The Art of Assessment
The Art of Assessment
A Client came in for an assessment recently. He has been dizzy for 2 years. In the past he was an avid mountain biker, but now his balance is precarious so he can only bike on the Pelaton.
He’s been to every medical resource that treats balance and dizziness. The only answer he’s received is neuritis due to a dead nerve in the inner ear for which there is no treatment.
I always think it’s a good thing when the medical profession can’t find a definitive pathology. In these cases there is a good possibility that the problem is functional, ie., something about the coordination of support and movement is undermining function.
It is true that a fixation in a muscle can affect a whole chain of muscle function. It is true that a fixation in a muscle can inhibit its opposite function ie., a locked/spasmed/fixated flexor makes it impossible for the reciprocal extensors to fire. This leaves us with the NEED to continue to overuse the flexor because our function depends on it. Half a leg is better than no leg to stand on.
I demonstrated to the client that the fixation under his left sub-occipital region was inhibiting the whole left lateral line of support through his shoulder and hip and even the peroneals in his ankle. There are 4 sub-occipital rotators. The top one on the left was rigid; inhibiting the top one on the right and the bottom one on the left. When he needed to turn left he tucked his chin in and side bent first before turning. In this way he could turn from a lower vertebrae than C2. C2 is the most commonly inhibited rotation. It often mirrors/mimics the upper thoracic rotation. For this client the upper thoracic had a right rotational preference: was inhibited for left rotation, JUST LIKE C2.
I made a simple correction of temporarily inhibiting the left Obliquus Capitus Superior and his whole left lateral line of support woke up/became functional, including the left C2 rotation. It was still faltering a little so I explored a little further to see that the right Obliquus Capitus Inferior was ALSO inhibiting left rotation at C2.
Even though we had corrected the upper cervical rotator functions, there were still other dysfunctional patterns in the neck that the neck had adopted while being unable to turn left at C2. For instance, the left Scalene inhibited C2 rotation also.
Secondary accommodations/compensations used to substitute for a dysfunctional muscle become part of the stored movement pattern and will undermine the corrections you make until you FIND THEM ALL. We also had not corrected the upper Thoracic rotation and THAT one undermines both neck and shoulder functions.
An associate who sat in with me on the assessment finished the whole sequence that needed to be addressed. We will see him again next week and see what changed have been wrought….!