Back Pain? Neck Pain? Be Sure Your Head's on Straight
Dr. Johanna Hoeller and the Story of NUCCA
By Cat Saunders
you heard that joke about the master mechanic who succeeded where all others
had failed? There was this couple who
owned a much-loved car that had chronic engine problems.
They took it to mechanic after mechanic, but
no one could offer more than a temporary fix.
they heard about a master mechanic who could work miracles with cars.
They took their car to him and stuck around
to watch. The master mechanic opened
the hood and peered inside. Without
touching anything, he stooped and stretched to scope out the engine, observing
it from every possible angle.
he was ready, the mechanic took out a simple tool, gently tapped one specific
part of the engine, and pronounced it fixed.
Then he handed the couple a bill for $2,000. "What?" they said, "All you did was tap the engine
in one place!" He smiled and said
the tap was free. The two grand was for
knowing where to tap it.
Dr. Johanna Hoeller is a "master mechanic" like
that, but she doesn't charge $2,000 and she works with people, not cars.
In specific, she practices a unique form of chiropractic called NUCCA
work (National Upper Cervical Chiropractic Association), which aligns
the entire spine through highly focused adjustments of a single vertebra,
the pivotal "kingpin" atlas vertebra at the top of the neck.
Johanna would be
the first to say that this work is not about her, but rather about the body's
own self-healing ability and NUCCA's exacting techniques for supporting this
ability. Even so, I believe there are
masters within any trade, and Dr. Johanna Hoeller is definitely a master.
Cat: Would you talk about the atlas vertebra and its relationship to
the body's self-healing mechanism?
The whole purpose of working with the neck
is to use the atlas-which is the top vertebra on the spine-as a lever.
The atlas vertebra, acting as a lever, is used to bring the foramen magnum into alignment with the
cervical spine, and thereby bring the head into alignment with the entire
spine. The foramen magnum is the hole
at the base of the skull where the brain stem passes through to become the
atlas can be used as a lever to help bring these three structures into alignment
because it's not anchored down like the rest of the vertebrae.
Other vertebrae have big disks between them,
so they're essentially locked in place.
By using the atlas in its position of leverage, you can move the entire
spine in relation to the head, and vice versa.
When the head,
neck, and spine are in alignment, the trillions of neural pathways that pass
from the brain through the foramen magnum into the body have clear passage,
which allows free communication between body and brain.
This alignment is very important to the
immune response and all functions of the body.
Cat: Would you briefly describe the birth of NUCCA work?
Chiropractic was founded by Dr. D. D.
Palmer, and his son was B. J. Palmer.
B.J.'s style was quite different from his father's, and he used an
adjustment of the upper cervical spine that was very harsh and intense.
So from the early days of chiropractic,
there were differences of opinion about how chiropractic really worked.
Later, a man
named Dr. Ralph Gregory also became interested in the upper cervical spine, and
he began refining this work along with Dr. John Grostic. When Dr. Grostic died
in the 1960s, Dr. Gregory founded NUCCA (National Upper Cervical Chiropractic
Cat: How did you come to upper
I was a patient of a NUCCA practitioner, and
because of how this work changed my life, I was motivated to become a NUCCA
chiropractor. I attended Western States
Chiropractic College in Portland, Oregon, and I studied NUCCA work through its
own seminars and classes. I'm also
involved in NUCCA's certification process, which is very difficult.
I've practiced this work since 1986, and I'm
halfway through NUCCA's third and final level of certification.
Cat: I understand that you do all your own X-rays.
Johanna: The films I take were
designed by NUCCA to view the relationship
of the head and neck in different ways than other chiropractors and
conventional medical doctors view it.
Because our goal is to balance the brain over the body, we must look
very clearly and specifically at the articulations in that region.
Standard cervical views don't provide the
accuracy we require.
Cat: Many people object to the use of X-rays.
Johanna: Medicine is gradually
moving to digital imaging technology and I look forward to that day.
Right now, high frequency technology is the
best diagnostic tool we have in the form of X-rays, and in this work, a degree
you flew from here to New York with just a half a degree off on your directional
readings, you would not land in New York.
Likewise, NUCCA practitioners could not help you get your brain fully
connected-by aligning your head precisely over your body-if we weren't so
exacting in our diagnostic measurements through X-rays.
practitioners are also extremely meticulous about how our X-rays are
generated. We align our tubes carefully
and check them regularly. We install
lead shielding around the beam before it even comes out of the housing, to
reduce "scatter" and radiation exposure overall.
Cat: For me, the post-adjustment X-ray immediately following my first
adjustment was particularly amazing, because it showed at a physical,
structural level-how much my alignment had shifted from just one treatment.
People can do all kinds of bodywork and not
make real progress. For example, people
sometimes think that because a bone "pops," it means they've been
adjusted. That's not true!
people might feel great for a while after bodywork, because you can create
rushes of endorphins and do all kinds of things with the body.
But the question is, how long does it
last? That's what matters. In many kinds of physical healing work,
people become reliant on their external environment (the practitioner) to
"save" them. That's not my
Cat: I was relieved to discover that you don't require patients to come
for endless adjustments. Would you
describe an average course of treatment?
Johanna: I like to work with
people a minimum of six weeks. In that
time, we'll know if this work is helpful for you or not. After the initial two extended visits for
X-rays, exam, and first adjustment, I generally see people once a week for the
first six weeks. Once patients start
holding their correction for two or three weeks, it might be six weeks before I
check their alignment again.
My job is to be
able to measure the alignment. If the body is out of balance, the muscles
on one side of the body will be working harder than the other side, which can
cause all kinds of problems. Aside from
the initial X-rays, the body's degree of balance can be measured with a simple
level. If the level shows you're out of
balance, then an adjustment is warranted.
I don't adjust people unless my measurements indicate it's necessary.
Cat: Would you talk about what you're actually doing when you adjust
Johanna: NUCCA practitioners use a leverage
system. A leverage system is primarily
designed to move large objects with minimal force. Levers have to do with effort, resistance, and fulcrum. The fulcrum might be the mastoid or some
other structure in the patient's body-it depends on what you're trying to
Before I go to
work on someone, I analyze all the X-rays, which are like
"blueprints" for the patient's physical structure. When the patient comes, I carefully position
him or her on the special table we use, which allows the body structures to
move as needed, once I begin the treatment.
Then I use my
body as an instrument to generate enough force to move these structures.
I'm not using brute force, but rather a
system of levers. I lock my hips into position to form a solid
base of support, then I position my body exactly where it needs to be in
relation to the patient. Next, I slowly
contract the triceps muscles in both of my shoulders, directing the energy down
through my arms into my grasped hands, and then into the patient.
At some point, the resistance in my own body
is overcome, and a controlled force
is generated that moves whatever structures need to move in the patient.
my hands usually pop and I sometimes grunt at the point of exertion, I don't
twist and pop the patient's body in any way.
I don't apply excessive force, because any excess force that goes in
would have to come out somewhere, based on the laws of physics. Therefore, I only apply the amount of force
necessary to move the structure.
Because I'm using a lever system, the actual force required is very
Cat: For me, your touch is barely discernible, yet 25 years of chronic
neck pain has been alleviated in just a few adjustments.
Is it difficult for new patients to
understand why NUCCA focuses on the neck, no matter what kind of spinal
misalignment is involved?
Johanna: Most of my patients come
to me as you did, by referral from a trusted friend. Most people can understand the concept of NUCCA work, but they sometimes have trouble with the lightness of the correction. The adjustment itself is so gentle that some
people don't get that anything happened.
don't realize what NUCCA adjustments can accomplish until they experience the
results. As their bodies' unwind after
an adjustment, their well-being increases and they gradually learn to trust the
work. Simultaneously, they learn to
trust their own bodies' healing process, because that's what it's really
Cat: You taught me a valuable tip that I wish was included in all those
pamphlets I've seen for back care. I
call it "the chin tuck."
Johanna: Yes, it's just tucking
the chin down. Dr. Gregory clearly
understood the reflexes in the body, and he discovered this technique when he
was teaching practitioners how to stabilize their bodies in order to adjust
patients. He found that by tucking the
chin, muscles around the spine are engaged, which give the spine more support
and thereby stabilize it.
A way to test
this reflex is to try running with your head up, then try pulling your chin
down while running. The power that
comes from this simple shift in alignment is extraordinary, because it "locks
down" the spine and prevents wasted motion.
The chin tuck is
a protective technique that you can use if you need to lift something or reach
a cabinet high above your head. It's
not good to throw your head back when lifting or reaching.
Instead, keep your chin tucked and be sure
your lower body is stabilized on solid footing. Then you can lift or reach without jeopardizing yourself. The chin tuck is also helpful when you're
driving, sitting, or standing.
Cat: Any parting thoughts?
Johanna: Most people are chronically in an unbalanced state.
Under stress from chronic misalignment,
people's behavior tends to be more reactive and less consciously processed by
higher levels of the brain. I sometimes
wonder, if everyone's head was on straight, what kind of world would we
This interview was originally published by
The New Times (August 2003).
For more information about Dr. Johanna Hoeller and
NUCCA (including referral information for other practitioners), please
or call (206) 547-6370 in Seattle, Washington.
The Seattle Post Intelligencer featured Johanna
in an article (6/6/07) about how NUCCA work can help to lower blood pressure.
To read it, see "Lower
Blood Pressure from Neck Adjustment?
If you'd like to read Cat's personal endorsement of
Johanna's work in "Links to Friends and Favorites" on this site, please
Special thanks to my longtime friend and colleague, Greg Ostergaard, M.S.W., for telling me about Johanna, who freed me from 25 years of chronic neck pain. I'm forever grateful to you, Greg!
Cat Saunders, Ph.D., is a counselor and consultant, death doula, and nonsectarian
minister in private practice in Seattle, Washington. She is the author of Dr.
Cat's Helping Handbook (available at Amazon.com).
Click here to contact Cat or learn more about
her work by returning to the home page. To schedule
in-person or telephone consultations,
please email Cat or call her 24-hour confidential voice mail at (206) 329-0125.