Expectation and Outome
14/08/10 13:50 Filed in: From the Research | Observations from the Field
As chiropractors we naturally possess confidence in the effectiveness of a spinal adjustment. Indeed, with an understanding of the neurological underpinnings of our art it is neither surprising nor unjustified that we look for scientific data to support our observations and theories. But as we dig beneath the surface of human physiology we come up against evidence that shows that our clinical successes might have just as much to do with the patient as they do with us.
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Does Distance Running Really Harm You?
03/08/10 18:32 Filed in: From the Research
I love it when new data challenges the conventional wisdom. And a truism that is often perpetuated without interrogation is that long distance running, particularly on the road, causes osteoarthritis of the knees, hips and possibly degeneration of the lumbar discs.
But is there any data to support these assertions?
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But is there any data to support these assertions?
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Adjusting Deranged Discs - Just What Are We Doing?
20/06/10 21:08 Filed in: From the Research
In our last blog post we examined the prospect of hypermobility being a common feature of many spinal pain patients. What’s more, we also suggested that it is these hypermobile segments that can benefit from the proprioceptive burst that accompanies a spinal adjustment.
But what is going on at a tissue level? And can our adjustments influence the connective tissue features of common spinal derangements?
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But what is going on at a tissue level? And can our adjustments influence the connective tissue features of common spinal derangements?
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What Are You Adjusting? Hyper or Hypo?
03/06/10 11:22 Filed in: From the Research | Clinical Pearls
To most chiropractors quality of spinal motion is a prerequisite for spinal health. We have an intrinsic understanding that a joint must move normally to be normal - or at least to stay that way. As such, our examinations are heavily geared towards assessing and quantifying the relative motion of each segment. We then give it a rating: 'normal', 'hypermobile' or 'hypomobile'.
Most of the time chiropractors tend to focus upon finding areas of limited motion - segments of greater stiffness that would benefit from an adjustment. Indeed, the majority of definitions of joint dysfunction suggest that reduced mobility is a cardinal sign, and that we should try to stay away from any hypermobile segment.
But is this really what's going on? Is it truly the stiffer joints that are the prime source of pain in most of our patients? And is it the stiffer joints that benefit the most from manipulation? Or could it actually be the hypermobile joints that should be the target of, and beneficiaries of, the neurological effects of an adjustment?
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Most of the time chiropractors tend to focus upon finding areas of limited motion - segments of greater stiffness that would benefit from an adjustment. Indeed, the majority of definitions of joint dysfunction suggest that reduced mobility is a cardinal sign, and that we should try to stay away from any hypermobile segment.
But is this really what's going on? Is it truly the stiffer joints that are the prime source of pain in most of our patients? And is it the stiffer joints that benefit the most from manipulation? Or could it actually be the hypermobile joints that should be the target of, and beneficiaries of, the neurological effects of an adjustment?
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Proprioception Part II - It's More Complex Than You Thought
22/05/10 16:36 Filed in: From the Research
In our last blog entry (Proprioception - The Key to Chiropractic Care) we looked at the accruing evidence that chronic and recurrent spinal disorders are frequently accompanied by proprioceptive deficits. We also took the view that these deficits might actually be the 'weakness' that precedes an acute episode of pain.
So far it has been suggested that this lack of sensory feedback might exist somewhere in the peripheral structures, such as in the multifidus muscle groups, or in the muscle spindles themselves. Brumagne and colleagues (1) suggested that "it is possible that reduced proprioceptive acuity in the lumbosacral spine is a precursor to back injuries and their sequelae. Poor perception of spine orientation may lead to more frequent excursions beyond the range of mechanical stability, thereby risking mechanical injury to spinal tissues."
But could the problem be central - in the brain itself?
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So far it has been suggested that this lack of sensory feedback might exist somewhere in the peripheral structures, such as in the multifidus muscle groups, or in the muscle spindles themselves. Brumagne and colleagues (1) suggested that "it is possible that reduced proprioceptive acuity in the lumbosacral spine is a precursor to back injuries and their sequelae. Poor perception of spine orientation may lead to more frequent excursions beyond the range of mechanical stability, thereby risking mechanical injury to spinal tissues."
But could the problem be central - in the brain itself?
Read More...
Proprioception - The Key to Chiropractic Care
11/05/10 20:10 Filed in: Clinical Pearls | From the Research
Since the inception of the chiropractic profession its practitioners have struggled with models of spinal dysfunction. While early notions of structural misalignment have largely given way to ‘functional’ concepts, the average field doctor still questions the exact nature of such lesions. So the question still remains, “What exactly is going on inside the spines and nervous systems of our patients?”
Clearly there are many differing clinical diagnoses that can be made when we attempt to pick a source of pain or a ‘tissue in lesion’. These might include a meniscoid extrapment, a zygapophysial synovitis or one of the various grades of annular tear/disc herniation. However, in such instances we could view any tissue damage as the result of a functional derangement that was already in existence at the time of injury. In other words, many spinal pain syndromes are a symptom of a greater deficit underneath - not simply the unlucky result of an inappropriate movement or accident.
But what ‘deficit’ might precede a spinal injury? And how would we know it was present if our patients are asymptomatic?
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Clearly there are many differing clinical diagnoses that can be made when we attempt to pick a source of pain or a ‘tissue in lesion’. These might include a meniscoid extrapment, a zygapophysial synovitis or one of the various grades of annular tear/disc herniation. However, in such instances we could view any tissue damage as the result of a functional derangement that was already in existence at the time of injury. In other words, many spinal pain syndromes are a symptom of a greater deficit underneath - not simply the unlucky result of an inappropriate movement or accident.
But what ‘deficit’ might precede a spinal injury? And how would we know it was present if our patients are asymptomatic?
Read More...
