I can’t breathe!

It is 4:30am and I am awake due to the pain in my shoulder and upper ribs.

It hurts to inhale and expand my ribcage.

OK, I am an expert at fixing bodies…I can fix this easily.

I’ll address the serratus anterior muscles and release the tension jamming my ribs into my spine!

Oh crap! That didn’t help very much at all. Now what do I do?

 

I can feel the spine and ribs at around T8 are not moving normally during inspiration.

I’m using my hand to press against the T8 spinous process but can’t effectively release the tension there.

 

What else attaches to the spinous process at that level?

Oh yes, the lower trapezius fibers insert into there. I will address the trap fibers along the spine of scapula and that should alleviate this pain!?

 

Nope, that didn’t work!

Now what???

 

I wonder if it could be from my latissimus muscle? It attaches into the spinous processes from T7 down to S2.

 

I grabbed the belly of the latissimus muscle at the posterior portion of my axilla and found the most tender fibers I could.

 

 

 

 

Oh snap!

Finally, I can breath again without pain.

 

Compressing the tender latissimus muscle fibers released the strain from my spinous process and unlocked the joints allowing for improved joint mobility and reduced nerve irritation.

I have shared my thought process for discovering how to relieve my pain and suffering in the hopes that you will gain insight into addressing issues with your body and your patient’s bodies.

 

I would appreciate your feedback [email me] about how this helps you in your diagnostic approach.

 

$24,000? For what?

Dr. Smith has been training with me in Myotonic Facilitation Technique and he sent me an email about learning the AtlasPROfilax method developed in Europe. This technique was developed to address the atlas and achieve permanent correction in only one visit according to their website.

Achieve permanent correction of the Atlas in only one visit!?!?

I am definitely interested in developing this kind of skill.

As a technique skeptic, I have three questions:

1-What will I learn?

  • The training module consist of two parts: the theoretical and practical part.
  • The theory includes anatomy, muscles, fascia, neurology, biomechanics lessons.

Awesome. They are focussing on correcting the dysfunctional suboccipital muscles.

Question 2 – How long is the training?

  • The training lasts 15 days.

2 Weeks of education on the atlas and associated structures???

Hmmmm??? Having developed over 30 hours of online courses in chiropractic continuing education, I am challenged to comprehend how you could produce enough material to fill 15 days (are these 6 hours days? = 90 hours total) of training.

 

3 – How much does it cost?

Dr. Smith’s response to the price quoted to him…

“Your kidding, right?  $24,000?   I think I’ll stick with Dr. Turnbull’s work.  Highly, highly effective, and fractions of the cost to train.”

 

What is the difference between AtlasPROfilax and other techniques?

The essencial difference between the AtlasPROfilax method and other techniques for correcting the atlas relies on the condylar decompression generated through muscle and ligament release in the cervical region and therefore results in a permanent alignment.

[from their website]

I hope I am not alone in my skepticism?

I have some good news for you.

I have just finished videotaping the shoulder, arm, wrist and hand live seminars and will be publishing the videos soon. I intend to keep the price affordable since I want the whole world to benefit from what I have learned.

I will videotaping my whole seminar series on MFT in the next 6 months.

STAY TUNED 🙂

Joint vs. Muscle Receptors

What happens when their are no joint receptors?

 

How does the brain recognize the position and motion of a joint?

Where does it get sensory input?

 

When a person undergoes joint replacement surgery the ligaments and joint mechanoreceptors are all removed permanently.

Kandel, et. al. published their findings in an article titled, The proprioceptive senses: their roles in signaling body shape, body position and movement, and muscle force.

In this article it was noted that the majority of joint sensory input comes from muscle receptors with little to zero input from joint receptors.

 

 

Where does that leave chiropractors that only focus on joint mobilization?

IF the goal of treatment is restore normal joint position and mobility then the muscle receptors must be addressed. The golgi tendon organs and muscle spindles are vital to making permanent correction of bony alignment.

I will be sharing these concepts and answering questions like, “why doesn’t the adjustment hold?” during my seminars.

 

On August 26, 2017 I will be hosting a 3 hour upper extremity class in Portland. I will also be videotaping this course so that others may gain access to this information.

CLICK HERE to see more details for this course.

Lumbopelvic Fixation

Ouch!

I just got zapped again in my left LumboPelvic (LP) region.

Shocking pain and muscle failure causing me to drop to my knees.

HVLA moves are painful and don’t relieve the problem.

I pull out my adjusting tool and go to town…

only getting temporary relief.

How many days will this continue?

What do I need to do to correct this?

 

My approach to dealing with my LP pain:

What I found gave me the most relief was addressing the hypertonicity in my left Latissimus Dorsi muscle.

 

 

When I squeezed and held the at muscle [near the white dot in the above pic] my lumbopelvic pain diminished significantly and my mobility opened up.

 

CRAZY?!!

Who would have thought that the lat could cause so much pain and immobility in my low back?

Look closely at the distal insertion of the lat. It attaches to the spinous processes of L1 thru L5 and into the superior aspect of the ilium.

When the left latissimus becomes hypertonic, it pulls the lumbar spinous processes up and to the left and pulls the ilium superior. This can create joint tension and locking of the SI and lumbars. It restricts pelvic elevation and lumbar lateral flexion.

 

Evaluation of the latissimus can be performed by testing muscle power output.

Below is a pic from the Myotonic Facilitation Technique manual of latissimus muscle testing protocols.

 

 

 

 

Dr. Brian Lattimer, DC

Greetings,

I just got off the phone with my friend and mentor, Dr. Brian Lattimer, DC. He was discussing the possibility of collaborating with me about helping chiropractors succeed in their practices.

[Brian lives in a remote town of 2,500 people, sees about 400 patients per week and none of them are repeat visits or on an extensive treatment plan. He is a master at practice growth and management.]

 

2 questions came out of our conversation:

 

– How satisfied are you with your practice on a scale of 1-10?

 

– How many doctors are willing to commit to a treatment plan involving 30 visits over a 90 day period? Pre-paid?

 

 

Take a moment to answer these questions before reading further…..

 

 

 


If the doctor is not willing to follow their own patient recommendations, how do they expect their patients to adhere to their recommendations?

This is incongruent and causes excess stress.

In the next several months I will be sharing insights from conversations with Dr. Lattimer.

 

The greatest practice growth advice I have received to date from Dr. Lattimer is to keep a ‘Gratitude Journal’.

Brian told me, “Every day write down several things you are grateful for in your journal. This allows you to see situations, people and opportunities in a whole new way.”

 

This daily practice has made a significant impact in my practice and my life. It has done the same for others that have incorporated this key tool for practice [and life] success.

 

 

My practice involves writing 5 things I am grateful for including those challenges that, when I adopt an attitude of gratitude, transforms the situation from adversity to adventure.

 

 

I look forward to hearing the success stories of those who implement this transformational action.

 

Anterior Tibialis

What Do Snowboarders and Runners Have in Common?

   Snowboarding is an exciting sport where athletes surf the powder, huck big air from jumps and spin on thin metal rails. Many people are captivated by the thrills they see on television and decide to go learn to snowboard.

   The first lesson involves learning to slide and stop on the heel-side edge of the snowboard for steering and control. If they let their toe-side edge get too low it catches in the snow and the participant is quickly slammed face first into the frozen ground. [pic 1]

   After several incidents of being planted into the snow, riders learn to use their anterior tibialis muscles to keep the toe-side edge from catching. Most beginners are not used to using these muscles and they get strained within hours of snowboard riding.

   The anterior tibias muscle originates from the anterior surface of the lateral superior tibia and inserts into the medial cuneiform and first metatarsal bones of the foot. [pic 2]

    It is responsible for dorsiflexing and inverting the foot. Runners commonly strain the anterior tibialis while running downhill.  Shin splints is the term used when there is a complaint about pain in the front of the calf.  The eccentric stress of running downhill and snowboarding can create tissue damage at the tendinous insertions, the fascia and in the muscle belly fibers.

   

Diagnosis

   Physical exam findings include tenderness and weakness of the anterior tibialis muscle. The pain may be exacerbated with stop and go running drills and/or walking downhill. When the anterior tibialis muscle is strained or irritated it can cause pain, weakness and nerve compression leading to tingling and numbness in the top of the foot and ankle.

   Look for a loss of range motion and/or a loss of coordination with foot dorsiflexion.  A dysfunctional anterior tibialis muscle can restrict ankle flexion preventing a deep squat from being fully performed and may also result in a foot drop with a “slapping” gait.

   Muscle test bilaterally and note the deficiency of the involved muscle. Eccentric-break manual muscle testing involves having the patient laying supine with foot fully dorsiflexed. The doctor stabilizes the lower leg with one hand and pulls the dorsiflexed foot downward. [pic 3]

Treatment

   Effective correction of the anterior tibialis involves reducing the hypertonic state of the muscle. Thrusting and/or pressing into the tender insertion points will affect the nerve receptors located there. Using 2-3 gentle thrusts with your hands or an adjusting instrument usually creates enough stimulation to cause a significant improvement in muscle power output, pain reduction and mobility. [pic 4]

   Adhesions in the muscle can be addressed by pressing and holding for 3-5 seconds into the tender muscle belly fibers. This typically unlocks the fibers and restores greater mobility and function to the muscle. Post treatment evaluation should be performed to determine treatment success and revealwether further correction is needed.

Rehabilitation

   The anterior tibialis can be stretched by opening the ankle joint. Gently bend the toes and top surface of the foot against the ground into plantar flexion then slowly roll the heel from side to side for five repetitions.

   Strengthening the anterior tibialis can be achieved by  elevating the distal foot while standing on the edge of a step. I prefer my patients work the good side first then train the involved side. This can be done using 10 second isometric holds, using multiple sets and reps without resistance or exercise tubing can be added to increase resistance.

Back Pain: Quadratus Lumborum

How do you evaluate the quadratus lumborum?

What tests do you use to distinguish between psoas, iliacus, obliques and quadratus lumborum [QL]?

These muscles are all involved in flexion, extension, rotation and lateral flexion.

How can we single out the QL from the rest of the muscles that directly affect the lumbar spine?

Side bends test the function of the obliques and QLs. [mobility]

 

Unilateral hip elevation also evaluate the obliques and QLs. [strength]

 

Prone/supine eccentric break testing evaluate both obliques and QLs. [strength]

 

Palpation directly addresses the QL muscles.

 

Combine range of motion, palpation and muscle testing to evaluate the degree of success obtained from your treatment.

 

Correcting the QL.

Insertion points – press directly into the osteo-tendinous junction at the site and angle of most sensitivity and tenderness. [See arrows]

Use a tolerable force. [2-3 on a 1-10 scale]

Apply thumb pressure with 3 to 4 gentle nudges into the most tender insertion

or…

press and hold the tender point for 3 to 5 seconds.

Immediately retest mobility and strength to track progress.

 

 

I read in bed every night

 

is what the patient said that triggered my brain to investigate his Sterno-Cleido-Mastoid [SCM] muscles.

 

His initial complaint was numbness in his right ear, jaw and upper chest.

[Alarms bells should be going off in your head regarding cardiac issues, mine did.]

 

Restoring strength to his SCM muscles eliminated the numbness and improved neck extension and rotation.

 

Evaluation

 

Correction

 

 

 

 

 

Patellar Tendonitis

 

 

 

The doctor said I have “growing pains”.

 

What does that mean?

 

 

 

I see many early to mid teen athletic patients that complain of knee pain.

The most absurd statement a provider can make is to tell the patient they have “growing pains”.

The explanation that usually follows is something like this, “Your bones are outgrowing your muscles and causing you pain”.

In which reality can a bone grow faster and farther than muscle fibers can stretch?

 

It is statements like that which propel me to write articles like this one:

 

“Patellar Tendonitis: Diagnosis and Treatment”

VOLUME 35, NUMBER 7

 

 

Here are some of my notes from the MFT treatment manual on how to apply these concepts.

 

Presentation

  1.  Pain is localized in the sub-patellar/tibia region.
  2. Kneeling may be painful.
  3. Calcification of the patellar tendon at the tibial tuberosity insertion may occur
  4. Squatting fully may not be possible due to pain and/or joint pressure.
  5. The quadriceps muscle will test weak.

 

 

MFT Diagnosis – Quadriceps muscle testing

 

 

MFT Correction

The arrows show which way to push into the insertion points.

The dots represent areas of muscle fiber adhesions that are addressed using perpendicular lines of force.

 

COMING SOON – Look for the blog post on MFT knee rehab techniques.

 

Piriformis Syndrome: A Pain in the Rear

 

I authored an article with the above title in the Dynamic Chiropractic journal.

Here is my short version on how to apply these concepts.

 

Presentation

  1.  There may be pain in the gluteal region.
  2. The patient may have external foot rotation during walking, laying supine or prone.
  3. The knee to opposite shoulder stretch will be restricted.
  4. The muscle will test weak.

 

Diagnosis – Piriformis muscle testing

 

Treatment

Effectively correcting the piriformis dysfunction involves reducing the hypertonic state.

Thrusting and/or pressing into the sciatic notch will affect the fibers at the origin, while forces applied at the femur head will address the insertion fibers.

Press and hold for 3-5 seconds into these areas in order to stimulate the golgi tendon organs and reduce hypertonicity.

 

 

Rehabilitation

Stretching:

With the patient lying supine, bring the involved-side bent leg across the body and up toward the opposite shoulder. While maintaining this stretch, the tender piriformis fibers can be massaged to release more muscle fiber tension.

Strengthening:

I prefer my patients work the good side first and then train the involved side.

Quadruped Hip Abduction: Beginning position is an all-fours position. Instruct patient to keep their knee bent and lift the involved leg in the air to the side until it parallels the floor. This can be done using multiple sets and reps without resistance; or exercise tubing can be used to add resistance.

Side-Lying Clam Exercise: Instruct patient to lie on their side with the involved hip on top; then bend their knees, keep the ankles together and raise the top knee away from the bottom one. Again, this can be done using multiple sets and reps without resistance, or exercise tubing can be used to add resistance.

 

CLICK HERE to read the full article.