Why Logan College of Chiropractic is a GREAT School
I had a patient come in for an evaluation. She was dissatisfied with her current chiropractor, who persuaded her to pay close to $3000 up front for 80 visits, “a year’s worth” of treatment in his office. (That will be discussed in a whole new blog — entitled “Why most people think Chiropractors are Quacks”) As I was examining her, she asked where I went to Chiropractic College, and I replied “Logan, in St. Louis.” She then told me that the other doctor told her that he went to Logan, but it’s a terrible school because it’s “too medical.”
Let me explain this for those of you who aren’t intimately familiar with chiropractic. Some chiropractic colleges teach mostly “chiropractic philosophy,” and teach as little as possible about the human body, disease, and such. They don’t like research because that is too much like the “medical model” of health care. They don’t want to know how to do a full physical exam on a patient, because they don’t diagnose “medical problems,” they only diagnose “vertebral subluxations.” They don’t “treat back pain,” they only adjust the spine, and so on.
Well, the truth is this. Most people who go to a chiropractor have some kind of back pain. And guess what . . . there are MANY different causes of back pain, not just vertebral subluxations.
This week, a patient that I hadn’t seen in awhile came in with a new complaint. She had severe pain in her neck and right arm. I examined her. When I examine a patient, I do neurological, orthopedic, and chiropractic testing. With this patient, I didn’t even get to the chiropractic component of the exam because my neurological tests told me that this patient was dealing with something that I do not treat in my office, and that’s metastatic lung cancer. She had no reflexes in the right upper limb. Skin sensation was decreased in some parts of the limb, and increased in other parts. The slightest pressure placed on the lower neck was very painful. She was holding her right arm against her chest with her left arm because it was very weak. Her health history revealed a 40+ year history of smoking at least a pack per day.
Almost immediately, I could hear Dr. Kettner, Dr. Geubert, Dr. Kuhn, Dr. Bub, Dr. Huber, Dr. Mannello, and others . . . their voices are permanently lodged in my head, reminding me of things to look for, what certain symptoms and signs might point to, other tests that may be applicable in helping to DIAGNOSE THE LESION!! This time I remembered Dr. Kettner and Dr. Geubert talking ad nauseum about Pancoast Syndrome, which is related to a metastatic tumor in the upper part of a lung. That was my diagnosis, and I sent her to the ER for immediate CT scans and bone scan. Sure enough, that was the correct diagnosis, (unfortunately, in this case). In fact, the ER doctor called me — she was impressed that I could diagnose that without ANY imaging, just history and physical exam. The patient called me from her hospital room a day later and thanked me for catching the tumor and sending her to the ER, because it gives her a chance to “get things in order” (unfortunately, the cancer had spread throughout her body, and she will probably not be with us for much longer).
So, Logan is a GREAT school. They teach you all of the things you NEED TO KNOW so that your diagnostic skills will be on par with (and sometimes better than) the practitioners in main-stream medicine. Chiropractic philosophy is important too, but a DOCTOR of chiropractic has the responsibility of knowing when the problem is NOT just another vertebral subluxation.
Why does my back hurt? We’re vicims of our own luxury. That’s why!
The most common question i get in my practice is “WHY”? “Why do I get headaches”? “Why does my back hurt when I get up in the morning?” “My fingers are numb. Why?” I do my best to explain biomechanically and chemically what’s going on, but that rarely answers the question “Why?” The exception, of course, being direct trauma — i.e. ” Your back hurts because you fell off a ladder onto your back and injured the tissues of your back.” The causes of most back problems, however, are not so simple to explain. You can have back pain, headaches, morning stiffness, etc., etc., even though you’ve never fallen out of a tree or been in an auto accident. Then the logical mind will just assume that it’s “genetic.” Plenty of people are satisfied thinking that they have “bad genes” and there’s nothing they can do about it, so might as well just stay high on narcotic pain killers and avoid exercise at any cost. Some people are just not satisfied with that verdict and sentence. (Not to diminish the importance of genetics, but genetics are only PARTLY responsible for the fate of your musculoskeletal system).
So here’s a possiblilty. We were born to walk barefooted on the soil, and we almost never do that. Think about it. Why do we have flexible feet and controllable toes? If we were made to be on concrete all day, shouldn’t we have wheels instead of feet?
When we walk on a soft surface such as a grassy field or a sandy beach, two things happen. 1) We leave a footprint, and 2) Our bodies have to use their sense of balance to keep us from falling over.
We leave a footprint. Footprints are evidence of a compliant surface, meaning that surface absorbs shock or impact as the force of our bodies lands on that surface. Every time we take a step, the force of that motion must be dissipated, or cushioned somehow. On a softer surface, a great deal of the force is dissipated externally, or outside the body. Blades of grass bend or break. Grains of sand separate. A slight indention is left in the surface. On a non-compliant surface, however, nothing changes. Concrete granules do not move farther apart. No indention is apparent. The question is, then, “where does the impact go?” The answer would be YOU. That’s where the impact goes. The ligaments and joint cartilages absorb most of that extra impact — which is exactly what they were meant to do. However, they were meant to have some help from the ground we walk on. All of this extra stress leads to tears in the fibers of these connective tissues. (references to come) Years of the abnormally high impact can lead to a high volume of these “micro-tears” which can have a negative impact on the integrity of the tissue, and thus lack of joint stability and strength.
On a softer surface, our bodies have to work harder to stay balanced. This is where a good dose of neurology is appropriate. It take quite a network of nerves and brain-firing patterns to keep us upright. Compare it to chewing food. How do you know when it’s safe to bite down without biting off your tongue? There are thousands of nerve endings in your tongue, called proprioceptors, that alert your brain as to the exact location of your tongue. The signals are processed in the brain, creating the proper motor signals to bite down and move your tongue out of the way at the same time.
We stay upright by a similar process. The muscles of our back, particularly the deepest layers of muscle that are fitted snugly against the spinal column, are heavily embedded with these proprioceptors. When we move, constant signals are generated by these nerve receptors and sent through the spinal cord to the brain. This way, your brain has a good “picture” of the exact location of your back based on the length of certain muscles and minute changes in the length of these muscles. These signals are processed by several areas of the brain and spinal cord to produce motor messages from the brain that coordinate the motions of the larger muscles that control gross movement of the spine (and other joints).
When we are on extremely stable surfaces, such as concrete and most flooring, that system no longer has to work very hard. As we all know, “if you don’t use it, you lose it.” The small, unexercised proprioceptive muscles in the deep back lose their tone. As a result, we lose CORE STABILITY. [ “Core” is such a buzzword and quite misused these days. That is for another blog. Stay tuned.] We are essentially left with weak & injured, lazy backs that have lost their ability to move correctly. There are even professional athletes with weak, lazy backs –they just don’t know it. Yet.
So how does a chiropractor “fix” this? These poor motion patterns cause certain segments of the spine to either “lock up” or move abnormally. A good chiropractor will pick out these joints, and through a series of “adjustments,” re-establish proper motion into these joints. (Beware of the chiropractor who just “pops” every bone in your spine. It feels good for a few minutes, but you certainly don’t want to introduce too much motion into joints that don’t need it). Once we start to get the dysfunctional joint moving again, we have a series of exercises to help build the “core strength” of that joint (Core strength training does not mean doing 4000 crunches, by the way). It involves mostly some stretching and balancing techniques that we teach you in our office and encourage you to continue doing them at home or at work. In my practice, we refer to this process as Spinal Reconditioning.
Alternatively, you should pack up (and get rid of) 96% of your “stuff” and move to a quiet sandy beach somewhere and live barefooted. Keep a garden to grow your own food, plus the exercise of bending down (a heavy-user of core strentgth) to pluck weeds. Probably not much need for a chiropractor in that environment.
