Part 17

Fig. 7. Morikubo Move. For correction of a lateral and rotated Atlas (L. A.). Pisiform contact with anterior transverse. ]

SPECIAL TECHNIC

MORIKUBO MOVE

A movement for the correction of a lateral and rotated Atlas, indicated for use only when the Atlas is recorded as R. A. or L. A. The position of the patient’s head renders the transverse process inaccessible unless it be anterior on the side from which adjustment is to be given.

Position of Patient

Place two sections of the bifid bench together so as to secure the effect of a solid bench with an upward sloping front. Have patient lying on back with back of head resting firmly on bench, chin slightly uptilted. Then turn patient’s head so that it faces sidewise and rests flatly on the side of the least prominent transverse. This exposes the anterior transverse in front of the tendons of the sterno-mastoid muscle.

Use of Hands

Stand leaning over head of bench and carefully place the pisiform bone of adjusting hand upon the tip of the transverse process, being careful to push aside the sterno-mastoid tendons if they interpose themselves between the pisiform and the process. The fingers of the adjusting hand extend downward toward the clavicle and rest lightly, very lightly, upon the patient’s neck. With the other hand firmly grip the wrist of the adjusting hand, fitting the pisiform of the upper hand into the hollow below the styloid process of the radius.

Movement

This is delivered straight downward toward the bench. It should be light and quick and the hand should not follow the process in its movement.

This movement is painful and should not be used if avoidable. When used it requires the utmost care and a careful measuring of force. Err, if at all, on the side of overcaution. The technic will be better understood after study of the more detailed description of “The Recoil”, since the position and use of hands, arms, and shoulders is much the same for both.

PISIFORM ANTERIOR CERVICAL MOVE

Indicated for rotation of a Cervical vertebra in which one transverse process is anterior to its normal position or more anterior than its fellow which may also be somewhat, though less, anterior.

Placing Patient

As for the Morikubo Move place the patient in the dorsal recumbent posture with head resting on bench and chin uptilted. Turn patient’s face slightly away from the side of the selected anterior transverse and steady the head with the free hand while palpating.

Making Contact

Palpate downward from the Atlas transverse along the posterior margin of the sterno-mastoid, dipping deeply into the neck and exploring with the tips of the first three fingers until the offending process is felt as a nodule of bone plainer to the touch than those above and below. Always reach across the neck to the selected transverse; if it be the right, stand on the patient’s left and use left hand for palpating and for contact hand as well.

Having found the process, gently move aside any tissues which tend to interpose between the finger and the bone, change hands so that the palpating hand is free and the other holds the contact spot clear of interposed tissue and plainly points it out, then place pisiform bone of contact hand gently but firmly against the front of the process so that a mass of bone is felt between the pisiform and the bench when downward pressure is made.

Completing Position

It will be noted here that the head is unstable and tends to rock with slight pressure or movement of the contact hand. Steady the head by placing the knee upon head of bench and against side of patient’s head, not roughly but so that the head cannot move further toward the adjuster.

Now reinforce the contact hand by gripping the wrist with the other, press slightly downward to tighten the contact and avoid slipping, and you are ready for

The Movement

which is directed sharply downward toward the bench. This move rotates the vertebra around its vertical axis and puts a strain in a backward direction on the whole column at this point.

Care must be used, because the move at best is painful. It is easy to slip across the end of the transverse. Take every precaution to avoid imprisoning a muscle, nerve, or blood-vessel between the contact hand and the vertebra. Rightly used this move is valuable, perhaps most valuable of all anterior Cervical moves, but it requires nice judgment.

LAST FINGER CONTACT

This movement differs from the preceding one in two important particulars; the contact hand must be so selected with relation to the side of vertebra adjusted that the fingers will extend upward toward the patient’s head, and the opposing hand supports the head instead of reinforcing the contact hand.

Placing Patient

As for preceding move. The head will remain in this position only until the contact is made, after which it will be raised by the supporting hand until a tight contact is felt and the neck muscles drawn fairly taut.