Transcript Vertebral Fixations

Meningeal Release - Coccyx
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What is it?
Therapy localization
Testing
Correction
Pelvic Floor
QuickTime™ and a
Cinepak decompressor
are needed to see this picture.
What is Meningeal Release?
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The dura mater is firmly attached
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inside the cranial bowl,
Atlas, Axis and third cervical
by the filum terminale into the dorsum of
the first coccygeal segment
What is Meningeal Release?
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In coccyx imbalances, abnormal stress
can be applied to the dura mater
causing reflex muscle tension along the
spine.
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Goodheart has described the coccyx as a
take up mechanism to keep constant
tension on the dura mater.
Tension on the dura appears to be
controlled by the coccyx
Symptoms
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Increased muscle contraction along the
spine from the lumbars through the
cervicals
Increased pterygoid pocket tenderness
Leg edema - tenderness
Visceroptosis
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Dropped bladder - uterus
Open ICV
Spinal Length
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Goodheart noted that healthy patients
had the same spinal length, within 14
mm. (use rolling tape measure from
coccyx to occiput)
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If they were measured in the supine, sitting
and standing positions.
Patient's with chronic problems have
dramatic differences in the length of their
spines.
Causes
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“hemi-pelvis”
Fall on the pelvis
Cycling
Prolonged sitting
with leg crossed
Child birth
Poor sitting posture
Therapy Localization
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The patient is asked to therapy
localize to the coccyx and apply
inferior pressure. A strong
muscle is tested for weakening.
Palpation of the paravertebral
muscles will show tenderness
on one side of the spine
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Cervical paravertebrals are
always present
Challenge
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Palpate the associated
muscle tenderness
Contact over the coccyx
and traction the skin
cephalad
Vary the vector until the
greatest reduction in pain
is found
Correction
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Contact the skin over the coccyx and pull in
the challenge direction found above.
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Apply this pressure in a cephalad direction while
the patient inspires.
Simultaneously, contact the atlas and pull inferior.
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Repeat this five to seven times
Palpate for reduction in muscle
tenderness
Remeasure the spinal length for
normalization
Pelvic Floor
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Test in cases of leg
edema, increased
venous pressure,
obturator syndrome,
general visceroptosis
QuickT ime™ and a Cinepak decompressor are needed t o see this pict ure.
Pelvic Floor
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Tests are similar to the
gluteus maximus starting
position.
These were developed by
Beardall
The leg is tested in a neutral
position and with the leg
internally and externally
rotated 30 degrees
Qui ckTime™ and a BMP decompressor ar e needed to see this pi cture.
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QuickT ime™ and a Cinepak decompressor are needed t o see this pict ure.
Pelvic Floor
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If any of the three tests shows
weakness
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Challenge the coccyx for a position that
strengthens the muscle
Correct in the challenge position
Coccygeus
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Coccygeus is often described as the
muscular belly of the sacrospinous ligament
with which it is fused to on its pelvic aspect.
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The coccygeus is occasionally absent, in which
case the sacrospinous ligament is more
prominent.
Proximal Attachment
This triangular sheet of muscle arises from
the pelvic surface of the ischial spine and
sacrospinous ligament.
Coccygeus
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Proximal Attachment
This triangular sheet of muscle arises from the pelvic
surface of the ischial spine and sacrospinous
ligament.
Distal Attachment
Its base is attached to the lateral aspect of the coccyx
and the fifth sacral segment.
Coccygeus Nerve Supply
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A branch of the sacral plexus, derived from
the ventral rami of S4 and S5 supplies
coccygeus.
Coccygeus Action
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The coccygeus muscle functions with the levator ani
forming the majority of the pelvic diaphragm, which
supports the pelvic viscera.
When the coccygeus and the levator ani contract with
the muscles of the abdominal wall, they help to raise
intra-abdominal pressure in such processes as
coughing, vomiting and forced expiration.
They can also become involved in inspiration during
respiration.
Sacrotuberous ligament
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Has an extensive attachment; to the posterior superior and
posterior inferior iliac spines, the posterior surface of the
sacrum (where it blends with the posterior (dorsal) sacroiliac ligaments), the lateral aspect of the lower sacrum and
to the upper surface of the coccyx.
The fibers converge as they pass downwards and laterally.
They twist on themselves and then diverge to attach to the
medial margin of the ischial tuberosity and the lower
margin of the ischial ramus.
Distal fibers of gluteus maximus attach to the ligaments
posterior surface.