The
Historical Development of
A pplied pplied Kinesiology and its
Diagnostic and Therapeutic Usage David Leaf, D.C. , DIBAK Appendix Compendiums Compendiums by Scott Cuthbert, D.C.
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Contents Introduction 3 The Beginning 5 Muscle Testing 17 Deltoid 19 Five Factors of the Intervertebral Foramina 31 Muscle Proprioceptors 33 Reactive Muscles 34 Spinal Extensor Muscle Weakness Pattern 36 Aerobic / Anerobic Muscle Testing 39 Challenge 51 Neurolymphatic Reexes 54 Neurovascular Reexes 55 Meridian - Muscle Relationships 60 Pulse Points 61 Alarm Points 62 Associated Points 63 Category II Pelvic Subluxations 65 Rectus Femoris 68 Sartorius 68 Gracilis 68 Gluteus Maximus 69 Hamstrings 69 Abdominal Oblique 70 Gluteus Medius 70 Muscle Testing and Upper Extremity Peripheral Nerve Entrapments 71 Costoclavicular Syndrome 71 Pectoralis Minor Syndrome 72 Suprascapular Nerve Syndrome 72 Pronator Teres Syndrome 73 Supinator Syndrome 73 Ulnar Sulcus Syndrome 73 Carpal Tunnel Syndrome 74 Cranial Motion 77 Respiratory Challenge 82 A Brief Discussion of the Neurology of Cranial Manipulation 83 Cranial Nerve Examination 85 Oral Nutrient Testing 89 A Pilot Study Showing Efcacy For Applied Kinesiology Muscle Testing Procedures as a Screening Tool For Immune System Mediated Food Allergy Patterns 91 Melzack & Wall Gate Control 97 Mental Recall 99 Injury Recall Technique 100 Alternative Pain Control Technique Technique 102 Acupunture Meridian Head Points Pain Relief Techniques 104
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Proposed Neurological Mechanisms for A.K. Pain Relief Inammation & Prostaglandins
106 108
Appendix A Partial List of Additional Procedures taught and developed in Applied Kinesiology Muscle Related Therapies 111 Antagonist Reactive Muscle Pattern 111 Ligament Interlink 111 Gait Testing 111 Synchronization 111 Right - Left Brain Activity 112 Gait Inhibition 112 Biological Closed Electrical Circuit 112 Repeated Muscle Activation (RMA) 113 Spinal Related Therapies 113 Vertebral Fixations 113 Hologramic Subluxation 113 Category I & II 113 Category III 114 Sacral Wobble 114 Iliolumbar Ligament 114 Meningeal Release - Coccyx 114 Spondylogenic Reex 114 Cervical Compaction 114 Hidden Cervical Disc 115 P. L. U. S. 115 Piriformis Gait Inhibition 115 Pitch Roll Yaw-Tilt 116 Stride Length 116 Jugular Decompression 116 Cranial Dural Torque 116 Meridian Related Therapies 117 Then and Now 117 Muscle Meridians 117 Beginning and End Technique 117 Visceral Related Therapies 117 Visceral Manipulation 117 Ileocecal Valve Disorders 118 Malabsorption 118 Respiratory Procedures 118 Lymphatic Disorders 118 Robert Fulford Concepts 118 Anatomy Trains 119 Appendix B Applied Kinesiology Status Statement 121 Appendix C Links to Applied Applied Kinesiology’s Kinesiology’s Published Research Papers as of June, 2012 124
Introduction Applied kinesiology began as a simple observation by the inquisitive mind of a very talented doctor. Many think of applied kinesiology as solely the work of George Goodheart. Dr.. Goodheart made three independent observations and these are 1. A muscle can change strength rapidly if properly treated 2. There is an organ muscle relationship 3. Therapy localization Every other technique or procedure in applied kinesiology came from other sources and muscle testing was applied to improve the usefulness of the procedure. From the eld of medicine come the works of Travell, Sutherland, Jones, Wirt, Perk, Nordstrom, Mann, and the list goes on. For over 40 years, Dr. Goodheart and others in the international College of Applied Kinesiology have looked to improve the works of others. This book has been written with a goal of exposing you to the concepts of applied kinesiology. It is not intended to teach you how to do applied kinesiology. The ICAK has developed an introductory course and advanced courses to accomplish that. The purpose here is to demystify applied kinesiology. The book borrows on the works of Walther, Schmitt, Powers, Belli, Grossman and Goodheart. The other parts are from a book that I have written “The Flowchart Manual of Applied Kinesiology”. Dr. Scott Cuthbert has done and continues to do a yeoman’s work at keeping all of the research papers on applied kinesiology organized for you to nd. After exposing yourself to the benets of applied kinesiology, we hope that you will pursue your knowledge and discover how the principles of applied kinesiology can aid every doctor and their patients. David W. Leaf, D.C.
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The purpose of this book is to give you an overview of how applied kinesiology came to be. Starting with my original observation that, in most cases, the strength of a weak muscle can be changed almost instantly, to the latest procedures in applied kinesiology, these procedures are based on principles of neurology and physiology. Most of the procedures and techniques in applied kinesiology were observations or developments of other health care professionals. The problem was that most of these techniques did not have a diagnostic test for their use. They were empirically used. What we have done is to develop a diagnostic test using the patient and muscle testing. The beauty of applied kinesiology is that it aids any practitioner to become better at analyzing what treatment procedure is the best for the patient. Too often, the patient is t to the treatment. In applied kinesiology, we have rened over 40 different treatment options that can be tested for their appropriate usage using muscle testing. The procedures enhanced by this run the gamut from physical therapy, osteopathy, chiropractic, medicine and oriental medicine. I hope that this course lights a re in you, as it has in so many others. Applied kinesiology is not the work of one but the ndings and hard work of many. The use of applied kinesiology, as taught by the ICAK, has spread in dentistry and medicine. It is now a subspecialty of medicine in Austria and is spreading in these professions throughout Europe, Russia, Japan and Korea. In closing, I would like to leave you with one thought. When confronted with a problem patient, ask “Why?” This was a lesson my father taught me in my rst years in practice and it is a question I have asked myself for years. This is the reason that this body of knowledge happened, simply by asking “Why” and then searching for an answer. George Goodheart, D.C.
Acknowledgment I would like to thank the following authors for giving permission to use their works in compiling this book. These include George Goodheart, David Walther, Kathleen Powers, Walter Schmitt, Richard Belli, Scott Cuthbert and Jason Grossman. This book was designed to expose the student to the development of applied kinesiology and to be used along with demonstrations of its use by the instructor. It is beyond the scope of this book to actually teach the procedures needed to apply the principles of applied kinesiology. The International College of Applied Kinesiology has developed courses for the student to become trained in accurate muscle testing and the procedures introduced here. It has been my privilege and honor to have known Dr. Goodheart for over 35 years and be able to bring this material to you. David Leaf, D.C.
All rights reserved. No part of this book can be used without the written consent from ICAK-USA. Published by ICAK-USA Copyright © 2012 by ICAK-USA 6405 Metcalf Ave., Suite 503 Shawnee Mission, KS 66202
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The Beginning by George Goodheart D.C. Reprinted from You’ll Be Better
was a stocky young man who was quite well built, and had recently been discharged from the paratroopers, but despite apparent good health he was suffering from a rapid hair loss.
I graduated from the National College of Examination revealed a hyperthyroid problem, Chiropractic in Chicago, Illinois in 1939, and at that time we were measuring the and previously attended pre-chiropractic at thyroid function as we still do, by measuring the University of Detroit. I began practice the speed of the Achilles tendon reex. The in association with my father late in 1939. Achilles tendon is put on a stretch and tapped However, the advent of World War II didn’t with a testing hammer; then the speed of the give me much time to practice. I went through Achilles as it moves, just as your knee would the Air Corps Cadet Program in 1941, during jerk under the knee jerk test, is measured by the early war years, but through a happy its path through a photo-electric beam. This series of fortunate events became involved impulse is transferred electrically to an EKG, in innovative air operations research, so my which then gives a printout of the degree of active practice really began in 1946 following functional capacity of the Achilles tendon to my release as a Major from the United States respond to the tap. Air Force. Having left the Air Force in 1946, I resumed active practice in association with The normal time is 330 milliseconds, and my father until his death in the early ‘60s. his was abnormally fast, approximately 220 ms. 220 milliseconds was quite fast, and Because of my father’s background in general nutritionally I had learned that natural practice, ours was a general practice, and we amounts of Vitamin A and a source of saw many patients with many problems. As Thymus, a small gland around the windpipe is usually the case, the further along I got which is associated with auto immunity, were in practice the more intelligent my father practically specic for hyperthyroid problems, seemed to become-the obvious fact being that along with regular chiropractic care. Upon I became more aware of my inadequacies and administering this nutritional support and the his excellent qualities; and I grew in stature proper treatment mechanically, he showed a and development because of my association tremendous response in about two weeks. His with his very, very practical and superb hairline stopped receding, for which he was very grateful and pleased, and he asked me diagnostic and clinical work. advice about another problem. My time in the Air Force had given me a taste for innovative opportunities, and also had taught me a practical method of dealing with problems, and this was to stand me in good stead later on.
Not long after my father’s passing, a young man presented himself at the ofce complaining of a relatively common problem, although at a very early age. He was losing his hair. He had a rapidly receding widow’s peak, and at the age of 24 seemed quite concerned. He
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He mentioned that he couldn’t get a job in any of the factories in our town because he was unable to pass the physical-and the reason he was unable to pass the physical was his inability to press in a forward direction with one of his arms. One of ‘his shoulder blades stuck out in a rather unusual fashion, protruding from the chest wall. He asked me if I could do anything about it. I said, “Well, probably it’s some type of anomaly, a variation in a probably normal function.” We did some x-rays to prove this potential which
revealed no abnormality, and I could offer him no further advice as to why this particular condition was present.
of inactivity that occurs, for example, if you keep your arm in a cast and the muscles wither from lack of activity.
Either fortunately or unfortunately, depending upon your point of view, I was able to procure a job for him with one of the companies in the building where we had our ofces, a nutritional company with whom we. did a lot of business. He would come into our ofce, and quite often in a crowded waiting room would ask me in a loud voice, “When are you going to x my shoulder?”. This embarrassed me somewhat, and I motioned. him to come into the inner ofce quickly, away from the sight and scene of my embarrassment, and I would tell him that there wasn’t much I could do about it.
Upon palpating the muscle I felt an unusual nodulation at the attachment of the muscle to the anterior and lateral aspects of the rib cage, which I didn’t feel on the other side. The small nodulations were quite apparent to the palpating nger, and in an effort to identify their nature I pressed on them. They were not painful other than minimally so, and they seemed to disappear as I pressed on them with my palpating pressing nger.
Having been embarrassed for the last time by his frequent inquiry, I resurrected a book that had been given me by a colleague of mine, Dr. Raymond Koshay, a very ne chiropractor in Port Huron, Michigan whom I had been able to help with a knee problem; and for Christmas he had given me a copy of the book. I remembered that there was a muscle that pulled the shoulder blade forward so that it would lie at on the chest wall, but something like the old adage-what you don’t use you lose - I knew the muscle existed but I wasn’t sure of its actual origin and insertion. When I applied myself to the .book he had given me, “MUSCLE. TESTING” by Kendall & Kendall, I soon found the muscle that pulled the shoulder blade forward on the chest wall was the anterior serratus. There was a method for testing it which involved placing the patient’s hand on the wall, and then pressing on the spine in a forward direction, and the shoulder blade immediately stuck out.
In an effort to identify the cause of the problem I palpated the muscle. He said he had the condition as long as he could remember-15 or 20 years-yet when I palpated the muscle left and right, on the side of involvement, I found no atrophy of disuse-the usual pattern
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Encouraged by the apparent disappearance of the rst one or two, I continued to press on all of the small areas which we later learned to be avulsive in character, a tearing away of the muscle from the periosteum. The attachment of the muscle to the covering of the bone, the periosteum, was producing a nodulation which is characteristic in these cases of micro avulsion. They are small tearings away of muscles from their attachment.
Having palpated and pressed on all the small nodulations which coincided with the attachments of the muscle to the rib cage, I then surveyed the muscle. It felt the same, but this time I noticed his scapula (shoulder blade) was lying in a normal position on the posterior chest wall.
Surprised but pleased, I repeated the test, having him place his hands in front of him against a plywood panel that separated one section of the ofce from another, and I pressed hard on his spine. The shoulder blade did not pop out, and he looked at me with an inquiring glance and said, “Why did you not do that before?” I looked back at him, serious of face and direct of eye, and said, “Well, you have to build up to a thing like this. You didn’t get sick over night.” It was an automatic response, but all I could think of at the time.
He was pleased, I was delighted. It was an unusual thing to see this quick a response.
In an effort to identify this unusual reaction, yet not reveal my surprise, I requested him to return to the ofce the next day so I could check his hair loss. He advised, surprised, that he hadn’t lost any hair in six months. I mentioned that he could never be too sure, so he showed up the next day. I looked at his hair and said it looked ne. Then I said “By the way, let’s test that muscle.” I tested the muscle, and it remained strong-and it has remained strong ever since! I have seen this patient from time to time since that rst incident, which occurred in 1964.
Emboldened by this unusual success, I began to test muscles by the method of Kendall & Kendall, a method which is used by military, civil and government agencies to rate disability and is a standard method of diagnosis. I found many patients showed muscle weakness. Many patients also denied a history of trauma, but many patients responded to the hard heavy pressure at the origin insertion, although many did not.
technic, he had been unsuccessful in relieving the patient’s pain or changing the disability which was diagnosed by the pattern of muscle testing. The muscle would test consistently weak on the side of involvement: tested by requesting the patient to abduct, moving the leg sideways, and then requesting the patient to resist the pressure to take it medially. This was accomplished while the patient was in the supine, back lying position.
Because of the unusual history, I felt that this was an involvement of the lymphatic system, which is the sewer or drainage system of the body. It is drained by a variety of modes, but fundamentally it is drained by the squeezing action of the muscles on the lymph system. Because walking relieved it, indicating this possibility, I palpated the lymph glands on the lateral aspect of the thigh and felt nothing unusual in comparison to the uninvolved left side.
I palpated also for the potential of any sacroiliac disturbance, because occasionally we get lymph nodulation in the region of the sacroiliac joint if there is a sacroiliac disturbance. I found none of these, and the patient was in a great deal of distress while lying on his back. After palpating for diagnostic information, which I did not nd, the patient looked up at me and said, “That’s the rst relief I’ve ever gotten.” I looked at him and said, very bravely, “That’s what you came here for,” indicating that it was not the surprise to me that it was.
Fundamentally, my rate of success with patients was rising and I had communicated this method of testing along with the rather primitive method of treatment to my colleagues. One of those colleagues, Dr. Pat Finucan, sent me a patient who had an unusual type of sciatic neuritis, a painful problem involving the lower limb that would cause severe pain if he were to stand, sit or Astonished by this rather quick success and lie down, but would disappear when he would yet not understanding the basis, I continued to walk. Dr. Finucan had found a weakness of initiate the palpation which I had accidentally the fascia lata, the muscle covering the lateral used to relieve his pain. He remarked that portion of the thigh associated with movement the pain which he had experienced for many, outward of the leg. many months was now completely absent, and subsequent investigation and diagnosis revealed a complete disappearance of the Despite efforts to correct it mechanically at the long-standing and chronic irritation of the spine and locally, using the origin insertion sciatic nerve.
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My secretary, who had been with me for many years and who was a very ne German woman, had quite a bit of sinus trouble and would consistently show a head tilt when she would have a sinus disturbance; and despite the fact that I could nd a weakened muscle which I associated with the head tilt, the original technic that had been used on the young man with the hair loss did not produce any muscle strengthening, nor did it affect the sinus involvement.
Thinking that one had to simple palpate and treat the muscle, such as had been done to the sciatic patient earlier that afternoon, I tested her neck exors by having her raise her head and turn it slightly to one side, and they showed immediate weakening on testing. I attempted to repeat the procedure that had helped the sciatic patient, running my hand along the lateral aspect of the muscle, the sternocleidomastoid muscle that runs from the back of the head bone to the collarbone. I felt nothing different on palpating and testing the muscle, using the technic that I had palpated and tested earlier on the gentleman with the sciatic neuritis.
I tried triumphantly to test her neck muscles again, and to my chagrin her neck muscles were possibly even weaker than before, and I almost injured her head by the sudden collapse of her neck to the testing direction of my hand. I said rather despairingly, “It sure seemed to work on that fellow this morning. I can’t understand why it doesn’t work on you now.”
Then I thought, perhaps what I pressed on was something unassociated with the muscle itself, but associated with, possibly, some lymphatic circuit breakers which had been postulated by an osteopath named Chapman. This had later on been discussed in a text, “AN ENDOCRINE INTERPRETATION OF
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CHAPMAN’S REFLEXES,” the second edition, which had been reprinted by the Academy of Applied Osteopathy, copyrighted May 6, 1946. It had originally been copyrighted in 1937 by Charles Owens, . D.O., and was a book on the diagnostic and therapeutic application of neurological reexes that had been the work of Frank Chapman. Both Dr. Chapman and Dr. Owens had postulated the existence of a reex called the neurolymphatic reex-a cutaneous visceral reex that had been under investigation at the Kirksville College of Osteopathy and Surgery.
“The surface changes that are present in a Chapman’s reex are palpable.” Dr. Owens spoke of the changes found in the deep fascia as well as the supercial tissues located at specic points (loci) and consistently associated with the same viscera. These little tissue changes, which began in the form of contractions, are located anteriorly in the intercostal spaces between the ribs near the sternum. They may vary in size from a half of a BB shot to that of a small shot gun pellet, and are generally multiple. This type of tissue change is apparent in some of the reexes found in the pelvis; but the ones found in the lower extremity, associated with the colon, broad ligament and prostate, vary in character. By trial and error, testing muscles and then comparing areas that Chapman had originally talked about, we found which circuits affected which muscles. Then, by trial and error and also by examination of a particular patient who had Hodgkin’s Disease, and who exhibited nodulations and lymphatic gland characteristics inherent as characteristic of Hodgkin’s Disease, we found that many of the nodulations corresponded precisely to the areas that Chapman had originally postulated; and by trial and error, and also by the discovery of nodulations in areas that Chapman had not discussed, we were able to nd the neurolymphatic reexes for most muscles.
By now I was becoming convinced that there was a relationship between muscles and particular viscera or organs. A moderately weak muscle on testing appeared to be associated with a weak viscera or organ, but every time I could see evidence of a weak pancreas, or a weak stomach, or a weak liver or a weak kidney dysfunction-of those organs which would be measured by x-ray or by biochemistry or by some other accepted biological test-I would nd a corresponding weakened muscle. This relationship, although rather tenuous at rst, became more and more evident as time went on.
This began to explain, at least somehow, the visceral response that occurred from muscular skeletal corrections and made a little more sense out of the observations that patients used to make following treatment for a muscular skeletal problem, and with the spontaneous resolution of the visceral or organ problem. I found a strong relationship to exist between the spinal level of neurolymphatic activity and structural aberrations of the spine, but this was not always the case.
It was just as if there might have been an original subluxation or lesion of the spine, a functional disturbance of the spine, that somehow was either self corrected spontaneously or corrected by manipulation; but the long term effects of that disturbance continued to remain. For example: if you have a home washer-dryer and perhaps place a heavy object such as a rug in it, as it starts to spin it dry, the rug’s eccentric position in the spinning washer causes a vibration, then the vibration sensor in the washer turns the washer off to prevent damage from the eccentric rotation. This usually sets an alarm going as well as turning the washer off, and the housewife then attends to the problem by opening the panel on the washer, and seeing the rug in an eccentric position rearranges the t he rug. Then she closes the panel on the washer and many times must then reset a circuit
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breaker if closing the panel did not already do so. In other words, she would have to do two things: rearrange the rug structure, so to speak, and then also set a circuit breaker.
We postulated that the lymphatic centers were circuit breakers in this sort of anal ago us context. This proved to be a valuable system of analysis and the response rate continued to rise in patients, and we started to see more and more patients upon whom we did more and more muscle testing.
An Italian woman came to see me and complained of a headache for 30 of her 49 years, and on testing the muscles I observed some muscles to be weakened on both the right and left sides of her body. I noticed that in an effort to maintain a response to testing of certain muscles, if she took a deep breath some muscles, for example on her right side, strengthened; but the same deep breath seemed to weaken the muscles on her left side. But instead of taking a deep breath and producing strengthening on her left side, letting the air OUT seemed to strengthen the muscles on her left side.
She also exhibited a rather unusual conguration in terms of analysis of the level of her head. Looking at the position of her ears in relationship to her head, her ear ea r was lower on the right than it was on the left, as was her occiput, the bones of her skull. Looking at her from the rear conrmed this position, lower on the right, but looking at her on a .face view, head on, an anterior look showed her eyebrow and eye to be higher on the right and lower on the left, just the opposite of what I had observed looking at her from the posterior view. Thinking perhaps that her ears were in an altered position, I compared her ear position by measuring down from the vertex and I found that the ears were equally spaced an her head measuring from the top down, yet there
was an obvious discrepancy between the level of her ears and the level of her eyes, instead of making a parallel pattern they made a wedge pattern, which was very confusing.
I had been aware of the work of William Garner Sutherland, an osteopath who had postulated the concept that the bones of the skull move as you breathe like the gills of a sh. He developed the concept that there was a vestigial gill mechanism in the skull, and by long experimentation with himself, using many ingenious devices, had attempted to limit the motion. He observed his own response, and published an original text based on his observations entitled, “THE CRANIAL BOWL,” by William Garner Sutherland. His work had later been documented and revised by Harold Magoun, D.O., entitled “OSTEOPATHY IN THE CRANIAL FIELD.” Both the rst and second editions of Dr. Magoun’s books are available.
The concept that the bones of the skull had motion seemed contrary to my anatomical and osteological training, yet in an effort to understand the problems produced by the patient I was examining, I attempted to move the mastoid process on one side of her head in a forward direction while she took deep inspirations, and at the same time moved the mastoid process in a backward direction while she took a deep expiration-in other words, using a counter-torque motion with the eshy part of my thumbs, the thenar portion of the palm of the hand-and the forward motion and the backward motion were accomplished simultaneously on this 49-year-old Italian woman.
After 4 or 5 deep inspirations and expirations, despite the fact that she had attempted these before, but not with the concomitant skull pressure, she looked at me and her eyes widened, and she said, “That’s the rst relief I’ve ever gotten.” I looked at her, again serious of face, and with true sincerity said,
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“Well, that’s what you come here for,” to again disguise my surprise at her rapid response.
We then began to test muscles against phases of respiration, and we found many muscles responded to inspiration, some responded to expiration, and interestingly enough some responded to half a breath taken out, some responded only to a breath taken only at the nostrils and some responded to a breath taken only at the mouth. Some responded to breathing through one nostril as opposed to the other, and some responded in an opposite fashion.
We soon found fourteen basic cranial faults which will be discussed later, but the primary investigation method was to nd a weakened muscle.
We had the patient take a deep breath in or out. If the muscle was found to be weak and responded to inspiration, the mastoid process on the side of the skull that the muscle weakened was located and pressed forward at the temporal bone mastoid process with the thenar eminence of the hand, with about 4 or 5 pounds of pressure coincident with 4 or 5 deep inspirations.
If the muscles found weak responded to expiration, the thenar eminence of the hand was placed anterior to the mastoid process of the temporal bone and the mastoid process of the temporal bone was pressed backward towards the occiput coincident with 4 or 5 deep expirations using 4 or 5 pounds of pressure.
This resulted in many, many cases improving from many, many conditions, and they postulated a concept of a cerebral spinal uid ow rate something like a dual irrigation ditch-with someone turning the rheostat down on the pump, and the tomato vines withering somewhat, and then when someone turned
the rheostat up on one side or the other, the tomato vines thriving due to an increased ow of the irrigation uid.
Investigation revealed that not only did the bones of the skull move in a predetermined fashion, but so also did the vertebral segments in which vertebrae went through a rocking type of motion-the tip of the spinous process of a vertebra involved moving in an inferior direction towards the feet with inspiration and a superior direction with expiration. The spinous process moves inferior, footward, with inspiration and headward with expiration.
We soon found there was also a sacral motion, the tip of the sacrum at the coccyx moving forward with inspiration, toward the front of the body, and moving backward, toward the back of the body, with expiration. We found a reverse movement to exist in the coccyx, a counter movement between the sacrum and the coccyx. We also found a counter movement between the total pelvis, the pelvis moving backward as the sacrum moved forward and the pelvis moving forward as the sacrum moved backward, coincident each time with phases of respiration.
This new cranial nding coincident with a method of diagnosis aided greatly in the application of the cranial concept. The original Sutherland concept, as well as those that followed, used topographical, anatomical changes for cranial corrections; but the addition of respiration added a measure of diagnostic certainty and also safety to this relatively new science. Time has shown that a respiratory relationship exists in the spinal uid ow rates, and a critical factor in the production of routine cranial correction was to correlate muscle weakness to strengthen with respiration. More of this will be discussed later on in chapters on cranial technic.
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By now we had the original methods of muscle testing with the concept of micro avulsion origin insertion technic; we now had the possibility of lymphatic blockagein other words, the muscle couldn’t ush its own lymphatic toilet; we now had the concept of cranial technic, respiratory systems; and we also had, prior to the development of cranial technic, the system which we call neurovascular response. I was lecturing in Rochester, New York discussing the original method of hard, heavy pressure at the origin insertion of the muscle in case of weakness caused by micro avulsion, and also demonstrating the lymphatic technic for nding the source of blockage in the lymphatic range of muscles. I was asked to treat a young boy with asthma who was having an acute attack and who did not respond to the usual medications. He was having some response to chiropractic technic by a young chiropractor attending the lecture, but he was suffering an acute asthmatic episode at the time of the lecture, during the lunch period.
By now we had found that the adrenal glands were responsible to a great extent for failure to produce adequate adrenalin, agreeing with the medical approach-the crisis care type of approach to asthma seemed time honored, at least pharmaceutically. We would nd a weak sartorius gracilis muscle which time had shown to be related to potential failure of the lymphatics of the adrenal gland to ush its own toilet, so to speak-its lymphatic toilet. But investigation of the neurolymphatic reexes and treatment for them did not change the weakness that we found on testing of the sartorius muscles.
The young boy was lying on this back, one foot pointing straight up and the other foot lying loosely to one side. In an effort to correct the problem I had already used the neurolymphatic reex and had attempted an origin insertion technic without any success. I knew that
occasionally the lymph system was sluggish because of failure of the lymph system itself to drain, and I was using what was called a lymphatic pump. The operator’s st rst was placed on the sternum of the individual and moderate pressure was exerted spineward while the patient attempted to take a deep breath. At the middle of the attempt to take a deep breath the st was suddenly removed, causing the succussion of the chest, changing the pressures within the chest, and literally succussing or shaking the thoracic duct, allowing better lymphatic drainage potential.
This too was unsuccessful, but at that time I was aware of a primitive cranial technic of simply spreading the cranial sutures as advocated by Dr. James Alberts, Sr., a very ne chiropractor in the southwest.
more insistent and more persistent and more evident in strength, until nally the young man gradually stopped his labored breathing, took a deep breath, began to breathe easily, and simultaneously his foot rotated up into a parallel position with its opposite member.
The doctor attending the youngster, who had asked me to see the patient, looked at me and said, “Good gracious, Doctor, that’s marvelous.” And I looked at the doctor, very serious of face, and said, “That’s what you come here for.”
We now had developed another method, called the neurovascular technic, for the correction of muscle weakness. In the embryo there is no heart, and for the rst three or four months the mother’s placental circulation is augmented by a network of vascular circuits which, as the tissues grow, exert slight traction on the blood vessel which then causes the blood vessel’s muscles themselves to pulsate in an augmented fashion, aiding the mother’s placental circulation.
In attempting to spread the cranial sutures in a very simplied fashion, I did not see any change, and in an effort to evaluate the problem I sat down and re-attempted to spread the sagittal sutures. From experience I had learned that this was of some value occasionally in lymphatic blocks. My index ngers were resting on the posterior fontanel area with the rest of my ngers spreading the sagittal suture which runs vertically along the At about the fourth month the heart is formed, top of the skull, separating the two halves of and many times the mother is delighted to hear the skull and joining the parietal bones of the the heart beat that her obstetrician allows her skull together. I felt that insistent pulsation, to listen to. At the advent of the heart beat, very faint at rst, at the posterior fontanel; the heart takes over part of the burden of and despite the fact that his carotid arteries supplying circulation to the growing embryo, were beating at the rate of about 120 and his and the neurovascular circuit of supply and respirations were at least 40, I noticed that demand circuitry goes on a standby basisthe pulsations that I experienced with my something like a generator behind a hospital ngertips were at the rate of 72 beats per in case of power failure, which can be turned minute. on for emergency use.
Thinking the beating was perhaps in my own ngers, I removed my ngers and placed them on a wall to identify if the 72 rate beating was in my own ngers. I noticed no change. I reapplied my ngers to the posterior fontanel and felt the continued pulsation, which became
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These neurovascular receptors were rst discovered by a chiropractor in California named Terence Bennett, who developed a foundation for teaching his material and who wrote extensively in the early ‘30s and ‘40s of their use. Upon his departure from
active practice, and upon his death, Dr. Floyd Slocum, one of the early pioneers in the American Chiropractic Association, took over his activity and the Neurological Research Foundation continues to be active under the auspices of Dr. Martin King from California.
We nd that many muscles lack a “thermostatic” conguration which allows them to function when under stress, and attention to the neurovascular receptors by a light tugging touch allows much better circulation to the muscle.
When a light tugging touch was applied to the vascular circuits a pulsation was felt beneath the nger. The light tugging touch is maintained for 20 or 30 seconds minimum time, the muscle is tested before and after, and many times this coincides with the need for cranial fault correction. But in any event, the light tugging touch is maintained for a variable period of time, a minimum of 20 or 30 seconds, and the muscle tested before and after to ascertain the return of strength.
We continue to observe the muscleorgan relationship and we were becoming increasingly convinced of the reasonably frequent relationship between weak organweak muscle, although we were not convinced of the contrary relationship of the weak muscle-weak organ.
It is just as if the neurovascular receptor acts as a thermostat. If the thermostat is set too low the muscle doesn’t get its proper circulation and the muscle’s lactic acid and other products of mechanical contraction of the muscle are not ushed or washed out, and the muscle therefore is clogged with its own waste products and shows weakness.
We now had four options for strengthening weak muscles. W~ had the hard heavy pressure described earlier, the activation of the lymphatic reexes, the application of cranial technic, and the use of neurovascular receptors.
The subject of acupuncture has long been a point of interest, but not much was-known of this concept until the early work of Bennett Cerf, who published in Random House publications the book, “ACUPUNCTURE, ANCIENT CHINESE ART OF HEALING,” by Felix Mann, an English physician. Some of the early Jesuits who had been missionaries in China had spoken of the unusual responses that were obtained in many instances from the practice of acupuncture, the insertion of tiny needles of metal or bamboo into prescribed areas on the skin of the sick patient.
Roger Bannister, who ran the rst four minute mile, became a vegetarian - not through embracing of the vegetarian concept, but because the vegetarianism put less of a load on his liver and he was able to oxidize excess lactic acid produced by the increased effort to run the four minute mile. Lactic acid, as it is produced by the muscle in function, causes the capillaries to dilate; and nally there is a status quo reached by the lactic acid level To quote Felix Mann in his acknowledgements producing the greatest amount of capillary at the beginning of his book, “ACUPUNCTURE, dilation. When the lactic acid reaches higher ANCIENT CHINESE ART OF HEALING” level, there is no further capillary dilation now published by James Heineman Company, until the liver goes into “overdrive” and Medical Books Ltd., London, “All European attempts to oxidize off the excess lactic acid; acupuncturists owe Soulie de Morant a and here, then, the muscle can resume a debt for his original translations of Chinese normal function. treatises. He developed much understanding of the subject and its practical application during the time he associated with Dr. Ferey
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Rolles. Those who read Chinese are few, but many may be greatly beneted by the French and German books on acupuncture mentioned in the bibliography.”
which included many of the aspects of acupuncture, giving four points to tonify or stimulate the area and four points to sedate if the organ was overactive.
Acupuncture is an ancient Chinese system of medicine in the practice of which a ne needle pierces the skin to a depth of a few millimeters and is then withdrawn. The only thing of real importance in the study of acupuncture is to know at what point to pierce the skin in relationship to which disease.
In an effort to relate these points to kinesiological parameters, we attempted stimulating the points for tonication and found occasional responses in muscles. We attempted to sedate other points and found occasional responses in muscles. Insertion of a needle at the so-called “rst point” invariably would produce a strengthening of a muscle if found weak on testing, and insertion of a needle at the rst point of sedation would invariably cause weakness of the muscle if the muscle was strong. We soon found that touching the rst two points for tonication would result in strengthening of a weak muscle. The converse was also true. Touching the rst two points for sedation and simultaneously the second two points for sedation would weaken the muscle.
The notion that a pin prick, often in a part of the body far removed from the seat of the disease, can cure ills is alien to conventional thinking. It is unfortunately the case that many doctors, even when faced with several former patients who have been cured by acupuncture where other efforts have proved fruitless, have refused to believe the evidence.
Acupuncture is not the exclusive possession of the Chinese. The papyrus ebers of 1150 B.C., one of the most important of the ancient Egyptian medical treatises, refers to a book on the subject of muscles which would correspond to the 12 meridians of acupuncture. The Bantu sometimes scratched certain parts of the body to cure disease. In the treatment of sciatica some Arabs cauterize with a hot metal probe a part of the ear. Some Eskimos practice simple acupuncture with sharp stones. An isolated cannibalistic tribe in Brazil shoots tiny arrows with a blow pipe at certain parts of the body.
We wrote the rst book on acupuncture in 1966, showing its relationship kinesiologically, and this was the only research manual that did not go through a second reprinting, because the concept was too new at the time. However, since that time it has grown to be a standard portion of Applied Kinesiology and forms a basis of much of the information we have been able to identify about acupuncture. We now have ve arrows, so to speak, in our quiver. We could shoot the arrow along the origin insertion, the neurolymphatic, the neurovascular, the cranial, and now the acupuncture path. Each of these develop their own special set of rules and special set of circumstances.
A patient, and a good friend, had returned from Hawaii and brought me one of the rst How The Body Heals Itself copies published by Random House of Felix Mann’s book. By now we have become pretty Applied Kinesiology is based upon the fact that well convinced of the relationship between body language never lies. The opportunity of viscera and muscle. In the chapter of Felix understanding the body language is enhanced Mann’s book entitled “The Five Elements” on by the ability to use the muscles as indicators page 92, he spoke about an organ relationship for body language. The original method for
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testing muscles and determining function, by the methods of muscle testing rst advocated by Kendall and Kendall, is a prime diagnostic device. Once muscle weakness has been ascertained, a variety of therapeutic actions are available which are too numerous to enumerate here. The opportunity to use the body as an instrument of laboratory analysis is unparalleled in modern therapeutics because the response of the body is unerring. If one approaches the problem correctly, makes the proper and accurate diagnosis and treatment, the response is adequate and satisfactory both to the doctor and the patient. The name of the game, to coin a phrase, is to get people better. The body heals itself in a sure, sensible, practical, reasonable, observable, predictable manner. ‘The healer within can be approached from without.” Man possesses a potential for recovery through innate intelligence or the physiological homeostasis of the human structure.
This recovery potential with which he is endowed needs the hand, the heart, and the mind of a trained individual to bring it to potential being, and allow the recovery to take place which is man’s natural heritage. This benets man. It benets him both individually and collectively, but it also benets the doctor who has rendered the service and allows the force that created the structure of the body to operate unimpeded. This benet to man can be compounded by knowledge with physiological facts and with predictable certainty.
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Muscle Testing History
force depends upon the relative strength and health of the person you are testing.
Muscle testing is the basic tool used in applied kinesiology. Kendall and Kendall wrote the 7. Instruct the patient to apply pressure against rst book on manual muscle testing in the late your hand. When you feel the patient apply ‘40’s based on their work with polio victims. the pressure, increase your resistance against They used a ve point system for grading their pressure. When there is no increase in muscle strength. In applied kinesiology, we pressure, apply an additional force in the testuse a muscle test that has been described by ing direction. the Institute of Sports Medicine and Athletic Trauma, as a “ break test technique “ method. You are testing the patient’s ability to react and adapt to the additional force applied. The basic concept of muscle testing is to challenge the ability of the muscle to adapt to an increase in force after the patient has reached maximal contraction of the muscle. Muscle testing is an art as well as a science and it takes time to become procient in learning muscle testing. The rules are rather simple. 1. Approximate the origin and insertion of the muscle and place the body part in a position that minimizes other muscles that can contract to support or recruit during the contraction of the prime mover. 2. Supply adequate support to the person being tested so that they do not move or alter their position during the test. 3. Use a broad at contact with the eshy portions of your hands so that you do not cause pain or discomfort where you test or stabilize the patient. 4. The testing pressure is applied at a 90-degree angle to the arc of movement of the body part. Another way of saying this is that the pressure is applied at the tangent to the arc of the movement of the body part. 5. Try to keep your forearm in line with the direction of force. 6. Testing should be done using your weight not your hand or forearm strength. The amount of
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The top picture shows the starting position of testing of the psoas muscle. Stabilization is given to the opposite pelvis upper thigh. A broad contact is used. Recruitment usually begins as a change in the angle of the pelvis or rotation of the femur. The stabilizing hand can detect these changes in the pelvis. The testing hand will detect the attempt of the subject to rotate the femur so as to recruit with the quadriceps. The soft portion of the hand is applied over the lower leg taking care to avoid any hard contact over the malleolus.
The angle of the test can be varied along the arc of the motion of the leg.
The graph to the right shows the normal response to muscle testing. Pressure is applied and resistance given until you reach a maximum level. Additional stress is then applied and the patient is able to adapt to that stress.
The lower graph shows failure to adapt to the additional stress. The part being tested appears to “break away”: thus the name Break Test.
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Deltoid
Action Abduction of the humerus. The anterior and posterior portions aid in exion and extension respectively. The anterior and posterior sections can function synergistically with each other or in an antagonistic fashion.
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Applied Kinesiology: Manual Muscle Testing and the Motor Neuron Richard Belli, D.C. Manual muscle testing has been a tool for medical and chiropractic evaluation for decades. The use of manual muscle testing as a tool in the medical community is mainly limited to evaluation of pathology whereas, in the chiropractic community it has been used for evaluation of functional disorders. It took the genius of George Goodheart, D.C. to see the value of manual muscle testing as an evaluative tool for functional disorders of the human system. His discovery earmarked the beginning of Applied Kinesiology (AK). Years later, Walter Schmitt Jr., D.C. coined the term, “muscle testing as functional neurology”, that started the era of describing the functional neurological aspects of manual muscle testing, and realization of the breadth of possibilities that manual muscle testing affords. Over the decades that muscle testing has been used as an analytical tool, there have been a multitude of meanings attached to a weak muscle. These include dysfunction of the electromagnetic system, the lymphatic system, the cranial respiratory system, and many more. But whatever you name the zebra, a zebra is a zebra, and the bottom line in AK is that a “weak response” to a muscle test means that the muscle’s motor neuron is not functioning normally, limiting the ability of the subject to contract the muscle. In other words, if the motor neuron is shifted too far towards hyperpolarization then the subject cannot depolarize the motor neuron enough to provoke a muscle contraction and the muscle tests weak. This leaves us with the question, “What does a weak muscle mean”? The term “weak muscle”, in respect to AK, is actually a misnomer. The muscle itself is not actually weak. Assuming there is no end organ pathology, the “weakness” is the result
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of inhibition of the motor neuron.. A muscle is simply contractile tissue that is depolarized by an efferent signal from the motor neuron. A weak muscle simply means that the muscle being tested is not appropriately depolarized by the motor neuron. Therefore, a more appropriate term would be a “neurologically inhibited muscle”. Hence one who uses manual muscle testing as an analysis tool needs to realize that muscle testing is simply a test of the function of the motor neuron. The anterior horn of the spinal cord is the location of the cell body of the motor neuron. The functional state of the anterior horn is maintained by convergence of multiple ascending and descending pathways. The descending pathways originate at suprasegmental levels both pyramidally and extra pyramidally. The ascending pathways are sensory pathways that are either of somatic or visceral origin. The descending pathways can be of conscious origin in which the subject voluntarily motivates the muscle, or it can be of reexogenic origin that is involuntary. Ascending pathways may be sensory from a variety of origins ranging from mechanoreceptors in skin and joints to nociceptive bers from soma and viscera. In an occurrence of a weak muscle, the total effect of the converging pathways may shift the anterior horn so far towards hyperpolarization that the neuron cannot be brought to it’s ring threshold, thus when the examiner tests the muscle the subject cannot resist the force of the examiner. There are a variety of reexes indigenous to the human system that are necessary to maintain life and limb. If there is either somatic or visceral tissue dysfunction there will be an associated reex affecting motor neurons and muscle function. A classic example is an inamed appendix in which the patient cannot extend the right hip. This exion contraction is a withdrawal reex that is a consequence of tissue irritation and a nociceptive driven withdrawal reex. For every hypertonic muscle due loss of appropriate inhibition of its’ motor neuron, there will be
a reexogenic inhibition or “weakness” of its’ opposing muscle. As a result, nearly every visceral or somatic dysfunction will result in a neurologically inhibited muscle. Lesser degrees of this example come in the form of the weak muscles that are examined with manual muscle testing. The nervous system monitors and drives virtually all the systems in the human body. When there is dysfunction of any part of the human system the central nervous system knows about it, and attempts to respond accordingly. The soma and viscera communicate with the central nervous system both chemically and neurologically. Therefore it is reasonable to say that both chemical and neurological dysfunction can be analyzed with manual muscle testing. Regardless of the name of the technique used, whether it is acupuncture meridian stimulation, neurolymphatic technique, spinal adjusting or other osseous manipulation, if it strengthens a muscle it is bringing the anterior horn and associated motor neuron to a more normal state of function. Hardly a single human function takes place without involvement of muscles. With that in mind, and procient knowledge of the human nervous system, the use of manual muscle testing in the form of Applied Kinesiology can provide an almost limitless tool for functional analysis of the nervous system and all that effects it.
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The Ventral Horn Cell What Happens When Muscle Strength Changes Kathleen M. Power, D.C., DIBAK, DABCI, DACNB THE VENTRAL HORN CELL When we test a muscle we are testing a number of parameters. We are testing the patient’s ability to listen and interpret what our request is. We are testing the capacity of the patient’s nervous system to translate our request into a motor event – the resistance of the muscle to our test pressure. The integrity of the motor response depends upon the ability of the motor neuron to reach a state of excitation sufcient to create an action potential. When we change the ability of the muscle to respond to our test pressure we have changed the ability of the neuron to reach its excitation threshold. Everything we do to, or for, a patient which has an impact on the strength of the muscle is related to this fact. In this article we will look at some of the factors involved in the ability of the neurons to reach an action potential and re to its target organ, the muscle ber. The efferent nerve is composed of large alpha motor neurons and small gamma motor neurons. The cell bodies of both of these are arranged in longitudinal columns at the anterior portion of the gray matter of the spinal cord, the anterior or ventral horn. The alpha motor neuron supplies the primary contractile tissue of the muscle. The gamma motor neuron supplies the contractile portion of the polar ends of the spindle receptors which are embedded within the muscle tissue. Dr. Goodheart has spoken of spindle receptors for many years. When the gamma motor neuron res, the ends of the spindle contract, thus “preloading” it. In a more contracted state, the spindle is more likely to re with less stretch upon the muscle. The motor neurons have thousands of synapses on their dendrites and cell bodies;
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these are both excitatory and inhibitory. Some presynaptic pathways to the ventral horn cells are segmental and some are suprasegmental. The ability of the ventral horn cell to summate and reach an action potential depends upon the addition of all excitatory and inhibitory inuences from all of these pathways at a specic moment in time. SEGMENTAL INFLUENCES Many of the local or segmental inputs into the ventral horn cell are associated with what we call the stretch reex. In textbooks it is described as a simple phenomenon -- an afferent arc from the muscle spindle and an efferent arc from the ventral horn cell to the muscle -- but it is in reality very complex. It is complex because there are many collaterals to many other areas of the nervous system. Some of the collaterals from the spindle receptors go to other ventral horn cells to bring them closer to threshold or to allow them to re. Other collaterals re to segmental autonomic supply. Still others ascend to suprasegmental systems which eventually modulate ventral horn cell output through descending pathways.
Segmentally, when the spindle receptor res, it res to the muscle in which it is located and to its synergists. It res to muscles associated with it in a gait type of conguration. For example, if the PMC on the right is stretched, the ventral horn cells to that muscle and its synergists and to the contralateral anterior lower extremity muscles will be excited; so will the ventral horn cells to the contralateral upper extremity posterior muscles and the ipsilateral posterior muscles. In addition, interneurons which have an inhibitory action will be red to inhibit the antagonists of the PMC on the right, to the left PMC, to the right anterior hip and leg muscles, etc. We may observe this when we nd a muscle
which tests weak; we may increase its ability to resist test pressure by asking the patient to contract a muscle whose reex connections cause increased strength in the muscle. For example, a patient may present with a weak posterior deltoid on the right, but contracting the PMC on the left will increase resistance to test pressure of the posterior deltoid. SUPRASEGMENTAL INFLUENCES The primary presynaptic inuences are descending suprasegmental inputs from many areas of the higher nervous system. These descending pathways change the ability of the ventral horn cells to summate; therefore, they modulate the ability of the stretch reex and other reexes to occur.
in the nervous systems of our patients. We may change resistance to test pressure by harnessing segmental synergists and antagonists. We may change resistance by affecting descending pathways. Right sided effects may be best produced by increasing afferent stimulation from the left: light, sound, stretch, etc., may be helpful. Cognitive types of activities may be used such as visualization, or specic left or right brain activities.
In Dallas, at the Modules in Neurology taught by Prof. Carrick, I have been privileged to witness the use of many creative applications using these pathways to change ventral horn cell function. Rather than use volitional muscle testing to determine ventral horn cell activity, he often uses EMG. It is an We all learned in our neurology courses in effective tool particularly when there is such chiropractic college that motor function is poor muscle activity that our standard AK initiated in the contralateral cortex; this is testing modalities cannot be utilized, such as essentially true although it has been shown in paralysis, motor neuron disease., etc We that the cerebellum on the side of movement have watched the EMG oscilloscope as muscle actually res rst. There are also ipsilateral activity increased when a spinal cord injury cortical inuences to motor function which patient was asked to contract the reexlyare very important to ventral horn cell associated muscles on the contralateral summation. Areas of the cortex called (“good”) extremity while visualizing “normal” neocortex (only humans have this area) re activity of the injured nerve/muscle pathway. down to brainstem areas which then re down We have seen an immediate decrease in into the cord. Their functional effects are abnormal ventral horn cell activity and to increase summation in ventral horn cells fasciculations in a group of upper extremity ipsilaterally, especially in upper extremity muscles when a patient diagnosed with a posterior muscles and lower extremity potentially fatal motor neuron disease was anterior muscles. asked to perform specic eye movements to harness pathways associated with ventral The neocortex responds to environmental horn cell function. input from the contralateral side (with the exception of smell). It also responds to cognitive The therapeutic applications available to processes initiated in the contralateral us, whether we call it AK or Neurology, cerebellum. When the neocortex increases include supplying appropriate environmental its ring, both the alpha and gamma motor stimulation to the patient to allow for the best neurons are affected. function of his/her nervous system. Whether we test a muscle manually or stick EMG WHAT THIS MEANS TO needles into it, the immediate changes we APPLIED KINESIOLOGISTS witness are reective of changes in nervous system function. To be neurologically correct The good news about all of this is that as we say that muscle testing is examining AK practitioners we may learn to harness the ability of the muscle to resist the test these pathways to effect positive changes pressure and represents the ability of the
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specic segmental activity to occur as it is modulated by suprasegmental activity. And whatever therapeutic modalities we choose, if we monitor the autonomic nervous system for indicators of increased or decreased sympathetic and parasympathetic activity as discussed in the previous articles, then we may be certain that our corrections will serve the patient in the long run. We are fortunate in AK that we have trained ourselves to interpret the ability of a muscle to resist test pressure and we therefore may monitor the effects of stimulations we give to an individual. We must guard against simple explanations as to how that stimulation affected the muscle, however. There are many integrated factors and we must realize that a single muscle test is associated not only with the stretch we place upon the muscle, but the position and activation of muscles reexogenically associated with our test muscle and the summative effect of all descending inuences – the sound, light, smell, temperature and cognitive environment of the patient as well. Rubbing a point activates certain pressure receptors, but also has a cognitive effect, perhaps an emotional effect, a visual effect as the patient moves his or her eyes to follow you, etc. A muscle which gets stronger may do so as a consequence of any of these inputs – probably as a consequence of all of them acting together upon pools of neurons which impact the summative capacity of the ventral horn cell. AK works, but we need to appreciate that testing a muscle and the response to sensory stimuli as determined by changes in muscle testing is multifactorial.
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History of Applied Kinesiology George Goodheart, D.C. Applied kinesiology is the child of the inquisitive mind of George Goodheart. In the early 1960's, he began to research the causes and effects of muscular weaknesses. Each year new and important ndings have been added to the body of knowledge known as applied kinesiology by Dr. Goodheart.
ICAK The International College of Applied Kinesiology was formed in 1976 to advance t he study of applied kinesiology in health care professionals. There are chapters around the world with members in all professions.
Developmental Milestones High points in the development were: 1964 1966 1967 1969 1970 1973 1974 1976 1980 1982 1988 1998 2003
rst book on muscle testing neurolymphatic research neurovascular research basic cranial motion-corrections basic acupuncture relationships fascial technique therapy localization temporomandibular joint corrections PRY technique strain counterstrain spondylogenic reexes myogelosis anatomy trains
Since 1964, over 40 different treatment options have been found. Added to this are special tests that allow the doctor to test the patient using tools like muscle testing, range of motion, tenderness, challenges and others that allow accurate diagnosing of exactly what procedures are indicated for a specic patient.
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Strain Counterstrain This condition will create areas of pain similar in nature to those described by Travell in her books and articles on myofascial pain. The major difference between the two lies in the type of treatment needed to alleviate the pain pattern. Jones’ procedure is based on trial and error to determine if his procedure of postural positioning is indicated. Goodheart has devised a system for evaluating the muscles to determine if Jones’ procedure of static positioning is indicated. The area of trigger point tenderness must be located by palpation. Check for fascial involvement by stretching the muscle that is associated with the region found and correct any imbalances. Check for fascial involvement by stretching the muscle and retesting for weakness. If weakness is found, treat accordingly. Fully contract the muscle by having the patient approximate the origin and the insertion as far as possible, and retest the muscle for weakening. Weakness found after this procedure indicates a need for the strain - counterstrain technique. Strain - Counterstrain Procedure While palpating the tender trigger point, the parts of the body where the trigger point is located will be positioned so that the greatest reduction in tenderness is achieved. As a general rule, if the trigger point is on the front of the body, the body part will be placed into exion. If the trigger point is on the posterior aspect of the body, extension will be employed. The farther from the midline that the trigger point is located, the more rotation will be needed to reduce the tenderness. Using Jones’ procedure, this position is held for up to 180 seconds for alleviation of the trigger point pain. Goodheart suggests that while the position is being held, a stretching of the spindle cells in the belly of the muscles be done. This will decrease the length of time that the position must be held.
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For multiple trigger points, test for the need of glycine or folate.
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Fascial Technique Fascia are sheets of avascular, transparent, elastic connective tissue covering and encasing each muscle and visceral organ. By connecting together, fascial tissues subdivide the body into functional units. Normally, the fascia and underlying muscle should be the same length. This allows the two to function as an integral unit. If the fascia shortens in relationship to the potential length of the muscle, it creates a neurological imbalance in the control of the muscular contraction. Janet Travell, M.D. researched fascial problems for over 40 years. She wrote a two volume set on the effects of trigger points and fascial problems. Unfortunately, she had no diagnostic test except the areas of complaint of the person and the nding that if you irritated a trigger point is would sometimes cause referred pain to specic areas. Goodheart found that if a strong muscle was stretched and it weakened, it would respond to the treatment options that Travell advocated. Here is his procedure: Test a muscle for strength and if weak strengthen by normal means. Stretch the muscle to its normal limit of motion. If the muscle is a weight bearing muscle, this is done slowly. Non-weight bearing muscles are tested by stretching the bers quickly. After stretching, the muscle is quickly retested for weakening. If found weak, involvement of the fascia is diagnosed. Utilizing a hard heavy pressure, “iron out” the fascia using pressure in the line of the underlying muscle bers. Massage from either the origin towards the insertion or from the insertion towards the origin. B-12 in low dosages, with the associated stomach and liver extracts which supply the intrinsic and extrinsic factors, is many times indicated.
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Multiple muscles showing a need for fascial technique are a good indication of need the of B-12 supplementation.
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Five Factors of the Intervertebral Foramina
By 1970, George Goodheart had determined body, and at least one of these ve factors will that six major imbalances or defects in the be functioning abnormally. body could cause muscular weakness and accompanying organ malfunction. One of these According to Dr. Goodheart, at each interverwas a nutritional imbalance and was therefore tebral foramina there is: a chemical cause. The others were structural a nerve problems and have been labeled the “ve fac- 1. 2. a blood vessel tors of the IVF”. 3. a lymphatic vessel cerebrospinal uid Alterations in the chemical, emotional or struc- 4. an acupuncture meridian connector tural homeostasis of the body will be manifested 5. by weakness in the muscle structure of the Malfunction of any one of the above can and does cause a weakness to occur in the body.
Nerve N
Acupuncture Meridian Connector
Neurolymphatic Reflex
AMC
Cerebrospinal CSF Fluid (Cranial - Sacral Fault)
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NV
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Muscle Proprioceptors This technique is indicated in any traumatic injury. Spindle cells are found in nearly all muscles and are more numerous in the muscles of the limbs than those of the trunk. They are located throughout the muscle, but are more concentrated in the center portion of the muscle. Because the long axis of the spindle is parallel with the long axis on the muscle, it is stimulated by stretch. This results in nerve impulses in the afferent nerve bers. These specialized cells are responsible for informing the brain on the degree of stretch that the muscle is under. Pressure, applied as to approximate together the bers of the muscle in its linear length, has the effect of relaxing or weakening the muscle. Pressure, applied as to stretch the muscle bers, has the effect of increasing the strength of a muscle.
Most tendons are supplied with stretch receptors which are located near the attachment of the muscle and the tendon. Tension on the tendon distorts these receptors stimulating them. They are called golgi tendon organs or GTO’s. Stimulation of stretch receptors in a muscle reexly excites contraction of the muscle while stimulation of stretch receptors in the tendon inhibits the contraction of the muscle. Pressure applied against the tendon towards the origin or the insertion of the muscle has the effect of weakening or inhibiting the function of the muscle. Pressure applied against the tendon is a direction towards the belly of the muscle, as if to lengthen the tendon, has the effect of strengthening or increasing the force of contraction of the muscle.
To turn down and weaken a muscle press the spindle cells together and push towards the origin and insertion at the tendons.
To turn up and strengthen a muscle pull the spindle cells apart and push towards the belly of the muscle at the tendons.
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Reactive Muscles This refers to the weakening of a muscle following testing of another muscle. This weakness occurs because of improper proprioceptor communication between the related muscles. A suspected muscle is tested to determine if it is strong. If the muscle is found to be weak, treat it in the normal fashion. Test a related strong muscle, for example a synergist to the original muscle, and then quickly retest the original muscle. If the reactive pattern is present, the original muscle will now test weak. Treat the spindle cells of the muscle that when tested caused the weakening of the original muscle. The spindle cells are stimulated as if to weaken the muscle. Imagine that the muscle is set too strong and therefore over powers the second muscle creating the weakness. Retest the muscle testing sequence to make sure that the muscle stays strong after treating the spindle cell. In today’s language, these reactive muscle patterns fall under the heading of proprioceptive neuromuscular facilitation problems. In the hands of athletic trainers and physiotherapists, patterning is done to normalize these spindle cell imbalances done in a global way around the joints in question. This method requires 15 - 20 minutes of “patterning” for this to occur. Using the Goodheart - applied kinesiology method, this can be done more specically and faster.
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Muscle Interlink This term is used to describe the relationship of muscles that interact as reactive muscles in a pattern similar to that of the ligaments in the ligament interlink condition. There appears to exist a correlation between the opposite muscle groups on a joint basis. For example, the biceps relate to the opposite quadriceps, the hamstrings to the opposite triceps, etc. Treatment involves correcting the spindle cell mechanism (testing and treating as for reactive muscles). This simple observation of muscle ndings opened the door for other techniques to both examine and treat gait patterns.
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Spinal Extensor Muscle Weakness Pattern
On standing, weight causes a spreading of the interphalangeal joints of the feet and a stretching of the interosseous muscles.
sertion to correct the golgi involvement.
The proprioceptors of the feet then cause an inhibition of the spinal extensors when they are stretched sufciently.
This condition is found frequently in chronic back patients.
In Understanding the Scientic Basis of Human Movement, O’Conner and Gardner describe the reex from the proprioceptors in the plantar muscles and joints that cause this extensor inhibition pattern. This pattern is easily demonstrated by testing a strong spinal extensor like the upper trapezius, middle trapezius or latissimus dorsi and having the subject lean forward loading the metatarsal arch. At one point, the muscle will become inhibited and explains why swimmers or sprinters commonly fault at the starting line. Observe the patient standing. Visually draw a vertical line extending down from the external auditory meatus. This line should bisect the shoulder, the acetabulum and the external malleolus. If this alignment is not found, test an extensor muscle of the spine. The mid-trapezius, upper trapezius or the neck extensors are easily tested. If weakness if found, have the patient remove the weight from the foot on the side being tested and retest the prior weak muscle. If the plantar muscles are in a state of hypertonicity, then the muscle will test strong and weak again if the weight is reapplied. Treat by correcting the spindle cell and golgi apparatus that are involved by applying pressure towards the center of the muscle in the belly, to correct the spindle cell, and by pulling away from the belly on the origin and in-
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Miscellaneous
If the patient is prone, squeezing the foot will cause weakening of the gluteus maximus, hamstrings, and the neck extensors.
In treating common ache or pain patterns that patient’s present, there are three major options that can be used. The two most common in applied kinesiology involve nding the specic muscles that are over contracting causing the abnormal inhibition pattern. The third option is using a PNF (proprioceptive neuromuscular facilitation) procedure that generally addresses normalization of these
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aberrant muscle patterns. The PNF procedure requires prolonged patterning to coordinate the muscle function. In all cases, examination and correction of a related spinal imbalance signicantly aids in a more permanent correction.
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Aerobic / Anerobic Muscle Testing Aerobic Muscles These are slow-ring muscles like the dark meat of turkey. They exhibit great elasticity and great endurance. They are fueled by oxidative metabolism of fats. Myoglobin holds the oxygen in the muscle for the oxidative process.
In scoliotic patients, examine and determine which muscles are not supporting the spine, as they should. A common nding is a unilat eral weakness of the psoas. Many times these muscles will test strong on a single test.
Anerobic Muscles Retest using the aerobic type of repeated testing and usually the psoas, for example, will show weakness.
These are fast-ring muscles like the white meat of turkey. They are less elastic and fatigue easily. They are fueled by the consumption of sugars in the Kreb’s cycle. They de- After correcting the lymphatic reexes, the spine will many times show a dramatic pend upon large glycogen storage. change. Test for and correct muscle weakness, if found, in the normal fashion. Use of these types of muscle tests can aid in For aerobic muscles, the muscles of support the establishment of an effective rehabilitaretest in a rhythmic, slow repetitive manner. tion program. Determining the number of repetitions that can be performed before the Do this testing at least twenty times. muscle fails sets limits on the number of repIf weakness occurs, treat the neurolymphatic etitions that are positive for the patient. reexes and test for the need of iron to replenish myoglobin levels. For anerobic muscles, the fast-ring muscles of the upper extremity, retest in quick, rapid succession at least twenty times. If weakness occurs, treat the neurolymphatic reexes and supplement with pantothenic acid to augment the breakdown of glycogen in the Kreb’s cycle. If the muscle tends to cramp during the testing procedure, have the patient hold the neurolymphatic reex. This will many times increase the blood ow and prevent the cramping.
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Muscle-Organ/Gland Association By David Walther, D.C., DIBAK Excerpted from Synopsis – Systems DC Pueblo CO 1988
The next factor introduced into applied kinesiology with specic organ/gland association was the meridian system. When treatment was applied, the stomach meridian Early in applied kinesiology Goodheart improved the pectoralis major (clavicular detected some consistency of specic muscle division) muscle, the small intestine meridian dysfunction with specic organ or gland improved the quadriceps muscles, and the dysfunction. For example, when the pectoralis large intestine meridian improved the tensor major (clavicular division) muscle tested fascia lata muscle. weak, there was often stomach dysfunction. When the quadriceps muscles tested weak, The muscle-organ/gland association of applied there was often small intestine dysfunction. kinesiology is clinically valuable in helping When the tensor fascia lata tested weak, there nd the primary areas of dysfunction when was often colon dysfunction. (The complete combined with other diagnostic disciplines. muscle-organ/gland association is included in The muscle-organ/gland association should the muscle testing section of this text.) The not be considered absolute. For example, observation of muscle-organ/gland association there may be local muscle dysfunction was strengthened as new examination and causing the quadriceps muscles to test weak, therapeutic approaches were introduced into with no dysfunction in the small intestine. applied kinesiology . On the other hand, an individual may have a gastric ulcer conrmed by radiology but the Treatment to Chapman’s reex for the pectoralis major (clavicular division) may not stomach, now called a neurolymphatic test weak. As one becomes more advanced reex, strengthened the pectoralis major in applied kinesiology, it is seen that nearly (clavicular division) muscle. Treating the always there is dysfunction of the pectoralis neurolymphatic reex for the small intestine major (clavicular division), but the body has improved quadriceps muscle function, and many ways of adapting to dysfunction. With the colon neurolymphatic reex stimulation advanced applied kinesiology techniques, strengthened the tensor fascia lata muscle. The it may be found that the pectoralis major Bennett reexes, now called the neurovascular (clavicular division) muscle tests strong in reexes, had a similar correlation. Stimulating the presence of an ulcer because there is the small intestine reex improved the weak over activity of the stomach meridian as an quadriceps muscles. Treatment to the colon adaptive healing effort by the body. Research reex improved the tensor fascia lata muscle on the muscle-organ/gland association is when it had previously tested weak. A similar ongoing, with much yet to be learned. 1, 2, 3, 4, 5, 6 correlation was found in the neurovascular reex treatment that improved function of 1 Burdine, C., “The reactivity of muscle the pectoralis major (clavicular division) strength to visceral stimulation and muscle. It was discovered that stimulation neurolymphatic point pressure.” Independent of Bennett’s emotional reex affected the Research, unpublished, University of Illinois, pectoralis major (clavicular division) muscle. Jun 1982 Reecting that emotions are often considered 2 Carpenter, S.A., J. Hoffman & R. Mendel, as the cause of stomach problems, especially “An investigation into the effect of organ ulcers, one can readily see a tie-in. irritation on muscle strength and spinal mobility,” Thesis, Anglo-European Coll Chiro,
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Bournemouth, England, 1977 3 Corneal, J.M. & R. Dick,”An attempt to quantify muscle testing using meridian therapy/acupuncture techniques” Proceedings of Winter Meeting, ICAK Palm Desert, CA, 1987 4 Jacobs, G.E., T.L. Franks & P.G. Gilman,”Diagnosis of thyroid dysfunction: Applied kinesiology compared to clinical observations and laboratory tests,” J Manip Physiol Ther, Vol 7, No 2 (Jun 1984) 5 Leaf, D.W., Nutrient Testing Evaluation” Proceedings of Summer Meeting , ICAK, Santa Monica, CA 1985 6 Wing, T.W., “Applied kinesiology, related organs, meridians, and auricular therapy,” Chiro Econ, Vol 21, No 4 (Jan/Feb 1979) .
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Introduction on Applied Kinesiology and Nutrition By David Walther, D.C., DIBAK Excerpted from Synopsis – Systems DC Pueblo CO 1988 A system for evaluating nutritional effects on body function has been developed in applied kinesiology by Goodheart. 28, 29 The system appears to provide additional information about how nutrition, or possibly adverse substances, may work with or affect body function. It is designed for use in conjunction with the physician’s general knowledge of nutrition, and laboratory and physical diagnostic ndings. It is important that the examiner using this technique be thoroughly knowledgeable about the usual methods for determining nutritional needs.
about nutrition may provide seven, eight, or even ten diverse philosophies leading to different therapeutic approaches, or perhaps to no treatment at all. Extremes range from the belief that if a person eats balanced meals no nutritional supplements are ever needed to recommendations of so many high-potency supplements that one would hardly need eat regular food, except for ber. Philosophies about nutrition vary from megadosages of numerous supplements to lowpotency products of natural origin only. Some recommend that specic nutritional products routinely be given with certain medications to offset any side effects1, others recommend no medication, with nutrition taking its place; still others recommend minuscule dosages of homeopathic remedies for the treatment of disease. There are vitamins, minerals, isolation of natural food products (such as the essential fatty acids), herbs to treat almost any condition, and Bach ower remedies for mental and emotional conditions. 2, 3, 4
Applied kinesiology nutritional testing appears to reect the nervous system’s efferent response to the stimulation of the gustatory and olfactory nerve receptors by various substances. The nerve pathways causing change in muscle function as observed by manual testing are unclear; Why are there so many philosophies with however, there is considerable evidence in different treatment approaches to something the literature of extensive efferent function as essential to our life as the food we eat? throughout the body from stimulation to The answer cannot be put into a simple the gustatory and olfactory receptors. There statement. There are many reasons for the is also evidence of afferent modication of confusion that reigns among nutritional gustatory sensitivity and central nervous authorities. Paramount among these is that system interpretation of gustatory impulses all nutritional factors have not even been ultimately modifying functional change as a discovered yet, and it is not known exactly result of oral stimulation. Applied kinesiology how the body uses many nutritional products. nutritional testing enables a physician to give As we progress with our discussion, keep in individual consideration to each patient’s mind that the rst description of treating nutritional needs. To properly apply this scurvy with ascorbic acid was done only fty method of testing, one should be thoroughly years ago, by Parsons. 5 familiar with the nervous system’s role in nutrition, and also be procient in manual The applied kinesiology method of evaluating muscle testing. changes in body function as the result of nutritional stimulation lls a specic void As one begins a serious study of nutrition in the question of nutritional deciency outside applied kinesiology, it is easy to diagnosis. The method consists of stimulating become very confused. Consulting ten the gustatory or olfactory nerve receptors different authorities on specic questions by having the patient chew or inhale 30 the
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substance to be evaluated, and then manually evaluating nutrition have sunk so low that testing a muscle for change. The muscle this writer once heard a woman at a nearby may appear stronger or weaker, depending table in a restaurant say, “If you don’t believe upon the type of evaluation being made and me, let me show you.” She then had a man at the muscle’s neurologic association with the the table stand up and hold a sugar dispenser substance stimulating the nerve receptors. in his hand. She proceeded to have him hold This system of testing is controversial. his other arm out and attempted to pull it One reason for this is that there have been down. He was a strong individual, and she many modications of Goodheart’s original almost lifted herself off the oor before she description. Some, rather than have the patient was able to pull his arm down. Then came the stimulate the gustatory or olfactory receptors statement, “See - I told you it would make you with the substance being tested, have the weak.” individual hand-hold the substance or lay it on the belly; some even have the patient hold Applied kinesiology nutritional evaluation is a bottle containing the substance to be tested. indeed a revolutionary method of determining 6, 7, 8, 9, 10 These modied systems are frequently nutritional needs. In my twenty-seven years of taught to lay people 6, 7, 8, 11, 12 who often do not practice, I have seen many changes take place have the anatomical knowledge necessary for in what is considered the routine nutritional accurate muscle testing, nor do they have a approach for health problems. Twenty-ve nutritional background or general diagnostic years ago I was increasing ber content in ability. the diet of patients with colon disturbances. On three different occasions when I took The testing of nutrition as advocated by the patients off the bland, rened carbohydrate International College of Applied Kinesiology diet prescribed by their allopaths, I was called is a discipline limited to stimulating the a stupid quack and accused of endangering gustatory or olfactory nerve receptors with the lives of my patients. Fortunately, the the substance to be evaluated, combined patients continued my therapeutic approach with accurate and specic muscle testing. and had uneventful recoveries, in spite of The information derived from these tests the diatribe against me and my procedure. must then be correlated with a standard Today, even television commercials and the diagnostic work-up by a person licensed in National Cancer Institute13 emphasize the the healing arts to be a primary health care need for ber in the diet. Those same doctors provider. The approach discussed in this who called me a quack now use the approach text is designed to be an adjunct to standard I used twenty-ve years ago. nutritional evaluation, not to take the place of it. Those who have the expertise to properly There are many reasons that nutritional test nutrition, as described by the ICAK, needs should be evaluated on an individual should not use this method as a sole approach basis. Applied kinesiology adds to the in evaluating nutrition and/or substances physician’s nutritional knowledge the ability harmful to the body. to determine, to a certain extent, the effects of various nutritional products on the specic This writer believes that the modied testing individual being considered. Furthermore, it procedures for nutrition - including hand- enables one to evaluate the difference between held, laying it on the skin, touching various nutritional products that may appear to be the areas of the skin, and teaching the material same according to the product’s descriptive to lay people - may lead to errors in diagnosis label, but act differently from individual to and are potentially detrimental to the health individual. of the subject being evaluated. People are different. Everyone does not The abuses of manual muscle testing in require the same nutritional program
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regarding the food eaten and possible supplementation taken. Williams14 points out that researchers must begin considering biochemical individuality in the study of nutrition. Individuality may have a genetic basis with different body composition, enzymatic patterns, and endocrine balance. Williams presents a hypothetical group of ten men (group 1), all of average height, with the same foot size. They have the same amount of hair on their heads, and an average tendency to put on body fat. They consume the same amount of alcoholic beverages, have the same sex urges, and their digestive tracts react the same to food. They all have normal teeth, without cavities or plaque buildup. Finally, they all have the same emotional reactions to the same daily stresses.
body wisdom was adequate in regulating food intake to an less than 1/20 of 1%. There is abundant data indicating that man and animals have innate self-selections to determine quantities and quality of food that will provide optimal health. Although this mechanism is constantly functioning to some degree and will be discussed later, it is not an answer to the nutritional question; there are many factors that interfere with proper selfselection.
In-depth study of nutrition is done to indicate the nutritional products needed for optimal health and for the treatment of various types of body dysfunction and disease processes. Why do many of the studies end with opposing conclusions? If complete data is available, one may nd that one study used a natural vitamin Contrast this group with another hypothetical product while the other used a synthetic one. population of ten men (group 2). In this One may have used a higher potency vitamin group is one man who has lost all his hair. than the other, or the studies were biased by Another seems to gain weight just by thinking group selection. Conicting conclusions may about food. Another has long, narrow feet be traced to the differences in manufacturing and ngers. One supervises 100 men on a nutritional products. One company may use production line, with a very tight productivity heat in processing, and another cold. Keep in schedule to meet. Another has no sex drive, mind that all nutritional cofactors have not and still another is a salesman with his two- yet been discovered. martini lunch schedule. Applied kinesiology nutritional testing, It seems that the minimum and maximum like the other considerations, is not alldaily requirement of nutritional complexes encompassing and must be correlated with can be easily gured for group 1, but what are other methods to determine nutritional need. the needs for group 2? If there is considerable In a status statement published in 1983 15, individuality among people, how has man 16 and updated in 1988, the International survived for so long before there was any College of Applied Kinesiology states, study of his nutritional needs? Is there an “Nutritional and chemical evaluation [by innate self-selection of the food needed by the muscle testing] should only be done with the body? Williams points out the body’s wisdom substance stimulating the subject’s olfactory with the illustration of an individual who has or gustatory receptors. It is also necessary no knowledge about nutrition and little or no to evaluate other factors that may inuence tendency to gain weight. If, during a ten-year the perceived muscle strength. Conrming period, he gains ve pounds, his self-selection diagnostic criteria for the need of any of food has regulated his caloric intake to a nutrition should be present from the patient’s minimum error. During this period, if he were other diagnostic work-up, which may include moderately active he would have consumed history, type of dysfunction, laboratory tests, approximately 12,000 pounds of moist food. physical diagnosis, and dietary inadequacies. If there was a 1% error of caloric intake over . . . An adequate educational background is the ten years, he would have gained or lost needed in evaluating nutritional needs and 120 pounds. With the ve-pound gain, his
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manual muscle testing. The use of manual muscle testing by lay salespeople has created problems due to their untrained nature and enthusiasm to sell their products.” Some have described the testing of nutrition by manual muscle testing as a simple procedure, 8, 9, 11, 12 which it certainly is not. One must be aware of the various factors that inuence manual muscle testing, such as subluxations, lymphatic drainage, intrinsic neurologic dysfunction, balance of the meridian system, and function of the cranialsacral primary respiratory system. These are only a few of the many factors that have been found to inuence the manual muscle test. They must be taken into consideration when evaluating an individual for his nutritional needs. Nutritional testing with the modied methods of holding the nutrition in the hand, laying it on the body, holding a bottle that contains the substance, and touching various “reex points” about the body is often the main subject of a book or booklet produced for general public reading. In some instances, these procedures are taught at weekend seminars that may be sponsored by companies trying to sell their nutritional products. In fact, some nutrition companies have taught lay people to do muscle testing to convince prospective customers to buy the product. When one tries to “prove something” to another individual with manual muscle testing, errors often result. The examiner may unconsciously change the parameters of the test (or may not even know what the parameters are), and make the test come out the way he expects due to his enthusiasm for the procedure. 17 In no way should the modied procedures be confused with applied kinesiology methods. The skilled applied kinesiologist uses manual muscle testing to evaluate nutrition as an adjunct to standard laboratory and physical diagnostic methods. All factors of the examination should correlate, or something is being missed. Research sponsored by the ICAK 18 points out that manual muscle testing to evaluate nutrition, whether chewed or held in the hand, is not a viable approach in and of itself.
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The primary method of testing nutrition in applied kinesiology is to have the patient chew the substance to be tested. The inuence on the body appears to be the result of stimulating the gustatory and olfactory receptors. Oral absorption may also inuence the body. In simple daily observation, one can see many instances in which chewing nutrition quickly changes an individual. A hungry, crying child quiets immediately upon nursing or obtaining other food. An irritable hypoglycemic individual calms immediately upon chewing food, long before there can be any rise in the blood sugar level from the substance. The importance of the gustatory system on health is illustrated in a report by Pangborn 19 about a Russian study by Murskii wherein dogs were “killed,” then resuscitated. Early recovery of the gustatory function was always associated with successful resuscitation. In cases where recovery was difcult and cortical cells did not regain full function, the ability to distinguish food from non-foods was sometimes disturbed. The early development of taste sensation emphasizes the importance of gustatory function. The newborn human infant is able to distinguish water from sugar solutions. 20, 21 Fetal sheep can taste, as measured at the chorda tympani nerve, as early as 100 days into the gestation period (term = 147 days).22 When chewing nutrition changes muscle function as perceived by the manual muscle test, the change is almost immediate. It seems evident that the effect is due to stimulation of the gustatory and olfactory receptors. Oral absorption of some of the chewed material may stimulate remote receptors. As will be discussed later, certain substances enter the bloodstream almost immediately by oral absorption. Most of the research done on testing nutrition by applied kinesiology methods has been clinical correlation of muscle testing results when specic nutrition is chewed, in correlation
with the clinical and laboratory examinations previously mentioned. The literature has many examples of how gustatory receptors and oral absorption change body function. Research shows widespread interaction within the nervous system and the body in general from nutritional stimulation. Most of the research discussed here was done prior to the clinical knowledge of the effect chewing nutrition has on manual muscle testing. Further research must be done, taking into consideration the inuence of nutritional products on the nervous system and the great amount of neuromuscular, organ, and gland interaction. Most of the basic research has been done on the control of food and water intake under normal and abnormal conditions. There have been group and isolated studies done on innate self-selection and its effect on health and diseased states. While these studies have nearly all indicated that self-selection enhances health, we will also consider how education, environment, emotions, and status satisfaction override proper innate self-selection. Progressive research on applied kinesiology nutritional testing should not be limited to the gustatory receptors. Food and water intake is regulated by a combination of peripheral and central systems. Stevenson 23 presents an overview of this integration. Chemoreceptors, such as the glucoreceptors in the hypothalamus and liver and liporeceptors monitoring the fat deposits, provide information about the body’s reserves. It has been suggested that glucoreceptors provide a short-term control of food intake relative to immediate energy needs, while the liporeceptors provide a longterm control for the maintenance of body weight. Additionally, the osmoreceptors, stretch receptors, and baroreceptors reect blood volume and extracellular uid volume. Even thermoreceptors playa role in regulating food intake. It is well-known that the environmental temperature inuences food intake in man and animals. Hypo- or hyperactivity of endocrine glands, such as the thyroid 24 and adrenal,25 modies taste sensation and reaction to stimulation.
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How a substance tastes to an individual does not appear to have any bearing on applied kinesiology nutritional testing. The results of the test appear to depend on how the nervous system reacts physiologically to the substance. The sensation of taste as subjectively evaluated by the subject is a hedonic one and appears to be evaluated on another level. 26 The attractiveness of food, its texture, and an individual’s previous experience playa major role in what he chooses to eat. A fresh apple is identied as such by its odor. Peel and mash a raw apple and a potato to eliminate the texture characteristics. It will be difcult to determine which is which when each is tasted with the nose and eyes closed. Cold milk, beer, and soup are distinctly different in taste from hot milk, beer, and soup. One easily recognizes the optimal temperature of wine or meat. Changing the visual stimulation of the food by adding tasteless food coloring increases or decreases its attractiveness. Try serving blue-yolked eggs or black cereal! The change in desire is due to a learned response, not the dark color, since black caviar and olives rank among the most desired delicacies. Stimulation of the gustatory receptors elicits specic preferences in drinking or eating or - on the other hand - in rejecting particular foods. Pfaffmann, 27 in discussing the “pleasures of sensation,” emphasizes the hedonic aspects of sensory stimulation and suggests that sensory input to the hypothalamus and other structures of the limbic system may be involved in hedonic and reinforcing features of stimulation, as compared with cognitive and arousal functions. Some items tested with applied kinesiology methods t into the pleasurable realm, while others are distinctly unpleasurable. Typically, sugar will cause a hypoadrenic individual to test weak on its ingestion, while a vile-tasting product for adrenal supplementation will cause a previously weak associated muscle to strengthen. Those who use manual muscle testing to evaluate nutrition should be thoroughly familiar with the nervous system’s role in nutrition. Although much of
the basic research was done prior to the use of manual muscle testing to evaluate nutrition, 13 Wynder, E. L., “ Cancer Prevention,” it provides a foundation for further basic and in 1981 Medical and Health Annual, ed E. clinical research to understand the action Bernstein (Chicago: Encyclopedia Britannica, taking place. 1980) 1 Roe, D. A., Drug Induced Nutritional 14 Williams, R. J., Biochemical Individuality Deciencies : (Westport, Ct: Avi Publishing – the basis for the Genetotrophic Concept Co. Inc. 1976) (Austin, TX: Univ of Texas Press, 1956) 2 Adolph, E. F., Urges to eat and drink in rats,” Am J Physiol, Vol 151 (1947) 3. Chancellor, P. M., ed, Handbook of the Back Flower Remedies (London: The C W Daniel Co Ltd. 1971) 4 Weeks, N. The Medical Discoveries of Edward Bach, Physician (New Canaan, Ct. Keats Pub. Inc. 1979) 5 Parsons, L. G., “Scurvy treated with ascorbic acid,” Clin Orthop, No 222 (Sept 1987) 6 Barton, J.E., How to take Care of yourselves – Naturally (Medford, OR: Harman Press, 1977 7 Barton, J. E. & Barton, M., Which Vitamin? Nutritional Care through Muscle Testing ( E. Longmeadow, MA: Celecom Corporation, 1979) 8 Fischman, W., & Grinims, M. MRT (New York: Richard Merk Publishers, 1979) 9 Peshek, R. J., Balancing Body Chemistry with Nutrition (Riverside, CA: Color Coded Systems, 1977) 10 Peshek, R. J., ed, Nutrition for a Healthy Heart – for the Treatment of Pain ( Riverside, CA: Color Coded Charting, 1979) 11 Sheinkin, D. M., Schacter & Hutton, R., The Food Connection ( Indianapolis: The Bobbs-Merrill Co. 1979) 12 Thie, J. F., Touch for Health, revised ed (Marina del Rey, CA: DeVorse & Co., 1979)
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15 International College of Applied Kinesiology, “Applied Kinesiology – Adopted Status Statement of the ICAK,” Chiro Econ, Vol 26, No 3 (Nov/Dec 1983) 16 International College of Applied Kinesiology, “Applied Kinesiology – Status Statement of the ICAK,” Am Chiro (Jan/Feb 1984) 17 Schwrtz, J. P., “Some dangers in the development of new techniques in applied kinesiology.” Proceedings of Winter Meeting , ICAK, St. Maarten, 1980 18 Triano, J. J., Muscle strength testing as a diagnostic screen for supplemental nutritional therapy: A blind study,” J Manip Physiol Ther, Vol 5, No 4 ( Dec 1982) 19 Pangborn, R. M., “Some aspects of chemoreception in human nutrition” in The Chemical Senses and Nutrition, ed M.R. Kare & O. Mailer (Baltimore: The Johns Hopkins Press, 1967) 20 Mailler, O.,& Desor, J. A., Effect of taste on ingestion by human newborns,” Oral Sensation and Perception – Development in the Fetus and Infant, ed J.F. Bosma (Bethesda: U.S. DHEW, 1973) 21 Nisbett, R. E., Gurwitz, S. B., “Weight, sex and the eating behavior of human newborns,” J Comp Physiol Psychol, Vol 73, No 2 (1970) 22 Bradley, R.M., & Mistretta, C.M., “Investigations of taste function and swallowing in fetal sheep,” in Oral Sensations and Perception – Development
in the Fetus and Infant, ed J.F. Bosma (Bethesda: U.S. DHEW, 1973) 23 Stevenson, J.A.A., “Sensory mechanisms and multi-factor regulation of food and water intake,” Ann NY Acad Sci (May 15, 1969) 24 Hoshisima, H. et al., The mechanism of insulin secretion after oral glucose administration, “Diabetologist, Vol 8 (Apr 1972) 25 Fregly, M.J., “Specicity of the sodium chloride appetite of adrenalectomized rats; substitution of lithium chloride for sodium chloride, ”Am J Physiol, Vol 195, No 3 (Dec 1958) 26 Kare, M.R., “Some functions of the sense of taste,” J Agr Food Chem, Vol 17, No 4 (Jul/ Aug 1969) 27 Pfafmann, C. “The pleasures of sensation,” Psych Rev, Vol 67, No. 4 (1960) 28 Goodheart, G. J., Jr., The Cranial Sacral and Nutritional Reexes and Their Relationship to Muscle Balancing ( Detroit: privately published, 1968 29 Goodheart, G.J., Jr., “Structural imbalance and nutritional absorption ( a new route to the brain),” Chiro Econ, Vol 13, No 3 (Nov/Dec 1970) 30 Brimhall, J.W., “Inhalation therapy”, Proceedings of Summer Meeting, ICAK, Detroit, 1979
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Challenge One of the three original ndings of Goodheart is the concept of challenge. Using muscle testing or other biomechanical indicators, the body is challenged for the positive or negative affects of different stimuli. In nutritional testing, substances that may be detrimental to a person can be insalivated or challenged by smelling and strong muscles will weaken or you may nd increased muscle tenderness or decreases in range of motion. The same negative effects can be monitored by changes in vital capacity and/or changes in pulse rate.
Structural Challenge This is a method of testing that will determine if a vertebra, when pressed in a specic direction, can return to its normal position in a state of equilibrium. It is used to determine the direction of a subluxation of a vertebra. If a subluxated vertebra is pressed in a direction that reduces the subluxation and is held in that position, a muscle that was previously weak due to that subluxation will now test strong. When the vertebra is released, the intrinsic muscles of the spine will contract and temporarily pull the vertebra further into subluxation and any previously strong muscle will now test weak.
The challenge concept is easy to understand in relationship to muscle weakness related with nerve problems. If they muscle is weak Test and nd a convenient strong muscle. A due to a nerve entrapment, correction of the force of 1 - 3 pounds is applied is a specic nerve entrapment will cause the muscle to vector. Quickly, within ve seconds, retest strengthen. Likewise twisting, rotating or the muscle and determine if the muscle has stretching the nerve may produce weakness weakened. if there is in involvement along the pathway of the nerve. Apply pressure in any and all directions that the vertebra in question can subluxate and Challenge can be used with either a strong retest the muscle. Record all directions that muscle or a weak muscle. If you start with a cause weakness to occur. weak muscle then only those factors, which are related to that muscle weakness, will cause a The vertebra is in a position opposite to that of change or improvement in the strength of the any vector of force which causes a weakening muscle. of the indicator muscle. Correction must be made into the direction that caused the greatest In discussing the challenge mechanism, weakness. Correction should be made on the it is common to refer to a strong indicator phase of respiration that abolishes the weakmuscle. This is a muscle which is strong and ness induced by the challenge. can easily be inhibited by using techniques such stimulating the spindle cells as to “turn If the subluxation is chronic, check for involv edown” the strength, the sedation point of the ment of the intrinsic muscles of the spine. If related acupuncture circuit, placing a battery the challenge direction is straight lateral, then over the related meridian or simply tracing the rotatory brevis will be the major muscle the meridian in the opposite direction of its involved. Lateral but superior direction is normal ow of energy to produce a temporary indicative of rotatory longus involvement, weakness. and superior-inferior directions indicate the interspinalis muscles. Pressure applied to a vertebra causes the muscles to react, opposing this motion and
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further subluxating the vertebra. been termed rebound.
This has
For example, pressure applied to the atlas on the right lateral mass will cause the capitis muscles to resist the pressure. On removing
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the pressure, the muscles momentarily contract, “rebounding” the atlas in a direction exactly opposite the original pressure. If the atlas was originally subluxated in this direction, the resultant rebound will cause the atlas to move into a position of greater subluxation and weaken a strong indicator muscle.
Chemical
When dealing with weak muscle organ related problems, consideration must be given to the biochemical factors that are necessary for proper organ function. For example, Goodheart found that the gracilis muscle is related with adrenal cortex involvement. The adrenal cortex produces steroid hormones. Cholesterol is the basic raw ingredient. The initial cofactors that are necessary for cholesterol to transform and stimulate the biochemical pathway are niacin and or niacinamide. Other cofactors such as vitamin E and zinc are necessary to produce testosterone and estrogen. Pantothenic acid, vitamin C, folic acid and B-12 are cofactors
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necessary to produce cortisol. If the patient presents with symptoms of hypoadrenia and has a weak gracilis muscle, then questions and challenges for the above factors will help isolate those nutrients that the patient specically needs. One interesting factor is that when the correct nutrients are introduced and chewed by the patient, related organ or muscle tenderness patterns will be dramatically reduced.
Neurolymphatic Reexes History
These were rst discovered by Frank Chapman D.O., in the 1930’s as reexes that would affect the lymphatic drainage of specic organs in the body. His system was to treat the area associated with an organ malfunction. In 1965, Goodheart related the lymphatic reex points to specic muscleorgan dysfunctions.
Location
There are both anterior and posterior reexes occurring in pairs for each muscle-organ relationship. The reexes are located over the muscles of the neck, back, chest, abdomen, and thighs.
Treatment The reexes are contacted with a rm pressure and manipulated in a rotary fashion. Time of treatment can vary from a few seconds to eight to ten minutes. Try not to over stimulate, as this will fatigue the point and cause the patient discomfort.
Symptoms Aside from the obvious symptoms of edema, whether pitting in nature or localized as in joint trauma, the following are indications of possible lymphatic congestion. Tenderness of muscles or organs Infections such as tonsillitis, otitis, lung infections, etc. Weakness upon prolonged exertion, like stair climbing Decreased organ function.
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Neurovascular Reexes History
These reexes were rst reported by Terrence Bennett, D.C., in the 1930’s, as empirical points that would affect circulation to specic organs in the body. In 1966, Goodheart related the vascular points to specic organ-muscle combinations.
Physiology
The vasomotor center is located in the lower third of the pons and the upper two-thirds of the medulla. The upper lateral sections control vasoconstriction while the rest inhibits the action controlling vasodilatation. The continuous working of these areas controls vasomotor tone. The control of vasodilatation and vasoconstriction can be inuenced by higher centers in the brain, and it is through the use of the “Bennett reexes”, somatoautonomic reexes, that circulation is inuenced.
Location
These reexes are almost entirely located on the skull. They consist of small localized areas that embryologically have a vascular relation with the associated muscle-organ complex.
Treatment
The points are contacted with a light tugging of the skin overlying the point. Vary the direction of the contact until a maximum pulsation is felt. The rate of pulsation should be between 70 and 74 beats per minute and will vary only slightly in relationship to the patient’s heart rate. The length of time is usually from 20-30 seconds, however, thermal biofeedback work has shown the need for selected points to be held for up to ve minutes.
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Partial list of commonly used lymphatic reexes
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Lung Liver Stomach Pancreas
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Deltoid Pectoralis sternal Pectoralis clavicular Latissimus Dorsi
Adrenals Bladder
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Sartoirius/Gracilis Tibialis anterior
Neurovascular reexes
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Meridian Therapy Goodheart became aware of the concepts of acupuncture from the book written by Felix Mann of England. This book outlined the basic concepts developed by the Chinese. It described the basic theories and the usage of the meridian points. This book and the one by Mary Austin formed the basis of the ideas developed by Goodheart. One of the most important sentences in the book was one that stated that every time there is a meridian imbalance there would be a spinal problem at a specic spinal level related to the median. The primary intent of the acupuncturist is to prevent sickness and disease. The doctor who treats disease is considered a secondary practitioner. The higher doctor prevents the disease. The oldest known reference is “The Yellow Emporeror’s Classic of Internal Medicine” or the Nei Ching. This was supposedly written by Huang Ti, the Yellow Emperor, who ruled from 2696 to 2598 B.C. The Nei Ching is a dialogue between Huang Ti and his minister Ch’i Po. In this discussion, the emperor poses questions and the minister branches into answers that turn into long discourses on health. Acupuncture, meridian therapy, has been practiced in China for over 5,000 years. The basic philosophy is that man is a small universe and the natural laws of positive and negative that control the universe also control man. Classical acupuncture consists of four basic methods of treatment:
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1. Stimulation of meridian points to balance the energies of the body. 2. Dietary changes as well as the use of herbs. 3. Manipulation of the spine. 4. Psychotherapy through meditation and introspective analysis. Energy, chi, ows through the body in distinct pathways called meridians. Chi is dened as the energy of life. Without it, we are dead. Chi has a positive, yang, nature and a negative, yin, nature. Both aspects of chi are essential to health, but a delicate balance must be maintained between them. Imbalances, in the meridian system, result in too much chi in one meridian and too little chi, energy, in one or more meridians. Imbalances can arise from dietary imbalances, trauma, environmental factors, seasonal changes, or emotional upsets. Imbalances of energy are corrected by stimulating acupuncture points on the meridian pathways and manipulating the spine at a specic spinal level. Dietary advice is also given to aid in the correction of the imbalance. There are twelve major and two minor meridians. The major ones are located on each side of the body and form a continuous pathway that energy is supposed to pass through daily. These meridians are mostly named for organs. Goodheart was able to conrm one of his prior observations, that muscles can be related with organs, by sedating a meridian and testing the muscle that he felt related to that meridian.
Meridian - Muscle Relationships The meridians are pathways that energy travels over. This energy appears to be electromagnetic as placing a battery or magnet over the meridian will "short" the meridian and the associated muscles will test weak. Research done at the National College of Chiropractic showed that there is an electrical resistance in the meridians that is related to the number of points that the Chinese believed the meridian contained.
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Meridian
Code
Associated Muscles
Lung
Lu
Deltoids, Anterior Serratus, Coracobrachialis
Large Intestine
LI
Tensor Fascia Lata, Hamstrings, Quadratus Lumborum
Spleen/Pancreas
SP
Latissimus Dorsi, Triceps, Mid and Lower Trapezius
Stomach
ST
Pectoralis clavicular, Neck Flexors and Extensors, Sternocleidomastoid, Biceps, Brachioradialis, Supinator, Pronator Teres, Masseter, Temporalis, Internal and External Pterygoid
Triple Warmer
TW
Teres Minor, Infraspinatus
Circulation/Sex
Cx
Sartorius, Gracilis, Gluteus Maximus, Gluteus Medius, Adductors, Piriformis,
Small Intestine
SI
Quadriceps, Abdominals
Heart
Ht
Subscapularis
Gall Bladder
GB
Popliteus
Liver
Lv
Pectoralis Sternal, Rhomboid
Bladder
Bl
Tibialis Anterior, Peroneus Longus& Brevis, Sacrospinalis
Kidney
K
Psoas, Iliacus, Upper Trapezius
Pulse Points Use
Pulse points are used to diagnose imbalances in the meridians.
Location
They are located on both wrists on the radial artery. Classically, there are 12 pulses, six on each wrist with three supercial and three deep. One other pulse position has been found by Goodheart. This position is diagnostic for imbalances in the Vessel of Conception and the Governing Vessel.
Therapy Pulse points are normally therapy localized by the patient. Localization Pulse points can also be therapy localized by the doctor. Care must therefore be exercised, when testing the arm that no contact is made by the doctor over the pulse points. If the pulse points are contacted, erroneous information may be ascertained. When a pulse point positively therapy localizes, an imbalance may exist, in either the supercial or deep meridian. To determine which, test the associated muscle or therapy localize to the Alarm Points to determine which (or both) is involved.
Circulation/sex (S) Triple warmer (D)
Stomach (S) Spleen/Pancreas (D) Lung (S) Large Intestine (D) Governing Vessel Conception Vessel
The exact points are located by having the patient touch the rst point and then just slightly separate the ngers so that they do not touch. There are in classical acupuncture supercial (S) and deep (D) pulses.
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Bladder (S) Kidney (D) Gall Bladder (S) Liver (D) Small Intestine (S) Heart (D) Governing Vessel Conception Vessel
Alarm Points Location Six are singular points for both the right and the left meridians, while six
meridians have both right and left alarm points. There are also two additional points for the Governing Vessel and the Vessel of Conception meridians.
Use
Therapy localization to the alarm points will cause a strong muscle to weaken if there is an imbalance in the meridian associated with the alarm point. If a weak muscle is strengthened by having the patient contact an alarm point, then treatment of the indicated meridian will help restore normal function to the indicated muscle-organ combination. Alarm points will be tender if there is an imbalance in the associated meridian. Alarm points are not treatment points. They are strictly diagnostic points.
Cv -17 Circulation/sex Triple Warmer Superior Point Lung Lu - 1 Gall Bladder GB - 23 Secondary ----Liver Lv - 14 Gall Bladder GB - 24 Main ----Spleen/Pancreas Lv - 13
Kidney GB - 25 on back -Large Intestine St - 25
Cv - 15 Pericardium discovered by Soulie de Morant Cv - 14 Heart Cv - 12 Triple warmer Middle point (Stomach) Cv - 7 Triple warmer Inferior point Cv - 5 Triple warmer Main point Cv - 4 Small Intestine Cv - 3 Bladder
FELIX MANN MB - BChir (Cambridge), LMCC (McGill) President of the Medical Acupuncture Society
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Associated Points Location
Each meridian has an associated point on each side of the spine. The points lie between two vertebrae, and can indicate a subluxation of either structure.
Use
Felix Mann has stated in his book on Acupuncture, that every time there is a meridian imbalance, there is a spinal subluxation at the level of the associated point of the involved meridian. Goodheart conrmed this nding and also determined that a spinal subluxation can cause a meridian imbalance. Research, performed by Robert Perolman, has shown that this subluxation will be found at the level of the excess meridian. Associated points will also be tender to palpation if there is an imbalance in the associated meridian. Every time that a meridian imbalance is found, after correcting the energy ow by treating the appropriate points, the spine must be challenged and adjusted at the level of the blocked meridian and its corresponding Lovett’s vertebra.
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T3-4
Lung
T4-5
Circulation/Sex
T5-6
Heart
T 9 - 10
Liver
T 10 - 11
Gall Bladder
T 11 - 12
Spleen/Pancreas
T 12 - L - 1 Stomach
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L1-2
Triple Warmer
L2-3
Kidney
L4-5
Large Intestine
S-1
Small Intestine
S-2
Bladder
Category II Pelvic Subluxations Denition This refers to a sacroiliac misalignment or subluxation. The category system was rst described by DeJarnette. Goodheart correlated muscle imbalances with the different possible misalignments of the pelvis. This correlates with the marking system developed by Gonstead.
Therapy localization With the patient either standing or in a supine position, the patient contacts rst one sacroiliac joint and then the other and a strong muscle is tested for weakening (one hand to one joint). If this causes weakening of a strong indicator muscle, respiration can be used to help determine if the innominate is rotated. The abdominals are inhibited on inspiration. This allows medial rotation of the posterior superior iliac spins (PSIS). On expiration, the abdominals contract and the PSIS is pulled laterally. Consequently, if the positive therapy localization is changed by either full inspiration or expiration, a rotation of the pelvis is present. If the strengthening occurs on inspiration, the PSIS has moved lateral and needs to be corrected medially. If the strengthening occurs on expiration, then the PSIS needs to be corrected in a lateral direction.
Posterior Ilium - Short Leg
should be challenged and corrected including nutritional support. The pelvic misalignment can be corrected by either placing a block at the level of the crest of the ilium on the short leg side and one on the opposite side below the buttocks to raise the ischial tuberosity, and have the patient lie supine until the pelvis no longer therapy localizes or challenges with the blocks removed; or place the patient in a side lying position and adjust the ilium in the challenge direction.
Anterior Ilium (Posterior Ischium) - Long Leg Tenderness is found on the lateral thigh, the obturator foramina and the rst rib attachments anteriorly and posteriorly with the anterior ilium (posterior ischium). Weakness of the biceps femoris and the vastus lateralis will be found and all associated reexes should be challenged and corrected. Occasionally, abdominal weakness is a contributing factor. The pelvic subluxation can be corrected by placing the patient in a side lying position and adjusting the ischium or through the use of the blocks as described above. An alternate blocking procedure is to have the patient stabilize the blocks and rst ex the short leg to ninety degrees and then rotate the leg away from the body and then straighten the leg. The long leg is then exed and rotated across the body and then returned to its normal position.
Tenderness is found at the origin and insertion of the sartorius and the gracilis as Internal - External Iliac Rotation well as at the rst rib head at the sternum and at the attachment of the rst rib and the Positive therapy localization of the sacroiliac joint may indicate either internal or external rst thoracic vertebra. rotation of the ilium. Weakness will be found of the sartorius and/or the gracilis. All associated reexes An internal ilium may be found to be associated
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with weakness of the transverse and oblique abdominals. An external rotation of the ilium is found associated with a weakness of the gluteus medius/minimus on the same side. Tenderness is found along the origin of the gluteus medius in external rotation and along the insertion of the oblique abdominals at the crest of the ilium when the innominate is internally rotated.
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In both cases, correction is obtained by adjusting the patient in a side lying position. The direction of force is determined by challenging the ilium to determine the vector of force that strengthens the indicator muscle the most.
Tenderness patterns First rib At both its anterior and posterior ends
Abdominal Oblique Internal rotation Gluteus medius External rotation
Iliotibial band Anterior ilium
Sartorius/Gracilis Posterior ilium
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Rectus Femoris Flexes the thigh on the pelvis and extends the lower leg on the femur. It is the muscle that initiates the forward motion of the femur in walking after toe off. The muscle is more active than other sections of the quadriceps in climbing stairs.
Sartorius During the swing phase of gait it contributes to hip exion. Aids in knee exion. Aids the prime movers of thigh abduction, exion and lateral rotation. The muscle is extremely active in running, jumping, throwing, cycling, the tennis serve and in baseball batting.
Gracilis Functions in adduction of the thigh Assist in thigh exion. Assists in knee exion if the knee is extended. Assists in medial rotation of the tibia when the knee is exed.
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Gluteus Maximus Extends and laterally rotates the thigh. The upper bers of the muscle aid in abduction of the thigh . It functions during walking only with long strides as in running or in jumping. It functions along with the hamstring to decelerate the leg when using a long stride and aids in stabilization of the knee after heel strike.
Hamstrings
When the leg is free to move, they ex the knee and extend the thigh on the pelvis. With the leg xed, they assist in maintaining erect posture while walking, and aid in the deceleration of the leg at the end of the swing phase of gait. The medial hamstrings aid in medial rotation and the lateral in lateral rotation of the thigh.
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Gluteus Medius This is the primary abductor of the femur. It stabilizes the pelvis on the femur as the weight is being transferred over the foot at mid stance. Assists in medial rotation of the thigh.
Abdominal Oblique The muscle supports the abdominal viscera, aids in rotational support for the pelvis. It aids in the respiratory process through its reex relaxation during inspiration and its contraction during forced expiration.
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Muscle Testing and Upper Extremity Peripheral Nerve Entrapments David W. Leaf, D.C. Abstract: Muscle testing can be used as a diagnostic key to determine the existence of peripheral nerve entrapments. This paper discusses the basic entrapment syndromes of the upper extremity and the related ndings using muscle testing.
pain from the shoulder to the hand and cold hands with symptoms similar to Raynaud’s phenomenon. The entrapment of the brachial plexus causes sensory symptoms on the ulnar side of the hand. Travell reports that trigger points in the scalene muscles will cause referred pain on the radial aspect of the hand. On inspection, the small muscles of the hand may appear to have atrophied.
Introduction In examining a patient, symptoms in the upper extremity are often confused and improperly related to a spinal causative factor. Especially following any fall or automobile accident the upper extremity must be examined for peripheral; entrapment syndromes. The major entrapment syndromes are presented here with their symptomatic picture and muscle testing ndings.
Discussion Anterior Scalene Syndrome
Compression of the brachial plexus, the subclavian artery and the subclavian vein between the anterior and medial scalene muscles and the rst rib can cause symptoms throughout the arm. The muscle bers, if continually contracted or hypertrophied, rst affect the lower sections of the brachial plexus. When this becomes chronic, the entire plexus, composed of nerve roots from C - 5 to T - 1 can be affected. Vascular symptoms occur due to the compression of the artery and/or vein. Symptoms reported by the patient will usually begin with numbness in the hand and ngers radiating up into the forearm,
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Muscle testing will usually reveal no overt signs of weakness unless the anterior scalenes are stressed. The stress is applied by varying the position of the patient, standing, leaning over and fully inspiring or having the patient elevate the head while lying supine. Examination of the anterior scalene will uncover an intact muscle that has trigger points. These are usually the result of another weak muscle. Frequently the latissimus dorsi is found involved. If weakness is found in the arm with the patient sitting or standing, raising the arm above the shoulder with anterior rotation of the shoulder elevates the clavicle reducing any neurovascular entrapment. This same position can be used in the following three syndromes to decompress the neurovascular bundles.
Costoclavicular Syndrome
This syndrome refers to entrapments of the brachial plexus, the subclavian artery and/or the subclavian vein as they traverse beneath the clavicle and over the rst rib.
Symptoms of entrapment are usually transient and brought on by motions of the clavicle or the rst rib. The symptomatic pattern is the same as in the anterior scalene syndrome. Muscle testing will reveal no overt weakness patterns until the clavicle or the rst rib is stressed. Hand muscles can be tested for weakening. There are two different positions that can elicit a weakness pattern. First, the arm is exed to 140 degrees and arm or hand muscles are tested. This motion rotates the clavicle involving the subclavius muscle. The shoulder can also be rotated posteriorly with the arm extended to 30 degrees. This shoulder position is similar to the position used in the military. Finally, the patient is asked to fully inspire. This activates the scalene muscles elevating the rst rib. If the clavicle has been displaced inferiorly or the rst rib is superior a weakness pattern will be created in the arm.
The classical test for entrapment of the axillary artery is the Wright maneuver where the arm is placed in external rotation and the shoulder is abducted. This same position will elicit weakness if the costoclavicular syndrome is present. Muscle testing will reveal no overt weakness patterns in some positions. Creation of the weakness depends upon the contraction or relaxation of the pectoralis minor muscle. If the latissimus dorsi is weak allowing elevation and anterior rotation of the shoulder, the pectoralis minor will be shortened with trigger points in the belly of the muscle. In this case, testing in the standing or sitting posture will reveal weakness of the hand muscles that will immediately strengthen if the arm is elevated above the horizontal with slight exion of the arm. Care should be taken not to maximally elevate the arm, as that will cause the weakness pattern to return.
Pectoralis Minor Syndrome In this syndrome, neurovascular entrapment of the brachial plexus, the axillary artery and the subclavian vein can occur between the bers and tendon of the pectoralis minor muscle, the head of the humerus and the coracoid process of the scapula. Symptoms of entrapment are usually transient. The symptomatic pattern is the same as in the anterior scalene syndrome. However, these patients have more vascular symptoms as well as signs of lymphatic blockage. This differs from the scalene involvement where venous blockage is paramount. Commonly, this is found in people who work over their heads or who have excessively developed the pectoral muscles. Symptoms are aggravated by sleeping with the arm elevated or by carrying heavy objects.
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Suprascapular Nerve Syndrome
This is a very commonly overlooked syndrome that can lead to atrophy of the infraspinatus and the supraspinatus muscles. The suprascapular nerve is composed of bers arising from either the C - 5 or C - 6 nerve roots. It traverses through the suprascapular fossa and the scapular notch to arrive at the supraspinatus fossa. After supplying bers to the supraspinatus muscle, the acromioclavicular joint and the subacromial bursa, it twists around the base of the spine of the scapula and enters the infraspinatus fossa. Due to this tortuous path, the nerve is stretched as the scapula moves if there is any scapula instability.
Symptoms, reported by patients, will run the gamut from diffuse shoulder pain that is hard to localize to complete atrophy of the infraspinatus rst and then the supraspinatus muscles. Symptoms are usually aggravated by any activity that requires extensive motion of the scapula. In most cases, there is no overt weakness pattern. However, if the scapula stabilizers are weak, especially the serratus anterior or rhomboids, the infraspinatus will test weak if tested with the arm exed to 90 degrees with anterior rotation of the shoulder. This position creates additional torsion on the suprascapular nerve and if the scapula has inadequate support, the infraspinatus will weaken.
Pronator Teres Syndrome This entrapment syndrome is of the median nerve as it passes between the ulnar and radial heads of the pronator teres muscle. After the nerve passes the pronator teres, it divides and supplies the exor muscles of the wrist and hand except for the exor carpi ulnaris and the ulnar portion of the exor digitorum profundus.
Symptoms reported by the patient will include loss of strength throughout the hand, difculty writing, paresthesia throughout the hand and especially the palm. Muscle testing will reveal weakness of the nger exors that resolves when the radius and the ulna are approximated just distal to the elbow.
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Supinator Syndrome In this entrapment syndrome the radial nerve becomes compromised as it passes beneath the supinator muscle. Symptoms occur during repeated motions of the forearm. The throwing motion uses all of these. These can include pronation, wrist exion and forearm extension. The pain pattern is described as deep on the posterior aspect of the forearm. Hand weakness is reported. The easiest muscle to test for this syndrome is the extensor carpi ulnaris. If it is found weak, the head of the radius is approximated to the ulna and the muscle is retested. The extensor carpi ulnaris can also be tested when the supinator is placed in a strain counterstrain position. This position fully relaxes the muscle.
Ulnar Sulcus Syndrome The ulnar nerve passes down the posterior surface of the humerus and passes through a sulcus on the medial epicondyle of the humerus. The epicondyloolecranon ligament stabilizes the ulna and the humerus. It also stabilizes the ulnar nerve at the sulcus and prevents it from moving during forearm motions. When the ligament is hypertrophied or stretched, entrapment of the ulnar nerve occurs. The nerve supplies the exor carpi ulnaris, the ulnar portion of the exor digi-
torum profundus, the interossei and hypothenar muscles, the adductor pollicis and the deep head of the exor pollicis brevis. Symptoms include paresthesia and pain over the ulnar nerve distribution and weakness of the above muscles. Testing of the exor carpi ulnaris with the elbow rst in extension and then in exion may uncover entrapment of the ulnar nerve. If found, the relationship between the humerus and the ulna needs further inspection. Any chronic subluxation, dislocation or avulsion can create ulnar nerve entrapment. After correcting any imbalances, direct attention should be applied to the integrity of the ligament. Flexor Carpi Ulnaris Syndrome As the ulnar nerve leaves the sulcus, it descends between the two heads of the exor carpi ulnaris muscle. The muscle has a tendinous arch that is formed by the arcuate ligament. This runs from the medial epicondyle to the olecranon. The symptomatic pattern is exactly the same as the syndrome of the ulnar sulcus. This makes differential diagnosis difcult without muscle testing. Accurate testing of the adductor pollicis with the forearm rst in a neutral state, then with full contraction of the exor carpi ulnaris and then with a relaxed approximated (strain counterstrain) position of the exor carpi ulnaris allows insight into the status of the ulnar nerve as it passes between the heads of the exor carpi ulnaris muscle. Carpal Tunnel Syndrome This syndrome consists of compression of the
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median nerve at the broosseous canal at the wrist. The tunnel is formed by four major bony prominences, the pisiform, the navicular, the hamate and the trapezium. Between these bony prominences runs the transverse carpal ligament. After this tunnel, the median nerve gives sensory branches to supply the palmar surfaces of the rst and second ngers and motor branches to the opponens pollicis, abductor pollicis brevis and the supercial head of the exor pollicis brevis. Compression of the contents of the tunnel can occur due to edema, local subluxation, fracture, etc. The patient reports symptoms ranging from paresthesia, thenar atrophy and weakness. These symptoms worsen as the condition becomes chronic. As noted above, the median nerve innervates the opponens pollicis muscle. Weakness of this muscle becomes the diagnostic key to isolating the problem. The muscle should be tested with the forearm and wrist in a neutral position, full pronation, full supination, wrist extension and wrist exion. Ulnar Tunnel Syndrome
The ulnar nerve can become compressed at the level of the proximal carpal bones. This tunnel is bordered by the pisiform and the hamate
as well as the transverse carpal ligament and the exor carpi ulnaris muscle. There are two entrapment syndromes in this area. These correspond to the supercial and deep branches of the ulnar nerves that run through the ulnar tunnel. These nerves supply the sensory distribution to the palmar aspect of the fth nger and the ulnar side of the fourth nger. The deep branch of the ulnar nerve supplies the interossei muscles the small muscles of the fourth nger and the adductor pollicis muscle.
The suprascapular nerve supplies the supraspinatus before it bends and winds itself around the spine of the scapula. Instability of the scapula, especially a loss of posterior support can lead to stretching of this nerve and subsequent weakness of the infraspinatus. The axillary nerve supplies the deltoid and the teres minor muscles. Note that before the nerve bifurcates to supply these muscles, branches are given off to the subscapularis, latissimus dorsi and the teres major muscles. Again, these are primary muscles to be used in ascertaining the existence of a peripheral nerve entrapment in the area of the shoulder girdle.
Weakness of either the exor digiti minimi or the opponens digiti minimi muscles is the key that indicates entrapment of the ulnar nerve at the wrist. Once the weakness is found, directional pressure is applied against the pisiform and the hamate until a vector is found that As you progress farther down the arm, the pronator teres is the last muscle supplied strengthens the weak muscle. superior to the elbow by the median nerve. Knowing the status of the pronator teres aids in diagnosing problems arising from Neurology review entrapment syndromes inferior to the elbow. A review of the muscular innervation of the For example, if the exor carpi radialis is upper extremity will aid in reviewing the weak and the pronator teres is strong, then muscle testing sequence for determining the median nerve is involved at the elbow. nerve entrapments When the ulnar nerve is entrapped at the Radial palsy has been reported after elbow, the exor carpi ulnaris is the rst repetitive forceful contractions of the upper muscle supplied inferior to the elbow. The arm muscles. Weakness of the deltoid, integrity of the muscle is important if the especially the middle and posterior sections is exor digit minimi or opponens digiti minimi commonly found in acromioclavicular strains. is found weak. Weakness of muscles above Severe thoracic outlet syndromes can entrap and below the carpal bones indicates an the superior sections of the brachial plexus entrapment syndrome at the elbow and not creating weaknesses in the deltoids and the just at the wrist. teres minor. When examining the radial nerve, important There are three muscles innervated by the muscles to test include the supinator, the musculocutaneous nerve in the upper arm. extensor digitorum muscles and the abductor Weaknesses of all three of these muscles, the and/or extensor pollicis muscles. Entrapment coracobrachialis, biceps and the brachialis syndromes as the radial nerve passes downs the forearm will create weakness patterns may indicate a thoracic outlet syndrome. relative to the level of the rst muscle found Notice that the ulnar nerve does not supply weak. Generally, all of these muscles will be any muscles until it is well down the humerus weak if the radial nerve is entrapped. On the posterior aspect of the shoulder, the major missed entrapment syndromes involve inadequate stabilization of the scapula.
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In the hand, weakness patterns of the opponens pollicis, with a nding of strength in the muscles innervated superior to the wrist
by the median nerve, indicates the probable presence of a carpal tunnel syndrome. A common testing procedure will nd the exor digitorum supercialis and profundus strong and the opponens pollicis weak. If all three muscles are found weak, the entrapment syndrome is at the elbow or mid forearm Testing of the ulnar nerve at the wrist consists of testing for the relative strength of the opponens digiti minimi or the exor digiti minimi in comparison with the strength of the exor carpi ulnaris. If the exor carpi ulnaris is weak along with the muscles of the fourth nger, then the ulnar nerve is entrapped at the level of the elbow or above. Weakness of the nger muscles in the presence of strength of the exor carpi ulnaris indicates a problem of entrapment at the level of the carpal bones. Note the innervation of the adductor pollicis. Improper testing of the opponens pollicis will result in recruitment of the adductor pollicis and erroneous ndings. Conclusions Muscle testing is an art as well as a science. One of the best uses of muscle testing is in aiding your examination procedures. Reproducible results depend on consistent testing. This testing must not only be reproducible from one examination of another, but must also be done accurately. A common error is improper testing of the opponens pollicis muscle. If this test is properly performed, you are testing median nerve function. If the test is done improperly, you could be testing the ulnar nerve or a combination test that would challenge the integrity of the median as well and the ulnar nerve. References Cravens, G.; Kline, D., Posterior interosseous nerve palsies, neurosurgery, Vol27, No. 3 (Sep. 1990) Gray, Henry; Goss, Charles, Anatomy of the Human Body, Philadelphia, PA, Lea & Frebiger 1966 Kendall, Florence; McCreary, Elizabeth,
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MUSCLES Testing and Function, Baltimore, MD Williams and Wilkins 1983 Streib, E. Upper arm radial nerve palsy after muscular effort: report of three cases, Neurology. Vol 42 No 8 Aug. 1992 Travell, Janet; Simons, David, Myofascial Pain and Dysfunction The trigger point Manual, Baltimore, MD., Williams and Wilkins, 1983 Walther, David, Applied Kinesiology – Synopsis, Pueblo, CO., Systems DC, 1981
Cranial Motion By David Walther, D.C., DIBAK Excerpted from Synopsis – Systems DC Pueblo CO 1988 One who works with the cranial-sacral primary respiratory mechanism is often confronted with the question, “Do the bones of the skull really move?” Although the question becomes an irritant to those knowledgeable about cranial function, it is a reasonable one to ask since most persons trained in the healing arts are taught that the primary purpose of the skull is to protect the brain and provide a place to hang the face. In addition, students are exposed to the skull as a dried osteologic specimen, or in a cadaver wherein little study is usually made of the skull and its mechanisms. This writer has spent hundreds of hours studying the disarticulated bones of the skull for initial education, and hundreds more while doing photography for a textbook.1 I cannot understand how anyone can study the pivot points, angles of articulation, lines from bones sliding on each other, and gear-train mechanisms of a disarticulated skull and not conclude that it is designed for motion. The ossication of sutures that occurs in some skulls in later life is a pathologic process, not a natural one. In addition to the joints of the skull, one must recognize the exibility of living bone. What is not considered in most doctors’ education is that the skull in vivo is a dynamic, plastic structure that has additional organized activity. Studying the skull from a dried specimen or in a cadaver is similar to studying a telephone pole as if it were a living tree. The telephone pole is rigid, the sap is dried, there is no living ow, and an effort to bend it could cause it to break. A living tree, on the other hand, has water and nutrients in its “veins.” It bends and sways with the breeze and progresses through its life cycle from year to year.
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The plastic nature of bone in vivo is illustrated in a study by Stowe et al. 2 Orthogonal x-ray beams were used to measure the absolute and relative movements and consequent torsion of the adult human forearm in vivo during its rotation from maximum voluntary supination to maximum voluntary pronation. A torsion of 69° was observed in the ends of the radius; 34° was seen between the ends of the ulna. The histology of a suture is that of a joint designed for motion. Pritchard et al. 3 found ve distinct layers of cells and bers between the edges of the adjoining bones in human specimens. They concluded that”. . . histology of the sutures suggests that it has two main functions, viz. that it is a site of active bone growth and that it is at the same time a rm bond of union between the neighboring bones, which nevertheless allows a little movement.” The rst of ve layers making up the suture is bone. The cambial layer is the growth center that thins as growth ceases, and the capsular layer is light cartilage that provides protection. The middle aspect in the suture is a vascular layer similar to the synovial joint cavity. Finally, covering the suture is the uniting layer that is the homologue of the brous capsule. Upledger et al. 4 studied specimens taken from living adult skulls at the time of neurosurgical craniotomies. Along with connective tissue, the sutures were shown to have the presence of viable myelinated and unmyelinated nerve bers and nerve receptor endings.5, 6 One method of examining the cranium for faults is for the applied kinesiologist to apply pressure to various portions of the skull and observe for a manual muscle test change. It appears that stimulation of the neurostructures in the suture is responsible for some of the remote muscle changes observed. Motion of the skull bones has been objectively measured. The rst study was made by Frymann.7 When she applied transducers to a subject’s head,
she found a rhythmic autonomous motion supporting Sutherland’s 8 original observation of 10-14 cycles per minute. Further motion studies have been done to eliminate effects of intervening tissue between the transducer probe and the skull. Michael and Retzlaff 9 attached force transducers to a screw eye placed in the parietal bone of anesthetized monkeys. A cyclic cranial bone displacement of 5-7 cycles per minute was observed that could not be attributed to either respiration or heart rate. The position of cranial bones in relation to each other can be observed on accurately positioned x-rays. 10 Cranial nerve V angles over the petrous apex of the temporal bone. Gardner 11 measured the height of the petrous apex by x-ray and found that trigeminal neuralgia occurred three times more often on the side of the high petrous apex than on the low side. Cranial distortion may change the dental occlusion by mandibular movement change or by disrelation of the cranial bones. Malocclusion is a common complaint following an auto accident with whiplash dynamics to the neck and head. Many doctors fail to appreciate this because the patient often does not discuss it with the orthopedically-inclined physician. If the patient discusses the matter with a dentist who is not knowledgeable about cranial motion, the teeth may be equilibrated to match the distorted skull; this locks in the cranial faults and makes correction difcult or impossible without further dental attention. Baker 12 found a 0.0276” increase in the distance between the second molars following cranial manipulation. It is important to understand all of the aspects that can be involved in dysfunction of the stomatognathic system. A patient may come to a chiropractor for a whiplash-type injury to the cervical spine. This condition often relates with cranial faults that may in turn cause malocclusion. Correcting the cranial faults may correct the malocclusion; however, if the
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condition has been present for a considerable time the teeth may have changed position by the natural process of remodelling, thus locking in the cranial faults. In this case it may be necessary to consult a dentist for a bite plane, and perhaps eventual equilibration of the teeth. The pelvis and sacrum are intricately involved in the cranial primary respiratory mechanism, and may require chiropractic correction to eliminate temporomandibular joint or occlusal problems. A short leg has been indicted as a cause of malocclusion. Strachan and Robinson, 13 of the Chicago College of Osteopathy, were the rst to observe a short leg’s inuence on malocclusion. Evaluating the pattern of masticatory muscles with electromyography, they removed a 3/8” heel lift from a standing subject’s shoe and found an altered ring sequence of the muscles of mastication during chewing. When the lift was worn, the muscles showed the ring pattern of normal occlusion; with it removed, the ring pattern was one of a severe malocclusion. In applied kinesiology, an apparent short leg is quite often found to be a result of pelvic distortion. The leg usually balances with pelvic correction. In any event, their study reveals the importance of remote postural imbalance on the stomatognathic system. The stomatognathic system is very active in the dynamic motions of the body. During walking the sternocleidomastoid and upper trapezius muscles are alternately inhibited and facilitated, providing a rhythmic pull on cranial bones. Because of the stomatognathic system’s muscle interaction with the rest of the body, improper gait and other dysfunction may be the perpetuating cause of recurrent cranial faults.
Integration of the Stomatognathic System
With normal function there is predictable movement of the cranial bones. It continues throughout life, cycling 10-14 times per
minute, and is called “the primary respiratory mechanism.”8 The motion is separate from the heart or breathing rate; however, cranial motion is enhanced by thoracic respiration. Although this inuence is always present, relaxed breathing and primary respiration do not always parallel.
of the frontal bone move medially. In applied kinesiology this is called external frontal rotation, as if the metopic suture area were moving externally. This is confusing, because an external frontal in DeJarnette’s sacro occipital technique 14, 15 is called an internal frontal in applied kinesiology, and vice versa.
Cranial motion is a combination of bending bone and suture motion. The motion between the sphenoid and the occiput is in the sagittal plane. There is a exion and extension of the sphenobasilar junction. Prior to the approximate age of twenty-ve, the motion is at the synchondrosis between the bones. After ossication, the motion is exion and extension of the cancellous bone. Sphenobasilar exion consists of raising the sphenobasilar junction and separating the superior portions of the occipital squama and greater wings of the sphenoid. Sphenobasilar extension is dropping of the sphenobasilar junction and approximation of the superior portion of the occipital squama and greater wings of the sphenoid. Sphenobasilar exion is enhanced by a deep phase of inspiration; extension is enhanced by expiration. Often sphenobasilar movement is called sphenobasilar inspiration or expiration.
The rest of the bones of the skull and face have specic movement in relation to sphenobasilar exion and extension. There is continuity in the movement by way of pivot points, gear trains, sliding action, and lever mechanisms; this interaction constitutes a closed kinematic chain. In any closed kinematic chain, when one portion moves the entire chain must move. This can be demonstrated by a system of levers or gears, both of which are present in the cranial closed kinematic chain. The occipitomastoid suture acts like teeth on a gear. The vomer is a lever mechanism between the rostrum of the sphenoid and the intermaxillary and palatine sutures of the maxillary and palatine bones.
The general axis of temporal bone rotation is through the petrous portion, which is at approximately a 60° angle with the temporal bone’s squamous. The apex of the petrous portion rises on inspiration with the sphenobasilar junction, and the petrous ridge rotates anterolaterally, causing the squamous of the temporal bone to rotate externally. The mastoid process moves posteriorly and medially with inspiration. The frontal bone, in most subjects, ossies at the metopic suture. In some cases a remnant or the entire suture persists throughout life. Motion on sphenobasilar exion (inspiration) spreads the frontal bone’s squamous portion. In applied kinesiology this is called internal frontal motion, as if the metopic suture were moving internally. On sphenobasilar extension (expiration), the squamous portions
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There is a synchronous movement between the sphenobasilar junction and the sacrum. The connection is the dura mater, which has a rm attachment at the foramen magnum and 2nd and 3rd cervical vertebrae. Attachment along the rest of the spinal column is loose, until the dura and arachnoid rmly attach at the 2nd sacral segment. The general axis of sacral rotation is at the level of the 2nd sacral segment about its transverse axis. Motion of the sacrum consists of lifting the anterior portion of the 2nd sacral segment as the sphenobasilar junction lifts in inspiration; thus, the apex of the sacrum moves anteriorly and the base posteriorly with inspiration, and opposite with expiration. The innominate bones also have a primary movement organized with cranial function. If one compares the innominate with the temporal bone, the comparative parts move in the same direction with inspiration and expiration. The ilium is compared with the squama of the temporal bone; it moves anterolaterally with inspiration. The ischium, compared with
the mastoid process, moves posteromedially. the cervical spine may ultimately become Pressure from the abdominal contents and the involved. They also point out the potential abdominal muscles contributes to this motion. hazard of the conventional treatment of On inspiration the abdominal contents move cervical bracing and traction on the TMJ, downward, putting pressure on the ilium which is not designed to be a pressure-bearing to move the anterior iliac spine laterally, joint. 20 anteriorly, and inferiorly. Simultaneously with inspiration, the abdominal muscles relax to permit this motion. During expiration, the 1 Walther, D.S., Applied Kinesiology, Volume abdominal muscles contract, reversing the II - Head, Neck, and Jaw Pain and Dysfunction motion of the ilia. - The Stomatognathic System (Pueblo, CO: Systems DC, Organization between the closed kinematic 2 Stowe, R.S., L.L. Lavoy, & N.A Frigerio, chain of the cranium, with its movement of “Measurement of bone torsion in vivo via the pelvis by the dura mater and abdominal biostereoroentgenography,” XIII lnt Congress muscle contribution, emphasizes how Photogrammetry (JuI11-13, 1978). integrated the motion of the stomatognathic 3 Pritchard, J.J., J.H Scott, & F.G. Girgis, system is with the rest of the body. “The structure and development of cranial and facial sutures,” J Anat, Vol 90 (Jan 1956). 16 Within the stomatognathic system as Shore 4 Upledger, J.E., E.W. Retzlaff, & J.D. denes it - from the shoulder girdle up - there Vredevoogd, “Diagnosis and treatment of is further integration and another closed temporoparietal suture head pain,” Osteo kinematic chain. This is a muscular closed Med (JuI1978). kinematic chain made up of the cervical exors 5 Retzlaff, E.W. et aI., “Nerve bers and and extensors, hyoid muscles, and muscles endings in cranial sutures,” JAOA, Vol 77 of mastication. The original presentation of (Feb 1978). the muscular closed kinematic chain of the 6 Retzlaff, E.W. et aI., “Temporalis muscle stomatognathic system was described in a action in parietotemporal suture compression,” program of the University of Illinois 17 in JAOA, Vol 78 (Oct 1978). 1949. Mintz 18 discusses the interaction of 7 Fryman, V.M., “A study of the rhythmic this closed kinematic chain and its correlation motions of the living cranium,” JAOA, Vol 70 with the rest of the body. Disturbance here No 9 (May 1971) can cause a chain reaction throughout 8 Sutherland, W.G., The Cranial Bowl the musculoskeletal system. On the other (Mankato, MN: privately published, 1939). hand, remote musculoskeletal imbalance or 9 Michael, D.K., & E.W. Retzlaff, “A dysfunction can disrupt the harmony within preliminary study of cranial bone movement the stomatognathic closed kinematic chain. in the squirrel monkey,” JAOA, Vol 75 (May 1975). In an article directed toward the legal 10 Greenman, P.E., Roentgen ndings in profession, Moses and Skoog 19 draw attention craniosacral mechanism,” JAOA, Vol 70 No 1 to the similarity of symptoms between (Sep 1970) cervical whiplash and temporomandibular 11 Gardner, W.J., “Trigeminal neuralgia,” joint conditions, indicating that either may be Clin Neurology, Vol 15 (1967) caused by an auto accident. Recognizing the 12 Baker, E. G., “Alterations in widge of interplay within the stomatognathic system, maxillary arch and its relation to sutural it is entirely reasonable that there are movement in cranial bones.” JAOA, vol similar symptoms. Often when the cervical 70, no 6 (Feb 1971) Reprinted in Dental spine is injured, the temporomandibular Orthopedics, ed H.E. Ravins (Beverly Hills, joint ultimately becomes involved; if the CA: Preventative Dental Res, 1981) jaw is injured, affecting TMJ dysfunction, 13 Strachan, W.F., & M.J. Robinson, “New
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osteopathic research ties leg disparity to malocclusion,” Osteo News, Vol 6, No 2 (Ape 1965). 14 DeJarnette, M. B., Cranial Technique 1968 (Nebraska City, NE:privately published, 1968) 15 DeJarnette, M. B., Cranial Technique 1979 – 1980 (Nebraska City, NE:privately published, 1979) 16 Shore, N.A, Temporomandibular Joint Dysfunction and Occlusal Equilibration, 2nd ed (Philadelphia: J.B. Lippincott Co, 1976). 17 Current Advances in Dentistry, Telephone Extension Program, Univ. of Illinois College of Dentistry (1949). 18 Mintz, V.W., “The orthopedic inuence,” in Diseases of the Temporomandibular Apparatus - A Multidisciplinary Approach, ed D.H. Morgan et al. (St. Louis: The C.V. Mosby Co, 1982). 19 Moses, AJ., & G.S. Skoog, “Cervical whiplash and TMJ - similarities in symptoms,” Trial (Mar 1986). 20 Robinson, M., “The temporomandibular joint: Theory of reex controlled nonlever action of the mandible,” JADA, Vol 33 (Oct 1, 1946).
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Respiratory Challenge Strong muscle weakens on a specific phase of respiration indicates the following cranial fault on the side of the skull that the muscle was tested on.
Maximal Inspiration
Sphenobasilar Expiration
Normal Inspiration
Expiration Assist
1/2 Inspiration
Parietal Descent
1/2 Expiration
Temporal Bulge
Normal Expiration
Inspiration Assist
Maximal Expiration
Sphenobasilar Inspiration
Weak muscle strengthens on the following phase of respiration indicates the following cranial fault
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Maximal Inspiration
Sphenobasilar Inspiration
Normal Inspiration
Inspiration Assist
1/2 Inspiration
Temporal Bulge
1/2 Expiration
Parietal Descent
Normal Expiration
Expiration Assist
Maximal Expiration
Sphenobasilar Expiration
A Brief Discussion of the the Neurology of Cranial Manipulation Richard Belli, D.C., D.A.C.N.B.
the cranium is believed to function as a closed kinematic chain, in other words you can not affect a bone as a single entity, manipulation of one bone will affect all of them.
For years clinicians have observed marvelous results from cranial bone manipulation, but along with these observations have come a great deal of conjecture and debate as to the The dura is supratentorially innervated by mechanism. This discussion covers some of the the trigeminal nerve and infratentorially plausible neurological mechanisms for these by the vagus nerve. This makes it enticing observations. These mechanisms include for cranial practitioners believe that cranial tonic labyrinthine reexes, dural innervation, manipulation may have it therapeutic postural modulation by vestibulospinal responses via the afferents of these nerves. projections, and vestibular projections to Another school of practitioners nds it the reticular formation, thalamus, and irresistible to believe that changes in hypothalamus. The most striking observation cranial motion and normalizing of the ow of cranial manipulation is the diversity of of cerebrospinal uids leads to therapeutic physiological and therapeutic response. For changes. And nally, some practitioners decades clinicians have observed resolution of believe that normalization of the temporal everything from low back pain to tachycardia. bone relationship to each other accounts for These observations, because they are so the therapeutic effect. Lets now look at these diverse have given cranial manipulation an suspected mechanisms and determine which almost mystical connotation, how else could can explain the spectrum of clinical change. Logic would tell us that the modality that such diverse responses be explained? encompasses the neurological pathways that The debate has raged among anatomist explain the broad spectrum of clinical change and clinicians as to whether cranial bones would be our prime candidate. Looking at do in fact move or if the sutures are fused the dura we have to take into consideration making the cranium an immovable vault. It the sensory innervation and such aspects as has been well documented by Upledger that dural tension. As previously mentioned the there is a cranial respiratory mechanism. dura is innervated supratentorially by the Many anatomist and clinicians claim that trigeminal nerve and infratentorially by the the cranium in vivo is wet and exible, thus vagus nerve. When the vagus and trigeminal allowing for movement. This all leaves us with nerves are brought to threshold by some sort a preponderance of evidence that the cranium of mechanical pressure the axons project to in vivo is an alive and movable mechanism. the sensory nuclei of each one of these nerves The aforementioned leads us to the discussion These include the sensory nucleus for the as to what mechanically happens when the trigeminal nerve and the solitary nucleus cranium is manipulated. Keeping it simple, for the vagus nerve. In theory the vagal and and without getting into specic techniques, trigeminal afferent input will facilitate via we assume that cranial techniques generally collaterals the motor nuclei for the reticular restore normal juxtaposition relationships formation and other bulbar nuclei facilitating and movement to the cranial respiratory visceral and somatic efferents. This in theory mechanism. By restoring normal motion can account for visceral changes seen with and function, one would assume that there cranial manipulation. The question at hand is a change in the dura, or better said in is whether the amount of movement that dural tension, as well as a normalization of the cranial manipulation imparts is enough the bilateral temporal bone relationship. As to bring the sensory aspects of the dura to discussed by Walther, Upledger, and others, threshold? Also we must consider that the
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majority of these afferents are nociceptive has are not restricted to blood pressure in nature. As Upledger describes there is changes. a The reticulospinal pathways great deal of movement in the cranial sacral drive the intermediolateral cell column and respiratory mechanism. If this movement subsequently is the autonomic system. The not enough to bring these afferents to threshold reticular formation involvement alone can it is not likely that cranial manipulation will. account for visceral as well as somatic changes. However, this constant motion of the cranial There are abundant vestibular projections to sacral mechanism may be enough to maintain the cerebellum. The cerebellum has projections a base line level of mechanoreceptor barrage to the reticular formation, and directly and from the dura. If this is the case, then indirectly in to the thalamus. These projections theory, if there is a change in cranial sacral can account for autonomic changes via the motion then the afferent barrage from the thalamohypothalamo pathways, and cortical dura to the sensory nuclei of the trigeminal changes from projections from the thalamus nerve and the solitary nucleus of the vagus to the cortex. Also, the cerebellum modulates nerve would change. In other words, movement a via cerebellobasalganglionic and normal amount of cranial sacral motion will cerebellothalamocortical projections. And maintain a normal amount of afferent input nally, the reticulospinal and vestibulospinal to vital centers. Looking at cerebral spinal pathways modulate trunk exion and uid ow as a candidate one must question extension. Additionally, the vestibular the actual changes that take place in pressure mechanism projects directly to the thalamus from normal abdominal and thoracic cavity and hypothalamus. The thalamic projections pressure changes. The CSF pressure ranges are thought to account for cortical appreciation from 50 to 150 mm Hg. Keeping this in mind of position changes. And the hypothalamic it is not likely that the subtle changes that projections are thought to be necessary for are made with cranial manipulation are going autonomic response to movement. After to have a signicant effect on the overall examining the three possible mechanism for pressures. the effect of cranial manipulation it is easy to see that the vestibular apparatus has The vestibular system is of primary the largest potential for affecting change on importance in maintaining upright posture, the central neuraxis and consequently the muscle tone and eye movement. The two overall physiology. However I also nd it vestibular apparati do not function properly difcult to completely ignore the possibilities unless they are in normal juxtaposition with of dural feedback from the mechanoreceptors each other. If their positional relationship located is there. So the conclusion that I would lost, the vestibular output is of two different draw, with the available information, is that messages, which makes accurate central the vestibular mechanism is the primary processing impossible. The central pathways mechanism with the dural mechanoreceptor of the vestibular system are principally motor mechanism secondary. reex connections to nuclei innervating extraocular muscles, the motor reticular If one takes into account the vast neuronal formation, the spinal motor neurons, and the network affected by the vestibular mechanism cerebellum. With this in mind one can see it is easy to account for the far reaching there is an enormous amount of potential effects that cranial manipulation can have on for affecting physiological function. The the health of the patient. If the practitioner vestibular projections to the motor reticular has these pathways to memory and available formation are multipurpose in nature. When for explanation it will be effortless for him you consider that blood pressure needs to to explain to other practitioners why he change with position and muscle tone needs is getting such fabulous results from his to change with position it is easy to see the treating techniques. This should be another necessity of these projections. Additionally, the example as to why we need to have a greater autonomic effect that the reticular formation understanding of what we are accomplishing 84 when we are using manipulative therapies.
Cranial Nerve Examination Olfactory Type Sensory Function Smell Cranial Fault Frontal- ethmoid Exits Cribiform plate Olfactory Sensory cells end in upper posterior portion of the nasal cavity Passes through the cribiform plate Dura mater covers the tract
Optic Type Sensory Function Vision Cranial Faults Sphenoid Exits Optic foramen Optic Three coverings Outer from the dura mater Middle from the arachnoid mater Inner from the pia mater Nerve lies in a canal of the lesser wing of the sphenoid
Eye motion Vertical oculomotor Down and in motion -Trochlear Lateral Cranial Faults Frontal, sphenoid, ethmoid, temporal Exits Supra Orbital ssure Oculomotor Passes between the attached and free borders of the tentorium cerebelli Trochlear Supplies the superior oblique muscle Follows along free border of the tentorium cerebelli Abducens Supplies the lateral rectus muscles Passes lateral to the dorsum sellae of the sphenoid bone Traverses the superior portion of the petrous portion of the temporal bone Eye motions Lateral Lateral rectus VI Medial Medial rectus III Medial & superior Superior rectus III Medial & inferior Inferior rectus III Lateral & superior Superior oblique IV Lateral & inferior Inferior oblique III
Trigeminal V Oculomotor 3, Trochlear 4, Abducens 6 Type Motor Function
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Function Opthalmic - Sensory Nose, forehead, scalp Maxillary - Sensory Cheek, nose, upper lip Mandibular - Mixed
Mandible, lower lip, Muscle of mastication Jaw reex Cranial Faults Frontal, sphenoid, ethmoid Exits Motor - Foramen ovale
Opthalmic Maxillary Mandibular
Sensory - Superior orbital ssure
Trigeminal Semilunar ganglion lies in a recess of the dura mater near the apex of the petrous portion of the temporal bone
Opthalmic Nerve Branches enter by superior orbital ssure Lacrimal Lacrimal gland Frontal Supratrochlear - conjuctiva, medial upper lid, lower & middle forehead Supraorbital upper eyelid, scalp, frontal sinus Nasociliary External nasal skin of apex and vestible of the nose Infratrochlear skin of side of nose & eyelids Ethmoid ethmoid & sphenoidal sinuses Internal nasal Maxillary Nerve Branches Exits through foramen rotundum Cranial - dura of the middle cranial fossa Pterygopalatine fossa branches
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Zygomatic Zygomaticotemporal skin side of forehead Zygomaticofacial skin over zygomatic arch Greater Palatine hard palate and gums Infraorbital canal alveolar socket and non-molar teeth - oor of nasal cavity Fascial lower eyelid, side of nose, upper lip mouth mucous membranes Mandibular Nerve Branches Exits through foramen ovale Ramus meningeus dura - mastoid air cell mucous membrane Reenters skull through the foramen spinosum Medial Pterygoid internal pterygoid, tensor veli palatini, tensor tympani Mandibular Nerve Branches Exits through foramen ovale Anterior division muscles of mastication skin and mucous membranes of the cheek Masseteric - masseter Deep temporal - temporalis Lateral pterygoid - lateral pterygoid Buccal skin of cheek, mouth mucous membranes, gums
Facial Type Mixed Function Taste anterior tongue Facial expressions Cranial Faults Temporal bone
Exits Stylomastoid foramen Supplies Buccinator, platysma, stylohoid and posterior belly of the digastric Lacrimal and salivary glands Membranes of the palate, nasal pharynx and nasal cavity
Vestibulocochlear Type Sensory Function Hearing / equilibrium Cranial Fault Temporal bone Exit Temporal bone
Glossopharyngeal IX Type Mixed Function Taste posterior tongue Muscles of swallowing Cranial Faults Temporal/occipital Exit Jugular foramen
Vagus Function Sensory Visceral organs, esophagus Muscles - Larynx. Pharynx Palate reex Autonomic Control gastric motility, Blood pressure, respiration, Heart rate
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Cranial faults Temporal/occipital Exits Jugular foramen
Spinal Accessory Type Motor Function Trapezius / SCM Cranial Faults Temporal/occipital Exit Jugular foramen
Hypoglossal Type Motor Function Tongue Cranial Faults Occitput - occiput/atlas
Cranial nerve function can be evaluated in a more objective manner using muscle testing. The procedure is to rst determine a normal testing muscle that you will use for the testing. The muscle will be tested for inhibition while the cranial nerve is either stimulated or caused to increase its function. Usual ndings will be a combination of positive tests that are related to the location where the cranial nerves exit the skull. The cranial nerves can be divided into four groups. The rst is olfaction that is an extension of the brain. Imbalances in the bones between the frontals may be found. The next group of cranial nerves, II - VI, is adversely affected by imbalances in the sphenoid and the frontal bones. The next group, VII and VIII, is related with temporal bone problems. The nal group, IX - XII, is related to imbalances of the occiput. A common nding is to have positive ndings on one side of the skull. If this is the case, have the patient place himself or herself in a gait position, one leg forward and the opposite shoulder rotated anterior, and retest for changes in the positive ndings. If this position changes the inhibition pattern, it indicates the effects of dural torque. Dural torque refers to mechanical problems where the dura mater attaches rmly. These can include coccyx, sacral, upper cervical or cranial problems like sphenobasilar and TMJ imbalances. Testing needs to be done to determine the location of the mechanical fault and proper correction given. It is not uncommon to nd dramatic changes in functioning of the cranial nerves after proper correction of the cranial and spinal faults.
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Oral Nutrient Testing by Jayson Grossman, D.C. In 1968, Goodheart introduced testing nutritional substances by monitoring muscle testing responses associated with gustatory stimulation by nutritional substances. Placing substances on the tongue, such as nutrients in which the patient is lacking, were associated with a conditional facilitation of otherwise inhibited muscles.
us represent three cranial nerve ganglia (CN VII, IX and X). These axons carrying taste information extend via the rostral/gustatory portion of the nucleus solitarius to the ventral posteromedial nucleus (VPM) of thalamus. The third order neuron in the pathway ascends to the ventral lateral portion of the postcentral gyrus, areas 3, 1, and 2. This pathway, the Solitariothalamic tract remains ipsilateral.
Placing offensive substances on the tongue, such as toxic substances, overdosed medications, and food allergens, were found to be associated with a conditional inhibition of otherwise facilitated muscles. Neurophysiological Rationale Taste receptors are found within taste buds located not only on the tongue but also on the soft palate, pharynx, larynx, epiglottis, uvula and rst one third of the esophagus. Taste buds are continually bathed in saliva, and excessive dryness can distort taste perception. This effect is commonly observed, for example, with gustatory receptor stimulation using syrup of ipecac, which induces an immediate and violent motor response, which induces the patient to vomit. Afferents from the taste bud receptors of cranial nerves VII, IX, and X synapse in the nucleus of the tractus solitarius with ongoing projections to the thalamus, hypothalamus and cortex. Changes in muscle testing outcomes following taste bud receptor stimulation is hypothesized to be associated with changes in the central integrative state (CIS) in the hypothalamus, cortex, or both.
The axons within the rostral tractus solitari-
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It is thought that there are projections from the primary somatosensory region in the postcentral gyrus (parietal lobe) to the primary motor cortex located within the precentral gyrus of the frontal lobe. These projections essentially modulate the central integrative cortical state thereby culminating in a net inhibition or facilitation of the motor axon pool.
The information is then sent via the descending efferent motor pathways and is demonstrated by the strengthening of a previously weak muscle (facilitation) or the weakening of a previously strong muscle (inhibition). Clinical Rational Oral nutrient testing is widely used by Applied Kinesiology practitioners to aid the cli-
nician in making the best choice of nutritional substances, medications, herbs, and other substances when there are numerous possibilities from which to choose. It is also widely employed as a screening test to identify which laboratory evaluation may be best suited to a patient. For example, a patient who shows a strengthening response to insalivation of an anti-histamine would be considered a candidate for allergy testing, regardless of what symptoms are displayed.
In this manner, the clinician may efciently identify dysfunctional physiological processes at the root of patients’ symptoms, rather than merely give the symptoms a named diagnosis. A single blinded, uncontrolled pilot study of AK and allergy testing was performed by Schmitt and Leisman (1998). In this study, 19 of 21 foods associated with muscle weakness on oral challenge showed a subsequent elevation of serum IgE, IgG, and/or IgG immune complexes.
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A Pilot Study Showing Efcacy For Applied Kinesiology Muscle Testing Procedures as a Screening Tool For Immune System Mediated Food Allergy Patterns
by Walter H. Schmitt, Jr., D.C Abstract: Seventeen patients were found positive on applied kinesiology (A.K.) muscle testing screening procedures indicating food hypersensitivity (allergy) reactions. Each patient showed muscle weakening (inhibition) reactions to oral provocative testing of one or two foods for a total of 21 positive food reactions. IgE (RAST), IgG (RAST), IgE immune complex, and IgG immune complex assays were performed for all 21 of the A.K. positive testing foods. 19 of the 21 foods (90.5%) positive for hypersensitivity response on muscle testing showed one or more positive blood tests. INTRODUCTION The four classic hypersensitivity reactions which describe allergic reactions to foods, airbornes, and other antigens are called the Gell-Coombs Types I, II, III, and IV reactions. 1 (See Figure 1.) In hypersensitivity reactions of the Gell-Coombs types I and II, higher than normal amounts of IgE (type I) or IgG (type II) are produced by plasma cells when they encounter antigens. (IgM or IgA can also be produced in a type II reaction.) Immune complexes which are produced and are not adequately broken down (by the liver and/ or the spleen) will be elevated in type III reactions. A typical type IV reaction is the tuberculin skin test. Type IV reactions will not be discussed further in this paper.
FIGURE 1 4 types of hypersesitivity response (Gell - Coombs) ANTIBODY MEDIATED IMMUNITY TYPE I - IgE - ANAPHYLACTIC TYPE TYPE II - IgG (and IgM) - CYTOTOXIC RESPONSE TYPE III - IMMUNE COMPLEXES CELL MEDIATED IMMUNITY (T CELLS AND MACROPHAGES) TYPE IV -DELAYED HYPERSENSITIVITY IgG (or IgE) combines with antigen to form an antigenantibody complex. One antigen can bind at least two IgG molecules together. This sets up the potential for chains of these antigen-antibody molecules which are called immune complexes. IgG is converted to IgG immune complex which should be cleared by the liver and/or the spleen. When these immune complexes build up, this is the basis for Type III reactions. The rate of formation and clearing of IgG immune complexes affects both the levels of IgG and its immune complex. In other words, IgG may be rapidly produced, but just as rapidly converted to immune complex form. This can result in low IgG while IgG immune complexes may be severely elevated. Likewise, IgG may be elevated while IgG immune complexes may be adequately cleared. This explains the necessity of measuring as many parameters as possible before ruling out immune hypersensitivity reactions. The type I reactions result in rapid (anaphylactoid) type reactions. Histamine release by mast cells is the major symptom producing factor. The half-life of IgE is 2 1/2 days. The type II IgG type reaction is complement mediated and results in a slower onset of symptoms (a type of delayed
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hypersensitivity). IgG has a half-life of 21 days, hence its effects are much longer lasting than an IgE reaction. Immune complex formation is potentially the most tissue destructive as these complexes settle in tissues and cause microthrombi formation, complement cascade which can result in tissue damage, and leukocyte chemotaxis with the subsequent release of inammatory mediators. Immune complexes have been implicated in autoimmune disease processes. Applied kinesiology procedures involve muscle testing as a functional evaluation of patterns of inhibition and facilitation in the nervous system. Many clinical factors have been found to effect neuromuscular function and result in patterns of inhibition which induces reversible weakness of muscles to standard testing procedures. One factor which is said to affect changes in muscle strength is the oral insalivation of allergic foods. A.K. procedures involve a particular type of provocative testing for food hypersensitivity which is based on the patient insalivating a food substance and the doctor performing muscle testing to various muscles. A weakening reaction of the muscle induced by the patient’s insalivation of the food is suggested to be indicative of a neuromuscular hypersensitivity (allergic) reaction to that food. Although this type of provocative testing procedure to identify food allergies or hypersensitivities is widely employed by A.K. doctors, only one study has been performed to test this hypothesis. 2 This project was designed as a pilot study to identify if, in fact, the reported weakness on provocative oral neuromuscular hypersensitivity to foods is due to food allergy or hypersensitivity as identied by measurements of standard immune system blood assays. MATERIALS AND METHODS Patients were tested using food allergy screening tests developed by Dr. Michael
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Lebowitz 3 and this author. 4 These included 1) a weak muscle strengthening on insalivation of the natural anti-histamine, yakriton, 2) a strengthening response on insalivation of copper, 3) a positive therapy localization (T.L. - causing a weak muscle to strengthen) to the thymus area over the angle of Louis on the sternum, 4) a positive T.L. to thymus with copper in the mouth, and/or 5) a strong muscle weakening during simultaneous T.L. to the thymus while a copper antagonist supplement (Cop Out) is in the mouth. These screening tests are listed in Table 1 under “pre-test ndings”. Patients who were positive on one or more of these tests were further tested for muscle testing reactions to common food allergens. These included whole wheat our, cornmeal, soy our, brewer’s yeast, baker’s yeast, cow’s milk powder, powdered , egg, potato our, and others. While the food was held in the patient’s mouth, various strong muscles were tested to observe for changes in strength. A weakening of strong muscles to oral challenge with a food is an A.K. nding suggestive of food sensitivity to that food. With the weakening food in the patients mouth, several additional factors were tested to identify possible negation of the weakening response. These factors were 1) placing yakriton in the mouth (with the food), 2) T.L. to the thymus area, 3) T.L. to the liver neurolymphatic reex (NL), and 4) placing the spine . in a right foot gait torque pattern (called a CCW torque) by placing orthopedic wedges under the right hip and the left shoulder. If a patient was negative to the CCW torque of the spine, other spinal positions were checked for negating the food induced muscle weakness. One patient (#14) was found to have the weakness negated by a left convex lateral exion of the spine. These ndings are listed in Table 1 under “with food in mouth”. When a weakening response to oral food challenge is observed, blood was drawn prior to further treatment. The patient’s serum was sent to Immuno Nutritional Clinical Laboratories in
Van Nuys, California 5 where it was analyzed for levels of IgE (RAST test), IgG (RAST test), IgE immune complexes, and IgG immune complexes for the suspected food(s). For several foods, only IgE and IgG are available. Patients were included in the study only when all four tests were available for the food(s) to which they showed sensitivity by neuromuscular hypersensitivity testing.
pre-test ndings and ndings with the food in the mouth were recorded for all patients. Table 2 SEVERITY OF TYPE OF REACTION TOTALS REACTION IgE IgG E-IC G-IC EQUIVOCAL 2 MODERATE 1 SEVERE 2 TOTALS
The laboratory reports results as either as reactive in one of three categories: equivocal, moderate, or severe, or nonreactive. These results are included in Table 1 under “laboratory results”. RESULTS 17 patients with positive muscle testing ndings had their blood tested for all four immune parameters. 15 patients showed positive blood tests which paralleled their muscle testing ndings. Four patients had two positive foods by muscle testing ndings which were compared with blood testing. Therefore, there were a total of 21 foods which were muscle tested and blood tested. 19 of the foods which were positive to neuromuscular hypersensitivity provocative testing also showed positive blood tests. The results are shown in Table 1. Of the 21 foods tested, the following positive reactions were found: IgE - 5, IgG - 14, IgE immune complexes - 0, IgG immune complexes - 10. The total number of positive blood reactions is 29 because a number of patients had multiple positive reactions. The severity of the reactions was as follows: equivocal - 8, moderate - 9, severe - 12. These ndings are summarized in Table 2. The pre-test ndings and ndings with the food in the mouth were included in the study to attempt to identify any diagnostic trends. None were observed, but the data is included in Table 1 also. Due to the nature of this study being compiled based on regular patients in our ofce during regular ofce hours, not all
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5
2 5 7
0 0 0
4 3 3
8 9 12
14
0
10
29
DISCUSSION The results suggest that applied kinesiology muscle testing procedures are an excellent screening test for positive IgE (Type I), IgG (Type II), and IgG immune complex (Type III) mediated hypersensitivity reactions. The percentage of positive laboratory ndings was 90.5% (19 of 21) of the foods which showed positive to provocative muscle testing procedures. A 95% condence interval of (.777, 1.00) was calculated for the data. The formula employed was: ... ‘d t\- Y I -n --” n where y = number of laboratory positives (19) n = number of foods tested (21).
Further research is denitely indicated. Three specic directions are recommended. First, a self-controlled pilot study using muscle testing to identify both positive and negative hypersensitivity testing foods needs to be performed. This can tell us whether muscle testing is predicting only positives or if it can be used to identify non-reactive foods as well. Secondly, a multi-center study needs to follow up on this study and the one just proposed. Thirdly, follow up studies on patients who have already been tested as positive with both muscle testing and blood testing should be performed after applied kinesiology desensitization techniques have been administered. . The pilot study for comparing both positive and negative muscle testing ndings with positive and negative
blood test reactions is being formulated in our ofce as of the writing of this paper. We are also planning follow-ups on as many patients in this study as possible following desensitization techniques. REFERENCES 1. Roitt, Ivan M., Brostoff, Jonathon, Male. David K. Immunology. St. Louis: C.V. Mosby. 1985. 2. Scopp, Al, An experimental evaluation of kinesiology in allergy and deciency disease diagnosis. Journal of orthomolecular psychiatry 7:2, 1978. pp. 137-8. 3. Lebowitz, Michael, A technique to abolish all food sensitivities. I.C.A.K. collected papers, 1988-89, volume II. 4. Schmitt, Walter H., Jr. Applied kinesiological observations of allergic patients - Parts I and II. Digest of chiropractic economics 27: 1, July August, 1984 and 27:2, September-October, 1984. 5. Immuno Nutritional Clinical Laboratory, 6700 Valijean Avenue, Van Nuys, California 91406. (818) 780-4720.
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TABLE 1
PRE-TESTING FINDINGS
pt
WITH FOOD IN MOUTH LABORATORY RESULTS
Thy-
Cu+
Cop
Yak.
Cu
mus
Thym
Out
Food
Yak Thym
Liv
CTS
IgE
IgG-
E-IC
1.
S
0
0
0
0
+
CCW
E
E
0
2.
0
W
0
S
0
MILK
0
+
0
S
S
0
0
3.
S
S
0
S
W BR. YEAST
+
0
0
CCW
0
S
0
E
4A.
0
0
0
S
W
+
0
+
CCW
0
M
0
E
4B
”
“
“
“
“
MILK
+
0
+
CCW
S
M
0
0
5.
0
S
0
-
W
MILK
0
+
+
0
0
M
0
M
6.
0
0
S
-
W BR. YEAST
0
+
+
0
S
0
M
7.
0
S
0
-
0
BR. YEAST
0
+
+
CCW
0
S
0
0
8.
S
S
0
-
W BR. YEAST
+
0
0
CCW
0
S
0
0
9A.
0
0
0
S
W
CORN
0
+
0
CCW
0
M
0
0
9B.
”
“
“
“
“
MILK
0
10.
0
0
0
S
W
11.
0
NA
NA
NA
NA
CORN
12.
0
0
0
S
NA
13.
0
0
0
S
W
14A.
0
S
S
-
W
MILK
14B.
“
“
“
“
”
15.
0
0
0
S
W
16.
NA
S
NA
NA
NA BR. YEAST
17A.
S
0
0
S
NA
17B
”
“
“
“
“
TOT
16
16
15
15
13
S=6
S=2
S=9
W=10
G-IC
S=4
SOYBEAN
+
WHEAT
0
CCW
CCW
0
+
+
CCW
M
S
0
E
+
+
CCW
0
S
0
E
0
+
+
NA
0
0
0
S
*CORN
NA
+
NA
NA
0
0
0
0
CORN
NA
+
NA
CCW
0
0
0
0
+
NA
)
E
0
0
0
NA
+
0
CCW
0
E
0
0
NA
+
NA
CCW
0
M
0
0
NA +
NA
CCW
0
0
0
M
BR. YEAST
CORN WHEAT
0
NA
CORN
NA
0
NA
NA
0**
0**
0
S
WHEAT
NA
+
NA
NA
0**
0**
0
S
21
14
17
21
21
21
21
+=15
+=9
14
0
13 +=5
W=1
CCW=15 5
10
)=1
* Corn oil only weakened; cornmeal tested OK
** General screening test for 6 grains including corn and wheat PRE-TESTING FINDINGS Yak. = Antronex in mouth strengthens a weak muscle
Cu = Copper in mouth strengthens a
weak muscle Cu+Thymus = Copper in mouth plus T.L. to thymus
Cop Out = Cop Out in mouth plus thy-
mus T.L. Thymus = T.L. to thymus (angle of Louis) strengthens a weak muscle
S = Strengthens
W = Weakens a = No effect on muscle
strength NA = Not tested
- = Not applicable since copper strengthened
weak muscle
WEAKENING FOOD IN MOUTH FINDINGS Yak = Antronex in mouth Liv = Liver NL T.L.
Thym = Thymus T.L. + = Negated weakening effect of food in mouth
CTS = Centering the spine-spinal position which negates food induced weakness CCW = Counterclockwise pelvic torque negated weakening effect of food in mouth ) = Lateral exion convex to left negated weakening effect of food in mouth
LABORATORY FINDINGS
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IgE = IgE RAST test
0 = Non-reactive
IgG = IgG RAST test
E = Equivocal positive reaction
E-IC = IgE Food Immune Complex Assay
M = Moderate positive reaction
G-IC = IgG Food Immune Complex Assay
S = Severe positive reactiousing
Oral or olfactory testing of nutrients is one of the controversial elements in applied kinesiology due to its abuse.
The system of nutrient testing for both positive and negative effects has been misrepresented by both professionals and non-professionals. Demonstrations of holding substances, pointing at them, visualization, or of having the testing person hold the substance are commonplace. To test for this, a study was done using a poisonous substance, The testing method was that four different sample groups masked so that the persons doing the testing and those being tested would not know what was in the bag. There were four containers, one of which contained the poison. A strong muscle, the rectus femoris was tested and the person being tested held the masked container against their solar plexus, a common place used by those using muscle testing in this manner. All four samples were tested and the results recorded by another person. Neither the testing person or the person being tested knew whether they were testing sample A, B, C or D. Doctors with over 5 years of experience testing muscles tested over 300 persons. There was no correlation between muscle weakness and the poison sample. This paper is being prepared for publication. Triano published a paper showing no correlation between the latissimus dorsi and nutrients that were supposed to be related to that muscle. The substances chosen were whole food products consisting of many macro and micronutrients. They were chosen from a list produced by a company that related specic nutrients with specic muscle weakness. Leaf published a paper with the following design. Persons with a weakness of the teres minor were asked to ll out a questionnaire with 30 possible symptoms related to thyroid dysfunction. The subjects were then tested with four different nutrients. Three had
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no relation with thyroid function. One had nutrients related to thyroid production. The nutrients were tested by insalivation and by holding them in the hand. These vials were masked and labeled A, B, C, and D with neither the tester nor the person doing the testing knowing the ingredients. The results of this test were as follows: 1. There was no strengthening of the teres minor by holding the nutrients in the hand 2. Those patients who reported less than 4 symptoms out of 25 did not show any correlation with the supplement designed to aid thyroid function. 3. Those who marked between 5 and 20 of the symptoms related to thyroid malfunction tested positive for the nutrient. 4. Those who marked over 75 percent of the symptoms, 23 or more out or 30, tested positive for 2 or more of the nutrient supplements. The proper use of muscle testing to aid in nutritional work depends upon knowledge of physiology, diagnosis, pathology and biochemistry. Goodheart coined the phrase 51 percenter. The changing of the strength of a muscle means little in itself. The change in the function of the muscle must be correlated with other ndings. Finding a weak latissimus dorsi, related with the pancreas, could mean a problem with blood sugar maintenance, but it could also indicate an injury to the muscle itself, a problem with the nerve supply to the muscle, a reex inhibition related to plantar muscle contraction, or even a problem with the production of digestive enzymes.
Melzack & Wall Gate Control Professors Ronald Melzack and Patrick Wall, of Montreal and London, proposed in 1965 that painful stimulations traveling up the spinal column are modulated by a gate mechanism. If the gate is open, all of the nerve impulses are allowed to pass, and if the gate is closed or partially closed, then only a few or none of the impulses are allowed to pass. Pain is transmitted up the spinal column by the activation of the T cell, and this cell can be activated by either large of small bers. Cells in the substantia gelatinosa (SG cell) can inhibit of block the transmission of the T cell thereby acting as a "Gate". The SG cell is activated by the large diameter bers, the A-beta bers. These are stimulated by light touch or vibration. The small bers, C bers, are stimulated by heavy pressure or painful stimulation. These bers activated the SG cell opening the gate and allowing passage of the painful sensation to the brain. 1. Nerve impulses from the afferent bers to the spinal cord neurons are modulated by a spinal gate mechanism located in the substantia gelatinosa of the dorsal horns. 2. The gate mechanism is inuenced by activity in the large and small diameter bers. Stimulation of the large bers inhibits the transmission by closing the gate. Small ber activity opens the gate facilitating nerve transmission. 3. The brain inuences the gate mechanism through efferent bers. 4. At higher levels, there exists a central control of large diameter, rapid conducting bers, that modulates the spinal gate through cognitive processes. 5. When a threshold level over the spinal cord transmission neurons is exceeded, an action system is activated that produces set patterns of behavior and experiences of pain.
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6. The gate regulates the amount of information going to the brain. 7. Pavlov observed that afferent signals from the nervous system must be identied, evaluated in relation to prior experience, localized and inhibited before the action system for pain perception and response is exceeded by the dorsal horn transmission neurons. Goodheart discovered that stimulation of certain acupuncture points would exhibit an inhibitory reaction at the spinal gate and thus help to control pain. Do a pulse diagnosis to determine the meridian imbalance. In pain patients, you will usually nd only one meridian out of balance. Test to nd the decient side as exhibited by the weak associated muscle. Tap the tonication point four to ve times and retest the weak muscle for strengthening. If the weak muscle strengthens, tap for two to three minutes and test for a reduction in pain. You may have to tap the associated point for the meridian along with the tonication point to achieve results. If this reduces pain, stimulation of the sedation point will cause the pain to return. If normal therapy localization does not disclose a known problem, pinch or spray, with a coolant spray, the dermatome over which the suspected problem exists. These actions will open the spinal gate and aid in nding hidden problems. In treating chronic problems, the brain may contain a pattern of memory that needs to be accessed to complete treatment. For example, if you cut yourself in opening a letter, the rst thing that you do is to move your other hand to protect the injured hand. The second action is head orientation towards the area injured. This action is followed by looking at the area. Vocalization is the next sequential action and this is followed by remembering a similar injury from the past.
In a chronic problem, therapy localize the area and treat all indicated reexes. Then, have the patient therapy localize and with the head turned towards the area look at the area or in that direction and retest. The area should now therapy localize and if it does, retreat all reexes. This action is followed by having the patient looking at the area and opening their mouth as to speak and again retesting and treating if indicated. The nal procedure is to have the patient therapy localize, look at the area, open the mouth, and nally think of the injury and retest and treat all indicated reexes.
To the brain
Stimulation of the large bers by vibration (tapping) closes the gate mechanism
Large bers (A - beta)
Pain
A - delta bers
Small bers (C)
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Stimulation of the small bers by pinching or cold opens the gate
Mental Recall Goodheart states that if emotional or physical trauma is out of the awareness of the body, the body cannot repair it.
2. Have the patient visualize the trauma and retest for weakening. Observe the eyes for rapid eye movements (REM'S).
After correcting all imbalances in a chronic area, consider that the mind may not be aware that a problem exists. For some reason the trauma has been blocked.
3. Hold the neurovascular contacts for emotional stress above the orbits. Palpate for a pulsation.
Ask the patient to remember the rst instance of pain or trauma. Treat any structures found weak while the patient is remembering the trauma or occurrence of symptoms. This mental recalling of the emotional event aids the mind in the correction of the problem if the structural corrections are performed while the recall is being done. 1. Test and treat all weaknesses and spinal imbalances. 2. Have the patient recall the trauma, either emotional or physical, and retest for the weak indicators. 3. Treat all returning weaknesses while the patient think of the trauma. 4. Retest again with emotional recall. In a seminar in Boston, Goodheart treated a doctor who had been attacked and ended up losing the sight in one eye and having chronic sciatica. He treated the doctor and obtained excellent results using structural corrections to the pelvis and lumbar spine. The next month when he returned, he asked the doctor how he was doing. He responded that he had complete relief for two weeks and then the pain in the leg returned. Instead of retreating the lumbar spine, Goodheart performed the following: 1. Test and nd a strong muscle.
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4. Ask the patient to again visualize the trauma and imagine that they have a movie of their life. Place the images in the movie where they belong and then turn the projector on fast forward and quickly go through their life until they reach the present. Have them open their eyes when they reach the present. 5. Visualize the trauma again and test for weakening of a strong indicator muscle. It should now test strong. This technique appears to remove the psychosomatic link between the emotional stress and the physical body.
Injury Recall Technique Walter H. Schmitt, Jr., D.C., DICAK, DABCN The following procedures were developed and presented to the ICAK by Walter Schmitt. They are presented here to show how members develop a concept, apply it in their ofce, share it with other mem bers of the organization and then present them to the Scientic Review Board of the ICAK to be tested and voted on to become part of the approved subjects in applied kinesiology. As of the writing of this book, these procedures are in the validation process of the Scientic Review Board awaiting nal approved status.
Injury Recall Technique (IRT) was taught to me by my friend, Dr. Gordon Bronston, a Southeld, Michigan podiatrist. Because it has immense clinical value and is practiced by only a handful of podiatrists, I adapted the technique in the late 1980s for use by other health care practitioners. Dr. Bronston taught me that “the single most important factor in a patient’s history is the history of injury and trauma.” I have learned that IRT is not duplicated by any other technique. In my clinical experience, IRT has been present in about 80% of my patients. In these patients, about 80% of their previous in juries responded to IRT. Although these are just general numbers, they give the idea of the widespread value of applying IRT.
The following is excerpted with permission from: McCord, KM, and Schmitt, WH, Quintessential Applications: A(K) Clinical Protocol. St. Petersburg, Florida: Privately Published, 2005.
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Does “Autogenic Facilitation” Strengthen Weak Muscle(s)? 1 .If Autogenic Facilitation (Stretching of Muscle Spindle Cell) Strengthens: No IRT Needed 1. If Autogenic Facilitation Does Not Strengthen: Identify Areas Needing IRT by Doctor Rubbing (or Patient TL) Over Areas of Injury (Past or Present) 2. Perform IRT to Areas Identied. 3. Retest for Response to Autogenic Facilitation a. If Autogenic Facilitation Strengthens: Go to NSB / Set Point Technique (If Needed) b. If Autogenic Facilitaton Does Not Strengthen: Repeat Steps 2 through 3 5. Continue Until Autogenic Facilitation Strengthens Weak Muscle(s) NOTE: MEASURE, MEASURE, MEASURE – Perform RANGE OF MOTION and/ or MEASURE PAIN (Pain Scale: 0 – 10) Before and After Performing IRT.
IRT DIAGNOSIS for HEAD & NECK PROBLEMS 1. TL to Area of Previous Trauma on the Head or Neck is Negative. 2. TL to Same Area with Head & Neck In Extension Weakens Strong Muscle. IRT TREATMENT for HEAD & NECK PROBLEMS: Firmly, but Gently, FLEX THE ATLANTOOCCIPITAL AREA, to the Limit of Motion, Three or Four Times: A. While Patient Touches Area of Previous Injury (or) B. After Doctor Pinches Area of Previous Injury (or) C. After Doctor Uses Origin-Insertion Technique in Area of Previous Injury IRT DIAGNOSIS for the REST OF THE BODY: Gently COMPRESS THE MORTIS JOINT (Push Talus Headward) A. While Patient Touches Area of Previous Injury (or) B. After Doctor Pinches Area of Previous Injury Observe for Strong Muscle Weakness IRT TREATMENT for the REST OF THE BODY: Perform a DISTRACTION (Micromanipulation) OF THE TALUS (Opening Mortis Joint) A. While Patient Touches Area of Previous Injury (or) B. After Doctor Pinches Area of Previous Injury (or) C. After Doctor Uses Origin-Insertion Technique in Area of Previous Injury
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IRT for the SPINE: Cervical Spine and Coccyx – ATLANTO-OCCIPITAL FLEXION A. While Patient Touches Cervical Segment or Coccyx (or) B. After Doctor Pinches Skin over Cervical Segment or Coccyx Sacrum, Sacroiliacs, and the Rest of the Spine – DISTRACTION OF THE TALUS A. While Patient Touches Sacrum, Sacroiliac or Spinal Segment (or) B. After Doctor Pinches Skin over Sacrum, Sacroiliac or Spinal Segment Perform IRT Bilaterally or Ipsilaterally (e.g. Sacroiliac) as Appropriate
Alternative Pain Control Technique Using the concepts developed by Goodheart, Schmitt has developed an alternative method for controlling pain. This is a combination of treating acupuncture meridians begin with using mental processes to access specic areas of the brain. Schmitt found that the points on the skull where meridian begin or end are effective treatment areas when the patient is in pain.
If the aggravation of the area does not cause weakening of a strong muscle, have the patient therapy localize to the area and test for weakening of a strong muscle. If it fails to weaken, tap the head acupuncture points until one is found that weakens the strong indicator muscle. This is the point that should be treated.
Schmitt has added the concepts of thinking of His basic procedure is to aggravate the area the pain, thinking of the memory of it and the where the pain is located and test for weaken- emotion of it as ways to access different areas ing of a strong indicator muscle. The patient’s of the brain that are then treated by tapping nger is then placed over one of the acupunc- the point found in the procedures above. ture points on the skull or the doctor taps the point until one is found that strengthens the Following this are the notes used by Dr. weak muscle. This is the point that needs to Schmitt in teaching this technique. be tapped.
Bladder 1 Gall Bladder 1 Triple Warmer 23 Small Intestine 19 Stomach 1 Large Intestine 20
Governing vessel 27 Vessel of conception 24
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103
Acupunture Meridian Head Points Pain Relief Techniques Walter H. Schmitt, DC, DIBAK, DABCN NOCICEPTOR STIMULATIONBLOCKING TECHNIQUE FOR ACUTE PAIN CONTROL 1. General muscle weakness is created by: a. Acute pain b. Pressure to a painful area c. Putting a joint into painful position 2. Patient TLs to ipsilateral acupuncture head points. One head point will negate general weakness. 3. Tap head point with 1a, 1b, or 1c. 4. Continue tapping with 1a, 1b, or 1c until pain relief is maximized.
SET POINT TECHNIQUE (“TOUCH AND TAP TECHNIQUE”) 1. Patient TL to the area of pain or previous injury is negative. 2. Patient TL to area PLUS tapping on one B&E point (ACUPRESSURE TAPPING POINT) on the same side of the body causes strong muscle to become inhibited. 3. Tap the related B&E point (ACUPRESSURE TAPPING POINT) on the same side of the body while the patient maintains contact with the area of pain. 4. Tap 100 times. You may tap more if doing so increases pain reduction further.
5. 1a, 1b, or 1c will no longer cause muscle weakness LQM (LOCATION, QUALITY, & MEMORY) TECHNIQUE LOCATION OF THE PAIN (SOMATOSENSORY AREA OF CEREBRAL CORTEX) 1. Have patient focus attention on a specic location in the body. 2. If strong muscle weakens: TL to acupuncture head points while patient continues to think about that part of body. One acupuncture head point will neutralize muscle weakness caused by focusing process. 3. Tap that head point 50 - 100 times while patient continues to focus attention on body part.
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4. Recheck 1. and test strong muscle to ascertain correction.
QUALITY OR NATURE OF THE PAIN (SOMATOSENSORY AREA OF CEREBRAL CORTEX) 1. Have patient focus attention on the quality of the pain. 2. If strong muscle weakens: TL to acupuncture head points while patient continues to think about the quality of the pain. One acupuncture head point will neutralize muscle weakness caused by focusing process. 3. Tap that head point 50 - 100 times while patient continues to focus attention on the quality of the pain. 4. Recheck 1. and test strong muscle to ascertain correction.
MEMORY OF THE PAIN (TEMPORAL LOBE) 1. Have patient focus on: a. memory of pain when it was at its worst, or b. memory of incident when pain began. 2. If strong muscle weakens: TL to acupuncture head points while patient continues to think about than memory. One acupuncture head point will neutralize muscle weakness caused by the memory of the pain (or incident causing pain.) 3. Tap that head point 50 - 100 times while patient continues to think about memory of pain (or incident causing pain.)
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4. Recheck 1.a. or 1.b. and test strong muscle to ascertain correction.
Proposed Neurological Mechanisms for A.K. Pain Relief Walter H. Schmitt, DC, DIBAK, DABCN
Nociception has three effects in the spinal cord: 1) transmission of the nociceptive message to higher levels; 2) exor reex afferent muscle response; and 3) excitation of intermediolateral cell column (IML). Mechanoreceptor (MR) activity blocks each of these three effects of nociception in the spinal cord. (Note: Only the MR inhibition of transmission to higher levels is shown in the drawing below.) The exor reex afferent response lays the theoretical foundation for the use of muscle testing procedures to evaluate the effectiveness of various pain relief therapies. That is, when a test stimulus of the appropriate pain relief therapy is used, it will result in a strengthening response of an inhibited muscle. Continued application of that therapy has shown to result in signicant pain reduction.
effective (and usually more effective and faster) for meridian pain relief techniques than acupuncture needling techniques. The pathways diagramed for nociception provide the theoretical basis for the clinical application of NSB Technique, Set Point Technique, and LQM Technique. Presumably, each of these techniques activates at least one of these pathways. When a particular pain relief therapy is needed, activation of the appropriate neurons by a challenge procedure specic to those neurons will result in positive muscle testing ndings, usually general muscle inhibition resulting in muscle testing “weakness.” Tapping ipsilateral acupuncture meridian head points has shown to be among the most effective therapies to relieve pain and restore normal function. However, to be effective, the points must be tapped in conjunction with some other nociceptive related activity. Said differently, a group of neurons along the nociceptive pathway must be brought to ring threshold simultaneously with tapping the meridian points in order for tapping to be effective. The nociceptive related activity is different for each of the above three techniques. Firing the appropriate neuron pools with the simultaneous meridian point tapping results in pain reduction as well as changes in muscle testing responses, ranges of motion, etc. The appropriate neurological stimulus for each technique is:
Activation of MRs can be achieved by tapping the skin, usually at a rate of about four to ve times a second. Tapping at this rate causes a repetitive stimulation of MRs including those that are rapidly adapting. At this rate, tapping 100 times requires 20-25 seconds. In the 1970s, Goodheart observed that tapping of acupuncture meridian points was at least as
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1) NSB technique: presence of acute pain, either immediately after injury occurs or by inducing pain by pressing on the area or moving it into a painful range of motion 2) Set Point (Touch and Tap) Technique: patient touches the area of pain 3) LQM technique: patient consciously activates neuron pools by thinking about the location of the pain, the quality of
the pain, and the memory of the pain. There is often an anatomical relationship between the pain location on the body and the meridian head point to be tapped. The body location is near or on the ipsilateral acupuncture meridian related to the head point (yang meridian) or its coupled meridian (yin meridian) in about 75% of cases. (For example, the Large Intestine-20 point is often related to a body location near or on the large intestine meridian or the lung meridian.) The other 25% of the time, there is no anatomical relationship between the meridian head point and the body location of the pain. In all cases, the meridian head point to be tapped is found by the muscle testing procedures described above. The acupuncture meridian head points receive their sensory innervation from the trigeminal nerve and synapse in the spinal (descending) trigeminal nucleus in the lower medulla and upper cervical cord. The sensory facial bers closer to the mouth synapse more rostrally in the spinal trigeminal nucleus and those farther away from the mouth synapse more caudally in the spinal trigeminal nucleus. Considering this sensory orientation of the facial tissues, these meridian points follow a more or less somatotopic segmental distribution from LI-20 extending centrifugally to SI-19. NSB Technique
the body when the nociception reaches a still higher threshold. NSB technique is indicated when elevated levels of nociception result in a weakness of muscles throughout the body to muscle testing, presumably since the acute levels of nociception achieve the level necessary to create general muscle inhibition as in 3) in the previous paragraph. The nociception-induced muscle testing weakness is negated by stimulation of the appropriate ipsilateral acupuncture meridian head point. Perhaps NSB helps to activate a sluggish self-limiting reex pathway through the CRN. Set Point (Touch and Tap) Technique Set Point (Touch and Tap) Technique is indicated when a change in muscle testing response (weakening of a strong muscle) results when the patient simultaneously touches the area of pain or injury (paralleling the instinctive response of touching the area that hurts) and the acupuncture meridian head point. Location, Quality, Memory (of the Pain) Technique LQM technique depends on the patient’s conscious activation of various cortical neuron pools by mentally focusing on the location of the pain (visceral or somatosensory cortex), the quality of the pain (visceral or somatosensory cortex), and the memory of the pain (temporal lobe.) LQM technique is indicated when mentally focusing on one or all of these cortical pain related areas creates a muscle testing weakness that is negated by simultaneous stimulus of the acupuncture meridian head point.
There is a self-limiting nociception reex arc from the spinal cord to the caudal reticular nuclei (CRN) and then back to the spinal cord. Incoming nociception excites CRN neurons whose descending axons inhibit the nociception at the spinal cord level. This is presumably one of the pathways that is activated in these pain relief techniques, especially NSB. Any or all of these pain relief techniques may Increasing levels of nociception cause, in be indicated in a patient. Muscle testing acascending order: 1) exor reex afferent re- companied with sensory or mental challenges sponse with excitation of exors and inhibi- of the various neuron pools guides the clinition of extensors near the nociceptive source; cian the most effective combination of these 2) a “splinting” facilitation of both exors and and other pain relief therapies. extensors around the nociceptive source; and 3) a general inhibition of muscles throughout
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Inammation & Prostaglandins
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Applied kinesiology testing is an ideal way to Arachidonic acid – found in dairy fats can be analyze the biochemical pathways of the es- used to increase the pain so that both oils can sential fatty acids. be tested. Using specic muscle tests, muscles related to You may nd that the patient requires one or the cofactors can be tested to determine the both oils to stabilize their symptoms. need for supplementation. Grip strength or neck exors - B-6 The chart below shows the biochemical pathSternocleidomastoid – niacin ways and the cofactors that are necessary for Pectoralis minor – zinc the transformation of the essential fatty acids Subclavius – magnesium into their prostaglandin end products. The individual omega oils – 6 and or 3 can then be insalivated and the local pain can be palpated for reduction.
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Appendix A Partial List of Additional Procedures taught and developed in Applied Kinesiology Muscle Related Therapies Antagonist Reactive Muscle Pattern
At one of the annual meeting of ICAK in the 1980's, Deal presented the idea that a muscle could be "frozen". In effect, the muscle could not be turned off by the usual means due to the under contraction of its antagonist. This condition leads to a loss of range of motion due to the failure of the antagonist muscle to relax.
activity. Imbalances in these receptors create muscular imbalances that lead to the continuation of many structural pain patterns. From the work of Montegue on the skin, diagnostic and treatment options were developed for correction of muscle inhibition patterns created by involvement of the skin or by scars. It is a common practice in Europe to treat scars when there is localized pain or joint malfunction.
Gait Testing Proper testing and treatment leads to normalization of motion. Ligament Interlink Coordination of walking is a spinal cord function. Goodheart discovered a spinal cord reex that is involved with gait that appears to relate opposing ligaments. This research was developed from material rst presented in Scientic American on the motion of limbs in a decerebrated cat. There is a relationship between a ligament on one side of the body to a corresponding ligament in a contralateral joint of the body. Proper treatment leads to derness and localized pain ligaments. This has been reduction in temperature ligaments
reduction in tenover the involved demonstrated by over the involved
Skin - Scars
Skin is the largest organ of the body. Proprioceptors in the skin tell us where our joints are and are involved in the inhibition of muscular
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Walking and running require coordination of motion between opposite extremities. As part of the compensatory mechanism of the body to react to xations and other imbalances, these coordinated activities are altered. Goodheart found that you could test for the proper functioning of these joint actions by testing the opposing extremities. The tests are performed in the cardinal motions of exion, extension, abduction, adduction and the rotational motions caused by the opposing contractions of the abdominal oblique and the gluteus medius and the psoas and the pectoralis sternal. Proper treatment leads to a normalization of the walking patterns of gait facilitation. Synchronization
In the 30’s and 40’s, a chiropractor, Watkins, began the advocacy for treating areas that appeared to help coordinate the function of the head and pelvis. He described areas perianally that effect muscle balance along the spine. These appear to be related to other “righting”
reexes that are well documented. Goodheart made the observation that when the visual reexes are in need of treatment, muscles will test weak with the eyes open but strengthen with the eyes closed. He related this to a carry over effect from trauma. If the patient is questioned as to the position that they were in when the trauma occurred, they will relate a position where these muscles are inhibited. It appears that the injury “locks in” this inhibition pattern. Proper therapy allows normal functioning of the muscles whether the eyes are open or closed and aids in normalization of gait as well as other body mechanics.
Gait Inhibition
During the normal walking pattern, muscles are inhibited to allow normal motion to occur. After injury or when fatigue starts after strenuous activity, this normal inhibition process may not occur properly. This leads to continual contraction of the muscle that fails to inhibit. This can easily be seen by a failure of motion of an arm, or a slight pulling of the head towards one side. Failure of proper inhibition can involve single muscles, muscles from a single spinal level or a complete side. Proper correction allows normalization of the proper inhibition pattern.
Right - Left Brain Activity There is a denite difference in the function of the right and left brains. The right side of the body receives at least 85% of its control from the left brain and the left side the same percentage from the right brain. The left side of the brain is basically logical, systematic, mathematical, lingual, etc. A bookkeeper or computer programmer is an example of a strictly left brain activity. The right brain is illogical, nonsensical, tonal, musical, emotional, creative, etc. Everything the opposite of the left brain. Artists are examples of right brain dominant people. James Pershing Isaacs wrote about the use of homeopathy in Europe and found that very low dosages of nutrients would appear to balance brain function. From these observations, Goodheart advanced these thoughts to show that specic nutrients would positively effect the different sides of the brain. Using these concepts, nutrition, cranial work and spinal work can be used to help patients with conditions like stroke, multiple sclerosis, learning disabilities, ADD, etc.
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Biological Closed Electrical Circuit
Nordenstrom, of the Karolinsk Institute in Stockholm, has shown that the blood vessels function as electrically conducting cables. This appears to be the upward communication link from the periphery to the brain. For example, the brain receives information molecules produced by white blood cells that modulate brain activity. This is the work of Pert. Nordenstrom has found that using electrical currents along the arteries, he has been able to reverse inoperable cancers. The kinesiological indication for this technique is when repeated testing of a muscle causes weakness and does not respond to nutrition or lymphatic reex contacts. If this pattern is found in an extremity, all muscles from the one distally will test weak for this pattern. For example, if the communication is blocked at the knee, all muscles from the popliteus distally would test weak on repeat testing, but the quadriceps would not. Goodheart found a manual correction for this condition.
Repeated Muscle Activation (RMA) Golgi tendon organs are located near the musculotendinous junction. To understand the function of these structures, realize that they are arranged in a series with the extrafusal muscle bers so that if the muscle is stretched or contracted, the tendon organ will be stimulated. Following the observations of Leaf that hidden muscle weakness patterns could be found if the patient was asked to activate the muscle repeatedly, Goodheart found that many muscles that would give the physical signs that they were weak would test strong. However, after having the patient activate the muscle 10 times, these muscles would then test weak. Goodheart found that over 90% of the patient's showing this muscle weakness pattern showed occipital or spinal xation patterns. Correction involves both a structural correction to the muscle and testing for a nutritional component
Spinal Related Therapies
Vertebral Fixations A muscular locking of three vertebral structures, or the ilium and the sacrum, thus restricting normal motion. In the spine, the rotatory longus and brevis on one side are found in contraction causing rotation of the vertebrae towards the side of contraction and thus restricting normal motion.
Goodheart found that these can be diagnosed because of specic muscle weakness patterns that are found associated with each spinal area. This allows testing for the existence of the xation pattern but also conrmation that the xation has been properly manipulated. The muscle weakness pattern will not test strong
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until the xation pattern has been corrected.
Hologramic Subluxation
When abnormal stresses are applied to bone, the bone will bend. This phenomenon is a contributing factor in scoliosis and the production of genu valgus deformities. This is also the underlying cause of bent spinouses. Studies have shown that there is an ion change in the crystalline structure of the bone where this deformity exists. Classically, when these subluxations are found, the bone will be very tender to palpation where the bone would bend. It is this small intense area of tenderness that is indicative of this problem. You will usually nd a decreased range of motion in a body part innervated from the area or related structurally. After correction, the range of motion improves dramatically.
Category I & II
For decades, Dr. Major DeJarnette discussed three types of pelvic problems. He named these conditions Category I, Category II and Category III. Category I is a locking of the sacral boot mechanism that is involved with the ow of cerebrospinal uid. There is no osseous misalignment or subluxation of the sacroiliac articulations. If an osseous misalignment or subluxaiton exists, it is called a Cetgory II pelvic imbalance. This was discussed in the main section of this book. Goodheart developed a diagnostic system to nd these conditions that can be used in different postural positions. He and others in the AK community have developed improvements in the standard treatments for these conditions.
Meningeal Release - Coccyx Category III The Category III problem was described by DeJarnette to be a pelvic imbalance that had an accompanying sciatic neuralgia. For years, Goodheart had difculty integrating this problem into the pattern of correction used in Applied Kinesiology. In 1991, he developed a procedure to correct this problem.
The dura mater is rmly attached inside the cranial bowl, at the upper cervical area and then again at the sacrum and by the lum terminale into the coccyx. In coccyx imbalances, abnormal stress can be applied to the dura mater causing reex muscle tension along the spine. Goodheart, following the works of Lowell Ward, has described the coccyx as a take up mechanism to keep constant tension on the dura mater.
Sacral Wobble
There is a torque pattern of motion that occurs at the sacrum during normal walking. This resembles a gure 8. This pattern was originally described by Goodheart in the early 70’s, and specic manual corrections developed to normalize this motion. Later in the 80’s, the importance of the function of the piriformis in controlling and supporting the sacrum and the sacroiliac joint added to the understanding of this condition. Iliolumbar Ligament Based on the concepts of Fred Illi, D.C. following his work at National College of Chiropractic in Illinois, Goodheart became interested in the function of the iliolumbar ligament Goodheart made the observation that imbalances, elongation, in this ligament caused improper inhibition patterns when the patient was tested in a gait position. Leaf later showed how to diagnose entrapment of the L - 5 nerve due to shortening of this ligament. Consequently, alterations in this ligament can cause gait imbalances or sciatic nerve type symptoms when the patient is in a twisted position.
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Spondylogenic Reex Goodheart was given a book Manual Medicine by Dvorák and Dvorák, two Czechoslovakian physicians working in Berne, Switzerland. In their book, they describe an interesting experiment where they irritated the facets of the spine and recorded hypertonicity in sections of muscles in the back. These experiments also showed that the hypertonic patterns extended to the muscles of the skull, eye and extremities. The intriguing part was that each spinal segment had a specic group of muscle sections that would become contracted by the irritation of the facets. For years, Goodheart studied this book and tried to put the information to use. It wasn't until he combined a few procedures that he was able to nd and correct these imbalances.
Cervical Compaction Barry Wycke, a noted English neurologist, developed a screening test to determine chronic imbalances in the cervical spine. This test appears to uncover hidden imbalances in the mechanoreceptors. This test was developed to ll a need to determine if cervical imbalances existed following auto - cervical spine injuries. It aids in nding if imbalances do exist and screens
for malingerers. As discussed by the Dvorak 's in ,Manual Medicine, this test coincides with imbalances in active and passive range of motion. These imbalances are due to alterations in the functioning of the mechanoreceptors of the cervical spine. This is of great importance as imbalances in these structures cause chronic pain patterns. Using the diagnostic test of Wycke, Goodheart developed a treatment to normalize the mechanoreceptor function thus normalizing ROM and reducing local pain patterns. Leaf later demonstrated that this condition can be found in other joints in the body. Hidden Cervical Disc
no rotation, the vertebral bodies would jam into each other. This rotation occurs because of inhibition of the piriformis. Everyone, in a normal condition, will have the right piriformis inhibit at approximately 30 degrees of lumbar exion. This same inhibition pattern occurs in extension. This pattern of muscular inhibition continues up the spine. The left latissimus, the left upper trapezius and the right sternocleidomastoid muscles inhibit at the same degree of lumbar exion and extension. When the inhibition pattern fails to occur, have the patient therapy localize to problems in the pelvis and the upper cervical area. When an uncorrected problem is found, the muscles will inhibit and test weak.
The cervical spine is not as prone to disc herniation as the lumber spine. However, the cervical spine does present with a special type of lesion Piriformis Gait Inhibition coined “hidden cervical disc” by Goodheart. This problem creates a special type of symptom pattern. As part of the gait inhibition pattern when walking, the piriformis is inhibited. This is in In the cervical spine, the sensory and the motor addition to the inhibition that occurs in the roots do not merge until after the interverte- PLUS technique when the lumbar spine is bral foramina. This causes patients to present exed 30 degrees or extended 20 degrees. with more varied symptom patterns than in the lumbar spine. Goodheart noted that while he was trying to do the PLUS testing, he would sometimes In this condition, the vertebrae slide up the line obtain aberrant ndings. These occurred of the facets. This causes an anterior superior when the patients would move their arms. misalignment of the vertebra and results in a Further testing showed that the piriformis bulging of the disc. This discal pressure may and the iliacus will be inhibited in a gait effect only the motor nerve root or may cause position. This will occur when the opposite cord pressure. arm and leg are brought forward into exion. This pattern occurs on both sides because it is a part of normal walking. P. L. U. S. This inhibition follows the pattern that Illi Illi made many important discoveries about the rst wrote about. He was the rst to describe mechanics of the lumbar and pelvic areas. One that as the ilium moves forward, the fth of these was further developed by Goodheart lumbar moves forward on that side and the and became a technique for determining if there sacrum moves backward. This motion is are any hidden problems that are restricting limited by the iliolumbar ligament, but it is normal spinal mechanics. the inhibition of the piriformis and the iliacus that are the causative factors. When you bend forward, the lumbar spine does not just ex. It also must rotate. If there was When the muscles fail to inhibit, there will be
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a hidden sacral, iliac or fth lumbar xation complex.
Upledger, in his classic Craniosacral Therapy, This is an excellent tool to nd hidden problems describes a procedure for decompressing the jugular foramen. This procedure causes rein the spine. laxation of all of the sub-occipital muscles and normalizes the ow of cerebrospinal uid through the foramen magnum. Pitch Roll Yaw-Tilt This procedure is useful in correcting imbalances in pelvis vs. skull positions. One follows the other as a tanker aircraft is locked into pattern with a refueling plane. Based on his military aviation background, Goodheart found that there are many imbalances between the motions of the head and of the pelvis.
Goodheart has noted that when this procedure needs to be performed, there will be a lateral deviation of the uvula to one side. This is due to interference with the glossopharyngeal nerve. Imbalances in the vagus nerve can be seen when levator palatini rises higher on one side than the other when the patient is asked to say "AH".
He developed a series of tests that stress This procedure is benecial whenever there are these coordination patterns and corrective potential imbalances in the functioning of the procedures for them. These are common cranial nerves that exit through the occipital ndings in the chronic patient that resists bone. It also appears to reduce stress on the jugular vein and reduces venous intracranial correction. pressure. Stride Length A Japanese researcher, named Isogaii, asked the question "Why do some people get the same pains back over and over?" He studied these people for over 40 years. His conclusion was very simple. They walked wrong. They had one stride longer that the other. This caused a torque to be applied to the spine and the muscle structure. Over years, Goodheart took this simple observation and developed a more complete concept of the dura. Imbalances in the stride effect the attachments of the dura and can cause problems throughout the body. The one signicant nding is that if the patient has a problem, and it is related to gait, you can place them into a gait position, one leg in front of another, and the pain disappears. At times, the gait position will allow hidden muscle weaknesses to be found.
Jugular Decompression
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Cranial Dural Torque Frymann states that "Motion of the skull bones has been objectively measured". Research from Fryman, Michael and Retzlaff has consistently shown that the skull is moving at between 10 and 14 cycles per minute. This is unrelated to the heart rate or to respiration. The cranial dura consists of two layers. The cranial section of the dura is divided into the falx cerebri, the tentorium cerebelli and the falx cerebelli and nally the diaphragm sella. These structures rmly attach inside the cranial bowl. When chronic stress has been applied to the dura from either cranial/dental stress or due to chronic spinal imbalances, these attachments become tender on their external surface. An example of this problem is the person with a headache who feel relief by pressing in against the skull. This dural pressure follows a distinct pattern and requires a specic treatment pro-
tocol to correct it.
TMJ Imbalances Goodheart rst learned of the works of Willie May, a dentist in 1975. From this work, the initial treatments for TMJ balancing using muscle concepts were developed. These concepts were developed and expanded upon in the early 80’s in a chapter written by Goodheart in a text by Harold Gelb a dental expert in TMJ function. From this work, applied kinesiology has expanded in the dental profession, especially in Europe, and in schools like Tuft’s College of Dentistry.
In a book titled Acupuncture, A Comprehensive Text, by John O'Connor and Dan Benske, a discussion of the distribution and pathology of twelve muscle meridians can be found. These meridians follow the basic course of the normal meridians and interconnect with each other. Goodheart has found that imbalances in these meridians can be found if the examination is done in a gait position. He also found that palpation of these meridians will reveal an area that is extremely painful and feels like it is swollen.
Neurological Tooth Beginning and End Technique There is a dental ligament surrounding each tooth. Currently, there are at least four different reex related areas that imbalances in tooth occlusion can precipitate. The organ tooth - muscle - organ relationships were published by Goodheart in 1976. Since then, further advances in these conditions have been researched and documented especially by the dentists using applied kinesiology in Germany, Austria and Italy.
Meridian Related Therapies Then and Now
According to the Chinese, the acupuncture energy ows through a 24 hour cycle in the body. It changes meridians every two hours, and follows a supercial ow of energy.
This refers to a procedure developed by Goodheart in which the rst and last points of meridians, which either start or end on the skull, are used for treatment. Goodheart found that treatment of these points changed many measurable parameters in the body. These included skin temperature, pH, vision, speech patterns, vitamin C absorption times, pituitary-hypothalamic function, etc.. This procedure is possibly indicated anytime there is an imbalance in a meridian that either starts or ends on the skull.
Visceral Related Therapies Visceral Manipulation
Diagnosis of problems occurring at specic times of the day can be enhanced by checking the patient at that time. However, this may prove to be impractical. Goodheart discovered a simple procedure using the alarm points and therapy localization to determine what is imbalanced in the patient. Muscle Meridians
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Portelli, following concepts rst developed by osteopaths and DeJarnette, has described that viscera can be challenged for their position. He wrote that if an organ is out of position and you further displace the organ, the muscle related to the organ will test weak. The related weakness only occurs in the muscle that has been classically related with the or-
gan. There is not a general weakening of the muscles of the body. This is again evidence that the organ-muscle relationship does exist. The treatment consists of repositioning the organ and then testing for the proper muscle support for the organ. For a complete discussion of the topic, read Visceral Manipulations by Barral and Mercier, an Eastland Press publication, P. O. Box 12689, Seattle WA..
Ileocecal Valve Disorders
The treatment of ileocecal valve problems was the rst use of visceral manipulation in applied kinesiology. Goodheart found that the valve could either be in an open or closed state. These imbalances had specic symptom patterns and nutritional as well as structural corrections. Over the years, other organs have been treated using the same basic concepts. Find the involved organ, test of the proper nerve control, test for related reex corrections, test for meridian related problems and nally apply specic nutritional protocols to aid in the normalization of function.
Malabsorption In the mid eighties, Goodheart became aware of some of the research that had been done by Candice Pert. At the same time, he was concerned with apparent malabsorption syndromes that he was nding in his patients. There appears to be an neuroendocrine axis that regulates the absorption of nutrients from the intestinal tract. This system works all day long, but is suppressed during stress times of the day. The other interesting observation was that the weakness pattern could only be produced by closing the eyes. Man is one of the only creatures that close their eyes when they are asleep. Consequently, Goodheart at times would say that this condition represented "patient
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awake - small intestine asleep". In addition to this concept in treating intestinal problems, it has been applied to other body funcitons like the immune system. Respiratory Procedures Specic techniques designed to increase respiration have been developed over the years. From concepts and observations from Israel to Switzerland on the ionizing function of the turbinates in the nose, to methods to help reset the carbon dioxide metering system in the brain to specic protocols to increase vital capacity. Goodheart and others in ICAK have developed effective treatment regimes to improve the breathing capacity of the patient. Lymphatic Disorders Beginning with the lymphatic reflexes of Chapman, Goodheart found methods to analyze whether they were indicated as part of a treatment protocol or not. Other advances in the treatment of lymphatic imbalnces are centered around restrictions in the right and left lymphatic ducts and their clinical importance. Additionally, Goodheart wrote about a nutritional imbalance that would lead to lymphatic uid leaking from the lymph vessels. In each of these cases, specic diagnostic signs and tests are used to make sure that the treatment is appropriate for the patient in question. Robert Fulford Concepts Fulford was an osteopath who developed specic ideas and treatments based on normalization of fascia and as he termed them “diaphragms”. These “diaphragms “ started with the feet and are found in the pelvis and solar plexus to name two others. He also developed a concept of birth trauma and the negative effects that this has on our health later in life.
Goodheart was able to organize these concepts and bring diagnostic criteria to them. The effects of these procedures help to normalize ROM, respiration and other visceral and structural problems found especially in the chronic patient. Anatomy Trains Thomas Myers, an anatomist, dissected fascial connections that he termed “anatomy trains”. These tend to follow from the feet ascending to the skull in specic patterns based on normal muscle function. Again, Myers developed a concept of these trains of fascial stress. Goodheart developed a method of diagnosis that the problem existed and then found a simple system for their correction. Leaf has shown that these patterns of aberrant muscle and fascial stress are usually related to foot subluxation patterns or to TMJ problems, depending on whether the problem is an ascending or descending muscle stress pattern.
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Appendix B Applied Kinesiology Kinesiology Status Statement The International College of Applied Kinesiology–U.S.A. provides a clinical and academic arena for investigating, substantiating, and propagating A.K. ndings and concepts pertipertinent to the relationships between structural, chemical, and mental factors in health and disease and the relationship between structural faults and the disruption of homeostasis exhibited in functional illness. A.K. is an interdisciplinary approach to health care which draws together the core cor e elements of the complementary therapies, creating a more unied approach to the diagnosis and treatment of functional illness. A.K. uses functional assessment measures such as posture and gait analysis, manual muscle testing as functional neurologic evaluation, range of motion, static palpation, and motion analysis. These assessments are used in conjunction with standard methods of diagnosis, such as clinical history, physical examination ndndings, laboratory tests, and instrumentation to develop a clinical impression of the unique physiologic condition of each patient, including an impression of the patient’s functional physiologic status. When appropriate, this clinical impression is used as a guide to the application of conservative physiologic therapeutics. The practice of applied kinesiology requires that it be used in conjunction with other standard diagnostic methods by professionals trained in clinical diagnosis. As such, the use of applied kinesiology or its component assessment procedures is appropriate only to individuals licensed to perform those procedures. The origin of contemporary applied kinesiology is traced to 1964 when George J. Goodheart, Jr., D.C., rst observed that in the absence of congenital or pathologic anomaly, postural distortion is often associated with muscles that fail to meet the demands of muscle tests designed to maximally isolate specic musmus -
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cles. He observed that tender nodules were frequently palpable within the origin and/or insertion of the tested muscle. Digital manipulation of these areas of apparent muscle dysfunction improved both postural balance and the outcome of manual muscle tests. Goodheart and others have since observed that many conservative treatment methods improve neuromuscular function as perceived by manual muscle testing. These treatment methods have become the fundamental applied kinesiology approach to therapy. Included in the AK approach are specic joint mama nipulation or mobilization, various myofascial therapies, cranial techniques, meridian therapy, clinical nutrition, dietary management, and various reex procedures. With expanding investigation there has been continued amplication and modication of the treatment procedures. Although many treatment techniques incorporated into applied kinesiology were pre-existing, many new methods have been developed within the discipline itself. Often the indication of dysfunction is the failure of a muscle to perform properly during the manual muscle test. This may be due to improper facilitation or neuromuscular inhibition. In theory some of the proposed etiologies etiolo gies for the muscle dysfunction are as follows: 1 Myofascial dysfunction (micro avulsion and proprioceptive dysfunction) 2 Peripheral nerve entrapment 3 Spinal segmental facilitation and deafferentation 4 Neurologic disorganization 5 Viscerosomatic relationships (aberrant autonomic reexes) 6 Nutritional inadequacy 7 Toxic chemical inuences 8 Dysfunction in the production and circulation of cerebrospinal uid 9 Adverse mechanical tension in the meningeal membranes
10 Meridian system imbalance 11 Lymphatic and vascular impairment On the basis of response to therapy, it appears that in some of these conditions the primary neuromuscular dysfunction is due to deafferentation, the loss of normal sensory stimulation of neurons due to functional interruption of afferent receptors. It may occur under many circumstances, but is best understood by the concept that with abnormal joint function (subluxation or xation) the aberrant movement causes improper stimulation of the local joint and muscle receptors. This changes the transmission from these receptors through the peripheral nerves to the spinal cord, brainstem, cerebellum, cortex, and then to the effectors from their normally-expected stimulation. Symptoms of deafferentation arise from numerous levels such as motor, sensory, autonomic, and consciousness, or from anywhere throughout the neuroaxis. Applied kinesiology interactive assessment procedures represent a form of functional biomechanical and functional neurologic evaluation. The term “functional biomechanics” refers to the clinical assessment of posture, organized motion such as in gait, and ranges of motion. Muscle testing readily enters into the assessment of postural distortion, gait impairment, and altered range of motion. During a functional neurologic evaluation, muscle tests are used to monitor the physiologic response to a physical, chemical, or mental stimulus. The observed response is correlated with clinical history and physical exam ndings and, as indicated, with laboratory tests and any other appropriate standard diagnostic methods. Applied kinesiology procedures are not intended to be used as a single method of diagnosis. Applied kinesiology examination should enhance standard diagnosis, not replace it. In clinical practice the following stimuli are among those which have been observed to alter the outcome of a manual muscle test: 1 Transient directional force applied to the spine, pelvis, cranium, and
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extremities. 2 Stretching muscle, joint, ligament, and tendon 3 The patient’s digital contact over the skin of a suspect area of dysfunction termed therapy localization 4 Repetitive contraction of muscle or motion of a joint 5 Stimulation of the olfactory receptors by fumes of a chemical substance 6 Gustatory stimulation, usually by nutritional material 7 A phase of diaphragmatic respiration 8 The patient’s mental visualization of an emotional, motor, or sensory stressor activity 9 Response to other sensory stimuli such as touch, nociceptor, hot, cold, visual, auditory, and vestibular afferentation Manual muscle tests evaluate the ability of the nervous system to adapt the muscle to meet the changing pressure of the examiner’s test. This requires that the examiner be trained in the anatomy, physiology, and neurology of muscle function. The action of the muscle being tested, as well as the role of synergistic muscles, must be understood. Manual muscle testing is both a science and an art. To achieve accurate results, muscle tests must be performed according to a precise testing protocol. The following factors must be carefully considered when testing muscles in clinical and research settings 1 Proper positioning so the test muscle is the prime mover 2 Adequate stabilization of regional anatomy 3 Observation of the manner in which the patient or subject assumes and maintains the test position 4 Observation of the manner in which the patient or subject performs the test 5 Consistent timing, pressure, and position
6 Avoidance of pre-conceived impressions regarding the test outcome 7 Non-painful contacts -- non-painful execution of the test 8 Contraindications due to age, debilitative disease, acute pain, and local pathology or inammation
In applied kinesiology a close clinical association has been observed between specic muscle dysfunction and related organ or gland dysfunction. This viscerosomatic relationship is but one of the many sources of muscle weakness. Placed into perspective and properly correlated with other diagnostic input, it gives the physician an indication of the organs or glands to consider as possible sources of health problems. In standard diagnosis, body language such as paleness, fatigue, and lack of color in the capillaries and arterioles of the internal surface of the lower eyelid gives the physician an indication that anemia can be present. A diagnosis of anemia is only justied by laboratory analysis of the patient’s blood. In a similar manner, the muscle-organ/ gland association and other considerations in applied kinesiology give indication for further examination to conrm or rule out an association in the particular case being studied. It is the physician’s total diagnostic work-up that determines the nal diagnosis. An applied kinesiology-based examination and therapy are of great value in the management of common functional health problems when used in conjunction with information obtained from a functional interpretation of the clinical history, physical and laboratory examinations, and from instrumentation. Applied kinesiology helps the physician understand functional symptomatic complexes. In assessing a patient’s status, it is important to understand any pathologic states or processes that may be present prior to instituting a form of therapy for what appears to be a functional health problem. Applied kinesiology-based procedures are administered to achieve the following examina-
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tion and therapeutic goals: 1 Provide an interactive assessment of the functional health status of an individual which is not equipment intensive but does emphasize the importance of correlating ndings with standard diagnostic procedures 2 Restore postural balance, correct gait impairment, improve range of motion 3 Restore normal afferentation to achieve proper neurologic control and/or organization of body function 4 Achieve homeostasis of endocrine, immune, digestive, and other visceral function 5 Intervene earlier in degenerative processes to prevent or delay the onset of frank pathologic processes When properly performed, applied kinesiology can provide valuable insights into physiologic dysfunctions; however, many individuals have developed methods that use muscle testing (and related procedures) in a manner inconsistent with the approach advocated by the International College of Applied Kinesiology–U.S.A. Clearly the utilization of muscle testing and other AK procedures does not necessarily equate with the practice of applied kinesiology as dened by the ICAK–U.S.A. There are both lay persons and professionals who use a form of manual muscle testing without the necessary expertise to perform specic and accurate tests. Some fail to coordinate the muscle testing ndings with other standard diagnostic procedures. These may be sources of error that could lead to misinterpretation of the condition present, and thus to improper treatment or failure to treat the appropriate condition. For these reasons the International College of Applied Kinesiology–U.S.A denes the practice of applied kinesiology as limited to health care professionals licensed to diagnose. Approved by the Executive Board of the International College of Applied Kinesiology–U.S.A., June 16, 1992. Updated May, 2001.
Links to Applied Kinesiology’s Published Research Papers as of June, 2012 Applied Kinesiology: Distinctions in its Denition and Interpretation, 2012. http://www.bodyworkmovementtherapies.com/article/S1360-8592(12)00122-2/abstract. Conservative Chiropractic Management of Urinary Incontinence Using Applied Kinesiology: A Retrospective Case-Series Report, 2012. http://www.journalchiromed.com/article/S1556-3707(12)00002-8/abstract Physical causes of anxiety and sleep disorders: a case report, 2012. http://www.ncbi.nlm.nih.gov/pubmed/22314717 Association of manual muscle tests and mechanical neck pain: Results from a prospective pilot study, 2011. http://www.ncbi.nlm.nih.gov/pubmed/21419360. In the developing model of Evidence-Based Medicine, the clinical studies that should be considered as providing evidence for the efcacy of a therapeutic system are: Single Case Study Case-Control Study Case Referent Study Case-Comparison Study Case Series Case Series-Control Cohort-Control Cohort Inception Cohort Cohort Analytical Survey Cost Benet Analysis Cost Effectiveness Analysis Crossover Trial Before-After Trial Nonrandomized Control Trial Randomized Control Trial Systematic Literature Reviews Meta-analyses Each of these forms of evidence have now been abundantly provided by 45 years of published, peerreviewed AK research
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Chiropractic management of a 30-year-old patient with Parsonage-Turner syndrome. http://www.journalchiromed.com/article/S1556-3707(11)00156-8/abstract
Conservative management of post-surgical urinary incontinence in an adolescent: A case history, 2011. http://www.ncbi.nlm.nih.gov/pubmed/21649458. Inter-Examiner Reliability of Manual Muscle Testing of Lower Limb Muscles without the Ideomotor Effect. http://www.chiroindex.org/?search_page=articles&action=&articleId=21711 Applied kinesiology methods for sciatica and restless leg syndrome, 2010. Iowa Chiropractic Society Review Applied Kinesiology management of long-term head pain following automotive injuries: a case report, 2010. http://www.chiroindex.org/?search_page=articles&action=&articleId=21424. Applied Kinesiology methods for a child with headaches, neck pain, asthma, and reading disabilities: a case study, 2010. http://www.chiroindex.org/?search_page=articles&action=&articleId=21378.
Intraexaminer comparison of applied kinesiology manual muscle testing of varying durations: a pilot study. 2010. http://www.journalchiromed.com/article/S1556-3707(10)00006-4/abstract.
Effect of a single chiropractic adjustment on divergent thinking and creative output: A pilot study, Part 1, 2010. http://www.chiro.org/ChiroZine/ABSTRACTS/Divergent_Thinking_and_Creative_Output.shtml.
Applied Kinesiology management of candidiasis and chronic ear infections: A case history, 2010. http://www.chiroindex.org/?search_page=articles&action=&articleId=21346.
Muscle Imbalance: The Goodheart and Janda Models, 2010. http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=54578. What Are You Doing About Muscle Weakness? Pt. 4: The Extremities, 2009. http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=54288.
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Developmental delay syndromes: psychometric testing before and after chiropractic treatment of 157 children, 2009. http://www.jmptonline.org/article/S0161-4754(09)00198-5/abstract.
What Are You Doing About Muscle Weakness? Pt. 3: Lumbar Spine, 2009. http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=54009.
What Are You Doing About Muscle Weakness? Pt. 2: Cervical Spine, 2009. http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=53894.
What Are You Doing About Muscle Weakness?, 2009. http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=53765.
Developmental Delay Syndromes and Chiropractic: A Case Report, 2009. Available as a chapter in the book: http://chiropracticpediatricresearch.web.ofcelive.com/printedi tions.aspx.
Manual biofeedback: A novel approach to the assessment and treatment of neuromuscular dysfunction, 2009. http://philmaffetone.com/mmt.cfm.
Evaluation of Applied Kinesiology meridian techniques by means of surface electromyography (sEMG): demonstration of the regulatory inuence of antique acupuncture points, 2009. http://www.ncbi.nlm.nih.gov/pubmed/19480696.
A pilot study to determine the effects of a supine sacroiliac orthopedic blocking procedure on cervical spine extensor isometric strength. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2780950/ Common Errors and Clinical Guidelines for Manual Muscle Testing: “The Arm Test” and Other Inaccurate Procedures, 2008. http://chiromt.com/content/16/1/16.
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A Moment of Remembrance for Dr. David S. Walther, 2008. http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=53458.
A review of the literature in applied and specialised kinesiology, 2008. http://www.ncbi.nlm.nih.gov/pubmed/19156969.
A Tribute to George J. Goodheart, Jr. D.C.: The Growth of the Chiropractic Research Culture, 2008. http://www.chiroeco.com/news/chiropractic-news.php?id=4200.
A Multi-Modal Chiropractic Treatment Approach for Asthma: a 10-Patient Retrospective Case Series, 2008. http://www.chiropracticuniverse.com/Asthma-Research--Chiropractic-Treatment-128.html.
Manual therapy in cervical dystonia: case report, 2008. http://www.springerlink.com/content/w5l067t242358716/.
Developmental Delay Syndromes and Chiropractic: A Case Report, 2007. http://www.sorsi.com/developmental-delay-syndromes-and-chiropractic.
Can ankle imbalance be a risk factor for tensor fascia lata muscle weakness?, 2008. http://www.ncbi.nlm.nih.gov/pubmed/18455436.
Applied Kinesiology: An Effective Complementary Treatment for Children with Down Syndrome, 2007. http://www.townsendletter.com/July2007/kinesiology0707.htm.
Foci and areas of disturbance in the trigeminal region. Implications for orthopedics, implantology, and Gnathology, 2007. http://www.springerlink.com/content/kp88t141m81vn634/.
The Effects of Chiropractic Care on Individuals Suffering from Learning Disabilities and Dyslexia: A Review of the Literature, 2007. http://www.jvsr.com/abstracts/index.asp?id=280.
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A musculoskeletal model of low grade connective tissue inammation in patients with thyroid associated ophthalmopathy (TAO): the WOMED concept of lateral tension and its general implications in disease, 2007. http://www.ncbi.nlm.nih.gov/pubmed/17319961.
Neurological inuences of the temporomandibular joint. http://www.bodyworkmovementtherapies.com/article/S1360-8592(06)00117-3/abstract
On the reliability and validity of manual muscle testing: a literature review, 2007. http://chiromt.com/content/15/1/4.
Cranial Therapeutic Care: Is There any Evidence?, 2006 http://chiromt.com/content/14/1/10/comments#237535
Proposed mechanisms and treatment strategies for motion sickness disorder: A case series. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2647056/
The Ileocecal Valve Point and Muscle Testing: A Possible Mechanism of Action. http://minerva.mq.edu.au:8080/vital/access/manager/Repository/mq:1643 Can the Ileocecal Valve Point Predict Low Back Pain Using Manual Muscle Testing? http://minerva.mq.edu.au:8080/vital/access/manager/Repository/mq:1414 Applied Kinesiology in Chiropractic. http://www.chiroindex.org/?search_page=articles&action=&articleId=18790 Chiropractic Testing for Equilibrium and Balance Disorders. http://www.chiroindex.org/?search_page=articles&action=&articleId=19025 Symptomatic Arnold-Chiari malformation and cranial nerve dysfunction: a case study of applied kinesiology cranial evaluation and treatment http://www.ncbi.nlm.nih.gov/pubmed/15883570 Chiropractic care for a patient with spasmodic dysphonia associated with cervical spine trauma. http://www.ncbi.nlm.nih.gov/pubmed/19674642
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Evaluation of Chapman’s neurolymphatic reexes via applied kinesiology: a case report of low back pain and congenital intestinal abnormality. http://www.ncbi.nlm.nih.gov/pubmed?term=Evaluation%20of%20Chapman%E2%80%99s%20neurolymphatic%20reexes%20via%20applied%20kinesiology%3A%20a%20case%20report%20of%20 low%20back%20pain%20and%20congenital%20intestinal%20abnormality The importance of proprioceptive testing to chiropractic. http://www.chiroweb.com/mpacms/dc/article.php?id=46406
Dr. George J. Goodheart Founder of Applied Kinesiology Understanding how to unwind the complex web of chronic fatigue immune dysfunction syndrome. http://www.chiroindex.org/?search_page=articles&action=&articleId=18581 Applied Kinesiology and the Motor Neuron. http://www.chiroweb.com/mpacms/dc/article.php?id=9140 New diagnostic and therapeutic approach to thyroid-associated orbitopathy based on applied kinesiology and homeopathic therapy. http://www.ncbi.nlm.nih.gov/pubmed/15353020 Fix foot problems without orthotics. http://www.kinmed.com/ak18.html Applied Kinesiology: How To Add Cranial Therapy To Your Daily Practice. http://www.chiroweb.com/mpacms/dc/article.php?id=9200 AK Manual Muscle Testing: As Reliable As The Deep Tendon Reex?, http://www.chiroweb.com/mpacms/dc/article.php?id=9243 Migraines – the Applied Kinesiology and Chiropractic perspective. http://www.sciencedirect.com/science/article/pii/S1360859202000657 AK classic case management: enuresis. http://www.kinmed.com/ak16.html. Applied Kinesiology and Down syndrome: a study of 15 cases. http://www.kinmed.com/ak16.html.
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Pediatric case history: cost effective treatment of block naso-lacrimal canal utilizing applied kinesiology tenets. http://www.kinmed.com/. A 39-year-old female cyclist suffering from total exhaustion caused by over-training and false nutrition. http://www.kinmed.com/. The piriformis muscle and the genitor-urinary system: The anatomy of the muscle-organgland correlation. http://www.kinmed.com/. Acupuncture in applied kinesiology: a review. http://www.kinmed.com/ak14.html. Applied Kinesiology and the Myofascia. http://www.kinmed.com/ak13.html. Applied kinesiology for treatment of women with mastalgia. http://www.ncbi.nlm.nih.gov/pubmed/14965552. Plantar fasciitis. http://www.sciencedirect.com/science/article/pii/S1360859200902031. A new breed of healers, Time Magazine Cover with George J. Goodheart, Jr. http://www.time.com/time/magazine/article/0,9171,999708,00.html
Applied Kinesiology’s Fundamentals The Clinical Utility of Force/Displacement Analysis of Muscle Testing in Applied Kinesiology. http://www.ncbi.nlm.nih.gov/pubmed/11264916. The role of the scalenus anticus muscle in dysinsulinism and chronic non-traumatic neck pain. http://www.kinmed.com/ak12.html. An applied kinesiology evaluation of facial neuralgia: a case history of Bell’s Palsy. http://www.kinmed.com/ak10.html.
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A Force/Displacement Analysis of Muscle Testing. http://www.ncbi.nlm.nih.gov/pubmed/11065332. Applied Kinesiology and the Immune System. http://www.kinmed.com/ak8.html. Manual Muscle Testing and Postural Imbalance. http://www.chiroweb.com/mpacms/dc/article.php?id=31991 Applied Kinesiology as Functional Neurology. http://www.manuellemedizin.org/. Expanding the neurological examination using functional neurologic assessment part I: methodological considerations. http://www.ncbi.nlm.nih.gov/pubmed/10681118. Expanding the Neurological Examination Using Functional Neurologic Assessment Part II: Neurologic Basis of Applied Kinesiology. http://www.ncbi.nlm.nih.gov/pubmed/10681119. Muscle Test Comparisons of Congruent and Incongruent Self-Referential Statements. http://www.ncbi.nlm.nih.gov/pubmed/10407911. Applied Kinesiology Helping Children with Learning Disabilities. http://www.kinmed.com/ak4.html. Applied Kinesiology and Homeopathy: A Muscle/Organ/Remedy Correlation. http://www.kinmed.com/ak4.html. Thoughts About Muscle Testing. http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=44344 Evaluating and Treating Functional Hypothyroidism Utilizing Applied Kinesiology. http://www.kinmed.com/ak4.html. Point-Counterpoint: Is O-Ring testing a reliable method? http://www.ncbi.nlm.nih.gov/pubmed/10729974. The Systems, Holograms and Theory of Micro-Acupuncture. http://www.ncbi.nlm.nih.gov/pubmed/10729973.
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Interactions within the Triad of Health in AK Correlation of Applied Kinesiology Muscle Testing Findings with Serum Immunoglobulin Levels for Food Allergies. http://www.ncbi.nlm.nih.gov/pubmed/10069623. The effects of a pelvic blocking procedure upon muscle strength: a pilot study. http://www.sotousa.com/wp/?p=8195. Jugular Compression in the Diagnosis and Treatment of Cranio-sacral Lesions. http://www.kinmed.com/ak2.html. George Goodheart, Jr., D.C., and a history of applied kinesiology. http://www.ncbi.nlm.nih.gov/pubmed/9200049. Interexaminer Agreement for Applied Kinesiology Manual Muscle Testing. http://www.ncbi.nlm.nih.gov/pubmed/9106846. A preliminary inquiry into manual muscle testing response in phobic and control subjects exposed to threatening stimuli. http://www.ncbi.nlm.nih.gov/pubmed/8792320. Ear infection: a retrospective study examining improvement from chiropractic care and analyzing for inuencing factors. http://www.ncbi.nlm.nih.gov/pubmed/8728460. Electromyographic Effects of Fatigue and Task Repetition on the Validity of Estimates of Strong and Weak Muscles in Applied Kinesiology Muscle Testing Procedures. http://www.ncbi.nlm.nih.gov/pubmed/7567418 The demystication of Chinese pulse diagnosis: An overview of the validations, holo grams, and systematics for learning the principles and techniques. http://www.acupuncturejournal.com/TablesOfContents.shtml Educational Kinesiology with learning disabled children: an efcacy study. http://www.ncbi.nlm.nih.gov/pubmed/8177643 A pilot study on the value of applied kinesiology in helping children with learning dif culties. http://icpa4kids.org/Chiropractic-Research/a-pilot-study-of-applied-kinesiology-in-helping-childrenwith-learning-disabilities.html
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Somatic dyspnea and the orthopedics of respiration. http://www.chiroindex.org/?search_page=articles&action=&articleId=8334 Objective Measurement of Proprioceptive Technique Consequences on Muscular Maximal Voluntary Contraction During Manual Muscle Testing. http://www.ncbi.nlm.nih.gov/pubmed/1844106 Failure of the musculo-skeletal system may produce major weight shifts in forward and backward bending. Proc Inter Conf Spinal Manip. Washington, DC;May 1990:399-402. Reliability of Manual Muscle Testing with a Computerized Dynamometer. http://www.ncbi.nlm.nih.gov/pubmed/2407795 Somatosensory Evoked Potential Changes During Muscle Testing. http://www.ncbi.nlm.nih.gov/pubmed/2714940 Cybernetic Model of Psychophysiologic Pathways: II. Consciousness of Effort and Kinesthesia. http://www.ncbi.nlm.nih.gov/pubmed/2664061 Cybernetic Model of Psychophysiologic Pathways: III. Clinical impairment of Consciousness of Effort and Kinesthesia. http://www.ncbi.nlm.nih.gov/pubmed/2769091
Chiropractic Management of Chronic Obstructive Pulmonary Disease. http://www.ncbi.nlm.nih.gov/pubmed/3253396 Intrarater reliability of manual muscle testing and hand-held dynametric muscle testing. http://www.ncbi.nlm.nih.gov/pubmed/3628487 On the balancing of candida albicans and progenitor cryptocides: a triumph of the science of applied kinesiology. http://www.icakusa.com/wp-content/uploads/2011/08/AK-Research-Compendium-Dr-Scott-Cuthbert10-08-11-LATEST.pdf Physical balancing: Acupuncture and Applied Kinesiology. http://www.acupuncturejournal.com/TablesOfContents.shtml
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Diagnosis of thyroid dysfunction: applied kinesiology compared to clinical observations and laboratory tests. http://www.ncbi.nlm.nih.gov/pubmed/6747487 Effects of Manipulation on Gait Muscle Activity: Preliminary Electromyographic Research. ACA J Chiropr Oct 1983;17(10):49-52. New simple early diagnostic methods using Omura’s “Bi-Digital O-Ring Dysfunction Localization Method” and acupuncture organ representation points, and their applications to the “drug & food compatibility test” for individual organs and to auricular diagnosis of internal organs--part I. http://www.ncbi.nlm.nih.gov/pubmed/6124084 Neuromuscular relaxation and CCMDP. Rolng and applied kinesiology. http://www.ncbi.nlm.nih.gov/pubmed/2701435 Applied kinesiology and dentistry. http://www.ncbi.nlm.nih.gov/pubmed/2957996 Applied Kinesiology: Muscle Response In Diagnosis, Therapy And Preventive Medicine. http://www.chiropractic-ecu.org/default.asp Quantication of the Inhibition of Muscular Strength Following the Application of a Chi ropractic Maneuver. http://www.icakusa.com/wp-content/uploads/2011/08/Research-AK-Treatment-Effects.pdf Applied kinesiology and colon health. http://www.ncbi.nlm.nih.gov/pubmed/2994623 Uses of applied kinesiology for dentists. http://www.ncbi.nlm.nih.gov/pubmed/2931070 Applied dental kinesiology: temporomandibular joint dysfunction. http://www.ncbi.nlm.nih.gov/pubmed/6221716 Applied kinesiology--double-blind pilot study. http://www.ncbi.nlm.nih.gov/pubmed/6938675 An Experimental Evaluation of Kinesiology in Allergy and Deciency Disease Diagnosis. http://orthomolecular.org/library/jom/1978/pdf/1978-v07n02-p137.pdf
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Evaluation of Muscle-Organ Association, Part I and II. http://www.icakusa.com/.../AK-Research-Compendium-Dr.-Scott-Cuthbert Applied Kinesiology: An opinion. http://www.drjohndiamond.com/index.php?option=com_content&view=article&id=136:applied-kinesiology-an-opinion&catid=45:main-kinesiology&Itemid=45 Applied kinesiology: its use in veterinary diagnosis. http://www.ncbi.nlm.nih.gov/pubmed/6916541 Kinesiology and Dentistry. http://www.chiroaccess.com/Articles/Technique-Summary-Applied-Kinesiology.aspx?id=0000144 Applied kinesiology – what does the term mean? (Letter to the Editor) J Am Dietetic Assoc, 89(4);Apr 1989:476. Combating a vitamin B deciency Today’s Chiro, 17(2);Mar/Apr 1988: 19-22. Structural imbalance and nutritional absorption . Today’s Chiro, 16(1);Mar/Apr 1987:19-24. Managing lactic acid excess. Am Chiro, Sep 1989: 48-52. Structural imbalance and nutritional absorption. Am Chiro, Oct 1989:40-44. Celebrating Applied Kinesiology’s gold and silver. http://www.chiroeco.com/50/timeline/1980/ The Clorox Test: A Screening Test for Free Radical Pathology, Part I. http://www.chiroeco.com/50/timeline/1980/ Further Explanation of Surrogate Testing and Therapy Localization. http://www.chiroeco.com/50/timeline/1980/ Fundamentals of Essential Fatty Acid Metabolism, Parts I and II. http://www.chiroeco.com/50/timeline/1980/
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Kinesiology Korner: 21st Century Chiropractic. Am Chiro, Dec 1985:55. Applied Kinesiology celebrates 20th anniversary. http://www.chiroeco.com/50/timeline/1980/ A study of the results of Applied Kinesiology in a group of 123 Patients. http://www.icakusa.com/wp-content/uploads/2011/08/AK-Research-Compendium-Dr-Scott-Cuthbert10-08-11-LATEST.pdf Applied kinesiology: the advanced approach to athletic health care. Canadian Runner, May 1983:18-19. Dyslexia and learning disabilities cured. http://www.chiroeco.com/50/timeline/1980/ Applied kinesiology – the tangible measure of health imbalance and correction. Nature & Health, Winter 1982:79-81. Iron, Vitamin B-12, and Folic Acid: A Correlation of Laboratory Findings (Complete Blood Count with Differential) and AK Findings. http://www.chiroeco.com/50/timeline/1980/ German electro-acupuncture, Applied Kinesiology and gastric digestion. http://www.chiroeco.com/50/timeline/1980/ The education dimensions of Applied Kinesiology. http://www.chiroeco.com/50/timeline/1980/ A multi-disciplinary view of Herpes Simplex II. The Journal of Energy Medicine, 1980, 1:12. Applied kinesiology diagnosis and treatment of emotional stress overload. The Journal of Energy Medicine, 1980, 1:40-45. The good hands man. Sports Illustrated, 51(3);July 16 1979:34 Applied Kinesiology, related organs, meridians and ear-ricular therapy. Dig Chiro Econ, 1979;21(4):51-3.
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Vertebral xations which mask other faults. Dig Chiro Econ, 1978;21(1):62-65. Applied Kinesiology used in detecting potentially harmful ingredients in nutritional supplements. Dig Chiro Econ, 1978;20(4):14-15. Kinesiological differentiation of low back syndrome including the pseudo disc and true disc and the ramrod spine. Dig Chiro Econ, 1978;20(4):60-65. Cranial Technique: A Clarication of Certain Principles. Dig Chiro Econ, Nov/Dec 1977;20(3):26-29,74. Correlative orthopedic kinesiology. Dig Chiro Econ,1977;20(1):32-4. One common cause of foot subluxations. Dig Chiro Econ, 1977;19(6):28. Experimental Characterization of The Reactive Muscle Phenomenon. Dig Chiro Econ, Sept/Oct 1976:44-50. Biofeedback and kinesiology. Journal of the American Society of Psychosomatic Disease. 1976; 6: 19-23. The vertebral challenge. Dig Chiro Econ, 1976;18(6):24-28. Applied Kinesiology and athletics. Dig Chiro Econ, 1976;19(2):30-32. Glaucoma and the kinesiological approach. Dig Chiro Econ, 1976;19(3):48-9.
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