There are two Dr Beckers and we have so far been involved with the work of Rollin Becker.
Alan Becker (1973) discusses ingrained patterns which we all carry, in much the same way as computers which have been programmed, whether these allow normal or abnormal function. In assessment and treatment he carries Rollin Becker’s ‘diagnostic touch’ concepts further, stating:
I make contact with the involved tissues and apply enough pressure to get the patient’s attention and to initiate the automatic response. Then I ask the patient to close his eyes and look at my fingers, to be aware of what is happening to his body. By this means I persuade him to take conscious control of the program and re-evaluate his standards of normal, acceptable and tolerable data. Then as I lead the structures towards increased ease and balance, the patient senses the changes and tends either to install new action programs which include the new data or to re-establish the ones which were in effect before abnormal data was encouraged.
In discussing a whiplash injury he illustrates this, saying:
The problem is complicated by the fact that the body has been subjected to forces that entered it in a direction that crosses the normal direction of movement. Such forces tend to produce wavelike movement within the fluid cells of the body, and the inertia of the body, which is trying to continue whatever programs are in action at the time, causes a counterwave directed towards the point of impact.
These two forces, according to Alan Becker, set up a wave-like pattern, a ridge of energy, a built-in distortion around which the defensive patterns are built. These have to be removed by dissipation of the energy rather than by force. Only then, Becker insists, can new, more appropriate patterns be established by the patient. The resistance of built-in patterns, whether these relate to habit or to injury, is something the palpating practitioner should be acutely aware of, for this is a key feature of the territory being explored.
We are now entering the area of structural reintegration, postural reeducation, Alexander technique, Feldenkrais’s work, somatics (Thomas Hanna) and other methods which require a relearning of how we use ourselves.
Alan Becker’s contribution seems to be that he calls on a conscious awareness from the patient, as methods such as those of Rollin Becker are applied, in order to have them become aware of the changes which are taking place and to have them support and encourage these.
EXERCISE 6.20: COMBINED PALPATION OF TISSUE CHARACTERISTICS
Time suggested: open ended depending upon your selection of options, but at least 30 minutes if possible
Choose an area of dysfunction on your palpation partner and prepare to palpate, incorporating, sequentially or at the same time, the concepts of Smith and Rollin Becker, as you palpate the intrinsic expressions of function in various areas of your
patient/partner.
Move from the methods of Smith (using a half-moon vector) to those of Becker (using the fulcrum) and back again. Which gives you the most information? Do the methods confirm each other’s findings? Which do you feel more comfortable with?
Do you now agree that tissue has a memory?
Are these exercises likely to be of value in a clinical setting?
DISCUSSION REGARDING EXERCISES IN THIS CHAPTER
Where have we come to by performing the exercises in this chapter? Have we simply acquired a series of experiences which we find hard to use or find relevance for? Or have the subtle skills which these exercises have encouraged a practical value?
Consider the words of one of the leading American osteopathic clinicians and academics, Philip Greenman (1989), who, when discussing myofascial release technique, a subtle yet extremely clinical tool, states:
This [myofascial release] is directed towards a biomechanical effect and a neurophysiological effect. Ward has coined a mnemonic: POE(T2). POE stands for point of entry into the musculoskeletal system. Entry may be from the lower extremity, the upper extremity, through the thoracic cage, through the abdomen, or from the cranial cervical junction. The two ‘Ts’ stand for traction and twist. In most of the techniques, traction produces stretch along the long axis of the myofascial elements that are shortened and tightened. The stretch should always be applied in the long axis rather than transversely across myofascial elements. Introduction of a twisting force provides the opportunity to localise the traction, not only at the point of contact with the patient but also at points some distance away.
He suggests that beginners try to develop the ability to sense change in the freedom or restriction of tissues, some distance from the point which is being contacted. Thus, if the ankles are being grasped and traction introduced, an attempt should be made to feel ‘through the extremities’ to the knee, hip, sacroiliac joint up into the spine itself. Concentration and practice can allow this skill to develop.
In his text Dr Greenman describes exercises which will allow the practitioner to develop the skills necessary to perform myofascial release techniques. These involve palpation of a body area, starting from above the skin, moving to a light contact which attempts ‘to sense the inherent movement of the patient’s tissues under your hand’ (an ‘inherent oscillation’) – a concept which we have seen described in other ways, many times in this chapter.
A first step in being able to do this involves the ability to apply pressure or make contact, without movement, followed by being able to palpate the motions which are constantly at work within the tissue, without influencing them. These skills are precisely what the various exercises given in this chapter should allow you to do.
Greenman gives a concluding exercise, palpation of the motion of the sacrum, with the patient first supine and then prone. This you should by now also be able to perform, based on previous exercises.
As Greenman says:
When you have been able to identify inherent soft tissue and bony movement you are well on your way to being able to use myofascial release technique.
It is hoped that the methods described above, based on the work of these marvellous researchers into human physiology, will allow greater skill in your diagnostic and therapeutic endeavours.
REFERENCES
Bassett C 1978 Pulsing electromagnetic fields. In: Buchwald H, Varco R (eds) Metabolic surgery. Grune and Stratton, New York
Baule G, McFee R 1963 Detection of the magnetic field of the heart. American Heart Journal 66:95–96
Becker A 1973 Parameters of resistance. Academy of Applied Osteopathy, Newark, OH
Becker R 1963 Diagnostic touch (part 1). Yearbook of the Academy of Applied Osteopathy Newark, OH, vol 63, pp 32–40 Becker R 1964a Diagnostic touch (part 2). Yearbook of the Academy of Applied Osteopathy, Newark, OH, vol 64, pp 153–160 Becker R 1964b Diagnostic touch (part 3). Yearbook of the Academy of Applied Osteopathy, Newark, OH, vol 64, pp 161–165 Becker R 1965 Diagnostic touch (part 4). Yearbook of the Academy of Applied Osteopathy, Newark, OH, vol 65 (2), pp 165–177 Burr H 1957 ‘Harold Saxton Burr’. Yale Journal of Biology and Medicine 30(3): 161–167
Burr H 1972 Blueprint for immortality. CS Daniel, Saffron Walden
Chaitow L 1999 Cranial manipulation: theory and practice. Churchill Livingstone, Edinburgh Cohen D 1967 Magnetic fields around the torso. Science 156:652–654
Cohen D 1972 Magnetoencephalography. Science 175:664–666
Erlinghauser R 1959 The circulation of CSF through the connective tissue system. Yearbook of the Academy of Applied Osteopathy, Newark, OH
Ford C 1989 Where healing waters meet. Station Hill Press, New York
Frymann V 1963 Palpation. Yearbook of Selected Osteopathic Papers. Academy of Applied Osteopathy, Newark, OH Greenman P 1989 Principles of manual medicine. Williams and Wilkins, Baltimore
Josephson B 1965 Supercurrents through barriers. Advances in Physics 14:419–451 Kennedy J 1955 Tubular structure of collagen fibrils. Science 121: 673–674
Korr I 1986 Somatic dysfunction, osteopathic manipulative treatment and the nervous system. Journal of the American Osteopathic Association 76:9
MacGinitie L 1995 Streaming and piezoelectric potentials in connective tissue. In: Blank M (ed) Electromagnetic fields. Advances in Chemistry Series 250. American Chemical Society, Washington, DC
Milne H 1995 The heart of listening. North Atlantic Books, Berkeley, CA
Nordenstrom B 1983 Biologically closed electric circuits: clinical, experimental and theoretical evidence for an additional circulatory system. Nordic Medical Publications, Stockholm
Oschman J 2001 Energy medicine. Churchill Livingstone, Edinburgh
Pick M 2001 Presentation ‘Beyond the neuron’. Integrative Bodywork Conference, JBMT/University of Westminster, London Richardson M 1988 Book review. The DO September
Selye H 1976 The stress of life. McGraw-Hill, New York
Seto A, Kusaka C, Nakazato S 1992 Detection of extraordinary large biomagnetic field strength from the human hand. Acupuncture and Electro-Therapeutics Research International Journal 17:75–94
Smith F 1986 Inner bridges – a guide to energy movement and body structure. Humanics New Age, New York Speransky AD 1944 A basis for the theory of medicine. International Publishers, New York
Sutherland WG 1948 The cranial bowl. Sutherland, Mankato, MN
Upledger J 1987 Craniosacral therapy II: beyond the dura. Eastland Press, Seattle
Upledger J, Vredevoogd W 1983 Craniosacral therapy. Eastland Press, Seattle Varma D 1935 The human machine and its forces. Health for All Publications, London
Wyckoff R 1952 Fine structure of connective tissues. Foundation Conferences on Connective Tissues 3:38–91
Zimmerman J 1990 Laying-on-of-hands and therapeutic touch: a testable theory. BEMI Currents (Journal of Bio-electro-magnetics Institute) 2:8–17