Posture is used by many in chiropractic to demonstrate to the patient that their structure is in abnormal alignment; e.g., health fair and mall screenings, plumb line analysis, visual analysis, and computerized plumb line analysis. However, few DC’s use the scientific analysis of head, rib cage, and pelvis postures in three-dimensions (3D) as rotations and translations along the three X, Y, and Z axes, such as performed by the Biotonix PosturePrintTM. In the early 1980’s, Dr. Don Harrison categorized human postures using this analysis.1,2
In CBP® Technique, we believe that the global postural subluxations (rotations and translations of the head, rib cage, and pelvis) are often missed, ignored, or assumed unrelated to a patient’s pre-senting condition by the evaluating doctor and, thus, are left uncorrected. In 1980, my father originated what was termed Mirror Image® adjustments, Mirror Image® exercises, and Mirror Image® traction to correct these global subluxations.1,2 Since becoming a DC, in 1996, I have added to these Mirror Image® procedures.3
There are some in chiropractic, who do not appreciate that abnormal postural displacements of the head, rib cage, and pelvis are, indeed, subluxations. In chiropractic, there are two parts to the definition of subluxation: 1) bone out of place from normal and 2) causes nerve interference.
1) Bone out of place: In kinematics research on the spine, it is known that a main motion (postural displacement) is needed to cause displacement of the spinal segments (coupled motion). For example, the main motion of anterior head translation (AHT) is known to cause a specific vertebral displacement pattern.4-6 With AHT, the lower cervical vertebra (C5-C7) will flex and the cervical segments C0-C4 will extend.4-6 In Figure 1, A-C, the coupling patterns for AHT are depicted. In Figure 1A, the neutral ideal alignment of the cervical spine is shown. In Figure 2B and C, a large amount of AHT is present. In large AHT subluxations (usually above 50 mm), the lower cervical spine will appear kyphotic and the upper cervical spine will be slightly lordotic. Thus, large head translations give the appearance of an S-curve with a lower cervical spine reversal.
2) Nerve Interference: My friends and colleagues, Dr. Dan Murphy and Dr. Chris Colloca, have outlined the neurological consequences of abnormal/asymmetrical posture via altered mechanoreceptor activity from spinal tissues8-12; while I (and co-authors)13-15 have written extensively about abnormal stresses and strains that the central nervous system experien-ces as a consequence of abnormal postures.
From the above brief review, it is apparent that postural displacements (main motion) with associated vertebral displacement (coupled motions) can cause altered nerve firing and abnormal nerve interference. Thus, postural displacements satisfy the historical definition of subluxation: bone out of place cause, nervous system interference. It may be obvious, but let me state that, to correct these global postural subluxations with CBP® Mirror Image® procedures, one must first determine exactly the directions of the rotations and translations of the global postural parts (head, rib cage, & pelvis).
In our seminars, we teach the separate rotations and translations of the head, rib cage, and pelvis, because of their complexity. While, in actual practice, we usually perform one full-spine lateral adjustment and one full-spine AP adjustment. This incorporates several postures at once and is more efficient.
To illustrate this idea, consider the common lateral posture in Figure 2. This posture is composed of (1) a forward head posture (+TzH), (2) a posterior translation of the rib cage (-TzT), and (3) a forward translation of the pelvis (+TzP). All these postures can be placed in their Mirror Image® for one set-up (see Figure 3).
Next, I wish to illustrate one common full-spine Mirror Image® set-up. Figure 4 illustrates a common AP posture, which is composed of a right low shoulder (right thoracic cage lateral flexion) and left head tilt (left lateral bending). Figure 5 depicts the CBP® Mirror Image® set-up/adjustment for this particular AP posture.
In summary, Mirror Image® postural set-ups/adjustments are unique in CBP® Technique. These methods were originated by Dr. Don Harrison in the early 1980’s. These set-ups/adjustments are the exact opposite posture (or in difficult cases, these may be in a more stressed position) of the patient’s initial presenting posture. While most doctors evaluate posture, they have not been taught the logical Mirror Image® methods that can result in routine postural correction. CBP® can make this claim of routine postural correction because we have investigated our methods with research designs. CBP® is the most published technique in the Index Medicus with over 80 published or in press research papers, of which six are Clinical Control Trials16-21 and five are Case Studies (these are available online at www.idealspine.com).
Deed E. Harrison, D.C., graduated from Life-West Chiropractic College in 1996. He has authored nearly 70 peer reviewed research articles in journals such as: the JMPT, Spine, Clinical Biomechanics, etc. Dr. Harrison is a manuscript reviewer for the orthopedic journals Spine and Clinical Anatomy. He is a member of The International Society for the Study of the Lumbar Spine (ISSLS) and is a lead instructor for CBP® Seminars.
References:
1. Harrison DD. CBP® Technique: The Physics of Spinal Correction. National Library of Medicine #WE 725 4318C, 1982-97.
2. Harrison DD. Spinal Biomechanics: A Chiropractic Perspective. National Library of Medicine #WE 725 4318C, 1982-97.
3. Harrison DE, Harrison DD, Haas JW. CBP Structural Rehabilitation of the Cervical Spine. Evanston, WY: Harrison CBP Seminars, Inc., 2002, ISBN 0-9721314-0-X.
4. Ordway NR, et al. Cervical flexion, extension, protrusion, and retraction. A radiographic segmental analysis. Spine 1999;24:240-247.
5. Penning L. Normal movements of the cervical spine. Am J Roentgenol 1978;130:317-326.
6. Penning L. Kinematics of cervical spine injury. A functional radiological hypothesis. Eur Spine J 1995;4:126-132.
7. Harrison DD, Harrison DE, Janik TJ, Cailliet R, Haas JW, Ferrantelli J, Holland B. Modeling of the Sagittal Cervical Spine as a Method to Discriminate Hypo-Lordosis: Results of Elliptical and Circular Modeling in 72 Asymptomatic Subjects, 52 Acute Neck Pain Subjects, and 70 Chronic Neck Pain Subjects. Spine 2004; 29(22):2485-92.
8. McLain RF (1994) Mechanoreceptor endings in human cervical facet joints. Spine 19:495-501.43.
9. McLain RF, Pickar JG (1998) Mechanoreceptor endings in human thoracic and lumbar facet joints. Spine 23:168-173.
10. Mendel T, Wink CS, Zimny ML (1992) Neural elements in human cervical intervertebral discs. Spine 17:132-135.
11. Perret C, Robert J (2001) Neurophysiological mechanism of the unloading reflex as a prognostic factor in the early stages of idiopathic adolescent scoliosis. Eur Spine J 10:363-365.
12. Roberts S, Eisenstein SM, Menage J, Evans EH, Ashton IK (1995) Mechanoreceptors in intervertebral discs. Morphology, distribution, and neuropeptides. Spine 20:2645-2651
13. Harrison DE, Cailliet R, Harrison DD, Troyanovich SJ, Harrison SO. A Review of Biomechanics of the Central Nervous System. PART I: Spinal Canal Deformations Due to Changes in Posture. J Manipulative Physiol Ther 1999; 22(4):227-234.
14. Harrison DE, Cailliet R, Harrison DD, Troyanovich SJ, Harrison SO. A Review of Biomechanics of the Central Nervous System. PART II: Strains in the Spinal Cord from Postural Loads. J Manipulative Physiol Ther 1999; 22(5):322-332.
15. Harrison DE, Cailliet R, Harrison DD, Troyanovich SJ, Harrison SO. A Review of Biomechanics of the Central Nervous System.. PART III: Neurologic Effects of Stresses and Strains. J Manipulative Physiol Ther 1999; 22(6):399-410.
16. Harrison DE, Cailliet R, Betz JW, Harrison DD, Haas JW, Janik TJ, Holland B. Harrison Mirror Image Methods for Correcting Trunk List: A Non-randomized Clinical Control Trial. Eur Spine J 2004; In Press.
17. Harrison DE, Harrison DD, Haas JW, Betz JW, Janik TJ, Holland B. Conservative Methods to Correct Lateral Translations of the Head: A Non-randomized Clinical Control Trial. J Rehab Res Devel 2004;41(4):631-640.
18. Harrison DE, Harrison DD, Betz J, Janik TJ, Holland B, Colloca C. Increasing the Cervical Lordosis with CBP Seated Combined Extension-Compression and Transverse Load Cervical Traction with Cervical Manipulation: Non-randomized Clinical Control Trial. J Manipulative Physiol Ther 2003; 26(3): 139-151.
19. Harrison DE, Harrison DD, Cailliet R, Janik TJ, Holland B. Changes in Sagittal Lumbar Configuration with a New Method of Extension Traction: Non-randomized Clinical Control Trial. Arch Phys Med Rehab 2002; 83(11): 1585-1591.
20. Harrison DE, Cailliet R, Harrison DD, Janik TJ, Holland B. New 3-Point Bending Traction Method of Restoring Cervical Lordosis Combined with Cervical Manipulation: Non-randomized Clinical Control Trial. Arch Phys Med Rehab 2002; 83(4): 447-453.
21. Harrison DD, Jackson BL, Troyanovich SJ, Robertson GA, DeGeorge D, Barker WF. The Efficacy of Cervical Extension-Compression Traction Combined with Diversified Manipulation and Drop Table Adjustments in the Rehabilitation of Cervical Lordosis. J Manipulative Physiol Ther 1994; 17(7): 454-464.