The Zen Corner

Science, Art, and Philosophy of Chiropractic


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Heel Lifts and Inserts

heel-lifts-for-scoliosis

Many people heard of heel lifts or inserts and some people were prescribed them by medical doctors. There are many experiences regarding heel lifts or inserts to help balance the leg length differences. Most often times they are used inappropriately. Some people have a functionally short leg which does not require heel lifts or inserts. Only to those who have an anatomically short leg with specific conditions may be helpful. Not all the time can the heel lifts can be helpful. How do we know when you have a functionally short leg or an anatomically short leg?

True Short Legdalton01__1_1_5760

To determine an anatomically short leg, the easiest way to find out is to get a ruler to put on the top of the knees parallel to the floor and then on the front of the knee while you are sitting. If the knees are even on the top but one leg is short on the front of the knees, it is a good possibility that there pelvic misalignment that can be corrected by a Chiropractor. If both top and front of the knee indicate a short leg on one side, then there is a pelvic misalignment or an anatomical short leg. If the ruler shows that it is only a slight difference, then most likely it will be a pelvic misalignment.
When it is a pelvic misalignment, it is considered a functionally short and chiropractic adjustments will help to regain balance. When it is a true anatomically short leg, there are conditions for giving heel lifts.

Dr. Gonstead’s Conditions for Heel Lifts:
  1. There must be a leg length deficiency of 6 mm on the radiological film.
  2. Rotary scoliosis must be toward the side of the leg in question.
  3. There must not be any hip joint degeneration to a marked degree nor a knee problem on that side.
  4. The client should not be older than 35 years of age. Never give heel lifts until growth has ceased, which would never be before 18 years of age.

After the first radiological x-ray film, chiropractic adjustments to correct the spine and using heel lifts, retake the radiological x-ray film after 30-60 days to make sure that the condition is not getting worse. The most area you will see changes in the most is the upper neck and the junction between the middle to low back will change for better or worse.

When the client gets a burning sensation in back after wearing the heel lift, don’t worry because it is a compensation and eventually the body will get used to the heel lift. Heel lift should not be given if there is pain involved, only after the pain is gone. The heel lift is for stabilization of the spine and hips and the heel lift itself does not correct anything.

The leg measurement from the crest of the ilium to the malleolus is worthless, but it is commonly used medically to determine if a built-up shoe is indicated.wpid-photo-12-jan-2014-0134

Potential Long-Term Side Effects of Using Heel Lifts:

If a lift raises only the heel, then there can be “bridging” between the heel and the ball of the foot. This lack of mid-foot support can cause arch problems, particularly if a soft lift is constantly pushing the foot upward against the tongue of the shoe. This can be avoided by using a lift which is long enough to support the mid-foot almost all the way forward to the metatarsal area, and which does not compress when walking. A well-designed heel lift should effectively tilt the footbed or insole forward as if it were part of the last of the shoe, rather than leaving the mid-foot unsupported. In heel lifts, longer is better.high-heel

The addition of a lift in the heel of a shoe causes the foot to be resting on a slope downward toward the toes. This can cause fore-and-aft slippage in the shoe when walking and can result in calluses under the metatarsal or ball of the foot or the large toe. This effect is very dependent on the person’s gait and stride and is seldom serious unless the calluses become corns, but they can be annoying. Such calluses can be avoided or reduced by the use of cushioned or silk socks, to reduce skin friction while walking.

Achilles tendon issues since a heel lift raises the foot within the shoe, it can cause inflammation of the tendon due to the pressure and rubbing of the narrower top part of the heel cup or heel counter pressing against the tendon, and it can cause shortening of the tendon and hamstrings due to the reduced angle at the ankle from the steeper slope on which the footrests. Tendons which are not stretched regularly tend to shorten. The reduction in tension on the Achilles’ caused by the use of a heel lift can be beneficial if the therapeutic goal is to allow for tendon healing. Achilles’ tendon shortening can be counteracted by regular stretching exercises which stretch the calf and bend the foot and ankle gently upward under light tension.

All molded foam in-shoe lifts are soft enough to create appreciable vertical motion in the shoe when walking or running, and the increased rubbing of the heel can cause calluses and blisters, inflammation of the Achilles tendon, and excessive wear on socks and shoes. Also, the constant pressure of a soft shoe lift pressing upward against the foot has the potential to cause or aggravate mid-foot and arch problems. Unless you are trying to cushion or reduce the impact on inflamed pressure points such as plantar warts or heel spurs, the use of compressible gel or foam heel lifts should be avoided.

A Short-Term Issue

In the short term, the acutest problem likely to come from using shoe lifts is associated with “height-enhancing” heel lifts, which are placed more than 1/2″ inside common types of shoes. If the height inserted is more than 1/2″, the heel will not be firmly held in place by the shoe and the wearer will tend to walk out of the shoe and be prone to sprain or break an ankle after losing control when the ankle rolls to the side with the foot tucked under. Shoe inserts which add more than 1/2″ of height should be avoided, due to this risk.

Only you can determine whether possible issues resulting from the use of therapeutic or height-enhancing shoes or lifts are acceptable for you and your body, but the use of in-shoe heel inserts is probably best prescribed and monitored by a Chiropractor.

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Good, Bad, and the Ugly. Crack My Neck for Relieving Pain.

There are many situations where your spine will crack on its own or intentionally cracking them. The cracking of the spine in any different situations has an effect that can be good, bad, or ugly.

Good:

After a certain time period of a Chiropractic adjustment, the spine tends to realign the other vertebra on their own. Most likely the other vertebra was not in the right position are starting to go in the right position by themselves. When your body introduces any kind of force, such as when you are doing light stretching, turning, bending the spine realign. There is nothing to fear but to let your Chiropractor know what happened. Check out the former blog about this topic: https://zenchiropractic.wordpress.com/2012/11/29/what-happens-when-my-spine-goes-pop/

Bad:IMG_0006

When your spine pops and pain follows immediately then the joint became unstable and causing inflammation and muscle spasm. Even if you didn’t put much stress or any motion on the spine something pops and then the muscles around are creating spasms and sharp pain. Often times these situations are the vertebra was already starting to fall out of place and it was a matter of time when it went out of position. In this case, put ice on the area and get to a Chiropractor that will use x-ray, neurological exams, and education on what has happened and properly adjust that vertebra.

Ugly:

The unprofessional person intentionally twisting of the neck or low back of themselves or to others may create the cracking noise but then they will cause tendon and ligament to tear and create more instability. Over twisting the neck without proper examinations and professional skill then people are at risk possibly damaging artery integrity that is already weakened and may cause cardiovascular problems in the brain. The mistake is to think that by over twisting the joint the crack is more intense and the better you feel.

26real_450That cracking noise is not what Chiropractic is defined by but that is a very big misunderstanding. Cracking in your joints creates an endorphin response that gives you a euphoria for a moment but does not solve the actual joint problem. Properly correcting your spine takes a long training from a graduate level school and getting a state license. A grand total of 4485 hours of clinic hours with health science education. Many people attempt cracking their neck and low back themselves or ask others that are not professionals to crack their spine.

There are many other professional and non-professionals that try to say that they do chiropractic. Professionals such as massage therapists, physical therapists, sports therapists, and even some medical doctors to copy chiropractic because they know how effective Chiropractic care is. Non-professionals such as your friends, families, people you meet at the bar or parties, or any individual that offer to crack your spine or neck on the street. This is why people have an incidence of having a very bad experience with cracking their neck or back because they think it is just cracking is what helps the person. People could get damage to their muscles and ligaments, and damage to the artery structure in the neck.

gonstead and spine

Dr. Gonstead’s Story:

Dr. Gonstead once had a farmer couple come to his office. The wife of this farmer was in a lot of back pain. Dr. Gonstead found the problem after careful analysis and adjusted the spine and told them to come back next week. The former couple did not come back. In fact, they didn’t come back for months. Then the farmer couple came back and the wife of the farmer was in a lot worse back pain. Dr. Gonstead analyzed again and it was much worse condition than before, so he asked the wife what happened. The farmer’s wife confessed that her husband tried to copy Dr. Gonstead after watching him adjust his wife after they went back home. They thought they could do the adjustment themselves not knowing how much science and careful skill that Chiropractic adjustment involved.

Summary:

There are many occasions were your spine will crack on its own. Some are fine because it is the process of our body to correct and heal itself. Some are bad because the spine got very unstable and finally went out of place. The worse is just because you want to feel the euphoria and cracking your neck or low back and causing a major set back of unstable joints does not help yourselves or the person you are trying to help. You could even cause serious damage to yourself or to others. It is not about cracking your neck and it is not about being a crack dealer for people. If it is about helping people, you should become a Chiropractor or go seek one to help your friend. They will find the cause and stabilize the situation.


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What is Chiropractic Treatment?

Chiropractic care is always misunderstood with medical care. Once the symptoms are gone, then the client tends to think that they have no need of care. This is a medical understanding of Chiropractic care. Chiropractic is originally was more concerned about the function of the body and the cause of the symptoms. Chiropractic should not be misunderstood as treatment care or therapy because they remedy the symptoms. Chiropractic is all about finding the cause and finding solutions instead of covering up the symptoms. Chiropractic doesn’t treat symptoms but rather they observe the cause of the symptoms and when the cause is gone then there is no need to do any chiropractic adjustments.

What are they really looking for? Chiropractors are looking for the cause of the symptoms which is subluxations. Subluxations are slight dislocation of the spinal segment that chokes the nerve and limits or interrupts the communication and function of individual nerves that connects to muscles movements, heart functions, and many more! Once these subluxations are gone, there is nothing to change. If there are signs of subluxations then that is what Chiropractors adjust and restore and monitor. If there are signs of subluxations then the Chiropractic adjustments continue.

How do Chiropractors monitor subluxations? Many Chiropractors do a physical examination of a range of motion, pain scale questionnaire, orthopedic tests to measure that the symptoms are gone. Although this method is still only measuring symptoms so in this set of examination they are only looking to cover up the symptoms. There are Chiropractors that go further and take radiological examinations and have x-ray films to see the spine and re-take x-ray films after a certain amount of time. The public and normal people are not educated in looking at x-ray films and anatomy of our skeletal structures. That means we are at the mercy of the Chiropractor to tell us if we are progressing well. Most often times they say that there is progress and we just agree because we don’t want to look like we have no idea what they are saying. There are also other assessments for subluxations such as monitoring spinal thermographs, a static electromyograph, electrocardiographs, and many more assessment tools.

X-rays:normal-cervical-curve1

Some chiropractors use x-rays mostly as a scare tactic to make you fearful of your condition and sign up for chiropractic adjustments and never use them. Very caring, objective and scientific Chiropractors are always looking at them when the client comes in and analyzing and comparing the x-rays to the client as a reference. Most of the time Chiropractors want to see if there are specific conditions such as fractures, malformation of the bone structures, and degeneration. This will help to specify the Chiropractic adjustments for more efficient structure in the body so that adaptation to stress is more efficient. When x-rays are taken, many Chiropractors are not being careful of positioning the client and sometimes create scoliosis like an appearance to the x-ray. Which means they are adjusting the spine thinking there is scoliosis but there really was a misinterpretation.

The most important part of using x-ray in the progress of care is to see if the Chiropractic adjustments are improving degeneration, changing the structure of the spine, and further specify the chiropractic adjustments for the clients.

Neurological/Physical Examination:

hc_epilepsy_diagnosis_neurological_exam_articleMany Chiropractors check for pain levels, sensations on different areas of your arms, feet, orthopedic tests, neurological reflexes, checking the range of motion of the neck or low back. Many times these tests are necessary for very severe conditions and not always accurate for subluxations. Most of these tests are orthopedic medical doctor’s procedures and is not designed for assessing subluxations. Often times these exams are initially examined but it is not too often that the results are re-examined again. The results are not explained and do not correlate very well with the client’s problems. Many health insurances require the Chiropractors to do these tests for insurance to cover the chiropractic adjustments.

Computerized Neurological Examination:

There are many emerging assessment technologies for subluxations to make the chiropractic adjustments to be specific and have the better idea of the progress of the personal health. Subluxation Station from Chiropractic Leadership Alliance has been in the industry for more than 20 years. Most common assessment has been measuring heat patterns of the spinal areas called Spinal thermography. Subluxations have inflammation of the nerve and the spinal thermography detect areas of subluxations and the conditions and progress of each nerve. Another common assessment is measuring the state of muscle spasms with static electromyograph. Subluxations cause muscle spasms with imbalanced contraction of muscles. By using the static electromyographs we can see the how new or old the subluxations are. After a number of chiropractic adjustments, the muscle condition can show us how our body is adapting to our stressful environments. A recent technology has been used for assessing subluxation is electrocardiographs. This is measuring the variability of our heart rate to assess how our body is adapting to the environment. Our body is dynamic and constantly adapting to different environments. Electrocardiographs will help chiropractors to assess their chiropractic adjustments are getting rid of the subluxations and helping people to have their body to adapt to the environment.

Before-Muscle1

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Thermal-before1

Chiropractic Adjustment:

In the media, the chiropractic adjustment is often confused with twisting the neck or low back quickly and making a cracking noise that reduces the pain. First ever chiropractic adjustment was not as such. D.D. Palmer investigated the medical history of a partially deaf man, Harvey Lillard. Lillard informed Palmer that while working in a cramped area seventeen years earlier, he felt a ‘pop’ in his back, and had been nearly deaf ever since. Palmer’s examination found a sore lump which he believed was a spinal misalignment and a possible cause of Lillard’s poor hearing. Palmer claimed to have corrected the misalignment and that Lillard’s hearing improved. Two important things from this D. D. Palmer: Chiropractic was not discovered to help back pain, Chiropractic was discovered because chiropractic adjustment helped restored the function of the body.

Chiropractic adjustment and Osteopathic Manipulation Therapy

Often times Chiropractic adjustment is confused with osteopathic manipulation therapy. Chiropractic has always been about restoring spinal misalignment and correcting subluxation only. Osteopathic manipulation therapy is a broader spectrum of therapeutic options in addition to thrust techniques, among which are myofascial release, muscle energy, counterstrain, visceral manipulation, prescribe medication, and surgery.

Chiropractic Adjusting Devices vs. Chiropractic Manual Adjustments

Chiropractic adjustments have various techniques and some useful tools to adjust the spine. Traditionally, chiropractic adjustment was performed by hand only. In the latest century, there were many devices innovated to do the adjustment such as an activator, adjustor, and much more is out there. Many people prefer the chiropractic devices because they seem safer. Although, there are controversies whether the chiropractic devices help people. With Chiropractor’s adjusting manually by hand only, the experience is the best indicator of getting best results for clients with specific conditions. Younger the chiropractor doesn’t mean less experience because some people will practice and discipline themselves to learn how to sharpen their skills.

Specific Chiropractic Technique websites such as Gonstead Clinical Studies Society shows the Gonstead technique practitioners when they attended the last seminars and how many years they are in practice. This may not always be the best indicator of how much practice and skill a chiropractor has. If anyone is looking for a skilled chiropractor, please contact the office.

Office:952-500-8733

http://www.zenchiropracticinc.com


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Does Chiropractic Care Never End?

This is a million dollar question. Does Chiropractic care ever end?

Many people are suspicious about Chiropractic care because in their experiences are that the care never ends. People pay thousands or dollars over the period of time. Their frequency of care doesn’t decrease and the cost keeps mounting up. At one point their most observable results starts to peak and you feel that your health condition is not changing. These are concerns of the public and this concern is very legitimate because they are paying clients that want to get observable results. People should reach their goals when they reach the result they wanted and eventually their chiropractic adjustments should end at a certain point. What is the starting point and how frequent is chiropractic adjustments?

Frequency of Chiropractic adjustments:

Only way to really know how frequent the person has to come in for chiropractic adjustment is determined by how the first chiropractic adjustment has helped the subluxation. Once the initial examination is done, we know what the condition of the person and the first chiropractic adjustment is done. Then the next visit is very important. If the person that was given chiropractic adjustments healed fast then the frequency will be less frequent. If the person healed very slow then the frequency will be more frequent. After several chiropractic adjustments, re-examinations is done to assess the healing progression.

Progession of Chiropractic adjustments:

The progression of chiropractic adjustments phases1depends on the starting point of their health condition. Many people are in pain and they have a lot or problems, but once the pain is gone many people don’t see the reason for continuing chiropractic adjustments. The problem is that many people are not told the damaged areas of the spine will not be stable even after the pain is gone. If people stop the chiropractic adjustments after the pain is gone then the unstable condition will revert back to the original condition and pain eventually.  The healing process of damaged areas to be stable takes long period time for the muscles and ligaments.

Once the damaged areas are completely healed the body has more adaptability and healing capability to maintain the spine by themselves. Eventually the nerves are in 100% function, so the frequency of chiropractic adjustments decreases.

End of Chiropractic Adjustment:

There are times when a client comes in to the office and there is no physical evidence of the need to adjust the person’s spine. As long as the chiropractor is always assessing the condition and progress of subluxation, then eventually there will be objective and scientific conclusion that there are no more subluxations. Then there is an end for chiropractic adjustments as long as the person can maintain their good condition. Find a chiropractor that will communicate and educate everyone about their progression and condition of subluxation will give the answer you seek.

How long this will take, how frequent the chiropractic adjustments are, and how much it will cost.

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Spinal Disc and Donut Disaster

Everyone likes to eat a donut! Especially with juicy jelly in the middle! The interesting part of this jelly donut is that it is very similar to the disc in your spine called intervertebral disc. This disc is made of fiber and water and has a jelly center. Sounds like a jelly donut to me. We have 24-26 of these cartilage discs to support the whole spine as a cushion, create mobility in the spine, and distribute the physical pressure from your body weight.

Disc and Jelly Donut

Once we damage the disc, the disc deflates and disappear and that is called Degeneration/Arthritis. The only way to find out if you have this problem, or if you already do know and want to know what stage of degeneration/arthritis, the best way is to do neurological examinations and radiological examinations. We can not feel or see these problems in our body so the best way is to get an objective physical examination to see what condition your discs are.

When there is an unstable spinal joint, the spinal bones will fall out of its original place and the disc will herniate. Then to make this unstable joint more stable, the body decides to cause a muscle spasm to form a temporary cast. The muscles are there to make sure that the spinal bones will not go any further out of place because the bones can cause damage to the nerves and spinal cord. Once you have damage to the spinal cord you will be paralyzed or have detrimental effects to the body that will cause death. So to prevent that the muscles cause a spasm. One of our neurological examination is to find out where the spinal muscles are in spastic state. To find the acute problems.

Sometimes the problems are chronic, the unstable joint needs more stability so the body eventually starts putting calcium on the disc structure to cement the unstable joint and spinal bones. What happens is that the joint and bones because completely fused and immobile. Then the muscle doesn’t have to move so you lose muscle contraction.

What also happens when you have an unstable joint and spinal bones, the disc will herniate and puts pressure on the nerve structure and cause inflammation. Nerve structures are very sensitive to pressure, by the weight of a dime the nerve structure will cause inflammation. Once there is inflammation, there is more blood flowing to the damaged joints. Just like a twisted ankle, it gets flared up and inflamed with heat. Same thing happens in your spine, so we can measure the heat on the spine and determine if there is damaged nerve structure.

Again, if the spinal joint has a chronic problem, then the disc is completely gone then the nerve structure is completely compressed. Eventually the nerve structure degenerates and the blood flow is constricted and causes less heat. Which will show in the neurological examination that you have a nerve structure that is degenerated to the point of heat being diminished. There should always be a blood flow that cause some amount of heat that measurable and maintained.

Here are the visual aides to what the spinal degeneration looks like on a model.

kitchener-chiropractor-spinal-degeneration

The best way to objectively see and measure disc degeneration is to get full spine radiological x-ray examination. Then you can compare yourself with the level of degeneration on this website:

http://www.echiropractic.net/subluxation_degeneration.htm