You Have Both a Right and a Left

It came as a bit of a surprise to me when I found out that when practicing, pro golfers will hit a bucket of balls right handed and then a bucket left handed, or vice versa.  This should not have surprised me because from a conditioning and biomechanical stand point, it makes perfect sense.  As humans we tend to be very one handed but using one side predominately can result in a host of problems.  By hitting balls both ways the pros are trying to minimize the possibility of these problems happening and at the same time improve their overall performance.  Given that I really can't hit a golf ball decently right handed, I can only imagine the challenge hitting it left handed.

Human balance can be thought of in two ways.  The first is whether or not a person has equilibrium.  That is whether they can remain upright.  If you lose your balance you fall down.  The second type of balance is whether a person has symmetry.  That implies the body having equal strength and mobility from one side to the other or front to back.  Having equilibrium is probably the most important type of balance, but having symmetry is important to having optimal equilibrium.  The two are related and both are important aspects of health.

The type of balance the golfers are working on when hitting balls both right and left handed is symmetry.  By doing this muscles and joints on both sides of the body are utilized.  Most significantly the "core" of the body is developed in a symmetrical manner.  This is particularly important for proper spinal function.  The nervous system also benefits tremendously when activities are done both right and left handed.

As a chiropractor, I see many spinal problems that are the result of people repetitively doing things one handed or one direction only.  When muscles are more developed on one side of the body, or more on the front or back, the joints of the spine move abnormally.  This results in the development of vertebral subluxations where there is not only a loss of joint function but altered nerve conduction as well.  A whole host of health problems can result.

It's not easy to use the body symmetrically.  Most of us are very one handed and it takes real effort to use the body in a balanced way.  It is particularly important to try to be balanced with the activities we do the most.  That means looking at the way we do our work and recreational activities.  For example I had to make a conscious effort to hold my Activator Adjusting Instrument an equal amount with either hand.  I had to train myself to work from both sides of the adjusting table.  By doing this over time my left hand has become almost as strong and coordinated as my right hand.  It certainly wasn't when I started doing this years ago.  I believe that doing this has not only prevented injuries but is a factor in my overall health.

It's important to also try to achieve symmetry when exercising.  This is particularly significant when rehabilitating injuries.  Stretching and strengthening should be done on both the right and the left.  Of equal importance is balancing the front and the back of the body.  Did you know that walking on the ground provides much more symmetry than walking on a treadmill?  When walking on the ground both flexor and extensor muscles of the lower extremity are used as opposed to the treadmill where the machine does most of the extension for you and the flexor muscles develop more than the extensors.

Take a tip from the pros to improve both your performance and your health by using your body in a balanced manner.  You will have fewer injuries, recover faster, have improved coordination, and better equilibrium.  Balance is part of a healthy chiropractic lifestyle.   It's not easy, but you will be better for it.

I Have Algorithms In My Head

When I'm consulting a patient for the first time I often tell them they are just like a jigsaw puzzle and I'm trying to put the pieces together so they make sense.  All the questions my staff ask and that I ask are designed to reveal glimpses of who this person is and what their condition really is.  Each examination procedure also reveals more pieces to the puzzle.  But just having all the pieces of the jigsaw on the table doesn't show you what the whole picture is.  The pieces have to be put together.  Each piece contains clues.  In a picture puzzle this includes shape, colour and pattern.  Every interconnection reveals more of what the whole will look like.

This is not dissimilar to the way I need to evaluate a patient.  Age, sex, family history, occupation, diet, physical activity, injuries, illnesses, and many other factors need to be probed.  Depending on the answer given to a particular question, it leads to the next question that needs to be asked.  The examination is then formulated from what has been gleaned from the history and consultation.  Each positive or negative finding leads to the test that should follow.

Over the years of evaluating many, many patients, I have developed algorithms that run through my mind to help me quickly and accurately assess what is going on.  An algorithm is defined as a formula or set of steps for solving a particular problem. To be an algorithm, a set of rules must be unambiguous and have a clear stopping point.  For example you can have an algorithm for baking a cake.  It might look like this:

 

Evaluating a patient is certainly more complex than baking a cake and instead of a simple algorithm, algorithms often need to be combined to get valid results.  If a patient has just one simple complaint, say a sprained ankle, there are few steps necessary to make the diagnosis and develop an approach for rehabilitation.  Few people present with such a simple situation.  Although a person may have one complaint, perhaps low back pain, there can be many factors which lead to the condition and usually involve more than just the lower area of the spinal column.  By having a logical sequence to follow, an algorithm, clues don't get missed and the best possible conclusions can be determined.  During both the history and examination of a patient with low back pain, algorithms for evaluating the lumbar spine, pelvis, and hips will likely be combined.  The knees, feet, and even the neck may be added depending on what is revealed.  

Activator Methods, my primary chiropractic technique, is based on a series of algorithms that allows for very efficient and thorough evaluation and adjustment of the spine and extremities.  The Activator Methods basic scan for the lumbar spine looks like this:

This basic algorithm covers most low back conditions.  Should a patient present with a more complicated situation there are advanced algorithms that can be applied to evaluate the lumbar spine more thoroughly.    Following the algorithms leads to effective care of low back conditions.  There is less likelihood of missing pieces to the low back pain puzzle.

Whether I'm work with a new patient or during a routine office visit, I have algorithms constantly going through my mind.  As a result I can quick evaluate the spine and extremities for subluxations and determine the best chiropractic adjustments for a given patient.  By putting the pieces together I know where, when, and when not to adjust.  This is crucial to being an effective chiropractor. 

  

Activator Methods Upgrading

Last weekend I participated in an Activator Methods Seminar.  The technique requires that in order to maintain my Advanced Proficiency status that at least once every year I attend a seminar to assure my competency in using the procedures.  This is something I really appreciate about Activator Methods.  They assure that all the doctors who are rated to use the technique, continue to maintain their competency.  This is important for patients and also for practitioners.

During the weekend our instructor, Dr. Rebecca Fischer, walked us through relevant research and showed us how to apply it in our practices.  Something that is not always easy to do is to take research and make it practical in a clinical setting.  In the rapidly changing health care world this is very valuable.  This year's focus was on osteoarthritis.  I appreciate not only the ongoing research that Activator Methods does but how they utilize research from many, varied sources to continually refine the technique.  There are few techniques that are so diligent.

Probably more important than the research however is the time spent on practical application over the course of the weekend.  Doctors are divided into basic, intermediate and advanced classes depending on their experience using Activator Methods.  In the advanced class with Dr. Fischer that I attended we spent a great deal of time refining our ability to use the technique.  That included hands on workshops, small group case studies, and a review of both old and new advanced procedures.  Nutrition, exercise, and lifestyle issues were integrated into the presentation and workshop.  This year the emphasis was on evaluating and treating the lower extremity.   Dr. Fischer and her helpers evaluated each attendee on their competency in using the Activator analysis.  It is wonderful to have this done every year.  It's amazing how many bad habits a person develops and this seminar always helps to bring back my focus.  There are also those, "Man I totally forgot about that test!" moments.

Not insignificant is the opportunity to connect with other like minded doctors.  This is often the only occasion where I get chance to see these people, may of whom are not from Alberta.  Time is spent sharing good and bad things that happen in our practices.  There is great value in this time of informal exchange.  I come away with a great confidence in many of the doctors I want to refer to and also recognize some I don't want to send patients to.

I commend Activator Methods for maintaining a system of quality control through their annual seminar requirement.  It's good for me as a doctor and also good for my patients.  For me it is not a burden, but a privilege to maintain my proficiency with Activator Methods.

Consistent & Reliable Adjustments

A couple of months ago I had the privilege of attending a couple of presentations on recent chiropractic research.  Dr. Walter Herzog of the University of Calgary and Dr. Greg Kawchuk from the the University of Alberta outlined the various investigations they are conducting to demonstrate both the effectiveness and the safety of chiropractic.  As they outlined each project and the methodology they were using I was stuck by the fact that both researchers were using the Activator Adjusting Instrument.  This is the same instrument we use in our office.

Both Dr. Herzog and Dr. Kawchuk stated matter-of-factly that they used the Activiator Adjusting Instrument because of it's consistency.  The could rely upon this instrument to produce the exact same thrust each and every time.  The force is consistent, the depth is consistent, and the line of drive is consistent.  The instrument has been validated by several previous research studies.  By using this instrument they reduce variables which makes their research more valid. 

As a clinician I have to constantly ask my self how does any given research apply to how I can better serve my patients.  While it's nice that the Activator Instrument is so valuable for research purposes, how does that translate to clinical practice?  The answer to that is pretty straight forward.  An instrument that produces a consistent and reliable adjustment in the lab will also produce a consistent and reliable adjustment in clinical practice.  As a matter of fact the instrument was developed for a clinical setting and was later proven to be reliable enough to be used for research purposes.

The benefit for patients is that every chiropractic adjustment with an Activator Instrument is the same as every other adjustment.  It is consistent from visit to visit.  It is consistent from doctor to doctor.  It is consistent whether the doctor is having a good day or a bad day.  (Can you believe that I occasionally have a bad day?)  That is not to say that the application of the instrument does not vary, but the instrument itself is consistent and reliable.  It is one variable in the care process that has been eliminated.  That is good news from a therapeutic standpoint.  That is good for patient care.  Patients can depend upon the Activator Instrument to provide the necessary force to create proper motion in joints.  Nerve function is restored and the healing process can proceed.

Researchers depend on the consistency and reliability of the Activator Instrument to produce the best research results.  Patients also can trust this instrument to provide consistent and effective chiropractic adjustments.

Beating Inflammation Naturally

Inflammation is the cause of a great deal of our pain.  There are a number of biochemical substances associated with inflammation that produce pain.  Pain in turn produces chemicals which increase inflammation.  Reduce the inflammation and the pain and dysfunction subside.  Unfortunately just because the pain is gone, doesn't mean the cause of the problem is solved. 

Chronic inflammation is known to be a factor in autoimmune disorders, cardiovascular disease, diabetes, cancer, neurological disorders, arthritis, and pulmonary diseases.  It's not something that a person should ignore.  To complicate the issue, it's also not something that is always obvious.  Inflammation of internal organs is not noticeable until disease symptoms show up.   Inflammation of the muscles, tendons, ligaments and joints are more obvious.  While chiropractic can affect internal inflammation by improving the overall health of the body, it's focus is on musculoskeletal inflammation.

In addition to improving motion, reducing nerve excitability, reducing pain thresholds, and improving sensory functions chiropractic adjustments also decrease inflammation in malfunctioning joints and tissues.  Often inflammation is due to mechanical dysfunction and nerve interference in the body.  When joints don't move properly inflammatory and pain chemicals are produced.  Chiropractic adjustments are very effective at normalizing body mechanics to reduce inflammation.  This is one way chiropractors are able to quickly relieve pain.  One study by XJ Song, published in JMPT, showed that inflammatory pain symptoms were reduced in 10 to 14 days with Activator Methods chiropractic adjustments as opposed to 3 to 4 weeks in the control subjects.

Low level laser therapy has also been demonstrated to be very effective in reducing inflammation.  Low intensity laser energy is known to improve how cells function.  As cells function more normally there appears to be a reduction in the inflammatory chemicals within and around the cell.  The result is not only decreased inflammation but pain as well.

For localized inflammation, ice is a great anti-inflammatory.  It constricts blood vessels to reduce fluids in the area of injury.  The quantity and activity of inflammatory chemicals are also reduced by decreasing the temperature of the area.  A note of caution: ice should never be used longer than 10 minutes at a time or the healing can actually be prolonged.

There are also several natural substances that have been shown to have anti-inflammatory properties throughout the body.  These are: 

• White Willow (Salicin), 
• Proteolytic enzymes particularly Bromelain,
• Ginger, 
• Curcumin (Turmeric), 
• Boswellia, 
• Magnesium,
• Omega 3 fatty acids.  

Many of these natural approaches have been shown to be as effective as NSAIDs (Non steriodal anti-inflammatory drugs), such as aspirin or ibuprofen, without the many side effects.

Dietary considerations to reduce inflammation include: red wine, fish, eggs, dark chocolate, vegetables, fruit, garlic, and almonds.  When making food choices to reduce inflammation a person must also avoid Omega 6 fatty acids which are know to increase inflammation. These are found in grains as well as oils produced from corn, safflower, sunflower, cottonseed, peanut, and soybean.  Grain feed meats are also high in Omega 6 fatty acids.

Inflammation, whether localized or found throughout the body, can have a detrimental effect on healing and overall health.  Fortunately, there are safe, natural approaches to beating inflammation.  

Dr. Yoon Han

Dr. Yoon Han has just joined our team of chiropractors.  We are excited to have him on board!  Although Dr. Han has just recently completed his license requirements for Canada, he has 10 years practice experience in Asia.  During that time he was able to develop the chiropractic skills he learned at Palmer College of Chiropractic in Davenport, IA.  This is the same school both Dr. Powers and Dr. Ruzycki attended.

Practicing in his home country of South Korea was certainly much more of a challenge than North American chiropractors face in the 21st century.  There is no licensing of chiropractors in that country, as a result many misconceptions of our profession persist.  This is not unlike what chiropractors in North America experienced 50 years and more ago.  Dynamic Chiropractic published an article recently on prosecutions of Korean chiropractors.  It is very difficult for Korean chiropractors to effectively help their patients.  They face so much opposition.  These circumstances forced Dr. Han to look beyond his homeland for practice opportunities.

Because of the persecution of chiropractors in Korea, Dr. Han and his family moved to Malaysia for four years where he practiced while waiting for Canadian Immigration to approve their move to Canada.  Canada is the country of their dreams!  We are happy they have chosen to make Medicine Hat their home.  As well as joining our office, Dr. Han and his wife own and operate the Esso convenience store and gas bar at the corner of 11th St. S.E. and Division Ave. 

Dr. Han is excited about helping people in Medicine Hat with their spinal health.  Although he is just learning the Activator Methods technique, he is already quite proficient with instrument adjusting.  He knows the body and the power of the chiropractic adjustment.  His experience helping patients is very transferable to his new technique.  You can schedule an appointment to see Dr. Han by calling our office at 403-529-9069.  

Welcome to Powers & Jans Centre Dr. Han!

Pain in the Neck

Do you suffer from a pain in the neck?  I'm not referring to your neighbour, child, spouse or parent (bad joke, forgive me), but to a physical pain in the upper part of your spine.  The pain may be an ache, a stab, a burn, a throb or a shock.  It can be an annoyance or debilitating.  Regardless of the nature of the symptoms you are experiencing, neck pain shouldn't be ignored.  Pain is your body's signal that something is wrong.  Ignoring the pain is like ignoring a warning light on the dash of your car.  Ignore either your body's signals or your car's signals and there can be long term consequences.  (It's okay to ignore other people who are being a pain in the neck).

There can be many causes of neck pain, some quite serious.  The most common cause is a vertebral subluxation.  This is a condition where the joints of the spine lose their proper motion and the nerves next to joints become irritated.  There is associated damage to the surrounding muscles and ligaments along with swelling.  The pain can be localized in the neck or can travel into the arms, upper back and chest.  Subluxations in the neck are a frequent cause of headaches.

Chiropractors are specifically trained to find vertebral subluxations and correct them with spinal adjustments.  We are the only profession with this specific training.  Should the neck pain be caused by something other that a subluxation, we are also trained to determine other problems.  If there is a more serious condition, that is beyond our expertise, we will refer you for appropriate care.

If vertebral subluxations are not corrected, they can lead to accelerated joint degeneration, muscle atrophy, chronic pain, loss of mobility, and nerve degeneration.  These are not things any of us want to experience.  At our office we use Activator Methods to correct subluxations.  This is a very specific and comfortable procedure which restores normal joint function allowing healing of all the associated tissues.  During correction pain is usually the first thing to disappear.  Getting rid of the pain in the neck is the starting point.  Rehabilitating the muscles, ligaments and nerves can take much longer.  We will assist you through the entire process if you desire.  At our office it is always the patient's choice on how they proceed with their chiropractic care.

Don't ignore neck pain, or any other pain.  Pain is your body's way of telling you to do something.

Stampede Time

The annual Medicine Hat Exhibition & Stampede is now going on.  It's the time of year when all things western are celebrated.  Living in Medicine Hat, it's hard not to be involved at least to some extent because ranching has historically and remains a big part of the economy of the area.  We have a large number of ranchers as patients in the office.  Although it's dangerous to generalize, but I'm going to state with confidence that as a group ranchers are wonderful people.  Their connection to the land, to their community, and to their roots helps them to develop great character traits.  

Work on the ranch can be physically demanding, involving heavy lifting as well as riding and wrangling.  I'd like to share a case of a rancher patient.  Todd (not his real name) came to our office with a complaint of low back and pain in both hips that had been persistent for the previous year.  The pain was constant and interfered with his sleep as well as making his work nearly impossible to do.  Riding his horse had become shear agony.  This was a serious situation for this 32 year old man!  No work, no pay when you are a self employed rancher.  Todd also had been experiencing headaches daily for the previous 5 years.  He discounted the severity of the headaches, but his wife insisted they were also interfering significantly with his life.

The exam we performed  showed several vertebral subluxations in Todd's spine.  We adjusted him using Activator Methods protocols.  After his first adjustment he experienced significant relief and was able to ride again. Even though he lives 2 1/2 hours from our office, he was desperate to get better and took the time necessary to come for treatment.   After the second adjustment he was able to lift light weight again and the headaches were very intermittent and mild.  After the fourth visit to our office Todd was pain free; no headaches, no back or hip pain.  He was pleased with the way his back now felt, but was ecstatic about how great it was to have no headaches.  Once the headaches had gone he realized how much they had been affecting him.


I don't necessarily like to relate cases where the results are nearly miraculous, but there is something very significant about Todd's case that can be a lesson for all of us.

One of the advantages of working on someone who rides horses regularly is that they usually have great core strength.  This is a real asset when rehabilitating the spine.  Strong core muscles are essential to support the spine.  Ranchers tend to respond very well to chiropractic care for this reason.  Many of the work activities, not to mention rodeoing,  can be hard on their backs, their strong core muscles help them recover quickly when they do injure themselves.
 
From my observations working with ranchers for many years now, their strong core muscles really protect their spines.  For those of us who do not have the opportunity to ride horses regularly, we have to find other forms of exercise to help us.  Our office can certainly provide you with some good core exercises.  Sorry, they won't be as much fun as riding a horse.

I Don't Have a Foot Fetish

New patients in our office sometimes think I have a thing about feet.  I'm always looking at their feet.  The truth is that as I hold their feet I'm comparing the length of their legs.  The relative length of the legs is a very reliable indicator of how the body is functioning.  I use the comprehensive system developed by Activator Methods.

The procedure begins by determining the functional short leg.  A functional short leg is a leg that appears to be shorter than the other one because of muscle imbalance which pull it up.  This is different than an anatomical short leg in which the bones of one leg are actually shorter than in the other leg, usually due to disease or trauma. 

Once the functional short leg is found a specific adjustment is applied to the pelvis to balance the leg length.  After the pelvis is corrected, various joints of the spine and extremities are stressed to see how the functional short leg reacts.  If the leg again shortens, it indicates that the stressed area is subluxated and also how an adjustment needs to be applied to make the best correction.  For a person who has not observed functional short leg checking, this may seem a bit strange.  However,  Activator Methods has 17 published research papers demonstrating the accuracy and reliability of this procedure.  The method has been accepted by independent panels on standards of practice as one of the most accurate assessment methods in the chiropractic profession.


Patients can think what they like when I'm looking at their feet.  The alignment of those feet mean a lot to me!

More is Not Necessarily Better

Recently, a colleague with a shoulder problem was frustrated that low level laser was not helping his condition like he thought if should.  Then after our latest Activator Methods seminar we were both reminded of the fact that when using laser more is not always better.  As a matter of fact high levels of laser actually inhibit the healing process.  This is one of the known features of laser.  Low dosages stimulate healing while high dosages inhibit.  Inhibition, while seemingly negative, can be of great therapeutic value.  In my friend's case the high power he was using was not beneficial.  He has since reduced the power of his shoulder treatment and is getting better results.

The more is not always better approach applies to more than just laser.  I've used the light force Activator adjusting instrument for over 25 years.  The results I've gotten have been equal to or superior to many procedures which use much more force.  As a matter of fact a research study at the University of Calgary has demonstrated the Activator instrument created more bone motion than manual adjustments which used many times the force.  The Activator analysis system also follows the more is not necessarily better approach.  It indicates where to adjust, when to adjust and, of equal importance, when not to adjust.  The when not to adjust is often the toughest part for us chiropractors to grasp but the body responds best when we pay heed to it's needs and not our wants.  I know that my body responds best when I'm I receive the only the optimal number of adjustive thrusts.

In human nutrition, each individual responds to differently to levels of specific nutrients.  Some people need higher dosages than other to achieve benefits.  On the flip side, some people respond much better to lower levels of nutritional supplement intake.  That's what makes nutritional counseling such a challenge.  Each individual is different and more is not always better.

The challenge as a chiropractor when adjusting, using laser therapy, or recommending nutritional products to determine the optimal level for each patient.  Too little and the results are poor.  Too much and the results are poor.  Reminds me of the three bears story.  The chair, the porridge, and the bed needed to be just rightto make Goldilocks happy .  Optimal therapy produces optimal results.  It can be a challenge to get it right.

Master Adjuster

A few weeks ago I attended a seminar for a chiropractic technique that I knew little about but was curious to find out more information on.  Also attending the seminar was a colleague I have known for years.  This fellow is a good friend.  I was struck when he told me he was adding this technique to the arsenal of methods that he regularly uses.  I was surprised.  This gentleman already utilizes an armada of techniques.

As the seminar progressed, I surveyed the room, and of the people attending whom I knew, I thought of the ones I most wanted to get adjusted by.  My friend was very low on the list.  The chiropractors at the top of my list were the ones who focused on a particular chiropractic technique.  Not to say they are not proficient at more than one technique, but rather that they focus on one technique.  It is their specialty.  They have mastered it.  I love getting adjusted by chiropractors who are masters of their technique.  The adjustments are usually special.  On the other hand when I've been adjusted by a jack of all trades chiropractor, the experience has never been so great. 

I want to be adjusted by a someone who is master of his technique.  I think my patients want the same.  That's why I have focused for 25 years on being the best I can be at using Activator Methods.  It seems I'm still learning the nuances of the technique.  When I give an adjustment, I'm confident my patient is getting the best adjustment I can give them.  I do have other adjunctive procedures I may use but they are not my main focus.  If a patient needs something I'm not proficient at providing, I like to refer them to someone who's a master in that procedure.  Be it laser, massage, ART, Thompson, NUCCA, cranio-sacral, etc. let the patient be treated by the practitioner who is the master at the technique.  That's what I want for myself.  That's what I think is best for my patients.