OA Decompression: So the OA junction
is a very important region
to evaluate and treat. If we find an
occipital condyle dysfunction,
we want to try to disengage that by utilizing
OA decompression technique.
We want to do here is to try to place our finger
on C1 and hold the C1 tubercle
and allow the occipital condyle to slide back.
So, I’m going to find the inion.
I’m going to keep my finger curled
pointing back up towards me
and slide down until I find and
drop off the edge of the occiput.
So the finger is aiming superiorly and almost
back up to the patient’s nose.
So, there’s a lot of soft tissue that
you have to kind of allow to soften up
until you get a sense of being on the C1 tubercle.
To better expose C1,
you can have the patient dip their chin forward.
Good. And with the other hand,
you can just gently support that for nodding
of the head. So I’m paying attention
to my middle finger here as it starts to
advance through the soft tissue
to contact the C1 tubercle. Once I reached that
point, what it kind of feels like is
a tip of the pen on my finger. You keep
holding it until that sensation
of that bony tubercle disappears. When it disappears,
that’s when the condyles
are sliding back, disengaging. So,
once you feel that area softening
and no longer feeling that firm,
bony tubercle with your fingers,
you know that the occiput has kind of
slid back away from C1.
Then you can bring the patient back
and then recheck to see
if the OA junction still has a
somatic dysfunction present.
Occipitomastoid Suture V spread: So,
our occipitomastoid suture
where the occiput and temporal bones
meet is a very important region
to examine. Remember the
jugular foramen resides there.
You have cranial nerves IX, X, XI
that pass through there.
Also, your venous sinuses drain through
there for blood to return
from the head back to the thorax. So first,
we want to assess to see
which side feels a little bit more restricted.
You could perform a base spread
to see which side feels more restricted or
you could kind of feel the tissues
around the occipitomastoid suture and
see which area feels a little bit more
tender or restricted. What we want
to do is to get our fingers
on either side of the occipitomastoid suture.
One finger is going to be
on the mastoid process and the other finger
is going to support the occiput.
So, what we’re going to do is to provide
a little bit of a gentle spread
with our fingers. As you’re spreading your
fingers, that’s helping to spread
the suture and to decrease any restriction in
that area. You could also try to help
improve the spread there by creating a little bit
of a fluid wave from the opposite side.
So, you could place your hand on the head,
get a sense of where the fluid wave
that you project from down here
will land on the opposite side.
Then when you find that, you’re going to then
project away from your top hand
to your hand on the occipitomastoid suture.
So, while I’m spreading,
I’m also creating a little bit of a
pulsatile wave with my top hand
to try to help utilize the fluid wave
to help open up that suture.
Once you feel the suture release, then
you come back. Reassess the region.
Perform your base spread again just to see
if the technique was successful
and really seeing the restriction
in that area.