Ak Lab Manual For Fwinter 2019(1) (3).docx

Applied Kinesiology ELECTIVE

CHSC 7403 001 Winter 2019

Presented by Thomas M. Redenbaugh, D.C

Applied Kinesiology

Winter 2019 ICAK-U.S.A.

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Applied Kinesiology • Syllabus • Calendar

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David S. W alther, D.C. 1937 - 2008 ICAK-U.S.A.

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George Joseph Goodheart, Jr. , D.C. (August 18, 1918 - March 05, 2008) ICAK-U.S.A.

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Chapter 1 Introduction to Applied Kinesiology p. 2-28 ICAK-U.S.A.

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Applied Kinesiology • Applied Kinesiology (AK) is a system for evaluating body function that is unique in the healing arts • AK came into being in 1964 when George J. Goodheart Jr., D.C. of Detroit, Michigan began evaluating his patients’ muscles with manual muscle tests

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• Sometimes a muscle tested weak with no atrophy or other apparent reason for the weakness • He observed nodules at the origin of patient’s serratus anticus muscle • He goaded the nodules and strength returned • Original AK technique of origin and insertion treatment was presented at the charter meeting of the American Chiropractic Association held in Denver, Colorado in 1964 ICAK-U.S.A.

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Applied Kinesiology • The technique of muscle testing Goodheart used was that of Kendall and Kendall now in its 5 th edition by Kendall and McCreary

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Applied Kinesiology • In AK the timing of the testing procedures has been changed and additional neurological hypotheses have been developed • Most muscle tests done in AK do not evaluate the power a muscle can produce; rather, they evaluate how the nervous system controls muscle function. ICAK-U.S.A.

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Applied Kinesiology • The changes in muscle function observed in AK MMT are assumed to be associated with changes in the central integrative state (CIS) of the anterior horn motoneurons. • The central integrative state (CIS) is defined as the summation of all excitatory inputs (ESPSs) and inhibitory inputs (IPSPs) at the neuron. ICAK-U.S.A.

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Applied Kinesiology • The terms “conditionally facilitated” and “conditionally inhibited” are more descriptive than strong and weak, respectively. • Although the terms “strong” and “weak” have generally been maintained in keeping with their general use in clinical practice, one should think in terms of the nervous system rather than the actual power the muscle is capable of producing. • Occasionally in this setting the terms “conditionally facilitated” and “conditionally inhibited” will be used interchangeably with “strong” and weak”

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Applied Kinesiology • The initial development of AK was directed toward correcting structural imbalance caused by poorly functioning muscles. • The main objective was to support chiropractic adjustments of the spine, pelvis, and other articulations.

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Applied Kinesiology • In the early development of AK there were only a few techniques for changing muscle function. • Sometimes the improved muscle function lasted, with no return of dysfunction; on other occasions, the improvement was short lived. • On still other occasions, a dysfunctioning muscle could not be returned to normal. ICAK-U.S.A.

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Applied Kinesiology • Another early problem in AK was in the apparent inconsistency in manual muscle testing results. • Over the years the inconsistency of MMT has been largely overcome as the various parameters that change the results of a test have been discovered.

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Applied Kinesiology • Those that persevered in their efforts to determine why muscles tested weak found that many therapeutic approaches were applicable in improving muscle function. • The major contribution AK makes to standard diagnostic procedures is functional evaluation.

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Functional Conditions • It is important for the reader to understand what is meant by the term “functional” when applied to a condition. • Hypoadrenia ≠ Addison’s Disease • Relative stages • Adrenal Stress Disorder

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Applied Kinesiology • AK recognizes that the body is self-maintaining, self-correcting mechanism. • W hen health is lost, something is interfering with the body’s adaptability and it is unable to cope with different environmental stresses. • Examination effort is directed toward how the body is dysfunctioning, the cause of the dysfunction, and finally the therapeutic efforts that will enable it to regain and maintain health. ICAK-U.S.A.

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Triad of Health • Structural • Chemical • Mental

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Triad of Health • Medical Profession – Chemicals to control body function

• Nutritionists – Building tissue and providing the basic raw materials for normal body function 1 – 2.

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Triad of Health

• Psychiatrists • Psychologists • Counselors

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Triad of Health • Emphasis on examination of all 3 sides • Directing therapeutic efforts toward the basic underlying cause of the problem

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Structural Balance

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Structural Imbalance

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Applied Kinesiology • Most of the examination and treatment procedures in AK relate to the nervous, lymphatic, and vascular systems, along with the relationship of CSF with the cranial-sacral primary respiratory motion, and with the meridian system. • Goodheart has related these five factors to the IVF and coined the term “five factors of the IVF” to describe the examination and therapeutic approaches used in AK. ICAK-U.S.A.

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Five Factors of the IVF

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Five Factors of the IVF • The “N” at the top of the triad refers to the nervous system. • Spinal subluxations • Peripheral nerve entrapments • Disturbance in neurotransmitters • Improper stimulation of nerve receptors • Nutrition ICAK-U.S.A.

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Five Factors of the IVF • The “NL” stands for neurolymphatic reflexes which are the Chapman reflexes that have been incorporated into AK • Other examination and therapeutic approaches are also used to influence the lymphatic system to help eliminate major blockages and improve lymphatic flow.

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Five Factors of the IVF • The “NV” stands for neurovascular reflexes, which are the Bennett reflexes that have been incorporated into AK. • Although Bennet reflexes are located throughout the body, AK primarily uses those located on the head.

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Five Factors of the IVF • The “CSF” of the five factors represents the cerebrospinal fluid associated with the cranialsacral primary respiratory mechanism described by Sutherland. • It relates to the autonomous movement of the bones of the skull, sacrum, and pelvis and has become an important part of AK examination and treatment. • The influence of jaw function on the cranium is included in both the “N” for nerve and “CSF” for cerebrospinal fluid. ICAK-U.S.A.

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Five Factors of the IVF • The “AMC” stands for the acupuncture meridian connectors. The acupuncture meridian system has become both an important examination and therapeutic aspect of AK.

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Five Factors of the IVF

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Applied Kinesiology Chapter 2 General Examination and Treatment Procedures p. 29

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Postural Analysis p. 30 • Postural analysis is a major source of information in AK • It is one of three main methods used in AK for quickly locating probable muscle dysfunction. • Use of a plumb line is recommended for static evaluation.

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Applied Kinesiology Chapter 8 Muscles - Testing and Function P. 303 ICAK-U.S.A.

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The Science and Art of Manual Muscle Testing p. 304 • Method of evaluating nerve function • Evaluate disability from poliomyelitis • Muscle function was graded, ranging from paralyzed with no palpable contraction to normal strength • From this background, manual muscle testing as used in Applied Kinesiology developed … ICAK-U.S.A.

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The Science and Art of Manual Muscle Testing p. 304 • The current Applied Kinesiology use of manual muscle testing varies considerably from the historic testing of paralyzed muscles • It is a much more discernible type of muscle testing to determine how muscle function is adapted by the nervous system.

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The Science and Art of Manual Muscle Testing p. 304 • Dr. Schmitt has used the phrase "muscle testing as functional neurology," which more aptly describes applied kinesiology use of manual muscle testing.

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The Science and Art of Manual Muscle Testing p. 304 • There have been many attempts to objectively quantitate the muscle test • Cybex II, measures strength, both isometrically and eccentrically • Fixed transducers

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The Science and Art of Manual Muscle Testing p. 304 • Unger study correction of a Category II Pelvic fault : – Significant increase in muscle strength of the: • pectoralis major sternal • pectoralis major clavicular • anterior deltoid • latissimus dorsi • psoas • tensor fascia lata • Adductor • gluteus medius ICAK-U.S.A.

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The Science and Art of Manual Muscle Testing p. 304 • Muscles identified as weak using applied kinesiology manual muscle testing methods are in a fundamentally different state than those identified as strong. • Muscles that test weak are fundamentally different from fatigued muscles. • The weakness identified by the AK manual muscle test is not attributable to fatigue. ICAK-U.S.A.

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The Science and Art of Manual Muscle Testing p. 304 • Applied Kinesiology muscle testing procedures can be objectively evaluated via quantifying the neurologic electrical characteristics of muscles. • The course and effect of Applied Kinesiology treatment can be plotted objectively over time.

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The Science and Art of Manual Muscle Testing p. 305 • A study by Leisman et al measured the way the central nervous system (brain) is functioning when muscles test strong versus when they test weak. • Clear, consistent, and predictable differences were identified in the brain between weak and strong muscle test outcomes. ICAK-U.S.A.

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The Science and Art of Manual Muscle Testing p. 305 • This supports the idea that manual muscle testing outcome changes reflect changes in the central nervous system.

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The Science and Art of Manual Muscle Testing p. 305 • Rybeck and Swenson, in a controlled blind study, evaluated the effect of subjects chewing sugar by testing the latissimus dorsi manually and against a force transducer. • The latissimus dorsi weakened significantly over the control group when measured by manual muscle testing, but it did not against the force transducer. ICAK-U.S.A.

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The Science and Art of Manual Muscle Testing p. 305 • Blaich and Mendenhall compared manual and Cybex II muscle testing and found that the two are statistically independent. • W hat is measured manually cannot be measured by the Cybex alone.

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The Science and Art of Manual Muscle Testing p. 305 • In this author's experience, there is a close correlation between the Cybex II dynamometer and manual muscle testing when the cause of muscle weakness is peripheral nerve entrapment, such as an intervertebral disc.

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The Science and Art of Manual Muscle Testing p. 305 • W hen other factors — such as the cranialsacral primary respiratory mechanism, active reflexes, or imbalanced meridian energy — are at fault, correlation is poor between manual muscle testing and the Cybex II dynamometer.

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The Science and Art of Manual Muscle Testing p. 305 • It appears that the major difference between testing against fixed transducers, whether isometric or concentric, is that the muscle is required to simply produce power • In manual muscle testing, the muscle is required to adapt to the changing pressure of the examiner's force. ICAK-U.S.A.

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The Science and Art of Manual Muscle Testing p. 305 • This requires effective function of the gamma system adjusting the neuromuscular spindle cell, and proper interpretation of its afferent supply and response by the neuraxis.

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The Science and Art of Manual Muscle Testing p. 305 • The manual muscle test, as generally described, starts with the examiner asking the patient to resist as he applies force to the patient. • W ith the examiner's application of force, a sensation of muscle locking is perceived.

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The Science and Art of Manual Muscle Testing p. 305 • It appears that a major factor in this type of test is the ability of the patient's nervous system to lock the muscle against the examiner's pressure, and to continue adapting the muscle to meet the changing • Often the examiner perceives a muscle as weak because it is late in adapting to his changing pressure. ICAK-U.S.A.

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The Science and Art of Manual Muscle Testing p. 305 • Often the examiner perceives a muscle as weak because it is late in adapting to his changing pressure. • If the examiner applies pressure very slowly, allowing additional time for the muscle to adapt to it, the muscle will be perceived as strong.

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The Science and Art of Manual Muscle Testing p. 305 • It has been generally assumed that manual muscle tests are tests of 'strength'; that is, of the force with which the patient resists the tester. • Our data indicates that time required to move the limb through a certain range of motion multiplied by the average force of resistance applied during that range was the factor most highly correlated with the tester's perception of deficits in strength." ICAK-U.S.A.

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The Science and Art of Manual Muscle Testing p. 305 • A manual muscle test that takes the muscle from isometric to eccentric contraction is called the "break test technique" by the group at the Institute of Sports Medicine and Athletic Trauma. • This type of manual muscle testing more closely parallels that of Applied Kinesiology than any other. ICAK-U.S.A.

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The Science and Art of Manual Muscle Testing p. 305 • Presently the best "instrument" to perform manual muscle testing is a well-trained examiner, using his perception of time and force with knowledge of anatomy and physiology of muscle testing

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The Science and Art of Manual Muscle Testing p. 305 • W ith this combination there has been positive agreement in some interexaminer reliability studies. Conable and Hanicke14 found 78.2% agreement between two trained muscle testers when each was blind to the other's findings. • After correcting cranial faults and ocular lock, there was 100% agreement between them. ICAK-U.S.A.

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The Science and Art of Manual Muscle Testing p. 305 • This brings up an important factor regarding the results of manual muscle testing. • The subject being tested may change the parameters of the test unknown to the examiner.

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The Science and Art of Manual Muscle Testing p. 306 • When cranial faults are present the phase of respiration that the patient takes or holds during the test has a bearing on muscle strength. • In fact, individuals with disturbance in the cranial-sacral primary respiratory mechanism will often innately take and hold the phase of respiration that gives optimal function to the muscle. ICAK-U.S.A.

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The Science and Art of Manual Muscle Testing p. 306 • In other respects, subjects who have muscles that are poorly controlled by the nervous system will innately attempt to change the test parameter in any way, such as recruiting other muscles, in an attempt to perform the test adequately.

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The Science and Art of Manual Muscle Testing p. 306 • In a double-blind study, Jacobs found 81.9% agreement between two testers. • There was no control of other factors — such as cranial faults and ocular lock as in the Conable/Hanicke study.

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Factors that Influence Muscle Testing p. 306 • Consistent timing • The most crucial portion of applying pressure in a muscle test is at the beginning. • “Doctor-induced“ - Gamma I test, GI – Is the most common type of testing.

• “Patient-induced" - Gamma II test, G2 • Gamma II test, G2 submax ICAK-U.S.A.

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Factors that Influence Muscle Testing p. 306 • Gamma I, GI, Type I – Type 1 test is used as a general screening test.

• Most of the techniques in Chapters 2, 3, 6, and 7 of this text are used to correct this type of weakness. • This includes spinal manipulation of subluxations, joint manipulation, reflex and trigger point treatment, and meridian point stimulation, among other treatments ICAK-U.S.A.

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Factors that Influence Muscle Testing p. 306 • Type 2 test indicates suprasegmental (supraspinal) problems. • These include chemical imbalances such as nutritional needs and hypothalamic monitored activities, e.g., electrolyte imbalances, autonomic imbalance, and stomatognathic system problems.

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Factors that Influence Muscle Testing p. 306 • Type 3 weakness relates to the withdrawal reflexes following injury, allergy and hypersensitivity type reactions, systemic functional endocrine imbalances, and visual motor problems such as functional problems with accommodation reflexes.

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Factors that Influence Muscle Testing p. 307 • A major objective of manual muscle testing in applied kinesiology is to isolate the muscle being tested to the maximum. • In all tests — with the exception of the muscles that move the distal phalanges of the fingers and toes — there is some synergism taking place.

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Factors that Influence Muscle Testing p. 307 • The starting position for the muscle test is that which places the muscle being tested at the greatest advantage, with the synergists at a disadvantage. • W hen the prime mover being tested is weak, the patient's natural reaction is to shift the test position to recruit synergistic muscles. ICAK-U.S.A.

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Factors that Influence Muscle Testing p. 307 • An expert muscle tester learns as much or more from observing what the patient does as from the perception of force produced by the tested muscle. • An example is how the side-lying patient with a weak gluteus medius will posteriorly rotate the pelvis on the side being tested to align the tensor fascia lata for hip abduction. ICAK-U.S.A.

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Factors that Influence Muscle Testing p. 307 • The muscle being tested must operate from a stable base. • In most cases this requires the examiner to stabilize the structure from which the muscle originates • The patient may attempt to shift the base from which the tested muscle originates, or there may be failure of the patient's muscles to stabilize the base. ICAK-U.S.A.

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Factors that Influence Muscle Testing p. 308 • The results of the muscle test may be influenced if the patient experiences pain during the test. • W hen attempting to produce maximum muscle power, it may be pain that causes the muscle to let go rather than fatigue or muscle weakness

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Factors that Influence Muscle Testing p. 308 • Usually it is obvious when pain causes the muscle to test weak; however, one should advise the patient to indicate when the test is painful. • The presence of pain does not mean that the test cannot be performed; in fact, additional valuable information can often be gained. ICAK-U.S.A.

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Factors that Influence Muscle Testing p. 308 • For example, when one of the rotator cuff muscles tests weak with shoulder pain, the patient can often perform the test very well, without pain, when therapy localizing to the neurolymphatic reflex, holding a certain phase of respiration, or adding some other applied kinesiology factor.

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Factors that Influence Muscle Testing p. 308 • This not only helps the examiner determine the cause of shoulder dysfunction, it is also strong positive feedback to the patient that the doctor understands the condition.

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Therapy Localization p. 37

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Applied Kinesiology The following is meant as a guide and general information. Please make appropriate notes during lecture and lab to augment this outline.

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5 Factors of the IVF

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Neurolymphatic Reflexes • Frank Chapman, D.O. • 1930’s • Chapman’s original observation linked the reflexes with specific organ and gland functions

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Neurolymphatics • Goodheart was able to correlate the NL organ association with specific muscles • MMT provides an objective method for determining the need for and the success of NL stimulation

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Neurolymphatics • Located: – primarily along the anterior inter-costal spaces – anterior abdomen down to the pubis – posteriorly along the spinal column

• Active neurolymphatic points can usually be palpated and are quite tender • Tenderness is usually in direct ratio to the chronicity and severity of the condition ICAK-U.S.A.

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Neurolymphatics • Palpatory evidence of the NL reflex changes with chronicity • Less chronic – puffy – doughy feeling over the entire reflex area

• More chronic – puffiness concentrates into globules the size of lima beans

• Most chronic – feels like many small “BB’s” in the subcutaneous fat

• Posterior reflexes are usually less tender (therefore we use the anterior points for diagnosis) • Active point will demonstrate positive TL of the anterior point ICAK-U.S.A.

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Neurolymphatics • Treatment – Rotary massage – Originally pressure used was light • about what you can stand on your eyeball

– Heavier and deeper for a shorter time – More pressure > less time – ~20-30 seconds – Treat both anterior and posterior points at the same time ICAK-U.S.A.

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Neurolymphatics • Upon successful stimulation of the NL there will be a dramatic improvement of the associated muscle on MMT • Recheck muscle • Recheck muscle with TL of the previously active NL point

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Neurovascular Reflexes • Early 1930’s • California • Dr. Terrence Bennett • Locations about the head that influenced vascularity of different organs and structures • Mid 1960’s Goodheart • Neurovascular Reflexes ICAK-U.S.A.

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Neurovascular Reflexes • Goodheart found that a specific muscle responded to only one reflex • Most reflexes influenced more than one muscle • Three NV reflex points demonstrate a one point to one muscle correlation • May pertain to the ectodermal unfolding of the embryo, relating the general nervous system with the skin receptors ICAK-U.S.A.

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• Find an inhibited muscle • Correlate that muscle with it’s point on the chart • Active point demonstrates positive TL

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Neurovascular Reflexes Treatment • The physician uses his/her fingertips to contact the NV point and gives a slight tug to the skin • A skin pulsation should be felt, if not… • alter the vector until it is • Once pulsation is felt, hold for 20-30 seconds • With some cases it may be necessary to hold the stimulation for up to five minutes before evidence of effective treatment is present

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Neurovascular Reflexes • Improvement of the associated muscle function on manual muscle testing is evidence of effective treatment • Recheck the muscle • Recheck muscle with TL of the previously active NV point

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CSF • Cerebral Spinal Fluid • Cranial Sacral Primary Respiratory Mechanism • Autonomous movement of the bones of the skull, sacrum, and pelvis • Influence of jaw function on the cranium is included in both the “N” for nerve and “CSF” for cerebrospinal fluid ICAK-U.S.A.

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CSF

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CSF 1. Find an inhibited muscle 2. Have patient inhale fully and retest muscle 3. If inhibited muscle strengthens there is an inhalation assist cranial fault, 4. If no change, have patient exhale fully 5. If inhibited muscle strengthens there is an exhalation assist cranial fault ICAK-U.S.A.

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CSF 6. 7.

Patient lays supine, doc sits at head of table Have patient TL first one mastoid process and check indicator muscle then the other mastoid process and check indicator muscle 8. For an inhalation assist cranial fault, push P-A on the appropriate mastoid with 4-5 pounds of pressure for 45 seconds, 4-5 times 9. For an exhalation assist cranial fault, push A-P on the appropriate mastoid with 4-5 pounds of pressure for 45 seconds, 4-5 times 10. Recheck muscle 11. Recheck muscle with POR ICAK-U.S.A.

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AMC Acupuncture Meridian Connector • Acupuncture • Meridian Therapy – thousands of years old • Introduced into AK in 1966 • Diagnosis and understanding why there may be an imbalance of energy in the system

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AMC Acupuncture Meridian Connector • Meridian therapy • Energy (electromagnetic) chi • Chi, Qi, or Ki • Flow of this energy through twelve bilateral meridians

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AMC Acupuncture Meridian Connector • Chiropractors have been affecting the energy level in the meridians since the profession first began in 1895 • Chiropractic adjustments of the spine and extremities influences the meridian system

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AMC Acupuncture Meridian Connector • Many parallels between meridian therapy and chiropractic • Both work to balance and release life force • Both are dedicated to the prevention of disease • Both use natural approaches to enable the body to heal itself

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AMC Acupuncture Meridian Connector • Goodheart found that muscles that tested weak were sometimes associated with imbalance of energy within the meridian system • The meridian-muscle association closely followed the previously developed muscleorgan/gland association

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AMC Acupuncture Meridian Connector • Associated points are located on the Bladder Meridian along the spine • Tends to be an active associated point adjacent to a subluxated vertebra or conversely a subluxation adjacent to an active associated point

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AMC Acupuncture Meridian Connector • Each of the twelve meridians has an alarm point • Only the lung, liver, and gallbladder meridians have their alarm points on their meridians (bilateral) • Liver meridian has the spleen alarm point (bilateral) • Gallbladder meridian has the kidney alarm point (bilateral) • Stomach meridian has the LI alarm point (bilateral) • Six alarm points on the CV (centrally located) ICAK-U.S.A.

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AMC Acupuncture Meridian Connector • W hen a meridian is out of balance, the alarm point is tender • W hen patient complains of spontaneous pain at an alarm point, the meridian is probably over-active • W hen there is tenderness on palpation but no spontaneous pain, the meridian is probably under-active ICAK-U.S.A.

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AMC Acupuncture Meridian Connector 1. Find an inhibited muscle 2. Therapy Localize the alarm point associated with the inhibited muscle 3. If muscle strengthens – meridian is involved 4. Tap the tonification point for 30 secs 5. Recheck muscle 6. Recheck muscle with TL of the previously active alarm point ICAK-U.S.A.

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Nerve 1. Find an inhibited muscle 2. Therapy localize the nerve root area with a broad hand contact 3. If muscle strengthens a subluxation is involved 4. Therapy localize individual spinous processes (with one finger instead of a broad hand contact) until muscle strengthens ICAK-U.S.A.

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Nerve/Nutrition • Using an indicator muscle: – Direct Challenge • push on transverse process and hold • Adjust into strength

– Rebound Challenge • push on the transverse process and release • adjust into weakness

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Nerve/Nutrition 5. Adjust 6. Recheck muscle 7. Recheck muscle with TL of the previously active broad hand contact of nerve root

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5 Factors of the IVF • Find an inhibited muscle • Test the 5 Factors in any order – TL all of the 5 Factors except CSF

• Fix in any order (Remember I favor “N”) • Remember that the only way that MMT can talk to us is with a change in muscle strength • Recheck muscle • Recheck the muscle with the previously positive TL or POR ICAK-U.S.A.

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Applied Kinesiology Neurologic Disorganization ICAK-U.S.A.

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When a person is healthy, muscles function in a predictable manner.

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Under certain conditions, muscles should test strong with manual muscle testing; under other conditions, they normally test weak.

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Please remember that strong and weak are really referring to facilitated and inhibited.

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An example of this is shoulder flexor and extensor facilitation and inhibition during gait.

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Shoulder Flexors • Anterior Deltoid • Coracobrachialis • Pectoralis Major Clavicular

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Shoulder Extensors • Latissimus Dorsi • Teres Major • Posterior Deltoid

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This can easily be demonstrated in a normal individual by first testing the general shoulder flexors and extensors with the person standing; normally the muscles will test strong.

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When the subject is put in a simulated gait position, there will be inhibition of one of the groups. The simulated gait position is static, with the majority of weight on the leading leg.

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In this position, the shoulder flexors on the leading leg side and the extensors on the trailing leg side test weak, which is the normal function coinciding with the arm swing of gait.

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Inhibition of the shoulder flexors or extensors with gait position results from the change of stimulation to the proprioceptors of the joints, muscles, and skin.

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This afferent supply is then mediated in the central nervous system to cause facilitation and inhibition of not only the shoulder flexors and extensors but also all other muscles alternately active during gait.

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This normal action can be disturbed if there is improper transmission from the afferent receptors.

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For one reason or another, it appears that any of the receptors can be stimulated or malfunction to create inappropriate afferent impulses.

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The central nervous system, acting on the erroneous afferent information, causes inappropriate facilitation and inhibition of muscles.

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Neurologic disorganization appears to result from afferent receptors sending conflicting information for interpretation by the central nervous system.

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The pencils placed under the 1st and 5th metatarsals stimulate the forefoot in a manner different from the normal gait position.

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The receptors in the rest of the foot, ankle, leg, knee, hips, and pelvis continue to send information of a normal gait position.

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Since the central nervous system can only act on the information it receives, the resulting inhibition and facilitation of muscles is not in keeping with the gait position.

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Subluxations of the foot appear to improperly stimulate the joint receptors in a manner similar to the simulated subluxations caused by the pencils.

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Improper afferent stimulation is not limited to joint subluxations. The many types of nerve receptors in the body can be inappropriately stimulated in a manner similar to the demonstration with pencils under the forefoot. ICAK-U.S.A.

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Trauma to ligaments, muscles, fascia, skin, and many other structures can parallel the improper stimulation to nerve receptors in the "pencil under the forefoot" demonstration.

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Disorganization from these factors relates to the structural side of the triad of health. Inappropriate stimulation to the chemical and mental sides of the triad can also be responsible for unpredictable muscle function in a manual test. ICAK-U.S.A.

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Early in Applied Kinesiology Dr. Goodheart recognized unpredictable muscle function. A high shoulder without upper trapezius involvement is usually caused by a weak latissimus dorsi muscle.

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In some cases, the latissimus dorsi fails to test weak on the high shoulder side; rather, it tests weak on the low shoulder side.

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Another example is muscle weakness associated with a deficient meridian.

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175

If the circulation sex meridian is deficient on the right and normal on the left, weakness of the gluteus maximus and medius — if present — should be on the right.

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An example of disorganization is when the gluteus maximus is weak on the left and the gluteus medius weak on the right.

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Since disorganization is often related to right and left switching of function, the term "switching" was coined to describe the disorganization.

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When using manual muscle testing as an indicator for therapeutic approach, it is necessary that the nervous system be organized to provide correct information; otherwise, therapy might be directed to the wrong area. ICAK-U.S.A.

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Disorganization may also result in failure to find dysfunction, or may indicate problems that are not actually present.

ICAK-U.S.A.

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The standard AK method for determining if a person is neurologically disorganized is testing KI 27 with therapy localization. Positive findings indicate probable neurologic disorganization.

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An example of and common test for neurologic disorganization is "ocular lock," which is a failure of the eyes to work together effectively.

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When the eyes are turned in a specific direction and a previously strong muscle weakens, it is a positive ocular lock.

ICAK-U.S.A.

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Ocular lock can also be observed when the examiner moves his finger in a circle for the patient's eyes to follow. This is first done clockwise or counterclockwise, and a previously strong indicator muscle is tested for weakening.

ICAK-U.S.A.

184

Ocular lock can usually be temporarily eliminated by treatment of KI 27-umbilicus.

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KI 27-Umbilicus. KI 27-umbilicus stimulation is indicated when there is positive therapy localization at KI 27 and lack of predictable results with manual muscle testing.

ICAK-U.S.A.

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One must remember that therapy localization tells that something is dysfunctioning at the area being therapy localized, but it does not tell what.

ICAK-U.S.A.

187

ICAK-U.S.A.

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In the general area of KI 27 there could also be a positive neurolymphatic reflex for the intrinsic spinal muscles, subluxation or strain of the sternoclavicular articulation, or 1st rib subluxation.

ICAK-U.S.A.

189

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The KI 27-umbilicus method of treating neurologic disorganization is to first vigorously stimulate one KI 27 and the umbilicus for about twenty seconds; then the other KI 27 point is vigorously stimulated along with the umbilicus for twenty seconds. ICAK-U.S.A.

190

When neurologic disorganization is treated by stimulating KI 27umbilicus, umbilicus- auxiliary KI 27, or GV-CV treatment, the correction is only temporary unless the cause of the neurologic disorganization is also found and corrected. ICAK-U.S.A.

191

To find the cause of neurologic disorganization, positive therapy localization at KI 27 is used as a tool for further examination.

ICAK-U.S.A.

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The basic concept is to use Applied Kinesiology examination tools to find what eliminates the positive therapy localization to KI 27.

ICAK-U.S.A.

193

For example, the patient therapy localizes to bilateral KI 27 points and a strong indicator muscle is tested. When the indicator muscle tests weak with the therapy localization, there is evidence of switching.

ICAK-U.S.A.

194

The examiner proceeds to evaluate various areas and functions of the body, as indicated by body language. For example, the examiner may observe calluses under the mid-distal metatarsals, indicating a dropped metatarsal arch that would be similar to the example of placing pencils under the 1st and 5th metatarsals. ICAK-U.S.A.

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Using this clue, he has the patient continue to therapy localize the KI 27 points while he challenges the metatarsal bones in a direction for probable correction.

ICAK-U.S.A.

196

If the dropped metatarsal arch is the cause of the neurologic disorganization, the positive KI 27 therapy localization will be eliminated when the proper vector of correction is obtained.

ICAK-U.S.A.

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Structural. The most common cause of neurologic disorganization is dysfunction of the cranial-sacral primary respiratory mechanism.

ICAK-U.S.A.

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It may require treatment to the stomatognathic system in general, which includes jaw function, dental occlusion, cranial faults, and cervical spine function.

ICAK-U.S.A.

199

To evaluate the stomatognathic system as a cause of neurologic disorganization, one uses the tools of Applied Kinesiology to determine what will eliminate the positive therapy localization to KI 27.

ICAK-U.S.A.

200

It may be eliminated by a phase of respiration, challenge to an area of the skull, having the patient stretch the jaw wide open, or moving the jaw into a certain position. Movement of the jaw pulls on the bones of the skull by way of the masticatory muscles and, in effect, is a type of challenge to the skull. ICAK-U.S.A.

201

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Unless the basic underlying cause of switching is found, it is mandatory to use the unswitching techniques previously described before treatment so that improper treatment is not applied as a result of erroneous examination findings. ICAK-U.S.A.

202

When a patient has positive therapy localization to KI 27, the only factors that should be treated are those which, when challenged, therapy localized, or otherwise evaluated, eliminate the positive KI 27.

ICAK-U.S.A.

203

Whenever the stomatognathic system is treated, the pelvis should be evaluated for Category I, II, and III faults. The sacrum should also be routinely evaluated when cranial faults have been corrected.

ICAK-U.S.A.

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The second most common cause of neurologic disorganization on a structural basis is foot dysfunction, which may be excessive pronation, tarsal tunnel syndrome, individual subluxations, and/or muscle dysfunction. ICAK-U.S.A.

205

Chemical. Chemical causes of in-the-clear neurologic disorganization usually relate to some form of nutrition, which in one way or another influences the neurotransmitters.

ICAK-U.S.A.

206

Mental. Mental causes of neurologic disorganization may be intrinsic to the patient's physiology, or extrinsic in his environment and interaction with people.

ICAK-U.S.A.

207

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Sometimes positive TL to KI 27 can be eliminated by having the patient therapy localize to the bilateral frontal bone eminences.

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208

This is the location of the neurovascular points for the pectoralis major (clavicular division). Successful treatment to the emotional neurovascular points will eliminate the positive therapy localization to KI-27.

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Applied Kinesiology

ICAK-U.S.A.

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Chiropractic Subluxation

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Chiropractic • Chiropractic is a health care discipline which emphasizes the inherent recuperative power of the body to heal itself without the use of drugs or surgery. • The practice of chiropractic focuses on the relationship between structure (primarily the spine) and function (as coordinated by the nervous system) and how that relationship affects the preservation and restoration of health. ICAK-U.S.A.

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Chiropractic Chiropractic is concerned with the preservation and restoration of health, and focuses particular attention on the subluxation.

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Subluxation A subluxation is a complex of functional and/or structural and/or pathological articular changes that compromise neural integrity and may influence organ system function and general health.

ICAK-U.S.A.

ICAK-U.S.A.

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215

Vertebral Fixations p. 86 Many in chiropractic have used the terms “subluxation” and “fixation” interchangeably. ICAK-U.S.A.

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In Applied Kinesiology, we recognize that there are fundamental differences between the two and we will explain the functional differences between the two as observed by manual muscle testing.

ICAK-U.S.A.

217

Difference between Subluxations and Fixations • Structures Involved • Muscle Weakness • Therapy Localization • Challenge • Static X-ray • Motion X-ray • Correction ICAK-U.S.A.

218

Structures Involved - Subluxation One specific structure of the spinal column is involved in a subluxation. It can be a vertebra, a portion of the pelvis, or the occiput that is out of normal function with the rest of the spinal column.

ICAK-U.S.A.

219

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Structures Involved - Fixation In a fixation complex a minimum of two structures will be involved, and they will have restricted movement between them. Usually three vertebrae are involved in a fixation; however, there may be two or up to five (and possibly even more)

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220

Muscle Weakness - Subluxation There is no consistency of muscle weakness associated with vertebral subluxations. The wide range of neurologic ramifications can cause almost any muscle associated with a specific spinal subluxation to be weak.

ICAK-U.S.A.

221

Muscle Weakness - Fixation There are specific bilateral muscular weaknesses associated with vertebral fixations

ICAK-U.S.A.

222

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Therapy Localization - Subluxation Therapy localization over a subluxation will cause a strong indicator muscle to weaken, or a muscle weak as a result of the subluxation to strengthen.

ICAK-U.S.A.

223

Therapy Localization - Fixation With therapy localization over a vertebral fixation, a previously strong indicator muscle will not weaken unless there is an attempt to introduce motion into the fixation complex.

ICAK-U.S.A.

224

Therapy Localization - Fixation Therapy localization over a fixation will strengthen the bilateral muscle weakness associated with the fixation.

ICAK-U.S.A.

225

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Challenge -Subluxation The vertebra or other spinal structure is challenged with a single point of contact.

ICAK-U.S.A.

226

Challenge - Fixation There will usually be no reaction to a single-point challenge. Challenge is accomplished by challenging two vertebrae at the same time, usually by pressing in opposite directions on the spinous or transverse processes.

ICAK-U.S.A.

227

Static X-ray - Subluxation A subluxated vertebra is usually observable as misaligned on a static xray film.

ICAK-U.S.A.

228

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Static X-ray - Fixation Generally no misalignment between fixed spinal structures is observed on x-ray.

ICAK-U.S.A.

229

Motion X-ray -Subluxation Serial static x-rays or cineroentgenography will usually show aberrant movement of the subluxated vertebra. ICAK-U.S.A.

230

Motion X-ray - Fixation There will usually be hypokinesis of the spinal fixation complex

ICAK-U.S.A.

231

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Correction - Subluxation A subluxation can be adjusted with a single point of contact.

ICAK-U.S.A.

232

Correction - Fixation A fixation requires a two-handed contact or some other method of stabilizing one of the structures while the other in manipulated, because a single-handed contact just moves the entire complex rather than unlocking the mechanism. ICAK-U.S.A.

233

Bilateral Muscle Weakness of Fixations Appears to relate with the equilibrium proprioceptors located in the ligaments along the spine. ICAK-U.S.A.

234

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78

The most thoroughly studied spinal equilibrium proprioceptors are the tonic neck receptors in the infant or head-on-neck receptors in the adult.

ICAK-U.S.A.

235

Their location relates with the upper cervical fixation and its associated bilateral gluteus maximus weakness

ICAK-U.S.A.

236

Schmitt demonstrated that contraction of the neck extensor muscles to forcefully extend the head on the neck causes weakness in previously strong bilateral gluteus maximus muscles as long as the contraction is held. ICAK-U.S.A.

237

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79

A belt can be tightly placed around the innominate bones to create an artificial sacroiliac articulation fixation with concomitant cervical extensor muscle weakness.

ICAK-U.S.A.

238

Evaluation and Correction • General localization of a fixation complex is found by bilateral muscle weakness • Not all bilateral muscle weakness will have an associated fixation complex – could be one or more of the 5 factors

• Therapy localization over the spinal fixation will strengthen the bilateral muscle weakness ICAK-U.S.A.

239

Fixation Scan • Neck Extensors – Group (Lumbars) – Right (Right SI) – Left (Left SI) – Both Left and Right (Sacrum)

• • • • • •

Lower Trapezius (Dorsolumbar Junction) Middle Deltoid (Cervicothoraci Junction) Teres Major (Thoracics) Gluteus Maximus (Upper Cervical) Popliteus (Lower Cervical) Psoas (Occipital) ICAK-U.S.A.

240

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80

Neck Extensors (Group) - Lumbars

ICAK-U.S.A.

Neck Extensors Right – Right SI

241

Neck Extensors Left – Lef t SI

Neck Extensors Bilateral-Sacrum

ICAK-U.S.A.

242

Lower Trap – Dorsolumbar Junction

ICAK-U.S.A.

243

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81

Middle Deltoid – Cervicodorsal

ICAK-U.S.A.

244

Teres Major - Thoracic

ICAK-U.S.A.

245

Gluteus Maximus – Upper Cervical

ICAK-U.S.A.

246

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82

Popliteus – Lower Cervicals

ICAK-U.S.A.

247

Psoas - Occipital

ICAK-U.S.A.

248

Procedure • Step 1 finds the vertebrae involved in the fixation complex • Step 2 determines the direction in which the vertebral motion is limited • Step 3 locates the vertebrae of the complex that are the keys to restoration of mobility

ICAK-U.S.A.

249

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83

Step 1 • Identify the general area of fixation by testing for bilateral muscle weakness of the muscles associated with fixation. • Palpate for motion between adjacent vertebrae by pressing on the spinous processes or TVP’s to rotate them in opposite directions. • Judge the motion available between the vertebrae; then reverse contacts to rotate them in the opposite direction. • Progressively evaluate motion between vertebrae until you establish the upper and lower limits of the fixation group. ICAK-U.S.A.

1

2

3

250

4

ICAK-U.S.A.

251

ICAK-U.S.A.

252

84

84

Step 2 • The fixation complex will be able to rotate easlity in one direction but will resist movement in the opposite direction • The top vertebra found in step one is the key • Press the spinous process both left and right and note which direction moves more easily and which has more resistance. • You can also press on the transverse or mamillary processes and observe for resistance on one side. ICAK-U.S.A.

253

Step 2 • The complex is considered locked posteriorly or anteriorly. • Reference to posterior and anterior relates only to movement ability not to the directional misalignment considered in vertebral subluxation analysis.

ICAK-U.S.A.

254

Step 2 • If the right transverse process resists anterior movement, it indicates that the vertebra is locked posteriorly on that side. • This is listed as a right posterior fixation. • This then would indicate that the left side is locked anteriorly so the complex would be a left anterior fixation and a right posterior one. ICAK-U.S.A.

255

85

85

ICAK-U.S.A.

256

Step 3 • The primary side of fixation is found by comparing bilaterally the resistance to digital pressure applied by the examiner over the facet articulations of the top two vertebra • First, press anteriorly on one articulation and then on the other, making comparison. • One side will resist more than the other, indicating the primary side of fixation.

ICAK-U.S.A.

257

Step 3 • If the fixation is on the posterior side, the top vertebra of the complex is adjusted on the vertebra immediately below. • If the fixation is an anterior one, the bottom vertebra of the complex is adjusted on the vertebra above • Only the top two or bottom two vertebrae are manipulated, but the entire complex will unlock regardless of the number involved. ICAK-U.S.A.

258

86

86

Press I – S on the left, then press I – S on the right. The side that produces the most resistance is the primary side.

ICAK-U.S.A.

259

The Adjustment • The contact points for unlocking a fixation are the transverse processes in the thoracic spine, mamillary processes in the lumbar spine, and laminae in the cervical spine. • The contact point for the vertebra adjacent to the top or bottom one is on the side opposite the fixation. • The top or bottom vertebra is contacted on the side opposite the adjacent vertebra. ICAK-U.S.A.

260

• The pattern, then, is to contact the top vertebra in a posterior fixation on the side of fixation, or the bottom vertebra on the side opposite the fixation. • The manipulation to unlock a fixation is a twostep thrust. The first thrust is on top or bottom vertebra of the complex as indicated. • Almost immediately following there is a quick thrust from the opposite hand on the adjacent vertebra. ICAK-U.S.A.

261

87

87

• There is usually an audible release; however, it is not necessary for effective correction. • Effectiveness is indicated by strengthening of the bilateral muscle weakness, and no positive therapy localization combined with spinal movement of the area.

ICAK-U.S.A.

262

Unusual Corrections • Occipital Fixation Complex – Palpate for tender nodule at Inferior Nuchal Line – LOC from nodule to glabella

• SI Fixation Complex – Simply open up the joint

• Posterior Sacral Fixation Complex – Adjust P-A & M-L at Sacral Ala ICAK-U.S.A.

263

Occipital Fixation p. 90

ICAK-U.S.A.

264

88

88

Sacroiliac Fixation p.93 • Indicated when the unilateral neck extensors test weak with the other side strong • Therapy localization to the sacroliliac strengthens the neck extensor weakness • Must diff dx from a Cat I and Cat II. • Correct with an adjustive thrust to separate the innominate from the sacrum ICAK-U.S.A.

265

Sacroiliac Fixation • Often, correcting hypertonicity of the piriformis or psoas is all that is necessary to eliminate a sacroiliac fixation • There may be a subclinical fixation – unilateral cervical extensors test strong in the clear but weaken with TL of the SI – With a true subclinical fixation only the cervical extensors will weaken with the TL ICAK-U.S.A.

266

Sacroiliac Fixation • W ith a subclinical fixation there is often a respiratory pattern • W hile the patient is TL’ing the SI, have them hold a deep phase of respiration to determine if it abolishes the positiveTL – If so, correct with a medial vector of force on the PSIS in the case of an inspiration assist – and a lateral vector of force on the PSIS in the case of an expiration assist ICAK-U.S.A.

267

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89

Sacrum • Indicated when testing neck extensors and head rotation to each side produces a weak muscle test • Analyze with the same three step process. • Step 1 – identify the stack (In this case it is the sacrum that you have already identified. • Step 2 – Find the rotation ICAK-U.S.A.

268

Press right to left and then left to right on the S2 tubercle. If you meet more resistance pushing right to left the sacrum is left posterior.

Step 2 is to induce theta Y rotation by either pushing on the S2 tubercle or on the ala.

Press P-A on the left ala and then on the right ala. If you meet more resistance pushing on the left ala, the sacrum is left posterior. ICAK-U.S.A.

269

Move in close to the S2 tubercle and press I-S first on the left and then on the right. The side that meets the most resistance is the primary side. ICAK-U.S.A.

270

90

90

Right Posterior Sacral Fixation Complex

ICAK-U.S.A.

271

Left Anterior Sacral Fixation Complex

ICAK-U.S.A.

272

Applied Kinesiology Low Back Scan

ICAK-U.S.A.

273

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91

Low Back Scan Supine • Abdominals (p. 316) – Straight (lean back 30 degrees) – Obliques • Shoulder back - internal obliques • Shoulder forward - external obliques

ICAK-U.S.A.

274

ICAK-U.S.A.

275

ICAK-U.S.A.

276

92

92

ICAK-U.S.A.

277

ICAK-U.S.A.

278

Low Back Scan Supine • Quadratus Lumborum (10 degrees away) (p. 372)

ICAK-U.S.A.

279

93

93

ICAK-U.S.A.

280

Low Back Scan Supine • Rectus Femoris • Iliacus (p. 326) • Psoas (p. 325)

ICAK-U.S.A.

281

ICAK-U.S.A.

282

94

94

ICAK-U.S.A.

283

ICAK-U.S.A.

284

Low Back Scan Supine • Sartorious (p. 324)

ICAK-U.S.A.

285

95

95

ICAK-U.S.A.

286

Low Back Scan • Gracilis (p. 324) • Adductors (p. 314) • Gluteus Medius (p. 320) • TFL (p. 319)

ICAK-U.S.A.

287

ICAK-U.S.A.

288

96

96

ICAK-U.S.A.

289

ICAK-U.S.A.

290

ICAK-U.S.A.

291

97

97

Low Back Scan Prone • Hamstrings (p. 310) – Group - Straight – Medial Hamstrings – Lateral Hamstrings

ICAK-U.S.A.

292

ICAK-U.S.A.

293

ICAK-U.S.A.

294

98

98

ICAK-U.S.A.

295

Low Back Scan Prone • Piriformis (p. 309)

ICAK-U.S.A.

296

ICAK-U.S.A.

297

99

99

ICAK-U.S.A.

298

Low Back Scan Prone • Gluteus Maximus (p. 321

ICAK-U.S.A.

299

ICAK-U.S.A.

300

100

100

Low Back Scan Prone • Sacrospinalis (p. 370)

ICAK-U.S.A.

301

ICAK-U.S.A.

302

ICAK-U.S.A.

303

101

101

Applied Kinesiology Lab – Low Back Scan 1. Abdominals Patient Position: Seated, knees together, arms crossed, lean back 30 ◦ Doctor Position: One hand on pt’s arms, the other stabilizes at pt’s knees A. Push straight through arms for rectus abdominus B. Rotate patient with 30 ◦ lean: 1) Right shoulder forward checks Right Ext Obl/Left Int Oblique 2) Left shoulder forward checks Left Ext Obl/Right Int Oblique 2. Quadratus Lumborum (testing the muscle contralateral to the doctor) Patient Position: Supine Doctor Position: A. kneeling facing pt. B. reach under both legs with inferior hand and positions the patient’s legs 10 ◦ away C. stabilize on greater trochanter with superior hand and pulls legs back to center with inferior hand 3. Rectus Femoris Patient Position: Supine, leg up 45 , ◦toes straight 4. Iliacus Patient Position: Supine, leg up 45 ,◦ externally rotated 5. Psoas Patient Position: Supine, leg up 45 ,◦ out 45 ,◦and externally rotated 6. Sartorious Patient Position: Supine, FABRE in the air Doctor Position: Inferior hand under ankle, superior hand on top of knee “Pull your heel up towards your shoulders, Pull” 7. Gracilis Patient Position: Supine, legs together Doctor Position: Superior hand stabilizes contralateral leg Inferior hand induces internal rotation & tries to pull legs apart 8. Adductors Patient Position: Supine, legs 6” apart Doctor Position: Superior hand stabilizes contralateral leg Inferior hand returns leg to neutral and tries to pull legs apart 9. Gluteus Medius Patient Position: Supine Doctor Position: A. At foot of table, grabs both ankles B. Move involved side laterally off the table C. Lower leg towards floor and internally rotate it D. Doc tries to move involved ankle towards other ankle 10. Tensor Fascia Lata Patient Position: Supine, legs same distance apart as Gluteus Medius Doctor Position: At foot of table, raises patient’s leg up to about 30-45 ◦ maintaining internal rotation, trying to bring legs together

102

11. Hamstrings Patient Position: Prone, lower leg raised 45 ◦ Doctor Position: Inferior arm locked and pushing down on patient’s ankle Superior arm stabilizes with fist on hamstrings (group test) Move leg medial and point toes lateral to test lateral hamstrings Move leg lateral and point toes medial to test medial hamstrings 12. Piriformis Patient Position: Prone, lower leg raised 90 ,◦ and bring it past midline Doctor Position: Inferior hand pulls leg M-L Superior hand stabilizes ilium, knee stablizes knee 13. Gluteus Maximus ◦ Patient Position: Prone with lower leg bent 45 and femur raised off table Doctor Position: Superior hand stabilizes ilium/sacrum Inferior hand pushes femur P-A 14. Sacrospinalis Patient Position: Prone, shoulder elevated off of table, ribcage rolled up and back Doctor Position: steep angle to roll shoulder back down to table (I-S, M-L, P-A)

103

Tibialis Anterior • Origin – Lateral condyle of tibia – Proximal 2/3 of the lateral surface of the tibia – Interosseous membrane – Deep Fascia – Lateral Intermuscular septum

• Insertion – Medial and plantar surface of medial cuneiform – Base of 1 st metatarsal ICAK-U.S.A.

304

Tibialis Anterior • Action – Dorsiflexes foot and inverts it

• Innervation – Peroneal, L4,L5, S1

ICAK-U.S.A.

305

Tibialis Anterior • Test – The supine patient inverts and dorsiflexes the foot, with the toes kept in flexion. The examiner applies pressure against the medial dorsal surface of the foot in the direction of plantar flexion and eversion. The examiner should see effective contraction of tibialis anterior as indicated by the tendon elevation during the test ICAK-U.S.A.

306

104

102

Tibialis Anterior • Meridian Association – Bladder

ICAK-U.S.A.

307

Tibialis Posterior • Origin – Lateral part of posterior surface of tibia – Medial 2/3s of fibula – Interosseous membrane – Intermuscular septa – Deep fascia

• Insertion – Tuberosity of navicular – Plantar surface of cuneiforms – Plantar surface of 2,3, & 4 metatarsal – Cuboid – Sustentaculum tali ICAK-U.S.A.

308

Tibialis Posterior • Action – Inverts and plantar flexes foot – Medial ankle stabilizer

• Innervation – Tibial, L5, S1

ICAK-U.S.A.

309

105

103

Tibialis Posterior • Test – The supine patient maximally plantar flexes the foot and then inverts it, keeping the toes in a flexed position. – The examiner places his hand on the medial side over the foot. Pressure is directed against the medial side of the foot in the direction of eversion. The examiner should observe for the rising tendon of the TP when the muscle contracts. ICAK-U.S.A.

310

Tibialis Posterior • Meridian Association – Circulation Sex

ICAK-U.S.A.

311

Peroneus Tertius • Origin – Lower one third of the anterior surface of the fibula – Adjacent intermuscular septum

• Insertion – Dorsal surface of the base of the 5 th metatarsal

ICAK-U.S.A.

312

106

104

Peroneus Tertius • Action – Dorsiflexes and everts the foot

• Innervation – Peroneal, L4, L5, S1

ICAK-U.S.A.

313

Peroneus Tertius • Test – The supine patient dorsiflexes and everts the foot with the toes kept in the neutral position, or toward flexion – Examining pressure is directed against the dorsal lateral surface of the 5 th metatarsal in the direction of plantar flexion and inversion

ICAK-U.S.A.

314

Peroneus Tertius • Meridian Association – Bladder

ICAK-U.S.A.

315

107

105

Peroneus Longus and Brevis • Origin (Peroneus Brevis) – Lower 2/3s of fibula on lateral side – Adjacent intermuscular septa

• Insertion (Peroneus Brevis) – Lateral side of proximal end of 5 th metatarsal

ICAK-U.S.A.

316

Peroneus Longus and Brevis • Origin (Peroneus Longus) – Lateral condyle of tibia – Head and upper 2/3s of lateral surface of fibula – Adjacent intermuscular septa and fascia

• Insertion (Peroneus Longus) – Proximal end of the 1 st metatarsal and medial cuneiform on their lateral portions ICAK-U.S.A.

317

Peroneus Longus and Brevis • Action – Plantar flexes the foot and everts it – Gives lateral stability to the ankle

ICAK-U.S.A.

318

108

106

Peroneus Longus and Brevis • Innervation – Peroneal, L4, L5, S1

ICAK-U.S.A.

319

Peroneus Longus and Brevis • Test – The supine patient maximally plantar flexes and everts the foot with the toes kept in the neutral position, or toward flexion – Examining pressure is directed against the dorsal lateral surface of the 5 th metatarsal in the direction of inversion

ICAK-U.S.A.

320

Peroneus Longus and Brevis • Meridian Association – Bladder

ICAK-U.S.A.

321

109

107

TA

Dorsiflexion

PT Medial La teral

TP

Plantarflexion ICAK-U.S.A.

PLB

322

Doctor pushes in direction of arrows

Muscles - Testing and Function

Gastrocnemius Origin: Medial head: medial condyle and adjacent part of femur; capsule of knee joint. Lateral head: lateral condyle and posterior surface of knee joint. Insertion: into calcaneus by Achilles tendon. Action: plantar flexes foot. Test: The medial and lateral heads of the gastrocnemius can be tested as described by Beardall. 5 The test must be correlated with hamstring strength because they are significantly synergistic in the test. For both medial and lateral heads of the gastrocnemius, the supine patient flexes the knee to approximately 110° and maximally

plantar flexes the foot. For the medial head, the leg is internally rotated; for the lateral test, it is externally ro• tated. The examiner stabilizes the knee while extending it by pulling on the calcaneus contact. Nerve supply: tibial, L4, 5, Sl, 2.

Neurolymphatlc: Anterior: 2" above umbilicus and 1" from midline. Posterior: between Tl1, 12 bilaterally near laminae. Neurovascular: lambda. Nutrition: adrenal concentrate or nucleoprotein extract. Meridian association: circulation sex. Organ association: adrenal.

NEUROVASCULAR

111

STRESS RECEPTOR

112

8---63. Internal leg rotation for medial gastrocnemius test.

8-64. External leg rotation for lateral gastrocnemius test.

hapter 8

Soleus Origin: posterior surface of the head and upper one• third of the shaft of the fibula; middle one-third of the medial border of the tibia; tendinous arch between tibia and fibula. ·Insertion: into calcaneus with gastrocnemius by way of the Achilles tendon. Action: plantar flexes foot. Test: The prone patient flexes the knee to 90° and plantar flexes the foot. The examiner directs traction on the calcaneus and pressure on the forefoot in a direction of dorsiflexion. The knee flexion helps take

the gastrocnemius out of the test. Because of the great strength of the soleusand its limited leverage, this muscle is difficult to evaluate. Nerve supply: tibial, L4, 5, Sl, 2.

Neurolymphatic: Anterior: 2" above umbilicus and 1" from midline. Posterior: between T11, 12 bilaterally near laminae. Neurovascular: lambda. Nutrition: adrenal concentrate or nucleoprotein extract. Meridian association: circulation sex. Gland association: adrenal.

8-61. Flexing the knee to 90° helps take the gastrocnemius out of the test. 11 2

Posterior

Anterior NEUROLYMPHATIC

NEUROVASCULAR

STRESS RECEPTOR

328

112

8-62.

Pelvic Categories Throughout Applied Kinesiology it is emphasized that the body functions as an integrated whole.

Pelvic function is an important example of this interdependence. The pelvis is an assembly that has sub-assemblies; that is, the pelvis can move as a whole, yet there is action between the innominates and the sacrum, and between the sacrum and the coccyx. ICAK-U.S.A.

325

Pelvic dysfunction is divided into three categories. Categories I and II are dysfunctions of the sub-assemblies. Category III is dysfunction of the intact pelvic assembly with the 5th lumbar. ICAK-U.S.A.

326

The pelvic category system was developed by DeJarnette and is practiced in Sacro Occipital Technique (SOT).

ICAK-U.S.A.

327

113

109

The original system of evaluation and correction as found in SOT is viable, and is the basis for additional diagnosis and therapeutic developments in Applied Kinesiology.

ICAK-U.S.A.

328

Pelvic category faults are intimately involved in creating dural tension because of the firm dural attachments at the occiput and upper cervical vertebrae, with no further firm attachment until the anterior portion of the 2nd sacral segment by the filum terminale. ICAK-U.S.A.

329

In between these firm attachments are the dentate ligaments, which only loosely support the dura.

ICAK-U.S.A.

330

114

110

It appears that the wide range of dysfunction and symptomatic problems from pelvic faults is due to dural tension and pelvic ligament relations with the spine, documented by Dvorak and Dvorak. 27 ICAK-U.S.A.

331

More than one type of pelvic category fault can be present at the same time. On an initial examination, usually one type of fault will be prominent. When it is corrected, another fault may be revealed. For example, after a Category I fault is corrected, the pelvis may test positive for a Category III fault that was not previously apparent. ICAK-U.S.A.

332

There are several methods of correcting pelvic faults; some were developed in SOT and others in Applied Kinesiology.

ICAK-U.S.A.

333

115

111

A recent study using SOT methods of examination and correction evaluated muscle strength change. 113

ICAK-U.S.A.

334

The anterior deltoid, latissimus dorsi, psoas, tensor fascia lata, adductors, and gluteus medius strength was measured pre- and post-treatment. There was significant strength increase in most of the muscles tested post –treatment. ICAK-U.S.A.

335

The choice of corrective method can be matched to the physician's training in manipulation and treatment style.

ICAK-U.S.A.

336

116

112

Category I

ICAK-U.S.A.

337

The Category I pelvic fault is torsion of the pelvis without osseous misalignment at the sacroiliac articulations; thus there are no subluxations as such in this involvement.

ICAK-U.S.A.

338

A common complaint of a Category I pelvic fault is cervical spine tension.

ICAK-U.S.A.

339

117

113

The patient complains of pain and limited motion on turning his head, making it difficult to back his car. This will usually be more marked on one side.

ICAK-U.S.A.

340

Secondary to the pelvic torsion, there is often torsion of the shoulder girdle that may manifest as a thoracic outlet syndrome.

ICAK-U.S.A.

341

Cranial faults are often associated with a Category I as well.

ICAK-U.S.A.

342

118

114

A Category I pelvic fault has a unique therapy localization that differentiates it from other pelvic disturbances.

ICAK-U.S.A.

343

The patient is usually examined prone, and strong hamstrings are used as indicator muscles for the therapy localization. There will be positive therapy localization when the patient places his hands on the sacroiliac articulations, right hand on right and left hand on left. ICAK-U.S.A.

344

There will be further positive therapy localization on one sacroiliac only, done with one of the patient's hands over the other.

ICAK-U.S.A.

345

119

115

This is considered the positive side of the category I pelvic fault. Neither sacroiliac articulation will show positive therapy localization if single-handed TL is done one at a time.

ICAK-U.S.A.

346

ICAK-U.S.A.

347

ICAK-U.S.A.

348

120

116

The torsion of a Category I pelvic fault consists of a posterior superior iliac spine (PSIS) on one side and a posterior ischium on the other.

ICAK-U.S.A.

349

A positive Category I challenge is simultaneous pressure applied on the PSIS and contralateral ischium in an anterior direction and released, followed by a strong indicator muscle weakening.

ICAK-U.S.A.

350

There will be one combination of vectors that causes the maximum amount of indicator muscle weakening. Because the pelvis demonstrates a rebound-type challenge, this is the optimal vector for correction.

ICAK-U.S.A.

351

121

117

Positive challenge will usually be with the PSIS posterior on the side of the short leg. If this does not correlate, consider anatomical variances, such as an anatomical short leg or neurologic disorganization.

ICAK-U.S.A.

352

If there is a discrepancy between the challenge and leg length and other factors have been ruled out, the challege takes precedence.

ICAK-U.S.A.

353

A Category I pelvic fault will not have a positive challenge when only one sacroiliac is challenged. This is the differentiating factor between a Category I and Category II fault.

ICAK-U.S.A.

354

122

118

Several muscle dysfunction patterns are often associated with, and probably the cause of, Category I pelvic faults.

ICAK-U.S.A.

355

The piriformis is often weak on the side of 2-handed therapy localization and hypertonic on the other, or bilaterally weak.

ICAK-U.S.A.

356

If the piriformis is weak only on the opposite side of two-handed therapy localization, the patient is neurologically disorganized.

ICAK-U.S.A.

357

123

119

Piriformis weakness is important because it crosses the sacroiliac articulation and helps provide stability.

ICAK-U.S.A.

358

1st Rib and Thoracic Outlet Shoulder girdle distortion is frequently secondary to a Category I pelvic fault creating pain at the 1st anterior and posterior rib attachments on the side of two-handed therapy localization. ICAK-U.S.A.

359

A positive thoracic outlet syndrome can often be corrected by making corrections only at the pelvis.

ICAK-U.S.A.

360

124

120

Block Adjusting Technique • DeJarnette blocks are placed under the prone patient's anterior superior iliac crest and acetabulum in a manner to relieve the pelvic torsion. • Block placement is determined by challenge • The posterior ilium side is the one where the PSIS was challenged from posterior to anterior and a strong muscle weakened; the contralateral side is the posterior ischium. ICAK-U.S.A.

361

• The posterior ilium is usually on the shortleg side, but the challenge takes precedence for how to block the patient. • A block is placed under the acetabulum on the posterior ilium side to bring the ischium posterior. Contralaterally, the block is placed under the ASIS to bring the ilium posterior. ICAK-U.S.A.

362

When the blocks are properly placed, there will no longer be positive bilateral sacroiliac therapy localization, and there will usually be relief of pain at the 1st rib head.

ICAK-U.S.A.

363

125

121

ICAK-U.S.A.

364

The patient's body weight lying on the blocks may adequately make a correction. A gentle thrusting-type action has been added in Applied Kinesiology to facilitate and speed the correction.

ICAK-U.S.A.

365

ICAK-U.S.A.

366

126

122

As mentioned earlier, one sacroiliac is the compromised or involved side; that is the one presenting the two-handed therapy localization.

ICAK-U.S.A.

367

The uncompromised or "noninvolved" side will not have positive two-handed therapy localization. The non-involved side is the side of contact for the manipulative effort. Contact is either on the PSIS or ischium in the direction of positive challenge. ICAK-U.S.A.

368

This indicates that the contact will be on the ischium if the DeJarnette block is under the ilium, and on the PSIS if the block is under the acetabulum.

ICAK-U.S.A.

369

127

123

• Corrective motion is a light, pumping-type action repeated approximately ten times. An excellent indicator for the number of repetitions is the reduction of tenderness at the posterior 1st rib head. • Before placing the DeJarnette blocks, palpate the rib head for tenderness; compare after the blocks are in place, and after the corrective manipulation has been applied. • Usually there will be great reduction of tenderness on digital pressure. A good indicator of effective correction is a minimum of 50% tenderness reduction; often it is much greater. ICAK-U.S.A.

370

With experience, one can readily determine the rigidity of the pelvis after the first few corrective thrusts. In a very rigid pelvis, it may take more thrusting actions than usual to obtain maximum correction.

ICAK-U.S.A.

371

After the corrective attempt there should be no positive therapy localization or challenge to the pelvis.

ICAK-U.S.A.

372

128

124

If a category I pelvic fault is not easily corrected or if it returns, some other factor is involved, such as muscle dysfunction, weight bearing, or gait dysfunction; this should be evaluated and corrected.

ICAK-U.S.A.

373

A patient may test negative for a Category I fault, but when tested weight bearing or immediately after gait, he will test positive.

ICAK-U.S.A.

374

A Category I pelvic fault can be evaluated for gait influence by simply having the patient therapy localize over both sacroiliac articulations while walking. When the patient stops, have him maintain the therapy localization while an indicator muscle is tested. ICAK-U.S.A.

375

129

125

If the Category I is specifically involved with gait, an indicator muscle will test weak; it will not test weak when the patient simply walks without the sacroiliac therapy localization.

ICAK-U.S.A.

376

Category II

ICAK-U.S.A.

377

The Category II fault has been recognized as an osseous subluxation at the sacroiliac articulation.

ICAK-U.S.A.

378

130

126

Dr. Goodheart recognized an additional type of pelvic fault in which the major involvement is at the symphysis pubis.

ICAK-U.S.A.

379

The original Category II is indicated by therapy localization at the sacroiliac articulation and is called a Category II sacroiliac pelvic fault, abbreviated Category IIsi.

ICAK-U.S.A.

380

The additional type is indicated by therapy localization at the symphysis pubis and is called a Category II symphysis pubis pelvic fault, abbreviated Category lIsp

ICAK-U.S.A.

381

131

127

A typical complaint with a Category II fault is leg pain that develops during the night but is not present during the day.

ICAK-U.S.A.

382

There is movement within the pelvis with respiration. On inhalation: • ilia move laterally • the symphysis pubis moves inferiorly • the sacral base moves posteriorly • sacral apex moves anteriorly • posterior iliac spine moves medially ICAK-U.S.A.

383

The opposite of each movement takes place with expiration.

ICAK-U.S.A.

384

132

128

Category lIsi

ICAK-U.S.A.

385

A Category lIsi pelvic fault is an osseous subluxation between the sacrum and the innominate. It is identified by positive therapy localization over the sacroiliac articulation.

ICAK-U.S.A.

386

• Therapy localization is usually done with patient supine, which yields a higher percentage of positive results than when done prone. • Usually only one will be positive. • It is possible to have bilateral category pelvic faults, in which case a differentiation must be made between a Category I and a Category lIsi. ICAK-U.S.A.

387

133

129

Pelvic respiratory movement can be used to advantage in diagnosis and treatment.

ICAK-U.S.A.

388

When there is positive therapy localization over the sacroiliac, have the patient take and hold a deep phase of respiration.

ICAK-U.S.A.

389

If the positive therapy localization is abolished it indicates movement in that direction is corrective. Adjust the structure in the direction of respiratory movement while the patient holds the respiration. ICAK-U.S.A.

390

134

130

If held inspiration cancels positive PI ilium therapy localiztion, adjust the PSIS in an anterior medial direction as indicated on the left innominate. If held expiration cancels positive therapy localization, adjust in an anterior lateral direction. In both cases have the patient hold the phase of respiraton that canceled the positive therapy 391 ICAK-U.S.A. localization while the adjustment is being made.

There are two major types of Category lIsi pelvic faults: the posterior ilium and posterior ischium. They have different muscle involvements and areas of tenderness that differentiate them from each other and from a Category I. ICAK-U.S.A.

392

Posterior Ilium

The posterior ilium is nearly always associated with dysfunction of the sartorius and/or gracilis muscles on the side of involvement. ICAK-U.S.A.

393

135

131

The muscle relationship with the sacroiliac sublux-ation can be demonstrated by correcting the subluxation with the usual manipulative techniques, but not strengthening the muscles.

ICAK-U.S.A.

394

The adjustment should balance the leg length and eliminate positive therapy localization and challenge. If it does, have the patient walk a short distance and then re-evaluate for the presence of the subluxation.

ICAK-U.S.A.

395

In many cases, when the muscles are not strengthened the subluxation will immediately return following walking. Correct the muscle dysfunction and repeat the process; the subluxation will usually not return. ICAK-U.S.A.

396

136

132

There are specific correlations to the posterior ilium Category IIsi pelvic fault. • The leg on the side of the posterior ilium will be short • Innominate will be longer on the posterior ilium side. • tenderness at the origin and insertion of the gracilis and/or sartorius • There will also be tenderness at the anterior and postIeri -or . 1 CAK U.S.A st rib heads

397

Challenge on the posterior superior iliac spine for the vector that causes the greatest weakening of an indicator muscle. Adjust in the direction of positive challenge with the phase of respiration that canceled positive therapy localization. ICAK-U.S.A.

398

Adjustment of the posterior ilium can be done with the patient prone or side-lying. The prone adjustment can best be done with a drop terminal point table. W hen done side-lying take care not to put excessive rotation into the lumbar spine that may cause disc trauma ICAK-U.S.A.

399

137

133

Posterior Ischium • The posterior ischium subluxation is not as common as the posterior ilium. • It is usually secondary to weak hamstring muscles, which give posterior stabilization to the pelvis on that side. • If the hamstrings are not weak in the clear, evaluate for subclinical weakness.

ICAK-U.S.A.

400

• The leg will be long on the side of the posterior ischium • Shorter innominate on the side of posterior ischium • There will be tenderness at the origin of the hamstrings on the ischial tuberosity, and there may be tenderness at any or all points of hamstring insertion. ICAK-U.S.A.

401

Challenge on the posterior ischium for the vector that causes the greatest weakening of a strong indicator muscle. Adjust in that vector on the phase of respiration that canceled positive therapy localization.

ICAK-U.S.A.

402

138

134

Category IIsp Associated with the pelvic torsion of a category lisp pelvic fault is tension in the sacrospinous and sacrotuberous pelvic ligaments.

ICAK-U.S.A.

403

These ligaments are important in pelvic balance and integrity. There are spondylogenic reflexes of the sacrospinous ligament to the occiput to C6 and of the sacrotuberous ligament from C7 to T8 that are often responsible for paraspinal pain in those areas, as described on page 129. ICAK-U.S.A.

404

A Category lIsp is identified by testing the sartorius for positive therapy localization over the symphysis pubis, slightly to the right and left

ICAK-U.S.A.

405

139

135

Challenge With the patient supine, place one hand under the ilium on one side and the ischium on the other side, and lift as if to lift the patient away from the table. A positive challenge is weakening of the sartorius or gracilis muscle, which is best, but any previously strong indicator muscle such as the tensor fascia lata can be used. ICAK-U.S.A.

406

The pelvis can then be rechallenged with a hand under the opposite ilium and ischium. There should only be one positive challenge. The challenge is of a rebound nature, as with other areas of the spine.

ICAK-U.S.A.

407

The side on which the ilium was lifted anteriorly, causing a weak muscle, is the posterior ilium; the side on which the ischium was lifted anteriorly, causing an indicator muscle to weaken, is the posterior ischium side.

ICAK-U.S.A.

408

140

136

Block Adjusting Technique A DeJarnette block is placed under the posterior superior iliac spine (PSIS) on the posterior ilium side, and under the ischium on the posterior ischium side. ICAK-U.S.A.

409

If the block placement is proper for correction, there will no longer be a positive therapy localization at the symphysis pubis and pubic bone.

ICAK-U.S.A.

410

With the patient remaining on the blocks, the physician grasps the patient's ankle and knee to move the leg on the posterior ilium side into flexion at the hip and knee. The thigh is adducted, bringing the knee across the body sufficiently to roll the patient gently onto the posterior ischium block. The knee and hip are then brought toward neutral, and the manuver is repeated about six times in a rolling fashion. ICAK-U.S.A.

411

141

137

It is usually necessary for the patient to stabilize the position of the DeJarnette blocks with his hands to keep them from slipping under the pelvis. A similar motion is then done about six times with the leg of the posterior ischium side, but with thigh abduction. ICAK-U.S.A.

412

ICAK-U.S.A.

413

Category III

ICAK-U.S.A.

414

142

138

In a Category III pelvic fault the pelvis in intact. The fault is dysfunction of L5 on an intact pelvis, or an intact pelvic dysfunction on L5.

ICAK-U.S.A.

415

Symptoms from a Catgory III pelvic fault can be local or remote • Severe sciatica that fails to respond. • Lumbar disc involvement • Facet syndrome • There may be cranial nerve involvement – IX, X, and XI

ICAK-U.S.A.

416

The Category III pelvic fault influences hip rotation because of muscle imbalance. To evaluate hip rotation the examiner internally rotates both legs by grasping the ankles. There will be much greater internal rotation on one side. ICAK-U.S.A.

417

143

139

Therapy Localization Because the pelvis is intact, there is no positive therapy localization at the sacroiliac articulations or at the symphysis pubis.

ICAK-U.S.A.

418

Challenge The Category III pelvic fault is determined by challenge with the patient prone.

ICAK-U.S.A.

419

Contact the anterior portion of the ischium, and lift it posteriorly while the L5 spinous process is pressed toward the side of ischial contact.

ICAK-U.S.A.

420

144

140

A positive challenge is indicated by weakening of a previously strong muscle, usually the hamstring group. The challenge is done bilaterally, and only one combination of ischium spinous process challenge will be positive. ICAK-U.S.A.

421

Block Adjusting Technique Proper placement of the DeJarnette blocks is indicated by reduction of tenderness present in the area of the 5th sacral nerve and at the 5th lumbar spinous process.

ICAK-U.S.A.

422

Place one block 90° to the spine under the anterior iliac spine on the side of L5 challenge contact. Initial location of the block under the ischium is 90° to the spine.

ICAK-U.S.A.

423

145

141

Evaluate the pain at the 5th sacral nerve and the lumbar spinous process. Progressively rotate the thick portion of the block under the ischium inferiorly until the pain is eliminated or is diminished to the greatest amount, indicating proper block placement that allows the pelvis to return to normal. ICAK-U.S.A.

424

ICAK-U.S.A.

425

While the patient remains on the blocks, test for a sacral inspiration or expiration fault, which is a complication of a Category III fault and often present.

ICAK-U.S.A.

426

146

142

• W hile the patient holds a deep inspiration, test the hamstring group on either side for weakening. • Next, test the hamstring group while the patient holds a deep expiration. • W eakening on inspiration indicates an expiration fault • W eakening on expiration indicates an inspiration fault. • Correct the sacral fault while the patient remains on the blocks ICAK-U.S.A.

427

Applied Kinesiology Cranial Lab

ICAK-U.S.A.

428

ICAK-U.S.A.

429

147

143

Inspiration/Expiration Assist Cranial Fault • Patient can have an inspiration assist cranial fault on one side – or the other – or both

• Patient can have an expiration assist cranial fault on one side – or the other – or both

• Patient can have an inspiration assist cranial fault on one side and an expiration assist cranial fault on the other ICAK-U.S.A.

430

Inspiration Assist Cranial Fault • Breathing Pattern – IM weakens on full exhalation • Rebound challenge P-A on left and right mastoid one at a time (IM goes weak) • Push P-A during inhalation on mastoid on the side that made IM weak (inhalation should take 6-8 seconds, repeat 4-6 times) • Recheck indicators – IM stays strong

ICAK-U.S.A.

431

ICAK-U.S.A.

432

148

144

ICAK-U.S.A.

433

Expiration Assist Cranial Fault • Breathing Pattern – IM weakens on full inhalation • Rebound challenge A-P on left and right mastoid one at a time (IM goes weak) • Push A-P during exhalation on mastoid on the side that made IM weak (exhalation should take 6-8 seconds, repeat 4-6 times) • Recheck indicators – IM stays strong ICAK-U.S.A.

434

ICAK-U.S.A.

435

149

145

ICAK-U.S.A.

436

Sphenobasilar Inspiration Assist Cranial Fault • Breathing Pattern - IM weakens on forced exhalation • Rebound challenge (simultaneously)-IM goes weak – P-A on mastoid – I-S on the ipsilateral palatomaxillary suture • Push simultaneously P-A on the mastoid and I-S on the hard palate as the patient goes from full expiration to full forced inspiration (repeat 4-5 times) • Recheck indicators – IM stays strong ICAK-U.S.A.

437

ICAK-U.S.A.

438

150

146

ICAK-U.S.A.

439

Sphenobasilar Expiration Assist Cranial Fault • Breathing Pattern - IM weakens on forced inhalation • Rebound challenge (simultaneously) – IM goes weak – A-P on mastoid – P-A on the ipsilateral central incisor • Push simultaneously A-P on the mastoid and PA on the incisor as the patient goes from full inspiration to full forced expiration (repeat 4-5 times) • Recheck indicators – IM stays strong ICAK-U.S.A.

440

ICAK-U.S.A.

441

151

147

ICAK-U.S.A.

442

Glabella Cranial Fault • Breathing Pattern – IM weakens on inspiration either through the nose or through the mouth but not both • Rebound challenge by approximating glabella and EOP (IM goes weak) • Two Steps: – Approximate glabella and EOP 4-5 times with the inspiration that did not weaken the IM – Continue with approximation of glabella and EOP and add P-A/S-I pressure on C1, C2, and C3 for 4-5 times • Recheck indicators –ICAK-U. 443 IM sS.A.tays strong

ICAK-U.S.A.

444

152

148

ICAK-U.S.A.

445

ICAK-U.S.A.

446

Temporal Bulge Cranial Fault • Breathing Pattern – IM weakens on one half held expiration • Rebound challenge – on one side, approximate frontal and occipital bones in three different directions (IM goes weak) – “Squeezy-Squeezy” – “Twisty-Twisty” one direction – “Twisty-Twisty” the other direction ICAK-U.S.A.

447

153

149

Temporal Bulge Cranial Fault • Often associated with bilateral weakness of Pectoralis Major Clavicular – W ill strengthen on one half held inspiration – May be associated with hypochlorhydria • Pressure exerted in direction of optimal challenge during the half breath phase of inspiration • Recheck indicators – IM stays strong ICAK-U.S.A.

448

ICAK-U.S.A.

449

ICAK-U.S.A.

450

154

150

Parietal Descent Cranial Fault • Most often present when there is a temporal bulge on the opposite side • This combination was known as the “banana head” • Correct the temporal bulge fault first and then re-evaluate for parietal descent

ICAK-U.S.A.

451

Parietal Descent Cranial Fault • Breathing Pattern – IM weakens on one half held inspiration • Rebound challenge by lifting the temporal border of the parietal bone I-S (IM goes weak) • Lift the parietal bone I-S during the half breath phase of expiration while spreading the sagittal suture with crossed thumbs • Recheck indicators – IM stays strong ICAK-U.S.A.

452

ICAK-U.S.A.

453

155

151

ICAK-U.S.A.

454

Internal Frontal Cranial Fault • Breathing Pattern – None • Rebound challenge A-P and slightly L-M on the malar surface of the zygomatic bone (IM goes weak) • Evaluate tenderness of either eye with digital pressure over the closed eyelid • Apply pressure on the posterior aspect of the palate on the side of positive challenge in a direction that relieves the eye tenderness • If there is no eye tenderness, apply pressure I-S • Apply 3-4 pounds of pressure for 20-40 secs ICAK-U.S.A.

455

Internal Frontal Cranial Fault • Contact the ipsilateral pterygoid process and pull inferior for 10-20 seconds • Contact the contralateral pterygoid process and push I-S for 10-20 seconds • Recheck indicators – IM stays strong

ICAK-U.S.A.

456

156

152

ICAK-U.S.A.

457

ICAK-U.S.A.

458

ICAK-U.S.A.

459

157

153

ICAK-U.S.A.

460

ICAK-U.S.A.

461

External Frontal Cranial Fault • Breathing Pattern – none • Rebound challenge by pulling inferior on central incisor • Evaluate tenderness of either eye with digital pressure over the closed eyelid • Apply pressure on the posterior aspect of the palate opposite the side of positive challenge in a direction that relieves the eye tenderness • If there is no eye tenderness, apply pressure I-S • Apply 3-4 pounds of pressure for 20-40 secs ICAK-U.S.A.

462

158

154

External Frontal Cranial Fault • Contact the ipsilateral pterygoid process and push I-S for 10-20 seconds • Recheck indicators – IM stays strong

ICAK-U.S.A.

463

ICAK-U.S.A.

464

ICAK-U.S.A.

465

159

155

ICAK-U.S.A.

466

ICAK-U.S.A.

467

Nasosphenoid Cranial Fault • Breathing Pattern – None • Palpation and Observation – Palpate greater wing of sphenoid • On the side of elevation there will be tenderness on the lower portion • On the side of depression there will be tenderness on the upper portion

– Observation • Generally, the eye on the sphenoid high side will be more prominent, appearing to bulge slightly ICAK-U.S.A.

468

160

156

Nasosphenoid Cranial Fault • Rebound challenge A-P/L-M to the nasal area on the high sphenoid side (IM goes weak) • Determine the phase of respiration (POR) that abolishes the positive challenge • Apply treatment pressure in the direction that caused maximal weakness of IM during the POR that abolished the positive challenge • Recheck indicatorICAK-U.S.A. s – IMstays strong

469

ICAK-U.S.A.

470

ICAK-U.S.A.

471

161

157

Nasosphenoid Cranial Fault • Sacral-Coccyx Association • TL sacrococcygeal junction (IM goes weak) • Determine POR that abolishes positive challenge • For an inspiration assist, push P-A on the sacral apex (4-5 times, 4-5 lbs of pressure) • For an expiration assist, push P-A on the sacral base (4-5 times, 4-5 lbs of pressure) • Recheck indicators – IM stays strong ICAK-U.S.A.

472

Universal Cranial Fault • Patient position - prone • Breathing Pattern – Breathing through one nostril only (IM goes weak) • Direct challenge occiput/mastoids by inducing torque in a clockwise or counterclockwise direction (IM goes weak) • Apply torque with both hands in the opposite direction that caused the IM to go weak while patient inhales • Recheck indicators – IM stays strong ICAK-U.S.A.

473

ICAK-U.S.A.

474

162

158

ICAK-U.S.A.

475

Sutural Cranial Faults • Examine for sutural faults after correction of any cranial faults • Sutural faults are a result of either jamming or separation • There is a positive rebound challenge and a POR that will abolish the positive challenge • The sagittal suture will be an exception to this rule ICAK-U.S.A.

476

Sagittal Suture Cranial Fault • Dysfunction of the sagittal suture is almost always a jamming problem • W eak abdominal muscles are often associated with the sagittal suture fault • Pressing the sagittal suture together will cause an IM to weaken • Correct by separating the sagittal suture. No specific breathing pattern is associated with this fault although pressure applied during inspiration appears to improve the correction • Recheck indicators – IM stays strong ICAK-U.S.A.

477

163

159

ICAK-U.S.A.

478

ICAK-U.S.A.

479

Lambdoidal Suture Cranial Fault • Dysfunction of the lambdoidal suture can be a jamming or separation problem (often associated with a closed iliocecal valve syndrome) • Rebound challenge by pressing on the occipital and parietal bones adjacent to the suture in a direction of separation or approximation of the suture (IM goes weak) • Check for POR that abolishes the challenge • Correct in the direction of positive challenge during the POR that abolished the challenge 3 to 4 times • Recheck indicators – IM stays strong

ICAK-U.S.A.

480

164

160

ICAK-U.S.A.

481

ICAK-U.S.A.

482

Squamosal Suture Cranial Fault • Dysfunction of the squamosal suture can be a jamming or separation problem • Rebound challenge by pressing on the temporal and parietal bones adjacent to the suture in a direction of separation or approximation of the suture (IM goes weak) • Check for POR that abolishes the challenge • Correct in the direction of positive challenge during the POR that abolished the challenge 3 to 4 times • Recheck indicators – IM stays strong ICAK-U.S.A.

483

165

161

ICAK-U.S.A.

484

ICAK-U.S.A.

485

Zygomatic Suture Cranial Faults • Dysfunction of the zygomatic suture can be a jamming or separation problem (often associated with an open iliocecal valve syndrome) • There are three sites for zygomatic cranial faults: – Temporozygomatic suture – Zygomaticomaxillary suture – Frontozygomatic suture ICAK-U.S.A.

486

166

162

Zygomatic Suture Cranial Faults • Rebound challenge by pressing on the suture in a direction of separation or approximation (IM goes weak) • Check for POR that abolishes the challenge • Correct in the direction of positive challenge during the POR that abolished the challenge 3 to 4 times • Recheck indicators – IM stays strong ICAK-U.S.A.

487

ICAK-U.S.A.

488

ICAK-U.S.A.

489

167

163

ICAK-U.S.A.

490

168

164

Applied Kinesiology Lab 1 Objectives: 1. Students will be able to define Applied Kinesiology (AK). a. Applied Kinesiology (AK) is a system that evaluates structural, chemical, and mental aspects of health using manual muscle testing with other standard methods of diagnosis. 2. Students will be able to differentiate between orthopedic muscle testing and the muscle testing used in AK. a. Orthopedic muscle testing is graded from 0-5 b. AK muscle testing is a lock (strong) or no lock (weak) 3. Students will be able to tell the difference between G1, G2, and G2sub max muscle testing as used in AK. a. G1 – Doctor induced “ Hold” b. G2 – Patient induced “When I ask you to, I want you to push into my hand. Push!”. Patient will push as hard as they can and doctor will add opposite force at the end. c. G2submax – Patient induced “When I ask you to, I want you to push into my hand. Push!” As soon as patient starts to push, doctor meets it and pushes back. 4. Students will be able to demonstrate reciprocal inhibition and provide examples. a. Latissimus Dorsi in Gate 5. Students will be able to demonstrate the elements of a good muscle test. a. 2 fingers b. 2 inches c. 2 seconds 6. Students will be able to explain the difference between an associated muscle and an indicator muscle. a. Associated muscle tests “weak in the clear” b. Indicator muscle tests “strong in the clear” 7. Students will be able to identify the characteristics of a good indicator muscle. a. Tests strong in the clear b. Goes weak one time with autogenic inhibition c. Test strong again 8. Students will be able to list the 5 factors of the IVF. a. N, NL, NV, CSF, AMC 9. Students will be able to perform the first 12 muscle tests for the shoulder.

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Applied Kinesiology Muscle Testing for the Shoulder 1. Latissimus Dorsi a. Grasp the patient’s wrist with your ipsilateral hand and position their arm in complete internal rotation and locked against their body in adduction while stabilizing their shoulder with your contralateral hand. b. Ensure that the patient’s elbow is locked in extension. c. Tell the patient to “Hold” and pull with your ipsilateral hand in an anterior and lateral direction. 2. Supraspinatus a. Grasp the patient’s wrist with your ipsilateral hand and position their arm with the cubital fossa facing anterior in about 10-15 degrees of abduction and slightly anterior while stabilizing their shoulder with your contralateral hand. b. Ensure that the patient’s elbow is locked in extension. c. Tell the patient to “Hold” and push with your ipsilateral hand in a posterior medial direction. 3. Serratus Anticus a. Grasp the patient’s wrist with your ipsilateral hand Step behind the patient and position their arm in about 100-130 degrees of flexion with abduction with their thumb pointing superiorly while stabilizing their scapular with your contralateral hand. b. Ensure that the patient’s elbow is locked in extension. c. Tell the patient to “Hold” and pull down with your ipsi lateral hand in an inferior direction. d. Must state that you are observing for scapular motion (O4SM) to differentiate between serratus anticus weakness and deltoid weakness.

170

4. Anterior Deltoid a. Position the patient’s arm in 90 degrees of abduction with the forearm flexed to 90 degrees and elevated 45 degrees in external rotation. b. Stabilize the patient’s shoulder with your contralateral hand. c. Tell the patient to “Hold” and pull down and back on the distal humerus with your ipsilateral hand in an inferior and posterior direction. 5. Middle Deltoid a. Position the patient’s arm in 90 degrees of abduction with the forearm flexed to 90 degrees and parallel to the ground. b. Stabilize the patient’s shoulder with your contralateral hand. c. Tell the patient to “Hold” and push down on the distal humerus with your ipsilateral hand in an inferior direction. 6. Posterior Deltoid a. Position the patient’s arm in 90 degrees of abduction with the forearm flexed to 90 degrees and depressed 45 degrees in internal rotation. b. Stabilize the patient’s shoulder with your contralateral hand. c. Tell the patient to “Hold” and push the distal humerus in an anterior inferior direction. 7. Subscapularis a. Position the patient’s arm in 90 degrees of abduction with the forearm flexed to 90 degrees and depressed 45 degrees in internal rotation. b. Stabilize on the superior aspect of the distal humerus with your contralateral hand (not on the elbow) c. Tell the patient to “Hold” and lift up with your ipsilateral hand just proximal to the patient’s wrist in a superior and anterior direction.

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8. Infraspinatus a. Position the patient’s arm in 90 degrees of abduction with the forearm flexed to 90 degrees and elevated 45 degrees in external rotation. b. Stabilize on the inferior aspect of the distal humerus with your contralateral hand (not on the elbow) c. Tell the patient to “Hold” and push down with your ipsi lateral hand just proximal to the patient’s wrist in an inferior and anterior direction. 9. Teres Minor a. Position the patient’s elbow against their body in complete adduction with your contralateral hand, and with your ipsi lateral hand, grasp their wrist and flex their forearm to 90 degrees with slight external rotation, wrist slightly flexed. Your thenar/hypothenar will be just proximal to their wrist and your fingers will be lightly touching the dorsum of their hand. b. Stabilize their elbow with your contralateral hand. c. Tell the patient to “Hold” and push with the heel of your ipsilateral hand in a lateral to medial direction while your fingers monitor for wrist extension. 10. Rhomboids a. Position the patient’s elbow against their body in complete adduction with your contralateral hand with their forearm flexed to 90 degrees. b. Stabilize their shoulder with your ipsilateral hand. c. Tell the patient to “Hold” and pull with your contralateral hand in a medial to lateral direction. (O4SM) 11. Levator Scapula a. Position the patient’s arm as in the rhomboid muscle test and then lower the patient’s arm about and inch and move it about an inch posterior. b. Stabilize their shoulder with your ipsilateral hand. c. Tell the patient to “Hold” and pull with your contralateral hand in a medial to lateral direction. (O4SM)

172

12. Coracobrachialis a. Position the patient’s arm in 45 degrees of flexion and 45 degrees of abduction and slight external rotation and grasp their distal humerus with your supinated ipsilateral hand. b. Stabilize their shoulder from behind with your contralateral hand. c. Tell the patient to “Hold” and push with your ipsilateral hand in a posterior and lateral direction.

13. Pectoralis Major Sternal a. Position the patients arm in 90 degrees of flexion and complete internal rotation. b. Stabilize their opposite ASIS with your ipsilateral hand. c. Tell the patient to “Hold” and push with your pronated contralateral hand in a superior and lateral direction (in alignment with the muscle fibers). 14. Pectoralis Major Clavicular a. Position the patients arm in 90 degrees of flexion and complete internal rotation. b. Stabilize their opposite shoulder with your ipsilateral hand. c. Tell the patient to “Hold” and push with you pronated ipsilateral hand in an inferior and lateral direction. 15. Pectoralis Minor a. Have the supine patient lift their shoulder off the table, and draw the coracoid process anteriorly, medially, and caudally. b. Stabilize the opposite shoulder with your ipsi lateral hand. c. Tell the patient to “Hold” and push with your contralateral hand in a superior and lateral direction.

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16. Upper Trapezius a. Have the seated patient elevate their shoulder and lateral flex their head to that side with slight rotation away from the shoulder being tested. b. Stand behind the patient and place your ipsilateral hand on their shoulder and bring your other hand over the top and on the ipsilateral side of their head. c. Tell the patient to “Hold” and push both hands in a direction to reduce the approximation of their head and shoulder. 17. Lower Trapezius a. Have the prone patient position their arm in 150 degrees of abduction, thumb pointing toward the ceiling (posterior). b. Standing on the same side, stabilize their shoulder with your contralateral hand. c. Tell the patient to “Hold” and push down with your ipsilateral hand just proximal to their wrist toward the floor (O4SM). 18. Middle Trapezius a. Have the prone patient position their arm in 90 degrees of abduction, thumb pointing toward the ceiling (posterior). b. Standing on the same side, stabilize their shoulder with your contralateral hand. c. Tell the patient to “Hold” and push down with your ipsilateral hand just proximal to their wrist toward the floor (O4SM). 19. Teres Major a. Have the prone patient position make a fist and place it in the small of their back and raise their elbow towards the ceiling (posterior) as far as they can. b. Cross your arms and place one hand on their distal humerus and stabilize with your other hand on their back. c. Tell the patient to “Hold” and push their arm toward the floor with a more medial to lateral than a P-A line of drive.

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Analyzing the Five Factors of the IVF 1. Find "weak" muscles. 2. To analyze the 5 factors of the IVF, you can start with any of them, and proceed in any order. The only requirement at this point is that you do not correct/treat/adjust any of them at this time. 3. To check the "N" factor, have the patient TL the nerve root of that muscle with a broad hand contact and recheck. If the muscle now tests strong, it's a positive test. 4. To check the "NL" factor, have the patient TL the NL point associated with the weak muscle. If the muscle now tests strong, it's a positive test. Note: We will use the NL points located on the anterior aspect of the patient for diagnostic purposes. For the most part, the NL points are located on the ipsilateral side as the weak muscle. Beware that there are some muscles that have their NL point only on the left side. 5. To check the "NV" factor, have the patient TL the NV point associated with the weak muscle. If the muscle now tests strong, it's a positive test. Note: We will use the NV points located on the ipsilateral side as the weak muscle with the exception of the three NV points located midline. 6. To check the "CSF" factor, have the patient take a deep breath in while you recheck the weak muscle. If the muscle strengthens, this represents an inspiration assist. If inhalation didn't strengthen the muscle, have the patient exhale all the way and hold it while you retest the muscle. If the muscle strengthens now it represents an expiration assist. 7. To check the "AMC" factor, have the patient TL the Alarm point of the meridian associated with the weak muscle. If the muscle now tests strong, it's a positive test.

175

Correcting the 5 Factors of the IVF 1. You may correct the 5 factors in any order that you wish. I favor the "N" factor because of the power of the chiropractic adjustment and its global affect on the patient. I find that if I correct this one first, the remaining factors often show clear. 2. To correct for the “N” factor, first have the patient repeat the TL of the nerve root for the weak muscle with a broad hand contact and confirm that it strengthens it. Now have the patient TL each individual spinous process within that broad hand contact with one finger and retest the muscle. Only one should strengthen it indicating the level of the subluxation. To arrive at a listing, establish a good indicator muscle and then rebound challenge each TVP of the specified vertebra. One side of the TVP's will weaken the indicator muscle and the other should not. Adjust the segment in the direction that caused the greatest weakness to the indicator muscle with the rebound challenge. Remember that you can adjust the segment with any technique you are comfortable with. After the adjustment, recheck the original weak muscle and it should test strong. If it is still weak, it generally means that there was a problem with your adjustment technique. Next have the patient TL the nerve root with a broad hand contact and this too should test strong. If TL causes a weakening this indicates that there is still more work to do. Continue the TL to individual spinous processes until you find the one that weakens it. Repeat the process of establishing a good indicator muscle and find the listing. Once again adjust in the direction of the greatest weakening of the indicator muscle during the rebound challenge. Recheck the original weak muscle and it should test strong. Next have the patient TL the nerve root with a broad hand contact and this too should test strong. If TL causes a weakening, continue to identify the level and listing and adjust until the muscle tests strong in the clear and strong with TL to the nerve roots. When the muscle is strong in the clear and strong with the TL you're finished with the "N" factor and now you can move on to the next factor. 3. To correct for the "NL" factor, have the patient TL the anterior NL point associated with the weak muscle and confirm that it strengthens it. Remember to be on the same side as the weak muscle unless it is in the group of muscles that only have a left NL point. Next rub the anterior NL point and the posterior NL point vigorously for 30

176

seconds. Recheck the original weak muscle and it should test strong. If it remains weak, rub the points for an additional 30 seconds. Once the original muscle tests strong, recheck the muscle while the patient TL the anterior NL point again. If this test is strong you're finished with the NL factor and can move on to the next one. If the muscle tests weak, continue to rub the anterior and posterior NL points for 30 second intervals and recheck until the muscle tests strong in the clear and strong with TL. When the muscle is strong in the clear and strong with the TL you're finished with the NL factor and now you can move on to the next factor. 4. To correct for the "NV" factor, have the patient TL the NV point associated with the weak muscle and confirm that it strengthens it. Remember to be on the same side as the weak muscle unless it is in the group of muscles that have their NV point on the midline. You will contact this point and tug it removing the skin slack and palpating for a pulse. Hold this point for 30 seconds and then recheck the original weak muscle. It should test strong. If it remains weak, continue to tug on the point for an additional 30 seconds and recheck the muscle. When it tests strong, have the patient TL the NV point again and recheck the muscle. If this test is strong, you're finished with the NV factor and can move on to the next factor. 5. To correct for the "CSF" factor, have the patient repeat the phase of respiration (POR) that strengthened the weak muscle and confirm that it strengthens it. Establish an indicator muscle with the patient supine and perform a rebound challenge on their mastoid, first one and then the other. You are going to treat the mastoid that caused a weakening of the indicator muscle. You may also do a rebound challenge for the medial and lateral component of the vector and then treat in the direction that caused the greatest weakening of the indicator muscle. The doctor will then push/pull on the appropriate mastoid 4-5 times for 4-5 seconds during the appropriate POR (For an inhalation assist cranial fault, push P-A on the mastoid. For an exhalation assist cranial fault, pull A-P on the mastoid). Recheck the original weak muscle and it should test strong. If it is still weak, do 45 more respiratory assists on the mastoid during the proper POR and recheck. When the muscle tests strong, have the patient inhale and check it again, and exhale and check it again. If either of these makes the muscle weak, continue to treat the mastoid on the proper POR until the muscle tests strong in the clear and strong while checking 177

respiration. Now you're finished with the "CSP on to the next factor.

5

factor and can move

6. To correct for the "AMC" factor, have the patient repeat the TL of the Alarm Point associated with the meridian of the weak muscle and confirm that it strengthens it Remember to be on the same side as the weak muscle unless the Alarm Point is on the midline. You will now move on to the Tonification Point associated with this meridian and tap it for 30 seconds. Recheck the original weak muscle and it should be strong. If it is still weak, continue tapping on the Tonification Point for another 30 seconds. When the muscle tests strong, have the patient once again TL the Alarm Point. The muscle should test strong. If it is still weak, continue tapping the Tonification Point for another 30 seconds. When the muscle tests strong in the clear, and strong with TL to the Alarm Point, you are finished with the "AMC" factor and can move on to the next factor. 7. The above represents the initial correction of any particular factor. Remember that we first analyzed the patient for any weak muscles. Then we used the 5 factors to find something that would strengthen the weak muscle. After we have corrected any of the factors, the original weak muscle now is strong and this will change the remaining analysis. A factor will still be active when there is a change in muscle strength (the now strong muscle will go weak) either with TL or a POR. We will be finished with the treatment when the muscles test strong in the clear and stay strong with TL and POR.

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Student Name Examiner1 Examiner2 Examiner3

Date_

E xaminer 1

1. Latissiums Dorsi Muscle Test N NL NV CSF AMC 2. Supraspinatus Muscle Test N NL NV CSF AMC 3. Serratus Anticus Muscle Test N NL NV CSF AMC 4. Anterior Deltoid Muscle Test N NL NV CSF AMC

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E xa miner 2

E xa miner 3

Student Name Examiner1 Examiner2 Examiner3

Date_

5. Middle Deltoid Muscle Test N NL NV CSF AMC 6. Posterior Deltoid Muscle Test N NL NV CSF AMC 7. Subscapularis Muscle Test N NL NV CSF AMC 8. Infraspinatus Muscle Test N NL NV CSF AMC

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Student Name Examiner1 Examiner2 Examiner3

Date_

9. Teres Minor Muscle Test N NL NV CSF AMC 10. Rhomboids Muscle Test N NL NV CSF AMC 11. Levator Scapula Muscle Test N NL NV CSF AMC 12. Coracobrachialis Muscle Test N NL NV CSF AMC

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Student Name Examiner1 Examiner2 Examiner3

Date_

13. Pectoralis Major Sternal Muscle Test N NL NV CSF AMC 14. Pectoralis Major Clavicular Muscle Test N NL NV CSF AMC 15. Pectoralis Minor Muscle Test N NL NV CSF AMC 16. Upper Trapezius Muscle Test N NL NV CSF AMC

182

Student Name Examiner1 Examiner2 Examiner3

Date_

17. Lower Trapezius Muscle Test N NL NV CSF AMC 18. Middle Trapezius Muscle Test N NL NV CSF AMC 19. Teres Major Muscle Test N NL NV CSF AMC

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Applied Kinesiology Pelvic Categories Pelvic Movement with respiration o Inhalation Ilia move laterally Symphysis pubis moves inferiorly Sacral base moves posteriorly Sacral apex moves anteriorly PSIS moves medially o Exhalation Ilia moves medially Symphysis pubis moves superiorly Sacral base moves anteriorly Sacral apex moves posteriorly PSIS moves laterally Cat II (Considered an osseous subluxation of the pelvis) Typical complaint o Leg pain that develops during the night, not present during the day o Mid-thoracic, lumbar, abdominal pain on lifting o May have a dropped arch on involved side Subluxation o Two Types (Identified by TL to the articulation) Sacroiliac Joint (Cat IIsi) Posterior Ilium o Associated Muscles Sartorious Gracilis o Short Leg o Long Innominate Posterior Ischium o Associated Muscles Hamstrings o Long Leg o Short Innominate Symphysis Pubis Joint (Cat IIsp) o Associated Muscle Sartorious

184

CAT IIsi Analysis and Correction o Patient supine o Find an IM (sartorious or rectus femoris) o TL each SI separately with one hand o Rebound challenge on the side of positive TL PI Ilium (Lift PSIS and release) Post Ischium (Lift posterior ischium and release) o Put a block perpendicular to the spine under the positive challenge on one side and perpendicular to the spine under the negative challenge on the contralateral side. o When TL to the SI is negative, pull the blocks o Recheck the TL to the SI Cat IIsp Analysis and Correction o Patient supine o Check sartorious (should be strong) o TL symphysis pubis (sartorious goes weak) o Rebound challenge opposite PI ilium/Post Ischium o Put a block perpendicular to the spine under the appropriate PSIS on one side and the Post Ischium on the other side o If block placement is correct, there will no longer be a positive TL of the symphysis pubis o Do short leg/long leg maneuver while patient is on blocks o Remove blocks and recheck TL of symphysis pubis) (sartorious should test strong)

185

Cat I (Torsion of the pelvis without a subluxation) Common complaint is cervical spine tension Pain and limited motion on turning their head Secondary to pelvic torsion there is often torsion of the shoulder girdle Muscle Involvement Piriformis o weak on the side of two-handed TL o hypertonic on other side o If weak on opposite side of two-handed TL patient is neurologically disorganized Gluteus maximus Gluteus medius Sacrospinalis Quadratus Lumborum Oblique Abdominals CAT I Analysis and Correction Patient prone Find an IM (usually hamstrings) TL both SI’s at the same time TL both hands on the same SI (weak side is primary side) Palpate posterior 1 strib head for tenderness Rebound challenge opposite PSIS’s and Ischial tuberosities Place blocks 45◦ facing each other on diagonals opposite the + challenge Monitor rib head for change in tenderness Use a pumping assist (10x) either on the PSIS or Ischial tuberosity according to the following rules: o Not on the primary side o Not over a block Recheck TL with patient on blocks Recheck TL with patient off blocks

186

Cat III (Dysfunction of L5 on an intact pelvis or an intact pelvis on L5) Common complaint is severe sciatica Can have lumbar disc involvement Can have Lumbar facet syndrome TL – none CAT III Analysis and Correction Patient prone Find an IM (usually hamstrings) Rebound challenge – o Contact one side of the L5 spinous with one thumb and grab the opposite ilium with the other hand and rotate them towards the midline. o Repeat on the other side Place one block 90◦ to the spine under the ASIS on the side of the + L5 challenge. Place the other block 90◦ to the spine under the trochanter Check for tenderness at L5 spinous Progressively rotate the block under the trochanter inferiorly until any pain/tenderness is diminished While patient is on the blocks, check for a sacral fault o Sacral Inspiration Assist Fault (S-W on exhalation) o Sacral Expiration Assist Fault (S-W on inhalation) Correct the sacral fault while the patient is on blocks o Sacral Inspiration Assist Fault SCP sacral apex P-A, 4-5 times, 4-5 lbs of pressure o Sacral Expiration Assist Fault SCP sacral base P-A, 4-5 times, 4-5 lbs of pressure Recheck sacral fault Recheck rebound challenge on the blocks Recheck rebound challenge off the blocks

187

Applied Kinesiology Peer Review of Pelvic Categories Student Name Examiner 1 Examiner 2 Examiner 3

Date

E xaminer 1 Pelvic Category I Indicator Muscle - Hamstrings TL-Both SI’s Same Time, then 2 on 1 1st Rib Check Rebound Challenge – PSIS/Opp Ischium Block Placement-45°Down/45°Up 1st Rib Check Pumping Assist On Block Check –Recheck TL both SI’s Off Block Check – Recheck TL both SI’s Pelvic Category IIsi Indicator Muscle – Rectus Femoris TL-One SI at a time Rebound Challenge – one SI then ischium Block Placement - 90° to Spine On Block Check – TL one SI Off Block Check – TL one SI Pelvic Category IIsp Indicator Muscle - Sartorius TL-Symphysis Pubis Rebound Challenge – PSIS/Opp Ischium Block Placement - 90° to Spine Short Leg Long Leg On Block Check – TL Symphysis Pubis Off Block Check - TL Symphysis Pubis Pelvic Category III Indicator Muscle-Hamstrings TL – None! Rebound Challenge – L5/Opp Ilium Block Placement - 90° to Spine L5 Spinous Pain Check – Move block Sacral Fault – Inhale/Exhale On Block Check - Rebound Challenge Off Block Check- Rebound Challenge

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E xa miner 2

E xa miner 3

Applied Kinesiology Peer Review of Cranial Bones Student Name

Date

Examiner1 Examiner2 Examiner 3

E x amin er 1 E xa miner 2 Establish a good indicator muscle Inhalation Assist Cranial Fault Rebound challenge P-A on each mastoid Push P-A on positive, 4-5x, 4-5 inhalations Retest rebound challenge Exhalation Assist Cranial Fault Rebound challenge A-P on each mastoid Push A-P on positive, 4-5x, 4-5 inhalations Retest rebound challenge Sphenobasilar Inspiration Assist Cranial Fault

Rebound challenge P-A on each mastoid and simultaneously push I-S on the palate. Push P-A and I-S on positive, 4-5x, 4-5 during forced inhalation Retest rebound challenge Sphenobasilar Exspiration Assist Cranial Fault

Rebound challenge A-P on each mastoid and simultaneously pull P-A on the maxilla. Push A-P on mastoid and pull P-Aon maxilla on positive, 4-5x, 4-5 during forced exhalation Retest rebound challenge Glabella Cranial Fault Rebound challenge approximating EOP and glabella at the same time. Assess whether inhalation through the nose or the mouth abolishes the positive challenge. Approximate EOP and glabella on the POR that abolishes the positive challenge 4x, then an additional 4x while pushing S-I on C1-C3 Restest rebound challenge

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E xa miner 3

Temporal Bulge Cranial Fault Rebound challenge approximating ipsi frontal and occipital bones: straight, cw twist, ccw twist Approximate in the direction which caused greatest weakening of indicator on ½ held inhalation, 4-5x (about 4-5 seconds) Retest rebound challenge Parietal Descent Rebound challenge parietal bone by flicking it I-S Cross thumbs and position finger tips on parietal bones. Lift involved side on ½ held exhalation, 45x (about 4-5 seconds) Retest rebound challenge Internal Frontal Cranial Fault Rebound challenge one cheek at a time Push I-S on ipsi palate, S-I on ipsi pterygoid, and I-S on contra pterygoid for 30 seconds each Retest rebound challenge External Frontal Cranial Fault Rebound challenge by compressing lip in front of incisor and pushing S-I Push I-S on contra palate and I-S on ipsi pterygoid for 30 seconds each Retest rebound challenge Nasosphenoid Cranial Fault Rebound challenge A-P/L-M on each nasal bone Assess whether inhalation or exhalation is able to abolish the positive challenge Push A-P/L-M on positive during POR that abolished the positive challenge 4-5x Retest rebound challenge Universal Cranial Fault Direct challenge -Twist occiput cw and hold, ccw and hold Assess whether inhalation through left or right nostril abolishes the positive challenge Twist opposite direction of positive direct challenge during POR that abolished positive challenge. Retest direct challenge

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Preface pages ix – x Introduction pages xi – xii Chapter 2, General Examination and Treatment Procedures pages 30 – 51; 60-67 Introduction to Applied Kinesiology pages 2-4 Triad of Health pages 11 – 12 Structural Balance page 12 Five Factors of the IVF page 13 Muscle-Organ/Gland/Meridian Association page 14 Postural Analysis pages 30-37 Therapy Localization pages 37-39 Temporal Tap pages 40 – 43 Origin/Insertion Technique pages 45 – 46 Neurolymphatic Reflexes pages 46 – 47 Neurovascular Reflexes pages 48 – 51 Extraspinal Subluxation Challenge page 61 Muscle Proprioceptors pages 62 – 64 (Autogenic Inhibition) Lovett Reactor pages 70 -71 Vertebral Subluxations page 71 Intrinsic Spinal Muscles page 72 Anterior Thoracic Subluxation page 73 Occipital Subluxation page 74 Upper Cervical Subluxation page 75-78 Sacral Distortion page 78 – 80 Respiratory Adjustment page 80 Persistent Subluxation page 81 Imbrication Subluxation pages 81 – 83 Vertebral Fixations pages 86 – 93 Pelvic Categories pages 109 -116 Sagittal Suture Tap Technique page 132-133 Nutrition pages 138 -142 Neurologic Disorganization pages 170-175 (Gait Inhibition) Injury Recall Technique (IRT) pages 184 – 187 Gait Testing pages 207-209 Walking Gait Temporal Pattern pages 210 – 211 Muscle/Meridian Association page 237 Alarm Points page 274 Pulse Diagnosis pages 275-276 Tonification and Sedation Points pages 284 – 288 AK Use of Melzack-Wall Gate Theory in Pain Control pages 289293 Muscle Testing and Function pages 305 -372 Stomatognathic System pages 376 – 402 Sacral Respiratory Function pages 403 -405 Psychological Reversal pages 427 – 428 Emotional Neurovascular Reflex pages 433-434 Ileocecal Valve Syndrome pages 494 – 500 Adrenal Stress Disorder pages 503 -514 191