Fitting Treatment to Condition
Vigorous corrective movements should not be used when great pain is present, as is often the case in neuritis and some¬times in arthritis. If there is only moderate pain, the move¬ments can be given lightly, increasing the pressure very gradually when stretching the joints. In all acute conditions rest is more important than exercise, and any manipulation given should be limited to the lighter spinal movements. Gen¬erally it is well not to use any such treatment until the acute symptoms subside. During pregnancy it is well to avoid any very strenuous stretching of the abdominal region or heavy exercise of this part. A light general treatment may be given to great advantage, however, as it maintains the flexibility of the joints, muscles, and ligaments about the pelvis. The same precautions should be taken during the menstrual period. If there is a profuse flow, however, no treatment, except possibly pressure on the spinal nerve-centers, should be given.
The extent of the movements and the amount of force employed in their application can be graduated to meet the needs of the young, the old, the weak, the strong, the sick, and the well. The movements may be given slowly when it is de¬sired to relax, or rapidly when it is desired to stimulate. Pres¬sure may be applied gradually or quickly. The amount of resistance offered when giving the exercises may be graduated to a nicety for each part and for each person. The treatment may be made long or short, general or local. By modifying the severity of treatments they may be used to assist the over¬weight person in reducing or the person below normal weight in building up.
F’or example we select the neck, as movements of this part are important. Generally, it is best for the patient to be in the reclining position, especially at first. The movements can be given in the sitting position, but it is much easier for the oatient to relax when lying down. The movements used con¬sist of lifting the head as high as possible, so that the chin touches the chest; lifting the head diagonally left and right :;o that the chin touches the shoulder; bending the head to the sides, left and right, until the ear touches or nearly touches the shoulder; twisting the head to the left and right; stretch¬ing the neck by pulling directly backward on the head; stretching the neck while bending and twisting it at the same time; and pressing downward on the head while it is in a lifted position. In other words, the neck is bent, twisted, and stretched in every possible direction.
corrective Movements for thje Neck It is seldom necessary for the patient to relax before the treatment, as the movements themselves are relaxing as well as stimulating. The patient may be told to relax, and if he is inclined to help the operator by using his muscles, he should bn told to take his mind from the part being treated. If there is great difficulty in relaxing or if there is some pain, a little massage may be applied to the muscles before beginning the Movement manipulation. The latter should be given lightly and slowly at first. Kach movement is executed several times, and the amount of force can be increased slightly at each repetition. The movements must be made smoothly and with a firm touch, as an indecisive touch or jerky movement will cause the patient
to tense his muscles.
The movement of lifting the head may be done by placing the hands under the back of the head, or by crossing the arms beneath it, and lifting. In either case the head is brought up smoothly and steadily, and, when it has reached the apparent limit of motion the pressure is slightly released, after which a brief, firm, fairly hard pressure is applied, so as to stretch thoroughly the muscles and ligaments of the back of the neck. The head is then allowed to return to the resting position.
To modify exercises, pressure may lie slightly released and re-applied several times before the head is returned to the starting’ position, making the pressure more strenuous each time. By thus beginning lightly and using the extra pressure at the top of the movement, it will be found that after a few repetitions the head may be lifted considerably higher than at first. It is this little extra pressure at the apparent limit of the movement which is characteristic of physical exercise move¬ments, and which makes them so valuable for increasing the flexibility of the parts and for stimulating the blood and nerve supply to the same region.
Corrective Movements Force Undesirable The next movement is performed in the same way, ex¬cept that the head is turned somewhat to the side. In bend¬ing the head to the right, the right hand grasps it beneath the occiput (the backhead), while the left hand is placed on the patient’s left shoulde: so as to hold it firm. If this is not done, the shoulder will be pulled over also and reduce the neck- stretching effect. In bending the head to the other side the position of the hands is reversed.
In twisting the head, one hand is placed beneath the occiput and the other grasps the chin. Care must be taken not to use too much force, as it may alarm the patient. The hands are placed in the same way for the pulling and for the combined pulling and twist¬ing movements.
In giving any neck movements, or in working on or about the face, it is important to watch the finger-tips so as not to thrust them inadvertently into the eyes or ears. Also, watch the finger-nails so that they do not scratch, and in grasping any part of the body, be sure that you do not pinch the skin. Make all your contacts smoothly and firmly and do not let the hands slip on the .skin, especially on parts covered with hair, or there will be painful pulling. Always consider the patient, and give the treatment in a manner that will be most comfortable for him, provided this does not interfere with its efficiency. Some well-intentioned operators give violent treatment, regardless of its effects on the patient, because they think they must use considerable force in order to do any good. But it is correct contact and the proper applica¬tion of force which governs the effectiveness of the treatment, not the force used It is well when planning to give treatments to perform movements on oneself, to know just how each movement af¬fects the patient. This will enable one to perfect his own tech¬nique considerably; for, when giving a movement, he will remember how it felt to him, and will therefore try to give it in the most perfect and satisfactory manner. While a treat¬ment will do good even when given by one not so expert, no one should be satisfied with doing less than his best.