Tuesday, July 24, 2007

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.

Tuesday, July 3, 2007

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.