03 14 20 Reverse Causality The Why and Three Point Bending and Whiplash How of Practice Traction for Scoliotic Injury: Three Outreach Curvatures Recent Reviews

January 2013 | Volume 23 No. 1 CONTENTS: 03 Research & Evidence A MERICAN 08 Business & Practice Tips JOURNAL 14 Editorial & Letters 17 BioPhysics Insights OF CLINICAL 20 Biomechanics Corner 22 Doctor Spotlight CHIROPRACTIC ISSN 1076-7320 | Published Quarterly

Your source of information for Chiropractic BioPhysics® — The Science of Spinal Health An Aspirin a Day May Take Your Vision The Passing of a Chiropractic Pioneer, & Hearing Away vascular protective effects. A Family Man, A Dear Friend & Mentor Of concern, there have Non-steroidal anti- been a number of scientific to Countless Life Chiropractic College inflammatory drugs publications discussing in 1974, which became Life College (NSAID’s) are widely the potential negative and is now Life University. Twenty used for general pain health effects of regular Two students attended the first classes relief and specific use of NSAID’s whether inflammatory control in January of 1975. These students for prevention, pain, became known as the “Day one class”. after an injury. Ad- or other use. Two recent Under Dr. Williams’ direction, Life ditionally, there is an publications have identi- Chiropractic College became the larg- increasing number of fied some serious negative people that are us- health risks that appear to est chiropractic college in the world ing specific NSAID’s be linked to regular aspirin with an 89-acre campus and more and aspirin for and NSAID use: than 3,500 students. perceived cardio- On a personal note, for me (Dr. The Beaver Dam Eye Study1 Deed Harrison), I was deeply touched In a longitudinal Dr. Sidney Earl Williams by Dr. Williams loss. Though I met population-based study of age- March 18, 1928 - December 27, 2012 Dr. Williams just a handful of times related eye diseases, Klein and col-

UTAH and exchanged only simple cordial

PAID 1

NON-PROFIT leagues examined the association of Most of the profession is already U.S. POSTAGE U.S. conversation; it is a man like him that PERMIT 750 NO. SALT LAKE CITY SALT aspirin use with the incidence of age- aware that Dr. Sidney Earl Williams, keeps a person like me continuing to related macular degeneration (AMD). founder of Life University in Marietta, strive for excellence through Chiro- They performed examinations every passed away peacefully in his sleep practic principles, purpose, and pas- 5 years over an approximate 20-year early Thursday morning the 27th sion. When I heard of Dr. Williams period (1988-2010). There were 4,926 of December. He was 84 years old. participants between the ages of 43 to loss, I was reminded of one of my late

Visitation was set from 2 to 4 p.m. 86 years. Study participants were asked father’s (Dr. Don Harrison) favorite if they used aspirin at least twice a on Saturday, December 29th, 2012, at sayings: “The person who says it cannot week for more than 3 months; which Mayes Ward-Dobbins Funeral Home be done, should not interrupt the person they termed ‘regularly’. in Powder Springs and services were doing it”! Looking at Dr. Williams’ life The study identified that ‘regular’ held at 2 p.m. on Sunday, also at achievements I bet that he lived by aspirin use 10 years prior examina- Mayes Ward-Dobbins, located at 3940 this motto in some regard. In the end, tion was associated with late AMD Macland Road in Powder Springs. Dr. Sid Williams did what few of us with an estimated incidence of 1.76% Along with his wife, Dr. Nell can but all of us strive for; he left See An Asprin a Day on page 9 Williams, Dr. Sid Williams founded Chiropractic BioPhysics Non-Profit, Inc. Non-Profit, BioPhysics Chiropractic ID, 83616 1361, Eagle Box P.O. See The Passing on page 9 Research & Evidence Jan 13

Reverse Causality It is usually stated in published methodological flaws. These authors conclude: “There studies, by insurance companies, • The best methodologically is a common perception that injury and Whiplash In- and by their representatives done studies show there is no compensation has a negative impact (lawyers, claims adjusters, IME association between litigation/ on health status among those with jury: Three Recent doctors, etc.) that injured patients compensation and recovery from verifiable and non-verifiable injuries, Reviews who seek compensation (ask for whiplash injury. and systematic reviews supporting compensation, hire a lawyer, etc.) • It is wrong to claim that chronic this thesis have been used to influence Dan Murphy, DC— Private Practice of (A), have worse health outcomes whiplash symptoms are primarily policy and practice. However, such Chiropractic; Diplomate American Board and slower recovery rates (B). the consequence of litigation and reviews are of varying quality and of Chiropractic Orthopedist; Faculty Life Chiropractic College West; Vice President However, such adverse health desire for monetary gain. See Reverse Casuality on page 24 ICA 2003-2009; outcomes do not consider or ICA Chiropractor of the Year 2009 evaluate the concept of Reverse Causality: “slower recovery (B) leads INTRODUCTION individuals to claim, seek legal Did You Know? By Dan Murphy DC. Reverse causality refers to advice, and litigate (A).” a direction of cause-and-effect The contemporary leaders in In patients suffering from chronic pain contrary to a common presumption. the research pertaining to injury subsequent to degenerative spinal disease, 59% can eliminate the need for pain drugs Reverse causality is cause and effect compensation, health outcomes, by consuming adequate levels of omega-3 in reverse. That is to say the effects and Reverse Causality are Natalie essential fatty acids. precede the cause. The problem is Spearing and colleagues from 59% (Surgical Neurology, 2006) when the assumption is A causes B the University of Queensland in when the truth may actually be that Australia. In 2011, they published a Removing aspartame and glutamate from the diet for 1 B causes A. study in the journal Injury, titled : Is 4 months can eliminate chronic pain symptoms. (Annals of Pharmacology, 2002) compensation “bad for health”? These authors performed a systematic 4 meta-review on this topic, which These published facts and hundreds lent for educating the chiropractor, A MERICAN constituted the most comprehensive more are available through my Article staff, patients and lecture preparation. JOURNAL Review Service, now in its 11th year. • Each Article Review is in PDF OF CLINICAL review pertaining to compensation Reviews are detailed, thorough, format for easy printing. CHIROPRACTIC and health outcomes through the timely and cutting-edge, with KEY • Sign up through my website with publication date. In this study, the POINTS summary and chiropractic a credit card on PayPal. Your source of information for Chiropractic BioPhysics® — The Science of Spinal Health Copyright Harrison Chiropractic authors used 11 studies that met practical applications. They are excel- BioPhysics Seminars and their stringent inclusion criteria and What our subscribers say: Dr. Dan, (DC) Deed E. Harrison, LLC Any chiropractor that truly cares about his noted that 9 of them were of low Dear Dan, Publisher: Deed E. Harrison, DC patients and not about just making a buck quality and suffered from a number I hope you can continue providing this needs to be subscribing to your Article Review 1-800-346-5146 or drdeed@ideal- information for many years to come. I have Updates. I certainly am going to do my part spine.com of methodological flaws. been in practice for 18 years and find these to see that each chiro I come in contact with The studies presented in this review citations to be the most informative, chiro- knows what an absolutely invaluable re- Editor: Deed E. Harrison, DC practically relevant information that I have source it is. I sat in amazement at the last two support these concepts: received in my career. I would be willing to Layout: Holmes & Co., articles you sent regarding antibiotic overuse • Studies that claim that those pay more for this information to make sure and atopic disorders. What crucial informa- Salt Lake City, UT 84102 that it keeps coming. tion to pass on to my practice members. suffering from chronic problems Printing/Labeling: Tooele Transcript, Thanks and keep up the awesome work. following whiplash injury Again, thank you! —Dr. G.M.; August 1, 2002 Tooele, UT 84074 do so in hope of gaining ARTICLE REVIEW SUBSCRIPTION | $100/year | www.danmurphydc.com Labels: American Journal of Clini- financial compensation have cal Chiropractic, P.O. Box 1361, Eagle, ID 83616 1-800-346-5146 American Journal of Clinical Chiropractic January 2013 03 Foot Posture and Foot Orthoses— The Lost Connection? Part II its intrerrater reliability5 and applicabil- a three dimensional ity to dynamic function.6 posture. Look- The Last Three Another attempt at quantification ing at some called the Foot Line Test (FLT) which is of the more College Football National Champions a measure of the medial prominence of the navicular in a mediolateral direction, was developed to investigate the relationship between Dr. Ed Glaser, DPM foot morphology Dr. Glaser is the President and and injury developer of Sole Supports orthotics. development. The measurement of medial/lateral INTRODUCTION posture that is to be achieved, it needs to movement of the medial prominence of recent measurements that have focused Previously, the midfoot was mod- be emulated and induced directly by the the navicular is primarily a frontal plane more on the medial longitudinal arch eled as one rigid segment based on the intervention, in this case a foot orthosis. measurement, and so while FLT has been reveals that there has been progress assumption that negligible motion took This direct intervention takes the form of shown to be a reliable measure,7 future with regards to defining more reliable, place within the midfoot.1 We now a full contact, weight-calibrated, ortho- work is needed to determine if this mea- clinically relevant measures. know that movements including walk- sis. Recent investigations have shown sure correlates with dynamic function. To date, much of the study of foot ing and slow running involve consider- that foot orthoses based on this correct- posture has included discussions of fron- able motion between midfoot bones.2-4 ed position (or posture) provide relief of DISCUSSION tal plane orientations such as calcaneal 12 With this knowledge of midfoot motion lower extremity musculoskeletal pain The longitudinal arch angle (LAA) is inversion. Given the above mentioned 13 it is logical to consider these motions and improved economy of gait. defined as the angle formed by two vec- evidence it becomes clear that more clin- in any attempt to control the foot with tors—one passing through the midpoint ically relevant measures may be found an intervention such as a foot orthosis. of the medial malleolus to the navicular in the midfoot and medial longitudinal Perhaps there is evidence that returning tuberosity and the other passing through arch. Accounting for the entire plantar the focus to the midfoot, medial lon- the midpoint of the medial aspect of the vault may give us a better understand- The MASS (Maximal Arch gitudinal arch and plantar vault, could first metatarsal head to the navicular tu- ing of what changes in foot posture are yield measurements that relate more Subtalar Stabilization) berosity (fig?). What is interesting about relevant to our clinical decisions. In an to the dynamic gait cycle and result in the work done with these angles, is that ideal scenario, a measurement would theory as proposed by improved clinical outcomes. they are starting to reveal measurements be accurate, reliable, backed by clinical 11 One recent attempt called Foot Glaser et al is designed that show good interrater reliability,8 outcomes, describe the entire foot and Posture Index (FPI) was designed to are prognostic of dynamic foot posture perhaps most importantly predict the to capture the foot in the be a valid, simple and clinically useful during walking and running and may dynamic function of the foot. tool. Its most recent version is based on most corrective posture. have some value in predicting the risk of So what is the ideal foot posture? 6 static foot morphology criteria (talar lower extremity injuries.9,10 This is good The MASS (Maximal Arch Subtalar head palpation, curves above and below news for the clinician who looks to the Stabilization) theory as proposed by the medial malleoli, inversion / eversion published research to confirm and vali- Glaser et al11 is designed to capture the date his clinical measures. foot in the most corrective posture. It SUMMARY It seems plausible that the closer the is defined as the maximal amount of Foot posture measurements taken measurements get to a measure of the closed chain supination that is achiev- in the MASS posture may prove more We now know that move- medial longitudinal arch and plantar able for any particular foot at midstance, applicable to clinical decision making vault of the foot, the more applicable with the heel, first and fifth metatarsals ments including walking with regards to orthosis manufacture as they are to the dynamic gait cycle. This in contact with the ground. The goals of they can be compared volumetrically and slow running involve correlates with the knowledge that this correction include: to a pronated foot posture or relaxed considerable motion significantly more motion occurs in the 1. adequate supination at heel strike calcaneal stance position. Knowing that sagittal plane during each step of the gait 2. the forefoot makes full contact on the there is an optimal foot posture that 2-4 between midfoot bones. cycle when compared to transverse and ground at midstance may be different for each individual, frontal motion. Put quite simply, there is 3. the majority of forefoot load is on the but based on the same reference points, Used MASS Posture Orthotics by Sole Supports, Inc. an accepted clinical relevance to the arch first metatarsal joint at heel lift logic follows that there is a spectrum of of the foot and its perceived posture— 4. the first MPJ is not limited in function (or dysfunction) and a zone either low or high—and it may very dorsiflexion of the calcaneus, bulge in the region of optimal control. Future writings and well be that the closer a measurement This posture is captured using a gait- www.solesupports.com of the talarnavicular joint, congruence investigations will focus on the zones of gets to describing this posture, the more referenced sequence with semi-weight- in the medial longitudinal arch, and postural control and their application to dynamically relevant it is. bearing loading. The casting method is adduction/abduction of the forefoot treatment with foot orthoses. (888) 650-7653 Therefore a distinction is needed the same for all feet though each foot on the rearfoot), and although there is between those foot type classifications yields a unique three dimensional shape some improvement in intrarater reli- REFERENCES that focus on frontal plane measure- due to unique anatomical variations and Lectures, Diagnosis’ and More on YouTube: Sole Supports TV ability and validity with this tool, there 1.Leardini A, Benedetti MG, Berti L, Bettinelli D, ments, and foot posture that is evalu- flexibility differences. It is based on the Nativo R, Giannini S. Rear-foot, mid-foot and fore- continues to exist significant doubt as to ated by the medial longitudinal arch or concept that if there is a corrected foot See Lost Connection II on page 18 http://www.youtube.com/user/solesupportstv 04 January 2013 American Journal of Clinical Chiropractic CBP® NonProfit, Inc. Research Update Check Out Our Research Reference List Online at: http://www.chiropracticbiophysics.tv/cbp-research/

cations. Further, CBP Non-Profit, Inc. around the world. Your (Chiroprac- • Spine modeling studies evaluating has funded many scholarships as well tic donations) support enables us ideal and average human align- as donated chiropractic equipment to to continue important research and ment variables, Paul A. Oakley, M.Sc., DC many chiropractic gives you a voice • Spine biomechanics studies CBP Research & Instructor colleges; always in the course our analyzing loads, stress, and strains, Private Practice New Market, trying to support studies take. Join • Posture modeling studies, Ontario, Canada chiropractic ad- Results of our studies today, either as a • Reliability of measurements vancement and regular member and evaluation of patients Chiropractic Biophysics Non-profit, education. Dr. Don have been published in or member of the (x-ray, posture), Inc. is a 501(c)(3) nonprofit corpora- Harrison was the prestigious research journals President’s Circle. • Validity of the measurements tion dedicated to the advancement acting president of The result will be and evaluation of patients, From lifting injuries to poor posture, of chiropractic principles through CBP Non-Profit, and presented at respected better chiropractic • Randomized trials evaluating falls to awful ergonomics, abnormal scientific research. Dr. Don Harrison Inc. since 1982. conferences around the techniques, stron- technique outcomes No matter what lordosis affects a lot of people. And that (deceased) and his second wife Dr. Currently, Dr. Deed ger chiropractic • Non-randomized trials evaluating world. means pain, muscle tension, and more Deanne LJ Harrison (deceased) found- Harrison (Don’s practices, and technique outcomes, pain. In the end, abnormal lordosis has ed CBP research foundation in 1982; it son) is the Presi- healthier chiro- • Case series studies evaluating makes lumbar lordosis been linked to a reduced quality of life was registered as CBP Non-Profit, Inc. dent of CBP Non- practic patients. technique outcomes, in 1989 by Dr. Sang Harrison (Don’s and poor health. Profit, Inc. • Case studies evaluating 3rd and final life’s love). Through this Results of our studies have been pub- CBP® research consists of studies on technique outcomes, abnormal, Denneroll With Chiropractic BioPhysics® techniques and the Lumbar organization Dr. Don and colleagues lished in prestigious research journals a variety of CBP® technique related • Literature reviews and Denneroll, you can provide relief and improve health for back- have published 140 peer-reviewed and presented at respected conferences topics including: professional commentaries. AJCC pain patients. spine and Chiropractic research publi- IC B can help get it back Designed by chiropractors and ACT IOP PR HY endorsed by CBP®, The Lum- O S Chiropractic Biophysics Non-profit, Inc. is a 501(c)(3) nonprofit IR IC bar Denneroll provides a H S Support better chiropractic. corporation dedicated to the advancement of chiropractic prin- C to normal. gentle, but effective, stretch ciples through scientific research. Results of our studies are pub- ® to coax the lumbar spine A lished in prestigious research journals and presented at respected T Support CBP Non-profit. back to its ideal curvature, or P conferences around the world. P C lordosis. Which relieves pain R U Your support enables us to continue important research and gives O D and reduces the risk of nerve, VED PRO you a voice in the course our studies take. Join today, either as a ligament, and muscle damage. CHIROPRACTIC Deed E. Harrison, D.C. regular member or member of the President’s Circle. The result will BIOPHYSICS® P.O. Box 1361, Eagle, ID 83616 be better chiropractic techniques, stronger chiropractic practices, In certain cases, the Thoracic Support Block System makes NON-PROFIT, INC. Phone: 1-800-346-5146, Fax: 1-208-209-6009 and healthier chiropractic patients. spinal treatment more effective. Contoured to allow the scapula and shoulder region to roll back into slight retraction and exter- nal rotation, the device reduces posterior thoracic cage transla- Journal Pubications Papers in Press Papers in Review 1 2 3 4 5 tion at the same time the Lumbar Denneroll improves lordosis. YES, I would like to partner with CBP Nonprofit Inc. in helping to further the research and advancement of chiropractic care around the world. Index Medicus = 92 Put Denneroll to work for your patients—with cervical, thorac- JMPT 54 AbnormAl lUmbAr lordosis cUrves (red line) normAl lUmbAr lordosis cUrves (Green line) Name______Office Name______Spine 8 ic, and lumbar devices available, you can improve the spine Clinical Biomechanics 6 from top to bottom. Address______City/State______European Spine J 7 Lower LUMBAr MiDDLe LUMBAr Upper LUMBAr J Spinal Disord & Tech 3 Zip______Phone (_____)______E-mail______Archives Phys Med & R 3 1-800-346-5146 | www.idealspine.biz Annual Membership Dues: q Silver Member: $400. Chiropractic & Osteopathy 3 J Electromyo & Kinesiology 3 Patent Pending –Lumbar Denneroll: Canadian Application No. 137758, US Application No. 29/377,956 q Gold Member: (CPB President’s Circle) $1,000. TOTAL AMOUNT J Rehab Research Dev 1 ENCLOSED: J Orthopedic Research 1 q Platinum: (CPB President’s Circle) $2,500. Spine Journal 1 $______Clinical Anatomy 1 Other Donation to CBP Non Profit Inc. $______Journal of Biomechanics 1 Method of Donation: CINAHL& ICL = 39 Chiro Pediatrics 18 q Check enclosed, #______Credit card: q VISA q MC q AMEX q DISC Chiro Technique 6 J Chiropractic Education 6 Credit Card#______EXP _____ /______J Canadian Chiro Assoc 4 J Vertebral Subluxation Res 4 2 Signature______Date _____ /______/_____ Chiropractic Sports Medicine 1 Totals 131 2

Before Lumber Denneroll treatment After Lumber Denneroll treatment American Journal of Clinical Chiropractic January 2013 07 Secrets to Buisness–cont’d from page 8 drugs (NSAIDs), and acetaminophen.” and risk of hearing loss in 62,261 and Dr. John Sidney Williams, of CBA’s program is made to fit your The participants were 26,917 men women aged 31-48 years. In this study Pennsylvania; and three grandchil- practice and goals, not the other way between the ages of 40-47 beginning of females, the regular use (2 or more dren. In lieu of flowers and cards, around. Call us and let us know how we in 1986 and were administered a times per week) of ibuprofen and contributions on behalf of Dr. Wil- Business & Practice Tips follow-up every 2 years for the dura- acetaminophen (not aspirin) was sta- Jan 13 can help. We are so sure our program 2 will increase your bottom line that we tion of the study. They found: “For tistically linked with an increased risk make that guarantee in our client service NSAIDs and acetaminophen, the risk of hearing loss. increased with longer duration of regular Secrets to Business Success agreement. REFERENCES Call my office today to schedule a free use. The magnitude of the association 1.Klein BEK, et al. Long-term Use of Aspirin survey, formal or informal. How does needed and wanted. By “build a ma- help any doctor who is willing to learn consultation to learn the exact system was substantially higher in younger men. and Age-Related Macular Degeneration JAMA. In addition to his wife, Dr. this apply to chiropractic practice? Well, chine” I mean you must hire or create and work. Our strategies are proven in ev- For men younger than age 50 years, the 2012;308(23):2469-2478. we have used to help thousands of chi- 2.Curhan SG, Shargorodsky J, Eavey R, Curhan Williams is survived by his hazard ratio for hearing loss was 1.33 kick your ego to the curb and ask yourself competent personnel. Lines and flows ery state and several countries for almost ropractors over the last 15 years! GC. Analgesic use and the risk of hearing loss in this question, “Does the public want chi- must be efficiently organized so daily two decades. 888-989-0855 AJCC for regular aspirin use, 1.61 for NSAIDs, women. Am J Epidemiol 2012;176(6):544-54. children, Dr. Kim Williams, ropractic?” I’m not suggesting blasphemy office traffic runs smoothly through the Conversely, many doctors miss a huge and 1.99 for acetaminophen”. 3.Curhan SG, Eavey R, Shargorodsky J, Curhan GC. Analgesic use and the risk of hearing loss in men. of Powder Springs, and Dr. here, I’m suggesting we be literal. To be business. Training manuals are needed opportunity because they don’t think to An Asprin a Day–cont’d from page 1 Ann J Med 2010;123(3):231-237. AJCC more specific, “Does an individual in the for reference by staff and to assist in contact us when they are doing well. This John Sidney Williams, of public want chiropractic?” No, of course in regular users versus 1.03% in non Pennsylvania; and three not—an individual, to be interested in regular aspirin users. Klein and col- The Passing–cont’d from page 1 grandchildren. purchasing and receiving the services of a leagues concluded: “...regular aspirin “For NSAIDs and acetamino- Chiropractic and the World a bet- Eric Huntington, DC chiropractor, would want the BENEFITS use 10 years prior was associated with phen, the risk increased ter place through his humanitar- Co-Owner Developer of the Chiropractic of chiropractic. a small but statistically significant in- ian, personal, and entrepreneurial Business Academy with longer duration of The benefits of chiropractic are crease in the risk of incident late and achievements. [email protected] numerous and can include a healthy neovascular AMD.” regular use.” A Williams family statement body, better movement, less pain, better INTRODUCTION Thursday morning (December 27, liams and his family can be made posture, etc. It’s worth listing out what Hearing Loss from Department of Why is Business Success a Secret? 2012) said: “Doc was a person of im- to: The B.J. Palmer Historic Home There are many aspects to running a you see as the benefits a patient receives Medicine, Brigham and Women’s 2,3 mense presence and personality. He will Foundation, Inc. 1950 Old Concord business which will determine its degree when under chiropractic care. This list Hospital in Boston, MA 2 be greatly missed by his family and many Road, Smyrna, GA 30080 or at success. From delivering good service should be used to help formulate your In 2010, Curhan and colleagues In a follow up investigation in others whose lives he has touched.” www.bjph.org. AJCC to honest dealing with your clientele to promotion and technical delivery. examined “the independent associa- 2012, these authors3 prospectively motivating staff—many of these things Secret #1 is that when you organize tion between self-reported professionally In addition to his wife, Dr. Wil- evaluated the frequency of aspirin, are “known” and applied broadly in your promotion and delivery, you must diagnosed hearing loss and regular use of liams is survived by his children, Dr. ibuprofen, and acetaminophen use our profession. But there are lesser do so keeping in mind what is needed training new staff. Written policy ensures is the optimal time to hire CBA because aspirin, nonsteroidal anti-inflammatory Kim Williams, of Powder Springs, known and applied business principles and wanted by the public. As an example, that staff actions are coordinated and we can help a doctor identify what is this is why some of the marketing strate- predictable. These are just a few building causing their success and strengthen it! that really separate the proverbial men from the boys. It’s these principles that gies taught by the Chiropractic Business blocks taught by CBA that can assist in In fact, the biggest practice gains from remain a secret. Academy utilize massage. By survey, mas- building your machine. our program are routinely experienced by sage is a more needed and wanted service You know when the machine is built clients who were already doing well when Secret #1 than chiropractic at the moment. and operating, because it will run with- they joined CBA. See what your x-rays are saying. You must find out what is needed out you having to do most of the work. and wanted by the public, and then fig- Secret #2 Depending on how you set it up, you Secret #4 ure out how you can promote and deliver Secret #2 is that you must build a may still work in the practice, wearing Your own happiness in practice may Make your patients’ x-rays become more meaningful, that item or service. This is best done by machine to promote and sell whatever is the hat of your choice, or you may phase be the most important factor. You get to yourself out completely. That’s up to you. define success in your life. You also get Exacting X-ray Analysis more informative, and more versatile. At the Chiropractic Business Acad- to decide how to measure your prog- emy (CBA) we have helped thousands ress toward your goals. So this secret PostureRay®quickly and automatically analyzes spinal x-rays and plots abnormal deviations. Which means your patients of chiropractors build their machine. is unique to each of us. You may find Exacting X-Ray Analysis can easily see exactly what corrections are necessary and track the progress of treatment, whether for simple subluxations Since we teach business skills, including it helpful to list out what would make AP Thoracic Scoliosis Projection X-Ray Impressions and Biomechanics Report | or serious conditions like scoliosis. The system even includes a “telestrator” function so you can draw as you demonstrate. Digitalization: 7/8/2011 X-Ray obtained: 4/8/2011 marketing, sales, staff training, finance, you happy in practice. For me, my list Name: Verybad Spine Date of birth: 4/8/1988 ® computerized X-ray digitizing system with impressions Ms. Verybad Spine’s x-rays were analyzed utilizing the PostureRay The x-rays, analysis, and documentation are easily exported to Electronic Medical Records, pdf leadership, etc, our program works for includes things like: interpreted by Dr. Joseph Ferrantelli. X-Ray digitization for spinal biomechanics has been shown to be valid when com- pared to standard hand drawn methods. The patient’s findings were then compared to established normals at each level Exacting X-Ray Analysis and then globally. The X-Ray mensuration method used in analyzing this patienthave been studied for reliability and files, or JPG images. Posture Ray is available for Windows7, XP, and Vista, and is compatible with any practice style. • Providing high quality service validity and these results are as follows: X-Ray Summary Travel Sheet | All views DMX and DICOM. Digital x-rays are not required. • Staff driven practice which I don’t Name: Verybad Spine Date of birth: 4/8/1988 1. C1- Horizontal: -23.1° ARA C2-7: .8°, 101.9% lost vs. normal Translation Secret #3 work in day to day. C2-7: .8mm Forward With Posture Ray, you’ll save time while you provide better care, and with just one new patient a 2. ARA C2-7: 25.0° Translation C2-7: The green line represents 67.4mm Forward Segmental flex- normal spinal position ion instability is noted at segments month, the system pays for itself. Starting at just $5999, financing is available with monthly Once you have attained your ideal • High personal income C5-6 Segmental translational instability is not noted The red line represents your 3. ARA C2-7: -43.1° Translation C2-7: payments as low as $217. practice scene, you must continually • Freedom to choose when to work current spinal alignment and 5.3mm forward Segmental exten- the projected centers of mass sion instability is noted at C2-3, of the spine. C3-4; Segmental translational insta- bility is not noted

monitor it using proper statistics. Secret #3 • Freedom to travel R-F: Rissor-Ferfuson 4. Rotation Angle T8: -4.1° left; 1. 1/7/2011 2. 1/7/2011 3. 1/7/2011 Method of analysis Cervico-Dorsal Angle C2-T8 )T2 Add Posture Ray to your practice. The advantages are easy to see. Cob: Cobb Methodfo Apex): 5.0° Right; translaton C2-T8: 8.5mm left is becoming an expert at looking at what These are just a few examples from analysis 5. Risser-Ferguson T5-L1: -44.8° righ; X-Ray Report of Findings | Cobb Angle T5-L1: -54.8° right; Exacting X-Ray Analysis Translation apex T9: -28.3mm righ; Lateral Cervical View (Side view of the neck ) you are doing that works, and improving my list, but what is important is that Translation T5-L1: 26.4mm left; Name: Verybad Spine Translation T1-L3: -8.2mm left Date of birth: 4/8/1988 X-Ray obtained: 4/8/2011 6. SBA: 47.3°; ARA L1-L5: -61.5°; 53.9% gained vs normal; Translation L1- Digitalization: 7/8/2011 those things—and also determining what you make your list and go for it! If you S1: 21mm forward 7. Sacral Base to horizontal: 1.7° PostureAnalysis.com rightRisser-Ferguson L1-5: -12.8° you are doing that is not working and are certain that you can achieve you right; Cobb Angle L1-L5: 18.5° right; Translation apex L1-L5 (L3): 4.7mm left; Translation L1-5: 26.7mm left; 4. 1/7/2011 5. 1/7/2011 6. 1/7/2011 making changes to those areas. goals without the help of a consultant, Translation T11-S1: 39.4mm left 8. Femur Unleveling (-25%): 2.3 866.577.7297 mm right; Sacral base unleveling (-25%): 5.4mm left; Pubic Symphy- I think it’s worth noting that more that’s great. If not, give my office a call sis to S2: 3.1mm left; Sacral Base to Horizontal L5: -1.8° left; Lumbo- Sacral Angle T12-L5 (L2 apex): -87.3°; Lumbo-Dorsal Angle T12-L5: than half of the doctors that contact CBA and we can talk about how CBA can Right 8.3°; Translation T12-L5: 7.6mm left for practice help are struggling to one de- help you get there! © 2012 PostureCo | Patent Pending | PostureCo.com gree or another. Good news is that we can 7. 1/7/2011 8. 1/7/2011 See Secrets to Business on page 9

The green line represents normal spinal The red line represents your current position spinal alignment and the projected January 2013 American Journal of Clinical Chiropractic centers of mass of the spine. 08 Above: X-ray of normal healthy curvature of a neck from © 2012 PostureCo | Patent Pending | PostureCo.com the side. No spinal arthritis is apparent. Healthy spaces are evident Above: Notes regarding your x-ray results: Your head is positioned 18.1 mm forward and you have lost 115% of your normal neck curve. This is the reason you have headaches and are in too much pain to play with your son.

The green line represents normal spinal position

The red line represents your current spinal alignment and the projected centers of mass of the spine.

© 2012 PostureCo | Patent Pending | PostureCo.com Learn to talk to a person with a subluxated posture at your ROF

problems for money. This means people MUST know their problem and be very Good clear. In a spinal corrective program we Good correct the WHOLE spine. Every spinal problem involves the WHOLE spine. The for you question is, “Do you have the systems that for your Fred DiDomenico, DC have the HIGHEST percentage of patients Practice Coach and Mentor understanding their WHOLE spine needs cor- “I’m learning things I’ve never seen www.elitecoachingllc.com recting?” The next question is, “Do they tell before and it’s revolutionizing my YOU they KNOW their WHOLE spine and PatiENtS INTRODUCTION posture is weak and subluxated?” The fact is practice and life.” Most management groups teach you can’t tell them. They MUST Say it to “Elite taught me how to communicate you scripts of how to talk ABOUT a you so they will understand. It’s not what —dr. S. Silverston, Ellicott City, Maryland subluxation to a person at your ROF. YOU say that matters. It’s what THEY say greater value for spinal corrective What does this imply? You are talking that changes their behavior. about the facts of a suluxated posture to rehab to patients (while increasing cash a person. It is as though the patient will 2. They MUST say, “I don’t want to be like understand the facts, see their x-rays and this anymore.” collections from $35K to $83K).” Out of our GREATEST crisis comes —dr. J. Purcell Las Vegas, Nevada our greatest breakthrough. Before people are willing to make a change in their life commitment to move in another direc- Elite Coaching provides these answers they MUST want to leave the condition tion, they need guidance as to the proper in systems so the HIGHEST percentage There are 5 steps a patient they are in. They must reach the point direction to move. You don’t achieve of people commit to corrective care by Good of ultimate frustration to change and be this by telling them “What to do.” You directing their actions. or any person who is going ready to move. Many patients that don’t achieve this by telling them “What NOT to make an empowered commit NEVER said, “I don’t want to be to do.” Research shows that people with 4. They MUST know what they DO want: for your like this anymore.” This is a CRUCIAL action toward a life change chronic back pain who do only exercise Once a person is ready to move in a EMOTIONAL decision people MUST have a greater probability of becom- specific direction they MUST have a goal. MUST progress through in CtiCE make to be ready to move in another ing disabled than if they did nothing at Without a goal they do NOT know what Pra a specific order. direction. They must have a strong emo- all. This eliminates traditional physical they want and will not buy and say, Dr. Fred tional desire to change or they will stay therapy, medical care, yoga, Pilates, gyms, “I have to think about it.” The problem is in their misery, whether it is their pain or “In 30 days I jumped in collections from DiDomencio, and all the other exercise related excuses, you didn’t direct them to have a vision founder and their disease. including, “Getting a second opinion.” If in advance. “Where there is no vision, $30K per month to $65K per month.” lead coach you don’t eliminate all other options, people perish,” right out of your office. lbuquerque, New Mexico of Elite commit to care because it makes sense. 3. Eliminate ALL other options: you will receive common objections to r. t. Pickman, a —d Coaching Unfortunately it doesn’t always seem to Once a person makes the emotional care and non-commitment at your ROF. See Learn to talk on page 25 work that way, because there continues to be people walking out your door who, “just don’t get it.” Have you noticed talk- ing MORE about the same thing doesn’t make you more effective? Successful busi- ness people don’t use the excuse, “they just don’t get it,” so why should we? People make decisions and buy based on an emotional progression of thought and feelings. There are 5 steps a patient or any person who is going to make an empowered action toward a life change Elite Coaching will help you unlock your potential, both personally and professionally. You can realize MUST progress through in a specific order. your dreams, help your patients achieve optimum health, and improve your profitability in the process. These 5 steps incorporated into your patient management system will raise Your best in you. And, with Elite Coaching, it’s in your future. Contact us for a free consultation. your percentage of people committing to your spinal corrective programs to SOAR HIGHER than ever before.

Call 253-851-8353 1. They MUST SAY they have a FULL spine problem: EliteCoachingllc.com Entrepreneurs solve people’s

American Journal of Clinical Chiropractic January 2013 11

in chiropractic. One example is the low There’s an old saying, you can steal fee Doc in a box corporate chiroprac- someone’s money and they can earn tor office that seemingly undercuts it back, but if you steal someone’s Editorial & Letters every chiropractor’s fee in their path. health they can never replace it.

Jan 13 As a practitioner for over 33 years I’ve Corrective care should be seen many financial games played in SUMMARY based on strict clinical pro- the profession and in my experience So, when recommending care to The Why and How of Practice Outreach the low fee high-volume chiropractic patients, tell them the truth, let them tocols such as those found offices eventually collapse financially, decide what’s important at that time in CBP® so that patients can tried and true strategies. As a matter When it comes to practice, doctors it’s not if it’s only when. My opinion to them and not necessarily to you. of interest, if done correctly they are have to have a certain amount of both. about your fees is simply charge what Lastly, what’s your plan for 2013 to clearly understand what more effective today then they have Everybody’s personalities are unique. you believe you are worth and the true increase your practice a minimum of they’re paying for and can ever been in the past. It is not unusual Some doctors gravitate towards why, value of the services you provide. One 25 to 30%? If you’ve not taken a day to Randall Hammett, DC easily see the postural x-ray to schedule 50 to 100 great patients at others towards how. Both can be Private Practice of Chiropractic of the things I recommend that you sit down and write out what your plan a 2-day screening, or schedule 20 to 30 successful, it just looks a little different. do in 2013 is receive chiropractic care is for the next twelve months I guaran- changes you’re providing. patients from a 20-minute dinner, or Here are my observations over the from a colleague near you and pay tee you that your practice will decrease corporate, presentation. past 27 years of practice and 12 years Certainty them their full fee for each treatment. and your income will fail. Those of you Yurij Chewpa, DC, RFCCSS(C), of coaching. The Why practice tends Psychologically, paying out of your reading this that got into chiropractic Co-Head Coach, Warrior Coaching DISCUSSION to have more new patients and better own pocket for chiropractic care will because it was a good career move, or and Warrior Coaching USA and 2013 put you in touch with the reality of good way to earn income I suggest you (www.WarriorCoaching.org) One of the advantages of doing the initial conversion, but more early outreach in person is that the doctor drop outs. This is because the doctor INTRODUCTION what your patients have to pay and in become quickly reacquainted with the and thrived in the last 100 years have INTRODUCTION has to wrestle with the question of why tends to be outgoing and passionate The one consistent thing is change, some cases you’ll find that you’re not purpose and philosophy of chiroprac- done so by first providing outstanding At the recent Warrior Coaching they are doing it, and face the fear of and has no problem attracting new and I tell you for sure 2013 will be a charging enough for the services you tic because if you’re in it just for the results, second by educating their pa- money you will never survive and you Leadership Summit in Toronto, the getting outside of their four walls. Are patients, but lacks the procedures to challenge for many chiropractors. With provide. The keynote for the year is to tients as to why they need chiropractic stay flexible in your business planning will always struggle financially and topic of the various presentations was they doing this talk to get new patients start a patient well and doesn’t have the changing health laws both federal and for a lifetime, and third understanding and in your practice marketing. Keep in emotionally. It amazes me to today practice outreach. Specifically, the to build their practice and pay their process to guide them on their path of state changing insurance policies to the limits of the care that they provide mind that patients will always gravitate how many chiropractors practicing speakers were discussing “the why” bills, or are they doing it to save the care. Practice tends to grow fast at the cover shortages you can expect more and the extent to which a chiropractic to the practice where doctors produce have never read any of the green books, —why do we do outreach, and “the sick people in their community? The beginning, but plateaus because of lack financial stress and more focus on adjustment, performed correctly can outstanding, fast symptomatic relief have never attended a chiropractic phil- how”—how do we reach out into our better the answer as to why the doctor of structure. This is a practice that tends documented care with less reimburse- change people’s lives. with good post pain educational infor- osophical seminar like DE in Atlanta. communities effectively to attract the is doing the talk, the more people will to have a high missed appointment rate ment. In my own town I’ve already Till next time, AJCC sick and lost. What strategies work best? been notified that several government- mation for patients to decide if they The chiropractors who have survived come in for a checkup. If it is all about and high dropout rates, but can be high inmates are not running the asylum like backed insurance plans are increasing wish to continue with the chiropractic the doctor, the potential patients will volume because the new patients are they are in the why practice, but it’s hard their deductibles and copayments by lifestyle. sense this and they will stay away. If ever present. The inmates are running to break into the asylum. By adding vast amounts to cover shortages. The Be sure in your practice that you the people have an understanding that the asylum. By adding structure, this more new patients, this practice is ready good news is, and there is good news! offer patients at least three types of care the doctor is there to serve them, then practice is ready to explode. to explode. Room for improvement. The health industry has typically been for their health. Pain relief, corrective that doctor has the capacity to attract as The How practice tends to have inflation and recession proof. Don’t care and wellness or maintenance care It is not unusual to schedule many patients as he can possibly serve. lower new patients and a slightly lower SUMMARY are typically the three types of care that Once the doctor knows why they conversion rate, but a much higher 50 to 100 great patients at As you can see, one is not better than we offer patients. An important part are doing the outreach, they need to retention rate, because the structure and the other, they are just different. The a 2-day screening, or to remember is that you must honor With space at a premium, Universal know how to do the outreach most procedures guide the patient through Why doctor is not mindful of structure what patients choose and not step over schedule 20 to 30 patients Tractioning System offers all kinds of effectively. The same doctor can give their months and years of care. Practice and procedure. The How doctor is your bounds. For example the patient One of the things I recom- from a 20-minute dinner, the same talk to the same group and growth is slower because the doctor fearful of outreach. Both need to step wants relief care for a few visits than advantages. For starters, it occupies change the content by five percent and tends to be more fearful of outreach, into fear to reach their full God-given mend that you do in 2013 honor that and when they are out of very little space so any practice can find or corporate, presentation. get a 30, 60 or 100-fold increase in and therefore new patient numbers are potential. Both doctors will have trouble pain release them and explain to them room for it. And despite its small size, follow-through. Likewise, we have had lower. Although practice growth is slow, is receive chiropractic care that they’re always welcome back if UTS accommodates every CBP® traction Warriors do screenings and schedule it is more consistent and steady. The See Why & How on page 25 from a colleague near you and when the pain returns. Corrective 100 new patients in a weekend, and a treatment you care to prescribe—every and pay them their full fee care should be based on strict clinical chiropractor at the same screening one LATERAL TRANSLATION TRACTION protocols such as those found in CBP® one of them. Which means UTS packs booth over only schedule 10 patients. for each treatment. so that patients can clearly understand more improvement for your patients The strategies being discussed were what they’re paying for and can easily screenings, corporate talks, and patient This patented into less room than any comparable “The why” or “the how”? see the postural x-ray changes you’re dinners. These three strategies have mechanical device. Log on, e-mail, or After the presentations at Leadership table design providing. Wellness or maintenance been around for decades and many Summit there was a lot of discussion aids in the care should be recommended for ev- call—and put UTS to work. falsely assume that they no longer about what is more important, “the correction get me wrong, doctor’s incomes have eryone but typically in the chiropractic work. Nothing could be further from why” or “the how”? Why we do of lateral dropped the last five years and yet it’s office only 5 to 7% will follow through, [email protected] the truth. While internet marketing, outreach, or how we do outreach? translations been estimated that 5 to 7% of doctor’s if this is true in your practice then 1-800-346-5146 a social media presence, and a Obviously, both are important, but does of the spine. incomes have increased. The question you’re doing a good job and continue great website are crucial in today’s www.idealspine.biz/p-226-universal-traction-system.aspx either one have an advantage when it is what will your practice hold for you with your treatment plans. There has wireless world, they do not replace comes to building a lifetime, wellness, in 2013? been in the last several years a propen- UNIVERSAL getting outside of your four walls family, principled practice? sity to base your care on what third- TRACTIONING and personally interacting with the The why v. how question can be DISCUSSION party insurance companies will pay for, SYSTEMS people in your community. Warrior stated in other ways as well: inspiration The last three years have seen and there could be no higher injustice Every Vector, One Device Coaching clients receive hundreds of v. perspiration, delivery v. content, unusual solutions to practice problems to a patient than treating their wallet new patients every month using these passion v. procedure. instead of their health. 14 January 2013 American Journal of Clinical Chiropractic American Journal of Clinical Chiropractic January 2013 15 Announcing the All-New Impulse Adjusting System® new! BioPhysics Insights ThR ee MoD u L e SeRIe S Jan 13 Clinical* and Business** Training Provide the ultimate Combining Specific Chiropractic Adjusting Techniques with Instrument Adjusting Success Solution CBP Corrective Care Techniques: Case #2 Regional neuromechanical® Focus on Spinal and extremity • Postural Analysis: Posture analy- the presence of edematous tissue to the patient. Lastly, a full foot lift of 9 Adjusting Leading to Certified Instrument Adjusting® sis revealed a significant left thoracic around the injured segment. mm was administered to the patient and translation, a right lateral flexion of the 3. A decrease in motion of the segment was placed in the left shoe. Qualification Plus new Boardroom Business Training ribcage, a right posterior pelvic rotation, in question, as compared to the sur- exclusively for Instrument Adjusting Practices a suspected left leg length inequality, a rounding area. Mirror Image Adjustments large posterior thoracic translation, and 4. Palpable muscle spasm or splinting The patient was administered mirror Todd Pickman, DC a slight forward head translation. “TeChnIQUe DOeS mATTeR In PRACTICe SUCCeSS.” around the area in question. image adjustments to correct posterior Private Practice of Chiropractic Eagle, ID • Radiographic Analysis: 5. Visualization of the area (looking for thoracic translation with hyper-kyphosis Chiropractors across the country and around the world who have Gonstead Technique & CBP Trained 1. In April of 2012, a modified AP Chirorpactor presence of pitting edema, asymme- and anterior head translation with head implemented the Impulse Adjusting System® have found that its femur head-ferguson view was ob- tained. On the left of Figure 1, this try in the tissues, etc). flexion postures. See Figure 3. research based approach to clinical evaluation and adjusting is easier on x-ray is shown. The PostureRay x-ray 6. Then, consulting the 3-shot, digi- their patients and themselves. software system was used to identify tally stitched, AP full spine x-ray Mirror Image Exercises Christopher J. Colloca, D.C. and quantify the extent of leg length and the lateral (2 shot) full spine The patient was administered mirror CeO and Founder, neuromechanical Innovations inequality. A 9mm left leg length x-ray to analyze the “foundation image® exercises to correct posterior inequality was identified with con- principle” and relate this to the thoracic translation with hyper-kyphosis sequent spine abnormality. examination findings. and anterior head translation postures. get ceRtified in instRuMent adJusting! 2. In April of 2012, a full spine lateral See Figure 4. To learn more about the CIA Program, please visit us online at: radiograph was obtained. While in For the full spine and posture cor- June of 2012, a follow up full spine www.impulseseminars.com/certified or call (888) 294-4750. rective care, CBP® mirror image® adjust- See Corrective Techniques on page 18 lateral was obtained to document ing, exercise, traction procedures were Deed E. Harrison, DC the response to intervention and utilized. Additionally, body weighting Download complete seminar agenda at: President CBP Seminars, Inc. potential modifications that might President CBP Non-Profit, Inc. be warranted. Figure 2 depicts these using the thoracic belt from Circular www.impulseseminars.com/agenda Chair PCCRP Guidelines full spine radiographs. Traction was applied 5 times per week Editor—AJCC • Interventions: A total of 24 treatment for 15 min walking intervals. These pro- ® INTRODUCTION sessions over the course of 2 months was cedures were administered on each visit Figure 3. Mirror Image adjustment. The All New 2013 Impulse Adjusting System® Three Module Seminar Series This adjustment focuses on positioning In our previous article (AJCC Octo- utilized in this case. For segmental adjust- the ribcage into anterior thoracic trans- ber 2012)1, we suggested that the astute 2013 Impulse Adjusting System® ing technique, the treating Chiropractor lation relative to the pelvis. Seminar Save Chiropractor should become skilled at (TP) exclusively adhered to and utilized administering both a segmental specific Seminar Dates, Locations and Modules the Gonstead Technique system for iden- Avatar slider thumbnails Registration Fee adjustment technique (such as the Gon- tified spine subluxations including: Jan. 19-20, 2013 Mar. 23-24-17, 2013 50%! stead system) and a full spine corrective PHOENIX, AZ COUMBUS, OH Special Discount Rate 1. Abnormal temperature differential pat- spinal module spinal module technique like Chiropractic BioPhys- Simply visit us online at: ics (CBP). In this manner, patients will terns (nervo-scope / tempo-scope). Jan. 26-27, 2013 Apr. 20-21, 2013 2. Static palpation data indicating ORLANDO, FL CHICAGO, IL www.ImpulseSeminars.com and experience the benefits of segmental extremities module spinal module ® enter Promo Code: P-AJC-2013 motion restriction improvement and the Figure 4. Left— mirror image exercise restoration of proper full body and spine Feb. 9-10, 2013 Apr. 27-28, 2013 and you will receive 50% off your Before Figure 1. focusing on positioning the ribcage into SAN FRANCISCO, CA DENVER, CO ImpulseAdjusting alignment. The case presented herein Before and anterior thoracic translation relative to extremities module extremities module seminar registration. ™ ® SYSTEM attempts to provide further rationale for After AP femur the pelvis. Right— mirror image body Feb. 16-17, 2013 May 4-5, 2013 the combination of these two uniquely head / ferguson weighting to reduce the left thoracic ATLANTA, GA NEW ORLEANS, LA RegistRation includes: distinct, but complimentary full spine tilt up x-ray. translation. spinal module spinal module • Complete Impulse Adjusting Technique® Chiropractic Technique systems. On the left Feb. 23-24, 2013 Seminar Manual June 1-2 , 2013 $ is the initial ST. LOUIS, MO DETROIT, MI • Hosted Luncheon, Saturday Before After spinal module spinal module CBP/Gonstead Case Study #2: neutral film. • 12 CEUs Approved In Most States* In 2012, an 8 year old male, who On the right is Mar. 2-3, 2013 June 8-9, 2013 * Business Training is not for CE Credits. Dates, 199! Per Doctor. After the follow up Figure 2. Before and After correc- TYSON’S CORNER, VA TORONTO, ON locations and tuition can be found online had no overt symptom complaints was extremities module Students $129. tive care full spine lateral radiograph. spinal module brought to the author’s (T.P) Chiro- x-ray taken in Two week advance registration June with a 9 On the left is the initial neutral film Figure 5. Mirror Image® denneroll trac- Mar. 9-10, 2013 Aug. 10-11, 2013 practic clinic for postural evaluation BOSTON, MA mm lift in the demonstrating a significant posterior tion using the thoracic denneroll and the PHILADELPHIA, PA Promo code: P-AJC-2013 required for $200 discount fee. and a spinal checkup. His parents had spinal module extremities module left shoe. translation of the ribcage. On the right translation support block. This traction noticed significant posture abnormality is the follow up x-ray demonstrating system focuses on positioning the ribcage Mar. 16-17, 2013 While applications relating to credit hours for license renewal in selected states have been executed for these programs, it remains attendees’ responsibility to contact the state board(s) from SEATTLE, WA whom they seek continuing education credits for purposes of ensuring said board(s) approve both venue and content as they relate to any seminar/course/lecture/webinar /online presentation and were concerned about underlying considerable correction of the spine into anterior thoracic translation relative extremities module (event). Neither a speaker’s or exhibitor’s presence at said event, nor product mention or display, shall in any way constitute NYCC endorsement. NYCC’s role is strictly limited to processing, submitting, and archiving program documents on behalf of course sponsors. spinal disorders. and posture abnormality. to the pelvis.

To Register Please Call (888) 294-4750 Or Visit Us Online At: www.ImpulseSeminars.com American Journal of Clinical Chiropractic January 2013 17 All New PostureScreen CBP® Mirror Image D-SERIES Exercise Content FDA Clearance K-SERIES and Launch launch and ® Mirror Image Exercise Videos we will be releasing full Mo- 2005 first dual wavelength class IV THERAPY CLASS IV THERAPY LASERS FDA clearance As a recap, once you have performed tion Capture and analysis as laser to be FDA approved 2005 a postural analysis you can then choose an in-app upgrade. This new · first independently selectable, ® dual wavelength THERAPY laser Mirror Image exercises to prescribe module will give you the ability · First portable class IV laser to your patient (assuming they are in to quickly assess any movement · first remotely upgradeable Joseph Ferrantelli, DC the rehab phase of care). These static pattern from spinal ROM to a software Platform CTO CBP Seminars; exercise images were hand selected by golf swing. Full running gait · first zoom handpiece CEO PostureCo, Inc CBP® as the most common postural ab- analysis can also be performed adjustable spot size) normalities and have been available in as well as pre- and post Rock PostureScreen Mobile for last 6 months. Tape movement analysis. The Now with the recent January release of videos will all be stored under the new video content, your patients the patient accounts providing Figure 1: Video instruction of Ribcage vs. Pelvis will be guided through their mirror im- comparisons that you can review K-LASER International

Mirror Image Posture Exercise 2009 age exercises by Dr. Harrison himself. later to track functional im- and now have full distribution Health Canada provements with your patient. coverage in Europe 2011 Denneroll Prescription Feature Posture Screen Mobile con- Gained health canada In January we will also be introduc- tinues to strive forward giving clearance, expanding ing video instruction for Denneroll the structurally based rehabili- First True our distribution Penetration Analysis use, again demonstrated by Dr. Deed tation specialist the tools they throughout north David Cruz, DC 2011 america. CEO WebExercises, Inc. Harrison. These videos will provide your need to accurately assess posture until this point, penetration patients with instruction on the proper and movement patterns while was only “guesstimated”. INTRODUCTION set up and use of the Denneroll traction aiding in exercise prescription this was the first thorough simulation and measurement We are excited to announce all new device. Both the corrective exercises and —all within the palm of the

of internal dosimetry. 2012 content has been added to the Posture- Denneroll videos are delivered to your clinician’s hand. Screen Mobile Mirror Image® Exercise Sec- QRT Technology patients via email utilizing WebExer- PostureCo, Inc. is a tech- K-CUBE™ SERIES (QUICK RELEASE) tion. Many of these exercises now feature cise’s secure cloud based system. This nology company focusing on FDA Clearance and Launch with additional tips

Figure 2: Video instruction on how to use 2012 instructional videos taught by Dr. Deed will allow your patients to review their radiographic and postural based EMR ® Denneroll Cervical Orthotic · first independently selectable, · adjustable therapy tip Harrison CEO of CBP Technique and personalized rehabilitation program products. PostureScreen Mobile is Seminars; these videos can be emailed FOUR WAVELENGTH THERAPY laser anytime whether traveling or from the available in Apple iTunes AppStore · first portable15 WATT THERAPY LASER to your patients in seconds using your comfort of their home. (Figure 2). as well as Google Android Play Store. WebExercises, Inc. is a cloud based iPhone or iPad. These new videos provide The exercise module for Android is exercise prescription and management the necessary follow up patient education Motion Capture Analysis targeted for release in mid 2013. platform with thousands of exercises. · ear, nose & throat ent attachment that will support your in office care. Additionally, coming in early 2013 www.PostureAnalysis.com. www.WebExercises.com. AJCC

Corrective Techniques–cont’d from page 17 Objectively, the patient’s follow cal_chiropractic/2012/12/18/combining-specific- Orthop Sports Phys Ther 2007; 37(11):703-707. up full spine radiographs in Figure chiropractic-adjusting-techniques-with-cb.html 8.Jonson SR, Gross MT. Intraexaminer reliability, · additional tips to come... Mirror Image® Body Weighting and interexaminer reliability, and mean values for nine 2 show remarkable reduction of the AJCC Denneroll Traction lower extremity skeletal measures in healthy naval spinal displacements. midshipmen. J Orthop Sports Phys Ther 1997; Mirror Image traction care was Lost Connection II –cont’d from page 4 25(4):253-263. administered to the patient. The patient 9.McPoil TG, Cornwall MW. Prediction of dynamic CONCLUSION received the denneroll traction system foot motion during the stance phase of gait. Gait foot posture during running using the longitu- The authors’ opinion is that the dinal arch angle. J Am Podiatr Med Assoc 2007; to correct the abnormal thoracic transla- Posture 2007; 25(3):453-462. patient’s improvements were directly 2.Benink RJ. The constraint-mechanism of the hu- 97(2):102-107. tion posture as shown in Figure 5. In ad- 10.McPoil TG, Cornwall MW. Use of the longitudi- related to both the segmental adjusting man tarsus. A roentgenological experimental study. dition the patient was instructed in the Acta Orthop Scand Suppl 1985; 215:1-135. nal arch angle to predict dynamic foot posture in and spinal corrective procedures applied walking. J Am Podiatr Med Assoc 2005; 95(2):114- use of the denneroll thoracic orthotic 3.Nester C, Jones RK, Liu A, Howard D, Lundberg using CBP Technique. Accordingly, for A, Arndt A et al. Foot kinematics during walking 120. and was advised to do this 5 times per 11.Glaser E.S., Bursch D, Currie S.J. Theory, Prac- optimum patient response, traditional measured using bone and surface mounted mark- week at home. ers. J Biomech 2007. tice Combine for Custom Orthoses. Biomechanics Chiropractic adjustments would seem to 4.Arndt A, Wolf P, Liu A, Nester C, Stacoff A, Jones 2006; 13(9):33-43. be enhanced by the addition of spinal R et al. Intrinsic foot kinematics measured in vivo 12.Trotter LC, Pierrynowski MR. The short- Case Outcome term effectiveness of full-contact custom-made corrective procedures as in CBP. In the during the stance phase of slow running. J Bio- Subjectively, at the end of 2 months mech 2007; 40(12):2672-2678. foot orthoses and prefabricated shoe inserts on end, it is the positive response of the lower-extremity musculoskeletal pain: a random- of corrective care, the patient’s posture 5.Cornwall MW, McPoil TG, Lebec M, Vicenzino B, patient that should dictate this com- Wilson J. Reliability of the modified Foot Posture ized clinical trial. J Am Podiatr Med Assoc 2008; was remarkably improved. NRS = 1-2 / 98(5):357-363. bined approach of classical Chiropractic Index. J Am Podiatr Med Assoc 2008; 98(1):7-13. 10. According to the patient’s parents, in 6.The predictive value of the foot posture index on 13.Trotter LC, Pierrynowski MR. Changes in Gait EVERYTHING WE’VE LEARNED care, with more contemporary corrective Economy Between Full-Contact Custom-made their own words, “It’s great to see how dynamic function. 1st Congress of the Internation- Chiropractic systems. al Foot & Ankle Biomechanics (i-FAB) commu- Foot Orthoses and Prefabricated Inserts in Patients quickly he has improved. The leveling of with Musculoskeletal Pain: A Randomized Clinical IN ONE REVOLUTIONARY DEVICE nity.4-6 September 2008.Bologna, Italy; 2008. his shoulders and hips is apparent and 7.Brushoj C, Langberg H, Larsen K, Nielsen MB, Trial. J Am Podiatr Med Assoc 2008; 98(6):429- 435. AJCC how he carries himself; he is dramati- REFERENCES Holmich P. Reliability and normative values of the 1.http://www.chiropractic-biophysics.com/clini- foot line test: a technique to assess foot posture. J EXPERIENCE THE INNOVATION www.k-laserusa.com · (866) 595-7749 cally more upright and balanced”. 18 January 2013 American Journal of Clinical Chiropractic Traction System–cont’d from page 20 symptoms have been reduced 90%. Figure 1. Figure 5. Fol- We believe the results are due to vital in consolidating the benefits Pre PA low up PA of the effective spine stretching us- Thoracic and thoracic and PA the combined effect of the Mirror Biomechanics Corner ing the denneroll 3-point bending PA Lumbar Lumbar radio- Image treatment methods includ- Jan 13 traction table. During the patient’s Stitched graphs after only exercise, neurological stimulation was together for 1-month of care convenience of demonstrates added by impulsing the spine during Three Point Bending Traction for Scoliotic Curvatures Using the New 3-D showing. considerable her exercise movements; thus turning improvement the exercise into the adjustment. in the scoliosis A remarkable reduction of Denneroll Traction System: A Case Report After 5 weeks and 13 sessions, we curvature. the PA Thoracic scoliotic x-ray, reported results were not very is not becoming overly painful height did not decrease the effects can see the corrective improvements accurate. More than a century later, from the increased frequency of of the ScoliRoll under the thoracic in the patient’s spine. The patient’s curve was identified from 41 CBP® researchers and clinicians have treatment. spine. This is obviously achievable symptoms have been reduced 90%. degrees down to 28 degrees found agreement with Bradford and • Traction duration should be Thus, she is symptomatically doing Brackett that exercises should be 20-30 minutes. The patient very well and began improving after on the post (a 13° net im- combined with short duration, high- starts with 2-3 minutes and over her 1st session and has reported no provement). force mechanical traction in order to consecutive sessions progresses symptoms at all for the last 3 weeks. obtain the most effective results in in time. From these in-traction x-rays scoliosis reduction. we can accurately assess that • 5 weeks-Follow up Radiography CASE REPORT A one month follow up radio- CBP’s Mirror Image® Traction for The current patient had a his- the block under the pelvis is graphs of the thoracic and lumbar Deed E. Harrison, DC Scoliosis tory of thoracic pain and had been best for the patient’s spine. spines were obtained to identify ing the 3-point bending traction President CBP Seminars, Inc. The traction employed by the under chiropractic care for many if the recommended and applied employed using the 3-D Denneroll Vice President CBP Non-Profit, Inc. CBP® practitioner for scoliosis man- years which she indicated gave her treatment was having the desired Traction Table. The patient is con- Chair PCCRP Guidelines agement requires critical reason- temporary relief. Now at 13 yrs effect. Obviously scoliosis of this tinuing care and perhaps a future Editor—AJCC ing and a thorough understanding old, her pain and frequency have magnitude might require more article will address her response. of the displacements of the spine worsened over the last 4 months to due to the downward pressure of frequent and increased numbers of and posture. Generally speaking a stage where she was experiencing the two straps pulling on the thora- sessions. However, only a follow Figure 2. Shown on the left is the three-point Stress radiography setup on the denneroll table. Note REFERENCES 1.Bradford EH, Brackett EG. Treatment of lateral that the scoli-roll denneroll orthotic is placed just below the patients apex of the thoracic scoliosis. this traction is of the 3-point- daily headaches and thoracic pain co-lumbar spine and upper thoracic up radiograph can truly determine curvature by mean of pressure correction. 1893 bending type of load application rated as severe on a numerical rat- region. The specific effects of using what extent more care or different On the right is the actual stress x-ray. AJCC or a transverse load applied at the ing scale (7-8 / 10). the block system to raise the pelvis care is required. apex of the curve with and without is really evident when you look at CLASSIFIED AD lateral bending, axial rotation, or Initial Radiography the stress x-ray in figure 3. other movements depending on 1. Primary Right Thoracic curve = From these in-traction x-rays we LIVE IN the specific case. The traction set- 43 degrees (see Figure 1). can accurately assess that the block PARADISE up must always be performed in a 2. Secondary Left Lumbar Curve = under the pelvis is best for the After 5 weeks and 13 ses- PRACTICE pre-determined optimum sequence 28 degrees (see Figure 1). patient’s spine. It also shows how x- sions, we can see the correc- Adrian Dennewald, DC of movements using stress x-rays to rays are essential in establishing the President / CEO Denneroll Industries guide the decision making process. 1st in traction x-ray using the best possible traction position. tive improvements in the Do you want to ENJOY YOUR LIFE Private Practice of Chiropractic Sydney, Mirror Image® traction sessions and Denneroll Table and the Scoli-Roll patient’s spine. outside of your practice in a recreational Australia duration should be a minimum of: Fulcrum System CHIROPRACTIC INTERVENTIONS Figure 3. Shown on the left is the three-point Stress radiography setup on the denneroll table with paradise? Join the largest, nicest and most modern diversified/CBP/rehab INTRODUCTION The first in-traction x-ray showed Due to the positive findings of 2 blocks placed under the right side of the pelvis to create thoraco-lumbar translation. Note the im- provement in the appearance of the lumbar curve while simultaneously decreasing the thoracic curve. practice in Port Angeles, WA. The In a study from 1893 regarding that the thoracic spine was well the stress radiographs, the patient Olympic Peninsula has miles of hiking, scoliosis treatment, Bradford and effected however the lumbar spine was recommended to undergo cor- Brackett1, stated, “there is not only biking, running, kayaking, skiing, boat- was bending and under the stress in rective chiropractic care including A remarkable reduction of the ing, fishing, skiing and other outdoor nothing irrational in the method of 1 Bradford and Brackett’s the incorrect direction (see Figure Mirror Image traction on the denne- PA Thoracic scoliotic curve was activities with a million acre national treatment by forcible mechanical cor- mechanical traction 2). This showed us that we needed roll table, Mirror image adjusting, identified from 41 degrees down to park in your back yard. Live in paradise rection when feasible, but it is manifest to raise the lumbar spine off the and Mirror Image Exercises. She was 28 degrees on the post (a 13° net but easily access Seattle or charming that when shortened ligaments in spinal protocol required patients table to help stretch the lumbar seen for 3 x week for 1-month (with improvement). Similarly, the PA Victoria. All aspects of the office are up curvatures are situated so that they to undergo traction for a spine correctly. a couple of interruptions) and was Lumbar curvature demonstrated to date including digital x-ray, full EMR, serve as a check to muscular action.”1 décor, written compliance plan. Office is half-hour daily. advised on doing home exercises on improvement. See Figure 5. They continue, “when they [ligaments] 2nd in traction x-ray the days she was not being treated poised for strong growth and will take are strong enough to withstand muscular In response to the first in-trac- in the office. SUMMARY off once the new doctor implements a full marketing plan and expanded hours. action, gymnastics [exercises] alone are tion x-ray, we decided to raise the This case presents the initial suc- 1 Owner doctor is retiring and health inadequate as a system of correction.” pelvis to a level of +2 (two blocks • Mirror Image® Exercises and cessful reduction of a primary tho- 1 issues prompt sale; favorable terms, Bradford and Brackett’s mechani- • At least 3-5 times per week. If the under the right hip to address the Adjustments racic scoliosis in an adolescent fe- ® including owner fiancing. Contact: cal traction protocol required pa- patient will traction more than concerns of the lumbar spine trans- We believe that both postural male with a history of chronic pain. Figure 4. On the left is the Mirror Image Postural based exercises the patient was tients to undergo traction for a instructed to before. Note that the movement is actively performed in the upright [email protected] or Profes- 1 time per day this would be lation. You will see in the 2nd in- based exercises and adjustments are After 5 weeks and 13 sessions, we sional Practice Specialists 800-645-7590 half-hour daily. Because this study posture and is nearly identical to the traction setup used on the denneroll table. On beneficial as long as the patient traction x-ray that raising the pelvis can see the corrective improvements ® http://www.practicesales.com. See Traction System on page 21 the right is the Mirror Image adjustment used. was done prior to the invention of in the patient’s spine. The patient’s 20 January 2013 American Journal of Clinical Chiropractic American Journal of Clinical Chiropractic January 2013 21 Doctor Spotlight Jan 13

Kinesiology Tape for Postural Control

or movement awareness. By stimulating Myers in his ground-breaking book, large skin mechanoreceptors, kinesiology “Anatomy Trains”2. He offers a tem- Recent research indicates tape can also downgrade painful stimuli plate to assess, treat, and manage from the nociceptors, which decreases body-wide motor dysfunction based that kinesiology tape has a pain perception. on myofascial meridians, and move- greater stimulatory effect Early and persistent reasoning sug- ment impairment. with compromised tissue gested that using the tape in an “ori- Physical Therapy professor, Heather gin to insertion”, or “muscle action” Murray, makes a strong case for the use (due to injury or fatigue due methodology, best serves to support/ of elastic therapeutic tape in those who to poor posture). Leslie Trotter BSc, DC, MBA, MSc stimulate external body areas. While maintain abnormal postures of the Dr. Leslie Trotter co-owns a sports this approach probably makes the most head and neck (i.e. in the work place). medicine clinic in Ancaster, Ontario, intuitive sense to medical practitio- Her team conducted a pilot study3, and is Canadian contact for RockTape ners as it follows anatomical “rules of which seemed to suggest that taping brand kinesiology tape. engagement”, emergent theories, which for scapular protraction could maintain (using Oswestry Low Back Disability INTRODUCTION consider entire postural muscle groups, better posture and decrease perception Index and Neck Disability Index) and As chiropractors, sometimes our are making a strong case. of pain. functional performance (using neck efforts become frustrating if our careful and low back range of motion scores) attention to adjusting, stretching and with the use of kinesiology tape during strengthening, is undermined by pa- surgery. This may have far-reaching tients resuming the same postural flaws implications for other jobs/activities that landed them in our offices in the where sustained positions result in first place. How exciting would it be to musculoskeletal pain. have a sticky, stretchy little assistant that Let’s look at a common complaint reminded our patients for 2-5 days about where chiropractors can utilize elastic positional awareness? Enter elastic thera- therapeutic tape to enhance postural peutic tape! control (awareness). Kinesiology tape is By now, the vast majority of practitio- commonly used in chiropractic offices ners have had some exposure to elastic to enhance scapular retraction, alleviat- therapeutic tape or “kinesiology-tape”, ing upper extremity discomfort caused the commonly used brand name of by internally rotating shoulders (espe- developer Kenzo Kase. Tape companies cially when the scapula is in a pro- claim it “reduces muscle soreness, im- tracted position). The tape, according proves function, decreases bruising, and Dr. Steven Capobianco, chiroprac- Recent research indicates that kine- to Dr. Capobianco’s model, is applied decreases pain” and to some extent, these tor and developer of the Fascial Move- siology tape has a greater stimulatory in a functional manner to augment its claims appear to be accurate. ment Taping (FMT) method argues, effect with compromised tissue (due to therapeutic effect. Begin by addressing Anything that touches our body’s kinesiology taping should be “based on injury or fatigue due to poor posture). the neuro-myo-skeletal dysfunction 4 biggest organ, the skin, has a cutaneous the obvious yet largely overlooked concept Thedon, et al conducted a study to associated with the protracted shoul- mechanoreceptor effect that stimulates of muscles acting as a chain… the body’s evaluate body sway in individuals with der girdle (manipulation, myofascial receptors to enhance body kinesthesia integration of movement via multi-muscle and without tape. They found that the release, movement re-patterning, etc.). contractions as a means of connecting tape showed very little change in the Once the patient is able to appreciate an the brain to the body’s uninterrupted uncompromised condition, but when appropriate retracted/depressed scapula, fascial web in order to enhance rehab and the subjects were fatigued, the tape apply the kinesiology tape (see inset) in athletic performance via cutaneous (skin) provided an added stimulatory effect a manner to, appropriately, stimulate the stimulation. By taping movement rather to the skin helping to compensate for How exciting would it be to local receptors once the intended posi- than muscles, FMT has demonstrated the loss of information fed to the brain tion is lost. have a sticky, stretchy little greater improvement in both patient care from the muscles and joints. For the Step 1: Manually mobilize/manipulate and sport performance.” pain and performance community, this assistant that reminded our the thoracic spine and shoulder girdle Dr. Capobianco is not alone in study provides insight into an “auxil- and associated myofascial chains patients for 2-5 days about this line of thinking. Leading fascia iary” system, such as the skin, to aug- Step 2: Place patient/athlete into appro- positional awareness? researcher, Robert Schleip PhD, under- ment treatment and training outcomes. priate postural position that centrates the 5 scores movement and its role in pain A 2012 study of 32 surgeons, scapula-thoracic segment. and dysfunction1. Additional support showed a statistically significant for this model comes from Thomas reduction in neck and low back pain See Kinesiology Tape on page 25

22 January 2013 American Journal of Clinical Chiropractic Reverse Casuality–cont’d from page 3 believe that compensation after are more likely to pursue compensation. a worse recovery than non-claimants; Kinesiology Tape–cont’d from page 22 Why & How–cont’d from page 14 present conflicting conclusions.” The whiplash injury does more harm Unless the latter possibility is considered, however, when reverse causality bias is Step 3: Tape the local area (see X pat- sustaining practice growth without contention that “compensation is than good. There is a view that injury decisions to reduce compensation benefits addressed, claiming compensation appears tern and H pattern) with “NO” stretch to investing consistently into both areas. ‘bad for health’, should be viewed compensation leads to worse health, may inadvertently disadvantage those to have a beneficial effect on recovery.” stimulate local receptors The best scenario is to have a good mix with caution.” called the “compensation hypothesis.” who are in most need of assistance, Reverse Causality must be Step 4: Corrective exercises that will help of both. With a good amount of how This view that compensation is which would be an undesirable (and evaluated to “avert biased policy and with postural re-education. and why, a practice can have steady, In June 2012, Natalie Spearing harmful has been used as an argument unintended) policy consequence.” judicial decisions that might inadvertently sustainable growth. and colleagues published another for reductions to compensation disadvantage people with compensable Questions for you to answer after on-topic study in the journal Pain, benefits, to influence judicial injuries.” And “Once reverse causality reading this should include: Where do your tendencies fall? Where do you need titled2: Does injury compensation decisions, and to advise people that bias is addressed, people who claim to be courageous, and where do you lead to worse health after whiplash? compensation payments will impede compensation appear to experience a Kinesiology tape breathes their recovery. After their review of the Of the 503 subjects who better recovery from neck pain at 24 need to step into fear? AJCC In this article, Spearing and colleagues well and flexes like a second introduce the concept of Reverse literature, these authors state: agreed to participate in the months compared with non-claimants.” “There is no clear evidence to “The results of this study suggest skin, unlike most braces Learn to talk–cont’d from page 11 Causality Bias in the evaluation of the study, 80% developed neck relationship between compensation support the idea that compensation and that compensation claiming may not that act more like abrasive Over 80% of people DON’T write goals. its related processes lead to worse health.” pain within 7 days of collision be disadvantageous to injured parties and health outcome. They note that exoskeletons. Without a vision of what they want Reverse Causality Bias occurs when Claiming “lawyer involvement leads to (early whiplash). after all and that it may even have they will not have the emotional com- the results of a study are interpreted worse pain,” could also be interpreted a beneficial effect,” because access to mitment or a clear destination to move to mean that whiplash-injured as “worse pain increases the likelihood of financial assistance and/or treatment may toward. For this reason we have patients people who hire lawyers to obtain lawyer involvement.” “indeed relieve pain and suffering. This write 20-30 year health/life goals. We “It is important to ascertain is, after all, one of the motivations for “coach” them to see the life they desire compensation have worse health SUMMARY whether statistically significant negative In November 2012, Natalie compensating people who have sustained with GREAT emotional attachment and recovery outcomes; when in fact it Clearly the use of kinesiology tape associations between compensation- Spearing and colleagues extended an insult to their health.” they also see they can’t live that life if may actually mean that whiplash- is popular (millions of users) and the related factors and health do indeed their research on these topics with “This study serves as a reminder they allow their subuxated spine and injured people with greater injuries, applications are broad (from athletic posture to remain and progress. NOW indicate that exposure to these factors a study published in the Journal of the dangers of drawing causal more pain and more disability are the injuries to edema). Specific evidence for your program becomes the vehicle to leads to worse health, or whether they of Clinical Epidemiology, titled3: interpretations from statistical ones who seek lawyers to help them efficacy is scant but growing, and plau- get what THEY want. This is one of the simply reflect the likelihood that people Research on injury compensation associations when the causal framework obtain the benefits they need. sible. There are currently no reported many reasons Elite Coaching clients The authors note that many in comparatively worse health (eg, pain) and health outcomes: Ignoring the is ambiguous. It establishes, empirically, dangers associated with using this elastic receive greater value for spinal correc- problem of reverse causality led to a that reverse causality must be addressed cotton mesh bandage, and the only tive care. We teach you how to TRULY biased conclusion in studies on compensation-related factors Prices are subject to change. significant contraindication is on open “coach” your patients. P.O. Box 397 This study highlights the and health outcomes.” wounds. Kinesiology tape breathes well Auburn, WA 98071-0397 serious consequences of ignoring and flexes like a second skin, unlike 5. Prove your correction: (253) 735-5139 or 1-800-525-6634 Reverse Causality Bias in studies on SUMMARY Show them a post rehab, corrected www.harrisonchirosupply.com most braces that act more like abrasive e-mail: [email protected] compensation-related factors and These authors reject the exoskeletons. It withstands sweat and/ x-ray of their spine. This is physical proof health outcomes. These authors hypothesis that the decision to or water and is by most comparisons a that builds trust, faith and confidence THORACIC ARCH TA-2 that proves your result without words. Use to treat hyperkyphosis. Firm foam. evaluated Reverse Causality using a claim compensation negatively cost-effective treatment modality. While Use in the office and send home with the patient. sophisticated mathematical assessment affects recovery. In contrast, they science is unlikely to discover that kine- Their check for your program relates to Firm Foam. Lie on back over the arch trust. When you follow ALL these steps TA-1 Size: 21” L x 16” W x 4” H $28.00 each of compensation claims associated show that people with worse health siology tape is the panacea for all aches, and finish with a post rehab x-ray they TA-2 Size: 22” L x 16” W x 6” H $37.00 each TA-4 with recovery from neck pain tend to claim compensation. injuries and postural distortions, medical lose the ability to object. Firm Foam. Lie on back over the arch. Let shoulders drop (whiplash) after rear-end collisions. Policies that restrict access to practitioners should keep this tool in the TA-3 Size: 21” L x 10” W x 4” H $23.00 each Of the 503 subjects who agreed compensation benefits or legal advice chest due to its vast possibilities in treat- TA-4 Size: 22” L x 10” W x 6” H $32.00 each These steps are in a very specific or- ing patient complaints and as a tool for L-3 to participate in the study, 80% may inadvertently disadvantage der with intention based on how people LUMBAR-SPINE EXPANDER FIRM FOAM L-1 postural re-education. L-1 Size: 18” L x 9” W x 6.5” H $24.00 developed neck pain within 7 days of people who need financial or legal act emotionally and make decisions. L-2 Size: 12” L x 12” W x 4” H $16.50 collision (early whiplash). Sixty-five assistance. In addition, many injured Follow these steps and you will have the L-3 Size: 12” L x 12” W x 5” H $22.50 percent of those with early whiplash people feel compelled to seek legal REFERENCES opportunity to help and serve MORE 1.Schleip R, Muller D. Training principles for SMALL CERVICAL FULCRUM symptoms became claimants, while counsel because it is their belief that fascial connective tissues: Scientific foundation and patients in 2013 than EVER BEFORE! At- F-7 Size: 13.5” L x 5.75” W x 4” H F-8 suggested practival applications. J Body Move Ther tend the Elite Coaching ROF Boot Camps Flat apex on top is 1” F-7 35% of those with early whiplash their insurance company is treating 2012;1-13. Firm Foam. $7.00 each and create the MOST FULFILLING prac- symptoms were non-claimants. Neck them unfairly, hindering them from 2.Myers, T.W. 2009. Anatomy Trains: Myofascial MEDIUM CERVICAL FULCRUM pain at 24 months was selected as the obtaining the treatment they need Meridans for Manual and Movement Therapists. tice of your life! Call Dr. Fred DiDomeni- F-8 Size: 13.5” L x 5.75” W x 6” H F-7 in use New York: Churchill-Livingston. co for more information, 253-851-8353. Firm Foam $8.00 each primary health outcome. Neck pain to recover. . 3.Heather M. Murray, Effects of Kinesio Taping AJCC severity was measured using the visual on Posture and Presence of Upper Extremity Pain TRACTION / EXERCISE BLOCK B-11 B-11 10” L x 6” W x 6” H, curve cut 2.5” deep. analogue scale (VAS) score (0–100). REFERENCES (http://www.theratape.com/education-center/ 1.Spearing NM, Connelly LB; Is compensation Firm Foam. $8.00 each These authors state: “Although wp-content/uploads/2012/11/Kinesio-Study-Upper- B-11 in use “bad for health”? A systematic meta-review; Injury; Extremity-Pain.pdf). PILLOWS FOAM CERVICAL / LUMBAR PILLOWS it is commonly believed that claiming January 2011; Vol. 42; No. 1; pp. 15-24. 4.Thedon T, et al. Degraded postural performance May be used to support the neck or low back while lying down. Also excellent for support of low back while 2.Spearing NM, Connelly LB, Gargett S, Sterling after muscle fatigue compensated by skin stimula- sitting. Sometimes used under neck while tractioning and for patients to clasp in front during anterior thoracic compensation leads to worse recovery, it is M; Does injury compensation lead to worse health adjustments. COVERS: removable, washable cotton/polyester fabric. Choose dark blue or gray. tion. Gait Posture, 2011 Apr;33(4) 686–9. also possible that poor recovery may lead after whiplash? A systematic review; Pain; June 5.Karatas N, Bicici S, Baltaci G, Caner H. The effects 12” LONG X 4” DIAMETER 2012; Vol.153; No. 6; pp.1274-82. P-1 Soft Density $9.00 P-1FOAM (no cover) $5.00 to compensation claims—a point that is of kinesiotape application on functional perfor- 3.Spearing NM, Connelly LB, Nghiem HS, P-2 Medium Density $9.00 P-2FOAM (no cover) $5.00 seldom considered and never addressed mance in surgeons who have musculo-skeletal pain P-3 Firm Density $9.00 P-3FOAM (no cover) $5.00 Pobereskin L; Journal of Clinical Epidemiology; after performing surgery. Turk Neurosurg 22(1):83- empirically.” And “When reverse causality November 2012; Vol. 65; No. 11; pp. 1219-1226. 9, 2012. AJCC 12” LONG X 3” DIAMETER AJCC P-4 Firm Density $9.00 P-4FOAM (no cover) $5.00 is ignored, claimants appear to have

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4805 DVD SemSer10.indd 1 1-800-346-5146 | www.idealspine.biz Patent Pending –Cervical Denneroll: Canadian Application No. 2560639, US Application No. 12/468547 Order at www.idealspine.com2/1/12 or 3:37 PM call 1-800-346-5146 toll free 4805 DVD SemSer8.indd 1 As you know, the thoracic segment of the spine should have a natural, ideal shape, or kyphosis, to its curvature. Correcting thoracic But, thanks to lifting injuries, falls, poor posture, poor ergonomics, and other abuse, abnormal kyphosis is altogether kyphosis is a stretch. too common. Compression. Extension. Push. Pull. Which causes pain and suffering, along with added risk of To reduce thoracic It often takes the action and reaction of nerve, ligament, and muscle damage, loss of function, and the opposite forces to correct abnormal cur- The Thoracic Denneroll potential of more serious back injury and poorer health. vature of the spine. And that’s just what you get with The Denneroll Compression The Thoracic Denneroll, developed by chiropractors and kyphosis and Extension cervical system device. provides it. endorsed by Chiropractic BioPhysics®, provides a gentle but effective stretch that assists in the correction of abnormal Designed by chiropractors and endorsed by Chiropractic thoracic kyphosis. And that means relief from pain, improved anterior head posture BioPhysics®, the system’s support base and Thoracic Denne- posture, reduced risk of further injury, and improved health. roll provides effective stretch, or extension, of the cervical and thoracic spine, while an adjustable, non-slip compression When indicated in certain cases, the new Thoracic Support while increasing band simultaneously corrects anterior head translation. Block enhances the effectiveness of treatment. Its unique design helps reduce posterior The system is designed and contoured for precise placement thoracic cage translation in TIC BI cervical lordosis and for effective treatment while providing maximum comfort combination with increased AC OP for the patient. Reduced pain, increased function, improved PR HY thoracic kyphosis. O S posture, and a lower risk of serious IR IC H S injury all result from the proper Put Denneroll to work for C anterior thoracic IC B push-and-pull the Denneroll ACT IOP your patients—with cervi- PR HY A Compression Extension O S cal, thoracic, and lumbar T R I P System provides. I C P C H S devices available, you can cage translation, C R U improve the spine from top O D Put Denneroll to work ThorA cic Kyphosis O A to bottom. VE R for your patients—with D P P T cervical, thoracic, and AbnormAl (red line) Normal (Green line) increAsed (red line) some must push and P C lumbar devices available, R U O D you can improve the spine VE RO 1-800-346-5146 | www.idealspine.biz some must pull. from top to bottom. D P Patent Pending –Thoracic Denneroll: Canadian Application No. 137759, US Application No. 29/377,954

1-800-346-5146 | www.idealspine.biz Patent Pending –Thoracic Denneroll Component: Canadian Application No. 137759, US Application No. 29/377,954

Increased Thoracic Kyphosis Stress X-ray On Denneroll As every CBP®-trained chiropractor knows, the more your patients know about our unique treatment methods and the resulting improve- ment in health, the better. Unfortunately, in the hustle and bustle of a Everything you want your busy practice, repeatedly explaining the basics to patient after patient can be impossible. That’s where CBP’s new Patient Education Program can help. patients to know about We’ve developed a series of informational brochures to provide a basic understanding of the relationship of the spine and musculoskeletal ® system to health, how chiropractic can help, and how CBP’s proven Chiropractic BioPhysics methods offer superior results. With this understanding, your discussions with patients will be more productive and beneficial, leading to improved communication and but you don’t have time understanding, resulting in more effective and efficient treatment. Currently available are four brochures on: “Better Back”, “Proper Posture”, “Spinal Remodeling”, and “Techniques of Chiropractic Bio- Physics” (mirror image® adjusting, exercise, and maintenance care). From lifting injuries to poor posture, to explain. They’ll look good in your office. They’ll make your patients feel falls to awful ergonomics, abnormal important. And they’ll make your education efforts more productive. So No matter what lordosis affects a lot of people. And that don’t wait—order a supply of CBP Patient Education materials today. means pain, muscle tension, and more pain. In the end, abnormal lordosis has makes lumbar lordosis been linked to a reduced quality of life 1-800-346-5146 | www.idealspine.com or visit and poor health. “Patient Education” at www.idealspine.biz CBP—The Science of Spinal Health abnormal, Denneroll With Chiropractic BioPhysics® techniques and the Lumbar Denneroll, you can provide relief and improve health for back- pain patients. S ® IC B CHIROPRACTIC BIOPHYSIC can help get it back Designed by chiropractors and ACT IOP PR HY C H I R O P R A C T I C B I O P H Y S I C endorsed by CBP®, The Lum- O S S ® IR IC bar Denneroll provides a H S C to normal. gentle, but effective, stretch A Better Back: to coax the lumbar spine A Improve Your Health With an Aligned Spine. Proper Posture: P T Fending off gravity for better health. R A I back to its ideal curvature, or C - T N P P E U B D lordosis. Which relieves pain C R - T R A I P N D C D O I B E O T and reduces the risk of nerve, D V O C C C T A E R O R ® D P R O OP D ligament, and muscle damage. S F CHIR O C C I T C H I R O P R A C T I C B I O P H Y S I C O T R AC OF PR In certain cases, the Thoracic Support Block System makes CHIRO CHIROPRACTIC BIOPHYSIC spinal treatment more effective. Contoured to allow the scapula S ® Techniques of Chiropractic BioPhysics: and shoulder region to roll back into slight retraction and exter- nal rotation, the device reduces posterior thoracic cage transla- A Better Approach to Chiropractic ® Remodeling Techniques 1 2 3 4 5 tion at the same time the Lumbar Denneroll improves lordosis. CBP R A I N Restoring health by- TrestoringE alignment. D - T R A P P I Put Denneroll to work for your patients—with cervical, thorac- B N AbnormAl lUmbAr lordosis cUrves (red line) normAl lUmbAr lordosis cUrves (Green line) B C E

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ic, and lumbar devices available, you can improve the spine D T D C O O A C C R T T P O C from top to bottom. OR O R I Upper LUMBAr OF HIR T Lower LUMBAr MiDDLe LUMBAr C OF AC CHIROPR 1-800-346-5146 | www.idealspine.biz Patent Pending –Lumbar Denneroll: Canadian Application No. 137758, US Application No. 29/377,956

Before Lumber Denneroll treatment After Lumber Denneroll treatment