Pope moves to Gordon!

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In Review

An Anatomical Overview of the Spine and Treatment Techniques

Myopractic Workshop Review

An Anatomical Overview of the Spine and Treatment Techniques

By Carlos Kaiser

Mark Philip Deal, a Chiropractor, Osteopath, Acupuncturist and Educator presented a comprehensive
and edifying workshop for the Association of Remedial Masseurs on November 11, 2007 at Gladesville
in Sydney. His workshop consisted of thorough explanations, a balanced mix of practical work and a
number of questions from the floor. Mark complemented the workshop with a fine set of notes for
participants complete with photos to illustrate the practical components.

I have extracted the information presented in this article in part from a condensed form of Marks notes
along with observations and comments that were made at the workshop.

I give full respect to any intellectual rights in respect to the information given at the workshop by Mark
Philip Deal and Peridor Health Schools and include portions here along with commentary purely for
the benefit of those members who could not attend.

The workshop commenced with the all-important Structural Analysis. Mark emphasised the importance
of performing and recording a structural analysis in a Postero-Anterior then a Lateral View before
assessing the spine.

Mark covered the essentials of structural Analysis in Postero-Anterior view in particular:

• Look at the level of the ears, occiput and shoulders.
• Note the prominence and level of the scapulae.
• Are the arms closer to the body on one side?
• Is there a scoliotic curve.
• Identify and touch the PSIS.
• Mark reminded us to inform the client that you are about to do this - and to tell them the things that
  you are doing as you do them.
• Assess if one of the PSIS is higher than the other.
• Assess the motion of the SIJ, ask the client to raise
  one knee then the other towards the chest. Observe
  any inferior motion to the PSIS on the side of leg rising.
• Observe any positive Trendelenberg phenomenon - an inability to stand on one leg where the pelvis drops markedly on the same side as the raised leg as this may indicate hip pathology or Gluteus Medius failure on the supporting leg side.
• Is the gluteal cleft diverted to one side?
• Is the gluteal fold higher than the other?
• Is the popliteal crease higher than the other?
• Is one foot turned out more than the other?

Mark explained that measuring leg length is too arbitrary and that our palpation skills are varied and very
subjective. He highlighted the fact that objective is what you can see and everyone else can see. Above
all, keep your mind open to what conditions may be present. It could be a primary or secondary condition
or a secondary that has become primary.

Mark then covered the essentials of structural Analysis in Lateral view in particular:

• Is the head further forward or back from the direct line?
• Are the shoulders held forward or backward?
• Is there a "Lordotic" curve in the Cervical spine?
• Is there a "Kyphotic" curve in the Thoracic spine?
• Are the forearms held more forward with respect to the body?
• Is there a "Lordotic" curve in the Lumbar spine?
• Is the pelvis "tucked under" or protruding backwards?
• The ASIS and PSIS should be level or slightly forward if it is up it is a posterior or anterior rotation
  of the ilium.
• Are the knees flexed or hyperextended (and / or with respect to each other).
• Are the feet arched?
• Is one foot being carried forward with respect to the other?
• Is the longitudinal arch exaggerated or depressed?

Mark defined the following terminology:

A Structural Scoliosis shows that the structure is abnormal.

A Functional Scoliosis indicates that the muscles are unbalanced and the muscles are
pulling things out of place.

Sherman's Disease or condition is where the bodies of the vertebrae collapse at the front so that there is an increased lateral curve (usually occurs in a growth spurt).

Osteoporosis' will have a tendency to increase Sherman's Disease.

Mark continued the workshop with Assessing and treating the Cervical Spine. Mark emphasised the importance of performing and recording Objective testing and findings which includes limitations of motion, guarding or more
serious conditions.

He identified two functional regions in the Cervical Spine. The first functional region is C1-2 and the second is C3-7, the difference being in structure and in movement.

Mark explained that:

• Performing a "safety test" is for the clients wellbeing and is a good thing!
• If or as soon as there is an experience of any pain - stop!

Mark gave an example of testing cervical range of motion using the provided chart (see below) as a reference for noting and recording any observations.

Mark then covered the Essentials of Compression, Distraction, Adson's test, Scapular Approximation, Bilateral grip strength, Consensual Light Reflex and Vertebral Artery test.

Compression is the application of pressure downward with your hands on the clients head.

• Indicates possible cervical disc protrusions particularly with neurological signs such as paraesthesia, numbness or causalgia radiation along the distribution of the nerve.
• Often reproduces local pain in the cervical spine due to inflammation of the local structures.
• Note observations whether positive or nil.

Distraction is the application of light upward pressure via occipital holding.

• Often relieves pain considerably in a true disc lesion.
• Reproduces pain due to ligament irritation.
• Note observations whether positive or nil.

Adson's test is performed by holding the pulse medial to radial condole while the arms abducted to 90 and the elbows are extended. Ask the client to turn their head to the side of the pulse and then slowly to the other side. Note any reduction in pulse pressure.

• Note any reduction in pulse pressure.
• Indicates possible Thoracic Outlet Syndrome condition.
• Note observations whether positive or nil.

Five main causes:

1. Anterior Scalenes compression of Brachial Plexus.
2. Costo-clavicular compression of the Brachial Plexus.
3. Presence of an extra Cervical Rib (X-ray required).
4. Pectoralis Minor causing compression of the Brachial Plexus.
5. Pancoast's Tumour in the apex of the lung (X-ray required).

Scapular Approximation is performed by instructing the client to flex their head "drop head forward" while bringing
their outstretched arms into extension at the shoulder.

• A positive test is indicated by pain in the Cervicothoracic junction. Some clients may experience pain in the pectoral region or anterior shoulder.
• Note observations whether positive or nil.

Bilateral grip strength is performed by asking the client to gradually squeeze your wrists.

• The client is normally stronger on their side of "handedness".
• Note observations whether positive or nil.

Consensual light reflex is performed by shining a light into client's eyes and noting papillary constriction. Alternatively, cover one eye and note if the other eye dilates.

• Note observations whether positive or nil.

A Vertebral Artery test is where the client lies supine with their eyes open. Gently turn the client's head
to one side and slowly side-bend, extend the head over the edge of the table, and note any variation in
pupillary size. Immediately stop the test if the client experiences any disturbance in vision, dizziness,
ringing in the ears or any other sign of discomfort including pain.

• This test excludes Vertebral Artery Insufficiency caused by compression of either Vertebral Artery in the neck.
• Note observations whether positive or nil.
• Repeat the test on the other side.

Mark continued the workshop with a practical demonstration of Cervical procedures, Lumbar procedures and Sacro-iliac techniques. After the demonstration, the participants paired off and worked on each other.

Cervical Procedures consisted of the application of some general massage to the cervical and upper thoracic spine areas.

Particular attention was given to:

• Flicking the facial anchor at the superior spine of the scapulae of Trapezius, supersprinatus and levator scapulae.
• Cross frictioning the joint capsular ligaments near the acromio-clavicular joints.
• Cross frictioning the tendinous fibres and apply pressure to the superior cervical musculature at the insertions into the Occipital bone. A special note is to be given to any inflammation that may suggest Cervical Lymphatic congestion.
• Applying deep pressure techniques to the supraspinatus and levator scapulae.
• Kneading the trapzii and supraspinatus muscles.
• Applying the "Stair-Stepping" manoeuvre on the cervical spine. This involved moving forward and backward over the segments with care while feel for restrictions or "jerkiness".

General massage continued with the application of passive movement through the mid-range. Particular
attention was given to:

• Taking the weight of the client's head in both hands and gently moving the cervical spine through flexion, extension, lateral flexion and rotation.

Lumbar Procedures and Sacro-iliac Techniques consisted of the application of some general massage to the lumbar spine area and the employment of Block Techniques involving the use of a foam wedge or a rolled up towel.

Particular attention was given to:

• Placing a wedge/towel under the thigh of the leg with external rotation.
• Placing a wedge/towel under the ASIS of the other leg.

General massage continued focusing on work around the lumbar sacral area.

During a Periformis release the blocks must be removed. To perform Periformis release first make a
visual analysis. The foot will be turned out on the side of the periformis spasm. Check the leg length at
the medial maliolus. To treat:

• Bring the bent leg and thigh up and a notice a divot appear at the periformis. To treat:
• Bring the bent leg in medially then apply pressure to the periformis while rotating laterally.

A Psoas test is performed when the client goes into prayer position and their bent arms are pulled above
their head while rotating then brought back to prayer position. Psoas is usually contracting on the
shortened side (the fingers of one hand slip downward). To treat:

• With their leg bent apply pressure off ASIS into the belly of iliacus and slowly let the leg straight and down.
• Perform a "Hip Lift".
• Pull the illium into posterior rotation while holding the pares process down.

The workshop completed with a general Q&A session, highlights include:

• L5S1is involved in true sciatica and involves pain going down the back of the leg.
• L4 is the femoral nerve and involves pain going down the front of the leg.
• L4/L5 is the femoral cutaneous nerve and involves pain going down the side of the leg.
• A pop is a combination of oxygen and nitrogen causing a bubble to "pop" within the synovial fluid. This will not occur for about 20min after there has been a reabsorbtion of gases into the tissues. This is a release or separation. Doing this does not cause arthritis "Its OK as long as it doesn't hurt" overdoing this may cause loosening of the ligaments.

Myopractic Workshop Review

By Carlos Kaiser

The Back-to-the-future of Bowen's Therapy workshop was held on Sunday 25 May 2003 at Gladesville in Sydney. Wayne Brown explained and demonstrated this therapy with the assistance of Abe Pollak during the practical components. The seminar commenced with a question and answer segment followed by a practical session for all attendees involving the demonstration and practice of a shoulder treatment. The workshop completed with a number of demonstrations including demonstrations of ankle and wrist treatments and a hip treatment.

Wayne Brown is the local instructor for the Australian College of Myopractic. He has been working in the health and healing field for over 20 years. He trained in massage, herbal medicine, hypnotherapy, counselling, Bowen Therapy and Myopractic. He explained that he now uses Myopractic almost exclusively, as he finds it to be the most effective, quickest and easiest to perform and the least demanding on the practitioner.

What is Myopractic?

Myopractic is a form of bodywork that utilises muscle movements to release lesions in soft tissue. Some movement are gentle, however, where the muscle condition has become fixed and crystallized then a type of deep tissue work is used to restore flexibility, softness and a more normal function back into the tissue.

During the seminar, it was explained that Myopractic can be performed to correct many body disorders. The practitioner aims to improve the body’s vital balance and posture by means of executing cross fibre techniques on muscles, tendons and ligaments. This treatment empowers the body’s natural healing forces, allowing a free flow of energy around the spine, extremities and internal organs. Myopractic practitioners endeavour to provide effective treatment for sporting injuries, aching muscles and joints, nervous stress, and many internal organ imbalances.

How did Myopractic develop?

Myopractic was derived from the principles formulated and applied by the late Tom Bowen. Tom Bowen lived from 1916-1982 and practised his methods in Victoria, Australia with great success. In the 1970’s Dr Neil Skilbeck became an understudy under Tom. Neil had previously been trained in chiropractic and osteopathic methods and through his experience in bone and joint manipulation, he added aspects of body assessment, diagnosis and other treatments to the method. This lead the method to evolve into a different type of bodywork than Bowen Therapy. In January 1999 The Australian Myopractic Association was incorporated and the Certificate IV in Myopractic was established.

How is it different to Bowen Therapy?

• Myopractic differs from Bowen Therapy by incorporating:
• Detailed diagnostic procedures to identify the true cause of the problem
• Feedback mechanisms to verify the desired results have been achieved
• Procedures for treating chronic/fixed muscle conditions

How long is the average treatment?

Wayne explained that a typical treatment takes approximately 15-20 minutes. The first visit takes longer due to an assessment of the clients posture and relevant muscle groups. Client may report and initial improvement taking place, however the full effect of the treatment will take many days to work. A couple of follow up visits may be necessary to stabilise the initial corrections and long-standing postural defects may require many more visits.

What is Myopractic suitable for?

According to Wayne, Myopractic is beneficial in treating sporting injuries and can assist a wide range of muscle and skeletal disorders. It can also promote healing of many imbalances of the body’s internal systems.

The following are some of the bodily disorders that have responded well to Myopractic treatments.

• Back and neck injuries
• Limb strains and pain
• Fatigue
• Nervous stress
• Digestive problems
• Respiratory difficulties
• Menstrual disorders
• Postural imbalances

How can I learn Myopractic?

Myopractic is registered at Certificate IV level and is conducted by the Australian College of Myopractic which is a Registered Training Organization. The course is structured as a combination of correspondence (theoretical modules) and practical seminars and is designed to take one year full-time or two years part-time to complete.

In summary

• “Muscles move bones” basically that’s what the Myopractic system works on.
• Most treatments can be conducted in 30 minutes.
• Most treatments require between 1 and 3 treatments.
• Employs some limited massage of the fixed lesions.
• A reported 99% success rate.
• Saves a lot of energy.
• There is some short-term pain however the results are quick.
• It works right on lesions so it can be painful.
• It can take at east a week for it to work properly even a fortnight if there are any negative reactions.
• It is claimed that 20% of clients get better and better. Of the remaining 80% a few may get reactions like nausea (resulting from toxins coming out of the muscles back into the system).
• Must drink plenty of water after a treatment to help flush out your system.
• Certificate IV course in Myopractic costs around $4000.
• RPL credits are available for modules covered in previous courses.
• Modules not common to other courses may be Medical terminology and radiology.

Myopractic is a great adjunct to most modalities of body therapy and a notable method in it’s own right.

Remedial Therapy Solutions
Suite 3, Level 2, “Gordon Centre”
802-808 Pacific Highway
Gordon NSW, Australia 2072
Phone: 0416 227 567