Deconstrucion of cranial manipulation

mike · 22-11-2007, 10:42 PM

Hi,
Today I had a discussion with a colleague about cranial manipulation. My colleague told me he once read a book about cranial techniques and tried one of them on a friend. He said he got an audible pop somewhere from the cranium. My take was that it could have been the sound from the separation of occipute from C1 since the described manipulation was a traction like movement with the hands holding the cranium (i.e. a manipulation of C0/C1). My colleague on the other hand said that he could swear the sound came from the cranium and that “he knows where the C0/C1 is located and this was not aimed to target those joints”
Now, my question to you is: Do you happen to know/have any references where you could find a discussion about the accuracy of therapists detecting where the audible pop occur?
I have the following references:

"The audible pop from high-velocity thrust manipulation and outcome in individuals with low back pain.Flynn TW, Childs JD, Fritz JM.
Department of Physical Therapy, Regis University, Denver, CO 80221-1099, USA. tflynn@regis.edu"

"The audible pop is not necessary for successful spinal high-velocity thrust manipulation in individuals with low back pain.Flynn TW, Fritz JM, Wainner RS, Whitman JM.
US Army-Baylor University Graduate Program in Physical Therapy, San Houston, Texas, 78234-6138, USA. timothy.flynn@cen.amedd.army.mil"

I only have the abstracts and I don’t think they discuss the accuracy of the therapist detecting from where the audible pop is coming. Since we know that the reliability (both inter- and intra-) of most manual examination procedures is quite poor and that we can not be so specific in our treatment with manipulation (exact target one joint etc). Doesn’t it also make you wonder if the audible pop also can “fool” us and maybe occur somewhere else from where we think?
I think I have read somewhere about how sound can “travel” in the body, but now I can’t find it.

Thanks in advance if you have the time to send some thoughts regarding this.

Kindly regards

Mike

**Luke Rickards** · 23-11-2007, 12:42 AM

Mike,

Funny you should bring this up now. An great paper on this very question has just been published in the same issue as my recent paper.

Check this out.

**Diane** · 28-11-2007, 03:39 PM

I can't resist adding this. Looks like neurologists are getting into helping infants with their head shape.

Chris F · 20-10-2011, 08:44 AM

http://www.sciencebasedmedicine.org/...-in-dentistry/

Adding to the debate

22-11-2007, 10:42 PM	#1
mike Senior Member Join Date: Apr 2005 Posts: 105 Thanks: 4 Thanked 3 Times in 3 Posts	Accuracy of detecting location of audible pops Hi, Today I had a discussion with a colleague about cranial manipulation. My colleague told me he once read a book about cranial techniques and tried one of them on a friend. He said he got an audible pop somewhere from the cranium. My take was that it could have been the sound from the separation of occipute from C1 since the described manipulation was a traction like movement with the hands holding the cranium (i.e. a manipulation of C0/C1). My colleague on the other hand said that he could swear the sound came from the cranium and that “he knows where the C0/C1 is located and this was not aimed to target those joints” Now, my question to you is: Do you happen to know/have any references where you could find a discussion about the accuracy of therapists detecting where the audible pop occur? I have the following references: "The audible pop from high-velocity thrust manipulation and outcome in individuals with low back pain.Flynn TW, Childs JD, Fritz JM. Department of Physical Therapy, Regis University, Denver, CO 80221-1099, USA. tflynn@regis.edu" "The audible pop is not necessary for successful spinal high-velocity thrust manipulation in individuals with low back pain.Flynn TW, Fritz JM, Wainner RS, Whitman JM. US Army-Baylor University Graduate Program in Physical Therapy, San Houston, Texas, 78234-6138, USA. timothy.flynn@cen.amedd.army.mil" I only have the abstracts and I don’t think they discuss the accuracy of the therapist detecting from where the audible pop is coming. Since we know that the reliability (both inter- and intra-) of most manual examination procedures is quite poor and that we can not be so specific in our treatment with manipulation (exact target one joint etc). Doesn’t it also make you wonder if the audible pop also can “fool” us and maybe occur somewhere else from where we think? I think I have read somewhere about how sound can “travel” in the body, but now I can’t find it. Thanks in advance if you have the time to send some thoughts regarding this. Kindly regards Mike Last edited by mike; 23-11-2007 at 12:08 AM. Reason: more suitable titel, missleding title

23-11-2007, 12:42 AM	#2
Luke Rickards Arbiter Join Date: Oct 2004 Location: Adelaide Age: 38 Posts: 2,520 Thanks: 3 Thanked 39 Times in 17 Posts	Mike, Funny you should bring this up now. An great paper on this very question has just been published in the same issue as my recent paper. Check this out. __________________ Luke Rickards Osteopath

28-11-2007, 03:39 PM	#3
Diane Human Primate Social Groomer and Neuroelastician Join Date: Mar 2004 Location: Weyburn Sask. Posts: 19,677 Thanks: 1,491 Thanked 3,198 Times in 1,571 Posts	I can't resist adding this. Looks like neurologists are getting into helping infants with their head shape. __________________ Diane www.dermoneuromodulation.com SensibleSolutionsPhysiotherapy HumanAntiGravitySuit blog Neurotonics PT Teamblog Diane Jacobs.com (personal website) Canadian Physiotherapy Pain Science Division (Archived newsletters) Canadian Physiotherapy Association Pain Science Division Facebook page @PainPhysiosCan WCPT PhysiotherapyPainNetwork on Facebook @WCPTPTPN Neuroscience and Pain Science for Manual PTs Facebook page @dfjpt SomaSimple on Facebook @somasimple "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

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20-10-2011, 08:44 AM	#4
Chris F Junior Member Join Date: Oct 2011 Posts: 10 Thanks: 0 Thanked 0 Times in 0 Posts	http://www.sciencebasedmedicine.org/...-in-dentistry/ Adding to the debate