Excerpted from: (Dalton, E. Myoskeletal Alignment Techniques. Freedom From Pain Institute.)
The body’s motor system functions as an entity. It is in principle a wrong approach to try and understand impairments of different parts of the motor system separately, without understanding the function of the motor system as a whole. Janda, Vladimir, M.D., 1964
Dalton’s Myoskeletal Method:
The neuro-reflexogenic relationship of muscles, nerves, and joints is at the heart of Myoskeletal Alignment Techniques (MAT). Any alteration of joint function is carefully monitored by the brain and spinal cord and may influence muscular function. To understand the fine control of motion, the separate activity of individual muscles is not as important as their coordinated activity within the different movement patterns.
Overapproximation of joint surfaces caused by isometric muscle contraction leads to irritation of the sensitive mechanoreceptors responsible for recording pressure changes in the joint capsule. Even though these pressure receptors are not nociceptive pain generators in and of themselves, prolonged compressive forces causes local irritation in the surrounding neural tissues, such as the sinovertebral nerve, and those messages are relayed to the spinal cord. The result of this continued stimulation can be palpated in the spinal groove as fourth-layer fibrosis.
Unfortunately, the manual therapist’s fingers cannot release all the fourth-layer fibrosis at these sites. Muscles such as the intertransversarii and interspinalis are sometimes impossible to palpate, and these are often the principle culprits creating facet joint locking. The Myoskeletal answer is to release these tiny muscles by mobilizing the bones to which they attach.
The goal of Myoskeletal Therapy is not to twist the torso, lock down, or “pop” these dysfunctionl joints into place. The Myoskeletal system, much like the Muscle-Energy system takes a kinder, gentler approach. The intent is to create whole body alignment by simply working through the bones to release hypertonic muscles responsible for the vertebral dysfunction, in other words, to work with the vertebral segment as a whole rather than a single unit.
In line with the concept of whole body alignment, the manual therapist must develop a strategy for carrying out the alignment and balancing process. The Myoskeletal “intent” is always directed at the deepest connective tissue layers…namely the skeletal system. Because we are anatomically required to work through the myofascia to reach the skeletal system, focusing on these deeper levels guarantees us whole body alignment. This “bony intent” provides the modern manual therapist with a powerful new tool for creating profound and lasting changes in the bodies of their clients.
The development of the strategy depends on the therapist’s ability to recognize common strain patterns in the human body. The Myoskeletal method intentionally keeps it simple by focusing on the two most prevalent strain patterns that are constantly and continually presented by clients. By observing and understanding the mechanisms of these dysfunctional patterns, the therapist can quickly locate and treat the muscle imbalances responsible for creating the asymmetry. If the client does not present with either of these two patterns, the muscle testing system still differentiates and corrects the existing dysfunctional pattern successfully. The goal is to always recognize the strain patterns that create most common neck/back dysfunctions and to correct the strain patterns before they become pain patterns. Unfortunately, some clients do not present until they are experiencing pain. The goal then becomes to prevent the pain pattern from continuing.
The upper and lower crossed syndromes taught in the Myoskeletal Method were originally described by Vladimir Janda, MD, who named these observations the “proximal and distal crossed syndromes.” Dr. Janda was the first to clearly illustrate the predictable effects stress has on specific muscle groups and to show how these muscle imbalances distort body structure and function.
An interesting discovery that seems to be present in every client that presents with vertebral misalignment is the finding of gristle-like tissue deep in the lamina groove. Dr. Philip Greenman summarized this finding: “Palpable fourth-layer muscle hypertonicity will always be found in the presence of vertebral dysfunction.” This has become a tremendous diagnostic tool for the type of deep tissue work performed by advanced myoskeletal therapists.
This means that trained myoskeletal therapists should be able to correctly locate vertebral dysfunction simply by directly palpating and assessing fibrosis in the fourth-layer musculature. The key words associated with correct diagnosis are “fibrosis” and “hypertonicity”. Vertebral dysfunction will not be present beneath tissue that is simply tight and constricted. The fibrotic tissue must feel lumpy and hard.
This wonderfully versatile tool becomes the method for simultaneously identifying, testing, and treating vertebral dysfunction, especially the method for correcting facet misalignment by application of direct pressure with the fingers or thumb.
“Whole body” alignment requires that both myofascia and osseous structures be systematically treated to prevent strain patterns from becoming, or continuing as, painful movement patterns. Optimal body alignment is impossible with the exclusion of structural facet work.
Janda’s original work describing proximal and distal syndromes has grown to include ligament work and continues to be a remarkable guide to understanding typical imbalance patterns. By identifying these typical imbalance patterns through observation and testing procedures, the modern manual therapist is able to quickly formulate routines that can restore order and bring balance to the body before, and during the presence of pain.
The idea of muscle imbalances is taken a step further to include skeletal alignment techniques. When short/tight muscles overpower weaker structures, the uneven pulling continually distorts our skeletal framework. Identifying and treating myoskeletal imbalances, creating symmetry through proper alignment , and then teaching neuromuscular re-education exercises to reinforce the myoskeletal work is the foundation of the Myoskeletal Method.