The spine has about 24 vertebrae with most having three joints. One joint is a disc and the other two are joints just like your finger joints that are synovial type but called facet joints. When we imbricate our facet joints of the spine as suggested by Horrigan in a condition called facet Arthrosis, pain can be generated just the same as when one stubs their finger or a toe. We all know that stubbing produces more than one type of pain because we have probably experienced it. The spine has 6 different pain mediators. Pain killers affect 2 or sometimes 3 different types of pain mediator. Meaning that pain killers have no effect on some back pain.
Imagine stubbing your finger against a wall over and over 24/7 for about two weeks. This behaviour would cause you to have a reasonably sore finger. You can stop stubbing your finger; probably because someone can point it out to you and unlike the spine you do not have to use it to move around. You have to use your spine when you move. Thus you will have a certain amount of stubbing that continues with regard to the spinal joints.
The spinal joints are surrounded by other tissues that can be pain sensitive and also be part of mixed up motor sensory signals within your nervous system. essentially a healthy joint is moving well in it’s full range of motion with synovial fluid providing nutrients in and waste product removal. A healthy joint is only part of the movement that you perform when you move. Having joint manipulation may be only part of a strategy to get you well, once again.
If you do nothing (called natural history) back pain will likely resolve in about 6 weeks. Pain killers can help to take the edge off of your symptoms during that time and you can get through it without body manipulation. Unfortunately the route of natural history can mean that your nervous system adapts to a new normal (learns to have back pain). This new normal is like updating your operating system on your computer; it is changed from the original. Once installed a new normal could return back pain as back pain is now part of your normal when you get up in the morning (load up your operating system).
Getting bodywork for a back episode helps prevent the accumulation of injuries that can occur when left to natural history. A psychological impact of (natural history) having pain in the body for over three weeks means that you become more sensitive to pain in the same area in the future. Over time you can accumulate many odd patterns of movement in a lifetime that lead you to abnormally load your tissues and send to the brain conflicting sensory motor signals. Conflicting sensory motor signals (subluxation, dysafferentation) can be the problem behind surprising bouts of back pain. The type of episodes that are really severe for a day or two and then symptomatically resolve like there was never a symptom. These conflicting messages are an indication that your sensory system could do with some help. A bodyworker provides sensory information to your brain about your body through the medium of touch (amongst other interventions). Once the right touch ‘language’ is used then your conflicting sensory motor signals conflict no more.
Chiropractic’s famous first adjustment story is recognized each year by the Chiropractic profession when we are reminded about our roots. There is much hyperbole about the story as one can imagine that occurs when embellishment meets embellishment and enthusiastic well meaning generations alter the story slightly to fit with their momentary feelings whilst retelling the story. This process repeated many times over gives a sense of mystery. The stuff every good story is made up of. For example this year the ICA have released their version of the story as:
‘On this day, 118 years ago, Dr. Daniel David Palmer administered the first specific chiropractic adjustment on his patient, Harvey Lillard in Davenport, Iowa. Dr. D.D. Palmer delivered this historic first chiropractic adjustment with the specific intent of realigning a malpositioned vertebra on the patient, restoring its normal position, and Harvey Lillard, who had lost most of his hearing 17 years earlier, noted his hearing swiftly returned under Dr. Palmer’s care.’
I personally have had two people have vast improvements in their hearing and know of 5 other chiropractic patients that have had vast improvements even two brothers under consultant supervision within the NHS who had years of tests and investigations as to their hearing deficits. The real life examples are there but few and far between to really ‘hang one’s hat on’.
Not only was the story of DD Palmer rare but a stroke of luck as described by Life University in their reconstruction of the story told by DD Palmer himself(!) http://www.youtube.com/watch?v=kSfQQGAkb7k In this telling the story is different to the intended and ‘specific’ nature of the first adjustment by DD Palmer. Here the story is that DD Palmer was saying goodbye to Harvey Lillard and on the staircase gave him a truculent slap on the back with a large book. A few days later Harvey returned to DD unannounced and said his hearing was significantly improved. Chiropractic had a chance beginning.
DD seemed to have gotten lucky and then set to work to explain what he observed. There is not mention of how many other people he tried to slap on the back with a book who had hearing problems or of his attempt to replay the context within which the slap was given. DD immediately set to work on the spine and tried to be more specific in his net application of force to Harvey. Further ‘ adjustment’ restored the rest of Harvey’s hearing (or now that Harvey was primed his expectation was to create the same state and rapport and he’d naturally get better). This is a great story and one that has set the tone of the profession from bone setting (DD had training in) into the muti technique conglomerate of done by hand that is helping millions of people get well today.
I have a particular view based upon how our practise is set up today that the first adjustment was as much about the context, meaning, intent, environment, priming and belief as much as it was the spine to ‘align’… Ever since Chiropractors have been stuck on just the spine. By using nothing more than interaction, simple props and rapport humans can help other humans over come just about anything as long as their culture and/or they think it is possible to get well (hope).
In my mind there are a myriad of explanations for why Harvey Lillard had an improvement in his hearing. DD Palmer explored many and found that adjusting the spine had a miraculous effect. Just as alcohol could fuel the first riders in the Tour De France times change, perceptions, knowledge and culture changes. Thus today the founding principles of Chiropractic cannot be held onto. They can however be kept as a comforting story about the beginnings of the largest non drug health care profession in the world. From such chance beginnings people have a way of being healthy that does not have to involve drugs. Education, knowledge and standards are changing and those for Chiropractors have changed too.
In yester year there may have been a singular adjustment that was considered the reference point that made a difference and lead to the ideas of administering an adjustment. Contemporary Chiropractors realise that the same rules do not apply today as they did one hundred and 18 years ago. The first subject may have been ‘subluxed’ at his T4 segment or his atlas (depending upon which story version you hear!) whereas today a look into the nervous system of a person may look something like:
Symptom: upper cervical pulling sensation that leads to an almost unbearable migraine that is not totally relieved with valium, pain killers and anti-inflammatories. Imaging was unremarkable.
Chiropractor interprets: Occiput dysfunction (CN10 vagus nerve), no sacral dysfunction or lower extremity dysfunction, CN9 motor dysfunction at back of throat, cn12 tongue motor dysfunction, cn11 traps weakness and opp scm (hemisphericity?), along with external ear pinna sensitivity (cn9), shimizu reflex, larger vessels in the eye, eye press dysfunction in changing heart rate; corneal reflex is ok so just cn10 dysfunction etc. Chiropractors continue along a deductive line of thought based upon the idea that somewhere the body is telling the brain the wrong information creating a Chinese whisper (subluxation) that creates an unconscious reflex response from the brain to create the sensation of a symptom. The point is that examination today is in more detail than it was in 1895 by a long way due to the advances in science and the understanding of the brain body and body brain connection.
Some chiropractors can rest on their laurels and only follow lines of possibility that are similar to the founding principle of everything comes from the spine. Even though this line of enquiry into human health was reinforced by Henry Windsor MD in 1921 for just over a decade who demonstrated that natural causes of death correlated exactly to the controlling level of the spine 99% of the time in cats dogs and humans. There have since been advances in knowledge around causes for changes in human health that are not considered a disease process. For example: development (attachment), interaction, genetics, trans-generation habits (copying conscious and unconscious aspects of influential people), environment, activation of HPA axis (trauma), culture, religion, mechanical injury, insidious injury, infectious load, fitness, family commitments, pressure of life, relationship with yourself, diet, hours driving, hours sitting, free time, spiritual development, social group, and knowledge are all factors to take into account when considering the health of a person’s nervous system.
Stories convey meaning and enable us to feel. We can all recognise a pleasant feeling over an unpleasant feeling and thus a good story from a bad. Altrusim / helping the greater good of mankind is a great theme to help Chiropractors be reminded of why they are chiropractors and not a time to return to the (original) adjustment being king and everything is from the spine! May the chiropractic profession expand, spread the modern word and help millions more people.
Sitting for long periods doesn’t help people feel good naturally but is this really a problem or are some people moaning?! When we sit we sit on our gluteal muscle group as well as the backs of our legs (Hamstring muscles), possibly sit bones and greater trochanter (hips). Recent findings about the gluts has changed professional opinion about the gluteus maximus in humans. It was thought to be different to monkeys but now is thought to be very similar to that of monkeys with almost identical origin (where the muscles starts) and insertion (where the muscle goes to).
What I can deduce from our current anatomy is that we’d have had a functional element to the gluteus maximus other than a cushion way before even the first chair or log was sat upon. Our anatomy suggests that we have a sling system (roughly) incorporating the tensa fascia latae, gluteals and sacroilliac ligaments; meaning we have the tools within our body to squat down and be supported by a sling of tendon know as the IT Band or Tensa Fascia Latae (TFL).
The ‘natural squat position of a child and that of a monkey are very similar. When we use a chair we do not need to hang supported on our natural sling and thus do not have the muscular co-ordination required to hold the body in the seated shape (within Earth’s gravitational field). Thus the brain will be getting ‘bum(!)’ information and given enough time will not be able to coordinate sit down or stand from sitting efficiently. It is common thought that people who have had more time on the planet cannot sit to stand or stand to sit due to age; this concept I dispute. We simply do not practise or reinforce the co-ordination of movement required to sit down and stand up efficiently and thus we will over time go more and more wrong. When we go wrong we cause wear and tear, pain and tight or slack musculature.
By squatting down we are resembling how monkeys will ‘sit’ and how our anatomy can increase circulation in our hips rather than reduce circulation by sitting on our gluteus maximus. It is a medical norm to expect to see some wear and tear (coxarthrosis) and reduced circulation in a man of only 40 years of age! I think this is a medical norm because medics are looking at the smallest parts of physiology and have not yet begun to understand the machinery (anatomy) of the body.
I believe that when we become uncoordinated it will be the cause of pain in cases where there is no obvious injury 97% of the time. An insidious onset for back pain is presumed to be due to age. Medicine falls so far short in understanding the body mechanics that it would be like going to see a caterer to help you put up a marquee. There are some overlooked aspects of muscles that can lead to musculo-skeletal dysfunction which are easily explained without having to describe a primary injurious mechanism. People who have had back pain or treat people that have low back pain are often fixated on the cause. This day and age if it isn’t cause and effect then it must be a trick or something sinister! Whilst almost every western person is having to perform sit to stand and stand to sit I suspect that very few are practising how to perform this movement. To condition our body to be strong in a particular way we need to repeat the action in an intensity that is enough to create adaptation but not enough to injure. The best posture to sit in is a squat. How you get to a squat position in my opinion is through the Qi Gong wall squat technique as this enables us to integrate our body from head to toe. Other variations on a squat movement may concentrate force at particular points of the body. Ideally for health one would look to integrate their whole body in a given movement. Through integration we reduce thixotropy and improve proprioception.
The time it takes you to learn the wall squat techniques can vary from a few weeks to a few years depending upon your current ability. The point of the exercise is to coordinate your whole body within the movement and not to simply reach the lowest point. If you can only squat down a very short distance like many out there will find, then begin with a short distance and with practise within your chosen personal limits increase the distance you can squat. The only thing to improve against is your previous ability. If you are not improving then you are likely getting worse as our dynamic body and brain do not hold static ability. The art of integration of your body is much more important than copying the full movement. If it doesn’t feel right then odds are it isn’t! consult an expert who can help you to reach the goal of always being able to sit to stand and stand to sit in a whole body integrated way so that you are aware of how your body works together through your own internal representation of your body through your mind’s eye. The internal art of movement is something being slowly lost from the human race which will lead to more focus on accumulating stuff and experiencing more pain. Movement and a chiropractor like me is what your body wants …
As humans we are driven by our nervous system, a system that facilitates an engagement with our environment and each other. The stimuli we receive from our genes and our environment via our nervous system molds us into the people we are, right now. Genes can be ‘changed’ by environmental neurological input called epi-genetic change. Our many bacterial cells, which outnumber our human cells 10 to 1 produce viruses in response to environmental stimuli (toxins). Whilst on the outside social interaction and our wider society teaches us to find our place and stay there for 30 years. Times are changing and people just do not have a job for life in the UK anymore. Yet finding our place is incoherent to our nervous system. We thrive on new experiences, problem solving, social connectivity (healthy relationships; including with ourselves). The industrial revolution gave us a division of labour tactic whilst stripping us of our individuality.
The human population was stable before the industrial revolution afterward however the population continues to rise. A continually rising population in the world is causing it’s own problems to solve but it is stimulating some change as people innovate their way into the market place. Who moved my cheese is a great economic guide to how people can have their jobs in a flux of constant change and thus so to must the individual which fosters neuroplasticity. In the case of becoming ill we have become stuck e.g. our inner processes and strategies have enabled us to get to our current position in life and when the external world changes the person doesn’t know they need to also change their inner world to suit reality. When we cannot match up the inner experience, with the outer reality then we will at some juncture in our nervous system go awry.
A constant trend of learning is helpful to continue the process of neuroplasticity as is also exercise. Inherently being ‘wired’ to seek a difference (or a newness) is therefore in our nature. At present however it is not in everyone’s behaviour. When we have not experienced a change for a while we can get ingrained in our ideas, behaviours, interactions and perceptions. We can actually feel a negative emotion when we encounter something in the outside world that is contrary to what we have become ingrained to except/expect. A negative emotion might be anxiety or disgust for example. Neurologically speaking we need the right input (the penny to drop) before we can move onto our next lilly pad or chapter of life. When neuroplasticity occurs our brain actually starts a process of re-wiring.
Changing your brain can occur instantaneously. Sounds easy doesn’t it… ?! Monkeys (of Silver Springs) have been studied with regard to neuroplasticity and have demonstrated a re-organisation in their brain cells within 2 hours. Macaq monkeys, elsewhere, have also been studied for their neuroplastic ability and are 30 million years behind homo sapien sapien in development, meaning that being 30 million years more advanced we humans can change our brains for sure; faster than two hours.
In the Chiropractic literature adjustments of the cervical spine have been shown to cause a ‘re-organisation’ of the human brain. Learning a language has also been shown to foster neuroplasticity in the hearing acuity of an adult human.
Looking for variety, feeling many differences in life, experiences outside of the hum drum and a constant vigil on our self improvement are behaviours that can enable us to drive neuroplasticity in ourselves throughout our life. Exercise, nutrition, education and body work are all examples of how we might go about ensuring that we have a variety of neurological input into our nervous system throughout our life. When neuroplasticity stops we get stuck in our ways, have to have things a certain way and perhaps transition into behaving ‘old’. Staying young at heart is a colloquial way of keeping neuroplasticity happening in your life. Staying ‘young’ is beneficial to your health.
We know the hypothalamus (a part of the human brain) is highly plastic (changeable), in fact some say the most plastic part of the brain. The hypothalamus stimulates or inhibits hormones. Hormones secreted by the hypothalamus are able to alter the job of certain cells. Thus a chain of possible change within any and every human is present. When we stimulate the hypothalamus to produce particular hormones we learn automatically a default to produce them. One could say we get more used to being us.
We are actually rewarded in the brain with opiates when our regular ‘molecules of emotion’ are released. When we try another way (state of mind) we do not get a reward, why effort is required to change, why a feeling of being wrong comes with any change we try. Those that are guided by that inner feeling are shied away from change because it doesn’t ‘feel right’. Those who are in their head have a flurry of mixed thoughts, tangential ideas and not knowing for sure that their current action is the ‘correct one’. Those that are guided by how their body is; tend to get a difference in their body such as they do not feel good in their body, they are sluggish or they have transitory pains that aren’t usually there, for example.
For me the way the media reports upon ‘mind over matter’ can lead one falsely down a path of whenever I need I can control anything that comes. Like being a superhero. In the real world we cannot control everything. Monks who live on mountain tops in isolation for 30 years do not get to reach enlightenment. Really any mind over matter situation needs to be delineated from ‘pushing through it’ and to have a time frame added. For most people they do not have a spare 30 years to try it out to see for themselves!
Essentially we are human beings with many different ways to be (states of mind). We will find it easier to be different or to change whilst our nervous system is still growing (spinal columns complete in 4th decade of life). After this time the amount of effort required for change becomes increased as more energy is required to make a change e.g. rewire our brain. With every change thus comes the wobbly part big or small, short or long.
The icing on the cake of difficulty with change after 40 is the future psychology of human beings. Doing things in the future is easier than actually doing them. The future psychology of taking out credit is a great example of how we consider it less of a risk because I can pay it (do it) later. Whilst we need time to be human beings with meditation we also need time to be human doings with exercise. Both exercise and meditation have been shown to have an epi-genetic effect toward health. Next time you are considering making a change do not underestimate the amount of effort required, time required and energy required whilst also not forgetting to include the amount of euphoria and reward you will receive when you ‘make it there’.
For example a study was able to demonstrate that actual physical muscle growth was achieved over a 6 week period of imagining a gym programme; yes our minds can affect physical body tissues and no it is not an easy thing to add to your already busy life. Hence why no man is an island and we need help from others e.g. a chiropractor to help my body move better helping my body tissues last longer as a complimentary lifestyle choice to regular exercise and a healthy diet. Sometimes however issues of trust and of giving over control can get in the way of you getting off your own inner island and making a powerful healthful connection with another human being (in my opinion).
when working with the body to get a message across body workers can often use didactic information which without prior knowledge, in detail, of a profession like Chiropractic, an outside of Chiropractic scientist may scorn at the turn of phrase used – e.g. fascia has memory or your emotions are stored in your fascia. Scorn away!
Due to the didactic information, as every educator on the planet will know, we need to tell lies to improve our communication, we need to express what isn’t true so that we may teach others what is true, to the level of their attention. Fascia is an extension of the skin between the muscles and the tendons, giving us a thicker skin or a second skin. An emotional trauma can affect the body: For example you are prone to anger bursts, anger is our emotion and kidney or stomach fascia is our targetted tissue.
Feeling the (usually right) kidney area and or the stomach area is easy to feel to a body worker trained in visceral manipulation. The left kidney in function is tied up in the reproductive system. How many of you will feel the difference of your visceral tissues from one day to the next?
The fascia is whitish in colour and thus has a poor blood supply, when a bout of anger hits the body tissue relative will tense, sometime we do not know our own strength and will break something when we are angry; the same happens to our fascia our muscular contraction or body contortion is so much that we create micro trauma to our tissues. Fascia will heal itself when we apply the correct forces across it. Once we have injured the fascia we will inherently move away from the tissues weakness and avoid applying forces that heal the body tissues naturally. This can lead to something as simple as oesophageal reflux, flank pain due to referred kidney pain without any physiological tests found positive or something a little more esoteric like have recurrent nightmares / terrors.
Thus the fascia does not heal and it seems as if the tissue has a memory as it does not change from the day you microtraumord it. The fascia looses it elasticity as part of applying a normal force across fascia is to stimulate the laying down of new ealstin and MG ion cross links. The micro movement nuance is missing from your body useage and the tissue is destined not to heal, leading ultimately to an ulcer formation, achalasis or perhaps needing hypertension medication or developing osteoporosis.
Simply noticing through a regime of working to get to know your body such as the chinese systems of qi gong allows us to be able to detect, as in get to know, the energy, the physical ease, your cognitive application and your balance of emotion within your body. Once we know these things we can regularly access information on them and know when they are not correct. Seeking the appriopriate helap of a body worker of of a psychotherapist when we need it. Utilising medication to cover up symptoms if you really need to, initially. Ultimately the problems or pain we face can be resolved before we get to pain. Pain tells you you are ignoring you… why then do we first reach for medication to cover up what we feel????
The classic example of somebody having a restriction in their flexibility and they feel it at the back of the legs is thought to mean tight hamstrings. Yet in a fascial model of the body the TFL muscle is actually under about twice the strain that the hamstring muscles are under during a straight leg raise. The most obvious place to consider changing would be the side of the leg in tight hamstrings and not the back of the leg where it is felt! The fascial connections of the thigh are complex and numerous; for example in clinical practice I have ‘worked’ on the adductor muscle of the lesser affected leg and gained 20-25 degrees of extra flexibility in a straight leg raise of the more affected leg.
Having the view that my problem is where I feel it is a difficult concept for most to let go of. Sometimes where you feel it does not need to be changed. Where you don’t feel it does! Having an in depth knowledge of anatomy and understanding human movement and how tissues interact within the human body is essential to truly get to the root of a musculoskeletal problem.
Training such as in a Chiropractic degree (undergraduate Masters) is ideal to start to see the root causes of a problem within the human body. When the human body is not able to change in a certain place, the body compensates and thus moves the symptom, yet the root cause is still the same; there is just a longer more complex chain of events that exist once a compensation occurs. Addressing the fascia before any adjustments is my strategy in clinical treatment. This way I am able to work through the layers of compensation until I find the root cause. Step one for you with tight hamstrings is to come to terms that the root cause is most likely (if you’ve had the problem for more than 5 days) somewhere else (in my opinion) than the back of your leg. Psychologically speaking if you keep on putting your problem to the back of your legs you will in fact keep a problem at the back of your legs! When seeking help from a Chiropractor it can be useful to look up the conditions that have evidence behind them.