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Recherches
cliniques et autres articles d'intérêts...
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Index of Papers
Subjet
sacro-iliac support versus structural
stabilisation and elimination of
myalgia.
Car's
seat versus coccyx subluxation
The
Temporo-Mandibular Joint involvement in
sports events.
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A-K. Research Paper June 1992
I.C.A.K. Seminar 1993
SUBJET SACRO-ILIAC SUPPORT Versus STRUCTURAL
STABILISATION and ELIMINATION of MYALGIA.
by Gilles G. Brisson D.C.
ABSTRACT
Belting of the sacro-iliac joint will permit the stabilisation of all the musculo-squelettal structures, thus eliminating different myalgia throughout the body and giving a better muscle utilisation by the elimination of incorrect recrutement.
Reinforcement of the proper muscle related to the S.-.I. joint, and the stabilisation of the other muscles related to the pelvis will be necessary, to insure a permanent and strong support to the body structure.
INTRODUCTION
Treating many national and international athletes involved in different sports gave me the opportunity to find numerous injuries which wouldn't be that evident on the normal type of patient. The fact that their bodies are very finely tuned means that their capacity to recuperate seems to be accelerated. Using athletes to verify different therapeutic approaches is very helpful, because they can give us almost immediate feedback of the body's reaction to the intervention, by the way they feel during the performance / execution of their movement.
These unique experiences with athletes permitted me to apply the acquired knowledge to my regular patients. This research paper is just one of its applications.
DISCUSSION
Many sports or exercises demand the utilisation of the buttock muscles. It seems, however, that they are not properly solicited, because there is recruitment of, or compensation by, the synergistic muscles such as the sacro-spinalis, the quadratus lumborum, and the gluteus medius. Hypertension of the psoas, and the rectus femoris may also explain this inadequate usage of the buttock muscles.
Single or multiple trauma might be the cause of certain sacro-iliac instabilities. In the example of gymnasts who often fall on their buttocks, or the woman who has recently delivered .a baby, one observes that the pelvis opens like a butterfly and does not return to it's original position.
I quite often find patients with a complete and partial atrophy of the gluteus maximus; this being unilaterally or bilaterally.
People who must repeatedly perform lifting movements while bending their knees, put a great deal of tension on their quadriceps. This will lead the pelvis to move to an anterior position. As a result, the gluteus muscle will not be in such demand, and will start to diminish in size and power. The same principle applies to people who do not push off with their back leg when walking in order to propels themselves. To determine pelvis instability, many parameters will be used.
1-OBSERVATION
-Gluteus maximus and medius atrophy :unilateral
/bilateral.
-Piriformis muscles weakness : bilateral.
-Muscular hypotonicity
-Lumbar hyperlordosis and shifting of the pelvis anteriorly
-Hypertrophy of the sacrospinalis muscles unilaterally/bilaterally
-Testing the Gluteus maximus -Extention of the thigh (trying to contract the gluteus maximus ) The leg and thigh segments move laterally.
2-Palpation
-Pain on the pubic bone.
-Pain at sacro-iliac ligaments.
-Pain in all muscles which are responsible for pelvic support and for the stabilisation of the spine anteriorly and posteriorly.
-The pain is alleviated after performing the strain counter-strain technique, but comes back in a matter of minutes by itself, or if the patient changes positions.
3-MUSCLE TESTING.
-Weakness of the gluteus medius bilaterally.
-Weakness of the gluteus maximus tested normally, or 2-3 times in a row ( be careful when you bring the muscle to the testing position, that the thigh segment doesn`t go laterally- even slightly. Watch carefully for recruitment of the hamstring and gluteus medius ).
-Adductor weakness- bilaterally, supine and/or sitting.
-Patient prone: a strong muscle indicator will become weak upon manuel and constant pressure at the sacro-iliac joint.
-Muscle testing verification for fascia involvement of the Psoas, Quadratus lumborum, Rectus femoris, Piriformis and adductor muscles.
4- OTHERS
-Recurring subluxation, fixations, imbrication, disc compression.
-Sacral and sacro-coccyx instability .
-The patient complains of pain when he/she is maintaining the same position for a while; sitting, standing or lying down.
-The patient has been diagnosed as having pubalgia. This problem has been found frequently in soccer players and in woman in their late phase of pregnancy or post-delivery.
If you find in your examination any of these parameters you should suspect an instability of the pelvis, due to hyperlaxity of the pelvic ligaments.
The best way to stabilize the pelvis is by the use of a belt.
PROCEDURE OF A SACRO-ILIAC SUPPORT.AND STABILISATION
A belt of 1 1/2 inches, or a thoracic band support should be utilized.
It should be worn around the hips at the level of the depression, and wrap around the buttock muscles half way between the origin and insertion .
The support should be tightened until the pain on the pubic bone disappears, and this, in the three different positions: lying, sitting, and standing. If certain signs or symptoms appear when the patient is asleep, or in the morning before getting up, the support should be worn during the night in addition to the entire day. This will give the ligaments of the sacro-iliac area time to heal and to regain their original strength.
Length of time to wear the support:
-23 1/2 hours a day for 10 days . -If any symptoms appear at night or in the morning when the patient is still in bed or just getting out of bed.
-During the entire day for the following 15 days.
-While the patient is wearing the support to stabilize the pelvis, it is necessary to get the musculo-sqelettal relationship functioning properly once again.
The muscles to be evaluated are :
RECTUS FEMORIS , ADDUCTORS , HAMSTRINGS.,
PSOAS , QUADRATUS LUMBORUM , PIRIFORMIS
These muscles should be investigated for :
STRAIN COUNTERSTRAIN, FASCIAL FLUSH, REACTIVE MUSCLE PATTERN.
Specific reinforcement exercises have to be performed for the GLUTEUS MAXIMUS, the GLUTEUS MEDIUS, PIRIFORMIS, and possibly the ABDOMINALS.
The structures to be evaluated and corrected are:
Category II
CategoryI
Sacral-wobble inspiration/expiration
Sacro-coccyx
Disc compression
Facet involvement
Subluxation
Sacro-occiput relationship
Associated cranial faults
Gait and synchronization
The procedure name ''ligament interlink'' as to be perform on the sacro-iliac ligaments.
Sacro-iliac ligament versus costal cartilage.
It is very important to rebalance the different types of affectations which you might find on the above-mentioned muscles and osseus structures. The sacro-iliac support will only help to relieve the symptoms and signs which you find in your examination.
Of course, the stabilisation of the sacro-iliac joint by means of the support will permit the ligaments to heal only if proper supplementation is given, and if the instructions as to how to wear the support are followed.
However, the mere fact that the patient is wearing the belt will not suffice, because as soon as he or she takes off the support, the same muscle pattern will start to develop again, and the same, or another problem will appear.
Different types of exercises may be used to get the Gluteus maximus muscle back into shape. In the first place, one has to evaluate the type of patient he is dealing with, whether it be an athlete whose sport requires force, resistance, and/or endurance, or a person who has to work long hours standing up or sitting down. One must then evaluate the degree of weakness associated with the atrophy of the muscle. Is it complete atrophy, or only a section of the muscle which is weak ?
There exists a wide range of specific exercises from which to
choose; from isometric to isotonic, from power to resistance-type
exercises, from dynamic to more passive-like
exercises. The type of exercise which you will choose for your patient has to be appropriate to the type of work or the sport he is involved in.
When the sacro-iliac joint is stabilized by the reinforcement of the ligaments and muscles, the dural
sheath, which, as you know, attaches at the sacral level will be supported even more, and will be able to work the way it was designed to.
Some have criticized that belting the pelvis will interfere with the normal and crucial sacro-coccygeal
pump. Since the procedure is temporary, it should not cause any disturbance to the pumping
effect, but rather regularize a wobbling movement of the sacrum due to the instability of the ligaments. 6
Sacro-iliac support - Gilles G. Brisson D.C.
Of course, the tension used to belt the patient should not be such that it strangles the pelvis .
NUTRITION
As for any weakness/instability of joints due to poor ligament support, manganese and B12 / LIGAPLEX 1 should be evaluated as a supplementation to help the healing of these ligaments. Very often patients who exibit ligament laxities have been under different kinds of stress, so adrenal evaluation should be carried out. More times than
not, we find an involvement of these glands related to the ligament
weaknesses.
CONCLUSION
The author could have included all of the statistics that he has accumulated to classify the types of problems which have been alleviated and cured by the stabilisation of the sacro-iliac joint, but the procedure would have taken up too much
space, and from experience, a very small percentage of readers would be interested in it .
After examining and treating various kinds of injuries, whether they be acute or
chronic, the author found that if one does not correct, stabilise, and reinforce the pelvic area when there is an instability of the pelvis (due to poor ligament and muscle support), any attempt to correct the initial problem will bring only temporary
results. Furthermore, the original problem may come
back, or even move to some other area in the body; (
e.g.: going from one shoulder to mid-thoracic
area, to a headache, or pain shifting from one side of the pelvis to the other
etc).
Sacro-iliac instability and weakness, even atrophy of the gluteus maximus due to the laxicity of the ligaments
is/are the underlying cause(s) of many injuries, as well as the occurance of myalgia which can not be specifically related to a trauma or an accident, but which appeared
gradually.
For any type of problem experienced by the patient,
who, after some time does not recuperate adequately or does not show
improvement, an evaluation should be made for any type of sacro-iliac
instability, and the procedure of treatment as explained previously should.be carried out.
In your practice, you should pay close attention to the stability of the pelvis with relation to: 1: different kinds of myalgia throughout the body. 2.: any returning fault that you have been working to
eliminate, or 3.: any problem which seems to move from one area to another .
REFERENCES:
Leaf,David, D.C., D.I.C.A.K., Seminar in Advanced
A.K., Montreal, Quebec, CANADA, 1990-91
Walther, David, D.C., D.I.C.A.K., Applied Kinesiology Synopsis, Systems D.C., 1988.
Spine Power Belting system, The Posture Research
Foundation, 261 Davenport Road, #301, Toronto, Ontario, M5R 1K3 .
Nous
ajouterons cet article sous peu!
Clini-Chiro
S.&R. inc., Gilles G. Brisson D.C.,
400 Grande-Côte, Boisbriand, (450)
434-1162
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Car's seat versus coccyx subluxation
By Gilles G. Brisson D.C.
ABSTRACT:
Some car seat or chair designs can cause a coccyx subluxation-misaligment or maintain and aggravate a coccyx subluxation-misaligment, causing back pain while the person is sitting in a car or in a chair.
INTRODUCTION:
After correcting a sacro-coccyx subluxation in the lying and sitting position, some patients still experience pain; not necessarily in the low back area, while they are sitting in their car or in a chair, especially those where the buttock tends to sink down into the cushion.
An evaluation of the coccyx while the patient is in the position corresponding to that maintained in a car seat will reveal a hidden sacro-coccyx subluxation.
The proper correction of the subluxation will solve the problem and at the same time, eliminate the pain in the area where it was present.
DISCUSSION:
Many patients are experiencing low back pain, mid dorsal pain or even neck pain when they are sitting their car, wether they are driving or not. The same type of pain occurs when they are sitting in a chair or couch but not in an upright chair.
Doctor George Goodheart said that we should always evaluate our patient in the position where the experience their discomfort. Since we do not have a car seat or a couch in our office and we cannot ask the patient to bring it with him, we should try to reproduce the condition which approximates the position in which the person experiences pain while in the car or on a certains pieces of furniture.
First of all, let's discuss the design of some car seats which are called ergonomic by the manufacturer. A lot of these seats are at an angle which is less then 90 degrees between the seat and the back (Fig.1).
When your are sitting in those type of seats your knees tend to be above your hips, causing the buttocks to sag, thus diminishing the normal lordotic curve of the lumbar area. This kind of design will cause the coccyx to move anteriorly in relation with the sacrum causing a sacro-coccyx subluxation. (Fig. 2)
The same holds true with those couches and chairs, where you feel as if you are sinking in a hole when sitting down on it, and you need someone to help you to get out of it.
The dura attaches at one end at the level of Sacrum 1-2 and the Coccyx, and at the other end Cervical 1-2 and in the Cranial bones more specifically, at the sutures themselves (1-2-3). If a sacro-coccyx subluxation is present, the patient may be experiencing pain at the attachement of the dura itself, or anywhere along the spine, even to the point of headaches.
Because it is a specific type of procedure, before using the evaluation to determine this hidden sacro-coccyx subluxation, it is important to correct any and all structural subluxations related to the spine, pelvis and lower extremities sitting and lying down. After these corrections have been made, if the patient is still in pain in the above position, then you can apply the following procedures:
1- The patient is sitting and both piriformis are tested individually. They should be strong. If not, evaluate the cause and correct it.
2- A small pillow or apparatus, no more than 4 inches, is placed under the distal part of the thigh near the knee in a sitting position.
3- When piriformis are tested again, one or two will show a weakness in this position.This is the positive indication for a hidden sacro-coccyx subluxation.
4- Challenge for the proper correction associated with the correct phase of respiration in the above position. Adjust according to the findings, while keeping the same position as above.
5- Verify the strength of the piriformis. If they show any weakness, you may challenge for a Categori I type pelvis or a sacral wobble. These challenges have to be done in the position with the pillow under the distal part of the thigh.
The correction should be made in the same position.
6- The correction found in #4 should be done by the patient at home, sitting in his/her chair or by placing a pillow in the position described in #2. The correction should be done once a day, 5-6 repetitions with the phase of respiration in step 4 above.
After this type of correction the pain experienced by the patient should be gone.
CONCLUSION:
This type of procedure is quite practical and does not require a long theorietical description. It was discoved after listening to the type of pain described by the patient's and observing the patient's position during those episodes of pain.
Recreating this position, and testing a muscle related to the area involved revealed a mechanical disorder which would not have been found in the normal sitting position.
As Doctor Goodheart says, " Patients do not have a chiropractic table attached to their abdomen."(4)
REFERENCES:
1- Upledger, John E. D.O., F.A.A.O., & Vredevougd,Jon O., M.F.A., "Cranio sacral Therapy"
(Seattle, Washington, U.S.A., Eastland Press 1983)
2- Upledger, John E. D.O.,F.A.A.O. Presentation, ICAK-USA Annual meeting 199, Pennsylvania, USA
3- Leaf, David D.C.,DIBAK, Applied Kinesiology Flowchart, 3rd. Edition ( Plymouth, MA, Privately published 1995)
4- Goodheart, George G., D.C., DIBAK, Quotation, Dr. Goodheart's research tape 108
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The
Temporo-Mandibular Joint involvement in sports
events.
by: Gilles G. Brisson D.C.
ABSTRACT.
A forcefull hypercontraction of the T.M.J. causing a malocclusion interferes with the mechanics of the movement and the performance during an activity involving the dominance of one side of the body.
INTRODUCTION
During the examination and treatment for various injuries of several of the throwers on the Canadian Track and Field team, as well as athletes participating in other sports involving the utilisation of an
implement, I found that even after having stabilised the different musculo-skeletal components, some of the athletes seemed to develop the same erroneous patterns during the execution of their
movement, which eventually brought back the pain.
Knowing the importance of the Temporo-Mandibular Joint, and its influence upon the biomechanics of the body, this element was evaluated with relation to the execution of the whole
movement.
It is evident that several other components may influence poor biomechanics during the execution of a
movement. The case which I am about to present is just one of these
elements.
DISCUSSION
Before starting any discussion about the T.M.J.
involvement, it is important, for the purpose of this study to define a unilateral event or sport.
A unilateral activity or sport could be defined as: any activity involving the dominance of one side of the body taking part in the major execution of the
movement; e.g. throwing events, or racket sports.
In this particular study, I have decided to analyse the example of javelin
throwing. It is possible to apply the results of this study to any other sport where an implement is
utilized, and or power is needed to execute any phase of the
movement. e.g: tennis, golf, hockey, etc.
First of all, it is very important to look at the movement in its
entirety, as well as the different transfers of force during the execution of the throwing action.
Technique of the Javelin Throw:
For the purpose of the description we will used a right handed person . (7 )
1° - APPROACH RUN.
2° - The FRONT LEG blocks (heel-toe
movement) and initiates the transfer of velocity from the run to the leg and thigh which is added to the power generated by the LEG and
THIGH.
3° - Forward acceleration of the right hip ( pelvic
girdle) adding to the power already
accumulated, while the right foot drags on the ground in order to control this action. The pelvic girdle should not at any time sag posteriorly during this action .
4° - Transfer of accumulated velocity and power to the trunk , which begins accelerating via forward rotation .
5° - Acceleration of the right shoulder
(scapular belt) commences, while the actions on the ground (foot dragging,left foot blocking ) continue, as well as the forward rotation of the right hip. This transfer of acceleration from the trunk to the right shoulder further amplifies the velocity and power which will eventually be transfered to the javelin
itself.
6° - Acceleration of the forearm and release of the javelin : The ground motions are
maintained, while the right hip has rotated forward to the point of being at the same level as the left hip .
Meanwhile, the right shoulder continues its forward rotation until it catches up with the left shoulder and in fact passes it . At the same time the right elbow begins its flexion . The elbow pivots slightly and continues moving forward toward the direction of the throw , while the forearm begin accelerating and generating more power through vigorous extension.
The javelin is released via the vigorous flexion of the wrist and the extension of the fingers outwards . At this moment, all velocity and power which as been generated and conserved is transfered directly to the implement . If all movements in these preceeding phases were executed in the axis of the throw
,with no biomechanical errors or deceleration , then the accumulation of velocity and power should have been conserved right up until the moment of release .
The summation of all forces generated in the preparatory phase of the
movement, if correctly applied to the implement to be
thrown, give it the maximum propulsion . Any changes or imbalances in the musculo-skeletal structure such as poor body
positioning, or contraction of the wrong muscles will bring about either a loss of
power, or an incorrect transfer of force towards another area of the body. Such errors directly affect the optimal execution of the
movement.
During observation and discussion with athletes on the National Throws team in track and
field, as well as the National Throws
Co-ordinator(8), it was noted that in the final phase of the throwing action, especially from the moment the athlete initiates the release movement at the scapular
belt, followed by the transfer of force to the
implement, and finally the execution of the throw
itself, many athletes had a tendency to clench their teeth in an ultimate effort to bring more power into the
throw. This contraction of the T.M.J. is not an addition of
power, but rather an inhibitor to the transfer of the force accumulated in the preparatory phase. We can calculate this as a loss of
power, which, instead of being utilized to throw the
implement, is lost in the jaw. It was also noticed that this contraction is more accentuated on the side of the body where the implement is
held, due to the fact that all forces are directed towards the side where the execution of the movement is to take place.
If you execute this movement repeatedly,
(the throwing action)100-150 times every training session, with the same erroneous pattern as explained
before, one will develop a unilateral hypercontraction of the temporo-mandibular joint. This results in what we would call a forcible mal-occlusion on that same
side, which might not show up upon normal evaluation of the T.M.J. .
This unilateral hypercontraction at the jaw level is a loss of energy
(negative) which could be used otherwise (more
positively) for the optimal execution of the movement,in such a way as not to alter the balance of the musculo-squelettal system during the last phase of the
throw.
This imbalance occurs more in the pelvic and scapular belt
area. At the pelvic level, one will notice a lowering of the pelvis accompanied by
sagging, with retraction of the buttock muscles. At the shoulder level we will observe the same pattern, meaning a dropping of the whole scapular belt accompanied by retraction of the shoulder joint, and a loss of force by the rotator
cuff. This deviation from the normal will displace the center of
gravity, thus modifying the whole approach of the throw by changing the body
alignment, resulting in a poor transfer of force from the leg to the
trunk, trunk to the shoulder, and shoulder to the arm .
The procedure used to verify the interaction of the musculature of the temporo-mandibular joint during the execution of the throwing movement is as
follows: Ask the patient to forcefully contract the muscles of the temporo-mandibular joint on the side suspected of
"closing mal-occlusion" (normally on the side where the implement is held ) and at the same
time, test a previously strong indicator muscle which is located on the side where the implement is held ( it could be from the
shoulder, or even the pelvic area ). If a forcible mal-occlusion is
present, a weakness in the indicator muscle will
appear. If one performs the same procedure on the opposite
side, no weakness will be apparent . I must emphasise here that a normal closure of the jaw without forcefull contraction of the muscles involved in the action
(masseter, buccinator, temporalis), would not give a positive response regarding the weakness of the strong indicator muscle .
Treatment approach :
The treatment approach for the correction of this forcible mal-occlusion is :
First of all, one must put a tongue depressor between the last two molar teeth on the side which is involved . Normally, the width of two tongue depressors is necessary, in order to annihilate the positive response illicited upon performing the same muscle test as previously described. If you need more than two tongue depressors to cancel the positive therapy localisation, you might need to seek the help of other professionals to rebalance the mal-occlusion .
The treatment itself, for the stabilisation and the equilibrium of the temporo-mandibular joint is well documented and explained by Doctor George J Goodheart(6), Doctor David S. Walther(3), and Doctor David W. Leaf(1), in their various research papers and lectures.
We must investigate , before carrying out this type of evaluation of the forcible mal-occlusion, any structural imbalances which could influence the temporo-mandibular joint and correct them.
These are:
-Ankle mortise.
-Category II-I.
-Dural sheath involvement
-Muscle imbalances: especially the Sterno-cleido mastoid , Upper trapezius , Masseter, Buccinator, Temporalis, External and internal Pterygoid.
-Any muscles related to the action of throwing.
-Cranial faults.
Thus, it is of utmost importance to properly stabilize all the musculo-squelettal imbalances that you find before evaluating for a forcible mal-occlusion of the temporo-mandibular joint during a specific action (such as javelin throwing as discussed in this paper).
It is quite possible that the athlete may have to perform what we can call "tongue depressor therapy". This means that the athlete will have to practice his throwing action while holding the tongue depressor(s) between his teeth (without clenching) in the back of his mouth, (this being on the side of closing mal-occlusion), until he can consciously perceive the adequate positioning of his jaw. This conscious perception has to become an automatism recorded by the brain as part of the procedure in the execution of the whole throwing action.
Subsequently, when the athlete executes his whole throwing pattern, he/she will be able to feel if there is any closing of the jaw which could disturb the musculo-squelettal balance needed to complete the generation and transfer of maximal force to the throw. In addition, he/she will be able to proceed with the correction of this incorrect gesture through relaxation of the jaw by bringing it to the the neutral position.
It is interesting to go directly onto the practice field , so that we may observe the athlete during his training session, and discuss the different problems which might appear during the execution of the whole movement with
him/her and the coach. With this information, plus the knowledge and comprehension of the biomecanics of the
throw, we can proceed with the correction of musculo-squelettal
imbalances, and have a direct feedback of our intervention . For
example, the tongue depressor therapy can be evaluated directly with the athletes while they are performing their
throws, followed by the correction of the T.M.J.
imbalances, thus enabling us to observe the immediate biomechanical changes .
During the execution of a movement which involves the dominance of one side of the body over the other, as in throwing, we notice that all of the muscles associated with the occlusion of the jaw very often go into hypertension, thus bringing about an imbalance of the Temporo-mandibular joint in the form of a closed mal-occlusion on the dominant side. This problem changes the whole biomecanics of the execution of the movement, resulting in a loss of power .
It is quite possible to find a bilateral hypercontraction of the musculature of the T.M.J. with the sport which sollicites both sides of the body, like gymnastics or weight lifting. The same procedure of examination and treatment is used to alleviate the problem. However, regardless of the fact that you can find a bilateral forcible closed mal-occlusion, it will exist on the side which is more involved than the other, and will correspond to the more prominant side that the person uses in his normal daytime activities .
Ideally, during the action of throwing or any other sporting activities, the jaw should be kept in a neutral position whereas all muscles related to the temporo-mandibular joint should not at any time be in hypercontraction.
CONCLUSION
It is important throughout the execution of any given movement to not only properly utilise the required components; but also to sollicit them in a precise order.
The repetitive hypercontraction of the musculature of the jaw , causes a forcible mal-occlusion of the T.M.J. leading to a loss of power, as well as negatively affecting certain biomechanical components of the movement.
The evaluation of the Temporo-Mandibular Joint is of prime importance during the examination of an individual who practices a sports activity an order to eliminate any components having a negative influence upon the execution of the movement in question, so that the athlete may develop his full potential.
BIBLIOGRAPHY:
1. Leaf, David, D.C. Seminars in Essentials and advanced Applied Kinesiology, Montreal, Canada
2. Leaf, David, D.C. Applied Kinesiology Flowcharts , 1990
3. Walther, David, D.C., Applied Kinesiology ,Volume II ,System DC . ,1983
4. Walther, David, D.C., Applied Kinesiology, Synopsis System DC. , 1988
5. Goodheart, George, D.C., Research Tapes,# 28, 32, 77,108,111.
6. Goodheart, George, D.C., Collected Published articles & reprints, pp.184-188 .
7. Didier, Poppe , E.P.S. Professor ,Le double appui au lançer du Javelot , CTR Nouvelle-Calédonie ,Wallis & Futura .
8.Baert, Jean-Paul, National Coordinator and Olympic coach of throwing events for Canadian Track and Field Association (Athletics Canada).
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Coordonnées
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Informations
Téléphone
450-434-1162
Adresse:
400, Grande-côte, Boisbriand, Québec, J7G 1B1
Carte
Courrier Électronique:
Pour communiquer avec le Dr. Brisson:
info@chiro-sport.com
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Dr.
Gilles
Brisson, Chiropraticien,