In the Sports Medicine Acupuncture Certification program, we look at the role that vertebral and sacral fixations play in patient complaints including musculoskeletal and zang fu disorders. In this blog, we will introduce the occiput and C1 fixation at the atlanto-occipital (AO) joint. A fixation at this joint can cause many patient complaints such as cervicogenic headaches, muddled or cloudy thinking, neck pain, low back pain and psoas strain.

Atlanto-Occipital Fixation

Atlanto-Occipital Fixation: A Culprit to Many Pain Patterns | SPORTSMEDICINEACUPUNCTURE.COM

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.

Module I of the SMAC Program

This blog is a taste of the content covered in Module I of the SMAC Program. The following courses are coming up soon—click below to register today before they are sold out!


About the author(s):

Brian Lau, AP, C.SMA is has been on the faculty of the Sports Medicine Acupuncture Certification since 2014, and also teaches foundation courses with AcuSport Education. Brian lives and practices in Tampa, FL where he owns and operates Ideal Balance: Center for Sports Medicine Acupuncture ( He blogs on anatomy and TCM at

Matt Callison is the president of the Sports Medicine Acupuncture Certification program. He has been combining sports medicine and traditional Chinese medicine (TCM) for over 26 years. He is the author of the Motor Point and Acupuncture Meridians Chart, the Motor Point Index, The Sports Medicine Acupuncture textbook and many articles on the combination of sports medicine and TCM.