Massage & Bodywork

July | August 2014

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108 m a s s a g e & b o d y w o r k j u l y / a u g u s t 2 0 1 4 MYOSKELE TAL ALIGNMENT TECHNIQUES the ability of the occipital condyles to glide back on the atlas. If there is restriction to the chin tuck (i.e., a hard restrictive barrier), the O-A is unilaterally or bilaterally restricted. To determine which side is stuck, simply right-sidebend the client's head 20 degrees and repeat the chin tuck technique. If no resistance is encountered, test the opposite side by left-sidebending 20 degrees and rolling the head into flexion. If the chin does not want to approximate the chest with the head in this position, then the right occipital condyle is stuck anteriorly and is unable to glide back on the right atlas condyle. If the client's pain is also on the right, the fixated right condyle is likely the main event causing occipital neuralgia. To free the soft tissues that are restraining joint motion, keep the client's head in the same left-sidebent position and ask for a chin tuck while your hands follow with two seconds of gentle overpressure at the end range of flexion (stop if the client experiences any discomfort). Repeat three times and retest with the head in a neutral position. Your clients will love this gentle myoskeletal O-A stretch and appreciate relief from the nagging, and sometimes debilitating, pain of occipital neuralgia. Assessing and correcting a fixated O-A. The client tucks the chin and the therapist adds two seconds of gentle overpressure with the head in neutral and left/right-sidebending. ©erikdalton.com 5 The Brugger Test palpates suboccipitals while standing and sitting. ©erikdalton.com 4 Start with the client standing, with your left hand on the client's forehead and the index finger and thumb of your right hand gently palpating and holding the knotty suboccipital spasm (Image 4). Continue to hold this hand position as the client sits. If the spasm decreases when the client sits, this suggests asymmetry somewhere in the lower body is forcing compensation at the O-A joint. A functional short leg, unlevel pelvis, or rotoscoliosis are examples of common postural faults that must be addressed before dealing with the fixated O-A. If the suboccipital spasm stays knotty when both standing and sitting, it's an O-A problem. O-A ASSESS AND CORRECT Begin by applying your favorite suboccipital technique to release the protective muscle guarding. Once the suboccipital hypertonicity has calmed, assess and correct O-A joint hypomobility by sliding the right hand under the supine client's head while your left palm secures the forehead. Without lifting the client's head, ask for a slow chin tuck toward the chest. As the head begins to flex on the neck, follow this movement with your right hand by softly pulling the back of the head superiorly, while the left hand gently pushes the forehead toward the eyebrows—imagine rolling a bowling ball using two hands (Image 5). By applying a gentle two-second overpressure at the end of this chin tuck maneuver, you should be able to assess If the spasm decreases when the client sits, this suggests asymmetry somewhere in the lower body is forcing compensation at the O-A joint. Erik Dalton is the executive director of the Freedom from Pain Institute. Educated in massage, osteopathy, and Rolfing, Dalton has maintained a practice in Oklahoma City, Oklahoma, for more than three decades. For more information, visit www.erikdalton.com.

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