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Hi, Due to all private requests about the mobilisation of the OA joints I thought I just post the description of the technique directly to the lists. So here it is. One of my primary interests in my work is the spine and I'm always looking for ways to improve my skills. I scan the Internet regularly to find new approaches, inspiration, etc. During one of those searches I came across some material and that really caught my eye. I must admit that the OA joint was something that I hadn't paid all that much attention to. That is until I realized its potential after reading these papers, especially the one about the fat pad entrapment (which I think is a quite plausible theory). You find that one on: http://www.life.edu/newlife/crj/42knutsn.html After that I devoured all information I could find on OA joint and UpC on the Web. In Sweden X-ray is only allowed to be used at hospitals and by dentists, therefor I have to rely on palpation skills. Since I know that motion palpation lacks precision I chose palpation of Atlas’s static position. The palpation points I use is: - The lateral aspect of the proc. transversii in standing with patient looking straight ahead. Palpating for laterality. - The inferior aspect of the proc. transversii in supine with patient looking straight ahead. Palpating to find what side is more cranial. - The superior to the proc. transversii in supine with patient looking straight ahead. Palpating for muscle tension. - The posterior aspect of Atlas in supine with patient looking straight ahead. Palpating for rotation of the Atlas. - The posterior aspect of the proc. transversii in supine with patient looking straight ahead. Palpating for rotation of the Atlas. - Obliquus capitis inferior (diagonally between proc. spinosus on Axis and proc. transversii on Atlas) in supine with patient looking straight ahead. Palpating for muscle tension. The muscle will be tense on the side which has rotated forward. To make the judgment of laterality I must find: - Laterality (in standing). - Superior proc. transversus on the same side (in supine). - Muscle tension superior to the proc. transversus on the same side (in supine). To make a judgment of rotation I must find: - The same palpatory findings on both locations (posterior aspect of Atlas and posterior aspect of the proc. transversus). - Increased tension in Obliquus capitis inferior on the side the palpatory findings indicate as forward rotation. Since I’m not trained in cervical manipulation I’ve tried to find another way of correcting the hypomobile atlas. Going through the material on UpC I found a variety of ways to perform a correction of the Atlas. One way (sorry, I don’t remember the name of the technique) was that after deciding the vector using a continuos pressure rather than a thrust of any kind, the correction was made. This sounded that something I could use, however I thought that since the muscles around the Atlas will be working against my force I would need more force than I felt comfortable with. What to do? Well luckily enough I’m trained in something called Acupoint Therapy (AT) where you use a blunt-tipped tool to stimulate acupoints. The techniques of AT enables me to cause a very high degree of relaxation very selectively. I will here describe how you with the stimulation of only 3 acupoints can very effectively relax the Rectus capitis anterior, Rectus capitis lateralis, the Obliquus capitis superior and Obliquus capitis inferior. First a short description of the stimulation technique itself. The technique is performed with a blunt-tipped tool called therapy stick (we use the same tool as the dentist uses to push down the filling into the tooth). It consists of a handle with a small (2 mm diameter) ball-point at each end, one of the ends is hooked. The stimulation of individual acupoints is achieved with a gliding pressure over the acupoint applied with the therapy stick’s hooked end. Hold the therapy stick as a pencil, stretch the tissue around the acupoint with the thumb and index finger of the other hand. Then press the ball-point gently into the tissue and pull it towards you in a short, about 5 mm, straight and rapid movement. Keep the hand and therapy stick as parallel as possible with the skin to get the best effect. Avoid any digging or scooping movements, since they are more likely to damage the skin. The stimulation is confirmed when the patient feels a slight stinging sensation. Occipital point 1. The point is situated on the occipital border, 1.5 cun (cun = the width of the IP joint of the thumb) lateral of the midline, stimulate on the opposite side of the laterality. This causes a relaxation of Rectus capitis lateralis and Rectus capitis anterior on the side of the laterality and thereby reduces the laterality. Frontal point 1. The point is situated just above the eyebrow, on the superior edge of margo supra-orbitalis, straight above the medial corner of the eye, stimulate bilaterally. This causes a relaxation of Obliquus capitis superior bilaterally and thereby reduces the rotation. Frontal point 2. The point is situated 0.5 cun lateral of frontal point 1, stimulate bilaterally. This causes a relaxation of Obliquus capitis inferior bilaterally and thereby reduces the rotation. When the points are stimulated I let the patient stand up, I give a slight traction (just enough to take the weight of the head of Atlas) by lifting with one hand below the occiput and the other under the mandible. While maintaining the traction I ask the patient to swing his arm forward and up (to 180°) and then repeat this movement with some speed until I can feel Atlas moving on the same side. I do this bilaterally, but always start on the side with the laterality. This technique is designed to cause a gapping in the OA joints. If the above is not enough to create a complete correction I use the following technique. The patient sits and I stand on the side of the laterality. I have slightly bent legs, I let the patients chin rest in the crook of my elbow and gently squeeze the head to my body. I place my other thumb on the proc. transversus. I give a slight traction (just enough to take the weight of the head of Atlas) by straightening my legs. The patient takes deep breath and holds it and I push gently but firmly along the optimal vector (which is opposite the laterality and rotation), the patient exhales and I maintain the pressure a few seconds. The technique is repeated if needed. Please try the above and let me know your opinion. All the best, David %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%