DETAILED
ANALYSIS OF PHRENIC 2 ARTICLE-
Dale G. Alexander’s "The Phrenic Circuit, Part II" article of
December, 2006
http://www.anatomyfacts.com/Muscle/dalealexandereditoral4.htm
ARTICLE
http://www.massagetoday.com/mpacms/mt/article.php?id=13513
SUMMARY
ANALYSIS OF PHRENIC 2 ARTICLE-(THIS WAS SENT TO MASSAGE MAGAZINE) FOLLOWS;
Dear
Editor,
This
is in response to Dale G. Alexander’s "The Phrenic Circuit, Part II"
article of December, 2006 [1] in
Massage today magazine.
The
notion that the phrenic nerve transmits tension built up (both because of early
childhood trauma and negative thinking) within the smooth muscle of the
esophagus, intestines is both probably wrong and as Alexander admits wholly
unproven/improvable scientifically. Alexander’s explanation relies on what has
been observed for many decades anecdotally in medicine that gall bladder/liver
disease refers sometimes to the right shoulder and stomach/heart et al
sometimes to the left.
The
sensory branch of the phrenic nerve which supplies some of the connective
tissue (made up of inert protein that does not contract) and neurological
structures might be the cause of organ referred pain to the shoulder. Although
sensory nerves may transmit pain to the shoulder and neck, it is rather
unlikely that this causes any orthopedic conditions as Alexander implies. It is
even less likely that childhood trauma or tensions created by negative mental
ruminations are stored in these core structures and beyond are
released/dispersed thru the sensory branch of the phrenic nerve and further
that this release causes orthopedic injury.
A
more probable/simple explanation of the role of the phrenic nerve function is based
on known neuroanatomy and physiology. As a previous letter to the editor
suggest;
“The
sensory fibers of the phrenic nerve supply structures, which are related to
increased exertion e.g. the heart, membranes in the chest (Mediastinum),
abdominal membranes attached to the diaphragm, ligaments which are attached to
the diaphragm, and endocrine glands, which give us the energy for exertion.”
“The motor portion of the phrenic
nerve probably forms a reflex arc (sensory nerves paired with motor nerve in
spinal cord=patellar reflex=knee jerk) with the sensory nerves coming from the
aforementioned structures. This gives more juice to the diaphragm (to increase
O2 delivery) during intense aerobic activity. If the heart is pumping away
because we are on the last 100 yards of a killer marathon this feedback loop is
just what the doctor ordered.”
“The phrenic nerves sensory
fibers become excited by all of the activity of the heart, lungs, ect thus
exciting the phrenic motor nerve, which increases contraction of the diaphragm
to deliver that last burst of energy as we cross the finish line.” The
connection of the phrenic nerve to the lower plexus centers and thru these
plexus centers to the abdominal cavity organs (digestive tract-small and large
intestine) may serve as a monitor to digestive tract activity. Obviously, the
organism is best served during heavy exertion if digestion is inhibited. If you
are running from a predator, for example, the digestion of a recent meal is the
least of your worries. Perhaps the sensory nerves of the phrenic form a feed
back loop (reflex arc) with the parasympathetic nervous system to inhibit
digestive tract activity.”
This theory that the phrenic
nerve forms a reflex arc with its own motor portion and with the
parasympathetic/sympathetic nervous system to improve oxygen intake efficiency
could be tested experimentally. Pre testing blood oxygen levels during heavy
exertion could be statistically compared to post oxygen levels after sensory phrenic
nerves had been severed. To avoid abuse of animal’s experimenters could compare
relative oxygen levels of animals that, for a variety of reasons, did not have
phrenic sensory nerve supply with levels in control animals who have phrenic
sensory nerve supply. If there was a significant statistical difference between
these groups in the oxygen levels, it might suggest that the sensory portion of
the phrenic nerve has a role in improving oxygen levels during heavy exertion.
The ideas that Alexander proposes
are unproven/improvable
scientifically. Alexander’s approach then appears to be more Pseudoscience,
Metaphysics, Ontological discussion rather than utilizing the Scientific Method
to discover truth. Since most of Alexander’s articles refer to his own writings
he is self referential, that is these writings do no even attempt to justify
scientifically the “ideas about relationships” that are presented by citing
scientific experiments and or the thoughts of experts in the field. The ideas
Alexander presents may be intuitively appealing to many. After all, after
traumatic life events, it is not uncommon to feel a deep ache in the chest and
or gut. It is likely though that, Alexander’s ideas would be questioned by the
multiple professions he references. Neurologists/Kinesiologists might question
the ability of the sympathetic nervous systems capacity to contract connective
tissue (sacs) or the smooth muscles capacity to store trauma, Cognitive
Behavioral therapists might think Alexander’s psychodynamic theories as
Freudian old school and unnecessarily complex and or doubt that simple touch
can be psychotherapeutically effective unless a persons irrational thinking is
examined and modified. In short, scientific study would be necessary to prove
or disprove Alexander’s ideas and this is lacking in both his writing and
citation. In fact Alexander dismisses the need to prove cause and effect
relationships as unnecessary.
One
reason we should be concerned about what other professions think of us is
financial. Other professions would surely want more proof and the massage
profession itself may suffer financially due to hesitancy of the medical
profession to refer for various conditions without experimental proof. The need
for more research is especially indicated with ideas such as Alexander’s which
make bold claims that transformation change from touch therapy can heal both
orthopedic injury and emotional distress.
Perhaps
focused research studies which examine the effectiveness of massage for common
complaints would serve to introduce the clinical effectiveness to physicians.
Research which demonstrates the effectiveness of massage to reduce
headache/heartache/anxiety/depression, for example, would encourage physician
referral for massage. If massage could be shown in controlled studies to lower
the frequency and intensity of headache pain with an overall less cost/side
effects than pharmacology, it is likely referrals from medical doctors would
increase.
Physicians
might be less inclined to refer their patients for touch treatment for a vague
condition involving stored childhood trauma (unproven scientifically) to treat
shoulder pain, as Alexander suggests. In this case, Alexander’s suggestion to
ignore cause and effect relationships would result in less referrals to the
massage profession and less money into the pockets of massage therapists.
Physicians may be skeptical that these deeply stored traumas, are released by
touch alone and that this resolves adhesive Capsulitis (frozen shoulder).
Insurance
companies are unlikely to pay touch therapy treatments in what ever form for
organ, smooth/core muscle massage with the goal of releasing emotional trauma
to treat orthopedic conditions of the shoulder and neck. The scientific method
at its heart does attempt to establish cause and effect relationships that are
not due to chance alone. The professions that are based on western scientific
method (Medicine, Psychology ect) would more likely trust the conclusions drawn
from scientific method and refer their patients to science based massage
therapists. If we wish to improve our financial bottom line it is in our best
interest to embrace well researched ideas and encourage thought leaders such as
Dale Alexander to do the same.
Ted
Nissen