Dr. Heller publishes extensively in the chiropractic field.
Below are links to Marc’s articles. Most of them have been published in Dynamic Chiropractic. The articles have been separated into categories to make it easier for you to find what you are looking for. They are also listed in reverse chronological order if you wish to browse the archives.
*Number of asterisks indicate level of importance.
Fascial Work for the Chronic Neck Pain Patient***
This article outlines a way to analyze and treat fascial restrictions in the neck, that can contribute to chronic neck pain.
Common Clinical Patterns in the Middle and Lower Cervical Spine***
Puts together deep soft tissue, the basic hypermobility pattern of excessive extension, and the anterior fixation of the lower cervical spine. A must-read to understand and solve chronic neck pain.
Cervical Radiculopathy: A Documented Chiropractic Clinical Approach**
Reviews Don Murpy’s evidence-based approach to cervical nerve root problems.
Cervical Spine Injuries: Treat the Damaged Ligaments**
Explains how to treat damaged cervical ligaments and tendons with cross-frictional massage, based on Ben Benjamin’s model.
Cervical Muscles and Postural Balance
Looks at the deep neck flexors and other critical cervical muscles that need rehab.
Covers the fascial contributions to the anterior cervical syndrome.
Ant Cervical Syndrome, The Subluxation**
This is the first article in another mini-series. Explores what happens in the front of the lower cervical spine. The anterior cervical is one of the most missed, most important areas, contributing to neck pain, thoracic pain, and shoulder pain.
Corrects the atlas.
The Upper Cervical and Occiput
The next series goes through the spine, from top to bottom. The first article is on the upper cervical spine.
An important article for understanding another source of lower back pain—peripheral nerve entrapment of the sensory nerves to the lumbar spine and pelvis, which can come from thoraco-lumbar fixation
Thoracic Spine: Solving Difficult Cases by Thinking Outside the Box***
Examines what to do when thoracic pain does not resolve with exercise, manipulation, and soft tissue. Looks at what other structures refer pain to the thoracic spine, with emphasis on the viscera.
Sitting Side Bending Intercostal Mobilization
Explains a simple procedure to release the side of the rib cage and the intercostals.
Looks at restrictions in the front of the chest, their importance, and low force methods for mobilizing these.
Subluxation and Muscle Patterns for the Lower Thoracic**
Analyzes the common pattern of restriction in the lower thoracic, including diagnosis and muscle energy treatment.
Upper Thoracic and posterior ribs
Discusses the upper thoracic spine and upper ribs, patterns of dysfunction.
Anterior and Lateral Chest Wall**
Studies the anterior chest wall and the importance of sterno-chondral and intercostal restrictions, another frequently missed area.
Find It, Fix It, Retrain It, or Release, Relax, Retrain
This is Marc’s very first published article. Introduces the concepts of low force manipulation and the importance of rehab.
Understanding and Diagnosis of Nerve-Related Pain
Examines neuropathy versus neuropathic pain, looking at the nerves themselves and the nervous system.
An important article for understanding another source of lower back pain—peripheral nerve entrapment of the sensory nerves to the lumbar spine and pelvis, which can come from thoraco-lumbar fixation.
A Seated Exercise for Daily Decompression
Examines sitting decompression, a simple evidence-based exercise.An Effective, Minimally Invasive Way to Treat Chronic Lumbar Pain
Explores the injection procedure Methylene blue for annular tears of the disc. Reviews a recent article on the risks of the discogram.
Manual Therapy for the Sciatic Nerve
Explores the application of Jean Pierre Barral’s approach to manual release directly to the sheaths of the nerves.
McKenzie, Decompression and Nerve Glide/Nerve Tensioning
Covers different ways to address nerve issues.
The Lumbosacral Dura and Sciatic Nerve Tension, Treatable Components of Discogenic Pain
In cases of discogenic pain and sciatica, explores how to address the dura and nerve glide methods for the sciatic nerve.
Discogenic Pain, Inflammation, and Exercise
Explains the importance of getting inflammation under control for discogenic pain, giving a brief intro to rehab for the disc patient.
Correction of Discogenic Pain and midline tenderness
Discusses using axial decompression to relieve discogenic pain.
This is the first of a series on axial discogenic pain, another under-diagnosed problem.
Addresses how to assess and when to suspect this.
Sometimes we forget the dura mater itself can be restricted and needs release work directed at the dura. Offers some simple ways to assess and correct this.
It’s Time to Take the Sting Out of Lumbar Facet Pain
Review of the 7th Interdisciplinary World Congress on Low Back and Neck Pain
Marc’s Most Missed Clinical Findings for the Lower Back
A bit of a potpourri. Includes Marc’s ideas of what is missed most often for lower back pain. Introduces the concept of initiating healing of ligaments and tendons with IASTM, references some rehab articles, and outlines the Gillet test. Addresses the importance of the muscle energy model for assessment and treatment of the SI.
Why Fusions Fail (also see this document)
Reviews the First International Fascial Research Conference, held in Boston, Massachusetts, in October 2007. Highlights why fusions fail when they don’t take the fascia into account.
Lower Back Evaluation Protocol: Finding the Sources of Back Pain
Offers 16 useful tests to differentiate where the pain is coming from.
Changing the Mythology of Low Back Pain
Beyond imaging results, what are the factors that contribute to ongoing back pain? How can we both educate our patients into a functional model and help them?
Differentiating Sources of Low Back Pain: Palpation Tools
Explains palpation findings that help differentiate facet pain from dural pain, disc pain, and SI pain.
Looks at the sacrum from an intraosseous perspective.
Piriformis Syndrome: Myth,Misdiagnosis or Just Rare?
How Piriformis Weakness Contributes to Sacroiliac Pain, Sciatica and Hip Dysfunction
Still More on the Sacroiliac: Basic Principles and Two More Sacral Lesions
The Sacral Side of the SI Joint: Correcting Anterior and Posterior Torsions
Covers the most common patterns on the sacral side of the SI joint.
Sacroiliac Mobilization, Part 1: Assessing for Fixation and Correcting Iliosacral Joints
Provides assessment and correction of the ilial side of the SI joint.
The Coccyx Revisited: External and Internal Exam Correction Procedures
Covers more on the coccyx and correction of same.
Sacro-Iliac Instability: An Overview**
Still relevant years after its publication, this article offers an overview of the correctable factors that contribute to chronic SI pain. Looks at ligamentous laxity, how to correct hypermobility, how to use IASTM of pelvic ligaments and tendons, and why to use low force manipulation.
Sacro-Occipital Technique’s ‘Category Two’: A Remedy for Fixated Thinking
Examines the views of Charles Blum, DC, on the SOT model of the category 2.
Sacroiliac Joint Correction: A Different Model
Presents the Richard Don Tigny PT model of correction for the SI joint.
Sacro-Iliac Revisited, the Importance of Ligamentous Integrity**
Looks at the ligaments of the sacro-iliac and the utility of instrument-assisted soft tissue mobilization (Graston technique) in correcting long standing SI hypermobility problems.
This is the final article in our journey down the spine. Introduces internal mobilization for the tailbone.
Ilio-Sacral Diagnosis, Gluteus Medius and Piriformis, and Pubic Symphysis
Explores the muscular components that affect SI function.
Ilio-Sacral Diagnosis and Treatment: Part 2
Covers more ilio-sacral patterns, including flares (internal and external rotation), ilio-sacral separation, and sagittal rotation patterns.
Ilio-Sacral Diagnosis and Treatment: Part 1 – Shears
Looks at the SI joint from the muscle energy perspective, starting with the non–weight-bearing side—the ilio-sacral joints. Covers shears: Upslips and Downslips.
Explores what happens when the hip rotates excessively inward, including effects on the SI and the knee as well as the muscular control patterns for this.
Anterior Femoral Glide Syndrome
Explores the Sahrmann model and how they look at the anterior hip placement.
The Hip and Groin: Focusing on the Myofascial Component
Offers a further look at Lucy Whyte Ferguson’s model of the hip, with emphasis on muscle imbalances.
The Hip Joint: Myofascial and Joint Patterns**
Discusses Lucy Whyte Ferguson’s model of the hip joint, the importance of resetting the hip joint, and correcting loss of internal rotation. A critical piece for LB and hip pain.
Chronic Effects of Ankle Sprain
Explores functional diastasis of the ankle mortise, where partially torn ligaments between the tibia and fibula create longstanding instability. Explains how to assess and correct.
Looks at the leg from an intraosseous perspective.
The Hip-Intraosseous Restrictions
Looks at the hip joint from an intraosseous perspective.
Assesses the hip joint and documents an older way to correct it (not what I currently use).
Looking at the sacro-tuberous ligaments, and the pubic symphysis, as missing links for difficult lower back or pelvic pain.
Peripheral Sensory Nerves: A Treatable Source of Pain?
Explores various models that attempt to treat the peripheral sensory nerves. Covers the Butler/Shacklock nerve tension model, Jean-Pierre Barral’s manual therapy to the peripheral nerves, John Lyftogt’s neuro-prolotherapy, and concepts of peripheral sensitization vs. central sensitization.
What Is Low Force Chiropractic? Palpation, Adjusting, and Soft-Tissue Applications
Examines the quality of our touch and how to get more information by starting slower and more gently.
When the Adjustment Won’t Hold, Taking an Integrative Approach
Assess, Correct, Reassess: Looking at integrating rehab, soft tissue, and mobilization for our tough cases.
Reviews the 2009 Sports Chiropractic Symposium with a look at the culture of sports chiropractic.
Extraordinary Knowing, Intuition as a Diagnostic and Treatment Tool
Reviews Malcolm Gladwell’s book Blink and how it relates to clinical practice.
Risks and Rewards of the Doctor-Patient Relationship
Offers cautions about boundaries and the risks we take when we touch our patients.
Understanding and Diagnosis of Nerve-Related Pain
Evidence-informed chiropractic meets intuition and clinical uncertainty.
Secrets of the Chiropractic Masters
What does mastery look like? What do masters of the chiropractic arts have in common?
Explores the art of chiropractic, offering a best practices approach to clinical decision making.
Integrates the scientific and intuitive, the physical and the energetic in a philosophical view of the healing arts evolution.
Neuromodulation Technique: Access, Assess, Modulate
Offers an overview of the Neuromodulation model, an informational or energetic system.
Principles of Low Force Adjusting
Presents the core principles of the low force adjusting concepts we teach.
Introduces strain–counter-strain, or positional release technique.
Examines the tensegrity model, a way of looking at tension and compressions elements that influence biological systems.
Joints and fascia are not the only structures that develop restrictions. Looks at restrictions within the bones themselves.
Prioritization tools, Find the Primary Restriction
Explores several tools for determining which area is most important to address first.
Adjusting Techniques: Engage, Listen, Follow; Recoil; and Muscle Energy
Offers another exploration of low force mobilization techniques, with outlines of three different methods.
Initial Response Testing: Different Way to Approach the Barrier**
Chiropractors and body workers tend to go too deep, too fast in their palpation. Explores the value of a softer initial touch and the information you can get at the very beginning to the barrier.
Advantages to Palpation-Based Approach: Why Low Force Adjusting
Explores why the therapist should use low force mobilization and why a palpation-based approach, rather than muscle testing or leg checks, is advantageous in developing the practitioners’ skills.
Framework Low Force Manual Adjusting: An Introduction**
This is the first article in my series on low force mobilization. Outlines the basic principles behind a philosophy of low force manual work. Introduces barrier principles and the idea of just enough force.
Find It, Fix It, Retrain It, or Release, Relax, Retrain
This is Marc’s very first published article. Introduces the concepts of low force manipulation and the importance of rehab,
Attempts to categorize the types of exercises we show our patients:
Category 1. Pain relief.
- Category 2. Self-mobilization. All of these exercises have to do with getting more normal movement into stuck muscles, stuck fascia, and stuck joints. These could then be subdivided into functional activities: a) stretching (length); b) softening the fascia; and c) self-mobilizing a stuck joint.
- Category 3. Stabilization: getting better stability for injured, degenerated, or inhibited joints and muscles.
- Category 4. Strength training.
To Your Health companion article
Written for patients. Includes basic ideas of when to use extension exercises and when to use flexion exercises.
Low-Back Self-Care, Part 1: Finding the Reset Button
I have asked many patients when they first see me, What exercises work for you? What relieves your pain? I am always amazed how few people know what to do for their own recurrent problems.
Stabilizing the Pelvis with Exercise
Looks at rotary stability, simple marching, and active single leg raise and how to correct these.
A More Complete Chiropractic Model: Finding the Site and Direction of Excessive Give
Chiropractors and body workers tend to look for what is not moving, for what is too stiff. Both Shirley Sahrmann and Kinetic Control take a slightly different look, attempting to control what is moving too much. I think this is a critically important concept.
Local Stabilizer Rehabilitation, Myths and Understandings
The local stabilizers are the smaller muscles, designed to activate even before a motion is initiated. These muscles, their function, and how to train them are somewhat poorly understood. Argues why abdominal hollowing is not a good strategy to use in day-to-day life.
Global Stabilizers for the Low Back
The global stabilizers are defined as those controlling a particular motion,
rotation, flexion, or extension. Addresses the importance of these in rehab and in function.
Gives an overview of the Kinetic Control model, dividing stabilization into local and global stabilizers.
Understanding and Diagnosis of Nerve-Related Pain
Decompression, Myths and Models
Explores decompression of the spine, focusing on daily home decompression strategies.
Assessing Core Stability: Basic Evaluation, Basic Exercise
Gives basic exam tools to assess rotational stability and strategies to correct same.
Pain-Relief Exercise: The Lower Back
Lists basic exercises for pain relief, including McKenzie extension, one leg press up, pelvic tilt, and spine squat.
Abnormal Scars as a Cause of Myofascial Pain**
Reviews how scar tissue can contribute to myofascial pain, based on Karel Lewit’s article in Journal of Manipulative and Physiological Therapeutics.
Fascial Work for the Chronic Neck Pain Patient
This article outlines a way to analyze and treat fascial restrictions in the neck, that can contribute to chronic neck pain.
Introduction to the Stecco method of fascial manipulation, releasing soft tissue densifications via deep oscillating pressure. This is a research-based fascial whole body methodology.
Soft and Not So Soft Tissue: Overview
Offers an overview of both soft tissue techniques and low force manipulation methods.
Examines the tensegrity model, a way of looking at tension and compressions elements that influence biological systems.
Soft Tissue, Fascia , and the Adjustment
Emphasizes the importance of fascial restrictions in reinforcing abnormal musculo-skeletal patterns.
More Solutions for TL Fixations & Nerve Irritation
This is a continuation of some significant solutions I have found to help patients recover from a spinal fixation and irritated nerve.
This was my first article on the thoraco-lumbar’s connection to pelvic and LB pain, reviewing Maigne’s concepts and how to assess and treat.
This article explains Lyftogh’s model (perineural injection therapy); provides an expansion of Maigne’s model; and an approach for chiropractors and other manual therapists to approach these nerve irritations that affect the pelvic and lumbar regions.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 1) October 15, 2014
This article explains that the upper lumbar spine is the origin of the superior cluneal nerve, a possible source for buttock pain that imitates SI pain. Part 1 focuses on assessment of this fixation; it is frequently missed
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 2) November 1, 2014
This describes how to correct upper lumbar fixations, with flexion distraction, with muscle energy maipulation, and a look at self-care.
How to Find and Fix TL Nerve Impingements April 15, 2016
This provides an updated algorithm for assessing and treating the TL and its nerves, with focus on posterior components.
Treating Hip & Groin Pain with Abdominal Release of Upper Lumbar Nerve Impingements June, 2016
This is yet another piece of the TL; anterior nerve impingements; a new look at psoas and abdominal release work for the anterior nerves from L1 and L2.