Leg-length and Posture: Dr. Bryce Crowley

Upper Cervical Adjustment:
A different approach to leg-length discrepancies

By LENNARD ZINN--VeloNews and Zinn's Cycling Primer (edited for content, updates by Dr. Crowley)

Very few people generate the same pedaling power with both legs. For some, the difference is dramatic, particularly if there is a measurable difference in the length of a rider's legs. We have noted, for example, that 1984 Olympic road race gold medallist Alexi Grewal suffers from a significant leg-length discrepancy due to an injury during his teens. Prior articles we have run on correcting leg length discrepancies using cleat shims, position adjustments and/or special cranks and pedals (VeloNews, May 8,1995 and VeloNews, March 1993) triggered a steady stream of correspondence.

No one disputes that there are thousands of people walking around with leg-length differences of more than half-an-inch. The controversy usually focuses on how the discrepancy was caused and how best to deal with it. One school of thought believes that it is natural and predictable for a significant proportion of the population to have leg bones of different lengths. Thus, shoes and other sports equipment should be corrected to accommodate it. Others argue that a structure as precise as the human body, whose operation depends upon exact and repeatable reactions occurring on the scale of milliseconds, would not produce bone length discrepancies as large as half-an-inch or more, except in cases like Grewal's, where an injury was involved. They argue that corrections should be performed on the body and not the equipment.

Misaligned (or "subluxated') vertebrae can impinge on the nerves and hamper body function. Chiropractors apply force to parts of the spine with the intent of returning vertebrae to their normal positions. Forceful cracking sounds usually accompany the adjustment. The NUCCA Spinal Correction is distinct in that the adjustment is only performed on the Cl vertebra. Furthermore, the direction of the application of force to perform the adjustment is not based simply on palpation (the chiropractors "feel") but rather on detailed analysis of X-rays. From the X-rays, a three-dimensional force vector is calculated and then applied to Cl to correct its position.

To learn more about NUCCA, click here...

A misaligned atlas throws off leg length and distorts the entire body. This distortion is easily measured.  The skull and the other vertebrae rotate and tip to compensate for rotation and tip in C1. The head weighs between 8 and 14 pounds. If it is not sitting straight on top of the spine, the muscles of the body must do something to counteract this bowling ball hanging off to the side. If the muscles on one side of the spine are tighter than those on the other, then the pelvis is pulled up on that side, thus "shortening" that leg and you suffer from reduced power output in your pedal stroke.

Diagnostic Methods

The NUCCA Doctor uses a complex postural analysis to quantify body distortion. Vertical pelvic tilt, leg length inequality,  pelvic rotation in a horizontal plane, the twist of the spinal column at the shoulder level, and the amount of weight the patient carries on each foot.

Patients first lie flat on a table to have leg length differences measured.  Then a standing postural analysis is conducted.  Muscle tension in the neck is tested.

The adjustment direction is based on very unique X-rays, which the Doctor takes to ensure accuracy.  Patient position and distance to the lens is precisely set in each of the three different X-ray angles.

On a light board, lines are drawn on the X-rays through a series of bone points. The precise relative angles of Cl, the head, and the spine are measured in three planes. Once the exact misalignment of the atlas is determined, a vector direction in three dimensions is determined, precisely opposing the misalignment.

Adjustment procedure

The NUCCA Doctor applies an extremely light force directly along the determined vector direction to return the atlas to its proper position. The force must be applied with enough pressure to overcome the body's internal resistance to the adjustment without going too far.

The patient lies on his or her side on a low inclined bed with a head support. The adjustment is performed with the side of the heel of one hand on a corner of the Cl vertebra located just behind the patients ear lobe.  The NUCCA Chiropractor takes a number of measurements with the tape measure to determine where to stand and how to orient his sternum relative to the patient.  A different corrective position is used with every patient.

He clasps one hand about the wrist of the other hand, sets the heel of the lower hand on the bone and aligns his arms and the top of his sternum directly down the force vector determined from the X-ray. He does not push by straightening the arms, nor does he push by rocking his back or body forward. With either of those motions, the heel of the hand does not move along a line connecting the top of the sternum and the heel of the hand. Instead, the chiropractor locks his body in place, and the force comes from the shoulders by contracting the head of the triceps muscle. To call it subtle would be an understatement.

Patient's say that they only feel a slight touch near their earlobe.  The slight warmth of the doctor's hand against their neck without any deflection of their neck, head or body during the procedure.  When the correction is complete the body has relaxed, returned to balance and the posture is re-tested.   

I observed the procedure being performed on a number of patients, and interviewed them before and after. They were long-term patients of the Ponds (some on the order of 15-20 years; Lloyd Pond has been doing this work in Farmington, New Mexico for 40 years). Several of the leg-length discrepancies were originally around an inch. Most patients were coming in for a semi-annual or annual checkup, although one had been involved in an automobile accident three days earlier.

Afterward, the leg lengths were even, and their muscles were relaxed.  

Patients' comments

The patients reported feeling immediate relief. The reduced strain in the face of the auto accident victim was obvious.

Patients commented that while many joke about "having magic words said over them... " One woman, noted that Pond's rates have gone up from $11 a visit when she first started seeing him 20 years ago to the current $50 per visit but quickly added that she "would pay any amount for it" Patients told me of not only a reduction in the symptoms of body aches, but generally improved overall health.

Lloyd Pond claims only to correct the position of Cl, and he acknowledges that it can improve overall health by improving delivery of nerve impulses and instructions from the brain, helping the body combat disease processes. Due to Cl's close proximity to the brain stem, it simultaneously affects the brain and the entire spinal cord, and thus the entire body.

Lloyd Pond comments that his method is simply the application of physics to the human body. The adjustments can hold for years, unlike most chiropractic adjustments. After the initial series of treatments, visits are separated by many months, and Pond says if alignment is not off, "we don't touch 'em".

History

The practice of chiropractic medicine was established in 1895 by D. D. Palmer, who founded the Palmer College of Chiropractic in Davenport, Iowa. In the 1940s, the late John F. Grostic, D.C. and Ralph Gregory, D.C. developed the Grostic Technique of adjusting the atlas vertebra. The current upper cervical technique is an outgrowth of that approach. The National Upper Cervical Chiropractic Association was founded in 1966, and states, "if normal nerve supply cannot pass from the brain down through the brain stem and spinal cord, it is not logical to adjust lower vertebrae to restore nerve flow to individual nerve roots that cannot receive normal nerve supply."

When asked why less than 1 percent of chiropractors specialize in this technique, Lonnie Pond says that chiropractors are pulled in many different directions toward various chiropractic specialties, and, he added, "it is easier to crack backs than to be good at NUCCA."

John Dunn, D.C., a cyclist, and NUCCA chiropractor from Tallahassee, Florida, says that it takes a certain type of person to practice the technique. It is an exacting method and a real-life application of vector analysis, and therefore, attracts "the pocket-protractor types who drive used cars."

Dunn notes that the work-up is time consuming, the adjustment is sublime, and the follow-up visits are less frequent so there isn't much motivation for a chiropractor to pursue the approach.

"It also takes alot of nerve to tickle someone behind the ear and tell them they are going to be just fine," joked Dunn.

Dr. Bryce Crowley | 1134 West 500 North, Centerville, UT | (801) 294-6333