Figure 1. Common postures seen with an atlanto-occipital fixation (A) Lateral tilt (to the right in this image) and (B) Capital extension.
Motion of the atlanto-occipital joint is primarily in flexion and extension that allows for the forward and backward nodding of the head. A smaller motion is into lateral flexion (lateral tilt of the occiput onto the atlas) to one or other side. Figure 1 (A and B) are postures frequently seen with AO fixations.
In (A), the AO joint is offset in a lateral tilt of the occiput onto the atlas and in (B) extension motion is altered and the occiput is “stuck” into a relative position of capital extension. Both postures contain myofascial jingjin imbalances and therefore local obstruction in the channels that lead to pain and dysfunction. Assessment for this fixation is through observation, palpation of motion and through manual muscle testing. This particular fixation will create bilateral psoas weakness and is therefore one reason why this fixation can cause low back pain and hip flexor strain.
The local treatment for this region includes a specific acupuncture protocol at addressing excess and deficiency at GB 20 (suboccipital muscles) and UB 10 (semispinalis capitis) on left and right sides (see video below and be sure and subscribe to our YouTube channel). These muscles play a crucial role in the balance of the atlanto-occipital joint. In addition, other points are used to treat this condition, which include the extraordinary point combination of UB 62-SI 3. A fantastic mobilization (muscle energy) technique follows acupuncture treatment that helps to restore functional movement of the atlanto-occipital joint and balance the local tissues.
In addition to the muscles address by GB 20 and UB 10, the practitioner can expand the treatment to include other muscles which can have an affect on the balance of this joint and can contribute to the patient complaints. Additional muscles to consider are the SCM, the upper trapezius (especially the part 1 fibers which go to the external occipital protuberance) and the levator scapula muscle. The SCM and upper traps are part of several jingjin channels and include a branch off of the Urinary Bladder channel. The levator scapula is part of the Small Intestine jingjin. This is why treating UB 62 and SI 3 has a great influence on the atlanto-occipital joint.
Module One will be going into much greater detail involving the assessment and treatment of the atlanto-occipital joint fixation and the other eight fixation locations in the spine and sacrum.