The g-max and lat dorsi are not only dynamic lumbar spine stabilizers, but when working in conjunction with other spring systems, play a major role in coordinated cross-patterned gait (Fig 2).

It’s easy to spot those with weak glutes. Due to reciprocal weakness, these folks tend to stand with the pelvis tilted one way or another with their butt kinda “hanging off” the hip capsules and lumbopelvic ligaments. If the muscles, tendons, and fascia are relatively weak in relation to the demands of a particular sport or repetitive activity, the vertebral joints (usually beginning with the disc) will deteriorate (Fig 3). When deterioration becomes severe it can be difficult to carry out the functions of daily living, let alone any high performance athletic endeavor. Any attempt to manually lengthen or stretch weak intrinsic and extrinsic spinal stabilizers causes greater forces to converge on the spinal discs and facets resulting in premature degeneration.

Spindle-Stim Technique

OK, so the glutes are typically weak….whadda we do about em? Even though the clients love it, the last thing we want to do is start massaging and digging around creating more stretch weakness. We could always send them to the gym for squats, leg presses, lunges, or…we could try to tonify them during the therapy session using fast-paced spindle-stimulating techniques.

Try this Spindle-Stim ‘test & treat’ routine:

• With client prone, ask them to lift their left leg as high as comfortably possible and get a sense of how high the extended leg comes off the table…then test the right.
• Place the left foot against the right knee forming a “Figure 4″ position with the leg. This places g-max on the stretch.
• With arms extended, use soft fists and begin bouncing on the left hip..
• Now, drop your body weight so all the energy is coming from your legs.
• Working the tissue in all directions, begin to gradually pick up speed until you see the entire body rocking & rolling. (This is not tapotement folks…use your body weight)
• The goal is to kick in a mild stretch reflex via muscle spindle’s dynamic gamma motoneuron system..
• After two minutes of rapid spindle-stim stop and retest their degree of hip extension.
• Results are often dramatic depending on your use of the technique and the degree of weakness the client presents with.
• Repeat on the opposite side and take notes on the degree of improvement so you can test them next session to see which g-max needs more work.

What about the tight lats?

Gotta love these guys. Considered a lower quadrant muscle, lat dorsi is innervated by the cervical ganglia and instrumental in all shoulder and arm movements, i.e., chopping with an axe. Two major structural/functional problems can occur in the presence of lat hypertonicity:

• Due to their attachment at the lesser tubercle of humerus, they work with teres major and the clavicular fibers of pec major to internally rotate the humeral head leading to upper cross syndrome patterns, forward head postures and rotator cuff injuries.
• Optimal functioning of the posterior spring system during cross-patterned gait demands there be precise length/strength balance between g-max and lat dorsi. In the presence of tight lats and weak glutes, the posterior spring system fails to participate with the other spring systems to wind up the lumbar spine and propel the legs forward in the gait cycle.

Try this ‘lat-lengthening’ technique: The client is left sidelying, knees flexed with his/her right hand grasping the top of the therapy table. With your left hand behind your back, grasp the client’s right ilium and lean against your arm to brace the hip. Place a soft right forearm along the lateral border of the lat fascia and get a good fascial hook. Establish a counter-force by anchoring with your left hand and slowly hooking and gliding up the lats with your right forearm. The goal is to lift the rib cage off the pelvic girdle and open up the lateral side of the body. After a few strokes, stop and this time ask the client to inhale to a count of 5 while gently pulling up on the top of the therapy table. As they relax and exhale, hook the deeper fascia so you can really decompress lat adhesions and activate the posterior spring system. Repeat on opposite side.

Clips from Level 4 Dynamic Body Home Study Note: An alternate ‘windshield-wiper’ lat technique is shown in the accompanying video. These are must-use maneuvers for decompressing the lumbar and thoracolumbar segments of this very complex muscle.

GOAL: Help your clients maintain a strong, mobile spine and spinal spring system to minimize injuries and maximize sports performance. Advise against overexertion during competitive or recreational activities to avoid microfailure (fatigue) and eventual spinal degeneration. Remember, the spine cannot support itself without help and that’s where these spinal engine spring system routines come in handy. Restoration of optimal range of motion, length/strength balance and proper firing order are essential components of the Myoskeletal Alignment Techniques(TM).

Massage and bodyworkers who specialize in chronic pain and postural problems profit by studying spinal biomechanics and learning to focus therapeutic intent on both myofascial and spine-related (articular) structures.

Poor joint function and accompanying protective muscle spasm is commonly seen in clients suffering long-term neck, upper-shoulder and arm pain. People who habitually hold a telephone with one shoulder frequently develop chronic unilateral hypertonicity in the levator scapula and splenius cervicis muscles. Because of their common attachments at the top three or four cervical transverse processes, unilateral contraction of these muscles sidebends and rotates the neck and elevates the shoulder to help secure the phone. Problems escalate as deep spinal “groove” muscles such as rotatores, multifidi, and intertransversarii (Fig 1) react to unilateral sustained hypercontraction. When overstimulated, these fibrotic little rascals are notorious for locking facets closed on the ipsilateral side and open on the contralateral side (Fig 2).

Sensitive joint mechanoreceptors respond to sustained torsional loading by flooding the spinal cord with noxious afferent messages that may cause the brain to further shorten these spinal rotators. Repeated exposure to compressive forces from prolonged unilateral neck sidebending also leads to joint cartilage degradation, which, in turn, promotes adhesive tissue build-up at the cervicothoracic junction, i.e., Dowager’s Hump (Fig. 3).

Picture for a moment the forward-drawn head also being pulled into right sidebending and right rotation due to combined hypercontraction in the levator and splenius cervicis muscles. As the client attempts to raise her head from a flexed to extended position, the facets on the right glide down on their inferior neighbor as they should. But the right sidebent positioning of the neck alters vertebral tracking causing the left-sided facets to “jam” as the head and neck attempt backward bending. Because the T3 facets on the left are unable to close properly, it forces the T3 transverse processes to rotate right, as illustrated in Figure 4.

Fig. 4: With a forward drawn and right sidebent neck, the left-sided T3 facets can’t glide down on T4 during extension. As the person attempts to backbend the head and neck, the facets jam on the left causing the T3 vertebra to rotate right.	Painful Rib & Vertebral “Dual Fixation” Prolonged T3 fixation into right rotation causes the accompanying T3 rib on the left to go into internal rotation and sometimes get stuck there. Now the nagging pain begins. The mechanoreceptors in this dynamic vertebra/rib fixation begin to feed off each other creating pain-spasm-pain cycles that reflexogenically inhibit surrounding paravertebral muscles, including the rhomboids and trapezius muscles. Retraining exercises to strengthen weakened lower shoulder stabilizers to help resist the powerful pull of the massive pectorals, are useless until both joint fixations are addressed. Between-the-blade pain resulting from this dual fixation is one of the longest lasting and most irritating joint-related problems our clients will ever experience.
Joint-Release Routine To remedy this distressful situation, the fascia of splenius cervicis, levator scapula and anterior scalenes on the right must first be lengthened (Fig. 5). Use whatever technique works best for you.
Next the therapist’s left thumb palpates the lamina groove on the left and scans in an inferior direction until the bony knot of the T3 transverse process is palpated (Fig 6). Using gentle, sustained anterior/inferior pressure, the client is instructed to inhale to a count of five, while carefully attempting to extend and left rotate her head against sustained isometric resistance from the therapist’s right hand. When the bony knot pushes back against the therapist’s resistance, a strong Golgi tendon organ release is transferred through the transverse process to the adjoining spinal rotator muscles, creating increased capsular flexibility and subsequent joint decompression. As the client exhales, a post-isometric relaxation response further softens the muscles and joint capsules creating better vertebral tracking. Pressure from the therapist’s thumb slowly de-rotates T3 allowing the fixated facets on the left to glide down properly on their inferior neighbor. Following this technique, if an immediate softening is palpated in the surrounding spinal muscles, then the therapist has done her or his job. NOTE: Always check to see if the rib on the left has corrected itself by lightly scanning the rib shafts with soft fingertips, superior to inferior, feeling for a bump at about T3. If a slightly bulging rib shaft is palpated, the rib is still stuck in internal rotation. With fingers or thumbs, simply release the intercostal muscles above the dysfunctional rib in a medial to lateral direction. Then apply the same basic procedure as above to align the costotransverse rib joint. Finish off the routine with a soft elbow dragging down the groove on both sides as the client extends and relaxes the head and neck. Click here To Order Level 2 Neck, Head and Back Pain Home Study	The therapist lengthens the splenius cervicis, levator scapula and scalenes by pinning the attachments with his or her left hand, while mobilizing the shoulder girdle with a right-arm lock. The therapist’s thumb contacts the client’s left T3 transverse process. With a 10-percent effort, the client inhales while extending and left rotating her head against isometric resistance. As T3 attempts to rotate right, the therapist’s thumb resists this effort, causing a Golgi tendon relaxation response in the fibrotic tissues that are restricting closure of the joint.

Dr. Benjamin will be interviewing Erik about his background, his work, and his thoughts about the field. Erik has practiced manual therapy for more than 33 years in a variety of clinical settings. He is the founder of the Freedom from Pain Institute and the author of two textbooks, Advanced Myoskeletal Techniques and Dynamic Body: Exploring Form, Expanding Function Book and the new Level 4 – 32 CE Home Study Course

Register here..
https://www2.gotomeeting.com/register/313698066

Three years ago we officially launched this adventure with the release of the 6-dvd Myoskeletal Alignment for Low Back, Hip & Leg Pain video series. At that point, none of the Freedom of Pain Institute staff (including my- almost- ex-wife) dreamed how long it would take to complete the companion Dynamic Body textbook.

But as months passed and the word spread, a host of luminary authors agreed to come aboard and, suddenly, the project exploded both with excitement and apprehension. Rich with 20 chapters from top practitioners and researchers in physical therapy, structural integration, osteopathy, functional movement, and chiropractic, the Dynamic Body book delivers its own unique and intriguing flow of ideas, techniques and research that visually stimulates even the layperson.

Dynamic Body captured the writings of influential pioneers such as Tom Myers, Serge Gracovetsky, Art Riggs, James Waslaski, Judith Aston, Gil Hedley, Robert Schleip, Jerry Hesch, Aaron Mattes, Aline Newton, Adjo Zorn, Robert Irvin, Divo Muller, Til Luchau and Craig Liebenson.  These forward-thinking clinicians and researchers have been influential figures in my work and played a substantial role in the concepts presented in the 6-DVD Myoskeletal Alignment set.

The collective vision of the Dynamic Body home-study program is to broaden the human perspective and demonstrate that there are many different ways to achieve balance.  We hope you agree.

Customarily, when we see cases of upward shearing of the ilium on the sacrum, the client’s SI joints are lacking either form or force closure. Form closure is provided to a joint by the skeletal framework. A series of ridges and complementary depressions produces friction and helps interlock the two bones, providing form closure to the SI joint (Fig. 2).

Synovial joints, on the other hand, perform best when there is minimal movement between the ilial and sacral articular cartilage surfaces. This minimal movement, termed joint play, not only provides spinal shock absorption, but also enhances lower extremity torque and transverse rotations, which help lift and propel the body through space (Fig. 3).

Musculofascial tissues reactto keep the sacroiliac joints in balance and move them back into form closure provided by the skeletal framework. The “binding” force contributed by musculofascial tissues is termed force closure. As defined by Andry Vleeming, Ph.D., force closure is Mother Nature’s backup system to nurture joint stability.

Force closure stability is generated by contractive action of core musculofascial tissues, such as the pelvic diaphragm, transverse abdominis, multifidus, and thoracolumbar fascia (Fig.4). In partnership, these deep core stabilizers provide a sophisticated neurologic feedback mechanism that reflexively interacts with the brain to provide coordinated movement and pelvic balance.

When the body is continuously subjected to an unbalanced load, viscoelastic tissues responsible for force closure can become strained. Prolonged cyclical loading can deform SI joint ligaments to the point where an act as innocent as slamming on the brake, tumbling on one hip, or clumsily stepping off a curb can jostle the joint enough to cause the ilium to “jump-a-notch” on the sacrum.

Read More ~
Low Back Piriformis SI Joint Pain

• Low Back Pain
• Sacroiliac and Pelvic Problems
• Hip Capsule Adhesions
• O-A and A-A Compensations
• Functional Scoliosis
• Rotator Cuff Impingement

This is the only time to catch Erik Dalton and his fabulous TAs in 2012 so don’t miss out on the fun in this 70% hands-on multi-media presentation. It’ll change the way you work!

OUTCOMES
Workshop participants will leave this 70% hands-on workshop with skills to help them: Identify and treat musculofascial length-strength imbalances. Understand theory and research related to neck, ribcage, low back and hip pain.

Join host Felicia Brown and legendary educator Erik Dalton PhD. for this special interview on ONE Concept Radio. Erik will be discussing his upcoming full day workshop at the American Massage Chiropractic and Acupuncture Conference : DALTON’S FAVORITE TECHNIQUES FOR NECKS, PECS, LOW BACKS & LATS.

Listen to Erik Dalton Pre-Conference Interview

***Attendees MUST bring a massage table (1 for 2 people), lotion and linens for this class. We will have limited massage tebales for rent. To inquire about sharing, please post on our AMC FaceBook page.****

CLICK HERE TO REGISTER

Let's call this guy Bob.. He sits at a computer all day and his brain relearns this aberrant posture as normal. On weekend outings, his hip flexed posture morphs into similarly distorted riding posture.

Like many of America’s other popular, but functionally abnormal, athletic endeavors, such as golf, tennis, and bowling, cyclists bring with them a complex biomechanical downside that’s often hard to completely fix. If you are a massage therapist or athletic trainer who treats cyclists it’s vital to precisely identify the anatomical structure at fault, and weed out any risk factors that may predispose the client to injury.

Risk factors will be:
Intrinsic (within the cyclist – any postural, overuse, or faulty movement dysfunctions)
Extrinsic (the bicycle setup)

Therefore, as a Massage Therapist treatment
is always twofold:
1.    Identify and correct muscle imbalances, joint dysfunctions, and motor control problems.
2.    Address the underlying causes for the injury by correcting bike setup and/or training errors.

The good news is that the human body is both adaptable and dynamic. The bad news is that our cyclists often bring along a lot of baggage, including flexion-addicted sitting postures, old injuries, compensations, and poor training habits. Any weakness or motor control issues are magnified by traumatic shocks due to unsavory road conditions or recurring bike injuries.

Cyclist who consistently ride with an anteriorly rotates pelvis and decreased hip angle are subject to capsular and ligamentus adhesions, short quadriceps and psoas, and a subsequent loss of economy and power.

A properly fitted bike, combined with a revitalized and functionally balanced neuro-myoskeletal system, allows muscles and joints to work at optimal levels of motor unit recruitment and synchronization. As endurance and performance improve, so does the enjoyment of cycling.

Cycling Biomechanics
The actual cause of ITB pain is an extremely important discovery for manual therapists or sports therapist who work with cyclists and runners. If the underlying fat pad is indeed the main cause of our client’s lateral knee pain, it is probably not a good idea to apply compressive forces over the ITB tendon, which is already squashing the inflamed fat pad. Traditional techniques, such as cross-fiber frictioning and ITB fascia-mashing, would be contraindicated.

Above from Erik Dalton’s Vicious Cycle
Chapter In the New Dynamic Body Textbook.

Enjoy a 10% discount off the $87.95 price
of the book by putting in the discount code dalton3 at checkout

Hard Cover – Over 400 glossy full color pages, hundreds of photos and illustrations.

To order… go to Order Dalton Dynamic Body Textbook

Click to look inside Dynamic Body Textbook

by Erik Dalton, Ph.D.

The biomechanical effect of heels in everything from running shoes to stilettos has puzzled researchers and fired controversy for almost a century. In a highly functioning body, the neuro-myo-skeletal system ‘hangs’ in dynamic equilibrium, each part balancing the other. But when a woman wears high heels, a new dynamic equilibrium occurs (Fig 1) If one body part becomes ‘fixed,’ the whole system must compensate with altered movement patterns resulting in kinetic chain ‘kinks.’ Here’s an interesting experiment that’ll help you get a feel for biomechanical adjustments high-heel wearers deal with every day: • Stand barefoot with the back against a wall. Observe how your ‘upright’ body column forms a perpendicular line (ninety degree angle) with the floor (Fig 2A).

• Slide a two inch wedge of some kind (phone book, etc.) under both heels and notice that by keeping your body column rigid, you’re forced to tilt forward from ninety to about seventy degrees (Fig 2B).

• Now replace with a three inch heel wedge and straighten up so you’re touching the wall again and feel the dramatic myo-skeletal adaptations that take place. Can you feel your ankles shift from dorsi to plantar-flexion? In this standing posture, the knees are buckled, hips flexed, low back swayed, and the shoulder girdle retracted (Fig 2C).

The brain, guided by foot, ankle and visual proprioceptors, must instantaneously make a whole series of myofascial and joint adjustments (ankle, knee, hip, spine, and head) to regain and retain erect stance and equilibrium (Fig 3). But high-heeled posturo-functional faults are not confined to the external milieu; they may also inflict compressional damage on the internal viscera…particularly pelvic bowl contents. According to research conducted by Diane Lee, excessive lumbar lordosis causes the pelvic bowl to dip anteriorly which raises the body’s center of gravity leading to reduced proprioceptive stability.1

Not only are we more unstable on our feet, but the increased anterior pelvic tilt squashes our poor organs. For example, when standing barefoot, the anterior angle (pelvic tilt) of the female pelvis is twenty-five degrees; on low, one-inch heels it increases to thirty degrees; on two-inch heels to forty-five degrees and on three-inch heels to sixty degrees. You don’t have to be a physicist to envision how increased heel height causes gravity to compress and distort abdominal organs (Fig 4). Hopefully one day we’ll see a well-designed study testing the relationship of long-term high-heel wearing and ‘gut’ problems such as prolapsed colons, distended bladders, hemorrhoids, etc.

Many women love to wear high heels, and I might add many men like women in high heels. However, it’s true that some women suffer for their vanities. In young women, this is accommodated fairly well by ankle and hip mobility and low back stability. But, many high-heel wearing women find that as they age and the hip joints stiffen, shock waves shoot through the lumbar spine causing disc compression, ligamentous laxity and facet joint spurring. Women should be cautious about wearing heels constantly, or over long periods of time.

Clearly, the human foot was not designed to walk in stilettos… or cowboy boots for that matter. The foot is specifically constructed to land in a heel to toe ‘rolling’ motion whereby the arch, ankle, and knee absorb shock (stored energy) and release the ground reaction force up the kinetic chain to counter-rotate the torso and pelvis. The heeled shoe steals this propulsive power from tendons, ligaments and leg muscles. Not only do heels place the foot and leg under greater stress to achieve the demands of propulsion, but the borrowed power must be ‘leeched” from higher structures in the kinetic chain, i.e., knees, thigh muscles, hips, and trunk. As a small army of anatomical reinforcements are recruited to rescue the handicapped fascial tissues, the body continues to lose energy to the ground. Shoe heels of any height set in motion a series of gait-negative consequences, making natural gait — meaning the barefoot form — impossible. Don’t let your clients be a slave to fashion; fix their feet and give them back the natural spring in their step.

Reference: 1. Lee, C-M et al. “Biomechanical Effects of Wearing High Heel Shoes”. Int’l J of Industrial Ergonomics 28: 321 – 326, 2001

Techniques as illustrated in
Level IV 6 DVD set…
Myoskeletal Alignment for
Low Back, Hip & Leg Pain

This is a portion of the Dalton Newsletter… to view the entire newsletter, and information about special newsletter offers and upcoming workshops… go to DaltonArticles.com

dollars on healthcare

Look at the $$$ we’re spending. New report from the Institute of Medicine: “Healthcare providers should tailor pain care to each patient’s experience and promote self-management of chronic pain, a condition that affects more than 116 million Americans and costs the U.S. up to $635 billion annually in medical treatment and lost productivity.”