Solving Today s Pain and Injury Puzzle with Erik Dalton An Online Workshop for ABMP Members Session 1 Handout Please Note: Erik Dalton teaches his Myoskeletal Alignment Techniques with the expectation that participants are well versed in anatomy, physiology, soft-tissue injury and dysfunction, palpation, and biomechanics, and have conducted thorough client intakes and health histories before using any of these protocols. These advanced techniques the presenter is demonstrating today will offer you a glimpse into the value this work, and its mastery, can afford your clients; more advanced learning of these techniques is available at www.erikdalton.com. Touch Tools 1. Tools a. Fingers b. Hands c. Fists d. Elbows 2. Body Mechanics a. Use of body weight b. Forearms firm c. Lumbar lordosis locked in 3. Pumping the Legs Notes 4. Ankle Twist Notes 5. Ankle Swing Notes 6. Swing and Resist Notes 7. Pin Stretches Notes 8. Sacrum Roll Notes 9. Erector Hook Notes 10. Duck Grip Notes
11. Scrub the Traps Notes 12. Thorax Spring Notes 13. Scrub the Erectors Notes 14. Side Spread Notes 15. Rib Spring with Webbed Hands Notes 16. Forearm Fascia Hook Thorax Notes Neurogenic Headaches 1. Occipital Neuralgia Notes: 2. Stomach-Sleeping Headaches Notes: 3. Parenthetic TMJ Symptoms Notes: 4. Warm-Up Technique: Drag the lateral fascia of the neck 5. Suboccipital O-A Technique a. The goal of this technique is to mobilize the occipitoatlantal (O-A) joint capsule side-toside. b. With the client supine the therapist s palms cradle the client s head so that the index and middle fingers meet in the lateral suboccipital fascia. c. With soft curled finger pads hooking the suboccipitals, the therapist steps to his right foot, sidebends the client s head to the right, and pulls up on the suboccipitals on the right. d. As the therapist steps to the right, the client s head sidebends left and finger pad pressure is applied to the suboccipitals on the left (dragging the fascia in a superior direction).
e. Once the therapist becomes comfortable with this movement, the fingers move to the lateral neck fascia just below the ears to loosen the O-A fascia. f. The therapist repeats this technique for 2 minutes. g. The goal is for the therapist s fingers to slowly make their way up under the transverse process of the atlas. It is not necessary to directly contact the inferior border of the atlas transverse processes. Simply hook the lateral fascia below the atlas and hold firmly during sidebending efforts. This helps open the contralateral O-A condyles, relieving many chronic head and neck complaints. 6. O-A Release Technique a. The goal of this technique is to increase O-A flexion, stretch the suboccipitals, and calm the joint receptors. b. With the client supine, stand at the head of the table with your right hand under the client s cranium. c. Place your left palm on the client s forehead and adjust your body to gently pull with the right hand and push with the left hand to roll the client s head into flexion (make double chins). d. Ask the client to tuck her chin. Then, step onto your left leg, extend your arms to allow your hands to bring the client s head into more flexion for two counts. e. Repeat this technique three times. f. To check the client s right occipital condyle function (its ability to glide back on the atlas), the therapist sidebends the client s head to 20 degrees to the left and repeats the technique three times. g. To check the client s left occipital condyle function (its ability to glide back on the atlas), the procedure is repeated with sidebending to the right and asking for the client to chin-tuck while the therapist adds pressure for 2 seconds. h. Do not lift the client s neck into flexion when performing these techniques. You re testing the ability of the occipital condyles to glide back on the atlas. Be gentle while stretching the suboccipital muscles. 7. Myofascial Atlas/Axis Release (A-A) a. The goal of this technique is to release rotational restrictions of the atlas on the axis. b. With the client supine, the therapist flexes the client s neck 45 degrees to ligamentously lock C2 through C7.
c. The therapist begins to slowly rotate the client s head, visualizing a pole penetrating straight through the head and neck. This allows only the atlas to rotate on the axis. d. The therapist continues to slowly rotate the client s head side to side, feeling for restrictions of the atlas on the axis. The client s head should be able to rotate 45 degrees in each direction if the atlanto-axial (A/A) joint is functional. e. If the client s head is restricted in right rotation, the therapist turns the head to the right to meet the first restrictive barrier and backs off to the left just a bit. f. The client is asked to gently attempt left rotation against the therapist s resistance to a count of 5 and then relax. g. The therapist very slowly engages the new restrictive barrier to right rotation by slowly turning the head more to the right. h. Repeat this technique 3 5 times. i. The use of client eye movements is helpful. 8. Closing Stretches a. Crossed-Armed Stretch I. The therapist crosses their arms and places one hand on the client s right shoulder and the other on the client s left shoulder. II. The therapist slowly straightens their legs, while maintaining bilateral pressure with both arms, until the client s head is flexed to the first restrictive barrier. III. Repeat this stretch 3 5 times. b. Sidebending Stretch c. Head Rolls I. The therapist places their right arm under the client s neck, and their right hand on the client s left shoulder. The left hand is placed on the client s forehead. II. Sidebend and then rotate the client s head to the left 3 5 times. Repeat this stretch on the opposite side. I. The therapist places their right arm under the client s neck and their right hand on the client s left shoulder. Their left hand is placed on the client s forehead. II. Roll the client s head in three large circles and then switch hands and repeat the head rolls in the opposite direction. d. Scalene Nerve Stretch
I. The therapist places their right arm under the client s neck with their right hand on the client s left shoulder. Their left hand is placed on the client s right shoulder. II. The therapist uses their right arm to slowly right rotate and left sidebend the client s head. Their left hand places gentle pressure on the client s right shoulder. III. Repeat this stretch 3 5 times on the left and then reverse the hands and repeat the stretch 3 5 times on the right. 9. How Do Nerves Get Injured? Notes: 10. Neck Cricks Notes: 11. Intertransversarii Stretch a. The goal of this technique is to stretch cervical intertransversarii muscles to relieve nerve root, trunk, and cord compression of the brachial plexus. b. With the client supine, the therapist stands at the head of the massage table and grasps the client s head. Rotate the head slowly to right until resistance indicates the client s rotational barrier. c. The therapist lifts the client s head and neck into flexion until the first barrier. d. The client is instructed to inhale to a count of five and gently extends the head back toward the table against the therapist s resistance. e. As the client exhales, the therapist slowly and gently lifts the client s rotated head to the next flexion barrier. f. Repeat this process three times on the right and then repeat the entire process on the left. g. Very little effort is needed to stretch the small intertransversarii muscles. Demonstrate caution during rotation and flexion and discontinue this technique if the client experiences discomfort. 12. Preview of Sidebending Translation Series (Discussed in depth in Session 2) a. Chin-Jutting (see Session 2 notes for details) b. Sidebending (see Session 2 notes for details) c. Translation/Undulation (see Session 2 notes for details)