THE FREE, EASY, EXERCISE THAT’S RIGHT UNDER YOUR NOSE!

THE FREE, EASY, EXERCISE THAT’S RIGHT UNDER YOUR NOSE!

Most of us can do it, and you don’t need a gym membership to sign up to this lifetime club. You know it, you love it, and you do it every day… it’s walking!

We talk about walking a lot, but that’s because we want to stress how great it is, not only for your spinal health, but overall fitness and well-being.

Four Ways Your Brain Is More Than A Logo

When most people hear the word “brand,” their minds instantly go to logos. They think branded pens, signs over doors and flashy business cards. In today’s gimmick heavy world, you can literally get anything branded. Exhibit A: There’s even talk of Richard Branson growing the Virgin Galactic brand to the moon via space hotels.

Branding on the moon. Heaven help us. Pun intended.

The fact is that branding is far more than a logo. For chiropractors and health practitioners, it’s the full patient experience, from when they first contact your business to when they walk out the door or need to contact you again.

It’s something every business person needs to think about, regardless of the field they are in.

Businessdictionary.com defines ‘brand management’ as “the process of maintaining, improving and upholding a brand so that the name is associated with positive results.” They go on to name a few important aspects that factor in to your customers (or patients) perspective of your brand.

Brand management, if done well, can result in a higher level of trust from your patient. It can flow on to higher sales, not only of the primary experience at the adjusting table but also the other complementary products you may offer. Think massage, myotherapy, counseling, supplements, postural aides and whatever else you may have on offer. This is as individual as the practice and practitioner, but the way it’s presented is essential.

It has the power to take you from chiropractor to confidante, and your practice from treatment venue to health-hub.

The brand experience, mood and vibe of the practice isn’t something that happens by accident. It is something built with intention. So how do you build a consistent brand to enhance your practice? Here are four key considerations.

  1. The customer experience. Good brand management all starts with the customer experience. However, this doesn’t start at the adjusting table. It begins when your chiropractic assistants answer the phone. It is foundated in tone of voice, answering times, and even hold music. It is built upon when the patient is booked in and followed-up in the lead-up to appointments. By the time the patient has walked in for their appointment, they have already been touched by your brand at least twice. These first impressions matter.Did they feel valued? Did they feel ignored or pressured?  Was the follow-up friendly and professional? What was the tone like?

    These aspects factor into their impression of your brand. Other aspects of patient engagement also factor in – I.E. websites, social media, advertising, and the tone of any newsletters you may send out.  Are you managing a patient, or building a wellness community? There is no right or wrong answer here. The key is to know what you are aiming for, and to tailor the patient experience towards this goal.

  2. In-store presentation. Once the patient parks out the front of your practice and walks through your doors, the next aspects of branding kick in. Did the venue back up their first experience (when they enquired or booked in)? Is the waiting room and adjusting rooms comfortable, professional and clean? Was the music relaxing? Clutter, smells, visual merchandising, and logo’s on business cards and other printed materials all factor in to the impression your customer leaves with. Smiles from staff matter. Room temperature has an impact. There are many aspects to balance when creating a customer experience that draws the patient back again.A rule of thumb in retail is that every customer should be greeted with eye contact and a smile within thirty seconds of entering the shop, even if they can’t be greeted with a verbal acknowledgement. It’s an interesting consideration to make when you create the mood and vibe of your business.

    Whole books and degrees have been dedicated to branding, visual merchandising and creating the ideal in-store experience. However, the beginners guide says this: Put yourself in the shoes of your customer and go through the four of the five senses. What do they see, smell, hear and touch? It should all line up with the way you want your patient to feel, and how you want them to perceive your practice.

  3. Cost is a tricky consideration for some products and services, but simple for others. Contrary to popular opinion, cheaper is not always better. If a customer wants quality, they won’t expect to pay a pittance. If a customer wants luxury goods, then they’ll expect to pay a premium. The price is a symbol of value.For chiropractors, the price of the chiropractic assessment is relatively standard across the board. It’s the pricing of the complementary items that you might want to think about. Many of them will carry a recommended retail price. Rather than straying from this, you may want to consider what type of complementary product fits your brand and perceived value. This gives you consistency across your full customer experience.
  4. For many products and services, the competition is an essential consideration. It is something that is researched extensively and entrepreneurs are advised to find ways to differentiate themselves from their competition. For chiropractors this is perhaps a little different. We don’t exist to talk-down other chiropractors in the area, we simply have to know what we offer. What is the care and intention that we bring to the patient, and the expertise and insight we present when we adjust? These are the aspects we must build upon when establishing and managing our brand.Competition may also come in the form of other complementary and alternative therapies.  Here, knowledge and confidence is power. We are communicators of our profession, as well as advocates of health. Staying up to date with current research and information can help us communicate the power of what we do, and understand how to link well with other therapies in order to present our patients with the best road to health.

Brand management is an art form that can never be fully condensed into one little blog post, but now you have a place to start. Good luck!

Migraines and Magnesium

New studies have revealed a link between Magnesium deficiencies and migraines, prompting some researchers to recommend that magnesium be included in the treatment plan for all sufferers of the debilitating neurological condition.

The reasons behind the link include the impact of magnesium on a number of brain structures and chemicals “suspected to be important in migraine [1].” The studies showed that magnesium levels impacted serotonin receptors, had an effect on nitric oxide synthesis as well as nitric oxide release, and affected NMDA receptors [2,3]. All of these are thought to be significant factors in the development and recurrence of migraine.

Other small studies have shown that migraine and cluster headache patients have responded positively to magnesium administered intravenously during attacks [2,3]. A larger study, which was double-blinded and controlled, looked at prevention and found the following [4]:

“The treatment group receiving 600 mg of magnesium for a 12 week period experienced a 41.6% reduction in headaches as compared to only 15.8% reduction in migraine headaches in the placebo group[2].  Another controlled trial at a dose of 485 mg did not show benefit [3].”

Yet another study linking magnesium levels and migraines found the following:

“Researchers looked at 50 migraine patients and 50 healthy subjects with no history of migraine. The migraine patients had average magnesium levels of 1.86  mg/dl, while the healthy subjects had magnesium levels of 2.10 mg/dl.

The researchers didn’t find any variation in magnesium levels in patients during or between headache attacks.”

Magnesium contributes to some 300 metabolic processes in the body, and is present in a number of important enzymes. However, it is often overlooked in terms of nutrition and supplementation – a fact that is evident in the studies revealing almost 50% of American adults who suffer a magnesium deficiency [5]. If magnesium deficiency is so prevalent in the typical western diet, then we have a little work to do in terms of empowering people to heal themselves from the inside out.

Where can magnesium be found?

Magnesium can be located in a number of freely available foods. These include [5]:

  • Almonds and cashews
  • Sesame seeds, pumpkin seeds and sunflower seeds
  • Bananas
  • Tofu
  • Flaxseed
  • Milk
  • Oatmeal
  • Broccoli
  • Sweet corn
  • Peas

In some cases, these foods (or other Magnesium rich foods) may not be included in a persons diet. This is where a number of readily available supplements may be employed to assist in bolstering magnesium stores.

Migraines change the structure of the brain

The migraine-magnesium link could be an important one for those wishing to prevent the recurrence of migraines, especially given the developing bank of knowledge about migraines. Where previously we believed them to be a benign occurrence that bore no long-term consequences for the brain, studies are now telling us that this isn’t necessarily true. The migraine can in fact change the structure of the brain. A study published in the Journal of Neurology found that [6]: “Migraine raised the risk of brain lesions, white matter abnormalities and altered brain volume compared to people without the disorder. The association was even stronger in those with migraine with aura.”

When discussing the findings, Dr. Yurgelun-Todd PhD (Professor of Psychiatry at Utah School of Medicine) said this to Prevention Magazine [7]:

“Individuals who have migraines are experiencing a neurobiological change that causes cells to die. Loss of tissue may not have an effect at first, but if you have enough, you may end up being less efficient cognitively.”

When asked what these changes are due to, Yurgelun-Todd said “the most prevalent idea is that there are changes in the brain due to dysfunction in delivering enough blood and nutrients to different brain regions—causing tissue loss.”

The damage is said to be cumulative and migraine-induced volume loss can be reversed with treatment, hence there is no cause for panic. However, it does paint a clear picture for us. We aren’t dealing with a painful condition that ‘just has to be dealt with every now and then.’ We are dealing with something that can change the brain.

The triggers for the condition are many: from stress to hormones, genetics, food and more. Many of these will be individual, and must be managed on a patient by patient basis. Checking magnesium intake and adjusting if necessary is just one way we can sure up the system to lower the risk of recurring migraines.

 

Science: The Good, The Bad, The Retractable

A concerning trend has emerged over the last few years, and it’s one that should make us sit up and think. “Retractions for all reasons, from honest error to plagiarism to the outright faking of data, are on the rise [1].”

Perhaps it’s the pull of the academic career path, the pressure to publicize or even lowered barriers to retraction that’s driving this change, but it presents us with some valid and valuable questions. What is good science? How do we insulate ourselves from the damage of retraction? It’s something Spinal Research takes seriously, because we have a cause to support, resource and back with solid evidence.

Concerns around the validity and reliability of scientific and research journals have existed for a number of years now, and some of the most vocal critics have occupied seats of influence in the industry. Two examples are Marcia Angell (MD) of the New England Journal of Medicine, and Richard Smith, editor of BMJ (previously known as the British Medical Journal). Their comments on the matter demand reflection.

“It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine (Marcia Angell MD).”

“…most of what appears in peer-reviewed journals is scientifically weak (Richard Smith, BMJ Editor).”

These two damaging conclusions, voiced by influential editors, could be somewhat disheartening for organisations and individuals who wish to seek out the truth rather than simply agreeable propaganda.  Indeed, it is a consideration that foundations like ours hold close to heart.

We exist to facilitate research and disseminate knowledge that furthers the understanding, development and effectiveness of chiropractic care. This is our research culture statement [2].

This mandate is based around a desire to back the chiropractic profession with that which is solid, reliable and scientifically valid. According to Dr. Mark Uren*, head of the Spinal Research Clinical Advisory Panel, this serves a very important purpose. “It isn’t just something that needs to be done for our own benefit, but also for a greater population to be able to access chiropractic. If we want more funding bodies to get behind us, more government support, or more awareness in the greater population, then research is essential.”

It just has to be good research. The implication is twofold, demanding a robust process that honours both scientific integrity and the donor dollar.

So then – what distinguishes the scientifically stable from the shaky and unreliable? The starting point is undoubtedly an understanding of what makes science “good.” An untainted peer-review process, the ability to challenge every hypothesis via experiment, and the ability for results to stand up to scrutiny all factor high on the list.

It all comes from a catch-cry researchers will know all too well: “Trust, but verify [3].”

This is the simple idea that underpins science. Yet last year saw a peak number of retractions from giants like PubMed. Why is this so? Perhaps, in the race for publication, there was too much trust and not enough verification going on. This is a suspicion shared by a couple of voices in the industry [3]. The ability to replicate results may not always be possible, but there are some guiding rules that can indicate when replicability percentages just aren’t adding up.

“A rule of thumb among biotechnology venture-capitalists is that half of published research cannot be replicated. Even that may be optimistic. (In 2012), researchers at one biotech firm, Amgen, found they could reproduce just six of the 53 “landmark” studies in cancer research [3].”

Frankly, that number is low enough to demand more than a raised eyebrow or two. There’s a catch-22 here though: research doesn’t come cheap. Having to go back and check data has the power to greatly stymie progress, not to mention tie up some of the sharpest minds in biomedical science with backtracking rather than forward momentum.

Perhaps big-pharma can afford this cross check, but the fact is that chiropractic isn’t yet attracting the multi-billion dollar budgets that pharmacological and other such research is attracting. It may be years before (if ever) we do. We still do have a responsibility to advance our field though. Hence the scrutiny needs to come in way before the post-publication review.

Here is the interesting balance we need to strike: financial responsibility, scientific and research reliability, and relevance to chiropractic. For Spinal Research, this starts with a peer review process that is solid, in-depth and unsullied.

For Dr. Uren, this is a balance managed through the robustness of the Spinal Research application process. “We have a research culture statement. There’s a clinical component to it, and a scientific component. Each research application has to satisfy both. We want to be responsible with the Spinal Research budget and we don’t want to waste the time of researchers who might propose something that is scientifically valid but not relevant to chiropractors, or something that needs a bit more work before it is solid scientifically.”

“That is why we have the expression of interest early on in the process. This goes to the Clinical Advisory Panel – these are practicing chiropractors. Their purpose is to check the expressions of interest for their relevance to the field of chiropractic. This ensures we are staying true to the research culture statement.”

In order to pass the initial Expression of Interest, applications then go to the Scientific Review Panel. “These are researchers, academics and scientists working in the field, not necessarily chiropractors. Their purpose is to look at the scientific merit of each expression of interest.”

It’s a blinded process, ensuring the reviewers don’t know who the applicants are or what institution they are from. This is a purposefully maintained safeguard against bias, that allows solid critiques and feedback to be given early and through-out the process. This aspect is important, as research is to be encouraged, even if it isn’t solid enough to be funded just yet.

We don’t want to waste precious research time. Hence the early communication. “Sometimes its valuable research, but it can be funded somewhere else as its not that relevant to chiropractic. Research on medications for example. Its good research, its just not what we want to fund. For others, there might be merit in what they want to look at, but it requires fine-tuning. We encourage them to look at certain areas of the application and come back to us” says Dr. Uren. “Everything is filtered through two lenses: the lens of our research culture statement, and the sense of scientific validity and reliability.”

Based on the score given by each of these areas, some applicants will be invited to move through to the full application process. Here, the applications face both panels again, but with far more detail worked in.

Yes, the process is in-depth and detailed, but it is so on purpose. Putting the right footwork in at the beginning is integral to maintaining the healthy track record Spinal Research’s projects have enjoyed. The transparent and robust nature of the process is paying off too: the nature of work that has come out of Spinal Research grants is something of which we are truly proud.

There has been an increase in the amount of applications that have come to us in recent years, and not just from Australia. It’s an encouraging trend, especially when there is so much left to explore. According to Dr. Uren, this includes more research on the mechanisms behind how and why chiropractic works, on the effects of subluxations on human health, neurology and neural plasticity.

Supporting good science pertaining to the field we believe in continues to be both a mandate and a passion. We are proud to get behind the work that has to potential to widen the reach of chiropractic into a population that could benefit so much from what we have to offer.

Patrick Gentempo- Bridging the Science/Philosophy Divide

“Many chiropractors feel like they are second class citizens in the world of health care and in the world of evidence. I’m showing up to make the argument that our evidence is robust, and its something we should be celebrating and promulgating not apologizing for,” says Patrick Gentempo of his visit to the Australia this month for  Dynamic Growth Congress and his Think! Chiropractic Without a Doubt day seminars. Gentempo will be bringing the applied science of the adjustment, and a powerful message of the impact of philosophy when he treads the stage at DG 2016.

“We are delivering this program on a Friday and a Saturday. My intention is that every participant in the program will be able to deliver a better adjustment on the Monday. I’m here to increase the three C’s: confidence, certainty and credibility for the chiropractor.”

Marrying the philosophy of chiropractic with a robust science base has long been focal point of Patrick Gentempo’s work. Indeed, the marriage of these two important aspects of chiropractic is an essential thing given the increased demand for evidence across many disiplines including chiropractic. “The problem is that people don’t start with any foundational philosophy. They don’t have any premise from which they are operating so they go down blind alleys. There’s a lot of rhetoric about evidence-based care, but really the answer to the question is ‘what would one accept as evidence?’ It’s a philosophical question. You have to have some context. Data in and of itself is meaningless. You have to have some framework from which to understand and interpret the data and then to apply it. Most people don’t really get that deep into the thinking or considerations relative to all of this.”

Patrick has been at this long enough to be sure of what he is saying, but it’s a long way from where he started. In fact his journey into chiropractic started young, when a neck injury caused him to seek treatment. “The medical doctor gave me pain-killers, muscle relaxers, and anti-inflammatories. The drugs didn’t work and made me a bit ill. My mom brought me to a chiropractor. After the first adjustment, I was 90% better. When he explained to me the principle of chiropractic, the lights came on and my path was set. I decided that day that that was what I was going to do [1].”

He had simply been shown the power of the adjustment. The experience was a transformational one, propelling him not only into the profession but also into business and innovations supporting chiropractors. This was, perhaps, the first step towards the type of chiropractic certainty he is now renowned for. For Gentempo, science and philosophy don’t clash at all. His rationale: if what you’re doing is true, the science will line up with it.

“Philosophy in chiropractic is a very polarising word. A lot of people think that to be philosophically oriented as a chiropractor you aren’t scientifically based or if you are scientifically oriented as a chiropractor, you can’t be philosophically based. My comment on that is that anyone who would make such a statement doesn’t understand either philosophy or science.

There has to be some framework to review the nature of reality and the rules of evidence and then the actions to take, which are the first three branches of philosophy: metaphysics, epistemology and ethics. It really is a structure to understand critical thinking and with that critical thinking you start to now look at the science that either supports or invalidates the premise. That’s all great to consider but the question is now ‘how do you get it to the patient? What are the things you can put on the ground on Monday?’ “

These key questions are what Gentempo will be targeting in his presentation to Dynamic Growth. “I’m not speculating a potential outcome. I know its possible.”

The reality is that the science behind the chiropractic profession is mounting up thanks to the tireless efforts of researchers, but Gentempo argues that even in this, philosophy plays a role. It’s an important consideration to raise, because if the answer is not firm and clear in our minds, we can be pushed back from the point of certainty on strong data. Worse still, we could accept false negatives as a quasi-gospel telling us that the adjustment isn’t as powerful as it is.

We can even become unsure of the simple evidence we see right under our noses every single week – the small miracles we witness when the subluxation is put right and the body finds itself once again able to heal. When he talks about this issue, Patrick raises the point that philosophy plays a lead role in science and research.

“There is no doubt that there are political agendas that people have in the profession. One must ask what are the motivations behind these agendas. What are the agendas people have? They have their own inherent contradictions. Here’s the thing about philosophy: everybody’s got one. Even those who are trying to promulgate that philosophy has no place in chiropractic – they don’t realise that’s a philosophical stance. Every thinking human being doesn’t have a choice about the fact that they have a philosophy. Their only choice is whether or not to define it in a conscious and rational way. So they can’t try to pretend philosophy is irrelevant or doesn’t exist. No. Everyone’s got a philosophy.

When it comes to subluxation, you can make the statement that you don’t like the evidence, but you can’t say that there’s none. There is data. There is research. It’s there. You can say you don’t like it. But you can’t say it isn’t there. To do so would be a complete factual inaccuracy. Such statements usually come from a warped and confused philosophy. I can tease it out if I ask questions but they often don’t know what their philosophy really is .

The question is what is your philosophy. Not do you have a philosophy. What is your philosophy? For people who don’t take the time to sort that out, they usually have a philosophy that accumulates more randomly, like a junk-heap, rather than a clean well, thought through, organised structure of thinking.

Philosophy isn’t something everyone will lay out branch by branch, but Gentempo believes that it is something that every DC should be able to do, and indeed every human beingshould be able to do.

“You should have a philosophy around work, parenting, relationships, money, health, safety and any number of things. Is it empowering? It should be. If not, its hurting you. People in the USA and NZ right now are getting their health philosophy from drug commercials.

He notes that culture around healthcare and wellness care is changing, and that there is an increased demand for wellness care rather than sickness care. There is a growing part of the culture that is interested in proactively enhancing health. There’s just one problem: the public hasn’t necessarily matched chiropractic with that.

At least, they haven’t done so yet. This places the profession in an interesting crossroad: do we stay true to vitalistic chiropractic philosophy, the foundational view of reality that concludes that adjusting the subluxation has a vast, wide-reaching impact on health, or do we accept the definition ascribed to us by the public? Patrick is very clear where he stands on this issue. “Some people see this as our area of opportunity, which I do. The others say ‘the public sees us as a back pain treater so we should just do that.”

Gentempo recalls a debate where one party was arguing that the surveys were done. The public didn’t understand chiropractic. They thought we were back and neck pain practitioners, so that is where we should be. The rebuttal remark, by Dr Christpher Kent, was poignant: ‘Aren’t you an attorney? Shall we see what the public thinks about you? Is that all you should be?’

“There are those who think chiropractic should be limited to back and neck pain only, that we should only deal with uncomplicated spinal syndromes, a subset of medicine as opposed to a distinct and unique profession that is distinct from medicine. It’s not that medicine that is wrong or bad but what we do and why we do it is completely different service.

If you think that you want to be a medical doctor and practice medicine, then you should have gone to medical school! We don’t need more people pushing drugs in this culture, that’s for sure.”

Patrick Gentempo’s vision has always been world domination of wellcare in a chiropractic model.

“Too many people look at healthcare as sickcare. Since I co-founded CLA in 1988, that’s been our mantra. I want to see the brand chiropractic have positive brand equity in the mind of consumers, that they recognise it that it’s a unique service that contributes to their health and longevity, and beyond that – their whole life. (My vision is) that we lead that. That we are in the number one position.

It has to start with philosophy. That’s what gives you identity. If you are confused on your philosophy, your identity is confused. That’s why people don’t know what chiropractic is. You look at brands like Apple. They have a very clear picture of what their brand is and they don’t violate it. We have to do the same thing.”

Book Review: Grain Brain by David Perlmutter MD

Since its publication in 2013, Grain Brain by Dr. David Perlmutter has been making waves [1]. Written by a practicing neurologist and fellow of the American College of Nutrition, this book is a well-written and compelling read from a renowned doctor with a unique combination of credentials.

Grain Brain gives us a close and well-researched look at the history of food and illness, and the common denominators behind many diseases that have neurological roots. It challenges commonly held perceptions of what good food is. For many readers, it’s been a breath of fresh air.

That’s not to say it hasn’t polarised its audience. For those dedicated to the traditional food pyramid, it was heresy. To those who had researched the perils of the now out-of-favour Aitkins diet, this was a thinly-veiled back door to the same dietary system. However, for Paleo eaters and the nutritionally curious, along with Caeliacs and Non Caeliac Gluten Intolerance sufferers, this book was music to tired and frustrated ears.

The detractors had a field day with objections including assertions that some traditional cultures with high carb intakes had low instances of neurological disease, and multiple claims that grains do not increase inflammation.

Let’s be honest: there is much science on both sides of the fence. For every study asserting the harmlessness of wheat and other grains, there seems to be a contradictory study. One such work was Daulatzai’s study which says that “Non-celiac gluten sensitivity triggers gut dysbiosis, neuroinflammation, gut-brain axis dysfunction and vulnerability for dementia [2].”

We are also seeing evidence that gluten may compromise the blood-brain barrier, and that something called ‘Gluten Cross Reactivity’ may result in the body confusing other foods such as dairy for gluten and reacting in kind [3].

This is surely not an idea we can ignore.

In his book, Perlmutter presents a plethora of thought-provoking information that he deems scientifically sound and undeniably conclusive. They’re big ticket items too. You’ve not long plunged into the opening pages of Grain Brain when Perlmutter makes some big statements:

“Diabetes and brain disease are this country’s costliest and most pernicious diseases, yet they are largely preventable and uniquely tied together: Having diabetes doubles your risk for Alzheimer’s Disease. In fact, if there’s one thing this book clearly demonstrates, it’s that many of our illnesses that involve the brain share common denominators.“

The common denominators include gluten and inflammation, and the flow-on effects are many. Perlmutter lists Parkinson’s, ADHD, depression, epilepsy, and Alzheimer’s disease as just some of the possible repercussions. His assertion is that we are “increasingly challenging our physiology with ingredients for which we are not genetically prepared.” Gluten and starchy foods commonly ingested in the western diet are major concerns for Perlmutter, which he urges his readers to be informed about and empowered to act upon.

Grain Brain is a compelling read, designed to be equipping rather than fear-mongering. It urges a return to the way our evolutionary forerunners would have eaten: a diet rich in vegetables, meats, fish, and eggs.

As advocates of health, it pays to be informed of both sides of the argument when it comes to work like this. Grain Brain challenges the status quo, but is well worth the read.

Self Control In Adolescence - How it Decreases Stress and Increases Coping

They say that the only constant in life is change. During adolescence, change becomes very constant. Not only is the teenager faced with a steep social and emotional learning curve, but also with a rapidly changing biological reality that represents a constant challenge to homeostasis.

Impulsivity is high during adolescence. Neuroscientists can tell us why that is. But interesting research is showing that the simple art of self-control may not only decrease stress but also increase the adolescent’s ability to handle it.

Impulsivity and risk taking seem to be hallmarks of the adolescent years. From learning to drive, to navigating relationships, teens can often appear to have a loose association between action and consequence. The reason for this is rooted in the neurological processes taking place inside the brain. At around age 11, the prefrontal cortex and parietal lobes “begin a period of prolonged pruning of neuronal axons resulting in thinning of cortical grey matter [1].” At around this time, the preteen child is disappearing and the teenager is emerging.

At the same time that the adolescent is engaging in novel and risky activities, it is argued that the prefrontal cortex has not yet matured to the point where risks can be adequately assessed and control over risk taking can be sufficiently exerted to avoid unhealthy outcomes. In particular, the PFC and its connections with other brain regions are thought to be structurally inadequate to provide the control that is optimal for adolescent behavior. This maturational gap in development of PFC-based control relative to more advanced motivational circuitry is said to result in an inevitable period of risk for adolescents [1].”

This research is now showing us what few would be surprised about: early and severe stressors, especially those in which the child has little or no control, can have negative, even toxic, impacts on a wide range of health outcomes [2]. Once again, stress takes centre stage in terms of health outcomes – even for the younger members of society.

Among the many risk-management theories circulating is a simple one: self-control. A recent article in the Journal of Personality found that “adolescents with higher self-control experienced fewer daily stressors and reported lower stress severity, particularly when daily mindlessness was high. Adolescents with higher self-control reported less mindlessness in response to daily stress [3].”

According to the authors of the study, self-control involves restraining maladaptive automatic processes that guide behaviour. Essentially, the higher the self-control, the lower the desire strength and the less likely there will be a goal conflict (For example, when a teenagers safety or health conflicts with the impulse of the moment). “The benefits afforded by high trait self-control might be attributable to proactive avoidance (i.e. anticipatory coping) of problematic situations rather than persistent resistance of moment-to-moment impulses. [3]”

The authors of the article also believe that higher self-control may influence the way the adolescent perceives a situation. A teenager with higher self-control and a teenager with low self-control may interpret the same situation differently.

Interestingly the development of self-control is now being shown statistically as an essential life skill with a significant bearing on stress and coping, and by virtue of this, health. Indeed, it moves self-control from being an old fashioned virtue to being a modern protective factor.

However, try teaching a teenager self-control and you might learn a lesson or two in stress yourself! According to Meichenbaum and Goodman [4], the development of self-control starts with developing self-instructional skills in childhood. This self-talk teaches the child to act intentionally rather than impulsively.

Childhood self-control can then be used to predict not only health, but also wealth and safety in later life. Perhaps it’s just a new take on an old value, but self-control is once again proving very important.

PTSD, Adaptation and Chiropractic

In terms of stress and adaptation, few examples are so emotive as the currently-topical issue of Post Traumatic Stress Disorder (PTSD). It is estimated that 1.4 million Australians have PTSD at any one time, this number making up 6.4% of the population. Not all of these cases are combat related either. In fact, they come from all walks of life [1]. Common flow-on effects of the disorder include depression, suicide or suicidal ideation, drug and alcohol problems and many social, economical and functional impacts.

Current research and practice is taking us away from the idea that mental illness is ‘all in your head.’ We now know there are physiological and neurobiological aspects of mental illnesses such as PTSD that make it very much a tangible, quantifiable issue.

A diagnosis of PTSD requires a history of exposure to a traumatic event, and “symptoms from each of four symptom clusters: intrusion, avoidance, negative alterations in cognitions and mood, and alterations in arousal and reactivity [2].”

In addition to these key clusters, there are marked differences in the brain scans of PTSD sufferers in comparison to the scans of those without the disorder [3]. Here’s the interesting thing though: the vast majority of people will experience or witness trauma over the course of their lifetime but not all of them will go on to develop PTSD.

This leads researchers such as Sherin and Nemeroff to the following conclusion: “The signs and symptoms of PTSD appear to reflect a persistent, abnormal adaptation of neurobiological systems to the stress of witnessed trauma. The neurobiological systems that regulate stress responses include certain endocrine and neurotransmitter pathways as well as a network of brain regions known to regulate fear behavior at both conscious and unconscious levels [4].”

Hence we may deduce that setting the body up for optimal neurological and endocrine function is important, both preventatively and otherwise.

Once upon a time, we believed that PTSD (originally called shellshock) represented a downstream effect. i.e. the trauma occurred and then triggered the disorder. Scientists now believe that the problem is also very much an ‘upstream’ one as well. There are strong indications that pre-existing factors can lie dormant until they are released by trauma exposure.

“Along these lines, recent interest has focused on factors that seem to modulate outcome variation in neurobiological systems following trauma exposure including genetic susceptibility factors, female gender, prior trauma, early developmental stage at the time of traumatic exposure, and physical injury (including traumatic brain injury – TBI) at the time of psychological trauma; these parameters likely contribute to vulnerability for, versus resilience against, developing PTSD [4].”

We cannot impact whether or not someone experiences trauma. This seems to be the unfortunate reality of life on the unpredictable planet that we share with other imperfect people. Where then should the compassionate chiropractor’s interest lie?

Perhaps it is in supporting neuroplasticity, thus empowering the person towards faster recovery. Perhaps it is in supporting optimal neurological function before the trauma occurs. The reality could even be a combination of both, with an extra emphasis on compassionate care. Either way, further research needs to be done.

So far, only minimal studies have been done on the effectiveness of chiropractic in helping people with PTSD. One such study focused on the effectiveness of chiropractic on combat-related PTSD sufferers. Of these, 61% of cases reported improvement [5]. However, many of these improvements were due to comorbid musculoskeletal complaints such as thoracic pain. The impact of chiropractic care on the person’s sleep was flagged, but no analysis occurred as to how this may have then impacted their overall health, including their mental health. No comprehensive study has looked at the impacts of chiropractic on the neuroplasticity of the brain alone.

The research that is available tells us that adjusting subluxations plays a role in supporting adaptation. We also have strong indications that adjusting subluxations can assist the brain in sending and receiving information without distortion.

We cannot yet say that chiropractic can help people with PTSD. Before we fully understand the role of brain plasticity, sleep and co-morbid musculoskeletal conditions in PTSD, it may remain a long bow to draw. What we can say is that compassionate care that allows the body to improve the physical condition, offers the person a better chance at restorative sleep, and supports brain plasticity is important. These can make the chiropractor a special part of the support crew for people with PTSD, during their road to recovery – however long or short that road may be.

FAQ- What's The Difference Between Food Intolerance And Allergy

“Are you really allergic? Or are you just intolerant?”

It’s a question often asked of a food intolerant person. It can often be disparaging, perhaps not intended to make to the sufferer defensive, but disheartening none-the-less. Oftentimes, people with food intolerances are treated as fussy eaters with no real problem. But the truth is that food intolerances are very much a physiological reality.

There is a difference between a food allergy and an intolerance. Basically, food intolerances are chemical reactions, while food allergies are immune responses [1]. However, regardless of whether or not you have a ‘true’ allergy, you’ll have a very real reaction. Pain, discomfort, and other serious symptoms can be the repercussions of both allergy and intolerance.

Never-the-less, it is helpful for patients to understand the difference between the two issues – if for no other reason than that it validates their issue, and gives them a way to respond to those who would discount it as some form of a lesser illness.

The difference all comes down to immunoglobulins – the antibodies that exist in the serum cells of our immune systems. There are five, but three of these immunoglobulins are responsible for reactions to food or other substances. Two of the, IgG and IgA can be very similar. They both affect bodily fluids, with IgA affecting tears, blood and saliva as well as protecting areas that are exposed to foreign substances. IgG antibodies are the most common of the immunoglobulins, making up 75%-80% of all immunoglobulins. They are present in all body fluids.
The third, IgE is quite different.

“IgE antibodies are found in the lungs, skin, and mucous membranes. They cause the body to react against foreign substances such as pollen, fungus spores, and animal dander. They are involved in allergic reactions to milk, some medicines, and some poisons.[2]”

Common testing for ‘true’ allergies involves skin prick testing. This can occur because with allergies, the reaction is most often instantaneous [3]. It occurs in the seconds and minutes after exposure to the allergen. True allergies often manifest in the following ways:

  • Tingling, itching or hives
  • Swelling of the lips, tongue, throat or other parts of the body
  • Wheezing, nasal congestion or trouble breathing
  • Abdominal pan, diarrhea, nausea or vomiting
  • Dizziness, lightheadedness or fainting
  • Anaphylaxis, in which the patient sufferers a severe allergic reaction requiring urgent medical attention [1].

Regardless of whether the patient has been exposed to a large or small amount of the allergen, the result will be the same. Even tiny exposures will reap the same result with allergies.
This is where food intolerances are different: they are often dose dependent, occurring only when you consume the allergen often or in high doses. Another point of distinction is that food intolerances take time to brew. You could consume a food and not feel the results until hours or even days later. This means a skin prick test cannot be used to determine the intolerance.

Commonly, elimination diets are used to determine them. These have to be spaced out and slow, as it can be very easy to confuse reactive foods should you reintroduce too many reactive foods in close succession.

Symptoms of food intolerances include:

  • Sweating and palpitations
  • Diarrhea and stomach upsets
  • Rapid breathing and asthma
  • Migraines and headaches
  • Tightness in the face and chest, or burning sensations on the skin

In fact, food intolerances may look a lot like allergic reactions. Hence, they can be quite serious. The difference between the food intolerance and the food allergy lies simply in the immunoglobulin – with one being instantaneous, and one being long term and dose dependent.

In recent years, a blood profile test has become available through some functional pathology companies. The IgG Blood Profile test helps discover food intolerances that would previously only have been discovered through elimination diets that may take months. We can finally test for IgG (food intolerances) as easily as we can test for IgE reactions or true allergies.
Good news for sufferers, indeed.

Enhanced Neural Plasticity - Max Cydaner

“Neurons that fire together, wire together,” says Max Cynader, a well-regarded Canadian Ophthalmologist and Neuroscientist, as he takes the TED Talks stage. It might be a common phrase to anyone who studied psychology at school, but to scientists and researchers, its applications are far from academic. It’s all rooted in the idea that “Contiguity breeds connectivity.”

We often say that the Nervous System is contiguous, that it is a vast but interconnected system where the actions of one part of it somehow touch the other aspects of the Nervous System. For Max Cynader his life’s work has meant an incredibly close look at how this contiguity can impact a very specific area of brain plasticity.

“Brain plasticity is the process by which your brain changes depending on what has happened to it. Brain plasticity would include for instance, memory. But brain plasticity is more than memory. It’s the process by which your brain is involved in learning a say new skill, like learning to ski or play Sudoku. It’s the process by which you recover from brain damage of various sorts, for instance a neuro-trauma or a stroke. It’s also the way you adapt to the fact that you way twenty pounds more after Christmas but still have to walk gracefully.”

To Cynader, memory is nothing more than your ability to reconstruct the whole from a degraded fragment. He uses the example of a person’s memory of their grandmother. There is the visual cortex: what she looks like. There is the auditory cortex: the things she said to them, and the sound of her voice. Up in the smell cortex, there is the smell of her perfume. In various other sectors of the brain, are the texture of her clothes, and the taste of her cooking. All of these neurons fired together every time the person was in the presence of their grandmother. Hence, these neurons wired together.

This is why you could walk past someone wearing the same perfume your grandmother used to wear, and all of a sudden all of the memories tied up with your grandmother come flooding back.

So what are the impacts of this type of memory contiguity and why is it so important to brain plasticity?

“In neuroscience, we can now make neurons fire together. We can take two neurons and force them to stimulate. If we can make it fire hard enough, we can access the next axon. After a time, we find that if we make those two neurons associate, the connection between them will get stronger,” says Cynader. “Strong inputs and contiguity will result in a stronger synapse.”

All of this understanding is leading to new strategies and therapies. Of course, many of them involve medical interventions such as drugs or brain stimulation. However, it should also prompt thought about how we stimulate neural plasticity on a practical level.

We used to think that we already had all the brain cells we were ever going to have, and that aging subjected us to a process of certain degradation in terms of the grey-matter. This is not what the current literature says. It is now telling us that the brain can adapt, change and indeed repair to a certain extent.

Better still, research has turned up one very specific way to stimulate the growth of brain cells.

The hippocampus is very important to memory. It represents the memory trace in a compressed and higher form. As you get older the hippocampus shrinks along with the rest of the brain. But exercise can actually arrest this process.

Yes, it is as simple as exercise. Of course, with many complex neurological disorders becoming quite common today, it may not be that simple in all cases. However, it does show us that sweating it out is good for body and brain.

“Physical exercise is important in improving memory. You can double or triple the new brain cells you are going to make next week by doing physical exercise. It is more important than playing Sudoku. The entire neuroplasticity machine is turned on (during exercise). Do both cardio and resistance training. This will enhance your cognitive performance,” says Cynader, although he is hardly advocating the abandonment of brain-teasing exercises.

He is simply telling us there is something that should make its way into every week, if not every day. Exercise can be the simple key to speeding up the brains production of new cells.

Epigenetic's: Why Your Future Isn't Set In Stone

For decades, the central dogma of genetics told us that our DNA dictated our future, that at the moment of conception our health destiny was set in stone. We believed that DNA was the molecule that controlled our life, programming us towards certain health realities. It was an inheritance that shaped our future. The DNA passed information down to the RNA which passed information to the protein.

We were the protein and the expression of our genes. We couldn’t pass information back up the chain, therefore we could not impact our DNA. The implication was that we could not improve or influence our health destiny. The whole allopathic medical system was built around this dogma – in managing our DNA doom the best way it could.

The science of epigenetics is now telling us something: DNA is not destiny.

Dr. Bruce Lipton (PhD) is a cell biologist who has devoted his life to the field of genetics. His first book, The Biology of Belief, was lauded by some and criticized by others. Contained within its pages was an empowering message that denounced the idea that we were not the masters of our health destiny – that belief could in fact alter biology.

It’s now ten years since publication and the science of epigenetics, the idea that we environment can in fact influence our genetic expression, is now well-documented and backs up Lipton’s work in many ways.

If you were to hear one of Lipton’s keynote speeches, you would quickly understand his aversion to the foundation of allopathic medicine. “The central dogma was a hypothesis. That’s all it was. It was never scientifically studied. It was never even observed to see if it was true or not. It was something everyone just believed because they were looking for the answer. When it came out in 1958, that’s all it was. It was an idea. By 1968 it was in all the text-books. Then it was 1978, then 1988. Guess what. No one remembered that it wasn’t even a scientific fact. It was just a hypothesis [1].”

Research is now presenting us with an alternate theory. The field of epigenetics has emerged in the last fifteen or so years, and it is challenging Crick’s central dogma. It is telling us that our genes are but a blueprint. How the genes are read and expressed can be heavily impacted by environment and, according to Lipton, our perception. In fact, he argues that perception influences biology.

So what are epigenetics? According to Lipton, epigenetics are the actions above the genetics which influence gene expression. Instead of focusing on the nucleus of the cell, commonly viewed as the brain of the cell, he focuses on the membrane. The membrane interacts with the environment around it and then sends this information to the nucleus of the cell. Here, environment is shown to have a profound impact on the cell, and thus on genetic expression.

This concept has been echoed in numerous twin studies that have taken identical DNA sets and compared health outcomes over years and even decades [3,4,5]. From cancer to age related illness, the research echoed remarkably common outcomes: genetics were seen as having a far lesser influence than environmental factors.

Put simply, Epigenetics is like a television broadcast. The signal that comes from the tower is our DNA. But we don’t have to receive it just as is. We can tune our television using the dials to influence contrast, brightness, sharpness and such. Does the original signal change? No. Does its expression or appearance on our television change? Yes, it can. Our DNA contains all the elements, but the way it plays out in our lives can be heavily influenced by our environment and our response to it.

This effectively puts another two layers above the ‘DNA – RNA – Protein’ chain. Lipton presents it this way [1]:

Environmental signals – The primary cause

+

Regulatory Proteins – The epigenetic control

+

DNA – Long term memory

+

RNA – Short term memory

+

Protein – Behavior

It may be easy to see how environment may contribute to epigenetics: how a diabetes gene may not be switched on in the life of a fit, paleo eater, or how an anxiety gene may not get switched on in the life of a yoga-practicing happy person with not a worry in the world.

How then does our perception alter it? Lipton argues that our response to our environment bathes our cells in certain chemistry [1]. Stress bathes our cells in cortisol and other stress hormones. Love bathes our cells in dopamine and oxytocin (for example).  Our response to the environment around us has the potential to either surround our cell membranes in crisis messages, or in much happier alternatives that enhance rather than interrupt adaptation.

Is Lipton saying that positive thinking is all you need to harness control of your life? Absolutely not. What he is saying is that belief can alter biology. “Our responses to environmental stimuli are indeed controlled by perceptions, but not all of our learned perceptions are accurate. Not all snakes are dangerous! Yes perception ‘controls’ biology…but these perceptions can be true or false [6].” He goes on to say this [6]:

 

Palmer College Of Chiropractic Releases Latest Gallup Polls

Palmer College of Chiropractic recently commissioned Gallup to design and conduct a study of more than 5,000 adults aged over 18 in the USA. The purpose was to discover attitudes to chiropractic care and the chiropractic profession. The results were released on September 8 2015.

This study is the first of its kind, being that it is the ‘first annual survey of U.S. adults measuring perceptions of and experiences with chiropractic care [1].’ It might not be based here on Australian soil, but it still gives us a good measuring stick on the attitudes towards the profession that may prevail in the western world.

Emerging from the study is a whole lot of good news. Chiropractic has a good reputation amongst the majority of US adults. Here are some of the key messages taken from the Gallup Poll [1]:

  • Two-thirds say chiropractic care is effective for neck and back pain
  • Only 11% disagreed with this and twenty-eight percent were neutral.
  • More than two thirds felt that chiropractors had the patient’s best interest in mind.
  • More than half of respondents felt chiropractors were trustworthy.
  • Less than 10% of respondents disagreed that chiropractors were trustworthy or had the patient’s best interests in mind.
  • Half of all the adults surveyed have had some experience as a chiropractic patient.
  • One in four adults saw a chiropractor more than five years ago
  • 12% had been to a chiropractor within the last five years
  • 14% had been in the last 12 months.
  • Forty-nine percent had never seen one.

There are some other interesting findings in the study. Adults aged over 35 are more likely to have seen a chiropractor than younger adults. Men are slightly less likely to consult a chiropractor than women (a statistic that may indeed echo across other health professions, not just ours).

Here is where it becomes clear that we have work to do in terms of communicating beyond pain: of those who had seen a chiropractor in the last five years, 60% said they’d only go to see their chiropractor because of neck or back pain. 31% said they’d go on a regular basis even when they didn’t have pain. 9% didn’t know.

When asked if they would want to talk to a chiropractor about general health and wellness issues such as diet and nutrition:

  • 7% strongly agreed
  • 15% agreed somewhat
  • 20% didn’t know or were neutral
  • 26% somewhat disagreed and 33% strongly disagreed

When asked if a chiropractor is the first healthcare provider they would want to talk to about their health:

  • 4% strongly agreed
  • 5% agreed somewhat
  • 17% didn’t know
  • 31% disagreed somewhat
  • 43% strongly disagreed

The report goes into great detail in comparing chiropractic to other forms of medical and physical therapy, but it gives us some key messages to consider. Our reputation is largely a good one. But people still don’t quite understand the power of what we do beyond back and neck pain.

Can The Mind Heal The Body? Why Compassionate Care Matters

The philosophy of vitalism that many chiropractors subscribe to holds that the force that sustains the body, heals the body. It’s a philosophical standpoint that some love and others are neutral to. After all, we have a mounting pile of proof that chiropractic works. We have thousands of happy people leaving our practices feeling better, living better, and regaining health. Isn’t that what matters at the end of the day?

Let us take pause to consider this though: if the body (and its master, the mind) can indeed heal itself, where is the evidence? According to Lissa Rankin MD, a researcher interested in this topic, the answer has been in front of us for a very long time. “The scientific community has been proving for over fifty years that the mind can heal the body. We call it the placebo effect and we have been trying to outsmart it for decades [1].”

We’ve all heard of the placebo effect: a response to a substance having no pharmacological effect but given merely to satisfy a patient who supposes it to be medicine. This results in a lessening of symptoms or the production of anticipated side effects [2].

It has long been reported as a sort of fallacy – someone talking themselves into feeling better or worse, depending on the situation. You’ll have heard the colloquial impact of the phenomenon. “Are you actually better, or is it just a placebo?”

We look down on the placebo. We believe it to be the poor cousin of genuine recovery. But is this actually true?

To Lissa Rankin, the placebo effect is actually good news. “It’s concrete evidence that the body holds within it innate self-repair mechanisms. In almost everything you study, if you give people a fake treatment… 18 – 80% of the time, people get better. It’s not just in their mind. That’s what I thought in the beginning – They’re just feeling better. They’re just thinking better – But its not. It’s physiological. It’s in their body. It’s provable. It’s happening in the body even though it’s happening in the mind [1].”

A fascinating example of this phenomenon is something called The Spontaneous Remission Project, an annotated bibliography collating more than 3,500 references from 800 journals in 20 countries. All reported “the disappearance, complete or incomplete, of a disease or cancer without medical treatment or treatment that is considered inadequate to produce the resulting disappearance of disease symptoms or tumor [3].” The ailments within the project were not insignificant either.

A quick look through the index list revealed serious diseases impacting many systems in the body. These cases were measurable, physiological, and scientifically provable.

Ted Kaptchuk, the director of Harvard University’s Program on Placebo Studies and the Therapeutic Encounter believes that it is always unethical to deceive a patient, but that placebos do indeed have a role to play.

“The bottom message is the drugs are real important, but also just taking care of people and the act of compassion, taking care, the act of trust is really critical. And that – and with lots of experiments – shows that that potentiates the effects of very powerful drugs. The bottom line is low-tech placebo may have something to contribute to high-tech procedures, surgery and medicine [4].”

Rankin paraphrases him this way: The most essential part is actually the nurturing care of the healthcare provider.

“To say that you can heal yourself is sort of a misnomer. The body can heal itself. It has these innate, natural self-repair mechanisms. The scientific data proves that. But you need the tending nurturing care of some sort of a health care provider, … a healer, to facilitate that process. It makes a difference if someone is holding that positive belief with you.”

But there is a problem here. As much as healthcare practitioners can be the agents of positive change, echoing the effects of the placebo pill, they can be an agent of fear or even a prophet of doom. According to Rankin, people need us to be forces of care and healing, not of pessimism and fear.

It boils down to something else that has been hiding in plain sight. The body can’t heal itself while it is stressed. When in this state, the adrenal glands are dispensing stress hormones and keeping the system on high alert. This is adaptive and protective, but not conducive to repair. Hence, the care and intent of a practitioner is important; they are able to influence whether or not the person leaves relaxed and hopeful, or stressed and worried. The effect this can have is quite powerful.

Rankin says “These self-repair mechanisms only flip on when the nervous system is relaxed.” This relaxation response may actually explain the placebo effect. It also backs up the idea that the physician is needed, and essential to the process. It is compassionate care that can build trust with the person so that they know they are cared for, and hopefully rest in the knowledge that repair is possible.

Like Kaptchuk said, it is unethical to deceive people. It frankly should not be done. But care is important. Believing in the person and their potential to recover is important and can have a powerful impact on healing.

Rankin’s scouring of copious data found some other things that had been proven as essential, the highlights of which give us some key take-aways regarding health and wellness [1]:

  1. Relationships matter. People who have a strong social network have half the amount of heart disease compared to those who are lonely.
  2. Your spiritual life matters. Those who attend religious services live up to 14 years longer.
  3. Your professional life matters. You really can work yourself to death. In Japan, they call it “death by overwork.” People who fail to take their vacation are actually a third more likely to get heart disease
  4. Your attitude matters. Happy people live 7 – 10 years longer than unhappy people. Optimists are 77% less likely to get heart disease than pessimists.

So the role of the healthcare practitioner and the mindset of the person under care are actually powerful agents in the search for healing. The body can’t heal itself while it is convinced it is under threat. If the placebo is the proof that the body can heal itself, so be it. This isn’t a bad thing. It’s just something we need to understand rather than try to outsmart.

 

Stress on The Spine: The Downside of Prolific Social Media Use

Ten short years ago, a great postural concern for chiropractors was the way backpacks were worn by students and young people. They were commonly slung over one shoulder, often heavily weighted with text books and other items. It took some time for this trend to change. In 2015, it is far more common to see the backpack worn over both shoulders – still too low in most cases, but a move in the right direction.

However, a new postural concern has entered the arena, and it has to do with smartphones, texting and social media usage.

According to numerous surveys, social media use is increasing by the year, with younger users (especially teens) spending the most time texting and online. The postural concern here lies not in the consumption of social media, but the way it is accessed.

Smartphones are the most common means of accessing Facebook and other social media sites. In a three year study of 1049 people, “70% of adults and 30% of children and teens reported that their use of electronic devices like smart phones, tablets and laptop computers had caused neck, shoulder, wrist or finger pain[1].”

For a chiropractor this would not be a surprising outcome. The more concerning issue would be the impact that this has on the cervical spine. A recent study by Kenneth Hansraj [2] measured the weight of the head when in a neutral position, and in increments as the head moved forward.

In a neutral head position (with the lateral posture line running straight through the earlobes and shoulders, with shoulder blades retracted), the average human head weighs 10-12 pounds (4.5-5.5 Kilograms). However, as the head moves forward, this number increases drastically.

  • At 15 degrees, the head weighs 27 pounds (12.3 kilograms)
  • At 30 degrees, it increases to 40 pounds (18.2 kilograms)
  • At 45 degrees, it weighs 49 pounds (22.3 kilograms)
  • At 60 degrees, it exerts a force of 60 pounds on the cervical spine. (27.3 kilograms)
  • At 90 pounds the force could not be measured.

When we look at these numbers, headaches, shoulder pain, and stress around the spine is absolutely unsurprising. The degenerative affect this can have on the anterior cervical spine, over years of usage, should be deeply concerning. Says Hansraj, a leading spinal surgeon, “When your head tilts forward, you’re loading the front of the disks [3].”

Hansraj’s study stated “Loss of the natural curve of the cervical spine leads to incrementally increased stresses about the spine. These stresses may lead to early wear and tear, degeneration and possibly surgeries.”

“People spend an average of 2 – 4 hours a day with their heads tilted over reading and texting on their smart phones and devices. Cumulatively this is 700 – 1400 hours a year of excess stresses seen about the cervical spine. It is possible that a high school student may spend an extra 5,000 hours in poor posture.”

This should be a significant concern for chiropractors, digital media users and especially parents of high school students. But how can we fix this problem when cellphone use and media use is so prevalent, with no imminent signs of slowing down?

In truth, it may take a while to correct. Much like the postural concerns of yesteryear when the backpack took a while to move to both shoulders, it all starts with awareness.

What can you do now?

  • Encourage your patients to use ergonomically configured desktop arrangements where possible (where the eyes are level with the top of the screen)
  • Encourage cellphone users to raise their phone to eye-level rather than bending their head to look down. This can be done (without looking odd) by using the free hand to support the elbow at the waist
  • Advise patients on posture correction stretches they can use.

Ageing And The Neurological Threat: Today's Prevention or Tomorrow's Problem

The percentage of Australians aged over 65 is increasing by the year, as part of a near-global trend towards ageing populations. As this trend progresses, chiropractors may find themselves caring for an increasing number of elderly people.

Gregory Petsko, an American biochemist and scholar, says the ageing population presents us with a problem: “Unless we do something to prevent it, over the next forty years we are facing an epidemic of neurological disease on a global scale [1].”

“For twelve thousand years, the distribution of ages in the human population has looked like a pyramid with the oldest on top. By 2050, it will be a column and will start to invert” says Petsko, as he describes the changing distribution across age-groups. “The average lifespan has doubled since 1840 and is increasing by about 5 hours every day.”

Petsko says this isn’t necessarily a good thing as the risk of getting Alzheimers or Parkinson’s disease increases exponentially over the age of 65. We have the potential for an epidemic of neurological problems in this growing population group unless science starts to tell us a lot more about how we can prevent such diseases.

Chiropractic must play a role in the management and prevention of neurological disorders in ageing and elderly people, as this sub-group of the population is turning to complementary and alternative healthcare (including Chiropractic) in increasing numbers.

Where previously, these people may have preferred traditional, pharmacologically-driven medicine, the percentage of older adults using alternative healthcare has increased over the last decade. In 2003, less than 48% of respondents in an American study reported using complementary and alternative healthcare. Of these, only 16.3% used chiropractic. Still, this placed chiropractic in the top five favoured modalities [2]. By 2007, that number had grown to 62.9% of respondents using complementary and alternative healthcare, and 17.8% of respondents choosing to see chiropractors [3].

Perhaps this upward trend is due to increased awareness and appreciation for the value of chiropractic, or as a result of long-term people ticking a different demographic box. Either way, once the person is on the adjusting table, the benefits of chiropractic can truly shine.

So how can we support optimal neurological function in ageing and elderly people, even acting to prevent neurological decline? Truly, there is a plethora of ways in which chiropractic can help. Here are just three of them, relating to neurological disorders and risk factors affecting the elderly:

  • A number of cases have been identified in which chiropractic care has helped decrease the symptoms and signs of Parkinson’s disease. In one such case, the person was cared for with a number of interventions including “blue-lensed glasses, vibration stimulation therapy, spinal manipulation and eye-movement exercises [4].” Within the first week of care, there was a reduction in symptoms, improvement in ambulation, and tremor. There is much research work to be done here, but it points us in a promising direction and reinforces the importance of chiropractic in enhancing and protecting function.
  •  High blood pressure has been identified as a significant risk factor in Alzheimer’s disease [5]. Though there is much research yet to be done to provide conclusive answers, some studies are indicating that spinal adjustments can indeed play a role in decreasing blood pressure and thus managing this risk [6]. New research by Bakris et al is set to investigate the potential of autonomic modulation therapies in targeting hypertension (and heart failure). Regardless of the outcomes of the study, the benefits of having a chiropractor who can adjust subluxations, enhance optimal neurological function and point people in the direction of healthier lifestyle can surely be of great benefit to patients. The earlier this occurs, the better, as Alzheimer’s starts in the brain some thirty to fifty years before symptoms can be seen [7]. Hence, the importance of nurturing wellness earlier on cannot be understated.

Of course the issue of Alzheimer’s Disease is complex, and a place in which General Practitioners and medical intervention certainly play roles. Managing hypertension, working with the client towards healthy and active living, and supporting optimal neurological function is only a starting point. We can’t identify all the risk factors in Alzheimer’s Disease yet, much less manage them all. But we can act to support the aspects of health that play such an important part in its prevention.

  •  Issues like back pain, neck pain, dizziness and falls often factor into the health concerns listed by elderly people. Preliminary evidence suggests that there is a role for neck adjustments in the prevention of falls in the elderly. “There is preliminary evidence that physical treatment of the neck may improve balance in neck pain patients. Therefore, it is important to examine the possible therapeutic effect of chiropractic interventions (particularly SMT) directed at the neck in treatment of this condition and prevention of falls in this subpopulation of the elderly [8].”

Of course, these are just three ways in which chiropractic can support optimal neurological function and support wellness in ageing and elderly people. We haven’t even mentioned the non-musculoskeletal benefits that can be reaped by being subluxation-free. But the truth of the matter is that it is far better to support health and wellness before the onset of Parkinson’s, Alzheimers or other serious neurological disorders than to intervene in the aftermath. And it is always better to be subluxation-free and have an optimal brain-body connection, than not.

As the population ages, optimal health and wellness must play an integral role in minimizing the fallout of neurological disorders. The evidence is showing there are roles for chiropractors to play in improving health and wellness, regardless of whether symptoms are present or not.

Surely, nurturing wellness early in life and providing a better platform for healthy ageing is a better place to start.

The Impacts of Electromagnetic Stimulation on Sleep

For some, bedtime is relaxing. The cares of the day fall away as you are lulled into the land of nod, where you rest and recharge before awaking fresh and ready to face the new day. For many others, this scenario is but a dream. Bedtime for them is a time of frustration marred by the inability to fall asleep or stay asleep.

Data now shows us that up to 35% of adults have brief symptoms of insomnia, 15-20% have short-term insomnia and around 10% have chronic insomnia [1].

Perhaps it wasn’t always so. The Hunter-Gatherer’s brain would have easily known when it was bedtime because the sun went down. This dimming light sent a message to the brain saying “It’s sleep-time soon. Start producing the hormone melatonin.”

We will never know how prevalent insomnia was then, but we do know that it is too prevalent now. There can be many factors contributing to this sleep disorder, which rarely presents without co-morbidities, but one theory points to something very simple: light.

Some experts are pointing the finger of blame at artificial lighting, especially late-night use of electronic devices. Why is this so? Dr. Daniel Siegel, professor of Psychiatry at UCLA, says “People are exposing their eyes to this stream of photons from these objects that basically tell your brain ‘Stay awake. It isn’t time for sleep yet.’ It tells your brain not to secrete melatonin [2].”

This is a problem, especially for those who stay up late on computers, or go to bed only to spend extensive time locked in the infinite scroll of social media. This stream of photons can suppress melatonin by up to 22% thus delaying the sleep-wake cycle [3].

How much light are we talking about here? Approximately 30 – 50 lux, or half the illumination of an ordinary room. Keep in mind that this light may be held only inches from your face [4].

Australian Researcher, Professor Shantha Rajaratnam, says “…the advent of electric lighting has significantly impacted upon sleep-wake patterns, but with the proliferation of electronic devices that emit light, we are expecting that these problems will increase [4].”

Interestingly, the blue light wave is thought to be the most disruptive. Such light can effectively reset the human circadian rhythm. This raises serious concerns. Dieter Kunz, of the Sleep Research and Clinical Chronobiology Research Group in Berlin said this:

“Maintaining synchronized circadian rhythms is important to health and well-being. A growing body of evidence suggests that a desynchronization of circadian rhythms may play a role in various tumoral diseases, diabetes, obesity and depression [5].”

Being that the average adult requires 7-9 hours sleep every night, it’s essential that we recognise the disruptive force that can be wielded by humble mobile phones and laptops.

So what do we do about it? Experts advise that we need to put space between our sleep zone and electronic devices. Suggestions vary as to how long this needs to be. Siegel advises that devices should be shut off at least one hour before bedtime. Rajaratnam believes this amount should be closer to two hours. Either way, the transition time is essential to sleep.

Pairing this electronic media block-out time with healthy sleep hygiene and routine can greatly boost your chances at attaining a good nights sleep. Good sleep and the absence of sleep disorders can then become part of a healthy lifestyle.

Facts About Sleep

  • Sleep aids concentration, memory and cognitive function. Sleep insufficiency is therefore a public health concern as it can impact on alertness while driving motor vehicles, operating machinery and performing medical tasks (for example).
  • Lack of sleep can have negative impacts on insulin and weight gain along with hypertension, depression and other chronic diseases [6].
  • The brain uses sleep to wash away toxins that build up from a hard days thinking. “Cells in the brain, probably the glial cells which keep nerve cells alive, shrink during sleep. This increases the size of the interstitial space, the gaps between the brain tissue, allowing more fluid to be pumped in and wash the toxins away. (Dr. Maiken Nedergaard) [7].”
  • Good sleep is therefore essential to general health and wellbeing, not just the ability to concentrate.

Todd Sampson's Design your Brain

Brain plasticity, or neuroplasticity, is a topic that many neurologists, scientists and chiropractors have known about for quite some time. Todd Sampson’s ‘Redesign my Brain’ is a TV miniseries that set about trialing the concept in practical ways, making the topic easily understandable to people from all walks of life. Series one aired in 2013, featuring three episodes on creativity, intelligence and ‘mind over matter.’ Series two aired last year, and it opened on a topic close to many a chiropractic heart: adaptability.

Todd Sampson is on a mission to prove that any brain can be trained to cope with the challenges of modern living. Of course, he is starting this process with a brain that has been instrumental in his rise to entrepreneurial success and media influence. Perhaps he is starting out with some above average grey-matter, but the mini-series was an inspiring and informative watch none-the-less.

In the opening minutes of season two, an episode called “Help Me Adapt,” rock climber Steph Davis issues Sampson with a challenge: climb a rock-tower while blindfolded in just six weeks time.  As she scales the rocky heights of the Moab Desert in Utah, she has an insightful remark to make: “Rock climbing is all about adaptability. You have to change your body to confirm to the rock climb and then throughout the experience things keep happening. I think humans are extremely good at adapting the environment to human needs and desires. So as a result I think a lot of people have lost the ability to adapt themselves.”

“The rock isn’t going to change. You have to change,” says Steph right before she challenges Todd to his own death-defying feat. This leads him into a six week challenge to make his brain more adaptable in the lead up to the big climb.

He’s studying the new science behind neuroplasticity, specifically targeting his journey at increasing his mental endurance, flexibility, decision-making and pain management. These are skills he will need for the climb, but that any one can benefit from.  In fact, Todd Sampson believes that every brain can be trained to cope better with the challenges of modern living.

First stop is the Australian Institute of Sport where scientist Dr. David Martin performs a simple test – how long Todd can stand with two litres of milk in each hand, with arms stretched out at right angles from the body? The big discovery: Todd’s brain gave out long before his muscles did. But it told the muscles he was done. He didn’t even get to half of his maximum muscular output. In fact, Dr. Martin believes many aspects of endurance actually come down to mental stamina. “The muscle can do more. It’s the mind that gives out. Its actually the feedback into the brain that is starting to limit you,” said Dr. Martin. But he has exercises and training approaches that can improve mental stamina.

It’s the first in a series of brain training exercises using things like physical movement, meditation techniques, visualization and reframing, and exercises in mental flexibility. Tested twice across every skill, Sampson manages to gain impressive improvements in his results. This is practical proof that brain training isn’t just a gimmick. It actually can work. Brain plasticity is something that anyone can benefit from, if given the right tools.

Neuroplasticity is no longer just a concept. It is a workable, quantifiable and practical field. ‘Redesign My Brain’ is a series that makes this beautifully obvious.

A partner in this project since season one is Dr. Michael Merzenich, a reputable speaker and pioneer in the field of brain plasticity. Lecturing on the topic, Merzenich has some interesting observations to make: “None of us have an identical path through life. Certainly none of us have an identical internal life. Each of is unique, made a unique product with, in a sense, a unique machine in our head. A unique person is created by these processes…Every time we acquire a new skill, the brain revises itself. We see zones of the brain operating in a different way [2].”

He asserts that the brain can change itself as a function of how we engage it, that change is under our own control.

If you were to cast an eye over the research, you would quickly learn that this can work in two directions. We most often think of neuroplasticity in a positive light – that we can engage our brain in such a way that it changes for the better. However, this isn’t the only neuroplastic reality. If we do not engage the power of the mind to rewire our brain, we can be letting negative neuroplastic changes set in. We see this with depression and anxiety disorders which cause damage to the brain or ‘negative plasticity [3].’

“Research suggests that treatments of depression and anxiety can actually slow this damage, and possibly even stop and reverse it. But the take home message … is that your day-to-day behaviors can have measurable effects on brain structure and function,” says Dr. David Hellerstein MD of Psychology Today.

It’s a poignant remark that should make us think: if we aren’t taking control of our own neuroplasticity, is it in fact taking control of us? It seems that the brain is changing and rewiring itself anyway. The power in Todd Sampson’s presentation is the very real ways in which we can engage ourselves in this process and make some very practical, very real gains.

Communicating beyond pain- Interview with Brandy Macdonald

 “When I get sick, I’ll go to the doctor. When I have a bad back, I’ll head to the chiropractor.” How many times have you heard it said?

This ill-fitting cliché around what a chiropractor does is something we battle when taking our message and the power of our adjustment to the world. We aren’t about ‘cracking’ backs. We’re about empowering wellness, changing the structure and function of the brain, and enabling the body to heal itself. We know that. Unfortunately, it can seem like the world is stuck in a sickness-centred paradigm and doesn’t quite ‘get’ us.

We offer so much more than pain relief, but how do we communicate beyond pain?

This is a question leadership trainer and chiropractic mentor Brandi McDonald has spent a lot of time immersed in. To Brandi, a major part of the conundrum is about who’s leading the dialogue. “Most chiropractors don’t know how to lead the conversation so the public is leading it, and the conversation they are leading is around pain. So what we’ve done is we’ve stopped there.

“We’re really good at fixing pain or being an analgesic for pain, but what we haven’t told the patient is that we haven’t treated their pain at all. What we’ve done was restored normal physiology to the body by removing interference to the master computer that runs the human body – the brain and central nervous system. Because we did that, then their symptoms went away.“

Having founded True Concepts Seminars and Epic CA, the latter being an online training program for CA’s, Brandi spends a lot of time training her own CA’s or hitting the speaking circuit to help others become a louder, stronger voice for chiropractic. It’s a cause she’s passionate about, but never intended to work in. “I was never going into practice. My background was in leadership.” But after her chiropractor husband Don MacDonald convinced her to join him in practice and work with their CA team, she never looked back.

This background in executive leadership, paired with passion and first hand experience in the power of chiropractic, now drives her. But in training CA’s to effectively communicate chiropractic, the first stop is with the leadership. “Most of my work is with the chiropractor, before I even get to the CA,” she says.

 

It Starts At The Top And Is More About The Right Questions Than The Right Answers

For the chiropractic profession, one of the challenges is to be relevant to the patient. When a new person calls into an office, or we see someone in the public, or we do a spinal screening, we often don’t know what questions to ask them so we just ask about where they are at. The mindset they are in then comes across. This starts to happen: the patient thinks, “I’m in pain. I have symptoms or problems. When that happens, I’m sick. I come to see you and you fix me. My symptoms go away. When that happens, I’m better” and the chiropractor struggles to find ways to explain why this isn’t necessarily the best model of health for them.

“It’s not about the right information, it’s about the right questions. We have to ask questions like this: “Would it make sense to you that you had dysfunction before the symptoms showed up?” People then start to think for themselves.”  

According to Brandi, this is where the lights can come on and we can start to change the dialogue. As soon as someone says “I never thought of it that way,” or “I never considered that I could have had a problem before the symptoms showed up,” we know we are on the right track. It’s about asking questions in a way that makes the person arrive at the answers on their own.

But there is a caution in this: just because a new practice member is starting to understand just how dysfunction can exist way before pain, doesn’t mean we can then overload them with information. “As chiropractors we are super passionate about what we do, but because of this passion we can often just vomit information at them. They can’t hear what we are saying because they are just thinking “I have this problem. Can’t you just fix the problem? I don’t know why you are loading all this other information on me.” I like to call it drip-feeding information, in the form of questions that make people think “I didn’t think of it that way.”

 

CA’s Have A Powerful Impact – It’s Simplicity On The Far Side Of Complexity

Communicating beyond pain starts with chiropractors themselves, but goes to every level of the practice – CA’s play such an integral role in getting the message out to the world. “This is not a complex model. For us, this is the value of our staff. This is the value of me not being a chiropractor. It is really simplicity on the far side of complexity,” says Brandi. “You have nerves. You have a brain. You have vertebra. You have a spinal cord. It makes sense that interference with that distorts the system that keeps you alive. That makes sense to people.

“If we give them too much information, they get lost. If we don’t give them enough information, we are not credible. It’s that fine line that’s so important. What the CA’s have that the chiropractor doesn’t have, is that simplicity. It’s one practice member to another practice member when it comes from a CA.”

This is why Brandi views CA’s as much, much more than receptionists, administrators, organisers or the welcome team. “My opinion on this is that all of that is secondary,” says Brandi. “They are educators first.  When you know that, in chiropractic, we are changing people’s belief systems not just their behaviours, it changes the way you answer the phone. It changes how you greet somebody. It changes how you process them. You can get a good customer service person anywhere. But a CA is just so much more than that. They are educators as-well. But in order for them to be that, we have to educate them.”

This is something Brandi and Don invest heavily into. To them, a new CA is just like a new patient. They go through all the processes a new patient would go through. They have the first visit, the report of findings, the health talk. They then build training and development into each bi-weekly and monthly staff meeting. There is goal setting. There is professional development. They go through the Epic CA training program, and once a year they go to a big seminar as an incentive.

“We are pretty intense about training for our staff” says Brandi. But the results seem to be empowering, with several of her CA’s going on to study chiropractic. “They don’t have to stay with me forever. I don’t have a staff turnover problem. But it doesn’t matter whether they are with me for three months or thirty-five years. I want them to be different by the time they leave – understanding health better, understanding their lives better.”

 

Empowering Patients with Information to Back Their Testimonial Is Intergal

Moving communication out beyond the practice can be a challenging area in terms of chiropractic communication. Oftentimes, we invest as much as we can into communication but still find ourselves at the mercy of sceptics and even the odd social media troll.

To Brandi, patients can be part of this if they have two things: consistency and tools. “If we aren’t using the right language, then they don’t have the right language. They start saying things like ‘getting cracked’ instead of ‘getting checked.’ But they also need tools. When they leave your office they need to be able to show people things. They need to have packets of information. This is where neuro-tests or x-rays can help patients present chiropractic in a credible way. They need tools. This helps them communicate what’s going on with them. The one thing you can never take away from a person is their testimonial. You can help them present it though.”

“I don’t believe this will change our market-share en masse. It will make a difference but we need a different approach. I’ll never forget this Ted Talk I watched called ‘Spaghetti Sauce and Happiness.’ In the 1970’s, a study found that 1/3 of the American said they loved chunky Spaghetti sauce, even though it wasn’t even on the market. They wanted it, but it had never been presented to them.

Chiropractic has never gone to the masses with a different model. We’ve gone to the market with the model they were willing to accept from us – back pain, neck pain, migraine, colic etc. We’ve never gone with a different approach, to say “What we do is help the body express health at a higher level  – and when it does, your life is expressed at a higher level.”

“Not everyone is going to want that. But a huge percentage of the billions of people walking around on the planet will want it.”

Gamifying Research: How MIT is mapping the Brain

Of all the organs in the body, the brain is surely the most complex. So much so that despite the all the advancements of the modern age, no computer equaling its flexibility and processing power has yet been developed. There are literally billions of neurons and synapses that make up this complex system, hence mapping it on a cellular level has been a task so big that it has not been attempted – that is until now.

Imagine the potential discoveries that could be made if we could see inside the brain, and see the neuronal pathways as they crisscross their way through the grey matter. It’s an opportunity MIT (Princeton University) has found a clever way to attain.

“Much of our difficulty understanding the brain has come because we are unable to see the basic structure of what the brain is like. In order to look at the structure of neurons we have to analyse images – a lot of images. Those images can’t be analysed completely automatically by computer. We actually need human intelligence. Humans are smarter than computers in many ways including seeing things” says Sebastian Seung, one of the minds behind an innovative project that is tackling this complex issue.

In the last two years, MIT (Princeton University) in partnership with Seung Labs, has developed an ingenious approach to this challenge – harnessing the gaming population across the world and turning idle hours into research hours. The result was a game called Eyewire. “It currently takes us about 50 hours to map one cell, that’s one neuron, and there are about 85 billion neurons in one human brain. So we built a game out of the task” says Amy Robinson, the Creative Director at Seung Labs.

Accessed online at eyewire.org, the game challenges players to map neurons from one side of a cube to the other. It’s a microscopic sector of the brain, blown up to essentially act as a 3D colouring book. Anyone can do it – they need no scientific background to contribute to the data that is actually showing us how the brain looks. In fact, 145,000 people from 60 countries have joined the challenge.

It’s not just a 3D colouring book though. It’s an interactive community that hosts Google hang-outs and has incentives and challenges built in. There are badges to earn, high scores to record, and levels to attain. You start by simply following a neuron through a cube and colouring it in. But as you level up, you gain the ability to look for errors in other players work. It’s a clever way of fixing a problem of cross-checking.

What’s more, it actually sounds like fun! “EyeWire holds regular competitions and a weekly “happy hour” on Friday from 2 to 4 pm. During challenges, players compete for bonuses, profile icons, unique chat colors and even neuron naming rights. In-game trivia occasionally takes place through chat. Players level up in EyeWire by beating the Starburst Challenge, unlocking the right to map difficult starburst neurons and earn double points. Advanced players participate in Hunts, where they scour completed cells looking for mergers or mistake branches that need to be scythed away by an ominous, in-game overlord character known as the GrimReaper. If a player finds enough, she is promoted to Scout and eventually many attain EyeWire’s highest ranking, Order of the Scythe [1].”

This project is an innovative step for the world of research, proving that there are many ways to expand the world of information at our fingertips. Who said gaming time had to be idle time? This project proves research, innovation and recreation can run hand in hand. What an exciting thought.