by Gerald Lamb DO, BSc (Hons)
Finally, a word about positional lesions. It is this concept that makes the SAT approach unique. When the upper neck is subject to physical trauma, such as a blow or a whiplash to the head, the segments of the upper neck go into lesion in a unique way. Such a force may cause the hyper-sensitive upper neck to ‘freeze’ and the segments get set in a one-to-one relationship like in the case of an unnormal physiological lesioning. It is possible for the segments to solve in a relationship having one segment holding bended forward and the other one below it bending backward. This kind of presentation is hardly ever illustrated in normal mobility restrictions. This happens because it is impossible to make these lesions undergo a mobility test because everything closes down and the segments will thus feel hard and unyielding.
This happens not because the segments are displaced, in fact they are still within their range of movement, but because they are at odds with the above and below segments. One might think of the segments as being up against the ropes and thus, to use a boxing analogy, with nowhere to move. It is also possible for one segment to be held in rotation on one side and the one below on the other side. Besides, side shift is another possible element of presentation.
This disturbed relationship in apparent positional disparity is why these post traumatic lesions are called positional and that is why they need a very particular way of mobilizing to restore their functional normality.
The way they are adjusted is called floating field adjustment. After having diagnosed the vectors of the lesion, the practitioner seeks to reverse the vectors in one motion. It is about taking all the vectors into account and reversing them with a really fluent maneuvers. The lining up is first achieved physiologically and then the practitioner keeps the position of locking in their mind whilst they ease off the alignment. Then, with a very light floating action the lesion is taken subtly toward the barrier but just for a short engagement, until the practitioner is ready to engage and follow through in one fluent action. It is precisely this fluency that corrects the lesion and brings out all the interior force. An ordinary mobilization does not resolve the force which might return.
In other words
In conclusion, SAT’s contributes to traumatically induced lesions in the atypical areas of the spine, respectively the upper neck and the pelvis. Theses lesions are positional in nature and therefore need to be corrected as such thus not according to the mobility findings. Once corrected, the specialized practitioner will attend to one segment per treatment, usually the pivots of the spine, until a satisfactory balance has been achieved.
Although the practice of positional adjusting requires a little reflex skill from the practitioner, it is a skill that can be learned with practice. Its performance, following one segment at a time, effectively gives the body back to itself with very little interference by the practitioner and is true to Still’s fundamental precept of ‘find, fix it, and leave it alone’