Spinal Mechanics

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What is PPT Manipulation?


With so many manipulative techniques currently available, what makes PPT’s so special?


Why haven’t PPT’s been developed before?


Are PPT’s the definitive answer?


Where can I find published research on this subject?


What are the benefits of PPT’s?


Do PPT’s treat the whole body?


Can the PPT protocol help with cranial work?


Do I have to treat the whole body in one session?


How long does a full PPT treatment last?



What is PPT manipulation?

PPT manipulation is an entirely new and highly advanced approach to spinal and peripheral joint manipulation used by Osteopaths. PPT’s work by reverse engineering  Osteopathic lesions.


With so many manipulative techniques currently available what makes PPT’s so special?

Nearly all of the current HVT and LVT techniques are based around the ambiguities of Fryette’s laws, and the Nutation/ Three Pole semi-dislocation sacroiliac theories. They work by placing the patient and lesioned joint into a position of maximum torsion and in order to lever the joint apart with an audible click. There is nothing  subtle about the techniques, no matter how refined. There are other techniques that rely on oscillation and harmonics or placing the lesioned joint into positions of strain or counter strain. There are even spinal guns that blast a locked joint with a single hit. However, none of these techniques reverse all of the forces that create an Osteopathic lesion.  


PPT’s are based on the years of research and development that went into identifying the forces that create pelvic/spinal/ribcage articulation in a way that complies with the harmonious and synergetic movement humans take for granted.  PPT’s reverse engineer all of the forces that create an Osteopathic lesion. For this reason their effects provide longer lasting and more substantial results.


PPT are silent and gentle and do not put the patient in any strained uncomfortable positions.


Why haven’t PPT’s been developed before?

The answer is they should have been but the reason PPT’s have not been developed before is because the professions consistently look backwards for inspiration rather than forwards. All past and current research is based on existing hand me down theories and techniques. Research is the buzz word, however, before reliable research can take place a viable working theory has to be in place. Otherwise the same old results are going to be replicated and regurgitated. That is why current published research whether Osteopathic or Chiropractic consistently comes up with so many disappointing conclusions.


You may disagree and insist that we already have in place viable working models and the current techniques work fine for me.  No one denies that manipulation professionally applied will get a patient out of pain and provide a level of posture symmetry and mobility that is not possible to attain with exercise alone. However the symmetry and mobility soon disappears. What the synergetic model provides is a blue print for human articulation and how joints can become so locked that they create changes to the local soft tissue. PPT’s are purpose designed to counter all of these forces and have the potential to provide better and more lasting results. In practice this is the case.



Are PPT’s the definitive answer?

The answer is probably yes. Having said this there may well be many more techniques using the synergetic protocol waiting to be developed. Once more professionals understand the forces that create skeletal articulation and how joints become locked and then lesioned, the better the future will be for the physical professions who use manipulation at the heart of their treatment. John Bayliss’s PPT’s are the first step, however, it is a gigantic step.


Where can I find published research on this subject?

Currently there is none. The subject of synergetic spinal mechanics and PPT manipulation is too new. It has been suggested by N.C.O.R that a single aspect of the synergetic articulation is individually researched. However this type of thinking creates a real problem; the pelvis/spine and rib cage move as a complex interrelated and harmonious structure, each part being dependant on the other. Therefore, you cannot look at one part without looking at another and then another. Focusing on one joint is a bit like homing in on a single cog in a mechanical clock and expecting everyone who currently understands the equivalent of a sun dial to understand how it fits in, without reference to rest of the mechanism. As an Osteopath I was always taught to look at the whole person but this philosophy clearly does not apply to research.


As an example, let’s look at the ‘Nutation’ sacroiliac theory which is a focus theory and meant to account for how humans walk forward, backwards, run and climb stairs etc. This focus theory apart from being unable to convincingly replicate any of the aforementioned functions makes no physiological sense. Further, no account is taken of how this theory fits in with how the rest of the spine and rib cage articulate. Some theory! Anomalies like this theory arise because the research was focused singularly on the sacroiliac joints, rather than how the sacroiliac articulation fits in with harmonious spinal and hip articulation.  


The ‘Nutation’ theory is often referenced in published research as one of the best theories. In other words, new research based on imperfect research. The ‘Three Pole’ pelvic theory fairs no better. Laughably, both theories rely heavily on the fact that the sacroiliac joints have the magical ability to semi-dislocate and re-align themselves with every foot step we make. Fans of these theories make excuses and say “but its only a couple of millimetres” . A couple of millimetres overlap in any joint is a semi-dislocation, no matter how you dress it up.


There is further contradiction regarding ongoing published research. The ‘Journal of Osteopathic Medicine’ published a paper by M.C. McGrath of the New Zealand University of Otago in 2004 concluded that “Manipulation of the sacroiliac joint has been shown to leave the position of the joint unchanged when compared with its pre-manipulative position’. If this is true, then no one has ever managed to correct a lesioned sacroiliac joint. Therefore as many suspect, all the past research that led to the currently accepted sacroiliac focus theories were derived from lesioned sacroiliac joints, which explains the subluxation part of their theories.


To look at the mechanical spine you need to look at the how the whole skeletal frame articulates without semi-dislocation and this is what synergetic spinal mechanics encompasses. Until more sophisticated and diverse research methodology is used to evaluate the whole spine articulation, human skeletal articulation can only be described in terms of theory.


You will often hear the manipulative professions talking about their holistic approach. PPT’s are truly holistic.


What are the benefits of PPT’s?

Sacroiliac, spine and rib joints rarely make a crack when they lock, therefore there should be no reason why they should crack when you put them back into place. Because PPT ’ retrace the forces that created the bony locking and Osteopathic lesion, there is no noise and very little force is needed. This makes the techniques not only safe and quiet but very efficient and effective. PPT’s open up a whole new vista in body symmetry and mobility and the benefits they provide.


Do PPT’s treat all the joints in the body?

Yes.  



Can the PPT protocol help with cranial work?

Yes, the synergetic PPT protocol can enhance cranial treatments, muscle and ligament techniques. They can also enhance medical palpation.


Do I have to treat the whole body in one session?

You will get much better results if you treat the whole body in one session. For example, if you correct selected spinal joints and  omit the sacroiliac and pelvic lesions, as soon as the body becomes weight bearing all the joints you have manipulated will return to their lesioned position by the time you next see your patient.


Having said this, if the way you work is to just correct a few selected joints (first aid) you still can. In the end PPT’s are just manipulative techniques.   




How long does a full PPT treatment last?

It can take between 10 to 15 minutes to correct all of the joints in a single treatment session Most often you will reposition the spinal joints several times. This is because certain joints will have forced other joints to tighten and when released the joints will put tension on other joints. If you realign the joints again (a bit like planing a piece of wood) the spinal symmetry gets ironed out until you have a very straight and mobile spine, far straighter and more mobile than is achievable with any other method of manipulation.




PPT Manipulation: Questions and Answers

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