Science and Chiropractic

Have you ever read or heard something that on the surface made sense for a second but when you thought about it, it was completely banal? I had that experience this morning. One of my patients shared an article with me from Fox News about chiropractic. The article (that you can find here) was overall very positive with some interesting things to say. Unfortunately, the last paragraph is so stupid it is laughable. Mind you, I am not criticizing the author but rather the quote. Here it is:

“We’ve all seen the results,” says Dr. Nicholas DiNubile, an orthopedic surgeon and the author of the FrameWork book series. “But we need scientific research that shows what chiropractors can do.” For serious pain, DiNubile recommends that an orthopedic or sports-medicine specialist be your first stop.

Let’s talk about Science, since he referenced it. If you look up the word “science” in the dictionary, there are several definitions each with the general concept of a system used to come to knowledge from ignorance. In the scientific method  one asks a question, hypothesizes the answer, experiments, observes, and finally theorizes. If you look at Dr. DiNubile’s quote, you wonder if he really knows anything about science. The first thing he says is that we have seen the results. So, if the modern concept of chiropractic has been an ongoing experiment since the 1800’s, and we have over 100 years of observation, and “We’ve all seen the  results,” what type of scientific research exactly is needed, Dr. DiNubile?

To me, this smacks of a turf war jab. For years many medical associations have tried to maintain their hold on the world of healthcare by demanding scientific proof on their terms from every other industry. For them, they have established that “scientific research” has to be double blind, random, controlled experiments published in a peer reviewed journal. That works great for medication because a placebo can look just like the real thing and neither the doctor or the patient needs to know, which constitutes the double blind, and as long as you do your best to control or account for all of the factors, you can can get published in a scientific journal. Try performing a placebo adjustment! For that matter, orthopedists cannot really follow their own ridiculously stringent definition of scientific research unless a surgeon is unaware of whether he did or did not do a surgery. Does this mean we need more scientific research to see if knee surgery works? Along the same line, does that mean that we should not be doing knee surgery until we have more research?

In this chiropractor’s opinion, we do not need more research we need more people. We need people with enough sense to look at the results and to give chiropractic a chance. Case studies and anecdotal evidence over a long period of time is some of the best research we can do. We need people who are willing to conduct their own scientific experiment to see if their condition can be helped with chiropractic care. Finally, we need to be open to considering what works instead of doing nothing because a so called expert thinks we need more research.

Massage and Chiropractic

Massage and Chiropractic care go together like peas and carrots. By the way, who eats peas and carrots together anymore? Anyway, suffice it to say that they are very complimentary. Chiropractic is great at improving joint movement and coordination but can often be encumbered by muscles and fascia that refuse to relax. Along those same lines, massage is fantastic for removing scar tissue and relaxing soft tissue but if  muscles are guarded in order to protect injured joints, the massage will be ineffective, at best.

Generally speaking, getting adjusted before a massage is the best strategy. Getting adjusted helps reset the never impulses in the area which can turn off the protective muscle guarding. This makes for a more comfortable massage as well as a dramatically more effective one. In addition, it allows me, as the doctor,  to give the massage therapist some target areas where massage would really help.

Occasionally, I have a patient that is just too tight and guarded to adjust. In that rare instance, getting massaged before the adjustment is warranted. Then, sometimes it makes no difference whether you get massaged or adjusted first, if you are healthy and maintaining. In conclusion, there is great benefit to massage including but not limited to improved muscle tone, better blood flow, mental relaxation, and the release of toxicity in the soft tissues. When you combine massage with chiropractic care, you can experience synergistic improvement in your health.

Momentum of Healing

It is always interesting when a new patient who has never seen a chiropractor before,  and knows very little about it, asks what it will take to get better. When I explain that we are going to start off adjusting them three times a week, their eyes usually get very big and the eventual question is, “Why so often?” My answer is always the same, because you need consistency and momentum to heal.

Healing can be like climbing up a sand hill. When you first start out, the sand is the thickest and you are very prone to getting stuck or sliding back down. Likewise, if you are not concentrating on healing correctly, you can start going sideways and waste a lot of energy but not get anywhere. Heading in the right direction with enough momentum to gain traction is the only way.

Getting adjusted three times a week in the beginning of care provides the momentum necessary to progress up the sandy hill of healing. A little higher up on that hill it does not take as much energy so twice a week is sufficient to keep healing. However, stopping or slowing too much can make it difficult to get started again and complete the healing process.

A Year in Review

I haven’t written anything in quite a while and I have to confess that I have suffered from a bit of writer’s block. Not that there aren’t a ton of topics out there, I just have not felt the passion to write about any of them. So, I decided to write a little more personal blog about some things that are going on in my life and at Thomas Chiropractic. If this totally bores you, please send me ideas of topics!

I wrote an article several months ago about my knee. Back in March, I completely tore my ACL and tore both menisci. I felt sucker punched after the MRI and wrote this article about the pros and cons of surgery. I eventually had the surgery and was doing really well. That is the story most people know. In September, about a week after I was cleared by my doctor to start pushing the rehab on my knee a little more, things went awry. I was about knee deep in a pool standing on a baja shelf.  I went to go in a little deeper and expected the step to be about a foot and a half when, in fact, it was more like two and half feet. My knee buckled and became significantly loose. I went back to my orthopedist, Dr. Hansen, who said it felt like the ACL was torn again. The MRI was inconclusive but because the knee was so loose, we scheduled surgery. On December 28th, I had the ACL re-done. It was 90% torn which is why it was so lax. I have been able to work with my brace on and I have committed to only walking on level surfaces and taking it easy for the next 4 months at least. If that doesn’t kill me first, I am optimistic of a full recovery in about a year.

October brought a new addition to my family. Nora Allison Thomas was born October 4th at Sutter Roseville. Dr. David Scates delivered her by C-section. My wife, Michal, was in the hospital with complications the week before. This was her sixth C-section. The final count on children is in this order, three boys and three girls. All have recovered and we are finally starting to get some sleep. I did say final, right? Yes, we have six children. Yes, we are busy and crazy. Yes, we know how these things work. And, yes, we are definitely done. I take Bill Cosby’s response when people ask me why we had six kids, “Because we did not want seven!”

If you have been in the office during the last six months, you may have met Dr. Matthew Huseboe. Dr. Huseboe is establishing his practice here in Thomas Chiropractic. He has done a great job covering for me during the surgeries and for a few needed days off. I have had positive reviews from my patients when he has covered for me so, rest assured knowing you are still in good hands when I take some time off. Dr. Huseboe is skilled in a wide array of techniques but specializes in adjusting the upper cervical spine.

This past year was my most successful year to date. Since moving to this office in October 2010, we have more than doubled the number of patients seen in a week. I am so grateful for patients who appreciate good health through chiropractic and are willing to share with others my vision of it. I am looking forward to another great year of helping even more people. Thank you to all who have helped and continue to support me on this journey. I wake up every morning looking forward to adjusting more people to better health.

Holiday Hours

Wishing everyone a Merry Christmas and a Happy New Year!

Monday, Christmas Eve, December 24th: 8:00 am until 12:30 pm w/ Dr. Huseboe

Tuesday, Christmas Day, December 25th: Closed

Wednesday, Boxing Day, December 26th: 2:00 pm until 6:00 pm w/ Dr. Thomas

Thursday, December 27th: 8:00 am until 6:00 pm w/ lunch from 12:30-2:00

Friday, December 28th: Closed

Saturday, December 29th: Closed

Monday, New Year’s Eve, December 31st: 8:00 am until 4:00 pm w/ Dr. Huseboe, regular lunch time from 12:30-2

Tuesday, New Year’s Day, January 1st: Closed

Regular schedule from Wednesday, January 2nd on.

Preventative Health Care?

For you football fans out there, you will get this analogy. Your team is up by 2 with just over a minute remaining in the game. Your offense has done just enough to be up but your defense has played lights out. Now they start playing “prevent defense” and everyone drops back. What are the odds the other team drives down the field and kicks a field goal despite your screaming at them through the television to keep playing aggressively? Prevent defense stinks!

Likewise, preventative health care in most forms either does not work or does not exist, no matter how popular the term is. What exactly are you trying to prevent anyway? In chiropractic we mostly treat injuries either from a one time big traumatic event or cumulative trauma. How does one prevent that? In medicine they talk about preventing disease. Besides the fact that most of their tools are designed to fight existing disease, the premise is wrong. What is disease other than the body not functioning the way it is supposed to? Shouldn’t we then focus on health rather than disease? If we focus on health, then what we are really saying is that we want to maintain good health. In my opinion, “maintenance health care” is a far superior term.

When we maintain good health we focus on the positive. Instead of trying to create scenarios where the possibility of injury or becoming sick is prevented, shouldn’t we put our energies into helping our bodies work the best they can? In this way, when pathogens or traumas come around, our bodies will be better equipped to either fight or heal in an efficient manner. We cannot live in a protective bubble!

Let us focus on attaining and maintaining proper health. If we improve function and keep making the healthy choices that helped us achieve better health, we will avoid all of the issues that so called preventative health care seeks to treat. Let’s make maintenance care our priority and get rid of the term prevention care.

Strengtheining the Core Through Coordination

When we talk about “the core” of the body, we are typically referencing the musculature around the abdomen and low back. These muscles consist of the abdominal muscles (rectus abdomini,  internal obliques, external obliques, and transversi) and the muscles of the back (lattisimus dorsi, serratus posterior inferior muscles, erector spinae, multifidi, interspinalis muscles, lateral intertransversi muscles, quadratus lumborum, and to some degree the iliopsoas).

Strengthening the core has become a fairly popular mantra these days. Many of us are walking around with poor posture and a fair amount of dysfunction as a result of poor core stability. A weak core leaves one susceptible to a host of joint and disc injuries as well as overly tight butt and leg and muscles. In contrast, a strong core can prevent a host of back injuries.

The word strength, however, needs some clarification in the context of strengthening the core. When most people think of strengthening muscles, they picture muscles moving against significant resistance like lifting weights or power movement against gravity or some other force. These type of exercises can actually be detrimental to the core muscles and increase the risk of injury to the spine. Coordinating the movement of all of these muscles is what is most beneficial.

I mentioned in my last article that postural muscles are slow twitch, white fiber muscles designed for endurance. They need to be strong enough to hold you up all day. Strength, in this case, does not come from bigger muscle fibers but from having all of the muscles firing in a controlled and proper order. For example, if you lift a box, ideally your abdominal muscle and your spinal muscle would contract at the same time to stabilize the body so the shoulder and arms and hips and leg muscles can utilize their power to lift it. What often happens is that core muscles lay dormant until a significant strain forces them to respond. So, when you lift a box, you first engage your back muscles until you are upright then, if you go past vertical, the abdominal muscles will engage. Then, they will fire back and forth while they try to find a semblance of stability.

I bring this all to your attention to encourage you to strengthen your core appropriately. Exercises that promote coordinated movement like yoga, pilates, and modified exercises from yoga can make a huge difference. It can take time to build coordination and it takes a consistent effort. In the following videos, I demonstrate four very useful exercises for coordinating core muscles and therefore, strengthening it.

Cat/Cow

Bird Dog

A Safe Crunch

Side Bridge

Photo by bruce mars on Unsplash

Muscle Pain? Stretch It! On Second Thought…

Have you ever noticed that anytime someone has a muscle that is tight or sore the first thought is to stretch it? Don’t get me wrong. Stretching can be great and flexibility is definitely a sign of healthy muscles. However, sometimes you have to stop and consider the reason the muscle is tight before you go and stretch the heck out of it.

Considering the source of tightness in postural muscles is especially important. Postural muscles in the neck, back and buttock are designed to hold you upright all day long. The muscle fibers are called slow twitch/white as opposed to fast twitch/red in the legs and arms. Postural muscles become tight under stress and strain or when they spasm. When muscles work too hard to hold you in a poor postural position, the muscle fibers shrink to try and gain leverage. Lengthening them alters the leverage and proliferates the problem. Let me explain with an analogy. Let’s say you have a boss who was working you hard 5 days a week 10 hour days. When he sees you are getting tired and burning out, he schedules you for 6 days the next week working 12 hour days so when you go back down to 5 days at 10 hours it is somehow easier. Think you will feel better? Unfortunately, we do the same thing with our postural muscles. We use poor posture which causes our muscles to have to work too hard to hold us up and then when they get tired and shorten up, we stretch them which causes them to work harder for a shorter period of time.

Muscle spasms are a protective measure. When muscles spasm there is something deeper that is either injured or dysfunctional. Stretching a muscle in spams is not only counterproductive but it can also cause more problems. At best what you accomplish is relaxing muscles that are protecting a very sensitive structure. At worst, you can tear muscle fibers and cause further damage to the injured structure.

The best thing to do in either case is to shorten the muscle and put it in a situation where it is under less strain. Generally, this means doing the opposite of what most people think you should do. If your neck is tight, bend it backwards looking up. For shoulders, pull your shoulder blades down and back away from the ears. For the low back, bend backwards. Movement is better than just being static so don’t hold the position but rather bend back and then it bring it back to neutral 10 repetitions at a time.

Remember that this mostly applies to postural muscles. Fast twitch red fiber muscles definitely need to be stretched on a regular basis. However, if you have a strained or torn muscle, stretching can prolong your recovery if you are not careful. Tearing a postural muscle with normal daily activity is difficult. So, the next time your postural muscles are feeling tight, don’t stretch them, shorten them.

USO Donation Drive (Ends Oct. 31st 2012)

In Exchange for a Donation, New Patients Receive:
-FREE Exams
-FREE X-Rays
-FREE 1st Adjustment

Donations requested are as follows:
Twin size Sheets
Twin size blankets
Pillows
Hand Wipes
Sanitizing wipes
Snacks- nuts, trail mixes, beef jerky, granola bars, pop tarts, candy, fruit snacks, cereal, Kraft Easy Mac, crackers, peanut butter crackers etc, tuna/chicken foil packs/pop tab cans, slim jims, protein bars, peanut butter to go containers, Nutella to go containers
Personal Items: Baby wipes, hand sanitizer, sunscreen, lip balm, dental floss, toilet paper, eye drops, liquid body soap, eye drops, shaving cream, razor blades, disposable razors, q-tips, foot/baby powder, hand/foot warmers, icy hot patches, batteries (preferably AA), toothpaste, shampoo, toothbrushes
Clothing: BLACK or WHITE COTTON long athletic socks, Dark colored knit hats/beanies
Specialty Items: Ground Coffee (Peets and Starbucks are popular), zip lock brand bags (all sizes)

The biggest request right now is Twin bedding and hygiene products.

We are unable to send glass containers, so plastic and metal only please! We can not send perishable foods, fireworks, firearms, aerosol cans, or pornographic materials.