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Microneedling for Acupuncturists

 

 

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, everybody. Welcome to today’s program. Microneedling for Acupuncturists. My name is Michelle Gellis and I teach cosmetic and facial acupuncture classes internationally. The slides, please.

A little bit about me. I was on faculty for the Maryland university of integrative health from 2003 until very recently. And I travel around the world. Teaching facial and cosmetic acupuncture classes. And I’ve been doing that since around 2005. Here’s a list of some of the classes that I teach. I have a one year.

Facial acupuncture certification class. I teach facial cupping in gloss Shaw. I do a weekend certification class that I teach. I teach drama, rolling skincare, treating neuromuscular facial condition. And self care and some other classes, I don’t need to go through all of them right now, but all of my classes are available online as recorded webinars.

Some of them I do as live webinars. And then I do hands on practice sessions when I’m. I’ve been published in the journal of Chinese medicine several times. And there are links to all of my publications on my website, facial acupuncture, classes.com. So today we’re going to be talking about Micronesia. Y microneedle lane for acupuncturists.

If you’re already doing cosmetic acupuncture, ma why might you want to incorporate microneedling into your practice? What is some of the risks, the benefits, and how does. So Mike we’re noodling is an alternative for a lot of individuals to getting things such as injections for skin conditions like fine lines, acne scars, it helps with some loose skin.

It has been FDA approved. There’ve been studies done for. Acne scars. It can help with large pores. And it’s really wonderful for some of those areas that can’t be addressed or can’t be addressed easily with acupuncture. Like some of those lip lines around the eyes where you would have to use a lot of intradermal needles.

Microneedle lane is great for stretchmarks and it even helps with hair restoration. So some of the benefits to microneedling and in this previous picture, this is a microneedle pen and this is the device that is used to do microphone. There is very little downtime with micro-needling. And so when someone has a microneedling session, I know, years ago, you might’ve seen people had microneedle Lang and their faces were all bloody, but that’s, they have fans.

Through years of research that is not necessary. So the downtime is minimal. There’s very little risk and there is a natural production of collagen. So you don’t inject anything into the skin or take anything out it’s relatively safe, but you do have to get. There it, again, it’s used for stretch marks, acne scars, hair loss, and it’s also really good for neck wrinkles, which can be hard to treat with acupuncture.

And if you just put some numbing cream on the face, and in some instances, people don’t need the need. It can be very comfortable. And the results last a long. What are the two main benefits? The two main benefits are stimulating your body’s own natural production of collagen, and it also helps to increase serum absorption by up to a thousand percent.

So any products that you would use on the. Can be absorbed up to a thousand percent and it’s not just used on the face. Microneedling can be used on many different parts of the body, the chest, the neck, the hands, and you can even use it on stretch marks on the stomach, things of that nature. So how does it work?

Microneedling creates these little micro channels in the surface of this. In the upper layer of the skin. And once those micro wounds or microchannels are created, the body is stimulated to produce collagen and the more college and you have, the more youthful your skin will look, it becomes tighter, firmer, thicker, and less wrinkles.

So here’s a picture of a piece of skin and where we’re going to be working right here. So here’s the epidermis and we have the dermal layer and then the lower layers, the hypodermis and the subcutaneous. Fat, but the place where we doing microneedling is right here in the epidermis. So here is a cross section of the epidermis.

And when you’re microneedling the needles, go through the very top layer, which is a stratum corneum and down right here into this base layer. This is where the fibroblasts or. Produce. So you don’t have to even get into the dermal layer, which means you don’t have to have any bleeding. The skin should just be a little pink and these little micro wounds are created and new collagen fibers, new venous and arterial capillaries are formed and fibrosis.

Or created and create collagen. And this is what it looks like with the microneedling tool. The needles go up and down just like this. And they, for our purposes, they shouldn’t be going in much deeper than about. One millimeter into the skin. I had mentioned that the micro channels are great for absorption of skincare products, CRMs, things of that nature.

Normally, when we have product and we put it on our skin, it can’t be absorbed. But once these temporary micro channels are created the product. I can go down and do the work that they need to do can get through that outer layer of the skin. Here is a biopsy. It’s a cross section of a skin cell. And what they did was they died the collagen.

And so you can see here on the top slide, the college and with purple and then about six weeks after a microneedle in session, they did the same thing and you can see how much more collagen was in the skin.

So again, this is a microneedle pen and if you are familiar, The AccuLift company that is my company. And we’ve just come out in the past six months. We’ve just come out with the microneedle pen and the needles are here. The white cap is on the needles here, but this is the needle cartridge. And the there’s an led readout, which shows you the speed.

And then here you can adjust the. And microneedling only needs to be done once a month. And when we’re working on the face, we go typically between 0.2, five millimeters, and 1.0 millimeters. But this pen will go as deep as 2.5 millimeters, the cartridges. This is what the cartridge looks like. And. There are 16 little microneedle pins in here.

And as I mentioned, they go up and down and when you purchase a microneedle pen, the AccuLift micro pen comes with a four hour training course. Four CEOs that goes over how to use everything, how to do everything, but essentially the microneedle cartridge is used everywhere on the face. You can also use it on the neck and the chest pretty much everywhere, except you wouldn’t want to use it on the red part of your lips or inside the orbital rim and see.

The cartridge itself has three connector points. And so there’s three places where this bayonet cartridge connects inside. And this makes a good firm connection. You don’t have to worry about the cartridge popping off, and it also prevents any black back flow of fluids back into the.

Nano noodling is another type of noodling. And so we’re microneedling. You really can only do once a month. Nano noodling can be done as much as twice a week, sometimes even more. And the noodles are. Only go in about 0.1, five millimeters. So it really just the scrap stratum, corneum the very top layer of the skin, but this is great for areas where you can’t microneedle, or if you just want a little touch up, it’s a wonderful way to get through that stratum corneum so that when you’re using your products, they can get.

And this is what the nano needles look like. It does increase product absorption up to 97%. And these little nano needles are only 110 nanometers long, which is one, 100th of a millimeter. They’re very short. They’re like little cones, but. I have my microneedle pen on my, I have one that I have for my patients and I have one of my bathroom sink and I use it a couple of few times a week and it’s pretty great.

So the nice thing about microneedling is it’s a very quick procedure. So you get your patient on the table between the time they lay down. And the time they leave, if you’re just doing microneedling, you can get them in and out. And a half an hour. I put some body points in to address the underlying conditions and ground my patient.

And normally after four to six sessions, They are good to go and the results can last up to five years. So it is pretty wonderful. But what are the differences between microneedling and cosmetic acupuncture? Because for those of you who know me, I th cosmetic acupuncture and it I’m still doing cosmetic acupuncture very much, but I’m using the micro needle.

The way I do it is one of one of three ways, some people just want the microneedling and that’s fine. For a lot of my cosmetic acupuncture patients, I’ll treat them three times with cosmetic acupuncture and then I’ll do one micro-needling treatment. And for some patients, they may just have an area like their chin or around their lips, or maybe just their forehead where they really need.

My coordinator lane and I’ll do an area. Maybe they just want their hands done or their chest done. And I will charge accordingly for that. And then at the, so I can prep them for that. I can put the facial acupuncture needles everywhere else. And then I end the treatment off with the microneedle Lang and send them on their way.

So let’s look at some. The differences and similarities. So microneedling is very much a skin level issue procedure, and it’s great for fine lines. Acne scars, any depressed scars, you don’t want to use it on a Ray scar. And with the nano needling, you can go inside the orbital rim. It’s great for those lip lines, because normally when you’re doing cosmetic acupuncture, you’re working with lip lines.

You would have to put little intradermal needles in all the lip lines that can be very time consuming and microneedling. You just go right around their lip lips. And sometimes they can have very rapid results where especially with darks. The results can be quite amazing, very quick. And there is some downtime.

I tell my patients 24 hours, no going out in the sun, no exercise. And of course I go through all this and my, where our training. I’ve got a half an hour here, so I’m trying to get as much in, at lightening speed as I can, but there is some downtime. Like 24 hours, no sun, no exercise. You just want to take it easy.

And as I mentioned, the results can last up to five years with cosmetic acupuncture. We’re really getting at the root cause of some of the issues that dark circles, the sagging a lot of different things that are apparent on the face. We’re going to address with body. Cosmetic acupuncture is wonderful for sagging.

It works on the muscle layer and the fascia and the blood and the cheek. So it’s much better for certain things like sagging eyelids that you really can’t do with microneedling the microneedling sessions. I don’t have it on this diagram, but microneedling noodling sessions. You’re going to charge anywhere from.

I’ve seen places charge as little as 2 75 to $300 on up to $600 for a half an hour treatment. It just depends on what your market will bear, where you are. And with cosmetic acupuncture, the results typically take a little longer and it’s going to take a few more treatments, but there’s no downtime and it is less painful.

Both are within our scope of practice and both increase collagen and elastin. Now you do need to check. Your local acupuncture board or with your insurance company, your malpractice insurance, to see if it is within your scope, where you are practicing. There are a lot of contraindications and by all means, this is not a comprehensive course on microneedle Lang, but just.

Give you a little information about that, but patients who are on blood thinners, maybe patients who are going through chemotherapy, radiation, if they have any moderate to severe skin conditions, key lives, if they’re pregnant. So there are contra-indications to microneedling that you need to know what.

And when you’re working with your patients, you have to set up realistic expectations based on a lot of different factors, their lifestyle, their genetics, their skin type, not everyone is going to have the same results. And as I mentioned, they’re going to come in about once a month. Usually sometimes. Quickest three sessions, but usually four to six sessions.

People have a chief of the results that they want. There can be some side effects. Typically the end point is just some pinkness on the skin, but they could have a redness, like a first degree sunburn some pinpoint pleadings and itching burning sensation. So your patients need to know what the side effects might be.

As far as what to look for in a device. There are a lot of devices out there. And as I mentioned, AccuLift skincare is my company and I have been selling. We’ve been selling Dermer wallers for close to 10 years now. And so when I went out looking for a manufacturer for micro-needling devices, I had the same high standards and there are a lot of things you need to look for things like the speed of the device.

And cause you want something that’s a minimum of 14,000 RPMs. You want safety, some sort of anti backflow technology something that works. And with the battery and something that comes with multiple batteries, you want to be able to see the speed. The AccuLift micro pen has this led readout. So you know what speed you’re at?

You want something that has a warranty if there is a problem and also what kind of support are you getting with? Are you getting trained? Does the company provide a referral service once they, once you’ve paid them to train you? Are they going to refer, have a referral service where when people are looking up the device that they will refer to you, does it come with brochures?

Does it come with marketing material? This is all the stuff that’s going to set you up for success. So you’re not just buying. So this is the AccuLift micro pen and it comes with the pen itself, two batteries, a charger five microneedles, five nano needles, a big instruction, booklet cord, just in case you need it.

Because maybe you’re seeing so many patients, you can’t keep those batteries charged. And then some people would just like using a cord It comes with a really nice storage case and down here and then products for your backbar come with it. So three different CRMs for different skin types. And a before and after spray and also a patient take home kit because when your patients leave, they have to be able to take care of their own skin.

So there’s aftercare Sprite for them for that night and then CRMs and lotions for the time following. So I’ve mentioned training and it is really important that you get trained, go on YouTube. You buy a pan, you’re going on YouTube, watching videos and think, okay, I’m good. It is important that you get trained because there are S there’s so much that goes into it.

Everything from setup to safety, to the prep, how do you set the needle speeds? How do you set the needle depths? What techniques are there out there? How do you properly use the pen? Had you cleaned the pen and what do you tell your patient when they leave? You can’t just say, okay, bye. You have to be able to give them some, take home instructions and really understand.

So just the setup alone, this is from my training, but there are a lot of things besides the pen that you would need to have in your. Treatment space. So really understanding what are did you need for setup? And then there were many different techniques that you use different ways that you hold the pen, use the pen and different speeds for different skin types, different conditions, different depths for different speed, for different conditions.

All of this right here is the. Protocol that I teach. And as you can see, it’s a lot of different steps. And really what can your patient expect? I let my patients know that they, their skin is going to be red for up to 12 hours, that they shouldn’t exercise. They need to stay out of the. They shouldn’t be putting makeup on or really even sunscreen because their skin is open.

And when they leave, if they put sunscreen on whatever’s in that sunscreen is going to get absorbed. Now I’m down in Florida. So this is really important that people know, if you live someplace sunny out west, down south, or even if it’s just summer that night until the outer layer of the skin kind of heals.

They can’t be putting sunscreen on their face anyway. There’s some other things that they need to know. And I review all of these in class. I had just enough time to show you a quick little demo. So I’m going to, this is just the four minutes of. Much longer demo that I show in my class, but I wanted you guys to see this.

Whoops, I lost. Hold on one second. Sorry. I lost my thing. Yeah.

So here I am. I’m putting I’ve a makeup remover, wife and some alcohol on taking the numbing cream off and cleaning her skin. Now I’m putting some serum on it’s vitamin C hyaluronic acid and collagen, and I’m setting an appropriate speed for first. And I’m going to start up. I’m just going to start off again.

So I just go up and down. I’ll have to ride a couple passes to get a little pink and then these little dark spots. Yeah. So he was a little. It doesn’t feel great, but it helps to break off the melanin, but your eyebrows just real quick passes on the end there. When you’re working around your eyes, you might want to turn it down to a 0.25, cause this scheme is too thin.

No analyze.

And I actually had this faded up a little bit. You a little bit more,

I’m going to go back on 0.5.

Like that,

I just gone back and forth. And make sure you get,

and afterwards I have a Allo. Arnica CBD spray, which is really cooling and feels wonderful on the skin. And here you can see, so this is a before this, another patient, and since before, and she was a facial patient. I worked on her neck and chest and I put some needles in her face and then she just rested it.

So you can see the, before here’s me during, and then after, I don’t know if you’re able to see on this slide, but she’s just a little pink, which is what you want. Here are some before and after pictures on acne scars and stuff. Fine lines around the eyes. And this is me. These are my eyebrows.

Believe it or not. It’s a funny story. I had been working on my own eyebrows and normally I used to use like eyebrow pencil. I’m 60 years old. And one of the things that happens when you get older is your, you lose the tails on your eyebrows and you can see in my, before. I didn’t have much eyebrows to begin with.

And one day I went to put my eyebrow pencil on and I looked at myself and I thought maybe I had some on from the day before. And I went to wipe it off and I didn’t. And as you can say, I don’t have anything on my eyebrows. It’s it was pretty miraculous. It was shocking actually. In fact, I had to go and get my eyebrows between us cause I started getting so crazy thick.

So as I mentioned for price pricing, you can charge like 3 25 for a half an hour session. I do some packages and it’s just been a really a wonderful add on, especially during the pandemic to my practice. And you can also do, different areas and charge just for that. And when you’re looking at products, there’s a lot of things you want to certainly look for the products that I include with my microneedle pen are organic vegan.

The very easily absorbed. They helped to brighten the skin. They nourish the skin. They won’t clog the pores. They help to reduce inflammation because they have CBD in them. And then I have an aftercare spray that helps protect the skin. And you want something that has really good slip. It’s a term that we use when you’re working with a microneedle.

If you’re interested in the pen itself, you can go to AccuLift skincare.com. You do have to open a wholesale account. It’s free because I do not sell these to the public only to health professionals. And I think that’s all I have time for right now. So this is just a little bit more about the products themselves.

Again. A couple of different serums for different skin types and the aftercare spray. So if you have any questions you can reach out to me either on social media, I’m on Facebook, under my name, Michelle Gellis. I also have a Facebook group called facial acupuncture. And you can go to my website, facial acupuncture, classes.com, and you can look at my classes and there’s links to some free videos and stuff.

And I want to thank the American acupuncture council. Next week is Lorne Brown. And thanks again for your time. And I hope to see all of you again soon. Bye-bye.

Michelle Gellis

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The How and Why of Physical Examination for Acupuncturists

 

 

So in general, I think the physical examination is essential to all of us, no matter what style of acupuncture we practice, especially if you’re treating any kind of pain or injuries.

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. Good afternoon. My name is Poney Chiang from neuro-meridian.net. I’m joining you today from Toronto Canada. Uh, welcome to this week’s show for the American Acupuncture Council. Uh, my guest for today is Jamie Chavez. Jaime Chavez has been a licensed acupuncturist in California since 2002, and he received his master’s in traditional Chinese medicine and 5, 4, 5 branches and has participated in internships in Beijing, China. He specialized in the treatment of a work-related injuries. He is currently the head acupuncturist in a prominent bay area. Workers’ compensation connects and works alongside medical doctors, physiotherapists and orthopedic surgeons. Jamie is passionate about the art of physical examination and integrates multidisciplinary approach in the assessment treatment of MSK pathologies. Jamie has been an instructor in several bay area acupuncture schools at both the master’s and doctoral level. It was during this time that he discovered his passion for teaching.

Jamie has had the honor of introducing acupuncture to medical residents who periodically shouted him for clinical rounds. He has been a guest lecture for Stanford physician assistant program, and it has been actively teaching physical examination skills to acupuncturist in hospital settings. Jamie continues to find joy in spreading the word about the effectiveness of acupuncture. Also, you may, in case you haven’t know, um, you don’t know, and you should, you, Jamie is also the admin and founder of the Dow, uh, Facebook group, which is discussion acupuncture, orthopedics. So it having waiting to interview, uh, Jamie for a long time. Now he’s a busy guy, our schedules just never coincided. So I’m very, very, very excited to finally be able to make that happen. And, um, and very much looking forward to this, uh, this interview. Thank you so much for joining us. Jamie,

Thank you for having me. It’s a pleasure. Yeah.

So you are, um, the, um, the very passionate about physical examination and, uh, I know, you know, a lot of people don’t do that. And so for those of us that probably need a bit of, um, motivation or, um, what is it that you can tell us in terms of what makes physical examination so important to clinical practice?

So in general, I think the physical examination is essential to all of us, no matter what style of acupuncture we practice, especially if you’re treating any kind of pain or injuries. Um, it’s a way of holding yourself accountable so that you can prove or disprove your own thinking about what you are, you know, thinking is going wrong with patient. So someone comes in with the chief complaint and you gather the data and you think something’s going on, but you have to hold yourself accountable. You have to keep yourself in check and try to, um, eliminate your own bias and, uh, basically try to get better at gaining clinical experience because we’re all researchers in the clinic. And so this is our way to do research. So we want to find things that are reproducible, repeatable, and physical examinations, that bridge, you know, for me.

That’s great. Um, I have heard you talk about, um, uh, I’ve heard that you really enjoy teaching through acronyms and mnemonics and, uh, you know, it was just, we learned by association. So it’s good to have something to kind of associate things with, um, when it comes to, um, physical examinations, is there any, uh, not mnemonics that you think would be helpful for us to, to become more comprehensive in our, um, uh, intakes or in our assessments?

Yes, there’s a ton of them out there. I mean, I’ve, I’ve gathered and tried all these different ones over the years. Um, but none of them really, uh, crossed over and applied directly to an acupuncturist. So, you know, there was, there was missing pieces or the order was not right. So I came up with a mnemonic, um, a horse, uh, H O R S E. And I’ve been sticking with that one ever since. And, um, I can explain a little bit about what each of those letters means. Um, the H is the history of the patient. So that’s, you know, their past history, which is the things they fill out on the initial intake form, but then there’s the present history, which is, you know, regarding their chief complaint, what brought the patient into the clinic to be seen today, let’s get all the data regarding that specific topic.

And then, uh, the, oh, is the, uh, observation. So what do you see from the patient? And that’s now we’re getting into the physical exam skills. So what do you see when you look at the patient? And that usually begins the moment you lays up, you know, they eyes on them when they’re in the waiting room, when you walk them back to the treatment room and then, you know, there’s other, you know, key pieces that you’re going to look for, depending on what they’re coming in to be treated for. But observations really important. I’m very passionate about observation because it’s so fast and you can see so much if you know what you’re looking at. And a lot of times we see things, we just don’t know how to interpret it. So that’s something I’ve been really passionate about over the last couple of years and just really diving deep into it, just diagnosing by looking, um, the are for horses, range of motion, which is essential.

It’s one of the most important things that anybody can start using right away, because it’s so fast and you get so much data from the patient. There’s different types of range of motion. So there’s active range of motion. There’s passive range of motion. There’s resisted range of motion, resisted range of motion could be like your manual muscle tests, right? It’s all in that frame. You know, passive range of motion could be your muscle length tests. You know, there’s many different ways to look at that. And then the S is the special tests. Um, so that’s the orthopedic tests. Some people call those provocative tests because you’re trying to basically tease out where the problem’s coming from. And then the E is explored by palpation. You know, hands-on diagnosing by touching. So each of those, you know, contributes to the horse acronym, and that is the order of operation for me.

So we talked to the patient first, and then when it comes to physical exam, we look at them, we have them go through a movement assessment and that could be active, passive, or resisted, or all of them at the same time, you know, check each one individually and you would want to do it in that order. So active range of motion is first because you want to see how willing the patient is to even move right away. You’re already, you know, gauging where they’re at when you want to do other tests down the road, and then you would do passive next. And then you would do resisted last because resistive could be provocative. It could cause pain in a patient. You always save painful tests for last, because if you cause your patient discomfort, you know, they may say, okay, I don’t want to do this anymore.

Right? Like, let’s stop the exam here. So you’d, and if they’re, if you provoke their pain, you know, it also skews your results for everything else you check, because now that, you know, they feel a little discomfort. Now, everything you check is you don’t know how valid it is. And then for us, you know, we’re acupuncturist. So what are we going to do before we stick a needle? Now we’re going to palpate. So why not do that last? Um, and that in itself, how patient is provocative, it causes pain and patients. So definitely we want to save that towards the end and then go right into our needle. Hm.

Okay. I like that. It’s like from the, from the, uh, assessment, the palpation diagnostics, and it goes transition smoothly into the actual needling component. So it’s, it’s very seamless. Um, I’ve heard of, you mentioned something called the ABCs before. Is that also a type of, uh, assessment or is that something different?

That’s another acronym. So like, you’re mentioning, I love, I love mnemonics and acronyms. Right? Um, what, what you see a lot of, and, you know, I, you know, with social media and things, you kind of get a sense for how well people are able to extract data from their patient. Um, but the ancient horse is the history. And I have an entire course just on how to do, you know, a history. You know, we could talk about that all day, but to keep it really simple, there’s key components that you have to get from your patient when they come in. And there’s tons of acronyms for this. But the one that sticks with me the most is just knowing your alphabet. Cause who doesn’t know their alphabet. Right. That’s like the basics. So it’s, but this part of the alphabet is old. P Q R S T.

If you can remember OPQ Q R S T, you can get all the data very quickly from your patient. So for example, like if you like pony, if you’re on my patient and let’s say you shoulder pain, I would ask you the O, which is, you know, when did this happen? The onset, the O is for onset. When did this happen? And how often do you feel this complaint? Is it 24 hours a day? Or does it come and go if it comes and goes, how long does it hang around before you know, those kinds of things? So that’s the O the P is palliative and provocative palliative means, you know, uh, soothing to the pallet. So something that makes you feel better. So pony, what makes your shoulder feel better? What makes it feel worse? The other part of the P is provocative. Like these are essential questions, because if you tell me it feels worse at night when you’re sleeping, I already know there’s something wrong with your sleeping position.

That needs to be correct. You know, those kinds of things. Can you tell me he feels good, then obviously you’re going to feel good when you leave. When I use infrared heat, moxa, hot pack, you know, we already know what it’s going to help. Um, so the next thing is the quality and the quantity. So, um, you know, the quality of your pain tells us a lot. Is it sharp, dull, achy, burning, throbbing, et cetera. You know, the nature of pain gives us some clues. And then we can go to the quantity, which is like zero to 10. How is your pain right now in this moment that you’re talking to me, you know? And then how is it at its worst in the last 24 hours? How is it at its best then the last 24 hours? So that’s how we could use that pain scale a little more accurately.

And then the RSM LPQ. So O P Q R the R is radiate. Does it radiate anywhere? Is your, is your discomfort localized or does it go to a different area of your body? And this is important not to lead the patient. So if someone comes in with sciatica, I don’t say, does the, does the pain radiate from your back down to the bottom of your foot? Like you wouldn’t ask, you wouldn’t lead the patient, you gotta leave the questions open. Like, does your pink go anywhere else? If so, where and how often, you know, and then T is time, is your symptoms worse during a certain time of the day, morning, afternoon, or night? If you say you keep waking up in pain, I know something’s going on with your sleeping position, or maybe you have some arthritic changes, you know, and they get better as you warm up.

So it already gives you a lot of clues, but what you see as a lot of people don’t gather that data when they present case studies and things, and in the subjective information is key. Like you already have a clue, like a very good clue of what the problem is before you ever laid hands on the patient. If you do that old PQRST. And now when you get into the rest, the physical exam, you’re again, just trying to prove or disprove your hypothesis. So if I tell you, Hey, pony, I think you have a rotator cuff tear, and this is the reason why you have these symptoms, but then you have these data points and, you know, it’s like proving a case to yourself, holding yourself accountable versus like, well, I just heard that pain there means you could have this, you know, like, or I, when I press here at Hertz, like that’s not enough data we need to, we need to be more, um, we need to, to raise the bar on our level of a practice, you know?

That’s great. Yeah. Um, I definitely think that if you, if one does a very good history, um, oftentimes, you know, with some, with enough clinical experience, you already have you already kind of starting to find out in New York, you almost, you’re just doing one or two orthopedic tests to confirm, you know? Um, so, uh, a good history taking can actually, in a way, it seems like time-consuming, people might not want to do it, but it’s actually the opposite. I think that if you did a good history taking, you end up having to hone in faster and you’re going to be, uh, maybe it’d be more, more efficient in your practice. Actually. It’s not, it’s actually the, counter-intuitive not the other way around. Um, um, like for example, um, uh, I like the accountability discussion, you know? Um, because here’s the thing, obviously, as a practitioner, we, we, we always, we sometimes deal with practitioner at patients that are more difficult to say, oh, the pain is still there.

The pain is still there. Yeah. But it’s like 10% of what it used to be. Right. So, you know, it’s, you can’t make a yes or no. You have to, you know, many ways the quantitative or qualify it. Right. It does not refer. So this is how, you know, as meditation is working, but also sometimes the patient needs help knowing that too, because to them it’s like yes or no. Right. And yeah, and now the weird thing is that, um, the opposite can happen. Sometimes they can not be getting better, but they have so much trust in you. They say, say they are better, you know, that happens too. So, so these tests go both ways. It actually helps you, you know, if is actually better than not even though the patient might say it’s better, but it actually may not be. Right. So that’s

A good point.

Yeah. I know. So like,

They don’t want to hurt your feelings. They want to say, oh yeah, you’re doing a good job, you know,

But, uh, but you know, some sometimes, you know, I mean, of course there’s the, the, this, the report is the placebo effect. You know, the attention being heard, you know, uh, you know, maybe we just, I keep putting in needles, we help them to sleep in their, you know, their stress level is better. So indirectly things have gone better, but right. But you know, maybe the range of motion didn’t get better, that sort of things. But, you know, it is, if you didn’t take the time to do these assessments, then you’d be, you know, you’re not really truly helping the patient. Right. So I, I, I’m such a big fan of, um, of, um, these, um, more objective measures and does, so I hope I have a chance to, uh, to take one of your classes in near future.

Thank you. Yeah. Likewise. Yeah. There’s, I mean, the, the objective things is amazing. Cause it’s really the whole story. Like if you just, if you don’t go, if you don’t do that, you’re missing half the story. It’s like going to the movies and walking out halfway through, you’d never even found out what the ending was. You know, like by doing these things, like you said, you hold yourself accountable, you can see the, you know, the full presentation and something that I’ve been really like, just kind of blown away is that the more you do this, you start to understand your patient, the person in front of you better, you understand how they hurt themselves. And then you, you know, as you treat them and they start to get better, you’re able to have a better picture on Tet, you know, how to teach them how to prevent themselves from getting hurt.

Again, you know, it’s like the back pain I’ve been seeing so much ridiculous at the, in the last few months, I think from all the people working at home, sitting too much and things, but it’s always like, you know, their sleeping position, their sitting position or their standing position, how they stoop and twist and things. And then if you can identify the activities for them and show them how to move a little better, it’s like, wow, these patients that have had pain for 11 months over a year, nothing’s helping them after a couple of visits, all of a sudden they just shift, you know, it’s like, wow, okay. Those are the patients that are listening to your advice, you know, and then, you know, your acupuncture treatment and or whatever treatment you’re doing is going to hold better. It’s going to have a better, uh, um, lasting effect because they don’t just go home and immediately do the thing that w was causing their injury to begin with.

You know, so those are, it’s just, it’s so it’s so vital. And before I forget too, one of the things that I think is really important as clinical experience. So I know we always talk about, you know, okay. People like to talk about how many patients they’ve seen, but I look at it as like, how many pushups can you do? You can probably do a hundred really lousy pushups, but could you do like 10 really good ones? And I think that’s the same with treating patients. Can you treat 10 patients really good? And if you can, I think your clinical experience is going to be so much more profound than treating a hundred or a thousand patients very quickly without getting all that data, getting that feedback and seeing what your, you know, your input, what your needles are actually doing. So the more you go deeper, you know, you get a richer, more fulfilling experience that, you know, it’s going to help other people more down the road, you know,

[inaudible], you know, I actually, I find, um, um, you know, a lot of times the patients that come to our practice, um, have gone through the conventional healthcare system, which is not known for spending time with their patients. Right. So how do you know you remember how many times patients say to you? Oh, you know, you, they, they say that, oh, you know, more than my neurologist or, you know, more than my surgeon. It’s not that we know more than them. It’s just that we actually take the time to ask questions and do the assessments. So, but, but for whatever it’s worth that time, that the demonstration of your knowledge and doing the testing, listen carefully, it’s actually building rapport and confidence. So they’re already ready to be needled and treat it right by you. Right. You know, that’s a, that’s a big part of, um, the efficacy. I think that, you know, yeah. Like, you know, you explain what’s going on. Why is the referring for example, right. And this is why I’m going to show you here, even though you, your, your pain is there, but I’m going to need a, you hear that, that you lay out in race, a logical progression, and th they put them put some at and comfortable with you. Right. And I think that goes a long way to, you know, that rapport building is huge.

Yeah. I think that’s it.

Yeah. And, and I think that’s one, um, value of a good history or assessment taking that is, you know, it’s not just a, you know, a left brain diagnostic thing is actually can become a right brain emotional and relationship building kind of thing.

Absolutely. I had a, um, a patient yesterday and she was telling me that she went to another acupuncturist and she had a bad treatment. And then I saw I’m naturally gathering data all the time. So I said, well, what defines a bad treatment to you? You know, I want to know, cause I don’t want to repeat those mistakes. And so, you know, basically she went in for back pain, the patient, the practitioner said, so what’s going on? You have back pain. Okay. Let’s have you lay on your stomach needles in needles out after she gets off the table. Okay. Have a nice day. Never once anything else. And I don’t, I don’t want to, I’m not saying that that’s bad. I mean, I’ve treated, been shaded by amazing practitioners that that can do that. But what I’m saying for us, you know, for the majority of people, you know, taking the time to actually figure out what’s going on with the person and letting them know that you, you know, what you’re doing is profound versus the shotgun approach where I just do protocols or recipes for every person.

And then you depend on that. So when it works great, you’re the hero. You feel so good about the experience, but when it doesn’t work, you have no idea what to do next, you know? And then it goes back to what you’re saying, like, you know, that, that rapport, but what I see as it comes down to trust, like your patients need to trust you. And if you know what you’re talking about, and you can explain it to the patient on their level, you can see that trust right away. I mean, I had a new patient yesterday. I didn’t even put needles in yet and he’s already trying to refer me people. I haven’t even treated him yet. It’s because he had four different complaints and we were able to like, okay, here’s, what’s at this. And he’s like, Hey, you know, you know where my problem’s coming from. He’s like, you know, can I send people to you? And I haven’t even treated him yet, you know? But the trust, the trust is already there.

So the take home message is that do good assessment through good history and it’ll lead to more referrals,

More trust. And not only tomorrow,

That’s talk about common mistakes that we make in our, in our, um, clinical examination, history, taking process. Uh, you know, as an instructor, you, um, must see this a lot. Can you help give us some ideas of what are some things that we can do better? Where some common examination mistakes. I thought you mentioned, for example, don’t say, does your pain start from here? Refer there. I don’t don’t coach them. That’s one. Right? Anything else that you can, you can let us know? Yeah.

Yeah. For sure. There’s a ton, obviously, you know, I’m making mistakes all the time and learn from them. But I say the number one mistake is to assume anything. Um, so if you start assuming things, you know, you don’t leave room for air and there, and as you, you know, get experience in this profession, you become very aware that nothing is always right. So you always see people say, oh, that treatment works like a charm. That treatment works every time that no, it doesn’t, you know, like there’s no, there’s no perfect of anything. So I wouldn’t jump on the thing and say, you have a rotator cuff tear based, you know, I’m certain of this for me. I like to say, well, these things suggest the possibility that this might be going on, but I could be wrong. And, but we’re going to treat it like that.

And we’re going to keep reassessing as we go. And if what we’re doing is working great, let’s keep doing it. If it’s not working, we’re probably missing something. Leave the door open for mistakes, because you’re going to make mistakes every single day. And if you’re at this level where you don’t make mistakes and you, you feel like everything works like a charm, um, you have to check yourself, you have to hold yourself accountable and get back to this understanding that, you know, there is no two people that are exactly the same. And you could be very wrong about this person in front of you. I mean, I had a person with supposedly a rotator cuff tear who had cancer in his shoulder. And it took, it took the doctors a while to figure out that there was a tumor in there, you know, but if I, I learned a valuable lesson from that experience, because if I was in private practice, he was getting better with acupuncture.

He was a swimming teacher and he was getting his range of motion, was getting better. He was getting stronger, less pain. He was doing good. Unfortunately, there was cancer in there and I did not, there was no way I would have known it. I would have thought that, Hey, okay, you’re doing good discharge you. So, I mean, never, never assume anything in this business. Um, so that’s a big mistake. I think another big mistake is to, uh, jump on a bandwagon. So you learn a couple of assessments tools, and you think that’s all there is you need to continue to go deeper. You know, it’s not one thing, you know, if you do manual muscle testing, for example, that’s a great tool, but that’s not your entire picture of that horse acronym. That’s a one little sliver and you need to incorporate as many of those pieces as you can, to develop an educational guests that support your hypothesis.

So if you only have one little sliver of information and you go, okay, you, your problem is this because you know, this muscle is weak or whatever you are missing, the bigger picture, you know? So I would say, you know, keep learning like never, never, you know, get satisfied. You got to go deep. And if you want to try to get better at something, what I found helpful for me is just pick a body part. So like, for example, I keep saying shoulder, cause it’s on my mind. But you know, if you go to the say, I want to learn shoulders, you can learn shoulders really easily. I mean, the technology is in your hand, the anatomy is in your, in your phone, just take some notes, right. But then what you need to do is just, you know, fill in the blanks of that horse.

So what kind of questions should I ask someone who has a shoulder problem? There are some specific questions that can help guide your, if you’ve got pain at nighttime, that’s a very common symptom of rotator cuff tears. When, you know, wakes you up from your sleep. It doesn’t mean you have a rotator cuff tear if you wake up from sleep. But it’s just one more data point or one more clue. You know, if you, you know, what do you see when you look at a patient who has a rotator cuff issue, what is their range of motion going to be like actively passively resisted? And then what special tests can help differentiate two competing diagnosis? So maybe there’s like, I think it’s this or this. Well, there’s going to be some tests that can be used that differentiate that. And then when it comes to palpation, that’s our, that’s our expertise.

But just know what’s underneath your finger. You got to get in there and know how to differentiate. If I pop a [inaudible] with the arm, you know, resting on some, like my hands on my belly and I press on July 15, I’m touching the supraspinatus tendon. But if my hand is out to the side on the table with my Palm to the ceiling and our press, I 15, I’m more likely pressing the biceps tendon now. So it’s just like little subtle things like that. Can, you know, they’re so basic, but when you apply them, it seems like it’s advanced, but it’s really not. Um, so those, those are some common things off the top of my head, but there are a lot of things that we do wrong and there’s still a lot of things that I do wrong, but I think maybe the, the worst thing you could do is stop learning, you know, keep being motivated because we’re helping people.

And we’re in this profession that is bridging this gap between surgery and everybody else that’s not helping these patients like we are on the frontline and acupuncture is that effective. It blows my mind every day, but we have to have a way to test how effective it is to get that experience that I was talking about that helps us to be better. And then share that information freely, freely with your colleagues. So everybody’s better. I think that is one of the best things we can do as a profession. And I hope we can get there.

Certainly I think if, um, we all up our own game by becoming better at doing assessments, it would transform the prestige and the, you know, the, uh, the reputation of our, our profession for sure. Right? Like, uh, the it’s, um, now I will run out of time, but I, I, I have to pick your brain. Okay. Um, I want you, can you share like a clinical Pearl with us? I always like to do this, something that you pay, perhaps you really good at treating, you know, you’re talking about shoulders today, anything about shoulders or something like that, that, uh, you know, some, some assessment or diagnostic advice you can give us so that we can maybe try it out, or maybe it’s something that we’re not, not thinking in that way and give us a different thinking cap to help us look at the body or assess, um, the patient, any advice for our fellow listeners and viewers today.

Sure. Um, my lead-in will be that, you know, there are, there is this like, you know, movement where people are saying, you know, special tests, orthopedic tests are not good. Those people unfortunately have not done the research. And it’s much easier to say it’s not good then to dive deep and learn it because it takes a long time to really understand all these things. And I know because I’ve been going through it. But one thing that I’ve been doing in the last year is digging in and picking apart all the research and starting to pick out, you know, tests that have been proven time after time to be effective and how effective those tests are like, uh, you know, changing your post-test probability of someone having a problem. So no orthopedic tests are not bad. Yes, they’re great. But you have to understand how to utilize them.

So a really simple clinical Pearl for shoulders is if somebody tries to raise their arm over their head, but they can’t. And they ended up shrugging their shoulder into their ear. Based on the research, they are 15% more likely to, if they, if they can do this without shrinking their shoulder, they’re 15% less likely I should say, to not have a rotator cuff problem. So people who can raise their arm easily and freely, you know, that’s, they could still have a rotator cuff issue because people are asymptomatic and so forth. But when you see somebody shrug their shoulder into their ear to try to raise their arm, what that tells you right away, is there something wrong with their shoulder? It doesn’t tell you what it is, but it’s what they’ve narrowed it down to. It’s either the rotator cuff it’s frozen shoulder, or they have arthritis in the joint so that there is a sh there’s a high probability that somebody has a shoulder issue.

If they put their shoulder in their ear to try to raise their arm over their head and they can raise it all the way. And then as a side note, let’s say, you’re that person that can raise your arm easily, but you can’t bring it down very easily. Like you have to bend your elbow to, to shorten the moment arm so that it’s not as heavy. You end up bending the arm or you support it to bring it down. That starts showing you like, okay, this person is more likely to have a rotator cuff issue. And that sign alone changes the post-test probability by 15%. So what does that mean? Wow, that’s a lot of information, but what they’ve shown is the number one risk factor for rotator cuff injuries is age. And if you’re 60 years old, you’re 25% more likely to have a rotator cuff tear.

If you come in saying my shoulder hurts. So 25% of those people have rotator cuff tears. If that person has a hard time lowering their arm, now you add to that 25%, an extra 15, and you go, oh, this person is 40% likely to have a rotator cuff tear going on. Just with that information alone. I didn’t even ask them any questions and they do it at intake. I didn’t do the other tests. Just those two pieces of information alone. He’s 40% more likely to have a rotator cuff tear. He’s 60 years old and he can’t lower his arm without bending his elbow and supporting it. So these tests, when you use them like that, they can give you some good clues to support your hypothesis.

Thank you so much. I would love that because a lot of times people look at things like under, you know, on the way up or, or, uh, doing the activation part, but they don’t look at the entire process. There’s another 50% of it is when they put themselves back into neutral position. And that, that part you mentioned where they with shortening their arm. Like if you just turn around to do your charting, you would miss that complete, right? Yeah. That’s exactly right. Yeah. So I really, I really, really watched the entire process. You know, I really read a lot, so I thank you very much. I’d love, I learned so much from you in this short amount of time that we have for today. Where can the rest of us go? If we want to find out more information about your courses, do you have any contact information, you know, website, social media, uh, work. When you go to, if you want to study more with you in the future,

Um, you can check out the Facebook group discussions on acupuncture, orthopedics, uh, Dao, D a O is the acronym to make it easy to remember. Cause I love that. There you go. So, and then I have my website it’s www.orthopedic-acupuncture.org, orthopedic-acupuncture.org.

Thank you so much, Jamie. It’s been a pleasure. It’s been an honor to finally meet you virtually face-to-face. Thank you very much. They are that. Yeah. Thank you for most of our fellow viewers. And don’t forget to join us next week, where we’re going to have my fellow host, Virginia Doran. Uh, gimme another excellent show.

 

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The Stomach Sinew Channel and Low Back Pain

 

 

 We want to discuss the, uh, low back pain and the significance of the stomach channel. So let’s take a look at that first slide. Our discussion, very short discussion about this topic is going to be looking at the stomach sinew channel from above the knee and into the rib cage region and its influence on low back pain.

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 everyone. My name is Matt Callison. I’m here with my colleague Brian Lau and everyone. Uh, thank you to the American Acupuncture Council so much for having us. We want to discuss the, uh, low back pain and the significance of the stomach channel. So let’s take a look at that first slide. Our discussion, very short discussion about this topic is going to be looking at the stomach sinew channel from above the knee and into the rib cage region and its influence on low back pain. Um, the techniques that we’re going to be presenting here today is just something that you can routinely check for low back pain patients to see if the stomach Sr channel is a contributing factor to this person that’s coming in with chronic low back pain. It could actually even be acute low back pain to go ahead and check that as well.

So I think we should probably get going. We’ve got plenty of, of information here. Um, the first slide or this next slide that we’re going to be getting into is going to be specifically about the lateral Rapha. Now the lateral Rapha is a very significant tissue along the stomach sinew channel. That can be a contributor to low back pain. Let’s discuss this very strong fascial connection to the lateral Rafat. Um, you can see there on that lower left-hand corner of that. Call-out if you can circle that there for us. Yeah, there we go. It’s a continuation of tissue from the abdominals, the fascia from the abdominals and the thoracolumbar fascia. Uh, for those of you that know about the thoracolumbar fascia, it’s gained a lot of popularity over this last 20 years, significantly over the last decade about its importance functionally, but also in low back pain.

So the thoracolumbar fascia, it has got three layers. You have a posterior layer that covers the erector spinae. Okay. You’ve got a middle layer that’s underneath erector spinae and above the quadratus lumborum and then you have a deep layer that’s between the quadratus lumborum and the LDO. So as each one of these layers connect laterally, it becomes the lateral Rafa, the thoracolumbar fascia specifically between the poster and the middle layers. However, if you also look at cadavers, you’ll see that that poster layer also has some contributions to the lateral Rafa. It’s a communication link. It’s a segway between the abdominal fascia and the thoracolumbar fascia, and it sits right on top of the quadratus lumborum and we can be able to pal that palpate that for Osher point. So, uh, the reason why we’re talking about the latter fr right now, before we go into an overview, just such an important tissue for us to be able to consider and then farther into this presentation and we’ll get into the assessment and the treatment of it. So let’s go into the overview of the stomach channel and Brian, do you want,

Yeah, yeah, sure. So next slide. Yeah, we have, um, just a real quick introduction or re-introduction of the stomach sinew channel, if you haven’t, uh, looked at it recently. Um, the secondary channel that includes the myofascial planes, uh, of the stomach channel, there’s really two main branches. Uh, we have one that travels up the anterior lateral leg and thigh goes around the genitalia and spreads out into the abdomen. Then from there, it travels up the chest neck and face to the lower eyelid. So this is the main channel that you’re seeing in this image and this kind of, um, 3d model image here. Um, you can see primarily that main channel coming up, the midline of the thigh are a little bit, uh, lateral on the thigh. And then up into the abdominal layers up through the chest, up into the neck and up into the face, um, that kind of follows the, the primary channel for the most part.

Uh, the second channel is another branch of this that you don’t really see from this image, but we’ll have plenty of opportunities to see it in the next few slides. Um, this other branch is on the lateral kind of starts from the lateral knee, goes to the region of gallbladder 30. Sometimes it’s in that translations, they might say it and it connects the shower young. That might be another way that it’s worded, but it kind of becomes a little bit more lateral as a sort of a segue between it and the stomach channel from there. It runs to the 12th rib and ends at the spinal column. This is kind of adapted from a Vanguard translation at the link shoe, which is a particular source that I really like. Um, but, uh, all of the sources say relatively about the same thing when you look at translations. So let’s go through each of those branches a little bit more clearly and to the next line.

So if we wanted to start at the distal part, um, from the lower extremities, we can look at the stomach DJing, Jen, how it travels along the anterolateral leg and thigh. I think actually these two branches actually, uh, start in this, uh, leg region below the knee. And you can kind of look on this image for the tibialis. Anterior tibialis. Anterior is just lateral to the tibia. This is where really the primary channel of the stomach, the stomach primary channel runs along this area. Stomach 36 would be noodling directly into the tibialis, anterior and happens to be the motor point, uh, for tibialis anterior. So that’s an actual primary channel point. That’s going right through that region. From there, we could kind of follow that up, uh, lateral to the knee, into the rectus femoris, continuing to follow that stomach primary channel. But if you look at this image, we also have the extensor digitorum, longest muscles.

Um, you know, there’s several slips of those. The two, um, create a poll extension for toes two through five and especially toes two and three are part of the stomach channel. So this in some ways is sort of the beginning of that lateral branch. It’s kind of a, between the stomach primary channel and the gallbladder primary channel. It’s part of the stomach sinew channel. You have those toe two and three slips that kind of drive up toes four and five would be gallbladder send new channel, but we’re on the stomachs in your channel. That’s going to connect into the vastus lateralis and start to become that a secondary sort of a branch that more lateral branch.

All right. So let’s go back to the main branch main branch is going to run up the rectus from Morris. You can see the rectus for Morris, this image that kind of dark line on the thigh is the kind of the fascial separation between rectus Morris and vastus lateralis. So that’s in my opinion where the stomach channel runs, but that rectus for Morris that more medial muscle in that picture is going to be the sort of primary channel branch of the stomach sinew channel that then connects to the a, I S it actually connects to the a S I S or it’s fascia. And then it runs up through the inguinal ligament up the abdominal layers up the chest, et cetera, kind of following the primary channel of the stomach. Um, so in this case, what we want to focus on for today’s lecture is the abdominal fascia in particular, because we’re going to look at how that connects and wraps around to the, um, to the thoracolumbar fascia and the lateral Rafa in the stomach channel. It’s all the fascia that lives in is found on top anterior to the M rectus for Morris. I mean, excuse me to the rectus abdominis. So it’s all the fascial layers that are on top of, or superficial to the rectus abdominis. Um, part of those fascial layers in wrap around the body, following the fascia of the abdominals into the thoracolumbar fascia, into the lateral Rapha, and then connecting all the way to the spine. So next slide.

So the lateral branch on the other hand is going to be a little bit more lateral on the thigh. It’s covering the vastus lateralis, which is a pretty big muscle. That’s the fastest part, I guess, but the vastus lateralis actually covers really a lot of real estate on the lateral thigh, really going into attaching all the way to the back of the femur. Um, so it really covers the territory of both the stomach primary channel to some degree. And the, also the gallbladder, um, primary channel, the iliotibial band would be running down on top of this structure. Um, so it would be a kind of in a pretty big area, but this is the link through that lateral branch. If you follow that fastest ladder up, you can see where it communicates the chair’s fascia. It attaches to the same region as the anterior portion of gluteus medius and minimus, especially minimis. So, uh, just that, that hip joint region, you can see where those two muscles are communicating. Then from there, it’s going to continue into the thoracolumbar fascia meeting with a lateral Rafa about anything you want to add on these are,

Yeah, that tissue with Cal patient is pretty significant when somebody has a posterior tilt or an N tilt of the anonymous bone, versus when it’s a neutral pelvis, you can really tell the difference in palpation of that fibers of the anterior fibers of the minimus and the medias, like I said, with quite a change in inclination with that.

Yep. And it’s an often, we actually had a discussion on our, uh, Facebook group on sports act, a sports, um, acupuncture group. And, um, we were talking about how often this fastest ladder Alice is ropey and rigid and dense. And I think if you palpated the thigh quite a bit, you can probably notice that you do know, you do find a lot of patients that have a ton of tension in this area. Right. So let’s move on to the next slide. All right. So we have a few, uh, three, I think, cadaver images. So just the general warning. Um, this was in the beginning, we have the warning on the bottom of the screen. We’ve already had one small image, but these are a little bit closer, a little bit, um, more obvious they fill up the screen. They’re a more obvious cadaver images. So just be aware of your surroundings, you know, if you’re at a Starbucks and there’s people looking at your screen, maybe, you know, get it into a position where they can’t see it, it’s better not to view these in public, don’t share these images, um, you know, keep, uh, it’s it’s, we have to be very respectful to the donors and make sure that we don’t do anything inappropriate.

So this is an educational settings. So we have these images, but, um, but don’t share them with the general public or be mindful where you’re watching this ad. All right. So next, uh, next slide, let’s start looking at this connection. So there’s two lines on this, uh, cadaver drawn over this cadaver, and it’s just the dissection image. And then the top one, uh, which is the shorter of the two lines that’s showing the upper border of the glute Maximus and sports medicine acupuncture. We’ve referred to this as the gluteal app and erotic line. So that’s going to be more superficial than the glute medius and minimus, but I just wanted to show that demarcation, the bottom line is traveling up from the vastus lateralis. Then as it kind of makes a curve, you see it connecting into the glute medius and minimus, and then it follows right up into that, uh, lateral border of the erector spinae, which is that top portion of the line, um, that is kind of that whole trajectory of that lateral branch of the stomach, uh, send you a channel going all the way through the lateral Rapha and a moment we’ll actually see the erector spinae lifted, um, so that we can, um, get a clear view of the lateral Rafa.

One other thing to highlight from this image, you can get your bearings straight is if you go to the very top of that, um, that line, the longer line that’s, um, from there, if you go to the midline of the spine. Yep. Right in that region, we actually have the erector spinae cut. So everything above that, you’re seeing deep to the erector spinae. That’s going to allow us to lift up that little flap of the erector spinae to see the lateral Rafa a little closer. So let’s go to the next image then. And, um, this is just the lines removed, right? So see if you can find that same territory we just discussed kind of look at that trajectory of the sort of channel, like portion going from the thigh all the way up the glute medius and minimus up into the lateral Rafa. Okay.

And now let’s look at with the rector SPI and a lifted. So that would be on the next slide. So there is that little portion of the erector spinae lifted. Then you can see deep to that, to the next fascial layer and that boundary of the lateral RFA. That’s just that little, um, band that runs just lateral to the erector spinae. So again, you can follow that line down from the thigh, from the lateral thigh, going through glute medius and minimus into that lateral Rafa all part of the stomach sinew channel, that lateral branch of the stomachs, a new channel and a pretty juicy area when you’re working with a lot of chronic back problems. Right. That’s pretty sick.

Yeah. It’s pretty significant, uh, continuation from the lower extremity into that latter Rafa, you can see that line with the erector spinae lift up and the thickness of that ladder Raffa as well.

Interesting. Yeah, for sure. Yeah. Get that image in your mind though, because you’ll see some palpation coming up in a bit. Um, and this is where actually, can we go back to the previous image with the erector spinae down? Imagine you are pressing not on a cadaver specimen necessarily, but on a person, if you were pressing and you could kind of see through the skin and, um, and see that your, your pressure is going right to that lateral edge of the erector spinae diving, just deep to it, to that, uh, that boundary of the lateral rafting, that’s going to be where we’re going to be palpating. Um, so this is a, a lot of the types of things we tried to get across. Like these images come from our, um, uh, uh, anatomy, cadaver dissection lab that is on, uh, LASA right now. So these are part of, uh, you know, we have a bunch of videos and I’m really a little more thorough presentation on this, but even just looking at these images, you can kind of get an idea of, okay, if I were to press into that tissue and try to reach the next image, go to that, the next slide and reach that tissue that’s on that boundary, just deep to the erector spinae and know that, okay, that’s the lateral Rafay, I’m palpating for tension at that region.

And knowing that that’s part of the stomachs and new channels. So we have a lot of information right there that you want to take it and kind of go over that. It kind of kind of started the process a little bit, but I wanted to highlight it on the cadaver portion. So when we see it, we know what we’re looking at.

No, that’s great. This is going to be the cadaver dissections in module two anatomy, politician, palpation cadaver lab on Los OMS. But what you said, bright for the person to really understand where that lateral Rafa is, which is going to help significantly when they’re looking for Osher points in this tissue. And also when they’re palpating for, so the lateral Rapha attention test, which is going to be coming up here in just a couple minutes. So am I next? Yep. Okay. Let’s go to the next slide please. All right, here it is Latta Rafiq tension test. So you guys hear it for your notes. Um, you have this a step-by-step, you’re going to ask the patient to designate the pain level with palpation of this tissue on a scale of one to 10. Um, many people are gonna be thinking, well, you’re just palpating. The quadratus lumborum is actually the depth of the palpation.

That is significant here. When you look at the video that’s coming up next, you’ll show it it’ll show that Brian is palpating within the first quarter inch of the superficial tissue. Just touching that lateral Rapha that covers the quadratus lumborum. If we’re looking for the quadratus lumborum trigger points or motor entry point ratchet pop hitting more from deeper into that tissue. So there’s a difference in the palpation of it. A practitioner is going to attempt to decrease the tension and the pain of the lateral Raphi by using the following acupuncture, motor points, stomach 41 works great. 43 can be used on 36 being the motor point, as Brian said of the tibialis, anterior, the vastus lateralis motor points work really, really well for reducing the tension and the latter Rafiq. Um, same with the rectus abdominis points. We’re going to be covering that because there’s four different segments of the rectus abdominis motor points.

And it’s usually going to be the lower aspect that is going to be changing significantly, the tenderness of that lateral Rafa. So let’s look at this image here. You can see how Brian was talking about the, uh, channel going all the way up the vastus lateralis, going to the anterior fibers. I’m talking about the lateral image here of the patient. So you can see going up the vastus lateralis, going up the anterior fibers of the minimus, the media’s going across that iliac crest, which you just saw on the cadaver going right into that lateral Rafa right now from that tissue, the lateral Rapha is going to be following along on the poster and the anterior aspect of the abdominal wall, going to the rectus abdominis. So there’s your connection, your significant connection of the stomach Sr channel for low back pain into the latter Rafa.

And also the abdominal aspect is contribution to low back pain as well. There’s something that we’ve been talking about for a few years now, it’s called acupuncture as an assessment. Um, this is something where you can use a couple of acupuncture points just to be able to see if they will decrease the tension of a particular orthopedic examination. In this case, what you’re going to see in this next video is Brian’s going to be using a couple of points to reduce tension in the lateral Rapha. So let’s check out the ladder off a tension test and acupuncture as an assessment, let’s go to the, into the video

[inaudible].

So we’re looking at the lateral branch of the strong stomach send new channel. So the lateral branch of the stomachs and new channel from the thigh comes up through the vastus lateralis, connects with the gluteus medius and minimus, and then to the thoracolumbar fascia. So one of the key areas we look for in this lateral branch that connects them to the lumbar spine from the stomach channel is the lateral Rafa. The lateral Rapha is the meeting point is the fascial wall. That is the boundary between the iliacus Dallas’ lumborum the erector spinning and the quadratus lumborum. So those fascial planes come together in a seam at the lateral Rafa, and we’re going to go right into that lateral Rapha at a Rambo level of L three. Doesn’t have to be exact, but L three is a good landmark, and we’re going to start to palpation following the angle. So here’s the erector spinae falling off following the angle of the erector spinae down into that valley of the lateral Rapha. And we’re just looking for tension, but also palpatory pain to that. So we can ask the patient on a scale of one to 10, how that, what that pain level is with palpation. So what does that pain level there? Three by three? Yeah, it feels denser. Doesn’t feel, it feels like it’s healthy tissue. Most likely go to a different area. How about right there?

Three. All right. So can you stop bad? But if this was a big pain producer for the patient, then we would look at reducing that with distal points for this assessment and come back and how pain and see if that changes it. So primarily we’re going to be looking down with stomach channel and we can include things like vastus, lateralis, vastus, lateralis Motorpoint would be a good one to consider. We could look at, even though it’s on the gallbladder channel, the most, uh, pasture and edge of the vastus lateralis would be a possibility. So that would be in the region of gallbladder 31, and then we could follow it down also into the stomach channel, just by palpating. It feels like tip anterior has a certain amount of tension. So I’m going to use Tim anterior. I don’t know if it’ll change much based on the fact that you didn’t have a high pain aspect with the additional palpation, but let’s go ahead and work on it anyways. So we’ll use stomach 36, 1 of the motor points for tibial anterior.

Now we’ll come back to the area. So there’s two things I can look for what my palpation tells me. Does it feel like that tissue softened? And then what does the patient report in terms of pain, quality back at the same area and scale the one from one to 10? Yeah. And it feels softer to me. She says the one now, and from a three to a one, I’m having a hard time finding the exact location where I felt that tension before. Cause it feels like it’s been reduced. So other points to consider the distal stomach channel points down towards the feet, stomach 41 would be a possibility stomach, 40 stomach, 36, just based on palpation, felt like a good starting point for me. And then also looking at points along the thigh.

All right. So let’s just talk logistically about what we just saw here. So if you’re going to be treating the patient in a lateral recumbent position like that, using acupuncture’s assessments going to be really quite simple, um, you can also check the lateral Rafiq, the tension tests when the patient’s going to be standing, which is nice because you’ll be bearing and load bearing. So therefore the tissues are going to be a little bit different. Um, in that case you can check for Osher points while the person is standing. You could still go ahead and needle stomach 36, or you can use some distal points to, to see if that was start to change the tissue. You can also do the, do the lateral Rafa tension tests when the patient’s Lang prom. Now that makes it a little bit more difficult when you’re trying to be able to needle the vastus lateralis points, but we will have more access to the distal stomach channel points using stomach 45 stomach 44 stomach 43.

Those points are going to be a lot more accessible when the patient’s link prone and they will also change the tension within the lateral Rafa. And that way you can be able to plug in those points and then continue with your treatment. Um, this is going to be, um, just kneeling some Osher points within that lateral rafting. And you could see with Brian’s angle that he is angling it more toward the belly itself. Not necessarily parallel with the table, like how you would be needling the quadratus lumborum so pressing into that ladder, I Fe looking for Osher points and just tapping on that tissue. Remember that lateral Rapha is going to be a thin tissue on top of the quadratus lumborum and you might have two or three different Oscher points within that lateral Rafa. That’s going to span the region from the 12th rib all the way to the iliac crest. So let’s remember the depth of where that lateral Rafiq is. I’m trying to be able get disperse Oscher points within that region. Bride. You wanna add anything to that before we jump into the next slide?

Yeah, just that it’s um, I think I have that needle in about L three. Um, I do find that that region of L three and the lateral Rafa tends to be, um, pretty responsive and, um, you know, it’s a, it’s a good, I, I often find that is kind of the greatest tension, but for those who followed, uh, Luigi Stecco his work, um, you know, he has these really involved system where he talks about these different points, that parallel acupuncture points to some degree, but he calls them the centers of coordination. Um, and they’re like fascial unions between certain, certain regions of Paul on the muscle. Like this would probably be, I’d have to go back and look, but it’d probably be the, uh, include like the quadratus lumborum the erectors and coordinating movement between those. Um, but it’s in the fascia itself of the lateral Rafa. So this is one of his points, one of his centers of coordination, um, is that, that, uh, L three lateral Rapha mark. So kind of interesting. And I do find that that’s, I don’t know if this works super well, but I know a little bit of it, but I do find that that L three region is usually pretty predictable predictably. Um, more of the center of, of, of tension of that lateral or FFA. Sometimes when I need a lead, I have a slight inferior angle though. Like you said that 45, but, but slightly inferior.

Yeah. So predictable Osher point within that. [inaudible] so that’s great. That’s good. All right. Let’s see what the next slide is, please. All right, let’s go over the best slash motor entry points. There’s two primary for the vastus lateralis. One of them will be extra points, team food two, which is located just one to two soon, lateral from stomach 32, which would be food too. We know that stomach 32 is located six soon up from the lateral border of the superior lateral border of the patella. Uh, so following that up, make sure that you are going to be in the vastus lateralis, not in the rectus femoris. You’re going to slide over then one to two soon, um, into sheen futu, if you cross fiber, the vastus lateralis, it will often facilitate, uh, which would also be at the definition of a trigger point. Uh, if shin futu is going to be referring somewhere, then that would end up being also location of point.

Um, so this is going to be a branch off the femoral nerve going into that vastus lateralis extra point sheen food to a pretty powerful point. So it makes sure when you are kneeling it pretty slow and methodical needling, otherwise it can be a strong cheese sensation can come up really quite quickly. Now the upper fibers of the vastus lateralis, which oftentimes, um, can atrophy on many patients where it’s not really quite used, if they’re having some mechanical problems with the extension or knee flection, those upper fibers, if you divide stomach 31 and the superior border of the patella divided by thirds, it’s the meeting point between the middle and the upper thirds. Uh, you’ll definitely find an off SharePoint within that meeting point. That’s going to be another motor entry point from the femoral nerve going into those upper fibers. Um, the needle technique, that being that should actually be a little bit deeper than that, uh, should be more like, uh, 0.75 to 1.25 inches because the innervation is actually going to be more to the medial side from that femoral nerve.

So you have to go a little bit deeper into that mass lateral, so you guys would be able to make that correction. That would be great. All right. So let’s now I believe let’s go to the next slide, our rectus abdominis motor entry points here. You can see four needles on the left and four needles on the right. It’s an old bleak angle going into the rectus abdominis. The needle is starting at the spleen channel and then directing it toward the wrench channel going. Uh, th the objective here is to try to be able to get the needle to go to the poster aspect of the rectus abdominis. That’s where the innovation side is more on the poster aspect and not necessarily on the Antar aspect. We have to be very mindful to make sure that we know where the tip of the needle is going, and it’s not going past the rectus abdominis, therefore into the peritoneal cavity.

So be very, very mindful of where that needle is going, but your goal is to cross fiber, the rectus abdominis, and angle it. So it is going to be affecting more of that poster aspect. Um, there’s a great video. That’s going to be in the motor entry-point protocol. This will be in module two part of the online recordings that we have thankfully have finished. We’re coming really close to getting them all aligned. Um, it’s been over a year endeavor and what an adventure that has been I’m sure Brian can agree to that. Um, so those are available on Lassa OMS, um, the research for the rectus abdominis motor, point’s the largest diameter of these intercostal nerves. That’s going into the rectus abdominis or the ones that’s going to be located in the lower half. So that means number three, and number four, that’s on this particular slide.

So you want to locate stomach 23, which we know is going to be too soon above stomach, 25 and needle towards stomach three from the spleen channel, right? So the rectus sheets you’ll be connecting the spleen with the stomach then. So the needle is going to be going from the spleen channel toward the stomach channel, going into the motor entry point for that particular muscular segment of the rectus abdominis. I believe that particular one is innervated by the T 10 intercostal nerve. I could be wrong. It could be T 11. Um, again, but those, the research was showing that’s more of the larger diameter, um, um, uh, nerves coming across into that motor entry point. The next one to choose here would be also just below stomach 27, which we know is going to be located to super low stomach 25. That was nice about this too, is you look at it’s pretty much at the same level as the lateral Rafa as well.

So with low back pain, many times practitioners are not needling into the abdominals. And boy, you can really great get really good results by combining treatment on the back and also treatment on the front. So if you’re not treating the abdomen with low back pain and maybe your results haven’t been as good as you want to please make sure that you are going ahead and needling into these, these points, you’ll see that it actually will help significantly. And just as a side note also, um, I’ve had many patients have actually had constipation and I’ve used this needle technique and it works really quite well, more for the excess type of constipation, not necessarily for the blood deficiency type of constipation, but it’ll change Paris dialysis pretty well. All right, Brian, I think we’ve got a myofascial release technique that you’re going to be showing that’s really a great for spreading here. So do you want to introduce that?

Sure. Uh, so Matt mentioned getting better results by including the abdominal layers, especially if you’re doing these assessments and you find that, you know, somebody reports a seven out of a scale of 10 on the palpation of the lateral Rafa on a pain scale, and you need all the rectus abdominis, uh, as a, um, assessment or the vastus lateralis. And you find that when you go back and pal plate that maybe it’s gone down to a four or a three, so that’s telling you that that’s a component, you know, part of their low back pain. Maybe it’s not the primary source, maybe it is, but a component of their low back pain has to do with that tension in the thoracolumbar fascia. So sure if that, if that assessment showing improvement and why not put those needles back again as part of the comprehensive treatment and, or, and I say, and or maybe the person doesn’t have enough, cheetah include that many more noodles, or for whatever reason, maybe you don’t do the needles that you can do the myofascial, or maybe you do the acupuncture and the myofascial.

But speaking to this tension in the abdomen and possibly on the lateral quadriceps is going to be important for these patients. So this is a technique on the rectus of the dominance and it’s working, you know, the rectus abdominis has the six-pack six-pack muscle, it’s actually an APAC, but each of those little packs are there because there’s a tendonous transcription that separates one of the four segments of the rectus abdominis. Um, you know, so that, that’s what creates the six pack, but actually there’s a, uh, pack on each rib cage that doesn’t show up when people have really developed at abdominals. So it’s a, technically, it’s an APAC, but we’re going to be working in those tendonous transcriptions to free tension in the fascia. And this would not be uncommon to refer to the back, especially in the 20, uh, stomach 25 region. But let’s go ahead and look at the video for that.

So we’ll be working now with the rectus abdominis, but specifically the tendonous inscriptions of the rectus abdominis. This would be really relevant for when there’s pain at the thoracolumbar fascia, or especially at the lateral Rafa because those abdominal layers wrap around and become part of the thoracolumbar fascia and can add tension into the lateral Rafa. So in your assessment with the thoracolumbar fascia test, if you find that it reduces palpatory pain by doing acupuncture assessment at the rec fem, these would be techniques you could do after the needling. So we’re going to start at stomach 25. I’m going to use my fingers, pads and my fingers to sort of find that tenderness inscription, I’m going to sink perpendicular. Usually I find that a little bit inferior, like I’m kind of dropping in perpendicular and a little bit inferior helps to hook into that tendonous tissue, that fascial tissue, you don’t have a bone to push again. So I can’t just go straight in and resist against the bone. So I need to find a way to hook into that tissue. And this is a good, that little kind of curving motion seems to get a good hook, a good investment on that tissue. And then I’m spreading my fingers apart. So you can’t see it much. It’s a small movement, but it’s just like you’re unzipping a zipper hook in and spread.

Sometimes patients actually will feel this refer towards the back or even into the lumbar region.

You can work up to the next one, well, into the tenderness inscription sink in and spread

You can notice that as we’re working here, she’s starting to be able to take a little bit deeper of a breath, cause it’s freeing that tissue that can clamp down and resist the breath. And we’ll be at the cost of margin. I can continue to do spreading apart, or I can go up or down. If the person has a very hold in, compressed lower rib cage, I might want to bring the tissue out if they don’t have good tone in the abdominal muscles and it’s over flared, I might want to move the tissue up or I could just bread. And either way, I’m working along that costal margin,

Mindful that I don’t want to go all the way to the xiphoid. I’m just going up towards the xiphoid

One last pass. I can be at the attachment and again, spreading at that rectus abdominis attachment where the fascia starts to meet the pec major

And then I can work at the final attachment site at the pubic bone. I want to start above the pubic bone. So there’s the pubic bone I started above so that my pressure can get deep to where the rectus abdominis dives deep today, a posterior border of the pubic bone tendon, a tender area. Is that okay? And I can do a slight minuscule across fiber, or I can try to lift the pubic bone and decompress. This is another region that might refer into the lumbar region.

Right. So you don’t need to do all of those areas. You might pick and choose one or two regions. Stomach 25 is often very frequently involved. Costa margin’s frequently involved. All of it’s going to free the breathing take tension off the thoracolumbar fascia. And you can consider this technique when there’s a stomach, send you channel relationship to pain, such as facet, joint problems,

Especially a great technique to be able to use after kneeling, because it also takes pain away or soreness away from the needles as well. Um, there’s a lot more great Mahvash release techniques that we’re showing. And that’s from the assessment and treatment of the channel, send you module two, available a loss of OMS, um, really great techniques to be able to use right after the needling that can reinforce what you’re trying to accomplish with the acupuncture.

All right. It’s a slow treatment. Yeah. Yeah. It just, it’s kind of a slow, you know, you don’t want to rush through those treatments at the same time I was talking and I was teaching. So it seems like it would take a long time, but you can actually get through those, those, uh, even if you do all passes, all four passes, you can do that pretty much quicker than I was doing it there, you know, there was teaching and discussion and where and what I was doing and all that. So it seemed like it would be a long, long time spent, but not, not so much in practice.

Hi, Brian, it’s always a pleasure to be able to hang out with you and to be able to share knowledge. Thank you very much. Thanks very much at the American Acupuncture Council. Also next we’ve got, uh, Lorne Brown is going to be coming in and discussing some great things. I’m sure Lorne has been in the field for a long, long time and a great pioneer in himself. So check out Lorne next week. Thanks again to the American Acupuncture Council. Thank you very much. You guys for attending and we’ll see you again. All right. Yep. Bye-bye.

 

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Segmental Acupuncture

 

 

Josh regularly, pursues high level trainings in cranial and visceral manipulation and has profound understanding of the interplay between the nervous system internal organs and musculoskeletal system.

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 is Poney Chiang from Toronto Canada. I teach continuing education courses from neuromeridian.net. Uh, welcome to this week’s live Facebook podcast show for the American Acupuncture Council. My guest for today is Josh Margolis. Joshua has been practicing manual medicine and bodywork since 1995 and acupuncture in Chinese herbal medicine since 2001 from 2005 to 2009. He was a faculty at the academy of Chinese culture and health sciences in Oakland. And yeah, I keep on change here to medicine in college in Berkeley, teaching anatomy, orthopedic acupuncture, advanced channel theory and pain management. Currently Joshua is on staff at the osteopathic college of Ontario and teaches in the doctoral program at several bay area acupuncture colleges. Additionally, he teaches segmental acupuncture and manual therapy of courses for acupuncturists throughout the United States. Josh regularly, pursues high level trainings in cranial and visceral manipulation and has profound understanding of the interplay between the nervous system internal organs and musculoskeletal system. In Joshua’s years of practice in the bay area, he has gained a diverse, loyal following comprise of professional musicians, dancers, yogis restauranteurs, athletes, and as well as children, the elderly and those with severe chronic illnesses, he has been practicing art from a Copia in Santa Rosa, California in 2011, as a pleasure for you to, for me to be able to have this chat with you today. Joshua welcome.

Thanks for having me here.

And, um, uh, are you joining us today from Santa Rosa right now?

Yeah, Santa Rosa, California. Yeah. It’s morning time here.

So I have been hearing really great, wonderful things about your courses. And I look forward to view a study with you in person, hopefully sooner rather than later. Um, so this is why I wanted to, um, use my spot for a guest today to steal all your secrets. I want to, I want to pick your brain and hear what is it that you do? What influences you like brings you? What makes you, you passionate about what you do? So let’s start by, um, telling us a little about, about yourself. I know I already give an in in-depth introduction, but you know, who, or what influenced you the most, would you say as far as, uh, practicing clinically speaking?

Well, I’ve always had my foot kind of into two worlds. Uh, I don’t that are not the domain. So, uh, and I used to feel like I put on two hats. Those are the two worlds being manual therapy and acupuncture, and I’ve always felt I had to kind of put two hats on and be like, okay, now it’s anatomy time and I’m going to do osteopathy. And now it’s acupuncture channel time and I’m going to do some kind of distill acupuncture, ear acupuncture. So, you know, I got pretty quick at, at, uh, switching my hats back and forth. Um, but of, you know, uh, thinking about how to integrate those things has been kind of an ongoing question for me. Uh, the, those two hats. So there’s been a couple key influences along the way. Um, Michael Kuchera who is, uh, an osteopath, I think he’s in, uh, Kirksville.

Uh, he wrote some great books on, uh, osteopathy for internal medicine, uh, disorders, and it really talks a lot about segmental organization and how you can, uh, exterminate you from external stimulus, uh, affect the internal processes. Um, and on a, another from the acupuncture side, uh, C Chan Gunn Chan Gunn, uh, really with the intramuscular stimulation and that concept of taking motor points and acupuncture or a trigger points and going back to the spine and treating the spine first and looking at that as maybe, uh, a more centrally mediated problem that, you know, partially maintained at the spinal cord level. Um, those two were really big in, uh, kind of my early, early career, uh, and continuing on. Um, there’s so many, there’s so many and Carol Levitt, uh, from the Czech Republic was a physician who really turned me on to, uh, functional, uh, musculoskeletal assessment and looking more beyond, you know, beyond what is sort of broken, but more how, how does movement happen and how can we coordinate movement?

And that has really influenced my acupuncture, uh, as well as manual work. And then, you know, researchers like you pony, to be honest, because, uh, you know, you’re taking that, looking at, uh, acupuncture, meridians and points through two lenses and, and really doing the research and the background work, um, and that, you know, that, that sort of legacy from Joseph Long and, and the others from the sort of Toronto medical acupuncture to unity, um, have been, uh, uh, a real influence to me. I was lucky enough to study with a medical acupuncturist, uh, early in my, in my career in that. So I’ve always been, uh, most of my professional life and very interested in that interplay and understanding, uh, kind of how, how things work, not just what works for what, right. I’m sure

For you, it’s the same as it is for me. The, the excitement is being able to find the similarities and find the anatomy and it, and it used to have medicine actually independently validate each other. There you find, uh, you know, oh, this is that same thing in the nature thing. And I say exactly about this anatomy, and then it just, uh, you know, you can have, I’m sure we can have a lot of decals and about all these, like, oh, how did these ancient people know like this anatomy, you know, um, so Russo, I’m glad that we, uh, like-minded because I know, um, you bring kind of the best of both worlds and that’s what I like to do also. Um, so tell me about, um, segmental acupuncture. Uh, I see that you’ve been teaching quite a bit of workshop about them. I know that’s probably a very in depth topic. Could you just, you know, give us with the coleslaw version of, uh, give us a sense of what is segmental acupuncture? How is it different from, um, you know, like, uh, a, a TCM approach, for example?

Yeah, that’s a great question. Um, I mean, the key thing is to understand that our tissues remember where they came from. So during embryologic development, you know, our, our tissues, uh, migrate off of, uh, you know, essentially a segmented worm type of, uh, uh, you know, our embryo is kind of a segmented worm and our tissues literally travel off that in different segments, but when they travel, they drag their nerve supply along with, um, so during that, during development and then on into, you know, birth and adult life, those connections stay, uh, PTEN the, you know, the segmental, the body doesn’t forget its segmental organization. Even if those tissues might’ve migrated quite far away from the original segment. And, you know, you have the, you know, the germ layers, dermatome, myotome, and sclera tome. And so now people are talking about the viscera Tom or the Interra tome for the internal organs, but essentially you have the skin, the muscles and the bone sensation.

Um, those, those might not overlap perfectly, you know, the muscles move in a different way than the dermatome moves and works in a little different way than the sclera tone. So, uh, we can access all these different layers and these different laborers can have their own ridiculously related pain too. You can have that sclerotomal pain, you know, with, uh, with, uh, someone who has a nerve, uh, nerve root injury that might be like this deep aching, hard to pinpoint just sort of pervasive pain, or you can have that more superficial dermatome pain burning, uh, you know, sharp, oh, kind of electric type sensation. So, you know, understanding that kind of, I find it’s very, very helpful. Um, another thing, uh, to, to understand key points regarding that, um, concept that the nerves have been dragged along is that, um, everything in, uh, in a segment influences everything else in a segment for good or for ill.

So that means that, uh, if you injure something in a segment, then it facilitates, it lowers the threshold for irritation, for other structures that share that same, uh, Embry logic, uh, source that seems segmental source. Um, so that, that’s a really key concept to understand, and that can help us develop, uh, distal type treatments are not always distillable. You might be treating appendicular really for, uh, for a trunk problem, or you might be treating actively for, uh, a peripheral problem, but, uh, that, uh, that those relationships has really stayed at stay active. And you can, you can, neuromodulate quite strongly, uh, using these inputs. So for example, like I, I’m very into, uh, periosteal pecking, uh, that’s real popular in the, in the, uh, British medical acupuncture world, uh, Felix man, and, uh, um, Cummings, uh, I think, uh, they, you know, that that approach is incredibly effective for modulating.

The whole segment. You can have a person who has, you know, a terrible rotator cuff injury, and then you heck the periosteum along the greater CA uh, treater tubercles or the humerus. Uh, and then, uh, you can change how the entire myotome behaves, uh, quite quickly, uh, very, very effective, very, very interesting. So, you know, the key being the non, uh, nociceptive inputs, uh, into the, into the segment, uh, will, uh, beneficially affect all the other structures. And, and also, you know, consequently, if there’s an injury that will negatively affect all the other structures that share that same sick mental intervention. So, you know, things like an injury to the sake of spring to the SSI joint, for example, could, can mimic sciatica, you know, [inaudible], uh, dermatome. So, you know, they might have a sclerotomal injury of the ligaments and the, and the, uh, periosteum and, uh, bone, but dogs are gonna feel the sensation, maybe along the S one S two dermatome, uh, you know, their heart disease coming down, the T1 T2 dermatomes, that’s more of a autonomic related segmental, uh, phenomenon or liver disease can show up sometimes in the C3 four, cause the capsule of the liver is innervated by the phrenic nerve.

So you can get liver disease. People can feel that right sided, neck and shoulder pain. These are just some very classical examples, but are relevant to, to assessment, uh, and understanding, uh, potential origins of things. Um, you know, I’m, I’m not going to go too long on this, but another concept that’s pretty awful here that overlays is the osteopathic consent concept of the facilitated segment, um, where, uh, through prolonged irritation or, uh, enough of an initial insult that the segment will itself will just become irritated and stay in an irritated state. And that, what that means is that the threshold for irritation for, to, to cause, uh, tissues to respond is becomes lower. Um, the, uh, reaction may be higher and, uh, you know, to the extent that even a non what should be a non painful stimulus might, might, uh, read as painful in, uh, to, to the body.

So these are all, uh, you know, assessable, uh, for us as, as acupuncturists doing physical medicine, doing physical assessments, we can see signs of all of this. So, you know, there’s something we call it, the red sign and osteopathy where you drag your fingers. Uh, so vigorously along the pair of spinal tissues, kind of along the Quato druggie points, um, you know, 2, 3, 4 times. And you’ll see at a segment that is, uh, more facilitated, more, uh, active, uh, irritated that you’ll have, uh, extended red response. Uh, you’ll see, pin will stay red, uh, you’ll find pseudo motor activity, uh, muscle shortening tenderness, uh, and perhaps, uh, Teebo like motion dysfunctions, uh, at these segments. And these are mostly autonomic signs and they’re probably autonomically. Uh, they seem to be autonomically mediated. So, uh, a lot of what we can do is then look back at a chart for, you know, sympathetic, uh, innervation in particular.

And, uh, you can learn a lot about what’s going on. Uh, there’s been some research that really shows that these pair of spinal signs show up before internal medicine, uh, disorders are, uh, measurable often that, you know, as the Oregon is inflamed and irritated, it’s sending back, uh, signals that it’s in trouble. And then that facilitates the segment. So, you know, we have, uh, so Maddow visceral and this row of somatic reflexes in the body, as well as some ADOT some ADOT and, uh, this were visceral reflexes, but from the acupuncture standpoint, a lot of what’s interesting are the interface between the Soma, our musculoskeletal system, our muscles joints, uh, cutaneous nerves, and internal body. And we’re starting to be able to map this, uh, pretty, pretty well. There’s been a, uh, osteopaths really researching this, uh, trying to validate, um, osteopathic, uh, uh, therapy theory and, um, uh, you know, things that people are noticing clinically, right?

We’ve been collecting clinical data for, you know, clinicians on our patients for a long time, but to start to understand that a little more with the science behind that. So they’ve been looking at that for, you know, 120 years now or something like that, but we can see these things in Chinese medicine, like the moon shoe points are very closely related to segmental innervation. Some of them are pretty precise and some of them are a little off like the small intestine and bladder points are more probably affecting the parasympathetics to the, to those organs rather than the FedEx small intestine much, but certainly the bladder and the uterus and so on using them like Bali out on the lower, the lower shoe points, the mood points are pretty, pretty, pretty well, uh, line up, uh, with very few exceptions, uh, segmentally, um, you know, things like spleen six, we can understand a little bit more about what we’re doing, and then there’s all these, you know, various techniques that have come out of, uh, mostly Western medical acupuncture, um, that are, are very helpful for us in the clinic. So that’s, uh, maybe a longer answer than you were looking for, but

No, that’s good. It’s important to lay the foundations. Right. Um, so the, the, the facilitation that you described does a work both as a lot of this, I be so sematic. Um, so that there’s some, if you have a chronic elbow issue that can lead to its corresponding segmental, glandular, or organ dysfunction, or like, you know, somebody who has a chronic organ issue when being more predisposed to certain types of joint or muscular movement disorders, um, that does that theory apply in both directions.

Yeah. That’s a great question. And yes, it does. Um, any, any irritant, you know, of enough, either severity like intensity or time will eventually have the potential to, uh, facilitate a segment. So when you go somato visceral, um, usually that’s, uh, like say you have like an upper back restriction, which could affect your, uh, cardiac function. There was like some cardiac chiropractors did a study and I’m sorry, I cannot find the study anymore. But I remember reading this study where they showed that there was a correlation between forward head posture and cardiac disease, for example, so tension in those upper, you know, 3, 4, 5, 6 thoracic vertebra and lack of movement, lack of nourishment seemed to affect cardiac function, have a interrelationship to cardiac. Um, and you can see it the other way. So, you know, someone has, uh, like heart disease. They’re going to potentially have more medial elbow pain because you’ve got that T1 T2 dermatome.

There’s going to be a, uh, there’ll be more easy. It’ll take less to injure that area. It won’t necessarily become like allogenic, except for in a more like severe case where you may have ongoing, uh, pain, like in head zones, for example, uh, and whatnot. But yeah, it’s, that’s important that concept that, uh, the somatic visceral, visceral sematic, it goes both ways. The work of, uh, uh, Akio Sato or Saito I, Japanese researcher, he wrote a great paper, like in 1997, that summarized kind of all that, all that stuff. Uh, and then, um, Myron Beale and Louisa burns are osteopathic researchers. Who’ve done a lot of work on the, on, on that, the sort of somatic and some out of visceral reflexes. There was a lot of literature on it actually. Um, but the Seto work is particular. It’s interesting because he was particularly looking at like, what happens if he massages little parts of like a rat and then looking at their autonomic nervous system and what was happening in like gastric motility, uh, bladder and those kinds of things. He, he did a lot of study on that. Him and his group did a lot of studies on that kind of thing. And I did the paper from 97 is sort of his retirement paper that covers all of his other videos. So the basic idea from the one,

Yeah. Uh, I wanna, I want to touch on what you talked about with the frame that phrenic nerve and its relationship to the capsule around the liver. Um, just as a reminder for everybody, because when I found out about that, that I was like, it was like a mind blowing emoji, like, uh, I, uh, when I thought about that, like, you know, the phrenic nerve innervates, the diaphragm, the diaphragm is in the TCM hypochondriacal region. And we also associate that liver she’s technician, right? So there’s a connection to the diaphragm and the FedEx nerve and the signs and symptoms there, but she’s stagnation. And now you have like actual anatomical basis to explain that the friend in there for some reason, get sensory information from the capsule and deliver. So the state of the tension, you know, Chinese person talks about like softening deliberate as a course of treatment.

The state of the tension of the liver through this capsule somehow is information that the phrenic nerve needs. And presumably that sensory input has there creates a reflexive, um, motor output to control the contraction of the, of the diaphragm. So it’s really, really beautiful that like, there is a connection between the liver and liver moving the cheese, you know, the, the, the, uh, the extradition we have in Chinese medicine. Yeah. So I, I, and now that’s related to like, you know, cervical radicular, apathy issues at the, you know, the upper cervical area and it’s associated with dermatomes and upper back. Um, it’s, uh, it’s just, you know, so exciting. Um, do you notice patterns like that? You know, like you can run a TCM and the patients, all of us all have like neck problems or something.

Yeah. Oh, certainly. I mean, certainly more like classical kind of distal acupuncture type techniques. You see all kinds of things that are sort of beyond the segmental thing and the, you know, like how did they figure out these interrelationships, like, you know, liver three improves blood flow at the brachial plexus. So yes, it works for neck problems. Right. But, you know, that’s a super segmental thing. Yeah. And the, and, you know, and you see the overlap with, as you mentioned with the liver, right. The C3 four, you know, you’ve got the super cool vicular nerves, you know, that’s a segmental relationship. So, you know, if the diaphragm or, uh, the liver at C3 four gets irritated, then there’s a potential to send hypersensitized C3 and four, which is, uh, you know, this whole, this whole region. So that kind of dive from attic or that, uh, trapezius pain that everybody sees often as related to, uh, some kind of liver congestion.

Okay. Interesting. So it’s all coming together. [inaudible] everyone has the richest, the nation, everybody has tight trapezius muscles. Right. So it can not be, um, I want you to discuss about German layers and, uh, do you use that, um, embryological concept and the way you select points or the way you assess a problem? How does that, how, how does that apply clinically?

Yeah, so, you know, the germ germ layers, dermatome, myotome, and sclerotomal, uh, just briefly those, those are the layers of, um, Misa term, he’s a normal development. So that’s what goes to make the dermatome goes to make the dermis. So the under deeper layers of the skin, uh, the myotome goes on to make the muscles that, and the sclerotomal goes on to make the, um, the, basically the spot, the spinal column and the ribs. Um, they, we do use the term sclerotomal a little more broadly in the adult, we know, refers to ligaments and bones, uh, and their innervation, but, uh, it’s so it’s used a little differently. The other two terms stayed pretty, pretty, uh, pretty, uh, uh, consistent. Um, but anyway, you know, one, one thing about using those different layers as these tissues migrate, you know, remember what I said earlier that the segment, uh, is continues to be interrelated and because tissues migrate it kind of different rates and different amounts, you may find that the dermatome and less Clariton don’t line up.

So someone may like have a broken phone, but you may be able to access the dermatome, uh, somewhere along the way. Um, or you may be able to access the myotome. You know, there’s a Hilton’s law, right? The, the, uh, that the, uh, basically muscles crossing a joint, uh, share fibers with the joint itself and with the, you know, overlying skin. So, uh, you can, you can access at any level to affect all the other levels. So, you know, that’s, that can be a really effective now, you know, thinking again, as general set mentally, you can go back to treat axially or peripherally for a problem. So if someone has a, I talked about shoulder problems earlier, right? So most shoulder, most of the shoulder, the glenohumeral joint is C5 C6, right? That covers pretty much the majority of the medial C4 on the, um, superficial bits and the skin.

But you could go back, uh, if someone had like a shoulder replacement surgery or frozen shoulder or whatnot, you could go back and look at the, uh, you could go back and look at like, see four or five and six at the neck, and you could treat the, uh, something I find is helpful is doing like a periosteal pecking on like C5, C6, uh, at the articular pillar can really neuromodulate the whole, that whole shoulder quite effectively. Uh, you could do that if you don’t do pecking and don’t have training in that are not interested in, you know, a stronger stimulation like that. You might just needle them all Tiffany in the neck, you know, do some deep repair of spinal noodling. Uh, you can run electrical stem, all those things are really effective for effecting, uh, sort of axial to peripheral. Um, you know, and then that goes both ways.

So if someone’s having C5, C6, right, C6 is kind of the, um, crisis point, uh, for the, uh, neck, right. Most mobile vertebra. And then it’s connected to C five or C seven, which already, which is one of the least mobile cervical vertebra. Um, and then T1, which of course has the ribs. So it’s more fixated. So there’s a sort of maximum movement, minimal movement right next to each other. And those time zones kinda ended up having problems. So you can, you could modulate C5 C6 on the, uh, C5. It like the greater tubercle of the humerus and C6 is more of the upper condoms or, uh, some parts of the posterior shaft of the humerus if you wanted to pack, but you could also look, okay, you can say C6, right, C6, you make a six, I don’t know if that’s coming out as a six, but, you know, in the old, uh, you could treat that dermatome only, you know, with like large intestine four or, you know, other other points that are related.

Um, so, you know, the germ layers, uh, I think are helpful, mark, conceptually, I haven’t found a way to go, like, you know, this is this and that, you know, like myotome is better for this, or dermatome is better for this, or sclerotomal, except for that, I would say sclerotomal stimulation is more effective for that really stubborn pain yeah. Pain that just won’t budge. And because there’s a lot of sympathetic innervation, uh, at the periosteum, uh, that kind of stimulation is really helpful if there’s like, uh, a, uh, some sort of autonomic piece and, you know, innovation is incredibly important. Um, and, uh, for everything including trigger points, right? You can feel a trigger point in if you know how you don’t even have to press the muscle. Cause there’s a pseudo-motor effect. There’s often a temperature difference. So, you know, every, almost every pain condition is going to have some change in the autonomics. And so if you, if you know how to look for that, that’s, that’s kind of a key to the assessment related to that, because your rotation at like a sclerotomal level, like a sprained ankle or a chronically sprained ankle is going to affect that whole segment. So you’re able to treat that, maybe that question.

Yeah. Um, just for our listeners, um, when Josh is talking about to a motor, you were talking about like, uh, the sweating, um, regulation of, uh, autonomic nervous system, right? Yeah. Yeah. So you’re able to is training, uh, palpate the, the, um, uh, the poor to the skin, um, in the vicinity of the trigger point and be able to diagnose, diagnose, uh, financial and point, even without having to push down to get that Asha tender feeling, just fine, touch alone, you’re going to start noticing some changes. Um, so this is, yeah, this is, this is really a very interesting, I, I, um, I, you know, everybody dermatomes in the mountains very well known third toast, you know, that started as the least well researched, but as, um, kind of the secret weapon in a way to be able to have that understanding, I would love to be able to combine those layers together and be able to treat, um, you know, cry problems from a different perspective.

That’s really, really interesting that you’ve had a lot of experience kind of seeing when to use which layer for which type of problem. Um, I also found it very interesting that like ligaments and, um, and, uh, and the attendants are, uh, part surely from the scotoma as well, because in Chinese medicine, they always talk about gene group, seniors and bone together as a binary. They don’t really separate those terms, um, you know, differently. So it’s interesting that those they share same, um, type of term, uh, German, um, innovations. Um, that’s finished up with the clinical Pearl. Um, uh, I heard that you have a lot of success in you. Um, I guess I’m very consistent results really inside a car. Is it possible for us to give, you know, give our viewers and listeners advice so that we can become more proficient in treating, um, such a debilitating problem as Sika?

Yeah, sure. Um, for a really acute sciatica, um, if there’s too much, uh, like muscle for boarding and spasm in the back or piriformis, uh, whether it’s, uh, radicular or a piriformis syndrome, these same approaches will, will be effective. Um, I often will use, uh, just the Bajan points, um, that, that when you get, uh, for really acute problems along the, and this is nothing new for Chinese medicine fans, um, really acute problems, the further away you are from the actual site often is more effective and like stimulating the cutaneous nerves, they’re the gene Wells or the, or the, the, uh, yang spraying points tends to be more effective for that really very hot acute pain. Um, I find you get a more complete, uh, regulation of the whole system. So I often will just for the first couple of visits at someone’s, you know, the people will get like brought in by their family member or, you know, couldn’t drive themselves to the clinic.

Um, those people I tend to use like often, uh, maybe kidney seven, especially if I can get a tibial nerve, you know, like, uh, if I can get a sensation down to the heel or to the toes when I, when I manually regulate it, those are usually my line of first, uh, first input, you know, maybe, uh, uh, like lingo.by something up there up higher, just to, you know, because sick mentally, uh, in terms of like gate control theory, if, if you, if you stimulate something at a higher level than the problem that does have an additive effect, it’s not as good as like treating the right segment, but, you know, your even 5% more is a lot for someone who can’t move, you know, so, so I do add some points that are higher up, um, but then for more chronic or, uh, pain, or if the muscle boarding’s not too severe, I often use, uh, Craig pins, which is, uh, is a, um, medical acupuncture technique where basically you needling along the bladder or the Pato judgy line make a central module encompassing the segments that are involved.

Uh, you can go higher, make it more like a profusion, include the autonomic levels, but you just do the sensory motor level. So say Attica is primarily S one S two. So you really need to focus on the sacrum. You might go up as high as T 12 a to L two, to cover those autonomics, but then we’re going to add, uh, local points as appropriate. So glute, max and piriformis, both of them, you know, primarily, uh, you’re getting like L five S one S two, uh, glute max. I think you get a little lower as well, but the, um, those are totally related to the Syns towed to dermatome problem that the person’s feeling pain they’re having. And then you can then add, uh, points like laying ho or, uh, which is like a posterior gallbladder 34 it’s sometimes called and, uh, and a bladder 40 to get the peroneal nerves and the, the, uh, tibial nerves as well.

So, you know, I, you don’t, you can be very flexible in terms of how you, how you do this, but each module goes at kind of a higher frequency usually. So, you know, it might be one to two Hertz, centrally, uh, two to four Hertz in the gluteus Maximus piriformis, and maybe, uh, like four to 15 or even higher, if you’re doing, um, sensory nerves, uh, down the leg way, sometimes bladder 60, or kidney three, you can, uh, kidney or kidney six, you can get more of the sensory fibers down there, uh, with a higher frequency, maybe as high as a hundred Hertz. Um, but I find that this works well.

I’m going to ask a question for the benefit of the listeners, because I know they’re going to want the specifics. So for the platform that you mentioned for the two sag example, um, would you be doing electrical stimulation there too? And what if so our frequency?

Yeah, the phone, if I tend to use, um, I tend to use a higher frequency. I can use like a hundred, sometimes 200 times even 500. Um, I, I do it either two ways, depending on kind of either position of the patient or their own squeamishness either. We’ll put it on like a high-frequency with like one to two Hertz. So it just goes back and forth so that they get,

Uh, connecting electricity between the web spaces. Is that how you’re doing it, um, for web spaces? So you’d be connecting needles together, or,

Yeah. So what I do is I take, I’m trying to get the camera oriented, uh, it’s backwards area area. So, you know, what I do is I get into all the web spaces and then I tend the needle. So I take all four [inaudible] and I put one clip on there. If I’m using, if I’m using the ITO, I might do that at, um, I might do that at like, with the black one, because the black leads a little stronger, stronger uneven, uh, stem, so that, because I’m in more sites, I might need a little stronger stimulation. And then I usually wire it up to like kidney kidneys, seven ish, but kidney seven is where I personally seem to get the tibial nerve, most distal, tibial, nerve, most reliable I’ll hook those like, like that. And I would generally use a high, um, if the, if the patient is able to crank it up themselves, get seven, there’s still a fair amount of motor.

So if I’m doing that, you know, you don’t want to at a high, at a hundred Hertz, they’re just like not comfortable. So if I’m doing sensory only, I might clip it like two buff on one param and just get one, you know, to the medial, to, and the lateral to do at a high, high frequency, or I’ll clip it at a lower frequency. And I include kidney seven as part of it. Um, and have that, even if they have a slight motor contraction, and then if I’m doing high, I give them the box and let them turn it up. And if I sometimes I’ll do a, my, I use pantheons mostly. And so they have the option to run like an alternating, like one to two Hertz or, and then like a hundred Hertz. So it goes back and forth. So they don’t accommodate to the, um, they don’t accommodate to the stimulation.

Um, again, just a little more detail because otherwise where they’re going to ask the questions. So you are doing the baffle on the effect of the size, same side as the sciatica, right? Or are you doing both sides? Counter lateral?

I often will do both sides. I mean, I immediately, you know, it’s enough to do the one side, but you get some Asian, you know, if you’re having more, any less to the segment, then that’s better for the you’re going to get a better outcome. So that’s where a lot of them like treating the left to do for the right and on up to the down, all that sort of Neijing, uh, links, shoe talk, uh, comes from, you know, really.

And the last question to summarize the protocol. How long do you use the electrical steam that you mentioned? High-frequency so in the order of a hundred Hertz, but how long do you do it for,

I do it for really hot static. I like to do a full 20 minutes. I really, I want to, I want to overwhelm that segment with non nociceptive input. I mean, to the extent that they can stand it. So if they’re able to turn it up themselves, that tends to actually work better because it could be accommodation and then they keep raising it and accommodation, and then I might run to hurt somewhere else in the body, one to two Hertz just to help with the beta endorphin release, but you know, like a large intestine for stomach 36, something, someone somewhere else, uh, you know, stomach 36 is great. It’s part of the peroneal nerve part of L L five. So that’s gonna relate to the sciatic symptoms. So, you know, you can, you can use your logic, whether TTM or from like a neuroanatomical standpoint.

That’s amazing. I can’t wait to try it tomorrow. And, um, so, um, unfortunately all the time we have her today, um, if we would like to step study more with you, is there, are there any resources or any contact that you have, um, for our listeners to the viewers?

Yeah. Um, on the east coast, uh, I’m working with the, uh, Dow collective and that’s a D a o-collective.com. That’s with, uh, Doty, uh, Chiang and pony and teach with them as well. So that’s exciting. Um, and, uh, the other place to find me is on Facebook. That’s where I keep most of my classes updated and that’s, um, uh, facebook.com/omt Lac. So that’s oh, as, and then, and then this is Mary T as in Tom, then Lac licensed acupuncturist, uh, OMT is osteopathic pathic manual therapy. So that’s my thing. And then the other way is to, you know, reach out to, yeah, I’m pretty fine to on the web and I can put you on my mailing list.

Yeah. Awesome. Thank you very much for sharing your experience and wisdom with us. Unfortunately, that’s all the time we have today. I’d like to thank all the, uh, other viewers and listeners for joining us, and don’t forget to join us next week. Uh, our guest for our hosts for next week is Matt Callison and Bri.an Lau. And, um, thank you once again and have a wonderful rest of the day.

 

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Supporting immunity with TCM – Yair Maimon

 

 

Today I will lecture about immunity or different aspects of immunity as you know, immunity or immune system is actually a Western term. So we need to do a lot of translational medicine to understand it from the Chinese medicine perspective.

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 everybody. This is Dr. Yair Maimon from yairmaimon.com. Uh, first of all, I would like to thank the American Acupuncture Council, put up this, uh, show in lecture. And, um, today I will lecture about immunity or different aspects of immunity as you know, immunity or immune system is actually a Western term. So we need to do a lot of translational medicine to understand it from the Chinese medicine perspective. It’s one of the most complex system in the body, and it encompasses, um, the root of many diseases we know from what immune to other. And obviously now during the pandemic, we know that the immune system plays a big part, both in, in protecting, but also a big part in the side effects of the COVID in recovery. Uh, so we’ll touch on few aspects of immunity and, um, later I’ll give kind of a small overview of the translation from Chinese medicine to Western medicine and immunity. So let’s start with some slides, please.

Okay. As the slides are coming up, um, uh, I would like to mention that it’s more, I’ll talk in this lecture about like few layers of immunity. One of them is to do with compromised immunity, like in cancer patients. And then the other one will, uh, I would like to discuss more the type of immune and immune response when the immune system is weak from both from how can we treat it from a horrible perspective and how can we treat it from acupuncture? I was very lucky to, um, do also research herbal research, uh, which proved the effect of acupuncture on immunity and especially on deep immunity or innate immunity, which is our, uh, um, the type of immunity that protects us also from viruses and protects us from, uh, all the different aspects of, uh, not acquire the immunity, which is the learning part of immunity.

So, as I say here, I’ll start with this general idea and move. And, um, also in the classics already, um, in so-and chapter 72, they mentioned if sanctuary and sanctuary is a kind of concept of all the upright chain, the body. So if Zen chief, the chief of the body remains strong shakuhachi, which is a general term for invasion of pathogens to the body cannot invade the body. Then she must be weak when invasion of Shechem take place. So already 2000 years ago, they were very aware that there is, let’s say constant war or a constant struggle between two aspects. And it’s important to understand that because when we treat, we are looking at this struggle on one hand, we want to strengthen immunity. On the other hand, if there is a pathogens we want to weaken the pathogen and there’s different ways to talk about immunity in Chinese medicine, and one of them, which I would like to start with, and I’ll try to evolve as, as we go on is to look at three different aspects of immunity Cenci and Shen is an important part of immunity Shen is our connection to self.

And let’s say even our emotional life and spiritual life. So when one is balanced, the immune system is better when one is not balanced emotionally or in the Xena life, then the immune system will go low, we’ll go low and weak. And we have a lot of examples for this, for myriad part of disease, uh, that can come up when the emotion and the spiritual part of the person are disconnected. Then we have the way cheese, white cheese, the very common way to discuss immunity in Chinese medicine. But it’s very superficial. It’s the kind of immediate fight from external threats. And then we have the gene chain, which is like the deepest part of immunity. And really immunity comes from the steepest part of gene chia or interaction all the time of our constitution and our gene with, with life. So, and, and when we go, we have look at the immunity also from a different perspective and I’m proposing different way of how we translate here.

Again, I’m taking this model that we discussed before and enlarging it. So if we look at way cheaper in Chinese medicine, we’ll look at the lung, we’ll look at the way pathogens are invading. The lung is the upper inner organ. Yeah, that is all the time connected with the external. So external pathogens will enter the lung the same as we have now with COVID. And then we can treat the, uh, external pathogens with different, um, method. By the way, also, by treating with 10 Damascus, meridians was divergent Meridian. A lot of the complications of COVID can be explained by the Virgin Meridian. Uh, and then we have [inaudible] and it’s more related to the kidney and it deals with more with internal pathogen. And then sometimes we need to resolve and look at extra meridians, and then we have [inaudible], which causes more collects to the heart and it relates to traumas.

And then we have different special points that can help the person to unlock trauma and deals better with trauma in Western medicine, we also differentiate between adaptive and innate immunity. Most of the lecture now will be on this innate immunity and also most of the, our herbal research. So we are kind of focusing on this aspect. When we look at the class practical example of a weakening of gene as a result, there is a weakened immune system, and you can see in one sentence, I’m talking Western medicine and Chinese medicine, Jenkins, Chinese medicine chemotherapy, which has given to cancer patient for example, is Western medicine. So that’s a classic example of chemotherapy will weaken immune system. And we can explain it from a Chinese point of view. So, um, you feel looking at this, the side effects, for example of chemotherapy, we’re looking at weakening of bone marrow and which causes reduce white and red blood cells.

That’s why I said medicine, Chinese medicine is weak Miro. We have general compromise the immunity and we have lots of hair and no Chili’s medicine Herod belongs to the kidney and to the gene, we have reduced in cognitive and memory functioning, more related to the gene, uh, reduced fertility, eh, aging people will age sometimes very fast when they’re exposed to chemotherapy and deep fatigue. So all this stuff I kind of explained in Chinese medicine, the weakening, this very deep substance, which is called gene. And that means also that when we applied therapy, we’ll use points or herbs to treat the, uh, this aspect of gene. I’ll give a simple example. Well, Herb’s like, uh, the best example is maybe to look at Wrenchen again, very special gene saying very special, a herb, which tonifies the gene and the UNG. So we have the normal [inaudible] that works mainly on the cheese.

We have the prepared, the red, eh, hungry tension. So it most tonifies the young, if there is more young and coldness, we have Xi and Chen, which is like the American ginseng. Um, tonifies the UN and also the superior engine St. Which is not exactly gene thing. See what ya, that actually strengthening the, not just the immune system, but also its ability to cope in stress and difficult times. So all of this herbs are very adaptogenic and this is actually the key strengths for herbal medicine in immunity. It helps to balance the immunity. If it’s overactive, it reduces it. If it’s underactive it, tonifies it. And this is the strength of, uh, looking at Chinese medicine. We hardly ever use single herbs in Chinese medicine. So we use formulas and the classic formula for immunities, you being [inaudible], um, Jane screen made of three herbs, one, she buys you think thing.

It’s amazing classical formula for general general tonifying of immunity. And obviously with the inspiration of this [inaudible] formula, we, we change it. I changed it to one formula, uh, which I’ve researched for many years in Altria, which is the result of research of just one research of almost five years when we tested this formula on different individual, both healthy and eh, cancer patients and immunities suppressed patient. So this is the LCS, eh, one or two in our research on tonics are called now. And then I did another research on the formula, which are let’s discuss here, which also affects immunity, they’ll say is 1 0 1 or protectable. So this formulas have been studied deeply. This is one of our, uh, um, published research on the effect of the botanical compounds, the LCS one-to-one and innate immunity. And I specifically mentioned the native immunity because this is the part of the immune system that both responds immediately to threads like viruses, but also has a very strong component of, uh, checking the body all the way, surveilling the body and killing cancer cells.

So this is the importance of this research. If you see, one of the conclusions was this, this research, uh, works, um, on the net immunity, but we also tested it with different types of chemotherapy and others just to see also that there is no drug in herb interaction. And that’s one of the key components of my work. And I had a very extensive, a biological lab where we can test things on different levels, not just test them on the, uh, immune system, but also see interactions with different drugs and see how different patients they’re responding to it. So this is how we ran the research. We take usually blood, uh, from, uh, patients and, uh, but also from, uh, volunteers, we isolate if you see in blue, the neutral fields from their blood. So we isolate the active, one of the active components of innate immunity.

And then in the next Quare, you can see that we are examining the neutrophil activity. So what we’re actually doing is looking at activity. When you have a normal blood tests, you just have quantity. How many you have, we are looking at how active it is after we are adding the LCS. Uh, one or two, the tonics are to the protectable, to the, uh, cells. So this is a example of, um, uh, in like four patients you can see in blue is their bladder that control Blab. And when we are adding the formula, it’s sometimes active three or four times more, both in healthy patients and in sick patients. So you can see the, how the neutrophil activity has been elevated in Chinese medicine. We also see tonifies cheese. So people are less tired, which is the classical effect of chemotherapy. So like you produce study, but I also think this formula just to sometimes when I’m fatigued I to, to tonify because it tonifies deeply, uh, the chair of the body and not a thing that we are checking, not just the neutrophil activity, but also the activity of natural killer cells.

This is the subtype of the, uh, white blood cells. And this actually are the cells that are both, uh, very active in killing viruses, but also killing cancer cells. So having a strong natural killer cell activity is something which is important to maintain health in all the levels. So here also, you see the difference between the control, uh, the component of the formula are quite interesting. There is three, um, mushrooms. It takes quite a lot of time to make the formula, to establish it, to concentrate. It, it’s always a process of testing it and testing on in, in the lab testing in different ways. And if you look at the three mushrooms put together, they also, uh, have a significant effect on immunity. In other studies, they improve the ability to cope with tress. They activate, um, and their, their active ingredient also being found and being isolated.

So on some of the mushrooms, we can really follow the active ingredient. And a lot of time is the polysaccharide like a big sugar component, which are very good in activating immunity and also balancing immunity, the other herd like a stragglers attracted. And lygus true. Also demonstrate a lot of immunomodulation function and they’re good for fatigue for mental function and stabilizing blood sugar level and even enhancing liver and kidney function. So if formula overhaul is, we know has allistic effect not much wider than just on the immunity, and this is the beauty of it. So when we are designing formula, we are looking at something that works on three different levels of immunity or Nietzsche, which is it’s actually designed Fuji that protects the Sandpoint. And [inaudible], so we’re looking at this different Herb’s and their component and how they work, not just on allowing the body to fight better with external pathogens, but also keep a better immunity inside.

And, um, I would like to know we’ll demonstrate it in a case so you can see how it is applied. A practically, as I say, I see a lot of patients in different stages and, um, this is, uh, a cancer patient. I am patient of mine. She’s 62 she’s after a lung cancer, that the main part of a treatment was removal of her left lung. She didn’t have any further treatment, just the removal of the lung, where the tumor, uh, was found. And she came immediately after the operation. So she was extremely lacking of energy. You can even see a she’s extremely vivid person. I knew her also, I used to see her in the past before she had the lung cancer. So series very active, but suddenly she was white. As we know what happened when you have achieved the efficiency. If you look in their eyes and I put the eyes, she was very depressed and detached and very sad, deeply sad.

I mean, her husband brought her in and, and really like, bang me know, do something for her. She, she really like, you know, she came before the operation. She was herself enough to shoot that. Like she lost it. You know, he feels like she’s, he’s losing her. I’ll not just on a physically, but mostly on this emotional product. So the points that I did was a combination of stomach 36 and large intestine, 10 to lead points since suddenly on the Lange and the lead point on the hand, which you combine it together as strongly tonifying the, and the chief, but again, on a deeper level, because they’re on the young meat and kidney nine, which will, tonify more the gene part of, uh, the, um, the immunity, especially working on the, on the sheet cliff points and the way my suite works deeply on terrifying immunity.

And on the back, this is one of the key points, bladder 42, the poo hall, the door of DePaul, uh, which will both work on her, Shen on the sadness. It’s quite amazing point it’s on the level of bladder, a 13.4, the lung, because it has few function. One, it treats severe immunity of the lung. It works on DePaul, the spiritual or deeper aspect of the land that is when you’re detached from it, there is deep sadness, but it also helps to reduce heat from the lungs. So it’s one of the key points to treat patients with COVID because it will achieve this dual thing that we want. In one hand, it will come this heat in the lung, which is part of the cytokine storm or excessive inflammatory reaction of immunity, but will also strengthen the land that has been weakened by the COVID.

Then by fighting the disease. And I gave her this botanical LCS one or two, the tonics are. So, by the way, if you want to read all the research, you can look away. We have just a research plant website, it’s for data formula with, for both the LCS. One, one that comes with just some pure research website and you have access to the research and also all the herds. So if you are interested, you can always read there more and, uh, to look at this, a prescription for this patient. So you can see again, I’m trying to, I have this kind of whole picture of the face. So for like, for the Shan part to do bladder 40 to DePaul who the tour of DePaul, so it will address not just the physical part, but also the shell is spirit part. This detachment is deep depression that she felt after the operation and then treating the way and the itchy by combining points on the young mean the stomach and large intestine combination and kidney nine, working on the gene.

So you’re seeing Chinese medicine. We kind of very much go from theory to practice and gave her the LCS one or two in the same times, again, to work on the way change, changing. So we are kind of having a complete, um, cover of, of immunity. And that’s the beauty of acupuncture to me that we can think in three dimension and, and treat them three dimension. And the results were amazing. I mean, a week later she was like a different person, you know, it’s like this patient tell you, wow, it’s a magic. So this is a, I think a good example of how it works. And, um, I did, there’s a lot in explaining, uh, especially during the coffin in explaining immunity. And, uh, I put it into one large teaching package it’s called to serve and protect where it has different components. So it doesn’t just look on the, uh, it looks on the foundation of immune system, like focuses also on allergies, inflammation, the way the body responds to external pathogen.

Then it goes deep into in Nathan adaptive immunity and talks about how the immune system works. And how can we it, and also talking about what we look like also deeply in this, uh, or started to look deeply in this teaching about, uh, internal causes and deeper aspects of immunity. And one of the interesting thing from a Western point of view, and it helps us to understand Chinese medicine actually goes deeper into it is when we talk about auto-immunity we talking about distinguishing self from non-self and in Chinese medicine, it has a lot of meanings. So if you will, wherever interested to look at it any further, you can look at the TCM academy website and are able to look at some of these lectures. I think they can kind of give you a wider range of appreciation of how immunity can be treated, especially with acupuncture, because it’s a vast subject.

And to me, one of the key in the clinic, so this is serving protect actually like the idea, cause immunity is a bit like, you know, it has all this aspects of having, uh, when you look in guarding, you know, society, so you have the placements, that’s how he took this name from, and then you have the, um, soldiers on the borders and you have the intelligence, et cetera, et cetera, all of them working to keep society safe and the same works in immunity. So, um, I think this kind of, uh, gives you some insight and some ideas of how we treat them to treat the immunity in Chinese medicine. So, uh, again, I would like to thank the American acupuncture council and, uh, thank you very much for watching wishing you the best of health and healing your ear. So all the very best, and you can watch also next week on the, on this channel and Matt Callison and, uh, Brian Lau talking about, uh, uh, the treatment of sports medicine. So you get another aspect of Chinese medicine and the scope of this medicine and how it treats the variety of problems. And, uh, so I hope now you’ll get more insights about immunity and then hope it was inspired and helpful. So thank you very much again for watching. Thank you.

 

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Chinese Medicine and Vision Conditions

 

 

“I believe that knowledge is power and we’re all trying to be have our patients and society become educated consumers. So as much as we can share knowledge, as much as we can share what we know with each other, the better.”

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, I’m Virginia Doran of luminousbeauty.com. And I want to welcome you to another edition of the point to the point. A show, very generously produced by the American Acupuncture Council today. I’m extra delighted to have as my guest, Dr. Mark Grossman. Uh, when I met Mark in 1992, we were both going to acupuncture school in, uh, New York and Connecticut. Uh, but Mark is very unusual in that he holds the licenses in both acupuncture and is a doctor of optometry and, uh, to fulfill his dream of practicing holistic and integrative eyecare, he’s fully trained in acupuncture. Uh, even though he, he didn’t need to be to, uh, to be practicing. Um, and he’s also trained in nutrition and visual vision therapy, and he saw this significant void in holistic eye care, um, and not only, you know, filled in to practice that way himself, but he trains practitioners internationally online and in-person, and, uh, he’s published many books.

Um, the four ones that, um, are probably most notable and, and, uh, appropriate for this audience is Nash, natural eye care, a comprehensive manual for practitioners of Oriental medicine, where he goes into both, um, acupuncture and herbal prescriptions. And then he has a book, natural eye care, your guide to healthy vision. They sound similar or different book. It’s an 800 page texts, and it covers about every eye condition from both the Western and Eastern perspective, plus nutrition and supplements, herbs, clinical tips. It’s really a must have for every practitioners library. He’s also written a book, very interesting book, very unusual, greater vision, a comprehensive program for physical, emotional, and spiritual clarity. Uh, another thing that he teaches about and the international bestseller magic eyes beyond 3d your vision. Um, so you can find more information about his books. Trainings has specifically done products, but also about many, many different eye conditions.

His website is full of information. He’s very generous with his knowledge as he shares it to people and that’s natural eye care.com. So after that, um, uh, I, I asked you to, to, um, you know, speak on this because I think it’s so necessary and there’s not much draining or, um, awareness of this in our field. And also, um, I think that, uh, you know, if you could give some examples of like, say glaucoma, for instance, you know, a common condition that, uh, to give an idea how you work, the in-depth, uh, approach, you have to things. So thank you so much for being out. Cause I know you were in the middle of her work day. Uh, so, you know, if you can tell us how you got into this, that’d be very briefly. And then, uh, you know, what you want to impart.

Oh, thank you so much, Virginia. And I’m very, very grateful to you, Dr. Alan Weinstein. Who’s a master of putting this out the American acupuncture council, because I believe that knowledge is power and we’re all trying to be have our patients and society become educated consumers. So as much as we can share knowledge, as much as we can share what we know with each other, the better. And it’s very interesting. I was meditating this morning and I was saying, oh, I think I know what I have to start with saying, and you said it beautifully. How did I get into this acupuncturist? Usually have a drive. It’s like, oh my God, this is my calling. This is my calling of what I want to do in life. And my story was, I was already an eye doctor for, uh, 16 years had just finished paying off my student loans.

And then I went to a friend’s house. And in the middle of her living room was one of the first books in the Western hemisphere, an acupuncture called the web that has no Weaver. And I felt that I could remember it. Like it was yesterday. The book looked at me, I looked at the book. I said, I can’t believe I got to go to acupuncture school. Now I thought I had a way out because acupuncture wasn’t licensed in New York state yet. And as you know, as one of my, uh, classmates, we had to go to school in Connecticut first. So we went to school in Connecticut for a year. And then we spent the next two to three years in new York’s New York city. So I said, well, I guess I got to go. I don’t know why I’m going. Uh, I just know I have the calling and we’re going to talk about the call and we can talk about those moments in our life that we get those signals of what we need to do and how our vision, how not only our outer vision, but our inner vision affects how we are in life and how it affects eye conditions.

And we are in an epidemic. That’s an epidemic in society right now. Do you know that over 90% of young adults from 14 years and younger in China and Japan are near-sighted, if you don’t consider 90% epidemic, then the thing is, you know, and with the advent of computers and being online. So we need to take care of our eyes. And as we know in Chinese medicine, if you can go to the first slide Allen, we know that all the meridians go to the eyes, all the meridians go through the heart. So when we are working with people with high conditions, acupuncture, Chinese medicine, I believe is an integral part of the integrative medicine team that needs to be to help these conditions. I, um, about a month or two ago, I lectured at the east west integrative medicine department that UCLA that’s been going on for over 25 years.

Oh my God. And we did an international conference, which I was part of the panel on Chinese medicine and vision. So the need is there, there were some amazing acupuncturist, like one of my colleagues and co-teachers Dr. Andy Rosenfarb who specializes in vision and Chinese medicine. So what I want to really put out today is how important and how Chinese medicine can be part of that team and myself. And I’ve been practicing for over 40 years as an optometrist. And what are we up to now, Virginia 26, 28 years, 26 years as an acupuncturist. And I didn’t even know when I was in a, I doctor school, optometry school. And I would say, excuse me, why did they get a cataract in the left eye and not the right eye? And they go, you mean, you want to know why I said, yeah, I’d like to know why.

And Ted Kaptchuk said it beautifully. He said in Western medicine, in which I was trained, we look had, how does X cause Y but in Chinese medicine, what do we look at? What is the relationship between X and X and Y? And I believe that all disease dis ease in the body mind has to do with relationships, relationships, to our environment, to the trees, to the oceans, to our, uh, families, to our friends. And what are, what is the goal of every acupuncture or Chinese medicine treatment, balance and harmony. And when we have balance and harmony and Chinese medicine speaks about it beautifully, we have no stuck energy. And I believe in my experience that almost all eye conditions, uh, due to stagnant energy. So let’s go to the next slide. Allen integrative medicine envision, we need an integrative approach. You know, I lectured at the integrative healthcare symposium and there were acupuncturists in the audience, functional medicine doctors, natural paths. Yes. I always tell people who I see, I’m just a little part of your team. We want to do integrative medicine. Next slide.

Can I interrupt a second? I went recently to an eye doctor to, you know, just have a checkup and tests. And I don’t think I’ve actually ever done that as an adult. And, um, you know, they dilated my eyes for something. They put some other drops in. I mean, for three weeks, I could barely see, and, and my eyes didn’t adjust back, you know, the dilation, but they were cloudy from the second. They put the first drops in and, um, you know, all they could suggest was a drug. And they said, oh yeah, it’s not, it’s not, it’s no problems with it. But I looked up the side effects of the drugs. It was every organ, every organ. And it was going to change. It could change the color of your skin, your eyes, but they thought, oh, no, this is totally benign. So there’s such a need for what you do, you know?

And for some and others to know about it, really, we all should be trained in this specialty because it’s, you know, what’s going on is kind of barbaric really anyway, sorry to interrupt, but you’re never interrupted. And yet at the same time, I talked to you about it and you were like, oh, we have, you know, we have technology and ways to do it, that you don’t have to be dilated. Oh, there’s different versions of these different medications without the preservatives. That cause a lot of the effects side of it, you know, why don’t other doctors know this?

So as somebody in both professions with both hats on I, doctors are really, really nice people. They really try hard. But as we know with most Western medicine, we have limited things in our toolkit. We have medication, we have surgery and that’s it. We are looking at the eye as an isolated organ. I had a patient I’m going to see later at my last patient today because he was told she has eyelid cancer, but I started talking to her. And what are the lids related to in Chinese medicine, the stomach and the spleen. Is she having problems with her microbiome? Is she having issues? Is she seeing a functional medicine doctor? Yes. But the eye doctor said, oh, you’ve got bumps on your eyelid. You know, it’s maybe it’s eye cancer, but I’m just saying, we need to look at the relationships. And remember when I just said before, um, well, why did you get a cataract in your left eye before the right Chinese medicine in most people?

Right. I father I male, I yang. I left, I feminine yen receptive. So when I really look in, I mean into why somebody develops macular degeneration, glaucoma cataracts, and why they may get an in one eye versus the others, I’m going to talk to them. What’s going on in their relationships with their father, with their husband. I mean, I’ve got stories, I’ve got stories, you know, after 40 years. So let’s keep going because this is just a preview because I really want acupuncture is to, to, to get the power that they have for this kinds of treatments. My website, natural eye care started about 20 years ago. My business partner in that is, uh, Michael Edson. And Michael is an acupuncturist also. So we refer to acupuncturist all the time because it’s both are bent. Uh, you see a pho a phone number there, (845) 255-8222.

The direct number for Michael, which is the new number on our website is 8 4 5 4 7 5 4 1 5 8. But you can go to the website and Michael loves talking to acupuncturists and we are there as a service to help you work with your patients. Next slide, Allen. These are some of my books beyond 3d magic eyes. Those of you who are old enough know about these 3d pictures that you relax your eyes and then a hidden picture comes out. Uh, it was published. We, uh, they sold over 30 million of those books. I wrote two of them. I’m the medical consultant to them. Uh, I got there, but after they sold the 30 million, so I didn’t really profit from it. Um, but those magic eye pictures, uh, one of the tools I use not only to help people’s eyesight, but to help reduce liver stagnation through the eyes, the greater vision book was written because I do believe in the Mati body, mind and spirit of all eye conditions, natural eye care that I wrote with about twenty-five years ago, which was the book before it’s time with a good friend of mine, Dr. Glenn sweat out is in Hawaii. Um, and then we can go to the next slide where we expanded on it to that 800 page, 2000 peer review references book, uh, on natural eyecare. And that book is also available on Amazon and then on Kendall. And we also divided it into about five or six smaller books because that’s a very heavy book, but it is, it is. I have had the 10 different doctors help me with it. So it is, uh, a really good resource. Um, next down, next slide.

So let’s talk just a little bit. The only thing worse than being blind is to have sight, but no vision. Where does vision happen? It happens in the mind. That was a quote from Helen Keller. Next slide, Dalai Lama, in order to carry a positive action, we must develop here a positive vision. One of the real keys in Chinese medicine is the person has to have it in their belief system that the, this kind of thing can help. You know, we’re not there to convince people. We want people to feel positive and if they can conceive, if they believe it, they can conceive it. Next slide. This is, uh, something which my magic eye books are based on vision is the art of seeing what is invisible to others. You know, we need to see the bigger picture and what does Chinese medicine do? It sees the bigger picture next, and this is how I sign all my emails.

And I’m going to give you all my personal email, um, today, because you’ll see if you have any questions that come up, because the question is not what you look at, but what you really really see next slide. Okay. And here we go. No, no, that’s good. We got to go to Shakespeare. The eyes are the windows to your soul. We know about that. People, the Shen the spirit, the pilot light our eyes tell us how much our spirit is connected with our soul. And I believe that through the eyes we can help people, uh, go through their soul’s journey next and Benjamin Franklin, an ounce of prevention is worth a pound of cure. So nutritionally Chinese medicine wise, if we can get people on good visual hygiene, the dentists talk about dental hygiene, plus your teeth, brush your teeth, brush your teeth, but we’re on computers. Yeah, because 11 hours a day on digital devices, we need to do visual hygiene. We need to take care of our bodies and our mind next.

And this is the integrative medicine approach, which is, I think the Chinese medicine approach imagine a oriented towards healing rather than disease, where physicians believe in the natural killing capacity of human beings and emphasize prevention above treatment in such a world, doctors and patients would be partners towards the same ends. And that’s why the minimum I’ll see patients or clients is I say, I want you to come in after we’ve worked for awhile, once a season, as the seasons change, as you are going to be relating to your environment different than, uh, we need to do a tune-up. So on all my clients, I say the minimum I’m going to see you is once we get everything balanced and in harmony is once a season. Next slide. So these are some of the allied complementary practitioners I might refer to for different eye conditions. Um, and acupuncturist is right there.

And even though it’s, it’s not on top, let me tell you, uh, my partners in my practice, my PA one partner is a chiropractor and the other partners, and as an acupuncturist. So, uh, acupuncture and chiropractic are some of the biggest referrals that I make in my, um, uh, integrative team approach, along with natural paths and functional medicine practitioners. But at different times, I may use any of these different complimentary practitioners. Next, this is the office I rent space in. This is the outside next slide. The reason I’m showing this is the waiting room before COVID where now we have people six feet apart. Next next one, contact lenses next, because contact lenses from an acupuncture standpoint, what they do is they put people who are very near-sighted. They create a larger retinal image size. So actually just switching people from an eye as an eye doctor from glasses to contact lenses may open up a whole way of Le less liver tree stagnation.

These are some of the, this is some of the high end technology that’s available today because, and I can help you as acupuncturists, uh, read the reports on this and, uh, talk to you about the findings on some of these tests, in terms of Chinese medicine. These are pictures underneath the retina. They take pictures underneath the macula, underneath the optic nerve. They take a 3d picture of the eye. And as, um, Virginia said some many times we don’t have to even dilate the eyes. Do you know, as we said, the eye Embrya logically physiologically and neurologically, what is it? It’s brain tissue. If you continue to mind, you can change your eyes. We all know about the neuroplasticity of the brain. Therefore we have neuroplasticity of the eye and you know, that you can diagnose, uh, Alzheimer’s disease early through retinal photos. Yes. This thing is out there. So the technology today in the eye will give good insight to people’s eyesight. Next slide. Okay, let’s go to slide 23. [inaudible].

So, as I said, the hi is brain tissue. Do you know that there are studies that in multiple personality disorders, they all had different prescriptions. Oh, very interesting. Mind, body spirit, next slide and trigger points. Uh, both me and Virginia. We had the pleasure and the utter gratitude that we were able to learn from. Uh, one of the, the pioneer of trigger points, Janet Trevell who wrote these two giant giant books, even bigger than my book on trigger points. And when I learned that it’s the neck, the shoulder, the upper trapezius, going to the sternocleidomastoid up to the suboccipitals that many vision problems come from, because why not that that happened? Because people have poor posture when they’re on devices and things tension. Exactly. Next slide Allen, the spleen is surveys is the neck muscle. So when we’re doing trigger point therapy, we can help with pain in the eyes.

We can help with glaucoma, which, um, I’ll talk about very briefly after, but I really wanted you to know that trigger points, uh, whether you do it through deep tissue or you do it through acupuncture could be very, very helpful in, uh, treating, uh, eye problems. Next slide again, the SCM, a biggie player, especially with musicians, especially like violin and Viola players. Ah, because those people I’ve got studies on how that affects a stigmatism. So yeah, the eye and the body and posture are very related. Next slide. The psoas muscle. If you have a tight psoas muscle, sometimes it relates to a vertical imbalance between the two eyes. So again, we have to look at the whole body next.

Okay. That’s it for the slides on. Thank you. So I’ve got about six minutes. I’m going to give you an overview of glaucoma because glaucoma is so we can do so many things because glaucoma is a disease, this ease of the optic nerve. But the only thing that I doctors having a toolkit of glaucoma is medication with lots of side effects and surgery, and they even have people. And then what they say is, oh, oh, we just have to lower the pressure. But look at that. Here’s the, here’s the optic nerve. Yes. According to physics, if you lower the pressure in the eye pressure hitting the optic nerve, that’ll be helpful because the higher the pressure, the more it could possibly break down the optic nerve, normal pressure and glucometers between 10 and 22. But wouldn’t it make sense to also build up the ocular blood flow to the optic nerve?

Wouldn’t it make sense to work on neurodegenerative neuro uh, uh, neurodegeneration? I mean, that’s what, uh, the eye research is showing. We want to have, um, things that are helpful for the nerves. So nutrition very helpful for that alpha-lipoic acid N-acetylcysteine, um, sublingual, vitamin B12, the B vitamins. So nutrition, very helpful acupuncture super-duper for, uh, helping with ocular blood flow and circulation because circulation, that’s why studies show that as little as aerobic exercise, four times a week can help with, uh, lowering the pressure. But what is one of the, some of the main things in Chinese medicine? You know, we all say liver, liver, liver, nice, but in Chinese medicine and glaucoma liver is a big player because it’s the stagnant liver cheat that can add to, to, uh, CA um, Livia, hyperactive, liver, young, that can cause a high eye pressure. So I’m always trying to bring the pressure down, bring it down.

I want to deal things with the earth element. I may have them stand in dirt, rub a, a ball on kidney. One, bring the energy down. So liver three, liver aids for blood, uh, gallbladder 20 to release the tension in the occipital. Uh suboccipitals so liver kidney very, very important. Especially sometimes the pattern is a kidney yin and Liberty in deficiency. So there’s basically, this is where it gets a little tricky. There’s like six different kinds of glaucoma. Some glaucoma is due to more due to inflammation, such as pseudoexfoliation glaucoma. Some glaucoma has normal tension, normal eye pressure, but has what we call large cupping in the optic nerve. And therefore, you know, we can lower the pressure, but it’s more about getting more blood flow to the optic nerve and, uh, helping the nerves. And then there’s the eye, the glaucoma that has high eye pressure.

But again, the tool dry doctors is just lower the pressure. So we can see very easily how Chinese medicine can have an effect. And going back to the muddy bind spirit stress, oh my God, they have studies that show that stress can increase the eye pressure. So even in the regular literature on Western medicine, so we want to relax. That’s why my favorite formula that I created with my, uh, acupuncture partner, Jason Elias, and we called revision. And what is it based on B Florim and Pini combination. Why, because what is that called relaxed wander? And I added some bilberry and some Ginko, and I added a little Licey and chrysanthemum to bring energy to the eyes. So we really want to do Western Chinese herbs coleus and air vinegar. That’s very good to lower eye pressure. So I really, what I really want to share with you and hope you get a, and if you want to learn more, I am totally available.

My personal email is D R Grossman 20 twenty@gmail.com. I really want to let you know that the ability for Chinese medicine to help with chronic eye conditions and basically all eye conditions, is there that Nick, that place that you, if you really into it, that you want to add to your practice is there. And you will, you will have patients. My friend and colleague, Andy Rosenfarb is busy, busy, busy, and he trains, uh, acupuncturists in a special kind of acupuncture called micro acupuncture. So again, thank you so much for your attention and your time. And hopefully listening to this, uh, again, knowledge is power, and I hope that you become part of an integrative medicine team to help people in the world keep their precious gift of sight. Thank you so much.

Thank you so much, mark. And thanks again to the American acupuncture council, um, Virginia Doran signing off from luminousbeauty.com and yeah, Yair Maimon is next week. So, so he’s always got something interesting. I hope you’ll check that out too. All right. Goodbye. Bye.