noted. If pain/restriction is reported/apparent previous evaluation, or combined point of ease on any given movement, muscles antagonistic following a number of previous evaluations. In to those operating at the time pain is noted will this way one position of ease is 'stacked' on be those housing the tender point(s). Thus, for another, until all movements have been example, pain (wherever it is felt) which assessed for ease. occurs when the neck is being turned to the left will indicate a tender point located in the Were the same fictional patient with the low muscles that turn the head to the right. back problem, as previously discussed, being treated using functional technique, the tense In examples 1 and 2, of a person locked in tissues in the low back would be the ones being forward bending with acute pain and spasm, if palpated. Following a sequence involving Goodheart's approach is applied, pain and flexion/extension, sidebending and rotating in restriction would be experienced as the person each direction, translation right and left, trans- straightened up (moved into extension) from lation anterior and posterior and compression/ their position of enforced flexion. distraction - so involving all available directions of movement of the area - a position This action (straightening up) would usually of maximum ease would be achieved after cause pain in the back but, irrespective of which (if the position were held for 30-90 where the pain is noted, a tender point would seconds) a release of hypertonicity and reduction be sought (and subsequently treated by being in pain should result. taken to a state of ease as in the Strain/ counterstrain described above) in the muscles The precise sequence in which the various antagonistic to those working when pain was directions of movement are evaluated seems to experienced - i.e. it would lie in the flexor be irrelevant, as long as all possibilities are muscles (possibly psoas) in this example. included. Note It is important to emphasize this factor, Theoretically (and often in practice) the that tender points which are intended to be used position of palpated maximum ease (reduced as 'monitors' during the positioning phase are not tone) in the distressed tissues should cor- sought in the muscles antagonistic to those where respond with the position which would have pain is noted, but in the muscles that antagonize been found were pain being used as a guide, as those which are actively moving the patient, or in either Jones's or Goodheart's approach, or area, when pain or restriction is noted. using the more basic 'exaggeration of distortion' or 'replication of position of strain' formulae. 5. Functional technique (Bowles 1981, Hoover 1969) Osteopathic functional technique relies 6. Any painful point as a starting place for SCS on a reduction in palpated tone in stressed (McPartland & Zigler 1993) All areas which (hypertonic/spasm) tissues as the body (or part) palpate as painful are responding to, or are is being positioned, or fine-tuned, in relation to associated with, some degree of imbalance, all available directions of movement, in a given dysfunction, sensitization or reflexive activity, region. One hand palpates the affected tissues which may involve acute or chronic strain. (molded to them, without invasive pressure). Jones identified the probable positions of This is described as the 'listening' hand, since tender points relating to particular strain it assesses changes in tone as the practitioner's positions. It makes just as much sense to work other hand guides the patient, or part, through the other way around, by identifying the strain a sequence of positions which are aimed at pattern associated with any identified pain enhancing 'ease' and reducing 'bind'. point. It is useful to consider that any painful A sequence is carried out involving different point/area located during soft tissue evalu- directions of movement (e.g. flexion/extension, ation can be treated by positional release, rotation right and left, sidebending right and whether the strain that produced the dysfunc- left, etc.) with each movement starting at the tion is known or not and whether the problem point of maximum ease, as revealed by the is acute or chronic.
This approach, of being able to treat any The effect of this would be to produce painful tissue using positional release, is valid (following the contraction) a reduction in tone in whether the pain is being monitored via verbal these tissues. The hypertonic or fibrotic tissues feedback from the patient (using reducing should then be gently stretched, as in any muscle levels of pain in the palpated point as a guide) energy procedure, so that the specifically targeted or a functional approach is adopted, assessing fibers are lengthened. for maximal reduction in tone in the tissues. The recommended time for holding the SCS rules of treatment position of maximum ease is 60-90 seconds. The following 'rules' are based on clinical Experience, and simple logic, suggest experience and should be borne in mind when that the response to positional release of a using positional release methods (SCS, etc.) in chronically fibrosed area will be less dramatic treating pain and dysfunction, especially where than from tissues held in simple spasm or the patient is fatigued, sensitive and/or distressed hypertonicity. Nevertheless, even in chronic (McPartland & Zigler 1993). settings, a degree of 'release' can be anticipated, allowing for easier access to the deeper • Never treat more than five 'tender' points at fibrosis. any one session and treat fewer than this in sensitive individuals. 7. Integrated neuromuscular inhibition technique (INIT) (Chaitow 1994) INIT involves using • Forewarn patients that, just as in any other the position of ease as part of a sequence which form of bodywork which produces altered commences with the location of a tender/ function, a period of physiological adaptation pain/trigger point, followed by application of is inevitable and that there will therefore be a ischemic compression (optional - avoided if 'reaction' on the day(s) following even this pain is too intense or the patient too sensitive) extremely light form of treatment. Soreness and followed by the introduction of positional stiffness are therefore to be anticipated. release. After an appropriate length of time, during which the tissues are held in 'ease', the • If there are multiple tender points - as is patient introduces an isometric contraction inevitable in fibromyalgia - select those most into the affected tissues for 7-10 seconds, after proximal and most medial for primary attention; which these are stretched to attempt to restore that is, those closest to the head and the center normal resting length to the tissues. of the body rather than distal and lateral pain points. Method A trigger point should initially be treated by direct inhibitory ('ischemic') pressure • Of these tender points, select those that are (sustained or intermittent) until a change in most painful for initial attention/treatment. perceived pain is reported. • If self-treatment of painful and restricted areas Pressure is continued as the tissues in which the is advised - and it should be if at all possible - trigger point lies are positioned in such a way as apprise the patient of these rules (i.e. only a few to reduce the pain (entirely or at least by approxi- pain points on any day to be given attention, to mately 70%). When this has been achieved the expect a 'reaction', to select the most painful most (dis)stressed fibers surrounding the trigger points and those closest to the head and the point will have been placed into a position of ease. center of the body). Following a period of 20-30 seconds of this The guidelines which should therefore be position of ease and inhibitory pressure (constant remembered and applied are: or intermittent), the patient should be asked to introduce an isometric contraction into these • locate and palpate the appropriate tender point tissues and to hold this for 7-10 seconds, or area of hypertonicity involving the precise fibers which had been repositioned to obtain the positional release. • use minimal force
• use minimal monitoring pressure • Apparently 'direct' approaches such as the • achieve maximum ease/comfort/relaxation of V-spread (see Exercise 7.6, Ch. 7) might actually involve PRT mechanisms, by virtue of a tissues slackening of internal fascial structures (e.g. • produce no additional pain anywhere else. tentorium cerebelli, falx cerebri) via the sustained light pressure involved. These elements need to be kept in mind as pos- itional release/SCS methods are learned and are MYOFASCIAL RELEASE (MFR) major points of emphasis in programs which teach TECHNIQUES (Barnes 1996, Shea 1993) it (Jones 1981). The general guidelines which Jones gives for relief of the dysfunction with which such John Barnes writes: 'Studies suggest that fascia, an tender points are related involve directing the embryological tissue, reorganizes along the lines movement of these tissues towards ease, which of tension imposed on the body, adding support to commonly involves the following elements. misalignment and contracting to protect tissues from further trauma' (Twomey & Taylor 1982). • For tender points on the anterior surface of the Having evaluated where a restriction area exists, body, flexion, sidebending and rotation should MFR technique calls for a sustained pressure (gentle be towards the palpated point, followed by usually) that engages the elastic component of the fine-tuning to reduce sensitivity by at least 70%. elastico-collagenous complex, stretching this until it ceases releasing. This barrier is held until release • For tender points on the posterior surface of the recommences as a result of what is known as the body, extension, sidebending and rotation should 'viscous flow phenomenon' in which a slowly be away from the palpated point, followed by applied load (pressure) causes the viscous medium fine-tuning to reduce sensitivity by 70%. to flow to a greater extent than would be allowed by rapidly applied pressure. As fascial tissues • The closer the tender point is to the midline, the distort in response to pressure, the process is less sidebending and rotation should be known by the short-hand term 'creep'. Hysteresis required and the further from the midline, the is the process of heat and energy loss by the more sidebending and rotation should be tissues as they deform (Darlands medical directory required, in order to effect ease and comfort in 1985). the tender point (without any additional pain or discomfort being produced anywhere else). Mark Barnes (1997) describes the simplest MFR treatment process as follows. • Sidebending when trying to find a position of ease often needs to be away from the side of the Myofascial release is a hands-on soft tissue palpated pain point, especially in relation to technique that facilitates a stretch into the tender points found on the posterior aspect of restricted fascia. A sustained pressure is applied the body. into the tissue barrier; after 90 to 120 seconds the tissue will undergo histological length changes PRT: the cranial dimension alloiving the first release to be felt. The therapist follows the release into a new tissue barrier and • The treatment of tender points on the cranium holds. After a few releases the tissues will become has been described in Chapter 10. softer and more pliable. • Many cranial methods involve functional tech- Shea (1993) explains this phenomenon. nique concepts (e.g. exaggeration of distortion). The components of connective tissue (fascia) are • All PRT methods can be safely used on soft long thin flexible filaments of collagen surrounded tissues attaching to the cranium, even in acute by ground substance. The ground substance is settings. composed of 30%-40% glycoaminoglycans (GAG) and 60%-70% water. Together GAG and • Upledger's release of 'energy cysts', as described in Chapter 10 (p. 326), incorporates positional release methods.
water form a gel ... which functions as a • In using patient assistance single directions and lubricant as well as to maintain space (critical small, slowly applied degrees of effort are fiber distance) between collagen fibers. Any called for initially until you are sure of what it dehydration of the ground substance will decrease is you want of the patient. the free gliding of the collagen fibers. Applying pressure to any crystalline lattice increases its MFR technique is used to improve movement electrical potential, attracting water molecules, potentials, reduce restrictions, release spasm, ease thus hydrating the area. This is the piezoelectric pain and to restore normal function to previously effect of manual connective tissue therapy. dysfunctional tissues. By applying direct pressure of the appropriate CONCLUSION degree, at the correct angle (angle and force need to be suitable for the particular release required), a The range of soft tissue methods available to treat slow lengthening of restricted tissue occurs. soft tissue dysfunction associated with the cranium is no less varied than for other parts of A number of different approaches are used in the body. This chapter has attempted to provide a achieving this (note that it bears a strong basic introduction to some of the most widely resemblance, in parts, to the methodology of Lief's used methods and their rationale. There are other NMT as described above). soft tissue approaches, as well as numerous other variations deriving from NMT, MET, PRT and • A pressure is applied to restricted myofascia MFR, that have not been described. What is of the using a 'curved' contact and direction of most importance is that skills be acquired that lie pressure in an attempt to glide, or slide, against outside basic cranial manipulation methodology, the restriction barrier. to enable the practitioner to encourage normaliz- ation of the soft tissues that attach to the cranium, • The patient may be asked to assist by means of as part of an integrated and comprehensive breathing tactics or moving the area in a approach to treatment. way which enhances the release, based on practitioner instructions. • As softening occurs the direction of pressure is reassessed and gradually applied to move towards a new restriction barrier. REFERENCES D'Ambrogio K, Roth G 1997 Positional release therapy. Mosby, St Louis, MO Barnes J 1996 Myofascial release in treatment of thoracic outlet syndrome. Journal of Bodywork and Movement DiGiovanna E 1991 Osteopathic diagnosis and treatment. Therapies 1(1): 53-57 Lippincott, Philadelphia, PA Bowles C 1981 Functional technique - a modern perspective. Dorlands medical directory 1985, 26th edn. WB Saunders, Journal of the American Osteopathic Association 80(3): Philadelphia, PA 326-331 Dvorak J, Dvorak V 1984 Manual medicine: diagnostics. Chaitow L 1992 Soft tissue manipulation. Healing Arts Georg Thieme Verlag, New York Press, Vermont Goodheart G 1984 Applied kinesiology. Workshop Chaitow L 1994 Integrated neuromuscular inhibition procedure manual, 21st edn. Privately published, technique. British Journal of Osteopathy 13: 17-20 Detroit, IL Chaitow L 2002 Positional release techniques, 2nd edn. Gray's Anatomy 1995, 38th edn. Churchill Livingstone, Churchill Livingstone, Edinburgh Edinburgh Chaitow L 2003 Modern neuromuscular techniques, 2nd Greenman P 1989 Principles of manual medicine. Williams edn. Churchill Livingstone, Edinburgh and Wilkins, Baltimore, MD Chaitow L, DeLany J 2000 Clinical applications of neuro- Hoover H 1969 Collected papers. Academy of Applied muscular technique. Churchill Livingstone, Edinburgh Osteopathy Year Book, Colorado Springs Clemente C 1987 Anatomy: a regional atlas of the human Janda V 1989 Muscle function testing. Butterworths, London body, 3rd edn. Urban and Schwarzenberg, Baltimore, MD
Jones L 1981 Strain and counterstrain. Academy of Applied Platzer W 1992 Color atlas/text of human anatomy: vol. 1, Osteopathy, Colorado Springs locomotor system, 4th edn. Georg Thieme, Stuttgart Latey P 1996 Feelings, muscles and movement. Journal of Ramirez M, Hamen J, Worth L 1989 Low back pain - Bodywork and Movement Therapies 1(1): 44-52 diagnosis by six newly discovered sacral tender points and treatment with counterstrain technique. Journal of Leonhardt H 1986 Color atlas and textbook of human the American Osteopathic Association 89(7): 905-913 anatomy: vol. 2, internal organs, 3rd edn. Georg Thieme, Stuttgart Rich G 2002 Massage therapy: the evidence for practice. Mosby, Edinburgh Lewit K 1986 Muscular patterns in thoracolumbar lesions. Manual Medicine 2: 105 Shea M 1993 Myofascial release - a manual for the spine and extremities. Shea Educational Group, Juno Beach, FL Liebenson C 1990 Active muscular relaxation techniques, parts 1 and 2. Journal of Manipulative and Physiological Simons D, Travell J, Simons L 1998 Myofascial pain and Therapeutics 12(6): 446-451 and 13(1): 2-6 dysfunction: the trigger point manual, vol. 1, 2nd edn. Williams and Wilkins, Baltimore, MD McPartland JM, Zigler M 1993 Strain-counterstrain course syllabus, 2nd edn. St Lawrence Institute of Higher Travell J 1977 A trigger point for hiccup. Journal of the Learning, East Lansing American Osteopathic Association 77: 308-312 Mitchell F Snr 1967 Motion discordance. Yearbook of the Travell J, Simons D 1992 Myofascial pain and dysfunction, Academy of Applied Osteopathy 15, Carmel, CA vol. 2. Williams and Wilkins, Baltimore, MD Moore M et al 1980 Electromyographic investigation manual Twomey L, Taylor J 1982 Flexion, creep, dysfunction and of muscle stretching techniques. Medicine and Science in hysteresis in the lumbar vertebral column. Spine 7(2): Sports and Exercise 12: 322-329 116-122 NIOSH (National Institute for Occupational Safety and Walther D 1988 Applied kinesiology synopsis. Systems DC, Health) 1997 Preventing allergic reactions to natural Pueblo, CO rubber latex [in USA call 800-365-4674]
This text has deliberately concentrated attention on the adult skull. The skull of the infant, and more so in the neonate by necessity, is immensely malleable, with the pliability of a milk carton. As a mainly cartilaginous structure at birth, the infant skull is ultraresponsive to direct molding pressures. The evolution of the neurocranium, through different growth centers, as well as the main sutural features of the skull and face are shown in Figure A2.1. The cranial bones are unconnected by sutures at birth and some of the cranial bones, known as composite bones (e.g. occiput, sphenoid, temporal) comprise several parts, allowing scope for the rapid growth of the brain (Carreiro 2003). The neo- natal cranium is remarkably soft and unstructured, to allow folding of the cranium as it passes through the birth canal, where it is particularly vulnerable to deformation during the birth process (see Figs A2.2 and A2.3). Cranial distortion can be created by prebirth influences, via trauma (seat-belt compression during an automobile accident, for example) or if the womb is crowded (perhaps by a twin) or if chemical influences distort development (drugs, toxins and/or nutritional deficits). Far more likely to produce damage, however, are the influences of the powerful forces acting upon the supple skull during the birth process. Among the factors which can produce cranial damage during birth are (Biedermann 1992, 2001):
Figure A2.1 The neurocranium increases through various Figure A2.2 Anteroposterior view of the neonatal growth centers: (A) the synchondroses in the skull base; (B) cranium. The periosteum has been removed from the right the sutures in the cranium. The growing brain (C) is a frontal bone but is still in place on the left. The sutures can mechanical entity with a stable skull base. (D) The sutures in be seen to comprise thickened connective tissue. (Reproduced the cranium allow movement of the dura mater (E). (F) The with permission from the Willard ft Carreiro Collection.) brain growth is buffered by the skull base and makes the cranium reform at the sutures. (Redrawn from von Piekartz evolved so that what is, evolutionarily, a huge ft Bryden (2001) with permission from Elsevier.) head can pass through a small birth canal intact. This is achieved by progressive and controlled • too rapid a transit through the birth canal cranial implosion. which precludes the opportunities for 'normal' molding to occur The cranioeervieal link • too extended a period in the birth canal with Biedermann (2001) suggests that the common excessive compression forces operating on the denominator in all of these negative influences is delicate membranes, sometimes for many hours undue mechanical stress impinging on vulnerable (Magoun 1976) cerebral tissues and the craniocervical area. The result may include asymmetrical posture, • anomalous prenatal positioning and/or morphology or movement patterns, as well as crowding (as in twins or triplets) inappropriate responses to external stimuli. • the application of mechanical force to extract Under normal conditions any minor distortions the infant via inappropriate use of forceps or imposed during birth will resolve as a result of the the stress of vacuum suction delivery (Noret influences of the reciprocal tension membranes 1993). within a matter of days, greatly assisted by the forces involved in suckling and crying (Frymann As Milne (1995) explains: A newborn baby has no sutural interlocking or interdigitation between adjacent cranial bones. The bony plates of the cranial vault are free to float like icebergs in an elastic sea of membranous dura. The mechanism of the fontanells, pliant cartilage, tender membrane, open sutures, cerebrospinal fluid and falx and tentorium has
Figure A2.3 Schematic diagram depicting the typical is torticollis, often combined with an asymmetrical cone-shaped, rotational strain seen at the sight of vacuum cranium, postural asymmetry and a range of placement. The depth of extension into deeper tissues dysfunctional symptoms (see Fig. A2.4). KISS is an appears to be dependent upon the duration and intensity of acronym for kinematic imbalances due to application of the device. (Reproduced with permission from suboccipital strain. Biedermann notes: '(KISS Carreiro 2003.) imbalances) can be regarded as one of the main reasons for asymmetry in posture and 1966). In many instances, however, such a consequently asymmetry of the osseous structures recovery is not achieved due to the degree of of the cranium and the spine'. distortion created, with sometimes disastrous consequences in health terms (Arbuckle 1948, Among the many symptoms reported by Frymann 1976). Biedermann in KISS children are torticollis, reduced range of head/neck motion, cervical Distortions and deformities are often easily hypersensitivity, opisthotonos, restlessness, in- noted and may be the reason the parent(s) seek ability to control head movement and one upper assistance. Behavioral problems such as incessant limb underused (based on statistical records of crying, feeding difficulties, 'head banging' or 263 babies treated in one calendar year up to frank illness might cause parents to attempt to June 1995). find appropriate professional help. Clearly if the health-care provider consulted is ignorant of the Biedermann (2001) is convinced that the most influence of cranial function on health, whatever effective treatment for such infants is removal of is offered will be less than satisfactory. suboccipital strain by manual treatment and not direct treatment of cranial asymmetry, as this is After birth the pliability of the infant cranium considered to be a symptom of the underlying continues to allow damage to occur more easily problem (most commonly suboccipital strain). than once ossification has taken place. Falls and Following appropriate treatment to re-establish blows are obvious possibilities, and indeed full range of upper cervical motion, functional probabilities, during the early years of life. If severe improvement is reported to be common within enough, these may produce problems similar to 2-3 weeks, although normalization of cranial those which can occur during childbirth. asymmetry takes many months. Biedermann (2001) describes what he terms How much treatment is required? According to 'KISS' children in whom the main clinical feature Biedermann, of the 263 babies treated, 213 required only one treatment, 41 were treated twice and the remainder more often, with just two requiring 4-5 treatment sessions. Sleeping position and cranial deformity One of the reasons for KISS-like problems seems to relate to infant sleeping position. A research study by plastic and reconstructive surgeons has concluded that the almost universal acceptance of positioning neonates on their backs to avoid SIDS may well increase the incidence of abnormalities of the occipital cranial sutures, causing significant posterior cranial asymmetry, malposition of the ears, distortion of the cranial base, deformation of the forehead and facial structures (Argenta et al 1996). The study reported that there had been a dramatic increase in the incidence of deformation of the occipital structures, although the patient
sudden infant death syndrome (SIDS). They report that older infants were treated with continuous positioning by the parent, keeping the infant off the involved side, while younger infants and those with poor head control were treated with a soft-shell helmet. Only three of 51 patients have required surgical intervention and other patients demonstrated spontaneous improvement of all measured parameters. The researchers report: We believe that most occipital plagiocephaly deformities are deformations rather than true cranio-synostoses. Despite varying amounts of suture abnormality evidenced on computed tomo- graphic scans, most deformities can be corrected without surgery. In cases where progression of the cranial deformity occurs, despite conservative therapy, surgical intervention should be under- taken at approximately I year of age. (Argenta et al 1996) Figure A2.4 Two KISS babies with their cranial asymmetries. Other reasons for serious cranial distortion in Both pictures were taken by the parents and are reproduced infants, according to medical authorities here with their kind permission. They show in both cases a right-convex KISS situation with the accompanying cranial It is reported (Miller & Clarren 2001) that scoliosis, microsomy of the left side of the face, flattening deformational plagiocephaly (cranial distortion or of the right occipital region and a seemingly asymmetrical 'crooked head shape') can result from three positioning of the ears. All these morphological asymmetries different etiologic processes. need many months to subside. The important sign at the control 3 weeks after the initial treatment is the free • Abnormalities in brain shape and subsequent movement of the cervical spine. (Reproduced from von aberrant directions in brain growth Piekartz & Bryden (2001) with permission from Elsevier.) • Premature fusion of a single coronal or referral base has not changed appreciably. Argenta lambdoidal suture et al note that the timing of this increase correlates closely with the acceptance of recommended • Prenatal or postnatal external constraint. changes in sleeping position to supine or side positioning for infants because of the fear of What are the long-term effects of deformational plagiocephaly? A study was conducted to determine whether there was an increased rate of later developmental delay in school-aged children who presented as infants with deformational plagiocephaly, without obvious signs of delay at the time of initial evaluation (Miller & Clarren 2001). A total of 181 families from the medical record review were notified about the study and 63 families agreed to participate in a telephone interview. The sample of participants for the telephone interview was random to, and
representative of, the group as a whole. The than would be needed to 'push a bell-button families reported that 25 of the 63 children (39.7%) energetically'. with persistent deformational plagiocephaly had required special help in primary school including Clinical researchers and authors such as Viola special education assistance, physical therapy, Frymann (1976) and John Upledger (Upledger & occupational therapy and speech therapy, generally Vredevoogd 1983) record many instances of through an Individual Education Plan. Only success in treating dysfunctional children, some seven of 91 siblings (7.7%), serving as controls, with severe learning and behavioral problems as required similar services. One useful finding was well as a host of physical complaints, utilizing that affected males whose deformity was due to cranial techniques (Upledger 1978). Some research uterine constraint were at the highest risk for has been undertaken, notably by these two subsequent school problems. pioneers but also by others such as Californian osteopathic physician Carlisle Holland (1991), It was also noted that the use of helmet therapy whose video evidence of the benefits of cranial to correct the distortion (a standard medical manipulation is well worth study. approach) did not seem to affect the rate of develop- mental delay, almost half of the delayed patients Holland discusses mainstream methods which having worn helmets (Miller & Clarren 2001). attempt to address infant cranial distortion (largely from a cosmetic perspective). Some of the Different cranial approaches methods currently employed by orthopedic surgeons to 'correct' cranial distortions involve This text is not an appropriate place in which to surgical removal of plates of bone from the skull, offer precise details of infant cranial care, as the fusion of sutures and the imposition of methods needed for application on such delicate irreversible damage to the cranial mechanism. An structures need to be learned in closely supervised alternative is to inflict growing infants with the clinical and classroom settings. Suffice it to say wearing, for years, day and night, of a 'helmet' that the method of application of cranial mani- which forcibly molds deviant skulls into pulation in infants is usually direct rather than cosmetically acceptable shapes, with no regard for indirect, i.e. the barriers of resistance are engaged functional integrity (and with an enormous and molding is applied to normalize distortions, degree of discomfort). utilizing very gentle and sensitive holding patterns. Visual evidence is available via videos (such as those produced by physicians such as Carlisle Biedermann (a physiotherapist, whose work on Holland) of the possibility of returning the growing KISS children is reported earlier in this appendix) skull to a degree of normality, structurally, with applies a direct approach in cervical treatment of benefits aplenty in terms of symptom relief, from KISS children, using what is described as 'minimal associated wry neck, visual and acoustic problems, impulse manipulation', commonly in a lateral as well as behavioral and learning difficulties. The direction but with a rotational component in some younger a baby's head is treated the better as, cases. once ossification commences, normalization becomes more difficult. We measured the force used in treatment of babies and adults [and found] the force used for treating Should cranial distortion occur in infancy and babies is 15-20% of that used in adults. In most childhood, when plasticity allows for a degree of cases the direction of the impulse is determined by movement not available in the adult skull, in radiological findings (85%).... The manipulation particular in relation to the sphenobasilar syn- itself consists of a short thrust with minimal force chondrosis (see especially Chs 1 and 2), the of the proximal phalanx of the medial edge of the resulting distortion patterns, with their associated second finger. soft tissue imbalances of the reciprocal tension membranes in particular, will become 'set' and The amount of force involved, tested with a will be largely impervious to 'corrective' treatment calibrated pressure gauge, required no more effort in adult life. Some modification of the associated stress patterns can still be initiated via cranial and
other therapeutic measures, even in adult life, but therapeutic movements, with the application of restoration of structural 'normality' and symmetry additional or sustained pressure'. becomes a virtual impossibility after childhood. In earlier chapters it has been suggested that Moving away from cranial distortion to far treatment of the adult cranium frequently involves more common patterns of ill health affecting indirect methods ('exaggerate distortion'), although infants leads inevitably to the topic of chronic ear direct methods can also be useful (springing infection. methods, decompression, V-spread, etc.). In contrast, when treating infants, direct approaches are most Ear disease and cranial care commonly utilized, reflecting the far more pliable nature of the tissues involved. Spermon-Marijnen & Spermon (2001) have treated many children with chronic middle ear disease, The following list is a summary of the methods using cranial techniques. They report that: '60 described by Spermon-Marijnen & Spermon children [with otitis media with effusion] were (2001) as relevant techniques used for children inspected and treated with passive movements of with chronic ear conditions. Some of these methods, the craniofacial region over the past 6 years; 49 as well as similar but not identical approaches, children were treated successfully and 11 showed have been outlined in previous chapters, most no change'. notably in Chapters 6 and 7. These children had been referred by general 1. Transverse movement of the sphenoid. Sitting physicians because standard treatments such as at the head of the supine patient, one index insertion of grommets, paracentesis, surgery and/ finger and middle finger on the sphenoid and or antibiotic usage had failed. Spermon-Marijnen the other index and middle finger on the & Spermon (2001) suggest that 'passive movement contralateral zygoma and frontal bone, of the cranium can restore the circulation and pressure is used to gently shunt the sphenoid motion by which drainage of the middle ear is into a translation. Hand positions then reverse stimulated'. and translation to the other side is introduced. In this same opposition rotation of the It is worth reflecting that this model of care sphenoid is also achievable. Note: this is represents one of the therapeutic choices, discussed similar to the method described in Exercises in Chapter 12, in which the objective is enhancing 6.5a and b and 7.8. See also method 10 in function so that the adaptation load (inflam- Chapter 10, describing Jones's method for mation, congestion, etc.) can be better handled via treatment of the sphenoid tender point. enhanced drainage and circulation, with homeo- static/self-regulating mechanisms effecting the 2. Longitudinal movements of the nasofrontal recovery. region. Standing to the side of the supine patient, one hand over the crown of the head, As discussed in Chapter 12, these clinicians the index finger contacts and stabilizes the commence the process of treatment by observation, supraorbital region on one side, while the palpation and motion palpation. other hand uses a pincer contact on the superior aspect of the nose to introduce a Look at symmetry or deformity, paying special distraction force. This may be sustained or can attention to asymmetry, the orbital line, the level rhythmically 'pump' the area. One side is treated of ears related to the level of eyes, and the and then the other to 'influence the frontal and mastoids. Palpate the vault and position of the maxillary sinuses'. While not identical, the sutures, noting swelling, overlap and mobility. methods described in Exercises 7.10 and 7.11 Test the condylar parts of the occiput and examine will achieve similar results. the occipito-atlantal mobility. 3. Transverse movement of the zygomatemporal As has been repeated throughout this book, and zygomamaxilla region. The patient is palpation and motion palpation merge readily supine and the practitioner is seated at the into treatment: 'The techniques of passive motion testing are, in our opinion, also effective as
Figure A2.5 Movement of the zygomatemporal region. Figure A2.6 Movement of the zygomamaxilla region. (Reproduced from von Piekartz & Bryden (2001) with (Reproduced from von Piekartz & Bryden (2001) with permission from Elsevier.) permission from Elsevier.) head. One side is treated at a time, (a) Using cradles the occipital region, to act as a finger and thumb contacts of each hand, one stabilizing force. The frontal bone is gently contact closer to the zygomamaxilla junction rotated clockwise then anticlockwise several and the other closer to the zygomatemporal times to influence sinus drainage. See junction, a gentle distraction/separation is also method 9 in Chapter 10, describing introduced as the patient's head is rotated Jones's treatment of the sphenobasilar tender contralaterally. (b) Thumb and index finger of point, which uses similar mechanics (see one hand is placed on the zygoma and the Fig. 10.10). same contacts of the other hand are placed on the maxilla, allowing distraction that eases the 6. Distractions of relevant sutures. A gapping zygoma laterally and cephalad and the maxilla pressure is applied at right angles across medially and caudad. The distraction is applied sutures. See Exercise 7.6 for a description of the and released synchronous with the breathing V-spread technique, as well as method 11 in of the patient several times. Spermon-Marijnen Chapter 10 describing Jones's treatment of the & Spermon suggest that these methods influence squamosal tender point, which distracts the the maxillary and frontal sinuses. See Exercises parietal bone from the temporal, gapping the 6.5c and 7.37 for variations on these approaches. suture between them (see Fig. 10.10). See Figures A2.5 and A2.6. 7. Opening external auditory meatus. The 4. Longitudinal movement of the petrous bone patient is sidelying, head on a firm pillow. The (mastoid lift). The patient is supine and the practitioner places two fingers of one hand on practitioner is seated at the head. With finger the mastoid process and two fingers of the contact on the petrous portion of the mastoid other hand anterior and superior to the external bone, rhythmic repetitive longitudinal traction auditory meatus. A rhythmic separation stretch is applied cephalad, synchronous with breath- is introduced, with the patient being asked to ing. This decompression approach is thought either swallow after each stretch, swallow to influence the craniocervical region. See also during the stretch or perform a Valsalva Exercises 7.32 and 7.34 for rhythmic approaches maneuver during the stretch (i.e. inhale, hold utilizing leverage of the mastoid processes. the nose and attempt to exhale through the nose, creating increased pressure in the naso- 5. Rotation of the forehead on hindhead. The pharynx, in an attempt to open the Eustachian forehead is held with one hand, while the other tubes).
CONCLUSION methods, examples of which have been described in this chapter. Cranial treatment of infants differs from the methodology applied to adults in that it usually involves direct approaches. Pressures used are even lighter for infants than the gentle methods suggested for adults. Whether problems are developmental or distortional or treatment is aimed at improving drainage (as in otitis or sinusitis), there are a range of effective treatment REFERENCES Arbuckle 13 1948 Cranial aspect of emergencies of the Magoun H 1976 Osteopathy in the cranial field. Cranial newborn. Journal of the American Osteopathic Academy, Kirksville, MO Association 47(5): 507-511 Miller R, Clarren S 2001 Long-term developmental Argenta L et al 1996 An increase in infant cranial deformity outcomes in patients with deformational plagiocephaly. with supine sleeping position. Journal of Craniofacial Pediatrics 105(2): 26 Surgery 7(1): 5-11 Milne H 1995 The heart of listening. North Atlantic Books, Biedermann H 1992 Kinematic imbalances due to Berkeley, CA suboccipital strain. Journal of Manual Medicine 31: 92-95 Noret R 1993 Craniosacral therapy. In: Chaitow L (ed) Biedermann H 2001 Primary and secondary cranial Alternative medicine - the definitive guide. Burton asymmetry in KISS children. In: von Piekartz H, Bryden Goldberg Group, Puyallup, Washington L (eds) Craniofacial dysfunction and pain. Butterworth Heinemann, Oxford Spermon-Marijnen H, Spermon J 2001 Manual therapy movements of the craniofascial region as a therapeutic Carreiro J 2003 An osteopathic approach to children. approach to children with long-term ear disease. In: von Churchill Livingstone, Edinburgh Piekartz H, Bryden L (eds) Craniofacial dysfunction and pain. Butterworth Heinemann, Oxford Frymann V 1966 Relation of disturbances of craniosacral mechanism to symptomatology of the newborn. A study Upledger J 1978 The relationship of craniosacral of 1250 infants. Journal of the American Osteopathic examination findings in grade school children with Association 65(6): 1059 developmental problems. Journal of the American Osteopathic Association 77(72): 760-776 Frymann V 1976 The trauma of birth. Osteopathic Annals 4(22): 8-14 Upledger J, Vredevoogd J 1983 Craniosacral therapy. Eastland Press, Seattle Holland C 1991 The biophysics of cranial osteopathy (viscoelastic/viscoplastic axes of motion in the cranium). von Piekartz H, Bryden L 2001 (eds) Craniofacial Video Medicine Labs Inc, Scottsdale, AZ dysfunction and pain. Butterworth Heinemann, Oxford
Abbreviations used: AK, applied chronic signs and symptoms of sphenoid, 193 kinesiology; BOCF, biodynamic model dysfunction, 347 temporals, 225 of osteopathy in the cranial field; CRI, vomer bone, 202 cranial rhythmic impulse; CSF, effects of functional nasal zygomae, 231-2 cerebrospinal fluid; FJO, functional breathing, 347 ARTT, 374 jaw orthopedics orthodontics; MET, Atlanto-occipital membrane (PAOM), muscle energy technique; MFR, obstruction and posture, 359 myofascial release; NMT, Akselrod, S, 36 posterior, 107 neuromuscular technique; PRT, Alkalization, 37-8, 247, 250 Attention faculty, 108, 338 positional release; SOT, sacro-occipital Allergic rhinitis, 81, 84-5 Auditory meatus, opening external, 405 technique; TMJ, temporomandibular Ancell, A, 133 Auditory symptoms, 9 joint Anderson, P, 42 Auric field, 106 Andresson activator, 342 Auricular tender point, posterior, 328, Page numbers in italics refer to Anterior dural girdle (ADG), 106-7,207 figures, tables or illustrations Anxiety, 89 331,331 Applied kinesiology (AK), 20, 68, Auricularis superior, 219 A Autonomic nervous system 123-6, 348-9, 393-4 Abram, D, 95 assessment with SOT and problems, 8 Acupuncture, 124, 318, 348 Acute systemic infectious conditions, 8 Kotheimer's methods, 128-32 B Adams, T, 25, 20-1, 29, 157, 160 definition, 124 Adaptation, 244-5 manual muscle testing (AK MMT), Back neck muscles and, 302-4, 303 exhaustion, 3 7 0 - 1 , 370-1 130-1, 133 superficial muscles of, 257 general adaptation syndrome rebound challenge, 125-6 techniques including Baker, EG, 14, 25,342, 352 (GAS), 244 Balanced membranous tension local adaptation syndrome (LAS), stomatognathic system, 124-5 theory of dysfunction, 225 (BMT), 99 244 Arbuckle, Beryl, 71, 73-4, 82, 362-3, 401 Baldry, P, 246 maladaptation and, 368-70 Arch development, controlled, 342 Baldwin, HS, 103 Adolescent growth, 81-3 Argenta, L, 162, 401-2 Balloon method (nasal specific Advanced Lightwire Functional Arm bones, 2 72 Artaud, A, 94 technique), 205-6 appliance (ALF), 339-40, 341, Articulations Barillon, B, 75 342, 344, 353, 353, 357, 359, 360 ethmoid, 200 Barnes, John, 396 Ahluwalia, S, 38, 251 frontal bone, 215 Barnes, Mark, 396 Airway function mandible, 206-7 Barral, Jean-Pierre, 70 acute signs and symptoms of maxilla, 234 Basmajian, J, 245 mobility at, 14-20 Bassett, C, 43 dysfunction, 347 occipital bone, 183 Bathie, R, 226-20, 122-3 palatines, 238 Baule, G, 42 parietals, 219
Becker, Rollin O, 44, 71, 74, 80,167, 309 palpation and treatment, Canthus tender point, lateral, 328, BOCF and, 95, 96, 98,106 222-4, 225 329-30, 330 CRI and, 25, 27, 27, 31, 36, 40 dentistry and, 351, 359 sphenoid, 192-9, 293, 295-9 Cantu, R, 250 temporal, 225-31, 226, 228-32 Capra, F, 102 Bel, F, 74-5 vomer, 202-6, 202, 203-6 Cardy, I, 95 Berchtold, T, 71 zygomae, 231-4, 232, 233-4 Caries, 348 Bergmann, TF, 112, 126 motion and, 146-7 Carlson, J, 339 Bernardi, L, 37, 37, 375 palpation, 146 Carpi, A, 350 Berry, Wendell, 96 resorption, 346 Carreiro, J, 399 Bertuglia, S, 38 see also Cranium; Skull Carter, J, 338, 359 Bicuspid extraction, 351-4 Bowbeer, G, 339 Carver, Willard (chiropractic college Bowles, Charles, 325, 394 compressive effects, 353 Braces, bridges and dentures, 355-7 head), 115 muscular imbalance, 353 suture Caso, M, 131 Biedermann, H, 196-7, 399-401, 403 constriction and, 355-6 Cathie, A, 251, 344 Biodynamic model of osteopathy in restriction and, 356-7 Cavitat ultrasonograph Bradbury, Parnell, 75 the cranial field (BOCF), 93-110 Brain three-dimensional imaging attention facility, 108 imaging, 29, 129 device, 349 chronology with OCF, 96 magnetic/electrical field of, 42, 43 Cavitations, 348-50, 349 comparison of O C F models, 100 motility of, 3, 97 cranial effects of, 350 evolution motion, 28 development of, 349 role in pumping CSF, 28-9 diagnosing, 348-9 of perceptual skills, 98-9 Breath of Life (BoL), 97-8, 99, 102-3, disease-related results of, 349-50 of thought, 96-8 104, 106 Dorland's dictionary definitions, of treatment processes, 99-101 Breathing pattern disorders (BPD), metaphor and archetype, 94-6 37-8, 244, 369 348 science: quantum consciousness, alkalization and, 246-7, 250 trauma leading to, 350 mouth, 362 treatment of, 350, 351 101-7 nasal, 347-8, 347 Celic, R, 339 Blechschmidt's embryology, rehabilitation and, 321-2, 374 Central nervous system (CNS), 101, see also Respiration 1 0 2 - 3 , 1 0 4 , 105 Breiner, M, 338 103, 105 embryology learning, 106-7, 107 Brodeur, R, 107 Cephalic-related complaints, 78, 83-90 functional midline, 106 Brookes, Denis, 7, 73, 75, 242, 252 Cerebrospinal fluid (CSF), 40-1, 42, 70, genetic contributions, 103-4 cranial bones and, 178, 194, 207, metabolic motion, 105-6 94 Biomagnetic energy, 42, 43-4 216,222, 227,233 BOCF and, 97, 98-9, 99-101 Bionator, 340, 341 occipital bone, 187,192 CRI and, 25-7 Birth, 362-3 CRI and, 25, 27 flow, 3, 106, 200, 256, 338 Bitemporal rolling, 228-9 Brown, J, 45 pressure, 129 Black box approach, 132 Bryden, J, 243-4 resorption, 280 Blechschmidt, Eric, 95, 96, 102-3, Bryden, L, 3, 22, 253-5, 368 Cervical muscles, posterior, 307-20 104-5, 105-6 Buccinator, 193, 207, 235, 243, 292 cervical lamina, 314 Blum, CL, 112, 115, 132 Buccolabial region, 384-5 cranial base release, 313, 323 BOCF see Biodynamic model of Buchbinder, R, 130, 133 Lief's NMT for cranial base, osteopathy in the cranial field Bullock-Saxton, J, 70 (BOCF) Bunt, E, 25 316-21,327 Bohm, D, 102 Burns, R, 349 NMT treatment, 313-16, 324, 325, Bohr effect, 247 Burr, H, 42 Bone groupings and sutural Burr Saxton, H, 353 326, 320 links, 148 Buskilia, D, 310 trigger points, 329 Bones, cranial, 96, 97, 98, 99, 123 Butler, David, 23 Cervical spine, 302, 305 assessment and manipulation, on clinical reasoning, 372-3 dysfunction, 86, 244 mobilization, 304-7, 304 177-239 c palpation, 305-6, 306 ethmoid, 199-201, 199, 200-1 restriction, 304, 321 frontal, 215-18, 216, 217-18 Cailliet, R, 209-20, 244, 309 scoliosis, 362 mandible, 206-15, 206, 209-10, Cant hook release methods, 298-9 strain, 83, 89 Cervicothoracic area, 371 211-15 Chaitow, Boris, 380 maxilla, 2 3 4 - 6 , 235, 236 Chaitow, Leon, 37-8, 244, 336, 358 occipital, 183-92,188-92 chiropractic and, 129, 133 palatines, 236-8, 237 clinical application and, 367, 374, parietals, 219-25, 229 375
key muscles and, 264, 278-9, 321 model for therapeutic intervention, Cranial rhythmic impulse (CRI), 7-8, soft tissue and, 380, 383, 391, 395 371-2 25-7 Chapman, Frank, 124 Chapman's points, 85 essential stages in treatment, 372 cranial bone motion and, 146-7 Char, J, 347 soft tissue dysfunction choices, 376 key elements, 3 Chen, C, 7 treatment methods, 373-6, 374 motion mechanisms and, 35-6 Chew, MK, 94 New York evidence on rates, 26-7, Chia, M, 347 Upledger's cranial assessment, Children, 358-64, 360, 362 375-6 27 KISS, 197,401,407,402,403 Norton's research, 25-6, 27 see also Infants Coccygeal lift, 333-6, 335 palpation, 40-1, 62-4, 63, 374-5 Chinappi Jr, AS, 133 Cognitive and constitutional delay, 81-3 primary forces on structures and, Chiropractic in cranial field, 68, 111-38 Cohen, S, 20, 349 application of techniques, 132-4 Colantuoni, A, 34 27-40 future trends, 134 Comeaux, Zachary, 71-2, 83, 85 intrinsic motion of the brain history of, 112-32 Common compensatory pattern hypothesis, 28 assessment of SOT, AK and (CCP), 370 lymphatic pump as motor force, Kotheimer's methods, Compression, 253, 384 128-32 32-4 CV-4, 8, 99-100,140, 289-92, 253, 375 McPartland & Mein's George Goodheart: applied fronto-occipital and, 153-4 kinesiology (AK), 123-6 ischemic, 274, 321 'Entrainment' theory, lateral pterygoid, 288, 288 39-40 MB Dejarnette of masseter, 278 muscles as motor force, 31-2 blocks or pelvic wedges, 227 MFR and, 287-8 Norton's tissue pressure manipulative reflex sphenobasilar, 83 hypothesis, 34, 36-7 technique (CMRT), TMJ, 86, 212-22, 363 pressurestat model: CSF as 115, 116-17 Computed tomography (CT), 349 driving force, 29, 31 sacro-occipital technique Connective tissue see Fascia role of brain in pumping CSF, (SOT), 115-23, 218-22 Connor, PJ, 103 28-9 Contraction vasomotion/venomotion Nephi Cottam: craniopathy, 112, isokinetic, 390-1 influences, 34 115 isolytic, 390 rates, 268 isotonic concentric, 389-90 Traube-Hering-Mayer (THM) and, technique evaluation, 112-14, isotonic eccentric, 390 36-7, 368 222-24 see also Isometric contraction Craniopathy (Nephi Cottam), 112, 115 Cooperstein, R, 222-23, 126, 134 Craniosacral motion, 5-6 WJ Kotheimer Cordoso, E, 35 Craniosacral theory, 165 distortion analysis, 126-8 'Corkscrew technique', 315-16, 326 Craniosacral therapy, 9-2 0 modified Malcolm Test, 227 Cornell, EA, 98 Cranium Coronal shear method, 297 anterior/frontal view, 26, 54, 143 Kaminski analysis, 113 Coronal suture, 148 fascial continuities and, 262 Christensen, M, 133 Coronal tender points, 328, 329 inferior view, 27, 55, 244 Circumorbital and palpebral region, Corrugator supercilii, 216 lateral view, 53, 242 Costen's syndrome, 345 neonatal, anteroposterior view, 400 383-4 Cottam, Calvin, 1, 112, 115-16 posterior view, 28, 56, 245 Clark, G, 352, 354 Cottam, Nephi, 112, 115,126 structures Clark's Twinblock, 341, 342 Cough test, 131 CRI and, 27-40 Clarren, S, 161-2,197, 402-3 Counterstrain see Strain and mobility and, 3-4 Claverie, J, 104 superior view, 28, 56, 245 Clavicular fibers, 269 counterstrain see also Bones, cranial; Palpation; Clemente, C, 385 Cranial base, 148 Skull Clinical applications, 267-377 Creep, 252, 396 release, 311, 313, 313 CRI see Cranial rhythmic impulse adaptation exhaustion, 370-1, Cranial bones see Bones, cranial (CRI) 370-1 Cranial dysfunction see Dysfunction Cross-fiber stretching, 280 Cranial fossa, anterior, 207 Crossed syndromes, 249-50, 250 adaptation and maladaptation, Cranial fundamentals see Crow, W, 16, 71 368-70 Crowns, dental, 354, 355, 356 Fundamentals, cranial Crozat appliance, 344 Butler's thoughts on reasoning, Cranial movement see Mobility; CSF see Cerebrospinal fluid (CSF) 372-3 Curry, Greg, 74 Motility; Motion; Movement: Cuthbert, S, 125,131 essential biomechanical mechanical and subtle components, 373 Cranial orthopedics see under Orthopedics clinical formula, 368-9 contraindications, 373 fixable problems, 370 model of care, 368, 368
Cutler, A, 348, 351 functional jaw orthopedic nasal, 330, 347-8 CV-4 (fourth ventricular compression), orthodontics (FJO), 338-44 nasopharyngeal airway, 347, 347 occipitomastoid, 331 8, 99-100, 140, 189-91, 253, 375 inappropriate oral surgical occiput, 187 procedures, 351-7 patterns, 321, 372 D multidisciplinary approach, 364 breathing (BPD), 37-8, 244, 362, D'Ambrogio, K, 368 structural/functional aspects of 369 Davidov, A, 45 Da vies, NJ, 133 cranial system, 344-7 alkalization and, 246-7, 250 Day, Ruby, 95 craniofacial approaches and, 20-22 rehabilitation and, 321-2, 374 Decompression, 253 dental education, 338 cranial changes and, 250 Denton, D, 124 ethmoid and, 200 of frontal bone, 217,218 Dentures see Braces, bridges and frontal bone and, 217 fronto-occipital, 154 mandible and, 208 maxillary, 236 dentures maxilla and, 236 occipital condyle, 188-9 Depression, 88 muscles and fascia and, 249-53, TMJ, 121,211-12, 333, 341 Deep tendon reflexes (DTRs), 131 loaded mandibular, 302 250 Defoe, G, 126 Depressor angularis oris, 207, 235 parietals and, 222 Deformation characteristics of Depressor labii inferioris, 207 sphenoid and, 194-5 Diamond, J, 342,347 temporals and, 227 connective tissue, 250 Diaphragma sellae, 6 vomer and, 202 Deformational plagiocephaly, 403 Dickson, BJ, 103 zygomae and, 233 Degenhardt, B, 27, 32-3,35-6 Digastric muscle, 207, 289-90, 290 pelvic and spinal, 83, 244 Dejarnette, Major Bertrand posterior auricular, 331 assessment and treatment of, PRT and, 330, 332-6, 333,335 (chiropractor), 99, 126, 128, 131, 289-90, 290 soft tissue, 246, 253, 321, 322-3, 376 225 sources, 373 blocks or pelvic wedges and, 117 trigger points, 289, 293 sphenobasilar, 332 chiropractic manipulative reflex DiGiovanna, E, 332-3, 388 sphenoid, 332 squamosal, 333 technique (CMRT) and, temporal suture 'spring' tests, sternocleidomastoid muscle (SCM), 116-17 152-3, 228 sacro-occipital technique (SOT) 270 and, 1, 10, 6 8 , 1 1 5 - 2 4 , Direct techniques, 280, 253 theory of, 225 118-21 Disease, dental, 348-51 TMJ (TMD), 85-7, 86 DeLany, Judith W, 358, 375, 383 see also Walker DeLany, Judith; cavitations, 3 4 8 - 5 0 , 3 4 9 , 350,351 dentistry and, 338, 357, 358-9, Walker, J intraoral metals and, 350-1, 352, 360,363 Denys-Struyf, Godelieve, 70, 80 Denslow, JS, 127 352, 354 muscles and, 279, 285-6 Dentistry, 337-66 Disengagement techniques, 280 posture and, 208, 211,242 classifications, 339 Distortion analysis, 126-8, 392 PRT and, 330, 332-6, 333, 335 cranial orthopedics in early life, DNA (deoxyribonucleic acid), 101 visceral, 8 358-64 Dorland's illustrated medical Dyslexia, 81 correcting cranial dysfunction, dictionary, 348-9 E 361 Dorland's medical directory, 396 early observation and cross- Dove, Colin, 35, 74 Ear Drain, James (chiropractic college bones of, 148 referral, 361-4 disease in infants, 404-5 preventative treatment, 358-60 head), 115 problems, 9, 339, 361, 362 cranial therapy Drangler, KE, 128 beneficial influences, 357-8 Drasby, E, 26 Ear-pull method for temporal release, Druelle, Phillippe, 76 230-2 lateral and medial pterygoid Duboule, D, 106 release, 357-8 Dummer, Thomas, 75 'Ease', position of, 325-6, 392, 393 Dura and BOCF, 97, 98, 99 Ebrall, P, 223 occipital release, 357 Dural girdle, anterior, 106-7, 107 Eccentric isotonic stretching, 253 sphenobasilar synchondrosis Duysens, J, 122 Elbert, T, 43 Dvorak, J, 217, 245, 379 Elden, H, 38 (SBS), 358 Dvorak, V, 117, 245, 379 Electrical currents, 351, 352 links with, 337-8 Dynamic neutral, position of, 325 Electro-Acupuncture (EAV), 348 cranial treatment and, 338-57 Dysfunction Electrodermal screening, 348 causes of dental distress and cervical, 86, 244, 307 disease, 348-51 cranial, 8-9, 86, 88, 325-36, 337-8 correcting, 361 lambdoital, 329 lateral canthus, 330 masseter, 330, 333
Electromyography (EMG), 299, 310 Falx cerebelli, 5 Friedenberg, R, 42 Electron microscopy, 251 Falx cerebri, 5 Frohlich, H, 45 Elliott, JM, 133 Frontal bone, 215-18, 226, 227, 228 Embryogenesis, 104 release, 218 Embryology learning from BOCF, Farasyn, A, 34 articulations, 215 Farvis, K, 128 dysfunctional patterns, 217 106-7, 207 Fascia influences, 217 Embryonic function, 95-6 muscular attachments to, 215-16 Emerson, Ralph, 95 continuities, 262 range and direction of motion, Emotional disorders, 8 distress see Muscular and fascial Endothelial relaxing factor (ERF), 347 216-17 Energy, 41-5 distress reciprocal tension membranes and, influences, 280 biomagnetic, 42, 43-4 properties of, 251 215 concepts and Fritz Smith, 140,170-5 restrictions release, 273-4 Frontal lift, 227-28 cyst release, 326-7 stress responses, 250-2 Frontalis, 186, 216 electromagnetic, 350, 368 see also Myofascial release (MFR) Fronto-occipital see also Muscle energy technique Feeley, R, 148, 345, 361, 364 Feinberg, D, 28-9, 35 compression and decompression, (MET) Ferguson, Andrew, 21-2, 24, 158, 241, 153-4 Engel, A, 248 Engeset, A, 33 374 hold, 163-5 Enlow, D, 339, 346, 352, 363-4 CRI and, 31-2, 34, 35-6, 41 Frontozygomatic suture, 148 Entrainment, 27, 44-5, 97, 100-1 Ferre, JC, 123, 128-9 Fryette, Harrison, 73 Ferreri, C, 124 Frymann, Viola M, 8,14,15, 34, 51-2,146 theory, 39-40 Fetzer, J, 348 Epicranium, 383 Fiber-line techniques, 128 dentistry and, 337, 344, 352-8, 361-4 Epstein, A, 372 Fibers infants and, 400-1, 403 Erlinghauser, R, 251 nerve, 20 integration with medicine and, 71, Ernst, 132,134 occipital, 226 Ernst, E, 129 trapezius, 116-17, 262 74-5, 82 Esthetics, 339, 342, 348, 353 trigger points, 268-9 Fulcrum concept, Smith's, 171,173 Ethmoid bone, 31,199-201, 199 types, 248 Fulford, Robert, 95, 96, 101, 106, 229 Fibromyalgia, 310-11, 322, 395 articulations, 200 Fiepel, V, 223,128 integration with medicine and, 71, dysfunctional patterns, 200 Fingers 74, 76, 82-3, 85, 90 influences, 200 intraoral approach, 203, 289 palpation and treatment, 200-1 NMT and, 382 Fuller, Buckminster, 7 range and direction of motion, 200 Fischer, M, 337, 345, 348-50 Functional jaw orthopedic reciprocal tension membranes and, Fistula, 348 Fitzgerald, D, 244 orthodontics (FJO), 338-44 200 Flexion (inhalation phase) analysis from cranial view, 343-4 Ettlinger, H, 141, 158-60, 289 cranial, 149 neck, 270 dental treatment, 344 CR1 and, 27, 41, 147 spinal canal and, 23 analysis from dental view, 338-42, reciprocal tension membranes and, Fluid body and BOCF, 96, 97-8, 98, 339 22, 24 99-101, 102 Class 1 relationships, 338, 340 European NMT see Lief's NMT Foldi, M, 34 Class II Division I relationships, Eustachian tubes, 85, 120, 361 Folweiler, D, 205-6 Evjenth, O, 286-7, 305 Fonder, A, 346-7, 361 3 3 9 - 4 1 , 340 Exhalation phase, 149 Force, application of, 173 Class II Division II relationships, Expression, muscles of, 383 Forces, assisting and activating, 280 Extension (exhalation phase), 149 Forsberg, N, (author), 244 341-2, 342 Eyes, 383-4 Foster, F, 106 Class III relationships, 342-3,343 Foundation joints, 170 dysfunction correction, 359, 360 eyelids, 216, 233 Fourth ventricular compression Functional technique, 253, 394 movement of, 193, 297, 307 Fundamentals, cranial, 13-49 (CV-4), 8, 99-100,140,289-92, CRI, 25-7 F 253, 375 energy considerations, 41-5 Frank, VL, 124 mobility at sutures and Face Frankel Witzig orthopedic corrector, bones, 148 342 articulations, 14-20 head muscles and, 272-90 Freeze-Frame technique, 101 palpating CRI, 40-1 pain, 242 primary forces moving cranial stress reduction, 338 structures and CRI, 27-40 reciprocal tension membranes, 21-5 Fushima, K, 344 G Gaidar, B, 26 Galbreath maneuver, 84, 85, 220
Ganong, W, 29, 36 key muscles and, 304, 310, 321 models for cranial therapeutics, 9-11 Garland, W, 37 reciprocal tension membranes and, prenatal, 361 Gashev, A, 34 reciprocal tension membranes, 4-6, Gasser, R, 95,105 21, 24-5 Gatterman, MI, 113,130 Greitz, D, 28, 97 5-6, 7 Ge, W, 122 Grodin, A, 250 Ho, Mae-Wan, 45 Gehin, A, 148, 355 Growth Hockel, J, 338, 341, 347, 352-3, 363 Gelb, H, 215 Hode, L, 350, 363 adolescent, 81-3 Hodgson, E, 337, 350 dentistry and, 345-7, 349, 352-3, centers, 400 Holism, 99,132, 140 358-9,361, 363-4 improper, 359 Holland, Carlisle, 160, 403 Holland, LZ, 103 FJO, 338,339, 341-2, 341 H Holland, ND, 103 General adaptation syndrome (GAS), Holography, soft tissue, 45 Hack, G, 186, 256, 308 Homeopathy, 102 244 Hair traction, 274-5 Hoover, H, 394 Genetics and BOCF, 103-4 'Hair tug' method, 224 Horn, JJ, 73 Genioglossus muscle attachment, 207 Hall, TE, 73 Howat, JMP, 226, 118-20,122-3,138 Geniohyoid muscle, 207, 293 Hallgren, R, 310 Howell, Dean, 339 Geny, Paul, 75 Hamberg, J, 286-7, 305 Hox clock, 106 George, S, 38 Hamerhoff, S, 45 Hruby, R, 338 Getzoff, HJ, 133-4 Hammer, WI, 126, 357 Hu,J,311 Gevitz, N, 72 Hansen, R, 337, 350 Huggins, H, 348, 350, 354-5, 361 Gibbons, P, 11, 128 Harakal, J, 74, 304-5, 321 Hutson, M, 76 Gillet, Henri, 126 Hargans, A, 72 Huygens, Christian, 39, 100 Gintis, B, 41,141,147,158-60,189 Harrington, M, 112, 116, 122 Hyoid bone, 291 Hartman, SE, 61, 113, 128-9 Hypoglossal nerve (12th cranial), 187 reciprocal tension membranes and, Hass, M, 130 Hypoglossus muscle attachment, 207 22, 24 Hastreite, D, 38, 251 Hypothenar eminence application, 217 Hayes, K, 36 Giodarno, J, 100 Hayoz, D, 34 I Glass, M, 103 Head Gleberzon, BJ, 113, 130, 133 Indian head massage, 112 Gliding technique on medial face muscles and, 272-90, 273 Indirect techniques, 180, 253 neck and lymph node sites, 33 Infants, 399^06, 400 pterygoid, 283 posture, 243-4 Global suture palpation, 53-7 rotation of forehead on hindhead, birth, 362-3 craniocervical link, 400-1, 401 seated, 58 405 deformational plagiocephaly, 402-3 Gloneck, T, 82 Headaches, 83-4, 86, 247, 339, 344 different cranial approaches, 403-4 Gluteal fibers, 117 Heart, magnetocardiogram and ear disease and cranial care, 404-5 Goldstein, J, 38 reasons for cranial distortion, 402 Goodheart, George, 10, 68, 115, 278, electrocardiogram of, 42 sleeping position, 401-2, 402 Heese, N, 115-16 Infrahyoid group, 301 282, 348 Heimdahl, A, 348, 350 Infraorbital tender points, 328-9, 329 applied kinesiology (AK) and, Heisy, S, 25, 21,29, 157, 160 Ingber, D, 7 Hensen's node, 95 Inhalation phase, 149 123-6 Herniou, JC, 123, 128-9 Inherent motion, 180 coccygeal lift and, 333-6, 335 Herzberg, MC, 348-50 Inion, 187 Hesse, N, 99 Integrated neuromuscular inhibition rationale and method, 334-5 Hestoek, L, 223, 130 Goodheart's approach, 393-4 Hicks, L, 126 (INIT),253, 318, 395 Goodridge, J, 60 Highwater, ], 95 methodology, 265-6 Gorbis, Sherman, 158 Hildreth, Arthur, 71 see also Muscle energy technique Gothic shoulders, 258 Hilton's law, 220 Grassi, C, 32 Historical perspectives, 1-12 (MET) Gravity effect, assessing, 57 Integration with medicine, 67-91 Cray's anatomy, 141,156,178, 383, 385-6 chiropractic in cranial field, 112-32 Green, C, 19,159 cranial dysfunction, 8-9 case examples, 78-90 Green, E, 99 cranial structures and mobility, 3-4 cephalic-related complaints, Greenman, Philip, 15, 101, 189-90, 251, CRI, 7-8 83-90 integration with medicine and, explanation and disclaimer, 78-9 388 approach to palpation, 53, 305-6, 67-9 306, 307 cranial movement and, 156-7, 159-60, 167-9 CRI and, 27, 27, 40 historical perspective and, 2, 4, 6
non-cephalic medical Jaslow, C, 159 Klinkoski, B, 130 presentations, 79-81, 81-3 Jaw Kmita, M, 106 Konia, C, 106 current focus, 69 bones, 355 Korr, IM, 32, 129, 132, 134, 245, 325 defining osteopathy, 69-71 opening and MET method, 212-14 Kostopoulos, D, 15, 38, 129, 141, 154, formats for, 71-7 surgery, 349, 354, 354 see also Functional jaw orthopedic 218 American osteopathic, 71-2 Kotheimer, WJ, 123, 115, 134 current cosmopolitan culture, orthodontics (FJO); Mandible; Maxilla assessment with AK and SOT, 72, 76-7 Jealous, James S, 74, 90 128-32 expanded physician interest, BOCF and, 9 4 - 5 , 96, 9 7 - 9 , 101-2, 106-8 distortion analysis and, 126-8 72, 76 CRI and, 25, 27, 27, 40 modified Malcolm Test and, 227 physician / non-physician Jecmen, J, 341, 342, 344-5, 352-3, testing procedures, 131 358-9, 361 Kovich, M, 35 mix, 76-7 Jerolimov, V, 339 Kravchenko, T, 26 European osteopathy and Jesuthasan, S, 103 Kuchera, M, 32-3, 35-6, 41 Johnson, SM, 134 Kurtz, ME, 134 cranial concepts, 73-6 Joints Kusunose, R, 285 historical perspective, 67-9 dysfunction, 321 osteopathic treatment, 77-8 foundation, 170 L Intracranial circulation and distortion, see also Articulations; Temporomandibular joint Lacrimal bone, 220 162-5 (TMJ) Lambdoidal dysfunction tender point, Intracranial and intraspinal Jones, Lawrence, 391-4 strain and counterstrain (SCS), 99, 329, 329 membranes, 97 325-6, 336, 396 Lambdoidal suture, 148 Intrafascial smooth muscle cells and tender points, 285, 327-32, 393 Lateral canthus tender point, 328, Jugular foramen, 187 (SMC), 251 329-30, 330 Intranasal manipulation, 204-6 K Latey, P, 158,177, 208, 245, 383 Intraoral treatment, 238 Laubichler, MD, 94 K-wire, 344 Laughlin, George, 71 contact, 297 Kaminski, M, 128-9, 134 Laughlin, John, 355, 358 finger approach, 203, 289 Lavitan, S, 122 of masseter, 278 analysis of chiropractic in cranial Lawson, A, 130 metals and, 3 5 0 - 1 , 351, 352, 354 field and, 112, 223 Lawson, W, 370 NMT Learning disabilities, 81 experimentation, testing process Leboeuf, C, 130, 133 of lateral pterygoid, 288, 289 and,131-2 Leboeuf-Yde, C, 123, 130 of medial pterygoid, 283, 284 Lee, W, 244 of temporalis, 282 Kappler, R, 35-6 Leeds, S, 31, 200 palpation, 283, 286 Kami, Z, 15, 21, 25, 327 Leg bones, 172 of temporalis tendon, 281 Katsev, R, 344, 352 Leisman, G, 130 thumb approach, 204 Katsev's K-Flex, 342 Leistevuo, J, 351 Ischemic compression, 274, 321 Keen, K, 132 Leonhardt, H, 386 Ischemic pressure, 395 Kelly, MB, 134 Levator labii superioris, 233, 235 Isokinetic contraction, 390-1 Kelso, J, 81 Levator palpebrae, 193 Isolytic contraction, 390 Kendall, 124 Levator scapulae, 320, 320 Isometric contraction, 304, 307, 318 Keramides, G, 25, 38, 129, 141, 154, 228 postisometric relaxation (PIR) and, Kida, S, 31, 200 shortness, 259-60, 260 Kimberley, Paul, 99, 132 trigger point site, 329 253, 389 Kimmel, D, 310 Levine, P, 90 reciprocal inhibition (RI) and, 388 Kinematic imbalances due to Levitsky, L, 38, 247 technique for cervical restriction, Levy, T, 348, 350, 354-5 suboccipital strain (KISS) Lewandoski, M, 14, 26,18, 219 304 children, 197, 401, 402, 402, 403 Lewer Allen, K, 25 Isotonic concentric contraction, 389-90 Kinesiology see Applied kinesiology Lewis, Douglas, 205 Isotonic eccentric contraction, 390 (AK) Lewit, K, 177, 224, 245, 245, 248, 388 Kinetic sutural palpation, 58 key muscles and, 262, 273, 311 J King, HH, 71,128 Li, Y, 38, 251 Kinmonth, J, 32 Libin, B, 14, 25 Jackson, DS, 38, 250 Jackson, Helen Emily, 22, 73-4,158,160 Jacobs, GE, 130 Jacobson, E, 325 Jahn, RG, 101 Janda, Vladimir, 70, 242-3, 245, 270, 388
Liebenson, C, 388 Maier, S, 28 Metastasis, 349 Lief, Stanley, 264-5, 313, 380, 387-8, Maigne, Robert, 70 Metastasize, 350 Malcolm Test, 126-8, 227, 131 Metopic suture, 148 397 Malocclusion, 244, 340 Mew, J, 352-3, 359, 361, 363 NMT for cranial base, 316-20, 317, Mandible, 206-15, 206, 209-20, 220 Mew orthotropics, 342 MFR see Myofascial release (MFR) 319, 321 advancement of, 342 Middleton, Clem, 73 Ligamentous articular release, 71 articulations, 206-7 Migraine trigeminal nucleus, 85-7 Ligamentum nuchae research, 311 cradling, 214-15 Miller, Herb, 74 Ligeros, KA, 112 dysfunctional patterns, 208 Miller, R, 161-2, 197, 402-3 Lin, J-P, 248 muscular attachments, 206, 207 Milne, Hugh, 9, 90, 288, 400 Littlejohn, JM, 68-71, 73 palpation and treatment, 222-25 Llinas, R, 39 posture and TMJ problems, 208, 211 BOCF and, 97, 99 Local adaptation syndrome (LAS), 244 range and direction of motion, cranial bones and, 194, 208, 222, 233 Long Tide, 98, 99,100, 106 cranial movement and, 141, 159 Longissimus capitis, 185, 225, 227 207-8 Mimetic muscles Longitudinal stretch, 280-1 see also Jaw; Maxilla of the buccolabial region, 384-5 Longus capitis, 186, 298 Manual approaches, 253 of the circumorbital and palpebral Marino, A, 351 MET stretch of, 298 Mark, A, 28-9,35 region, 383-4 Lum, L, 37-8, 246, 374 Maschhoff, KL, 103 of the epicranium, 383 Lumbosacral area, 371 Massage, 379-80 of the nasal region, 384 Lumsden, C, 35 friction and cross-fiber friction, 253 palatine and tongue, 383-7 Lundberg, J, 346-7 Masse, M, 126 Mitchell, B, 256, 311 Lymph node sites and channels of Masseter, 207, 232, 235, 275-9 Mitchell Jr, F, 14, 15, 25, 27, 35, 96 massage/myofascial stretch and, Mitchell Snr, F, 388 head and neck, 33 Mobility Lymphatic drainage, 124 276-8 at sutures and articulations, 14-20, Lymphatic pump as motor force in MET treatment, 275-6, 276 positional release of, 278-9, 279 338 CRI, 32-4 tender point, 328, 330, 330, 333 CRI in adults and animals and, Lynch, O, 205-6 Mastoid lift, 405 Lynch, TM, 103 Mattila, K, 348, 350 15-16 Maxilla, 220, 234-6, 235, 236 research evidence, 14, 18-20 M articulations, 234 tissues found in sutures, 20-1 dysfunctional patterns, 236 of cranium bones, 3-4, 97 McCatty, R, 358 influences, 235 of sacrum, involuntary, 97 McDaniel, J, 130 muscular attachments, 234-5 see also Motility; Motion; Movement: McFee, R, 41 palpation and treatment, 236 MacGillivray Smith, E., 112, 115 range and direction of motion, 235 mechanical and subtle MacLean, R, 20 rotation of, 2 55 Macnab, 1, 325 see also Jaw; Mandible Mod els McNaughton, F, 310 Maxillae-nasal junction, 148 McPartland, John, 21, 60,186, 375, Maxillary/midsagittal suture, 355 cranial therapeutics, 9-11 Medical integration sec Integration energy concept, 170 394-5 OCF and BOCF, 200 BOCF and, 97, 99-101, 103, 106-7 with medicine pressurestat, 40-1,97 CRI and, 25, 28, 33-4, 35-6, 36 Mein, E, 375 Mogyoros, I., 247 dentistry and, 238, 310 Molding, 280 'Entrainment' theory, 39^10, 97, BOCF and, 97, 99-100 Mollanji, R, 31,38, 200 CRI and, 28, 33-4, 35-6, 36, 39-40 Monro-Kellie doctrine, 29 100-1 Melzack, R, 177, 245 Moore, M, 391 historical perspective and, 2, 8, 9-10 Memory Moran, P, 11, 128 Magnetic field of brain, 42, 43 loss, 351, 352 Morgan, D, 337, 339, 341, 345, 354, 361 Magoun, Harold, 7, 29, 35, 400 tissue, 45 Morphic resonance, 96, 102 BOCF and, 95, 97-100,106 Meniere's syndrome, 345 Moskalenko, Y, 16, 18, 35, 72,168 chiropractic and, 115-16, 124-5 Mentalis muscle attachment, 207 Motility cranial movement and, 141, 147, Mercury, 350, 351 of the brain, 3, 97 MET see Muscle energy technique of intracranial and intraspinal 149-51 dentistry and, 338, 341-2, 342, (MET) membranes, 3, 97 Metabolic motion and BOCF, 105-6 of the spinal cord, 97 344-5, 355-6, 358 Metals, intraoral, 350-1, 352, 352, 354 Motion integration with medicine and, 75, Metastases, 350 of the brain hypothesis, 28 cranial, 223, 146-7, 355 82, 90 Mahoney, D, 352-3, 361, 363 vault palpation for, 61-2, 62
craniosacral, 5-6 lateral pterygoid and, 286-7, 287 to parietals, 219 inherent, 280 lavator scapulae and, 320 to skull, 285, 222, 322 mechanisms and CRI, 35-6 longus capitis muscle and, 298 to sphenoid, 193 range of (ROM), 61 restricted jaw opening and, 222-24 to temporals, 225, 227 scalenes and, 294, 294-8, 295, 296, to zygomae, 232-3, 232 ethmoid, 200 Muscular and fascial distress, 241-54 frontal bone, 216—17 297 disturbance factors, 243-9, 243, 245, mandible, 207-8 sternocleidomastoid muscle (SCM) maxilla, 235 249 occipital bone, 186-7 and, 270-1,270, 271 dysfunctional breathing, 246-7 palatines, 238 TMJ restriction and, 277 postural considerations, 244-6, parietals, 219, 222 upper trapezius (UT) and, 260, sphenoid, 194 245, 246 temporals, 227, 228 262-3,262 sutural distress, 247-9, 249 vomer, 202 Muscle testing (AK MMT), 124, 130-1 dysfunction patterns, 249-53 zygomae, 233 Muscles, key cranially associated, fascial stress responses, 250-2 sacral, 3,165,166-8,180 primary target, 252-3 Motor force 255-324 upper crossed syndrome, lymphatic pump as, 32-4 digastric, 289-90, 290 muscles as, 31-2 geniohyoid, 293 249-50, 250 Motyka, TM, 131 levator scapula, 320 techniques for soft tissue Movement: mechanical and subtle longus capitis, 298 cranial bone motion, 146-7 masseter, 275-9 dysfunction, 253 cranial palpation and observation, mylohyoid, 293 Muscular imbalance, 353 obliquus capitis (OC) inferior and Myers, T, 80, 204-5, 252, 262 147,148-56,152 Mylohyoid, 207, 293 New York research, 156 superior, 311 Myofascial chains, 262 Fritz Smith's energy concepts, occipitofrontalis, 272-5 Myofascial release (MFR), 266-7, 271, omohyoid, 294-8 170-5,271, 172,173 platysma, 299-307 276, 287-8, 384 learning tools, 140-1, 146 posterior cervical muscles, 313-20, techniques, 253, 321, 396-7 Myofascial trigger points, 251, 265, 266 palpation pressure, 141, 146 313-17,319-20 reciprocal tension membranes and protocols and choices, 320-3 N venous sinuses, 168, 168-9 breathing pattern disorders, Nakao, K, 38 sacral involvement, 165, 166-8 321-2 Nakata, A, 32 Smith's sailing boat, 140 Nambudripad, D, 124 sphenobasilar synchondrosis, soft tissue dysfunction and Nasal region, 384 cranial treatment, 322-3 156-65,156,157,162 dysfunction tender point, 328, 330, palpation of resilience/ soft tissue and joint 330 dysfunction, 321 movement at, 163-5 effects of functional nasal Muesham, D, 44 pterygoid breathing, 347 Muir, John, 108 lateral (external), 285-9 Murray, M, 38, 251 medial (internal), 282-5, 283 maxillae-nasal junction, 148 Muscle chain pattern, 80 nasopharyngeal airway Muscle energy technique (MET), 253, rectus capitis anterior, 298-9 rectus capitis posterior major, 308 dysfunction, 346-7, 347 321, 375, 379, 388-91 rectus capitis posterior minor specific technique, 205-6 anterior neck muscles and, 300-2, Nasofrontal region, longitudinal (RCPM), 308-11 301, 302 splenius capitis, 308 movements of, 404 assessments and use of, 391 sternocleidomastoid, 267-72, 268, National Institute for Occupational Safety cervical restriction and, 304, 307 enhanced stretches, 313-20, 313-17, 269 and Health (NIOSH), 385 sternohyoid, 293 Neck 319-20 stylohyoid, 291-3 isokinetic contraction, 390-1 temporalis, 279-82 anterior muscles, 291-307, 292, 295 isometric contraction thyrohyoid, 293-4 manual release of, 294 upper trapezius (UT), 256-67, 258, MET stretch, 300-2, 302, 320 postisometric relaxation (PIR) MET treatment of short and,389 259, 260 scalenes, 294-8, 296, 297 Muscular attachments reciprocal inhibition (RI) and, back muscles and, 302-4, 303 388 occipitalis, 274,314 extension, 297 to frontal bone, 215-16 flexion test, 270 isotonic concentric contraction, to hyoid, 291,300 head muscles and, 33, 273 389-90 to mandible, 206, 207 Nelson, KE, 22, 36, 72, 82, 97 to maxilla, 234-5, 235 isotonic eccentric contraction, 390 to occipital bone, 183, 185, 186 to palatines, 238
Nerves 0 general versus specific, 70-1 cranial, 187, 194, 200 growth of ideas, 70 fibers, 20 Obliquus capitis (OC) European, 73-6 muscles innervated by, 185, 221, 312 inferior muscle, 311 integrated treatment, 77-8 superior muscle, 186, 311 current practice, 77 Neuberger, A, 250 indications and Neural crest cells (NCCs), 102-3 Observation, cranial, 149-51, 3 6 1 - 4 Neuromuscular technique (NMT), 253, birth, 362-3 contraindications, 77-8 childhood, 363^1 manipulative (OMT) 277-8, 379-88 prenatal history, 361 application of, 382, 387-8 techniques, 134 corkscrew technique, 315-16, 326 Occipital bone, 183-92, 296 prescription: technique selection finger technique, 382 articulations, 183 gliding technique, on masseter, dysfunctional patterns, 187 and dosing, 78 influences, 187 see also Biodynamic model of 277, 278 muscular attachments to, 183, 285, lateral pterygoid and, 288, 288, 289 186 osteopathy in the cranial medial pterygoid and, 283-5, 283, palpation and treatment, 188-92 field (BOCF) range and direction of motion, 186-7 Oszewski, W, 33 284 reciprocal tension membranes and, Otitis media, 85 posterior cervical area and, 313-16, 183 Overbite, intraoral view of, 340 release, 357 Owen, C, 124 314,315,316,320 sternocleidomastoid muscle (SCM) Occipital fiber-line techniques, 128 P Occipital fibers, 226 and, 271 Occipital mastoid suture, 59, 148, 152 Page, D, 337-8, 346-7, 352-3, 363 temporalis tendon and, 282 Occipital and sacral motion, 167-8 Page, M, 358-9 thumb technique, 380-2, 388 Occipitalis, 183 Pain, 246, 305,322,313 upper trapezius (UT) and, 263-6, trigger points, 273, 274, 314 chronic, 8 263, 264, 265, 266, 267 Occipitoatlantal area (OA), 87, 107, cranial and PRT, 325-36 Neurovascular reflexes, 124 facial, 242 Neutra, R, 351 370-1 painful points, 392-3 Neutral, the, 99 Occipitofrontalis, 183, 186, 215-16, painless treatment, 317-18 Neville, B, 348-50, 354 preventative treatment and, 358-60 New York evidence on CRI rates, 26-7 219, 272-5 referred, 273, 308 Newman, H, 348-50 NMT treatment, 273-5, 274 threshold levels, 310 Newman, SA, 103 Occipitomastoid tender point, 328, TMJ, 345 Newton, E, 38 Paired bones, 148 Newtonian physics, 101-2 331, 331 Palatines, 236-8, 237 Niculescu III, AB, 129 Occipitosphenoidal translation, 154-5 articulations, 238 Nimmo trigger point therapy, 128 Occiput distortions, 161-2 influences, 238 NIOSH (National Institute for Okeson, J, 208 mimetic and tongue muscles, 383-7 Oleski, SL, 16, 19,128 muscular attachments, 238 Occupational Safety and Health), Olfactory nerve (1st cranial), 194, 200 range and direction of motion, 238 385 Omohyoid muscle, 294-8 Palmer, BJ, 115 Nitric oxide (NO) production, 347 Onghena, P, 20 Palpation N M T see Neuromuscular technique Opperman, L, 20 accuracy, 60-1 (NMT) Oral surgical procedures, cervical, 305-6, 306, 307 Non-cephalic medical presentations, cranium, 53, 82, 146, \\47, 148-56 77-8 inappropriate, 351-7 CRI, 40-1, 62-4, 63, 374-5 cranial treatment and, 81-3 bicuspid extraction, 351—1 essential touch, 170-1 manipulation and, 79-81 braces, bridges and dentures, 355-7 ethmoid, 200-2 Nord, CE, 348, 350 dental surgery, 354-5 fronto-occipital hold, 264 Nordstrom, D, 3 3 9 ^ 4 , 342, 353, 353, Orbicularis oculi, 216, 233 intraoral, 283, 286 357, 359, 360 Orbicularis oris, 207, 235 mandible, 222-25 Noret, R, 400 Orthopedics in early life, 358-64 masseter, 276 Northfield, D, 310 see also Functional jaw orthopedic maxilla, 236 Northrup, C, 362 motion and, 133 Norton, James, 20, 25, 61, 98, 223, orthodontics (FJO) occiput, 288-92 128-9, 267-8 Oschman, James, 41-5, 101, 170, 368 parietals, 222-5 CRI and, 22-7, 27, 32, 35-6, 39-10 Ossification of sphenobasilar patterns, 173 tissue pressure hypothesis and, 34, synchondrosis, 156-65 36-7 Osteopathy, cranial, 9, 67-8 Novak, V, 36 Nutrition, 124 defining, 69-71 dialectic drugless science, 69-70
pressure, 141,146 back and neck muscles, 302-4, 303 Pressure bars, 264, 265 of sacral motion, 266-7 balancing methods and the hyoid, Pressurestat model, 40-1, 97 skills, 52-65 sphenobasilar synchondrosis (SBS) 300 CSF as driving force in CRI, 29, 31 MET stretch, 300-2, 301, 302 Preventative treatment, 358-60 and, 263-5 mobilization of cervical spine, sphenoid, 295-9 improper growth and, 359 static, 133 304-7, 304 posture and airway obstruction, 359 sutural, 188 self-treatment for shortness, 300 TMJ dysfunction (TMD), 358-9, 360 for synchrony between occipital Platzer, W, 383, 385 Pribram, K, 45 Podlas, H, 27, 28, 40 Price, P,341, 349 and sacral motion, 2 67-8 Poly-vagal concept, 22 Primary forces moving cranial tender points, 329, 330, 332, 332, Polymyalgia rheumatica (PR), 280 Polyrhythmic cycles in OCF and structures and CRI, 27-40 333 Primary perceptions, 108 trigger points in lateral (external) BOCF, 98 Primary respiration, 101, 102 Porges, S, 22 Primary respiratory mechanism pterygoid muscle, 286 Positional release, 318, 379 vault, 40, 61-2, 6 2 , 1 6 3 , 1 6 4 (PRM), 97, 106, 129 zygomae, 233-4 cranial pain and dysfunction, 325-36 Procerus, 216 Palpebral region, 383-4 Jones's cranial methods, 327-32 Proprioceptive manipulation, 282 Parietal lift, 222-4 tender points, 327, 329, 330, PRT sec under Positional release Parietals, 219-25, 219 331,332 Pryor, J, 38, 247 articulations, 219 TMJ problems, 332-6, 333,335 Pterygoid muscle, lateral (external), dysfunctional patterns, 222 Goodheart's coccygeal lift, influences, 222 333-6,335 193, 207,285-9 muscular attachments, 219 Upledger's concepts, 326-7 manual treatment of, 286-8, 287 range and direction of motion, 219, release, 288-9, 357-8 of hyoid, 300 trigger point assessment, 286, 286 222 of masseter, 278-9, 279 Pterygoid muscle, medial (internal), reciprocal tension membranes and, of pterygoid, lateral, 288-9 of pterygoid, medial, 285 193, 207, 234-5, 282-5 219 techniques (PRT), 253, 274, 375, anatomy, 284 Parietotemporal suture, 252 NMT treatment, 283-5, 283, 284 Passatore, M, 32 391-6 release, 285, 357-8 Pathobiology, 373 common basis, 392-5 trigger point assessment, 282-3, 285 Patrick, K, 130, 133 cradling mandible, 214-15 Pulsed electromagnetic field therapy Paulsen, AR, 101 see also Strain and counterstrain Peacock, R, 124 (PEMF), 43 Pearce, JC, 108 (SCS) Pederick, Frank, 223, 128-9, 367-8 Postencephalopathic hemiparesis, 88-9 Q Pelvic and spinal dysfunction, 83, 244 Postencephalopathic partial Pelvic wedges, 116-18, 127 Quantum coherence, 45 Penfield, W, 310 quadriparesis, 88 Quantum consciousness, 101-7 Percussion vibrator, 83, 119 Posterior atlanto-occipital membrane Periaqueductal gray (PAG) tissue, 100 R Perot, C, 130 (PAOM), 107 Pert,C, 101 Posterior auricular tender point, 328, Radiographs, 339, 348 Peterson, KB, 130 Ramirez, M, 393 Petrous bone, longitudinal movement 331,332 Randomized controlled trials (RCT), Posterior cervical area, 307-20, 320 of, 405 Postfacilitation stretching, 389 132 Peyralade, Francis, 75 Postisometric relaxation, 253, 389 Range of motion (ROM) see under Pharynx, muscles of, 243, 292 Posttraumatic stress, 89, 89-90 Phasic muscles, 248-9 Posture Motion Phillips, D, 361-3 Rasmussen, S, 112, 226, 229, 123 Physiology, 69-70, 73 adaptation and, 244-6, 369 Rathbun, J, 325 Pick, Marc, 19, 54, 57, 247, 368, 380-1 airway obstruction and, 347, 359 Raue, H, 351 birthing, 362 Ray, J, 351 chiropractic and, 111, 123, 122 forward head, 243—4 Raynaud's syndrome, 8 clinical applications and, 374, 376 phasic muscles and, 248-9, 249 Reciprocal inhibition (RI), 253, 275, cranial movement and, 141, 146, practitioner's, 317, 327 TMJ problems and, 208, 211, 242 388, 391 159, 161 tongue, 359 Reciprocal tension membranes, 4-6, Pierce, J, 361 Pourquie, O,101 Plantar fasciitis, 79-81 Prasad, S, 38, 247 5-6, 7, 2 1 - 5 Platysma muscle, 207, 299-307, 299 Prayer and Traube-Hering-Mayer in diagnosis and treatment, 24—5 ethmoid and, 200 (THM) oscillations, 37 Prenatal history, 361
Reciprocal tension membranes (contd) rhythmic, mobilization methods, Side-bending rotation dysfunction frontal bone and, 215 253 patterns, 250 occiput and, 183 parietals and, 219 Rocobado, M, 208, 244 Sills, F, 106 sphenoid and, 193 Rolf, Ida, 204 Silver, I, 38, 200 temporals and, 225 Rolling, 228-9 Simon, J, 337-8, 343, 351, 355, 358, 361 venous sinuses and, 30, 168, 268-9 Roppel, R, 147 Simons, D, 208, 209, 245, 246, 385, 387, Rosen, MG, 115 Rectus capitis anterior, 186, 298-9 Roth, G, 368 388 self-treatment for shortness, 299 Rowell, J, 42 key muscles and, 268, 274, 285, 290, Rowlerson, AA, 248 Rectus capitis lateralis, 186 Rubin, J, 347 308,318 Rectus capitis posterior major, 186, 308 Russek, L, 45 upper trapezius (UT), 256, 263 Rectus capitis posterior minor Sinus function, 345-6 s improper function, 346 (RCPM), 186, 256, 308-11, 309 proper function, 345-6 fibromyalgia connection, 310-11, Sacral motion, 3, 165, 166-8, 180 respiratory sinus arrhythmia Sacro-occipital technique (SOT), 10, 68, 312 (RSA), 12 ligamentum nuchae and dural 115-23, 123 see also Venous sinuses AK and Kotheimer's assessment, Sisken, B, 43 connection, 311 Sjostrom, H, 122 Rees (author), 124 128-32 Skaggs, Clayton, 208, 300 Reflex technique, 115, 226-27, 128 categories, 118-21 Skull Reich, Wilhelm, 106 definition, 122-3 cross-section, 162 Release diagnostic tests, 133 disarticulated, 145 testing procedures, 129-30 frontal view, 282-2 cranial base, 288, 311, 313, 323 Sagittal suture, 59, 148 inferior view, 2 84-5 energy cyst, 326-7 Sahar, T, 11 ethmoid-nasomaxillary, 200-1 Saxon, A, 122-3 of muscular attachments, 322 falx cerebri, 218 Scalenes, MET treatment of, 294-8, lateral view, 182-2, 220-2 fascial restrictions, 273—4 median section view, 282-2 integrated neuromuscular, 253 295, 296, 297 mobility, 3 ligamentous articular, 71 Scapulohumeral rhythm test, 259-60, shape at birth, 363 meaning of, 179 superior (vertical) view, 282-2 multiple method, 229-30 260 see also Bones, cranial; Cranium occipital, 357 Scariati, P, 250, 332-3 Smith, Audrey, 75 pterygoid, 285, 288-9, 357-8 Schleip, R, 38, 97 Smith, Fritz, 159, 165, 178, 369 sphenoidal, 195 Schooley, Thomas, 74-5 Smith, Fritz and energy concepts, sutural, 192, 231,253 Schultz, RL, 80 temporal, 230-1 Schwarz, G, 45 170-5, 272 vomer, 203-4 Schwenk, T, 103 balancing energy, 174 zygomae, 233-4 Scoliosis, 9, 402 essential touch palpation, 170-1 see also Myofascial release (MFR); Selden, G, 351,359 fine-tuning, 171-2 Sellars, R, 351 force application, 173 Positional release Sellars, WA, 351 implications in cranial therapy, Replication of position of strain, 392-3 Selye,H, 177,254, 369 Respiration Semispinalis capitis, 186 174-5 Separation techniques, 180 interpretation, 172 alkalinity, 247, 250 Sequential sutural releases, 253 manipulation and, 173-4 smooth muscle and, 37-8 Sergueef, N, 36 palpated patterns, 173 Sergueef, V, 128 repetition and comparison, 172 assistance, 180 Serous otitis media, 84 Smith's sailing boat, 140 primary, 101,102 Seto, A, 44 Smith, G, 16, 344, 354, 355-6 Shankland II, W, 349-50 Smith, SD, 342 impulse see Cranial rhythmic Sharpey's fibers, 20 Smith, William, 69, 71 impulse (CRI) Shea, M, 10, 3 9 6 - 7 Soft palate, 385-6 Sheldrake, R, 96,102 see also Palatines motion (PRM), 97, 106, 129 Shiatsu, 112 Soft tissue respiratory sinus arrhythmia Shore, NA, 125 dysfunction, 246, 253 Siclare, R, 126 (RSA), 22 Sicotte, Jean-Guy, 76 choices, 376 see also Breathing pattern disorders cranial treatment and, 322-3 joint and, 321 (BPD) holography, 45 Retrusion mobilization, 288 manipulation, 253, 379-98 Retzlaff, E, 14, 25, 20-1, 25, 27, 29, 35, 96, 148 Rheumatoid arthritis, 8 Rich, G, 380 Rocking, 287
muscle energy technique (MET), Spine see Cervical spine Structural/functional aspects of 388-91 Splenii tendons, 315-16, 316 cranial system, 344-7 myofascial release (MFR), 396-7 trigger points, 315-16 correct airway function, 346-7 neuromuscular technique Splenius capitis, 186,227, 307-8 sinus function and, 345-6 vertical dimension implications, (NMT), 379-98 trigger point site, 308, 319 mimetic, palatine and Splint therapy, 355, 357 344-5, 346 Spondylogenic reflex syndrome, Stylohyoid muscle, 291-3, 292 tongue muscles, 383-7 Styloid process, 386 positional release technique Sutter's (SRS), 117 Suboccipital muscles, 309 Sprains and strains, 8 Sudden infant death syndrome (SIDS), (PRT), 391-6 'Spring' tests, 152-3 stress response sequence, 245 Squamous suture, 148, 231 401-2 Solberg, W, 352, 354 Superconducting quantum interference Solitons, 45 tender point, 328, 332, 333 Solow, B, 244 SQUID (superconducting quantum device (SQUID), 42, 43, 44, 129, Somatic model, 10 368 Somatognathic system, 354 interference device), 42, 43, 44, Superior pharyngeal constrictor, 207 Song, ZH, 103 129, 368 Surface detectors, 129 Sortebecker, P, 351 Stack, B, 338 Surgery, 349, 351, 359, 362 SOT see Sacro-occipital technique (SOT) Static suture palpation, 57-61 complications, 88 Spahl, T, 339, 341-2, 352 Staubesand, J, 38, 251 see also Oral surgical procedures, Spector, M, 38, 251 Sternal fibers, 268-9 Speece, C, 71, 98 Sternocleidomastoid muscle (SCM), inappropriate Spermon, J, 404-5 225, 256, 258, 267-72, 269 Sutherland, Ada, 96 Spermon-Marjnen, H, 404-5 anatomy of, 268 Sutherland, William Garner, 14, 35, 37, Sphenobasilar compression, 83 assessment of dysfunction, 270 Sphenobasilar dysfunction patterns, MET treatment of shortening, 158-9,334 BOCF and, 94-5, 96, 97-9,101-2,108 150 270-1, 270, 271 chiropractic and, 112, 115-16, 118, Sphenobasilar symphysis (SBS), 341 myofascial release (MFR) treatment, Sphenobasilar synchondrosis (SBS), 124 271 cranial bones and, 194, 204 156-65,156,157,162, 358 NMT treatment of shortening, 271, five key elements, 3, 11 accommodation rather than historical perspective and, 1-4, 7-8, 272 movement, 160-1 trigger point site, 319 9-10 distortion and intracranial Sternohyoid muscle, 293 integration with medicine and, 67, Stewart, I, 39,100 circulation, 162-5 Stiles, E, 304-5, 321 70-2, 73, 75, 80, 82, 87 muscles and, 160 Still, Andrew Taylor, 68-72, 73, 77, 80, Sutherland wave see Cranial occiput distortions, 161-2 ossification and, 159 132 rhythmic impulse (CRI) palpation of resilience/movement BOCF and, 93-5, 97, 101-2, 104, 108 Sutter, M, 117 Still point application, 180 Sutures, 20 at, 163-5 Stirling, Major, 75 Sphenobasilar tender point, 331, 332 Stockton, S, 337-8, 347-9, 361 dental therapies and, 355-7 Sphenoid bone, 192-9, 193 Stoddard, Alan, 74-5 distress, 247-9, 249 Stomatognathic system, 124-5 gapping of, 231, 405 articulations, 193 Stone, R, 115 links and bone groupings, 148 dysfunctional patterns, 194-5 Strain, 8 mobility at, 14-20, 338 frontal restrictions, 198 cervical, 83, 89 palpation, 188 influences, 194 pattern in KISS children, 401 muscular attachments to, 193 replication of position of, 392-3 global, 53-7 palpation and treatment, 195-9 torsion dysfunction patterns, 150 static, 57-61 range and direction of motion, 194 Strain and counterstrain (SCS), 99, 253, sequential releases, 253 reciprocal tension membranes and, 'spring' tests, 152-3 379, 391-6 tissues found in, 20-1 193 pain and, 318, 325, 336 V-spread at, 8, 224, 253, 375 transverse movement of, 404 rules of treatment, 395-6 see also specific sutures Sphenoid lift, 195 Stress, 244-5 Sved,341 Sphenoid tender point, 328, 332, 332 facial, 338 Symphysis menti, 355 Sphenotemporal suture, 152-3 posttraumatic, 89-90 Synchronous temporal rolling, 229 Spinal canal in flexion and extension, Stressors, background, 374 Szegvari, M, 32 Stretching, active and passive, 253 23 Strogatz, SH, 39,100 T Spinal cord, motility of, 97 Structural integration method, 204-5 Spinalis capitis, 186 T-bars, 264 Spindle cell manipulation, 282 Takagi, Kunihiko, 76
Tallgren, A, 244 contact in ethmoid treatment, 202 pterygoid Tally, R, 208 intraoral approach, 204 lateral (external), 286, 286 Taylor, G, 32 NMT technique, 380-2, 388 medial (internal), 282-3, 285 Taylor, J, 396 Thyrohyoid muscle, 293-4 Temporal bones, 220, 225-31, 226 Tiller, WA, 100-1 semispinalis capitis, 308, 309 Timmons, B, 246 splenii tendons, 315-16 articulations, 225 Tinnitis, 9, 344, 358 splenius capitis, 308, 319 dysfunctional patterns, 227 Tissue sternocleidomastoid, 268-9,269,319 influences, 227 memory, 45 suboccipitals and, 309 muscular attachments, 225, 227 pressure hypothesis, 34, 36-7 temporalis, 280, 280 palpation and treatment, 228-31 sensation, 51-3 therapy, 128 range and direction of motion, 227 see also Fascia; Soft tissue treatment, 264 reciprocal tension membranes, 225 TMJ see Temporomandibular joint upper trapezius (UT), 258, 263,263, TMJ dysfunction and, 85-7 Temporalis muscle, 279-82 (TMJ) 264, 264, 265, 266 anatomy of, 280 Tongue Trowbridge, C, 70-1 attachments, 193, 207, 215, 219, 225 Truhler, R, 69 trigger points, 280 freedom, 363 Tucker, CA, 122 Temporalis tendon treatment, 282 muscles, 235,386-8 Tuner, J, 350, 363 Temporobasilar suture, 253 Turjanmaa, V, 36 Temporomandibular joint (TMJ) palatine and mimetic, 383-7 Turner, S, 95 associated musculature, 221 posture, 359 Twomey, L, 396 clenching reflex, 363 Torsion strain dysfunction patterns, 250 clicking of, 339, 354 Traditional Chinese medicine (TCM), u compression, 86, 211-12, 363 decompression, 222, 222-22, 333, 170 Underbite, 343 Transverse friction, 283-4 Unger Jr, JF, 130 341 Trapezius fibers, 116-17 Unilateral gapping of the squamous discs and, 209-10 Trapezius (lower) trigger point sites, dysfunction (TMD), 85-7, 86 suture, 231 329 Unpaired (midline) bones, 148 dentistry and, 338, 357, 358-9, Trapezius muscle (UT), upper, 186, Upledger, John, 21-2, 27, 52-3, 242, 360, 363 256-67, 258, 260 396, 403 muscles and, 279, 285-6 assessment for shortness, 258-60, BOCF and, 95, 97-100 posture and, 208, 211, 242 chiropractic and, 123, 115, 128-9 PRT and, 330, 3 3 2 - 6 , 333, 335 259 clinical applications and, 368 function, 243-4 muscle energy technique (MET) pain, 345 cranial assessment, 375-6 restriction and MET, 277 and, 260, 262-3, 262 energy cyst release, 326-7 self-treatment, 225 myofascial release (MFR), 266-7 positional release (PRT), 326-8, support, 342, 353, 353, 361 NMT assessment and treatment, Tender points, 329, 330, 331, 332, 395-6 333-4 locating, 327, 327, 328-32 263-6, 267 cranial bones and, 188-90, 224, 231 as monitors, 393 trigger points, 258, 263, 263, 264, cranial movement and, 141,148, Tendon reflexes, deep (DTRs), 131 Tensegrity, 7 264, 265, 266 159-61, 267, 170, 174 Tentorium cerebelli, 5 Traube-Hering-Mayer (THM) CRI and, 15, 24-6, 28-9, 31, 35,40-1 Tepper, S, 87 dentistry and, 338, 344, 346, 353, 357 Terminology, cranial, 149 oscillations, 22, 97, 368, 375 historical perspective and, 1-2, 4, Terrier, Christian, 76 CRI and, 36-7 Tettambal, M, 15 Trauma, 350, 369 7-8, 9-10 Therapeutic touch, 43 Travell, J, 245, 385, 388 integration with medicine and, 68, Thie, JF, 124 key muscles and, 268, 285, 290, 293, THM see Traube-Hering-Mayer (THM) 74, 87, 90 oscillations 308, 318 key muscles and, 258, 268, 279-80, Thomas, T, 351 upper trapezius (UT), 256, 263 Thoracic strain, 89 Triano, JJ, 130 286, 293, 298, 308 Thoracolumbar area, 371 Trigger points, 246, 395 Urayama, K, 31 Thoreau, Henry, 95 deactivation, 318 Urbanowicz, M, 244 Thumbs, 316-17 digastric, 289, 293 application for frontal lift, 228 levator scapulae, 329 V lower trapezius, 329 masseter, 275, 276 V-spread technique, 140, 169, 174, medial and anterior scalenes, 296 292-2,228,396 myofascial, 251 occipitalis, 273, 274, 314 at sutures, 8, 224, 253, 375 occipitofrontalis, 274 Van der Post, Laurens, 94-6, 96 platysma, 299, 299 posterior cervicals, 319
Van der Wal, JC, 104 w Woods, John, 7, 15, 25, 74, 97 Van Essen, DC, 104 Woods, Rachel, 7, 25, 25, 97 Vasomotion/venomotion influences in Wales, Anne, 74, 95, 96, 98-9, 101 'Working levels', 368 Walker, BF, 130, 133 CRI, 34 Walker DeLany, Judith, 264, 277-8, X Vault 281, 283, 288, 313-16 X-rays, 339 bones, 248 see also DeLany, Judith; Walker J palpation, 40, 61-2, 62,163, 164 Walker, Dr (osteopath), 73 Y Venous sinuses, 168, 2 68-9 Walker, J, 43 drainage, 162, 225 see also Walker DeLany, Judith; Yahia, L, 250-1 sagittal and coronal views, 30 Yanuck, SF, 131 Venter, JC, 104 Walker, J Young, J, 45 Ventricle, compression of fourth Walker, M, 349-51 Walker, S, 124 z (CV-4), 8, 99-100,140, 289-92, Wall, P, 177, 245 253, 375 Wallace, W, 25 Zanakis, M, 14, 26, 18, 24, 26-7, 27, 156 Verhulst, J, 20 Walter, G, 72 Zawieja, D, 34 Vernon, H, 22,310-11 Walther, D, 20, 68, 87, 348, 391, 393 Zeines, V, 337-8, 342, 344, 349, 351-2, Vertical dimension, 344-6, 346 results of restoration, 345 chiropractic and, 124-6,131 358, 363 symptoms of inadequacy, 344-5 key muscles and, 278, 282, 285 Zero balancing, 170 Vimy, M, 351 positional release (PRT) and, 325, Zhong, M, 103 Vines, G, 129 Ziff, M, 351-2 Visceral dysfunction, 8 334-5 Ziff, S, 351-2 Visual disturbances, 9 Ward, R, 84-5 Zigler, M, 394-5 Visual postural method, 133 Warwick, R, 334 Zimmerman, J, 42, 44 Vogel, Marcel, 85 Water imprint theory of homeopathy, Zink, G, 370, 372 Voll, R, 348, 353 Zink test exercise, 370-2 Vomer bone, 202-6, 202 102 Zygomamaxilla region, transverse articulations, 202 Weaver, Charlotte, 87, 96 dysfunctional patterns, 202 Weiant, CW, 121-2 movement of, 404-5, 405 influences, 202 Weigert, Carl, 350 Zygomatemporal region, transverse palpation and treatment, 203-6 Weight transfer, 317 range and direction of motion, 202 Weitzberg, E, 346-7 movement of, 4 0 4 - 5 , 405 Von Piekartz, H, 3, 22, 253-5, 243-4, 368 Wenban, AB, 132 Zygomae, 231-4, 232, 233-2 Vredevoogd, J, 21-2, 52,115, 242, 258, Wernham, J, 73 368, 403 Weyer, MW, 348-50 articulations, 231-2 BOCF and, 95, 97-9 Whiplash, 83-4, 90, 322 dysfunctional patterns, 233 cranial bones and, 188-90, 224, 231 Wiebrecht, A, 338 influences, 233 cranial movement and, 159-61, 167, Wiegand, R, 126 muscular attachments, 232-3 Wieman, CE, 98 palpation and treatment, 233-4 267 Willard, Frank, 107 range and direction of motion, CRI and, 24, 28-9, 31, 35-6, 41 Williams, P, 334 historical perspective and, 1-2, 4, 7-8 Wirkus, M, 101 233 key muscles and, 258, 268, 279-80, Wirth-Patullo, V, 36 Zygomatic tender point, 328, 332 Witzig, J, 339, 341-2, 352 Zygomaticomaxillary suture, 148 286, 293, 298, 308 Wollacott, M, 122 positional release (PRT) and, 326, Woo, SL-Y, 248 333-4
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