This article is dedicated to the thousands of students out there, who are justifiably confused. As an instructor, we travel to many different cities each year to teach the diagnostic procedures of motion palpation to students of all ages (that includes doctors in practice). More often than not, the information we present is indeed contrary to what most chiropractic schools and technique organizations teach. Recently, a friend who is still in chiropractic school called in a state of confusion over his x-ray listings and what his intern found via motion palpation.
This particular dilemma affects many students because of the huge generation gap that chiropractic teachings suffer from. Why aren't the bones-out-of-place on x-ray the same as joint dysfunction findings noted during a motion palpation exam. The answer is quite simple; one exists in real life and the other does not. X-rays at any one time tell nothing about function or how the spine works. Minor shifts in bony alignment determine nothing because the joints of the spine are still well within their normal range of motion. An atlas that appears severely rotated based on x-ray listing systems can, in fact, be compensating for other areas of joint dysfunction and performing its primary function, rotation.
There are real bony subluxations noted in the literature. Some prime examples are the atlas in Down's syndrome, the stair-step pattern seen in advanced rheumatoid arthritis and spondylolisthesis. The misalignments seen in these cases are very severe and, although chiropractic manipulation can be said to relieve the pain associated with these conditions, it has never been documented that it can reduce the subluxations present. In the Down's case, it can even be deadly to the patient if an attempt is made to reposition the atlas.
We started this article with a question, "Who should you believe?" At the Motion Palpation Institute we have endeavored to apply modern science to an old art, manipulation. Certain theories, i.e., the bone-out-of-place theory, have been disproven by modern science for many years. However, we know that chiropractic works and there must be a reasonable theory that can describe the results we see in practice. The subluxation complex as described by the Motion Palpation Institute is a compilation of theories that define chiropractic. It is not a philosophy but a scientific representation of modern data that fits the chiropractic philosophy. The literature we use at our seminars is often medical literature only because there are still very few chiropractic researchers.
Who should you believe? It becomes a choice between a scientifically-based practice and a dogma-based practice formerly called philosophically-based practice (see Webster's definition of philosophy and compare to most chiropractic philosophy). In a scientific field of endeavor such as chiropractic, you can not choose to ignore scientific evidence. When we ignore this evidence it is called dogma. This practice is common in church and is quite allowable. In the health field it lessens our abilities as doctors because it strips away our ability to think. To finally answer the question, don't believe anyone. Read and study current literature and make your own decisions. Start with any '90s test in the field of manipulation, low back pain, cervical syndromes or anatomy/physiology texts. Some examples of current authors are: Kirkaldi-Willis, Grieve, Cassidy, Bogduk, Twomey, Punjabi, White, Lewit, Magee, etc.
Terry Elder, DC
Winfield, Kansas
