HEAD WEIGHT DIRECTIONS

1. 20 MINUTES; TWICE A DAY

2. UPON AWAKENING AND BEFORE BED (IF YOU MISS AM- DON’T DO PM)

DO NOT USE THESE WEIGHTS TONIGHT

3. IT IS EASIER TO WEAR A BASEBALL HAT UNDERNEATH THE WEIGHTS.

4. START WITH 1 AND LET US KNOW WHEN IT’S TOO EASY

5. BE SURE THE WT.(S) IS/ARE DIRECTLY IN THE MIDDLE OF YOUR HEAD.

6. MAY GET “SEASICK FEELING AT FIRST” IT WILL SOON PASS

7. NEED TO ADD WT. ASAP TO WORK THE BEST

IT IS BEST IF YOU USE A TIMER RATHER vs A CLOCK OR A WATCH.

Don’t Do

Drive/Sit Stand/Walk

THIS IS AN EXTREMELY IMPORTANT PART OF YOUR CORRECTION PROCESS, SKIMPING ON THIS PART WILL DELAY YOUR CORRECTION & DECREASE YOUR CHANGE TO A LESSER TREATMENT SCHEDULE

The Pettibon Body Weighting System™

The Pettibon Body Weighting System™ utilizes specially designed head weights for attaching to specific areas on the patients body to cause reflex reactive spine and posture correction. The Pettibon Weighting System™ is actually the adjusting force that causes the patient’s own nervous system, righting reflexes, innate organizing energy and spinal muscles to correct the spine and posture, as they react to the purposefully placed head weights. The righting reflexes reactions cause the necessary involved muscles to relax while others are contracted, thereby pulling and holding the spine and posture into alignment. The muscles can cause the spine to align without other treatment. However, when the elastic energy in the spinal white tissues has been lowered by loading and un-loading procedures in preparation for changes, less time and effort is required. The muscle actions caused by the weights hold the discs and ligament in their newly aligned position during the twenty (approximate) minutes required for them to regain their elastic energy. The combined actions cause the tropa-collagen fibers of the discs and ligaments to re-align with the stress of the new position, thereby permanent correction of spine and posture is ultimately achieved. Obviously, the actions described above (weights used for 20 minutes twice-daily) must be performed as a part of the patient’s home care rehabilitation for at least 90 days. Up to 24 months or more may be required in some cases before permanent measurable spinal changes (adjustments) can be enjoyed. Figure #9 FRONTAL HEAD AND SHOULDER WEIGHTING TO CORRECT THE FOLLOWING:

1) Skull-atlas non-forward flexion and/or over-extension correction. 2) Forward head posture correction. 3) Cervical lordosis correction (Fig. #2). The proper amount of weight is calculated by visual examination and/or by a neutral lateral x-ray. (Figs. #12 and #13). The weighting procedure begins by utilizing the weight calculated or the amount that can be tolerated for 20 minutes. The most common weight for the introductory period is 4-6 pounds, with

more weight being added to the patient’s toleration, until the total weight reaches the previously identified needs. The head weight is attached and/or placed on the high shoulder side of the forehead. The shoulder weight, with 8-12 pounds or the amount required to cause the patient’s low shoulder to be raised slightly higher than the other, is placed on the low shoulder.

HEAD AND SHOULDER WEIGHTING ACTIVATES THE NERVOUS SYSTEM’S RIGHING REFLEXES. THE INNATE ORGANIZING ENERGY CORRECTS THE SUBLUXATIONS. Shoulder weighting corrects and stabilizes the thoracic cage, then front-lateral head weighting causes a reflex over-rotation upward of the skull and eyes by the cervical extensor muscles (Fig. #14). The upward rotated eyes/skull activate the optic and labryinthine righting reflexes, as well as the joint receptors in the neck (Guytons, 1976; Krandel, Schwartz and Jessell, 1986). The activated righting reflexes then cause the cervical flexor muscles to pull the skull-face back down until the eyes are level. These combined actions pull the skull backward re-establishing the center of skull mass (sella turcica front over the front of C4/C5 disc and perpendicular relative to gravity, Kapandji, 1974) ( Figs. #11, #14, and #15).

The skull’s backward translation, in conjunction with the shoulders forward or backward rotation, forces the skull-atlas extension to be corrected as well. Then the lordosis is corrected as a result of the muscle actions caused by the same forces that caused the head forward posture correction. After the cervical extensor and flexor muscles’ strength and endurance have had sufficient time to equalize, the elastic and “creep” properties of the discs and ligaments that were holding the cervical spine displaces can then be reorganized and healed. It is obvious that cervical lordosis and head forward posture is corrected and maintained by the muscles (Wyke and Davis, 1984) (Fig. #15).

Temporary spinal correction may be accomplished within a few minutes after the weights are installed. However, permanent correction takes a minimum of 90 days and in some displacement configurations may take 24 months or more. For

Figure #13

Figure #14

Figure #15

maximum results, 20 minutes of exercise utilizing the fully loaded head and shoulder weights must be performed a minimum of twice a day. The patient must commit to the needed exercise period of time each day and for the prescribed duration, to equalize the cervical flexor and extensor muscles and increase their strength and endurance. Increased muscle strength and endurance insures permanent correction of spine and posture form and function. After corrective-rehabilitative care is complete, the patient should be able to maintain muscle strength and endurance and the cervical lordosis corrections with one weekly, fully-weighted 20 minute exercise session (Ross 1959; Kuland, 1982). References:

1) Guytons, Physiology 6th

Edition, pg. 640-682, Saunders Co. Philadelphia.

2) Principles of Neural Science. 3rd

Edition, Krandel, Schwartz, Jessell. Appleton

and Lange, Connecticut.

3) The Physiology of Joints, Kapandji, IA. Churchill, Livingston, 1974 London,

N.Y.

4) Wyke B. Davis G.J., A Copendium of Isokinetics in Clinical Usage. LaCross, S

and B Publishers, 1984.

5) Ross, D.L. Southern Medical Journal, 52:1549-1552, 1959.

6) Kuland, DN; The Injured Athlete, pg. 138, JB Lippincott, 1982.

Wobble Chair™ Exercises The Pettibon Wobble Chair™ produces loading and unloading cycles for spinal rehabilitation and to prepare the spine to be adjusted.

Motion is essential for a strong, pain-free spine.

Bernini, Wiesel and Rothman explain that, twice daily, full range of motion called “osmosis and imbibition” is absolutely essential for daily metabolic interchange. This is described as nutrition intake and elimination of waste products in order to maintain healthy, well hydrated spinal discs, ligaments and tendons (Bernini, P. M.D. et al. The Aging Lumbar Spine, Saunders. 1982). By contrast, they have found that up to 500 days is required for metabolic interchange by sedentary patients and patients that do not engage in daily full range spinal workouts. This full range is necessary to mix the glucosamine, chondroitin sulfate and proteoglycan aggregates that nourish the discs. Often patients are prescribed vitamins and minerals by well meaning clinicians. It is obvious that the supplements can do little or nothing for the patient unless sufficient loading and unloading exercises are performed where the avascular discs have a complete metabolic interchange. In other words, so that the discs absorb the supplements from the surrounding fluids during contraction and expel tissue cell waste during compression.

NOTE: Pettibon Head and Shoulder Weighting™ during Wobble Chair exercises, are beneficial advanced procedures.

FORWARD FLEXION

Figure #5

Figure #6

RIGHT AND LATERAL FLEXION AND EXTENSION

Figure #5

Disc stresses with bending. (A) during bending (flexion, extension and lateral bending), one side of the annulus is subjected to compression while the other side is put under tensile load. The instantaneous axis of rotation separates the two zones. On the compression side the disc bulges, while it contracts on the tension side (B). The stresses vary in magnitude from maximum in the outer laminae of the annulus to zero at the instantaneous axis of rotation. References:

1) Biomechanics of Musculoskeletal System, Nordin M. and Frankel V. Lea and Febiger, Philadelphia, London 1989. Pg. 67.

2) A Compendium of Isokinetics and Clinical Usage, LaCross, S and S Publishers, 1984.

3) Commentary, Larson, R. American Journal of Sports Medicine 9(3): 148, 1981.

4) Textbook of Orthopedic Medicine, Volume 1 & 2. Williams and Wilkins Col, Baltimore, 1969.

INSTANTANEOUS AXIS OF ROTATION ↑

TENSILE STRESS →

A B

BIOMECHANICS OF THE INTERVERTEBRAL DISCS

Figure #8

Pettibon Cervical Traction™ By the time a person is 12 years old, their spinal discs, ligaments and cartilage no longer have a direct blood supply for the nourishment and elimination of tissue cell wastes. These tissues are then referred to as a-vascular. Avascular tissues require nourishment and waste elimination to function normally, to repair and to regenerate as they did when they were vascular. Motion is now required to pump the nourishing fluids into, and the wastes products out of, avascular tissues such as the spinal discs and ligaments. It is difficult to correct #2 and #3 cervico-thoracic spinal posture configurations unless repetitive cervical traction is performed with an adjustment. Repetitive cervical traction also remains a daily activity during rehabilitation and correction of low back problems. This is important because of the effect it has on cervical and lumbar lordosis and lateral spine angle deviations that cause impedance on the cord tracts connected to the brain, low back and legs. The first reaction to an injury is splinting by the muscle to protect the injured part. Splinting, however, prevents the motion necessary for nourishment, waste elimination, repair and healing of the injured tissues. Traction and compressive motion rehabilitation should be started as soon as practical. Researched conclusions regarding the repair and healing of avascular tissues, such as spinal discs and ligaments, during the healing of mobile tissues:

1) Cyriax (1982) found immobility was harmful.

2) Salter and Oglive-Harris (1994) presented evidence that continuous passive motion caused healing of interarticular fractures. In their experiments they found that chondrogenesis of bone and cartilage was produced by intermittent compression and traction.

3) Panjabi, White, Morris and Markoff (1974) used loading and unloading

cycles that were initiated by traction and compression of the spine. Their experiments demonstrated a repair mechanism in the spinal disc which is mechanical in nature. Long axis loading and unloading cycles of the injured discs of the spine caused a remarkable “self healing” time. During the third cycle, the motion segment revealed near “intact” behavior again, independent of the type of injury.

4) Markoff and Morris (1974) showed that a defect in the annular ring alters

the mechanical characteristics of a disc. Loading and unloading traction cycles cause an adjustment that restores near perfect disc function.

5) Virgin (1951) performed experiments to determine the physical properties

of the intervertebral discs. He found that there was no herniation of the nucleus pulposis due to very high compressive loading. An incision was then made in the annulus fibers all the way to the center, followed by compressive loading. There was very little change in the elastic properties of the disc and definitely no herniation.

6) Farfan (1973) proved by a number of tests, that degenerated discs are

actually stronger than normal discs when subjected to compressive loading and traction unloading cycles.