Functional Technique Part 2 Cervical & Lumbar Spine Stephen Tyreman PhD MA DO

Guidelines for Treatment The initial introduction of motion in any one elementary direction is small, with minimal forces applied Motion directions are toward a sense of immediately increasing ease; this response is manifested by a decreasing sense of resistance- to-pressure at the fingers monitoring the response at the tense dysfunctional segment. (At the same time, motions are away from the opposing direction in which increasing resistance is encountered.)

Guidelines cont. 2 Single elements of rotary and translatory directions are combined, effecting the control of an eventual smooth torsion arc for body movement. The order of introduction of these elements is not important. The final step of the functional procedure involves request for a specific direction of active respiration, whichever direction (inhalation or exhalation) contributes further to the increasing ease. For example, if inhalation, the request is for the subject to take a deep breath slowly, and hold briefly.

Guidelines cont. 3 This respiratory interval, adding to a continuous feedback of decreasing resistance, allows the operator to actively finalise the combination of translatory and rotary elements most appropriate to reach the objective of a sense of release of tissue tension at the fingertips monitoring the dysfunctional segment. The release of restraint in the motor mechanism allows the return to midline resting, unobstructed by any of the sense of resistance previously encountered in the return direction.

Cervical diagnosis Patient sitting Scan tissues Superficial & Deep Motion testing sidebending or rotation to the same side Patient supine (Head over end of table)

Cervical treatment Axial movements Flexion/extension Side-bending left/right Rotation left/right Translatory movements Antero-posterior shift / P-A shift Lateral right shift / lateral left shift Caudad shift (compression) / Cranial shift (traction) Respiration Inhalation / exhalation

Lumbar Spine Diagnosis Standing & sitting Scanning Percussion Motion testing (also test supine) Treatment Sitting, sidelying, prone and supine Position according to diagnostic findings

Treatment of thoracic & lumbar spine sidelying Position in accordance with examination findings Lying on right side entails sidebending left Think about relative position of hips and shoulders Add additional components until lesion is corrected

Treatment of lumbar spine prone & supine Position in accordance with examination findings Use elbows supine to elevate shoulders Use pillow prone to elevate hips or shoulders Add additional components until lesion is corrected

Physiological theory Explanation of Functional Technique depends on a number of assumptions Nervous system organised around reflexes cybernetic control Nervous system is not hard-wired Nervous system is adaptable Maladaptation (inappropriate physiology rather than pathology)

Compliance

Compliance 2

Motor Control

Spindle Control

Muscle Spindle

MS system as an expression of human behaviour Human behaviour is the final pathway of a number of events: volitional commands physical actions including their physiological support social and psychological ‘norms’ activities we take for granted expectations innate physiological reflexes

Human Behaviour