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Many believe the body only begins to mechanically malfunction when some component is damaged. They miss the small tolerances necessary for the most efficient and effective working of this complex a machine. They also miss the importance of instantaneous transmission of mechanical stress by the meninges and the fact of true interdependence of all motion in the body and, most importantly they miss the fact that bones and other structures can and do get moved in directions from which the body cannot retrieve them.

Other people do approach structural therapy with the presupposition that the condition presented can be a distant sequel to a mechanical pathology elsewhere. Those practitioners have the idea of slight changes in position causing large changes in function of the body and they have the thought of interdependence of motion (holism). However, they most often act and treat on a local effect basis because the theories on which their treatment is based have no specific cause consistently and predictably accounting for ALL the phenomena noticed in the body.

Via objective analysis of biomechanics using standing and sitting radiographs of the entire spine on one film or using two 14"x17" sectionals shot at 72" with the patient completely relaxed, the practitioner will find a consistent index and pattern of change in mechanics that can be used to determine the primary biomechanical pathology(ies) for which the compensations are generated, resulting in the various patterns of sequelae named as diseases. Knowing that data, appropriate application of biostructural treatments can be instituted. (This can now be done without x-ray.)

Nothing in this presentation should be interpreted to mean that manipulation of osseous structures is the only, treatment in these disorders. Depending upon the extent and intensity of the condition presented or permanent damages developed as sequelae to the mechanical pathology other biostructural therapies might be included to allow motion of the structures into their optimum positions or to provide the support needed for recovery. There is also the need to develop supports for those not able to fully recover to maintain and improve the extent of recovery available to all.

As Breig notes in his comment describing the sequence of improvements of neurological function in Cervicolordodesis patients (1), the traditional naming of neurological and spinal cord disorders "according to début, epidemiology, acute or chronic nature, etc., does not reflect the histodynamic causation of the symptoms." That method of naming disorders has misled practitioners into thinking they have different etiologies. Breig further notes in that discussion, "It would be useful if the origin of the tension were stated in the diagnosis, for then the patient is more likely to receive the appropriate treatment."

Below are films which demonstrate some of these changes and a basic explanation.

These are the films taken on the same person on the same day. The person is standing and sitting each picture is one minute apart. Note some changes on the laterals.

These pictures are not very clear for faster loading of this page. If you right click on the picture and click open in another window, you can get a more clear view. Do it for each picture pair and place them side by side. You can also print them out and look at the hard copy which will have better resolution.

Most notable on the lateral view films above is that the cervical spine is military standing but becomes normally lordotic sitting. Also, the lumbar spine is in a hyperlordosis or sway-back standing and military/top half slightly reversed when sitting. These two curves are supposed to go in the same direction in a normal person. In this person, at the time of the x-rays, one is normal in the standing position or a bit more than normal, while the other is reversed. Sitting they switch but are still opposite. There is a compensation mechanism here in which they are working synchronously (changing instantly in concert with one-another)?

Which one do you treat? How do you treat it, and in which direction? Does it matter where the patient had pain? Should you treat at that point? Look below.

These are cutouts of the thoracic spines from the above films. The sitting thoracic section (middle) has been rotated 12o counterclockwise so the curves can easily be compared.

How about the thoracic spine?

In this person the thoracic spine shows very little change from standing to sitting. It is easy to note that there are few significant changes from standing to sitting. All the changes are below the level of the apex of the kyphosis which is at T10 sitting and above T4 standing. (Apex = furthest point backward or forward in a curve. Important in analyzing the point of focus of mechanical stress.)

Also note that the mechanical leverage created by those changes in the thoracic spine, small as they are, account for the fact that the lumbar spine becomes hyperlordotic as the cervical spine loses its lordosis standing while the cervical spine is not forced to become hyperlordotic in compensation sitting when the lumbar spine loses its lordosis. Some of the increase in mechanical stress is taken up by the thoracics.

What about between T5 and the apex of the kyphosis when standing? The thoracic spine above T10 is not really a kyphosis. It just drops forward and would probably completely fold forward if it were not for the ribs. The ribs do not hold the thoracic spine rigid as so many biomechanical theories state they do. The ribs provide some support, but not stiffness to the point of rigidity. The thoracic spine has plenty of motion, especially in the AP direction.

The thoracic spine is a major compensator of biomechanical pathology and the most frequently injured portion of the column in P-to-A traumas such as automobile collisions.

That fact is not yet well documented or researched because not many doctors seem to notice. The reason might be that humans, in the standing position, use the large muscles attaching from the legs to the pelvis and spine to flex the pelvis and twist the lumbar spine into a hyperlordosis forcing the trunk backward to balance the collapsed thoracic spine. That makes the collapse of the thoracic spine less noticeable in the standing position as a biomechanical event because a pseudokyphosis is created by the compensation of the lower thoracic spine (canted posterior) and the portion of the thoracic spine above the standing apex falling anterior.

Why do the head and neck not fall anterior? They do but not completely. The effect of the meninges (Breig) and the leverage effect of the change in curve between the upper thoracic and cervical spine hold the neck and head up as much as possible just as the lumbars force the thorax posterior. What is often noted as normal is not even close to the optimum position. The variations from normal account for thoracic outlet syndrome including vascular and neurological signs as well as the many other symptoms and effects noted in this patient.

Common in the literature of radiology describing the various radiographic measurements of posture is the comment that such and such a range is normal. However, there is no specific correlation between findings outside of the range and symptomatology in the patient. The reason for this is stated at the outset of this presentation. The data of these measurements is not correlated with other mechanical data from the entire spinal column-pelvis to determine relative changes. With data from the entire spinal column-pelvis specific correlations between measurements and would quickly be determined.

The basic correlation is the determination of the lateral direction of that patient’s primary biomechanical pathology at that time.

The hypothesis for finding that, simply, follows this line. When standing, the body can arrange the bones of the lower extremities and use the contraction of the muscles of the lower extremities to twist the pelvis and spinal column into a compensated position.

When one sits with the feet flat on the floor before them, the use of the lower extremities and muscles are reduced. They cannot twist and pull enough to compensate as well so the collapse of the thoracic spine above a given point becomes more evident. Why say "more evident"? Shouldn’t the phrase just be evident? No, the collapse is noticeable standing if one knows what to look for.

After reading this you can probably find the flat spot in the lower thoracic curve (T12,11,10) above which the thoracic spine collapses even in the standing view. Go back to that film and check..

Comparing the standing film to the sitting one can predict the sites of pain via mechanical stress analysis and correlation of intensities with direction of mechanical stress. Also, the vertebrae in need of treatment can be determined since one can determine which are in flexion and unable to be repositioned by the body.

On the other hand, once one has x-rays comparing the pelvic tilts one can determine to which direction the body is falling due to inadequate bone leverage resulting from the biomechanical pathologies (people do stay upright because of muscle power but it is less necessary to use the muscles as the bones become more optimally positioned for leverage). Using that information, one can observe the body response to simple physical testing and determine which vertebrae to treat and which to ignore on any given day be they at the level of another type of pathology or not.

Important is that the segments malpositioned but not to be treated is determined. This is a vital determination because, though they may also be out of optimal position and may be at the site of mechanical stress causing other damage, those segments are out of position to compensate other malpositioned vertebrae and actually support the body. Changing their position can change their

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