Massage & Bodywork

SEPTEMBER | OCTOBER 2015

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is little agreement about the optimal direction of this coupling, with several conflicting models of "normal" spinal biomechanics in existence. For example, some models (such as Fryette's Laws) assert that in a neutrally positioned spine, when the lumbars sidebend to the left, they rotate right; others (Lovett) say the opposite (i.e., left sidebending is coupled by left rotation); while still others (Roland) say there is no coupled motion at all in this situation. 8 Real- world studies of asymptomatic 3D spinal motion have not settled these disputes, as different studies have shown "variable" and contradictory results, particularly at different levels of the spine. 9 One likely possibility (which has been documented in coupled motion controversies about other parts of the body 10 ) is that healthy individuals' joints do not all seem to move in the same ways, probably due to differences in bone and joint shape. One recent overview of biomechanical theory concludes that although cervical dynamics are similar from person to person, "no consistent coupling behavior has been demonstrated in the thoracic or lumbar spine." 11 108 m a s s a g e & b o d y w o r k s e p t e m b e r / o c t o b e r 2 0 1 5 In other words, in spite of being an important aspect of many hands-on modalities, some of the fundamental "laws" of spinal biomechanics don't seem to apply in many cases. As practitioners, where does this contradiction and uncertainty leave us? Speaking only for myself, after having studied, used, and taught Greenman-influenced coupled-motion biomechanics for many years, my approach has become more pragmatic than theoretical. 12 My current working hypothesis is that mobility is indeed vitally important for pain-free, easy functioning, but that concepts of "normal" or correct biomechanical motion are probably less predictably meaningful. As a guiding principle, it might be said simply that when things don't move enough, and in different directions, they don't feel good; when we can help them move again, they feel better. VERTEBRAL MOBILITY TECHNIQUE A good example of this simple principle at work is the Vertebral Mobility Technique. Because it allows the practitioner to feel, see, and address vertebral mobility restrictions, and because it can quiet and focus the client's attention, we use this technique in our Advanced Myofascial Techniques trainings before performing other One model of lumbar vertebral motion, illustrating the coupled relationship of sidebending (A) with rotation around an oblique axis ( B). While it is generally accepted that motion of a vertebra in one dimension is coupled with motion in all dimensions, there is a lack of agreement between different theoretical models (and between different 3D studies) about the normal direction of coupling. Image courtesy Primal Pictures, used by permission. 4 work with the spine or rib cage. On its own or in combination with other techniques, it is indicated as assessment and preparation for many of the spine-related conditions listed at the beginning of this article. Standing beside your prone client, gently, but firmly, grasp the spinous processes of several thoracic vertebrae (Image 5). When the spinal erectors are very large, the spinous processes can be deep and hard to grasp; if this is the case, use a deeper touch, or the sides of your fingers, rather than fingertips alone. Use the spinous process as a handle to gently move the group of vertebrae from side to side, using small, rhythmic motions to rock this group of vertebrae within their attachments to the surrounding ribs (Image 3). Begin delicately, feeling for the amount of subtle mobility that is possible with very little force. Is the motion and resistance the same left and right? Don't confuse position with mobility—a vertebra's spinous process can be hooked or bent to the side, independent of its mobility. Does movement vary from place to place? Investigate this subtle rotational movement throughout the spine, noting restrictions as you find them. Often, these small, focused movements will result in more vertebral movement, probably as a result of mechanoreceptor Assessing the rotational freedom of a group of vertebrae in the Vertebral Mobility Technique. Image courtesy Advanced-Trainings.com, used by permission. 5

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