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Michael Thomas, DC
Folks come into the office for some particular reason. They have neck pain or low back pain, sciatica or dizziness. If they are new to the office, they have heard that chiropractors can help these problems, or that I helped someone they know with a similar problem. . Once adjusted, these acute symptoms frequently resolve pretty quickly. A few weeks into care, I often begin to hear that other issues, that weren’t boiling over and might not have even been mentioned before, have resolved or are beginning to resolve, too. Sometimes its musculo-skeletal issues like hip, knee, ankle, or foot pains that have dwindled or gone.
Other times it is very different. “I am digesting my food much better,” people often say. “I am sleeping better. “ “I am not depressed anymore.” “I can think more clearly.” “ I can take a deep breath now. “ Secondary complaints have dissolved slowly over a period of time as the adjustment and the effects of the adjustment settle more deeply into their balance of health. People often remark that they just simply feel better all the time.
Through decades of clinical experience and research, we are beginning to understand that misalignment of the bones in the upper neck, and conversely, the upper cervical adjustment, both cause profound changes in internal homeostasis (balance) as well as the way we stand and move. Recent studies are now revealing that not only are the affected tissues twisted and pulled, but metabolism is significantly changed too. Blood flow is altered, as is cerebral spinal fluid (CSF) flow. It is now our hypothesis that tractionization of tissues (particularly the dentate ligaments), alteration of venous drainage out of the head ,and interference with CSF flow change the balance of the nuclei (brain centers) in the brainstem just above the neck in the bottom of the head. This area of the brain acts to maintain a basic balance of health. This balance is ever changing as we receive information from around us (our environment) through our senses, and then use this information to drive our actions, our responses to the world around us.
Through decades of clinical experience and research, we are beginning to understand that misalignment of the bones in the upper neck, and conversely, the upper cervical adjustment, both cause profound changes in internal homeostasis as well as the way we stand and move.
We now understand health to be an on-going process. It is not something that is finally achieved but rather, something that is forever unfolding. Adapting to new information is very much a part of being healthy. Poor adaptation to new environmental input IS dis-ease. Mal-adaption leads to pathology, the point when internal changes cannot match the changes being sensed and they fall behind. The tissues are disturbed. It is the beginning of sickness. Internal balance becomes disordered. As within, so without. Our posture, the very way we greet this world begins to diminish in vitality, stability and strength. The natural flexibility and ease of give-and-take in health is increasingly replaced by compression and resistance. The healthy give and take, push and pull of life begins to polarize and we find ourselves resisting the natural flow, hardening our tissues in the process. This response/reaction diminishes our potential while salvaging as much of it as possible. With observation, we see our bodies change from optimally dealing with the effects of gravity in a unified way -standing tall and at ease, fully aligned and essentially symmetrical, to a segmented, cantilevered state of uneven, and generally twisting resistance.
Something happens, perhaps a physical trauma, (bump head, lift a refrigerator, push a car, trip and fall, etc.), perhaps a mental or emotional trauma (anger, disappointment, frustration, fear, getting fired, divorced, losing a loved one, etc.). Something happens that you cannot fully abide within yourself. We can handle a lot of things, but sometimes the force of life that comes at us is more than we can dissipate. Our defenses cannot fully shield us and we absorb more than we can accommodate. We begin to fall back, to break down. Life isn’t gone, it’s still present, just impeded, and it makes a valiant effort to stabilize albeit in a less unified way. We settle and list and twist -our mass now more cumbersome and ungainly. The forces don’t cancel each other out like they do when we are optimally aligned with gravity. Ease becomes burden. This configuration leaves discrete areas of too much and too little force within us. After a while we begin to feel these areas as hot or cold, muscle spasms, areas of pain and numbness and tingling. Joints feel locked up and we may not feel as steady on our feet.
At the same time that our posture and movement is affected, so is our internal balance of life. We learned in the 2007 study that we can directly affect the brainstem centers that maintain blood pressure through corrective upper cervical adjustment. Obviously, we don’t consciously control all the parameters of our internal environment. Most of us don’t give it much thought. The controls for our ‘inner balance’ are located in the brainstem and are significantly affected by the torsion, blood flow and CSF flow changes that occur when the structures of the upper neck become misaligned. We found that 60% of the people in the study (folks who were on two antihypertensive (blood pressure) medications and were, up to that point, unable to get their blood pressure into a normal range, went on and maintained normal blood pressures –off their meds!- for two months after being properly adjusted upper cervically. We have many decades of clinical information that has shown us that the brainstem centers which control posture are also significantly affected. Together, these finding indicate that we have real ability to modulate (regulate) these brainstem centers. Not turn them up or down necessarily, but rather to help them all work together in a balanced way for optimal health.
Removing substantial interference to the nervous system and freeing the expression of life within each of us is a healthcare measure that the vast majority of humankind has not even glimpsed as a possibility.
The ability to ‘neuro-modulate the autonomic nuclei’ (what I was just writing about!) constitutes a remarkable primary health care measure that would fundamentally improve the health of humankind if they could be made aware of this possibility and, could gain access to corrective upper cervical adjustments. Removing substantial interference to the nervous system and freeing the expression of life within each of us is a healthcare measure that the vast majority of humankind has not even glimpsed as a possibility. No one looks for something that they are unaware of; and so we remain, for the moment, possibly the great secret in healthcare in the world. After studying many kinds of health care over the last few decades, I have never found anything else with the overriding potential of the upper cervical adjustment to fundamentally improve the health of people. I am proud to offer this work to all of you and I continue to write and conduct studies for publication which, if there is any justice in the world, may help to open the eyes of the world to this precious jewel in their midst.
Autonomic Modulation and the Tensegral Array
Michael Thomas D.C.
(Note: this paper was published in the April 2013 newsletter for Quantum Spinal Mechanics)
We have done a fairly good job of explaining what goes on up to the point of the performance of the adjustment itself. We understand what happens afterwards fairly well too. It is the moment of the adjustment itself that has been a great mystery. What happens in that instant? How does the adjustive force cause the outcome we have empirically experienced? What actually happens during an adjustment?
The following is the beginnings of a tensegrally derived autonomic modulation theory for upper cervical chiropractic.
Distribution of vectored force by the adjustor translates the potential mass of the adjustor’s body into an incremental build-up of tension within the body of the adjustor that appears to match the magnitude and direction of resistance to optimal flow at the craniovertebral junction. This area of contact is a multifactorally important node where the tensegral forces fine-tune (minimize) themselves to the effects of gravity using the sensors in the cranial area for feedback. The accommodation of the sensors is however, from a practical perspective, secondary to the ongoing position of the pelvis with respect to gravity. In other words, these sensors at the cranial end of the organism can only adapt and compensate to a certain degree because they cannot by themselves, overcome the disequilibrium of a malpositioned pelvis with respect to gravity. (Big mass rules small mass). Once they have made all possible accommodation, the rest of the tonic musculature must release the optimal orthogonal strategy for stabilization and utilize whatever strategy is available to maintain upright status with respect to gravity. This is the origin of frontal and transverse obliquity in the pelvis as well as movement of the torso in the frontal and transverse planes.
Using directed incremental buildup of force is utilized by many chiropractic techniques in many areas of the body (generally as muscle focused therapies). Such introduction of force had long been observed to diminish the local muscle tension, releasing aberrant resistance throughout aspects of the whole myofascial envelope. The tension appears to be set by feedback between central pattern generators which make pragmatic decisions to moderate tension and protect the integrity of the tissues. This maintains as much local stability and function as possible. In an optimal, coherent organism, this pragmatic decision is also optimal for the stability and function of the entire organism. When there is a breakdown of the tensegral distribution of forces, a compartmentalization occurs in which sections optimize themselves and then work to coordinate with other sections, often creating a cantilevered balance of sections, decreasing overall efficiency but providing a diminished but engaged stability with respect to gravity. This sectional stability represents suboptimal solutions or ‘stability basins’ that lie around the optimal answer of coherent verticality. These are the misalignment patterns we have identified in standing neutral position. These misalignment patterns are static representations of available strategies for organismic movement with respect to gravity given the currently available parameters. (We have not yet examined the resultant movement patterns.)
Addition of a properly delivered adjustive force into the array at the craniovertebral junction overcomes the pragmatic and diminished solution of sectionalization by introducing enough force to redirect the local flow at the craniovertebral junction and provide the area with enough energy to restore the optimal balance of force and resistance. It does so by first physically introducing a vectored force that unbinds the local buckling and increased resistance but also by restoring blood flow, cerebral spinal fluid flow and unwinding tissue tractionization which secondarily, although more importantly, modulates the autonomic nuclei in the brainstem. The unique positioning of all these elements at the craniovertebral junction fundamentally changes neurologic traffic and distribution of force in the myofascial envelope with respect to gravity (regaining tonic symmetry) through this remodulation of the autonomic nuclei-specifically the pontine and reticulospinal tracts- when referencing alignment with gravity. The proximity of other brainstem nuclei to these tracts may also explain the multisystemic effects long noted after corrective upper cervical adjustment. Restoration of optimal integration requires addition of properly designed energy to the organism in a form it can use. The incremental buildup of force in the adjustment allows a matching of resistance (resonant energy transfer) while the direction is a function of analysis of the specific misalignment factors.
In real time, the distribution of tensions and resistances are being calculated by the nervous system on an ongoing basis. Each pull by the adjustor potentially changes the system’s potential to respond to gravity, etc., and so kinesthetic feedback between the adjustor and patient’s own neurological calculations are critical. Accessing the pathways is Dr. Friedman’s current focus. It is doubtful that any one vectored force, calculated by 2-D analysis (analysis of one plane at a time) of the 3-D bony aspects of the craniovertebral junction will restore the entire organism to optimal function. Most misalignment patterns are complex in nature and require an unwinding in more than one plane.
At the demand of the scientific community, we continue to look for a ‘biomarker’ which will allow us to step onto the world stage for their evaluation. The very idea of a biomarker however, presupposes a mechanistic problem and solution. In a mechanism, a part may become defective. This part is replaced. The mechanism runs properly again. The Atlas Subluxation Complex Syndrome (ASC syndrome) seems to occur in a different way. It is analogous to the view through a telescope. When the lenses are properly focused on what one wishes to observe, the picture is crisp and clear. When the lenses become unfocused, the whole picture becomes blurry and less recognizable. Optical resolution and functional coherence may be seen in analogous ways. Coherence requires optimal communication. Alteration of blood flow, CSF flow and tractionization of neural tissues at the craniovertical junction diminishes coordinated communication through the organism. Restoration produces the coherence necessary for the system to optimally resolve.
Michael Thomas, DC
My wife Lexi, fell and hurt her knee recently. The next day, after walking on it around campus at school (she is finishing up a mathematics degree at the University of Florida this term), the two of us piled into the car for a trip to Atlanta. I was out of adjustment and we had made plans to get an adjustment for me. My Chiropractor is however, seven hours away (in Atlanta) and it takes some extensive planning to get adjusted!
Unfortunately, the car ride was very rough on her knee and the vibration of driving on the interstate felt excruciating to her by the time we arrived. I got my adjustment the next day and after lecturing at Life College with Dr. Friedman (my chiropractor, good friend, and the founder of Quantum Spinal Mechanics (QSM3), we drove home the next day. That night I found a proper brace and crutches and my resilient wife was off to school again that Monday.
The effect of not putting weight on one leg and using crutches soon told a story of pain in her neck and shoulders that actually became more painful than the knee itself! I was working with her, adjusting as needed and doing a lot of muscle work, but the stress of these days was wearing on her and she would come home and collapse on the couch for the evening. Slowly, too slowly for both of us, she began to feel the pain diminish. She took a day off from school and was able to rest for a long weekend and this helped quite a bit.
Lexi is still not out of the woods, but her knee has improved to the point she can begin to put weight on it and her neck and shoulders are recovering too although not without times of pain and spasm. She is now looking at graduating to a cane for some extra support and stability this next week. We are keeping her in adjustment and doing muscle work a couple of times a day.
I tell this story because it reminded me yet again that almost everybody has to deal with the effects of injuries. Things happen to us and we must recover. Standing on one foot with the crutches as she walked, caused her body to torque and deal with the stress of walking in a twisted, asymmetrical way. As her muscles attempted to keep her upright and moving forward, they had to absorb a lot of twisting force and this caused her to lose her alignment. Once she was out of adjustment, the muscle spasms and pains accelerated quickly. The brace stabilized her knee but also kept it from transmitting the force of her activities in a normal way. This (and her twisted posture) resulted in abnormal forces being built up and created a pattern of spasmed muscles all through her body. Adaptation and compensation are the best the body can do at times, but this alteration creates new problems too, as so many of you who come to see me for care are already aware.
When we are out of adjustment, our muscles do not function in a normal way. The messages they receive from the central nervous system are skewed. The normal tension of muscles that hold us upright begin to twist and compress. This leads to the many .variations of misalignment that we fall into when we are out of alignment. Everything is virtually connected to everything else and when one big problem occurs, it often causes problems in other places too. The problem is that the nervous system doesn’t know it is ‘out of calibration’ so to speak and it continues to make the same systematic error. If we have enough vitality, enough resilience, we can often overcome this issue and find a way to function, but often we can’t find a peaceful way to coexist with this twisted postural set and we begin to break down.
Some people are so strong and vital it can take five years before they realize they must get some help. Others, perhaps those with more extensive injuries, or perhaps just less resilience, find that life becomes painful and difficult almost immediately after a precipitating incident.
Most of you now know that once a set of pains has taken up residence in your frame and stayed for more than three days, it is time to get an upper cervical adjustment to resolve the twisting, the un-leveling, and the resulting pains, spasms, tingling and/or numbness that may accompany misalignment. Other times, the symptoms are manageable enough that people just ‘deal’ with it for weeks or even months before the slow acceleration of pains and other symptoms has become too strong to ignore any more.
Of course some people do not feel musculoskeletal pains but rather things like brain fog, headaches, dizziness, difficulty taking a deep breath, or change in digestion. Some of us have both! Each of us is a bit different in terms of the symptom picture that makes us realize we are out of adjustment. The upper cervical area is important in so many ways and misalignment is a profound insult to the normal function of our bodies and lives.
These deleterious changes are progressive and degenerative. Ignoring them seldom makes them go away. Over months and years of time they can slowly grind the quality of your life away. I am just trying to put words to what so many of you tell me when you come in to see me. You realize the profound effect of a corrective upper cervical adjustment in your own lives.
Many of you also consider the adjustment to be primary healthcare. It is just as important as making sure your organs are functioning properly because the nervous system is the controller for them! Upper cervical chiropractic often greatly helps acute problems such as sciatica or neck pains or shooting pains into the arms or legs but it also operates on a much longer timeframe, ensuring that all of your cells are receiving proper nutrition and instructions. This is long term health, the kind that perhaps will help you live into your 80’s and 90’s and beyond with a sound framework, a sparkle in your eye, and a lightness in your step!
As always, I wish you well and encourage you to stay in adjustment for the value it adds to your life.
Michael Thomas, DC
PS: Spread the word!
Michael Thomas, DC
When Dorothy clicked her heels together in the “The Wizard of Oz”, she fervently wished to go home again. “There is no place like home”, she repeated. Many of us feel a relief when we get home from our day’s activities and feel comfort in being back inside the familiar walls of our own homes. We feel safe and at peace. We don’t need to read a book or watch television or have someone else tell us we are at peace. We are in the ‘right’ place.
This same feeling of ‘rightness’ occurs for many people who receive an adjustment in the office. An inner knowing occurs accompanied by a feeling that everything is ‘right’ (or is returning to ‘right’!). The upper cervical adjustment creates a sense of well-being unlike anything else most people have experienced. This, more than all the talking we do in the office is what makes long term clients. Honestly, upper cervical work is extremely difficult to explain and only now are we really starting to understand why this return to well-being and health occurs. What is much easier is adjusting someone and letting them feel and experience the difference in their life. This is really the only way that upper cervical chiropractic has grown over the decades it has been available.
Only now are we beginning to understand the improvement in blood-flow through the head and improvement of cerebral spinal fluid flow through the head that accompany the adjustment. Only now are we beginning to understand that the adjustment can balance the control centers in the bottom of the brain that monitor body activities below the level of consciousness. As we begin to understand our relationship to our world, we are realizing that we must be in balance with it, we must be in exquisite coordination with our environment; and primary to that is our relationship with gravity. We are not as separate as we like to think. We are en-nested in many levels of relationship with the world around us.
The upper cervical misalignment and the related postural changes are a fallback mechanism that works to improve the remaining possibilities once we are not able to optimize our relationship with gravity (once we have gone ‘out’ of adjustment). Our bodies always know how gravity is affecting us. The best solution is to align our bodies with the force of gravity. This is why we measure your posture when you come into the office. Moving away from the vertical axis (this ‘line of gravity’) causes an abnormal cantilevering of our body position. When we are misaligned, our pelvis loses its optimal relationship with gravity and begins to tilt and twist. Our upper bodies must counter-lean and twist so we don’t fall over. Our head positions (head-tilt) are often the fine-tuning. Improper relation to gravity takes a toll on all of us. Muscles and ligaments must do their best to keep us upright. At first they tighten and harden, but after a while, they get tired and begin to spasm. We feel this as aching, burning pains that can be sharp or dull, in one place or generalized over larger areas. For some of us, the worst part is the change in brain function. Many people remark on ‘brain fog’. Some people feel emotionally depressed when they are out of adjustment. Things aren’t ‘right’.
Corrective upper cervical adjustment restores your relationship with gravity. It helps to re-balance not just your posture but also the function of all of the systems of the body through its effect on the brainstem. People often express a return to ‘rightness’ after an adjustment. Some people feel it immediately, others take some time. There is an inner peace that comes with the adjustment for many people. In this increasingly complex and uncertain world, feeling ‘at home’ inside your own body is a great comfort and ultimately necessary for long term health. Restoring our alignment with gravity greatly aids in restoring our relationship with our own bodies and the world around us. This inner knowing acts as a foundation for our actions in the world. When we are ‘home’ inside ourselves and in our relationships, we make better decisions. We worry less. We feel stronger and more vital. We trust the sense that ‘all is well’.
There is no place like home.
Michael Thomas, DC
Dr. Gregory, the founder of NUCCA, often said he didn’t care how the spine got adjusted, -even if someone was adjusting the big toe-, if it resulted in correction on the post film. The outcome defined by the post film has become the gold standard for outcome measurement within upper cervical work. This makes great sense because the post film will not be orthogonal (with gravity) if the pelvis and all the ascending elements are not aligned with the vertical axis, gravity. We have learned that even if all the elements are ‘zeroed out’ on the film, -if the neck and skull are not on the vertical axis-, then the correction is not complete –nor often is the whole symptomatic picture of the patient. In fact we now realize it is possible to ‘force’ the elements into relative alignment as measured on the post films but that there is a difference. Reduction of the upper cervical elements but continued misalignment of the pelvis sets up an ongoing situation of aberrant tension in the whole kinetic chain. The clinical clue is in the stability. Some patients tell me that their dog can just nuzzle them, touching their face, and they go back out of adjustment. The whole kinetic chain remains under tension and one nudge can cause the misalignment pattern to return.
The upper cervical spine is the terminal end of the kinetic chain that originates in the pelvis. Forcing alignment of the skeletal elements in the neck and head is not the same as un-torqueing the whole array, bringing all of the elements back to the minimal stress, minimal energy state that we strive for on postural measurements. We all know of the immense improvement that resolution of upper cervical misalignment can have on health and function. Now we are beginning to understand how release of compression can un-torque the whole kinetic chain creating real equipoise for the patient.
One of my friends noted that he had tried to ‘turn people over’ when he was having trouble and while he could get reductions on the post he wasn’t getting the ‘wow factor’ he had come to expect after the adjustment. He had concluded that this wasn’t a viable idea. By itself, ‘turning people over’ is certainly not an answer. In the context of the biomechanical process, addressing the misalignment from the side which will give the most mechanical advantage and decompress the whole spine is the bigger picture here. Having a process by which you can reason through your measured data and know exactly what to do next is imperative and fundamental to safe and effective care of people’s spines.
Although the use of roentgenography in chiropractic has a very long history, no one has yet been able to show in the peer reviewed, indexed literature (the papers available to the scientific and healthcare community at large in the world) that we can set people into the x-ray chair, clamp them in, take a proper picture, and analyze the films with the degree of accuracy which is fundamental to a ‘gold standard outcome measure’.
Unfortunately, the current literature shows the opposite. Twenty seven years ago, a grossly flawed study was published in JMPT which asserted that doctors can only be within 2 degrees of each other in terms of inter-examiner accuracy. This is what the rest of the world knows about us. In the current paradigm, atlas laterality is the cornerstone of the work, the ‘biomarker’ so to speak. We know through long clinical experience that ¾ of a degree is all it takes to see loss of optimal alignment with gravity and initiation of the postural distortion associated with upper cervical misalignment. Rochester has verbally asserted that we probably can’t resolve accuracy to less than one degree. To “prove” the validity of using atlas laterality as a gold standard outcome measure, we would have to be within ½ degree of precision and accuracy.
UCRF is currently attempting, after all of these decades, to finally do a study that will assess what is possible for both inter and intra-examiner accuracy in x-ray marking. Since the whole basis of the NUCCA work rests on this critical issue it is timely if long overdue. The study should be complete at the end of the year. We wish them well. A rising tide carries all boats.
Dr. Friedman is now showing that while the misalignment of the upper cervical elements is critical and probably causal to the neurological effects that people experience, it may not be a primary cause but rather an effect of the disarray in the tensegral system of tension and compression throughout the body. It is not in dispute that once misalignment of the upper cervical elements has occurred that they cause the progressive and degenerative effects we have come to know as the ASC. It is rather that the misalignment pattern represents the best fallback position the body can accomplish given its options. The adjustment can correct the local misalignment of the upper cervical spine and greatly diminish or even eliminate the neurological distress at the brainstem. It may not resolve the dis-relationships in the rest of the kinetic chain including the largest mass, the pelvis. The heretofore undisclosed cause (compression) constitutes the long unexamined ‘elephant in the room’.
Upper cervical chiropractic is indeed a full spine technique but it must acknowledge and resolve all of the deleterious factors causing disharmony in the entire kinetic chain. QSM3 represents the first systematic process by which this critically important aspect is recognized and resolved. Many offices using the QSM3 protocols are now reporting phenomenal successes in correcting previously ‘impossible’ misalignments. While we have long acknowledged the full spine implications of upper cervical work, now we are able for the first time, with QSM3, to directly address this elephant in the room and give all patients an adjustment that frees the body from its compressive prison.
As an example, one of the patients I referred to earlier would go out of adjustment from a simple nudge of his dog’s nose on his chin. The NUCCA work had long been a great blessing to him in his life and had actually transformed his health and profession. Even so, he was a frequent visitor to the office. Once the QSM3 protocols began to come together, his misalignment was re-examined and the vector was greatly modified. He began to hold for many weeks at a time and related one day, that he had been playing volleyball in the sand. At one point, he dove headfirst for a ball and landed in a crumpled pile. His alignment remained intact. He wasn’t ‘holding’ it, He had an ease in his whole body that allowed him to absorb the force of hitting the sand without disrupting the structural elements. His happy story is now multiplied by many people in my practice. Reducing aberrant tension in the body increases resilience and vitality.
QSM3 protocols continue to evolve. While this may be frustrating for people who are used to a stable set of procedures, it actually an incredibly exciting time when old limits are being left behind and new possibilities are coming to light which are and will change the work forever and open it up to humanity in a way that hasn’t been possible before. No longer are we ignoring the elephant in the room, we are riding it!