Grostic and Wernsing apparently contemporaneously and yet independently, conceived of the possibility that the frontal plane rotation of the atlas under the skull, what we have called atlas side-slip, or atlas laterality, could be measured in degrees. This idea was one significant aspect of Grostic’s basic elemental relationship between the condylar and axial circles (C/A).

Grostic believed that atlas laterality was the primary cause of neurological interference.

The area is dense with neurology and the dentate (pia) ligaments often attach at the craniovertebral junction. J.D. Grostic hypothesized a dentate ligament tractionization theory to explain the possible effects of upper cervical (atlas) misalignment.

Current studies in the chiropractic profession as well as medicine are examining the role of upper cervical misalignment and alteration in blood flow (compliance) into and out of the head. CSF flow may also be altered. Restoration of alignment may greatly improve compliance. Misalignment is asymmetrical by its nature and therefore may affect blood flow differently on each side.

The concept of tensegrity as promulgated by Levin and Ingber (as well as many others) was seen as debatable until recently. It seems that the literature has been able to define the cell as a tensegral structure although looking at the whole body biomechanically as a tensegral array remains a bit controversial.

Our perspective as orthogonally based upper cervical doctors predisposes us to see relationships that are not apparent to others who do not look at the aspects we focus on. The concept of tensegrity has been empirically accepted by Dr. Friedman who has expanded the concept of bone out of place, segmental misalignments, and other partial examinations of the soft tissue/skeletal system to include the whole organism.

In a tensegral array there are no actual lever systems because there are no fulcrums. When in proper apposition, the skeletal elements do not touch each other. A lever arm must have a fulcrum with which to do its work. It is the tensional elements (the muscles, ligaments and tendons and the whole myofascial envelope that is under continuous tension. The skeletal (compressive ) elements are discontinuous (separate) in the system. When a tensegral array comes under axial tension, the compressive elements (the bones) line up with the tensional elements to make the system more stiff.

Bones do not lock out of place. They don’t even touch each other unless there is local collapse of the tensegral array. The tensional elements may, under deleterious forces, buckle or compress. When this occurs in the low back, there is progressive degeneration of the spinal elements as they attempt to adapt to deleterious forces. When this occurs at the craniovertebral junction it appears to cause a change in the symmetry of the paraspinal musculature with resulting postural distortion.

We have long realized in orthogonally based upper cervical chiropractic that although the pelvis is the greatest mass in the kinetic chain of the spine, it is not necessary to address it’s misalignment by directly adjusting the pelvis. We have long found that upper cervical adjustments can affect the whole system and restore alignment to ALL of the spinal elements (with respect to gravity) because the tensegral array that we ‘are’ is neurologically modulated. A small amount of misalignment in this area is magnified due to its neurologically central location. So if bones do not lock out of place, what causes the atlas laterality and rotation that we can consistently measure on x-rays?

In the tensegral model the spinal elements are passive, they are utilized to maintain shape, but it is the soft tissue elements that are active. Force is distributed throughout the whole system as evenly and as immediately as possible. If the neurology has become imbalanced causing the tensegral array to have to deal with asymmetric non-anatomical forces, the whole body distorts. When the center of mass in the pelvis moves away from the gravity line, the body immediately adapts, usually by leaning back toward the gravity line. The atlas, in its function as a coupling between the head and the C2-pelvis kinetic chain will move to equilibrate the forces of the kinetic chain and the head. This is an effect not a cause. Measurement of ¾ of a degree or more of atlas laterality is certainly coincident with postural distortion.

Dr. Friedman is now showing, in an ever growing number of successive cases, that the misalignment we have recognized for the last 70 years is comprised not just of the upper and lower angles and rotation of C1 and 2, but also of a compressive component existing throughout the entire tensegral array that can impede and sometimes preclude correction of the linear elements. If compression remains in the spine, the attempt to restore the skeletal elements to the vertical axis will only jam the structures into line.

He is finding that the bow we often see in the frontal plane, the loss of curve (or even reversal of cure in the sagittal plane)  as well was the rotation in the transverse plane all constitute radiographic evidence of this progressive, compressive force. Another indicator is the presence of more weight on the side opposite the short leg. The last blog by Dr. Friedman discussed the primary importance of decompressing the misalignment before attempting to restore it to the vertical axis. We have long done with this type II’s when we drop the head so that we close the facets on the side opposite laterality and allow the circular forces to restore the lower angle to the vertical, taking the bow out. However, believing that the atlas laterality is the CAUSE of the problem, we have had a more difficult time with opposite angle misalignments because to decompress the spine one would have to adjust the patient on the side opposite laterality.  If atlas laterality is the cause and not a critically significant effect, then we would have no choice and indeed, many people have had to accept the presence of lower angles that won’t reduce.

Dr. Friedman reasoned that atlas laterality may be an effect of distortion in the whole tensegral array and that decompression of the array could facilitate not just improved reductions but improved stability and truly unencumber the whole system. Up and open he calls it. Over the last few months he has been working with many dozens of patients and this in fact is the bottom line.  He is restoring people to the vertical axis and unwinding previously intractable lower angles and rotations.