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The Case for Immunization
As long as I have been a chiropractor, I have seen many in this profession oppose vaccinations. Indeed, it has often been taken as a "given" that to be a principled chiropractor requires a curmudgeon's willingness to hold aloft that banner of opposition.
Commingling Money: 12 Questions for the ACA About the CHAMP / NCLAF Merger
The American Chiropractic Association recently announced it was merging the National Chiropractic Legal Action Fund and the Chiropractic Health Advocacy and Mobilization Project into a single entity that will support both legal and legislative actions.
The Heart Protector
On the physical level, the Pericardium is a double-layered sac of fibrous tissue that envelops the Heart. The space between the layers is filled with serous fluid that protects the Heart from external shock or trauma and lubricates to allow for normal Heart movement.
Lime Jello on Morphine
Taste is in the eyes... actually the mouth... of the beholder. My food preferences have changed, lightening from the food of my youth. My parents loved heavy eastern European cuisine and I loved it as a child. Now I enjoy leaner, healthier whole foods.
Sports Science: What's in That Drink?
Athletes frequently ask me what the best liquid is to drink during exercise – water or a sports drink? Water provides the necessary hydration, but unfortunately, it lacks the key nutrients to aid in performance and recovery.
Uncle Sam Needs You (Part 2)
Where chiropractic care has been used in the military health services, it has been deemed very successful.
To The Finish Line With the Help of TCM
When acupuncturist Eddy De Smedt pursued a career in Traditional Chinese Medicine, he knew he wanted to make a difference.
Essential Orthopedic Testing: Tests That Involve Standing on One Leg
Since these tests have a common mechanism of performance (standing on one leg), there are differential diagnostic concerns during testing. The tests cannot be completely isolated from each other for performance.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 2)
As mentioned in part 1, using a flexion-distraction table is a great way to unlock this particular fixation. You have found the stuck segment. You have determined whether it is unilateral, midline or bilateral.
The Tao of Gender
If you think gender is as simple as having a new client check off the "male" or "female" box on your intake form, we hope this article will expand your understanding and thus the reach of your health care.
Dr. George Goodman and His Legacy to Logan University
Those who knew him called him a revered leader, a visionary and one of chiropractic's biggest advocates. George A. Goodman, DC, Logan University's sixth and longest-serving president, passed away on Sept. 9. He was 70 years old.
CMT & Stroke Risk: Myth vs. Fact
By now, most of you have probably heard that the American Heart Association recently published a statement regarding the association between cervical dissection (CD) and cervical manipulative therapy (CMT).
The Wonders of Light Therapy: An Interview with Wes Burwell
I first met Wes Burwell in 2011 when he was teaching a class on light. Since then, every time I hear him speak, his understanding of the benefits, function and capacity of light has evolved.
Healing With TCM at San Quentin State Prison
For the prisoners at San Quentin State Prison, life-sentences are the reality of every day life. It is not often that prisoners get the opportunity to use alternative medicine to deal with common ailments they encounter behind bars such as, depression, anxiety and pain.
Pulse Diagnosis: What We Know
I am still finding pearls of wisdom from the books and papers that I inherited from my pulse diagnosis mentor Jim Ramholz.
Correcting Pelvic Rotation Around the Long Axis: Adjustment Protocol
The pelvis can be considered a ring that can misalign on the sacrum rotating around the long axis. The following is a description of an adjustment that helps to correct sacroiliac rotation around the long axis.
Communication 101: Please Explain Yourself!
Twice this past week, I overheard conversations about chiropractic. As you can imagine, it is a topic my ears naturally pick up. In both cases, a patient was talking to a friend about their experience with a chiropractor.
AOMA Strengthens Leadership Team
AOMA Graduate School of Integrative Medicine, a leading college of acupuncture & herbal medicine, announced the appointment of Donna LaPoint Hurta, MBA as the new VP of Finance & Operations this Fall.
Chiropractic Research in Review
Predicting Pain With Disability in Office Workers; Traction Approaches for Discogenic Cervical Radiculopathy; Intra-Articular Gas Bubbles Following Manipulation; Nonresponsive Chronic Ankle Sprains: Think Tendon Rupture.
Managing Patient Expectations About Acupuncture
Last year, I attended the Pacific Symposium in San Diego for the first time in six or seven years. It was the 25th anniversary of this event, and on one evening there was a panel discussion with the title; "What is Qi?."
Jingei Diagnosis: An Effective and Powerful Diagnostic
I graduated from the Kotatama Institute under the direction of Drs. Masahilo and Katsuharu Nakazono in 1984. As a student, I was exposed to the practice of most of the various theories and modalites of Oriental Medicine.
Managing Today's Fertility Patient
I recently received an email from one of my fertility patients: "Got my lab results back. FSH is 11, AMH is 0.7. My doctor said these numbers aren't good. I guess I'm infertile. Just as a thought. Just set up an appointment to speak with an adoption agency."
June, 2010, Vol. 10, Issue 06
The 42-Pound Head
By Erik Dalton, PhD
"For every inch of Forward Head Posture, it can increase the weight of the head on the spine by an additional 10 pounds." Kapandji, Physiology of Joints, Vol. 3
It's not uncommon to have clients walk into your office sporting a 12-pound head that's migrated three inches forward of their shoulders. You know prior to palpation that their cervical extensors (semispinalis, splenii, longissimus and upper traps) are in a losing battle attempting to isometrically restrain 42 pounds against the unrelenting force of gravity. (Fig. 1) Rene Cailliet, MD, former director of the department of physical medicine and rehabilitation at the University of Southern California wrote:
The body follows the head. Therefore, the entire body is best aligned by first restoring proper functional alignment to the head".1
The effects of poor posture go far beyond just looking awkward. In fact, the January, 2004 issue of the American Journal of Pain Management reported on the relationship of poor posture and chronic pain conditions including low back pain, neck related headaches, and stress-related illnesses. "The extra pressure imposed on the neck from poor posture flattens the normal cervical curve resulting in abnormal strain on muscles, ligaments, fascia and bones."2 Research presented at the 31st International Conference of the IEEE EMBS Minneapolis (2009) stated; "Over time poor posture results in pain, muscle aches, tension and headache and can lead to long-term complications such as osteoarthritis. Forward head carriage may promote accelerated aging of intervertebral joints resulting in degenerative joint disease."3 (Fig. 3). It appears posture impacts and modulates all bodily functions from breathing to hormonal production. Spinal pain, headache, mood, blood pressure, pulse and lung capacity are among the many conditions influenced by faulty posture.
Additionally, Dr. Roger Sperry demonstrated that 90 percent of the brain's energy output is used in relating the physical body to gravity. Only 10 percent has to do with thinking, metabolism, and healing.4 Consequently, a FHP will cause the brain to rob energy from thinking, metabolism, and immune function to deal with abnormal gravity/posture relationships and processing. The March 2000 Mayo Clinic Health Letter expounded on Sperry's findings by reporting that prolonged FHP also leads to "myospasm, disc herniations, arthritis and pinched nerves." Degenerative neck pain goes hand-in-hand with balance problems especially in the elderly. Sensitive cervical spine mechanoreceptors govern the body's ability to balance and must be perfectly coordinated with the inner ear's vestibular balance system to stabilize equilibrium in both static posture and gait. Keeping the eyes looking forward is a basic life-preserving reflex, and as such, dominates nearly all other postural considerations. Proprioceptive signals from the first 4 cervical vertebrae are a major source of stimuli for regulating the body's pain-controlling chemicals (endorphins). FHP dramatically reduces endorphin production by limiting the cervical spine's range of motion. Inadequate endorphin production up-regulates the central nervous system causing non painful sensations to be experienced as pain. Figure 4 shows a couple of good mobilization techniques to restore joint-play to upper cervical fixated facets.
Dr. Alf Breig, a Swedish neurosurgeon and Nobel Prize recipient coined the termed 'adverse neural tension' to describe the mechanism by which loss of normal cervical lordotic curve creates dysfunction and disease.5 Through cadaver studies, Dr. Breig demonstrated that neck flexion could stretch the spinal cord 5-7 cm causing tensioning of the meninges (covering of the brain and spinal cord) and elicit measurable pressure on brain-stem nuclei (nerve control centers) which control all basic life functions. The increased compression led to dysregulation of basic metabolic control functions. Recall that the spinal cord is actually only "tethered" to the bony skeleton in the upper cervical and lowest sacral areas (top and bottom ends of the spine). In between these polar attachments, the spinal cord is relatively free to move up and down. Free-floating mobility of the cord is essential in allowing bending and twisting of our bodies. Anything that reduces that freedom, i.e., exaggerated or flattened spinal curves, dural impingement, etc. increases cord and brain stem tension. Increased tensile stress on the cord and brain stem not only interferes with the control of basic body processes such as breathing and motor control but in cases of dural impingement, may encourage painful cervical radiculopathies.
Identifying Common Compensatory Patterns
Fortunately, the legendary biomedical researcher Vladimir Janda, MD has helped simplify assessment of commonly seen muscle imbalance patterns consistent with FHP. Janda's Upper Crossed Syndrome (Fig. 5) is characterized by overactivity or tightness in the upper trapezius, levator, suboccipitals. sternocleidomastoids and pectoralis major and reciprocal weakness of the deep neck flexors and lower scapular stabilizers. Trained therapists visually recognize this aberrant pattern through postural and gait analysis and kinesthetically through tissue palpation and muscle length testing. Unfortunately, as normal movement patterns are altered by persistent pain, joint fixations or muscle imbalances, new neuronal pathways are burned into the central nervous system and gradually memorized as normal (neuroplasticity). Any deviation of normal head and neck movement alters precise firing order patterns causing the prime mover to be slow to activate. Substitution patterns develop as synergistic stabilizing muscles are recruited to do the job of the prime mover. Some believe the first step in restoring proper muscle balance is to mobilize dysfunctional joints to help reprogram these garbled neuromuscular pathways. Once normal joint play is established and muscle splinting removed, structural integrative soft tissue work creates functional length/strength balance. Correction of Upper Crossed neck posture is key to stopping and possibly reversing decay, degenerative changes and pain from headaches, rib dysfunction, TMJ, and Dowager's Humps...but it takes time and a concerted effort to repair the damage caused by faulty neck posture.
Often seen as a structurally subtle body segment, the neck is burdened with the challenging task of supporting and moving the human head. Because of tension, trauma and poor postural habits inherent in today's workplace, it comes as no surprise that head-on-neck and neck-on-thorax disorders rank high among the most common pain generators driving people into bodywork practices. When spinal tissues are exposed to continued compression, they deform and go through a transformation that can become permanent. Correction of Upper Crossed neck posture is key to stopping and reversing degenerative joint disease and pain from headaches, rib dysfunction, TMJ, and Dowager's Humps. English philosopher Bertrand Russell once stated, "A physical system expresses its energy through function". Any loss of function sets off reactions within the body's open, dynamic system which manifests as structural abnormalities...and vice-versa. When treating functional problems such as loss of joint play, therapists must look beyond the symptoms and the artificial dividing of the body into systems and treat the whole.
Click here for more information about Erik Dalton, PhD.
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