I have recently had a wave of some very tough cases. Most of us dread these moments in our practice. It seems that just as you learn the missing piece to one case, anothercome right behind it to replace it. I imagine this is universal intelligence’s way to keep us growing.
Low back pain patients seem to be particularly difficult for me (often big twist). Compared to migraine and TN patients, they don’t seem to correct well in the frontal plane aspect of the correction. Both headpiece positions on the bow side have not been a success with these ones. My initial thought was that low back issues bear a large amount of torsional and mechanical load as gravity breaks down the patient’s tensegrity, making the correction unstable. However, I live in a place that everyone is correctable with the proper protocol within the QSM3 tensegrity model. I just need to figure outtheir individualpattern.
The protocol oncases has been to integrate, decompress, frontal, skull, frontal. This recipe usually seems to be a 1-2-3 … corrected. One or two visits and we correct the issue and move into stabilization care. This aspect of the QSM3 protocol (3-D pelvis-to-skull closed kinetic chain discussion) has been a great source of knowledge for our practitioners and a benefit into the most problematic cases. Instead of a force IN, it’s a decompressive approach to restore the compressed misalignment to an orthogonal stable steady state.
However, recently, this 1-2-3easy approach has not been the case for me. When technical challenges arise, I have found that a break-throughfollows. One of my past friendsand mentor used to say; “You need to have a breakdown to have a breakthrough”. Although I do not like these moments, I do know they are necessary in the learning process and have learned to be patient until the gift of wisdom and growtharrive. I always look at these cases as a group to see consistencies that may shorten the learning process.
The commonality of these casesis that they all had large pelvic rotations (7mm or more). We know that the pelvis is the rotational primary component but we have not observed it as a function of the compressive forces of gravity. As the spine breaks down over time, it spirals downward from the pelvic center of mass. The relief pressure points (where the body moves to reduce pressure) as the body breaks down are all transverse as it collapses downward. Simply said, the rotational component is directly related to the compression of the body. The bigger the rotation of the pelvis the more compressive forces are present.
The rotational component of the misaligned spine is a symptom of the biomechanical pressure relief from the compressive forces of gravity.
To correct this rotational downward spiral, the energy to overcome and release the resistant friction must be UPWARD IN the correct pathway that REMOVES & RELEASES.
Therefore, the corrective pathway must be the reverse of the breakdown pathway.
The correct rotational leverage to free pelvic rotation must be in an upward spiral. This would include three wrist lever actions:
- I to S with a circular pathway (DOWN hdpc)
- The proper pelvic rotation leverage
- The correct torque to unspiral and lift the resistant pathway
The pelvis is the rotational primary and when misaligned it breaks down in a spiral under the pressures of gravity. This phenomenon (collapse and spiral)demonstrates that the body’snormal healthy posture must be tensegral to overcome gravities downward forces. Otherwise, we would be flat. It’s ourtensegral structure that is larger than the downward forces that keeps us UP & Open. It is only when the spine is at a critical misaligned point, and the energy capacity of the body is low, that the forces of gravity become greater than the inherent upward pushback of the body. This creates the collapse and the dis-ease process we see everyday.
The largepelvic rotation can be seen as an indicator to ONLY decompress for a period of 14-60 days prior to the UP headpiece to restore the frontal plane. These misalignments are apparently more unstablethan the average case and cannot initially handle the 1st and 4th step of integration and frontal protocols. The linear (UP headpiece) seems to be too much and RE-collapses the misalignmentto its original broken down state.
I have seen this does not just apply to large rotation cases. Multiple S curves, non-coplanar shoulders, low back misalignments, and non-vertical corrections appear to fall in this category of decompression only. The spine and or body must unwind upwardly before any frontal plane corrections can be corrected and held.
The indicator for any misalignment that decompression must be stabilized over time is by watching the digital scales when you
integrate or address the frontal plane(UP headpiece).
The frontal plane (scales)may increase in weightinstead of becoming vertical. As if to show you are compressed, it is reacting like a spring that is unable to handle any more compressive forces – it pushes back.
The decompression of the BOX and the skull must always be with the DOWN circular pathway headpiece. Do not get hung up on the weight scales during this process initial process. Weight may increase and if it does, do not worry about it for now. The goal here is to create an UP and OPEN coplanar structure that can ultimately handle the linear forces of the UP headpiece.
Unfortunately, there is no cookie cutter way to tell when decompression is complete without setting the UP headpiece, delivering the energy and measuring what happens in the frontal plane weight scales. The weight will increase or stay the same. Also, if you have developed the tactile feel of resistance, there will be a bounce feeling in the UP position indicating a compressed state still being present.
The 7-20 mm pelvic rotation combined with a small frontal plane weight differential seems to be automatic that we should decompress only. This misalignment is a screwed downward compression with no frontal relief. The big weight differentials with big pelvic rotations seem mixed. Use the rotation of 7mm or more as an indicator to only use the decompression protocol first.
You will notice a change in your tough cases here. The protocol to decompress is an insight but it is also complex. The discussion is on where the rotational resistance comes into play. For a 10 mm rotation; is it all 10 mm on the left, the right or some left and some right? It is important you understand this concept. The fact that you must find the correct pathway is not a guessing game in QSM3 The driving force in a successful correction is the un-spiraling, decompressing, and removing the rotational resistance thataffects the nervous system and every other system. Do not be concerned with the frontal plane until the rotation is clear. Determining the correct pathway is imperative.
I always start on the side of the bow. Drop the headpiece and use the appropriate leverage points. If the rotation does not clear, I look to see if the skull tilt is opposite the weight differential. If so, flip and decompress (even if it is biomechanically incorrect in the frontal plane), and if not stay decompressing on the BOW side until clear. In some big wavy spines, I have randomly worked on both sides on a search and release mission,always using a DOWN headpiece. BOTTOM LINE is; if the BOW pathway does not clear the compression, there must be another opposite compression on the other side that is hindering the decompression process from occurring that must be addressed first. This would be a double compression that cannot be seen visibly. The smaller compression on top must be removed before getting to the primary. Working on both sides is a must.
Correcting the rotation of the pelvis and these severely unilateral rotational compression misalignments is a time contingent journey. I have learned patience over the last few months. Not everyone is correctable on the first visit. It is not that you are missing something in the correction. It is a first phase that needs patience and diligence. It is a case of the sixth principle of chiropractic. Every process takes time. Now when I see these big pelvic rotations,or present with a case that will come vertical initially, I know that I must first decompress, be patient, and be assured that everyone is correctable given enough time in the QSM3 progressive procedure.
Just decompress, give it time, and remember and explain the 6th principle.
Left short leg, Left 20lbs, pelvis posterior 8mm, left 3 or (L1/2 L20 p8 L3)
R head tilt
Protocol: with left side up (BOW), drop head directly based on 8mm pelvic rotation.
Headpiece is DOWN
Leverage: P to A, I to S, Inferior torque
Post 1 Data:
Left 18lbs, pelvis posterior 6mm, left 3
R head tilt
Protocol: based on the head tilt place right side UP and decompress
Headpiece is DOWN
Leverage: A to P, I to S, superior torque
Post 2 Data:
Right 1lbs, pelvis 0 mm, Right 0
This demonstrates that the original left down headpiece (right access pathway) had 2 mm of the rotation and the right downheadpiece (left access pathway) had the remaining 6mm of pelvic rotation and left frontal resistant pathway of 18-20lbs.
December monthly webinar will feature a discussion, a case study, and video of this process. Attendance is limited.
Happy holidays and enjoy the TIME,