our fifth year of publication, we have decided that each issue will
center around a specific theme, starting with this issue dedicated
to the muscle. In the muscle issue we hope to broaden
the understanding of certain conditions and the different approaches
that can be taken using various techniques. When should you stretch
a muscle to bring it to its normal function? When should you put it
into hyper-contraction? When should you stimulate or use percussion?
I would like to thank my friend Marcantonio Pinci, the grandson of
Janet Travell, who introduced me to his mother Janet Powell Pinci.
Mrs. Pinci graciously invited me into their home and subsequently
loaned me several photographs and documents as well as her personal
copy of her mothers autobiography, Office Hours: Day and
Night. Together with Dr. Travells other daughter, Virginia
P. Wilson, they have been very generous in helping our managing editor,
Erin McCloskey, confirm the information contained in our feature article.
Throughout our research the Travell family has been supportive and
has given continuous feedback so as to help us write an article on
a true pioneer and a person they deeply cared about.
We have also been very happy to publish the work of up-and-coming
professionals such as Scott Cuthbert, DC, the author of the essay
Applied Kinesiology and the Myofascia. Dr. Cuthbert is
one of those rare individuals who can effectively combine the clinical
aspect of treatment with adept research in writing a sound scientific
On a more contentious matter, in issue # 11 we published an article
that has caused some controversy. Applied Kinesiology and Evidence
Based Medicine may have caused offense to some of our readers
and certainly to the person to whom some of the comments were directed,
and to these people I apologize. While freedom of opinion can allow
for interesting debate, I do not intend for individuals to feel attacked.
In this issue we have published the rebuttal to the article in fairness
to the defendant. The comments and opinions given in these articles
are those of the authors and are not expressed by AK Journal.
Our initial goal has been and will continue to be to unite the world
of kinesiology, not divide it.
TRAVELL: HER SPIRIT AND WORK LIVE ON
issue of AK we proudly feature a past pioneer in alternative medicine.
The work of Dr. Janet Travell has influenced traditional and alternative
medicine and is one of the foundations of kinesiological medicine.
Her revolutionary discoveries into the alleviation of myofascial
pain led to the identification of what she defined as trigger
points and the development of trigger point therapy,
which has not only led to a recognized modality for treating myofascial
pain, but it has allowed thousands of people to seek relief from
pain that was often previously diagnosed as chronic or untreatable.
Dr. Travell challenged a conservative medical profession hesitant
to accept alternative health care back in the 1950s, and she had
a strong and positive influence on the public to investigate such
OF MYOFASCIAL PAIN
I shall discuss
today the ubiquitous myofascial pain syndromes of the head and neck
that depend on trigger points and their feedback loops to the central
nervous system. These trigger points are located in the myofascial
structures: skeletal muscle and its fascia. Trigger points also occur
in skin, tendons, joint capsules, and periosteum.
talk written by Janet G Travell, MD, November 1, 1984
(Presented at the Palm Springs Seminars, Inc., November 26,
1984 and to the DC Dental Society, April 16, 1985)
One of the curious things about myofascial trigger points and their
pain syndromes is the fact that the symptoms often long outlast the
precipitating event of trauma, either gross or microtrauma, due to
perserverating reflex patterns in the central nervous system.
In addition, the trigger points are perpetuated by continuing mechanical
stresses (not the precipitating strain) on the myofascial structures,
which create repetitive or sustained overload of the affected muscles.
Such perpetuating stresses include, for example, a short leg and small
hemipelvis, short upper arms, poor posture, inefficient body mechanics,
immobility or immobilization, and chilling the bodyalso unphysiological
seating design. Chairs can be a serious health hazard (chair pollution).
Systematic perpetuating causes may also be multiple. These include
infectious (especially oral herpes simplex), metabolic, nutritional,
allergic, vicerosomatic, and psychogenic factors. Marginal vitamin
deficiencies and hypometabolism (borderline subclinical hypothyroidism)
are especially frequent causes.
MYOFASCIAL GELOSIS A STAND ALONE CLINICAL ENTITY THAT
MAY ACCOMPANY SUBLUXATIVE, FIXATIVE, AND OTHER MUSCULOSKELETAL FAULTS
By George J Goodheart, Jr, DC, DIBAK
The monumental work of the late Janet Travell, MD, is well known.
Reference to her published text, films, and tapes are available
through education and publication venues. This material on myofascial
gelosis is a further AK development of her original and most recent
publication and represents further therapeutic utilization of some
of her observations.
Previous AK manuals have delineated the fascial flush
technique with folic acid and B12 for spray and stretch
type of muscle trigger point activity. The subsequent use of a hand
ice-cup with moving contact on the skin followed her discontinuation
of the spray technique (ecological reasons). Previous AK manuals
describe the strain and counterstrain technique of Lawrence Jones,
DO, and the muscle weakening following muscle contraction associated
with this technique. Experience with the Robert Fulford, DO, method
of treatment using percussion technique with the muscle under stretch
shows the benefit of this technique in decreasing pain and increasing
range of movement (ROM).
The following discussion represents a new concept of the fascial
involvement and the identification of an AK method of diagnosis
of a stand alone clinical entity in myofascial
gelosis. Previously we have identified a Travell type of myofascial
trigger point by the response of the muscle involved
to a rapid stretch and subsequent testing for weakness; this still
holds true. The new use of the pincer palpation of the
muscle belly, which Travell described in her Myofascial Pain
and Dysfunction: The Trigger Point Manual (1), represents a
valuable AK breakthrough.
AND THE MYOFASCIA
By Scott C Cuthbert, DC
This essay will focus on local muscle problems that are not found
by therapy localization to one of the five factors of the intervertebral
foraman (IVF). The physical nature of myofascia will be described.
The importance of myofascial analysis in chiropractic treatment will
be explored, as well as the interactions between the myofascial system
and the craniosacral system. The implications of myofascial dysfunction
on body language will be discussed. The use of percussion to release
the myofascial dysfunctions that have been described by Fulford, Travell,
Jones, Nimmo, Rolf, and others will be reviewed. Finally, the applied
kinesiology approach to myofascial disorders will be presented.
Goodheart and the ICAK have kept expanding our therapeutic approach
as we have discovered other factors that produce muscle weakness or
dysfunction throughout the body. At this point in the development
of AK, the evaluation of muscle dysfunction has become very broad.
Life is the expression of tone. In that sentence is the basic
principle of chiropractic. Tone is the normal degree of nerve tension.
Tone is expressed in functions by normal elasticity, activity, strength
and excitability of the various organs, as observed in a state of
health. Consequently, the cause of disease is any variation in tone.(1)
Nerve, muscle, and fascial tone are expressions of the chiropractic
principle of health. With AKs manual muscle testing (MMT) procedures,
we are able to assess tissue tone and the factors affecting
it like no other professionals in the healthcare field.
PERCUSSION TECHNIQUES FOR CHIROPRACTIC PRACTICE AND HOLISTIC HEALTH
By John W Brimhall, DC, FIACA, DIBAK and Stephan Cooter, PhD, Editor
There are three basic bodily rhythms: the cardiac rhythm of the heartbeat,
the respiratory rhythm of breathing, and the craniosacral rhythm that
results from the increase and decrease in the volume of cerebrospinal
fluid within and around the craniosacral system. Craniosacral Therapy
originally monitored this subtle rhythmic wavelike motion, which ranges
from 610 oscillating cycles per minute and is for the most part
unaffected by heartbeat and breathing, to determine any restriction
or dysfunction in the craniosacral system. Doctors were taught to
feel with their hands for the wavelike motions of this system for
its unified movement. With an extremely sensitive touch, the physician
was able to diagnose the movement of the system by locating critical
sites of restriction in the cranium.
The sutural technique was popularized by William G Sutherland, DO,
in the early twentieth century. This technique involves manipulating
the sutures of the skull to ease pressure, increasing the mobility
of cranial bones. By removing stress between the bones, the sutural
technique normalizes the relationship of bones to each other, helping
restore the craniosacral system to homeostasis.
In the 1920s, Major B DeJarnette, DC, developed a technique that combined
sutural, meningeal, and reflex approaches after his work with Sutherland,
which became known as Sacro-Occipital Technique and craniopathy.
DeJarnette recorded that many conditions improved with this technique,
including anxiety, inflammation, asthma, cataracts, diabetes, impotence,
and constipation, when associated with restrictions.
In the 1970s, John Upledger, DO, pioneered the meningeal technique,
which has become known as CranioSacral Therapy. This technique
focuses on finding tension and restriction in the connective tissue
that lines the skull and the vertebral canal. The therapist brings
about a release by gently applying pressure with the hand to traction
and elongate the membranes.
After John Brimhall, DC, presented his first paper on craniosacral
therapy to the ICAK in 1993, George Goodheart, DC, the father of applied
kinesiology, combined a reflex technique with cranial adjustments,
stimulating nerve endings in the scalp, or between cranial sutures,
to locate and release distortions in the craniosacral system as well
as other structures and bodily organs.