I have noticed, during 25 years of teaching seminars, that all healthcare professions seek therapeutic corrections for alleviation of symptoms, a “this-for-that approach.” Seldom do we seem to focus on finding the cause of the symptoms. In this column I have been advocating an examination approach that recognizes that muscle contraction, accompanied inevitably with loss of range of motion, can be caused not only by a structural problem but visceral function as well. In other words, they should not be separated when we attempt to establish the cause of chronic recurring subluxation patterns.
I would suggest that to enhance your practice you need the following:
1. An examination that identifies the exact cause of your patient’s symptoms - be it structural, visceral, or emotional.
2. Absolute confidence that your examination will stand the light of scientific scrutiny and will yield information quickly and accurately.
3. A ceremony that both educates and inspires your patient. Ceremonies are important and you already have one. It is your office procedure.
In my last column, I discussed an easy and quick way to determine the structural side of weakness in your patients. This month I want to discuss three easy to perform tests for determining the flexibility of a patient’s spine. Specifically where it may be compromised and how the answers will help you determine the cause of a patient’s chronic symptom/subluxation patterns.
Any patient, regardless of age, sex, or size should be able to cross their arms over their chest (so they cannot use their hands to assist them) and raise both legs from the table simultaneously, keeping the knees straight. The inability to perform this task indicates loss of structural integrity in the spine. The problem may be acute as in a recent sprain or strain, with considerable pain quite evident. The problem may be chronic without evident pain and discomfort, only a history of chronic health problems. Regardless, a positive bilateral straight leg raise test calls for a careful and thorough examination to determine the affected lumbo-sacral spine. Most patients will have no problems raising their legs together.
So we proceed to the second test.
Stand or sit at the patient's head. Place your palms on top of their head so that your middle fingers are in front of their ears and your ring fingers are behind their ears. Press strongly toward the patient's feet, without bending the patient’s head, and ask them to try and raise their legs together again. If the patient can still raise their legs, the test is negative. But, if the task is much harder or the patient cannot raise their legs at all, the increased spinal pressure has produced an irritation the body cannot compensate for.
This usually involves a condition of lax ligaments as depicted in an interruption in George's line. This condition will allow continual irritation of the involved spinal sympathetic nerves and result in symptoms of sympathetic dominance to the involved organs. Muscle contractions will be found around the involved spinal joints, muscles around the involved viscera, and can be palpated in the upper cervical spine below the skull.
Continual sympathetic stimulation is associated with vasoconstriction and elevated blood pressure. It also produces inhibition of exocrine secretions from the digestive organs and bowel as well as peristalsis. Conversely it stimulates endocrine or hormonal secretions. Eventually these organs produce symptoms and nutritional problems.
Continue standing or sitting at the patient's head. Place your hands at the side of their head so that your fingers can wrap around the mastoid process and the base of the occiput. Now, traction the head and cervical spine strongly, without bending the patient’s head, and ask the patient to try and raise their legs again. If the patient can still raise their legs, the test is negative. If the task is much harder or the patient cannot raise the legs at all, then spinal traction produced an irritation the body cannot compensate for and has shown the spine is not capable of extending.
This often involves a lumbo-sacral instability that is compensatory for a structural weakness in the lower extremities or sacral base. This condition will allow continual stimulation of the parasympathetic nervous system and result in symptoms of parasympathetic dominance. While the textbooks indicate that parasympathetic dominance increases digestive and bowel function, the point is that this cannot continue indefinitely due to an unidentified structural cause. Also remember that endocrine secretions will be decreased, giving rise to “subclinical endocrine” syndromes.
Three simple and easy to perform tests that can be done quickly with the patient lying supine may provide the answer to perplexing cases of chronic, recurring symptom/subluxation patterns that no one else has been able to find. It is from such things that successful practices are built.