Need help from someone who expertly understands OMT

[applicant2002]

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Greetings, 🙂

I'm confused about a particular topic: rib raising. The way I understood the technique was that while it initially increases sympathetic tone, after a while, sympathetic tone is decreased, and the goal is to decrease sympathetic tone and increase parasympathetic tone.

So my question sometime last year was, why would you do rib raising in asthma?. . . the sympathetic nervous system is responsible for bronchoconstriction.

I had asked this of a professor, and then I had also came across this from a web site:

"Lung adrenergic receptors are minimally innervated by sympathetic fibres but may be stimulated by circulating catecholamines or specific adrenergic agonists. "

So combining what the professor said and the above information, it all made sense to me: you decrease the sympathetic nervous imput and it reduces the amount of vasoconstriction and makes the secretions less viscous (because parasympathetic is vasodilation and less viscous secretions), and you have no impact on the degree of bronchoconstriction because those receptors are not innervated by specific nerves that come from T1-L2.

But then in class the other day, another professor stated that the reason rib raising works in asthma is by increasing sympathetic tone.

So I was wholly confused.

I tried to find the above quote again, and I did, only it was on the following website:
http://education.vetmed.vt.edu/Curriculum/local/VMS6534/respir/rb/autonomicreview.doc

which means it applies to horses. It could also apply to human lungs, but I found no evidence either way.

Could someone help me resolve this dilemma? Are lung B receptors directly innervated or not?

 

[DOSouthpaw]

You've kinda confused me. Let's straighten stuff out:


1) SNS does VASOconstriction(Alpha), but BRONCHOdilitation(Beta).

2) Rib raising does nothing to the parasympathetic, just the sympathetic. They are two totally different systems that act on their own. So by upregulating one, you don't necessarily downregulate the other. You can, but it's not automatic.

3) Rib raising also can free up restrictions in the ribcage. If you do that, then you help a person with asthma by allowing their primary repiratory muscles to do more.

 

[applicant2002]

You've kinda confused me. Let's straighten stuff out:


1) SNS does VASOconstriction(Alpha), but BRONCHOdilitation(Beta).

2) Rib raising does nothing to the parasympathetic, just the sympathetic. They are two totally different systems that act on their own. So by upregulating one, you don't necessarily downregulate the other. You can, but it's not automatic.

3) Rib raising also can free up restrictions in the ribcage. If you do that, then you help a person with asthma by allowing their primary repiratory muscles to do more.

#1: i understand that...
#2: so with rib raising, is it true that while you initially upregulate the sympathetic for a few seconds, the net effect is that you downregulate sympathetic system. (thus, causing less viscous secretions, and less vasoconstriction)...but that still doesn't answer the bronchodilation question...
#3: good point, thanks for bringing it up.

 

[babyruth]

From what I understood about it is that it is the amount of vigor you apply to the treatment. Therefore, to stimulate the SNS, you need to do agressive ribraising or a double arm thrust etc to do this. These, therefore, are good treatments for someone having an asthma attack (although they are not going to lay down to do double arm...).

 

[Hernandez]

#1: i understand that...
#2: so with rib raising, is it true that while you initially upregulate the sympathetic for a few seconds, the net effect is that you downregulate sympathetic system. (thus, causing less viscous secretions, and less vasoconstriction)...but that still doesn't answer the bronchodilation question...
#3: good point, thanks for bringing it up.

#2: think of it this way, with Somatic dysfunction impingin on the sympathic chain, it makes it irratable, and decreases the threshold needed to cause it to fire (keep in mind this is an over simplification, but a very real aspect of much of osteopathic treatment)

#3 I forget the exact numbers, but for every 1 inch improment in chest excursion, respiratory intake increase ~250-300 cc, so any improvement in chest movement that allows for a greater inspiration is good.

And I'm pretty sure that sympathetic innervation (β2) cause vasodialation of the bronchial smooth muscles. ergo increased firing of the nerves increases dialation. It's part of the Fight of flight mechanism, you need more air.

 

[macman]

Here is what we learn/teach at DMU:

Rib Raising-as stated above can be used to treat both rib cage itself (incr. ROM, tx SD's) and can also be used to affect the sympathetic chain anterior to the costovertebral junctions.

The benefits of incr ROm and alleviating SD's is already discussed above.

In terms of affecting the sympathetics-you can stimulate them with agrressive rib raising or HVLA to that area. You can calm/reduce sympathetic flow with gentle rib raising.

Thanks for the good question!

 

[OMMFellow06]

The reason that you do rib raising is to "normalize" sympathetic tone just like when you work on the OA to treat parasympathetics, you are "normalizing" What does that mean, it means that you are creating an environment for the body to adjust the amount of sympathetic and parasympathetic tone to what is optimal.

Using rib raising more or less rigorously does not make much of a difference as long as you are treating the dysfunctional rib and relieving the restrictions that caused it to be dysfunctional.

As for asthma and sympathetics you already answered yourself with the secretions. Sympathetics increase the viscosity of secretions as well as bronchodilate. Parasympathetics do the opposite. That is the reason that you treat both the sympathetics AND the parasympathetics when treating asthmatics. You want to normalize sympathetic and parasympathetic tone so that the body can have a good balance of both.

Also, as with what others have said, improving rib function will aid in decreasing the work used in breathing and increasing the amount of air moved through the lungs.

 

[JP2005]

I must say....

I LOVE NYCOM (esp the hardcore OMM fellows)....

thank you...

 

[OMMFellow06]

I must say....

I LOVE NYCOM (esp the hardcore OMM fellows)....

thank you...

Thanks JP!