So fascial patterns hopefully are ideal.
If you’re young, if you’re healthy,
and if the body is working well
you’ll have equal fascial glide—
the fascial movement
will be good in all directions.
You could turn to the left or
you could turn to the right.
Sometimes people overdevelop
one side of their body.
They may become fencers, they may run,
or work out in certain ways
where certain parts of their body
get better developed
and others lesser developed.
When that happens, the body
will start to compensate
and they’re still going to need to have a healthy body.
You’re still going to need to
look straight forward.
So if your right side is stronger, you may
need to get your left hip stronger.
And that’s going to be a
Still healthy. You still have good flow
but your body is compensating.
Some of these changes can be congenital.
Some people are right handed
and are going to overdevelop
their right side.
Some people are left handed
and may underdevelop their right side
and overdevelop their left side.
These are patterns that the
body takes into effect
so that it can function well.
But that doesn’t always happen.
Sometimes, we get stuck.
And we always twist to the right.
And we always sit on one side of our butt.
And we always use one side
more than the other.
And we get congestion
or decreased functioning on
the side that’s not used.
That’s an uncompensated pattern.
And is more common in people who are sick
or have chronic illness or
have other conditions
that limit their activity.
And this becomes the spiral downward
where if you allow that to happen
and you’re not restoring motion,
after 2 to 3 years, it becomes
harder to change.
The body becomes set in that
system, in that pattern.
And more needs to be done
in order to intervene
and get the patient back to baseline,
and hopefully, to ideal functioning.
In people who are in a compensated system,
the goal is to get them to an
ideal functioning system.
Sure, they’ve found a way that they’re comfortable
Sure, they have compensated
for the twist and turns of their bodies
or imperfections or overdevelopment
in some ways.
But the goal is to have the body function
in any which way it wants to.
At any time it wants to.
So the goal is to get to ideal functioning.
Having said that, 80% of the people
that Dr. Zink saw in his office
had a compensatory pattern.
They did have some strengthening
of the right side of the neck
and then the left side of the thorax and
then the right side of the lumbar,
and the left side of the pelvis.
So take a minute and look at the
common compensatory pattern.
The left, right, left, right pattern
This is the most common
If you were to guess, 80% of patients
are going to have this.
And what they have, is their OA
on the left is going to be rotated,
their cervicothoracic region is going
to be rotated right,
the thoracolumbar region
will be rotated left,
and the lumbosacral region
will be rotated right.
This is the most common
This is your typical right-handed individual
who’s going to have good drainage,
good flow, good connectivity,
and good functioning.
And this is how they’ve compensated.
This is one of those things you should know.
When you have a patient who’s ill,
who just says they’re not feeling right,
check to see if there is a change.
And on my charts, I know if they’re
or uncommon compensatory.
Just so I know when the change occurs
or if things are dysfunctional.
People who change from one to the other,
may go through a transition.
They may not sleep. They may lose weight.
And they may gain weight.
So people tend to have one
The uncommon compensatory—
the left handedness
of compensatory patterns—
is found in about 20% of people
where the OA is rotated right,
the cervicothoracic region is rotated left,
thoracolumbar region is rotated right,
and lumbosacral is rotated left.
That’s the uncommon compensatory pattern.
And, again, what is this compensation for?
These are where you find
Where you find hypertonicity.
Where you have musculoskeletal findings
that may or may not reach
the need for treatment but are there.
The uncompensated pattern
is any pattern where you just
don’t have a good flow.
Where you’ll have congestion, swelling,
or just continued hypertonicity,
continued swelling, and continued congestion
on a single side.
It’s not healthy.
It doesn’t allow for the patient to feel
good energy, good feeling, or feeling right.
These are some of those vague complaints
where things just don’t feel right. I’m not
sleeping right. I’m not eating right.
I don’t have the life I want.
I don’t have the strength I want.
And that’s why this becomes a more
because not everything is over an illness.
Some of it is, I’m just not feeling right.
So, a quick question.
Here we have a 40-year-old male
come in with back pain
and you find that the OA has a
shallow sulcus on the left.
Cervicothoracic junction is rotated left.
The thoracolumbar junction is rotated right
and the lumbosacral junction
is rotated left.
Which pattern is this according to Zink?
And the answer is it’s an uncommon
This is a simple question, simple knowledge,
and something you should have
committed to memory.
So just to reinforce why this is important.
Zink found that patients with one of the
common compensatory patterns
tolerated stresses, tolerated
and were able to resolve somatic
dysfunctions on their own
without the aid of a practitioner.
So we try and get people to this level.
It also gives us a sense of when
people need to be seen again.
People who have a common
may not need to be seen as frequently
as somebody with an uncompensated pattern.
If you have an uncompensated pattern,
then the doctor’s help is going to be needed
to get people to an optimal
level of functioning.
It also tells us where to focus
so the transitional zones are the areas
that are going to take the stress.
They’re the areas where you’re going
to see the changes early
and they’re the changes that
are going to predict
health and illness.
So addressing the transitional zones
becomes a focus of an osteopathic
The diaphragms are part of the areas
that need to be looked at
because you know you’re going
to have issues there.
So before we go further,
I just want to take a minute and
have you think about
yourself and your own body.
Are you doing well at compensating?
Are you doing well at functioning?
And where are you feeling stress?
And is it always the same point?
Is it always the same area
where you going to have the pain
when you have problems?
Most people can identify 1 or 2 areas—
1 or 2 transitional zones.
And they know the diaphragms that
are going to give them trouble.