Practice Tip - INCREASE COMPLIANCE WITH EXERCISE PRESCRIPTION

Perceived indifference is the number one reason for patient drop out - AND - the number one need of each of your client's is the perception that you have heard and understood their biggest concerns. A major shift in consumer power is the demand for self-help advice. While most MDs THINK that their patients come to them for a prescription; and most DCs THINK that their new patients have come to get their backs cracked; One of the first questions in your patient's mind/s is "what can I do to help myself?"

I still remember one particular new patient who consulted me. He was wanting help with his chronic recurrent Low Back condition and had already seen his MD for an "expert" opinion. The GP had given him a sheet full of exercises as his prescription. This sheet had actually convinced the man that he was in the wrong place! You see, the copyright symbol at the bottom of the page was 1965! The guy said to me - "if that's how up to date the MDs are then I figured I needed to find another profession".

A lot of chiropractic treatment programs are very "front-ended" - That is the new practice member gets a lot of attention and information in the first 1-2 weeks of care: And then they become part of the daily schedule - Arrive, wait, guided into the adjusting room, face down, adjustment, "powers-on, see you next visit", pay and make an appointment, leave. And as each visit passes they develop a growing dis-ease that they might just be a number.

Here's one technique to help your practice members feel like you continue to see them as individual, important and cared for: It's called drip-feeding. People respond and comply much more effectively to your educational inputs when they are in small bite-size chunks, instead of a huge plate full of stew that exceeds the appetite. You can apply this to any aspect of your ongoing systems and procedures but let's use the example of exercise prescription:

Many DCs have given up on prescribing exercises because of perceived poor compliance and persistence. The primary cause of this poor outcome is the way in which the exercises are taught, delivered and reviewed. Instead try these guidelines...

1) Only teach 1 and never more than 2 exercises at any one visit.

2) Demonstrate the exercise by assisting the person to perform the exercise there and then - it's fine to give a sheet but these are just visual reminders - NEVER expect a client to perform an exercise from a still picture without demonstration, and DVDs will rarely make it into the player more than once.

3) Let them know that you will be teaching them another exercise next week, and that you will be reviewing their progress.

4) When you teach them the next exercise, get them to quickly show you how they are doing the last one you taught them.

This process should only add 1-2 minutes to that consult if you do it effectively - if this is too long, this can be delegated to a tech CA who you should have assisting you if you are seeing high volume anyway.

This process achieves a number of things - implementation because they will remember the exercise, compliance because they know you will be checking on them, persistence because they have been made accountable.

When we teach the Super Posture program I show a set of 12 simple exercises which are very effective for improving postural habits, and can also be used to improve response to your adjustments. Click Here To Learn More About Super Posture...

Now the challenge for you is to review the information that you currently bombard your new patients with, and take some time to trim it down into smaller bite size pieces, to mix into your drip-feeding recipe...

CHIROPRACTIC PROFESSIONAL DEVELOPMENT COMES TO YOU

Are you involved in a group practice, mastermind meeting group, or regional chiropractic group? You could have CPD come to your group instead of you traveling hundreds of kilometres to further your professional development. And when you calculate the cost of traveling, extra time out of your practice to get to and from a program, the costs of accommodation and meals, and, time spent away from family and leisure - this can calculate to a saving of hundreds of dollars and large amounts of YOUR time...

Below is a list of training programs that we can provide to your group:

Torque Release Technique Seminar - A 2-day technique program that upgrades your analysis and adjusting skills to 21st century chiropractic...
Click Here To Find Out More...

Advanced Torque Release Technique Hands-On-Workshop - Follow-up to the TRT Seminar: A 1-day technique program that converts your TRT skills from competency to mastery...
Click Here To Find Out More...

"ADHD, To Drug Or Not To Drug" - A 1/2 day program which teaches the truths about ADHD and related behavioural disorders and gives you clear and effective strategies for managing the number one paediatric crisis...
Click Here To Find Out More...

Super Posture Workshops - A 1/2 day program which shows you the skills, strategies and solutions to one of the biggest causative and aggravating factors for the Subluxation...
Click Here To Find Out More...

Auriculotherapy Seminar And Workshop - A 1 day program that trains you in the principles and application of the most congruent ancillary modality for chiropractic practice...
Click Here To Find Out More...

Click Here To Email Me An Enquiry About Any Of The Above...

Practice Tip - HELP YOUR PRACTICE MEMBERS TO FIND ONLINE HELP

The Internet has now become one of the primary ways that practice members and prospective customers find out answers.

Do you help to direct them to congruent health related resources?

65% of people report access to the internet. A total of 74% of those with access use the Internet to find health information for themselves or family members. Disease-specific information is most frequently sought, followed by medication information, and then information about nutrition and exercise. Did you know that as a health care professional you can significantly build your relationship and loyalty with your customers by referring them to useful and helpful web sites?

Here are some short cuts to assist you to point your patients in the right direction...

1) Collect your patients email addresses and offer them a periodical email update service: Send out a periodical group newsletter with links to interesting health articles that align with your philosophy and services. Nowadays you can even remind some patients about their appointments via email.

Click Here To Find Out How To Send Powerful and Impacting Emails...

2) Get a web site: Not just an online business card - but one that has significant amounts of health related and even self-help information, which is regularly updated. There are chiropractic specific services that can help you with this.

3) Have a list of health sites that you regularly refer to yourself - link to these from your web-site, and try to set up reciprocal links from their site to yours.

Click Here To Visit My New Health Blog Suitable For Anyone To Read...

CAN YOU SEE WHAT YOU ARE DOING?

Many aspects of chiropractic practice have evolved - there have been so many modern developments from within our profession, and from complementary professions - many of which make daily practice simpler, more efficient, more effective, more objective, and even more profitable... Whether we talk about the computerisation and even automation of our front desks, technological advancements in our investigative tools, online education and marketing tools, new and diverse technique systems, in-house entertainment and educational multimedia, online and electronic banking options, and I could go on...

But at the same time could it be that as we utilise more and more technologies, and become more dependent on machines to make decisions and record memories for us - That our own innate and intuitive recording, analysing and comparative skills may be withering and vanishing?

How seriously and consciously do you control what you are seeing and absorbing in your mind's eye, as you are working on each and every practice member, on each and every visit? This was named INTENT by our pioneers.

While you are leaning over and assessing your patients: Are you thinking about what you are going to have for lunch, reviewing your golf swing, planning your next holiday, worrying about your debts, or even rewinding the last patient who was complaining that you hadn't fixed them yet?

Make a commitment to include the following steps as you examine and treat each person...

1) Become One: When you enter into someone's field of intelligence (their personal space), you are being allowed into a very privileged place - AND you also enter into a dimension where you can gather enormous perceptions about the state of mind and body of that person - IF you are willing to perceive and observe them! The way to take this to its full potential is to comprehend that when you enter into this "zone" you and your patient become one. Have you ever started to feel angry, sad, frustrated, or agitated while adjusting someone - guess what - it might not be you feeling it - it may be them. See if you can develop this skill of knowing more about your clients than they know about themselves...

2) Visualise: As a Chiropractor, you are extremely blessed, because you have done some of the most comprehensive anatomical, physiological, biomechanical, neurological and even pathological studies possible. As you examine and adjust each person, develop "XRay Vision": Visualise the structures and functions that you are examining and adjusting as you perform each procedure. Makes the job much more interesting and fascinating. Your diagnostic and technical skills will improve in a quantum leap if you integrate this one skill...

3) See Whole: This transports your visualisation skills to the next dimension: Making the jump from observation, to influence! See the fixated joints start to move again; visualise a person's alignment being restored; feel the surge of nerve flow and energy transmission; envision cells, tissues, organs and beings becoming whole and vital once again...

When we teach Torque Release Technique we equip you with a comprehensive range of indicators which you use in your ongoing evaluations of your patients' state of wellbeing, and degree and location of Subluxation. These build and strengthen your intuitive and innate abilities to perceive and differentiate what condition someone is in, AND where and how they need to be adjusted.

When you put this all together you achieve what is probably best described as TOTAL CERTAINTY.

Click Here To Find Out More About TRT Training...

Practice Tip - EMPOWER AND RELEASE YOUR MOST VALUABLE ASSET

Here’s some vital questions to ask yourself: Which member of your business...

1) Educates your practice members more simply and effectively than you do?

2) Listens to your patients' "dirty laundry" and counsels and advises them at the same time?

3) Stimulates more referrals than any other marketing source than you could ever invent?

4) Is more likely to hug, wipe tears, encourage and listen to the people who pay your bills?

5) Placates disgruntled customers who are sick of being kept waiting, or haven't had their questions answered to their satisfaction?

6) Would like to be more involved in the healing process than you recognise and give credit for?

And all we worry about is did they take the correct money, make the next booking correctly, get people into the adjusting room when we needed them there, keep the kids quiet in the play area, and still manage to book in 3 new patients who rang while 5 people were queued at the front desk?

That's right, I'm talking about your CA, receptionist, secretary, personal assistant - whatever you call them.

After asking yourself the above questions; next ask your best CA/s: "Would you like to be more involved in the healing process, and learn some new skills?" You may be surprised by the answers you get.

Here's three ways you can up-skill your most valuable business asset:

A) Involve them in the interview or case history process - Use pre-formatted questionnaires to save you time and actually improve your record keeping. A good CA will have already heard most of the person's life, family and health history, and will probably know more about what is really worrying the person, before they even see your face: Your CA is the ideal person to select the most appropriate paperwork for each new client, and then to follow up at a pre-determined time to review the questionnaire again.

ACTION STEP: Click Here To Check Out Health Questionnaires That Your CA Could Be Trained To Administer...

B) Get them trained in aspects of the examination procedures - There are some amazing technologies which improve your objective analysis of your patients' state of wellbeing, and some of these can be trained and delegated to a tech-CA.

ACTION STEP: Make sure you bring some CAs to the Super Posture program - there they will learn how to perform low-tech and high-tech postural assessment and even how to prescribe some corrective exercises: Click Here To Find Out More About The Super Posture Program...

C) Select some therapeutic modalities which can be administered by an assistant under your oversight - Consider this - As your practice expands you may assume that the way to increase your volume and turnover is to employ an associate DC. Most associate DCs will drain up to 60% of the money they generate. How about delegating some of the less skilled and time effective activities to well trained staff who work for an hourly rate? You could dramatically increase your patient flow and diversify your services (and increase customer satisfaction) at a fraction of the overhead.

ACTION STEP: Click Here To Find Out About A Treatment Modality That Can Be Delegated To Tech Assistants...

TIME-SAVING SHORT CUTS

Have you ever bet on the horses, played two-up or any other form of gambling? The nature of this industry is that the most likely outcome is also the least rewarding one! Bet on a horse that has odds of 2/1 and most likely it is going to win, but you are only going to get a little bit of extra cash for this achievement. On the other hand if the horse you bet on is 100/1, more than likely you are going to be waiting for a while after the winner passes the post to see your horse cross the line - but IF he does win then you are going to get a great return on your "investment".

What if there was a "game of chance" that paid higher dividends when the odds/ratio was also going to make your bet the most likely winner? Wouldn't this mean less time wasted looking for the the "long shot" and bigger returns on your input? Fortunately such a "game" does exist - it's called chiropractic...

Did you know that two separate research processes have confirmed and agreed on the "odds ratio" for subluxation probabilities? That is; a patient is lying prone on your adjusting table - which level of the spine is most likely to be subluxated, and hence is the fist level of the spine that you should always check? Why would you waste your time looking at the least likely spinal level first? If you knew the ranking list of primary subluxations then you would save yourself a LOT of time as you would on average find EVERY subluxation quicker. The less time it takes to find it, the less time it will take to fix it: Less time CAN be converted to more money.

So what is this ranking list I hear you ask? Unfortunately space does not allow me to cover this comprehensively. To give you a hint though - If you take the name of one of the most-used low-force techniques and reverse the order of the words, you have the first and second most likely primary subluxations on the planet. The rest of the list is covered thoroughly during the Torque Release Technique Program, including the differential diagnostic tests that reliably tell you whether each segment needs to be adjusted, OR NOT, and what correctional vectors will give you the greatest return from your adjustment.

Due to popular demand we have booked another TRT program for this year - to be held on Friday/Saturday November 23/24 in Auckland, New Zealand...

Click Here To Find Out More...

Practice Tip - ASKING FOR REFERRALS

I can remember paying good money to attend a practice management seminar that promised me I'd be able to see more people, charge more for my services, work less hours, convert everyone to lifetime care, and attract hundreds of new patients. The crux of the seminar was rehearsing, memorising and then regurgitating powerful "scripts" which if said in the correct manner, guaranteed that everyone would do anything you told them to do. I must say they did work well, but here's the glitch: When you've been in practice for a little while, and you start to see the same people over an extended period of time; and you also see their family members, and friends and colleagues, and reactivated patients; and if your CAs and associates are also using those same power scripts - eventually you are all going to be "found out". You see this technique is based on "Disney" systems - BUT; how many times have you visited Disneyland? Once, maybe twice to go to the bits that you missed the first time? And guess what - you only have to listen to the script once! If YOU are going to be a wellness DC with people seeing you 12 or more times a year, for many years, then you'd better have something different to say... Here's the best way to develop dialogue processes that evolve and adapt to where you practice members are at... Ask better questions!

Here's a really simple strategy that doesn't take long; builds rapport, intimacy and relationship; and produces numerous opportunities for generating referrals: Get to know the practice member's family, friends and colleagues by asking a simple series of questions... My CA even knows their Dog's name/s!

It goes something like this:

Q: "What does your husband/wife/partner do for a living?" A: ........

Q: "Wow, does he/she enjoy that?" A: .........

Q: "Has your husband/wife/partner seen a chiropractor before?" A: ........

This is where the brief conversation can take a number of turns, but regardless of the answer, your questions should search for a reason for you to recommend that they bring their partner in to be checked to see if you can help.

On subsequent visits I'll take some brief moments to get to know their kids, and then their friends, and then their colleagues...

I know this sounds really simple, but I have got to tell you that the conversations are much more interesting than listening to the sound of your own voice saying the same thing over and over again?

POSTURE - THE SIMPLEST AND MOST POWERFUL PRACTICE TOOL

A Picture Paints A Thousand Words!

Many Chiropractors analyse their new patients' posture, and then scribble lines on a stick figure chart that is supposed to represent the person's postural distortions? Try showing the hand-drawn diagram to the person - IT WILL MEAN NOTHING TO THEM - And it's not a very convincing communication medium. Try showing the diagram to another chiropractor - I bet they won't even understand what the markings mean. Then try using this diagram at the re-exam - How could you objectively measure, let alone demonstrate to the client that any sort of change has occurred?

Some others have entered the twentieth century and have started to take digital photos of their practice members' posture. I've seen some who print the photos and then draw lines all over the picture to highlight the problems. But the question remains - How can you objectively track and demonstrate the changes that are occurring in their posture? And, how could you store, file and retrieve all those images?

There is a twenty first century technology that is cheap and effective for storing, analysing, calculating, retrieving, and comparing digital postural analyses - And it takes about the same time as a traditional postural assessment...

Click Here To Find Out More...

Practice Tip - WHAT DO YOUR PRACTICE MEMBERS REALLY THINK ABOUT YOUR CARE?

The Million Dollar Question

Many of us now call ourselves "Wellness DCs" or "Healthy Lifestyle Doctors" or some other impressive sounding title - I guess we are trying to differentiate our services from the other "garden variety" DCs? But these titles often are a reflection of us, and not a true reflection of how our customers really see us, or how they themselves behave. Maybe we exercise regularly, get adjusted every 1-2 weeks, keep a positive outlook, eat organic etc. But then we have 80% of our practice on monthly schedules, and have no discernable influence on their other healthy habits?

I suffered a daunting revelation when I upgraded my technique and scheduling systems to a more "wellness" driven focus. You see I used to spend ~15 minutes with each client, and they loved my soft-tissue techniques, and often complimented me on my ability to find the sore spots and to provide instantaneous relief from their musculoskeletal aches and pains. Not that there is anything wrong with this - but my mission is to improve the health and wellness of everyone that I can influence - not to be the natural alternative to Nurofen and Panadeine. And when I changed my technique to a neurological model, many left the practice before they could possibly experience the extra health benefits - why? "Because I didn't rub their shoulders"!

So, what do YOUR clients really think of YOU? Here is the million dollar question to ask your practice members that will inform you of the truth...

"If you could come and have an adjustment whenever you wanted to, and it didn't cost you anything, how often would you come?"

1) If the answer is, "Oh I'd come every single week, and sometimes even more": Congratulations - you probably are truly a wellness DC - your clients truly comprehend the global benefits of an adjustment. They probably perceive the reduction in tension and stress, the improved sleep patterns, the maximised immunity, and the increases in energy after each adjustment.

2) "Oh, I'd come every 4-6 weeks": Maybe you should replace the title "Wellness" with "Maintenance" DC. Your clients have probably discovered that if they go longer than 4-6 weeks, that their aches and pains start to increase in severity and regularity. Your periodical adjustments offer them effective and lasting pain relief.

3) "Oh, I'd come a 2-3 times a year": I actually don't quite understand this concept - maybe it's because they get their car serviced twice a year, and go to the dentist twice a year, and floss their teeth twice a year, and make love twice a year? I'm not sure of what possible benefit two adjustments per year could have - maybe I underestimate the power of an adjustment?

4) "Oh, I'd come in whenever I had a problem": Whoops, if you get a lot of this answer, then it is time to change your title to "garden variety DC".

To take this question to the next level: If your practice members answer that they would like to come more often than they actually do - the next question to ask is - "What do we need to do to help you come as often as you would really like to?" - now its time to work out a strategy, schedule, fee, that makes their dream a reality...

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

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.

WHAT IF YOU WERE ONLY ALLOWED TO MAKE ONE ADJUSTMENT?

Imagine if every Australian was allowed to receive one adjustment per week, and that adjustment was covered under Medicare? But here's the condition: You can only deliver one adjustment per week, per person, and you have to demonstrate the measure benefits of those adjustments every three months using impartial objective outcome tools. I guess there would be a minority of DCs who would think they had found easy street and delivered any old adjustment, in any old fashion, without much consideration for where or how they delivered that adjustment - just so long as the cheques keep rolling in. But for the rest of us, we would want to be completely diligent in ensuring that this one adjustment was a good one, a really good one, and that we adjusted the segment which most needed to be adjusted, and in the right direction because you can't just hit it on both sides - you only get one shot!!

Think about this in the context of how you currently prioritise how you deliver your adjustments each and every day:

1) Do you start at the bottom and work your way up, or some other variation of this theme? Check and adjust the low back, check and adjust the thoracics, then roll them over and check and adjust their neck? Most DCs have an order in which they adjust everyone. It may not be the order I mentioned, but in most cases it will be a "routine" based on the practitioner's habit as opposed to some patient-centred findings dictating where you start and finish. STOP IT: Take an extra few seconds to analyse your patients' spines and make a decision about which is the most important adjustment to make on that visit.

2) Do you adjust the same segments in the same order, any three visits in a row? I thought your practice members were supposed to be getting better and progressing to a new level of health - why then would they continue to have the same subluxations? If you are activating retracing in their body then surely the next layer of subluxation should appear and need to be corrected? And, since they last saw you a lot of different stresses have presented, so they may have a new and different layer appearing on the next visit. Why do we say that the body is a self-healing adaptive organism and then fail to adapt and change our adjustments to keep up? BEWARE: If you check your notes and see that patients are getting the same mix of adjustments on every visit then there's only two options - A) you put the stuck pattern there with your repetitive habituating stimulus, or, B) their spine isn't evolving under your care - either way you need to try a new strategy.

3) Do you have a system that allows you to make a live analysis and differential diagnosis of which subluxation wants to be adjusted at any given moment in time? When we teach TRT we show you 14 different indicators of subluxation and train you in the differential diagnosis technique that gives you absolute certainty and precision in making this vital decision...

Click Here To Find Out More About TRT Training...

An interesting question arising from my hypothetical above is for our profession as wellness providers. I used the weekly example based on the observation that: 1) If I could get adjusted as often as I liked I would probably get an adjustment every week; 2) I conducted a highly informal survey of a group of my practice members when I asked them "if you could get adjusted whenever you liked and it didn't cost you anything, how often would you get adjusted?" The most common reply was "I'd come every week"; 3) I have been using functional assessment technologies in my practice for over a decade and have observed qualitatively and quantitatively the biggest changes when clients are getting adjusted weekly (go beyond three weeks and you will see a significant percentage of clients start to deteriorate functionally); 4) Many chiropractors I have met who claim to be wellness DCs get adjusted weekly and recommend weekly adjustments.

But, how much would this cost the community if every man, woman and child was adjusted weekly: Using the round figure of 20 million people and $40 per adjustment, that comes to $800 million per week.

Here's the ultimate challenge: We would have to be able to demonstrate without a shadow of a doubt that we were saving the Australian economy at least $1 Billion per week? Can we do this? Your thoughts are welcome...

CONVERT YOUR EXAMINATION EXPLANATIONS TO NEUROLOGICAL EXPLANATIONS

There seems to be a mythology in chiropractic that the average person is unable to comprehend the nervous system - IF this is true it is because no-one has ever taken the time to teach them...

Masseurs and Physios are hardly going to teach ANY principles that explain the nervous systems' role in health and disease. The pharmaceutical companies and AMA would probably prefer that the average person did not understand the CNS, except that they have drugs that can block all pain and unwanted emotions. Not many people are going to see a neurologist in their life - and those who do rarely come away with any insight into the normal functions of the CNS. You're a chiropractor - it is your calling to teach the world about the importance of a healthy and fully functional nerve system. No-one else will. The simplest way to do this is in bite-sized chunks...

1) Explain at the very beginning of your relationship with a new client that the nervous system controls and regulates ALL bodily functions, and therefore everything that you do to them is is all about improving their nervous system; and warn them that you will tend to explain everything to them in terms of the nervous system so that they can better understand their own body and how to look after it.

2) Convert your explanations of your exam procedures to neuro speak: eg. POSTURE - Posture is not a biomechanical phenomenon - it is a neurological phenomenon - it represents the body's ability to perceive and position itself against gravity - its effectiveness in maintaining the sphenoid directly above the coccyx - this requires proprioception and fine-motor control. When you display a person's postural distortions to them, forget the mechanical talk about the spine bending forwards and putting more strain on the discs. Instead explain to them that the reason their head has got into such a ridiculous position is because their brain doesn't know where their head is; and the most likely reason for this is something (a subluxation) blocking the information getting from their neck joints and muscles to their brain.

When you explain spinal XRays spend as little time explaining the shape and position of the vertebrae; instead teach them how the changes on the XRays will be affecting their CNS: "See how your neck is leaning forward, and has become straight - this will be stretching your spinal cord like someone trying to wring out a wet towel". Look at this extra backwards bend in your low back; look at the size of the holes between the vertebrae - this is where the nerves have to exit to control your body - what effect do you think this squishing will have on the nerve's ability to transmit information?

3) Do an audit of each of your exam procedures and examine your explanations. Then re-write your description for that procedure in terms of the nervous system - you can do it - you're a chiropractor. AND/OR Attend a TRT seminar and we will help to show you all the neurological indicators that you can use to assess, explain and educate your practice members.

4) Explain the outcomes of your adjustments in terms of the nervous system and then show them the changes that occur in their positive findings when they are adjusted. When you learn TRT you will be able do do this in a few short moments...

Click Here To Find Out More About TRT Training...

Practice Tip - HOW TO SEE MORE KIDS IN YOUR PRACTICE

I was recently cleaning up a shelf in my store-room when I found an old post-pack - not sure what was inside, I blew off the dust and opened the cover and found dozens of Polaroid photos of all the kid's that had arrived as new patients at our practice through the nineties. I called in my CA and we spent a few joyful minutes recalling all the memorable moments and miracles. Then we noticed that there was a whole bunch of kids (some now teens) that were still regularly seeing us - and as you can imagine they are now all a lot taller and bigger, some 10-15 years later. So, our new project has been to recreate their photos when they come in for their tune-ups. The funniest is two small giggling boys squeezed closely together in an arm chair - they used to keep the whole reception room laughing because they used to be so ticklish that they would laugh uncontrollably through their adjustments - now one is nearly 6 foot and the other nearly 100kgs - and they still both giggle when I adjust their necks! We are going to produce a "where are they now" display with the title - "Want your kids to grow up healthy and straight? Then get them adjusted regularly."

Our kid's room walls used to be covered with photos of kid's and all their colour-in sheets and drawings of their chiropractor, and this was without a doubt the biggest referral tool for us when attracting families and kids. Why?..

1) People love to be where people are - when parents are in your practice and see all the kids that see you, they will ask you about chiropractic for kids... On the other hand if all they see is trendy prints and the latest edition of WHO weekly and the Bulletin - then they will not give a single thought about whether or not their kids need chiropractic care - they'll probably read the last advert for kiddy pain killers instead.

2) You can tell the success stories. If someone asks you about chiropractic for asthma, or bedwetting etc - it's great to be able to quote the latest research, but what really works is when you can point to a number of kids on your photo wall who you have treated for that very same condition.

3) Kid's see the photos and ask what they have to do to get included on the wall of fame - say no more...

4) When you see a kid new patient there is a reduced factor because they can see so many other kids smiling and being adjusted in the photos (make sure you take lots of photos with you adjusting, laughing, and interacting with the kids - but no photos that show images of the kids in twisted positions).

5) Dedicating a room or area to kids shows that you are family and child-centred - if your practice looks like a kid has never stepped inside - then they probably won't?

Your Philosophy May Be Vitalistic, But Is Your Art?

Your Philosophy May Be Vitalistic, But Is Your Art Mechanistic?

What is Vitalism?

1) Theory that life originates due to a force distinct from chemical and other physical forces. The classical 18th century vitalist doctrines propose that all life phenomena are animated by immaterial life spirits. These life spirits are unexplainable and undescribable from a physical point of view, but determine the various life phenomena.

2) Where vitalism explicitly invokes a vital principle, that element is often referred to as the "vital spark," "energy" or "élan vital," which some equate with the "soul." Vitalism has a long history in medical philosophies: most traditional healing practices posited that disease was the result of some imbalance in the vital energies which distinguish living from non-living matter.

3) Was once a term of Aristotle pertaining to a cosmic force known as "ether" that was supposedly giving life to dead things.

Chiropractic has a vitalistic philosophy in the sense that we claim we all have an innate intelligence which gives our human bodies their healing potential - the ability to intelligently regenerate. To take this one step further, it was proposed by our pioneers that this information is transmitted through the body via the "Mental Impulse". This is a separate and distinct concept to that of action potentials and electrical currents...

D.D. Palmer: "Chiropractors do not treat diseases, they adjust the wrong which creates disease; they have discovered the simple fact that the human body is a sensitive piece of machinery, run throughout all its parts by mental impulse." (1910)

Stephenson: "We might conceive of this mental impulse as being composed of certain kinds of physical energies, in proper proportions, which will balance other such forces in the Tissue Cell; as electricity, valency, magnetism, cohesion, etc., etc.. Perhaps some of these energies are not known to us in physics. What right have we to assume that we have found them all? The writer presents this as a hypothesis or theory in order to get a working basis... It is no discredit to Chiropractic that it must also use theories concerning the transmission of mental forces." (1927)

So, here's the challenge - how does this affect the way we adjust each and very patient? Is our application, or the "Art" of doing what we do, a reflection and outpouring of this vitalistic philosophy? Let's contrast the above definitions of vitalism with those of mechanism...

Mechanism:

1) Machine part: A machine or part of a machine that performs a specific task.

2) Something like machine: Something that resembles a machine in having a structure of interrelated parts that function together the fragile mechanism of the planet's ecology.

3) Method or means: A method or means of doing something.

4) Philosophy philosophical theory: The philosophical theory that all natural phenomena, including human behavior, can be explained by physical causes and processes.

To be perfectly honest - this sounds more like the practice of chiropractic as it is practised in most chiropractors' rooms.

Now here's the challenge: If we have a vitalistic philosophy, but this has no application in what we do - then what's the point of having this philosophy? After all - isn't the purpose of a philosophy to provide an internal compass, via which we make decisions about what we think and believe, and hence how we behave?

This leaves us with two options...

1) Jettison our traditional philosophy and replace it with one that sounds more like the mechanistic methods - so that our Art follows on from our philosophy - that is - change our philospophy to match our behaviour.

2) Upgrade our behaviours so that they align with our core vitalistic philosophy.

Torque Release Technique provides chiropractors with a much more vitalistic model of applying their philosophy on each and every patient. And here's what most practitioners find when they make this upgrade - they see more vitalistic changes in their practice members: Over and above the garden variety mechanistic changes - That is - they see MORE LIFE returning into the faces, minds and bodies of their patients.

Are You Relieving Your Patients' Emotional Pains And Strains?

Are You Relieving Your Patients' Emotional Pains And Strains?

Whether or not we all agree on the theory that Subluxation is the cause of ALL illness - most DCs agree that there are three primary causes of Subluxation - Physical, Chemical and Mental.

At our TRT programs I ask the participants to rank these factors, and we always get 100% agreement - Emotional factors are by far the most common cause of Subluxation. So how does this revelation impact your every day clinical conversation and your adjusting procedures? Let me put this another way - what system/s do you have in place in your practice to identify and correct the emotional component which is causing most of your practice members, the majority of their problems?

What happens in your practice when someone is responding slower than you would expect, they keep exacerbating their condition, or you keep identifying the same recurring subluxations?
Here's what it sounds like in most chiropractic offices: "Well Fred, what did you do on the weekend - did you do any gardening or lifting? Tell me about your office chair at work. How many hours do you spend in front of the computer? Are you doing some exercises? What position do you sleep in? Tell me more about that car accident you had 55 years ago."

Notice something missing? Where were the questions to identify the emotional cause, let alone the second most common cause of subluxation - chemical? Physical, physical, physical...

Do you want to be a wellness chiropractor and not a back doctor? Then you need to connect with your practice members on an emotional level. This has got nothing to do with counseling or psychology, and it's definitely not about finding new referrals for the Beyond Blue program. But it is about providing your customers with a more holistic service...
Next time you find yourself in the above scenario, stop yourself before you blow the opportunity for a learning moment, and try this instead...

"So Fred, why do you think that your body is having trouble getting better as fast as YOU would like?" Fred's usual answer will be "well I d'know, your the doctor?"

"Have I told you that there are actually three causes of subluxation? There's the obvious one, the physical stuff that happens to you and that you do to yourself. Then there's chemical stuff; you know, all the toxic stuff that we eat and drink, and all the poisons that exist around us in our homes and in the environment, like allergies. Then the one you might not have thought of before, is the mind - this is actually the most common and the most severe cause of subluxation. Fred, can you think of any mental or emotional stuff in your life that might be creating stress inside your body?" Now don't drop the ball, stay silent until Fred comes up with some ideas... Then adjust him as per usual.

Like I said, this doesn't have to lead to a psychotherapy or hypnotherapy program; just the therapeutic power of the identification and connection of HIS emotional stuff with his subluxation will astound you....

PROVE IT!

Gill and I have just gone through a major change in our practice and personal lives. After 18 years of owning and practising in the one location, we have handed over ownership to another chiropractor. So it feels like an appropriate time to reflect and to share some experiences, and some insight into the challenges and potential of our great profession.

It was an emotionally charged time as we started to tell our patients and practice members that we were going to be moving on and that we were going to be handing over their care to a new chiropractor. And there were three groups whose reactions really impacted me: The first group was those old faithful regular clients who had been seeing me for 15 to 18 years. Some reminded me that they had seen me in my first weeks of practice. A couple of people even reminded me that they'd seen me in the first days of my practice. And they reminded me how young and “green” I was; and many thanked me for how much I had grown up and evolved in that time.

Now, this raises an interesting question: why would someone see a chiropractor consistently, and regularly over a period of 18 years? I can guarantee you that it wasn't because I signed them up with an 18 year prepayment plan. But instead, they must have some conscious value for the benefits that they receive from their adjustments. And they have enormous experience in terms of how chiropractic has helped them – beyond the relief of an acute low back episode

The second group that probably affected me the most was a group of 18 to 22-year-old’s, who when I told them that I was going to be moving on, and that they were about to be under the care of another chiropractor; they looked at me with sorrow and surprise and even disappointment. And most of them said to me, “what am I supposed to do, you have been my only chiropractor for my entire life. You have kept me healthy for all these years?” - Many of them since birth. And it reminded me of how much children intuitively love chiropractic care when they have a good experience. You don't need to educate or intellectually explain the benefits of chiropractic to a child who experiences them. It's like a seven-year-old boy said to me once, “I love getting adjusted, you recharge my batteries”.

The third group that probably surprised me a little was a significant group of people who'd only been seeing me for weeks, perhaps months, maybe a year or two: In the bigger scheme of an eighteen year old practice, not a long time. But they too were shocked and disappointed that I was going to be moving on. I guess every chiropractor has patients like this: People who'd been to every other doctor and had all sorts of medical tests and been to other alternative practitioners. And then they stumbled upon you and the healing magic started to occur. And I realised that this group associated their healing with ME and perhaps not so much CHIROPRACTIC. They also place an enormous amount of value on our adjustments. The next part of their journey, being under a new chiropractor, will be to discover that their healing comes from chiropractic, not from Nick Hodgson.

So here is the big question: Do you underestimate the value of the benefits from YOUR chiropractic to the health and wellbeing of your patients and your community? Are you aware of the changes that are happening in the lives of your practice members?

I know there was a time in my practice life where I underestimated the value of what I did. And I remember sitting in a packed theatre at a Dynamic Growth Congress on the Gold Coast, on a Friday night. And one particular speaker was sharing a case story of someone that he cared for over a long period of time. This patient was in a wheelchair as a result of previous injuries, and as the story unfolded, we saw photos of this guy, looking sickly and drawn, in his wheelchair; through to a time when he was no longer in his chair; and then he was holding a newborn baby; his own son in his arms: Both events that should not have happened – but for a chiropractic miracle. And I can remember sitting in my chair, feeling really tense, and then I broke into a cold sweat, and then tears started to well up in my eyes. And later that night, I was tossing and turning in bed, trying to get sleep, and I realised that there was a deep burning question building up inside of me; and it sounded something like this: “Nick, where are your miracles, where are the miracles in your practice?”

Now you might be thinking that when I got back to practice on Monday morning, that there was a guy in a wheelchair, or a deaf or a blind person, waiting to see me, who had a miraculous healing after I adjusted them, and that from that day on I produced miracles of my own. No, my outcomes didn’t change: But instead what happened was my awareness changed. And over the next few weeks and months I started to notice changes and miracles that had already been occurring in my own patients – I just had never taken the time to notice. And as a result I developed a deeper appreciation for the changes that occur as a result of my adjustments. So, let me ask you again: Do you underestimate the value of YOUR chiropractic care?

How do you start to identify and become more aware of the changes that are happening in your practice? In the past, the main way we used to help ourselves to become aware of our miracles was through the patient testimonial. When we had a patient who had a dramatic response to our treatment, we would get them to write a short story about their experiences. And after a while we would have a collection of a range of these testimonials. But what about all the other patients in your practice? How do you know what changes they are experiencing under your healing hands?

Now is one of the best times to be a chiropractor, because we have so many fantastic tools and technologies to measure and demonstrate what happens as a result of an adjustment: We can use health questionnaires to record someone's state, at any given time. Anything from a neck disability, or low back pain questionnaire; through to specific health problem questionnaires, like asthma or ADHD or any named illness for which I guarantee you can find the questionnaire that matches the ailment; through to health and wellness, and quality of life questionnaires.

And there are also numerous functional assessment technologies, which can measure almost any aspect of your patient’s physiology. From taking digital photographs, and then using software to analyse their postural alignment; Or digital radiographs, where we can store the images on our computer and draw angles and measurements and calculations to be compared later; Through to surface EMG, paraspinal thermography, and pain algometry, and flexibility inclinometry; and now even heart rate variability, brain EEG, skin conductivity, and bio feedback assessments: You name the thing you want to measure, and the technology probably exists to demonstrate the changes.

So what are the benefits to the average chiropractor of utilising these technologies? The first and most obvious reason is that it helps to identify the miracles that you might otherwise miss. Often people don't tell you about some of the less predictable changes that have happened in their lives until you see the changes in their physiology, and then they'll say, “oh so that's why I'm sleeping better, or playing better golf, or feeling happier?” And like me you've probably noticed that sometimes people have short memories. Those people who, when you first met them were in a terrible state, and were struggling to do even daily activities. And after a period of being under your care life is now going pretty well. But then, they say to you, “why do I need to keep coming? I'm not sure whether I'm getting any value out of my adjustments?” And you think “what are you talking about, don't you remember how bad you were? Can't you see how much you have improved?” So the benefits of using outcome tools is that you have a “snapshot” in time of what they were like back then, and you can show them and remind them as to how far they have come, and how much value they do receive from chiropractic.

So which tools should you be using in your practice? Here's a really big question that you need to be asking yourself: What do you claim to change? What changes do you expect to see in your patients when you adjust them? A useful bit of homework to do is to take a blank sheet of paper and down one side list what are the major changes that you focus on that indicate that your chiropractic is working? And come up with a short-list of what are the most important functional improvements that you expect. Is it an improvement in posture, a change in a cervical curve angle, a reduction of muscle tension, improved flexibility, less pain and daily dysfunction, or an increased state of well-being and quality of life? Then, next to each of those listed changes, you need to identify the tool that you can use to prove that you change what you claim to change.

I've noticed that this can be really, really challenging for many chiropractors. And there seems to be only two possible reasons why a chiropractor would resist utilising these tools: The first is that they perceive these technologies as being expensive or time-consuming: In fact most technologies are now more than affordable and cost effective than ever before, and can usually more than pay for themselves via the extra revenue they generate: Some can be delegated to staff members who are usually more than enthusiastic to get more involved in the clinical and healing process.

And the second “excuse” appears to be a degree of fear of exposure. “What if I don't change what I claim to change?” And I guess that are only two possibilities to this scenario: either chiropractic doesn't work or YOUR chiropractic doesn't work! But this perception is best resolved by putting the outcome tools to work – You either discover that your chiropractic is working; it’s not working as well as you would like (in which case you can modify your management plans and procedures); or it isn’t working (in which case you will need to discover a way that does work): Any of these three possibilities leads to improved quality in your products and service to your community – a win-win situation for everyone.

It is now the 21st century, and if you are practising in the same manner as you were in the 1990s, then you are not a 21st century chiropractor. Assessment and treatment technologies have evolved greatly in the last decade, including the chiropractic adjustment – there are new ways of adjusting which are gentler and faster, which work as well as, and perhaps even better than the “old” stuff. And there is no doubt that the chiropractic profession needs to redesign its packaging IF it wants to be seen as the leaders of the wellness revolution, as opposed to just another provider of drug-free back treatment.

What will happen if our profession doesn’t embrace the technologies and opportunities of the 21st century? There’s a saying, “put up or shut up”: Show your evidence and be listened to and respected, or stay silent and have your ways of life dictated to by others. I know there was a period in my practice life when I was waiting for the definitive study that proved that chiropractic did what I thought it did – improved state of wellbeing, maximized health and optimised human performance. And that once this paper was published in a legitimate scientific journal, the rest of the world would sit up and listen to us. It’s been eighteen years, and I am still waiting! And the profession is 112 years old, and we are all still waiting. That’s not to say that
there haven’t been some good papers – but the “breakthrough” has not occurred.

Here’s what I have discovered to be a fact: The evidence that chiropractic works exists inside the four walls of each and every chiropractor’s office – they are just not using the tools to prove it – they are waiting silently for someone else to present the evidence – maybe someone really famous and trendy who will receive a chiropractic miracle and do a testimonial on national TV, and then everyone will want to get adjusted??

Imagine if every DC used outcome tools in their practice, and that as a result they had enough evidence in their practice to publish just one case study in their career: That would mean that the Australian chiropractic profession would contribute 2,500 case studies to the evidence base. And the US contingent could produce tens of thousands of case studies. Case studies are a legitimate means of scientific endeavour, and the registration boards can’t silence you from sharing this information with the world.

But here’s what happens if you stay silent, and have no evidence to “put up” – third parties start to dictate to you the terms and conditions of your practice life... When the chiropractic profession shuts up, we wake up one morning and discover that our patients cannot share their success stories with the outside world; we wake up and discover we can no longer use the title Dr. What wake-up call will it take to make you put up your proof? Waking up to discover that it is now illegal for you to care for children; waking up to discover that you can no longer adjust necks because some other profession thinks it’s not safe; that you must discharge your practice members once their symptoms subside; or that if their symptoms haven’t subsided after four weeks that you must refer them to another profession anyway?

Maybe we shut up because we lack certainty? THE BEST solution to a lack of certainty is EVIDENCE: Evidence that what you do makes a difference in the world – and the most convincing way to collect the evidence is through the use of relevant outcome tools to measure what it is that you claim to change. You see, nowadays I have complete certainty that MY chiropractic works exactly as I thought it did; it improves state of wellbeing, maximizes health and optimises human performance – I know this because I have used the tools to measure what I claim to change, and they change!

Please join me in the 21st century…

THE ADJUSTMENT SECRET FORMULA

What are the secret ingredients which define a chiropractic adjustment? What are the features that separate an adjustment from other therapeutic modalities? What are the factors that differentiate a good adjustment from a bad adjustment?

Most definitions of “Adjustment” are very mechanistic in nature: “Moving the joints of the spine beyond a person's usual physiological range of motion using a fast low-amplitude thrust”; “low-amplitude, high-velocity thrusts in which vertebrae are carried beyond the normal physiological range of movement without exceeding the boundaries of anatomic integrity”. The glaring pitfalls of such predominant definitions are that not all chiropractic adjustments carry the joints into their para-physiological range: Does this mean that SOT Blocks are not an adjustment, and that all instrument-based adjusting protocols are not chiropractic?

Perhaps it is time that we re-define the core components that describe a chiropractic adjustment?

Early chiropractic concepts spoke of universal and innate intelligence, the mental impulse, and proposed that a chiropractic adjustment doesn’t correct anything, but innate utilises the forces transmitted to the body following an adjustment to correct itself: In other words, the body is intelligent, but sometimes needs information from an external source to be able to make better perceptions, decisions and choices.

So, an adjustment is not so much an imposition of our will upon another person’s physiology; as it is the delivery of a new and enlightening piece of information which attempts to facilitate neurological change.

Torque Release Technique defines an Adjustment as “communication through touch”. What are the fundamental factors of this healing touch?

Perhaps we could define these in a physics-like formula…

A = F × CV × I2

In long-hand this translates to: Adjustment equals Force times Correctional Vector times Intent (squared).

Let’s explore this formula in greater detail:

The times signs indicate that each factor has a more significant impact on the other and on the total result than if instead the addition symbol was present; and that if all factors are present the resulting answer will be huge:

For example, in mathematical terms if each factor = 10, then A = 10 × 10 × 100 = 10,000

If the symbols had been additive the answer would be A = 10 + 10 + 100 = 120

If you minimise one of the factors then the answer is minimized:

To alter the above example slightly, if F = 1, then A = 1 × 10 × 100 = 1,000

The square symbol shows the “I” factor has the potential for greater impact: If this factor is small then the formula will not change much. Increase this factor and its impact becomes greater and greater at an exponential rate:

For example if we alter our original formula so that I = 1, then A = 10 × 10 × 1 = 100

Whereas if I = 100, then A = 10 × 10 × 10,000 = 1,000,000!!

Now let’s define the factors in more detail:

Force = Mass × Acceleration:

This is an old Newtonian formula. Every adjustment has force – an adjustment with no force at all is just a good intention. To increase force we either increase the mass or the acceleration, and if you increase both then the force greatly increases. In terms of a chiropractic adjustment, any experienced chiropractor knows the importance of speed over mass: The quicker you are the less the mass you have to use, and the more easily an adjustment is accepted. I guarantee that an adjustment will appear “heavy-handed” to a client due to excessive mass, and not due to excessive speed

Correctional Vector = Contact Point + Three-Dimensional Vector:

The force of an adjustment must have a point of contact and a direction: Specificity is what separates chiropractic adjustment from so many other therapeutic modalities, and without correctional vector I doubt that chiropractic would have attained separate and distinct status. Firstly we are more discerning in where we place our hands; for example, we don’t just stretch the lumbar spine, we adjust an L5.

Also integral in most chiropractic adjustment protocols is the direction in which we apply our force: Our predominant “listing” systems incorporate three letters to define the direction and combination of vectors in three dimensions, which we utilised in our adjustment. And we may even add a fourth letter to further define our contact point… For example: C2 PLI-S – we contacted C2 and our vector was in a direction to reduce the left and inferior vectors of the subluxation, and we used the spinous process as the contact point.

Intent = Become One + Visualisation + See Whole

R.W. Stephenson described the essential components of intent. Intent could be simply explained as what we are thinking about as we deliver an adjustment. But it can also mean much more than this as it may include our own emotional, physiological and even spiritual states.

“Become One” encompasses an almost spiritual connection that occurs when we as a practitioner enter into another’s “energy” or “intelligence” field. The insinuation is that when we come so close there is an influence between the two fields of intelligence. This has ramifications at a diagnostic level in the sense that we can potentially gather much deeper levels of information if we are perceptive to the other person’s “field”; and at a therapeutic level we potentially enter into a deep level for the transaction of information taking place.

“Visualisation” defines the need to see what we are doing: Can we imagine the structures and tissues that we are examining; can we envisage the impact that our testing and corrective vectors are having on the person’s physiology; can we see the effects of our adjustment before they actually occur?

“See whole” describes our intent: Wholeness. After our practice member is adjusted their mind/body is able to better perceive itself, the communications between mind and body are restored, and their physiology becomes more efficient and effective. Do you expect this? Do you actually SEE this occurring in your mind’s eye?

What separates an adjustment from other therapeutic modalities? The size of each factor illustrates its relative importance in the formula:

Massage = f ( m × a ) × CV × I2

Therapeutic massage is separated from relaxation massage by how deep the practitioner penetrates; that is by how much mass they use: Mass is probably the most dominant vector in the therapeutic formula. Acceleration is extremely small as most massage involves slow strokes. The vectors are usually unfocussed and very mixed, sometimes the more directions you sweep across a muscle the better. Intent is somewhat diminished due to poor visualization (most masseurs have inferior anatomical and physiological knowledge) but will have a high degree of connection and a desire to see whole.

Manipulation = f ( m × a ) × CV × I2

Manipulation is usually a mechanistic attempt to produce separation and preferably cavitation of joint surfaces: The Mass is increased and Acceleration is relatively high to achieve this end. Correctional vectors are minimised usually only involving two dimensions and are not seen as so important many times both directions/sides being manipulated to maximise the stretch effect. The intent is small, the need to become one being irrelevant, visualization being for the purpose of finding the structure to be manipulated and the outcome seen being no bigger than to cavitate a joint or to increase flexibility.

Acupuncture = f ( m × a ) × CV × I2

An acupuncture needle delivers minimal mass with no acceleration, so force is almost absent. The correctional vectors are so important, much care being taken in the location of the needles and in the precision of their insertion. The contact points are very different to a chiropractic adjustment relying on a totally different bodily system. The vitalistic intent of the acupuncturist must be considered equal to that of the principled chiropractor as they too expect great things from their therapeutic modality and it could even be argued that they are bolder in their therapeutic claims.

What differentiates a great adjustment from a bad adjustment? The adjustment with “that something extra” requires a precise combination of the secret ingredients…

Great Adjustment = f ( m × a ) × CV × I2

Bad Adjustment = f ( m × a ) × CV × I2

Keys to the adjustment with “that something extra”…

• Maximise acceleration and minimise Mass.
  
• Utilise a precise system to determine the most effective combination of contact point and correctional vectors.
  
• Maximise Intent by respecting and perceiving the connection between you and your practice member, visualizing every aspect of your analysis and correction, and having a clear picture of the intended outcomes.

CHIROPRACTIC EVOLUTION

Through the mid-nineties pivotal chiropractic research was conducted and was published at the beginning of the 21st Century, and yet a large segment of the profession missed it! Why?
1) The findings weren’t published in a peer-reviewed chiropractic journal – they were actually published in two major psychiatric journals; the Journal of Molecular Psychiatry (published by Nature) and the Journal of Psychoactive Drugs: No chiropractor would have received these journals in their post-box.
2) The research involved a patient population commonly ignored by comfortable middle-class chiropractors, namely an addicted population. But this study population was chosen for very specific scientific reasons – they biogenetically possess an inability to achieve a state of wellbeing.
Why was this research potentially so paradigm shifting for the chiropractic profession?
1) The design of the study was overseen by a leading medical biostatistician from the University of Miami, School of Medicine: Nothing was included in the study unless it stood up to his rigorous statistical and evidence-based standards.
2) The study involved randomization, and all of the scientific design expected of longitudinal clinical research, and, three-arms – not just active treatment and control groups, but also a placebo-control group.
3) The acceptance and rejection of various chiropractic examination procedures which lead to a short-list of evidence-based indicators of Subluxation, ultimately synthesizing a technique for analyzing and differentially diagnosing a Primary Subluxation.
4) The need to design an adjusting instrument that provided true reproducibility of the adjustive thrust and the vectors of the classic chiropractic adjustment – the Toggle Recoil.
5) Acceptance of the research results by peer review panels far more rigorous and skeptical than normal chiropractic peer review.
6) A documentary featured on Discovery Health Channel highlighting the findings of the research and giving chiropractic a glowing review.
What was so impressive about the results? To understand this we need to tell you a little about the clients accepted into the trial: These were recovering addicts with many substance-abusing habits, who were undergoing normal 30-day withdrawal in an in-patient facility… Nasty stuff: Major withdrawals, cravings, severe physical and mental symptoms, abstinence-based challenges… all going on at the same time. What happened when they received specific chiropractic adjustments?
1) They finished the program: The gold-standard of recovery is how many clients make it to the end of the thirty days? Good rehab facilities achieve somewhere around 70% retention. When they were adjusted as well, the retention rate increased to 100%... That’s right no-one left! In recovery circles it is common knowledge that if someone drops out of care it isn’t because they’ve started a new job, or had a miraculous healing and didn’t need to hang around. No, they’ll usually be back in their old haunts doing the same old stuff. This finding is huge – if they stayed they must have been doing really well.
2) Their anxiety levels dropped dramatically: This research project didn’t just measure one outcome, it also utilized internationally accepted state of wellbeing questionnaires: When the clients were adjusted the Spielberger’s State of Anxiety Test scores dropped the same amount that it normally takes six months of standard care to achieve.
3) Their depression levels dropped markedly. When the clients were adjusted the Beck’s depression inventory scores dropped the same amount that it normally takes twelve months of standard care to achieve.
4) They didn’t need the usual nursing and first-aid measures demanded by this population. Nursing station visits are actually the biggest overheads in running a rehab facility: When the clients were adjusted only 9% needed to make any nursing station visits – the placebo and normal care groups made visits in 56% and 48% of cases respectively (that’s right the placebo group was more miserable than the normal care group – so much for the argument that chiropractic is a good placebo – this suggest it’s actually a “nocebo”!)
Now wait a minute I hear many of you saying – “I have no interest in treating drug addicts in my practice, so why would I want to learn a technique to treat them?”
Here is the point… the CHIROPRACTIC IN THIS STUDY DID NOT TREAT ADDICTION, IT ADJUSTED SUBLUXATIONS. The in-patient program treated the addiction with the normal abstinence strategies, group therapy, counseling etc. The chiropractic produced massive increases in state of wellbeing, helping the recovery to be more effective. You need to learn how to produce such massive increases in state of wellbeing to, in all of your practice members…
Isn’t this what great chiropractic is about? We don’t fix them, but when we adjust them their body’s healing and recuperative processes are exponentially released to fulfill their true potential – great chiropractic that is…
So why would you learn Torque Release Technique the chiropractic model that evolved through this scientific process?
1) Wouldn’t you love your client retention to reach record proportions? There’s only one thing that really increases retention – RESULTS. You might be a great salesperson and be able to coerce people into hanging around, but when they FEEL the benefits they don’t need any convincing.
2) No-one refers like an excited customer: Do you think that massive changes in emotional and mental status would excite your clients? When their back pain’s gone they quickly forget why they are coming to see you: But when the lights get turned on every adjustment, you’ll be impressed when they start to ask if it is alright for them to regularly come back for more, and and can they bring someone else with them?
3) If we are truly a wellness profession, then our clients’ dependence on symptomatic and crisis care should start to vanish. How thankful do you think your clients will be when they notice how they aren’t spending so much on panadol, panadeine and nurofen, and they no longer have to spend ages sitting in the MD’s waiting room with all those miserably infectious people? How much easier will your practice hours be when no-one is winging and whining about their latest ache?
4) Wouldn’t you like to get to the end of the day after having seen more clients than ever before, and not be emotionally and physically spent? With TRT you can speed up your decision making, reduce the number of adjustments per visit, and minimise all the extra stuff you do trying to hit the right spot.
5) So you can be sure you are using the most evidence-based technique ever available to the chiropractic profession. Make sure you have total proficiency in the procedures accepted by one of medicine’s top biostatisticians – discover if you’re wasting your time doing stuff that was rejected?
6) So you can access the Integrator Adjusting Instrument, the only instrument with pre-loading, recoil, torque, stunningly high speed (1/10,000 sec), low force, and neurologically-based impulse frequency.
7) To be trained in the technique that provides you with the vitalistic, tonal, non-linear, neurologically-based adjusting technique to go hand-in-hand with your vitalistic chiropractic philosophy – Leave behind the mechanistic methods that have held back chiropractic practice in the twentieth century.

FLAWS OF A MANUAL CHIROPRACTIC ADJUSTMENT

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…