Treat Back Pain Patterns
by Erik Dalton, Ph.D.

In order to treat something, we must first be able to recognize it… Sir William Osler

Once typical patterns are defined and understood, then atypical problems can be identified and resolved…
Dr. Robert Kappler 

Hello Friends:
May’s newsletter introduces a “fly-by” summary of my 
FREE World Massage Conference podcast at 9 pm EST, Thursday, May 31, 2012.

Let’s visit briefly today about “pattern recognition” and its role in your pain management practice. First, a historical refresher: 

As you are aware, Myoskeletal Alignment assessment is based on three posturofunctional models:
1. Vladimir Janda’s Upper and Lower Crossed Syndromes;
2. Serge Gracovetsky’s Cross-Patterned Gait, and 
3. The Motor Dominant Pattern

In the history of bodywork, Dr. Ida Rolf had her students sit in outdoor malls and observe the structural and movement of all those who passed within view. It was the ideal venue for observing and learning a person’s natural movement patterns since it was outside office confines where people may try to impress others with their superficial gait making it difficult to pinpoint each and every posturofunctional deficit.

The Motor Dominate Pattern 

With encouragement from a colleague, Ross Pope, DO, the right motor dominant pattern has become the most challenging and intriguing of the three patterns that will be discussed today. (fig 1).

As Gray Cook so eloquently states:“Removing the crack in the foundation is the best way to progress the strength of a structure — not simply adding another floor to the building, 
but strengthening the foundation before the new construction starts.”

The effective bodyworker must respect the impact of motor dominance on the asymmetrical posturomovement patterns seen in clinic and correct this faulty foundation. Assressing these patterns with manual and functional movement training is the foremost prerequsite for restoring pain-free gait during the walking cycle. 

Motor dominance has greatest hypertonic effect on highly innervated postural (tonic) muscles such as iliopsoas, lumbar erectors, piriformis, TFL, and biceps femoris… and inhibiting effect on dynamic (phasic) muscles such as thoracic erectors, 
G-max, G-med, and G-min.

Postural (tonic) muscles tend to shorten and phasic muscles weaken in response to over-use creating predictable motor dominant patterns.

A composite of these findings produces the so-called “typical case” i.e., the most commonly found postural asymmetries (fig 2) 

Upper & Lower Crossed Syndromes

In the early 90s, I was given the chance to study with the legendary Czech researcher Vladimir Janda, MD. His upper and lower crossed syndrome model depicted exactly the aberrant postural patterns I’d been seeing in my flexion-addicted clients (fig 5). This awakening sent me on a long journey to learn as much as I could about common pain patterns. For several years, I experimented with various techniques aimed at correcting Janda’s sagittal plane dysfunctions and, in 1998; released Myoskeletal Alignment Techniques™ based on Janda’s work. The upper and lower crossed patterns are extremely helpful tools to assess sagittal plane dysfunctions, yet I still yearned for a theoretical approach for side-to-side functional scoliotic patterns prevalent in my practice. 
Cross-Patterned Gait

Thus, into my life entered the famed physicist and biomechanical researcher Serge Gracovetsky at his “Spinal Engine” keynote address at a Rolf Institute Convention and many years later at the 2007 Harvard Fascial Congress.

Serge efficiently and effectively depicted the body’s spiraling spring systems (fig 5) and proposed an eloquent picture of the evolution of cross-patterned gait and it’s dependence on proper lumbar spine mechanics (fig 6)

All this information will be presented in detail at the 
World Massage Conference podcast this Thursday. 
Bring your thinkin’ caps…see you there!

World Massage Conference Registration