Similarly, Lamont's nutritional observations would need verification, something which does not alter the fact that some patients demonstrate this unusual 'black streak'. As with so much in palpation there is little question of 'something' being 'felt' or observed. It is the interpretation of what it means that excites debate.
The simpler observations of Upledger, Hoag, Morrison and McConnell are readily applicable, and should be tested against known dysfunction to assess the usefulness of these methods during assessment.
The research of Cox et al indicates that one musculoskeletal assessment method alone is probably not sufficiently reliable to be diagnostic, however when for example tissue texture, changes in range of motion, pain and the ‘red reaction’ are all used, a finding of the presence of several of these is a good indication of underlying dysfunction which may involve the process of facilitation.
A Simpler Use for the Reaction
A less complex use of the red reaction is to go back a century to McConnell’s method, described earlier in this special topic note, in order to highlight spinal deviations. By creating erythema paraspinally you can stand back and visualise the general contours of the spine as well as any local deviations in the pattern created by application of your firm digital strokes.
How do you know whether your palpating fingers or thumbs are applying equal pressure bilaterally during such assessments, or when palpating elsewhere, bilaterally?
A useful guide to the uniformity of pressure can be obtained by comparing the relative blanching of your nail beds; are they equally white, pink, red?
1. McConnell C The Practice of Osteopathy 1899
2. Hoag M Osteopathic Medicine McGraw Hill, 1969.
3 Upledger J. Vredevoogd W. Craniosacral Therapy, Eastland Press, Seattle 1983
4. Newman Turner R Naturopathic Medicine Thorsons, Wellingborough UK, 1984
5. DeJarnette B Reflex Pain (Nebraska,1934)
6. Korr I The Physiological Basis of Osteopathic Medicine, Postgraduate Institute of Osteopathic Medicine and Surgery, N.Y. 1970
7. Morrison M Lecture Notes, London 1969
8. Cox, Gorbis, Dick and Rogers Journal American Osteopathic Association vol.82 No.11 1983