Practice Article December 2008

Last month I was a keynote speaker for one of the sections of the World Federation of
Chiropractic Convention, held just outside Beijing, China. It was co-sponsored by the
World Health Organization and included representatives from Chinese Manual
Medicine. When we toured a combined traditional medical and Chinese medical
hospital, I was asked to explain chiropractic manipulation in 15 minutes. They had no
idea of the articular neurology and the biomechanics of the locomotor system as it
relates to manipulation.
The form of manipulation they demonstrated was called Chiuna and was mobilization
not producing any audible releases. Some of the stretching techniques were low force,
low amplitude lumbar rotation, which did produce audible releases quite often, the
doctor, said. The seated patients’ pelvis was held immobile with wide leather straps and
the spine was rotated, leaning forward from the waste. I wasn’t impressed.
My topic at the convention was on the subject of web-based distance learning of
chiropractic manipulation. There were representatives from most of the major colleges
from around the world. Only one college out of thirty, actually was employing video
presentations of the technique labs, which enables a student to pre-empt a class
presentation, as well as, review a lab presentation. Knowing what is going to be
presented, helps the learning of a psychomotor skill.
Practice makes perfect if the person is practicing perfectly. Practicing with a visual
reference is much better than trying to remember what was shown in the lab. Students
all learn psychomotor skills at different rates. By having a visual reference, the slower
learners of a certain skill can do extra review and practice. The goal is to be consciously
competent by clinic entrance. Without this method trimesters go by and skills not
learned in one tri are forgotten and never accomplished.
The videos I am familiar with, are the ones I made demonstrating Motion Palpation as
an indicator that a motion unit needs to be adjusted and in the specific directions it
needs to be adjusted. Yes, you read it right, DIRECTIONS. A motion unit allows
movement around the three axes in both directions. For example, flexion and extension
are two rotations around the x-axis. Rotation posterior to anterior and anterior to
posterior are two rotations around the y-axis. Joints have the ability to rest at a point
necessary to conform to our posture and the adaptation required by all the other joints
in the closed kinematic system. There is no absolute posture, we are always moving,
even in our sleep. To take a person and stand them in front of a bucky and take an
x-ray that is supposed to detect abnormal bone positions is very unscientific. The
result is a still picture of a mobile system. Reading this film can not tell us where
to adjust and around what axes to adjust.

I received some brochures about a technique that uses 4 full spine pictures to make an
analysis of posture sitting and standing. The guru stated that bones needed to be put
back in place, especially the ones misaligned anterior. The reason being no muscles
were designed to pull the vertebra backwards. What amazed me is that some people
were allowing him to use their names as satisfied customers.
I ask the question, “When are we going to relate chiropractic adjustments to
biomechanical dysfunction?”
In countries like Canada and Denmark where we do have a dominance of rational
chiropractors, the governments fund research and help us increase our knowledge
base. As a profession we can’t remain on the outside, with antiquated theories and
expect to survive.
Being in Beijing made me realize we are making great progress around the world but
here in the U.S.A. we have so many diverse groups all under the umbrella of
Chiropractic. Our associations are afraid to lose members by stating the rational,
scientific, evidence based model is what we promote. The religious fanatics who think
they can spin the atlas back to neutral and turn on innate, no matter what, are still
tolerated. Patients are getting joints cavitated, which are already mobile and normal.
Popping a normal joint is not therapeutic and prevents nothing.
The rest of the world is not steeped in the “Static” historical model. They change with
the discovery of new evidence and research. I am always hopeful that these articles will
help young doctors start out on the evolving path. I don’t want to be like B.J. Palmer. He
knew diddly-squat by comparison to a modern chiropractor. I understand he is a part of
our history and accept it as that. When I heard him speak in 1956 he was incoherent
and rambled on about the innate abilities of the body. It is called Physiology,
Biochemistry and the Immune System.
We are learning how Homeostasis is achieved and the relationship of the locomotor
system and the facilitation of the Sympathetic Nervous System and certain diseases
and syndromes. We are all pioneers in a very new field. We need to be rational and
realistic. We need to denounce the past and present nonsense and get on with the big
job at hand. Our job is to shift the paradigm both inside and outside the profession.
It is going to happen with or without us।

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