ELDOA Bay Area

Specific to the lumbar, we can find four distinct intertransverse fibers. The three internal: intermamillian (red), mamillo-styloidian (orange), inter-styloidian (green); and for the external: intercostiform (purple). Between these fibers there is passage of the dorsal ramus nerves. Because the axis of the lumbar zygapophyseal joints are perpendicular to the direction of these nerves, a small lesion in this direction (i.e muscle spasm or misalignment of the vertebra) accentuates the tensioning of the aforementioned tissues and creates a shearing effect, which can cause back pain. Normalization of these muscles via 2TLS (transversal tendinous ligamentous stretching) can be particularly painful. Pain associated with this lesion in the lumbar can be more pronounced at the T12-L1 level, for example with Maigne’s Syndrome, due to T12’s unique characteristics. See post for more info on this.

The ANS: the sympathetic thoracic ganglia (yellow) exists is in front of each rib and vertebrae. Each ganglion gives further nerves, connecting to specific organ, muscular area, dermatone, etc. One needs to work specifically (whether exercise or therapy) at the level above and below at the minimum to consider the links.

The radiate ligament of the head of the rib (green) has attachments to the IVD, ALL and is also in link with the pec major fascia.

Due to its attachments, it can further compress the spine, thoracic cage and compress the sympathetic chain ganglia. It’s an important link to not forget.

Hepatic Flexure: The concept of tissue relationship allows one to relate different structures involved in a lesion. Looking at the fascia of this level allows us to see the link between the right phreno-colic connecting the diaphragm and right colic angle (light blue). We can see another ligament which connects the right colic angle to the terminal end of the greater curvature of the stomach (dark blue). This ligament is a reinforcement of the greater omentum, a continuation of the phreno-colic ligament, and part of the gastro-colic ligament at this section. The hepato-colic (underside of the liver, red) supports the suspensory ligament of the phreno-colic angle, but it is also helped by the reno-colic (antero-supero surface of kidney, yellow) and the cystico-colic ligaments (gallbaladder, pink). Tension of the cecum pulls the ascending colon down, and puts in tension not one, but five major players of the human body - the liver, gallbladder, stomach, kidney, and the diaphragm. If one is in tension, all are affected, and this will undoubtedly have an impact on the lumbar spine.

Finished the first week of Chiro school. Currently also seeing patients at their home/office.

SomaTraining ELDOA: to decoapt the joints, because articular dehydration and arthrosis are immediate consequences of compression.

Out of desire to grow myself further and take on greater responsibilities, I am excited to bring my passion for health to

Fat digestion and hiatal hernia: The tortuous coronary ligament widens posteriorly and encompasses the IVC. Its union with the left triangular ligament gives birth to an extension called the Arantius ligament, the place of insertion of the lesser omentum in direct connection with the stomach. Here includes the common bile duct, hepatic artery, and portal vein.
According to AT Still, “The role of the artery is absolute” - when a tissue is in a situation of lesion or in tension, the structure can be treated via understanding the links so fluid flow is not obstructed.
The same tissue that connects the liver to the diaphragm (triangular, coronary, and falciform ligaments), liver to stomach (lesser omentum), IVC and hepatic portal system (coronary and Arantius ligaments), hepatic artery and the stomach (insertion of the lesser omentum on Arantius).
All of these elements are linked - disruption of one will affect all.
This may help to explain fat digestion problems of patients with hiatal hernia, with the lesser omentum being around the hepatic hilum and putting tension on the entire vascularity and hepatobiliary intake and excretion. From this point of view, a lesion of the liver, in addition to its own repercussions on its functions, will be transmitted directly to the diaphragm and/or the stomach, and therefore the lumbar spine.

The ascending lumbar vein drains the entire lumbar region and flows into the azygous and hemiazygous veins. They run under the arches of the psoas, the reinforcements of the fascia iliaca on the lumbar spine, and in front of the lumbar vertebrae.
Given the numerous insertions of the fascia iliaca, cases of it being in torsion are more frequent. The spasm of an iliopsoas muscle can cause the rotation of one of these vertebrae, narrowing the space of the arch and therefore the space of the vein. Compressing the ascending lumbar vein means reducing the nutrition to the lumbar spine via decreasing the venous return to the posterior muscles of the lumbar spine.
The muscular aponeurosis then stretches under the pressure of the blood and ends up containing pressure such that it also obliterates the arteries and arterioles, leading to pain often described in lumbago and lumbar compartment syndrome. Patients often cannot pinpoint the location of their general low back pain in these cases.
The problem can be a consequence of a torsion of the fascia iliaca, a spasm of a psoas-iliacus muscle, or a lesion of a lumbar vertebrae. As the vein is also in direct relation to the lumbar plexus, it can contribute to other pain symptoms.
Given the myriad visceral and orthopedic relationships of the fascia iliaca, the frequency of these pathologies are quite common. Quick tests can be done to evaluate if a psoas is stuck in torsion, and exercises can be prescribed to detorsion it.

Tensegrity - It is important to examine/treat the container and its contents. An example is the pelvis (the container) and its viscera (the contents). All the viscera are held and maintained by fascia tissue - the structure which is open to compressional forces has constant tension via the connective tissues linking the bones and the viscera.

In tensegrity, the structures are stabilized not by the resistance of each of their constituents, but by the distribution and the balance of the mechanical stresses in the totality of the structure. Thus, a mechanical system comprising a discontinuous set of components compressed within a continuum of strained components may be in a stable state of self-equilibrium. This means, for example, by connecting a set of bars with cables without directly contacting the bars together, we manage to form a rigid system. This approach makes it possible to articulate the tensions between them and to visualize the consequences of tissue damage on its environment. To respect this, we must consider the links between the container and its contents.