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Practical Guide to Cranial Adjusting |  | This is a hands-on and detailed guide that covers ROM testing, sutural adjustment techniques, rapid eye movement, analysis and application, clinical recordings and case histories. It contains short, simple and yet specific instructions, making it an easy-to-use guide.
To purchase the book click here |
Learn SOT From Clinical Case Studies |  |
Explore an eclectic approach to actively learning how SOT can be used in a clinical practice by utilizing actual case studies from an experienced SOT practitioner's office. To purchase the book click here.
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Compendium of SOT Literature 1984-2000 | |
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All SOT peer reviewed published literature from 1984-2000 has been professionally reformatted into one text. Aside from offering excellent research information the majority of the articles offer extensive methods for treating patients utilizing SOT and cranial procedures. To purchase book click here.
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Compendium of SOT Literature 2000-2005. |  |
All SOT peer reviewed published literature from 2000-2005 has been professionally reformatted into one text. Aside from offering excellent research information the majority of the articles offer extensive methods for treating patients utilizing SOT and cranial procedures. To purchase book click here.
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SOT Manual
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This state of the art sacro occipital technique (SOT) text takes SOT into the "evidenced based" 21st century while remaining true to the work of Dr. DeJarnette. While using clear explanations and graphics, this book helps eliminate the mystery and dogma from SOT so that the doctor can understand the why behind various methods of treatment. To purchase book click here.
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Join the SOT
Case Studies
Q & A Forum
"Ask Questions and Learn From Discussions"
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Dear Colleague,
This newsletter has been created by Dr. Harvey Getzoff an instructor, researcher, and practitioner of SOT for over 35 years. [See biography below] Case studies or reports are wonderful ways to combine learning about SOT, incorporating novel treatment methods, and creating a forum for discussion and learning.
These newsletters will be shared quarterly. To make this process dynamic a specific yahoo group has been created to discuss these newsletters with Dr. Getzoff and create an open question and answer forum. To join this forum please click here.
The following is a novel case history of a 65 year old male patient was seen at this office presenting with chief complaint of left lower back pain radiating into the left groin, the left hip area (iliofemoral), and down the left lateral leg, but not below the knee. He will present novel methods of treatment and diagnosis involving SOTO (Step Out Turn Out) Procedure, Sitting Disc Technique, and Straight Leg Raise Test.
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| Case Study #3 | | BASIC HISTORY:
A 65 year old male patient was seen at this office presenting with chief complaint of left lower back pain radiating into the left groin, the left hip area (iliofemoral), and down the left lateral leg, but not below the knee. The duration of pain was three weeks. He experienced difficulty getting up, sitting, standing and was unable to get comfortable sleeping. He was medicating himself with Advil and Aleve but was not experiencing any relief.
KEY FINDINGS:
At the initial office visit the plumb line analysis noted no lateral motion and no unilateral differences on first rib/first thoracic motion palpation. Category II patients will usually have lateral sway within ten seconds on the plumb line with their eyes closed while category I patients will tend to move anterior to posterior. Category II patients will also have one side moving in excess of the other when they forward flex their head with your thumbs contacting the T1/Ist rib articulation. Relative to the plumb line the patient's head was tilted left and his spine was tilted to the right.
There was a right leg deficiency with a left iliofemoral restriction, which was evaluated in the supine position, when the hip was rotated externally and compared to the opposite side. A left Step Out Toe Out (SOTO) maneuver was also difficult comparatively and initiated greater pain in the left iliofemoral area. The Straight Leg Raise (SLR) was difficult (10 degrees) and painful in the lumbar spine and left hip area on the Left Straight Leg Raise (SLR).
The Sitting Disc Technique (SDT), lumbar flexion from a neutral position with your thumb contacting the interspinous spaces as the patient flexes the lumbar spine. The SDT is positive if the spinous processes are painful and spacing does not occur on flexion. Also, as an additional evaluation tool, the SLR should improve immediately after the SDT is effectively done.
There were no Arm/Fossae, Psoas, or Heel Tension findings. The patient was classified as a Category III. Patients who lean to the opposite side of the pain and the pain does not go below the knee are diagnosed as having a disc bulge. The primary lumbar disc as diagnosed by SDT was lumbar 4/5. The patient's MRI reported a lumbar 4/5 diffuse disc bulge with an encroachment of the descending L5 nerve root.
ADJUSTING METHODS:
Left iliofemoral adjustment (goading technique) was performed prior to category III blocking. Category III blocks, according to leg length, were positioned. SOTO was repeated two times with two-minute intervals on the blocks with less pain and restriction occurring on the second application. Following the SOTO procedure the patient was taken off of the pelvic blocks (on category III blocks for total of four-minutes) and the SDT was performed. With this application of the SDT lumbar spine flexion improved throughout the technique with a 30 degree improvement when the SLR was tested immediately after the SDT adjustment.
COMMENTARY:
The patient physically and symptomatically showed steady improvement over a four week two times per week initial adjusting schedule. His home-care regiment was lying down for periods of time in the supine and side positions with his knees bent. He also went on frequent short walks and performed flexion exercises (pelvic tilt, knee to chest, and knee to chest with a hamstring stretch on the right side only). He was also advised to sit as little as possible. The SOTO became less painful and responsive, as did the SLR prior and after the SDT. The patient no longer took any medication and was able to go back to work and function without pain after three weeks. I believe this case illustrates the diagnostic and therapeutic effectiveness of both the SOTO and the SDT. Also, that spinal and pain patterns can be helpful in making accurate diagnosis and planning treatment schedules. Furthermore, home care is vital and the SLR is a great tool for monitoring the effectiveness of the SDT.
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 Sitting Disc Technique (SDT)
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The patient sits on a flat table, a table board, or just on a chair with the doctor behind. The edge of block or a thumb is placed just under spinous process of involved vertebra. As patient inhales, he pulls the chin toward the chest, leans forward, and forces lumbar spine into kyphosis, applying pressure to the block so as to lift itself. The patient then exhales, and extends the spine, while the doctor relaxes pressure. The cycle is may be repeated three times and its progress can be monitored by evaluation of the SLR.
Getzoff H, Disc Technique: An Adjusting Procedure for any Lumbar Discogenic Syndrome. Journal of Chiropractic Medicine. Fall 2003; 2(4): 142-4.
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Step Out Turn Out (SOTO)
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Patient is prone (on or off blocks) and the doctor stands on the side of affected piriformis (or iliofemoral restriction in external rotation)  supporting the lower thigh and foot. Doctor lifts the leg off the table, moves it laterally until hip rises off the table, and then externally rotates it. The leg and foot is held in this position for 15 seconds and then replaced on the table. Repeated after waiting 1-2 minutes.
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Straight Leg Raise (SLR) Test
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The SLR (Lasegue Test) can be performed during the physical examination to determine whether a patient  with low back pain has an underlying herniated disc, commonly located in the lower lumbar region. With the patient lying down on his/her back on an examination table/or exam floor, the examiner lifts the patient's leg while the knee is straight. With this case Dr. Getzoff found that improvement in the SLR was a sign that the SDT was effective. Getzoff H. SOT procedures, case studies, and standard orthopedic testing: A case series. 3rd Annual Sacro Occipital Technique Research Conference Proceedings: Nashville, TN. 2011:65-72. [Annals of Vertebral Subluxation Research. November 10, 2011:165-182.]
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| SOTO-USA Symposium and Research Conference |
The 13th SOTO-USA Clinical Symposium is getting finalized and you can get information about the schedule and how to get special early bird registration rates. Click here
Case reports are wonderful ways to share the interesting cases you may have in your practice, for help in writing a case report click here. A perfect place to share your valuable case is at the SOT Research Conference May 3, 2012 in Atlanta, submission deadline is February 28, 2012. Your case, if accepted, will be published in the SOT Research Conference Proceedings and its abstract published on the SOTO-USA website, the SOT Compendium of Literature, and Annals of Vertebral Subluxation Research as well as searchable through MANTIS and chiroindex.org To submit your case or for more information click here. |
| Dr. Getzoff's Bio |  Dr. Getzoff was board certified in Sacro Occipital Technique in 1981 through Dr. M. B. DeJarnette. He became a board certified Craniopath by the International Craniopathic Society in 1982 and later received his Fellowship and Diplomate status in Sacro Occipital Technique in 1990, also by the International Craniopathic Society. Dr. Getzoff co-authored three articles in the Journal of Manipulative and Physiological Therapies (JMPT) on "The Dental-Chiropractic Co-Treatment of Structural Disorders." He also authored four papers in the Journal of Chiropractic Technique and one paper in the Journal of Chiropractic Medicine. Dr. Getzoff has authored the following books: "A Practical Guide to Cranial Adjusting," published January 1996 and "Learn SOT From Clinical Case Studies, " published January 2006. He has practiced in Marlton, New Jersey since 1973. |
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Do you have questions about this case or others? Would you like to have a forum where you can ask your questions and received answers from Dr. Getzoff and other SOT doctors with decades of experience, then please join the SOT Case Study "Question and Answer" Forum.
Hopefully together through SOT clinical case studies we can explore the many facets of clinical experiences possible in chiropractic practice.
Sincerely,
Harvey Getzoff, DC
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