AK issue n.13 - Spring 2002


Articles - Abstract

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EDITOR’S NOTE

To start our fifth year of publication, we have decided that each issue will center around a specific theme, starting with this issue dedicated to the muscle. In the “muscle issue” we hope to broaden the understanding of certain conditions and the different approaches that can be taken using various techniques. When should you stretch a muscle to bring it to its normal function? When should you put it into hyper-contraction? When should you stimulate or use percussion?
I would like to thank my friend Marcantonio Pinci, the grandson of Janet Travell, who introduced me to his mother Janet Powell Pinci. Mrs. Pinci graciously invited me into their home and subsequently loaned me several photographs and documents as well as her personal copy of her mother’s autobiography, Office Hours: Day and Night. Together with Dr. Travell’s other daughter, Virginia P. Wilson, they have been very generous in helping our managing editor, Erin McCloskey, confirm the information contained in our feature article. Throughout our research the Travell family has been supportive and has given continuous feedback so as to help us write an article on a true pioneer and a person they deeply cared about.
We have also been very happy to publish the work of up-and-coming professionals such as Scott Cuthbert, DC, the author of the essay ‘Applied Kinesiology and the Myofascia’. Dr. Cuthbert is one of those rare individuals who can effectively combine the clinical aspect of treatment with adept research in writing a sound scientific essay.
On a more contentious matter, in issue # 11 we published an article that has caused some controversy. ‘Applied Kinesiology and Evidence Based Medicine’ may have caused offense to some of our readers and certainly to the person to whom some of the comments were directed, and to these people I apologize. While freedom of opinion can allow for interesting debate, I do not intend for individuals to feel attacked. In this issue we have published the rebuttal to the article in fairness to the defendant. The comments and opinions given in these articles are those of the authors and are not expressed by AK Journal. Our initial goal has been and will continue to be to unite the world of kinesiology, not divide it.

JANET TRAVELL: HER SPIRIT AND WORK LIVE ON
By Erin McCloskey

In this issue of AK we proudly feature a past pioneer in alternative medicine. The work of Dr. Janet Travell has influenced traditional and alternative medicine and is one of the foundations of kinesiological medicine. Her revolutionary discoveries into the alleviation of myofascial pain led to the identification of what she defined as “trigger points” and the development of trigger point therapy, which has not only led to a recognized modality for treating myofascial pain, but it has allowed thousands of people to seek relief from pain that was often previously diagnosed as chronic or untreatable. Dr. Travell challenged a conservative medical profession hesitant to accept alternative health care back in the 1950s, and she had a strong and positive influence on the public to investigate such options.

BASIC PRINCIPLES OF MYOFASCIAL PAIN
A talk written by Janet G Travell, MD, November 1, 1984
(Presented at the Palm Springs Seminars, Inc., November 2–6, 1984 and to the DC Dental Society, April 16, 1985)

I shall discuss today the ubiquitous myofascial pain syndromes of the head and neck that depend on trigger points and their feedback loops to the central nervous system. These trigger points are located in the myofascial structures: skeletal muscle and its fascia. Trigger points also occur in skin, tendons, joint capsules, and periosteum.
One of the curious things about myofascial trigger points and their pain syndromes is the fact that the symptoms often long outlast the precipitating event of trauma, either gross or microtrauma, due to perserverating reflex patterns in the central nervous system.
In addition, the trigger points are perpetuated by continuing mechanical stresses (not the precipitating strain) on the myofascial structures, which create repetitive or sustained overload of the affected muscles. Such perpetuating stresses include, for example, a short leg and small hemipelvis, short upper arms, poor posture, inefficient body mechanics, immobility or immobilization, and chilling the body—also unphysiological seating design. Chairs can be a serious health hazard (chair pollution).
Systematic perpetuating causes may also be multiple. These include infectious (especially oral herpes simplex), metabolic, nutritional, allergic, vicerosomatic, and psychogenic factors. Marginal vitamin deficiencies and hypometabolism (borderline subclinical hypothyroidism) are especially frequent causes.

MYOFASCIAL GELOSIS A “STAND ALONE” CLINICAL ENTITY THAT MAY ACCOMPANY SUBLUXATIVE, FIXATIVE, AND OTHER MUSCULOSKELETAL FAULTS
By George J Goodheart, Jr, DC, DIBAK


The monumental work of the late Janet Travell, MD, is well known. Reference to her published text, films, and tapes are available through education and publication venues. This material on myofascial gelosis is a further AK development of her original and most recent publication and represents further therapeutic utilization of some of her observations.
Previous AK manuals have delineated the “fascial flush” technique with folic acid and B12 for “spray and stretch” type of muscle trigger point activity. The subsequent use of a hand ice-cup with moving contact on the skin followed her discontinuation of the spray technique (ecological reasons). Previous AK manuals describe the strain and counterstrain technique of Lawrence Jones, DO, and the muscle weakening following muscle contraction associated with this technique. Experience with the Robert Fulford, DO, method of treatment using percussion technique with the muscle under stretch shows the benefit of this technique in decreasing pain and increasing range of movement (ROM).
The following discussion represents a new concept of the fascial involvement and the identification of an AK method of diagnosis of a “stand alone” clinical entity in “myofascial gelosis”. Previously we have identified a Travell type of myofascial “trigger point” by the response of the muscle involved to a rapid stretch and subsequent testing for weakness; this still holds true. The new use of the “pincer palpation” of the muscle belly, which Travell described in her Myofascial Pain and Dysfunction: The Trigger Point Manual (1), represents a valuable AK breakthrough.


APPLIED KINESIOLOGY AND THE MYOFASCIA
By Scott C Cuthbert, DC

This essay will focus on local muscle problems that are not found by therapy localization to one of the five factors of the intervertebral foraman (IVF). The physical nature of myofascia will be described. The importance of myofascial analysis in chiropractic treatment will be explored, as well as the interactions between the myofascial system and the craniosacral system. The implications of myofascial dysfunction on body language will be discussed. The use of percussion to release the myofascial dysfunctions that have been described by Fulford, Travell, Jones, Nimmo, Rolf, and others will be reviewed. Finally, the applied kinesiology approach to myofascial disorders will be presented.
Goodheart and the ICAK have kept expanding our therapeutic approach as we have discovered other factors that produce muscle weakness or dysfunction throughout the body. At this point in the development of AK, the evaluation of muscle dysfunction has become very broad.
“Life is the expression of tone. In that sentence is the basic principle of chiropractic. Tone is the normal degree of nerve tension. Tone is expressed in functions by normal elasticity, activity, strength and excitability of the various organs, as observed in a state of health. Consequently, the cause of disease is any variation in tone.”(1)
Nerve, muscle, and fascial tone are expressions of the chiropractic principle of health. With AK’s manual muscle testing (MMT) procedures, we are able to assess “tissue tone” and the factors affecting it like no other professionals in the healthcare field.

ADVANCES IN PERCUSSION TECHNIQUES FOR CHIROPRACTIC PRACTICE AND HOLISTIC HEALTH CARE
By John W Brimhall, DC, FIACA, DIBAK and Stephan Cooter, PhD, Editor


HISTORY
There are three basic bodily rhythms: the cardiac rhythm of the heartbeat, the respiratory rhythm of breathing, and the craniosacral rhythm that results from the increase and decrease in the volume of cerebrospinal fluid within and around the craniosacral system. Craniosacral Therapy originally monitored this subtle rhythmic wavelike motion, which ranges from 6–10 oscillating cycles per minute and is for the most part unaffected by heartbeat and breathing, to determine any restriction or dysfunction in the craniosacral system. Doctors were taught to feel with their hands for the wavelike motions of this system for its unified movement. With an extremely sensitive touch, the physician was able to diagnose the movement of the system by locating critical sites of restriction in the cranium.
The sutural technique was popularized by William G Sutherland, DO, in the early twentieth century. This technique involves manipulating the sutures of the skull to ease pressure, increasing the mobility of cranial bones. By removing stress between the bones, the sutural technique normalizes the relationship of bones to each other, helping restore the craniosacral system to homeostasis.
In the 1920s, Major B DeJarnette, DC, developed a technique that combined sutural, meningeal, and reflex approaches after his work with Sutherland, which became known as Sacro-Occipital Technique™ and craniopathy. DeJarnette recorded that many conditions improved with this technique, including anxiety, inflammation, asthma, cataracts, diabetes, impotence, and constipation, when associated with restrictions.
In the 1970s, John Upledger, DO, pioneered the meningeal technique, which has become known as CranioSacral Therapy™. This technique focuses on finding tension and restriction in the connective tissue that lines the skull and the vertebral canal. The therapist brings about a release by gently applying pressure with the hand to traction and elongate the membranes.
After John Brimhall, DC, presented his first paper on craniosacral therapy to the ICAK in 1993, George Goodheart, DC, the father of applied kinesiology, combined a reflex technique with cranial adjustments, stimulating nerve endings in the scalp, or between cranial sutures, to locate and release distortions in the craniosacral system as well as other structures and bodily organs.
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