Tuesday, November 5, 2013

Chiropractic treatment enhances performance and reaction time.

Guest Author: Justin Copeland, D.C.

The term “athlete” encompasses a massive spectrum of constituents. Membership in the club is hardly exclusive and ranges from the three year-old T-baller to the Olympian performing at the highest level of competition. Without exception…well, almost without exception as little Jack the T-baller might not yet have that killer instinct…athletes continually seek a competitive advantage. One competitive advantage that is trending upward among athletes is the use of chiropractic care for improved performance.

In general, quantifying the benefit of the countless tactics used to enhance athletic performance is a futile undertaking. It is improbable if not impossible to incrementally calculate added benefits of performance boosters. In fact, in the professional sports realm if something is simply perceived as a performance enhancer then it is generally defined as such.

Why is this the case? In short, it results from the fact that the specific mechanisms through which performance is improved are often unknown and heavily debated.

 In contrast, the mechanism through which chiropractic care improves athletic performance is simple: “where chiropractic truly excels is in its ability to actually improve performance, since it is through the full use of the nervous system that peak performance can be achieved.” (1)

As the control center of the human body, the nervous system regulates and coordinates each and every function of the body. This biological fact makes the nervous system inarguably the most important unit of the human body. Spinal misalignments have been proven to wreak havoc on this control system resulting in decreased function and a reduction in overall health. Chiropractic treatment, as a means to eliminate these spinal misalignments is therefore invaluable for improving overall function and health in the human body. 

These improvements in function can manifest in several ways in athletes. One functional parameter, muscle inhibition, has been shown to be reduced in individuals after undergoing chiropractic care. Muscle inhibition occurs when there is a breakdown in communication between the brain and the muscle itself. If muscle inhibition occurs the muscle cannot completely contract and thus is firing at less than full capacity. This renders the control of muscle contraction highly inefficient when muscle inhibition is present. In 2000, Suter et al. found that after a chiropractic adjustment of the sacroiliac joint, muscle inhibition was markedly decreased in the legs of the involved group. Similarly, in 2002 Suter and McMorland determined that significant decreases were found in muscle inhibition in the triceps muscle groups following cervical spine adjustments. These improvements in muscle efficiency portend elevated performance in athletes.(1)

Likewise, the force of muscle contraction is vital to athletic performance. Pollard and Ward found that short-term increases in muscle strength were realized subsequent to chiropractic adjustments in the lumbar spine. In fact, an increase of 3.03 Newton’s (4.6% higher than before the adjustment) was recognized as potentially beneficial to “the performance of strength athletes.”(1) It is reasonable to conclude that chiropractic adjustments that increase functional strength of skeletal muscle would be optimal for the peak performance of any athlete.

The premise that chiropractic care can decrease reaction times has been tested as well by several investigators. Reaction time represents the interval between the introduction of a cognitive stimulus and the body’s response in the form of a motor function. In 2000, Kelly et al. determined that reaction times decreased in subjects immediately following cervical spine adjustments. Similarly, Taylor and Murphy discovered improved sensorimotor integration as well as improved response of the central nervous system to a functional task directly following chiropractic adjustments. The link between decreased sensorimotor reaction times and enhanced athletic performance is easy to bridge.

More often than not, athletic performance is reactionary in nature. Reaction time is essential for a batter facing a pitcher that has a multitude of speeds and planes with which he can throw a pitch. In fact the difference between a hall of fame player and someone that never even sniffs the field in Major League Baseball is measured in reaction differences of hundredths of a second. Improved reaction times allow for improved performance.

The literature points to decreased muscle inhibition (increased muscle efficiency), increased muscle strength and decreased reaction times following chiropractic adjustments. Each of the aforementioned gains subsequent to chiropractic adjustments herald improved performance in the athlete.

What does all of this mean to you? It’s simple. Before you reach for the supplement that claims to improve performance but harbors a litany of toxic chemicals, give your chiropractor a shot at improving your performance at the field, on the course and in the gym.

1. Miners AL. Chiropractic treatment and the enhancement of sport performance: a narrative literature review. J Can Chiropr Assoc. 2010; 54(4):210-221.

Tuesday, August 20, 2013

Chiropractic care is the most cost effective treatment for low back and neck pain. Issaquah Chiropractic Blog


Guest author - Justin Copeland, DC
Weighing one’s options with regards to health always results in a comparison of value. Does the benefit of undergoing a certain treatment or therapy add enough value to justify the costs? This question whether spoken aloud or rationalized internally is at the forefront of each decision with regards to healthcare. The same holds true for chiropractic treatment.

Instances of low back pain and neck pain make up a significant portion of medical conditions that are treated within the U.S. In fact, “low back pain alone accounts for 2% of all physician office visits; only routine examinations, hypertension and diabetes” account for more.(1) If spinal conditions and specifically, musculoskeletal spinal conditions make up such a large piece of the healthcare pie then the cost-effectiveness of therapies that treat these conditions should be weighed more heavily.

 

A standard measurement of effectiveness within the healthcare setting is deemed quality-adjusted life years (QALYs). When a simple calculation in which the total cost of care per episode (a single neck pain episode or back pain episode) is divided by the QALY of that care, the standard for assessing the value of healthcare is determined as dollars per QALY units. Ratios below $50,000-$100,000 per QALY are considered to be cost-effective. (1) 

 

Applying these concepts to two high-quality randomized control trials completed in Europe show that chiropractic care for both neck pain and low back pain is remarkably cost-effective in comparison to medical physician care (MD, PT, DO and others). A single episode of low back pain as treated by medical physician care has an average cost of $2,355. A single episode of low back pain as treated by a chiropractor is only $75 more than medical physician care. However the efficacy of treatment with regards to chiropractic care and low back pain is measured at .659 QALYs whereas the efficacy of medical physician care for this same ailment is measured at .618 QALYs. The large discrepancy of success between these two interventions results in a cost-effectiveness ratio of $1,847 (Remember, any ratio less than $50,000 is considered cost-effective). This comparison renders chiropractic care as extremely cost-effective when compared to the most widely-utilized treatments for low back pain.(1)

 

The cost-effectiveness of treatments for neck pain is no comparison at all. Chiropractic treatment not only has a higher efficacy (.82 QALYs to .77 QALYs) but it also allows for a cost savings of $302 per patient per episode. In fact, chiropractic care is still cost saving in contrast to medical physician care if the fee per chiropractic visit were increased five-fold!(1)

 

While the internal deliberation of cost vs. perceived value rages on with regards to most healthcare treatments, the cost-effectiveness debate of chiropractic care for low back pain and neck pain is hardly a debate at all.

 

1.https://images.vortala.com/chiropractor/USA/California/Carmichael/Foundation%20for%20Chiropractic%20Progress/SiteGraphics/ChiropracticServicesReport.pdf

Monday, July 15, 2013

What are the stakes? Consult a surgeon...get a surgery!

http://www.chiroeco.com/chiropractic/news/13521/52/f4cp-points-to-new-study-documenting-chiropractic-as-first-option-for-back-pain-relief/?skeyword=f4cp

http://www.mayoclinic.com/health/back-surgery/HQ00305

According to a collaborative study conducted by the University of Washington School of Medicine, the University of Washington School of Public Health, the Washington State Department of Labor and Industries, Ohio State University College of Public Health and Geisel School of Medicine (Dartmouth College), 42.7% percent of workers that first consulted a surgeon for back pain underwent spinal surgery. In contrast only 1.5% of the individuals that initially consulted a chiropractor underwent spinal surgery.(1)


Incredibly invasive and risky procedures that often result in subsequent surgeries or even death are in most cases unnecessary. Even the renowned Mayo Clinic accepts the evidence that “back surgery is needed in only a small percentage of cases.”(2) If chiropractic care can prevent spinal surgery approximately 40% of the time then why is spinal surgery growing at such an alarming rate?

A simple answer to this question is that the general public just doesn’t know their options with regards to treatment. Chiropractic Biophysics (CBP) is a highly-researched chiropractic treatment (the single most researched technique) and literature abounds supporting the efficacy of this treatment for spinal health. This conservative form of care is a more than fitting alternative to cutting on/into/around the control system (sounds important right?) of the human body; the nervous system.

A highly-effective, non-invasinvasive, research-driven technique that has been shown to prevent 40% of spinal surgeries…what do you have to lose? The stakes are much less than the alternative.

Contributed by Justin Copeland, DC

Tuesday, April 23, 2013

Leg Length Discrepancy - Heuter Volkman Law - and the unequivocally great mom moment

The phenomenon of the anatomical short leg can occur for many reasons and throughout the childs growth cycle and can lead to; overuse injuries, a variety of joint problems through the hip, knee, and ankle related to asymmetry, meniscal tears, herniated disc, back pain, etc..


An experienced professional should be able to identify leg length discrepancy through observation while the child is standing and should include a quick examination of the feet. Measures of functional leg length are NOT the same thing. There are many reasons why there could be a functional leg length deficit while lying down; muscular injury and contraction and back problems being the most likely. There are also problems in the feet such as a pronation "flat foot" or ankle rotation that could be false indicators of a short leg.

So how do you tell if your child may have a short leg? Well, we noticed in our own child when his tummy started protruding slightly and his body began to shift to the left. His left foot also began to splay out and the arch to drop slightly toward the ground. Did we rush to get him a heel lift? Of course not, physician heal thyself is a common saying for a reason. The condition continued and his shift became more pronounced, the left shoulder began to shift up compared to the right and the tummy protruded even more. His posture began to look very similar to this, but in the picture the left shoulder has not begun to shift up, a more chronic sign.
So now did we spring into action? Yes, finally! Just as we have prescribed to many kids in our clinic over the years, we recognized the Heuter Volkman LAW was at work and we needed to use this law of nature to our advantage. What is the Heuter-Volkmann Law? This is a phenomena whereby bone remodeling takes place due to gravitational stresses as well as asymmetrical forces upon bones. Growth is retarded by increased mechanical compression, and accelerated by reduced loading in comparison with normal values. Sustained compression of physiological magnitude inhibits growth by 40% or more. In other words a short leg will only get shorter as the body starts to shift to that side. But, if we were to shift the weight to the long leg side, we would increase compressive loads on the long leg side, slowing growth and allowing the other leg to "catch up".

Guess what. It works! And it worked for our son, thus the one moment of being an unequivocally good mom. Over a period of six months, through two growth spurts, he went from having marked postural problems and foot pronation with accompanying motor dysfunction (mild clumsiness), to being perfectly balanced. All we did was give him orthotics for both feet to support the arches and under the orthotic, a heel lift on the short leg side. We did not equalize the legs with the heel lift but actually went higher to cause the weight to shift to the long leg side. And upon normalizing the posture, which we look for in follow-up appointments, we stopped the intervention. The most important part!




Sunday, February 3, 2013

A Crooked Body Self test - Five ways to identify your risk factors for back pain

It has long been known, within the Chiropractic, BioMechanics, and Research communities that asymmetrical posture is a risk factor for uneven wear on joints, abnormal use of muscles and resulting back, knee, hip and joint pain. Finally we are seeing trickle down to the media, even the greatest general interest mag of all time....

I was absolutely delighted to see that Readers Digest focused on Posture this month in the HealthDigest. In the article, titled Hidden Hazard: A Crooked Body, they emphasize that asymmetry in posture, though perhaps not visible to the lay person's naked eye, can be easily identified by using two scales side by side. Stand with one foot on each scale in your neutral resting posture (just relax until you feel natural). In the article they say that measurement differences over three pounds are significant and indicate body imbalance that may lead to uneven wear on joints and future pain. While there are certain compensation postures that can result in extremely uneven posture with relatively equal weight distribution, it does seem that the more a person's center of gravity deviates from center line, the more pain and symptoms are evident.

Modern technology has brought the lay person two amazing ways to identify postural abnormalities at home, XBox Kinect and Wii Fit. Both of these reveal postural abnormalities during set-up and many fitness programs. In particular, the Kinect is amazing at identifying postural rotations, which are normally rarely noticed. When setting the Kinect sensor and you are standing facing the TV, if the view of you from above appears to be rotated, you have a significant pelvic rotation. The sensor is reading one side of your body is closer to the TV. To confirm, look down at your thighs relative to your feet. One thigh will appear further forward. This is also an indication that you may have a short leg or significant foot problem. Both devices will show postural abnormalties in your avatars and you can scrutinize your body's outline for high shoulders, head tilts, etc.

A third way to identify abnormal posture is to take a picture from the front and have someone take a picture of you from the side while standing in a doorway. From the front, your body should be straight with no head tilt or high shoulder. Look for the small indent at the base of your neck, your head should not be shifted right or left and your nose should be facing straight ahead not rotated to the side. As you look down your body, are both arms hangng equal distance from the waist. That is a huge indicator for low back pain, uneven arm gaps reveal shifting of the upper body or rotations. This means you have the weight of the whole torso moving improperly over the hips. From the side your ear should be over your shoulder, NOT way forward like your head is falling off your body. Can you imagine the work the muscles at the base of your skull have to do just to hold that big head up.


Fourth, flip through your old photo albums and new facebook photos. Have you had the same cute headtilt for years. That may not be something you do just when having your photo taken. It could be a risk factor clue that has been beckoning for decades.

Finally, listen to your body. Postural asymmetries are evident every day in normal activites. When you hold the phone to your ear, does it feel like you are really stretching on one side but not the other. If you bend over, can you go further on one side. When you try to touch your toes, does only one hamstring feel like it is stretching. Watch and feel yourself walking. Where is the motion coming from. Do you lean from side to side making most of the motion in your hips or does your upper body rotate at the waist fluidly. Do your arms swing forward the same distance.

There are many clues to asymmetrical posture. The most important step you can make is to recognize it for the risk factor that it is. Investigate with your chiropractor, determine what is causing the postural problem and make the changes to fix it. Often it can be as simple as a heel lift, other times it will require rehabilitation and a change in your habits and lifestyle.