Ortho
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A PRACTICAL MANUAL
Ortho -
A PRACTICAL MANUAL
by Kathy L. Kain
with Jim Berns
North Atlantic Books
Berkeley, California
We would like to thank all of our teachers and students who
have accompanied us on our exploration of Ortho-Bionomy.
In particular, we want to thank Arthur Lincoln Pauls,
Founder of Ortho-Bionomy for sharing his vision with us.
Many thanks to all of you who proofread, offered sugges-
tions, corrected our errors and held our hands. Special
thanks to Vicki Pearson-Rounds and Carolyn Buck
Reynolds for letting the heart of Ortho-Bionomy express
itself in your photos and drawings.
Models: Leslie Batz, Ivy Kohler, Angela Ramos, Bill Rounds
Figure Photography: Vicki Pearson-Rounds
The information in this book is not a substitute for appro-
priate medical care. If the client has any injury, illness or
other condition that may need medical attention, that care
should be sought prior to use of any of the techniques in
this book. The authors take no responsibility for the mis-
use of any of the techniques presented here.
If you think this work is valuable enough to pass on to a
friend, please support it by asking them to purchase a
book rather than making a copy of this one. Thank you.
The Sand Dollar design, Society of Ortho-Bionomy
International® and Ortho-Bionomy™ are used by permis-
sion of the Society of Ortho-Bionomy International, Inc.
The Sand Dollar design is a registered trademark of the
Society of Ortho-Bionomy International, Inc. and cannot
be used without written permission from the Society of
Ortho-Bionomy International, Inc.
Society of Ortho-Bionomy International® is a registered
collective membership trademark of the Society of Ortho-
Bionomy International, Inc. and is used by the Society to
indicate that a person using the mark is a member of the
Society of Ortho-Bionomy International, Inc. and cannot
be used without written permission from the Society of
Ortho-Bionomy International, Inc.
Ortho-Bionomy™ is a trademark of the Society of Ortho-
Bionomy International, Inc. and cannot be used without
written permission from the Society of Ortho-Bionomy
International, Inc.
Ortho-Bionomy, A Practical Manual
Copyright © 1997 by Kathy Kain. All rights reserved.
No portion of this book, except for brief review, may be
reproduced, stored in a retrieval system, or transmitted in
any form or by any means—electronic, mechanical, photo-
copying, recording, or otherwise—without written permis-
sion of the publisher.
Published by
North Atlantic Books
P.O. Box 12327
Berkeley, California 94712
Cover Illustrations by Carolyn Buck Reynolds
Cover and book design by Nancy Koerner
Printed in the United States of America
Ortho-Bionomy, A Practical Manaul is sponsored by the
Society for the Study of Native Arts and Sciences, a non-
profit educational corporation whose goals are to develop
an educational and crosscultural perspective linking vari-
ous scientific, social, and artistic fields; to nurture a holis-
tic view of arts, sciences, humanities, and healing; and to
publish and distribute literature on the relationship of
mind, body, and nature.
1	2	3	4	5	6	7 / 00	99	98	97
Table of Contents
Preface................................................................vii
Foreword.....................7..........................................ix
Section 1:	Introduction
The Development of Ortho-Bionomy......................................3
A Few Words from the Founder..........................................5
General Introduction..................................................7
Introduction to Practice.............................................11
Section 2:	Vertebral Column & Thorax
Neck ................................................................21
Thoracic.............................................................31
Ribs.................................................................37
Lumbar ..............................................................49
Section 3:	The Pelvis
Iliopsoas............................................................61
Ilium ...............................................................69
Sacrum...............................................................77
Section 4:	The Lower Limbs
Femur................................................................85
Knee.................................................................93
Ankle................................................................103
Foot.................................................................109
Section 5:	The Upper Limbs
Shoulder.............................................................119
Scapula..............................................................131
Clavicle ............................................................135
Sternum..............................................................141
Elbow................................................................145
Wrist ...............................................................153
Hand.................................................................159
Section 6:	Post-techniques
Post-techniques .....................................................167
Course Descriptions and Training Information.................................179
Bibliography.................................................................181
Glossary ....................................................................183
Index
187
Preface
The intent of this manual is to present the Basic
(Phase 4) techniques in a way that captures the
simplicity and the essence of Ortho-Bionomy.™
As with the learning of any hands-on technique,
learning to practice Ortho-Bionomy effectively
requires not only study of written material but
direct practical experience with the techniques
themselves. We encourage students to take advan-
tage of the deeper exploration of Ortho-Bionomy
that is available with the guidance of an experi-
enced instructor and let this manual be a support
for your learning.
Foreword
In the seventeen years that I’ve been practicing
Ortho-Bionomy I’ve learned that life changes and
body changes intertwine: if our life changes, our
body will change; if our body changes our life
will change. The Phase 4 techniques of Ortho-
Bionomy provide a potent form of accessing
physical change.
I believe much of the effectiveness of Ortho-
Bionomy comes from its ability to inform us of
relationship: of oneself to oneself; oneself to envi-
ronment and oneself to others. If any of these
relationships are not working well, the body will
express this. As a metaphor for our lives, our
bodies don’t lie. Ortho-Bionomy mirrors the story
of our lives in physical or energetic forms. It acts
as a reflection for recognizing life patterns that
don’t work or that create pain. If we cannot move
our arm, we may adjust to this restriction so effec-
tively that we stop noticing it. Ortho-Bionomy
helps bring the noticing back. We may have so
much pain that we forget how to pay attention to
comfort. Ortho-Bionomy is a way for us to notice
comfort. It gives a way to access choice and cre-
ate change that is natural, non-intrusive and self-
generated.
Ortho-Bionomy is also a form of education, but
not in the usual sense of that word. Education
implies that we are learning something we don’t
already know. The ability to find comfort and
balance is an ability that is inherent in us from
birth. If you watch small children you will see
that they have an immediate understanding of
what is comfortable and what isn’t. We slowly
subvert this understanding of harmonious func-
tion through injury, through forcing ourselves to
remain in stressful or tension producing situations
and positions. Eventually, we train ourselves not
to notice our body’s attempt to communicate its
needs. Ortho-Bionomy helps to remind us of the
availability of comfort and of change. It isn’t
teaching us something new, it’s “teaching” us
what we already know. That’s another form
of education, probably most accurately called re-
education.
The beauty is that the re-education often happens
spontaneously. It’s not a laborious process of
learning prescribed postures or positions, but
rather a spontaneous rediscovery of the form
of comfort. Through techniques like Ortho-
Bionomy we can learn again to be ourselves —
in comfort.
Kathy L. Kain
Berkeley, 1997
ix
Section 1
INTRODUCTION
The Development of Ortho-Bionomy
The history of the development of Ortho-Bionomy
gives some important clues to its current practice.
Ortho-Bionomy, as it came to be called, started
with the coming together of two apparently dis-
parate arts: osteopathy and Judo. The background
of osteopathy gives Ortho-Bionomy a strong
grounding in the understanding of the physical
structure. Through Judo comes the understanding
that the greatest strength and fluidity come from
moving WITH our partner, not against him.
Combined, these two elements provide a potent
tool for bringing about change in our bodies.
The founder of Ortho-Bionomy, Dr. Arthur
Lincoln Pauls, was a Judo instructor in England
when he was exposed to osteopathy from the
patient’s point of view. “It did me a lot of good.
But then I realized there was no real lasting com-
fort to it because I just went back the next week
and injured the same parts I’d worked on the
week before.” Eventually, Pauls went on to study
osteopathy himself, and brought with him this
curiosity about how the structure could be
“repaired” while the understanding of the change
necessary to keep it in good repair could be miss-
ing. “I came to understand that the real osteopa-
thy is when the practitioner nurtures the parts of
the body back to where they belong so they func-
tion better and the client has an understanding
of that improved function.”
But Pauls still hadn’t figured out how to do that
kind of nurturing in a way that was consistent
with his understanding of movement from Judo.
The missing piece was provided by the work of
Lawrence Jones, D.O., an American Osteopath.
A substitute instructor in one of Pauls’ osteopathy
courses provided the introduction: “He showed
us, and demonstrated on some of us, this new
thing called Spontaneous Release by Positioning
by Jones (reprinted in the Journal of Osteopathy
from The D.O. of January 1964). I was very
impressed by this demonstration. I had a copy
of Jones’ article made and I started using these
techniques with my clients and realized that this
was what I wanted to do.”
The article presented Dr. Jones’ experience, over
the course of 10 years, of correcting osteopathic
lesions (usually described as “abnormal” place-
ment of the bones within a joint) by placing
patients in positions of comfort, rather than per-
forming a manipulation. Strangely enough, Dr.
Jones had discovered, the comfortable position
almost invariably was an exaggeration of the
“abnormal bony relationship found upon exami-
nation.” In other words, an exaggeration of an
eccentric posture. Aha! Here was something that
made sense to the Judo instructor: you move
WITH the body, not against it. It also made sense
in Pauls’ patient experience; the patient needs to
come to a physical understanding of how the
imbalance occurred in order to avoid future return
to old patterns of injury or misuse. By letting the
body find its own balance without force, inherent
re-education was possible.
At this point, Pauls’ own exploration took over.
Combining his Judo experience, his osteopathic
training, his knowledge of various systems such as
homeopathy, and the simple approach outlined in
Jones’ article, Pauls began to evolve a system that
eventually became Ortho-Bionomy. Through the
twenty-two years of development since that initial
introduction to Jones’ work, Pauls came to include
much understanding about the emotional and
energetic implications of structural imbalance. The
following is a brief introduction to his philosophy.
3
A Few Words from the Founder
The root words of Ortho-Bionomy can be broken
down as follows: “Ortho” means straight or cor-
rect; “bio” means life; “nomy” means pertaining to
laws. So the term Ortho-Bionomy can be defined
as the “correct application of the laws of life.” It is
just a word used to define the philosophy behind
the work we do called Ortho-Bionomy. That work
is really about understanding your whole life cycle.
Naturally, we focus on the structure because that
is the literal skeleton upon which our life is built.
When your structure works right, your circulation
works better, you feel better, you think better.
The body is very limited. It requires great disci-
pline to stay alive in a human body without hav-
ing it injured in one way or another. If you don’t
stay within its limitations you end up hurting it
very badly. Staying within healthy bounds takes
learning about space and time. We occupy space
in the universe. If we don’t respect that space, then
we’re going to get in our own way and in other
people’s way; this is called an accident. If we hap-
pen to be in a car when we get in someone else’s
way, this is called a car accident. We’re in the
wrong place at the right time, or the right place
at the wrong time. I believe that accidents are an
emotional expression of how we feel about life,
how we feel about ourselves, how we love our-
selves and those around us. An accident is also a
physical expression of our misunderstanding of
our place in time and space.
I believe we are all born with great understanding.
We are all born equal, with equal opportunity to
understand ourselves and our place in the greater
scheme of things. Misunderstanding, I believe, is
literally missing the understanding that we were
born with. The understanding is still there, we
just have to learn to recognize it by dropping the
“miss” — it’s not something you add, it’s some-
thing you take away. If there’s trouble in a partic-
ular part of the body, it’s not the body part that’s
the problem. It’s the person, being out of harmo-
ny, who is the problem.
In Ortho-Bionomy, we help a person to recognize
the state of their own limitations. We show the
body, through physical and energetic patterns,
how to understand its own functioning. Then we
help the person to re-discover how to keep their
body functioning in a harmonious way. The per-
son must come to the point where they realize that
only THEY are responsible for keeping themselves
healthy. As practitioners, our job is not to make
perfect bodies. There are no perfect bodies. We’re
here to help people to find a better working
arrangement with their structure. Most people
aren’t interested in great health, they are interested
in functioning well enough to use their body, mind
and heart for what they feel good about.
If we want to change, we can begin with our phys-
ical structure and move on from there. Our bodies
are capable of correcting themselves, but we must
be given the motive to discover how to make the
change. Unless there is some level of recognition
of the problem, and then a motive for correcting
it, there will be no action. Like the vicious circle:
headaches cause tension; tension causes head-
aches, we become repeatedly emotionally re-
involved in our involvements (stuck patterns)
until they become evolvements. In other words,
if we get stuck in a pattern (emotional or physi-
cal), we generally repeat it until something hap-
pens to break the pattern. It becomes a tight circle
with no exit, no beginning, no end.
5
Ortho-Bionomy
If we want to move onward, we must break the
circle. We must evolve past the stuck pattern. Part
of our job, then, in Ortho-Bionomy is to help the
client recognize these stuck patterns (sometimes
by repeatedly calling their attention to them
through exaggeration), and then to recognize that
they have the energy within themselves to change.
Through the principles of Ortho-Bionomy, we can
help the client to find their own motive, their own
way out of the cycle of their stuck patterns.
6
General Introduction
One of the simplest metaphors I’ve found to
explain the principles of Ortho-Bionomy is the
tent pole example: Imagine a pole being held
straight by a number of wires attached to stakes
in the ground. The tension of each wire pulling
against the other holds the pole upright and
aligned without any strain on the pole itself. Now,
a large wind comes up and whips the pole around,
causing a knot to form in one of the wires. This
shortened wire pulls the pole out of balance. If we
push the pole upright we may approximate align-
ment by stretching the tightened wire. But there’s
an easier way of returning the pole to its true bal-
anced position. Pull the pole in the direction of the
tightened wire, use the slack created to loosen the
knot, and let the existing tension in the remaining
wires pull the pole back into its original position.
We use this same principle in Ortho-Bionomy. If a
muscle is contracted, perhaps even to the point of
creating an imbalance of the bones within a joint,
we position the body in such a way as to contract
the muscle a little further. This positioning does
a few things at the same time. First, it takes the
strain off of the contracted muscle by allowing it
to complete the motion of contracting, much the
same as the wires in the example above. This in
turn sets off a reflexive response within the body
to begin adjusting the position of the opposing
muscles to accommodate this change in muscle
length. As with the tent pole and it’s supporting
wires, this muscular rebalancing alone is some-
times enough for the body to return to a state of
balance. But there is an additional neurological
response that happens in conjunction with this
muscular response.
This neurological response happens through the
proprioceptive reflexes. Proprioceptive nerves are
the nerves, usually clustered in and around the
joints, that give us information about body posi-
tion and rate of movement. (Proprioception - per-
ception of oneself.) If you’ve ever had the experi-
ence of sitting or lying still for a period of time,
and then noticing that you can’t feel the position
of your arms or legs, you’ve had a direct experi-
ence of the function of proprioceptors. These
nerve endings are stimulated by movement, specif-
ically by movement of a joint. You can anesthetize
all the soft tissue surrounding a joint, and by mov-
ing the joint you can still get the information nec-
essary to know where that part of the body is in
relation to the rest of your body, and how quickly
that part of your body is moving.
Spraining the ankle is the classic example of insuf-
ficient proprioceptor communication. As you take
a step, and overextend the ankle, the propriocep-
tors send the neurological equivalent of “alert,
alert, you’re about to hurt yourself!” If that mes-
sage doesn’t get through quickly enough for you
to recover your equilibrium, you don’t have time
to reposition your weight to prevent injury to the
joint. When you injure a joint in this way, you
often injure the proprioceptive nerve endings
within and around the joint, limiting their ability
to respond in similar situations in the future. This
is one of the reasons that injuries tend to reoccur
in the same joints. Their communication links are
slightly damaged in an initial injury, increasing the
likelihood that warning information will not be
received in time to change joint position or rate
of movement in order to save further injury.
In Ortho-Bionomy, we use this proprioceptive
communication system as a way of communicat-
ing with the body through direct neurological
information. Moving the affected joint stimulates
the proprioceptors, effectively sending the signal:
“hey, pay attention here.” Once a release position
7
Ortho-Bionomy
is found, compression (pushing gently into the
joint) is usually applied. Compression is another
way the proprioceptors are stimulated, so an even
clearer message is sent: “Hey, notice THIS.” Now
we have combined muscular and neurological
information available to the body about how the
body is experiencing itself at this moment. In
Ortho-Bionomy, the focus is on finding a release
position that creates comfort, so that the body
notices how to be comfortable. Once the body is
comfortable, it relaxes. When it relaxes, as with
the wires in the tent pole example, the natural,
inherent harmony of the physical structure can
reassert itself.
It would be lovely if it were all exactly that sim-
ple, and sometimes it is. But the reality is that
most of us have physical and energetic patterns
of holding that interfere with our inherent ability
to find alignment. These patterns can develop
through injury, stress, misuse or any number of
other causes. Let’s look at one of the physical limi-
tations that complicates the process of restoring
balance to joints. This first requires a little expla-
nation of some basic physiology.
Every joint has two ranges of movement: physio-
logical and anatomical. The physiological range is
the available range of movement of a joint which
can be performed without outside assistance. If
you bend your finger down toward the palm of
your hand, your physiological range extends to
the limit of this movement. But there is a small
additional range of movement available with the
application of outside pressure or force. Notice
that you can slightly flex your finger a little fur-
ther toward the palm by gently pushing on it. This
additional limit of movement is called the anatom-
ical range. It is the absolute limit of movement
available to the joint before it is dislocated. This
additional “cushion” of movement acts as a nat-
ural shock absorber. It allows you to sustain a
mild overextension of the joint without injury.
The distance between the physiological and
anatomical range can be increased through injury
or other restriction to available joint movement.
Let’s say you can only move your finger 10 degrees
toward the palm of your hand. Even though this
is not the usual physiological range, it is now your
own individual physiological range for that finger.
So the distance between your physiological range
and your anatomical range for that finger is quite
large and movement within that distance is un-
available to you from the inside. However, from
the outside, the practitioner may be able to move
the joint within that restricted range, finding ways
to access movement. This in turn gives access to
the possibility of altering the restriction.
Another way that patterns of holding can keep
us from moving back to alignment on our own is
repeated stress or injury that creates compensat-
ing patterns. If we spend many years using incor-
rect posture, repeating movements that are
stressful to the body and generally subjecting
ourselves to the wear and tear of daily life, we
create stress patterns that bring the body to the
edge of its limits of accommodating any excess
strain. Then one day we bend over to pick up
that box which is just a little bit too heavy and
ARGH! I call this the Myth of All-of-a-Sudden.
“I’ve had no problems with my back before, then
all of a sudden it just went out on me.” This “all
of a sudden” type of injury is not a simple case
of letting the muscles relax from the strain of lift-
ing the box. There are probably numerous
underlying imbalances in the muscles of the
back, the structure of the pelvis, perhaps the
bones of the spine or ribcage. The immediate
pain of the back may be eliminated rather quick-
ly, but the underlying imbalances will still be
there. Sometimes it’s like unravelling a snarled
ball of twine: you follow the red string, only to
discover that you have to unknot the blue string
before you can free the red one.
8
Introduction
The unravelling process in itself provides an
important element of re-education. Contained
within patterns of holding and tension is the
information the body needs about how to return
to balance. By unravelling the strands of our
intertwined patterns we often come to new
understanding about how to return to balance
spontaneously, without outside assistance. I often
use the analogy of driving someone around in a
car, explaining the landmarks about how to get
to the final destination: turn right at that big tree,
go straight six miles. In Ortho-Bionomy, the body
provides the guidance for what it needs to redis-
cover balance and comfort. The map of the jour-
ney is created in the very process of releasing held
patterns.
As we come to greater understanding of how the
body responds to stress and tension, and develop
more flexibility and relaxation, we are better able
to respond appropriately to future stressors. We
also tend to start noticing earlier in the process
when we are overstepping our limits or when we
are using our bodies incorrectly. As happens at the
specific muscular and joint level, the body as a
whole has more information available about how
it is experiencing itself. The changes in the whole
body affect change at the muscular and joint level
and so on in a continuously linked cycle of change
and self-discovery.
Kathy L. Kain
9
Introduction to Practice
Procedures — Introduction
In order not to burden the main text with repeti-
tions of the procedures which will be the same
from section to section, we have summarized them
in this introduction to practice. Here you will find
such information as the specific indicators to look
for that tell you that a particular part of the body
needs attention, how to fine tune release positions
and how to re-check the original indicators of
imbalance. In this section we also present infor-
mation on the general practice of Ortho-Bionomy
such as taking a client history and how to know
when your work is complete. This section is for-
matted as a walk-through of a session, beginning
with the taking of the initial client history, then
outlining the process of determining where and
how to work, and ending with suggestions for
bringing the session to a close. Those of you who
are just beginning in Ortho-Bionomy may find the
general information to be more than you need at
the moment. Feel free to skip forward in this sec-
tion to the specific information that you need, but
please don’t skip this section altogether because
the text is written on the assumption that you
have read the summarized information. As you
progress in your training, you can come back to
this section as is appropriate.
Before You Begin
There are certain responsibilities you have when
you work with the public. One of the first is to
ensure your client’s safety. The techniques present-
ed in this manual are not intended to replace or
precede appropriate medical attention. If a client
has a problem that you suspect might be serious
enough to need medical attention, have that per-
son check with his or her medical practitioner
first, or take the time to check with the medical
practitioner yourself. In other words, use your
common sense if you don’t have experience with
the presenting problem, or with the client’s other
health problems which might affect your work.
Educate yourself enough to know what is a threat-
ening problem and what can be safely worked
with. We recommend that you develop an ongoing
working relationship with a physician or other
medically-trained health practitioner who is will-
ing to consult with you about your clients.
Taking a Client History
Taking a client history (also called an intake inter-
view in some professions) gives you access to the
information you will need both to ensure your
client’s safety and to make a preliminary plan for
your initial session. Some practitioners perform a
very thorough interview which includes a detailed
history of accidents, injuries, illnesses and so on.
Others ask just the limited number of questions
necessary to establish the starting point and the
immediate history of the problem. In either case,
it’s best to know in advance what you will need to
know from the client in order to feel comfortable
with proceeding into the session.
Eventually you will develop your own form of his-
tory taking that fits with your style of working. At
minimum, you will usually need to know what the
client’s presenting problem is and its immediate his-
tory. It is also wise to ask if there are any current
injuries or medical problems that you need to know
about before proceeding.
The information the client gives you as part of
the history taking interview will also help you
organize the session so you can allow enough time
to work with each area that needs attention. You
may also find it helpful to establish certain com-
munication guidelines with the client. For exam-
ple, many people are used to receiving work that
11
Ortho-Bionomy
is uncomfortable. You may need to state quite
clearly, and emphasize during the session, that the
client should let you know immediately if any-
thing you are doing is uncomfortable.
Beginning
Knowing Where to Start
After you’ve gathered the basic information about
the client’s condition, you will need to determine
where to begin working. In a general sense, this
means you will need to decide which part of the
body to start with. Then, specifically, you will
need to decide where to begin within that particu-
lar area.
There are various ways to determine where to
work. The first is to gather information from the
client as to where they experience discomfort,
restricted movement and so on. This you will have
done in the history taking discussion, or as part of
the ongoing discussion during the session as you
work. The client’s information is likely to have
narrowed down the choices somewhat. Perhaps the
client complains of a stiff neck, discomfort in her
shoulders and pain in her lower back. You will
probably begin with one of those areas. At a prac-
tical level, the client may not be able to lie com-
fortably on her stomach until her neck is less stiff,
so you may have to start there, at least with some
general releases.
In the beginning, you may want to develop your
own pattern of working (say, beginning at the top
of the body and moving down) until you feel more
certain of how to choose among the various
options presented by the client, and by your own
observations.
Often, in spite of the information the client may
give you in the history taking interview or as you
work, you will need to rely on your own observa-
tions to tell you where to begin, both in a general
area and specific points within that area. Over
time, your proficiency at observing subtle indica-
tors and at “reading” the client’s non-verbal cues
will increase. In the beginning, you are likely to
observe only the larger signals (like the client not
being able to lift her arm above her head).
Experience is the best teacher of observation and
palpation skills. As a start, the following is a basic
list of some of the signs to take note of as you
decide where to work.
General Indicators
•	Notice the way the client is lying on the table.
Is he lying with his body in a slight curve; with
his head turned slightly to one side; with one or
both of his legs rolled externally; without letting
his back rest flat on the table? (What might
these signals mean? Perhaps his psoas muscle
is contracted, pulling his body into a curve;
perhaps his neck is tight on one side; perhaps
his femurs are rotated externally; maybe his
lumbar spine is tight.)
•	Are there any areas that just seem to get your
attention: they aren’t as relaxed as the surround-
ing area; the client’s breath is restricted in that
area; the skin looks different than surrounding
areas; the muscles look contracted or tight.
• You may want to gently check the range of
motion of the joint you will be working with,
or just gently move the general area. Notice
whether there is restriction in the movement,
or discomfort during the movement. Take note
of any strong preferences of movement in one
direction or another (pay attention not only to
how far the joint moves but also how comfort-
ably it moves).
Specific Indicators
Once you’ve decided on the general area you will
be working with (e.g., the shoulder or the neck),
you will still need to decide where, specifically, to
work in that area.
12
Introduction
•	You may check specific joint movements. For
example, you may have checked the general
movement of the shoulder. Now you may want
to specifically check the movement of each joint
within the shoulder and whether or not the
client is uncomfortable with any of the specific
movements.
•	You may feel (palpate) the soft tissue in that
specific area. When palpating, use the pads
of your fingers, not your thumb, so you don’t
press too hard or too specifically. Palpate only
as firmly as is needed to gather information,
and do your best not to create discomfort.
Gently feel the condition of the tissue in the
affected area and notice if there is discomfort;
if there are knots in the tissue; if the muscle is
overstretched or tight; if the connective tissue
is rigid and so on. In each area worked, make
sure your palpation covers the entire area of
the joint. For example, in the neck you will not
only palpate directly on the side of the neck
over the transverse processes, but also along the
entire back surface of the neck. In the shoulder
you will check the entire front, top and back of
the shoulder in addition to the specific shoulder
joint.
•	You don’t always have to focus on pain as an
indicator. You may focus on movement or lack
of movement, or sensation versus reduced sen-
sation. You may find that a specific area simply
attracts your attention. Many practitioners who
work with clients who have chronic problems
have learned to focus on pain as a secondary
indicator of problems. Often a client with
chronic problems is very much past the point
where pain is relevant — she is in the numb
stage. Pain happened years ago. Pain informa-
tion is no longer neurologically available
because after a certain amount of time of send-
ing indications of pain the nerve endings simply
stop firing. This is a survival mechanism that
allows the organism to continue to function.
Until those nerve endings are reawakened, the
client will have no sensation of pain, even in
an area of her body which is in tremendous dis-
tress. So asking her if something is comfortable
or uncomfortable is an irrelevant question.
With clients like this, you will likely need to
focus on available joint movement and the
quality of the soft tissue in the area. Take the
affected joint through its available range of
motion as mentioned in the General Indicators
section. Any restricted area then becomes your
focus for release work. In the soft tissue, any
signs of tension such as knots or overstretched
muscles will be your focus of work, regardless
of whether or not the client experiences dis-
comfort there.
Indicator Points
Any specific area of discomfort or tension can be
used as an “indicator point.” This point, when
monitored during a release position, allows the
practitioner to feel any changes that happen as
a result of that position. It also gives the client a
focus for the position and allows for feedback
about any change in the level of sensitivity or ten-
sion. Maintaining contact with the indicator point
during the release work allows you to monitor the
possible positions for release to tell which gives the
most change at the indicator point. Keeping con-
tact with the indicator point also ensures that you
stay on the same point as you move the client, in
turn guaranteeing that you know if the point
released or not. Remember, however, that it is the
release position that catalyzes the release, not the
indicator point. You don’t need to press or mas-
sage the indicator point. Once you know that the
indicator point is tight or sensitive, you don’t need
to keep pressing on the point. Maintain a gentle
contact with the point, only as deep as is needed
to notice changes during the release position.
13
Ortho-Bionomy
Working
Once you’ve decided which specific area to work
with, you may then experiment with different
release positions until you find the most effective
one. You don’t need to know the release position
in advance, you can discover it by following the
client’s lead. Literally, you could do a pretty effec-
tive session by simply presenting options of posi-
tions and asking: “which do you prefer, this or
that?” and following the most preferred positions
until you get the best one. Then repeat for the
entire area. It would be tedious for the client, but
would probably work very well to release the area.
The client can communicate his preferences directly
or you can gather the information by observing
how his body responds to the release positions:
which positions are resisted and which are accept-
ed; which positions allow the most movement and
breath; which positions encourage the client’s entire
body to relax and so on.
As mentioned previously, some clients can’t tell
what’s comfortable. In this case, find the move-
ments which are easiest. As discussed previously,
it is common to find that the position of release is
one which exaggerates the eccentric posture, or
exaggerates the current imbalance. Notice which
movements the joint with which you’re working
prefers and do more of that movement.
If you can’t remember a specific technique for the
area with which you’re working, there are a few
general rules of thumb that will probably get you
close to a workable release position:
•	If there’s pain in a specific point or a general
area, find a position that lessens or eliminates
the pain.
•	Make a curve around the sensitive area. For
example, for tightness or sensitivity on the right
side of the neck, you will probably curve the
neck around to the right. For sensitivity on the
front of the shoulder, you will probably curve
the arm around to the front of the shoulder and
chest.
This principle usually works because contrac-
tion of one set of muscles will usually curve the
surrounding area around that contraction. So
making a curve around a tight or sensitive area
will often be an exaggeration of an existing
contraction.
•	If you find a muscle that’s contracted (i.e., short-
ened), find a position that shortens it further.
•	Remember that rigidity (all muscles of the joint
contracted at the same time) also has a position
of exaggeration: compression. There is little or
no movement within an area so you exaggerate
that lack of movement by compressing or
shortening all the muscles at the same time. As
the area begins to open and movement becomes
available, then you can follow any expressed
preference.
Getting the “Right” Release Position
How do you know when you’ve got the best
release position for the specific area with which
you’re working?
•	The tissue in the indicator point that you’re
monitoring may soften and relax.
•	The client will often feel more comfortable in the
release position than in the neutral position.
•	You may feel more comfortable in your own
body.
•	There may be a pulsation in the indicator point.
•	Knots in the tissue may “dissolve.”
•	There may be changes in skin color.
•	Breathing may change (usually a deepening of
the breathe or a sigh).
•	Skin or body temperature may change.
14
Introduction
•	The affected area “sinks” deeper into the
release position.
•	The client’s overall body comfort and relax-
ation increases.
•	There is an increased liveliness in the tissues.
Fine Tuning
In the text you will find instructions to “fine tune
the position.” This means that you may have found
a reasonably effective release position, but you
want to make sure it’s the best one. Try small varia-
tions in the position: try a slightly different angle;
more or less compression; more or less rotation and
so on, and keep choosing the best of the various
options. Keep this up until there is no other posi-
tion that feels better than the one you’ve got, and
then stay in that position for 10-60 seconds.
Compression
In Ortho-Bionomy, we usually use compression
as part of the release position. However, traction
(pulling slightly on the affected joint) may some-
times feel better for the client. If the client resists
compression, you may be pushing too firmly.
Lighten up on the pressure. If she still resists the
compression, try gently pulling. The line of com-
pression is usually toward the indicator point or
into the joint.
Using Your Own Body Correctly
Be aware of how you use your own body. Comfort
and presence within yourself will be communicated
in your touch. Relaxation on your part will allow
more sensitivity to perceiving what’s happening
with your client. Once you get the client into a
comfortable release position, take a moment to
check in with your own body and ensure that you
are also comfortable. If you hold yourself in ten-
sion, you are communicating to the client that it’s
okay to make yourself uncomfortable.
Ortho-Bionomy uses more lifting than massage
and many other bodywork techniques. This makes
it important to protect your own back as you
work. As much as possible, keep your spine
straight as you lift and take the client’s weight
down through your pelvis and legs rather than in
your arms and back. This takes a little practice to
get used to, but it actually makes lifting easier and
will save injury to your back.
Holding the Release Position
Once you’ve found the best release position, you
will usually hold that position for 10-60 seconds,
or until the release indicators that you are moni-
toring signal that the release is completing.
Generally, you want to hold the position long
enough for the body to come to a level of stability
in the releasing process. For example, if you are
noticing a pulsation in an indicator point, you
probably don’t want to move out of the release
position while the pulsation is increasing in
strength. Once the pulsation has levelled off and
become regular, it’s probably fine to move out of
the release position. You don’t need to hold the
position until the pulsation diminishes entirely,
just until it has crested past its full momentum.
Re-checking
In the text, you will find references to re-checking
the indicators. This means you will go back to
your original indicators of imbalance or tension
and check to see if they’ve changed. If you were
using a specific indicator point, is it still sensitive
or contracted? If you were using the restriction in
movement in a joint as your indicator, has that
restriction lessened? If you re-check the indicators
and find that they haven’t changed, or have only
partially improved, you may need to keep finding
variations on the release positions. It is possible
that tension in surrounding areas may keep the
area that you’re working with from releasing com-
pletely. If you’ve tried a few release positions for a
specific area and find no change in the indicators,
go on to work with adjoining areas and come
back to the original area later.
15
Ortho-Bionomy
Once the indicators have all improved to the point
where there is no discomfort or restriction in the
area (or as much improvement as seems available
for the moment), you may move on to the next
area, or finish up.
Finishing
How to Know When You’re Finished
The finishing of the work process is almost a mir-
ror image of the beginning to work process. Rather
than checking indicator points, tissue condition and
joint movement as a way of figuring out where to
begin, you will check these same indicators as a
way to determine if your work is finished. In a spe-
cific area, are all the indicator points soft, relaxed
and comfortable? If not, there’s probably more
work to do. Are the muscles and other soft tissues
in the areas with which you’ve been working re-
laxed and comfortable when you palpate the area?
Has the range of motion within specific joints, or
in the combination of joints that you worked with
improved?
Sometimes there’s more work to be done, but
the client has simply had enough. There’s been
enough physical, energetic and emotional input
for today. If you persist in working at this stage,
you may begin to overload the client’s ability to
respond, undoing some of the work you’ve just
done together.
How will you know if this is happening?
•	Areas that released earlier in the session start
tightening again.
•	You no longer get responses from the areas
you’re working with: no change in indicator
points even when the release position other-
wise seems ideal; no change in muscle tone
after the release position, etc.
•	The client begins to over-respond to release
positions: muscles spasm as you move into a
position; the release position produces a burn-
ing sensation in the indicator point, etc.
•	An area that was feeling comfortable begins to
ache again.
•	The client “disappears” energetically, or there
seems to be no further invitation to work.
•	The area with which you are working comes to
a stable resting place that seems fairly complete.
Generally, if the client starts cycling back towards
discomfort after an area has released well, that’s
an indication to stop working on that area, or per-
haps stop working altogether. If you find yourself
wondering if the client has had enough work, he
probably has.
Integrating
After you’ve finished work in a specific area, you
will want to make sure that the changes that have
taken place are integrated with the current bal-
ance in the rest of the body. The easiest way to
do this kind of integrating is to make some gentle
movements within the area with which you’ve just
worked and slowly extend that movement into
surrounding areas.
For example, if you’ve done a lot of work with
the pelvis you might want to gently rock the pelvis
back and forth and then extend that rocking
motion up into the spine and down into the legs.
Some practitioners make it a practice to do some
movement or rocking with each part of the body
as a way to bring the session to completion.
This integrating time also includes the internal inte-
gration the client might need to do. Leaving a little
extra time at the end of the session to let the client
rest quietly can provide her with the time she needs
16
Introduction
to check in from the inside and notice how things
have changed. Some practitioners encourage their
clients to do a little moving or stretching at this
point to bring specific attention to areas where
change may have occurred.
Talking About the Session
Just as the taking of the client’s history at the
beginning of the session helps determine what
work will be done, discussing the session at the
end may help clarify what was accomplished dur-
ing the session. As with the history taking inter-
view, there are a wide variety of ways to bring the
session to a close.
Some practitioners prefer to keep the talking to
a minimum and gather only enough information
to know if their work was effective, that there is
nothing else that needs doing for the day and to
make arrangements for follow up appointments, if
any. Other practitioners perform a fairly thorough
assessment after the session, taking note of changes
in each area and finding out from the client how
each area feels and what may need additional
work in the future. From that information, a plan
for subsequent sessions may be worked out, client
home exercises given and future session dates
arranged.
As with the history taking interview, you will
eventually develop your own style for bringing the
session to a close. At minimum, we recommend
that you make sure that the client is clear and
alert enough to be safe to drive or return to work.
Taking Notes
Most Ortho-Bionomy practitioners maintain some
kind of client files. As with the history taking inter-
view and discussion after the session, there is a
wide range for how these records are kept. Many
practitioners keep note cards or file folders for
each client, with brief notes as to the dates of ses-
sions and what was done in each of those sessions.
Other practitioners keep extensive files with
intake interview information, detailed notes of
what was done in each session and recommenda-
tions for follow-up work or referrals to other
types of health care providers. If you are working
in a more structured environment, such as a
physical therapy clinic, those are the types of
records you will probably be required to keep. If
you are working independently or in a less struc-
tured environment, you are free to establish the
kind of note-taking process that suits your needs.
We recommend that you keep sufficient notes to
be able to determine what general work you did
with a client if, for example, a client comes back
to see you after a year or two with no contact.
17
Section 2
VERTEBRAL
COLUMN & THORAX
Neck
a
Vertebral Column & Thorax — Neck
NECK — ANATOMY
See Illustrations 2.1 and 2.2
The neck is made up of seven vertebrae, called the
cervicals, numbered one to seven from the top of
the neck down. The first and second cervicals have
forms that are different from the other vertebrae
in the rest of the spine. These two vertebrae are the
only vertebrae in the spine with no disc between
them. The first cervical, called the Atlas, rests just
below the base of the skull and has very wide trans-
verse processes. A common image associated with
the first cervical is that of Atlas holding up the
world on his shoulders and arms. The Atlas has
almost no central body to the vertebra, instead it
has a large hole at its center. The second cervical,
ANTERIOR VIEW
Illustration 2.2
called the Axis, has a finger-like projection (the
dens) that protrudes through the opening in the
Atlas. The Atlas pivots upon this axis, giving the
first and second cervicals more rotational ability
than the other five cervicals. The Atlas has a spinous
process which is smaller than that of the other cervi-
cals, which allows for more flexion and extension
than is available in the other cervicals. If you cup
your hands at the very top of your neck, including
the base of your skull, you will notice that you have
some rotation, quite a bit of lateral flexion and
almost no flexion/extension available. That’s
because the primary movements of the first two
cervicals are flexion/extension and rotation (the
“yes” and “no” movements of the head). So the
release positions for this part of the neck will usual-
ly include a combination of these two movements.
The remaining five cervicals have some
flexion/extension, rotation and lateral bending
available between each two vertebrae. If you cup
your hands around the middle of your neck, you
will notice that you still have some rotation and
quite a bit of flexion/extension available, but are
severely restricted in your side-bending. That’s
because the middle portion of the neck has lateral
flexion (side-bending, ear toward shoulder) and
23
Ortho-Bionomy
rotation as its primary movements. So the release
positions for this section of the neck will usually
include a combination of those two movements.
The sixth and seventh cervicals have thicker and
wider transverse processes than do the other cervicals.
The seventh cervical has a longer spinous process,
which shows as a lump at the base of your neck when
you drop your head toward your chest.
The accumulated movement of the individual ver-
tebrae gives the neck great flexibility. However, it
also makes the neck vulnerable to injury because
it hasn’t the built-in stability given the thoracic
spine by its attachment to the ribcage or the lum-
bar spine by the size of its vertebrae.
NECK — EVALUATION
Because of the neck’s vulnerability to stress and
injury it is especially important to take an injury
history before beginning to work. DO NOT
WORK ON SOMEONE’S NECK IF THERE IS A
POTENTIALLY DANGEROUS INJURY THAT
HAS NOT BEEN CHECKED BY A MEDICAL
PRACTITIONER. The neck is also one of the
areas of the body that is often quite strongly
guarded. As you work, make sure you support
your client’s head gently and securely, without
squeezing and without pulling his hair. MOVE
SLOWLY. Abrupt or fast movements of the head
may cause your client to tighten and hold his neck.
General Evaluation / Release
If the client’s neck is comfortable enough to allow
movement, you may begin with a simple evalua-
tion of his neck’s range of motion and with gener-
al release positions. If the client has relatively
minor discomfort and restriction in the movement
of his neck, sometimes general release positions
are sufficient to bring relief from discomfort and
increased ease of movement.
1.	Gently, and without forcing, rotate the client’s
head to the left and to the right. Notice if there
is greater movement or more ease of movement
to one side or the other. Move the client’s head
into whichever position is most comfortable.
Compress down the line of the spine. Hold for
10-60 seconds. Return the head to the neutral
position and recheck the movement.
2.	Gently flex the client’s head up toward his
chest. See Figure 2.1. Then bring his head
back down to the table and gently extend his
chin up toward the ceiling, giving an arch to
the back of the neck. See Figure 2.2. Notice
if there is greater movement or more ease of
movement into flexion or extension, and
move the client into whichever is most com-
fortable. Hold for 10-60 seconds. Return the
head to the neutral position and re-check the
movement.
Figure 2.1
24
Vertebral Column & Thorax — Neck

3.	Gently laterally flex the neck by bringing the
client’s ear toward his shoulder. This is usually
done most comfortably by including some
rotation of the head in the movement. Notice
if there is greater movement, or ease of move-
ment to one side or the other. Move the client’s
head into whichever position is most comfort-
able. Compress down the line of the spine. Hold
for 10-60 seconds. Return the head to the neu-
tral position and re-check the movement.
Neck — Specific Evaluation
If the client is uncomfortable during the general
movements, or he has more complex tension pat-
terns, you may need to begin with more specific
release techniques.
For release purposes, the neck is divided into three
general areas: upper, middle, lower. The upper
neck consists of the first two cervical vertebrae
(Cl-2). The middle neck consists of the next three
cervicals (C3-5). The lower neck consists of the
last two cervicals (C6-7), and sometimes the
uppermost thoracics (Tl-2). These divisions will
vary slightly from client to client, but are present-
ed here as general guidelines for deciding which
release positions to use.
Generally, you will release the middle neck first,
then the lower neck and finally the upper neck.
This order is used simply because the middle and
lower areas of the neck are usually a little easier to
work with, but you may find that a different order
works better for your particular style of working
or for certain clients. Experiment with different
combinations and use whichever works best for
you. (See “Notes” at the end of the neck section
for additional information on choosing positions.)
Usually, you need only perform release positions
for those areas of the neck where you find tension,
discomfort or restriction.
For each area of the neck, gently contact the specif-
ic point or points with which you are working. You
may use a single finger (usually the middle finger
is most sensitive), or two/three fingers to contact
lightly enough that you are not causing any discom-
fort. Remember that it is the position that facilitates
the release, not pressure on the indicator point.
Keep your contact at the side or back of the neck
so you don’t impinge on breathing or blood flow
in the neck. See Figure 2.3.
Figure 2.3
1. Using the pads of your fingers, not your thumbs,
gently palpate the client’s neck for specific
areas of tension or discomfort. See Figure 2.3.
Include the muscles both along the side and
back of his neck. Notice if there is any discom-
fort in any of the areas you are contacting. Any
area of sensitivity, contraction, or restricted
movement may be used as an “indicator point”
for a release position. Other things to notice
include knots, stiffness or a stringy feel in the
tissues, swelling or lack of tone in the muscles.
2. Contact the vertebrae themselves, at the trans-
verse processes on each side, and gently *-ock
them from side to side. Notice if there is any
discomfort or restriction in the movement of
the bones.
25
Introduction
•	You may check specific joint movements. For
example, you may have checked the general
movement of the shoulder. Now you may want
to specifically check the movement of each joint
within the shoulder and whether or not the
client is uncomfortable with any of the specific
movements.
•	You may feel (palpate) the soft tissue in that
specific area. When palpating, use the pads
of your fingers, not your thumb, so you don’t
press too hard or too specifically. Palpate only
as firmly as is needed to gather information,
and do your best not to create discomfort.
Gently feel the condition of the tissue in the
affected area and notice if there is discomfort;
if there are knots in the tissue; if the muscle is
overstretched or tight; if the connective tissue
is rigid and so on. In each area worked, make
sure your palpation covers the entire area of
the joint. For example, in the neck you will not
only palpate directly on the side of the neck
over the transverse processes, but also along the
entire back surface of the neck. In the shoulder
you will check the entire front, top and back of
the shoulder in addition to the specific shoulder
joint.
•	You don’t always have to focus on pain as an
indicator. You may focus on movement or lack
of movement, or sensation versus reduced sen-
sation. You may find that a specific area simply
attracts your attention. Many practitioners who
work with clients who have chronic problems
have learned to focus on pain as a secondary
indicator of problems. Often a client with
chronic problems is very much past the point
where pain is relevant — she is in the numb
stage. Pain happened years ago. Pain informa-
tion is no longer neurologically available
because after a certain amount of time of send-
ing indications of pain the nerve endings simply
stop firing. This is a survival mechanism that
allows the organism to continue to function.
Until those nerve endings are reawakened, the
client will have no sensation of pain, even in
an area of her body which is in tremendous dis-
tress. So asking her if something is comfortable
or uncomfortable is an irrelevant question.
With clients like this, you will likely need to
focus on available joint movement and the
quality of the soft tissue in the area. Take the
affected joint through its available range of
motion as mentioned in the General Indicators
section. Any restricted area then becomes your
focus for release work. In the soft tissue, any
signs of tension such as knots or overstretched
muscles will be your focus of work, regardless
of whether or not the client experiences dis-
comfort there.
Indicator Points
Any specific area of discomfort or tension can be
used as an “indicator point.” This point, when
monitored during a release position, allows the
practitioner to feel any changes that happen as
a result of that position. It also gives the client a
focus for the position and allows for feedback
about any change in the level of sensitivity or ten-
sion. Maintaining contact with the indicator point
during the release work allows you to monitor the
possible positions for release to tell which gives the
most change at the indicator point. Keeping con-
tact with the indicator point also ensures that you
stay on the same point as you move the client, in
turn guaranteeing that you know if the point
released or not. Remember, however, that it is the
release position that catalyzes the release, not the
indicator point. You don’t need to press or mas-
sage the indicator point. Once you know that the
indicator point is tight or sensitive, you don’t need
to keep pressing on the point. Maintain a gentle
contact with the point, only as deep as is needed
to notice changes during the release position.
13
Ortho-Bionomy
Neck — Specific Release
Middle Neck
With one hand, gently contact the specific point
or area of the client’s middle neck with which you
are working. Maintaining contact with the indica-
tor point, use your other hand to slowly rotate
and side-bend the neck around the point until
there is maximum softening of the point, and
maximum comfort for the client. Compress slight-
ly from the top of the client’s head down toward
the indicator point, or down the line of the neck.
Check with the client to ensure that you are
using a comfortable amount of compression.
See Figure 2.4.
Hold for 10-60 seconds. Return the head to its
neutral position (nose toward ceiling), pulling
gently out of the compression as you do so, and
re-check the point. Repeat for any other points in
the mid-neck that need attention.
Lower Neck
If you simply side-bend and rotate the head, most
of the curve of the position is absorbed by the
middle of the neck. This makes it difficult to get
an accurate release position in the lower neck. For
this reason, you will use a “set-up position” for
the lower neck. The purpose of this set-up posi-
tion is to focus the curve of the release position
into the lower part of the neck.
Making sure that your contact is in toward the
neck, not down toward the shoulder, gently con-
tact the specific point or area of the client’s lower
neck with which you are working. With the other
hand, gently rotate the client’s head away from
the point, (i.e., if working with a point on the left
side of the neck, rotate the head to the right). Do
not force the movement, but simply let the head
roll to the side opposite the point. This is your
set-up position. See Figure 2.5.
Figure 2.4
Figure 2.5
26
Vertebral Column & Thorax — Neck
Maintaining contact with the indicator point, and
maintaining light compression down the line of
the neck, slowly and gently curve the client’s neck
and head back around the point (you may also
de-rotate the head slightly.) Hold in the position
that maximizes softening of the indicator point
and comfort for the client. Compress down the
line of the neck toward the point. See Figure 2.6.
Hold for 10-60 seconds. Return the client’s head
to the neutral position (nose toward ceiling),
pulling gently out of the compression as you do
so. Re-check the point. Repeat for any other areas
of the lower neck that need attention.
NOTE: The most common error students make
with this release position is to move too quickly
and too far into the position. The best release
position is most often found at the beginning of
the movement. Go slowly and pay attention to
what happens in the point.
Upper Neck
As with the lower neck, you will need to use a set-
up position for the upper neck to focus the release
position at the top of the neck.
Gently contact the specific point on the upper
neck with which you are working. With both
hands supporting the client’s head, gently lift his
head and side-shift it directly to the side away
from the point (i.e., if the point is on the left,
move the head to the right). Do not rotate or side-
bend his head. The client’s face stays in a direct
line with the front of his torso (like the side-to-
side head movement the Balinese dancers make).
You will need to support the head in this side-
shifted position because it will tend to slip back to
the neutral position. See Figure 2.7.
Usually, the nose will not move past mid-line in
this position. If the curve created in this position
moves up into the middle of the neck, you’ve gone
too far into the release position. Return the
client’s head to the neutral position and start the
release movement over.
27
Ortho-Bionomy
If possible, maintain contact with the indicator
point while you move into the release position.
From the side-shifted position, gently curve the
client’s neck and head around the point by rotat-
ing, side-bending and extending the head. You
may need to practice making each of these move-
ments separately at first. Eventually it should be
one fluid movement. See Figure 2.8.
Compress down the line of the neck, or toward the
point. Hold for 10-60 seconds, return the head to
the neutral position and re-check the point. Repeat
as needed for other points in the upper neck.
NECK — RELEASE INDICATORS
If there are no other imbalances present:
•	There will be increased range of motion and
ease of movement in the neck.
•	There will be increased comfort and decreased
tension in the soft tissue (indicator points) of
the neck.
•	There will be increased comfort and decreased
restriction of movement in the individual verte-
brae of the neck.
Notes
1.	Notice that in each area of the neck, regardless
of the starting position, the final movement
into the release position is the same: curve
around the affected point.
2.	For points toward the back of the neck in each
area, you may need more extension in the release
position. If necessary, you may gently lift at the
back of the client’s neck to get his head into
extension. See Figure 2.9. For points toward the
front, more flexion may be needed (remember
the idea of creating a curve around the point).
You may work on the front of the neck if need-
ed, but be aware that most people are somewhat
nervous about contact in such a vulnerable area.
Keep your contact light and check with the client
about the comfort of your touch.
3.	In any of the release positions, if you pass the
position of maximum softening in the indicator
point and it begins to stiffen, you have proba-
bly passed the best release position. Go back to
the neutral position and begin again.
4.	The compression used in all release positions
should be comfortable. Check with the client as
to whether he wants more or less compression.
28
Thoracic
Vertebral Column & Thorax — Thoracic
THORACIC — ANATOMY
The thoracic spine consists of those twelve verte-
brae to which the ribs connect. What many peo-
ple call their backbone is actually the spinous
processes of the thoracic spine. The joints of the
thoracic vertebrae permit all movements: rota-
tion, flexion/extension and lateral bending. The
movements within each joint are slight, but the
accumulated movement of the twelve vertebrae
make the thoracic spine quite flexible. It has its
greatest mobility on the rotational plane, as com-
pared to the lumbar which has its widest range
in the flexion/extension movement.
The transition from thoracic to lumbar spine is
made at the twelfth thoracic vertebra. The upper
part of this bone has the facets of a thoracic ver-
tebra, its lower facets are those of a lumbar verte-
bra. This is an abrupt shift from the less mobile
thoracic joints to the more mobile lumbar joints
and makes the twelfth thoracic the vertebra most
susceptible to strain. The eleventh and twelfth
thoracics are the most commonly fractured in
a broken back. The twelfth thoracic is also the
uppermost origin of the psoas muscle, which may
account for some of that muscle’s vulnerability
to chronic contraction.
THORACIC — EVALUATION
With the client prone:
1. Check for sensitivity or contraction in the
muscles along each side of the thoracic spine.
Do this by palpating along the length of the
thoracic within an inch on either side of the
spinous processes.
2. Check for movement of each thoracic vertebra.
Do this by rocking the client’s pelvis and visual-
ly noting whether the movement of the pelvis is
transferred up the full length of the spine. Then
place your thumb or finger against the sides of
two adjoining spinous processes. Continue the
rocking of the pelvis and feel for movement
between each successive pair of vertebrae. Any
area of sensitivity, contraction, or restricted
movement may be used as an “indicator point”
for a release position.
33
Ortho-Bionomy
THORACIC — RELEASE
All of the following release positions are per-
formed with the client in the prone position. To
avoid straining the client’s neck, her face should
be turned, if possible, toward the side of her body
that is being lifted.
Upper Thoracic
Stand on the same side as the sensitive or contract-
ed point (the “indicator” point), reach over the
client’s back and slide your hand under her oppo-
site shoulder. Gently lift her shoulder and bring it
back towards the indicator point until the point
softens and relaxes. Fine tune the position for
maximum softening of the point. Gently compress
from the shoulder towards the point. Hold for
10-60 seconds. Return the shoulder to the neutral
position and re-check the point. See Figure 2.10.
NOTE:
• You may find that you need to experiment with
different ways of holding the shoulder:
a.	If holding on the outside of the client’s
shoulder is uncomfortable for you or for her,
try holding under her arm, with your hand on
the front of her shoulder.
b.	If it is comfortable for the client, you may
bend her arm and lift her shoulder from the
elbow. This position is usually most comfort-
able for the practitioner, but is sometimes too
much of a strain on the client’s shoulder.
•	For points high in the upper thoracic (Tl-3)
you may want to gently shrug the shoulder up
towards the ear as you lift it. Be careful not to
cause discomfort in the neck or upper shoulder.
Figure 2.10
Middle Thoracic
Stand on the same side as the indicator point.
Reach over the client’s back and gently hold the
side of her ribcage. (If it is not comfortable for th
client to be held directly on her ribcage, you may
hold her arm against the ribcage and use it to
cushion the lift.) Gently lift the ribcage up and
back towards the indicator point until you find a
comfortable position that softens the point. Fine
tune the position. Gently compress with the liftin;
hand towards the point and hold for 10-60 sec-
onds. Lift away and return the arm and ribcage
to the neutral position and re-check the point.
See Figure 2.11.
Figure 2.11
34
Vertebral Column & Thorax — Thoracic
NOTE: Because of the angle of the ribs, your lift-
ing hand will be placed lower on the ribcage than
the hand contacting the point.
Lower Thoracic
Stand on the same side as the indicator point.
Reach over the client’s body and slide your hand
under her hip bone. Making sure that your con-
tact is secure and comfortable, lift her hip up and
back towards you until you find a position that
relaxes the point. Fine tune the position. Compress
from the hip toward the point and hold for 10-60
seconds. Return to the neutral position and re-
check the point. See Figure 2.12.
Figure 2.12
NOTE: If it is more comfortable for you or for
your client, you may have your client “frog” her
leg slightly, on the side being lifted. Notice that this
bending of the knee will begin to lift the pelvis.
THORACIC —
RELEASE INDICATORS
If there are no other imbalances present:
•	There will be reduced sensitivity and contrac-
tion along the spine.
•	There will be increased mobility of the thoracic
vertebrae.
Notes
•	After each of the release positions, you may
want to do some gentle rocking of the entire
thoracic spine as a way of integrating any
changes that may have occurred.
•	If you find that a thoracic vertebra does not
release with the above positions, try lifting
from the same side of the spine as the indicator
point. If that doesn’t work, check the associat-
ed rib. It may be holding the vertebra from
releasing.
•	IMPORTANT: As you find the most comfort-
able position for the client, make sure that you
find a comfortable position for yourself. You
will be lifting a considerable amount of weight
when working with the spine so it is important
to take care of the health of your own back
while working. If necessary, use pillows to sup-
port the positions.
35
Ribs
Vertebral Column & Thorax — First Rib
RST RIB — ANATOMY
; Illustration 2.4
e first and second ribs have a particular influ-
:e on the shoulder and the neck due to inter-
ating muscle attachments, nerve and blood
jplies. The first rib connects from the sternum
the first thoracic vertebra, passing under the
vide at the front of the shoulder. The scalenus
terior and medius muscles, which originate at
‘ transverse processes of the cervical vertebrae,
ach directly to the first rib. The scalenus pos-
ior attaches to the second rib. These muscles
particular link tension in the neck to imbal-
ce of the first and second ribs. The placement
the clavicle in relation to the first rib makes
iusceptible to disruption by an imbalance of
? first rib, in turn disrupting the function of the
odder. The sternocleidomastoid muscles of the
;k (the large muscle band at each side of the neck)
aches at the clavicle, again linking the function
the neck with that of the shoulder girdle and
per ribcage.
FIRST RIB — EVALUATION
With the client supine, her arms at her sides,
locate the muscles at the top of the shoulder in
the wide part of the “V” formed by the clavicle
and scapula. With your fingertips, gently palpate
these muscles for contraction or discomfort. If the
muscles are contracted to the point that you can-
not feel the underlying rib, use this as an indica-
tion that the first rib needs attention. If there is
enough softness in the muscles to allow you to
feel the rib underneath (the first rib), gently con-
tact the rib itself. You should be able to gently flex
the rib without causing discomfort to the client.
If the t'D itself is rigid, or there is pain on contact,
you may also use this as an indication that the rib
needs attention.
FIRST RIB — RELEASE
Isometric Release
With the client supine, have her bend her elbow
on the affected side and bring that arm up so her
elbow is pointing toward the ceiling. With one
hand, contact the client’s first rib, or the muscles
overlying the rib, on the affected side. With the
other hand, cup the client’s elbow. You will use
the hand on the client’s elbow to provide resis-
tance to an isometric movement of her arm.
Have the client initiate a small movement of her
arm, as if she is beginning to bring her elbow
back down toward the table, (so it would rest
directly next to her torso). At the same time, pro-
vide gentle but firm resistance to the client’s
attempted movement so her arm stays basically
still. See Figure 2.13
NOTE: This is NOT a contest of strength.
The most common error made with the isometric
release is to use too much muscle contraction
which brings the focus of the movement into the
39
Ortho-Bionomy
Figure 2.13
arm rather than the shoulder. The client should
initiate only as much movement as needed to
engage the muscles of the shoulder. You should
provide only enough resistance as needed to keep
her arm from moving.
Hold the isometric for approximately 10 seconds.
Have the client relax her arm as you follow
through on her attempted movement by gently
bringing her arm down to the table and, without
pausing, bringing it out to the side and compress-
ing through the line of the upper arm and into the
shoulder. See Figure 2.14. Re-check the first rib.
If this isometric does not completely release the
first rib, try one of the variations listed below, or
the positional release that follows.
Variations on the Isometric
1.	Try the isometric movement at various angles
(i.e., with the arm next to the torso; pushing
the elbow straight out to the side; pushing from
the shoulder straight up toward the head, etc.).
2.	Use an isotonic rather than an isometric. This
is similar to the standard isometric release.
However, as the client attempts to move her
elbow down toward the table, instead of resist-
ing the movement completely, slowly allow her
elbow to move toward the table as you contin-
ue offering some resistance.
3.	With the client supine, stand at the side of the
massage table. Slide your arm (palm down)
under the client’s armpit and hold the top edge
of the table. The back of your forearm will be
under the back of the client’s shoulder; her
armpit will be against the crook of your elbow.
Have the client initiate a small movement with
her arm, as if she is reaching toward her foot.
Provide gentle resistance to this movement and
hold for 10 seconds. Have the client relax her
arm as you follow through on her attempted
movement by drawing the shoulder down
toward her foot. Then, as in the standard iso-
metric, draw the client’s bent elbow out to the
side and compress up the line of the arm into
the shoulder.
40
Vertebral Column & Thorax — First Rib
First Rib — Positional Release
With the client in a supine or side posture, shrug his
shoulder up towards his ear. Compress straight into
the shoulder joint/upper ribcage from the outside
edge of the shoulder. See Figures 2.15 and 2.16.
Monitor the muscles at the top of the shoulder and
choose the position that maximizes softening and
comfort in these muscles. Hold for 10-60 seconds,
then re-check the first rib.
Figure 2.15
FIRST RIBS —
RELEASE INDICATORS
If there are no other imbalances present:
•	The muscles at the top of the shoulder will be
more relaxed and comfortable.
•	The first rib itself will have increased flexibility
and comfort on contact.
Notes
The word “isometric” means same (iso) measure
or length (metric). An isometric exercise is defined
in Taber’s Cyclopedic Medical Dictionary as:
“Contraction of a muscle that is not accompanied
by movement of the joints that would normally be
moved by that muscle’s action. The muscle length
is not changed by this type of exercise.”
The word “isotonic” means same (iso) tone (tonic).
Taber’s defines an isotonic exercise as: “.. . equal
tension on the muscle is maintained while the
length of the muscle is decreased . . . Contraction
of a muscle during which the force of resistance
to the movement remains constant throughout the
range of motion.”
If this position does not completely release the
first rib, try variations on positions (i.e., with the
arm out to the side, with the shoulder rolled for-
ward) until you find one that works.
41
Vertebral Column & Thorax — Ribs
BS — ANATOMY
Illustrations 2.5 and 2.6
Illustration 2.5
e twelve ribs on each side of the ribcage form
alf-circle, with the upper ten ribs attaching to
: sternum on the front of the torso and to the
responding thoracic vertebra on the back. The
lenth and twelfth ribs are called floating ribs
:ause they connect only to the thoracic spine
d have no attachment to the sternum. The mus-
s between the ribs, called the intercostals, assist
the breathing process and give the ribcage addi-
>nal stability.
le bones of the individual ribs are quite flexible, as
the ribcage as a whole. This flexibility allows the
>cage to do its job of surrounding and protecting
the vital organs such as the heart and lungs, but it
also makes the ribcage susceptible to distortion. In
sports which cause repeated stress to the ribcage,
such as pole-vaulting, it is not uncommon for the
ribs to take on unusual shapes. Many people have
distortions in the shape of individual ribs, or in the
entire ribcage, that do not impair the function of the
ribcage. For this reason, when evaluating the ribs
and ribcage, it is generally best to look for discom-
fort and/or restriction of movement, rather than for
anatomical differences in the shape of the ribs.
RIBS — EVALUATION
Before you begin, you may want to visually check
the ribcage for its balance. As mentioned in the
anatomy section, the physical shape of the ribcage
does not necessarily indicate its actual condition
and function. However, the shape of the ribcage
may provide clues regarding an imbalance. For
example, you may see that one side of the ribcage
appears to be smaller than the other. This might
indicate that the ribcage is constricted on that
side, or that there is a rotational tension pattern,
making it appear smaller.
If the imbalance in the ribcage is due to an overall
pattern of distortion, or to minor distortions in
some of the ribs, a general release movement may
be sufficient to restore balance and flexibility.
43
Ortho-Bionomy
Ribs — General Evaluation I Release
The general evaluation/release movements may be
done with the client either prone or supine. The
ribcage will have more general movement avail-
able when the client is supine.
1.	Gently rock the client’s ribcage directly from
one side to the other (laterally). Notice if there
is more movement, or more ease of movement
in one direction or the other. Gently pull the
ribcage in the direction of greatest movement
and hold for 10-60 seconds. See Figure 2.17.
Release the position and re-check the movement.
2.	Gently rock the client’s ribcage down toward
the table (anteriorly if she is prone, posteriorly
if she is supine). See Figure 2.18. If there is
more movement, or more ease of movement,
on one side or the other. In this plane of move-
ment, you have a few choices for finding the
best release position. On the side that moves
most easily toward the table, you may compress
(as you have done in the evaluation movements).
If one side is resisting compression toward the
table, you may lift that side and, if comfortable,
compress the opposite side toward the table.
See Figure 2.19.
3.	Gently flex each side of the client’s ribcage
down toward her feet (inferiorly). This move-
ment is sometimes easier to do with the client
on her side. If there is more movement or ease
of movement on one side, compress that side
toward the client’s feet. Hold for 10-60 sec-
onds, release the position and re-check the
movement.
You may use the pattern of three breaths, as
described in the Specific Release section, to
increase compression in the ribcage during the
general release positions.
Figure 2.18
Figure 2.19
44
Vertebral Column & Thorax — Ribs
Ribs — Specific Evaluation
If general release positions are not sufficient to
restore flexibility and comfort to the ribcage, you
may need to evaluate the balance of, and then
release, individual ribs or adjoining groups of ribs.
In evaluating the balance of the ribs, you have the
advantage of having full access to the entire length
of the rib bone. If you are not certain what you
are feeling in one area of the rib, simply trace
along the rib to its opposite end and see if this
gives you a better idea of its position.
Gently feel for the position of the individual ribs
in relation to their adjoining ribs. Notice if each
rib is aligned with the ribs next to it. Also notice
if there is restriction in the movement of any indi-
vidual ribs or if there is discomfort on contact
with the rib. Remember that the ribcage has a
wide range of “correct” variations. If you find a
rib that seems to be out of balance, check for dis-
comfort and/or restriction in movement as well
as for physical distortion.
Ribs — Specific Release
The following release positions are given for
the client in a supine position. You may use the
same techniques with the client prone or in a side
posture.
1.	For a rib that protrudes beyond the line of the
surrounding ribs:
Contacting directly on the affected rib, lift it fur-
ther above the line of the surrounding ribs. At the
same time, compress each adjoining rib in the
opposite direction. See Figure 2.20.
If this simple release position doesn’t work, try the
following variation:
Contacting the ribs as described above, add the
following pattern of three breaths, which uses the
lungs to add further compression to the release
position.
a.	With minimal pressure on the ribs, have the
client take a deep breath. As she exhales, com-
press the ribs on each side of the affected rib
and lift the affected rib.
b.	While maintaining the compression on the
adjoining ribs, have the client take another
deep breath. (Let the affected rib lift with the
inhalation). As the client exhales, go a bit deep-
er into the compression on the adjoining ribs
(if comfortable).
c.	As the client takes another deep breath, let the
expansion of her ribcage slowly push her ribs
out of the compression (i.e., you release the
compression as she inhales).
Gently rock the area of the ribcage you’ve been
working with to integrate possible changes.
45
Ortho-Bionomy
2.	For a rib that is depressed in relation to the
surrounding ribs:
Contacting directly on the affected rib, depress
it further. At the same time, lift each adjoining rib.
See Figure 2.21.
RIBS — RELEASE INDICATORS
If there are no other imbalances present:
•	The ribcage as a whole will be more symmetri-
cal and will have more flexibility.
•	There will be more movement available in each
plane of movement in the ribcage.
•	Each side of the ribcage will move as easily as
the other side.
•	The individual ribs will have more movement
and less discomfort.
•	The individual ribs will be balanced in relation
to the surrounding ribs.
You may use the same pattern of three breaths as
described above, compressing the affected rib on
the exhalations, and letting the surrounding ribs
lift with the inhalation.
3.	You may perform specific positional releases:
a.	If some of the ribs are too close together,
squeeze them closer together and hold for
10-60 seconds.
b.	If a rib is slightly rotated, rotate it a little more
and hold for 10-60 seconds.
c.	If a few adjoining ribs are compressed (or lift-
ed), compress (or lift) them a little more. Again,
you may use the three-breath pattern to add
additional compression.
46
Vertebral Column & Thorax — Ribs
'otes
If a rib doesn’t release, check the corresponding
thoracic vertebra.
When working with the ribcage, you will need
to know how to cope with two problems that
typically arise: how to work with someone who
is ticklish; and how to appropriately and com-
fortably work around the area of the breasts.
a.	If your client is ticklish, try using a firmer
pressure as you work. This usually eliminates the
ticklish response. If that doesn’t work, you will
probably need to contact in a different area of
the ribcage in order to comfortably perform the
release position. If ticklishness is a sensation in
the tissues (as opposed to a trained response)
you may use this as an indicator of problems.
The sensation of tickling is produced by the
same nerve endings as those which indicate pain;
it’s just that fewer nerve endings fire. So tickling
may be interpreted as a mild pain response.
b.	When working near the breasts you need to
be aware that some women will have physical
discomfort in this area and sometimes under
their armpits also, especially around the time of
menstruation. You may need to vary the pres-
sure of your contact, or the placement of your
hands in order to avoid creating discomfort as
you work.
You also need to be aware of the appropriateness
of your contact near your client’s breasts. Gener-
ally speaking, it is considered inappropriate to
touch your client’s breasts as you work. However,
there may be occasions when some contact in the
breast area is appropriate. For example, a female
practitioner may work with a woman who is at
ease about non-sexual contact with her breasts.
In this case it would be appropriate to simply
move the breast tissue aside in order to make con-
tact with the underlying ribs. It is essential that
you have clear permission from your client before
making any kind of contact that might be consid-
ered inappropriate.
47
Lumbar
Vertebral Column & Thorax — Lumbar
LUMBAR — ANATOMY
See Illustration 2.7
The lumbar spine, which rests above the sacrum,
is composed of five vertebrae, numbered from
top to bottom. The weight-bearing requirements
of the individual vertebrae increase as the spine
descends, so the vertebral bodies become larger
from the cervical to the lumbar area. The discs
also become correspondingly larger.
Because movements between individual vertebrae
are greatest where the discs are thickest and where
the joint surfaces are largest, the lumbar region is
subjected to considerable strain. The structure of
the lumbar spine allows for full flexion and exten-
sion, and some lateral bending. If rotation were
also available, the torsion on the lumbar discs
would be excessive. Consequently, the lumbar
vertebrae have an interlocking joint structure that
severely limits rotation. However, even with the
added protection of restricted rotation, the lumbar
discs are the most prone to injury.
51
Ortho-Bionomy
LUMBAR — EVALUATTON/RELEASE
In the lumbar spine, it is common to have no actu-
al discomfort at the spine itself, even when there
is an imbalance present. In addition, this part of
the spine is heavily muscled, sometimes making it
difficult to assess the condition of the spine with
direct palpation.
For these reasons, trigger points are used to evalu-
ate the condition of the lumbar. Check for sensitiv-
ity, discomfort or contraction at the trigger points
indicated. See Illustrations 2.8, 2.9 and 2.10.
Illustration 2.8
Illustration 2.9
Notes
1.	Trigger points are specific areas of sensitivity
which are remote from the area for which they
indicate an imbalance. For example, the trig-
ger points for the lumbar spine are located on
various parts of the pelvis. Information on
myofascial triggers is widely available through
the writings of Jones, Chapman, Travell,
Prudden, etc.
2.	The area to check for triggers is within a
3-fingers’ width of the point indicated, to ensure
that you don’t miss the area of sensitivity.
3.	Softening in the trigger point area is an indica-
tion of the correct release position. It is impor-
tant to remember that it is not the triggers you
are releasing, it is the spine. When the spine is
released the tenderness at the trigger will lessen
or disappear. The trigger is a clear indicator
of the change in the spine.
52
Vertebral Column & Thorax — Lumbar
L5 TRIGGER--—
The location of trigger points may vary from per-
son to person. Presented here are the most com-
monly agreed upon locations. However, you may
use any specific area of discomfort in the approxi-
mate area of the listed points as a trigger.
LI Trigger
Location: In the muscle inside the medial edge
of the ASIS. See Illustration 2.8.
LI Release — Supine
Draw both of the client’s knees up toward her
chest and drop her knees slightly toward the side
being released. Generally the feet / lower legs are
then brought slightly to the side opposite from the
knees. However, it is sometimes more comfortable
for the client if the lower legs are left in line with
the knees, or brought to the same side as the
knees. Experiment with the lower legs position
and notice which is most comfortable for the
client and/or which softens the trigger point.
Compress from the knees into the hip joint and
hold for 10—60 seconds. If possible, stay in gentle
contact with the trigger point so you can monitor
for signs of release. See Figure 2.22.
Figure 2.22
53
Ortho-Bionomy
NOTE: This is the standard release position for
LI and L2. The side posture release described
below is an alternative if the client is unable to
lie comfortably on her back.
LI Release — Side posture
Draw both of the client’s knees toward her chest
(in fetal position) and adjust the position of her
legs until the trigger area softens or discomfort
lessons. Hold for 10-60 seconds.
L2 Trigger
Location: Immediately superior and/or inferior to
the inguinal ligament at its midpoint between the
ASIS and the pubic symphysis. See Illustration 2.8.
L2 Release
Same procedure as LI. The position will be slight-
ly different because you are working on a slightly
lower point on the spine. Monitor the trigger
point and choose the position that softens/relaxes
the point most thoroughly. Generally, the legs will
be at a less severe angle for L2 than for LI. See
Figure 2.22.
L3 Trigger
Location: At the posterior edge of the tensor fas-
ciae latae on a direct line posteriorly from the
ASIS. Alternately, you may also locate the point
by moving 2-3 inches lateral and inferior to the
PSIS. If a line were drawn straight through the
body, front to back, L3 would be approximately
opposite LI. See Illustration 2.9.
L3 Release — Prone
Holding at the client’s ASIS (hip-bone), lift and
compress her opposite hip toward the trigger
point. Monitor the point and adjust the position-
ing until maximum softening and/or comfort is
found. It may be more comfortable for you or the
client to have her bend her knee and bring it out
to the side (this is sometimes called “frogging” the
leg). Hold for 10-60 seconds. See Figure 2.23.
Figure 2.23
NOTE: This is the standard release position for
L3 and L4. The alternate supine release position
may be used if the client cannot lie comfortably
on her stomach.
L3 Release — Supine
Similar procedure as LI. The position will be
slightly different because you are working on a
lower point on the spine. Monitor the trigger
point and choose the position that softens/relaxes
the point most thoroughly. Generally, the legs will
be at a less severe angle for L3 than for LI or L2.
54
Vertebral Column & Thorax — Lumbar
L4 Trigger
Location: Mid-buttock. Slightly superior to the
midpoint of the gluteus maximus. If a line were
drawn straight through the body, front to back,
L4 would be approximately opposite L2. See
Illustration 2.9.
L4 Release — Prone
As in the L3 release, lift and compress the client’s
opposite hip toward the trigger point. The position
will automatically be different because you are lifting
toward a point lower on the pelvis. See Figure 2.23.
L4 Release — Supine
Similar to LI through L3, with the release posi-
tion adjusted for the difference in point location.
See Figure 2.22.
IS Trigger
Location: On the medial or lateral side of the
PSIS. See Illustration 2.10.
L5 Release — Prone
You may use one of two release positions. Choose
the one most comfortable for the client.
1. Stand on the same side as the sensitive trigger.
Have the client move toward the edge of the table
on that side. Bend her knee, and bring her leg
off the edge of the table. With her knee pointing
down toward the floor, compress, from the knee,
straight up the leg into the hip joint. If the com-
pression is uncomfortable, simply support the leg
without compression. See Figure 2.24.
Figure 2.24
NOTE: There are two ways to easily support the
leg in this position. You may sit next to the table
and support the knee/leg in your lap, while hold-
ing the client’s leg in the position that is most
comfortable for her. Alternately, you may stand
next to the table, while holding the client’s leg at
the ankle and resting her knee against one or both
of your legs for support.
Make sure the client’s weight is balanced on the
table. This may be accomplished by having the
client move to a more diagonal position, with the
affected hip at one edge of the table, and the
upper torso at the opposite edge.
When you lower the client’s leg off the table,
make sure you bring her knee down toward the
floor and not directly out to the side. This will
avoid strain at her hip joint.
Caution: Make sure YOU move the client’s leg
back onto the table. DO NOT let her lift her
own leg.
55
Ortho-Bionomy
2. Stand on the same side as the sensitive trigger.
Lift the client’s leg on the side opposite the trig-
ger. Hold her leg just above the knee (leg may
be straight or bent) and bring it slightly toward
you. Be aware of both the client’s comfort
and your own as you do this. It is particularly
important to protect your back as you lift.
See figure 2.25.
LUMBAR —
RELEASE INDICATORS
If there are no other imbalances present:
•	The triggers will be softer and more comfort-
able.
•	There will be more freedom of movement in
the lumbar spine.
•	There will be less discomfort in the lumbar
spine.
NOTE: Position 1 is usually more comfortable
for a client with a relatively flat lumbar spine;
position 2 is usually more comfortable for a client
with a relatively deep lumbar curve.
These are the standard L5 release positions. The
alternate supine position may be used if the client
cannot lie comfortably on her stomach.
L5 Release — Supine
Similar to LI through 4 with the position adjusted
for the difference in point location. See Figure 2.22.
56
Section 3
THE PELVIS


The Pelvis — Iliopsoas
PSOAS — ANATOMY
lustrations 3.1 and 3.2
Illustration 3.2
liopsoas group is made up of three muscles:
soas major, the psoas minor and the iliacus.
psoas muscles originate at the transverse
ssses of the twelfth thoracic vertebra and
e first four lumbar vertebrae. They pass from
ow back, cross the front of the ilium and the
c bone (passing under the inguinal ligament)
attach at the inside of the femur at the lesser
ranter. The iliacus originates at the anterior
let of the ilium and is overlapped by the psoas
ties as it follows the same path to attach to the
:r trochanter. See Illustration 3.1.
The iliopsoas muscles act to slightly lateral
flex and rotate the trunk and, if the femur is
fixed, to increase the lumbar curvature. They
are used to tilt the pelvis forward (anteversion)
and hollow the lower back while sitting or
standing. When the lower back is fixed, these
muscles assist in lifting and rotating the leg.
See Illustration 3.2.
63
Ortho-Bionomy
ILIOPSOAS — EVALUATION
Each of the following indicators can mean some-
thing other than iliopsoas tension, so you may get
mixed indications. Don’t worry. Either take the
strongest indicator, or check all indicators to see
if a pattern emerges to indicate the affected side.
To check for tension at the iliopsoas:
1. Compare resistance to internal rotation of the
femur. Because the iliopsoas attaches to the lesser
trochanter of the femur, the iliopsoas stretches
when the femur is internally rotated. If the iliopsoas
is contracted, it will resist this stretch. Therefore,
tension in the iliopsoas can be detected by testing
its resistance to internal rotation of the femur. To
do this with the client supine, grasp her ankles, lift
her legs slightly, and firmly rotate them internally.
If there is no iliopsoas contraction, the legs should
rotate evenly and without resistance. This is a test
of the condition of a muscle that attaches at the
head of the femur, so make sure your rotation is
focused at the hip, and not at the ankle or knee.
See Figure 3.1.
NOTE: The results of this test can also be an indi-
cator of external femur rotation or of tension at
the sacro-iliac joint. An externally rotated femur
or a tight sacro-iliac will resist internal rotation
with a bone-to-bone resistance. A tight iliopsoas
will resist internal rotation, but with some muscu-
lar stretch available at the limit of the rotation.
2. Compare leg length. As the psoas contracts,
it brings the femur with it, making the leg appear
shorter. Therefore, the short leg is generally the
side of the contraction, or in the case of two ilio-
psoas contractions, the side with the stronger of
the two contractions.
You can compare leg length at either the ankles
or the feet. With the client supine, make sure she
is lying straight on the table, with her legs in line
with her pelvis and torso. Bring her legs and feet
as close together as is comfortably possible. Com-
pare the length of her legs by one or both of the
following:
a.	Flex her feet and notice if her heels are even
with each other. See Figure 3.2.
Figure 3.1
Figure 3.2 Note that the left leg is slightly shorter to
the right.
64
The Pelvis — Iliopsoas
b.	Place your thumbs under the ankle bones on
the inside of the legs (at the inferior surface of the
medial maleolus) and notice if your thumbs are
level with each other.
NOTE: This test may also indicate an ilium rota-
tion. To determine if it is the ilium or the iliopsoas,
check the balance of the ilium at the pelvis. If the
pelvis is in balance and the legs are uneven, it is
likely to indicate an iliopsoas contraction.
It is not common that legs are anatomically
different lengths, but it is sometimes the case. This
test may occasionally indicate an actual anatomi-
cal difference in leg length.
3. Check for tension or discomfort within the
musde itself. On the side of tension, the muscle
may be sore to the touch, or feel tight. To check
for this, gently contact the muscle at the point
where it comes near the surface, midway between
the ASIS and the navel.
NOTE: This test may also detect lumbar referred
pain.
I Preference of movement with the ribcage.
Because the psoas originates at the twelfth thor-
acic vertebra and at the upper four lumbar verte-
brae, if it is contracted it will tend to pull the
trunk into a slight curve on the side of the con-
traction. The ribcage will express this curve by
moving more easily to the inside of the curve (the
side of the contraction).
You may test for this preference of movement
with the client supine by gently pulling the entire
ribcage first to one side and then to the other.
Notice if one side moves more easily than the
other.
NOTE: This test may also indicate an imbalance
in the thoracic spine and/or the ribcage.
5. Compare arm length. As the iliopsoas con-
tracts, it pulls the trunk into a slight curve on the
side of the contraction, making the arm appear
shorter. Therefore, the side of the contraction will
generally be on the side of the shorter arm.
To check for this, with the client supine, pull her
arms above her head, so they are in a straight line
with her body. Maintaining a constant and even
tension on both arms, have the client straighten
her fingers. Bring her hands together without
releasing the tension and check for a difference
in the arm length.
NOTE: This test may also indicate an imbalance
in the arm or shoulder.
Ortho-Bionomy
ILIOPSOAS — RELEASE
1. Shoulder/hip compression. Stand on the affect-
ed side. With the client supine, bring her leg on
the affected side straight out to the side, with her
foot and leg rotated slightly outward. Hold her
wrist on the same side (she may also hold your
wrist for additional support). Gently compress
into the client’s hip from her foot/leg, while
pulling her arm/shoulder gently toward her feet.
The client’s body will automatically move into a
slight curve on the side of the contraction, exag-
gerating the position the iliopsoas would produce
if severely contracted. Hold for 10-60 seconds.
See Figure 3.3.
It is important in this release position that you
take care of your own comfort, in addition to that
of your client.
Figure 3.3 Note that the client’s leg is abducted.
Figure 3.4
3. Ribcage release. Gently pull the ribcage toward
the side to which it moves most easily. Hold for
10-30 seconds. This movement may need to be
repeated once or twice more for complete release.
See Figure 3.5.
Figure 3.5
2. Knees toward chest position. Stand on the affect-
ed side. Draw both of the client’s legs up, knees
bent, toward her chest. Lean her knees slightly
toward the side of the contraction and gently com-
press into her hip from her knees. Twist her lower
legs slightly toward the side of the contraction to
further shorten the affected muscles. Hold for
10-30 seconds. See Figure 3.4.
66
The Pelvis — Iliopsoas
ILIOPSOAS —
RELEASE INDICATORS
If there are no other imbalances present:
•	The legs will rotate internally without
resistance.
•	The legs will be the same length.
•	Discomfort or tension in the muscle itself will
be reduced or eliminated.
•	Movement of the ribcage will be even.
•	The arms will be the same length.
Notes
1. The iliopsoas muscles are strongly involved
in the “fight or flight” mechanism, making them
particularly reactive to any stressful situation.
Since the psoas is such a reactive muscle, it is diffi-
cult for it to stabilize in the released state, particu-
larly if the contraction is a chronic one. Teach
your clients the release positions so they can work
with the psoas regularly to help speed the change
in its contraction pattern.
2. The psoas will tend to respond to the release
positions more readily than other parts of the
body, so you may need to move out of the release
positions within 10-15 seconds.
67
Ilium

The Pelvis — Ilium
ILIUM —ANATOMY
See Illustrations 3.3, 3.4 and. 3.5
Illustration 3.4
The ilium, commonly called the hip bone, is a
fan-shaped bone that connects with the sacrum to
form a weight-bearing arch which directs the body
weight to the femurs. Бу adulthood, the ilium has
fused with the ischium (the sit-bone) at the back,
and with the pubic bone on the front. The three
together, combined with the sacrum, form the
pelvis. In the lower portion of the ilium, where it
has fused with the pubis and the ischium, is the
hip socket (acetabulum). The ilium on each side
forms one half of the sacro- (sacrum) iliac (ilium)
joint. When people talk about the movement
of the ilium, they are actually talking about the
movement of the pelvis on each side of the
sacrum.
The pelvis varies in shape from one person to the
next. In addition, the pelvis of the male is shaped
differently than that of the female. Principally,
the male pelvis is narrower and longer than the
female’s. The female pelvis is wider, with a larger
opening to allow for passage of the infant during
birth.
71
Ortho-Bionomy
ILIUM — EVALUATION
The ilium can pivot at the sacro-iliac joint in
various ways. To simplify evaluation of the bal-
ance of the pelvis, the indicators given are for
posterior/anterior rotation of the ilium. When
moving your client into the release position, it is
important to notice fine variations in the prefer-
ence of movement and to follow them.
There are two simple tests to use to check for
imbalance of the ilium:
1. Compare the balance of the ilium at the pelvis.
An imbalance of the ilium may be detected by
comparing the position of each ilium in relation
to the other. Two places that are convenient
bony landmarks are the iliac crest and the PSIS.
To check for an imbalance with the client
prone, place your thumbs at the iliac crest or
72
The Pelvis — Ilium
PSIS on each side. If the ilium is balanced,
these points are level with each other. If the
ilium rotates anteriorly, the iliac crest and the
PSIS on that side will move superiorly to those
on the other side. In a posterior rotation they
will move inferiorly. See Figure 3.6.
Figure 3.6 Note that the left PSIS appears to be
lower than than the PSIS on the right.
2. Compare leg length. When one side of the
pelvis moves, the hip socket located within it
will also move. Consequently, if the top of the
ilium rotates posteriorly, the hip socket located
in the lower portion of the bone will be levered
forward and up, bringing the leg with it. This
will give the leg on that side the appearance of
being shorter. On the other hand, if the top
of the ilium moves anteriorly, the hip socket
will be levered back and down, giving the leg
on that side the appearance of being longer.
See Illustration 3.6.
Therefore, comparing the length of the legs
at the ankles or at the bottoms of the feet may
give an indication of the movement of the
pelvis. See Figure 3.7.
Illustration 3.6 Note that the posterior rotation of the
ilium makes the left leg appear shorter.
Figure 3.3 Note that the client’s leg is abducted.
73
Ortbo-Bionomy
NOTE: This indicator is not always an accurate
indicator of the balance of the pelvis. A difference
in leg length may be anatomical, or it may indi-
cate a contraction of the psoas muscle.
You may find that the pelvis is out of balance, but
at this point you don’t know which is the affected
side. You may use any of the following tests to
determine which side has moved (it is possible
that both sides have rotated, either in the same
direction, or in opposite directions so be aware
that you may get mixed indicators):
1.	Try the appropriate release position on each
side. The side that moves most easily into the
release position, and is most comfortable in the
release position, is likely to be the affected side.
If you can’t tell by the feel of the movement,
ask the client which is more comfortable.
2.	Check for discomfort at the triggers for the
sacro-iliac:
•	1 inch from the PSIS, at 5 o’clock on the right
and at 7 o’clock on the left;
•	at the posterior superior surface of the greater
trochanter of the femur;
•	on the superior margin of the pubic bone 1Уг
inches lateral to the pubic symphysis.
If some or all of the triggers are tender on only
one side, that is likely to be the affected side. If
some or all of the triggers are tender on both
sides, it is likely that both sides are affected.
3.	Discomfort at the center of the wrist and/or
ankle joints may indicate an ilium imbalance.
Check both wrists and both ankles for discom-
fort. If the triggers on only one side are tender,
that is likely to be the affected side. If triggers
are tender on both sides, it is likely that both
sides are affected.
NOTE: Experienced practitioners find that
it often takes longer to check all of the triggers
than it does to simply try the release positions as
recommended in #1.
ILLIUM — RELEASE
Posterior rotation (short leg)
Prone
Bend the client’s knee on the affected side. Bring
his leg out to the side and let it rest in this posi-
tion. This is sometimes referred to as “frogging
the leg.” With one hand on the ASIS and the other
on the ischium, gently rotate the ilium posteriorly.
Hold for 10-60 seconds and release. This release
is performed most easily by standing at the side
opposite the ilium being released, and reaching
across the client’s body. See Figure 3.8.
Side posture
The client lies on the unaffected side with his
bottom leg straight and his top leg bent. On the
affected side, place one hand on the ASIS, the
other on the ischium and rotate the ilium poste-
riorly. Hold for 10-60 seconds and release. This
release is performed most easily by standing,
facing the client’s back. See Figure 3.9.
74
The Pelvis — Ilium
Figure 3.9
Anterior Rotation (long leg)
Prone
Stand on the affected side. Gently lift the client’s
leg on that side straight up toward the ceiling and,
with the other hand on the top of the ilium, rotate
the ilium anteriorly. Hold for 10-60 seconds and
release. See Figure 3.10.
Side posture
Have the client lie on the unaffected side, with
his bottom leg bent, and his top leg straight. Stand
at his back. Gently push anteriorly on the crest
of the ilium, while bringing his leg straight back
toward you. Hold for 10-60 seconds and release.
See Figure 3.11.
Figure 3.10
ILIUM — RELEASE INDICATORS
If there are no other imbalances present:
•	The iliac crest and PSIS on each side will be
level with one another.
•	The legs will be the same length.
•	The discomfort at the referred pain points will
be relieved.
Notes
1. Note that the side postures simply duplicate the
prone release positions, but on a different plane
of movement.
2. All positional movements are done firmly, slow-
ly and gently.
75
Sacrum
The Pelvis — Sacrum
LCRUM — ANATOMY
’ Illustrations 3.7 and 3.8
Illustration 3.7
he five sacral vertebrae fuse to form this single
one. It transmits the body weight to the hip
tints via its articulation with the pelvic girdle. At
ach side, the sacrum meets the ilium, forming the
acro-iliac joint. At its upper edge it forms a joint
nth the fifth lumbar vertebra.
SACRUM — EVALUATION
1. With the client prone, check the general move-
ment of the sacrum. Use “soft” hands, one
on top of the other. Move slowly and ask the
client to tell you immediately if there is any
79
Ortho-Bionomy
ILIUM
SACRUM
Illustration 3..8
discomfort. Check for a slight flex in the move-
ment. The sacrum (more accurately, the sacro-
iliac joint) should not be rigid.
•	Gently and slowly compress the sacrum
straight down toward the table/floor.
•	With gentle, yet firm, pressure on the sacrum,
check rotational movement (as if gently
unscrewing the cap of a jar clockwise and
counter-clockwise). See Figure 3.12.
•	Check the sacrum’s ability to rock in various
directions (like a teeter-totter).
2. Check for any discomfort or tension along the
edge of the sacrum. Pay particular attention to
the edge of the sacrum where it meets the ilium
at its uppermost points.
SACRUM — RELEASE
Positional Release
If there is a preference for movement in any par-
ticular direction (i.e., feels more comfortable
rotating to the right), gently exaggerate that posi-
tional preference and hold for 10—60 seconds.
Usually, gentle compression will be used as one
element in positioning. See Figure 3.12.
Figure 3.12
80
The Pelvis — Sacrum
ir-
osi-
ie
Point Release
Any sensitive area on the surface of the sacrum or
at its margin may be used as a release point.
Position the sacrum/ilium to relieve tension or dis-
comfort. Generally, compression of the sacrum
will be towards the sensitive point. See Figure 3.13.
Often, compression straight in toward the sacrum
from the hip will be effective for releasing tension
on the opposite sacral border. The leg may be
used to assist in positioning (such as lifting the leg
slightly and compressing up the line of the leg into
the sacro-iliac joint).
SACRUM —
RELEASE INDICATORS
If there are no other imbalances present:
•	The general movement of the sacrum will
increase.
•	Imbalances in the movement will even out.
There will be a lessening of discomfort and
tightness at the sacrum.
81
Section 4
THE LOWER LIMBS
Femur

The Lower Limbs — Femur
FEMUR — ANATOMY
See Illustrations 4.1 and 4.2
Illustration 4.1
The femur is commonly called the thigh bone.
It allows the weight of the upper body, as support-
ed by the pelvis, to be transferred down the legs
through the knee joints and the feet. At the knee,
the femur forms the knee joint with the tibia and
the patella . The head of the femur rests in the
acetabulum (hip socket), forming a ball and sock-
et joint.
87
Ortho-Bionomy
FEMUR — EVALUATION
If the femur is not balanced in its connection to
the pelvis and/or knee, it will disrupt the balance
of weight distribution. This in turn affects stand-
ing posture and walking.
To check for an imbalance of the femur:
1.	With the client supine, notice if his feet are
naturally resting at a slight angle externally
(towards the outside). If the feet are turned
externally more than 45 degrees from midline,
this may indicate an external rotation of the
femur. If they rest pointing straight up toward
the ceiling, or in towards midline, this may
indicate an internal rotation.
2.	With the client supine, hold both legs under
the ankles and gently lift and rotate them exter-
nally and internally. Remember that you are
checking the movement of the femur, so the
focus of the rotation should be at the hip joint,
and not at the knees or ankles. Notice if the
legs move more easily one way or the other.
If they resist internal rotation, this may indicate
an external rotation; if they resist external rota-
tion, this may indicate an internal rotation.
See Figure 4.1.
Figure 4.1
NOTE: Resistance to internal rotation may
also indicate a contraction of the psoas muscle,
since it attaches to the femur. A psoas con-
traction will have a muscular “bounce” to the
restriction. A rotation of the femur will usually
have a more solid bone/joint restriction.
3.	With the client supine, notice the balance of
the legs at the thigh. An internal rotation will
present as a rounded thigh and an external
rotation as a flat thigh.
FEMUR — RELEASE
Positional Release
Exaggerate whichever imbalance is indicated by
using one of the following two release positions:
1. External rotation: On the affected side, bring
the client’s leg laterally (out to side) and rotate
his foot/leg externally. Gently compress from
the foot, up the line of the leg into the hip joint.
See Figure 4.2.
Figure 4.2
88
The Lower Limbs — Femur
2. Internal rotation: On the affected side, lift the
client’s leg slightly across midline (toward the
inside) and rotate it internally. Gently compress
from the foot, into the hip joint.
Return the leg to its neutral position and re-
check the indicators. If the imbalance is still
present, try the isometric release described
below:
Isometric
Have the client sit on the edge of the table. On
the affected side, bring his ankle up to rest on his
opposite knee (as if he were going to cross one leg
over the other, but stopped with the ankle resting
on the knee), with the knee dropped comfortably
toward the table.
From this position, you will do one of the follow-
ing two isometrics:
1. External rotation: Face the client. Place one
hand on the inside of his bent knee (as if to
push his knee toward the table) and your other
hand flat against the front of his opposite
shoulder. The client gently attempts to bring
his shoulder and knee toward each other (with
equal pressure) as if they would meet in front
of his chest. While he attempts this movement,
you will provide gentle, but firm, resistance so
that his knee and shoulder stay basically still.
Hold for approximately 10 seconds. The client
relaxes and you follow through on the attempt-
ed movement (i.e., you bring his knee and
shoulder toward each other, only as far as is
comfortable). See Figure 4.3.
Figure 4.3
2. Internal rotation: Face the client. The client
brings his knee on the affected side and his
opposite shoulder together so they touch in
front of his chest (or as close to this position as
he can comfortably get). Place one hand on the
outside of his knee, the other on the back of his
opposite shoulder. The client gently attempts
to “open” the posture by pushing his knee and
shoulder away from each other. Gently resist
the movement for approximately 10 seconds.
The client relaxes and you follow through with
the movement by gently moving the shoulder
and knee away from each other. See Figure 4.4.
Figure 4.4
89
Ortho-Bionomy
FEMUR — RELEASE INDICATORS
If there are no other imbalances present:
•	The legs will rest at a more balanced angle.
•	The legs will rotate internally and externally
without resistance.
Notes
•	Ask the client to notice the movement in his hi]
socket as he performs the isometric. This will
help him focus on the movement of the muscle
in the hip rather than in the knee.
•	An easy way to remember the isometric exercis
is: If the femur is rotated OUT, you hold the
client OUT; if the femur is rotated IN, you hoi
the client IN.
•	If the rotation is chronic (long-standing), it mz
take more than a few sessions to come back tc
balance. There will usually need to be addi-
tional work done to change standing and wall
ing patterns so the muscles can realign with tl
new joint balance.
•	The client can perform the appropriate exerci
at home by holding his own knee to provide t
necessary resistance.
90
Knee
The Lower Limbs — Knee
KNEE — ANATOMY
See Illustration 4.3
The two main bones of the knee are the femur
(commonly called the thigh bone) and the tibia
(commonly called the shin bone). In order to
maintain the stability required in the knee, these
two bones are lashed together by a series of carti-
lages, ligaments and tendons that severely restrict
the movement available in the knee. The resulting
joint, called a hinge joint, is basically only capable
of flexion and extension. Aside from minor
movements within the joint itself, there is no rota-
tion or lateral bending available in the knee. The
knee is at its most vulnerable when it is straight,
because any rotation or side pressure will immedi-
ately stress the joint.
95
Ortho-Bionomy
The patella, commonly called the kneecap, is an
unusual type of bone which develops within a
tendon. The patella is held by this tendon over
the front of the knee joint. When the knee is bent,
the patella naturally fits into the gap created at the
front of the joint, giving bony protection to the
underlying soft tissue.
The second bone of the lower leg, called the fib-
ula, does not meet the femur, but connects under-
neath the lateral aspect of the head of the tibia.
The importance of the fibula to the health of the
knee is often overlooked. The fibula and tibia are
constructed something like a bow and its draw-
string, with the fibula being the flexible bow and
the tibia being the taught bowstring. This combi-
nation makes a natural shock absorber of the
lower leg. When the fibula loses its flexibility, the
lower leg also loses its shock absorption ability
and the stress of walking, running, etc. is trans-
ferred directly to the knee.
KNEE — EVALUATION/RELEASE
Before releasing the knee joint itself, it is impor-
tant to check the condition of the patella, and to
work with it if necessary. In order to bend the
knee without strain, the patella must move. The
condition of the patella is your first line of infor-
mation on the rigidity or flexibility of the knee.
If the patella is rigid, or has too much movement,
you already have enough information to know to
move slowly and carefully as you proceed with
your work.
Patella — Evaluation and Release
1. With the client supine, check the movement of
her patella by gently sliding it in its available
planes of movement: superiorly, inferiorly,
laterally, medially. You may want to combine
these movements to check diagonal movements
as well.
a. The patella will naturally have more move- i
ment available medially than laterally, but all
other movements should be approximately
equal. If the patella shows a preference of
movement in any particular direction, take it
in that direction and hold for 10-60 seconds.
Re-check the movement and perform any other
release positions that may be indicated. j
b. If the patella does not move, or there is
discomfort upon movement, gently compress
from the kneecap straight back against the
joint. Support the back of the knee as you
do this so you do not hyperextend the knee.
Compression of the patella will generally begin
to free up enough movement to begin to notice
preferences in the available range. If there con
tinues to be no movement of the patella, be
very cautious with any movements of the knee
that involve bending. You may not be able to
move into some of the release positions for the
knee until the patella has some movement to :
96
The Tower Limbs — Knee
2. Check around the edge of the patella for spe-
cific areas of discomfort. If there is sensitivity,
position the patella to relieve the discomfort.
For example, if there is a point on the lateral
edge of the patella that is uncomfortable you
may try pulling the patella towards that point
and gently compressing it straight back against
the joint.
Knee — General Evaluation /Release
The techniques used to evaluate the knee’s condi-
tion are also the techniques used to create release
positions. Each of the evaluation techniques in
this section will place a slight strain on the knee
joint, so move slowly and check with your client
about the comfort of what you are doing.
Check the following intrinsic movements of the
knee:
1.	With the client supine, check for incomplete
extension of her knee. First, visually notice
if the client’s knees are fully extended. Then,
hold the client’s thigh firmly against the table
and gently lift her ankle towards the ceiling.
The knees should be resting relatively flat on
the table and there should be a slight flex avail-
able when lifting the ankle.
If the knees are slightly bent, or there is no
hyperextension available: Stand on the affected
side and slightly bend the client’s knee on that
side. Slide your arm, palm down, under that
knee and place it on top of the client’s opposite
thigh, just above her knee. The client’s lower
thigh on the affected side will now be resting
on the back of your forearm.
Place your other hand just below the client’s
bent knee. Gently compress the client’s lower
leg straight back/down towards the table. Hold
for 10-60 seconds. Re-check the extension of
the knee. See Figure 4.5.
Figure 4.5
2.	With the client’s leg straight, place one hand
above her knee on the front of the thigh, the
other below the knee on the front of the shin.
Check the knee’s intrinsic rotation by holding
the femur stable and gently rotating the tibia
first medially and then laterally. There should
be roughly equal, though slight, movement in
each direction. If there is restriction or discom-
fort upon movement in one direction, rotate
the tibia in the opposite direction and compress
from the lower leg into the knee joint. Hold for
10-60 seconds. Re-check the movement. You
may also check this rotational movement with
the knee flexed. There should be more rotation
available in the knee joint when the knee is bent
than when it is straight. See Figure 4.6.
Figure 4.6
97
Ortho-Bionomy
3.	Check for available lateral slide within the
knee joint. Side-pressure on the knee with the
leg straight is the most stressful movement pos-
sible for the knee. The movements you will be
looking for in this test are minute, so go slowly
and stay within the range of movement that is
comfortable for the client. Some people find
this lateral slide movement uncomfortable so
if you or your client have any concerns about
doing this test just leave it out of the work you
do with the knee.
With the client’s leg straight, place one hand on
the medial side of her knee, just above the joint,
the other hand on the lateral side of her knee,
just below the joint. Slightly slide the lower
hand medially, while restricting any movement
if the thigh. Reverse the position of your hands
and repeat the movement, with the lower hand
sliding laterally.
There should be a slight flex in both of these
directions. If there is not, hold the leg in
whichever of these two positions has the great-
est possible movement and which is most com-
fortable for the client. Compress into the joint.
Hold for 10-60 seconds. See Figure 4.7.
Check the knee’s extrinsic movement:
With the client supine, bend her knee up towards
her chest. If possible, gently bounce her heel
toward her buttock. There should be enough
range of motion available in the knee for it to
have a slight “bounce” when it is fully flexed.
If there is not, straighten the client’s leg and com-
press into her knee joint from both the upper and
lower leg. See Figure 4.8.
Figure 4.8
Figure 4.7
98
The Lower Limbs — Knee
Knee — Specific Evaluation/Release
Indicator Points
As with the shoulder, specific points may be used
to indicate possible areas of tension in the knee.
For each specific area of tension or discomfort
that you find, you may gently contact that point
and use the appropriate release position as given
below. The release positions described are approx-
imate starting places only. You will need to fine
tune them by finding the slight variations which
maximize the softening of the point.
Location of points:
Trace around the heads of the femur, the tibia
and the fibula, paying particular attention to the
areas where the heads of the bones narrow down
toward the necks of the bones. Any area of sensi-
tivity may be used as an indicator point. The
most common points of tension are shown in
Illustration 4.3.
Release positions for medial points:
Stand on the affected side. With the client supine,
flex her knee and allow it to drop slightly toward
you (laterally). Place your hand on her foot as
shown in Figure 4.9 and flex her heel to the inside
(invert her foot). Monitor the indicator point and
with a combination of inversion of the foot and
flexion of the knee, find the position that maxi-
mizes the softening of the indicator point. Com-
press from the foot, up the line of the leg, into the
knee. Hold for 10-60 seconds. Re-check the indi-
cator point.
Release positions for lateral points:
Stand on the affected side. With the client supine,
flex her knee and allow it to lean slightly away
from you, across the midline (medially). Support
her knee with one hand and hold her foot as
shown in Figure 4.10. Flex the foot laterally (evert
Figure 4.9
the foot) and with a combination of eversion of
the foot and flexion of the knee, fine tune the posi-
tion to maximize softening of the indicator point.
Compress into the knee joint from the foot. Hold
for 10-60 seconds. Re-check the point.
If the above position is uncomfortable for the
client, try the alternative position of bringing the
foot and lower leg below the line of the table.
This position will relieve strain at the hip socket
by reducing the angle of the leg.
99
Ortho-Bionomy
Fibula Release
As mentioned in the Anatomy section, the fibula
plays an important role in the health of the knee.
The lateral release position described above will
often relieve minor tension in the connection of
the fibula to the tibia. However, there will some-
times be a more severe imbalance in the fibula
that will need a more specific position.
To evaluate the balance of the fibula you will do
much the same kind of test as you did when test-
ing the intrinsic rotation of the tibia. But you will
restrict the movement to the fibula only. To do
this, with the client supine, gently hold the heads
of the fibula at each end (near the knee and the
ankle). Gently flex the fibula back toward the
table (posteriorly) and then forward toward the
front of the shin (anteriorly).
Make sure that it is only the fibula that is moving,
not the entire lower leg. There should be a slight
flex in the fibula in both of these directions. If
there is not, roll the fibula in the direction that is
most comfortable, or that has the most available
movement. Hold for 10-60 seconds. Re-check
the movement and repeat the release position if
necessary.
NOTE: You may need to use your thumb in
order to get a firm enough contact for the release
movement, but be careful not to cause discomfort.
If making contact directly on the head of the fib-
ula is uncomfortable for the client, try moving
your contact further up or down the length of the
bone.
If there was restriction in the intrinsic movement
of the knee that did not resolve with the release
positions given in that section, try the same movi
ments now that the fibula has been released.
Sometimes restriction in the movement of the
fibula will, in turn, restrict movement of the tibi;
KNEE — RELEASE INDICATORS
If there are no other imbalances present:
•	The patella will move freely and jvithout dis-
comfort.
•	Intrinsic movements of the knee will be more
balanced and comfortable.
•	Extrinsic movement of the knee will be com-
fortable and will have full range of motion.
•	The indicator points will have reduced
sensitivity.
•	There will be comfortable and balanced move-
ment available in the fibula.
100
Ankle
The Lower Limbs — Ankle
\NKLE — ANATOMY
\ee Illustrations 4.4 and 4.5
LATERAL VIEW
MEDIAL VIEW
Illustration 4.4
Illustration 4.5
The ankle joint is the connection of the leg to the
foot and is formed by the tibia and fibula meeting
the talus. What many people call their ankle
bones (the bumps on each side of the ankle) are
actually the heads of the tibia and fibula. On the
inside of the leg the head of the tibia is called the
medial maleolus, on the outside of the leg the
head of the fibula is called the lateral maleolus.
The names for the anatomical movements avail-
able in the ankle are somewhat different than
those of other joints. Flexing the foot is called
dorsiflexion and pointing the toes is called plan-
tarflexion. Rolling the foot to the inside is called
inversion and rolling it to the outside is called
eversion. When you are standing or walking,
these two movements are called supination and
pronation. The movements of compression and
traction are especially important in the ankle
because the amount of compression or traction in
the ankle joint helps us determine how our foot is
placed in relation to our legs and whether or not
we have the correct weight distribution needed to
maintain balance.
105
Ortho-Bionomy
ANKLE — EVALUATION
Check for imbalance in the ankle by taking the
joint through its possible movement patterns.
Hold the leg stable and move the foot through
dorsiflexion, plantarflexion, inversion, eversion,
compression and traction. The foot will naturally
have slightly more movement in inversion than
eversion, but otherwise there should be relatively
equal movement available in the full anatomical
range. Notice if there are any movements in the
ankle that are restricted or uncomfortable.
ANKLE — RELEASE
General Positional Releases
If one movement is uncomfortable, try the oppo-
site movement as a release position. For example,
if there is resistance or discomfort on eversion,
invert the foot and compress from the bottom
of the foot into the ankle joint for 10-60 seconds.
Give some gentle traction to the joint as you move
out of the position, and re-check the movement.
See Figure 4.11.
Figure 4.11
Release for Incomplete Flexion
If the ankle is unable to completely dorsiflex or
plantarflex, try each of the following two release
positions and use the one that is most comfortabl
for the client.
1. With one hand, hold the client’s leg firmly
on the table. With the other hand under the
client’s heel, gently and firmly pull her foot
straight up toward the ceiling. This will pro-
duce a sliding movement in the ankle joint,
with the talus sliding anteriorly.
2. With one hand, lift the client’s ankle slightly
off the table. With the other hand on the top
of the foot, near the ankle, gently and firmly
push the foot straight down towards the table.
This will produce a movement of the talus slid-
ing posteriorly. See Figure 4.12.
Figure 4.12
Hold for 10-60 seconds. Give some gentle trac-
tion to the ankle joint as you move out of this
position, and re-check the movement.
106
The Lower Limbs — Ankle
ANKLE — RELEASE INDICATORS
If there are no other imbalances present:
• There will be comfortable and balanced range
of motion in the ankle joint.
Notes
1. Because the ankle joint bears so much weight as
part of its natural function, firm compression is
usually required when working with it. Check
with the client to ensure that your compression
is adequate, or if you are using too much.
2. When the ankle has almost no movement avail-
able (for example, an ankle recovering after
having been in a cast), you may need to begin
with simple compression or traction until the
joint regains enough movement to express a
preference.

Foot
The Lower Limbs — Foot
— ANATOMY
Illustration 4.6
LATERAL ARCH
MEDIALARCH
Illustration 4.6
foot can be divided into three general seg-
its: tarsals, metatarsals, and phalanges. The
als are at the rear of the foot and are composed
te calcaneus, the talus, the navicular, the cuboid
the three cuneiforms. The metatarsals are the
long bones that make up the midsection of the
. They are numbered, one to five, from the
ial side of the foot to the lateral side. The pha-
es are the fourteen bones that form the toes.
The foot is a very powerful weight-bearing struc-
ture. Its bony architecture has two difficult jobs,
both made possible by its arches: to balance the
body as it moves, and to absorb the shock created
by movements such as running and jumping. The
foot is commonly thought to have one arch, running
the length of the foot. Anatomically, the foot actu-
ally has three arches: the medial longitudinal arch,
the lateral longitudinal arch and the transverse arch.
111
Ortho-Bionomy
FOOT — EVALUATION
General Evaluation/Release
You may need to work with the ankle before the
foot will release completely.
Check the movement of the arches of the foot:
1. Place your hand on the bottom of the client’s
foot. Gently dorsiflex her foot, first with the
emphasis on the lateral arch of the foot, then
with the emphasis on the medial arch. There
should be enough flex in these two arches to
absorb most of the movement without trans-
ferring it up the leg. If there is not, gently
squeeze the entire midsection of the foot while
compressing the midsection back towards the
heel. Re-check the movement of the arches. If
there is still not adequate movement, you may
need to do some specific releases as described
below.
2. Place your fingertips on the top of each side of
the client’s foot, near the base of her toes. On
the underside of the foot, place your thumbs
in the center of the ball of the foot. Using
your thumbs, gently flex the center of the trans-
verse arch up towards the top of the foot,
while pulling down on the outer edge of the
foot. Then, reverse the movement by using
your fingertips to gently press the center of
the arch down toward the bottom of the foot,
while lifting up on the edges of the foot with
your thumbs.
These two movements look something like
shuffling a deck of cards. There should be a
slight flex available in both of these planes of
movement. If there is not, choose whichever
of the two movements is most comfortable for
your client and gently squeeze her foot while it
is in that position.
Check the movement of each of the general
segments of the foot:
1.	Check for balanced movement in the tarsal
area of the foot in relation to the ankle (see
ankle section for a complete description of
these movements and the associated release
positions).
2.	Gently rotate the front section of the foot
medially and laterally to check the movement
of the metatarsal section in relation to the
tarsal area. If there is more movement avail-
able in one direction of rotation, hold the
front section of the foot in that rotation and
compress it straight back towards the heel.
See Figure 4.13.
You have already checked the movement within
the metatarsal area itself when you checked the
movement in the lateral and medial arches.
3.	Check the general movement of the toes in
rotation, flexion and extension. Hold the toes
in any positions of preference and compress
into the associated joint.
112
Ortho-Bionomy
• Bunion
Technically, a bunion is an inflammation of the
bursa of the metatarsal. In common usage, how-
ever, the word “bunion” is used to describe an
enlargement (possibly accompanied by inflamma-
tion) of the joint at the base of the big toe. Some
people may have a “bunion” with no associated
pain, while for others it is a painful and debilitat-
ing condition.
In working with a “bunion” you may approach
it as you would an imbalance in any of the other
metatarsal joints. Begin by finding any preference
of movement within the joints of the big toe, and
gently compressing into the joint with the toe in
its most comfortable position. Hold for 10-60
seconds.
Next, place your thumb at the base of the big toe,
on the top of the foot, and your first finger of the
same hand at the base of the toe on the bottom
of the foot (as if you are pinching the base of the
big toe). Gently pull the joint medially (toward
the inside edge of the foot). At the same time,
gently pull the big toe in the opposite direction,
across or underneath the other toes. Hold for
10-60 seconds.
To assist in re-educating the toe into the correct
alignment, the client may want to put a rolled up
piece of cloth between the big toe and the adjoin-
ing toe. Then place an elastic band around the
front of the foot, near the base of the toes, to sup-
port the joint.
•	Specific Points of Discomfort
In the course of working with the client’s foot, if
you find any specific points of discomfort, you
may release these points with a positional release
that maximizes softness and comfort in the affect-
ed point. See Figure 4.16.
FOOT — RELEASE INDICATORS
If there are no other imbalances present:
•	There will be increased flex in all of the arches
of the foot.
•	There will be increased movement in each of
the general segments of the foot.
•	There will be increased comfort and movement
in each of the joints of the foot.
•	Discomfort in specific points on the foot will bt
reduced.
114
The Lower Limbs — Foot
Specific Evaluation/Release
If the general releases described above do not free
up the movement of the foot, it may be necessary
to perform specific releases for individual bones of
the foot. As you evaluate the movements of the
various bones of the foot, it is important to
remember that the natural movement available
within the joints is quite small compared to other
joints in the body. If you are not sure how to eval-
uate the movement of the bones, base your release
positions on how comfortably the bone moves.
There are 26 bones in each foot. This can make
working with the foot seem complex. A simple
way to approach working with the foot is to begin
at the heel and work forward on the foot, check-
ing each joint for flexibility and comfort.
Some suggested release positions are given. How-
ever, the best approach is to experiment with
different release positions for each joint and use
whichever is most comfortable for the client.
•	TALUS: The release positions for the talus are
effectively the same as for the ankle releases.
•	CALCANEUS: Hold the client’s ankle still
while gently moving just the calcaneus (heel) in its
various possible movements. Hold it in whichever
position is most comfortable and compress the -
heel towards the ankle. Also check the movement
:igure 4.14
of the calcaneus in relation to the rest of the
tarsals. Hold in the most comfortable position
and compress. See Figure 4.14.
•	NAVICULAR, CUBOID, CUNEIFORMS:
Move each bone in relation to the surrounding
bones. Hold the individual bones, or that section
of the foot, in the most comfortable position and
compress. A combination of compression by
squeezing the foot and simultaneously compress-
ing the front section of the foot towards the heel
is usually most effective. For the navicular and
cuboid, experiment with rotation of the front sec-
tion of the foot (metatarsals) in combination with
compression. See Figure 4.13.
•	METATARSALS: Move each individual
metatarsal. Use a combination of compression
and rotation to find the most comfortable posi-
tion. Check the head of the metatarsal on the
underside of the foot, just below the base of the
toes. If there is any discomfort in this area, you
may use the toe associated with the affected
metatarsal as a lever. Use the toe to push the head
of the metatarsal inferiorly by flexing the toe and
compressing it straight down towards the bottom
of the foot. See Figure 4.15.
113
Section 5
THE UPPER LIMBS
Shoulder
The Upper Limbs — Shoulder
SHOULDER — ANATOMY
See Illustrations 5.1 and 5.2
The shoulder is made up of a series of joints and
muscle attachments. The clavicle forms the only
bony connection of the shoulder to the trunk.
Therefore, there is more mobility than stability
in the shoulder joint.
The scapula attaches to the clavicle at the front
of the shoulder. It attaches to the ribcage only
through muscular connections.
BICIPITAL
GROOVE OF
THE HUMERUS
HEAD OF THE
HUMERUS
LONG HEAD
OF BICEPS
ACROMION
CORACOID
PROCESS-
SCAPULA
SHORT HEAD
OF BICEPS
ANTERIOR VIEW
Illustration 5.1
CLAVICLE
Illustration 5.2
121
Ortho-Bionomy
There are three articulations (joints) within the
structure of the shoulder:
1.	acromio-clavicular — the joint between a
projection of the scapula, called the acromion,
and the clavicle.
2.	sterno-clavicular — the joint between the
sternum and the clavicle.
3.	scapulo-humeral — the joint between the
scapula and the humerus.
SHOULDER —
EVALUATION/RELEASE
In assessing the balance of the shoulder, a series of
points is used to indicate possible areas of tension.
See Illustration 5.3. The points are numbered
for convenience and do not necessarily have to be
released in the order given. Evaluations/ releases
for the scapula, clavicle and sternum will be given
separately.
SHOULDER POINT 1
SHOULDER POINT 8
'//fl
SHOULDER
POINT 6
SHOULDER
POINT 7
SHOULDER POINT 2
SHOULDER POINTS
SHOULDER
POINT 4
SHOULDEF
POINTS
ANTERIOR VIEW POSTERIOR VIEW
Illustration 5.3

122
The Upper Limbs — Shoulder
For each of these points, you will gently contact
the point, observing any tension or discomfort.
For any points that are tender use the release posi-
tion described for that point. The release positions
described are approximate starting places only.
You will need to fine tune them by finding the
slight variations which maximize the softening of
the point. You don’t need to release the points
that aren’t tender or tight.
When moving into the release position, the con-
tact on the point should be gentle and at skin-
level. It is the POSITION that helps catalyze the
release, not the point. If you cannot easily moni-
tor the indicator point while holding the release
position, it is better to focus on the position and
re-check the point after the release. When moving
out of the release position, unwind back out with
a slight, gentle pull from the joint.
ANTERIOR VIEW
Illustration 5.4
Shoulder Point 1
Location: Coracoid process of the scapula (a
thumb-like projection of the scapula that pro-
trudes toward the front of the ribcage). See
Illustrations 5.3 and 5.4.
To find SI: First find the head of the humerus.
Then, move slightly medial into the soft tissue. Feel
for a point (about the size and shape of a fingertip),
that protrudes more than the surrounding tissue.
SI Release: With the client supine, bring his arm
across his chest with his elbow bent, to form a
right angle to the chest. Fine tune the position
by rotating the forearm and/or changing the angle
of the humerus (i.e., reach further across the chest,
bring arm down toward abdomen, etc.). Com-
press slightly down the line of the arm from the
elbow into the joint. Hold for 10—60 seconds.
Bring the arm back to the neutral position and
re-check the point. See Figure 5.1.
123
Ortho-В ionomy
Shoulder Point 2
Location: Inside the V formed by the acromio-
clavicular joint. See Illustration 5.3.
To find S2: On top of the shoulder, find the inside
tip of the V formed by the clavicle meeting the
scapula. Make sure you are contacting all the
way out to the very tip of the V, almost at the
point where the shoulder begins to curve around
to the arm.
b. If the above position is not comfortable, try
bringing the client’s arm, (with the elbow bent
and the hand resting on his opposite shoulder)
across his chest. The elbow should be pointing
toward the opposite hip, as if the client is giv-
ing himself a half-hug. Gently compress his
elbow straight down against his ribcage
(toward the table). Hold for 10-60 seconds.
Bring the arm back to the neutral position and
re-check the point. See Figure 5.3.
S2 Release: With the client supine, use whichever
of the two following release positions is most
comfortable for him.
a. Bend the client’s elbow. Bring his arm directly
out to the side. The release position is generally
within the arc between the 90 degree and 180
degree sweep of the arm. When you find the
arm position that feels most comfortable for the
client, compress gently from his elbow into the
shoulder joint. Hold for 10-60 seconds. Bring
the arm back to the neutral position and re-
check the point. See Figure 5.2.
Figure 5.2
Shoulder Point 3
Location: Anywhere along the inferior edge of the
spine of the scapula (the bony projection that runs
just below the upper edge of the shoulder blade).
See Illustration 5.3.
S3 Release: With the client prone or in the side
posture, bend his elbow. Then bring his arm
back toward the scapula, and fine tune the posi-
tion. Compress up the line of his arm into the
shoulder joint. See Figure 5.4.
124
The Upper Limbs — Shoulder
the side posture, the shoulder can also be
lied back toward the point and additional com-
ession given straight into the ribcage from the
pulder/arm. Hold for 10-60 seconds. Bring
e arm back to the neutral position and re-check
e point. See Figure 5.5.
lure 5.5
Shoulder Point 4
Location: At the midpoint in the triangle of the
scapula. See Illustration 5.3.
S4 Release: Use the same starting position as
for Point 3. The specific release position will be
slightly different because you are working a differ-
ent part of the shoulder. Monitor the point and
position for maximum softness and comfort.
See Figures 5.4 and 5.5.
Shoulder Point 5
Location: At the upper deltoid separation on the
posterior of the shoulder. See Illustration 5.3.
To find S5: With the client’s arm against the side
of his ribcage, the point is approximately 2 inches
above the armpit crease on the back of his shoulder.
S5 Release: With the client supine, bend his arm
and bring his elbow below the level of the shoul-
der so it is pointing toward the floor. This posi-
tion may be sufficient for releasing the point.
If not, shrug the shoulder forward, fine tune the
position, and gently compress from his elbow up
into the shoulder joint. Hold for 10-60 seconds.
Bring the arm back to the neutral position and
re-check the point. See Figure 5.6.
Figure 5.6
125
Ortho-Bionomy
Side posture: With client’s arm bent, bring his
elbow back toward the spine (similar to the
release for Points 3 and 4). See Figure 5.5. Shrug
his shoulder forward and compress from the
elbow into the shoulder joint. Hold for 10-60
seconds. Bring the arm back to the neutral posi-
tion and re-check the point.
Shoulder Point 6
Location: On the side of the arm, at the mid-
point of the upper deltoid (approximately 2-3
inches inferior from the tip of the shoulder.)
See Illustration 5.3.
S6 Release: With the client supine, bend his
elbow, and bring his arm straight out to the side
(at a right angle to the side of his body.) Rotate
the humerus superiorly (toward head) or inferior-
ly (toward feet) until the point is at the maximum
relaxation. Compress from his elbow into the
shoulder joint. Hold for 10-60 seconds. Bring
the arm back to the neutral position and re-check
the point. See Figure 5.7.
Shoulder Point 7
Location: At the bicipital tendon of the humerus.
See Illustration 5.4.
To find S7: Locate the head of the humerus.
Directly on the anterior aspect of the head of the
humerus, you should feel the tendon of the biceps
as it passes over the humeral head to attach to
the shoulder blade. Feel for tension 1-2 inches
down the line of the bicipital tendon, into the
biceps itself.
S7 Release:
a.	Bend the client’s elbow slightly, and bring his
arm across his chest, as if he were trying to
touch his opposite hip. Roll the humerus inter-
nally (in toward the ribcage). Compress directly
from the side of the shoulder into the ribcage.
Hold for 10-60 seconds. Bring the arm back
to the neutral position and re-check the point.
See Figure 5.8.
126
The Upper Limbs — Shoulder
b.	If the above position does not release the
point: bend the client’s elbow and bring his
arm across his chest to form a right angle to
the chest (forearm is above chest and parallel
to the table). Gently twist his upper arm mus-
cles internally (toward the inside of the arm).
At the same time, gently rotate his forearm
toward his face (as if he were brushing a fly
off his nose). Compress from his elbow into
the shoulder joint. Hold for 10-60 seconds.
When lifting out of the position, gently rotate
the upper arm tissue back out of the twist.
See Figure 5.9.

Figure 5.9

Shoulder Point 8
Location: The lateral aspect of the acromio-
clavicular joint (the outside tip of the V of the
clavicle and scapular joint.) This point is opposite
Point 2. See Illustrations 5.3 and 5.4.
S8 Release: The release positions are similar to
the release positions for Point 2. The arm will
usually be at more than a 90 degree angle from
the torso. The most common release position is
shown in Figure 5.10.
SHOULDER —
RELEASE INDICATORS
If there are no other imbalances present:
•	The points will be softer and more comfortable.
•	The ease of movement will be increased.
•	There will be increased range of motion for the
shoulder.
127
Ortho-Bionomy
Notes
•	Notice that the points and release positions
are numbered so they form a spiral around the
shoulder when counted from 1 to 8. This is a
simple way to remember the location and
release positions for the points.
•	These are not the only points you may work in
the shoulder. They are common problem areas
and approximate release positions. You may
use any points of tension as release points and
experiment with various positions of release.
•	The shoulder is particularly susceptible to
“freezing” up and becoming restricted in its
movement. If you cannot get enough move-
ment in the shoulder joint to perform the stan-
dard release positions, start with various angles
of compression into the shoulder, with the arm
kept close to the torso. See Figure 5.5. This
will often free up enough movement in the
shoulder to use the more common release posi-
tions. You may need to supplement release
work with gentle movement exercises for the
client to do at home.
•	There is sometimes a shoulder-opposite hip
connection. Sometimes releasing the pelvis
assists in relaxing the shoulder.
128
Scapula
The Upper Limbs — Scapula
ANTERIOR VIEW
POSTERIOR VIEW
Illustration 5.5
Illustration 5.6
133
Clavicle
Ortho-Bionomy
The scapula, commonly called the shoulder blade,
is a triangular-shaped bone which attaches to the
clavicle at the front of the torso. Through a series
of muscle attachments, the scapula “floats” on the
back of the ribcage. Notice that you cannot lift
your arm straight above your head without the
glide of the scapula across the ribs. Also notice
how much further forward your reach is extended
when the scapula is included in the movement.
SCAPULA — EVALUATION
The movement of the scapula may be restricted by
contraction in the muscles which attach it to the
ribcage, with no apparent imbalance or discom-
fort in the shoulder joint itself. It is important to
check the movement of the scapula, even if the
shoulder points are not sensitive.
To do this, with the client prone or on his side,
gently slide the scapula through its range of
motion: superiorly, inferiorly, laterally, medially.
You may keep the client’s arm against his side and
move only the scapula, or you may include his
arm in the range of movement.
Check for tension or discomfort in the muscles
along the entire border of the scapula.
SCAPULA — RELEASE
With the client prone or in the side posture, roll
his shoulder back towards his spine, monitoring
the muscles at the edge of the scapula. Find the
position which maximizes relaxation and comfort
of the muscles bordering the scapula. Compress
the shoulder straight in towards the ribcage. If
possible, gently lift the edge of the scapula away
from the ribcage, to give the muscles a slight
stretch before you move out of the release posi-
tion. See Figures 5.4 and 5.5.
SCAPULA______
RELEASE INDICATORS
If there are no other imbalances present:
•	There will be increased ease and range of move-
ment of the scapula.
•	There will be increased relaxation and comfort
in the muscles along the border of the scapula.
134
The Upper Limbs — Clavicle
CLAVICLE — ANATOMY
See Illustrations 5.7 and 5.8
The clavicle (collar bone) joins the sternum at
one end, and the scapula at the other. It forms
the only bony connection of the shoulder to the
torso. For such a small bone, it bears a lot of
stress from supporting the shoulder and absorbing
the force of its movement. Consequently, the clavi-
cle is the most-often broken bone in the body.
As the clavicle acts mainly as a stabilizer, its joints
(the sterno-clavicular and the acromio-clavicular)
have little movement. When checking for move-
ment, as described in the Evaluation section,
remember that the movements will be slight.
ANTERIOR VIEW
Illustration 5.7
SCAPULA
FIRST RIB
CLAVICLE
STERNUM
Illustration 5.8
137
Ortho-Bionomy
CLAVICLE —
EVALUATION/RELEASE
Check for an imbalance in the various planes of
movement:
1.	With one hand on the sternal end of the clavi-
cle, the other hand at the scapular end, gently
rock each end alternately toward the table (like
a teeter-totter). Hold in the preferred position.
You may bring the shoulder forward to exag-
gerate the position. See Figure 5.11.
2.	Gently holding the clavicle along the length
of the bone (with fingertips or the edge of the
hand), rock inferiorly (toward feet) or superior-
ly (toward head). Hold in the preferred posi-
tion. See Figure 5.12.
3.	Check for preference in the rotational move-
ment by gently holding the clavicle near each
end and slightly rotating in each direction.
Hold in the preferred position. See Figure 5.12.
4.	Bilateral balance: Compare the movement
of one clavicle to the other by rocking the
shoulders in their various planes of movement
(i.e., down towards feet). Hold in an exaggera-
tion of any imbalance found. Release and rock
both clavicles/shoulders to integrate.
Check for discomfort:
If there is discomfort or tension near the joint,
at either end of the clavicle, gently position with
one or both shoulders and/or compression on the
sternum to release. (See shoulder points 2 and 8
for acromio-clavicular releases.)
CLAVICLE —
RELEASE INDICATORS
If there are no other imbalances present:
•	There will be more balance in the planes of
movement.
•	There will be less discomfort at the joint(s) of
the clavicle.
138
Sternum
The Upper Limbs — Sternum
STERNUM — ANATOMY
See Illustration 5.9
The sternum (breast bone) is the narrow plate
to which the upper ten ribs attach on the front
of the chest. The clavicle (collar bone) joins the
shoulder to the torso through its connection
with the sternum.
MANUBRIUM
BODY OF STERNUM
XIPHOID PROCESS
STERNUM —
EVALUATION/RELEASE
With the client supine, check for imbalance in any
of the planes of movement of the sternum by gently
rocking it towards the table alternately on each side,
and at its superior and inferior ends. To check the
general flexibility of the sternum, gently compress it
in a posterior direction (straight down towards the
table.) The sternum should have a slight flex in all
1 of these movements. See Figure 5.13.


Ortho-Bionomy
Use the ribs and shoulders to assist in positioning
the sternum in the preferred position. For exam-
ple, if the sternum rocks easily toward the right
side, but doesn’t move on the left at all, you may
compress on the right side and lift the left shoul-
der and ribcage to exaggerate the imbalance.
Hold 10-60 seconds. Bring the shoulder(s) back
to the neutral position and re-check the movement
of the sternum. See Figure 5.11.
STERNUM —
RELEASE INDICATORS
If there are no other imbalances present:
•	There will be increased ease of movement of
the sternum.
•	There will be more balance in the planes of
movement of the sternum.
144
Elbow
The Upper Limbs — Elbow
ELBOW — ANATOMY
See Illustration 5.10
The elbow joint is a hinge joint made up of three
bones: the upper arm bone, called the humerus;
the bone on the thumb side of the forearm, called
the radius; and the second bone of the forearm,
called the ulna. The olecranon (head) of the ulna
cups around the back of the head of the humerus,
holding the ulna still during rotation of the fore-
arm. During this rotation, the radius rolls across
the ulna. If you alternately pronate (palm down)
and supinate (palm up) your forearm, you may
notice that the radius and the ulna stay relatively
still at the elbow, and that the rotation is achieved
by the radius crossing over the ulna as you turn
your hand. It is easiest to notice this rotational
movement with the elbow bent so the rotation
of the humerus is not included in the movement.
With the elbow bent, the forearm normally has a
range of 140-180 degrees of rotation available.
Along their entire lengths, the radius and the ulna
are held together by the interosseus ligament, or
membrane, that runs between the two bones. This
membrane should be taut only when the hand is
midway between pronation and supination and
should be somewhat relaxed in complete prona-
tion or supination.
ELBOW —
EVALUATION/RELEASE
Working with the elbow is similar to working
with the knee, and the basic evaluation and re-
lease techniques are much the same. As with the
knee, the techniques used to evaluate the elbow’s
movement are also the techniques used to create
release positions. Begin with a general evaluation
and release of the elbow and move on to specific
points of tension and their associated release posi-
tions as needed.
Elbow — General Evaluation/Release
Check the general movement of the elbow joint:
1. Gently flex and extend the client’s elbow joint.
Notice if full flexion and extension are avail-
able and if the movements can be made without
strain or discomfort in the elbow.
If the client’s arm will not fully extend, flex her
arm and compress down the line of the forearm
into the elbow. If the arm will not fully flex,
straighten it and compress into the elbow from
the forearm. Repeat as needed, with variations
in the angle of flexion/extension and with the
addition of rotation of the forearm.
147
Ortho-Bionomy
2. Gently rotate the client’s forearm in each direc-
tion (pronation and supination), both with the
elbow bent and with it straight. Notice if full
rotation is available in each direction without
restriction or discomfort.
If there is an imbalance in the rotation of the
forearm, rotate the forearm in the direction of
most available movement and compress up the
line of the forearm into the elbow joint. For
example, if there is more internal rotation than
external rotation available, begin by placing the
client’s arm flat on the table, palm up. With one
hand just above the client’s elbow, gently rotate
her humerus externally. With the other hand,
gently rotate the client’s forearm internally
(pronation). Compress up the line of the fore-
arm into the elbow and hold for 10-60 seconds.
Return to the neutral position and re-check the
movement. See Figure 5.14.
Figure 5.14
If the forearm has little or no rotation available,
begin by compressing into the elbow joint, both
from the forearm and from the upper arm. Try
slight variations on the angle of compression until
enough movement is available in the joint to
express a clear preference of position.
Elbow — Specific Evaluation /Release
Indicator Points
As with the shoulder and the knee, specific points
may be used to indicate possible areas of tension
in the elbow. For each specific area of tension or
discomfort that you find, you may gently contact
that point and use the appropriate release position
as given below. The release positions described
are approximate starting places only. You will
need to fine tune them by finding the slight varia-
tions which maximize the softening of the point.
Check for specific areas of tension or sensitivity
around the heads of each of the bones of the elbow.
Remember to check the “funny bone,” the area at
the back of the elbow around the olecranon. See
Illustration 5.10. The most common areas of sensi-
tivity are indicated on Illustration 5.11.
148
The Upper Limbs — Elbow
Indicator Point Release Positions: Experiment
with a combination of flexing the client’s elbow,
rotating her forearm and flexing/extending her
hand until there is maximum softening and com-
fort in the indicator point. Compress down the
line of the forearm into the elbow joint. Hold for
10-60 seconds, return to the neutral position and
re-check the points. See Figure 5.15.
Generally, the medial elbow indicator points
release most easily with the forearm pronated and
the hand extended. Leaning the client’s forearm
slightly toward her torso may also assist in the
release. For lateral points, the release position
usually includes supination of the forearm, some
flexion of the hand, and leaning the client’s fore-
arm away from her torso. For both medial and
lateral points, compression down the line of the
forearm into the elbow joint is included in the
release position.
Interosseus Ligament
Check for tension or contraction along the inter-
osseus ligament by gently palpating the area along
the middle of the forearm between the ulna and
the radius. Notice if there is any tension, sensitivi-
ty or areas of contraction along the ligament.
Use the combination of elbow flexion and forearm
rotation that maximizes softening in the affected
area of the ligament. Sometimes simply squeezing
the radius and the ulna together along the length
of the forearm will release general tension in the
ligament. Combine this forearm squeeze with rota-
tion of the forearm and positioning of the hand to
release the ligament along it’s entire length so there
are no areas of discomfort or tension along the
forearm.
You may find that you need to work with the
wrist before the interosseus ligament releases
completely.
149
Ortho-Bionomy
Movement of Individual Bones
Check for the movement of the individual bones
at the elbow by gently “bouncing” or flexing the
head of each bone. The head of each bone should
move slightly within the joint. If it does not, com-
press into the elbow from the forearm and the
upper arm, at various angles, until movement
within the joint is restored. Remember that the
radius and the ulna are the same bones that form
the wrist joint, so if the releases at the elbow do
not free up the movement of the bones, try the
releases described in the wrist section.
ELBOW — RELEASE INDICATORS
If there are no other imbalances present:
•	The range of motion of the elbow will be bal-
anced and movement will be comfortable.
•	Specific areas of tension or discomfort around
the elbow joint, or along the forearm, will relax
and become more comfortable.
•	The individual bones within the elbow joint
will have adequate movement.
NOTE: Problems with the elbow may originate
at the shoulder or wrist. Be sure to include releas-
es for these joints when addressing elbow pain.
150
Wrist
The Upper Limbs — Wrist
WRIST — ANATOMY
DORSAL VIEW
Illustration 5.12
The wrist joint is formed by the meeting of the
bones of the forearm (the radius and the ulna)
with the metacarpals of the hand. The primary
movements of the wrist are flexion/extension and
abduction/ad duction (tilting the hand to the ulnar
side of the wrist/tilting the hand to the radial side
of the wrist). Flexion and extension are normally
about equal in the degree of movement available,
but there is usually greater movement available in
adduction than abduction. The combination of
these movements of the wrist with supination and
pronation of the forearm allows the hand to lie in
any plane of space in relation to the forearm.
155
Ortho-Bionomy
WRIST —EVALUATION /RELEASE
General Evaluation /Release
As with the elbow, the wrist may be taken through
its range of motion as a beginning evaluation of
its balance. Take the client’s hand through its full
range of flexion, extension, abduction and adduc-
tion. Notice if there is full and balanced move-
ment available in each of these ranges, and that
the wrist is comfortable through all types of
movement.
If the wrist’s movement is not balanced and com-
fortable, find the most comfortable position for
the wrist and compress from the hand into the
wrist joint. For example, if there is restriction in
extending the client’s hand, flex her hand and
compress from the hand into the wrist joint. If
there is restriction to one side or the other in the
hand’s tilting movement (abduction/adduction),
tilt the hand to the side which has the most
movement available and is most comfortable.
Compress from the hand into the wrist. Hold for
10-60 seconds, return to the neutral position and
re-check the movement. See Figure 5.16.
Figure 5.16
Specific Evaluation /Release
Indicator Points
You may also use any specific areas of tension
or discomfort at or around the wrist joint as
indicator points. As with knees and elbows, the
most common areas of tension are at the heads
of the bones.
Experiment with a combination of flexing and
tilting the client’s hand until you find the position
that maximizes comfort and softening in the indi-
cator points. Compress into the wrist from the
hand and the forearm. Hold for 10-60 seconds,
return to the neutral position and re-check the
point.
Check the movement of the individual bones:
The individual bones of the wrist joint should
have slight movements within the joint itself.
Gently flex, or “bounce,” the heads of the ulna
and the radius. If there is little or no movement
available in these bones, gently compress into the
wrist joint, from the hand and from the forearm.
Repeat the compression, with slight variations in
the angle, until movement within the joint is
restored. Remember that the bones at the wrist
are the same ones that form the elbow joint, so
if the releases at the wrist don’t free up the move-
ment of the bones, try the releases described in the
elbow section.
156
The Upper Limbs — Wrist
WRIST — RELEASE INDICATORS
If there are no other imbalances present:
•	The range of motion of the wrist will be bal-
anced and movement will be comfortable.
•	Specific areas of tension and discomfort will
relax and become more comfortable.
•	The individual bones within the joint will have
adequate movement.
157
Hand
The Upper Limbs — Hand
HAND — ANATOMY
See Illustration 5.13
The 27 bones of the hand can be divided into
three general segments: the 8 carpals that form
the base of the hand where it connects to the fore-
arm; the 5 metacarpals which complete the body
of the hand; and the 14 phalanges that make
up the fingers (3 per finger, 2 per thumb).
Illustration 5.13
161
Ortho-Bionomy
HAND —EVALUATION /RELEASE
General Evaluation /Release
Working with the hand is similar to working with
the foot. The primary difference is the opposable
thumb, which means the hand has gripping move-
ment available.
Check the movement of each of the general
segments of the hand:
Like the arch in the foot, the arch of the hand (the
body of the hand) should have flexibility. Check
for the general flexibility of the hand by gently
flexing the body of the hand, both from the palm
side and the back side of the hand. If there is little
or no flex available, you may begin with a general
compression (squeeze) of the entire hand. Adding
compression into the body of the hand from the
fingers sometimes aids in the release. This general
compression is sometimes enough to free up the
movement of the hand. If not, go on to specific
release positions as given below.
Check the movement of all of the fingers together
as a single segment. Gently curl the fingers down
toward the palm of the hand. Then gently flex
them back toward the back of the hand, first with
the fingers straight, then with the fingers bent.
Notice if the range of movement available is the
same for both hands. The fingers should be able
to curl all the way into a fist and to flex back to
approximately a 45 degree angle from the palm
of the hand. It is not uncommon to find that the
fingers of the most-used hand (the right hand for
most people) have a much more restricted range
of movement than those of the least-used hand.
Many people assume that the fingers are designed
only to bend forward, but in a relaxed hand the
fingers can extend back far enough to create a
distinct angle at the back of the hand.
If the fingers are restricted in their general move-
ment, hold them in the position of greatest com-
fort and greatest available movement and com-
press gently from the fingers into the body of the
hand. For example, if the client’s fingers cannot
extend back towards the back side of the hand
more than about 10 degrees, curl her fingers into
a fist and gently compress from the fingers into
the body of the hand. Hold for 10-60 seconds
then re-check the range of movement.
See the Specific Release section for a more detailed
description of releasing restriction in individual
finger movement.
Specific Evaluation/Release
Check for movement of the individual bones of
the hand.
•	Carpals: In the carpal section of the hand,
check for a slight flex in each of the bones. If
there is little or no movement available, com-
press from the body of the hand into the carpal
section. Repeat as needed, varying the angle
of compression.
•	Metacarpals: Each metacarpal should have
movement separate from the adjoining bones.
Check this by holding the head of each
metacarpal separately and moving it forward
and back (anteriorly and posteriorly). There
should be a distinct movement of each bone.
If there is not, compress from the associated
finger into the metacarpal, and from the
metacarpal into the base of the hand. Hold for
10—60 seconds, then re-check the movement.
Each metacarpal should also have some rota-
tion available in each direction. Check this by
gently rolling each metacarpal from side to
side. If there is uneven movement available,
gently roll the metacarpal in the direction of
162
The Upper Limbs — Hand
most movement and most comfort and com-
press down the line of the bone into the base
of the hand. Hold for 10-60 seconds, return
to the neutral position and re-check the
movement.
•	Phalanges: Check the rotation and flexion/
extension of each of the phalanges. If there is
restriction in any of these movements, hold the
individual phalange in whichever position is
most comfortable and has the most available
movement. Compress into the associated joint.
Hold for 10-60 seconds, return to the neutral
position and re-check the movement.
Sometimes incomplete extension of the fingers
is coming from tightness of the muscles in the
hand. Try some positional releases, curving the
palm in on itself, then re-check the finger move-
ment. If the extension is still restricted, work
with the individual joints. Curve the finger for-
ward and compress the base of the finger into
the joint. Hold for 10-60 seconds, then re-
check the movement. Repeat as needed, vary-
ing the angle of compression and with the addi-
tion of rotation of the affected joint.
In the case of incomplete flexion, compress into
the affected joint with the finger straight. Repeat
as needed, varying the angle of compression and
with the addition of rotation of the affected joint.
Indicator Points
Check for specific areas of sensitivity in the palm
of the hand, particularly around the base of the
thumb, and around the heads of each of the
bones. Also check for areas of sensitivity around
the joints of each of the fingers.
Use whichever combination of rotation and flex-
ion in each joint maximizes softening and com-
fort in the indicator points. For example, if there
is discomfort at the base of the thumb, rotate and
flex the thumb until the indicator point is soft
and comfortable. Compress from the thumb into
the joint. Hold for 10-60 seconds, return to the
neutral position and re-check the point. See
Figure 5.17.
HAND — RELEASE INDICATORS
If there are no other imbalances present:
•	There will be increased flexibility and increased
comfort of movement in the hand.
•	The individual bones of the hand will have bal-
anced and comfortable movement available.
•	Specific areas of tension and discomfort will
relax and become more comfortable.
163
Section 6
POST-TECHNIQUES
P ost-techniques
Post-techniques are used to integrate the changes
that may have occurred in the spine during release
work. They assist in restoring flexibility and give
some light exercise to the spine.
The discs in the spine have no direct internal
blood supply. They receive their nutrition and
dispose of waste through osmosis and through a
process called “imbibition” (literally “drinking”
from surrounding fluids). The discs must rely on
movement of the spine to keep the internal fluids
circulating and the cycle of waste and nutrition
exchange functioning. When the spine is com-
pressed or rigid, the movement around the discs is
impaired and the discs may begin to deteriorate.
Post-techniques provide a way to encourage flexi-
bility in the spine, and to give the spine the move-
ment required to keep the discs healthy. Neuro-
muscularly, post-techniques also help to integrate
changes that may have occurred during the release
work with the spine.
Generally, these techniques are used after the
practitioner has worked with the related area of
the spine (hence the name “post” techniques). Be-
cause some of these techniques require the client
to sit, some practitioners will do a series of post-
techniques at the end of the session. You may also
include the specific post-techniques directly after
working with each area of the spine.
Some of the post-techniques, notably those for
the neck, may be adapted to use as evaluation tech-
niques prior to working. Specifically, you may
use the post-techniques as you would a range of
motion test to notice restrictions in movement.
Because some of the post-techniques are the equiv-
alent of light exercise for the spine, you will gener-
ally use them only after the muscles around the
spine have been warmed up with some release work
or gentle movement.
As with other Ortho-Bionomy techniques, the
post-techniques should only be done in a way
that’s comfortable for the client. Since these tech-
niques specifically move the discs, you may not be
able to use them if your client has disc problems.
For a client with severe disc problems, such as a
herniated or ruptured disc, you should not use the
post-techniques for the affected area of the spine
unless you have the medical training necessary to
ensure your client’s safety.
These are naturally occurring movements for the
spine when it is relaxed. However, for someone
with a tight spine, even small movements can be
extreme. Move slowly and notice the body’s will-
ingness to move, rather than imposing a move-
ment that may be too much of a stretch for the
client. Particularly in the neck, keep your atten-
tion on the available movement and don’t force
through any restrictions. Go back and do some
more release work, if necessary, then come back
to the post-technique.
The techniques presented here are the most com-
monly used post-techniques. There are some
additional post-techniques that are beyond the
scope of this simplified presentation. If you are
interested in a more detailed presentation of the
Ortho-Bionomy post-techniques, there are specific
classes available.
167
Ortho-Bionomy
POST-TECHNIQUES — NECK
Each of the following post-techniques gives a
slightly different movement to the vertebrae and
discs of the neck. Some of these techniques have
acquired commonly-used nick-names. These
names are included in parentheses to help identify
the technique to students who may have learned
it by that name.
Neck — Lateral Rocking
On each side of the client’s neck, place your
fingertips on the transverse processes of a single
vertebra. Gently rock the vertebra from side to
side (laterally). You may begin at either the top
or the bottom of the neck. Work your way up or
down the neck, gently continuing the rocking
movements. See Figure 6.1.
1.	With your hands holding the client’s head as
shown in Figure 6.2, gently flex his head up
toward his chest. See Figure 6.3. Return his
head to the neutral position, resting on the
table.
Figure 6.2
Figure 6.1
Figure 6.3
Neck — Flexion/Extension
(Sivan Dive)
This exercise begins with two separate movements
that may be combined into one fluid movement, if
the flexibility is available in the client’s neck.
168
Post-techniques
2.	Gently extend the client’s chin. See Figure 6.4.
If necessary, gently lift at the back of the client’s
neck to assist in the extension.
Figure 6.4
3.	If both flexion and extension are comfortable
for the client, you may combine these separate
movements into one continuous movement.
Begin by fully extending the client’s neck (chin
pointed toward ceiling). Maintaining as full an
extension as possible, slowly lift the client’s
head off the table.
You will find that his head will start to roll
toward flexion once the neck reaches its com-
plete extension. Gently follow this flexion
forward until the client’s chin is flexed toward
his chest as far as is comfortable. Following
the forward roll of the head, gently bring the
back of the head back down to the table.
See Figures 6.2, 6.3 and 6.4.
You may want to repeat this movement a few
more times.
NOTE: When full range of motion is available
in the neck, the chin will make a complete circle
during this movement. If full range of motion is
not available, the neck may need additional
release work.
Neck — Spinous Process Expansion
(Butter Knife)
With one of your hands fully supporting the
client’s head, flex his head forward toward his
chest. Place the index finger of your other hand
between two adjoining spinous processes at the
back of the neck. See Figure 6.5. Gently bring
the client’s head back toward the table. At the
same time, gently lift up on the finger that is
between the spinous processes. See Figure 6.6.
NOTE: If the lift with the finger is uncomfortable
for the client, you may leave it out.
Figure 6.5
169
Ortho-Bionomy
Neck — Stair-Step /Slide
(The Chicken)
With both hands holding the client’s head as
shown in Figure 6.2, gently compress straight
down the line of his neck. This will help you con-
trol the movement of the head/neck in the next
stage of the exercise.
Continuing the compression, gently lift the head
straight up toward the ceiling. See Figure 6.7.
Return the client’s head to the neutral position,
resting on the table. Repeat the exercise a few
times.
When this exercise is done correctly, you will feel
each individual vertebra slide forward past the
one below it as you lift, producing a “pecking”
movement similar to the movement a chicken
makes with its head as it walks.
NOTE: It is important to keep the client’s face
pointed straight up toward the ceiling. You are
not flexing or extending the neck in this exercise.
Figure 6.7
170
Post-techniques
POST-TECHNIQUES — SPINE
Spine — Prone Positions
Spine — Lateral Rock
This technique is a good beginning flexibility
exercise for rigid spines because it puts minimal
stress on the spine and yet encourages movement.
It also works well as an integrating movement.
With one hand, gently rock the client’s pelvis firm-
ly enough to create movement up the length of her
spine. With the other hand you may add an addi-
tional rocking in a specific area of the spine, or
you may use a broad contact on the spine and rib-
cage to assist in rocking the entire torso.
Sacral — Spinal Balance (Cat Paws)
1.	Place one of your hands fully on top of the
client’s sacrum, the other hand flat on her lower
spine. Gently, but firmly, push straight forward
(toward the table) on the sacrum. With rhe other
hand, notice if this movement of the sacrum is
transmitted up the spine.
2.	Slowly release the pressure on the sacrum. At
the same time, gently compress straight forward
(toward the table) on the spine itself. Notice if
there is movement in the sacrum in response to
the flex of the spine.
NOTE: If pressure on any area of the spine is
uncomfortable for the client, do not press in
that area.
3.	Slowly release the pressure on the spine. At
the same time, gently press on the sacrum
again. Then, keeping your hand in place on
the sacrum, move your other hand slightly
higher on the spine and repeat the exercise.
Continue until you have “walked” the second
hand up to the top of the thoracic spine. A
flexible spine will transmit subtle movement
through its entire length. Any areas that are
uncomfortable or have restricted movement in
this exercise may need additional release work.
Spine — Side Postures
In all of the following exercises, the client lies
on her side, with a pillow supporting her head to
keep the spine aligned. Each of these exercises is
designed to flex the spine on a particular plane of
movement. Those exercises which are one-sided
in their movement will have to be repeated with
the client lying on her opposite side (these are
noted in the text). You may do all of the one-
sided exercises together on one side before having
the client roll to her opposite side. In each of
these exercises, the movements are made slowly
and without strain on either you or the client.
Lumbar Lateral Flexion (The Pump)
The client lies on her side, facing you, with her
knees bent and drawn up toward her chest. With
one hand, hold the client’s ankles. Place the other
hand flat on the client’s lumbar spine. Gently lift
her ankles straight toward the ceiling, only as far
as is comfortable. Monitor the movement at the
lumbar, making sure there is no strain and that the
pelvis does not roll back toward the table.
Bring the legs back down towards the table.
Repeat the pumping movements a few times, with
a steady rhythm. This exercise will need to be
repeated on both sides, because it “opens” the part
of the spine closest to the table. See Figure 6.8.
171
Ortho-Bionomy
Figure 6.8
Lumbar Flexion /Extension Isotonic
The client lies on her side, facing you, with her
knees bent and drawn up toward her chest. With
one hand, hold the client’s ankles. Place your
other hand flat on her lumbar spine. Place the
client’s knees against your belly/hips as shown in
Figure 6.9. In this exercise you will use your body
to provide resistance to the client’s movement, so
it’s important that you are in a balanced stance,
with your spine comfortably straight.
Have the client gently attempt to straighten her
legs. Provide gentle resistance to her movement
through the full range (i.e., let her “push” you
gently with her knees as she straightens her legs.).
See Figure 6.10.
Notice that her lower spine will flex slightly
against your hand as she does this movement.
You may ask the client to push against your hand
with her lower back as she straightens her legs so
her focus stays on the spine.
Bring the client’s knees back to the starting posi-
tion and repeat the entire exercise a few more
times. Ideally, the straightening/bending move-
ments are done with a continuous flow, with no
pause in between.
Figure 6.9
Figure 6.10
NOTE: If you can’t comfortably support the
client’s legs with one hand, it is better to use both
hands and leave out the contact with the lumbar.
172
Post-techniques
Spinal Bounce (Fanny Kick)
Use the same starting position as for the two
previous exercises. Gently bounce the client’s
heels toward her buttocks (as if she is kicking up
her heels). Support the lower back if necessary.
Repeat the kicking movements a few times.
See Figure 6.11.
This is NOT a forceful rotation or manipulation
of the spine. It is a gentle, comfortable, SLOW
stretch. If a steady stretch is not comfortable, you
may slightly rock the client’s hip forward (or the
shoulder back) as a beginning movement for the
stretch.
Spinal Rotation and Stretch
The client lies on her side, bottom leg straight, top
leg bent. Pull the client’s lower arm forward so she
is lying on the back (not the tip) of her shoulder.
This position will naturally give the spine some
rotation.
Stand facing the client with one hand on the
back of her hip and the other on the front of her
shoulder. Gently stretch the spine by rolling the
shoulder back and pulling the hip forward.
See Figure 6.12.
You or your client may find the following varia-
tion more comfortable: With your arm bent,
place the inside of your elbow on the back of the
client’s hip, with your forearm following the line
of her spine. Use your elbow to pull the client’s
hip forward and support/monitor the stretch in
her spine with your hand and forearm as you roll
her shoulder back with your other hand.
173
Ortho-Bionomy
Spine and Ribcage — Seated Postures
Thoracic Flexion (Disc Fluffer)
The spine should be warm and relatively mobile
for this exercise. Don’t do this as a beginning
movement of the spine.
Have the client sit on the edge of the table, with
her hands placed on the back of her head. Stand
behind her with one hand on her lower belly, the
other hand on the back of her head (on top of her
hands). Support the client’s belly as she rolls for-
ward into a C-curve. It is important that the client
doesn’t simply collapse down onto her pelvis, com-
pressing the spine rather than curving it.
Continuing to support the client’s belly, use the
hand on the back of her head to gently bounce her
head and upper torso down toward her knees.
At the same time, bring her torso forward so she
leans farther over her knees; then back toward
you. See Figure 6.13.
Notice that the focus of the compression will
move higher in the spine as the client leans back,
and lower in the spine as she leans forward. This
exercise literally pumps or “fluffs” the discs of the
entire spine.
Notes
1.	For some clients, the stretch in their spines will
be too much with the above exercise. If your
client experiences discomfort with this exercise,
try one of the following variations and use
whichever the client prefers.
a.	With the client seated, have her cross her
arms and place her left hand on her right
shoulder and right hand on her left shoulder
(as if giving herself a hug). Have her roll for-
ward into the C-curve as above. Gently bounce
forward and back as above, but with the com-
pression on the client’s shoulders rather than
on her head/neck.
b.	If the first variation is still too much of a
stretch, have the client hang her hands off the
edge of the table, on either side of her knees.
Instead of bouncing her torso, gently rotate her
shoulders from side to side as she leans forward
and back. This will provide a very gentle
stretch in the spine while allowing for some
movement of the discs.
2.	The Disc Fluffer is often recommended by prac-
titioners as a home exercise for the client, espe-
cially for those whose spine has a tendency to
tighten.
Figure 6.13
174
Post-techniques
Seated Spinal Rotation (Love Seat)
This exercise will need to be repeated on each side
of the spine. For ease of explanation, assume you
are beginning on the client’s right side for the fol-
lowing description.
With the client seated on the table, sit next to her
on her right side, but facing the opposite direc-
tion. Your right hips should be immediately next
to each other. With your right arm, reach in front
of the client’s right shoulder, across her chest and
under her left armpit. Your right hand should end
up flat on the back of her left shoulder, or gently
holding under her left armpit. See Figure 6.14.
Place your left hand on the client’s back, with
your thumb against the side of the spine closest
to you. See Figure 6.15.
Figure 6.15
Rotate the client around toward her right by
pulling her left shoulder slightly forward and
toward you. At the same time gently push on the
side of her spine with your left thumb, to give the
spine a slight flex. See Figures 6.14 and 6.15.
Move your hand up and down the spine as you
repeat the rotation. Continue until you have
moved your hand up the full length of the spine.
Change sides and repeat the exercise.
NOTE: In order to support the client’s movement
adequately in this exercise, you will need to rotate
your entire torso (rather than just pulling her
shoulder forward with your hand). If necessary,
put one of your feet on the floor, or rest one or
both feet on a chair so you have a stable base
from which to move.
175
Course Descriptions and Training Information
The original term that Dr. Pauls used for Ortho-
Bionomy was the Phased Reflex Techniques. This
was the name that was used in the experimenta-
tion stage that he conducted with his osteopathic
instructor, Dr. K. D. A. Basham. They used the
term “phased” because the work was developed
in phases. The term “reflex” was used because
reflexive response within the body seemed to be the
constant factor among all of the techniques they
were drawing upon in their research. Phase 1 was
the name they gave to Jones’ original work, with
Phases 2 and 3 denoting further refinements. When
they arrived at what they called Phase 4, they were
finding that the results produced with these tech-
niques lasted longer than any other techniques they
had encountered in their osteopathic training.
Basham and Pauls eventually went their separate
ways, Pauls retaining the term Phased Reflex
Techniques of Ortho-Bionomy and Basham
using the term The Basham Technique. Slowly,
in Ortho-Bionomy, the term Phased Reflex Tech-
niques has fallen out of use and just the term
Ortho-Bionomy is commonly used. But we still
use the titles of the different aspects of the work
based on the idea of phases. The following is
a summary of the different phases of Ortho-
Bionomy and of the allied courses presented in
Ortho-Bionomy training programs.
PHASES 1-3
These phases can best be described as the educa-
tion process that Pauls went through in develop-
ing Ortho-Bionomy. They can also be described
as the learning phases that a student goes through
before arriving at the sensitivity necessary to per-
form Phase 4 well. The human form also has a
version of these phases in its attempts to come to
balance on its own.
PHASE 4
This is what we call the Basic phase of Ortho-
Bionomy and is the phase about which this manu-
al is written. Phase 4 is made up of the physical,
technique-oriented work of Ortho-Bionomy. It
relies primarily on static positions of release that
are largely determined from physical feedback
from the client and sometimes verbal feedback
as to what is comfortable and easy and what
causes discomfort. Within this phase are included
specialized techniques such as Posture and Post-
techniques, Isometrics and other physically-orient-
ed techniques.
PHASE 5
This is a bridging phase between purely physical
and purely energetic work. This is where the
energetic movements of the human form can be
accessed as they are expressed at a physical level.
There is a particular quality of energetic relation-
ship between the client and the practitioner in
Phase 5 that catalyzes spontaneous but, at the
same time, passive movements on the part of the
client. The practitioner follows and supports
those movements. The release positions of Phase
5 tend to be movement-oriented, rather than the
more static positions of Phase 4.
PHASE 6
This can be called the purely energetic phase of
Ortho-Bionomy. Some practitioners perform
Phase 6 while physically touching the client, while
others may follow energetic patterns with little or
no physical contact with the client. As can hap-
pen at a physical level, there may be energetic dis-
ruptions that cause distress or discomfort for the
client. These energetic imbalances can be worked
with in much the same way as in Phases 4 and 5.
179
Ortho-Bionomy
PHASE 7
This Phase of Ortho-Bionomy uses a more gener-
al energetic pattern that influences not only the
client’s individual energetic form, but their ener-
getic relationships with others and with their
environment.
POST-TECHNIQUES
Post-techniques are designed to give exercise to
the spine and to increase mobility and flexibility.
Some basic post-techniques are presented in this
manual.
POSTURE
The posture work in Ortho-Bionomy is a combi-
nation of techniques that assist in understanding
balanced posture and help clients correct their
posture and walking patterns. It also includes
specific home exercises for working with specific
spinal imbalances such as scoliosis and spinal
rigidity.
EXPLORATION OF
MOVEMENT PATTERNS
These techniques focus on observation and
exploration of joint and muscle movement pat-
terns and their inter-relationship with tension
patterns.
ISOMETRICS
Teaches the use of isometrics consistent with the
principles of Ortho-Bionomy.
CHAPMAN’S
NEUROLYMPHATIC REFLEXES
Although not technically a part of Ortho-
Bionomy, Chapman’s Reflexes are an important
tool for assisting in improving the function of the
lymphatic system and for showing the relationship
between structure and endocrine balance. This
system of reflexes is presented from an Ortho-
Bionomy perspective.
In addition to the specific techniques summarized
above, the Ortho-Bionomy Practitioner Training
Program includes additional classes related to the
general practice of Ortho-Bionomy such as Ethics
and Emotional Issues, Elements of a Successful
Practice and so on.
Bay Area Ortho-Bionomy is an alliance of instruc-
tors in the San Francisco Bay Area which offers
various training options. For those interested in
a full study program, we offer Practitioner and
Senior Practitioner training programs that fulfill
the Society of Ortho-Bionomy requirements. The
basic program consists of approximately 350
hours of course work and an additional 150 hours
of practical experience in sessions. The senior
program has a similar number of class hours, with
a more advanced focus, and additional practice
hours. Completion of the basic and senior practi-
tioner programs is a prerequisite for entry into
instructor training. The practitioner training pro-
gram is designed to give students a well-rounded
exposure to the techniques, practice and philo-
sophical base of the work. We assume those
studying in this program intend to use Ortho-
Bionomy as their primary form of practice,
although we encourage students to blend their
experience and studies into a system of practice
that expresses their own personal philosophy
of work. Students are also free to study Ortho-
Bionomy on a more informal basis, integrating it
into their current form of practice.
For specific training information, please contact
Bay Area Ortho-Bionomy, P.O. Box 7538,
Berkeley, CA 94707.
180
Bibliography
1.	Basham, K.D.A. and A.L. Pauls. “Phased Reflex Techniques.” Unpublished article, 1975.
2.	Basmajian, John V. Primary Anatomy, 7th ed. Baltimore: The Williams & Wilkin Company, 1976.
3.	Calais-Germain, Blandine. Anatomie pour le Mouvement, Introduction a I’analyse des techniques
corporelles. Meolans-Revel, France: Association A.M.S., 1989.
4.	Display Atlas of Elementary Anatomy. London: Wolfe Medical Publications, 1980.
5.	Germain, Patrick. Economic du Geste, fascias et mouvement. Meolans-Revel, France: Editions
Desiris, 1989.
6.	Gorman, David. The Body Moveable, Blueprints of the Human Musculoskeletal System its Structure,
Mechanics, Locomotor and Postural Functions. Guelph, Ontario: Ampersand Printing Co., 1981.
Volumes I-III.
7.	Jones, L.H. “Spontaneous Release by Positioning.” The D.O., 4:109-16, Jan. 1964.
8.	Kapit, Wynn and Lawrence M. Elson. The Anatomy Coloring Book. New York: Harper & Row,
1977.
9.	McMinn, R.M.H. and R.T. Hutchings. Color Atlas of Human Anatomy, 4th ed. Chicago: Year Book
Medical Publishers, 1977.
10.	Pauls, A.L. “The Philosophy of Ortho-Bionomy: The Evolvement of the Original Concept.”
Unpublished article, circa 1980.
11.	Taber’s Cyclopedic Medical Dictionary, 13th and 15th editions, ed. C.L. Thomas. Philadelphia: F.A.
Davis Co., 1977, 1985.
NOTE: Many of the anatomy illustrations in this manual were derived from Gorman’s The Body
Moveable. We highly recommend this three-volume functional anatomy text. It can be ordered from:
Ampersand Printing Co., 123 Woolrich St., Guelph, Ontario, Canada, N1H 3V1. (519) 836-8800.
181
Glossary
Abduction — To draw away from the median line
of a bone or muscle, or from an adjacent part or
limb.
Adduction — To draw toward the median line of
a bone or muscle, or toward an adjacent part or
limb.
Affected side — The side of the body which is
uncomfortable, out of balance, or which is being
worked with.
Anterior — Front of the body; toward the front.
Articulation — A joint between bones or between
moveable parts.
ASIS — Anterior Superior Iliac Spine, commonly
called the hip bone.
Associated rib — The rib connected to a specific
vertebra.
C-curve — To place the body in a posture resem-
bling the letter “C”: seated, with the head down
and the torso curved forward.
Chronic — Long, drawn out; lasting or develop-
ing over a long period.
Compress/compression — Gentle pressure; a
squeezing together; state of being pressed together.
Contract/contraction — To draw together; a
shortening or tightening; restricted area; holding
or held point.
Disc (or disk) — “A round, flat, platelike struc-
ture. Specifically, the intervertebral discs are fibro
cartilage substances between vertebral surfaces. It
may rupture but it does not slip. It serves as a
shock absorber. The gelatinous mass in the center
is called the nucleus pulposus. When the disc pro-
trudes into the neural canal, pressure on the adja-
cent nerve root is manifested by pain. This is
called herniation of an intervertebral disc.
Symptoms will depend upon the location of the
herniation. Those in the cervical area produce
distinctive signs and symptoms in the cervical
area. Those in the lumbar area cause symptoms
of lumbar nerve root pressure.” — Taber’s.
Distortion — A twisting out of regular shape;
deviation from natural shape or position.
Dorsiflexion — Flexing the foot up with the toes
lifted toward the front of the knee.
Eversion — Rolling the foot outward to bring the
sole facing away from the other foot.
Extension — The straightening of a part of the
body; lengthening of a limb or the body. In the
neck, extension is accomplished by moving the
chin up and away from the chest.
External/externally — Exterior; opposite of medi-
al or internal; outwardly.
Extrinsic — Coming from without; movement of
a joint. In muscles, the extrinsic muscles are those
which are partly attached to the trunk and partly
to a limb.
Facet — Any small smooth surface on a bone or
other hard surface.
Fine tune — Making small, subtle changes in posi-
tioning to find the best release position; bringing
the indicator point to maximum softness and
comfort.
Flex/flexion — The act of bending or being bent.
In the neck, flexion is accomplished by moving the
chin down toward the chest.
Head of bone — Technically, the proximal (closest
to the heart) end of a bone. The distal end is fur-
thest from the heart. In this text the term “head
of the bone” is used as a general term to describe
the end of a bone.
183
Ortho-Bionomy
Hinge joint — A hinge-like joint allowing only
flexion and extension.
Hyperextend — Extension beyond normal limits.
Imbalance — An area or joint that is not in its
natural state of balance or balanced
movement/function.
Indicator point — Specific areas of sensitivity,
discomfort or contraction; focal area.
Inferior — Lower toward the foot of the body.
Inferior aspect — Lower side.
Insertion — The place of attachment of a muscle
to the bone which it moves, usually lower in the
body than its origin.
Intemal/internally — Located inside; inwardly;
medially.
Intrinsic — Located within or belonging solely to
a body part; movement within a joint. In muscles,
the intrinsic muscles are those which have their
origins and insertions entirely within a structure.
Inversion — Rolling the foot to the inside to bring
the sole facing toward the other foot.
Isometric — Contraction of a muscle during
which the force of resistance to the movement is
in continuous movement throughout the range of
motion. Muscular contraction in which the mus-
cle does not change its length.
Isotonic — Contraction of a muscle during which
the force of resistance to the movement remains
constant throughout the range of motion. Mus-
cular contraction in which the muscle maintains
constant tension by changing its length during
the action.
Lateral/laterally — Toward the outside edge of the
body; away from the median line.
Lateral flexion/bending — Bending toward the
side of the body.
Medial/medially — Toward the middle of the
body.
Midline — Middle line of the body going from the
head to the toes.
Mobility — Movement; range of motion; avail-
ability of movement.
Monitor — Bring attention to changes.
Neutral position — Place of body before being
moved; body in resting position.
Origin — The more fixed attachment of a muscle,
usually higher in the body than the insertion.
Palpate — To examine by touch or feel.
Pattern — A combination of contractions, or
movements, that is identifiable as distinct and
repeated. For example: one shoulder dropped,
one leg rotated externally and an imbalance in the
pelvis can be seen as a body pattern of tension and
imbalance. Or, a shoulder which has a restricted
range of motion will have a particular pattern of
movement that expresses that restriction. Having
habitual muscle contractions in the neck could be
a pattern of tension or will produce a pattern of
muscle response.
Plane — Used as points of reference by which
positions of parts of the body are indicated.
Plantarflexion — Straightening or extending the
toes.
Positional release — The use of generalized posi-
tions to release a restricted or contracted area.
Posterior — The back of the body; toward the
back of the body.
184
Glossary
Preferred position — The position of a specific
part of the body, or of the entire body, in which
the client is most comfortable.
Pronate — To turn the palm or foot downward
or backward.
Prone — Lying face down.
PSIS — Posterior Superior Iliac Spine, a protru-
sion of the ilium near the sacro-iliac joint.
Re-check — To go back to the original indicators
of imbalance or tension and notice if they have
changed after a release movement.
Re-educate — To bring back into awareness; to
retrain a part of the body to function effectively;
physical means for restoring muscular tone and
activity.
Referred pain points — Pain felt in a part
removed from its point of origin.
Release — Letting go; softening; rebalancing;
relaxing.
Release points — Specific areas of relaxation or
softening.
Rotation — To turn on an axis.
Side-shifted — Sliding toward the side.
Spinous process — Posterior bony landmarks of
the vertebrae.
Superior — Higher toward the head of the body.
Supinate/supination — To turn the forearm or
hand so the palm faces upward or forward; to
rotate the foot and leg outward.
Supine — Lying on the back or with face upward.
Symmetrical — Equal on both sides.
Traction — Process of drawing or pulling.
Transverse process — A bony protrusion project-
ing laterally from the side of the vertebra.
Trigger point — A specific area of pain or reactivi-
ty related to a specific, but distant, area of rhe
body. “Any place on the body that when stimu-
lated causes in a specific area a sudden pain, espe-
cially a type of pain previously felt spontaneously
at the same location.” — Taber’s.
185
Index
Acromio-clavicular joint, 122
Ankle, 103
anatomy, 105
evaluation, 106
release, 106
release indicators, 107
ASIS (Anterior Superior Iliac
Spine), 71
Atlas, 23
Axis, 23
Bunion, 114
Calcaneous, 111, 113
Carpals, 161
Cervicals, 23
Clavicle, 121, 135
Compression, 15
Cuboid, 111, 113
Cuneiforms, 111, 113
Elbow, 145
anatomy, 147
evaluation/release, 147
release indicators, 150
Exaggeration, 3, 5
Femur, 85
anatomy, 87
evaluation, 88
release, 88
release indicators, 90
Fibula, 96, 100
Fine tune, 15
First rib, 39
anatomy, 39
evaluation, 39
release, 39
release indicators, 41
Foot, 109
anatomy, 111
general evaluation/release, 112
specific evaluation/release, 113
release indicators, 114
General indicators, 12
Hand, 159
anatomy, 161
evaluation/release, 162
release indicators, 163
Iliacus, 63
Iliopsoas, 61
anatomy, 63
evaluation, 64
release, 66
release indicators, 67
Ilium, 69
anatomy, 71
evaluation, 72
release, 74
release indicators, 75
Indicator point, 13
Integrating, 17
Interosseus ligament, 147, 149
Isometric,
definition, 41
femur, 89
first rib, 39
Isotonic-definition, 41
Knees, 93
anatomy, 95
general evaluation/release, 97
specific evaluation/release, 99
release indicators, 100
Lumbar, 49
anatomy, 51
evaluation/release, 52
release indicators, 56
Maleolus, 105
Metacarpals, 161
Metatarsals, 111, 113
187
Ortho-Bionomy
Navicular, 111, 113
Neck, 21
anatomy, 23
general evaluation/release, 24
specific evaluation, 25
specific release, 26
release indicators, 28
Olecranon, 147
Patella, 96
Phalanges, 111, 161
Phased Reflex Techniques, 179
Phases 1-7, 179
Post-techniques, 165
introduction, 167
neck, 168
spine, 171
Proprioception, 7
PSIS (Posterior Superior Iliac
Spine), 71
Psoas muscles, 63
Radius, 147, 155
Re-checking, 16
Release Position, 14
Ribs, 37, 43
anatomy, 43
general evaluation/release, 44
specific evaluation/release, 45
release indicators, 46
Sacrum, 77
anatomy, 79
evaluation, 79
release, 80
release indicators, 81
Scalenus, 39
Scapula, 121, 131,
Scapulo-humeral joint, 122
Shoulder, 119
anatomy, 121
evaluation/release, 122
release indicators, 128
Specific indicators, 13
Sterno-clavicular joint, 122
Sternum, 141
Talus, 111, 113
Tarsals, 111
Thoracic, 31
anatomy, 33
evaluation, 33
release, 34
release indicators, 35
Tibia, 96, 105
Trigger points, 52
Ulna, 147, 155
Wrist, 153
anatomy, 155
evaluation/release, 156
release indicators, 157
188
Kathy L. Kain
Kathy has been teaching and practicing Ortho-
Bionomy since 1980. She has trained extensively
with, and со-taught classes and Instructor
Training Seminars with, Arthur Lincoln Pauls, the
founder of Ortho-Bionomy. She was President of
the Society of Ortho-Bionomy International® for
six years, overseeing the creation of the
Practitioner Training Program curriculum, and is
both an Advanced Instructor and Advanced
Instructor Trainer of Ortho-Bionomy. More
recently the focus of Kathy’s work has moved
toward the fields of somatics and trauma recovery.
She is one of the Senior Trainers of the Somatic
Therapy and Psychotherapy training program
offered by the College for Experiential
Psychotherapy in Sydney, Australia and offers a
somatically-oriented training program in the San
Francisco Bay Area. She teaches regularly in
Australia, Europe, Canada and the U.S. and main-
tains a private practice in Berkeley, California,
where she lives.
Jim Berns
Jim is a Registered Advanced Instructor of Ortho-
Bionomy and has been trained directly by the
founder, English Osteopath Arthur Lincoln Pauls,
D.O. He has been a Registered Instructor since
1980, and has taught Ortho-Bionomy internation-
ally. Jim’s background in the health education
field includes: B.A. in Sociology, California certi-
fied instructor in Massage Therapy, training and
instruction in numerous body therapies, personal
growth seminars and communication skills. Jim
has served on the Board of Directors and the
Practitioner Evaluation Committee of the Society
of Ortho-Bionomy International. He resides and
has a private practice in Northern California.
The Society of Ortho-Bionomy oversees
training programs and provides certification of
Ortho-Bionomy Practitioners and Instructors.
The Society can be contacted at:
Society of Ortho-Bionomy International
P.O. Box 869
Madison, WI 53701-0869
U.S. and Canada toll free: (800) 743-4890
International: (608) 257-8828
Additional copies of this manual may be ordered
from:
North Atlantic Books
P.O. Box 12327, Berkeley, CA 94712
Phone: (510)559-8277
Fax: (510)559-8279
189
$19.95
1-5554 5-250-Х
Health/Psychology

This is the first book on Ortho-Bionomy, a bodywork technique which is quickly
gaining popularity among laypeople and therapists from all bodywork disciplines.
Ortho-Bionomy was created twenty years ago by Dr. Arthur Lincoln Pauls, an
osteopath with training in the martial arts. Pauls wanted a system of bodywork
which would teach structural understanding of the body simply and safely enough
that anyone could learn to work with their family and friends. For the last twenty
years Ortho-Bionomy has maintained the tradition of keeping the techniques simple
enough for anyone to learn.
Kathy Kain gives clear descriptions of the philosophy and concepts of Ortho-
Bionomy. The illustrations and easy-to-understand technical instructions show the
standard releases taught in Ortho-Bionomy classes. The student is guided from
the beginning of a session to the end, in learning this gentle, effective approach to
somatic re-education. Ortho-Bionomy’s primary benefit lies in helping people to
break the cycle of pain by learning how to correct structural and somatic dysfunc-
tion and to release stress. This non-invasive, quick-acting anproach is an effective
preparati u- Ration, movement and therapeutic exercise.
“Kathy Kain, one of the foremost international instructors of Ortho-Bionomy, has
managed in this book to be both technically and humanly accurate. Anyone who
wants to be qualified at a master level of practice in bodywork would benefit from
being fully familiar with the methods and philosophy of Ortho-Bionomy.”
— Julie Henderson, Ph.D., Somaticist,
author of The Louer Within and Restoring The Mother
North Atlantic Books
ш Berkeley, California
781556
432507
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