節分の候 ご自愛専一 こちらはまもなく節分です 12 reaction zones from Hirata’s hot-needle therapy 1 bronchi 2 lungs 3 heart 4 liver 5 gallbladder and excretion of the pancreas 6 spleen and secretion of the pancreas 7 stomach 8 kidneys 9 colon 10 small intestines 11 bladder 12 reproductive organs

💚💡Critical clinical reasoning - shoulder💭💚 Shoulder pain & stiffness are commonly seen in clinical setting. Among physiotherapists, we discussed how difficult it could be to help these patients from full recovery, because there are myriad causes leading to shoulder symptoms. In visceral manipulation (VM), we learn the relationship between internal organs/structures and the osteoarticular system (ie. Bones & joints). A shoulder problem is seldom due to the joint problem itself (but, even talking about the joint system and there are 6 joints for shoulder complex). So far I learnt from my patients is that liver congestion contribute the most to right shoulder problem (via the right phrenic nerve and fascial relationship of endothoracic fascia to mid-cervical the ligaments of shoulder); while oesophagus & aortic tension (via fascial & arterial system) contribute to left shoulder problem. Ipsilateral pleural/respiratory tension (lungs, bronchi) contribute to ipsilateral shoulder condition. To a certain extent, I think we all encountered during medical consultations, the doctor told us that all objective findings were “normal” and that our symptoms could not be explained from orthopedic point of view. I don’t agree with doctors denying patients’ symptoms when objective findings fail to explain patients’ symptoms. An objective investigation like X rays, MRI, CT scan, can only show if there is structural / tissular change, which is not sensitive to determine the function of the body structure. Instead, a dynamic ultrasound is the way to prove that organs can move and this in turn affects joint mobility and its symptoms. Jean-Pierre said, “A “normal” liver ultrasound report does not prove that this organ is functioning in an optimal, healthy manner. A “normal” X ray of the spine does not prove that it is functioning optimally, or that there is no back pain. When you have shoulder pain, consider something more than articular, ligamentous, or muscular problems, and discuss with your doctors or therapists, maybe you can get a better treatment direction and recover earlier. 📸 : Advanced Visceral Manipulation - viscero-osteo-articular relationships (AVMOR)

🌜The body never lies 🌛 It is beyond normal imagination that stiffness (or pain) of shoulder can be due to ......Tension of the 🌵BRONCHUS 🌵of the same side ‼️ Recently I have seen several patients with tight neck and shoulders. A lady came for treatment with very stiff neck and tension on left shoulder. The Internal rotation of left shoulder in 90 deg abducted position was 40 deg. Upon listening (a type of assessment from Visceral Manipulation (VM)) the body led me to ....the left 🌵Bronchus🌵! Instead of using my 🧠logical mind 🧠with knowledge, I followed my feeling from my hands 🤲🏼👂🏼🤲🏼 👂🏼on what I felt from the patient’s body. I did NOT touch her shoulder joints (shoulder is a complex, it is comprised of literally 6 joints) and I only released the tension on left bronchus and left endothoracic fascia. Immediately I retested the internal rotation of the left shoulder and it achieved full range 🙆🏻‍♀️🙆🏻‍♂️🙆🏾‍♀️🙆🏾‍♂️🙆🏼‍♀️🙆🏼‍♂️. So, why is that the shoulder range of motion is related to the left bronchus? 🤔 “💡Endothoracic fascia 💡surrounds the bronchi as they pass through the root of the lungs; this fascia becomes continuous with the stroma of the airways and the septa of the lungs” (Frank Willard, 2012). Hence, the bronchi have this relationship with the endothoracic fascia, which has an intimate relationship with the shoulder complex as follows: ⚡️Endothoracic fascia ⚡️is the outermost fascia of the rib-cage (this fascia is actually inseparable from the ribs in dissecting a cadavar), it has connection with ⚡️clavipectoral fascia⚡️, which thickens and forms as conoid and trapezoid ligament (ie coraco-clavicular ligament) on coracoid process (see photo), and with this fascia being in tension, with time, your shoulders will not be in good condition. Patient suffered from chronic cough 😷 for ~a month before and then she developed this left shoulder stiffness after recovering from the cough. Can you see the relationship? 🤓 When it comes to treating patients, we cannot really separate one system from another. To be a really good therapist, we should see patients as a whole to assist them in thriving on health.