If you’ve ever attended a Steve and Roger seminar you probably have heard the statement, “A trained monkey could do what Roger does,” and the follow up, “But there’s never a trained monkey around when you need one, Steve.” So, unless you have a trained monkey around, you may be interested in the simple way that we approach rehab. As you know, a loss of cervical lordosis has been associated with cervicogenic headache, so today we’re going to talk about some simple traction methods that you can use to address that problem. But first, let’s start with the general rules. If there are no contraindications then:
1) If the spine doesn’t have enough range of motion, do something to increase range of motion.
2) If the spine is moved to one side in the AP view, do something that moves it back toward the midline.
3) If the spine doesn’t have enough lordosis, do something to increase the lordosis.
4) If the spine has too much lordosis, do something to reduce the lordosis.
5) If a muscle is too weak, do something to make it stronger.
6) If something is too tight, do something to make it more flexible.
Seems pretty straight forward, and it is. Then, we just reach in the old toolbox and pull out the tool we want for the job at hand.
We’ve roughly divided many of the things we do into categories, based on what we want to use them for. Since our tools do more than one thing, this was very easy. In our toolbox we have three basic areas: adjustments, traction and exercise. Let’s start with adjustments.
Adjustments are the easiest to talk about because we’re just going to give them the once over. Adjustments are something that can be used to try to change alignment and increase motion. Which type of adjustment is best? Who knows? No adjustment technique has proven itself to be the “be all and end all,” so, we’re going to let you pick the adjustment procedures that you think are best for your patient.
Next is traction. At this point we’d like to focus on just the cervical traction methods. There are three types that we like and all of them can be used to help improve the cervical lordosis and provide stretching in the neck. But, before we start, as with anything, make sure that you know how to use the procedure correctly and that it is not contraindicated. For those of you who would like more information, you can contact the manufacturer for the proper use of particular devices, read books on the subject (Steve’s book, Structural Rehabilitation of the Spine & Posture: A Practical Approach, is a good place to start) or attend appropriate classes.
The first type of or tool traction is the Coleman 3 strap cervical traction and it’s the method we both use in our respective offices. Because it has the disadvantage of being a large device, a little expensive, and somewhat more complicated, we’re going to focus on two other traction methods.
Next is the Dakota Traction Method. This type of traction is cheap, small and can be used in the office or sold to the patient for home use. It can be ordered from Matlin Manufacturing. As you can see in Figure 1, the patient is placed on the device and the elastic cord of the head strap can be adjusted to provide varying amounts of pressure.
Then we have the Noodle™ (patent pending). It’s the most versatile device of all. You can do all sorts of exercises with the Noodle™ as well as cervical traction. And, Matlin Mfg. invented it, too, so it’s easy to find. The Noodle™ is usually used for exercise, but you can add a headpiece and also use it for cervical traction. It allows you to place two straps behind the neck just like the Coleman 3 strap cervical traction. For cervical traction, one end of the Noodle™ is properly secured to a wall or door, two straps are behind the neck and a harness-type traction device is placed on the patient with an appropriate weight attached.
The Noodle™ really fits into our idea of rehab. It’s versatile, so you can use it for exercise and traction. It’s also inexpensive and you can use it in the office and sell it to your patients for use at home. It’s a pretty amazing device. Of course, like everything else, you need to make sure you know how to use it properly and that there are no contraindications before you start using it with your patients.
Note: This information in not intended as healthcare advice. The determination of the risk and usability of information rests entirely with the attending doctor of chiropractic.
Dr. Roger R. Coleman is a 1974 graduate of Palmer College of Chiropractic, practicing in Othello, WA. He is a member of the Adjunct Research Faculty at Life Chiropractic College West, and on the postgraduate faculty of National University of Health Sciences.
Dr. Stephan J. Troyanovich is a 1987 graduate of Palmer College of Chiropractic, practicing in Normal, IL, and a member of the Adjunct Research Faculty, Dept. of Research, at Life Chiropractic College West. He may be reached at 309-454-5556.