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Irrespective of where the pain is noted when trying to straighten from this position, the tender point would be sought (and subsequently treated by being taken to a state of ease) in the muscles opposite those working when pain was experienced - i.e. it would lie in the flexor muscles (probably psoas) in this example.

Tender points which are going to be used as ‘monitors’ during the positioning phase of this approach are not sought in the muscles opposite those where pain is noted, but in the muscles opposite those which are actively moving the patient or area when pain or restriction is noted. Goodheart has added various refinement which reduce the amount of time the position of ease needs to be maintained, from 90 seconds to 30 seconds.

5. Functional Technique9,10

Osteopathic functional technique ignores pain as its guide to the position of ease and relies instead on a reduction in palpated tone in stressed (hypertonic/spasm) tissues as the body (or part) is being positioned or fine-tuned in relation to all available directions of movement in a given region.

One hand palpates the affected tissues (moulded to them, without invasive pressure). This 'listening' hand assesses changes in tone as the operator’s other hand guides the patient or part through a sequence of positions which are aimed at enhancing 'ease' and reducing 'bind'.

A sequence of evaluations is carried out, each involving different directions of movement (flexion/extension, rotation right and left, sidebending right and left etc) with each evaluation starting at the point of maximum ease discovered during the previous evaluation, or at the combined position of ease of a number of previous evaluations. In this way one position of ease is ‘stacked’ on to another until all directions of movement have been assessed for ease.

Were the same patient with low back problems(examples 1, 2) being treated using Functional Technique the tense tissues in the low back would be palpated. A sequence of flexion/extension, sidebending and rotation in each direction, translation right and left, translation anterior and posterior, and compression/ distraction, would be painlessly attempted, involving all available directions of movement of the area, until a position of maximum ease is arrived at and held for 30 to 90 seconds. This produces a release of hypertonicity and reduction in pain.

The precise sequence in which the various directions of motion are evaluated is irrelevant, as long as all possibilities are included. Only very limited range of motion would be available in some directions during this assessment and the whole procedure would be performed very slowly.

The position of palpated maximum ease (reduced tone) in the distressed tissues should correspond with the position which would have been found were pain being used as a guide, as in either Jones’ or Goodheart’s approach, or using the more basic ‘exaggeration of distortion’ or ‘replication of position of strain’.

6. Any Painful Point as a Starting Place for SCS.

All areas which palpate as painful are responding to, or are associated with, some degree of imbalance, dysfunction or reflexive activity which may well involve acute or chronic strain (see March, April and June articles in this series).

We might therefore consider that any painful point found during soft tissue evaluation, massage or palpation, including a search for trigger points, could be treated by positional release, whether we know what strain produced them or not, and whether the problem is acute or chronic.

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 About The Author
Leon Chaitow ND, DO, MROA practicing naturopath, osteopath, and acupuncturist in the United Kingdom, with over forty years clinical experience, Chaitow is Editor-in-Chief, of the ...more
 
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