A procedural protocol for the application of applied kinesiology techniques is presented. It is based on neurological and biochemical principles and thirty years of clinical observations of comparative applications of techniques. Short summaries of each section are included prior to the section to enable a brief review of the information.

25. Check Chapman’s Reflexes for Weak Muscle(s) – If Positive: Treat by Rubbing

26. Check Fascial Sheath Shortening

27. Check Iliolumbar Ligament

28. Check Pelvic Categories - Iliac & Sacral Fixations

29. Check Spine (and Feet) using FRA activity:

1. Challenge Vertebra (or Foot) to Determine Direction of Correction
2. Add Spinal Position to Determine Optimal Coupled Position for Spinal Adjustment
3. If Uncoupled Mechanics: Look for Source of Uncoupling

30. Challenge Extremities and Adjust as indicated

Summary: Having already addressed systemic factors creates an environment for an amplified response when treating remaining dysfunction directly related to local muscle and ligament involvement, and adjusting spinal, pelvic, and extremity subluxations.

The area of a local problem is the starting point for most practitioners of any discipline. However, by employing this protocol, most, and sometimes all of the patient’s symptoms will be improved, if not eliminated, prior to local assessment. When there are still persistent local symptoms, it is time to investigate local muscle weaknesses and find and correct the “local” source(s) of inhibition.

Recall that a weak muscle, as seen in AK, represents a net inhibition at the anterior horn motorneurons for that muscle. The protocol has comprehensively addressed the various factors that will impact the spinal cord AHMNs from both somatosomatic and viscerosomatic sources and from all major descending and ascending pathways. What remains to be treated are problems associated directly with the muscle(s) used to perform the symptomatic activity. This includes spinal cord reflex activity arising from the iliolumbar ligament, pelvic categories, spinal fixations and subluxations, and extremity subluxations. It also encompasses the application of therapies tied directly to a muscle such as Chapman’s reflexes, fascial release technique, and even isolated IRT corrections to specific muscle and/or ligamentous tissues.

The concept of spurt muscles and shunt stabilizer muscles provides additional perspectives (biomechanical as well as neuromuscular) regarding the organization of this protocol. Any muscle initiating an action (a spurt muscle) must have a stable base to pull from provided by a shunt stabilizer muscle or risk unsafe mechanical stresses to the joint. Many local problems recur due to treating the muscle at the point of the problem (the spurt muscle) while ignoring the shunt stabilizer muscle. A muscle may be a spurt muscle for one movement and a shunt stabilizer for another. Shunt stabilizer activity can be traced back to extensor muscles that connect to the spine and inevitably the spinal intrinsic muscles themselves. The spinal intrinsic muscles are under unconscious control through descending pathways originating in the cerebellum. (See next paragraph.) Note that the latissimus dorsi and the trapezius (upper, middle, and lower) combine to provide connection (stabilization) to the shoulder joint from the entire spine. It is interesting to note that when we correct immune system problems related to the spleen, we are providing shunt stability for many shoulder problems by normalizing middle and lower trapezius function.

Taking a larger view, centering the spine corrections (flexion-extension, lateral flexion, spinal torque or gait pattern) will provide intrinsic spinal muscle stability that originates in the pattern generator cells in the mesencephalon. The feedback from muscle spindle and joint receptors activated by centering the spine correction will fire into the midline cerebellum which then fires back into the brain stem and down into the intrinsic spinal muscles for central shunt stability. Correcting anything that impacts these pattern generator cells including factors mediated through the hypothalamus-mesencephalon reticular formation connections will ultimately provide shunt stability for virtually any movement in the body. This includes immune problems, endocrine problems, systemic autonomic problems, emotional stresses, and others. Therefore, at several steps along the course of this protocol, corrections have been made to provide for spinal shunt stability for virtually any movement. The concept of spurt versus shunt muscles provides additional perspective on how correcting the systemic problems first will often clear up local problems, or at worst provide an environment for local treatment to create rapid improvement and long-standing correction.

It may be wrongly assumed that any origin and insertion injury would have been corrected during IRT and other pain relief corrections. Occasionally, the origin-insertion of a local muscle will need IRT and this will elude the early screening with AF. It is wise to have the patient TL to the origin and insertion of muscles associated with local problems as well as nearby ligaments. Use TL to identify therapeutic need to muscle origin(s), insertion(s), and ligaments, but do not correct until after TLing to Chapman’s reflex for the muscle and the associated spinal areas. It is easier to identify these and other factors (see immediately below) with the muscle weakness present. Correct OI and Chapman’s reflex one after the other.

25. Check Chapman’s Reflexes for Weak Muscle(s) – If Positive: Treat by Rubbing

If a weak muscle is still present, TL to the Chapman’s reflex, the muscle’s OI, and the associated spinal levels and extremity joints. It is more efficient to TL these factors using the weak indicator muscle prior to correcting any single factor that may be present.

Chapman’s reflexes will affect muscles and the associated viscera, if the organ is involved. Although it is likely that any visceral Chapman’s reflex will have already been corrected, these reflexes can still be present and related only to the associated muscle, so they should be TLed, and corrected after any other local problems (spinal, extremity, OI) are identified.

26. Check Fascial Sheath Shortening

In persistent pain and decreased range of motion, after strengthening any local muscle weakness, check for and correct fascial sheath shortening problems. Since many fascial sheath problems are related to the need for vitamin B-12, and its absorption, the patient will likely have had these factors identified and corrected long before getting to this step. However, if there is a local fascial sheath problem and response to oral B-12 has not been checked, it should be checked now. If B-12 negates the fascial sheath challenge, then digestive factors associated with B-12 activation and absorption should be investigated. It is possible that a B-12 need has been missed (e.g., supplementation with folic acid can obscure the laboratory indications of a simultaneous need for B-12.)

Laboratory assessment (CBC with differential, etc.) may be indicated and reassessment for B-12 (including fascial sheath shortening and small intestine evaluation) should be performed earlier in the protocol (Step 8b) during subsequent visits to ensure proper use of this important nutrient. Fascial sheath stretching manipulation should not have to be performed more than once in any patient. Recurrence suggests some other underlying factor (e.g., injury, intestinal malabsorption, or subluxation) is at fault.

27. Check Iliolumbar Ligament

IRT to the IL ligament is the most common finding in my practice. Often it will be missed on initial evaluation for injuries because its presence may be only evident by AF in the weight-bearing position.

IRT IL ligament problems are so important that it is recommended that they be checked for during initial injury screening, whether by testing for AF in the weightbearing (sitting or standing) position or by direct challenge with the patient recumbent using the cephalward talus pressure challenge. IRT IL ligament problems are usually related to gait asymmetries, but like the chicken and the egg, it is difficult to say which one causes the other. If there is no IRT ligament evident during initial IRT / AF screening, it should be tested for directly with talus challenge at this point and corrected, if indicated, usually with the patient prone. IL ligament problems are often a result of a repeated minor repetitive injury arising from structural manifestations of body chemistry imbalances (off-centering of the spine) and visceral disturbances. These should be negated by this point, with the exception of endocrine (and occasionally other visceral) problems that will be picked up during the gait assessment below.

Most Category 1 and some Category 2 and Category 3 pelvis problems will be eliminated by IRT IL ligament correction. Some other spinal problems will also resolve with IL ligament correction due to the unwinding (re-centering) of the spine associated with these corrections. So it is essential to check and correct the IL ligament prior to looking for any spinal and pelvic problems.

In this regard, IRT of the sacrospinous (SS) and sacrotuberous (ST) ligaments can also create pelvic Category 3 problems. SS and ST ligament IRT involvement will also elude AF screening unless the patient is weight-bearing, but may be challenged at this time.

It was previously mentioned that hyperinsulinism creates a SYM effect including spinal flexion and secondary spinal torque (gait) patterns. This sympathomimetic effect of insulin results in repetitive asymmetric insult to the IL ligament, hence, chronic hyperinsulinism frequently creates an IL ligament IRT pattern. This pattern becomes ingrained in the patient’s nervous system and is often mistaken for the commonly found chiropractic neurology pattern referred to as hemisphericity.

Treating a patient for a hemisphericity lesion when the problem is really a neuromuscular pattern secondary to hyperinsulinism not only addresses the wrong problem, the treatment usually causes the patient to respond by a change in symptoms, rather than true correction. That is, since the underlying hyperinsulinism pattern remains, neurological therapies and rehabilitation procedures drive the adaptation (to the insulin problem) to another area of the body, sometimes creating new symptoms, sometimes not, but allowing the underlying hyperinsulinism to go untreated. This is detrimental to the patient’s overall good. Following the protocol will help to avoid this potential pitfall and subsequent misdiagnosis

28. Check Pelvic Categories, Iliac & Sacral Fixations

29. Check Spine (and Feet) using FRA activity:

1. Challenge Vertebra (or Foot) to Determine Direction of Correction
2. Add Spinal Position to Determine Optimal Coupled Position for Spinal Adjustment
3. If Uncoupled Mechanics: Look for Source of Uncoupling

30. Challenge Extremities and Adjust as indicated

The bread and butter of the chiropractor, pelvic and spinal adjusting, is left to a point near the end of the protocol. This is the reason why: If you want the maximum response from your adjustment; if you want it to impact the most neurons in the spinal cord, brainstem, cerebellum, and cortex; then you want to make sure as many neural pathways as possible are operating as open channels to carry the consequences of restoring normal afferentation to the most distant and isolated areas of the nervous system. You also want to be certain that the necessary neurochemistry is in place for optimal signal transmission.

Said differently: Get the entire smokescreen out of the way before taking aim at bombarding the nervous system with such an important input as the spinal adjustment. Or clear the static from the radio before trying to hear every piece of an orchestral movement that is being played. Just like getting the static cleared from the radio signal so we can hear all of the parts equally, so do we want to clear the nervous system from aberrant signals so that the normalizing message from the adjustment gets through loud and clear and penetrates the entire nervous system.

Pelvic Categories 1, 2, and 3 are often corrected by treatment of IRT to the IL ligament and/or the SS and ST ligaments as mentioned above. Correction of centering the spine factors (which includes IRT injuries and endocrine imbalances) also allows for self-correction of many pelvic problems, especially Category 1 lesions. When one follows the protocol, one encounters far fewer structural faults (subluxations and fixations.) However, the impact of their correction is significantly magnified.

Identifying subluxation correction hierarchy by the flexor reflex afferent (FRA) subluxation nociceptive challenge is usually a multi-step procedure. NOC afferents create the FRA (flexor withdrawal response.) The nervous system can only respond to one NOC input at a time. In fact, any FRA inhibits all other FRA afferents. Hence the “worst” FRA overrides the “lesser” FRAs and causes its specific pattern of muscle withdrawal preferentially. Certain other non-NOC sensory pathways also create an FRA response. These include receptors in joints and secondary muscle spindle cell receptors (from the nuclear chain) which would fire in the presence of a subluxation.

Adding nociception (by mild pinching) over the next subluxation to be corrected will yield an FRA response of weakening any extensor muscle. Pinching over any other subluxation will not override the more powerful FRA response, so no muscle weakness will be induced except by pinching over the next subluxation to be corrected. Following correction of the primary subluxation, another subluxation becomes primary and pinching over it (and only it) will result in extensor muscle weakening. The optimal order for correction of the spine and feet is indicated by pinching over the vertebrae (and feet) until a weakness of an extensor muscle is found, identifying the next segment to adjust. FRA activity (pinching over the vertebrae and feet) is continued until there is no extensor weakness induced by nociception over any vertebra or either foot.

Spinal corrections should be made using coupled mechanics. Sources of uncoupled mechanics include injuries, centering the spine problems, cranial faults, TMJ faults, visceral referred pain patterns, sclerotogenous referred pain patterns, and Lovett reactor vertebra subluxation patterns. All of these should have already been cleared with the possible exception of sclerotogenous and Lovett patterns. If an abbreviated protocol has been performed, (that is, not all steps are performed on any one visit) which is the most likely case (few practices are set up to take the time to cover the entire protocol in one visit) and an uncoupled subluxation pattern is identified, it is worthwhile to identify and correct the source of uncoupling rather than adjust the uncoupled segment.

Extremity symptoms that are still present (the feet should have been corrected during FRA subluxation activity) may be related to local muscle weakness (even local IRT problems) and extremity subluxations. As with vertebral corrections, extremity adjustments will be more effective since the nervous system is clear of other sources of interference and has the chemistry needed to amplify the effects of the adjustment.

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