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SOT for pregnancy & pediatrics

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Jurjen Haitsma

on 19 July 2014

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Transcript of SOT for pregnancy & pediatrics

Useful SOT for pregnancy & pediatrics
The Pre & School Aged Child
Infant SOT care

The Cranium & Cerebro-Spinal Fluid
What Category?
The five step analysis
1. Mind Language
2. Visiual Analysis
3. 1st Rib Analysis
4. Supine leg lift with cervical compaction
5. Arm Fossa Test
Categories
Normal neurology when traumatized, may either orchestrate a return to ideal function, or adopt a CI pattern of adaption.
With further time and/or trauma, when a CI adaptation is no longer sufficient; a CII pattern of adaptation may develop. With further time/trauma a CIII pattern may develop.
Each of these adaptive states enables the neurology to hold its state at that point, maintaining acceptable function until a return toward ideal becomes possible.
Anatomy Review of the Pelvis
The Sacro-iliac joint anatomically is divided into two of man’s functions. The top and posterior part of the joint are weight bearing and the anterior medial part is the boot structure. A Category II problem a slip or separation of the weight bearing part of joint. A subluxation of the boot part produces a Category I patient.
The sacro-iliac joint has no muscular motivators. This is the only joint in the body not endowed with voluntary muscle control
The sacro-iliac joint is divided into amphiarthodial at the weight bearing and diarthrodial at the boot part. The weight bearing part of the joint is joined by interosseous fibres, the boot part of soft fibrocartilage. The boot part is protected by synovial fluid, and the weight bearing part by hyaline cartilage.
The boot part of the scaro iliac joint has a rocker, semi-rotating gliding motion and is termed the primary sacral respiratory boot motion. The sacro-iliac joint proper has three ligaments
1. Anterior Sacroiliac
2. Posterior Sacroiliac
3. The Interosseous
The arrangement of the sacro-iliac joint allows for much give and take in body mechanics, but once the weight bearing articulation subluxates, this is lost and man is in big physical trouble!

Who was DeJarnette?
Dr MB DeJanette 1899-1991
"It is not another technique within the body of chiropractic rather it is a method of chiropractic and as such is a full science"
What is SOT?
A method of chiropractic based upon the premise that normal respiratory function activates the flow of cerebro spinal fluid and from this function depends the harmony of all body structures
Blocking
Preconception & Fertility
In a category II a female patient has a high probability of menstrual disturbances due to the high nerve innovation around the sacrum to the reproductive organs and the pituitary involvement in the cranial/sutural component of a CII pattern.
It has been clinically noted that patients can have difficulty conceiving while in a CII pattern (CASE EXAMPLE)
Symptoms commonly seen in the expectant mother & helpful SOT adjustments
Pelvic pain including symphysis pain - CII
In any category the developing fetus has a compromised uterine environment due to the pelvic distortions and uterine ligaments attachments, however in a CII the pelvis is unstable and the tension patterns through the uterus are significant.
Shortness of breath, Indigestion - Diaphragm & Pseudo Hiatus Hernia
Fatigue - CII (due to compensation patterns)
Malposition of baby - CII, Psoas, Fascial Tension
Constipation - Bowel CMRT?*
How to check a Pregnant Mother using SOT
Pelvic Adjusting
There are different considerations when checking a pregnant mother depending on her presentation and time of gestation. Here is a basic indication of what is possible in each trimester.
Other Pelvic techniques that will be suitable throughout pregnancy and after birth.
Cranial Adjusting
Things I am not covering but hope that you have in this course as they relate to SOT analysis...
Primitive reflexes
Cranial Nerve exam - very important when adjusting the cranial system!
Social & Emotional development - right brain development
Cognitive development
Fine motor skill development
Speech and Language development
Spinal + Cranial growth and ossification
Plagiocephaly & developmental effects
Infant Cranial Assessment
1. Visual Analysis
2. Infant Cranial Palpation
3. Palate, Suck and ROM
Heel swing, Inverted hang or Ankle suspension
*EXPLAIN THOROUGHLY TO THE PARENTS AND GAIN CONSENT 1ST*
Contraindications:
Unstable ankles, knees & hips
Recent feed
Possible congenital heart deformity
Hydrocephaly
Hemorrhagic conditions
Down's syndrome
Epilepsy

The heel swing is both a method of analysis of a lesion pattern and an adjustment. The procedure stretches the Dura and increases intracranial pressure

Infant Condylar Correction
Indications: Lack of motion observed in motion palpation test for occipital condylar motion.
Contra-indications: Uncorrected Infant sacral subluxation
Method: Place index (& middle fingers) on occiput superior to atals ring. Thumbs to parietals with light pressure. DO NOT CONTACT MASTOIDS
Holding skull lightly side bend skull onto cervical spine & feel for restriction.
Correct via DIRECT (or into restriction) or INDIRECT (pull occiput away from restriction) force.
Can have parent traction heels simultaneously for dural stretch
Skull Moulding
Indications: Appearance of incongruence with skull development. Bulging or depressed areas of the skull.
Contraindications: Uncorrected sacral subluxation
Method: Have parent/assistant stabilise the pelvis & have the child suck a pacifier or bottle if available. (a bilateral ankle pull will also have a similar effect)
With your fingers gently remould the skull over the bulging areas using a DIRECT force. Holding a broad contact over the opposite side.
Infant Temporal Adjustment
Indications: Balance problems
Late learning to walk
Eacrache
Crying for no apparent reason
Contraindications: Uncorrected sacral subluxation
Method: with fingers under occiput & mastoids resting on thenars let sucking motion (bottle/pacifier) provide corrective force. DO NOT APPLY PRESSURE TO MASTOIDS!
5 step analysis can be done in a weight bearing (compliant) child
Mind Language & Arm fossa test: Use from the time they become compliant 15m-5+ years!! There is no surrogate, use other CI & CII indicators if muscle testing is not appropriate.
Use 2 fingers when testing the fossas of a child.
*The most common category in children is CI for which the main indicator is heel tension.

Blocking Children
Children can be placed on children's blocks from around 18 months (earlier if you can get to wriggling) and sometimes a parents helping hand to keep them there may be required.
For a CI adjustment on a child without blocks a sacral tong contact can be used. Hold the heel OSO heel tension and strongly dorsi flex the foot while holding a tong contact at the level of S2 introducing a stretch to the sacral dural attachments.
Gastro-intestinal visceral reflex work
This technique is an adaptation of CMRT by Dr Stephen P Williams.
The 6 step GI correction
*Start with a diaphragm release
Respiratory visceral reflex work
This series of visceral releases is an adaptation of CMRT by Dr Stephen P Williams
Start with a Diaphragm Release
Cranial adjusting for the child.
The Dental Maxillary Adjustment
* This is an important adjustment for the growing face, or for someone with a narrowing of the middle 3rd of the skull, nose breathing difficulty, blocked sinuses or anyone undergoing dental or orthodontic treatment. It is the starting point for working with a "Chiro-dontic" approach of co-management.
Stabilising hand over zygomatic bones or frontal.
With a gloved finger press along the hard palate suture
Roll the finger from the central line out to the alveolar processors from anterior to posterior
Pull out the finger and grasp around the outer aspect of the alveolar processes
Squeeze, press posterior and rotate maxilla from side to side
Remove gloved hand and grasp Zygomatic bones (stabilising hand on frontal ridges)
Sheer the facial bones gently in opposite rotational directions
Category I
A cranial-dural subluxation which alters CSF supply to the CNS resulting in changed neural function. It involves the synovial part of the sacro-iliac joint which we term the boot.
The muscle groups involved in a CI are erector spinae, semi spinalis, longissimus cervicus, longissimus thoracis & quadratus lumborum. These main para-vertebral muscles directly connect the occiput and sacrum and provide the external stability for an erect spine ensuring uniform function between sacrum and occiput.
CI is initiated by trauma causing one innominate to anteriorly and the oppoosits reciprocates by going posteriorly, creating a bi-lateral sacro-iliac fixation. The posterior ilia motion produces a short leg and results in heel tension.
Category II
Category III
Nerve root compression or stretching syndrome often involving the lumbar chord and occasionally the thoracic or cervical chord
The muscles involved in a CIII are the psoas and piriformis. The psoas when it contracts unilaterally can put pressure on any one of the lumbar discs.
SOT is based on the following premises
Innate
is that force which controls and regulates the functions of all living things
The nervous system controls all body functions
Proper nervous system functioning depends on
CSF circulation and contents
CSF flow depends on respiratory, osseous and meningeal movements
Changes in CSF flow and contents due to traumatic, chemical or emotional
stressors
will adversely affect the functioning of the nervous system,
necessitating adaptation
, ie producing a subluxation complex
Visceral dysfunction
will follow
Pathological reflexes
are established
Finally,
disease
will manifest in the form of
symptoms

Chiropractic Craniopathy is the diagnosis and correction of disruptions to the environment of the brain. It involves the meningeal structures, their associated vascular, lymphatic and neural components, and the osseous structures that house and protect them.
By means of intelligently directed osseous contacts we influence anchor points of the dural meningeal system.
The cranium has 59 basic articulations that we must deal with in cranial adjustments. The facial structures add another 43 articulations, so we have a potential total of 102 articulations in
Chiropractic cranial technique
.
Cranial motion was first propounded by the osteopath Dr William Garner Sutherland in the early 1900’s. In 1933 DeJarnette further advanced the cranial analysis and adjustment with the development of the category system of analysis and treatment.
There is an existing rhythmic pumping action to the brain environment. There are 3 observed pulsations.
1. Cardiac Pulse
2. Respiratory Pulse of D-waves
3. Cranial Rhythmic Impulse or Primary Respiratory Motion
The sutural system of the cranium and face allows for a limited degree of mobility which is greatly influenced by the forces of respiration. Very light touch with gentle pressure is important to master

Catergory I
Mind Language = Left PSIS
Visual Analysis = AP sway
1st Rib = Bilateral Hypermobile
Leg Lift = Normal (or fast)
Arm Fossa = Negative


DO NOT BLOCK A CI UNTIL 42 DAYS AFTER BLOCKING A CII
Category II
Mind Language = Medial Iliac/L5TVP
Visual Analysis = Lateral sway
1st Rib = Unilateral painful movement
Leg Lift = Difficulty raising legs
Arm Fossa = Positive

Other Indicators of CII:
Lateral symptomatology
Pain at left lamina on posterior aspect of C4
Right thenar pad (Pancreas involvement)
SCM
Medial knee pain OSO SL
Lateral knee pain OSO LL
Unilateral body drop
Category III
Mind Language = Left styloid
Visual Analysis = No Motion/Antalgia
1st Rib = No movement
Leg Lift = None
Arm Fossa = Negative

Other indicators of CIII
Calf sign - pain along the medial portion of the calf to palpation. Normally the belly of the gastrocnemius
Possible disc prolapse
Antalgia
Sciatic pain
Other nerve root compression type symptoms
1) Mind Language
Right arm extended. DC stands behind and supports shoulder while patient resists footward pressure from DC, with command "Hold"
Using Pt's left index finger on
CI Left PSIS
CII Medial to illiac crest & tip of L5
CIII Left styloid

2) Visual Analysis
Analysis of pelvic motion using a plumbline.
CI A-P rocking motion
CII Lateral movement
CIII No motion
3) 1st Rib Analysis
To assess de-afferentation of nerve fibres and the balance between anterior and posterior musculature.
Nodding head to full flexion and extension while DC thumbs palpate 1st rib head motion
CI Bilateral Hypermobile movement
CII Unilateral painful movement
CIII No Rib Head Movement WORKSHOP
4) Supine Leg Lift with Cervical Compaction
Pt supine with hands resting over abdomen. Pt raises legs simultaneously and DC notes ease of performance.
Initial leg raise
CI normal leg raise
CII difficulty raising legs
CIII pain too extreme to raise legs
DC Applies cervical compaction with broad contact pushing inferior over the skull
CII leg raise more difficult
Easier with compaction = cervical subluxation that needs to be cleared first.

Arm Fossa Test
*Pathognomonic of CII*
DC start on right side of supine Pt. Muscle test the vertical right arm with DC pulling down/forward, simultaneously with the command "HOLD"
Test first the upper and then lower fossa before moving around the table to test the left side.
CII = A weak muscle test in any of the fossas
WORKSHOP
CII Block placement
Pt supine
PLACE SHORT KEG BLOCK 1st
Have Pt flex knee/foot oon table OSO short leg to elevate their pelvis
Place SL block perpendicular to Pt's body so the crest of the ilium is resting on the centre of the block
Same kneeflex/pelvis elevation on LL side
Place LL block so that greater trochanter is resting on block and block is angled along the femoral neck (toward the opposite block)
Recheck ARM FOSSA immediately
Remove blocks after 30sec-1m or when fossa had strengthened.
CIII Block placement
Pt Prone
PLACE SHORT LEG BLOCK 1st
Lift pelvis OSO short leg and place SL block under trochanter angled obliquely inferior toward opposite obturator
Lift pelvis on opposite side and place LL block under the ASIS angled obliquely inferior

CI Block placement
Pt Prone
Determine # & $ signs
$ = over Glut determine higher tone to bounce test = major $ sign
# - superior to the iliac crest lateral to L3-4 the higher tone = # sign
PLACE SHORT LEG BLOCK 1st
Place Sl block under trochanter angled superior towards opposite ASIS
Place LL block under ASIS angled toward SL block

1st Trimester
Pre Blocking techniques as per normal
Blocking Techniques as per normal


For nausea: spend longer releasing the PHH & Diaphragm

2nd & 3rd Trimester
This is where your basic SOT technique can be altered appropriately
Pre Blocking
:
Psoas - release will have a more lateral in contact (closer to the ASIS)
Diaphragm - is very important as baby starts to invade mums rib capacity. The contact for this may also be shifted more lateral
PHH - The stretch will only go as far as the top of the fundus
Kidney Ptosis - Can be done side lying with mum's arm extended over head.
Blocking techniques:
Blocking for CII is very important in the gravid mother (which we will cover in greater detail in the next slide)
CI & CIII blocking becomes more difficult and cannot be done with a belly support cushion.
Blocking the pregnant mother
CII mothers will often present to the office in the 2nd & 3rd trimesters with symptoms. This is often due to pelvic pain, symphisis diastysis, Malposition and Visceral disorders (Gestational DM, Hypertension, Hyperemesis, Pre Eclampsia)
Your analysis of a mother for CII remains the same (however she may not be able to complete the leg lift) and even the most descended baby the fossas are still accessible.
While on CII blocks:
Pelvic stretch
- contacting the ASIS & ipsilateral thigh introduce a gentle stretch off the blocks.
Reset muscular memory
- DC hold lateral malleoli & get mum to push against your hands up, lateral, down and individual legs.
Basic II Cranial adjustment
- Important for ensuring sphenoid mobility. One hand under occiput the other over frontal with fingers either side of the nose.
Inhale, flex sphenobasilar, dorsi-flex ankles
Exhale, extend sphenobasilar, plantar flex ankles
Round Ligament release
- where tension felt
Pelvic fascial unwinding
- Anterior and Posterior contacts
Sacro-iliac weight-bearing subluxation altering the body's ability to maintain itself with gravity. It involves the sutural system and the TMJ.
If a CI is not corrected the physiological adaptive range becomes stressed and the tolerance diminishes. The interosseous ligaments across the SI joint start to stretch (and may partially tear if trauma) so that the weight bearing joint slips. Synovial fluid leaks into the hyaline cartilage and becomes moist; this in turn causes friction and an inflammatory reaction occurs activating proprioceptors and the CII weight bearing sacro-iliac lesion evolves.
The most important muscle involved in the CII complex is the Latissimus dorsi due to it's attachments illium, sacral fascia, lumbar & T12-6, transversly to the scapula and the humeral head. Also consider the trapezius, the SCM and the temporalis muscle. In the legs consider the sartorius, gracilis & the iliotibial tract.
Visual Analysis
Infant Cranial Palpation
WATER BALLOON WORKSHOP

Remembering that the infant's skull acts essentially as a fluid filled sack. Areas to consider are;
Fontanelles
- Anterior 4-cm + closes 9-24m, Posterior 1-2 + closes by 2m. Intracranial pressure may cause bulging.
Sutures
- Feel for ridging or dipping or tension along suture lines
Cranial Bone symmetry
- ROM of individual bones (often easier felt while infant is sucking)

Suck, Palate & ROM
Visually look into the mouth to assess for symmetry of palate and shape.
Place one hand under occiput.
Using a gloved finger slide your finger to the posterior part of the hard palate. Encourage the baby to suck by rolling the finger from side to side. Feel what the suck is doing. Drawing deeply (correct) or any pushing or light sucking (incorrect) Feel Spheno-basilar ROM by gently pushing superior on posterior hard palate and flexing occiput.
Move had from under occiput to different skull points. Frontal. Sphenoid. Temporals. Parietals. Zygomas.
Apply DIRECT gentle corrective force into areas of restriction.
Observe the face and its symmetry.
Orbits
Nostrils
Nasal septum
Mouth
Frontal bone shape
Depression of greater wing of spheniod
lower jaw position
Maxilla
Observe the skull from superior, posterior & lateral.
Also observe the lie of the infant supine. Babies will often take on the distortion pattern they held in utero.
sam@balance-chiro.co.nz
Method
Infant Supine
grasp around infant's heels inferior to achilles. Index (& middle fingers) on sole, little and ring around dorsum of foot. Thumb around heel
Slowly raise infant off table until fully suspended.
Gently induce mild swinging in difficult cases.
5 sec normally enough, no longer t 30 sec. Do in small 5-10sec bursts if infant's legs go rigid
WORKSHOP
Dural Stretch & Sacral Subluxations
Indication: To stretch and balance the dural system and correct any sacral subluxations.
Method: Baby supine, observe any torque. Inferior hand between baby's legs on sacrum. Superior hand holds occiput.
Gently lift baby off the table and laterally flex feeling for restrictions to movement. A slight torque can also be introduced.
Correction is done via slow DIRECT gentle force into the restricted side.
Saturday
SOT introduction
Anatomy review
Category system
* Adjusting a 12 week old @ 12pm
Care of the expectant mother

Sunday
Infant care
Care of the school aged child
* Adjusting a 12 week old @ 12pm

Dr Samantha Haitsma (BChiro)
SOTOA Certified Craniopath
Director of Balance Chiropractic in Waiuku & Mum to 3 lovely girls

CII for the infant
To find the CII in the non weight bearing child first determine the short leg while supine. In a CII the child will often pull this leg in closer to their body and will be quite uncomfortable while supine.
Gently pull the child to the edge of the table and dangle legs over. A CII child will become very reactive and pull legs sharply into body as this position aggravates the sacro-illiac lesion.
To correct hold hands (or fingers) in the CII blocking position
CII in a non weight bearing child is often formed from a 'decending' pattern of sutural stress. Common in birth trauma. Will contribute to vestibular disturbances and poor balance, bum shuffling and as a older school aged child nocturnal enuresis.
Psoas Test and Correction
Test: DC extends arms overhead of supine Pt and with equal traction determines "short side" by comparing palms
Correction: DC standing opposite reactive psoas side. Pt knee flexed. Inferior hand supports under thigh and hand grasps glut med. (Locking in the sacro-iliac joint) Heel of superior hand tourques lower abdominal quadrant lateral to release psoas fascia.

Diaphragm
Indication: Tight/nodulation at SCM level 4-5 cervical indicates diaphragm fixation OSO.
Correction: Locate tender area under anterior ribs. Double thumb pressure/stretch on exhalation.
Pseudo Hiatus Hernia
Indication: Painful nodule in mid clavicular line at 3rd rib on the left
Correction: DC on Pt right side. Traction epigastric area through 3-4 respirations finishing with an Allen flip on last inhalation.
WORKSHOP
Kidney Ptosis (Inferior Kidney)
Indication: when overhead arm test still shows a short arm
Correction: Pt supine. DC grasp tissue medial to ASIS and above iliac crest posteriorly. Pt inhales and cycles leg up (OSO) and exhales cycles leg down
Anterior Ilio-femoral
Indication: Pt supine. Restriction on internal rotation of the leg.
Correction: Pt knee flexed with foot on table. DC grasp greater trochanter and tension superior. Gently force Pt knee lateral, back to midline and extend leg. Hold tissues for further 5 sec.

*Before blocking commences 'pre blocking' adjustments must be completed to set the body up for the use of pelvic blocks.
Adjusting # & $
Rule 1
Adjust the major (higher tone) # or $ 1st. Only adjust a # or a $ not both on one visit
Rule 2
Never adjust onto a block

# Adjustment
= Roll over iliac crest & P-A thrust over opposite ischium
$ Adjustment
= Gluteal Scoop & Thrust with medial torque over PSIS
RSL R#
R roll crest & L P-A Ischium
RSL L#
L P-A Ischium & R roll crest
RSL R$
R medial torque & L gluteal scoop
RSL L $
L gluteal scoop & R medial torque
LSL R#
R P-A Ischium & L roll crest
LSL L#
L roll crest & R P-A Ischium
LSL L $
L medial torque & R gluteal scoop
LSL R$
R gluteal scoop & L medial torque

The CI Child
Visceral disturbance
- Respiratory, Digestive, Immune
Skin disorders
- Eczema, dermatitis
Numbness in facial structures & extremities
- poor latch, poor proprioception, mouth breathers.
Insomnia
- irregular sleep patterns
Headaches
- irritability
Nervousness
- ADD, ADHD
Weight problems
- failure to thrive
The CII Child
Jaw problems
- poor latch, poor speech development, aversion to solid foods.
Neck pain
- torticollis
Ear pain/loss of balance
- earaches, poor eustation tube draining, recurrent infections, poor proprioception, inability to walk, delayed walker, bum shufflers
Knee, ankle, feet problems
- "growing pains"
Fatigue
- poor attention
Menstrual problems
- late onset menses. Pain
BED WETTING - VERY COMMON!
The Meninges of the brain and spinal cord

Intra cranial dural membranes
Falx cerebri
Tentorium cerebellum
Falx cerebelli
Diaphragm sellae
Spinal dural attachments
Foramen magnum
Ring of atlas
Body of axis
Body of C3
2nd sacral tubercle
(*
Marc Pick has repeatedly found spinal attachments throughout
)

Other indicators of a CI
:
Central symptomatology
Locking of the pelvis
TIppage of the occiput
Heel tension
Dural membrane torque
WORKSHOP
WORKSHOP
WORKSHOP
WORKSHOP
T5 Stomach reflex
What is CMRT I hear you say?
CMRT (Chiropractic Reflex Manipulative Technique) is based on the premise that:
1. Changes in CSF flow and contents due to stressors will adversely affect the function of the nervous system and therefore affect the subluxation complex
2. Visceral dysfunction will follow
3. Pathological reflexes will be established
4. Disese will manifest itself in the form of symptoms

CMRT normalises somato-visceral and somato-spinal reflex arcs thereby:
Preventing the "repeat adjustment" syndrome
Interrupting chronic pain patterns
Correcting functional organ disturbances

The Sacroiliac stabilisation belt
Use in a repeat CII.
An 'unstable CII'
Pt can wear 24/7 (remove for showering)
Transverse Sacral Flexion/Extension
Pt prone on pregnancy cushions
DC place thumbs on sacrum. One side at S1/2 the other at S3/4.
On Inhalation press thumbs toward one another. Relax at exhalation
Reverse position and repeat until pliability is felt in the sacrum.
This exaggerates the primary respiratory pliability within the sacrum to increase CSF flow
Sacral Alar Rotation
Pt Prone on pregnancy cushions.
DC thenar contact either side of sacral crest. Alternate light bouncing on one side of the sacrum then the other
SB+
(Sacral Base + or dura stuck in extension)
Traction sacral apex on inhalation and relax on exhalation. Repeat until pliability is felt.
WORKSHOP
Pubic Symphysis
Pt Supine. Test the strength of the adductor muscles in 3 positions with knees bent and feet flat on the table.
Toes together heels out
Heels together toes out
Feet together
Weakness indicates symphysis dysfunction
Indirect correction: Resisted abduction & quick release. Do this 2-3 times.
Direct method: Palpation of inferiority or superiority and activator adjustment.
Pelvic Fascial Unwinding
Good as an addition to Webster Technique
Can be used while on CII blocks
Good for Optimal Foetal Positioning
Pt Supine, legs comfortable maybe with pillow. DC places one hand behind back (over sacrum L5 and the other anterior.
Light tonal release along lines of tension over the front of Uterus. Using posterior hand to 'unwind' torque.
This CMRT reflex is done after a neutralising adjustment at T5.
In SOT this is a pluck & thrust type adjustment. Pluck Occipital fibre while holding T5 painful TVP. Then thrust on T5 TVP.
Correction:








1. Neutralise T5
2. Hold right shoulder with left hand while working (gently) painful area between Xyphoid and Umbilicus with right hand
3. Manipulate left thumb web while holding umbilical area until relaxtion.
NB always check for PHH, Diaphragm & Psoas
Other involved subluxations to look for:
Inferior Occiput - vagus constriction
Occipital side slip - vagus constriction
Cervical 3,4,5 - cause diaphragm dysfunction
Anterior Tjoraic 4,5 - cause increased gastric enzye activity and upsets HCL function


Colon CMRT for Constipation
Neutralise Occipital line 2 area 6 and L4 (S4)






Contact both shoulders & colon points alternatively. Heavy pressure medial to ASIS with particular attention to the side of blockage (nodulation)
Palpate colon bilaterally find the most tender area.
With the left hand work the lateral clavicle while massaging the colon from the most tender area WITH peristaltic action.
WORKSHOP
WORKSHOP
Post Birth SOT
Due to the ligament laxity a CII will not completely heal in a pregnant patient. It is post birth that your blocking and other pelvic adjustments will be really stabilising the patient
In addition to the BII cranial adjustment there are other adjustments that can be of benefit during pregnancy.
Basic One
This is the cranial component of a CI adjustment. It should not be done on the same visit as blocking of a CI. It can be done before blocking a CI on any visit.
DC hold occiput cupped in 2 hands
Pt places their thumb on the hard palate and sucks
Inhalation flexion - Pt dorsi flex feet
Exhalation extension - thumb suck relaxed and feet plantar flex
This adjustment is a very simple and effective way of releasing spheno-basilar fixation, lifts the occipital bowl, stimulates the choroid plexuses and expands the ventricular system.
(Respiratory Temporal Rocker Technique)
RTRT
Use at the end of an adjusting session as a finishing technique.
Place the hands (fingers interlocked) under the skull with the mastoids resting on the thenar pads.
Inhalation - slowly move elbows laterally
Exhalation - move elbow in.
This adjustment realigns the skull by balancing the intra-cranial membranes and CSF balance.
CRI
Cranial Rhythmic Impulse Technique

Use as a finishing technique

Thumbs to parietals
Index on frontal
Middle on sphenoid
Ring on temporal
Little on occiput

Hold the contact lightly observing the pulsation in the fingertips. If pulsations are imbalanced over any one bone gently direct the force back to the opposite finger/bone.

This is a CSF & relaxing technique.
WORKSHOP
WORKSHOP
1. ICV
(Iliocecal Valve)
Work
- Anterior tubercle of right humerus CC/C
Hold
- Ileocecal reflex point, 5cm inferior to McBurney's
2. Ampula of Vata
Work
- Ampula of Vata, 4cm right lateral & 8cm inferior to umbilicus (in an adult!) - drainage point of common bile duct into small intestine (2 in pic)
3. Gallbladder
Hold
- inferior margin of 8th Rib (Right)
Work
- Right thumb web
Then reverse (1 in pic)
4. Stomach
Hold
- umbilical area
Work
- left thumb web
5. Colon
Work
- colon WITH peristaltic movement for constipation
6. Liver
Hold
-T3 R TVP
Work
- Anterior 3rd rib lateral to sternum

Liver Pump
Left hand over right liver area presses and pumps in a rotating motion, while right hand lifts and holds. Then stretch back out to original position
1. Throat Release
Grasp and pull laryngeal/pharyngeal tissues medially while other hand on forhead forces head to opposite side
2. Costo-chondral junction release
Massage with bent knuckle or soft ball at the costochondral junction
3. Clavicular Lift
grasp the superior aspect of the clavicle while elevating the arm
4. Mediastinal Assessment and Release
With a broad flat hand over the sternum feel for areas of tonal tension and gently massage out. This is a type of fascial release
5. Lung Lobe Balancing
with a broad contact traction over the lateral aspect of the ribs, hands moving in counter directions.
WORKSHOP
Some Case Studies
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