Part 2 of "Holistic Approach to Injury" picks up where Part 1 left off, as Paul introduces the survival totem pole and describes how it should be used to during your comprehensive screening assessment of all clients.
Follow the Survival Totem Pole
Once we have determined how stressed the client is and how much stress the ANS and hormonal system is under, we then know which tests must be used to objectify the client’s situation. We make the decisions as to which clinical or lab tests we need to run based on practical screening tests and a review of the reptilian stressors described above. Having gathered this valuable information, we then proceed to physical testing to determine the state of the key body systems that regulate and control the musculoskeletal system. To complete this comprehensive screening assessment, one must follow what I call the survival totem pole (see Figure 4).
I developed the survival totem pole after many years of clinical experience with challenge patients. I found that most challenge patients had multiple ailments and that if my therapeutic protocols did not address the primary stressor, my therapeutic interventions were both short term in effect and palliative. Having spent many years studying human anatomy and human development, I built a system of analysis that identified stressors in the order of importance to survival so that I could prioritize both my therapeutic and coaching efforts. This dramatically improved my clinical results, and the system has allowed me to get results with many challenge patients that were unsuccessful with other approaches. To better understand the survival totem pole, I will briefly explain each symbol and it’s significance. As you review the survival totem pole, keep in mind that each symbol reigns superior to the symbols (systems) below it when viewed from a survival perspective.
Oxygen is the most vital nutrient of the human body. If you don’t take it in with each breath, you have about three minutes before your brain begins to die, and in five minutes, you are dead! With that in mind, it is pretty safe to say that breathing is so vital to life that the body will do almost anything to accommodate respiration. Anything altering respiration must become high priority in any treatment protocol seeking long-term resolution!
Second only to breathing, which provides oxygen, we must consider mastication. Mastication is a fancy word that embodies the chewing of your food and how your teeth fit together. When we chew our food, the teeth must fit together in a smooth, well coordinated manner, much like the gears in the transmission of your car. If you miss-shift, you grind the gears. If you do that too often, your transmission will fail, and you must get it repaired. Your teeth are no different. If your teeth don’t fit together properly, you develop what is called a hit and slide bite. This means that your teeth mesh incorrectly. and the little guiding facets of your teeth have to usher the teeth into the correct position. When you consider that the average person opens and closes his mouth some 4,000 times a day, it becomes apparent that if the teeth don’t fit together correctly, they will quickly wear out. Imagine miss-shifting in your car 4,000 times a day, and think how quickly that would wear out the steel gears in your transmission!
The masticatory apparatus consists not only of the teeth and jaw but the head, neck, shoulder and arm complex, which are all one working system. This system is technically referred to as the stomatognathic (sto-mat-o-nathic) system. Since the stomatognathic system is co-dependent upon all systems inferior to it on the survival totem pole, you will see the logic behind assessing the overall functionality of each individual client, regardless of where his pain may be!
Quite simply, as a developmental being, if you couldn’t see, you wouldn’t know what was going to try and eat you, and you wouldn’t be able to see what you were going to eat. The result of this is obvious! When the eyes are imbalanced for any reason, the eye muscles can fatigue, and their length/tension relationships are often altered. This results in a visual field dysfunction. Because the body is so dependent upon both focal vision (target recognition) and ambient vision (proprioception), anything that disrupts binocular vision will cause the body to compensate below in attempt to correct eye position. It is not uncommon to see a patient with an eye muscle imbalance or one weak eye stand with his head or body twisted to one side in attempt to correct eye alignment. As you can well imagine, this could cause a lot of musculoskeletal stress, such as back pain! No matter how hard you try to poke, prod, stretch, exercise or mobilize the back, until the eyes are working correctly, you will never alleviate the stress in the back because it is sacrificial to the eyes, which are superior on the survival totem pole.
Auditory – Vestibular
You can well imagine how essential hearing was to our survival in the wild. Our nervous systems are structured such that any loss of hearing automatically results in a compensatory change in the orientation of our posture to bring the good ear closer to any sound. If you work as a bank teller, for example, you will end up talking to and listening to people with your head slightly turned to favor the good ear. It won’t take long before your musculoskeletal system becomes strained and imbalanced due to the task of accommodating faulty hearing. This is yet another example of how the body is structured in a hierarchical manner for the purpose of survival.
The vestibular system works intimately with your eyes and upper cervical spine to maintain your balance. The vestibular system monitors head position relative to the body and serves to activate the extensor muscles to right the body. For example, if you begin to fall to the left when riding a bicycle, your vestibular system will sense you are falling left and reflexively activate the left knee extensors and hip extensors so that you can push against the ground or foot pedal to right yourself. When someone has a vestibular dysfunction, his balance is impaired and his chances of injury are much greater. Therefore, before going out of the way to do a bunch of work on the body to treat an injury, we need to make sure the individual has the ability to maintain his balance.
The Upper Cervical Spine
The top three cervical vertebra are classically referred to as the upper cervical spine. This region of the spine is loaded with specialized proprioceptive nerve endings to inform the body of where the head is relative to the body and where the body is relative to the head. The combination of information coming to the brain from the eyes, vestibular system and upper cervical spine is primarily what is used to keep upright while performing activities of daily living. The atlas, the top cervical vertebra, is the most easily subluxated (malpositioned) vertebra of all spinal vertebra. An important and intimate communication link to the spinal cord via specialized ligaments called denticulate ligaments is created at this level of the spine. Because of this link, if for any reason the atlas is malpositioned, compression, torsion and/or sheer can result in the spinal cord at this level. Since every nerve root in the body passes through the atlas, if there is a problem at this level, literally any body system or body segment can be negatively affected. Clearly, assessing optimal function of the upper cervical spine is a must!
Next, we must make sure that the hormonal glands and organs of digestion and elimination are working correctly. Using a comprehensive questionnaire system and hands on assessment techniques I developed through my clinical practice, I can identify any gland or organ that may be causing reflex dysfunction in the musculoskeletal system. We can make this assessment two ways:
- The questionnaire system looks for key indicators of glandular and organ stress, directing the clinician to look more closely at those systems.
- Each organ borrows it’s sensory fibers from the sympathetic nervous system, which is intimate with the sensory and motor nerves of the musculoskeletal system at each level of the spinal cord (see Figure 5). Due to this anatomical relationship, when pain fibers are activated in any organ or gland, there is a corresponding response in the skin and muscles innervated by the spinal segments that also have nerve roots feeding the organ in distress.
As you can see by the symbol showing the broken heart, the lightening bolt in the stomach and in the tail end of the colon, our emotions can greatly influence any organ or system in our body. It is my philosophy that energy precedes structure. Stated another way, this means that thoughts create words and words create deeds. Your body is a physical expression of that transfer of energy. I listen to my clients carefully and use careful assessment techniques to determine where there is an emotional imbalance because the emotions are so powerful and influential over the body that this symbol of the survival totem pole is what I refer to as a floating symbol: it has the power to override any other symbol and can be the source of any and all problems in the body and mind.
The body in pain also produces high levels of stress that must be managed, or it may cause permeant damage. Generally, when there is an inflammatory process in the body, there is an abundance of energy. In time, if this inflammatory process is not properly managed, it will shift from being an inflammatory condition to a degenerative condition. For example, a tendonitis may eventually become a tendinosis. The degenerative condition marks the point at which the body runs out of restorative energy.
By tracking which zone of the body (chakra association) each client has musculoskeletal, hormonal or visceral problems, we can use the Eastern system of yoga to correlate emotional issues commonly related to a given body region, gland or organ (see Figure 6.). When the client can be shown the correlation between his emotional status and his physiology, he generally becomes more willing to receive coaching for emotional self management. Failure to address emotional imbalances and the associated energy dysregulation is a common stumbling block to conventional approaches to pain and dysfunction of all types.
The sacrum is derived from the Latin sacer, meaning sacred or strong bone. This sacred bone is also intimate with the tail end of the nervous system, which attaches at the coccyx. It is important to realize that anything that disrupts the position of the upper cervical vertebra, particularly the top vertebra (C1 or Atlas) and the second vertebra (C2 or Axis) at the top, or the sacrum at the bottom, can cause torque in the spinal cord. The axons of the spinal cord are extremely sensitive to tension and compression, and the brain will do its best to alter your body position to minimize aberrant mechanical tension in the central nervous system. This means that any faulty biomechanics of the upper cervical spine and cranium or of the sacrum can result in shifted and twisted postures. The common result of these compensations is low back pain, pain in one of your legs and concomitant dysfunction of any physiological system being fed by the distorted nerve fibers.
Because the head contains the eyes, ears and vestibular system and the teeth, which must be maintained level with the horizon as their functional working position, the body will sacrifice anything below the head/neck interface to accommodate maintenance of the sensory organs of the cranium. For this reason, I always clear and correct dysfunction in the order of the survival totem pole. Frequently therapists and doctors try to correct the position of the pelvis and sacrum without paying attention to the fact that many systems use the pelvis and sacrum as a buffer system to maintain optimal function of key survival systems.
The two halves of the pelvis, each called a “hemipelvis”, the spinal joints from C3-L5 and the joints of the upper and lower extremity are called slave joints. This is because they will be sacrificed by the CNS in attempt to maintain optimal head position, as stated above. By assessing and correcting dysfunction in any and all systems above the slave joints on the survival totem pole, I have successfully resolved cases of seemingly intractable musculoskeletal pain.
As you can see after going through the survival totem pole, there is a very logical structure to our body plan. Mother Nature has done an excellent job over time to assure our survival. Now we just need to survive ourselves! As you can well imagine, following this plan to assess the body results in the accumulation of a lot of information.
The next real secret of my success as a therapist and coach lies in my system of prioritizing our approach to rehabilitation and revitalization of body/mind systems. For more on this, stay tuned for Part 3!
- Connolly, Ceci. March 29, 2002. Pharmaceutical Spending Continues Steady Increase. Washington Post, p. A09.
- MacLean, Paul. (2002). The Evolutionary Neuroethology of Paul MacLean: Convergences and Frontiers. Ed: Gerald A Cory, Jr., and Russell Gardner, Jr. Praeger, Westport, Connecticut.
- Pearce, Joseph Chilton. (2002). The Biology of Transcendence: A Blueprint of the Human Spirit. Park Street Press.