What is Chiropractic Manipulative Reflex Technique (CMRT)?
CMRT is a type of soft tissue work developed by a chiropractor and osteopath named Dr. M.B. DeJarnette. It involves manual stimulation to the organs of the body. A CMRT-trained doctor may also touch various reflex points on the body depending on which organ is affected. This is additional work beyond simply adjusting the spine. What's the general idea behind CMRT? Each spinal vertebra in the thoracic and lumbar spine corresponds with an organ or organ system. For example, thoracic vertebra 5 goes with the stomach. When thoracic 5 is subluxated (chiropractic term for a vertebra not functioning properly), the stomach function can be affected (a somato-visceral reflex). Similarly, if the stomach is irritated by something, it can send signals back into the spine causing the vertebra to become subluxated (a viscero-somatic reflex). This is part of why some people have to go back to chiropractors again and again to have the same vertebra adjusted. They haven't fixed the viscerosomatic reflex. Who performs CMRT? Only chiropractors with advanced training in Sacro-Occipital Technic® (SOT®) practice CMRT. It requires additional continuing education after a doctor graduates school and then practices using it on patients. I am the only doctor certified in SOT® Methods in Pinellas county and only 1 of 2 in the entire Tampa bay area. What are SOME of the problems I have successfully treated with CMRT:
Want to know more or see if CMRT might be the right therapy for you? Email thedclcsw@gmail.com or call 727-509-3760.
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Post Traumatic Stress Disorder (PTSD) can be a complicated disorder to treat. I am trained in a variety of techniques to treat PTSD, including Cognitive-Behavioral Therapy, regular behavioral therapy, Neurofeedback, and Eye Movement Desensitization and Reprocessing (EMDR). EMDR is something that only licensed mental healthcare professionals who have been trained can provide. According to the EMDR institute:
Those are impressive numbers, especially when you consider the years of therapy that some people have to go through to deal with PTSD and sometimes only get partial relief. EMDR is thought to work at a biological level involving trauma networks in the brain. However, the exact way it works remains unknown. What I like about EMDR is that it guides the person to have awareness of how their psychological issues are manifesting in their body. With some patients, I do both EMDR and chiropractic in the same session. With those patients, I find that the areas that the psychological issues manifest are the same areas that require chiropractic treatment. Thus, my expertise in both mental and physical health may potentially help to improve patient outcomes because I can target the problem in a variety of ways. Of course, any patient can elect to only do EMDR as a therapy in my office. I do not pressure patients into any therapy they do not wish to partake in. EMDR isn't just for PTSD. It has been used to treat phobias, panic disorder, somatoform disorders, performance anxiety, chronic pain, headaches, GI problems, eating disorders and negative body image. If you are interested in seeing if EMDR might be the right therapy for you, give my office a call at 727-509-3760 or send me an email to thedclcsw@gmail.com. People are often surprised to learn that chiropractic can help with Temporomandibular Joint (TMJ) problems (also called Temporomandibular Disorder, or TMD). The TMJ is really two bones coming together - the temporal bone and the mandible (jaw) to form the TMJ. Symptoms of TMJ dysfunction include:
Structures in the body are connected. Although TMJ dysfunction is often the chief complaint in terms of symptoms, the cause of the discomfort may actually be coming from somewhere else in the body. Other things that might be causing the TMJ to not function properly include:
A lot of times I find that so-called TMJ problems really aren't TMJ problems at all. I will work on other structures in the body, especially the pelvis, cervical spine and cranial bones in the head and the TMJ symptoms disappear. That said, there are times when the TMJ needs to be worked on. There are GENTLE chiropractic adjustments for the joint itself and the soft tissue structures of the face and neck. However, depending on the nature of the condition, chiropractic may not be enough to resolve the presenting TMJ issues. That is where co-management of the condition is necessary with a dentist. A dentist may use an appliance in the mouth or otherwise adjust the bite. It is important that the structures of the body including the pelvis and cranium be in balance before the fitting of such an appliance or adjusting the bite. It is also important to examine the pelvis, cervical spine and cranium after the fitting of an appliance to ensure stability of the entire system. I am happy to work with any dentist on achieving the best possible outcome for my patients. Sacro-Occipital Technic® (SOT®) is a gentle form of chiropractic that includes cranial work. I am the only chiropractor in Pinellas county that is certified in SOT® Methods and only one of two in the Tampa area. SOT® doctors have been working with dentists effectively for years and have presented and published research both in the United States and internationally on co-management of TMJ conditions. Please contact my office to schedule an appointment to see if you can benefit from my unique ways of addressing TMJ problems. Call 727-509-3760 or click on the link above to schedule online.
I've had several patients come and see me for stomach pains and acid reflux. These are problems often dealt with by medical doctors and managed by medication. But do those medications get to the cause of the problem? In these cases, the answer was definitively "no!" I successfully treated all of these cases with something called Chiropractic Manipulative Reflex Technique (CMRT). It's an advanced part of Sacro Occipital Technic® (SOT®). CMRT involves soft tissue work on the body. Food moves into the stomach through the diaphragmatic sphincter. Like the other sphincter we all know and love, it should properly open and close to function. When it doesn't do that, stomach acid can pass backwards into the esophagus causing what is called acid reflux. In both of these cases, the diaphragm was under tension and was affecting the diaphragmatic sphincter. Part of fixing the cause was to pull the stomach away, since it was also pushed up under the diaphragm. The psoas muscle also connects at common points with the diaphragm. When the psoas muscle shortens or tightens, it pulls on the diaphragm. The psoas muscle also is involved with low back problems and this is why acid reflux and low back issues can go together. Both these cases also had subluxation of the 5th thoracic vertebra (T5). T5 has connections with the stomach (gastric) reflex, which influences acid production. As part of CMRT, I did reflex work on this area too. These cases resolved relatively quickly: an inexpensive fix to what can be a very costly problem. Antacids lower the pH in your stomach. This can allow for bad bacteria to grow in your digestive tract that aren't supposed to. Yuck! If you are experiencing acid reflux, please give me a call. I can tell you after an initial exam if you have this problem causing your reflux. If not, I can help develop a plan to figure out what other problems could be causing the pain. There are several chiropractic techniques I use to treat sciatica, based on patient needs. Sacro-Occipital Technic® (SOT®) is unique in the usage of wedge-shaped blocks under the pelvis. People with sciatica are in acute pain, and the blocks help guide the body back into balance and stop the pain. Blocks are especially effective at getting rid of the "antalgic lean" or lean to one side that people with sciatica develop. SOT® also deals with the soft tissue components of sciatica, including the piriformis muscle. As described in my other blog entry on sciatica, the muscle can either be too tight or too loose. Either way it can affect the sciatic nerve leading to pain. Even if the vertebra or disc is causing the sciatica, people with sciatica will usually have some involvement of the piriformis muscle that needs to be addressed to resolve the problem. The psoas muscle is also involved in sciatica. The psoas muscle attaches to the intervertebral discs themselves. Getting the psoas muscle to relax is an important part of sciatica treatment. The other way I treat sciatica is with Cox Technic®. This is another low force method I use in my office. It helps open up the disc space and increase mobility in the lumbar spine. Research shows that Cox Technic® reduces pressure in the disc, reduces pressure on spinal nerves, and widens the spinal canal foraminal area. Cox Technic® even works on cases of failed low back surgery! Yes, even if you have had surgery and are still suffering, research shows that Cox Technic® may be able to help. And it helps with problems in the cervical spine (neck). Both SOT® and Cox Technic® are gentle forms of working on the spine. This is in contrast to traditional "popping and cracking" done by more traditional forms of chiropractic. Want to know more or schedule an appointment? Please contact my office 727-509-3760, email thedclcsw@gmail.com or book online. What is sciatica? Sciatica means you have pain along some part of the sciatic nerve. The sciatic nerve is the longest nerve in the body, coming out of the lumbar and sacral parts of the spine. It travels through the buttock and down the back of the leg into the heel and foot (technically it gets some other names down there, but it's all part of the same big bad nerve). What isn't sciatica? Some patients will tell me they have sciatica, but then point to part of there leg that isn't related to the sciatic nerve. Leg pain doesn't necessarily mean sciatica. If the pain is on the side front, or doesn't go below the knee, it might not be the sciatic nerve. Those are often sacroiliac joint issues. What causes sciatica? The sciatic nerve exits out of the lumbar spine. It can get irritated by abnormalities there including
BUT...it can also be aggrevated by the PIRIFORMIS MUSCLE. In layman's terms, that's a muscle in your butt and the sciatic nerve passes right under it (in most people). The piriformis muscle can either become too tight or too loose and that will trap the nerve creating the pain. For a small number of people the nerve passes through the muscle. A word about discs When MRI's first came out a lot of low back pain and sciatica was blamed on the disc. There was a study done in the 1990's showing that people without back pain and without sciatica have abnormal discs. In other words, just because you have an abnormal disc doesn't necessarily mean that's what's causing your sciatica. Nor does it mean that you have to have surgery. I have a very high success rate of treating sciatica (or what patients initially thought was sciatica) in my practice. If you do need another type of healthcare provider, I will refer you to someone else. Look for part 2 of my blog on sciatica and the unique ways I treat it. Patients are often surprised to see wedge-shaped blocks in my office. Even patients who have been to other chiropractors will say "my other chiropractor never used those before." The blocks are part of Sacro-Occipital Technic® (SOT®), which is the primary form of chiropractic I do. People love them because they are gentle. Often patients also say that adjustments work better or seem to "hold" better when I use the blocks. Blocks are placed under your hip bones (pelvis) in various positions. Your body will naturally bring itself back into alignment while laying on the blocks. Patients who don't like the traditional popping and cracking associated with traditional chiropractic are especially fond of the blocks. But other patients ask me how something so simple could do anything? It's a myth that a crunch must be heard for an adjustment to have occurred. In fact, I have conducted and presented research at international conferences showing that laying on the blocks changes brain function. Yes, really! Click here for a portion of that study. Bottom line, the blocks are awesome. Call my office at 727-509-3760 or email thedclcsw@gmail.com to schedule an appointment today to learn how the blocks can help you. Depression is becoming more and more of an issue. And more and more young people are depressed, according to this article here: https://www.webmd.com/depression/news/20180511/depression-striking-more-young-people-than-ever#1 Some depressed people have been in psychotherapy for years or even decades. The absence of a resolution of the depression symptoms suggests that there may be a brain-based reason for the depression. Younger people may not have been depressed as long, but the same analysis can be used to figure out what are the best treatment options. Depression and the brain More and more studies and research are showing that particular areas of the brain are involved in depression. These include areas like the frontal lobe, which often shows asymmetry in function when viewed on a qEEG brainmap. Another area is the anterior cingulate. I have the ability to look at these areas of the brain and determine if they may be contributing to your symptoms of depression. When a patient comes and sees me for symptoms of depression, I first take a history of symptoms and what seems to have helped and not helped. If appropriate, we can record the brain to determine if there are dysregulated areas of the brain that can be linked to symptoms of depression. The Depression discriminant I utilize a program called Brain Dx that has in it a multivariate discriminant that essentially calculates the likelihood that a brain is that of a depressed person. It's not a stand alone tool for diagnosing depression. But if I'm trying to figure out if a person has a brain-based depression vs. a depression that would respond better to psychotherapy, the discriminant can really help. The discriminant helps further confirm that the symptoms of depression are brain-based and brain-based interventions are appropriate. Neurofeedback for depression If the brain is found to be abnormal in the areas of the brain related to symptoms of depression, Neurofeedback therapy can be used to re-train those areas of the brain. Let's say we learn that you have an excess of alpha wave activity in a certain area of your brain. We can downtrain (or inhibit) this activity by offering you "feedback" whenever your brainwave moves in the direction we want it to go. "Feedback" can come in the form of a noise (beep or click), music, visual images (i.e., movies) or a combination of any of the above. By reinforcing activity in the direction we want the brainwave to go, brain function changes. Over a series of sessions this change can become permanent and then no more training is needed. Depression and inflammation In Atlanta I had the opportunity to view a lecture given by Andrew Miller, MD, who has done extensive research in the relationship of depression to inflammation. In his studies he was actually able to take non-depressed people and give them inflammation that would make them depressed. He would then give a drug that would combat the inflammation and the person would stop being depressed. For some people, inflammation may be a component of their depression. I can order certain tests to determine if this may be the case. Sometimes psychotherapy is the appropriate treatment I had a patient years ago who came to me for Neurofeedback treatment for depression. We ran the brain mapping and his brain was one of the most normal brains I had ever seen! Going over the results, I asked him if anything else might have happened to him that he didn't tell me about in the initial history taking. That was when he told me he witnessed his father commit suicide. For this person, psychotherapy was indicated for treatment. His problem was psychologically based and not neurologically based. How to get help I have 11 years experience working with the brain using Neurofeedback for treatment of a wide variety of conditions including depression. You can schedule an appointment by calling the office at 727-509-3760 or emailing thedclcsw@gmail.com or clicking on the schedule an appointment button above. It all starts with an initial consult to determine what treatment options are the best for you as an individual. In part 1 of my blog, I previously discussed how instability of the sacroiliac (SI) joint can cause all sorts of problems in the body. That blog entry talked about how the hypermobility of that joint can cause problems such as low back pain, neck pain, headaches, shoulder pain, TMJ problems, elbow pain, wrist pain, hip pain, knee pain, ankle pain… and the list goes on. What if I told you there were actually 2 parts of the SI joint? The part I discussed previously IS NOT supposed to move. The part I am discussing in this blog entry is the part that IS supposed to move. Part of the sacroiliac joint is a synovial joint. Synovial joints have synovial fluid in them, which allows them to move. Your knee, for example, has synovial fluid in it. So does the SI joint. Curiously, it is shaped like a boot and is sometimes called the "boot" portion. Since the 1920's, chiropractors doing what I do, called Sacro-Occipital Technic® have been saying the SI joint moves. Conventional medical wisdom dismissed this, but science has now shown that the joint moves. 1 Why does the joint move? One of the functions of the movement of the "boot" portion of the sacroiliac joint is to circulate cerebrospinal fluid (CSF) throughout the brain and spinal cord. The brain and spinal cord are surrounded by sheath called the dura mater and inside that is the CSF. Conventional wisdom used to teach that the CSF was simply padding for the brain and spinal cord. But recent science has confirmed what chiropractors and osteopaths have been saying for almost a century - that CSF is vital to the health of the nervous system and the rest of the body. CSF brings nourishment to the brain and spinal cord. It also helps remove toxins from the brain and spinal cord. Picture your kitchen with no new fresh food in it and nobody taking out the garbage. Eww! Now it has been shown that it has a relationship with the lymphatic system (which also removes waste from the body). And CSF has been found to have a relationship with the immune system. 2, 3, 4 Restriction of this part of the sacroiliac joint interferes with the ability of CSF to move throughout the body, which can interfere with the processes I just mentioned above. Would you like to have a well nourished brain and spinal cord that removes toxins and interacts with the lymphatic and immune system effectively? Heck yes! That is something that I do for every one of my chiropractic patients. The nervous system exerts a tremendous amount of influence on the rest of the body. Therefore, effects of CSF restriction are thought to be related to a variety of symptoms including:
A chiropractor fully trained in Sacro-Occipital Technic®, AKA SOT Methods®, looks at both parts of the SI joint to make sure they are working properly. This helps the body have the stability it needs to function properly and the motion necessary for CSF to be moved throughout the body. This works to ensure proper functioning of the nervous system to promote health. SOT Methods® takes hundreds of hours of additional training beyond that of a basic chiropractic education required in school. This is a specialty I am proud to offer at my practice. You can schedule an appointment to get your SI joint checked by clicking above or at the Tuttle Health, LLC Facebook page. Or you can call the office at 727-509-3760 or email thedclcsw@gmail.com 1. The Sacroiliac Joint: a Review of Anatomy and Biomechanics with Clinical Implications. Harrison DE, Harrison DH, Troyanovich S. J Manipulative Physio Ther .1997. 2. Reassessing cerebrospinal fluid (CSF) hydrodynamics: A literature review presenting a novel hypothesis for CSF physiology. Chikly, B and Quaghebeur, J. Journal of Bodywork and Movement Therapies. 2013. 3. A Paravascular Pathway Facilitates CSF Flow Through the Brain Parenchyma and the Clearance of Interstitial Solutes, Including Amyloid β. Illif et. al. Science Translational Medicine. 2012. 4. Vascular, glial, and lymphatic immune gateways of the central nervous system. Engel B. et al. Acta Neuropatholigica. 2016. Sleep is really important. During sleep, there is all sorts of repair that goes on in your body. In layman's terms, the body shuts down from it's daytime activities and can focus on internal housekeeping. Waste and toxins are removed from the brain during sleep. Consolidation of memories occur when you sleep. But what happens when you don't sleep? All of these health promoting processes are interfered with. And that's called insomnia. Insomnia is subdivided into different types.
I have a variety of things I can use to treat people with sleep disorders. Neurofeedback Yes, neurofeedback can have great effects on sleep. And it makes sense, because it is your brainwaves that change when you fall asleep. While every individual is different, often stimulation of the sensory-motor rhythm (SMR) can greatly improve people's sleep. Chiropractic Many people report improvements in sleep patterns after undergoing chiropractic care. I myself find that difficulty sleeping can be an indicator that I need a chiropractic adjustment. Generally speaking, chiropractic increases parasympathetic nervous system activity. As with so much of chiropractic, more research is needed to validate what people have been saying for decades. Biofeedback Not to be confused with neurofeedback, biofeedback measures things that are indicative of a non-relaxed state in the human body. These are things like temperature, heart rate variability, and galvanic skin response. You can learn how to relax your body and increased parasympathetic nervous system activity by doing biofeedback. And that's good for sleeping and health in general. Nutrition Valerian root can be very effective for treating sometimes of insomnia. It is an herb and I used to take it the night before a big test or national boards when I was in school. There are other supplements like melatonin and 5-hydroxytryptophan that can be used as well. However, it is important to not ignore addressing the reasons why a person may not be making enough melatonin or why they are not absorbing the nutrients they need to create the proper neurotransmitters. That is really a topic for another discussion. Psychotherapy Intertwined with all of this is stress. There's insomnia for no reason and then there is insomnia related to stress in life. Psychotherapy can help identify the cognitions that may be contributing to the sleepless state. Insomnia doesn't always exist in a bubble. It can relate to lots of other mental health problems including anxiety, depression and trauma. That's an advantage to working with someone who is a licensed psychotherapist - they can help tease out what is what to determine the most appropriate and effective interventions. As you can see there really are a lot of treatments for insomnia that I can offer people that do not involve taking medicine. If you are suffering from insomnia and looking for help, please contact my office so that we can set up an appointment and discuss treatment options tailored to your individual needs. Image above Copyright: <a href='https://www.123rf.com/profile_bialasiewicz'>bialasiewicz / 123RF Stock Photo</a> |
AuthorI'm a Chiropractic Physician, Psychotherapist and researcher. I'm interested in helping people live their lives to their full potential. That could be simply without pain. Or it could be without more complicated physical or mental health problems. Or it could be getting help in making changes in their life so that they can achieve their dreams. Archives
June 2023
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