The spinal cord is a direct extension of the brain, as both contain the same type of nerve and glial cells. And, although researchers have long dismissed René Descartes’s hardwired central nervous system (CNS) model, the spinal cord, in some ways, still resembles a hardwired switchboard and cables (Image 1).
As a cable, it connects the brain with the body’s peripheral nerves, and, as a switchboard, it coordinates muscle movements and spinal reflexes under its direct control.
Optimal positioning of the head, pelvis, and spinal cord enhances nerve impulses and reflexes traveling to and from the brain. By manually leveling the head on the neck and balancing the spinal column on a horizontal sacral base, Myoskeletal Alignment seeks to normalize electrical activity in these righting reflexes.
In Image 2, notice how CNS righting reflexes from visual, vestibular, and somatosensory feedback work together to make instantaneous neuromuscular postural adjustments.1 In his classic 1949 book Body and Mature Behavior, Moshe Feldenkrais offered this explanation of righting reflexes: “When the head has been righted and the body is held in a lateral position, the neck is twisted. The proprioceptive nerve organs in the neck muscles, joints, and tendons are stimulated and the thorax rights itself so as to untwist the head. The twist is now displaced to the lumbar joints, and the pelvis is righted as well by the proprioceptive stimulation arising from the lumbar region. We see here the neck and lumbar-righting reflexes acting so that the body stands properly and follows the movements of the head.”2
Clinically, it appears righting reflexes may trigger neck and pelvic muscle spasticity in an attempt to level the eyes against the horizon. Further, if the reflexive spasm alters ilium and sacrum alignment, the CNS may generate ascending syndrome compensations that spiral up the rib cage, shoulders, and neck, forcing further unleveling of the eyes. Images 3 and 4 show a couple of my favorite iliosacral alignment techniques for leveling the sacral base and relieving reflexive muscle spasm.

Head Righting Reflex (HRR)
The head houses sensory organs (teleceptors) that connect us to the exterior world. When floating comfortably atop the spine, cranial teleceptors reflexively orient head placement using light, sound, and gravitational sensory information. However, our brains are often unable to make sense of visual input without movement. The eyes must constantly move for light to traverse across the retina, which allows the CNS to construct visual images by comparing adjoining structures in the environment. Teleceptor function is compromised when the head is persistently maintained in an abnormal position. As spastic neck and jaw muscles inflict whole-body reflexive movement constraints, CNS “noise” heightens the body’s stress response.
A Catch-22 occurs when a poorly aligned body initiates HRRs that trigger spasm and mechanically alter spinal joint movement. When hyperexcited joint and ligament mechanoreceptors initiate protective splinting, some muscles overwork and others are inhibited. This results in reduced mobility, excessive energy consumption, exhaustion, and, if the brain perceives a threat, pain.
During forward bending and rotational movements, all vertebrae that can participate should do so. Chronic immobilization due to protective guarding shifts excessive strain to the remaining mobile joints, increasing risk of injury by limiting available motion. Well-coordinated HRRs rely on an aligned pelvis, a springy rib cage, and a cervical spine that’s both flexible and stable. In Images 5 and 6, I demonstrate head-on-neck leveling techniques for relieving suboccipital spasm and accompanying cervicocranial misalignment.

Summary
Always try to level the head and tail in a single therapy session and retest in subsequent visits. Try to include movement awareness dialog during your hands-on work, such as, “Feel how your low back and hip bones contact the table as you slowly tilt the pelvis forward and back.” Offer immediate feedback if you sense unnecessary effort or rigidity.
Helping clients become aware of inefficient movement patterns is a learning process, not a procedure. Our bodies are shaped by how we use them, and habits determine use. It is the client’s underlying habits that need to change, and we can help. When confronted with pain and injury cases, rather than chasing the pain, first evaluate what the client may be doing to cause the problem, and help her learn how not to do it. Manual and movement therapy can then address abnormal neuromuscular righting reflexes that may be causing protective muscle guarding and accompanying joint dysfunction.

Notes
1. Jay M. Goldberg et al., The Vestibular System: A Sixth Sense (New York: Oxford University Press, 2012).
2. Moshe Feldenkrais, Body and Mature Behavior: A Study of Anxiety, Sex, Gravitation, and Learning (New York: International Universities Press, 1949).

Erik Dalton, PhD, is the executive director of the Freedom from Pain Institute. Educated in massage, osteopathy, and Rolfing, Dalton has maintained a practice in Oklahoma City, Oklahoma, for more than three decades. For more information, visit www.erikdalton.com.

Editor’s note: Massage & Bodywork is dedicated to educating readers within the scope of practice for massage therapy. This column is based on this author’s years of experience and education. The column is meant to add to readers’ knowledge, not to dictate their treatment protocols.