Looking Globally /Not Chasing Pain: A NYC Chiropractor/Applied Kinesiologist/NeuroKinetic Therapist Explains

When patients come in with a local problem such as leg  pain, the first question is where is the source of the pain; is it from the leg itself or the the low back. The other important question is what “set up” the problem. Without answering this question,the problem is not really resolved; the patient will come back with the problem again; you will be just “chasing pain*.”

The answer to the second but more important question may be in the global muscles or core stabilization muscles, these muscles are the Rectus Abdominus, the Transverus Abdominus, the Internal & External Obliques, the Quadratus Lumborum, the Erector Spinae and the Multifidus.

Recently new patient came in complaining of feeling “unbalanced on her right side” siting specifically her right leg and hip.

The lower extremities were a quick fix: a Rectus Femoris – major muscles in the front of the thigh -compensating for a weak Gluteus Maximus. Also the patella and the rotation of the femur (thigh bone) on the tibia (lower leg bone) needed to be adjusted and the Popliteus ( a muscle that rotates the tibia) released.

But during the examination, on lateral flexion of her truck, I noted that her rt shoulder was rotating. I asked her to try to not rotate her shoulder but she was unable; in fact she was unaware of doing it.

I tested her Oblique muscles and they were weak on the right side. Touching (therapy localizing) her Quadratus Lumborum strengthened her Obliques when retested. So I released the QL and the Oblique were strong.

coremuscles

 

A Category One pelvis which involves rotation was found and fixed.

Low Back Pain & Non Force Adjustments/SOT Blocking: A NYC Chiropractor/Applied Kinesiologist/NeuroKinetic Therapist Explains

When she stood back up, the rt. leg felt balanced and the rotation of her shoulder on lateral flexion was gone.

It was a great illustration of how sometimes part of the problem you have to look above the area of complaint to truly fix the problem; a local problem with a global part.

Stretches and exercises were given as homework.

In my practice, I Iisten, observe and test during the examination and use a combination of NKT, Applied Kinesiology and Chiropractic to help my patients; it’s a strong combination.

How a Combination of Applied Kinesiology, NeuroKinetic Therapy and Chiropractic Works

The Use of Applied Kinesiology in a Chiropractic Examination

© 2017-Dr. Vittoria Repetto

Want more information on Dr. Vittoria Repetto and her  ANYCpplied Kinesiology/Chiropractic/ NKT practice at 230 W 13th St., NYC 10011; please go to www.drvittoriarepetto.com

And please check out the Patient Testimonials page on my web site.

 Want to be in the know on holistic information and postings? 

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*I thank Dr Perry Nickelston for his phrase “Stop Chasing Pain.”

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Scars & Muscle Control – A NYC Chiropractor/Applied Kinesiologist/NeuroKinetic Therapist Explains

A while ago I had two patients where scars left from operations affected muscle function.

The first patient came in complaining of acute low back pain that happened on lifting a box that was too heavy for her; one of the muscles I tested is the Rectus Abdominal, it was weak in the clear. The Rectus Abdominal (RA) is part of the support for the Lumbar (low back);she had mentioned that she had had a tummy tuck years ago.
When she touched the scar (therapy localize) which was above her pubes (RA tries into the pubes) her RA tested strong so I massaged the scar and the RA now tested strong.

I find that the T10-T11 vertabrae which are part of the innervation of the RA were subluxated and adjusted them. I also adjusted subluxations in the low back.

The Subluxation/Spinal Joint Dysfunction

I showed her which abdominal exercise I wanted her to do after a daily massage of the scar.

The second patient come in w/ thoracic weakness; she have a history of different cancers.
When I tested her Pectoralis  muscles, both parts (Clavicular & Sternal) tested weak. She said that she was not surprised as a “good part of the muscle was removed” where they removed her breast. I therapy localized the scar from the breast removal and retested as I touched the scar…both parts of the muscle now tested strong.
I massaged the scar… and the muscle tested strong.  I found subluxations at C5 for innervation of the clavicular section and C7 for the sternal section and adjusted them both.
Patient’s homework was to massage that scar before doing exercises for the pectorlis.

Please click on below research articles on relation of scars to muscle pain and function.

CLINICAL IMPORTANCE OF ACTIVE SCARS: ABNORMAL SCARS AS A CAUSE OF MYOFASCIAL PAIN

Surface electromyography of abdominal and back muscles in patients with active scars.

A CASE OF A PATHOGENIC ACTIVE SCAR

Skin, fascias, and scars: symptoms and systemic connections

© 2017-Dr. Vittoria Repetto

 

Want more information on Dr. Vittoria Repetto and her NYC Applied Kinesiology/Chiropractic/ NKT practice at 230 W 13th St., NYC 10011; please go to www.drvittoriarepetto.com

And please check out the Patient Testimonials page on my web site.

 Want to be in the know on holistic information and postings? 

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Low Back Pain & Non Force Adjustments/SOT Blocking: A NYC Chiropractor/Applied Kinesiologist/NeuroKinetic Therapist Explains

One of the major complaints that causes patients to seek out a doctor of chiropractic is low back pain; it can be caused by either a problem with the lumbar spine or the sacrum.

As a doctor of chiropractic who is also an applied kinesiologist, I use a technique developed by Dr. DeJarnette called Sacro Occipital Technique (SOT); so named because of the relationship between the sacrum (base of the spine) and the occiput (base of the skull).

One of the functions of the sacrum is to pump cerebro-spinal fluid (CSF) from the base of the spine back up the spinal canal to the brain and throughout the nervous system. The occiput also helps to pump CSF. The minute rhythmical motion is essential to optimal health – CSF effectively acts as the circulatory system of the brain and spinal cord.

The pelvis forms the foundational support of the human skeleton. It supports the upper body right up to the skull, and enables us to transfer our weight to our legs. The sacrum is a large bone located at the terminal part of the vertebral spine, where it forms the posterior aspect of the pelvis. The spine holds our body upright, supports all of our organs and provides anchor points for our muscles. It also protects our delicate nervous system. The nervous system controls our body, and can only function normally when our structures are balanced and our pelvis, sacrum and lumbar is stable.

Dr. DeJarnette’s studied two aspects of the sacroiliac joint; the anterior synovial portion and the posterior hyaline cartilage portion. The anterior sacroiliac joint should have motion and this is where sacral nutation and counternutation takes place. The posterior sacroiliac joint is focused on weight-bearing stability and support, which is why at the posterior joint surface there are interlocking of the ridges, and grooves by structures like muscles, ligaments and fascia.

DeJarnette evaluated the weight-bearing characteristics of the sacroiliac joint and determined that when the joint could not adequately support body weight then load bearing stress will be moved upward to the L5/S1 and L4/5 discs, most commonly.

DeJarnette developed an analysis which classified pelvic problems into three different categories and three different non-force techniques using SOT blocks in positions that correct the involved category.

sot-blocks

One of the major complaints that causes patients to seek out a doctor of chiropractic is low back pain; it can be caused by either a problem with the lumbar spine or the sacrum.

As a doctor of chiropractic who is also an applied kinesiologist, I use a technique developed by Dr. DeJarnette called Sacro Occipital Technique (SOT); so named because of the relationship between the sacrum (base of the spine) and the occiput (base of the skull).

One of the functions of the sacrum is to pump Cerebro-Spinal Fluid (CSF) from the base of the spine back up the spinal canal to the brain and throughout the nervous system. The occiput also helps to pump CSF. The minute rhythmical motion is essential to optimal health – CSF effectively acts as the circulatory system of the brain and spinal cord.

The pelvis forms the foundational support of the human skeleton. It supports the upper body right up to the skull, and enables us to transfer our weight to our legs. The sacrum is a large bone located at the terminal part of the vertebral spine, where it forms the posterior aspect of the pelvis. The spine holds our body upright, supports all of our organs and provides anchor points for our muscles. It also protects our delicate nervous system. The nervous system controls our body, and can only function normally when our structures are balanced and our pelvis, sacrum and lumbar is stable.

Dr. DeJarnette’s studied two aspects of the sacroiliac joint; the anterior synovial portion and the posterior hyaline cartilage portion. The anterior sacroiliac joint should have motion and this is where sacral nutation and counternutation takes place. 

pelvic-ligaments-ant

si-movement

The posterior sacroiliac joint is focused on weight-bearing stability and support, which is why at the posterior joint surface there are interlocking of the ridges, and grooves by structures like muscles, ligaments and fascia.

postsacrummuscles

DeJarnette evaluated the weight-bearing characteristics of the sacroiliac joint and determined that when the joint could not adequately support body weight then load bearing stress will be moved upward to the L5/S1 and L4/5 discs, most commonly.

DeJarnette developed an analysis which classified pelvic problems into three different categories and three different non-force techniques using SOT blocks in positions that correct the involved category.

Category One is a pelvic torsion with altered sacral nutation(motion)  This lack of nutation affects the spinal and cranial meningeal and CSF systems which function to a degree like a closed kinematic chain. Therefore symptoms can be low back pain, chronic shoulder complaints, thoracic outlet syndrome, CSF stagnation, and altered vasomotor function.

Involved muscles can be the piriformis, quadratus lumborum, sacrospinalis, gluteus medius and gluteus maximus. As an applied kinesiologist, I’d check to see if they are hypotonic or hypertonic; as a neurokinetic therapist, I’d check to see if a muscle is weak (or inhibited) by another muscle compensating.

Therapy localization (TL) is done by putting 2 hands on each sacral-iliac joint and then challenging the pelvis for a structural listing and then blocks are put under the patient’s pelvis based to the findings.

The positive Tl’ed side is not adjusted. Cranials are checked.

Category Two happens when ligaments that hold the sacroiliac joint are stretched or sprained, allowing the joint surfaces to separate. Stress can aggravate this ligament weakness via adrenal hormone overdrive.

Symptoms can be low back pain, bowel complaints, possible dysfunction of the reproductive glands and the adrenals, shoulder problems and decreased cervical range of motion.

Involved muscles in addition to the ones mentioned in Category I are the sartorius, gracilis, rectus abdominals and hamstrings along with the iliolumbar ligament. These structures are tested via applied kinesiology and neurokinetic protocols mentioned above. Cranials again are checked.

Category Three occurs when the low back can no longer tolerate the physical stressors placed on it and involves both disc and nerve root aggravation. This can be a sudden one-off event such as a lift, or it can be a pre-existing weakness that is aggravated. Often Category Three produces pain in the low back and sometimes pain radiates down a leg as sciatica.

Muscles to be checked are the psoas as it attaches into the front of the lumbar vertebrae as well as the muscles involved in Category One as Category Three can be a Category One that was never corrected.

Correction in all the categories involves using blocks under the pelvis in specific directions related to the category and the subluxation/misalignment of the pelvis/sacrum. The patient’s weight and breathing help to balance the low back, sacrum and CSF flow and takes the pressure or irritation off the nerve. This allows the body to heal.

Patient is told to ice the involved areas, how to do daily activities, given stretches and exercises and advised on nutrition to help the body heal.

For more information on issues mentioned:

Cranial Sacral Therapy in Applied Kinesiology

How a Combination of Applied Kinesiology, NeuroKinetic Therapy and Chiropractic Works

The Use of Applied Kinesiology in a Chiropractic Examination

© 2017-Dr. Vittoria Repetto

Want more information on Dr. Vittoria Repetto and her NYC Applied Kinesiology/Chiropractic/ NKT practice at 230 W 13th St., NYC 10011; please go to www.drvittoriarepetto.com

And please check out the Patient Testimonials page on my web site.

 Want to be in the know on holistic information and postings? 

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Rib Pain or Intercostal Neuritis – A NYC Chiropractor/Applied Kinesiologist/NKT Practitioner Explains

Every few times during the year, I get a patient with a displaced rib head. (I’ve had one or two myself)  The sensation is an intense stabbing pain that “takes your breath away” in either the back or the front of the chest; sometimes the pain goes round the rib and sometimes seems to go from the back to the front like a knife.

When a patient comes in, we evaluate them via examination and a detailed history to rule out things like shingles or referred pain for heart, lung and gastrointestinal problems. A lot of the times, the patient has already been evaluated by their M.D. for these conditions with negative results.

But it’s usually a rib head displactment either at the anterior attachment at the sterum [breastbone] or at the posterior attachment at the transverse process of a thoracic vertebrae. The intercostal nerve runs from the anterior rami of the thoracic spinal nerves from T1 to T11 and runs [along with the artery and vein] between the intercostal muscles to the breastbone.

intercostal-nerve

intercostal-muscle

Of course it’s not surprising that a rib displacement “takes yr breath away” as the ribs (& the clavicle) and a lot of the muscles attached to them are involved in inspiration and expiration. Some of these muscles are the diaphragm, the external & internal intercostals, the serratus anticus, pectoralia minor, scalene & SCM muscles.

breathing-muscles

Muscles attached to the ribs or thoracic spine which may not be directly involved in breathing but may be compensating for a problem with the breathing muscles. Some of these muscles are the rectus abdominis, the abdominal oblique muscles, the quadratus lumborum, the rhomboids and latissimus dorsi; they may be on the same or contralateral side to the displaced rib.

Before I adjust any displacement of the ribs involved or the breastbone or the clavicle as a doctor of chiropractic; I need to balance the muscle pull on the affected area.

I use the muscle testing used in both Applied Kinesiology and NeuroKinetic therapy.

As a Applied Kinesiologist, I test for the function of individual muscles. The questions to be asked are: why is the muscle weak? Is the muscle on the other side hypertonic or “too stronger.” Is the weakness due to a spinal/nerve problem, a vascular problem, a problem with lymphatic function, a nutritional default, a problem with organ function or an acupoint associated w/ that muscle?

The Use of Applied Kinesiology in a Chiropractic Examination

As a NKT practitioner, I ask “Is there a dysfunction in the coordination of muscles working in patterns?” NeuroKinetic Therapy works with that concept that movement is performed in systems or patterns. NKT identifies muscle imbalances by using muscle testing to determine what muscles are inhibited and what muscles are compensating (facilitating) for them.

How a Combination of Applied Kinesiology, NeuroKinetic Therapy and Chiropractic Works

Once the above muscle related questions are answered, I can adjust the involved rib, clavicle or spinal segment.

Stretches are given to the previously facilitated (or hypertonic) muscles and exercises given to the previously inhibited (or weak/hypotonic) muscles in order to break the pattern that caused the problem.

For a blog on the effects of the breathing muscles on asthma, please check out: The Musculoskeletal Aspects of Asthma

© 2016-Dr. Vittoria Repetto

Want more information on Dr. Vittoria Repetto and her NYC Applied Kinesiology/Chiropractic/ NKT practice at 230 W 13th St., NYC 10011; please go to www.drvittoriarepetto.com

And please check out the Patient Testimonials page on my web site.

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How Really Small Muscles Can Be A Real Pain In The Neck – A NYC Chiropractor/Applied Kinesiologist/NKT Practitioner Explains

When a patient complains of neck pain or headaches, I first muscle test both the cervical flexor and extension muscles and muscles which when they test bilaterally weak such as the psoas or gluteus maximus suggest a fixation of the cervical vertebrae.

I ask questions: are the muscles weak and therefore affecting the alignment, movement of the cervical vertebrae?

Are one set of muscles weak or inhibited because of compensating (facilitating) muscle.

Or is the opposite true? Is it the hypertonic or facilitated muscle the problem?

Sometimes it’s not the bigger cervical flexor/extensor muscles that are causing pain either directly or by pulling vertebrae out of alignment and putting pressure on the nerves supplying the cervical area.

Sometimes it’s the half inch to inch muscles just below the occipital (base of your skull) that attach it to either the atlas (C1) or the axis (C2) or attach atlas to axis.

These muscles are called the Rectus Capitis Posterior Major, Rectus Capitis Minor, Obliquus Capitis Superior and Obliquus Capitis Inferior.

suboccipitaltriangle

The Rectus Capitis Posterior Major extends, laterally flexs and rotates the head.  The Rectus Capitis Minor extends and laterally flexes the head. The Obliquus Capitis Superior extends and laterally rotates the head. The Obliquus Capitis Inferior  rotates C1 and cranium.

Problems with these muscles can pull vertebrae out of alignment and put pressure on the cervical spinal roots and cause neck stiffness, pain and headaches. See dermatome map below for areas of innervation.

head dermatome

Note there is no C1 dermatome. The C1 root innervates the meninges of the posterior fossa of the skull and has no cutaneous branch; the posterior fossa also contains the meningeal branches of vagus and hypoglossal nerve. Neck stiffness may be a test of the C1 root that innervates the meninges.

For more information, please see the following blogs:

https://drvittoriarepetto.wordpress.com/2014/08/09/the-use-of-applied-kinesiology-in-a-chiropractic-examination/.

https://drvittoriarepetto.wordpress.com/2010/12/13/spinal-pain-not-being-helped-see-an-applied-kinesiologist-it-may-be-a-fixation/

https://drvittoriarepetto.wordpress.com/2016/06/23/how-a-combination-of-applied-kinesiology-neurokinetic-therapy-and-chiropractic-works/

For discussion about meninges:  https://drvittoriarepetto.wordpress.com/2016/05/28/why-is-my-neck-problem-causing-low-back-or-leg-pain-a-nyc-chiropractor-applied-kinesiologist-nkt-practitioner-explains-the-lovett-brother-effect-on-the-spine/

https://drvittoriarepetto.wordpress.com/2010/05/17/cranial-sacral-therapy-in-applied-kinesiology/

© 2016-Dr. Vittoria Repetto

Want more information on Dr. Vittoria Repetto and her NYC Applied Kinesiology/Chiropractic/ NKT practice at 230 W 13th St., NYC 10011; please go to www.drvittoriarepetto.com

And please check out the Patient Testimonials page on my web site.

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How a Combination of Applied Kinesiology, NeuroKinetic Therapy and Chiropractic Works

A patient comes in with a problem, maybe low back pain. Most chiropractors would figure out what vertebrae /spinal nerve is involved and then adjust the segments involved.

However what is missed is why did the problem happen and how can it be fixed so that it does not happen again.

First we need to look at the muscles innervated by the spinal segment

As a Applied Kinesiologist, I test for the function of individual muscles. For example, we may find the latissimus dorsi muscle weak; that is a muscle that internally rotates, extends and adducts the arm/ shoulder. It also attracts into the lumbar and sacral vertebra and part of the pelvic crest. The weakness may seen either as a higher shoulder on the weak side or a rotation of the lumbar vertebrae. The questions to be asked are: why is the muscle weak? Is the muscle on the other side hypertonic or “too stronger.”

Is there a problem with the vascular or lymphatic drainage of that muscle? Is there a problem with the cranial-sacral system?

Is there a Lovett Brother association where a twisting of the spinal meninges affects an upper vertebrae as well as a low back spinal segment.

As a NKT practitioner, I ask “Is there a dysfunction in the coordination of muscles working in patterns?”

Is the above mentioned latissimus dorsi inhibited by the muscles that attach to the shoulder like the upper or middle trapezius or the levator scapulae or is it compensating (facilitating) for weak or inhibited muscles like the gluteus maximus or the quadratus lumborum or core muscles, for example.

back muscles

Is the patient using their neck muscles in the movement of their low back?

NeuroKinetic Therapy works with the concept that movement is performed in systems or patterns. The human brain has an affinity toward habits.

NKT identifies muscle imbalances by using muscle testing to determine what muscles are inhibited and what muscles are compensating (facilitating)for them.

I would test the muscles involved in the problematic movement. After an inhibited/weak muscle is found, I would muscle test a synergistic (a helper muscle) or an antagonist muscle (an opposing muscle} which is strong/facilitated that may be affecting the inhibited muscle.

That facilitated muscle would be therapy localized (the muscle is either touched or put in motion) and the inhibited muscle retested. If the TL strengthens the inhibited muscle, then I know that the TLed muscle is affecting the inhibited muscle.

And I can use AK techniques to release the TLed muscle. The inhibited muscle is then retested which should test strong now, the retesting causes a “neural lock” which reprograms the motor control center in the brain.

After balance is restored to the muscles, the vertebrae  ( or extremity joint) are adjusted.

Stretches are given to the previously facilitated muscles and exercises given to the previously inhibited muscles in order to break the pattern that caused the problem.

For more detailed information, please click on the following blogs:

https://drvittoriarepetto.wordpress.com/2014/08/09/the-use-of-applied-kinesiology-in-a-chiropractic-examination/.

http://neurokinetictherapy.com/what-is-neurokinetic-therapy

https://drvittoriarepetto.wordpress.com/2010/06/21/muscle-balancing-in-applied-kinesiology/

https://drvittoriarepetto.wordpress.com/2010/05/06/the-art-and-science-of-muscle-testing-in-applied-kinesiology/

https://drvittoriarepetto.wordpress.com/2015/09/20/a-nyc-chiropractorapplied-kinesiologist-starts-adding-neuro-kinetic-therapy-to-the-mix/

https://drvittoriarepetto.wordpress.com/2016/05/28/why-is-my-neck-problem-causing-low-back-or-leg-pain-a-nyc-chiropractor-applied-kinesiologist-nkt-practitioner-explains-the-lovett-brother-effect-on-the-spine/

https://drvittoriarepetto.wordpress.com/2014/01/01/a-nyc-chiropractorapplied-kinesiologist-talks-about-chiropractic-adjustments/

https://drvittoriarepetto.wordpress.com/2010/05/17/cranial-sacral-therapy-in-applied-kinesiology/

 

© 2016-Dr. Vittoria Repetto

Want more information on Dr. Vittoria Repetto and her NYC Applied Kinesiology/Chiropractic/ NKT practice at 230 W 13th St., NYC 10011; please go to www.drvittoriarepetto.com

And please check out the Patient Testimonials page on my web site.

 Want to be in the know on holistic information and postings? 

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Or join me at Twitter: www.twitter.com/DrVRepetto

 

Why Is My Neck Problem Causing Low Back or Leg Pain? A NYC Chiropractor / Applied Kinesiologist / NKT Practitioner Explains the Lovett Brother Effect on the Spine.

It is not unusual to have a patient come in my office with neck pain also complaining of low back or leg pain that starts with or soon after the onset of the neck pain. Or vice versa: neck pain or headaches or jaw problems after the onset of low back pain.

A lot of doctors don’t think that there is a relationship. But since they came on around the same time they probably are related. The major thing that could connect them is the meninges; three membranes covering the brain, spinal cord and housing the cerebrospinal fluid. If injured it could affect nerves throughout the spine.

spinal-anatomy-e1409590019734

A good illustration of how an injury can affect different levels is to hold the upper part of an elastic band with your hand and then hold the bottom of the band with your other hand. Then twist your upper part of the band; note how the bottom of the elastic band also twists. Now imagine how the meninges surrounding a spinal nerve as it comes off the spinal cord can affect the structures innervated by that spinal nerve.

This explains why if there is a rotation in Cervical 1 there will always be a rotation in Lumbar 5, its ‘Lovett Partner’. With all the listings they can work both ways. For example, a dysfunction at L5 can cause a C1 dysfunction and a C1 dysfunction can cause an L5.

Here’s a helpful illustration: lovatt-brother-relationship

These relationships are looked at by Applied Kinesiologists and NKT Practitioner.

Another possible relationship is one of spinal fixations; please check out this blog for more information: https://drvittoriarepetto.wordpress.com/spinal-pain-not-being-helped-see-an-applied-kinesiologist-it-may-be-a-fixation/

So if you are having unexplained pain in different areas, please consider being examined by someone familiar with the above principles.

 

 

© 2016-Dr. Vittoria Repetto

Want more information on Dr. Vittoria Repetto and her NYC Applied Kinesiology/Chiropractic/ NKT practice at 230 W 13th St., NYC 10011; please go to www.drvittoriarepetto.com

And please check out the Patient Testimonials page on my web site.

 Want to be in the know on holistic information and postings? 

https://www.facebook.com/wvillagechiropracticappliedkinesiologynkt/

Or join me at Twitter: www.twitter.com/DrVRepetto