somewhat related from the same website-
Evaluating Patterns of Function: Effects of Kinetic Chain Dysfunction on the Neck and Back
midway in the article was interesting to me- this section-
[....Neck pain can also be evaluated globally. During examination, do you do the examination by the numbers, with all the orthopedic tests, and ignore their shoulders and overall posture? Posture can have a devastating effect on the way the neck functions and can cause chronic cervical joint dysfunction/subluxation. What about the jaw? If the patient's upper neck is locked up repeatedly, the jaw is most definitely involved. How can someone adjust subluxations without evaluating the effect of these structures on the spine? Obviously you cannot, and you are ignoring causative factors which can help you resolve, often for good, a neck, jaw or shoulder problem. Patients with chronic neck problems have tight, ropelike muscles which are weather sensitive. We often try to adjust through this, and create discomfort for the patient during the process. Is it any wonder you need a great deal of speed and force to adjust them? Perhaps the reason we do not look at people globally is because we were never trained to think and evaluate this way. I know I was never trained to do it.
While evaluating the upper body, I will perform a talking examination on these patients and tell them what I find, showing them where they are restricted and pointing out musculature which is contracted and preventing movement. This makes them well informed. At your report of findings, your job is much easier, and the patient will more likely follow your instructions. Current studies do indicate that patient compliance now typically hovers at about 40 percent.
Upper body kinetic chain problems are also somewhat predictable. For instance, when you look at someone from the top down, and see one shoulder more forward than the other, the anteriorly placed shoulder will be weak. I have theorized that this occurs because as a system of pulleys, the more anteriorly placed the shoulder is, the more dysfunctional the joint becomes, as the angle of pull of the shoulder muscles becomes more disadvantageous and makes the patients shoulder muscles work harder.
I often tell the patient, "This is what I will find. All the muscles in this right shoulder will be weak and your neck motion in the opposite direction will be restricted by the trapezius due to the tension it exerts on your neck from poor posture." I then muscle test them and show them what I said is true. I will then pull the shoulder back and retest. With the new angle the shoulder functions at, it is noticeably stronger. I also show them their neck moves more easily with their shoulders back vs. their current posture and make them see what posture does to their neck. Seeing is believing and our more sophisticated '90s public always wants more proof.
How can a doctor justify the ignorance of saying, "I just adjust subluxations"? The spine doesn't exist in a vacuum. While I am sure many "principled" chiropractors would beg to differ, as they download me with Palmerian philosophical stuff from the early 1900s, the fact is that ignoring the effects of the other structures on the human frame is unjustifiable. Simply put, would you go to a medical doctor practicing 1950s medicine? I wouldn't. Our profession continues to evolve and in the '90s, results are what counts, period. The game now is how to get them better, cheaper, faster, with better quality of care.
A relatively new treatment which has been rapidly gaining converts is myofascial release. Taught by Leahy, Barnes, the Rolf Institute and others, this method has received some heavy promotion and deserves the good reputation it has received so far. It solves many of the treatment problems we have come to expect and gives us a way to resolve many conditions, often in half the time and with better long-term outcomes. The great thing about myofascial release technique is it fits into today's protocols and makes us look great with managed care companies by enhancing results, shortening treatment times, and increasing patient satisfaction. I would recommend all doctors begin to learn how to use this very effective treatment tool.
Myofascial release comes in different flavors: Leahy's "active release techniques," Barnes' rolfing, Mock and others. My own methods, drawn from the others previously mentioned, have evolved with the realization that not one approach works equally well on all tissue density types; that it is certainly helpful to change to different techniques for the same area, depending on the patient's muscular topography. This is not dissimilar to changing adjustive methods for different patients, because some techniques work better in different situations.
full article here-