
Doctors' Corner
The Universal Compensatory Pattern
G. Dallas Hancock, D.C., Ph.D.
The typical human body is asymmetrical in both structure and function. Contributing
significantly to these asymmetries is the body’s patterns of musculoskeletal compensation for the
presence of two cranial chronic distortion patterns: a Right Torsion and a Left Lateral Strain.
These cranial patterns, and their associated musculoskeletal patterns, appear to be universally
present and may result from a retained Asymmetric Tonic Neck Reflex (ATNR).
The ATNR is a primitive reflex which develops in utero and is important for the infant’s
development. It is initiated by the proprioceptors of the upper cervical vertebrae when the head is
turned to the left or right. When the head is turned to either side, the tone of the flexor and
extensor muscle groups of the upper and lower extremities is altered. On the side which the head
is turned towards, the tone of the extensor muscle groups of the upper and lower extremities is
increased and the tone of the flexor muscle groups of the upper and lower extremities is
decreased. On the side which the head is turned away from, the tone of the extensor muscle
groups of the upper and lower extremities is decreased, and the tone of the flexor muscle groups
of the upper and lower extremities is increased. Bobath (1) attributes these findings to Magnus
(1924) and other animal researchers.
A change in the tone of a muscle results in a change in its function. An increase in the tone of a
muscle generally results in its facilitation (strengthening); a decrease in tone generally results in
its inhibition (weakening). Manual muscle testing and other techniques derived from Applied
Kinesiology indicate that the head-turned-left ATNR pattern is generally present, even when the
head is in a neutral position (not turned to the left). An upper cervical fascial bias may be
responsible for this ATNR phenomena.
According to Pope (2), the fetus spends a large portion of its time during the third trimester of
pregnancy in a longitudinal twist in which the head and right shoulder are twisted to the left and
the pelvis is twisted to the right. He points out that this twist could result in the left fascial bias
of the A/O region and the right facial bias of the pelvic region seen in the Common
Compensatory Pattern (CCP). These fascial biases are also seen in the cranial Left Lateral
Strain. The presence of a left A/O fascial bias might also provide a constant stimulus for the
head-turned-left ATNR.
The combined global compensatory musculoskeletal patterns produced by the Right Torsion and
Left Lateral Strain components of the Universal Compensatory Patterns include a lateral tipping
of the sacrum to the right in the coronal plane and a compensatory spinal rotational scoliosis with
four opposing curves. The lumbar curve is convex to the right with a right rotation of the lumbar
vertebrae. In addition, the Left Lateral Strain produces a shearing of both the cranium and the
pelvis in the horizontal plane, with the left side moving anteriorly and the right side moving
posteriorly.
Manual muscle testing in the supine and prone positions generally reveals a global imbalance in
the function of paired muscles, with one testing strong (facilitated) and the other testing weak
(inhibited). This applies not only to the flexor and extensor muscles described above, but also to
the adductors, abductors, internal rotators, and external rotators. Other applied kinesiology
evaluation procedures (Challenge and Therapy Localization) can be used to demonstrate that
paired muscles of mastication and eye movements are also involved in this global muscular
imbalance.
When the chronic Right Torsion and Left Lateral Strain patterns have been removed by the
treatment techniques in CranioStructural Integration (CSI), turning the head right or left no
longer initiates the ATNR and its compensatory musculoskeletal patterns and the symptoms
described above are immediately resolved.
Chiropractors, osteopaths, physical therapists, and others use a wide variety of modalities to treat
cranial, spinal, pelvic, and other neuromusculoskeletal dysfunctions. However, manual muscle
testing and other evaluation procedures from Applied Kinesiology demonstrate that the chronic
cranial Right Torsion and Left Lateral Strain distortion patterns, as well as their related
compensatory musculoskeletal patterns, are almost always still present in both the general and
clinical populations. These findings indicate that the treatment procedures currently in general
use are not effective in correcting these chronic cranial patterns.
An explanation for the failure of traditional approaches to correct these two chronic patterns may
have to do with both the extent of the cranial distortions and their chronicity. The ATNR appears
in utero and both the cranial and musculoskeletal patterns can be identified in infants (3). In
adults these chronic cranial patterns, and their resulting chronic compensatory musculoskeletal
patterns, are long-standing and require changes to the cranial soft tissue holding elements to
release them.
The resolution of these cranial patterns, and their compensatory musculoskeletal patterns,
requires the application of new concepts and treatment procedures. These include adequate force
(a pound, or more for some releases), and a handhold capable of applying and maintaining the
forces needed to release the cranial soft-tissue holding elements and realign the osseous cranial
structures. The application of the cranial concepts and treatment procedures presented in
CranioStructural Integration (CSI), the third workshop in our CranioSomatic Therapy series,
quickly and permanently removes the chronic cranial distortion patterns. The treatment
procedures can be performed in one or two sessions and do not need to be repeated.
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The elimination of the Right Torsion and Left Lateral Strain patterns, and their related
compensatory musculoskeletal patterns, may be the key to the successful resolution of several
difficult-to-resolve conditions. These cranial patterns may be the underlying etiology of
DeJarnette’s SOT Categories 1, 2, and 3 described in Sacro Occipital literature (4,5). They may
also be the etiology of the Common Compensatory Pattern (CCP) described by Zink and Lawson
(6) in osteopathic literature.
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References
1. Bobath, B. (1985). Abnormal Postural Reflex Activity Caused by Brain Lesions (3rd ed.).
Rockville, MD: Aspen Systems Corp.
2. Pope, P. E. (2005). The common compensatory pattern: Its origin and relationship to the
postural model. In E. Dalton, Eric Daltons Advanced Myofascial Techniques (pp.176-205).
Publisher: Freedom From Pain Institute
3. Hancock, G.D., Dissertation. A New Diagnostic Approach and Innovative Cranial Treatment
Procedures for Chronic Neuromusculoskeletal Patterns: A Manual and Contextual Essay.
Union Institute & University: Cincinnati, OH; 2011.
4. DeJarnette, M. B. Sacro Occipital Technic. Nebraska City, NE: Author; 1984.
5. Monk, R. Sacro Occipital Technique: SOT Manual 2006. Sparta, NC: SOTO-USA; 2006.
6. Zink, JG & Lawson, WB. An osteopathic structural evaluation and functional interpretation
of the soma. Osteopathic Annals. May 1979; 7(5): 208-214.
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