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Dynamic Chiropractic
March 25, 1994, Volume 12, Issue 07

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Book Reviews


By Stephen M. Savoie, DC, DABCO

Title: Down Right! Up Right! Chiropractic: Inside Out Author: William Tickel, DC Tickel Office, (708) 369-4295 Publisher: M & D Printing Category: Doctor education/enjoyment Publication: Soft cover, 177 pages, $18.95

This is a truly delightful book. It is a collection of short stories, anecdotes and letters both from and to others in and out of our profession.

Dr. Tickel begins appropriately with the opening of a practice. The description of those first months by Dr. Tickel and his wife, Dr. Pamela Fyler, will strike a sympathetic cord in many of us.

In the telling of these short stories and sharing of letters, Dr. Tickel expresses his exuberance for his profession. It is clear from his writing that this is a chiropractor committed to chiropractic. He talks about adherence to the chiropractic principle being the secret to a successful practice.

Although he makes no secret that he believes "straight chiropractic" is the best way to practice, the points he makes about the power of the human body to heal itself when interference is removed are lessons all chiropractors must not forget.

In addition to chiropractic philosophy, there are lessons on hiring and training staff, promoting the practice and becoming a "people person." Dr. Tickel's comment, "you better educate them," when referring to staff, is so important. It forces us to remember when someone calls your office and talks to a staff member, that staff member is your office. If they don't know what you do, neither will your potential patient.

In my opinion this is a book that can benefit every member of our profession. For some it will provide reinforcement of those principles they put in practice every day, for others it will provide a reminder of lessons learned long ago in chiropractic college.

At $18.95, this book is a bargain.

Savoie Rating: 9.5


Keith Innes, DC

Title:       Orthopaedic Testing
Author:      Janet Gerard, DC, DABCO, Steven Kleinfield, DC, DABCO
Publisher:   Churchill Livingstone
(212) 206-5000
Category:    Student education
Publication: 668 pages, hardcover, $129.95

This text is a visual reminder only.  The authors have taken on a
monumental task and produced a text that one can only assume was
rushed into print without actually taking it for a test drive.
There are many examples of crude inaccuracies and gross liberties
taken with the human anatomy and I have chosen but one as an
illustration.  On page 541 the authors describe the Macintosh Test,
and I quote:

Procedure:  The patient is supine.  Place a valgus force
into the knee while applying internal rotation to the
foot.  Then slowly flex the knee (Figs. A-D).

Rationale:  Normal knee mechanics require properly
functioning synergy between the ligaments and menisci as
well as between the acting and relaxing muscle groups.  In
this instance, a positive test indicates laxity in the
structures that provide anterolateral rotatory stability.

Classical Significance:  If the lateral tibial plateau
subluxates forward at 20 to 40 degrees of flexion and then
falls back after this point, consider anterolateral
rotatory instability (Figs. E-F).

Clinical Significance:  The reduction shift of the knee on
the affected side is due to contraction of the iliotibial
band or tensor fascia lata.

Follow-up:  Perform the jerk test of Hughston, Losee's
test, or the crossover test.
The accompanying photos do not show correct hand placement for this test and with the indicated hand position there is no way to palpate the "clunk" of reduction.

What is this test supposed to tell the examiner? Well, from the above description it looks like the problem is anterolateral rotatory instability or the iliotibial band or the TFL. How unique this approach is! I thought it was for the ACL. A phone call to the chiropractic college clinic enlightened me to the fact that this test was actually one of the definitive tests for anterior cruciate ligament disruption or tear.

The above clinical significance is rubbish. Try this instead: Articular dysfunction of the flexing subluxed knee during the pivot shift demands a comprehensive understanding of more than just the buzz words of popular anatomy. When there is axial loading of the lateral joint compartment, the posteriorly displaced lateral femoral condyle jams itself into the posterolateral articular margin of the tibia, forming a shift in the instantaneous axis of movement and creating a fulcrum. Instead of the lateral condyle gliding, further flexion causes the femoral and tibial articular surfaces to gape open anteriorly. The gaping displaces Gerdy's tubercle distally, which palpably tightens the iliotibial tract. You see the iliotibial band/TFL is a symptom and not a cause.

The section on the sacroiliac joint is at best a feeble attempt. The authors would do well to read the proceedings of the First Interdisciplinary World Congress on Low Back Pain and its relation to the sacroiliac joint to name one text, there are many others as well.

The last thing a student or doctor needs is a text that forces the owner to purchase a second text to allow a complete understanding of the former. This text needs a major revamping.

Innes Rating: 3

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Dynamic Chiropractic
March 25, 1994, Volume 12, Issue 07

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