I periodically receive mail admonishing me for teaching soft tissue evaluation and treatment. Somehow I am denigrating the purity of chiropractic. My answer to the above is that chiropractors, who are truly interested in the welfare of their patients from a spinal subluxation point of view and who do not evaluate and treat the related soft tissue, are responsible for the perpetuation of the subluxation. A subluxation does not exist in a vacuum. A vertebral segment is a passive structure made up of bones, discs, cartilage and ligamentous structures. Adjusting this segment cannot adjust all of the supporting chronic soft tissue stress that surrounds it.
The spine does not support the human body. A tent pole cannot hold up a tent by itself. It is the guy wires that attach to the tent pole that are responsible for the shape and movement of that pole. Movement of the tent pole is limited by the attached guy wires. If the guy wires (muscles & fascia) are stressed due to shortness or tension then the tent pole no matter how it is moved will not be able to substantially affect the guy wires.
Similarly, a chronically shortened upper trapezius will continually stress the cervical vertebrae. A chronically shortened iliopsoas will continually stress the lumbar spine and pelvis. The chronic shortness will alter the normal pattern of spinal movement. Chronic trigger points can alter the patterns of movement. Abnormal patterns of movement cause and perpetuate spinal subluxations. Adjusting the subluxation will relieve the patient, but as General McArthur said, "I shall return." A tight iliopsoas might be responsible for a weak antagonistic gluteus maximus which will adversely affect hip extension during walking and result in spinal subluxations anywhere from the sacrum to the occiput.
The fascia, which is omnipresent throughout, the body is a three dimensional elastocollagenous complex that has the ability to shorten and restrict the quantity and quality of movement of our total body. It is logical to expect a patient with a forward head position and protracted shoulders and an increased lumbar lordosis to suffer with more subluxations than a vertically balanced posture. Soft tissue treatment of the muscles and fascia is a method of preventing subluxations. Soft tissue treatment is a method of preventing subluxations from returning after they are treated. An adjustment often cannot prevent a subluxation from reappearing unless all the forces responsible for its appearance are modified. The position and function of passive osseous structures in space is determined by the balance or lack of balance of its myofascial breadth.
Techniques of analysis and treatment of the myofascia are available and chiropractors using these methods are realizing a more functional spine in their patients. Chiropractor should do everything in their power to prevent the subluxation from returning. We owe it to our patients and our profession to expand our consciousness.
Editor's Note: Dr. Hammer will be conducting his next Subluxation Myopathology (SM) seminar November 19-20, 1994 in Kansas City, Missouri and his next Soft Tissue (ST) seminar January 28-29 in Portland, Oregon. To register, you may call 1-800-324-7758.
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
Spearheaded by burgeoning scientific and clinical research literature, psychedelics have reached a level of media coverage and popular interest that has not been seen for over half a century. By “psychedelics,” we are referring to the unique class of substances that includes psilocybin (the active compound found in so-called “magic mushrooms”), LSD, dimethyltryptamine (DMT), ayahuasca, 5-MeO-DMT, and mescaline – each of which occurs in the natural world (except for LSD, which is a semi-synthetic compound).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
