DNL – Myofascial Connections - Workshop Summary

Using identification of the Dominant Neurological Layer with Adaptability Testing and light skin pressure on spinal segments to direct myofascial percussion therapy.

Summary

The workshop established clinical protocols for integrating dominant neurological layer diagnostics with targeted myofascial percussion therapy.

Neurological Assessment and Therapy

Clinicians identify the dominant neurological layer via spinal skin pressure combined with adaptability testing to guide targeted percussion therapy. This method prioritizes specific spinal segments established through prior differential diagnosis.

Muscular Targets and Application

Therapy focuses on muscles associated with cervical, thoracic, and lumbar segments including specific ligaments. Clinicians utilize the 3D energy gun with rotational torque for myofascial lengthening.

Clinical Feedback and Evaluation

Practitioners use patient feedback mechanisms to locate precise tender points during treatment. Clinicians must perform bilateral examinations based on symptomatology to determine appropriate myofascial intervention sites.

Use Light Pressure: Examine and explore tissue using light perpendicular skin pressure. Stimulate points with only light skin pressure contact.

Train Feedback: Train practice members, patients, or clients to learn how to give feedback. Teach them to signal when finding tender points.

Check Both Sides: Always check both sides connected to the dominant neurological layer.

Details

Introduction to Dominant Neurological Layer (DNL) and Myofascial Connections: Nick Hodgson introduced a workshop focused on connecting a dominant neurological layer (DNL) to associated myofascial connections, drawing on 30 years of clinical experience and aiming to base decisions on available science. The discussion centers on using adaptability testing and light skin pressure on spinal segments to identify the DNL, which then directs the application of percussion therapy to relevant myofascial tissues. This approach supplements work done on the specific spinal segment after a clinician has established a differential diagnosis to determine the segment to be treated.

Clinical Decision-Making and Resource Recommendation: The decision regarding which muscles to stimulate or percuss is based on the differential diagnosis of the dominant spinal level. For clinicians lacking this differential diagnosis skill, Nick Hodgson recommended they consult the "spinal percussion therapy using the 3D energy gun” program found under the programs tab of the www.superhealthy.com.au website. The selection of muscles of interest is further guided by muscle attachments to the DNL, muscle bellies crossing the DNL, muscle kinesiology impacting the DNL, and the neurological pathways stemming from that spinal level.

Muscles Associated with Occiput and C1: The discussion began with the occiput, noting that muscles covering this area, including all suboccipital origins (e.g., rectus capitis, obliquus inferior) and the upper trapezius attachments, are relevant targets for therapy. For C1, intrinsic upper cervical muscles surrounding the area are involved, and tenderness in the upper trapezius may be found laterally in the belly. The sternocleidomastoid should also be checked for tenderness and trigger points, especially when working on C1.

Muscles Associated with C2 through Thoracics: For C2, intrinsic and extrinsic upper cervical muscles surround the level, and trigger points are often found deep in the belly of the upper trapezius. C5 involves intrinsic rotatories and multifidi, as well as the levator scapula, which descends to the scapular insertions. C7 involves muscles around the segment and the rhomboids, which run down the medial border of the scapula; the intrinsic muscles of the thoracic spine may necessitate treatment one or two levels superiorly or inferiorly due to their length in the deeper areas.

Muscles Associated with Lumbar and Sacrum: L3 involves intrinsic lumbar muscles and the quadratus lumborum, where vicious trigger points may be found laterally. L5 requires checking intrinsic muscles and specifically the iliolumbar ligaments, which often exhibit point tenderness that can sometimes be misleading in relation to the patient's perceived pain. For a lateral sacrum, clinicians should examine the sacroiliac ligaments and the piriformis, while an anterior inferior sacrum necessitates checking the iliolumbar, sacroiliac and sacrotuberous ligaments.

Muscles Associated with Pelvic and Hip Issues: For a PI ilium, relevant areas include the iliolumbar ligaments, sacroiliac ligaments, and all gluteal muscles around the iliac crest. Hip and trochanter issues should lead to an examination of the gluteus minimus, tensor fascia latae, iliotibial band, and adductors, as identifying problems in the adductors can significantly improve hip range of motion and reduce discomfort. A pattern sometimes observed is an occiput and sacrum issue occurring together, suggesting a head-to-tail compression, which necessitates checking anterior muscles like the SCM and the psoas muscle.

Application of the 3D Energy Gun for Myofascial Work: The 3D energy gun allows for the addition of rotation (torque) to impulses, which is unique to this instrument. When deciding whether to use clockwise or anticlockwise torque, the clinician should select the one they believe will produce the greatest lengthening effect on the muscle, although microscopically, any torque will separate the myofibrils. Clinicians are advised to use light, perpendicular skin pressure when applying the 3D energy gun and to avoid "digging deep" to prevent damage to the instrument, relying on the torque and impulse transmitted through the tissues.

Patient Feedback and Bilateral Examination: Training patients to provide feedback is critical for identifying and spending time on tender points, which can sometimes be tiny. Clinicians should teach their patients a method, such as the "thumb meter," to visually signal when the most tender points are found. Finally, when determining which side to perform myofascial work on, such as with a right short leg and a C1 RP, there is not always a direct connection, requiring reliance on symptomatology, observation, palpation, and checking both sides connected to the dominant neurological layer.