Balance and Movement and The Effect
of Chiropractic Care
Utilization with the Elderly, Cerebral Palsy, the Athlete
and the General Population
Chiropractic care reverses maladaptations in sensorimotor integration
and improves motor control
A report on the scientific literature
By
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
William J. Owens DC, DAAMLP
Sensorimotor is defined as our ability to feel and move. With infants, Piaget, the renowned researcher, categorized the first 2 years of an infant’s life as the sensorimotor stage. "During this period, infants are busy discovering relationships between their bodies and the environment. Researchers have discovered that infants have relatively well developed sensory abilities. The child relies on seeing, touching, sucking, feeling, and using their senses to learn things about themselves and the environment. Piaget calls this the sensorimotor stage because the early manifestations of intelligence appear from sensory perceptions and motor activities" (Anderson, n.d., http://facultyweb.cortland.edu/andersmd/PIAGET/sms.html).
As we develop and our nervous systems have acquainted us to our surroundings, we need the neurological "hookups" to remain intact to function optimally and pain free. In addition, our sensory and motor systems need to work in tandem in order for us to function normally.
To further break it down, our sensory system is part of the nervous system that consists of receptors that receive stimuli from both our internal and external environments. These receptors, such as the ones located in our fingertips, sense external stimuli, such as hot or cold, or what we feel. An internal receptor may be found in the tendons (connect your muscles to your bones) and lets you know what your joints are doing, such as are my fingers sensing if they are relaxed or in a fist. The sensory system is also controlled by the brain that processes what we feel.
Pain is part of the sensory nervous system and to the surprise of many, pain is an important component to protecting yourself. Without pain, you could get seriously hurt, such as by keeping your finger on a hot stove too long or touching a sharp object too heavily and cutting your hand. Internally, pain is a warning sign that an organ or system is "sick" and alerts you to seek medical care.
All pain receptors are free nerve endings, meaning they only bring information to your brain and function as the "pain receptors." There are three types of pain receptors; mechanical, thermal and chemical. They are found in skin and on internal surfaces such as the coverings of the bone and joint surfaces. "Deep internal surfaces are only weakly supplied with pain receptors and will propagate sensations of chronic, aching pain if tissue damage in these areas is experienced. Pain receptors do not adapt to stimulus. In some conditions, excitation of pain fibres becomes greater as the pain stimulus continues, leading to a condition called hyperalgesia [commonly known as, "WOW, that hurts a lot!"]" (Global Oneness, n.d., http://www.experiencefestival.com/a/Pain_-_Physiology/id/597137).
Your motor system is what allows you to move, maintain your posture and control your muscles. The motor system is controlled through nerves similar to the sensory system and like the sensory system, has a controlling element in the brain.
Functional tasks are defined as those things we do in our lives. Answering a telephone, putting a key in a door lock or picking up a fork to eat are all examples of functions. These functions, just like Piaget described in infants, are how we have a relationship with our body and the environment and require an integrated motor and sensory nervous system. Every functional task that we do involves both the motor and sensory components of our nervous system and while performing these tasks, we are protected by our ability to perceive pain.
Due to the development and integrategration of the world around us necessary to complete every task in our lives, as we get older, postural disturbances can arise and negatively affect how we integrate the sensorimotor information we are receiving both internally and externally and lead to significant balance disorders. Lord and Ward (1994) reported that, "All of the sensory, motor and balance system measures showed significant age-associated differences" (http://ageing.oxfordjournals.org/cgi/content/abstract/23/6/452). This means that as one gets older, his/her sensorimotor system often fails to integrate the internal and external environment as it once could.
A research study by Taylor and Murphy (2008) concluded that chiropractic care reverses maladaptations in sensorimotor integration and improving motor control. The study suggests that spinal dysfunction may lead to muscle specific alterations of the brain’s ability to process motor control. The "real-life" implications of this finding affect every facet of our lives and every person. Whether it be an older person who is starting to exhibit balance disorders, or a cerebral palsy victim who struggles on a daily basis with the simple tasks of life or a world class athlete looking to increase his/her fine motor skills just 1/10 of 1%, the results of chiropractic care can be dramatic.
From the clinical observation of Dr. Mark Studin, a co-author of this article and a practicing chiropractor for 30 years, "This now gives scientific evidence and validation to what patients have been sharing after receiving chiropractic care. The most common comment from patients post care is, 'I perceive my surroundings more acutely and feel straighter.'" Dr. Studin continues, "Although I have heard this from every age group, my first patient was a cerebral palsy patient who stated that without getting adjusted he could barely function. With care, he walked to and from the office, a distance of 3 miles."
These studies, along with many others conclude that a drug-free approach of chiropractic care is one of the best solutions to increase integration between the motor and sensory systems of your body. To find a qualified doctor of chiropractic near you, go to the US Chiropractic Directory at www.USChiroDirectory.com and search your state.
References:
1. Anderson, M. (n.d.). Sensorimotor stage. Jean Piaget's Theory of Development. Retrieved from http://facultyweb.cortland.edu/andersmd/PIAGET/sms.html
2. Global Oneness. (n.d.). Pain - Physiology. Retrieved from http://www.experiencefestival.com/a/Pain_-_Physiology/id/597137
3. Lord, S. R. & Ward, J. A. (1994). Age-associated differences in sensori-motor function and balance in community dwelling women. Age and Ageing. Retrieved from http://ageing.oxfordjournals.org/cgi/content/ abstract/23/6/452
4. Taylor, H. H. & Murphy, B. (2008). Altered sensorimotor integration with cervical spine manipulation. Journal of Manipulative and Physiological Therapeutics, 31(2), 115-126.
The Effects of Chiropractic Spinal Adjustments on Heart Rates
A report on the scientific literature
By
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
William Owens DC, DAAMLP
"Heart rate is the number of heartbeats per unit of time - typically expressed as beats per minute (bpm) - which can vary as the body's need for oxygen changes, such as during exercise or sleep. The measurement of heart rate is used by medical professionals to assist in the diagnosis and tracking of medical conditions. It is also used by individuals, such as athletes, who are interested in monitoring their heart rate to gain maximum efficiency from their training...Heart rate is measured by finding the pulse of the body. This pulse rate can be measured at any point on the body where an artery's pulsation is transmitted to the surface - often as it is compressed against an underlying structure like bone - by pressuring it with the index and middle finger. The thumb should not be used for measuring another person's heart rate, as its strong pulse may interfere with discriminating the site of pulsation" (Wikipedia, 2010, "Heart rate").
"The autonomic nervous system (ANS or visceral nervous system) is the part of the peripheral nervous system that acts as a control system functioning largely below the level of consciousness, and controls organ functions. The ANS affects heart rate, digestion, respiration rate, salivation, perspiration, diameter of the pupils, micturition (urination), and sexual arousal. Whereas most of its actions are involuntary, some, such as breathing, work in tandem with the conscious mind" (Wikipedia, 2010, "Autonomic nervous system").
For our conversation, it is this autonomic nervous system that largely controls the heart rate. Dr. I Kestin, Consultant Anesthesiologist, Derriford Hospital, UK, stated in 1993, “The heart will beat independently of any nervous or hormonal influences. This spontaneous rhythm of the heart (called intrinsic automaticity) can be altered by nervous impulses or by circulatory substances, like adrenaline. The muscle fibers of the heart are excitable cells like other muscle or nerve cells...This automatic rhythm of the heart can be altered by the autonomic nervous system. The sympathetic nervous system supply to the heart leaves the spinal cord at the first four thoracic vertebra, and supplies most of the muscle of the heart...There are nervous reflexes that effect heart rate. The afferents are nerves in the wall of the atria or aorta that respond to stretch. The aorta contains high pressure receptors. When the blood pressure is high these cause reflex slowing of the heart to reduce the cardiac output and the blood pressure. Similarly, when the blood pressure is low, the heart rate increases, as in shock. Similar pressure receptors are found in the atria. When the atria distend, as in heart failure...there is a reflex increase in the heart rate to pump the extra blood returning to the heart. When there is a sudden reduction in the pressure in the atria the heart slows" (http://www.nda.ox.ac.uk/wfsa/html/u03/u03_011.htm).
Increased heart rate can lead to cardiomyopathy, damage of the heart muscle and according to Cook, Togni, Schaub, Wenaweser, and Hess in 2006, “Since 1980, it is known that resting heart rate (RHR) is a prognostic factor in coronary diseased patients. Data from the Coronary Artery Surgery Study (CASS) published last year underline the prognostic importance of RHR for morbidity (time to rehospitalization), as well as total and cardiovascular mortality. Heart rate proves to be the best predictor after myocardial infarction, in patients with congestive heart failure, as well as in patients with diabetes mellitus or hypertension. In addition, it was found that elevated RHR is also strongly associated with mortality in the general population” (p. 2387).
It has been the independent clinical observation and conclusion over the course of 30 years by Dr. Mark Studin, one of the author's of this article, that post chiropractic adjustment patients have experienced lowering heart rates and subsequent high blood pressures. Dr. Studin states, “Many patients have reported that their increased heart rates have abated for long periods of time.”
Budgell and Polus reported in The Journal of Manipulative and Physiological Therapeutics (2006) that chiropractic adjustments of the thoracic spine were associated with significant heart rate values and influenced the autonomic output of the heart, meaning that heart rates generally lower with the chiropractic adjustments because of the shift in the neurological communication of the autonomic nervous system (to the parasympathetic nerves) causing the heart to slow or normalize.
This study by Budgell and Polus offers potential answers to many as to why patients' heart rates spontaneously spike for no apparent reason. The spine, although a great influence the nervous system, has often been overlooked in the clinical arena as the prime cause for cardiac issues. The authors of this article want to emphasize that chiropractic care has a positive effect for many conditions, including cardiac, and should be considered in conjunction with all other health care specialists, as clinically indicated, as a conclusive diagnosis to rule out life-threatening illnesses must be rendered.
References:
1. Wikipedia, The Free Encyclopedia. (2010, July). Heart rate. Retrieved from http://en.wikipedia.org/wiki/Heart_rate
Acute Neck Pain (Torticollis), Disability
and Chiropractic:
Patient Satisfaction Results
The overall patient satisfaction rate was 94%
A report on the scientific literature
By
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
William J. Owens DC, DAAMLP
"Acute neck pain means immediate neck pain. Neck pain that just started. This type of pain comes on suddenly and affects the ability to properly move your head in its proper range of motion. One serious type of acute neck pain is whiplash - the sudden jarring motion of your head going backwards and forward. This often occurs with a rear end collision. Acute neck pain can also be the result of a fall, sleeping awkwardly, a trauma or even a fall.. Often times when someone has just strained or irritated their neck in some way the pain is most severe. There is usually inflammation, immobility, and muscle tenderness. Often with acute neck pain, the muscles or ligaments are involved" (The Neck Pain Relief Shop, n.d., http://www.neckpainreliefkit.com/acuteneckpain).
The “real life” issue for the patient who either wakes up with this debilitating pain or is in an accident that causes it, is that taking drugs without narcotics is insufficient for relieving the pain. With the narcotics, one can be severely hampered and may not be able to go about his/her life. It is often a double-edged sword; take strong drugs and compromise your life or don't take drugs, receive no chiropractic care and suffer.
A 2006 study examined "...the extent to which a group of patients with acute neck pain managed with chiropractic [adjustments]...and the degree to which they were subsequently satisfied...A total of 115 patients were contacted, of whom 94 became study participants, resulting in 60 women (64%) and 34 men. The mean age was 39.6 years...The mean number of visits was 24.5...Pain levels improved significantly from a mean of 7.6...before treatment to 1.9...after treatment...The overall patient satisfaction rate was 94%" (Haneline, 2006, p. 288).
"There were reductions in disability recorded during the study that were statistically significant. Approximately 84% of the patients related that their activities were restricted before chiropractic treatment because of their neck pain, whereas only 25% still had activity restrictions at the time of the interview. Furthermore, 57% of those with physical restrictions described their disabilities as moderately severe or greater before treatment, whereas at the time of the interview, just 12% did (Haneline, 2006, p. 294).
"When comparing trauma with no-trauma cases, Trauma cases received more than 3 times as many visits. This difference may be related to tissue damage that often accompanies trauma, which, many times, heals imperfectly. In addition, patients with this type of problem may have ensuing long-term pain and physical impairment, which further shows that trauma complicates the recovery of acute neck pain (Haneline, 2006, p. 294).
This study along with many others concludes that a drug-free approach of chiropractic care is one of the best solutions to acute neck pain and returning to a normal life. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.USChiroDirectory.com and search your state.
References
1. The Neck Pain Relief Shop. (n.d.). Acute neck pain.Retrieved from http://www.neckpainreliefkit.com/acuteneckpain
2. Haneline, M. T. (2006). Symptomatic outcomes and perceived satisfaction levels of chiropractic patients with a primary diagnosis involving acute neck pain. Journal of Manipulative and Physiological Therapeutics, 29(4), 288-296.
Increased Balance, Movement
& Kinematics as a Result of Chiropractic Care
A research conclusion that affects rehabilitation patients, athletes, balance disorders and increased production in the workplace
A report on the scientific literature
By
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
William J. Owens DC, DAAMLP
"Much chiropractic research has been devoted to determining the effects of chiropractic care on various symptoms and disorders such as low back pain, neck pain, and headaches. In addition, some basic science research demonstrates that these disorders (particularly low back pain) are related to perceptual and behavioral changes in individuals ranging from reduced proprioception to changes in muscle recruitment patterns to altered kinematics" (Smith, Dainoff, & Smith, 2006, p. 257).
"Proprioception (pronounced /ˌproʊpri.ɵˈsɛpʃən/PRO-pree-o-SEP-shən), from Latin proprius, meaning "one's own" and perception, is the sense of the relative position of neighbouring parts of the body" (Wikipedia, 2010, http://en.wikipedia.org/wiki/Proprioception).
"Proprioception doesn't come from any specific organ, but from the nervous system as a whole. Its input comes from sensory receptors distinct from tactile receptors — nerves from inside the body rather than on the surface. Proprioceptive ability can be trained, as can any motor activity" (Anissimov, 2010, http://www.wisegeek.com/what-is-proprioception.htm).
"Without proprioception, drivers would be unable to keep their eyes on the road while driving, as they would need to pay attention to the position of their arms and legs while working the pedals and steering wheel. And I would not be able to type this article without staring at the keys. If you happen to be snacking while reading this article, you would be unable to put food into your mouth without taking breaks to judge the position and orientation of your hands" (Anissimov, 2010, http://www.wisegeek.com/what-is-proprioception.htm).
"Kinematics is the study of motion and the forces required to produce it. This includes the different forces at work during the movement of a single part of the body, and more complex movements such as running and climbing" (NASA, 1999, http://spaceflight.nasa.gov/history/shuttle-mir/references/glossaries/science/sc-gloss-g_m.htm).
"Chiropractic research has looked mainly at movement control from neurophysiological and biomechanical perspectives. This research has shown that chiropractic affects several factors that influence movement control. For example, reductions in resting muscular tone (quantified by surface electromyography in prone posture) have been documented following adjustments, as have improvements in muscular strength. In addition, reaction times to a complex mental rotation task have decreasedwith adjustments. A recent review of the neurophysiological effects of spinal manipulation identifies experimental evidence that spinal manipulation influences proprioceptive primary afferent neurons from paraspinal tissues. Spinal manipulation also affects how pain signals are processed, possibly by altering the central facilitated state of the spinal cord. In summary, the available biomechanical and neurophysiological data indicate that spinal manipulations can affect the motor control system" (Smith, Dainoff, & Smith, 2006, pp. 257-258).
"Kinematic changes following chiropractic have also been noted…findings by Smith also indicate that coordination and balance changes result from chiropractic adjustments. A recent study using magnetic resonance imaging has shown that spinal adjusting produces movement at the zygapophyseal joints of the spine, thus revealing biomechanical effects of chiropractic" (Smith, Dainoff, & Smith, 2006, p. 258).
In designing a model for studying human movement time (MT), we look at accepted scientific principles and laws for standardization of evaluation. "There is at least one immutable rule for interface design and movement that we know about, and it's called Fitts's Law. It can be applied to software interfaces as well as Web site design because it involves the way people interact with mouse or other pointing devices. Most GUI platforms have built-in common controls designed with Fitts's Law in mind. Many Web designers, however, have yet to recognize the powerful little facts that make this concept so useful" (Microsoft Corporation, 2010, http://msdn.microsoft.com/en-us/library/ms993291.aspx).
"The basic idea in Fitts's Law is that any time a person uses a mouse to move the mouse pointer; certain characteristics of objects on the screen make them easy or hard to click on. The farther the person has to move the mouse to get to an object, the more effort it will take to get to. The smaller the object is, the harder it will be to click on...It means that the easiest objects to locate and target are the ones closest to the mouse's current position and that have large target spaces. Fitts wrote several papers describing these findings, with significant mathematical rigor, expressing in formulas how you can measure the impact of different velocities, distances, and target sizes on a user's ability to click on objects" (Microsoft Corporation, 2010, http://msdn.microsoft.com/en-us/library/ms993291.aspx).
Results of Chiropractic and Movement Time
"All participants in the experimental group had significantly improved movement times following spinal adjustments compared with only 1 participant in the the control group. The average improvement in movement time for the experimental group was 183 ms, a 9.2% improvement, whereas the average improvement in movement time for the control group was 29 ms, a 1.7% improvement" (Smith, Dainoff, & Smith, 2006, p. 257).
Implications of Increased MT Time Based on Chiropractic Care
MT is one of the most important variables influencing the way we control our movements. It can affect athletes, Parkinson’s patients, and balance disorder patients. It can increase productivity at work and influence every other facet of our lives that increased movement can help. What business wouldn’t want a 9.2% increase in work productivity where movement of your body is required for production? What balance disorder patient wouldn’t want a 9.2% increase in balance? What sprinter wouldn’t want 9.2% of their time taken off without the use of performance enhancing drugs?
While many see chiropractic as an effective modality to relieve back or neck pain, this study along with many others, see chiropractic as the solution to many interrelated issues in health, work, sports, rehabilitation and the workplace. This study along with many others concludes that a drug-free approach of chiropractic care is one of the best solutions to increasing your body’s ability to function better. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.USChiroDirectory.comand search your state.
Cervical and Lumbar Disc Herniations and Chiropractic Care
A report on the scientific literature
80% of the chiropractic patients studied had good clinical outcomes
By
William J. Owens DC, DAAMLP
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
Work Injuries, Full Recovery and Chiropractic Care
Resolving the myth that doing nothing is better
A report on the scientific literature
By
William J. Owens DC, DAAMLP
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
Thousands of people have realized the benefits of receiving chiropractic after a traumatic injury at work. Many of the things we are employed to do often cause injuries to the neck or the lower back. This can include repetitive lifting, bending, twisting and sitting at a desk or computer for a prolonged period of time. It is incorrect to assume that because your are lifting car engines or leaning over a desk for 8 continuous hours that you can’t hurt your back. There is a term called “creep” that is used to describe a profound effect on the health of your spine and joints. In this case, "creep" refers to the change in shape one experiences as a result of constant stress, and is similar to pulling slowly and steadily on a bar of salt water taffy. If you were to do this for a while, the taffy would stretch and be reluctant to return to its original position. That is why postural trauma, such as sedentary work or driving for long distances, can have negative consequences over time.
A doctor of chiropractic is trained to evaluate this type of condition as well as injuries to the spine that result quickly from a single incident. Both can have profound negative effects on your body and can cause pain and loss of function. Proper treatment for work related injuries is critical to returning to work in a timely manner and preventing recurrence. Although pain is an important part of the evaluation process of work related injuries, functional status (the ability to carry out one's activities)2 is equally important; you need to be out of pain and be able to do what you want and need to get done without any limitations. Your chiropractor wants you to get you back to your normal routine as quickly as possible and should then work with you to stay that way.
In a recent research paper published in 2009, the authors stated, “Over the last 15 years, the percentage of pre-retirement disabled US workers has increased from 5% to 9% such that more people receive disability income than are unemployed.” (Aspegren et al., 2009, p. 765). This has tremendous implications on the workforce, productivity of businesses and your ability to earn a living. The data for the study was listed by the authors as records containing 249 patients ranging from the age of 18 to 65 years (mean = 38.3 years, SD = 10.7 years, 84 women) with dates of service ranging from January 1, 2003 to December 31, 2006. These were retrospectively analyzed (100 records were used). Based on date of injury to first date of chiropractic care, the cases were subdivided into acute (0-21days), subacute (22-90 days), and chronic (>90 days) injured workers.3
One powerful conclusion of the research was that workers in the acute or subacute groups had better treatment scores than patients with a chronic condition. This indicates that the sooner the patient received chiropractic treatment, the better the outcomes. Access and treatment is the key to long term success in the workforce.
MYTH: Problems resolve themselves
The idea that lower back pain has a “natural history” and will resolve on its own has been recently challenged in the scientific literature. Several papers have reported actual statistics. “Hestbaek et al, Carey et al, and later Nicholson and Jonsson who describe how acute low back pain becomes chronic or recurrent more frequently than previously suspected. Jayson expanded on these concerns, noting at 3 months that the natural history prognosis [allowing it to get better on its own] for patients having experienced an acute episode of low back pain was as follows: 27% were completely better, 28% improved, 30% had no change, and 14% were actually worse” (Aspegren et al., 2009, p. 768). The idea that pain in your lower back gets better is actually a myth; the results show that 75% of participants actually had pain that continued and 44% had no change or got worse. Thinking it will go away is just not a good idea.3
The conclusion of this study was, “Patients recorded improvement in functional scores and subjective response involving work-related spinal injuries. Improvement was noted in all 3 time-based phases of patient status (acute, subacute, and chronic)" (Aspegren et al., 2009, p. 770). Therefore, when you have a work related injury, although care is most effective when you see a doctor of chiropractic as soon after the injury as possible, patients seeking care 90 days or greater after the injury will still receive tremendous benefit from chiropractic care. In other words, the sooner you see a doctor, the better chance you have of recovery, but better later than never.
Being cared for by a doctor of chiropractic is an essential and effective way to decrease pain and increase function. Full recovery from a work related injury and the assurance that you will be able to continue your job, with no limitations, is everyone’s goal. The doctor of chiropractic works with both you, the patient, and your employer to ensure that you do recover and are able to return to work, with as little disability time as possible, functioning in your full capacity with no limitations.
References:
1. LoveToKnow, Corp. (n.d.). Creep definition, YourDictionary.com. Retrieved from http://www.yourdictionary.com/creep
Chronic Neck Pain and Chiropractic:
A Comparative Study with Massage Therapy
A report on the scientific literature
By
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
William J. Owens DC, DAAMLP
Neck pain is a very common problem, second only to low back pain in its frequency in the general population and in doctors' offices treating musculoskeletal injuries. "The musculoskeletal system is an organ system that gives [humans] the ability to move using their muscular and skeletal systems" (Wikipedia, ,2010, http://en.wikipedia.org/wiki/Musculoskeletal). "Estimates of the prevalence of chronic neck pain vary. In a Swedish population 18.5% of females and 13.2% of males had neck pain for longer than 6 months; however, when continuous chronicity was rated, these figures were reduced to 10% and 7%, respectively. A Finnish study reported chronic neck pain in 13.5% of females and 9.5% of males. A Norwegian studyreported an overall rate of 13.8% for neck pain greater than 6 months duration; however, for subgroups with age greater than 43, the rate rose above 20%. It would appear that approximately 15% of females and 10% of men have chronic neck pain at any one time. Chronic neck pain produces a high level of morbidity by affecting occupational and avocational activities of daily living and by affecting quality of life" (Vernon, Humphreys & Hagino, 2007, p. 215).
"Manual therapy [chiropractic adjusting] is a generic therapeutic category that is composed of a variety of procedures directed at the musculoskeletal structures in the treatment of mechanical pain. Two major subcategories exist that divide these therapies into those which produce joint motion and those which do not. The first subcategory includes manipulation, mobilization, and manual traction. The second subcategory involves both generalized soft tissue therapies, such as the many types of massage, and focal soft tissue therapy, such as trigger point therapy, shiatsu, and acupressure. For this review, we used the separate therapy categories of manipulation, mobilization, manual traction, massage, and pressure techniques" (Vernon, Humphreys & Hagino, 2007, pp. 215-216).
There are numerous systematic reviews of the treatment of neck pain by manual therapy. With few exceptions, they have included studies of manual therapies for acute, subacute, and chronic neck pain. They have also included studies of subjects with neck pain due to whiplash-type injury as well as those in which whiplash-associated disorder (WAD) was not involved. These reviews have also included studies of subjects with or without concomitant headaches and/or arm pain...Finally, these reviews have included studies where manual therapies have been combined with other therapies such as exercises, relaxation therapy, etc (so-called 'multimodal therapy'). The most recent reviews by Gross et al, Bronfort et al and the Canadian Chiropractic Association Clinical Practice Guideline have brought the evidence base up to date but are similarly broad in scope" (Vernon, Humphreys & Hagino, 2007, p. 216).
The results of these research studies included studies that provided information of long-term outcomes, meaning they continued their study up to at least 52 weeks, with one going as high as 104 weeks (2 years) in order to determine the validity over a long period of time confirming the non-recurrence of the pain. The results of one long-term study that examined the effects of chiropractic treatment on the recovery of clinical trial patients found that approximately 70% of the patients showed full recovery. However,100% of the patients in five studies that varied in length had positive changes. It was also reported that 0%, or none of the massage therapy patients had positive outcomes at the 6 week period.
This study along with many others conclude that a drug-free approach of chiropractic care is one of the best solutions to neck pain. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.USChiroDirectory.comand search your state.
References
1. Wikipedia, The Free Encyclopedia. (2010, July). Human musculoskeletal system. Retrieved from http://en.wikipedia.org/wiki/Musculoskeletal
Increased Sports Performance and Chiropractic
A report on the scientific literature
By
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
William J. Owens DC, DAAMLP
Allison Bonk BA
Strength training is a critical component of fitness for every athlete. Although coaches used to believe resistance exercises only added unnecessary bulk to the athlete, hindering their ability to execute skill, that notion has been proven false.1 The basic conecpts behind this training is to promote a steady and specific increase in strength and other abilities by customizing the routine to the needs of the sport and to the physical capacity of the individual. The rules and principles work hand in hand in order to try to obtain superior programs of strength.2
The benefits of strength training to an athlete's performance are numerous. It is a vital conditioning component for power atheletes and can also be a source for improvement in pure endurance events. However, much sport-specific resistance training requires a more cultivated approach than basic weight-lifting. Explosive power, muscular endurance, maximal strength or some combination of all three are often required in order for a sports participant to be superior. The focus is rarely on pure muscle bulk and even when it is, that does not eliminate the need for strength training.1
Over the past few years, the sport and fitness market has been inundated with products claiming to greatly improve athlethic performance. However, an understanding of biomechanics and exercise physiology reveals that few of these products actually do what they claim to, such as improve strength, speed and power. In fact, many inhibit them. Rarely do these devices address the issues of anatomical and neuromuscular adaptation, key components for performance improvement.2
SPORTS SPECIFIC
Regardless of an athlete's sport of choice, stength training is included in the development of one's abilities. Stength training programs can be geared towards overall muscle strength, but many sports trainers focus on specific muscles needed to thrive in a particular area. Therefore, a golf strength training program will differ from that for baseball or tennis; any athlete's stregnth training will focus on the muscles used in their preferred sport. For example, the muscles used in golf need to be trained to work together as one unit. In order to hit the ball, the muscles must twist and turn during the swing and work together to provide a hit stronger hit. In other words, in the case of golf strength training, the focus is on the mucles as a group, rather than individually.3
In the case of football players, the benefit of strength and strength training is strongly supported by research. For example, De Proft and colleagues had one group of Belgian players engage in extra weight training during the season. When compared to a control group of colleagues who did no extra training, it was found that the players improved their kicking power and leg strength. In addition, British researcher Thomas Reilly demonstrated that stronger players outlasted weaker players in regards to a regular place in the team. They also had reduced injury risks. His recommendation is to develop leg strength in particular, especially in the quadriceps and hamstrings, in order to help stabilize the knee joint. That joint is the most frequently injured joint in these types of professionals.
Peter Apor, a Hungarian researcher who has been involved in long-term studies of Hungarian professionals, supports this idea, as he has found that the knee-extension torque has been associated with success in the game and that strong hamstring muscles in relation to quadriceps are crucial to knee injury prevention. Another common football injury is hernia. Developing strong abdominal muscles is the best prevention for this type of injury.4
RESEARCH
In 2006, a research study was performed to assess whether chiropractic adjustments increased muscle strength in leg muscles and the results were conclusive and imperative for any athlete, either professional or recreational. The implications go well beyond sports, as this also affects the workplace and manual labor of any kind.
Simply put, the brain has to communicate or talk to muscles in order to fully function or recruit all motor units (individual parts of the muscle) during a maximal voluntary contraction. The adjustment activates mechanoreceptors (parts of the nerve responsible for firing the muscle and causing contractions).
The study showed a significant (10%) increase in quadricept (leg muscle) strength in the treatment group after the chiropractic adjustment, while prior to the adjustment there was no statistical difference between treatment groups. This clearly indicates that chiropractic care increases muscle strength in any individual and has far reaching affects in every type of athlete as well as every other activity of daily living.5
This study along with many others conclude that a drug-free approach of chiropractic care is one of the best solutions to increase muscle strength. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.USChiroDirectory.comand search your state.
References
1. Sports Fitness Advisor. (n.d.). Strength Training Section. Retrieved from http://www.sport-fitness-advisor.com/strengthtraining.html
Arthritis and Low Back Pain:
Chiropractic Care vs. Heat Treatment
A report on the scientific literature
Chiropractic care rendered significantly greater relief of pain
and significantly more mobility
By
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
William J. Owens DC, DAAMLP
"31 million Americans experience low-back pain at any given time" (The American Chiropractic Association, 2010, https://www.acatoday.org/level2_css.cfm?T1ID=13&T2ID=68)
Interesting facts about back pain:1
What Causes Back Pain?
The back is made up of bones, joints, ligaments and muscles. Ligaments can be sprained, muscles can be strained, disks can rupture, and joints can be irritated. All of these can result in back pain. It doesn't always take a major event like a sports inury or an accident to cause back pain. Even the simplest of movements, like picking a small object up from the floor, can have painful results. There are also numerous conditions that can cause or complicate back pain, such as arthritis, poor posture, obesity, and psychological stress. Disease of the internal organs, such as kidney stones, kidney infections, blood clots, or bone loss, can also result in back pain.1
The most common form of arthritis is called osteoarthritis. It is also known as degenerative joint disease and is a disease of the joints. It affects more than 20 million American adults. The cause of osteoarthritis is a breakdown of cartilage, the connective tissue that provides a cushion between the bones of the joints. Healthy cartilage is what permits bones to move over one another and acts as a shock absorber during physical movement. Those afflicted with this disease experience a breakdown of cartilage that wears away. As a result, the bones under the cartilage rub together, resulting in pain, swelling, and loss of joint motion.2
What Causes Osteoarthritis?2
There is often no known cause of osteoarthritis. Risk factors include:
Signs and Symptoms of Osteoarthritis2
Osteoarthritis often begins at a slow rate. Early on, joints may be sore after physical work or exercise. The pain of early osteoarthritis dissipates and then returns over time, particularly as a result of overuse of the affected joint . Other symptoms may include:
In 2006, "...an experimental design was used to compare the effects of chiropractic care (and moist heat) to the effects of moist heat alone for treating lower back pain that is secondary to [arthritis] of the lumbar spine" (Beyerman, Palmerino, Zohn, Kane, & Foster, 2006, p. 107). This was the first study of its kind. There were 3 parameters measured, pain, mobility and activities of daily living. The results conclusively revealed in every metric analyzed that chiropractic care rendered significantly better results, rendering greater relief of pain and significantly more mobility had been restored.
Low back pain and osteoarthritis is a very common condition treated daily in chiropractor’s offices nationwide. This study confirms scientifically the clinical results treating chiropractors have been experiencing for over 100 years. The degree to which pain interferes with aspects of daily living was statistically measured, specifically with walking, sitting and social life and those test subjects under chiropractic care had superior results that simply utilized moist heat.3
These studies along with many others conclude that a drug-free approach of chiropractic care is one of the best solutions for patients with low back pain and arthritis. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.USChiroDirectory.com and search your state.
References:
1. The American Chriopractic Association. (2010). Back pain facts and & statistics. Retrieved from https://www.acatoday.org/level2_css.cfm?T1ID=13&T2ID=68
2. Dawson, E. G., & Shaffrey, C. I. (2009, December). Osteoarthritis: Degenerative spinal joint disease. Spineuniverse. Retrieved from http://www.spineuniverse.com/conditions/spondylosis/osteoarthritis-degenerative-spinal-joint-disease
A report on the scientific literature
By
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
William J. Owens DC, DAAMLP
Here are the facts:[1]
When conservative therapies for low back pain (LBP) are not effective, elective surgery may be proposed to these patients. In the United States, it has been estimated that between 6 and 7.5% of chronic LBP patients undergo spinal surgery. The main reasons for surgical treatment of
LBP are high levels of pain, disability and underlying pathology. Patients with disc degeneration represent a large part of spinal surgerypractice. Over the last 20 years, a new technology, disc replacement, has become increasingly popular because it is believed to maintain or restore the integrity of spinal movement and minimize the side-effects compared to fusion. Although disc replacement may relieve a patient from pain and related disability, soreness and stiffness of the lumbo-pelvic region seem to be common aftermaths of the surgery.[2]
While this type of surgery, or the necessity for surgery is not the topic of this article, the authors feel strongly that the decision for spinal surgery, predominantly an elective procedure should be made via a team approach. The patient must (not should) consult both the non-surgical health care provider as well as the surgical provider and those specialist must have a level of dialogue to reach a consensus of the best course of care weighing all of the risks vs. benefits with the patient. No one provider has all of the answers.
Spinal manipulation (adjustments) is one of the recommended conservative therapies for low back pain. Usually, adverse events occur in the first 24 to 48 hours, are benign and resolve completely in a few days. Major complications, for which the overall prevalence is unknown, include increased pain from disc herniation (transient) or cauda equina syndrome (estimated to be less than 1/ 3,700,000 to 1/1,000,000 of lumbar manipulations) and are considered irreversible. Since disc prostheses are believed to restore normal segmental range of motion and reduce potential residual instability, patients with total disc replacement could probably be manipulated similarly to patients with specific low back pain by standard side posture spinal manipulation to alleviate residual pain.[3]
After disc replacement, patients with residual, chronic low back pain would present spinal manipulation side-effects similar to those generally described in a chronic low back pain population.
The main objective of a 2010 study was to evaluate the potential adverse events of lumbar spine manipulations in disc replacement surgery patients. The most frequent side-effects reported were a slight increase in pain as well as minor to moderate lower back stiffness. Both side effects are frequently seen in non-surgical LBP patients after manipulation. In a recent study, Rubinstein described post-spinal manipulation adverse events as being mild to moderate in intensity, with little or no influence on daily activities. He also showed that such events are brief, with spontaneous recovery and typically lasting no more than a few days.[4]
In the same article, it was mentioned that adverse events usually appear at the first treatment and are the result of muscles accommodating to the correct positioning of the spine and need a day or so to “calm down.”
In a recent systematic review of safety of chiropractic intervention, the frequency of adverse events reported after a chiropractic intervention varied between 33 to 60.9%, regardless of treatment type and the patients' clinical presentation and again, is a minor to moderate stiffness and resolves in a very short time spontaneously. Regarding severe adverse reactions; in the present study, none of the patients had severe and irreversible reactions after spinal manipulation.
These studies along with many others conclude that a drug-free approach of chiropractic care is one of the best solutions for patients with post surgical low back pain. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.USChiroDirectory.coman search your state.
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