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Thread: Summation of Research

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    Summation of Research - Ideopathic Scoliosis

    I thought this might be of general interest to some folks. It offers a fairly diverse display and analysis of a variety of studies performed. Interesting reading at the least.

    Scoliosis and Proprioception

    Robert Schleip

    Published in Rolf Lines, Vol. 28, No.4 (Fall 2000)


    Most types of scoliosis are classified as ‘idiopathic scoliosis’ which means that the reasons for this type of rotational deformity of the spine are yet unknown. Nevertheless there are all kinds of assumptions, beliefs and anectdotal reports available in the alternative health community concerning the main causes and driving factors. For example the following factors have been suggested as causes : traumatic events (if birth trauma, then scoliosis is believed to start at the cranial end, if sexual trauma usually at the caudal end), visceral tensions (uncomplete embryological rotational movement of organs); psychological problems (not facing the world, making yourself smaller), unilateral psoas shortening, nutrition, the Corriolis force (which makes hurricans and bath tap water to spiral in a counter-clockwise motion in the Northern hemisphere) and so on. Yet when applying usual scientific research standards, most of these claims have not been able to be substantiated, despite the fact that every year an impressive amount of money and research projects is devoted to improve our understanding of the causes of this dysfunction.

    In preparation of my recent talk on ‘Working with Scoliosis’ at the Annual Rolfing Conference 2000, I did a MEDLINE search of published scientific research papers on this subject. While most of the papers are still on surgical and measuring techniques, there have also been a few hundred published studies in the last decade which concern the etiology and causative factors of this deformity. I will try to summarize some of the themes and findings here:
    • Among identical twins the concordance rate for idiopathic scoliosis is about twice as high as among non-identical twins. This is seen as strong evidence for a genetic predisposition; although environmental factors seem to be involved too.
    • Chicken whose pineal gland is cut away, develop scoliosis with very similar features to that of an idiopathic scoliosis in humans. Since the pineal gland produces only one hormone, melatonin, it had been suggested that melatonin deficiency could be a primary factor for scoliosis in humans (as well as in chicken). In January of this year a study was published that showed in fact a lower melatonin serum level in scoliotic patients than in a matched control group. Yet just a few months later a more careful study was published, which had been measuring the serum level throughout the whole day; and this study did not show any signficant differences in the melatonin level of scoliotic patients compared with others. Also more recent studies with chicken showed that the induced scoliosis after pinealectomy has probably more to do with a secondary lack of serotonin (which has been known to influence general muscle tonus).
    • Attempts to link idiopathic scoliosis with changes in genetic collagen morphology, or with zinc or potassium levels in the body have failed.
    • Also no correlation could be found with the position or functioning of visceral organs. Except that in high-degree scoliosis the position of the aorta is changed. Yet this has been shown to be a secondary effect of the scoliosis, not related to a primary causative factor.
    • Attempts to decrease the degree of scoliosis by cutting the psoas on the suspected ‘short side’ have failed. . This is also congruent to my own experiences in testing the myofascial length of the iliopsoas in the ‘Thomas Test’ manouver. My scoliotic clients seem to have ‘on average’ a similar myofascial length of the iliopsoas as other people.
    • Histochemical analysis of the paravertebral muscles showed no myopathic changes. Flexiblity studies of the lumbar spine, shoulder and hip joints showed no significant changes to a control group. This findng points to idiopathic scoliosis being an organic rather than a systemic disease.
    • A computer aided biomechanical three-dimensional osseo-ligamentous model of the human thorax was constructed to explore how asymmetric growth of the thorax might initiate spinal lateral curvature and axial rotation as seen in idiopathic scoliosis. In fact their model showed that slightly larger ribs on one side could result both in a sidebending convexity towards that side plus in an axial rotation of the spine similar to that observed clinically. "The model supports the idea that growth asymmetry could initiate a small scoliosis during adolescence".
    • An anatomical study of muscle biomechanics found that the "spatial displacement of vertebrae in idiopathic scoliosis is not explicable by forces created by the muscles which act upon the spine only (intrinsic muscles). The trapezius and latissimus muscles are attached to the spinous processes and the upper limb". "The peculiarity of the vertebral anatomy, together with the direction of pull of these muscles, permits an explanation of the biomechanics of the development of 'idiopathic' scoliosis"
    • "A 10-fold higher incidence of scoliosis was found in rhythmic gymnastic trainees (12%) than in their normal coevals (1.1%). Delay in menarche and generalized joint laxity are common in rhythmic gymnastic trainees". The study observed "a significant physical loading with the persistently repeated asymmetric stress on the growing spine" in these young gymnasts. A"dangerous triad" is attributed for the etiology of this type of idiopathic scoliosis: "generalized joint laxity, delayed maturity, and asymmetric spinal loading".
    • In general the morphology of scoliotic clients has less mesomorphic features. This seems to be also a predictive factor: if the mesomorphic values are low on the SHELDON typology, the scoliosis has a high probability to increase with age.
    • The multifidus fibers tend to be more fast twitch than normal on the concave side of the apex (most likely as a result and not cause of the sidebending). Myofascial release work on the (shortened) concave side tissues yielded significant improvements in one study.
    • Trunk rotation against resistance is usually weaker in one direction. A systematic strength training using a MedX Torso Rotation exercise machine, seemed to improve the degree of scoliosis in a recent study.
    • MRI studies have shown significant proportion of abnormalities in the brain stem area (as well as in the spinal cord) among idiopathic scoliosis clients when compared with other types of spinal assymmetries or normal people.
    • A significant correlation with otolith vestibular dysfunction could be shown. An interesting newer finding (which needs to be confirmed by others) is that people with hearing problems seem to be ‘immunized’ against idiopathic scoliosis; i.e. idiopathic scoliosis seems to be much more rare among them than in normal people. Which is seen as another indication for a strong neural factor in the etiology of scoliosis.
    • Previous attempts to show a correlation between handedness and the direction of the primary curve had failed. Yet a newer study looked at the direction of convexity of the low thoracic spine regardless of the primary curvature. Their result: "The correlation between scoliosis configuration and handedness was statistically significant. This is in contrast to the findings of previous studies, which have considered convexity only, without reference to the configuration of the whole spine. The implication of this finding is that scoliosis is associated with cortical functions".

    This seems to be the general trend in scoliosis research: compared with previous years most of the newer research apparently explores the central nervous system as a primary causative factor. The study by Maguire et al on ‘Abnormal Central Processing’ (see article from Jerry Larson about it in this issue of ROLF LINES) is a typical example of it. It fits very nicely to another study, which I found even more intriguing, and which I will therefore choose for a more detailed description here. The study is called ‘Proprioceptive Accuracy in Idiopathic Scoliosis’ and was done by W.Keesen and others in the Netherlands. With the pulisher’s permission, let me quote from the original text and also add some commentaries from my side.

    The article starts with: "Defects in proprioceptive postural control have been linked to the etiology of idiopathic scoliosis". Actually this has been found in several studies already since the early 80ies: that postural control – e.g.. walking on a high beam – tends to be less accurate in these people. Also the amplitude of their ‘postural sway’ – i.e. the balancing movements of the body in standing – has been found to be slightly larger than normal. Yet it was unclear whether that is the result or the cause of the spinal deformation.

    The article goes on "In particular a rearrangement of the internal representation of the body has been proposed in these cases." Now this sentence caught my personal interest, as I am quite fascinated in the correlations of outer body changes with specific dysfunctions in cortical body representation. In other words there is some evidence that the diminished postural control in these clients does not come from a less accurate motor execution but from a perceptual weakness based on an inaccurate ‘body image’ in their brain. Rolf Movement Practitioners, Feldenkrais Teachers, and other somatic practitioners involved with the internal body organization, this is your field!
    to be continued...
    Last edited by structural75; 06-17-2007 at 01:57 AM.

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    continued...
    The researchers then describe the following experiment: 200 patients were asked individually to sit in front of a table. The table had a visible grid consisting of 24 points on its upper surface. These 24 points corresponded with dome-shaped holes in the undersurface of the table platform. The experimenter would then place one index finger (‘target finger’) into one of the holes on the undersurface and asks the person to bring the index finger of the other hand (‘searching finger’) as close as possible to the target finger on the upper surface of the table, without being able to look under the table.

    If you are sitting on a desk right now, try this out yourself. You will find out – even without a measuring grid as used in this experiment – that the accuracy of your searching finger is not perfect, i.e. it deviates from the position of the target finger by a few millimeters or even more. If you do this a couple a dozen times, you will quite likely find that when your right index finger is the ‘searching finger’ it tends to point too much towards the left, and vice versa. This phenomenon is described as ‘overlap effect’. If you have a chance to compare your accuracy with that of a child or a teenager, you will also quite likely find, that you are slighlty better than they. Which indicates that proprioception usually improves in life and might therefore be open for further improvement, e.g. through active facilitated learning.

    Yet how do you guess was the finger accuracy in this test among the patients with scoliosis? The result of the study by Keesen et al was that there was a significant difference in the average accuracy between scoliotic patients and others. In the language of the authors: "In the present study, an inaccurate proprioceptive performance was ... established in patients with idiopathic scoliosis."

    Now one could speculate, that maybe the spinal assymetry was the cause of the inaccurate proprioception, rather than the other way around.. Yet the study reports that "no correlation could be found between the degree of scoliosis and the magnitude of inaccuracy. In our view, it is not likely that the ability to bring both index fingers together is influenced to a great extend by a spinal deformity. If this were the case, we would be at the root of a new adverse effect of scoliosis, as yet unrecognized. However because the inaccuracy also is observed in subjects with a nonprogressive spinal asymmetry, which is often found in adolescence, the cybernetic defects in these subjects is more likely to be at the origin of a postural instability, which may, but not always, lead to idiopathic scoliosis."

    How can a proprioceptive inaccuracy lead to a spinal deformation? Let me quote again the author’s explanation: "Hermann et al postulated that ... a sensory (proprioceptive) rearrangement or recallibration of the internal representation of the body in space is present, and that a nonerect vertebral alignment may be erroneously perceived as straight." So when standing or moving in the upright position my body is in constant adjustments and oscillations to keep organized around a vertical axis in order not to loose balance. To do so we rely to a large degree on our internal perception of the alignment of our body in space (also called proprioception). If my thorax leans for example too much forward or to the right, my body will correct this automatically, i.e. without me having to pay conscious attention to these adjustments all the time. What happens in people with idiopathic scoliosis, is that they perceive and accept their body position as straight, when it is already slightly off center and when other people would continue to adjust and correct their balance. Over time – specially if this happens during the years of most sceletal growth – this could lead to an uneven usage and development of the osseoligamentous and muscular components of the spine and ribcage, such that their habitual off-center position becomes the ‘neutral position’ and a straight position of the spine becomes difficult or strainful.

    Now this reminds me of similar distortions of the internal body representation which influence the outer shape of the body. For example in anorexia it seems clear, that many of these skinny persons feel ‘too fat’ in their internal body perception. And therapeutic experience often shows that unless one succeeds in altering the internal body perception, curative attempts will be limited.

    Another similar pattern has been discribed as ‘anterior pelvic shift’ or ‘banana posture’ by Hans Flury. When standing these clients have their pelvis shifted (not necessarily tilted) anteriorly in relation to the thorax above. Flury attributes this to a chronic ‘primary shortness’ of the connective tissue on the posterior side. Yet in my experience I find also many clients in which this seems to be purely a ‘postural habit’ without any corresponding chronic tissue shortness as a cause. When lying on the table (on their side or any other position) or when floating in water there is no more banana posture. And when testing the overall myofascial length of the erector spinae according to Janda (in asking them to bend their head forward and downwards passively in sitting on a chair without changing their pelvis position), some of these people bring their forehead even closer towards their knees than their non-banana average competitors. In other words they only stand in such a banana posture, because in their internal perception this feels straight. When temporarily shifted into a more straight posture by a therapist from the outside, this feels to them as ‘bent forward’.; and even if I ask them to concentrate consciously to carry their thorax more vertically over the pelvis, as soon as they shift their postural control back to the unconscious self regulation of every day life, they will return to their previous banana posture; not because of any tissues pulling them there, but because this feels ‘straight’ in their internal body organization.

    Looked at this way, at least some of the cases of idiopathic scoliosis could have started the same way. Except that in their case it is not the sagitally oriented inaccurate proprioception which is the problem, but the lateral ‘banana deviation’ of the spine, which is inaccurately perceived as straight.

    Now that is where I suggest that Rolf Movement comes in handy. Try to correct a pure habitual sagital banana posture with myofascial manipulation alone, without any postural education trainng, and you will most likely find only very limited or short lived results. Yet if treated with the wisdom and various tricks of Rolf Movement towards altering the internal body representation, it is often possible to achieve lasting results in as little as one session.

    Let me therefore share with you how this research article by Keesen et al influenced my current work with idiopathic scoliosis. Besides myofascial work on the shortened tissues, besides encouraging them to build up a more healthy tonus in their trunk by an active healthy lifestyle, besides helping them to become ‘a bigger person’ physically and psychologically, and besides me cooperating actively with their other health care providers including their orthopedist, - besides all this, I involve them now more and more in exercises which facilitate refinement in proprioception.

    One direction to do so are active micromovements of the client on the area of their body which I am working on. With proper coaching they learn to bring small undulations to even a single rib or vertebra at a time; without any spurious co-contractions somewhere else. Then even without my touching hand or elbow, they later learn to keep that sensory and motor refinement in sitting and standing.

    Another direction is via all kinds of moderated balancing refinements in gravity. I usually start by Darrel Sanchez’ ‘Tuning Board’ in standing with open eyes, and having them notice their balancing habits plus various alternatives to that, with facilitated finer and finer perceptions. Then if they are ready, we can increase the level of complexity and stimulation, e.g. by having them close their eyes, by balancing a small cushion simultanously on their head, by giving moderated ‘earth quakes’ to the board or gentle perturbations to their body with my hand from the outside, etc. Later they learn to balance sitting on a large ball without their feet touching the ground and by constantly adjusting their relative upper body position to the movements of the ball. Or they learn to squat like a downhill ski racer on two ‘wobble boards’ (each foot on one half hemisphere platform). Additionally I encourage them to take up inline scating, snowboarding or similar hobby activities between sessions. Since most of the patients who come for scoliosis treatments are teenagers, this is often not that difficult, once a good rapport has been established. Often I give them the choice (I phrase it actually more as a ‘requirement’) to accompany my session either by weekly Pilates or Gyrotonix sessions or by taking up some kind of balancing sports activity like inline scating, etc. Some even start doing both, as these patients often have a high motivation and compliance.

    If this sounds like fun and creative playful work, that is partly true. Yet no solid scoliosis (of 30 degrees Cobb angle and more) will be ‘cured’ by movement work and proprioception enhancement alone. At the most they can be powerful adjuncts for the much needed myofascial work. And as much as I don’t like it myself, the use of a corsett or even a surgical operation is often indicated in strongly developed cases if their history and situation shows signs towards further progression.
    Last edited by structural75; 06-17-2007 at 01:49 AM.

  3. #3
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    The figures regarding gymnasts does not surprise me. Gymnasts tend to fall- hence spine compression - hence what I am finding- large numbers of patients with a scoliosis caused by a fall. Off a horse, on ice, on any hard surface. Another new patient yesterday. Competitive swimmer with back pain severe enough to cause her to be told to give up her sport. 15 years of age. Scoliosis and she remembered a couple of hard falls on her bottom.
    If anyone is interested in how her treatment went I will keep you posted. But she will be back swimming next week.

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    ray, in all respect, i do not think there are many people who have never fallen on their bottom in their lives, so it can hardly be that there is an unique correlation between falling on bottoms and scoliosis. People with astma have fallen on their bottoms in the past, people with heartdisease have fallen on their bottoms in the past, doesn't mean there is a correlation, does it?

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    Gerbo,
    I know I am ridiculed when I say this, but I can tell by the feel of the spine whether a patient has fallen hard on their bottom. I wish I had you here that I could actually show this to you. The joints are extremely fixed in all cases and if you know of a better way of freeing them up than the TAMARS tool I would be very interested to see it. Manipulation, chiropractic etc does not work to free these joints up. All the patients with this condition have curvatures of the spine.
    This seems to be more common in female patients as well. Whether they fall without getting their hands down to protect themselves, or more likely they are just less muscular, I don't know.
    As for a connection with other complaints, statisticians could link anything to anything or disprove anything. But how do I ignore what I am finding.
    Obviously the force of the fall, and the angle have an impact on the outcome.
    Last edited by Rayknox; 06-18-2007 at 08:57 AM.

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    Ray

    Lets leave the bottom theory as it is, we all have our pet-theories (me too) and in the end nobody has firm evidence for anything

    What counts is what works and I am kind on interested in this tamar treatment as I do feel that in scoliosis there is a secondary contracture of ligaments round the curve, maintaining the curved position and giving resistance against correction. anything that can loosen/ stretch those ligaments should be of benefit.

    need to read up a bit more on Tamar, will give it the google treatment when i have some time

    gerbo

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    Hey guys,

    Not to interupt or fan any fires, but.... . I posted that brief summation of some of the 'other' research going on out there just for curiosity sake and to maybe help folks start thinking about the other half of this condition... its potential causes, etc. . I also realize that suggesting any type of adjunct complimentary therapy to people here is basically futile, and I understand why. So I thought it might be more helpful to you folks if I exposed some less commonly discussed matters in the hopes that it might help people make more appropriate and educated decisions before starting or trying 'alternative' or complimentary therapies in conjunction with bracing. This post was not an attempt to sell you guys anything at all or impose theories, beliefs etc... .

    So regarding the highlight of the gymnastic study/observation... I think all the study is suggesting or showing is that there is an increased incidence of ideopathic scoliosis in populations of children who do this sport verse those who don't. The reason that this study suggests for such an occurrence has to do with asymmetric spinal loading during the landing phases of all of the jumping around (cart wheels, hand springs, vaulting, etc.). Everytime an individual lands on their FEET while performing these repetitive activities there is always an increased and asymmetric force that travels from the impact of the feet on the ground up through the spine. Therefore the repetitive nature of the activities can certainly cause uneven development of the growth plates. This very principle is applied to bracing.. correct the curve (to whatever degree possible) while the individual is still growing (growth plates active) and they will grow more evenly, so long as the impetus for the curvature is not too strong and overcomes the corrective device.

    To be clear, that study doesn't make any remarks about falls on the coccyx bone. I don't believe it is the only potential cause, but certainly can influence matters for some. Clinical and scientific evidence has validated the biomechanical importance and influence of the coccyx and sacrococcygeal joint on entire spinal mechanics (it's pretty much impossible to debate the reality of that fact), so the possibility is quite valid, but I don't feel it's the main reason all the time... or the only reason for that matter. This study noted was referring to compressional loads for jumping and landing on the feet.

    structural

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    Gerbo,

    The correlation to an injury and consequent fixation of the coccyx to spinal mechanics is actually pretty direct, after all, it is the bottom segment of the spine. We know that people with spinal fusions often develop problems involving disc degeneration above and/or below the actual fusion. Therefore, even though the disc problem isn't in the spinal segments that were fused, one can easily see why such a problem would/could develop around it in the segments that still move and consequently take on the majority of the work.

    A fall on the bottom may not cause heart problems, but a kyphosis would/could. Dr. Joel E. Goldthwait, professor at Harvard Medical School and founder of the orthopaedic clinic at the Mass. General Hospital, developed successful therapeutic approaches to chronic disorders by working with people to re-establish a more proper relationship to gravity or the vertical. Goldthwait's approach was based in part on observations made while performing surgery on such patients. He noticed that abdominal nerves and blood vessels are under tension in individuals whose bodies are out of alignment (not the chiro type of alignment of singular segments, but gross body alignment). He also reported 'stretching and kinking' of the cerebral arteries and veins in those whose necks were bent. Various cardiac problems were correlated with 'faulty body mechanics' that distorted the chest cavity in a way that impaired circulatory efficiency. His therapeutic approach corrected many difficult problems without the use of drugs.

    So if someone has a moderate to severe kyphosis you might consider the cardiopulmonary affects as well. Just as if someone has an ideopathic scoliosis it can't hurt to test the mobility of the coccyx that might be influencing spinal mechanics from the one end (it only takes about 10 seconds if that, if no problems, move onward). I'm not an all or nothing kind of person, but I do think that it's worth considering all the potential possibilities and factors that might be involved.

    Also, I thought you might find this article interesting given your stance on ligamentous contraction, etc... (first paper on the list)
    http://www.fasciaresearch.de/#For%20Scientists

    Kindly,
    structural

    p.s. Ray - Fascial (parietal fascia, ligamentous, periarticular, membranous) manipulations (non-chiro/not high velocity thrusting) can and do in fact mobilize the joints throughout the spine, including the sacrococcygeal and SI joints.... often with very lasting effect.

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    Gerbo,

    sorry for the long posts.. . Be careful about stretching ligaments. It may not be having the desired effect.


    TITLE: The ligamento-muscular stabilizing system of the spine.
    AUTHORS: Solomonow M; Zhou BH; Harris M; Lu Y; Baratta RV
    AUTHOR AFFILIATION: Department of Orthopaedic Surgery, Louisiana State University Medical Center, New Orleans.
    SOURCE: Spine 1998 Dec 1;23(23):2552-62
    CITATION IDS: PMID: 9854754 UI: 99071918
    ABSTRACT: STUDY DESIGN: Electrical and mechanical stimulation of the lumbar supraspinous ligament of three patients with L4-L5 spinal deficits and of the feline model, respectively, was applied while recording electromyography on the multifidus muscles. OBJECTIVES: To determine if mechanoreceptors in the human spine can reflexively recruit muscle force to stabilize the lumbar spine, and to demonstrate, in the feline model, that such ligamento-muscular synergy is elicited by mechanical deformation of the lumbar supraspinous ligament (and possibly of other spinal ligaments), the facet joint capsule, and the disc. SUMMARY OF BACKGROUND DATA: The literature repeatedly confirms that ligaments have only a minor mechanical role in maintaining spine stability, and that muscular co-contraction of anterior and posterior muscles is the major stabilizing mechanism of the spine. The literature also points out that various sensory receptors are present in spinal ligaments, and that the ligaments are innervated by spinal and autonomic nerves. Data that describe how ligaments and muscles interact to provide stability to the spine were not found. METHODS: The supraspinous ligament at L2-L3 and L3-L4 was electrically stimulated in three patients undergoing surgery to correct deficits at L4-L5. Electromyography was performed from the multifidus muscles at L2-L3 and L3-L4, bilaterally. In 12 cats, the supraspinous ligaments from L1-L2 to L6-L7 were mechanically deformed, sequentially, while electromyography was performed from the multifidus muscles of the six levels. Loading of the ligament was applied before and after each of the two vertebrae were externally fixed to prevent motion. RESULTS: Electromyograms were recorded from the multifidus muscles, bilaterally, in the two of the three patients, demonstrating a direct relationship to receptors in the supraspinous ligament. Electromyograms were recorded from the feline multifidus muscle with mechanical loading of the supraspinal ligament at each of the L1-L2 to L6-L7 motion segments. In the free-spine condition the largest electromyographic discharge was present in the level of ligament deformation, and lower electromyographic discharge was recorded in two rostral and caudal segments. After immobilizing any two vertebrae, loading of the ligament resulted in electromyographic discharge in the muscles of the same level and at least one level above and/or below. CONCLUSIONS: Deformation or stress in the supraspinous ligament, and possibly in other spinal ligaments, recruits multifidus muscle force to stiffen one to three lumbar motion segments and prevent instability. Strong muscular activity is seen when loads that can cause permanent damage to the ligament are applied, indicating that spastic muscle activity and possibly pain can be caused by ligament overloading.

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    I am not isolating the coccyx bone on its own. The joints that are affected are all of the joints of the spine from a hard knock. Severe kyphosis is also a symtom of such an occurrence. And again I have had patients with problems possibly related to a kyphosis. One had both lungs collapse at different times and another had both kidneys failed. (Kyphosis with severe twist at the point of entry of the kidney nerves)
    The spine is the electrical conduit for the body. Any distortion of the spine can put pressure on nerves that supply any part of the body. So it would be reasonable to assume that the heart bladder or even brain could be affected.
    Fascial manipulations I have not seen performed but I again doubt it will be as effective as the TAMARS manipulations. I have read it up but still come to the same conclusion.
    Don't get me wrong. I do not knock any of these other treatments. If I find something that helps with what I do then I will certainly use it. But nothing so far that is about has been overly effective on it's own.

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    Ray,

    Fascial manipulations have been used for decades to release joint fixations... which is surely where the basis for the mechanistic TAMARS device was conceived from. Clinical experiences from thousands of practitioners clearly shows its effectiveness. Besides, the TAMARS is in part manipulating the fascial tissues and membranes surrounding the joints which in turn is what allows for their subsequent mobility. Soft tissue fixates joints... so anything or method to mobilize them is directly effecting the soft tissues, of which fascia is inextricably the basis. It is the most abundant substance in the human body, next to water. Mechanical devices can't possibly be the only thing that can effect it... Can it?

    You might be interested in this link: http://jeffreymaitland.com/index.html
    He wrote a wonderful book on the subject as well.

    I'm sure the TAMARS is very effective, but to say that nothing else is capable of having such effect alone is very short-sighted and simply false.

    The spine is the electrical conduit for the body.
    Actually the nerves and the connective tissue matrix (fascia, etc.) are the eletrical conduits. The spine is one portion that houses some of these structures. It has been scientifically proven that the fascial system (connective tissue matrix) exists a its own communication network, able to send messages/information from one part of the body to another without ever going to the spinal cord. It also preceeded the nervous system evolutionarily speaking, existing as the only communicative network prior to the development of the nervous system out of presumable need for further specialization. Piezoelectric charges are measurable current sent through the fascial network.

    Of course, I don't believe there is one single dominant system in the body, they're all important individually and more importantly as an entire whole working seamlessly together.

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    structural,
    I am not suggesting that mechanical devices are the only thing that frees up connective tissues or ligaments or whatever. The TAMARS tool mobilisation mode is actually a much improved means of doing maitland mobs. Your thumbs cannot do what this tool does. That is why it was invented. But you must realise that the mobilisation of the joints is not the most important part of tamars. It certainly is very important but the second mode - reflex - is the mode that actually straightens the spine. There is no force involved in this mode, pressure is only applied to counter-rotate the joints to free them up.
    And I still feel there is more than connective tissues fixing the joints in a lot of cases.
    I have no doubt that your techniques are very good and very effective. I know that what I do is also very effective with cases that nothing else helps. There is probably a middle ground where using both techniques makes for very effective treatment.
    I only mentioned the spine to highlight the effect that twisted vertbrae has on the nerves exiting the spine. I am no neuro specialist so I would not want to enter into a discussion along those lines as I am not qualified to do so.

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    Ray,

    Just a side note, the Rolfer Jeffrey Maitland, PhD is not the same person as Geoff Maitland, creator of the "Maitland Techniques" that I believe you were referring to... "maitland mob".

    And actually, no tool can do what the human hand (not thumbs) can do. Of all the sophisticated technologies we've created, which serve us tremendous benefit no doubt, nothing is as powerful, dynamic and sophisticated as the human hand. Everything has its place but you cannot match the responsiveness and receptivity that comes along with using ones hands verse a mechanical device that does not respond at all to the human body... it simply works on it.

    The tool offers more consistency in a realm where individual skill is a huge variable. Not everyone who is taught to work in the field of manipulative therapies can actually execute the work well. TAMARS, in part, offers more people the ability to 'execute' the 'theories' behind it with greater consistency.

    And I still feel there is more than connective tissues fixing the joints in a lot of cases.
    I'm confused, what else connects and thereby restricts two or more bones from moving in relation to one another??? There may be numerous stimuli that cause the contracture or inflammation of tissues that fixate or displace a joint, but their lack of movement or aberrant positioning is determined by the tissue surrounding the joint(s). Aside from fusions, I've never heard of anything else 'fixating' a joint.

    I didn't post this thread to debate my profession again. I just thought it woulld make for interesting reading.

    structural

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    72
    structural,
    You would be amazed the feel you get with the tamars tool. And you should try using it if you get a chance. I agree that if you are working with tissue your hands are powerful diagnostic tools. But you do get the feel through the tool into your hands. Obviously if you just picked it up and used it for the first time you might as well be using a brick for all the feel you get, but with time ....
    I was referring to the condition where the individual vertebrae are jammed tightly together. I know- old theory but anyway.
    And yes I was confusing the two Maitlands. I checked the web site quickly and thought it didn't seem right. And I think Geoff Maitland is in Australia now.
    But I will read the site fully to get a better feel for what you do.
    Makes a change that I am in a thread that everyone is not ridiculing the others! A debate on different methods is what it should be. I am in this business to fix patients spinal problems. If I learn anything from anyone that helps me then thats the way it should be.
    Ray.

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