Delivering the promise by re-inventing chiropractic

Part 6 in a series...

The pre-frontal lobe of the human brain is programmed to screen out all concepts and ideas that are not consistent with what we believe and accepted as fact.

Pre-frontal lobe protection is a two-edged sword.

On one side, the pre-frontal lobe of chiropractors protects them from having to think and/or test new ideas against their belief system. The other side of the sword guarantees them that they are locked in time and will never make progress. They are as good as they will ever be.

Practice is boring. Practice is not fun anymore. They see the same old patients with the same old complaints every week or two. The patients never get much better and they never get much worse. They may feel better for a few hours or a few days after they get a therapeutic external mechanical force application over the spine that the straights call an adjustment and the mixers call a treatment.

While chiropractors take initial x-rays of the spine to show patients they have a spinal problem, they never take a post x-ray to see whether they fixed it or what they really did. They claim that objective outcome assessments of their clinical procedures are not necessary, especially if they don't believe in chiropractic philosophy.

Both believing and non-believing is in reality a belief system protected by the pre-frontal lobe of the brain. Practice is just as boring to the believer and non-believer. Practice burn out can be anticipated and it will happen unless the fun is put back into your practice.

Being 'gutsy'

It takes guts to evaluate what you really do versus what you say you do.

Chiropractors take spinal x-rays and mark them so that they can show patients how their spines are subluxated and, therefore, the cause of their presenting problems. They tell patients they are going to "correct" the subluxations so that the symptoms will go away.

Maybe the symptom was just changed and a headache is changed to a heart condition or cancer by non-corrective chiropractic care. The question is, are the subluxations ever corrected? How would one know if post x-rays are never taken, or if post x-rays are taken, they show that the spine is the same or worse than before chiropractic care began?

Is this being honest or dishonest with yourself and your patients? How does this make you feel about yourself? How does this make you feel about chiropractic? Do you think knowing that you don't know what you are supposed to know or not doing what you say you are going to do will cause burn out?

One may be disenchanted with what he or she has accepted as fact, but change is difficult. The basis of change and acceptance of new procedures are that they must be understandable, explainable and repeatable.

Easing change

Agreed-upon definitions and examples make change easier. In order to have agreement about spinal subluxation complexes, we must first agree that there are four major body tissues involved.

1) VERTEBRAE: they are entirely passive. They don't care whether they are subluxated or un-subluxated.

2) LIGAMENTS: hold vertebrae together and in place whether subluxated or un-subluxated.

-- A) LIGAMENTS HAVE VISCO-ELASTIC PROPERTIES. This visco-elastic stability forces the spine to faithfully return to its subluxated or un-subluxated position after any force has caused the spine to move.

-- B) ELASTIC STABILITY DEFINED. When a structure such as the spine is subjected to a load, such as an adjustive or manipulative thrust, it deforms, that is, it temporarily changes position. Upon the release of the thrust, the spine or vertebra returns to its pre-adjusting/manipulating position. No permanent change (adjustment) occurred.

-- C) PERMANENT SPINAL CORRECTION. In order to make spinal correction, the spine must first be pre-stressed in at least two dimensions so that the spinal unit is stressed past the elastic barrier. That is, to 40% of the ligaments' ultimate resistance (load) that is holding the joints subluxated.

Then, an additional force will cause the tropa-collagen fibers in the ligaments holding the subluxated joints and osseous structures to plastic un-load and re-load in a new position. The ligaments and joints now have been permanently changed, i.e., corrected. (See accompanying figure)

Note: Stretching a part of the spine such as the cervicals into lordosis may produce a temporary lordotic curvature, however, such changes will only last for an hour or two.

3) MUSCLES: Muscles are responsible for the integrity of all joints and therefore the position of the upright spine. If your corrective procedure does not include muscle rehabilitation and maintenance of the muscles involved in the subluxation complexes, there is no chance of permanent spinal correction.

4) NERVES: Nerve impedances are the reason for correcting spinal positions. The nerves of the five righting reflexes have the major purpose of keeping the eyes and skull upright perpendicular to gravity.(1)

The righting reflexes supply the nervous system and the innate organizing energy with the necessary information so that the head will be maintained upright. This information from the righting reflexes causes the innate organizing energy to either subluxate or correct the lower spine in order to maintain the head and eyes perpendicular to gravity.

Helpful definitions

To facilitate communication with peers, patients and recipients of your reports, these definitions help explain how the body -- especially the spine -- functions:

1) Subluxation: A subluxation may be defined as a partial dislocation. It is any pathological situation in which there is not a normal physiological juxtaposition of the articular surface of a joint. Such situations should be readily demonstrated radiographically.(2)

2) Elasticity: The property of a material or structure to return to its original form following the removal of the de-forming loads.(3)

3) Elastic Range: A range or loading in which a specimen of structure remains elastic.(4)

4) Elastic Stability: When a specimen or structure is subjected to a load, it de-forms. If the deformation is such that upon releasing of the load the specimen or structure returns to its pre-loaded shape then the deformation is called elastic deformation.(5)

5) Plasticity: The property of a material to permanently deform when it is subjected to loading beyond its plastic range. The permanent deformation of a ligament after it has been subjected to greater than 40% of its ultimate load is an example of plastic behavior.(6)

6) Shear: The intensity parallel to the surface on which it acts.

Example: It may produce permanent changes in the juxtaposition of articular surfaces of joints after visco-elastic stability has been overcome and plastic un-loading and re-loading of the visco-elastic material has taken place.(7)

7) Viscosity: The property of a material to resist loads that produce shear.

Example: In lubrication of joints, the viscosity of joint fluids play a very important role. If the viscosity is too high, the joint resists motion. If viscosity is too low, the joint will have less resistance to motion, but it can now support only small loads before the thin lubrication film breaks down allowing a build up of friction with joint destruction.(8)

8) Visco-elastic Stability: The type of stability in which the critical load is a function of time as well as the geometry and material properties of the structure. Biological structures are visco-elastic and therefore have time dependent stability. They are able to respond to unstable situations by altering their structures so as to re-create structural stability.(9)

Understanding of the above definitions add to an understanding of the righting reflexes and the actions and reactions that subluxate or un-subluxated spine during clinical chiropractic care.

References

1) E. Krandel, J. Schwartz, T. Jessell, "Principles of Neural Sciences, 3rd Edition," Applieton and Lange, Connecticut, 1997, PP 600-604.

2) White, A. and Pandjabi, M., "Clinical Biomechanics of the Spine," Philadelphia: J.B. Libbencott, 1978 P 504.

3) Ibid, P 470-71

4) Ibid, P 471-72

5) Ibid, P 472

6) Ibid, P 490

7) Ibid, P 496

8) Ibid, P 513