Archived Issue - PRAKTIKOS Summer Solstice, 2007

Change your thoughts and you change your world.
    - Norman Vincent Peale

Nice and Easy Does It

I still remember the patient that changed my life and my way of practicing chiropractic forever. I was holding Bob's head in my hands, sweating bullets. Now this wasn't just any old patient; he was probably the most important patient I had worked on in my young professional career. You see, Bob was not only a successful entrepreneur in the software field and a brilliant man, but he was also one of my parents’ best friends since their high-school days. I was anxious to impress him with my new profession and my skills.

Bob had been suffering from horrible daily headaches when my Dad and Mom convinced him to give little Bobby a try. Because I had just left the offices of my mentor, Dr. Robert Ohlson, to set up my own office, this opportunity was important to me both personally and professionally. I desperately wanted to help Bob beat this problem in order to prove to him, my folks, and myself that chiropractic worked.

The good news was that I knew his headaches were coming from his upper neck. The greater occipital nerve, which leaves the spine at the second cervical vertebra (C-2) level and curves up and over the back of the skull and ends over the eyes, was the culprit. This sensitive nerve structure had been irritated by a strong muscle spasm and vertebral twist that I could easily palpate. As final confirmation, I could actually reproduce his pain with gentle pressure over the affected spot.

The bad news was that up to that point I wasn't helping him at all; in fact, I seemed to be making things worse. I was in the right spot and it was easy to feel which way the vertebra needed to move but each time I twisted his neck and delivered a strong thrust in the proper direction there was no release, no pop, no movement, no improvement. His spasm, swelling, and pain were only increasing. That is why I sat holding his head in my hands, questioning myself and my skills.

But that day was the beginning of something new and amazing. As I held his head and palpated his neck, I noticed that his muscles were actually looser and the twist in his upper neck was less severe. Bob informed me he had been trying something on his own at home with a vibrator and a slow holding pressure while pushing the vertebra into the right position. He was even starting to feel better.

Of course, it all seems so obvious now but it was a revelation to me then: vertebrae could be slowly and gently moved with a sustained holding pressure. There was no need to pop the bones with a fast thrust as I had been taught in school.

In chiropractic college I had been taught a technique of adjusting called High Velocity, Low Amplitude (HVLA). This style of adjusting involves taking someone's neck and twisting it as far as it would go and then delivering a quick thrust in a specific direction on a specific vertebra to move the bone forcefully back into its proper position.

The quick snap was the high velocity part of HVLA. This rapid movement acts to turn off the tight muscle via an internal circuit-breaker reflex. You are probably familiar with this effect if you have ever sprained an ankle. Let's say that you are walking along and step off a curb wrong and your ankle begins to roll over. If the forces are rapid and strong enough, the muscles protecting the joint could be injured and ripped so this protective nerve reflex tells the muscles to just relax.

This reflexive muscular relaxation protects the muscles but it leaves you in a heap on the ground and it leaves your ligaments unprotected from over-stretching. This is where the low amplitude part of HVLA comes in. A chiropractor using HVLA techniques must thrust fast and deep enough that the muscles reflexively let go but stop quickly enough that the local ligaments are not damaged.

This balance between hard enough and deep enough to get the reflexive release and yet not going too deep and causing ligament damage is a very difficult task. Not only does the amount of force and depth of thrust needed vary from person to person, but it also varies from time to time in the same person. No wonder I was frustrated; each time I made an adjustment it was hard to know if I was going to help or harm my patient.

What Bob pointed the way to that day was a new method of working on spinal problems that was both highly effective and fear free. We now call this a low-velocity technique of adjusting and use it exclusively on all our patients.

Low-velocity techniques are much like a very gentle and highly specific "micro-yoga." These non-traumatic adjustments are designed to work with the muscles that hold vertebrae out of place. Rather than use a simple home vibrator as Bob did, we use a more powerful ultrasound beam to soothe and relax muscles so we can slide vertebrae back into position.

After all, "muscles move bones;" that is to say, bones are kind of like a puppet in that they have no ability to move on their own but rather are pulled this way and that by muscular action. This is why our examination is so heavily focused on areas of abnormal muscular contraction rather than just bones out of place.

Just as in Bob's upper neck, it was the muscle spasm that needed to be addressed first so that it took only a gentle pressure to move the specific vertebra rather than a sharp thrust. This gentle and effective technique works no matter which part of the spine is involved. It matters not whether you have low-back pain, or sciatica, or shoulder spasm, or a hand falling asleep, or neck pain, or calf cramps; you can be repaired.

If you have had prior surgery, our technique is still safe. If you have osteoporosis, there is no need to fear. If your problem is so painful and acute that you can hardly move, we can still gently heal you. If your condition is decades old, we can unwind those knots and return you to a comfortable life. If you have been frightened by chiropractic before, we can ease your mind. If your problem has resisted all treatment, we can provide a new approach and a new hope. If you have osteoarthritis, we can help. If you don't want to get that knee or hip replaced, we have a plan. If you want to do something for yourself other than just take drugs, you can. If you want to help yourself, you will be taught how to do it. If you want partners who will doggedly work side by side with you in your battle to regain health, we are the guys.

If you thought there was only one way to do chiropractic, it is time to change your mind and change your world.