The dura mater is the most dense and superficial of the meninges, the connective tissue layers surrounding the brain and spinal cord. It is firmly attached to the occiput superior to the circumference of the foramen magnum, the posterior surfaces of the 1st, 2nd and 3rd cervical vertebra and the sacrum.
In some cases the dura mater can develop a torque (twist) around the spine, causing a variety of symptoms including low back pain, neck pain, mid thoracic pain and aggravating pelvic stress. These symptoms are usually aggravated by walking and especially running.
The condition is commonly the result of O/F psoas, piriformis or gluteal muscles on one side of the pelvis, leading to shortening of these muscles and an associated gait fault. The stride becomes longer on this side than the other, resulting in an exaggerated twist of the pelvis in one direction and thereby twisting the dura mater.
The muscle tightness on one side of the pelvis also typically leads to a reduction in internal rotation of the femur. This means that we can identify and assess dural torque by the following methods:
- Observing the walking gait and looking for a longer-stepping
- Assessing the internal rotation of the feet with client lying supine (see below).
- Monitoring the psoas, piriformis and gluteals to identify O/F (sometimes U/F) muscles on one
One or more pelvic muscles shortened on side with least rotation
Usually longer stride length on this side
Shortening of muscles is usually the result of long periods of over-facilitation. After a certain point, however, the muscle may enter a state of exhaustion, akin to Stage 3 Stress (when the muscle can no longer maintain its compensated state and loses function). They will become under-facilitated, while retaining the overall shortening of the muscle fibres. As a result, when assessing Dural Torque, the shortened muscle/s may actually be U/F when monitored.
A common correction for dural torque is to stimulate the release of the priority shortened muscle, using deep pressure in the belly of the contracted muscle to reset the proprioceptors (similar to trigger point techniques in massage therapy). The practitioner then returns the muscle to its resting position with absolutely no assistance from the client. This technique is known as strain/counter-strain.