Soft-Tissue Manipulation: A Practitioner's Guide to the Diagnosis and Treatment of Soft-Tissue Dysfunction and Reflex Activity (3rd edition)

264 Pages·1987·10.4 MB·English

by  Leon Chaitow

SOFT-TISSUE MANIPULATION
An authoritative textbook dealing with Neuro-Muscular Technique,
Muscle Energy Technique and Strain-Counterstrain — diagnostic and
therapeutic methods which restore the structural, functional
and postural integrity of the body, removing pain,
muscular tension, stress and restrictions to health.
SOFT-TISSUE
MANIPULATION
A Practitioners Guide to the Diagnosis and Treatment of
Soft Tissue Dysfunction and Reflex Activity
LEON CHAITOW
N.D.,D.O
Illustrated by Bevil Roberts
Healing Arts Press
One Park Street
Rochester, Vermont 05767
www.InnerTraditions.com
Healing Arts Press is a division of Inner Traditions International
Copyright © 1980,1987,1988 by Leon Chaitow
All rights reserved. No part of this book may be reproduced or utilized in any form or by any
means, electronic or mechanical, including photocopying, recording, or by any information
storage and retrieval system, without permission in writing from the publisher.
Note to the reader: This book is intended as an informational guide. The remedies, approaches,
and techniques described herein are meant to supplement, and not to be a substitute for,
professional medical care or treatment. They should not be used to treat a serious ailment
without prior consultation with a qualified healthcare professional.
Library of Congress Cataloging-in-Publication Data
Chaitow, Leon.
Soft-tissue manipulation : a practitioner's guide to the diagnosis and treatment of soft-tissue
dysfunction and reflex activity / by Leon Chaitow.
p. cm.
Reprint. Originally published: New rev. and expanded ed.
Wellingborough, Northamptonshire ; Rochester, Vt. : Thorsons, 1987.
Bibliography: p.
Includes index.
ISBN 0-89281-276-1
1. Manipulation (Therapeutics). I. Title.
[DNLM: 1. Manipulation, Orthopedic—methods. WB 535 C435n]
RZ342.C47 1988
615.8'22—dcl9
DNLM/DLC
for Library of Congress 88-24482
CIP
Printed and bound in the United States
10 9 8 7 6
Contents
Page
Acknowledgements 7
Introduction 9
Chapter
1. Somatic Dysfunction — The Soft Tissue Component 15
2. Reflex Areas and Somatic Dysfunction 41
3. Diagnostic Methods 75
4. Postural and Emotional Considerations 97
5. Techniques and Index of Neurolymphatic Reflexes 121
6. Basic Spinal Neuro-muscular Techniques 173
7. Basic Abdominal Techniques 187
8. NMT in Clinical Use 195
9. Muscle Energy Techniques 201
10. Modified Strain-Counterstrain (Tender Point) Technique 241
11. On Energy 257
Bibliography 265
Index 267
To my wife, Alkmini and our
daughter, Sasha.
Acknowledgements
My grateful thanks go to Dr Boris Chaitow for the notes, photographs and
guidance which greatly aided me in the preparation of the chapter on abdominal
technique in particular and the whole book in general. I also wish to express my
thanks to Peter Lief D.O. for his permission to quote from his written and spoken
comments on his and his late father's contribution to manipulative therapy. My
thanks go too, to Brian Youngs B.Sc., D.O. for his generous permission to quote
from his authoritative articles on the theoretical and practical aspects of Neuro
muscular Technique. Also, my special thanks to Terry G. Moule N.D., D.O.
for his contribution to Chapter 8 'NMT in Clinical Use'.
I acknowledge with gratitude Michael M. Patterson Ph.D., Associate Professor
of Osteopathic medicine at The College of Osteopathic Medicine, Ohio University,
for his assistance in giving permission to quote from his writings. My thanks,
also, to Churchill Livingstone for permission to quote from the book Connective
Tissue Massage by Maria Ebner (a book now sadly out of print).
Thanks are also due to the Rolf Institute's Executive Director, Richard
Stenstadvold, for permission to quote from the writings of the late founder of
the Institute, Ida Rolf; to The Japan Publishing Company for their permission
to quote from Tsubo— Vital Points for Oriental Therapy by Katsusuke Serizawa
M.D.; to Randolph Stone D.C. for the quotations from his work on Polarity
Therapy—there is a lot of common ground between his methods and those of
Stanley Lief; and to Williams & Wilkins Co. for muscle tests quoted from Posture
and Pain by Kendall, Kendall and Boynton.
My sincere thanks go to all the writers, medical, osteopathic, chiropractic and
others, whose work I have alluded to or quoted from; and especially Bevil Roberts
for his dedicated work in illustrating this book.
On a more personal level I wish to thank my father, Max Chaitow, for providing
the information regarding the early family history of his cousin Stanley Lief;
and to thank most sincerely my wife, Alkmini, without whose patient help this
book would not have been written.
Finally, and most importantly, I wish to express my thanks and deep respect
to the memory of that giant among men, the late Stanley Lief. His work goes
on, and the spread of the knowledge of Neuro-muscular Technique serves to
underline yet further his contribution to natural healing. I hope I have done him
justice.
Introduction
The role of the soft tissue of the body in terms of health and dysfunction deserves
re-emphasis, as does the relationship of the muscle, fascia and connective tissue
in general to the overall economy of the body and to its ability to function efficiently.
The ways in which dysfunction in the soft tissue mirrors deeper pathology of both
mind and body, and the ways in which it influences such pathology, directly or
reflexly, are profoundly important.
A factor common to the various reflex systems (such as acupuncture points,
Chapman's neurolymphatic reflexes, myofascial trigger points etc.) seems to be
their siting in fascial tissue. The stresses and strains produced in this ubiquitous
tissue produce definite patterns, many of which are related to lines of postural
stress, which are fairly uniform in man. Andrew Taylor Still, the founder of
osteopathic medicine, was clearly prophetic when he stated that the fascia is the
place to look for the cause of disease, and the place to begin the action of remedies.
Palpable tender areas of dysfunction, which often display measurable changes
of cutaneous electrical potential, may be regarded as common to all these systems.
This aspect of soft tissue manipulation will form a major part of this book.
It is the intention to introduce a variety of systems, which have in common the
use of distinct, palpable, usually sensitive, areas of the soft tissues which may be
contracted, in either a diagnostic or a therapeutic manner, or both. The classification
of such points into particular types, with their own characteristics, in terms of
the effects they have on local or general function and pain, is a practical necessity.
It has been suggested, however, with some seriousness, that there are in fact so
many points and areas charted that the entire body surface is potentially of
diagnostic or therapeutic value. This will be discussed further in Chapter 2, when
we examine some of the more developed classifications of reflex points, as well
as acupuncture points with which they are often interchangeable.
The designation of some of these points as being 'neurovascular', or
'neurolymphatic' points, does not indicate that these are necessarily accurate
descriptions of their nature. What is clear is that they are not mere figments of
the imagination.
The noted chiropractic researcher, and developer of a system of treatment of
the musculo-skeletal system known as Receptor-Tonus technique, Raymond
Nimmo D.C, stated in 1971 (The Receptor, Vol. 2, No. 1, pp. 47): 'There is no
such thing as a neurolymphatic reflex, and the osteopathic profession discredited
10 SOFT-TISSUE MANIPULATION
the Chapman system years ago.'
This is far from the truth, as evidenced by the employment of neurolymphatic
reflexes in clinical trials. In Chapter 2, for example, details are given of one clinical
trial, conducted under hospital conditions in 1979, in which stimulation of the
Chapman's neurolymphatic adrenal point was shown to produce significant
alterations in serum aldosterone levels, over a three-day period, whilst a 'dummy'
point nearby, produced no alteration on stimulation. These points may not be
related neurologically to the lymphatics, in a direct sense. Clinically, however,
they have been shown to beneficially influence lymphatic stasis. The neurovascular
points, described by Bennett (Chapter 2), may also have no proven neural
connection with vascular structures, but improvement in circulatory function
follows their employment. Bennett's points have a close resemblance to some of
the reflex abdominal areas, described by McKenzie, and both sets of points have
many resemblances to traditional acupuncture points. Their description in this
book relates to the designations given them by the practitioners who noted their
importance, and who rightly or wrongly, named them in these ways, Frank
Chapman and Terence Bennett.
The methods of treatment of these reflex areas vary, and these will be discussed.
We will also present variations in the use of soft-tissue manipulation, which are
applicable to such areas. The use of other modalities, such as local anaesthetic
injections of trigger points, will not be discussed, as such information is available
in appropriate texts. Apart from the various systems, involving reflex points, and
the discussion of the significance and methods of treating trigger points, the three
methods of soft-tissue manipulation which will be presented are Neuro-muscular
Technique, Muscle Energy Technique, and the functional technique known as
Strain Counterstrain.
There are a number of additional individual techniques, specifically related to
particular areas, such as the psoas, piriformis and tensor fascia lata, which will
be included in the text but what will not be presented in detail are those techniques
which form the major part of traditional massage therapy. These are available
for study in appropriate texts, and it is not considered necessary to do more than
briefly review these. Soft-tissue manipulation is capable of being used as part of
any physical form of treatment, and may be combined with osteopathic,
chiropractice, physiotherapeutic and gymnastic therapy, to great advantage. It
may also be used on its own, in a paliative or corrective manner, as we shall discover.
All dysfunction of the musculoskeletal system requires that an overall
appreciation be made as to causative factors. The treatment of symptoms is never
more than of short-term value, without attention to the correction of those factors
from which these symptoms derive, whether these be postural, occupational,
habitual, emotional or any other form of misuse of the primary machinery of
life, the musculo-skeletal system. The accusation may be that by paying undue
attention to the soft-tissue component of the musculo-skeletal system other vital
aspects are being ignored. If the advice of this book were that correction of joint
problems, and overall postural and functional re-education, as appropriate, were
to be ignored, then this would be a valid criticism. This is not the viewpoint expressed
in this book. We are stressing the vital need for attention to be paid to the soft-
tissue component, but not to the exclusion of attention to the joints and skeletal
structures, and certainly not with any thought of avoiding the correction of those