An Ounce of Prevention

I've been avoiding studying for finals today by browsing the internet for preventive health strategies. I think prevention is defined and used incorrectly by the medical profession. Just plain "prevention" is defined as the action of stopping something from arising or happening. "Prevention" as it relates to medicine or the medical profession apparently means the activity which reduces the burden of mortality or morbidity from disease. This it seems indicates the practice of getting regular screening...which would ultimately result in the early diagnosis of disease....not in the actual prevention of disease.

Prevention, as the act of stopping something (disease) from arising, can only be achieved through life style. This includes the replacement of unhealthy dietary practices and the inclusion of healthy ones - replace processed foods with all their synthetic chemicals with whole natural foods; reduce the consumption of white sugar and flour, trans-fats, growth-hormone and steroid laden meats and increase the consumption of anti-oxidant-rich fruits and vegetables and omega-3 rich fish (organic would be even better!). Less time sitting in front of computers and video games or laying on the couch in front of the television and more time playing with the kids (quality time), participating in sports leagues or community clean up programs. These are preventive practices. These are the things that will lead to decreases in inflammatory diseases which include cardiovascular diseases, diabetes and cancer.

Self-Adusting

All you back crackers out there, this is for you. You need to STOP!! Getting a back to "crack" is no difficult feat, but making it through over 5 years of chiropractic school on top of 4 years of undergrad, essentially 9 years of schooling after high school is. It takes a lot of time, frustration and dedication to get here, so please allow me to do what I have been trained to do. After all, I'm not trying to be an accountant, psychologist or whatever it is you do.

Here's the deal with self adjusting. A subluxation is a motion segment that has become fixated, it has decreased motion. In an attempt to maintain global range of motion, other segments become HYPERmobile, they move too much. Studies have shown that when you self adjust by twisting your neck, what you're actually adjusting are those hypermobile segments.

Adjusting hypermobile segments sets you up for developing chronic instability. In attempt to create stability the body will build bone spurs, aka degenerative changes, aka arthritis.

Yeah yeah yeah. But when you pop it it feels so much better. This is because the quick impulse causes the musculature to relax, as well as cause mechanorecptors to override the signals from nociceptors (which detect pain) and what have I said in other posts? Just because you don't feel pain doesn't mean there's nothing wrong. And how long is it before you feel it's necessary to crack your back again? See, you didn't fix anything. Please, allow the experts (CHIROPRACTORS) to be the ONLY people who adjust you. We go through extensive training to learn this, in fact it's where our education differs from medical doctors, they focus on pharmacology and we focus on adjusting. Your long term health will thank you for it.

Structure and Function

I had a new patient today, a teenage girl with back pain. Cervical, thoracic and lumbar, but especially thoracic (right below her shoulder blades). I'm so excited, finally a BACK to work on. So far I've dealt mainly with extremities, although I shouldn't complain, people are finally realizing that chiropractic extends beyond the spine! But this situation got me thinking about the competing philosophies in chiropractic.

This girl has a scoliosis. She also has weak core musculature and weak serratus anterior musculature - muscles that keep your scapula lying flat against your rib cage. (She's also a chronic self adjuster, as well as recipient of "adjustments" from her brother. I'll write another blog on this.) Several weeks of a few treatments a week and exercises and she'll regain the strength and stability she's lost and she'll be back to life, pain-free. Fixed?

This brings us to chiropractic philosophy. There are several people at school who call themselves "function people." By this they mean they look at how the body physically functions. Can you perform this test? If not, there's a muscular imbalance for which you'll receive exercises to do and if you perform those exercises and get adjusted along the way to restore motion where it doesn't currently exist you'll reduce your current symptoms.

I don't consider myself a function person per se. When I think of body function I don't think it ends with physical movement. It includes our digestive system, allergies, asthma, colds and flus, everything that our body actually does. What does this have to do with chiropractic? Well, as I said in an earlier post, every function of your body is controlled by our nervous system. With something like a scoliosis, there stands to be a lot of nervous system interference. How does this affect her optimal health? Should her back pain be her primary concern? Am I doing this patient a disservice by not attempting to restore normal spinal curvature?

I understand how strongly what I just said differs from everything you've ever been taught about health (if it ain't broke, it don't need fixin). So I understand that hearing this for the first time, you might be a bit skeptical. This is where I really need to shine. The word "doctor" means "educator." At this point I believe I owe it to patients to explain both sides of the coin and let them decide what they want to do (how will they ever be compliant if they don't agree to the treatment as well?). If they only want to fix the scapula, I do that, but I need to constantly educate my patients on the importance of chiropractic until they finally get it and enter into a world of prevention through maintenance care.

Who, me? Couldn't be!

There's a wide spread deficiency in the world and its called personal responsibility. In today's world you can spill hot coffee on yourself and sue the people from whom your purchased it, as if you'd prefer to sip mildly warm coffee. CEOs can mismanage their companies with horrible unethical business practices and escape under the cover of a monstrous bailout plan. This could go on forever, but the point I'd like to get to is our health.

Fortunately our health is within our grasps. But we've given that up with all the other responsibilities. "It's in my genes" is the excuse. Today we believe we can't do anything about our weight because our parents were fat too. With that attitude we've freed ourselves to consume absurd amounts of nutrient-less, high calorie junk food while we sit in front of our tv's or computers. All this is guilt free because it's not my fault I have fat genes.

Unfortunately, an increased waistband is not the only perk of an activity-free lifestyle. Muscles begin to atrophy and dysfunction ensues. Eventually this becomes painful and the easy solution is a muscle relaxant and/or pain reliever pill. Many of us will reach for this cover up, but it does nothing for the actual problem. It takes exercise to build muscle strength and regain proper nervous control. This is something no one else can do for you. To obtain those results it takes personal responsibility and commitment to your health.

Today's society needs to take control of their health. Don't wait for symptoms to appear, we need to be proactive. We need to take the steps in the form of diet and activity (lifestyle) to prevent disease. This is not something anyone else is going to help us with, our government is certainly in no rush to encourage insurance companies to cover health maintenance programs to promote the prevention of disease. The results of improved lifestyle would reach far beyond our waists. Our self image and confidence would be greatly improved, rates of depression could potentially decrease, relaxing our reliance on our Prozac prescription which would ease up on our monthly budget. See where this is going? Whether we like it or not, healthcare is a business in today's world. And like so many of today's businesses it's being poorly managed and it's only a matter of time before it goes bankrupt. Unless someone starts taking some responsibility.