Posts Tagged ‘Stiffness’

MAYBE THOSE PHYSICAL FINDINGS… AREN’T…

Friday, July 18th, 2008

THE MIND BODY CONNECTION

Within our chiropractic training and culture is a diverse range of physical indicators that we observe, measure and monitor to help us to diagnose our patients’ physical state: The history is used to narrow down our list of disorders or even diseases which may be causing the problem; Posture tells us how misaligned someone’s body and spine is; Radiographs show us how much decay and degeneration has developed; Range of motion tests measure how stiff they have become; SEMG assesses how tight muscles are; our palpation skills feel where there is contraction, restriction, fixation and misalignment.

And then we apply a physical therapy to try and intervene on the physical disorder that we have isolated.

It has almost become a cliché that there is a mind/body connection. But have we tended to minimise this relationship? Or have we even missed the point of this revelation? Are we persisting with the convenient separation and compartmentalisation of these two dimensions? We say, “oh yes the mind can affect the body, and the body can affect the mind” – but in saying this do we miss the paradigm of the mind/body relationship?

In other words the mind IS the body, and the body IS the mind.

When you are feeling certain emotions like anger, resentment, guilt, frustration – your physical body is different to how it is when you are feeling emotions like love, acceptance, peace, joy, reward. And if your physical body is different, then your thoughts, feelings and emotions are different. One doesn’t lead to the other – one is the other.

Let’s take another look at our list of “physical indicators” from another point of view, to see if we can see what they might really mean in terms of the mind/body:

The History is really someone’s story about the suffering they currently feel. And we are very good at asking questions about how the suffering feels: Where it hurts, how much it hurts, how big an area does the hurt cover, when does it feel a bit better and when does it feel a bit worse? But do we miss the most important question? What does the hurt mean – to them? Here’s another way of asking this question to help those who can’t make a connection – “if this hurt didn’t go away what would it mean you couldn’t do?”, or “if this hurt didn’t go away what aspect of your life do you think would be most affected?” Do you know that if something in your therapeutic relationship and encounter doesn’t allay or release this connection between their pain and suffering, that their mind/body will resist healing?

Postural Assessment: Why does anyone have bad posture? Because they don’t know they have it! Why would anyone carry their head too far forwards when that skull and its contents are as heavy as a bowling ball? Because they don’t recognise that it is where it is – they have poor somatic awareness. Here’s a thought – they will also have a proportionately poor psychic awareness. In other words they will actually have poor somatopsychic awareness. Check it out next time you examine someone with really bad posture: Ask them how they are feeling emotionally, ask them how aware they are of each of their internal bodily functions: More often than not the same disconnect will exist.

What about those protective buttresses that are being layered down inside their body – the ones you see growing around their skeleton on their Radiographs? Ask yourself this question: How strong, thick and solid are the protective mechanisms that this person has built around their emotions and memories? What will it take to chip away this person’s emotional fortress? The resistance, slowness of their recovery and the common poor prognosis could be reflective of their hardened interaction with the world in a more general sense.

And that stiffness that has built up in their Spinal Range of Movement, that you prescribe stretching exercises to reverse. Here is my observation: Range of motion is directly proportionate to range of emotion. My saying goes like this – “concrete body – concrete mind”. Observe how flexible these people are to suggested changes in their state of mind or lifestyle, and you may see a mirror image of their body’s flexibility.

What about that tension that you see on their SEMG? You may interpret it as physical tension: And you might ask; “maybe you are working too hard”, “maybe you did too much gardening on the weekend”, “maybe you aren’t sitting up straight”? How about this one – muscle tension is proportionate to neurological tone, which is dependent on emotional state. Maybe their body hasn’t been working overtime – maybe their mind has.

And all those things you “feel” while you are Palpating: Stiffness, resistance, swelling, and misalignment. Have you ever taken a moment to ask yourself while you have a direct connection with this person’s field of intelligence: “What am I feeling as I palpate this person?” You may be great at palpating, but, if you get good at feeling, then you will get even better at FEELING. You may even glean more insight into that person’s state of wellbeing in thirty seconds of palpation than sixty minutes of talk…

How does any of this help you to become a better healer, or a more profitable businessman? When you GET IT, that you are a body/mind and that your practice members are body/minds – Then you will experience greater quality and wholeness in your life, and your customers will receive greater quality and wholeness from you as a healer – and people pay for quality

(ps. If you think that this is suggesting that you have to become more of a psychologist or counsellor to be a better chiropractor – then you have missed the point – this has nothing to do with analysing and identifying the past hurts and experiences and helping someone to cognitively overcome the related dysfunctional thoughts and feelings. What this is about is that there is a whole new dimension awaiting you when you become more conscious of the mind/body synergy – what you are doing right now therapeutically will offer a much deeper meaning for both you and your practice members. In other words I am not talking about a change in procedure – but a change in consciousness.)

Find Out More About Training To Help You Make This Transition at http://www.torquerelease.com.au/TRT-Training.htm

Practice Tip - CLOSING THE GAP BETWEEN WHAT PEOPLE THINK AND WHAT THEY DO

Wednesday, October 17th, 2007

There is compelling scientific evidence that what people know about diet and how they eat are in many cases two different issues? I’m sure you have observed that this void between knowing and doing crosses over into all health behaviours?

1) The acute antalgic low back or torticollis crisis patient who promises you that they will keep seeing you forever for maintenance care if you can only help them get out of agony; who then discontinue somewhere between visit two and six because “they are fine now and will ring if they have any further problems”.

2) The reactivating patient that confesses that they were feeling great while they were doing the exercises that you taught them, but then they just forgot about them because they didn’t have any pain. And then they ask you “why does this problem keep coming back?”

3) The osteo-arthritic retiree that starts complaining of increased aching and stiffness, and when you ask them if they are still taking their Glucosamine, they respond “Oh I finished the bottle and thought I’d see how I’d go without them for a while”.

4) You meet an old regular practice member who discontinued 1-2 years ago, and when you ask them how they are going they give you the long list of ailments, diagnoses and prescriptions that they now take, and then pass comment “you know when I used to see you I didn’t have any of these problems”.

There’s a push in our profession right now to adapt us into risk-factor screening machines, who then pass appropriate educational brochures to those at risk, and warn them of the dangers of not changing their ways. Think about this: Most people who are overweight already know they are overweight; most people who are unfit already experience the effects of it; most people experiencing symptoms of Diabetes are aware of the symptoms… They don’t need you to identify the symptoms of their condition. They need help closing the void between their awareness and their behaviour!

If you want to be a wellness practitioner let me tell you a major paradigm shift you are going to have to make - It’s not about you, it’s about them. Wellness is a personal journey of lifestyle choices leading towards better life and health outcomes. You can’t make the decisions for them - if you try to then its not wellness - it’s medicine.

Here’s four questions that you must ask your practice members to make massive changes in your wellness relationship:

1) “What is your biggest health priority right now?” Their choice not yours.

2) “What are three things you think you could do to improve this area of your life?” Their choice, not yours. But this may be the point where they ask you for your educated opinion.

3) “What information do you think you need to help you make this change?” This is the point where they will most likely give you permission to feed them with resources.

4) “What would you like me to do to make sure you follow through on your plan?” This is where you help them to make some commitments, set some goals for them to achieve, define some measures for monitoring their progress, and set a time-line for review.

Click Here To See How Wellness Coaching Is Done…

FLAWS OF A MANUAL CHIROPRACTIC ADJUSTMENT

Friday, June 8th, 2007

DD Palmer was the first practitioner to deliver a correctional thrust to the spinal column in an attempt to restore nerve function. DD must have been aware of the shortcomings of the manual adjustment as he very clearly stated that future generations of his profession would find better ways of delivering the goods. But for many decades it has become taboo to discuss the limitations and flaws of our wonderful healing art. Thankfully there are some pioneering practitioners exploring new means of facilitating neurological change.

But first let’s do some serious soul searching…

1) Difficulty isolating a segment

We’ve all been guilty of this one – your intention is to adjust C2, but when you set up and deliver your dynamic thrust, you may or may not feel the cavitation at one of the C2 articulations; can you ever be truly sure that the joint that you wanted to move – moved? And then there are those extra “pops”. I remember being adjusted by an “old-timer-chiro” years ago: He insisted on adjusting me so I could experience a “real adjustment”. I guess he was intending to adjust my upper cervical spine, because they were the first joints that I felt separate. But then his thrust continued and I felt numerous more joints move further down my neck and what felt like my upper thoracic spine. Apparently the soreness and stiffness that I experienced for the next two weeks was an essential and needed healing process? Now I know that most of us are much more specific than this life-crunching experience; but let’s be really honest – we don’t truly know whether we hit our target on each and every adjustment.

There is an alternative means of adjusting which guarantees that you will impact exactly the joint/nerve you intend – one that delivers its impulse exactly where you place it…

2) Inability to deliver specific frequency

The thing that first got me excited about chiropractic was the suggestion that spinal adjustments might improve neurological performance. I was studying a Bachelor of Science at the time and had no trouble with the concept of the supremacy of the central nervous system over all other body systems – this understanding is not peculiar to the chiropractic profession. But let’s have a moment of awakening – the thought that the delivery of a correctional force vector to the spine to change nerve activity appears quite peculiar to many other members of the scientific and general community.

The ONLY way that an adjustment could change nerve function is if it can change nerve frequency.

Can you deliver exactly the right frequency needed to correct aberrant nerve activity due to Subluxation with your hands? Thankfully, technology exists that can deliver specific vibrational frequency…

3) Speed/acceleration variable

The best manual adjusters are fast. The faster you are the less the mass you have to use. This is a simple physics formula: Force = Mass times Acceleration. Increase the speed and you increase the impact of your adjustment without increasing the body weight that is needed. “Small” chiropractors can adjust just as well as “big” chiropractors – if they have speed on their side.

Imagine if you could adjust with an impulse that is finished in 1/10,000 of a second? You would hardly need any mass whatsoever to produce the same physiological changes – such a tool exists today…

4) Increased Mass

Higher speed reduces the mass you have to use. Low speed with high mass meets with more tissue resistance, reflex muscle guarding, patient discomfort and fear, and increased pressure against supporting soft and hard tissues. In other words, increased likelihood of developing clients that don’t like you and that are sore after you adjust them. If you can make this one shift alone in your adjusting proficiency, then you will dramatically increase your patient satisfaction and clinical outcomes.

Why not remove your dependence on mass altogether by using an instrument that is so fast that mass is almost irrelevant?…

5) Reliance on cavitation as THE outcome

I can still remember my early days in practice. I inherited a few patients who showed up sporadically to get their “back put back in”. I don’t know whether they had been taught that cavitation was evidence that the bone had returned to its rightful place, or whether they had made their own conclusions due to their previous DCs gleeful comments when a good “pop” was produced. Anyway, some of them would refuse to leave the practice until they were satisfied that an adequate noise had emanated from their spinal column. Praise God, I know longer have any of these kind of clients in my rooms. Most of my practice members seem to intuitively as well as intellectually get it that there are many more signs and symptoms that their adjustments are delivering health improving benefits, than just the production of “spinal farts”.

If you can rehabilitate yourself from the false belief that cavitation is any kind of sign of a neurological response then you are ready to evolve to the use of newer adjusting methodologies…

6) Poor inter-examiner reproducibility

I’ve had a lot of locum and associate DCs grace my practice rooms over the last eighteen years, and the variance in client satisfaction, and obvious variability in touch, technique and practices has been astounding. No two DCs are the same, and no two chiropractic experiences are consistent it would seem. Contrast this to my current situation – I have been fortunate over the last three years to employ locums who use the same system, method and adjusting technology that I use every day. Most recently one of my clients commented, “it was like you were there, even though you were in Marysville!”

I’ve got to tell you that it makes leaving your highly valued business and long-term clients in the hands of someone else VERY easy, when you can rely on the fact that what you do and what they do is so reproducible. Wouldn’t you like that same degree of confidence and security?…

7) Move joints into para-physiological range

Real Estate Agents speak of the golden rule of investing in property – “Position, position, position”. In terms of effective manual adjusting perhaps we can steal and adapt this concept to – “Positioning, positioning, positioning”? Previously when tutoring associate DCs to deliver precise neck adjustments I always found that if you get their patient positioning right then “all else followed”. We all know that to get a joint to cavitate we must get the joint into its para-physiological zone – don’t get there and it won’t move without extra force and excursion in our thrust; go too far and woops we’re talking sore clients.

Wouldn’t it be good if we could find a way of adjusting which didn’t require resting on that knife’s edge? A way of adjusting that could be performed with a joint in its neutral, totally relaxed position? That “way” already exists and patients will love you and enter into very deep states of relaxation when you adjust with this method…

8) “Bone-crunching”

“Bone-crunching” has made chiropractic famous – It has also made Chiropractic infamous: There is a large segment of the population who will never go to a chiropractor that “crunches bones”. And I know that there isn’t a single chiropractor on the planet that thinks they are a bone cruncher – but if you manually adjust, producing audible popping sounds, then good luck trying to convince the skeptics that what you do is not bone crunching. These skeptics will however visit a chiropractor who uses a low force methodology: I know this to be true because 50% of my new clients nowadays, have never been to a chiropractor, and all of them tell me the same story; “I swore I would never go to a chiro but then someone told me that you helped them without crunching their bones, so I figured I would give it a go”

There’s lots more of this untapped new patient market place awaiting you too…

9) Less specificity of vectors

Imagine if there were some tests you could perform that would differentiate exactly what correctional vectors were needed to provide the most effective adjustment – wouldn’t that be great? They exist and are very quick and simple to perform. However, is there any point knowing within a few degrees these vectors required, if you then cannot deliver those vectors with your adjustment. Unfortunately with a manual adjustment there are some basic flaws which preclude exact correctional vectors.

It requires an instrument which has true reproducibility to be able to deliver precise vectors. Unfortunately most instruments on the market require the practitioner to fire the instrument, and research has shown that this can vary the reproducibility of the thrust by as much as 300%. There is however one instrument which has pre-loading with pressure sensitive firing, so that every adjustment varies minimally from the last…

10) Iatrogenic risks – disc, Fx, vascular

We all know that what we deliver is amazingly safe, especially when compared to the statistics from other more “conventional” healing practices. Nevertheless there are some published risks especially associated with manual adjusting: Most of the risks appear to be proportionate to the amount of mass delivered during the adjustment, and the positioning of and thrusting upon patient’s joints into “para-physiological” ranges.
Exacerbation of disc prolapse is one such documented risk – I would hope that every DC exercises a great degree of caution and a certain amount of hesitancy when faced with a patient showing classic signs of disc protrusion; and I would hazard a guess that a significant number of DCs have erred on the side of too much force on at least one occasion.

I’ve seen two cases of cracked ribs in my practice in 18 years of practice – one was produced by a locum DC who adjusted an elderly female client’s thoracic spine in the prone position producing a loud crack, and instant pain which took 6 weeks to resolve and much “TLC” to appease. The second happened to me when I was setting up for a prone thoracic adjustment on a seemingly healthy mid 30’s male – we both heard the weird cracking noise – and then I was astonished when he announced that he should have told me that he had cracked that same rib several times and he sincerely apologised for not warning me!? I suspect that any other form of fracture supposedly attributed to chiropractic would be due to some un-diagnosable pre-existing weakness in the bony architecture.

The issue of vascular complications due to neck adjustment is controversial: It is clear that the estimates of the relative risk are at best imaginary and seemingly always overestimated. I have seen other statistics which claim that chiropractic reduces the risk of stroke in an adjusted population! The obvious fact is that nearly every DC will never see this in their practice. Let’s say that the risk of stroke from cervical “manipulation” was 1 in 1 million. In my estimate this means that there are 20 people in the whole of Australia who shouldn’t have their neck adjusted manually. My secret prayer has been that not one of this tiny group lives anywhere near my rooms, and that if they do, they intuitively know to go and see a Physio instead of me…

It would seem that every chiropractic cynic has a story of someone who was crippled by a chiropractor; one loud-mouthed critic I was confronted by once even claimed that “a nurse had told him that there was a whole ward full of chiro-cripples at a well-known Melbourne hospital”. We all know that this is absolute nonsense, but this does demonstrate a common fear of our “therapy” – safety – there are chiropractic techniques available right now which minimise risk and maximise safety…

11) One segment at a time – no “Double Ended Contact Assist”

To understand this concept fully you need to attend Torque Release Technique training. The concept of Lovett Brother Reactors is not a new one in chiropractic, but it is an ignored concept in many manual models. I wonder if this is due to the fact that you cannot manually adjust two segments at the same time? Most DCs if they possess a protocol to determine if an adjustment has held (you’ll learn this at TRT too) will keep adjusting the same segment until it submits. Deeper understanding of the neurological coupling known as Lovett Brothers provides the answer to this scenario though; and if the DC also possesses a protocol to simultaneously correct the two coupled segments at the same time then these persistent subluxations can be coerced into correction in a very quick and gentle manner.

The shortcomings discussed here have all been carefully solved through the research and development of Torque Release Technique and you will learn numerous strategies to evolve beyond these flaws as well as how to adjust with the purpose-built Integrator Instrument…