said that, and I remember this from the first week of Chinese medicine school, and I Really, honestly, at that time, I thought it was a little bit of a crazy thing to say.
I’m a research psychologist by training in the Western medicine, so to say, Oh, emotions cause all physical disease made me feel like, what? Are you kidding? But as I’m feeling people’s pulses, you can feel that back and forth movement, or the scattered of the heart pulse, is eventually causing a physical symptom.
And if you want to think about it, and when we talk about the amygdala, you will know, it’s a physical disease. The amygdala is a physical organ in our body. We’re feeling the person’s anxiety and or depression, and that’s physically in their body. We’ve managed to get this idea of anxiety and depression down to a physical problem.
Now, sure, we have bacteria, viruses, that sort of thing causes physical disease, but also your patient’s emotions getting stuck. Your patient’s emotions, like if the heart pulse is scattered, blood flow isn’t going to be very good, right? This is why our fertility patients need treatment on the heart because that blood flow is going to eventually go to the uterus.
And without that connection, people are not going to be able to get pregnant very easily. So we’re going to be talking about the physical brain and how we’re going to deal with that in Chinese medicine. But it all started with this idea about that. Emotions caused all physical disease. And now of course, I’m big on treating emotions.
I love to treat emotions. I think we all need to let our patients know that Chinese acupuncture, Chinese medicine doesn’t only treat fertility and pain. I think those are two of the big topics, but we also treat the person’s emotions and their spirit. So the amygdala is a little tiny part of your brain, but it has a big function.
It’s one of the major. are the major processing center for your emotions. It also links the brain with other brain activities like memories, learning, and our senses. So that’s why sometimes when people have a panic attack, they have all of their senses seem to be involved in that. But it’s main, going to be talking about is how it can cause disruptive feelings like anxiety and depression.
It’s inside your temporal lobe. As I said, it plays a key role in emotions and memory and learning and It’s actually a little structure, but it’s part of a bigger network called the limbic system. And we all remember that the limbic system has to do with emotions. It’s part of our, very important part of our survival, because without fear in the, what I call the old days, when we were, threatened by tigers at the door and dying in childbirth more and that sort of thing.
We had to have fear, like that idea that the hair stands up on end on your arms when we’re fearful or we are worried for our own survival. If you’ve ever almost been hit by a car, you will know that your hair stands on end because you, Your survival was threatened. So these parts of the brain, including the amygdala, what we call detect danger.
But now the danger isn’t a tiger at the door. The danger is we can’t pay our bills. We’re afraid we’re not going to pass an exam. Our business has declined. Maybe we’re having a little bit of a relationship problem. Those are now the issues that really aren’t what you would call survival. They’re not really, I’m going to die because I can’t pay this bill.
I can do other things about not being able to pay that bill. But the amygdala doesn’t know that. It, all it sees is it’s, Just processing the things that we are seeing and hearing, like literally look at the bill and the amygdala goes into that feeling of, oh my gosh, I’m going to die. So we get fear, we can get aggression.
As I said, it’s a part of learning through rewards and punishment. So again, we can cognitively train it to learn this is not a survival, death threat. And then with memory, and it also is a part of social communication, which is what amygdalizing is. When I tell my patients to amygdalize, it means that they need to just express the emotion they’re feeling, express the situation to someone.
In fact, they don’t even need to. They don’t even need feedback. It’s not I need to have a conversation with somebody about this. In fact, my friend and I do emails back and forth and we’ll say, I need to amygdalize in the subject line, which means to our friend, my friend and I, you don’t have to call me back.
You don’t have to even email back. I just am having this situation. I need to express it. I’m going to say it to you or leave a message, leave a phone message. Hey, this is an amygdalization thing. phone voicemail and just blah, blah, blah, blah, blah, blah, what’s happening because we need to express that. And the masters were right about that.
I tell all my patients, your emotions are better in, sorry, your emotions are better out than in. They’re better expressed than held in. It’s the holding in that creates the stagnation and the weakness, the deficiencies or excess. Stagnation can be. either deficiency or excess, but it’s the holding in of the emotion that’s going to lead to some physical problem or anxiety and depression, which we consider emotional problems.
So they were right about that. Now, I always tell my patients, I’m not suggesting that we all become raging maniacs and road ragers. I’m just saying that you need to say it. You’ve had a bad day at work. Your boss has been a jerk. You just need to get in your car and do the, Oh my boss, blah, blah, blah, blah, blah.
Or you’re sad about something, I’m sad about this particular thing happening. And I always tell them if you’re sad and you can cry, or you’re crying with words processes things faster than just crying with your frontal lobe and your amygdala going on and on inside this loop, right?
That’s what worry does to the pulses, as I mentioned earlier. It’s a loop between earth and the kidneys back and forth. And that’s very dangerous to our health. So what the amygdala ization does, which that’s a phrase I’ve coined, amygdalize and amygdalization, is it helps your amygdala calm down.
It helps the neurons because what the amygdala is made of is neurons and they’re sending and relaying electrical and chemical signals throughout your brain and nervous system so that you see a threat, your bill, and then these neurons start to go through your whole brain, your whole nervous system. And It’s the protective cells for those nerves don’t recognize that this is not a threat to my life.
When we start to have anxiety disorders, PTSD, any mood disorder, panic disorder, these phobias, fearful things, these are all how These are all affected or started in the amygdala. So again, we need to be always thinking about getting that out for our mental health because your amygdala can get hijacked.
If we don’t recognize that this is not a danger to my life, then those emergency signals are just going to keep going and going and going and other parts of your brain are going to react you. to that. So you might have a startle reflex. As I said, you’re going to have anxiety or depression.
It’s an emotional hijack, if you will. So what the amygdala starts in your central nervous system is this process to protect yourself, protect your body, from a dangerous situation or from danger. So again, this helps in a dangerous situation, right? If a car is coming and your ears hear it and you’re on your bike and you’re, you suddenly get a fight or flight response, that’s going to save your life.
So it’s protecting your body from danger by putting you in fight or flight. But now, as I said earlier, The fight or flight isn’t survival. The fight or flight is worried about having a fight with our partner worrying about our business, having to pay some bills, something, our child is a little sick, but we turn it into a bigger worry.
Again, we need to. Nip that in the bud. So then that’s when I tell my patients to amygdalize. I say that’s not a life threatening thing, but your body feels like it’s life threatening. So you need to not neglect your mental health. You need to realize that your physical body is your mental health.
So again, talking to a friend, you don’t need feedback. So what I tell my patients is you don’t need to. Say to a friend, Oh, I need to talk this over with you. You just need to tell him, Hey, my practitioner told me to do this thing called amygdalizing, which means I’m just going to talk about the thing.
I’m just going to repeat the thing so I can get it out of my mind, get it out in a situation where I get my brain to realize, Oh, actually this is a bill. I can do something about that. I can call the company. I can make payments. I’m not going to die. And we can calm ourselves down by doing what the master said, which is getting the emotional, getting the emotion expressed right in a healthy way, not being over angry, not, it.
Not yelling at anyone, not hurting anyone. We just get the emotion out by expressing it to someone. Or like I said I call it talking crying is a great way to get it out and process it if you’re a crier. If you’re a crier and you say the words, I miss him, I’m in your frontal lobe. Let’s say it’s that you miss someone.
Your frontal lobe just gets in that loop. I miss him. I miss him. I miss him. I miss him. I miss him. I miss him. But if You can’t say that out loud when you’re crying. You can’t possibly say, I miss him. I miss him. I miss him. I miss him. I miss him. Like it goes on in your frontal lobe. You’ll start to process it.
I miss him because he’s going to a different school now, but Hey, there are airplanes, there are cars. I can still see him. He’s growing up, whatever it is that you’re trying to process. That little bit of grief, but you need to process it. I remember my mother died suddenly and so when I went to see my doctor for my annual exam, she said I was crying because I just reported that my mother died a couple months ago or whatever, and she said, Oh, do you need some antidepressants?
I said, No, I don’t need antidepressants. My mother just dropped dead. I need to cry. is what I need. You put me on antidepressants, it’s going to make me stop crying because that’s what they’re really good at. You can feel that in the pulses. You can feel the liver energy go up to the heart and stop when a person is on antidepressants.
We of course need that energy to get over, over to the spirit, right? Over to the heart to keep the heart blood flowing and the spirit flowing well. I know for that from Chinese medicine. Now, if I wasn’t a Chinese medicine practitioner, I wouldn’t have needed that. I wouldn’t have known that. And maybe I would have said, sure, let me have some antidepressants for a while.
But we all know as practitioners, we have to get that depressed energy flowing. Get that grief, get that shock going because otherwise my kidneys were going to suffer, right? And the last thing.
When you feel the emotions in the patient’s pulses, sometimes get them to amygdalize while your hands are on the pulses. And I’ve done it plenty of times the other way. I make a joke in my pulse diagnosis class about how, you know what, you want to feel somebody’s anger pulse in the liver, talk to them about their divorce.
It’s the opposite too. I can tell them, amygdalize, get, and old childhood trauma. They’re amygdalizing in front of me about that and you can feel their earth pulse Sink down deep because this is something they’ve had in their system for a long time about not being nurtured So at any rate I wanted to introduce you to this technique I call amygdalizing able to tell your patients to amygdalize and If you have any questions, you can contact me at LucasTeachings.
com or my private practice site is AcupunctureWoman. com and I’ll be happy to answer your questions. I love to help practitioners be better at our craft because I really, after more than 25 years, I really do believe that Chinese medicine rocks. Again, I want to thank the American Acupuncture Council for this opportunity to speak with you and, as I said Feel free to contact me if you have any questions.
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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, everyone, and welcome! I’m Dr. Krystal Lynn Couture, and today we’ll be talking about the pelvic floor and menstruation. But first, I want to take a moment to extend my abundant gratitude to the AAC, the American Acupuncture Council, for hosting this educational video, as well as other amazing videos that are on their vlog.
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Seriously, check it out. There are tons of clinical pearls and nuggets of wisdom on all topics acupuncture and Chinese medicine. So let’s get started with today’s topic. the pelvic floor and menstruation.
In today’s mini workshop, we’re going to be talking a little bit about the history of menstruation and how it was viewed through society. We’ll talk about some Chinese medicine philosophy, including what the Siwen says about menstruation. We’ll talk about the elemental cycles as well as the hormones.
We’ll also talk very briefly about some of the common dysfunctions that are associated with menstruation, such as dysmenorrhea, or painful menstruation, irregular cycles, menorrhagia, which is heavy bleeding, or amenorrhea, which is the absence of the menstrual cycle. We’ll also chat about the connection to the pelvic floor throughout the menstrual cycle.
Let’s get into it. So let’s look at the Western history first. And there are some pretty interesting things to note here. In ancient Greece and Rome, in antiquity, menstruation was often viewed with a mix of awe and fear. The ancient Greek physicians, like Hippocrates, described menstruation as a natural process but it was surrounded by a variety of superstitions.
As we moved into the medieval period, menstruation was actually framed within religious and moral contexts, and the women’s menstrual cycles were actually associated with sin or divine punishment. Now moving into the 19th and early 20th century, This was our first sort of win, if we can call it that.
Menstruation was actually considered a biological process and given a scientific definition. And this was basic in that the blood and mucosal tissue fluid flowed once monthly throughout the vaginal opening. Now, as we move into the 1960s and 1970s, Okay, so this is really recent. Women have been bleeding since the beginning of time, and yet it was the 1960s and 70s when feminists began to challenge the stigma that surrounded menstruation.
And there was an increased awareness of the impact that menstruation can have on a woman’s social and professional life. Finally, in the state of present feminism, the world has recently started talking about menstruation. Amazing! And there are some really big voices out there in both Western and Chinese medicine that are setting the stage for women to learn about their bodies, to talk about menstruation, and to honor their cycles.
As a woman, this feels huge because there are so many questions that I feel women have regarding menstruation. And growing up in the 80s and the 90s, as a child during that time, I didn’t ask questions. I wondered what was happening in my body, but it didn’t seem like there was an opportunity to ask those questions.
I didn’t feel like there was a stigma, but there wasn’t an opportunity either. And I think of women feel that way. And a lot of women continue to feel that way. So as acupuncturists, we’ve got this beautiful opportunity to help clients understand their bodies, to help them honor their monthly bleed, to help them gain some knowledge.
about what’s happening within their biological system, within their ecosystem, so that they can then, one, get help when they need it, two, identify when something doesn’t feel right, and three, feel like what’s happening is okay. And it’s normal and there shouldn’t be shame and other negative emotions associated with it.
I love this quote from Christiane Northrup, an MD. She says, The macrocosm cycles of nature, such as the ebb and flow of the tides and the changes of seasons, are reflected on a smaller scale within the menstrual cycle. I think if we can instill One connection for our clients that are coming to see us for menstrual support.
It’s that the menstrual cycle is natural and it is called a cycle for a reason. It is not a stable process within the body. The hormones are changing throughout that cycle. And it is okay to feel differently. throughout the month. It’s okay that we might have more energy at some times and a little bit less energy at other times and that our output and our input might be gauged differently depending on what’s happening in our cycle and our own unique ways of processing that.
And again, as acupuncturists, if we can support our clients to feel into the cycles, to understand that just like the seasons outside change, the season in our body is changing on a monthly basis. And that’s okay. That’s brilliant. In fact, that’s an opportunity, not a negative subset.
So the Siwen, two times seven, the age of 14, the Du of heaven rises. The Ren channel begins to flow and the Chang is flourishing. Menstruation comes regularly.
In Chinese philosophy, when we’re talking about menstruation, I want to try to bridge the gap here a little bit between the tangible of what’s happening from a Western perspective, and the more ethereal that’s happening from an Eastern perspective, or Chinese. Ethereal emotional. So during phase one, we’ll call that menstruation.
The bleed. This is usually days one to four. Most of the hormones are going to drop off during this time. And of course this is when the uterine lining is shedding if one does not become pregnant. The uterus is cleansing out the old blood. In Chinese medicine philosophy, this is the time to regulate the flow of the blood and qi.
So that means that because so much is happening in the body, we don’t want to put a lot of demands on the body. We want to encourage our clients to eat easily digestible, protein rich foods like soups and stews with Iron in them as well that are going to help them to continue to regulate that flow and also build the blood throughout the cycle.
We want to prevent stagnation of blood. which can come in the form of endometriosis and excessive bleeding, which of course that can be our depletion, right? So during this time, I like to encourage clients to conserve their qi. I encourage them to rest during this time. If they’re going to do exercise to be doing exercise that is low impact like yoga or meditation, Or Qigong.
This is not the time to encourage your client to be going for, their strongest pump or something like that because the body wants to utilize that energy. And as acupuncturists we know, there’s only a certain amount of energy to go around the body. And at certain times, like menstruation, that energy is concentrated in the uterus, which, is why we feel a little bit more fatigued, which is why we feel a little bit more depleted.
The uterus is taking all of that energy to release the uterine lining, to let go, to shed. So when we start to shunt that energy in other places, what we can have is then the uterus not having the energy it needs. So resting, staying warm, gentle exercise, avoiding sex during menstruation is really important because the process of the bleed is a downward and outward process, right?
It is a releasing process. Taking in during a releasing process goes against, in Chinese medicine philosophy, what is naturally occurring in the body. And that’s the key. Helping our clients just to tap into the logic of what is their body saying and using the simple cues of how their body responds.
To then make choices. Avoiding heavy lifting, of course, and hydrating well. This is one of my big tips for clients is to encourage them to stay maximally hydrated. The blood in essence is water. It has that capacity to it, so we want to keep the fluids in the body flowing. We want to keep the digestive tract flowing.
We don’t want this to be a time when things are bound up. Let’s talk about phase 2, the follicular phase. So this is going to be approximately days 5 to 11. During this time, this is going to be when FSH is secreted follicle stimulating hormone. Follicles develop during this phase, and estrogen is secreted from the follicles.
FSH is secreted from the follicles. There’s the activation of the egg and the endometrium thickens. The Chinese medicine philosophy here is that it’s time to nourish the blood and nourish the yin. We also want, for fertility’s sake, we also really want to be strengthening that uterine lining and the follicles, which means that a diet should include proteins, it should include leafy greens, and it also should include foods that are moistening.
So sweet potatoes are a great example of a food that is moistening. During this time, we want energy to be contained, but we can have output. So that means we can start to move our bodies more. We can start to go to, maybe a hot yoga class. We can start to get back into the gym, doing some lifting, some of those activities that make you sweat.
a little bit. Ideally, you still don’t want your peak activity to be during this time, but you can definitely ramp up to, let’s say, what one would call their normal activity level. So if their normal activity level is going out and hiking nine miles three times a week, Living in Boulder, Colorado or something, then they should be able to do that with comfort during that time.
But they’ll save their, big hike, their 20 mile long weekend hike for a different season in the menstrual cycle. So let’s talk about ovulation. Days 12 to 16, approximately. During this time, we’re gonna see luteinizing hormone LH surge. We’re going to see the basal body temperature dip down and then increase.
The egg is going to be released from the ovary, okay? The cervix is going to start to soften. Cervical mucus is also going to thin, so it’s going to be like the consistency of egg whites. This is so that the sperm can easily pass through and fertilize the egg. Now, during this time, the Chinese medicine philosophy is really such that we want qi and blood to be moving.
There’s going to be a lot of energy in the system. We want to use pungent foods to help us move that qi and blood on a dietary level, and we want to strengthen the yang. So this means this is our time for vigorous exercise. Obviously, if one is trying to get pregnant, that there’s some exceptions here.
But this is the time to do that super long hike. This is the time in one cycle, if they’re going to be doing a triathlon or a marathon, something like that. This is the moment to do it. And then we want to encourage that creative output, that manifestation and expression, right? Because the egg serves as that.
When the egg is unfertilized. We’re not producing a child, but utilizing that energy of creation, that energy of manifestation, that energy of expression, encouraging our clients to get into that slipstream. Progesterone is so important for their spirit during this phase, for them to stay on the path of their Dao.
The final phase we’re going to talk about, phase 4, the Luteal phase, days 17 to 28. So this is when progesterone is going to increase, estrogen is high, and the uterine lining thickens. The Chinese medicine philosophy here is that we need to boost qi. So we can get into this phase of vigorous and competitive exercise until about day 26, leading right up to the bleed, because we don’t want to be utilizing all the energy we’ve got and then bleed the next day, ideally.
So eating lots of veggies to increase fiber. And of course, starting that heavy increase in hydration is really important. during this phase. I wanted to post this image of the balance between yin and yang. So we see when we start off with the menstruation phase on the bottom of the chart there.
We start off with menstruation, go into the follicular phase, ovulation, and then the luteal phase. Of course we’re gonna see the red line is young, the blue line is old. Yin. Now, we’re going to see that Yin and Yang rise in correlation and coordination with each other. Yang becomes Yin during menstruation and Yin becomes Yang during ovulation.
The seasons within. Okay. So let’s think about that phase one, that menstrual phase. This is going to be our inner winter. This is a phase where we have. Blood, we have the element of water, which makes sense, and the seeds or the essence are where we return to. In the spring, our follicular phase, we’re going to have the fluid of yin.
the element of wood, and we’re going to start to see those buds form. During our inner summer, we’re going to have ovulation. This is when yang is building. We have that fire energy, right? And of course the flowers are blooming. In the autumn, the luteal phase, we’ve got the qi, we’ve got the metal element, and then we’ve got those petals starting to shed, right?
And of course, earth remains as the element in between. So just like it does in the seasons when we don’t know if it’s winter or spring, that’s the, that’s Earth, when it’s an equinox, that’s Earth, right? When things are harmonious or we can’t quite tell what they are. That’s that Earth element coming in to provide that balance and totality.
I love explaining a menstrual cycle to clients through the lens of the seasons, because it really gives them like that aha moment, that fresh breath of Oh, it’s okay that I feel this way. Okay. So let’s talk about the hormones. First off, estrogen. Estrogen is going to peak in the days just before ovulation.
It is made in the ovaries and it is secreted by the adrenals as well as the adipose tissue. It thins the cervical mucus. This keeps the walls of the vagina thick and elastic and also lubricated. The estrogen is going to support a healthy libido. It’s also going to regulate the metabolism of litter.
Lipids and our cholesterol levels, so this is really important to consider as well. It stimulates cells to develop insulin to the muscles which actually lowers blood sugar. So I’m putting some of these sort of effects of the hormones in that don’t menstruation, but they’re things that we might commonly see.
with women that we’re treating. So the connection between cholesterol and the collection between blood sugar. Okay. So estrogen also is known to improve muscle mass and strength. Again, makes total sense from Chinese philosophy as to why when the estrogen peaks, that we are really able to start pushing ourselves with exercise, right?
Promotes activity of the osteoblasts. And these are the cells that make bone. So this is important to consider, especially as women age. Finally, estrogen binds to the fibroblasts and supports collagen production. So if you start to put pieces together here, face, aging, collagen, menopause, right? It all comes together.
And finally, estrogen is neuroprotective, which means it supports brain health. Let’s talk about progesterone. It peaks after ovulation in the luteal phase. It is produced by the adrenal cortex and the ovaries. It is produced and secreted by the corpus luteum, and that’s really that uterine lining. So a new corpus luteum is formed during each ovulation.
Thickens the endometrium for fertilized egg to implant and grow. Regulates bleeding during menstruation, prevents ovulation during pregnancy, prepares the mammary glands for lactation, that’s important, and has a reciprocal relationship with thyroid hormone. So if you have a client that is having menstrual challenges and they’ve got a thyroid condition, There’s a link there and a place to start looking might be Progesterone.
Their Western physician may or may not know that there’s a connection there but it’s an important one for us to be aware of and to know especially if they have not had a blood panel done. Let’s talk about LH, luteinizing hormone. Luteinizing hormone surges to cause the egg release, peaking of course at ovulation.
It is secreted from the pituitary gland and it works alongside follicle stimulating hormone, which makes sense. Causes the corpus luteum to produce more progesterone during that luteal phase. It plays an important role in sexual development as well as an important role in fertility. So some of the chromosomal disorders that result in Sexual anomalies are related to luteinizing hormone and follicle stimulating hormone deficiencies during the embryonic development.
Follicle stimulating hormone. It is produced by the pituitary gland, works alongside luteinizing hormone, stimulates follicles, and stimulates follicles. On the ovary to grow and prepare the egg for ovulation plays an important role in the sexual development and of course infertility. So here’s a chart. I actually really like this chart.
Believe it or not, it is from Encyclopedia Britannica in 2013. But it is a great chart that shows The rise and fall of the hormones. It’s another great tool to have in your clinic to be able to show clients what’s going on with their cycle at any given time. Menstruation. In Chinese medicine, a harmonious cycle begins with the kidney supplying Qi to the organ systems that produce the blood and lining of menstruation, while also filling the extraordinary vessels.
which are essentially the reservoirs for the five vital substances. Once these vessels are full, then menstruation can begin. Healthy menstruation is pain free, with bright red blood and a moderate flow. Blood should be minimal. Sorry, blood clots should be minimal. Short cycles are generally caused by excess heat, whereas long cycles are generally caused by excess cold.
So that’s an important one to keep in mind. And to define a short cycle is going to be a cycle that is 26 days or less. Long cycle is going to be 32 days or more, depending on where you use your def you get your definition. But generally speaking, that’s how we’re going to look at the concept of what a short cycle is and what a long cycle is.
So it’s the totality from menstruation, through ovulation. Let’s talk about dysmenorrhea. So dysmenorrhea is painful menstruation, which can include menstruation. It can include pain in the abdomen, the pelvis, the lower back, even the thighs before and or during menstruation. It is also often combined with a feeling of heaviness or pressure, and in severe cases, the pain can be correlated with nausea or vomiting.
Okay, so primary dysmenorrhea is somewhat poorly understood. And it is usually linked to the excess production of prostaglandins, which cause the uterus to contract and shed its lining. That contraction is a bit of an over contraction, which is why there’s pain. Secondary dysmenorrhea is a diagnosis within the organ systems, such as endometriosis, fibroids, pelvic inflammatory disease uterine lining growing into the wall of the uterus.
And of course Stenosis of the cervix. The pain patterns that we usually see with dysmenorrhea are blood stagnation and Qi stagnation. Now blood stagnation is often going to have a sharp, localized, unrelenting pain. There’s going to be commonly blood clots And there will be relief with NSAIDs so non steroidal anti inflammatories would cause relief because they’re going to change the patency of the blood.
Now with Qi stagnation, this is usually going to be a dull, achy, widespread, diffuse type of pain. It’s going to be relieved by pressure, massage, movement, and heat. Let’s talk about irregular cycles, or chaotic menstruation, as they’re often called in Chinese medicine. They are chaotic? Inconsistent and unpredictable.
So the liver stores blood and the kidney stores essence, right? The combination moves qi and blood into the uterus and the extraordinary vessels. Thus, irregular cycles are essentially caused by either liver qi stagnation, kidney indeficiency, or kidney yang deficiency. Liver qi stagnation is going to be marked by scanty, dark blood with clots.
and difficulty releasing the blood. Kidney indeficiency is going to have a component of heat or empty heat. And kidney young deficiency, of course, the opposite is going to have that cold. Now overwork can cause Inconsistency in the filling of the vessels, right? Again, it’s about the distribution of energy.
There’s so only so much in the body. So that overwork, of course, as it affects the kidneys in many ways, it can certainly affect the kidneys in relation to how they move blood and qi into the uterus. Menorrhagia, excessive menstrual bleeding. This is defined as a heavy menstrual flow. Abnormal uterine bleeding.
We have to Define this separately because that is spontaneous and out of cycle bleeding and can also be considered flooding when we look at the Chinese medicine definition. So we’re not going to talk about abnormal uterine bleeding today. We’re going to stick to heavy menstruation or menorrhagia.
So this is often caused by spleen cheat efficiency or blood stagnation or heat in the blood specifically. Now cheat efficiency. Is going to allude to the qi not being firm enough to hold the blood, right? So often we’re gonna see a combination of spleen qi deficiency here or the spleen not controlling the blood with spleen qi deficiency, right?
Blood stagnation is going to create an overfilling of the vessels and the uterus with no place for the blood to go. So it’s a little bit of A little bit of confusion in our mind when we think about this because we say we have stagnation and an overfilling. But what happens essentially if we think of this like a stream in a river yeah, stream or a river, and there’s lots of logs and leaves and stuff like that’s blocking it up.
That’s stagnation, right? And also there’s this overfilling. There’s a seeping of the water. into the land, into the space around that river or that stream, right? So that’s essentially what we have going on when we’ve got blood stagnation. No place for the blood to go, it goes out the uterus. Then we’ve got heat in the blood, and this is essentially heat going to be agitating the blood and causing the blood to just not want to stay in the system.
Finally, amenorrhea. This is the absence of menstruation. We’ve got primary and secondary. Primary, those assigned female at birth who have not menstruated by the age of 18 years old. Secondary, no cycle for three months or more. Any age above 18. This is very often caused by dampness in the uterus. So spleen chi deficiency is often the cause here, creating poor transformation, thus obstruction of the lower jowl and the uterus, which then leads to a series of other problems in patterning, right?
We essentially end up with chi and blood deficiency due to poor nourishment throughout the system or chi and blood stagnation, which is more of an excess condition and the blood is stagnant but not deficient.
So what about menstruation and the pelvic floor? This is an important conversation and one that I have very often with my clients and my students. So there are three components that we’re going to talk about very briefly and basically. One is the muscles, two is inflammation, and three is pressure changes.
Muscles. The changes in estrogen create changes in the muscle suppleness throughout the body. Okay. This also occurs in the pelvic floor. So estrogen is the lowest when we are leading up to and during the monthly bleed. Okay. So what this means is that the suppleness is at its minimal during this time.
There’s also an increase in prostaglandins, which further relaxes the smooth muscle tissue leading up to the shedding of the uterine lining. And of course, the shedding of the uterine lining creates a micro inflammatory response, right? So now we’ve got muscles that are starting to be less supple, we’ve got inflammation, and on top of that, Progesterone increasing can slow digestion, estrogen rising can cause gas and air to be trapped within the intestines, which means we have pressure changes.
So we have some slack muscles, we have inflammation, and we have pressure changes. All of this means that leading up to one’s bleed and during one’s bleed, they can experience increased urinary and bowel incontinence, urinary and bowel frequency, urinary and bowel Urgency, loose stools, of course abdominal distention, and pain leading up to the cycle and during the cycle.
The pelvic floor is directly impacted by what’s happening with the hormones during, leading up to, and during menstruation. Now why is this important for us to know? One, when we’re questioning our clients, when we’re asking them about their cycle, when we’re asking them about their pelvic floor, and the function of their pelvic floor, it’s important for us to know, is the pelvic floor, let’s say weak or tight, all the time?
Or is the pelvic floor just tight? At a disadvantage, a hormonal disadvantage, let’s say, when they are leading up to their cycle. Now, as acupuncturists, we have a brilliant gift of connecting with our clients and understanding a little bit about their bodies on both a Western and an energetic level.
We also have this great tool in our toolkit called acupuncture. And what does acupuncture do? It creates a neuroendocrine effect. So great news about that. We can understand hormones, but we don’t have to totally understand hormones to make a difference within the body because if we understand the pattern and we’re inserting needles into the body, we’re going to elicit a neuroendocrine effect.
What does a neuroendocrine effect do? It balances the hormones. in the body system so we can really make a big impact. And I honestly see a lot of clients that have pelvic floor dysfunction specific to menstruation have a major improvement just from having general acupuncture that isn’t specific to the pelvic floor.
It’s such an amazing benefit. Thank you so much for joining me today. It’s been such an honor to have you with me for this workshop. I want to again take a moment to thank the AAC, the American Acupuncture Council for hosting this video. If you don’t already know, I have recorded a pelvic floor intro, and coming soon, you’ll have the opportunity to watch my fertility, pregnancy, postpartum, and menopause videos in relation to the pelvic floor.
And again, thank you so much for joining me. If you’d like to look at my references, go ahead and just pause this slide. Otherwise, I’ll see you next time. Thanks to the AAC!
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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, everyone, and welcome! Welcome! Welcome! This is an introduction to the pelvic floor. My name is Krystal Lynn Couture and I am the pelvic acu. I want to first take an opportunity to thank the American Acupuncture Council for hosting this webinar. this video, as well as the many other educational video series that they have on their vlog.
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Let’s get started. First off, I want to let you know just a little bit about me. I became a PT in 2006 and later became an acupuncturist. I actually started dry needling in 2009 and very quickly I found that the power of a needle was more than just muscle release. I was immediately drawn to Eastern medicine.
And as doing so, I was also really drawn to treating the pelvis because these clients kept showing up in my practice. They didn’t know that much about it. I didn’t learn about it in school, in PT, in school for acupuncture, just, And it just kept happening that these clients needed help, they trusted me, they were seeing me for something else, and then it was like, hey, by the way, I’ve got this thing going on that I really don’t know who to talk to about it.
And so at first I just listened, and I educated myself and educated myself. And eventually, I developed a system to bring pelvic care to clients. Through the lens of acupuncture to create successful treatment plans for these clients that address the root of the dysfunction through the physical body, through the emotional body, and of course, through the spirit, which is what we do really well with our medicine as acupuncturists.
Today, we are going to have a very brief introduction to the anatomy of the pelvis and the pelvic floor. First, we’re going to talk about the bony structure of the pelvis, then we’ll start talking about the superficial and deep musculature layers. We’ll talk about the differences between the female and the male pelvis.
We’ll get into the functions of the pelvic floor in relation to organ support, in relation to sexual function and reproductive function, as well as bladder and bowel function. And then finally, we’ll have a quick chat about qi and blood. If we can understand the science and the physiology of the pelvis.
and the organs that are contained within it, as well as the muscles and also the energetics that are contained within the qi and the blood, we can start to produce a really amazing way to treat the pelvis comprehensively. And this is what I love about bringing pelvic care into your acupuncture practice.
So let’s start with anatomy.
All right, I have my amazing pelvis here, and I’m going to use this as a model to serve us. So what can see first in the bony anatomy? We’ve got our iliac crests. Our iliac crests come into the pubic bone and the pubic symphysis. This forms our ischial, there we go, ischial tuberosities, or our sit bones.
And then on the back of the pelvis, We’re going to have our sacrum right here in the center with the sacral foramen, right? And then we’re going to come down to the coccyx. So that’s the basis of our pelvic bony anatomy. Now if we orient ourselves to the pelvis in the position from inferior to superior, we’ve got on each side those ischial tuberosities.
We’ve got our pubic bone, pubic symphysis, and then we’ve got our tailbone, right? So that forms a diamond. That diamond is what supports the hammock like structure of the pelvic floor musculature. Speaking of, let’s talk about the pelvic floor musculature. All right, so this is a very brief lesson today.
We’ve got a female pelvis here, so let’s go ahead and just orient ourselves. So we’re going to have the tip of the coccyx or tailbone. Then we’re going to have the external anal sphincter and the opening of the anus here. We’ve got the perineal body, right? And then we’ve got the vaginal opening. So if we want to talk about the superficial musculature, first off coming off of that perineal body, we’re going to have the transverse perineal muscle.
Okay. Next we’re going to have. Next to the vaginal opening, we’re going to have the bulbospongiosus muscle. And then coming right along the ridge, the underside of the ridge of the pubis, we’re going to have the ischiocavernosus muscle. Now let’s go to the deep layers. So we’ve got the levator anni, which is the magic of the pelvic floor muscles that most people refer to.
So levator anni is going to be these layers here. We start off with the puborectalis muscle. Then next we have the pubococcygeus muscle. And next we have the ischiococcygeus muscle. I hope the anatomy lesson provided you with the start of a foundation for understanding the pelvis and the pelvic floor.
Now let’s talk about the differences between those assigned female at birth and those assigned male at birth when we’re talking about the pelvis. So first up we’re talking about the inlet. Okay. This is the inlet. This oval shape here of the female pelvis is going to be wider and oval shaped. In the male pelvis, we’re going to see a little bit of a narrower opening, as well as a more heart-shaped inlet.
When we talk about the sacrum in the assigned female at birth pelvis, we’re going to see a wider and shorter. sacrum with a greater curve to it. In the male pelvis, we’re going to see a longer and narrower sacrum. But when we talk about the coccyx, what we’re going to see is actually the male coccyx has a little bit more curve to it than the female coccyx.
The female coccyx is going to be a little bit straighter, which allows that opening to be a little bit more open and spacious when we push A baby through the opening. The iliac crest. We know this from palpation and also observation. The iliac crests. on the male pelvis are going to sit a bit higher than they do on the female pelvis.
So there’s actually a little bit of a height differentiation. And then of course we have the pubic arch, which you can see here. This pubic arch is going to be much wider in the assigned female at birth pelvis versus the assigned male at birth pelvis. Finally, the bones of the female pelvis are going to be a bit lighter and thinner than the bones of the assigned male at birth pelvis.
So now we’ll go ahead and look at some graphics. Since my demo pelvis is just a female, we’ll go ahead and look at some graphics to explain these differences. So here we have the illustration of the pelvic inlet shape. On the left we see the male pelvis. We can really see that heart shaped On the right we have the female pelvis and we can really see that we’ve got a more oval and wider shaped inlet.
Next, with the sacrum and the coccyx shape. We can see on the left that male pelvis has that elongated sacrum that’s a bit straighter. Whereas the female pelvis is going to have that wider, shorter, more curved sacrum. On the contrary, we’ve got the Coccyx on the male, which curves forward a bit and the coccyx on the female, which is a little bit straighter.
Chatting about the pelvic height and pelvic angles. This is displayed a really nicely here. We can see that those iliac crests on the male pelvis on the left are a bit higher than those of the female. You can see there’s a little bit more width in the female. pelvis, right? And this makes sense when we just look at body shape, very often the male has that more triangular shape and the female has a little bit more curve shape to it.
So that makes good sense. In this picture, we can also see that pubic arch very well. illustrated. And so the pubic arch is going to be 60 to 70 degrees on the male pelvis and on the female pelvis that’s going to be more like 80 to 90 degrees. So now we want to talk about pelvic floor function.
Okay, so first off, the muscles of the pelvic floor provide that hammock like structure. As you can see, in our model, right? We’ve got that beautiful hammock like structure. What that does for organ support is it keeps the lower abdominal organs in alignment. And this is so important because the pelvic floor is actually activated in conjunction with the abdominal muscles and the muscles of the back, especially when we’re doing activities like lifting and bending and carrying and jumping, right?
What happens when we’re doing these activities is actually the pressure in the abdominal muscles. increases. Now the pelvis, the pelvic floor and the pelvic openings are obviously below when it comes to gravity, the abdomen, right? So what that means is the pelvic floor is particularly important in keeping those lower abdominal organs from being pushed outward.
or prolapsing. So you can start to see the importance of the pelvic floor, right? It keeps everything up and in and also helps to support the pressure between the abdomen, the back, the base of the pelvis, and also that respiratory diaphragm. When we talk about sexual function, and reproductive function.
It’s quite obvious that during pregnancy, the pelvic floor is going to support the pregnancy. It’s also going to relax and stretch during labor and delivery to allow that baby to come out, right? To be delivered. But sexually, what happens? The pelvic floor muscles actually play a key role both in those assigned female at birth and those assigned male at birth in labor.
providing movement of blood flow. So in females, the pelvic floor muscles help to increase blood flow to the genitals, which promotes arousal promotes lubrication, and it allows for ease of penetration and thus orgasm. In men, of course, the pelvic floor muscles help to manage the blood flow to the genitals by compressing the veins to the penis and thus trapping blood in the penis which creates an erection leading to eventual orgasm.
So those pelvic floor muscles have a big impact on our reproductive and our sexual function. Let’s talk quickly about the urinary and bowel function. Now, the pelvic floor is going to house the openings for the urethra from the bladder, the anus from the bowels, and the vagina from the uterus in females.
The pelvic floor is going to help close those openings to prevent leakage and then relax them for emptying. The pelvic floor essentially supports continence in both males and females. So here’s a quick image so that you can just orient yourself to the opening’s anatomy. So we can see on the left we have the male image, on the right we have the female image.
Left to we have the pubic bone to the tailbone. In between the pubic bone and the tailbone, guess what, we’ve got the pelvic floor. And then, in males, we have the bladder, the prostate, and the urethra. Then we have the bowel. So those are our two openings and our two spaces to consider. In females, we have the bladder opening to the urethra.
We have the uterus opening to the vagina, and then we have the bowel opening to the anus. So here’s your example. You can also see this really well from my superior to inferior view. of my pelvis here. So we can see there we go. We can see the rectal opening, we can see the vaginal opening, and then we can see where we’ve got the urethra as well.
Up next, let’s get in to chi and blood. Okay. Chi and blood are that crucial energetic aspect that are going to help us put everything together as we bring a unique lens to treating the pelvic floor as acupuncturists. The Great Void consists of qi, and qi condenses to become the myriad of things. In terms of Chinese medicine, qi is the energetic foundation of the universe, as it is the physical and spiritual substrate of human life.
Life.
So what does Qi do? Qi is going to promote, it’s going to warm, it’s going to protect, it’s going to hold, and it’s going to transform. Qi promotes the essential functions of the organs and channels in the human body. So when we think of the body as the body kingdom and the organs as officials, And the channels as communication between the officials, we can see how Qi is the director of essential function, warming.
Qi is going to be young in nature, and it’s tasked with warming the body and providing heat. Qi defends us against pathogens or the six evils, which we know in the winter we have colds, In the spring, we have wind. In the summer, we can have summer heat, which is that damp heat, or heat, which is dry heat.
We can also have damp or dry in their own right. Qi is going to hold and contain substances in their respective places and control secretions. We know this when we think about spleen qi deficiency becoming, um, spleen chi sinking, right? Transformation. Chi also metabolizes fluids and substances within the body, which includes our blood and the chi itself.
So when we’re looking at chi as a vital substance and thinking about these functions, we can already start to see how we’ve got all these fluid balances that are occurring in the pelvis. itself within the organs, but we also have that musculature that’s going to require qi and blood as well.
Let’s talk blood. Put simply, blood is going to carry oxygen and nutrients to the cells while carrying away waste. Chinese medicine believes this too and Chinese medicine believes that blood carries the human conscious or consciousness within it. So blood has this very physiological robust nature to it, and by carrying the consciousness within it, it’s got a very robust spirit as well.
Just to review, the spleen is going to make the blood. The heart will govern the blood, and the liver will store blood. When it comes to the uterus will store and release the menstrual blood. Blood functions include nourishment, moistening. Holding the mind or the spirit and determining menstruation.
The blood circulates continuously through our system, providing us with nutrients to our organs on the interior and to the muscles, the tendons, the bones, and the skin on the exterior. The blood of each specific organ ensures that the skin. and the hair and the eyes and the sinew and the tongue are properly moistened.
So the blood has a direct role in moistening. This is really important as we start to think about female cycles. Chinese medicine teaches us that the heart and specifically The blood vessels hold the shen or the spirit. Finally, blood determines menstruation. The quality of blood determines one’s bleeding cycles monthly and also throughout the lifespan.
So how are qi and blood alike and different? First off, blood, of course, is the mother of qi. And qi is the ruler of blood. Talk about that for a mouthful, right? Blood has a yin nature to it, where qi has a yang nature to it. Blood nourishes and sustains the zongfu organs that help produce qi, while qi provides the force and the energy to the zongfu to produce blood.
So we can see that they have a pretty symbiotic relationship. Qi is I’m sorry, blood is essentially a denser form of qi. Blood and qi are inseparable. Qi will move blood. And Q will also hold blood. So once we understand the energies of QI and blood, we can start to understand the source of the function or dysfunction within the pelvis.
We can start to understand how to put the layers together, and then all of a sudden, instead of treating the diagnoses of erectile dysfunction, we’re able to go to the depths of kidney young deficiency, or whatever it might be, whatever pattern we come up with, and also identify emotional patterns, spirit patterns that could be contributing, and get really deep into the source.
And treat the pelvic floor, treat the pelvis, treat the root of the body, and treat the root of the dysfunction to really help our clients to feel better and to improve their quality of life. So once again, this presentation is brought to you by the AAC, American Acupuncture Council, and I hope you loved it.
We are also going to be doing a few more presentations. We’re going to be sharing presentation on the pelvic floor and menstruation, the pelvic floor and fertility, the pelvic floor and pregnancy, The pelvic floor and postpartum, and of course the pelvic floor and menopause. I would love to have you join me for this series.
Once again, my name is Dr. Krystal Couture, and I am the pelvic acu. It has been a pleasure to be with you today, and I can’t wait to see you soon.
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