QUANTUM CHIROPRACTIC

Chiropractic has been around since the late 19th century and its founding principles really haven’t changed much since the early part of the 20th century – in fact one might argue that chiropractic philosophy has devolved from some of the dizzy heights reached by some of the early chiropractic authors.

The science of Physics was going through a quantum shift during this same era, evolving from Newtonian Physics to what is now commonly called Quantum Physics. In chiropractic we often talk about paradigm shifts and this is often in the context of everyone else needing to have one in order to catch up to our principles of health and illness.But maybe we too need a paradigm shift?

Let’s take a look at the shift that occurred in Physics as a metaphor or simile to the paradigm shift that the chiropractic profession needs to make if it is to climb up to its perceived position of superiority on the wellness ladder.

Newtonian Physics was man’s logical attempts to make the universe fit into his objective and mechanistic model of how the world works: Based on the observation that big complex things are made up of lots of little simple things that combine numerically to produce basically a big machine with small moving parts. And as this domineering science invented lots of really cool machines based on this principle, and as they discovered smaller and smaller components that appeared to follow the same principles, the belief system was self-justified.

Within this model matter was made up of particles which behaved in predictable ways, while energy was seen as a separate and distinct component of nature, and this consisted of wave forms: Substances whether organic or inorganic are composed of atoms which are themselves made from smaller particles of electrons, protons and neutrons; while energy forms like light and sound are produced by different spectrums for vibratory frequencies.

But there came a point along the Newtonian quest to find the smallest particle and to better understand more about how these particles behave where this separation started to dissolve. As Physicists studied the behaviour of electrons in different environments they found that sometimes electrons behaved like particles and sometimes they behaved like energy!

This lead to enormous friction within the scientific community and pushed supposedly intelligent men to the point of irrational argument, name calling and sledging. Till finally one man, a school dropout came up with a formula that made sense of it all: E = MC2. That man was Einstein and while the understanding and the application of this seemingly simple formula has progressed with succeeding physicists, they themselves cite this “shift” as the pivotal breakthrough.

Most people can quote the E = MC2 formula as belonging to that cute and cheeky looking silver haired king of the geeks. Many can even translate it as energy equals mass multiplied by the speed of light squared. But let’s take a closer look at what this really means? Let’s forget the constant in the formula for a moment – take out the C2 and you are left with E = M! That’s the breakthrough people – energy and matter are actually different manifestations of the same thing. In other words matter is just stored energy, and energy is matter in its higher forms of existence.

We can see this transition in its simpler forms when we do our most basic high school chemistry experiments of heating ice, which becomes water, which becomes steam – they are all still water, but at different states of their energetic existence. But E = MC2 is a much bigger picture than this.

Many modern physicists are still more comfortable referring to matter and energy as almost distinct phenomena, and take solace in the fact that it takes the speed of light squared to make the change between being in a matter state versus being in an energetic state. The speed of light is basically the biggest number scientists can think of, so they argue the formula is saying that it takes something huge to shift energy into becoming matter.

Einstein actually originally proposed the formula as M = E/C2 – that matter was really just another form of energy. And this is what quantum physics is really all about – that matter is really just what we observe when energy is being pooled or stored – but it is really still just energy!

So this is where quantum physics and chiropractic could meet – if chiropractic is ready to make the same paradigm shift. I believe that some of the earlier chiropractic philosophers made this shift at about the same time as the physicists did. But unlike the Physics profession that got to the point of accepting the new idea, the chiropractic profession successfully suppressed and circumvented the shift.

RW Stephenson authored the 33 principles in 1927, and this could perhaps be the analogous shift in understanding the human state as E = MC2. Stephenson talks of the three components of our formula as force, matter and intelligence: This is the chiropractic equivalent of E = MC2! Force equals energy, matter equals mass, and intelligence is the hugest constant that we can possibly think of. Maybe our formula could read as F = MI2.

So why am I saying that the chiropractic profession missed this shift? Firstly the self-proclaimed intelligentsia and political leadership have quite successfully removed the constant from the formula. It has been successfully argued that intelligence is not required to practice chiropractic! And what I really mean by this is that concepts such as innate intelligence and the mental impulse have been denigrated as being pseudo-religious nonsense. When in fact intelligence is the missing piece that makes matter possible!

Secondly chiropractic has been successfully reduced to matter therapy – bones, muscles, ligaments, alignment and manipulation. It is becoming rare to see any reference to the nervous system when reading articles written by chiropractic publishers – but the nervous system connection is the connection between our matter and our force – our energy. And this capability is the ultimate representation of intelligence.

Hence, the current chiropractic formula looks more like “M = M”…

I was listening to one quantum physicist speak and he made the statement that the only place we really see Quantum Physics at work is in space. And then I had the revelation that he was SO WRONG. You see, most living biological organisms are classic examples of quantum converters. And the human being is the best example of a system that is able to use intelligence to continuously convert matter to energy, and energy to matter!

Now let’s get back to the paradigm shift that could happen, which would position chiropractic as the quantum shift in the healing arts: If matter is energy in a different state, then a subluxation is a person’s matter in a different energetic state. In other words a subluxation is not a physical state, it is an energetic state – it has less to do with what the particles of the body are up to, and more to do with what the wave forms of the body are up to.

Wave forms in the human body are represented by frequencies, so a Subluxation could be defined as an abnormal frequency pattern. There appears to be a movement in the chiropractic profession that dislikes the term subluxation because of its medical definition – “less than a dislocation”, which has obvious shortcomings as a clinical description, and at the same time they dislike what they see as almost esoteric connotations of the word to Chiropractors. The problem that results though – is that the offered alternative terms are almost universally less encompassing and in the context of this discussion grossly inadequate: spinal joint dysfunction, biomechanical lesion, mechanical back pain.

So let’s take a fresh look at the word subluxation:

• Sub = Below; under; beneath; less than completely or normally.
• Lux = A basic unit of illumination
• Ation = The act of; the condition of being; the result of

So why couldn’t we redefine the term Subluxation as something like “the condition of less than normal energy transmission”. If you wish to be more philosophically correct you might adapt this to “less than normal intelligence transmission” (Intelligence being the chiropractic equivalent to light).

If we can grow up enough to jettison the Newtonian model of subluxation description, and accept that Quantum Physics has filled the knowledge void, and that our definitions of chiropractic must evolve to a similar level, then we might even find that chiropractic makes more than a paradigm shift – it could make a quantum leap into the hearts, minds and bodies of the community.

How? If Chiropractic persists with its Newtonian descriptions of what it is about then it will continue to receive a Newtonian response from the public – “spine doctor”, “back cracker”, “bone cruncher”. But if the profession shifts to the quantum model, and effectively communicates this shift, then the connection between what we do and the nervous system is completed, the relationship between an adjustment and someone’s quality of life is restored, and the explanations of how chiropractic relates to issues like emotions, human potential and wellness become logical.

Torque Release Technique training provides you with the Science, Art and Philiosophy of how to make this Quantum Leap: Check it out at this link: http://www.torquerelease.com.au/TRT-Seminar.htm

MAKING EVERY ADJUSTMENT COUNT

I’ve organised a lot of seminars over quite a few years now (my first was in 1996) and as a result I have had the privilege of meeting every “type” of Chiropractor – and I have found that there is one constant trait that exists across all philosophies, techniques, practice management styles and scopes of practice – and that is a strong desire to provide the best possible therapeutic benefit from each and every “treatment”. Ignoring the very small segment of the profession that is more interested in the bottom line, than the spinal column – I know that each one of us hopes for and even expects that when we adjust someone, something good is going to happen for that person.

And that encounter can look quite different between practitioners. For example, it’s Monday morning and the first patient for the day is waiting, eagerly anticipating that they will be feeling “better” after their adjustment: Here are some possible generic scenarios:

1) The Chiropractor goes through their standard procedure of adjusting both sides of the neck, thrusts on a few thoracics, then rolls the patient onto both sides to loosen up the low Back.

2) The Chiropractor checks their notes from the last progress exam to see which segments had been determined to be needing adjustment for the next course of corrections, and then follows that recipe.

3) The Chiropractor palpates down the spine to find tight and tender points then proceeds to manipulate those symptomatic areas to improve the mechanical function of the spinal joints.

4) The Chiropractor uses some form of orthopaedic or neurological examination which can lead them to adjust anywhere between 6 and 12 subluxations on any given visit.

But there are some inherent weaknesses in the above approaches which must be reconciled if our goal is truly to deliver adjustments with that something extra:

1) If we don’t have a method to prioritise where someone really needs to be adjusted then should we call ourselves practitioners or technicians? One root of burnout is boredom: When every spine starts to look the same and when we start to diminish the value of each adjustment, then our sense of importance and passion also diminishes.

2) If we believe that adjustments initiate change, then shouldn’t the adjustments need to change through time? If a person’s spine and nervous system is healing, adapting and even evolving under our care, then why would today’s adjustment be the same as last month’s adjustment? And if someone’s life circumstances have altered since they started care, wouldn’t the pattern of Subluxation change to reflect this, and last week’s adjustment would now be inappropriate?

3) Chiropractors have long made the claim to be treating the cause. But if we treat based on symptoms, whether pain or tenderness, then don’t we make a mockery of this claim? If we claim to be removing interference from the nervous system, then shouldn’t we have some means of determining where that interference is, and how best to reduce that interference?

4) Most chiropractic techniques have talked about concepts such as primary and secondary subluxations, compensations, referral, distant effects from local interference, reflex projection. In other words not all Subluxations are created equal, and not all Subluxations need to be adjusted on every visit, because adjusting the “primary” subluxation will influence and reduce the connected secondary and compensatory malfunction. If we don’t have a method to differentiate between these types of Subluxations then won’t we be wasting some of our precious time?

Now consider a fifth option: On any given day, at the very moment that you are examining a spine, depending on the most recent physical, chemical and emotional stresses to your practice member’s nervous system, and superimposed over the long term accumulation of tension in their spinal system – there is one predominating subluxation, which if adjusted will produce bigger neurological changes than adjusting any other segment in the spine at that time. You would want to know how to differentially diagnose that segment wouldn’t you?

This model has been developed during the research method design for a ground breaking, randomised, placebo controlled, prospective scientific project run in conjunction between Holder Research Institute, Turning Point Addiction Recovery facility, and the University of Miami School of Medicine’s famous Biostatistician Bob Duncan. This technique is today called Torque Release Technique and has been published in major journals such as Molecular Psychiatry, the Journal of Psychoactive Drugs, and Journal of Vertebral Subluxation Research, as well as being featured on the Discovery Health Channel.

Thankfully modern chiropractic can stand on the shoulders of its technique pioneering giants: Palmer, Thompson, DeJarnette, Van Rumpt, Logan, Toftness and more contemporary ground breakers like Epstein; and the development of TRT saw the best of the best being integrated to produce an amazingly streamlined and efficient means of determining which segment of the spine needs to be adjusted, with precise correctional vectors, and to confirm the success of a single adjustment or plot the objective improvement in indicators of subluxation through time.

Another gift from the research project was the Integrator – the first chiropractic instrument to be specifically designed and patented for the correction of Subluxations. What makes the Integrator stand alone is its ability to deliver a three-dimensional correction which includes all of the defining features of a Toggle Recoil adjustment – high speed, recoil, and torque. Plus it offers a feature that takes reproducibility and reliability to new levels – a preloading trigger that means that every adjustment delivers just the right amount of force and frequency.

Because of these breakthroughs TRT developed the reputation for being the twenty first century technique for Chiropractors to shift their practice model away from a mechanical and orthopaedic paradigm, towards a neurological and tonal application of our wonderful vitalistic philosophy.

And the consistent feedback from the hundreds of Chiropractors who have now completed TRT training is that it provides that missing piece in the technique puzzle – how to provide an adjustment which responds to the current physiological needs of the practice members’ nervous system, and how to generate big changes in state of wellbeing on each and every adjustment – physical, chemical and emotional.

2010 sees TRT in its 8th year of training Australian Chiropractors with Dr Nick Hodgson offering training programs in varied locations each year. Nick has organised numerous TRT training programs, has been personally mentored by the developer of TRT, Dr Jay Holder, and is one of Australia’s most experienced practitioners.

Click Here To See Upcoming Dates and Locations…

GROW YOUR PRACTICE IN 3 EASY STEPS

1) More word of mouth referrals

How many times have you been talked around by a slick sales-type offering you the greatest marketing opportunity yet? From Newspaper ads, to calendars and target audience magazines, to bigger and bigger Yellow Pages displays, to online directories with millions of visitors, to radio stations and even TV presenting themselves as the only way to convert prospect to buyers!

Have you worked this out yet? Some of your ads work and some don’t; but when you average the cost of all your campaigns against the return on your investment – you might be better spending your hard earned cash on something more reliable and sustainable.

What about spending some of that money on a practice resource that will consistently and persistently increase the number of word of mouth referrals you receive, AND, is a one-off investment?

Don’t we all know that word of mouth referrals are what have built this great profession? Nothing will grow your practice faster and stronger than a steady stream of new patients who have been recommended by an established patient – it seems to become contagious.

2) Impress your new patients so much that they commit to your recommendations

Do you hear this after you have examined and explained your recommendations to a prospective patient? “Why hasn’t anyone else checked me out this thoroughly before? You are the first person who has been able to explain why I am feeling the way I am! What do I need to do to fix this?”

If on the other hand you hear statements like this after conducting your report of findings: “So is it just muscles?” (they haven’t understood a word you said); “how long do you think it will take for my pain to go away” (you haven’t shifted their consciousness beyond how they are feeling to how they are functioning); “My doctor said it was lumbago” (you aren’t the expert in their mind and they won’t listen to you); “so overall I’m not so bad” (nothing you have done or said has shifted their denial mechanisms).

To make this quantum shift in practice growth in this day and age requires technology that demonstrates clearly, visually and impressively that the person has definite functional problems which need your help to correct (whatever it is that YOU do to help, regardless of how long you think this will take, and no matter how much you charge to do it).

3) Maximise your patient retention

Fred Barge used to ask the pointed question: “Are you the doctor, doctor?” Here’s the plain truth – if you are relying on how your patients are feeling to determine if they continue to see you – you are at the mercy of the retention angels: Some people will feel better, and will still stop coming to see you. Some won’t feel better and will stop coming to see you. Some won’t hang around long enough to even find out if they are feeling better or not. In other words you could be practicing in a leaky boat, and totally dependent on the flow of new patients in, to compensate for the outflow.

There are only three reasons why someone continues to see you, regardless of whether we are talking about for the next few weeks, or for the next several years:

a) They are consciously aware of the benefit/s that they have been receiving from seeing you: Do you have the tools to assist them to be completely aware of the benefits of your care?

b) They perceive that they will receive benefits in the future from continuing to see you: Do you have a tool that can demonstrate room for improvement, and justify them to continue to see you till their next re-exam and beyond?

c) They like you and your staff and will do whatever you say to continue the relationship: This may be enough to plateau a practice but it will never grow a practice.

Posture Pro Digital Postural Analysis Software is a tried, trusted, reliable and proven tool to stimulate referrals, improve conversion and increase retention for the following reasons:

1) Generate an impressive full colour report which people not only look at themselves, but they show it to others, and refer others to have an assessment

2) It is very quick and efficient to conduct an exam: Can even be performed by a trained tech CA

3) Is very visual requiring little translation: People usually can see the problems without any need for explanation – “is that really me – what do I have to do to change that?”

4) Is an objective functional assessment: Posture is an accepted functional outcome by many professions and has a substantial research base which justifies the need for corrective measures – It’s convincing!

5) Can be monitored and compared through time as regularly as you like – you don’t have to wait three months to re-exam if you don’t want to. Posture can be improved quickly and progressively through time, making it both a great short term and long term measure

6) Demonstrates both visually and objectively progress under care acting as a reward for positive response, and as a motivator for continued improvement under your care

7) Is an awesome quality assurance tool – I often get asked, does posture improve under your care? There are two answers to this: “YES”, and, “if it doesn’t then it’s about time you had the tool to direct you to improve your methodologies to improve your outcomes”.

8) When you compare the initial cost to the returns from referrals, compliance and retention this software pays for itself in a couple of months, and then generates consistent increased returns for miniscule ongoing costs (paper and ink for your printer)

9) Can be completely portable making it great for presentations, screenings, expos and external events.

10) Is simple and easy to introduce and implement into any style of practice: Easy to install, email tech support, free upgrades, thorough instruction manual, plus a pile of bonus materials to help get you started or to maximise your results in diverse ways.

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GUIDELINES FOR CLINICAL GUIDELINES?

There seems to be a progressively increasing number of practice guidelines appearing on the horizon for Chiropractors. If enough of these are generated could it get to the point that depending on whom a Chiropractor is dealing with, they will need to behave and practice in a chameleon-like fashion – what’s good for one patient, may be very different to what is good for another – depending on which guideline oversees that person’s situation?

Some of these guidelines appear to be less like best practice guidelines and more like agenda-based guidelines.

Most recently the Chiropractors Registration Board of Victoria has crossed over a boundary not previously entered into, and that is into the arena of clinical practice guidelines (http://www.chiroreg.vic.gov.au/comment.php). This is being justified on the basis that they act to protect the public against unethical chiropractice – but once reviewed against the standard of everyday chiropractic one might ask who will protect the chiropractor from the public and other third parties?

And if many established and widespread chiropractic practices such as X-raying for biomechanical assessment, use of physiological assessments such as surface EMG, adjusting children and newborns, caring for people with non-musculoskeletal conditions, maintenance and even wellness adjustments are guidelined as fringe, questionable and even unacceptable behaviours, then will future chiropractic practice resemble the service that so many chiropractors have offered to their communities for over 100 years?

Most of these guidelines are presented under the umbrella of “evidence-based practice”: Evidence-based clinical practice is defined as “The conscientious, explicit, and judicious use of the current best evidence in making decisions about the care of individual patients... (it) is not restricted to randomized trials and meta-analyses. It involves tracking down the best external evidence with which to answer our clinical questions.” (Sackett DL. Editorial. Evidence Based Medicine. Spine 1998.)

However it appears that some guideline developers twist the definition of “best” – disqualifying research and publication, or evidence, which isn’t the “best” – that is, if it isn’t a randomised, placebo-controlled, longitudinal, multi-centred, independently peer reviewed, published in a journal which the expert panel subscribes to, then it ain’t “best” and therefore it doesn’t exist…

In fact “best evidence” means the best level of evidence that we can find and what it tells us… If we don’t have the gold standard evidence, then do we have silver, bronze and even minor placing evidence to review and interpret? It is no secret that not only is chiropractic not very amenable to controlled study for a plethora of reasons, but the bulk of our evidence exists in the realm of longitudinal outcome studies, case series, and case studies. If this is the “best evidence” what does it tell us – there can be no denying that they tell us that a massive diversity of health complaints present in chiropractors’ offices, and that positive changes seem to happen?

We can’t say that if 100 “Syndrome A” sufferers present to chiropractic offices tomorrow, what percentage of these people will receive some degree of improvement let alone a complete resolution. But based on the evidence wouldn’t it be fair to say that if a “Syndrome A” sufferer presents to your office tomorrow, that it would be rational to initiate a course of treatment with clear goals and terms for review? How does that seem inferior or unacceptable to any other health care profession’s plan of action? Even after the gold standard research measures that 45% of patients receive an average of 35% improvement, what can we guarantee Mrs Jones on Monday morning? A course of care with clear goals and terms for review…

“Well it might mean that they aren’t receiving necessary medical intervention and maybe they have some terminal condition and detection will be delayed by this unproven approach!” Welcome to the life of a health care consumer trying to deal with a “primary care practitioner” – maybe the medications that the MD would prescribe as an “alternative” to our care would be ineffective or even damaging; may mask or delay the identification of other pathology; and maybe it could take months and even years to get a correct diagnosis in the medical system anyway? Sound familiar?

The chiropractic profession is not alone in the struggle to produce relevant and applicable guidelines which guide best practice, as opposed to restricting practice. “The National Health and Medical Research Council (NHMRC – an Australian Government body) has statutory responsibilities to raise the standard of individual and public health throughout Australia and to foster the development of consistent health standards. As part of this role, the NHMRC encourages the development of evidence-based guidelines by expert bodies.” (NHMRC standards and procedures for externally developed guidelines, updated September 2007)

Is a health care profession’s registration board an example of such an “expert body”? A quick read of the profiles of members of the board suggests that there is not much representation of the chiropractic profession’s academic and scientific community. So has the board received significant funding to employ the services of such experts? Who would know – no names or qualifications of any contributors or peer review panel members are listed in any of the guidelines. The guideline which covers the issue of paediatric care is an exception: It gives thanks to a Medical Paediatrician and an American Chiropractor who also holds Medical Degree, who is a self proclaimed “Quackbuster” who deals with healthcare consumer protection, and is therefore about quackery, health fraud, chiropractic, and other forms of so-Called "Alternative" Medicine (“sCAM”): Is this our desired expert body?

“It is now widely recognised that guidelines should be based, where possible, on the systematic identification and synthesis of the best available scientific evidence. The NHMRC requirements for developing clinical practice guidelines are rigorous so as to ensure that this standard is upheld. As such, guidelines with NHMRC approval are recognised in Australia and internationally as representing best practice in health and medical knowledge and practice.”

I’ll leave it to the educated reader to review the current proposed guidelines based on the following information:

Key principles for developing guidelines:

The nine key principles are:

1. The guideline development and evaluation process should focus on outcomes: This statement shouldn’t be glossed over as it seems that some of the worst examples of guidelines are more interested in practice than outcomes.

2. The guidelines should be based on the best available evidence and include a statement concerning the strength of recommendations. Evidence can be graded according to its level, quality, relevance and strength; (Ideally, recommendations would be based on the highest level of evidence. However, it has been acknowledged that the levels of evidence used by the NHMRC for intervention studies are restrictive for guideline developers, especially where the areas of study do not lend themselves to randomised controlled trials. It is proposed that this issue will be addressed when the toolkit publications are reviewed.)

It is tradition when presenting scientific evidence, to cite the source of your evidence. The proposed guidelines of the Registration Board list no references, and request for such evidence is refused on the grounds of “intellectual property”. Does this mean that there is no evidence? Is it only some “expert’s” opinion? Or are there too many pages of citations to fit in the publication? Who would know?

3. The method used to synthesise the available evidence should be the strongest applicable;

4. The process of guideline development should be multidisciplinary and include consumers early in the development process. Involving a range of generalist and specialist clinicians, allied health professionals and experts in methodology and consumers has the potential to improve quality and continuity of care and assists in ensuring that the guidelines will be adopted;

The board’s approach is to implement this step as late as possible, input only being sort after the guidelines have been drafted; and if past guidelines are representative, additional input will only lead to minor amendments at best.

That’s also why it is best to employ a medical paediatrician and an overseas chiropractor to produce a guideline on chiropractic care for children in Victoria. Perhaps the Australian chiropractic paediatric specialists that abound and the university academia that are responsible for the undergraduate paediatric curriculum were out to lunch when the document was written?

5. Guidelines should be flexible and adaptable to varying local conditions;

6. Guidelines should consider resources and should incorporate an economic appraisal, which may assist in choosing between alternative treatments;

7. Guidelines are developed for dissemination and implementation with regard to their target audiences. Their dissemination should ensure that practitioners and consumers become aware of them and use them;

In the case of the guidelines being discussed here you can download them from the web-site – otherwise you can get someone else to download them from the web-site for you.

8. The implementation and impact of the guidelines should be evaluated; and

9. Guidelines should be updated regularly.

I look forward to the dissemination of the steps and process for implementation of steps 3 and 5 to 9 with our newest guidelines – don’t hold your breath.

So, if the Registration Board’s attempt to offer guidelines is severely flawed where can we turn?

Guidelines have been produced which would more likely live up to the standards of the NHRMC. The Council on Chiropractic Practice Clinical Practice Guideline (“CCP”) is currently undergoing its’ second revision. Following publication of the CCP Guidelines the document was submitted to the National Guideline Clearinghouse for consideration for inclusion. The NGC is sponsored by the U.S. Agency for Health Care Research and Quality and is in partnership with the American Medical Association and the American Association of Health Plans.

Its mission is as follows: “The NGC mission is to provide physicians, nurses, and other health professionals, health care providers, health plans, integrated delivery systems, purchasers and others an accessible mechanism for obtaining objective, detailed information on clinical practice guidelines and to further their dissemination, implementation and use.” In other words the US equivalency of the NHRMC.

The AHRQ contracts with ECRI, a nonprofit health services research agency, to perform the technical work for the NGC. ECRI is an international nonprofit health services research agency and a Collaborating Center of the World Health Organization.

In November of 1998, following review by ECRI, the CCP Guidelines were accepted for inclusion within the National Guideline Clearinghouse.

The CCP has developed practice guidelines for vertebral subluxation with the active participation of field doctors, consultants, seminar leaders, and technique experts. In addition, the Council has utilized the services of interdisciplinary experts in the Agency for Health Care Policy and Research (AHCPR), guidelines development, research design, literature review, law, clinical assessment, chiropractic education, and clinical chiropractic.

The Council additionally included consumer representatives at every stage of the process and had individuals participating from several major chiropractic political and research organizations, chiropractic colleges and several other major peer groups. The participants in the guidelines development process undertaken by the CCP and their areas of expertise are clearly disclosed.

The Guidelines offer ratings of practices based on the following system:

Established: Accepted as appropriate for use in chiropractic practice for the indications and applications stated.

Investigational: Further study is warranted. Evidence is equivocal, or insufficient to justify a rating of “established.”

Inappropriate: Insufficient favorable evidence exists to support the use of this procedure in chiropractic practice.

Categories of Evidence underpinning each rating are presented as:

E: Expert opinion based on clinical experience, basic science rationale, and/or individual case studies. Where appropriate, this category includes legal opinions.

L: Literature support in the form of reliability and validity studies, observational studies, “pre-post” studies, and/or multiple case studies. Where appropriate, this category includes case law.

C: Controlled studies including randomized and non-randomized clinical trials of acceptable quality.

To download the full version and updates of the CCP guidelines go to http://www.worldchiropracticalliance.org/

CHIROPRACTIC AND THE BRAIN

The brain is sexy! Let me put this another way – Talk about the brain and how to make it work better, and people sit up and listen.

Let me illustrate this with three examples: I contribute health related articles to a number of online magazines and forums, and I have to tell you that it is hard work finding topics and content that pulls readers. You probably already know this as a Chiropractor – especially if you have run regular “spinal health” workshops, covered your coffee table in health brochures (which gather dust), or grappled with how to get people to line up at your booth at a health expo or shopping centre? On one site that I contribute to my articles usually get just over 100 hits with about ten comments. This disappoints me as I believe the message I share is applicable to everyone searching the net – and when you can log onto YouTube and see some chick in knickers getting millions of hits. But to put this in context, most of the other contributors receive 60-80 hits to their offerings. Recently however I ran a piece on “how do you keep your brain healthy?” I posted this a few weeks ago now and it is still running with close to 800 hits and nearly 50 comments.

I regularly send in article submissions and short health tips to the local media, with the all too common cold shoulder response – “we had too many other news pieces to run this week”, “we didn’t think this would appeal to our readership”, “if you’d like to run a half page ad I’m sure we could get that article included”. Recently I promoted a “healthy brain workshop”, and received a number of “bites” and coverage from the local media with much larger than normal attendances to my workshops.

In May I was privileged to be invited to train a group of Chiropractors in Johannesburg in Torque Release Technique. The organiser had struck up a conversation with a PhD Psychologist who specialises in Brain EEG mapping, and when he had suggested to her that he believed that a chiropractic adjustment changed brain function, she had politely snubbed him based on her scientific experience. When he asked me what to do I suggested that he invite her to our program and ask if she would be wiling to do pre and post exams on the Chiropractors that were adjusted at the end of a long day of training. She happily accepted the challenge. We only had time to do a limited (“statistically insignificant”) number of trials, and afterward when we asked her what she had observed she commented that each participant had experienced a “shift” in their brain function. Most of us being EEG novices we pressed her further to explain this – apparently it usually takes approximately 6 months of neurobiofeedback to achieve this phenomenon – not bad response to the carefully selected delivery of 1-3 primary subluxation adjustments? Her response was to demand that I adjust her before she left – I think her scientific opinion had been shifted.

Some research supports this observation that chiropractic adjustments change brain function (1-3): Hang on a minute – don’t skim over that statement – CHIROPRACTIC ADJUSTMENTS CHANGE BRAIN FUNCTION. Do you own that statement yourself? Do you comprehend the implications to the community IF that statement is correct and consistent?

Let me propose two shifts that may need to occur in our profession for this secret to get out to where it needs to be heard:

1) Our comprehension of the spine as being ligaments, muscle, discs, joints and biomechanics; needs to mature to neurones, neuropeptides, tensegrity, brain holography and quantum physics.

2) Our model of analysis, adjustment and communication needs to shift from a bone/back focus to a nerve/brain focus.

Are you ready to make this shift yourself? Torque Release Technique training provides you with comprehensive training in the Art, Science and Philosophy of adjusting from a more neurological, quantum physics and vitalistic model. The next training program will be held on Saturday/Sunday October 18/19 2008 in Geelong. Check out details at http://www.superhealthy.com.au/

1) New Technique Introduced - EEG Confirms Results: (Jay Holder. ICAC Journal, May 1996.) http://www.torquerelease.com.au/ICAC%20EEG%20Confirms%20Results.pdf

2) The effect of the Chiropractic adjustment on the brain wave pattern as measured by QEEG. A Four Case Study. Summarizing an additional 100 (approximately) cases over a three year period. (Richard Barwell, D.C.; Annette Long, Ph.D; Alvah Byers, Ph.D; and Craig Schisler, B.A., M.A., D.C.) http://www.worldchiropracticalliance.org/tcj/2008/jun/n.htm

3) New Science Behind Chiropractic Care http://www.scoop.co.nz/stories/GE0711/S00116.htm(Altered sensorimotor integration with cervical spine manipulation. Haavik Taylor H and Murphy B. Journal of Manipulative and Physiological Therapeutics. Feb 2008. http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pubmed&dopt=Citation&list_uids=18328937)

NATURAL PERFORMANCE ENHANCEMENT

HEALTH COACHING VERSUS HEALTH CARE

Defining Terms:

Health – A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

Coaching – A method of directing, instructing and training a person or group of people, with the aim to achieve some goal or develop specific skills.

Health care or healthcare – The prevention, treatment, and management of illness and the preservation of mental and physical well-being through the services offered by the medical and allied health professions.

You pick the sport

Unless you were born behind the iron curtain – you probably picked the sport that you most like to play, and that you have spent most of your spare time participating in. There could have been a number of reasons why you chose to start playing a sport, but guaranteed you would only continue to play the sport if you fell in love with it. Similarly, health coaching allows you to pick the game you want to play – weight loss, increased fitness, less allergies, digestive system that works better, greater flexibility, improved concentration, control over a habit or compulsion...

If you did live behind the iron curtain then they would have put you through a bunch of physiology tests and told you what sport you were going to play – based on their expert opinion. This is a bit like modern health care – if you have a health issue that you want help with you will consult an expert who will run a bunch of tests, tell you what they will do to fix it, and you will do as you are told. And it might not be the game you expected to play: You want to run up a flight of stairs, your doctor wants to reduce your blood cholesterol...

You have the aspirations

What is the highest high you want to attain in your sporting life? Under-16 grand final, or the Olympics; Getting to the shops without becoming breathless, or climbing to the peak of Mount Everest; To make daily living more comfortable, or to discover the limits of your human potential?

With health coaching you get the privilege of setting the height of the bar. With health care you will be given the goal – it is called a normal value – Blood pressure, heart rate, breathing capacity, blood cell count, liver function, cholesterol reading, aerobic capacity, sitting reach, Xray reading...

You turn up to training

Training was banned from the original Olympics – it was supposed to be a test of natural ability. Somewhere between then and now, we worked out that you could develop and maximise your innate potential by training and practising. And if you do the right quantity and quality of training – you can transform from a loser to a winner.

Health coaching says “now is the time to start training for a healthy future – to prevent injuries and to enhance your performance in the heat of the big game”. Health care says “get in there, just play, we’ll patch you up if you tear or break something, and then we’ll rehabilitate you back into the shape you were in immediately before the game”.

You do the work

The coach can’t do your training for you, your team mates can’t compensate for your lack of fitness. In health coaching, the coach designs and schedules your program, but at some point you have to follow the program to get the benefits and the rewards. In health care we hope that there is someone out there who can make us feel the way we would like to feel, “is there a pill that can make this go away?” “Can you put my back in for me?” “The doctor said that they will find the cure for this in a few years.” “I’m on the waiting list for some surgery to fix this problem once and for all!”

It’s all fun

Even the most professional athletes need to have fun to keep them in the game. When the joy has gone, the heart has left, and the motivation will quickly wane. With health coaching you get to participate, and you get to express your personality and you can factor in serious amounts of silliness. Health care is a serious business – you should be impressed by the years of training, the amount of technology, and the visible signs of wealth and authority. And please don’t laugh too loud – you might disturb the other patients!

Playing the game is as important as the results

When I was an athlete, I used to enjoy training as much as I did competing. And the moments of sheer joy and reward weren’t standing on some medal dais; they were the actual microseconds of absolute focus, coordination and motion that constituted each component of the performance itself.

Health coaching offers the opportunity to be in the now – and to discover the healing that comes from becoming more conscious and reconnected with your inner self. Health care will be satisfied when you achieve that negative test result, a normal reading, or the ablation of that pain or discomfort without the need for any form of awareness or awakening.

It’s up to you on game day

You’ve done the training, followed the advice, mastered the rules of the game and now you are faced with the ultimate challenge – will you respond or choke? Health coaching prepares you for the challenges of the real world, and assists you to develop the coping mechanisms, visualisations and affirmations that will equip you for the battles of life. Health care sits on the sidelines and waits for you to fail – it will be there to help you pick up the pieces and maybe come back to fight again another day.

You get the credit

What is the name of Tiger Woods’ coach? How about the guy who taught Michael Jordan how to dribble a basketball? Who gets paid more – the best player in the best team – or the fitness coach? In health coaching you are at the centre of attention – when you achieve your goals you will be the one that everyone notices – how good you look, how much stamina you have, how much energy you exude. In health care the good doctor gets the credit – he’s the one who cured your cancer, removed your pain, knew what to do to save your life, told you which pill would do the job.

You get the blame

Coaches might get sacked, but the players are the ones that bear the brunt of the blame. With health coaching you might dismiss the coach if you aren’t happy with the results, but at some point you have to take responsibility for the fact that it is your body, and you are in control – or should be. In health care you are absolved from your personal responsibility – “that doctor didn’t know what he was doing”, “that chiropractor couldn’t get my neck back in”, “the cure was worse than the disease”. This might sound attractive but it excludes you from the benefits of growth and true healing.

You get the medals

The coach doesn’t get to keep your medals, certificates, endorsements, awards – he just gets a photo of him standing next to you holding your rewards. In health coaching we love to stand alongside you and bathe in your glory. In health care there are no awards for the contestants – the practitioner gets the awards and certificates and the guest spot on Oprah Winfrey...

Who won?

Using a sporting metaphor might lead the reader to take on a competitive mindset: “So is health coaching better than health care?” “Should I choose which team I am going to follow and swear to never cross camps?” “If I see a health coach and still get sick does that mean if I’d been smarter and chosen health care – I wouldn’t have got sick – did I pick the wrong team?”

Now let’s take our competitive hats off – A coach who doesn’t want to work with a team of trainers and therapists in a cooperative effort, will have a short resume’. And health care that only responds to illness crises and lacks a bigger picture of prevention and wellbeing is a sick model.

The name “coach” allegedly originates from the multitasking skills associated with controlling the team of a horse-drawn stage-coach. The ability to get two, four or six horses all going in the same direction at the same time and at the same speed is one to be admired. Make sure that your health care relationships integrate a balanced and symbiotic mix of COACHING and CARE…

Who’s your health coach?

© Dr Nick Hodgson www.superhealthy.com.au 2008

MAYBE THOSE PHYSICAL FINDINGS... AREN’T...

THE MIND BODY CONNECTION

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

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

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

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

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

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

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

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

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

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

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

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

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