1. Start with "Dislocated Bones and Dislocated Tendons"
In the early manual treatment, Mr. Long was puzzled by the unclear etiology of spinal diseases, which led to poor treatment effect. During her three-year study of Chinese medicine in medical college, she was inspired by the concept of "bones are staggered and tendons are out of the ditch". In the following years, starting from the doubt that the imaging diagnosis of cervical spondylosis is often inconsistent with the clinical manifestations, the joint dislocation between normal joint structure and subluxation was discovered, and a set of perfect chiropractic techniques was further developed from the perspective of spinal biomechanics, which became a classic theory of spinal etiology.
2, the technique should be stable, mainly based on skills, to avoid violence.
"Add flash power when necessary, and don't force all patients to take pictures." Now many doctors who study Long's manipulation still regard snap as an indicator of curative effect. In this regard, Teacher Long's request for manipulation, "Manipulation can not only cure diseases, but also hurt people." She has treated six or seven cases of illness aggravated by violent means, mostly because doctors are eager for success. Therefore, on the basis of accurate positioning, the technique should be skillful.
3, palpation must run through the diagnosis and treatment.
Palpation has always been a difficult point in chiropractic treatment. By touching the transverse process and articular process of the patient's cervical vertebra with a doctor's finger, we can feel whether the patient's cervical vertebra is dislocated or not, and judge the condition by combining clinical manifestations and imaging data.
Palpation must run through the diagnosis and treatment. After each manipulation, palpation should be performed to reduce joint changes. In the three-step localization diagnosis, palpation takes precedence over imaging examination. In this regard, Teacher Long talked about a case in the 1970s: the patient's symptoms were very serious, but there was no obvious abnormality in palpation. After asking about the patient's previous medical experience, Mr. Long suggested that he go to neurosurgery. As a result, he was diagnosed as a benign tumor of spinal cord by myelography. After the operation, the patient's family was very grateful to Mr. Long. This experience tells us that when palpation is inconsistent with clinical symptoms, patients should consider other spinal problems.
4. Operation skills of angle drawing method
In the research process of manipulation, the angle-pulling method was put in the last study because of its complexity. "This is the most troublesome technique, and it is also specifically for headaches." This manipulation is mainly aimed at cervical 2-3 mixed dislocation, which is common in patients with headache and dizziness. When using this technique, you should pay attention to bow your head, shake your head, push your side, and then press it with your arm. After that, bow your head, shake your head and push your side.
5. The importance of traction bonesetting in chiropractic therapy.
For complex mixed dislocation in many difficult cases, Mr. Long emphasized the importance of traction. "When you have difficulty in manual reduction, you can increase traction." Traction is the most suitable method for patients with osteoarticular degeneration. Teacher Long pioneered traction bonesetting. The cervical traction chair, which she is responsible for developing, has gone through seven generations. She often uses traction chair for self-care, and the traction weight reaches 20kg, and there has never been any problem. Osteoporosis patients have no problem with longitudinal stretching, and osteoporosis is afraid of longitudinal extrusion.
6, the relationship between yaw and rotation
"If there is rotation, there must be a side swing, and if there is a side swing, there must be rotation." "Platycladus orientalis and spinning are brothers." This is Teacher Long's vivid description of lateral rotation, because the minimum movement stage of the spine is composed of two vertebrae and soft tissue connecting them. When a load is applied to it, it can move in three dimensions and six degrees of freedom, that is, three displacements and three rotation angles. One of them is the main motion curve, which represents the motion consistent with the loading direction. Therefore, it is necessary to judge whether the dislocation of vertebral body is mainly rotation or lateral swing in clinic to determine the priority of manipulation.
7. Shake your head
In the latest edition of Etiology of Vertebra, Mr. Long has divided the head-up method into two types, one for occipital-atlantoaxial dislocation and the other for atlantoaxial dislocation. Head-up method is suitable for rotational dislocation of occipital-atlantoaxial joint. During the operation, the patient lies on his back with his pillow low. The surgeon holds his occipital bone with one hand and his mandible with the other hand, so that the patient's head tilts upward (lifting the head can lock the C2-7 cervical joint as a "fixed point") and turns sideways, and asks the patient to relax the neck muscles (move slowly for 2-3 times). When the head is turned to the maximum angle, a limited "flash force" can be applied to reset the dislocated joint, and sometimes the click of joint reset can be heard during this operation. You can also sit and operate.
In clinic, many doctors use bow-rocking method to reduce the dislocation of the first and second cervical vertebrae, and they are skeptical about the reduction effect of bow-rocking method. In this regard, Mr. Long thinks that the bow-shaking method can achieve the reduction effect. For the cervical vertebra, if the bilateral transverse processes are not obvious during palpation, it is necessary to consider the whole cervical vertebra moving forward, and the mandibular low horizontal traction method can be added on the basis of the arch shaking method. Unless the odontoid process is fractured, the whole cervical vertebra moving backward is not common. Shake upward with horizontal traction.
8. Bowing and shaking method
The method of rocking under the arch is suitable for the rotational dislocation of the 2-6 posterior joint of cervical vertebra. During the operation, the patient lies on his side, lying flat on the pillow and bending his head (if the middle cervical vertebra is dislocated, it will bend about 20 degrees). The flexion of the lower cervical spine is greater than 30 degrees. ) The operator gently holds the back neck with one hand, and presses his thumb under the dislocated transverse process as a "fixed point", while holding his cheek as a "moving point" with the other hand, and rotates his head with the pillow as a fulcrum. When shaking your head to the maximum angle, use limited "flash force" and "fixed point" thumb to press in the resistance to make the joints move. The slow reset method can be repeated 2-3 times as needed.
9, side head shaking method
The lateral shaking head method is suitable for the rotational dislocation, lateral bending dislocation and lateral dislocation of the uncinate process joint of cervical vertebra 2-6. During the operation, the patient lies on his side and his head leans forward. The performer holds his head in the ear area with one hand, gently holds the back neck with the other hand, puts his thumb under the dislocated transverse process, and raises his head and shakes his head in a lateral flexion posture, which is the same as the bow shaking method.
10, spinal etiology theory
Spinal etiology involves diseases in various departments, but its clinical value has not been paid attention to, so Teacher Long hopes that her students can popularize the theory of spinal etiology in various disciplines. In the genre of techniques, she does not advocate calling her own techniques "Long's techniques", and each technique has its advantages. Students should learn from other people's strengths and experiences, and never be biased. Teacher Long often said, "I'm just an ordinary doctor, a grassroots clinical researcher, and I'm not a master".
Teacher Long Cenghua combined traditional Chinese medicine with modern spinal physiology and biomechanics, and created a set of methods to treat spinal diseases such as spinal soft tissue injury, dislocation of spinal joints, synovial incarceration of joints, and disc herniation. This manipulation can be used to treat diseases caused by spinal etiology based on syndrome differentiation. Its characteristics are: stable, portable, painless, safe and effective. Now it has become a key scientific research topic and achievement in state administration of traditional chinese medicine, and it is being popularized and applied.