1. Concepts Applicable to All Manipulative Therapies Adapted for presentation in HW210, Complementary and Alternative Medicine course for Kaplan University, by Earon Davis, Adjunct Professor Source pp. 112-117, Micozzi, Marc S. Fundamentals of Complementary and Integrative Medicine, 3 rd Edition, Saunders Elsevier, St. Louis, 2006

2. Concept 1. Bilateral Symmetry right side affects left; front affects back, top affects bottom.

3. Concept 2. Gravity Our weight affects the wear and tear patterns on our bodies.

4. Concept 3. Tensegerity (Tensional Integrity) Our bodies balance counteracting forces from muscles and other soft tissues acting upon the structural presence of the bones.

5. 4.Postural Maintenance and Coordinated Movement We are able to know where we are in space and thus can engage in complex movement patters that are smooth and well planned.

6. 5.Connective Tissue (Fascia) Connective Tissue gives form to our tissues and organs. The fascial matrix can become distorted by injury strain, postural or musculoskeletal abnormalities and illness.

7. 6.Segmentation (functional spinal unit) The spinal column contains vertebrae and spinal nerves which connect in patterns throughout the body, called dermatomes. The functional spinal unit consists of the “individual spinal nerve and all the tissues that it innervates”. (Micozzi, p. 114)

8. 7. Reflexes and Autonomic Nervous System The brain processes information sensed throughout the body, unconsciously. This causes interactions between sensory and motor nerves, which result in reflexes that may trigger the sympathetic and parasympathetic divisions of the autonomic nervous system.

9. 8. Pain and Guarding Internal or external stresses can result in tissue damage causing pain, which, in turn, can cause surrounding tissues to become tightened or guarded, which can cause muscles to become severely contracted, as in a spasm. The spasm, itself, and restrictive barriers to movement cause further pain and damage.

10. 9. Compensation and Decompensation As there are postural distortions or imbalances, the body attempts to compensate by changing the tension or angle of function of other muscles. This “compensation” may work well (e.g., limping or favoring one shoulder) for a while, but when the whole system becomes overwhelmed, decompensation occurs.

11. 10. Range of Motion/Barrier There are normal ranges of motions for each joint and normal barriers to motion at the end of the normal ranges. Tightened and/or injured muscles and structural problems in the joint can create a restrictive barrier to normal movement.

12. 11. Active vs. Passive Active movement or stretching is where the patient moves their own body. Passive movement or stretching is where the therapist moves the patient’s body.

13. 11 (b) Direct vs. Indirect Direct movement of a patient’s body by the therapist challenges the affected muscle to stretch beyond any barrier to movement. Indirect movement of a patient’s body by the practitioner will encourage the affected muscle to relax.

14. Summary (Micozzi, p. 117) Practitioners of manual therapies seek to restore balance by: 1. Restoring joint range of motion and body symmetry. 2. Restoring balance of nervous activity. 3. Restoring proper arterial, venous and lymphatic flow.

15. Source Adapted from Micozzi, Marc S., Fundamentals of Complementary and Integrative Medicine, 3 rd Edition, Saunders Elsevier, St. Louis, 2006, pages 112-117. Prepared by Earon Davis, Adjunct Professor, School of Health Sciences, Kaplan University, for Course HW210, Complementary and Alternative Medicine. 1/4/2010