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A Catch-22 occurs when a poorly aligned body initiates HRRs that trigger spasm and mechanically alter spinal joint movement. When hyperexcited joint and ligament mechanoreceptors initiate protective splinting, some muscles overwork and others are inhibited. This results in reduced mobility, excessive energy consumption, exhaustion, and, if the brain perceives a threat, pain. During forward bending and rotational movements, all vertebrae that can participate should do so. Chronic immobilization due to protective guarding shifts excessive strain to the remaining mobile joints, increasing risk of injury by limiting available motion. Well-coordinated HRRs rely on an aligned pelvis, a springy rib cage, and a cervical spine that's both flexible and stable. In Images 5 and 6, I demonstrate head-on- neck leveling techniques for relieving suboccipital spasm and accompanying cervicocranial misalignment. SUMMARY Always try to level the head and tail in a single therapy session and retest in subsequent visits. Try to include movement awareness dialog during your hands-on work, such as, "Feel how your low back and hip bones contact the table as you slowly tilt the pelvis forward and back." Offer immediate feedback if you sense unnecessary effort or rigidity. Helping clients become aware of inefficient movement patterns is a learning process, not a procedure. Our bodies are shaped by how we use them, and habits determine use. It is the client's underlying habits that need to change, and we can help. When confronted with pain and injury cases, rather than chasing the pain, first evaluate what the client may be doing to cause the problem, and help her learn how not to do it. Manual and movement therapy can then address abnormal neuromuscular righting reflexes that may be causing protective muscle guarding and accompanying joint dysfunction. 3 4 5 6 Left anteriorly rotated ilium correction: the therapist braces the client's hip with his body and extends the right thigh to extension barrier. The client pulls on the left knee to posteriorly rotate the right ilium and level the sacral base. Right posteriorly rotated ilium correction: the client presses the knee against the therapist's chest and relaxes. The therapist leans into the leg while pulling on the left posteriorly rotated ilium (left leg can hang off the table edge if needed). Suboccipital release: the therapist right side-bends the client's head as soft finger pads softly drag on lateral suboccipitals. Occipitalatlanto (O-A) correction: the client tucks the chin and the therapist applies 2 seconds of mild overpressure to help align the O-A and level the craniocervical junction. Side-bend the head 20 degrees to the right, and then to the left. Repeat. Notes 1. Jay M. Goldberg et al., The Vestibular System: A Sixth Sense (New York: Oxford University Press, 2012). 2. Moshe Feldenkrais, Body and Mature Behavior: A Study of Anxiety, Sex, Gravitation, and Learning (New York: International Universities Press, 1949). Erik Dalton, PhD, 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. Editor's note: Massage & Bodywork is dedicated to educating readers within the scope of practice for massage therapy. This column is based on this author's years of experience and education. The column is meant to add to readers' knowledge, not to dictate their treatment protocols. C h e c k o u t A B M P 's l a t e s t n e w s a n d b l o g p o s t s . Av a i l a b l e a t w w w. a b m p . c o m . 103