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33 Principles of Chiropractic Reconsidered for the Post Modern* and/or *Deconstructionist DC

“Be silly. Be honest. Be kind.” – Ralph Waldo Emerson

1803-1882 founder of Transcendentalism, author, poet, philosopher

This paper is dedicated to all the students I have been privileged to instruct;

if it was to learn what you don’t want, then it was a most valuable lesson for us.”

Mark Thompson

Mark Thompson

Each one of us has our own unique journey through this fascinating and innately vital world of chiropractic. Over the past 40 years, I have become completely enamored with its language, belief system, physicality, culture, lifestyle, and history. The sum is even greater than the parts. Each of these magnifies and reflects the manner in which chiropractic never commits itself to anything concrete on either end of any health care spectrum. * (This is where you use your smartphone and communicate with each other and decide why or if postmodernism and deconstructivism have anything to do with chiropractic). Here is a kind of “mash-up” of ideas that I have pilfered along my way, at times literally quoting, at others paraphrasing interpretations from others to make a point. Stephenson’s 33 Principles from 1927 are brilliant; each one truly a discourse unto itself. Using those and these points as lenses to encourage discussion, not discord, is this work’s highest aspiration.

There is no intentional connection between the original and what is following, though it is there; I have seen it personally over the years on my journey. People, places, and things have always amazed me; using them as optics to appreciate my gift as a doctor of chiropractic is second nature. The close connectedness of ideas became apparent when actually trying to find 33 separate thoughts that do not repeat themselves. At a certain point they all run into each other which has been both rewarding and frustrating. With that in mind, the paper is arranged into three topics; 1 through 11 philosophy, 12 through 22 technique, and 23 through 33 science. Yet another platform for dialogue and exchange of ideas, any of the 33 could easily be placed into another topic and make sense. Since we cannot see each other in person, I get to irritate you like this and then go run away and hide. Damn I miss you. Smile emoji here.

PHILOSOPHY

ONE: “The reason why I know so much is because I know I know nothing.” – Socrates (5th c BCE Greek philosopher; founder of western philosophy.

Over the better part of the last 45 years as a “miracle patient,” student, doctor, professor, and now aging scholar of chiropractic, language and culture continues to inspire and humble me. Persistent application of what I have learned has been rewarding and has allowed me to help those I may not have been able to help previously. Socrates saying, “the unexamined life is not worth living,” has been useful while searching out all sorts of “new age” type experiences, not always great but always educational. The only way for me to be successful with chiropractic, as with anything, has been to always be open to learning new things, not get attached to passing fancies, and changing previous notions as new insights to clarify and further hone skills.

TWO: “Be curious, not judgmental.” – Leaves of Grass 1855, Walter Whitman (1819-1892), American poet, essayist, journalist.

    When entering chiropractic school my philosophy for living had already been framed by anthropological perspectives which understand by reporting human experience, rather than critiquing it. Realizing that there is not a single bit of information regarding a patient that can be discounted by the chiropractor, allowing preconceived notions to create attitudes and expect outcomes are self-defeating in an ethnographic approach. Consider the four disciplines of Biological Anthropology, Archaeology, Sociocultural Anthropology, and Linguistics as pathways towards common ground for our individual doctors and ultimately, our profession. You may find this way of walking enlightening as it helps to “think things through”, a road which far too many people do not readily take.

THREE: “A miracle is a shift in perception.” A Course in Miracles 197.  Helen Schucman  (1909-1981), American medical psychologist, author.

When I began my chiropractic education, armed with my own “transcendent” experience, I came to Life West to see the explanation of how it works, and learn to do it myself.  While mechanisms are more understood today, a formula for reproducing and measuring how the adjustment works is still elusive; this is compounded and dumbfounded by a list of effective techniques. Still, when getting an adjustment, the effect is a predictable shift in my awareness to a better place, even to this day. And then, when patient after patient tells me how much it helps them to this day, I am dumbfounded, as if I sincerely did not expect it to happen.  I smile every time.

FOUR: “Wonder and miracle lie embedded in the world’s structure alongside of established and predictable order. Conceiving phenomena in disparate principles dies hard; with science, one range of phenomena after another is controlled.” Macdougall, R. (1913). Neo-vitalism and the logic of science. Science37(942), 104-106.

It is my firm belief that the Palmers’ philosophy was brilliant; if alive today (besides being quite old), their genius would have embraced new advancements in science and culture rather than stay in the late 19th century when their work began. A problem for those like myself who strive to think things through empirically is that while vitalism is clearly necessary as the glue that holds our philosophy together, linguistically and historically, it sells our message short. So much has happened scientifically, culturally, and phenomenally since vitalism first appeared in the oeuvre of human enlightenment. The simple use of the prefix “neo-” implies (at least as subtext) progress; without it we are easily dismissed as not grasping a clarified contemporary understanding of the concept.

FIVE: “Almost everything worthwhile carries with it some sort of risk, whether it’s starting a new business, whether it’s leaving home, whether it’s getting married, or whether it’s flying into space.” Chris Hadfield (1959 – ), Canadian Astronaut.

When considering the techniques used by our profession, one realizes there are as many unique benefits as there are individual chiropractors; risks always accompany our work and our advice as well. Our responsibility is easily seen with effects of the adjustment, though what we say and suggest will carry the most weight for the longest time. It behooves the chiropractor to become extremely adept at high benefit/low risk suggestions such as postural advice regardless of more esoteric philosophy of health insights provided. The given is, of course, that people will do things anyway and at times not want any advice – just the adjustment. It becomes clear very quickly that adjusting people is by far the easiest and most rewarding benefit of practice. People are the risk.

SIX: “To know the rules of the game, you need to be educated.” – LL Cool J (1968 –   ), American Singer

Owning the basic belief systems of our profession is essential to be able to provide care that is as unique as the doctor and the patient; the fact that the vertebral subluxation complex exists as a real entity becomes more apparent with each passing day in practice. With that in mind, a far too common mistake both student and doctor make is assuming that any formal education in their life experience will not help to understand and remove that subluxation. Mindsets and activities that would seek to undermine our profession by implying such things as not needing to understand differential diagnoses is short sighted and counterproductive. I must admit the older I get the more dumbfounded I am by folks complaining more than applying themselves. You know you need to vote. I believe it was Beyonce that said ‘Nobody gives you power. You have to take it.’

SEVEN: “All knowledge of reality starts and ends in experience.”- Albert Einstein (1879-1955), Time Person of the Century, 2000.

        In addition to an essential lifetime of soaking up as much formal learning as possible, one must consider the compressed schedule that chiropractic education has in comparison to what might serve best. Young doctors are urged to consider their first three years fully licensed as a self imposed residency; the valuable growth that occurs with unbridled experience as well as seeing practical facts, such as overhead and cost-to-benefit strategies, exponentially increases each day. Deciding to be on one’s own has the benefit of autonomy though one must consider overhead as a risk. Being with another DC in any way, we should carefully consider the fiscal and physical value of what is at the established practice as well as the doctor’s expertise that is ideally shared from them. The unique doctor/patient bond created over time as we learn how to help each one invariably leaves space for an experiential form of philosophical relating that is natural, not forced.

EIGHT: “Failure is a great teacher, and, if you are open to it, every mistake has a lesson to offer.”  Oprah Winfrey (1954 –   ), Producer, actress, author, and philanthropist.

The Japanese have a saying, “every mistake is a pearl,” creating an honored space for the richer learning which comes when something goes wrong. While making a mistake in practice is not the goal for anyone, when they invariably happen, an honest game plan is always a best tactic to follow. Encouraging the clearest communication possible while creating a safe space for patients, along with good note taking are pragmatic ways in which to minimize mistakes. Comparing and contrasting previous patient histories and care outcomes will help ensure that errors are not wasted, therefore destined to happen again with similar or worse outcomes. One thing is for sure, whatever the mistake was, become an expert in that thing; ignoring it would be a bigger mistake.

NINE:  “Subvert the Prevailing Paradigm” The Structure of Scientific Revolutions, Thomas Kuhn (1922 – 1996), American philosopher of science, professor, author.

    In the real world, when it comes to influence and resources, the most widely accepted position reflects who has the most political and fiscal clout; the allopathic model by far being the prevailing pathway through which healthcare is delivered. In order to meet and surpass the medical model of patient care, chiropractors must take it on themselves to understand how any human condition might be treated outside of our scope of practice along with expertise in chiropractic adjusting and management. This is life’s reality, prudence here is a virtue. The very simple fact that our patients’ are our best advocates behooves us to thoroughly understand why and how other modalities are applied, ours being understood by others will come as a natural progression from this perspective. As people know and understand what we do in a musculoskeletal sense, their understanding of the more holistic outcomes is a natural progression.

TEN: “It is important that students bring a certain ragamuffin, barefoot irreverence to their studies, they are not here to worship what is known, but to question it.” Ascent of Man, Jacob Bronowski (1908 – 1974), mathematician, historian.

The only way any human endeavor moves forward in a positive direction is by seeing the subject at hand from as many angles as possible; at times heavy duty scrutiny is required. To do this, the chiropractor must be able to question what is known and accepted regarding subluxation so that each patient will receive the benefit of our ethical striving for a more perfect adjustment outcome: less visits, less often. It is important here to recognize that every technique that is used in the adjusting room today at one time came from an individual questioning what they had learned previously from another person or belief system. Experience shows that eventually we could put a catchy name to our adjustment and patient care approach, getting “all up in someone’s gravy,” for sure.

ELEVEN: “Don’t compare yourself to others. Compare yourself to the person from yesterday.” – Dr. Franco Colombu (1941-2019), chiropractor, bodybuilder, powerlifter, producer, actor, and author.

Looking to the successes and failures of others to judge oneself is not only self-defeating, it is an exercise in futility. Even if each doctor in our profession were to utilize the same evaluation and adjusting techniques, the countless differences in patient and doctor body types alone dictate unique parameters for success even within one’s own adjusting room, let alone across different practices. Anatomical variants are the rule not the exception in anatomy. With all the helpful hints and perspectives available from other sources, the one that is going to be most telling of success is the inside job of what happens in each office each day with each patient. Days when things are especially difficult and I want to run away or quit, staying in my own life is ultimately more rewarding than when things are fine. Exercising to exhaustion works for me, so does stopping and breathing.

TECHNIQUE

TWELVE: “It is not the -tic, it’s the -tor.” Carl Dieter, DC, (last day of chiropractic school), March 1991.

    Dr. Carl Dieter came to give our last class meeting an uplifting but direct piece of advice; it is our presence the public sees, not our profession in the same way that we see ourselves. Countless variations in each patient require that they be cared for in a manner that fits their lives; over time we develop a more in depth understanding of each individual’s subluxations. Each doctor’s unique delivery of care refines their own “technique that is unique” to them so that ultimately patients identify the “-tic as the -tor.”  Eventually, “talk the -tic” is actually “talk the -tor” as each of us has our own linguistic expression of what we do and how we do it: one of the many cool things about being a chiropractor. We are all the same and all different; just like life.

THIRTEEN: “People first, then money, then things.” Suze Orman (1951 –    ), speaker, author, host.

In practice, we need our hands and an effective space to provide adjustment; anything else can and will increase the cost for us to deliver it. Very simply put, we can do whatever we want to help people, and someone has to pay for it beyond the overhead it will take to provide care before we receive payment for our work. If we keep service at the front of our mind while being conscious of how frugally we can do it, with a bit of tenacity and patience our practices will more than survive, they will thrive. Any bells and whistles we may think we need might be questioned early on as they take away from developing our skills, plus they will usually increase overhead.

FOURTEEN: “Sometimes the body says what words cannot.” Martha Graham (1894 – 1991), Time Dancer/ Choreographer of the 20th century.

Ever-increasing understanding of the enormous complexity of our contiguous nervous system deters us from separating structures into categories such as nebulous soft tissue. Over time, we see that our bodies can be subluxated and adjusted in a myriad of ways; “hard” structures such as bone and cartilage are not the only places where nerve activity can be dampened or hyperactive. Tuning in to how the body appears and reacts non-verbally with and without movement gives us a wealth of information regarding subluxation; observing how the patient uses their body will point to where primary subluxations are found. Combining all this with a sense of the patient’s history and ADLs will give you a wealth of information.  The more you study posture and anatomy you will find that watching people walk and move and comparing their movements to what would be highest benefit lowest risk is another cool activity.

FIFTEEN: “All human wisdom is summed up in these two words – wait and hope.” Emily Dickinson (1830-1886), American poet.

Simultaneously we learn with each new encounter while we grow our business, trusting that over time more people will appreciate our expertise as with each patient’s experience “each one teaches one.” A sure way to make each encounter as useful as possible is to become obsessed with all the anatomy of every new area of subluxation. Each new patient presentation will add to what you have seen to the point that the first time you see it, the second time, you begin to recognize it, and after the third time you “best know it” and begin to own it. All of this wrapped in a mindset that can be rattled whether we are busy with a full book or not so busy with few patients; not knowing the future can be tough. If only everything would always proceed at a predictable pace.

SIXTEEN: “Do or do not, there is no try.” Yoda (896 – 986 BYY), Jedi Master.

A recent study in Canada estimated there are about 200 techniques to choose from, each with increasing anecdotal evidence of efficacy, if not having been subjected to research scrutiny.  The common ability for each method to influence nerve activity is apparent, yet is empirically elusive; regardless patients’ seek and receive care in each of these perspectives on removing subluxation. It is apparent when a practitioner does their work with full commitment: it will show beneficial results which the doctor will seek to repeat and clarify over time, adding to growing methods for successful care plans to eliminate or manage subluxations. All of this must come from a place of positively knowing that we are on the right track, regardless of obstacles.

SEVENTEEN: “It is important to ask yourself why you’re doing what you’re doing and what purpose it serves in the big picture.” Miley Cyrus (1992-    ), singer, song writer, actress, producer.

Our care focuses most often on joint complexes; the spine always and extremities sometimes. Many of us see joint integrity, tissue extensibility, and proprioceptive capability as a broader scope of how a vertebral subluxation complex appears and will somehow address all three. Regardless of technique it is prudent to appreciate this inevitable triad and be open to ways of addressing them that will more quickly return the patient to a “wellness” status; if any of these is not in your way of practicing, a proper suggestion is either learn it or refer them out when they need it. Personally, I am a control freak; I need to do everything myself as quickly and efficiently as possible.

EIGHTEEN: “If trying harder doesn’t work, try softer.” – Lily Tomlin (1939-    ), actor, comedian, writer, singer, producer.

With such a range on how effectively chiropractic care is delivered, it is useful to appreciate three aspects of the adjustment they all have in common; velocity, amplitude, and line of force. On one end of the spectrum, adjustments with little or no speed and depth and a straight forward trajectory can be juxtaposed with those at the other end that are very quick, deeply set, in a torquing direction; each spectral approach and everything in between aimed at removing misalignment. When matching a patient’s individual needs, the possibilities of how to alter these factors is almost endless, hence the realization all of us come to at some point: we must match the adjustment to the patient’s needs. Notice that several assessment and adjustment techniques over time have developed far less vigorous styles than what has been archetypal in our profession.

NINETEEN: “When you know better, you do better.” Maya Angelou (1928-2014), poet, writer, civil rights activist.

    Often our chiropractic education becomes so invested in minutia and less practical aspects of the real world, we miss the forest for the trees. The vertebral subluxation complex exists as an entity and differential diagnosis is designed to further clarify the subluxation, not dismiss it. These diagnoses are simply variations of the subluxation and are often useful as guides to care that are most beneficial with the least risk. As one of endless examples, ignoring the very real differences between rheumatoid arthritis and osteoarthritis (easy to do with a narrow subluxation only mindset), is irresponsible to say the least, never mind potentially dangerous. Truth be told, understanding it will build your practice as the ability to help people whose results with others were not so good; you become the “go-to for everything” chiropractor as the patients’ main health care provider.

TWENTY: “Sometimes when things fall apart, well, that’s the opportunity to change.” Pema Chodron (1936-   ), Buddhist nun.

When the inevitable happens and an adjustment does not work or gets worse, it can be for so many reasons. Responsibility of service with honesty and integrity may require that we change our viewpoint, or even manner of care. For example, a joint complex in the spine or peripherally that has acquired instability or congenital laxity of ligaments clearly will not benefit from a high velocity and low amplitude thrust, we can either develop a new way, ignore it, or refer out. As a doctor who has seen many patients who have been to other chiropractors, it was hard to hear too often that “the doctor just kept adjusting me and nothing changed,” (sometimes they got worse), “they just had me keep coming back with no change in care or advice.” I suppose the real miracle is that they had not let negative experiences stop them, and did not give up on our work.

TWENTY ONE: “Beautiful young people are accidents of nature, but beautiful old people are works of art.” Eleanor Roosevelt (1884-1962), first lady, political figure, diplomat, activist.

Regardless of the patients’ age or condition, compression in the long (Y) axis of the spine is likely to be found in everyone at some point; when side to side components (X) and hyper and hypo alterations (Z) occur early enough they also become chronic accentuating the effects of aging. Gravity sucks, and time takes its toll on our bodies regardless of when care begins; at a very basic level the stimulation that accompanies any adjustment creates crucial imbibition at the joints. Rapidly heading towards 70 years old myself, from personal experience, getting adjusted is crucial to maintaining my health as never before. Truthfully, because of it, in my life I know I can do things that people my age are not supposed to do. It is the lynch pin that holds it all together.  I also know it is because I am open to learning and changing as needed to thrive.

SCIENCE

TWENTY TWO: “Nothing in life is to be feared, it is only to be understood. Now is the time to understand more, so that we may fear less.” Marie Curie (1867-1934), Nobel prize physics/chemistry, early 20th century.

    Science wants to understand the adjustment; to explain it and replicate it in order to make our work more effective and efficient, therefore reaching more people in a positive light. Having been in a range of chiropractic settings over the last several decades, with each philosophically heavy encounter I come away feeling as though some colleagues fear science is going to prove chiropractic doesn’t work; it just ain’t so. The anecdotal evidence is far too immense to ignore; this time, historically, the world is more open to us than ever, science just wants to understand not ignore or implicate. In this deconstructionist world of empirical appreciation for individual case studies it is as if a door has been opened to our profession to accumulate data on both predictable and outlying cases of care outcomes so that understanding may increase, thus bringing more people under care.

TWENTY THREE: “Nervi nervorum are the nerves of the nerve sheaths with multiple nociceptor receptor fields; essentially creating a contiguous nervous system where all parts in some way connect to each other. Sensitivity and location implicate them in chronic pain as they may initiate events and signal pain from direct stimulation; very likely maintaining chronic pain”  Bove, G. M., & Light, A. R. (1997, September). The nervi nervorum: missing link for neuropathic pain? In Pain forum (Vol. 6, No. 3, pp. 181-190), Churchill Livingstone.

    My goal of continuously striving to enlighten myself in a way that acknowledges all beliefs as real and understanding philosophies of hands-on healthcare outside of chiropractic has been rewarding. Wrapping my brain around the fact that nerves have a blood and nerve supply and that vascular structures have blood supply and nerves was like a bank of klieg lights for me. Much of this mindset in particular comes from a book called “The Sensitive Nervous System” by George Butler, 2000. His presenting laboratory and clinical evidence of how the nervous system is viewed in all known disciplines helps to bridge the gap of known ideas for clearer clinical understanding and application. A shared understanding regarding nociceptive pain, C fibers, the nerve root complex, sympathetic pain, their clinical patterns and more, makes this a must-read for the 21st century chiropractor. If I could gift this book to all my students, I would do that.

TWENTY FOUR: “The current paradigm of OA is evolving from a purely technical disease caused by cartilage wear toward a complex biological response connecting biomechanics, inflammation, and the immune system.” Woodell‐May, J. E., & Sommerfeld, S. D. (2020). Role of Inflammation and the Immune System in the Progression of Osteoarthritis. Journal of Orthopaedic Research®38(2), 253-257.       

Clinically the most likely aberrant bone and joint descriptor chiropractors see with or as VSC is osteoarthritis, also known as degenerative joint disease. At once we realize that all the tissue will be affected, not just bone and joint tissue. The amount of evidence pointing to the natural, necessary cascade reaction to trauma of any kind in the human body is at the very least a generic inflammatory response that will turn things for the worse if left unchecked. Truly it is like the old story of goldilocks: which amount of inflammation is just right?  Movement, as in an adjustment on a physical, physiological, and emotional level has a direct impact on the inflammatory response, if for no other reason than creating the “weeping lubrication” and joint centration needed to stimulate structures to return to homeostasis.

TWENTY FIVE: “Cumulative Trauma Disorder is the effect that acute injury, repetitive trauma, and constant pressure or tension has on neurovascular structures, muscles, bone, and literally all connective tissue.” P Michael Leahy Cumulative Trauma Disorder Defined US Patent 6,491,651 – 2002.

    Many, if not all, subluxations end up here: this straightforward view of a cumulative incident and how the immune system will predictably respond is simple, yet elegant. Movement without full range of motion and less than ideal posture can tear and crush; chronic, while repeated movements, increasing tension and pressure will stimulate inflammation. From this cascade of events, more adhesions appear; weakness, pressure, decreased circulation and edema as well, in a never-ending loop that will continue to degrade to full disuse unless the cycle is interrupted. There is even a formula, I=NF/AR that shows how to make changes to manage the subluxation. It is: (I)Insult to tissue is equal to the (N)number of repetitions times their (F)frequency divided by the (A)amplitude of the movement times the (R)rest in-between movements. Understanding connective tissue viability and ultimately proprioceptive capability as well as understanding joint integrity is crucial for these patients. The bottom line here is that if you are able to address these things your patients are more quickly able to get back into life and there is no greater advertisement for you and your work.

TWENTY SIX: “It all comes down to function.” Cross Syndromes, Vladimir Janda (1928-2002),  Czech Republic, DPhT.

Janda’s ideas about the most likely postural deviations humans take propose a “most normal” imbalance pattern in structure and function; upper and lower crossed syndromes. One sees a vertical ground reaction with a center of gravity norm anterior to S2 tubercle. With this controlled “falling forward” gait pattern in gravity, our upper body, neck and head project forward with shoulders rounded forward, while in the lower body the Gluteus maximus is incredibly weak and overpowered by the deep hip flexors often creating unsynchronized gait, altering lumbar curve, and pelvic centering in the Y axis. Folks with scoliosis and other discordant presentations will still have a propensity for these findings, their variations from it will show the body’s attempt to compensate in this pattern.

TWENTY SEVEN: “If you want to train for size, strength, and performance, the first thing you need to find is a really good chiropractor.” Lee Haney (1959-    ), Eight-Time Mr. Olympia Muscle and Fitness Training Camp 1991.

Most people in a normal lifetime experience injury; at times surgery and medications are prescribed. Healthcare without drugs and surgery is a noble cause, though it is not realistic, nor inviting to patients like me. For a Doctor of Chiropractic to hold up blinders to other forms of care people receive, that at times actually are in their best interest, is quite similar to a medical doctor dismissing chiropractic. It is not holistic in my understanding of the term. The best Doctor of Chiropractic constantly learns and stretches their understanding of our patients and our profession in the real world. Everyone needs our care, especially those who push themselves beyond limits that naturally test the integrity of our musculoskeletal system. Supporting them with a high benefit, low risk perspective will keep them able to live their lives in their own personal way; it is surprising sometimes how much you can help someone who is constantly getting subluxated and has no intention of stopping.

TWENTY EIGHT: “Muscle recruitment and force are determined by its mechanical function as a joint mover and a joint stabilizer. The coordination of muscle contraction affects joint stability.” An, K. N. (2002). Muscle force and its role in joint dynamic stability. Clinical Orthopaedics and Related Research®403, S37-S42.

Easily 95% of joint complex stability is determined by the tone of muscles and tendons that it is associated with; without it, adjusting becomes an expensive aspirin of sorts for some patients. As joint experts, to not aspire to understand the entire musculoskeletal system from a clear kinesiological viewpoint is not business savvy, let alone helpful to bring a best resolution. Joint centration, open and closely packed positions of joints, how the joints articulating surfaces facilitate and limit joint motion cannot be fully understood without clearly knowing all of the anatomy associated with the subluxation, both locally and peripherally. Being able to grasp and relate the fact that all skeletal muscles must work all the time or we would be like a boneless chicken. They contract when they lengthen, when they shorten, and when they don’t change length at all. Let that in.

TWENTY NINE: “Note that patient’s symptoms appear in local, diffuse, and dermatomal patterns, indicating possible subluxation, DJD, trauma, capsule ligaments, and other connective tissue issues.” Dr. Norm Strutin, (day 1 spinal orthopedic examination lecture), LCCW, 1988.

    When I attended chiropractic school, so many things made no sense to me until I got out into practice. However, when they did, everything began to connect. The truth is you really do not understand a space occupying lesion until you have either had one, or the next best thing, have a patient with one that is incredibly painful. The idea that all of the tissue has the ability for nociceptive referral of symptoms, such as facet joint versus a muscle referral, is so enlightening to me as I began to learn how they are similar and different, all being part of the subluxation complex in some direct or indirect way. Understanding these nuances of neurology in all the tissues and what it means clinically can only help to make our work proceed faster and more efficiently.

THIRTY: “The spinal engine is comprised of three sections to achieve the dual purpose of locomotion and stabilization of the control platform (the head). Each section is akin to a specific curvature of the spine: lordosis for the lumbar spine, kyphosis for the thoracic spine, and lordosis for the cervical spine.” Gracovetsky, S. A., & Iacono, S. (1987). Energy transfers in the spinal engine. Journal of biomedical engineering9(2), 99-114.

Established models of the human frame attribute locomotion solely to the legs with torso et al. being simply “carried” by the legs. A newer, more dynamic viewpoint is that the rotation of the spine creates the lower extremity ground reactions necessary for bipedal motion; immediately one sees the necessity for chiropractic in maintaining a skeletal frame where each segment works independently so they may come together for a larger motion. Comparing the lateral undulation of fish swimming, and babies as they first learn to crawl, then stand, shows how the adaptation to efficient gait requires that the spine be the driver of energy into lower extremities assisted by upper extremity arm swing which adds still more power to the rotation. When considering how the human shoulder and entire upper extremity optimally performs also requires consideration of their effect on gait and how moving through space will affect them as well.

THIRTY ONE: “Research shows the influence of thoughts and emotions on tissue pain and healing. Clinically it is noted that optimism and coping skills are great healers. Mechanisms could be related to sympathetically mediated neurotransmitters and modulators as well as immune cell involvement in inflammation and dorsal root reflexes.” Butler, D. S. (2000). The sensitive nervous system. Noi group publications. 

    The idea that a person’s thoughts and nervous system in turn affect immunity first came to light through research done to understand the immune system via the AIDS virus which specifically attacks the immune system. This discipline, coined as Psychoneuroimmunology by George Solomon in 1989, compared T cell numbers of patients; those with low numbers should be the most sick, when in fact it was the ones with the most, will to live each day and manage their illness rather than give in to it that did well, regardless of T cell count.

A strong connection between chiropractor and patient has patients reporting all sorts of extraneous benefits from having their contiguous nervous system stimulated this way. This very real connection is not only a viable answer, it has to be in some way a piece of the puzzle that is being revealed over time.

THIRTY TWO: “Good posture can be successfully acquired only when the entire mechanism of the body is under perfect control.” Joseph Pilates (1883-1967) coined and invented Contrology (Now Pilates method) posture and fitness expert, mid 20th century.

    While we as chiropractors are licensed to utilize any number of modalities outside of the adjustment which defines our work; historically the most successful patient experience is a compliant patient. While nutritional advice and exercise prescription may be utilized among other adjunctive therapies and suggestions, there is one most important and often missing link of advice for the patient. The doctor must understand and be able to coach the patient on maintaining the healthiest posture possible in all ADLs, thus making every day movements a benefit rather than a risk to good health. There is an abundance of research and clinical evidence to show that the healthiest posture actually has the ability to alter brain chemistry as well as physiology of the entire system; leaving the tongue on the roof of the mouth and lifting the back of the head up in the Y axis can lower blood pressure.

THIRTY THREE: “The doctor of the future will give no medicine, but will interest his patients in the care of the human frame, in diet and in the cause and prevention of disease.” Thomas Alva Edison (1847 – 1931), inventor, businessman.

    Boy, this quote is so loaded no matter how you look at it, don’t you think?  Having no idea where to stop this principle is actually added to underscore the previous principle, no. 32. Wanting to leave you in a place where you are of course relieved that it is over and perhaps waiting for a practical use for all this verbiage, here is the idea. I have put together a very simple and straightforward set of protocols that are not exercises, but verbal cues to help folks feel and maintain their best body mechanics in any life situation. Simply put, the book in progress is called “The Science of Posture” or to more clearly explain it; “The 7 Essential Postural Habits of the Highly Effective and Efficient Obligately Bipedal Homo sapiens sapiens.” You may call them “body mantras” if you like. (I would love to use you all as guinea pigs). To be continued …

To Jonathan, Life Lines and of all my chiropractic colleagues, wherever you are on your journey…

Thank you so much for allowing me the time and space for this catharsis. If anything here makes anyone think beyond the box we are in, regardless of opinion, then I will feel accomplished. We all must learn to try and think things through more often, if we can. Life encourages it with each passing year, and yet not everyone listens or has the capacity to do it. With that, I miss my students so much, even the ones I have never had the good luck to teach. The amount of life force that you all project individually and collectively reassures me that the future is in good hands: it will be better. I don’t doubt for a minute that in the new world you will progressively and positively move forward; you will give everything a most excellent adjustment.

 

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