Chapter 3: THE HEALTH-SERVICE ROLE OF THE DOCTOR OF CHIROPRACTIC
Chapter 3:
The Health-Service Role of the Doctor of Chiropractic


From R. C. Schafer, DC, PhD, FICC's best-selling book:

“The Chiropractic Assistant”

The following materials are provided as a service to our profession. There is no charge for individuals to copy and file these materials. However, they cannot be sold or used in any group or commercial venture without written permission from ACAPress.

Support Chiropractic Research
Help Chiro.org support Chiropractic research.
Your donation will make a difference.

We are an Amazon Associate
We make a small commission on every purchase you make
Help us support chiropractic research with your purchases.



All of Dr. Schafer's books are now available on CDs, with all proceeds being donated
to chiropractic research.   Please review the complete list of available books
.



Diagnostics: The Art of Deciding What Is Wrong
     Background
     Overview of the Diagnostic Process
Therapeutics: The Art of Correcting What Is Wrong
     Physiotherapy and Physical Therapy
     Rehabilitation: The Art of Aiding Natural Healing Processes
     Nutritional Considerations
     Autointoxication
     Food Alteration
     Physiologic Needs
     Posture and Physical Fitness
Counseling: The Art of Preventive Therapy and Enhancement

General Practice and Specialized Interests
     Pain and Preventive Care
     Common Complaints
     Resistance to Disease
     Sports Injuries
     Prenatal and Postnatal Care
     Pediatric Care
     Professional Groups
Closing Remarks


Chapter 3: The Health-Service Role of the Doctor of Chiropractic

This chapter briefly describes the role of the doctor of chiropractic in the health care of the nation. It also introduces the reader to the rationale of clinical diagnostics, therapeutics, rehabilitation, and counseling in the chiropractic approach. Some particular areas of special interest are also described.


     DIAGNOSTICS: THE ART OF DECIDING WHAT IS WRONG

The diagnostic process of a patient’s disorder begins with the recording and interpretation of the patient’s medical history. Thus, the initial interview and consultation with the patient is of utmost importance. It will direction the examinations and tests that are to follow. Every measure of observation that will substantially profile the patient is employed and recorded. A systematic and thorough physical examination is conducted using the methods, techniques, and instruments that are standard with all health professions. In addition, the doctor of chiropractic will include a postural and spinal analysis, an innovation in the field of physical diagnosis and examination.

Background

The chiropractic physician uses the standard procedures and instruments of physical and clinical diagnosis, and he is well acquainted with the need for differential diagnosis. Diagnostic radiology, especially as it pertains to the skeletal system, is a primary clinical diagnostic aid in chiropractic and has been since the early 1900s.

In addition, doctors of chiropractic are knowledgeable in the standard and special clinical laboratory procedures and tests usual to modern diagnostic science. Facilities for roentgenography (x-ray), thermography, electrocardiography (ECG or EKG), and electromyography (EMG) are standard among many other technologic advancements. Each accredited chiropractic college has a laboratory licensed to carry on clinical laboratory examinations, including such fields as cytology, chemistry, hematology, serology, bacteriology, and parasitology.

After experiencing a diagnostic evaluation from a doctor of chiropractic, many patients report that it was the most thorough examination of their lifetime. The reason for this is that the chiropractic physician views each patient as an individual who has been subjected to both unique outside and inside forces, who is interested in both correction and prevention, and who is interested in the preservation of both the quantity and the quality of life. Thoroughness is a necessity to achieve such goals.

Overview of the Diagnostic Process

Any professional therapy administered ethically, professionally, and legally must be based on the doctor’s diagnosis of the patient’s condition. That is, the diagnosis must direct the treatment. By understanding why the doctor does what he does during the diagnostic process, the CA will be in a better position to answer patient questions. Diagnosis (determining the cause of the patient’s complaint) involves the use of inductive and deductive logic. This process can be divided into two major divisions: data gathering and data interpretation (Table 3.1).


     Table 3.1. Elements of Diagnostic Logic

1.   Collect the Facts (Data Gathering)
  • Clinical history
  • Physical examination
  • Orthopedic examination
  • Neurologic examination
  • Laboratory data
  • Ancillary examinations
  • Periodic re-examination

2.   Analyze the Facts (Data Interpretation)

  • Critical evaluation of data
  • List of reliable symptoms, signs, and findings in the order of their apparent importance
  • Exclude disorders that might produce similar data
  • Select disease(s) or disorder(s) that best fit the facts at hand
  • Continually verify the current diagnosis

Once the initial collection of facts has been completed, the patient’s complaint will tend to fall into one or more of 13 general etiologic classifications:

(1) traumatic (extrinsic or intrinsic),
(2) inflammatory,
(3) neurologic,
(4) vascular,
(5) endocrine
(6) metabolic,
(7) neoplastic,
(8) degenerative,
(9) deficiency,
(10) congenital,
(11) allergic,
(12) autoimmune, or
(13) toxic.


Each of these general classes contains hundreds of specific disorders. The suspicions obtained at this point will then be either confirmed or rejected by the results of further examination and test data until the likely cause remains.

The above process is aided by determining whether the patient’s symptoms arise from physiologic, structural changes, or mental/emotional changes. This process is often called problem group analysis.

  1. Functional:   a physiologic disorder; a pathophysiologic disease process without overt structural changes. Symptoms resulting from physiologic changes arise from:


    • Increased function: eg, nerve irritation such as in hypertrophy, spastic paralysis, anxiety, tachycardia, diarrhea, pain, edema, fever, or articular instability.

    • Decreased function: eg, nerve pressure such as in atrophy, flaccid paralysis, depression, bradycardia, constipation, numbness, dehydration, hypothermia, or articular fixation.

    • Altered function: eg, nerve irritation or compression such as in convulsions, tremors, arrhythmia, various visual disturbances, paresthesiae, and aberrant articular movement.


  2. Structural:   an organic disorder, with or without signs of overt pathology. Symptoms resulting from structural changes arise from:

    (a) bone and joint infection with resultant soft-tissue reactions, subperiosteal calcification, decalcification, bone destruction, and infiltration processes;
    (b) congenital anomaly;
    (c) deformity—witnessed as abnormal changes in angularity, displacement, or loss of continuity;
    (d) degenerative process;
    (e) endocrine and metabolic imbalance;
    (f) tumor (malignant or benign); and/or
    (g) trauma.

  3. Mental/emotional:   a neurosis or psychosis; a predominantly psychosomatic or somatopsychic disturbance. Symptoms resulting from mental/emotional changes may be the result (or cause) of either a physiologic or structural lesion.

    It is often difficult to draw the line between functional and organic illness. In functional disorders, there is undoubtedly a degree of chemical and intracellular alteration preceding gross structural (organic) manifestations. In addition, nontraumatic altered structure and its gross signs and symptoms are inevitably preceded by altered function and its more subtle symptoms. A clinical sign or a symptom is never an isolated phenomenon. It has multiple interrelationships, some physiologic and some psychologic, that can be of a major or minor importance.



     THERAPEUTICS: THE ART OF CORRECTING WHAT IS WRONG

Chiropractic treatment methods are determined by the scope of practice authorized by state law. In all areas, however, these methods do not include the use of prescription drugs or major surgery, thus avoiding the dangers therein. Essentially, treatment methods include the chiropractic adjustment when indicated and, according to the doctor’s judgment, such ancillary services as necessary dietary advice, nutritional supplementation, physiotherapeutic measures, and professional counsel.

The most characteristic aspect of chiropractic practice is the release of one or more hypomobile (fixated) and possibly subluxated spinal or extraspinal articular surfaces by making a specific predetermined adjustment. The purpose of this correction and its determination is to normalize the dynamic relationships of segments within their articular range and thus associated neurologic, muscular, and vascular disturbances.

Physiotherapy and Physical Therapy

Physiotherapeutic methods and procedures are frequently used as adjunctive therapy to enhance the effects of the chiropractic adjustments. Such procedures may include the use of diathermy, galvanic current, infrared and ultraviolet light, ultrasound, paraffin baths, hot or cold compresses, acutherapy, hydrotherapy, heel or sole lifts, foot stabilizers, and other commonly used modalities. Taping, strapping, and other forms of minor surgery are sometimes used in injuries of the spine or extremities. Neck, lower back, elbow, knee and ankle injuries may require supportive collars or braces to enhance the effects of corrective treatments during recuperation to help tissue healing and strengthening.

Nutrition.   The adequate intake and assimilation of essentials nutrients is necessary to maintain health, and tissue demands increase during illness and stress. Vitamin, mineral, enzyme, and tissue (eg, protein) supplementation can, if professionally supervised, serve to prevent the onset or assuage the existence of some types of dysfunction of the nervous system and other tissues. If deemed necessary in case management, dietary regimens and nutritional supplementation are often advised.

Patient Counsel.   Rehabilitative exercises, as a physical therapy, comprise an important aspect of professional counsel to aid recovery and prevent further strain. An assistant may be asked to record in a patient’s entering data a few words that would describe the patient’s common exercise level. Descriptors are shown in Table 3.2


Advice is often given in such areas as dietary regimens, physical and mental attitudes affecting health, personal hygiene, occupational safety, life-style, posture, rest, work, and the many other activities of daily living that would enhance the effects of chiropractic health care. Chiropractic is truly concerned with the total individual: the patient’s health, welfare, and survival.


     Table 3.2. Descriptors in Recording a Patient’s Exercise Level

Light   Light means light office work, auto driving, desk work, typing, slow walking, sewing, cooking, riding lawn mower, piano playing, golf with a cart, etc.

Light-moderate   Light-moderate includes the light construction trades, welding, cleaning windows, truck driving in traffic, fast walking, golfing without a cart, small boat sailing, bowling, friendly volleyball, touch football, pushing a light lawn mower, pitching horse shoes, house cleaning, etc.

Moerate-heavy   Moderate-heavy effort includes soft-soil digging, splitting wood, tennis, skating, bicycling, square and disco dancing, cross-country skiing, etc.

Heavy   Heavy effort includes activities such as digging ditches, aerobic dancing, sawing hardwood by hand, jogging, basketball, hockey, mountain climbing, weight lifting, and other activities requiring much energy.

Nutrition and counseling will be described further in the following sections of this chapter.


REHABILITATION: THE ART OF AIDING NATURAL HEALING PROCESSES

The human body is a complex, integrated organism. It has been explained how spinal disorders may cause or contribute to disease processes and/or how these processes may cause or contribute to spinal disorders. While the nervous system influences the glandular system, for example, hormones in turn have a great influence on the nervous system. A digestive disturbance may result in spinal pain, and a spinal disorder may result in digestive dysfunction. A heart condition may send shooting pain down the arm, and a spinal or rib joint disorder may mimic a heart condition. The cycles are endless. The processes are one of life and dynamic motion and reaction that, unfortunately, cannot be truly identified by static x-ray studies or even on autopsy. It can only be witnessed in life by thorough examination.

The name given to a disease process does not negate the chiropractor’s duty to correct the anatomical disrelationship and/or the neuromechanical disorders that are causing, maintaining, or associated with the disease process. Through the ages, the musculoskeletal system has been cooled, heated, massaged, stretched, cut, and injected, yet never truly considered of primary importance until the birth of chiropractic concepts.

Today this is changing as witnessed by publicity for external heart massage and the diaphragm “lift” to dislodge a food bolus. Both procedures are adaptations from chiropractic techniques developed many decades ago. Publicity surrounding the chiropractic care of various athletes enabling several world records to be broken is also a compliment to the chiropractic approach.

The concept that mechanical spinal disorders such as subluxation-fixations may cause functional abnormalities is the basis of chiropractic thought and one of its major contributions to generic medicine. Continuous research in this area must be made for this precept promises to answer many unsolved problems facing health science today.

Nutritional Considerations

Besides the correction of localized biomechanical faults, the development of good posture habits, and the necessity for regular exercise, nutrition plays an important role. Nourishing food that builds bone and muscle and maintains nerve and blood integrity is essential to good health and repair mechanisms.

      AUTOINTOXICATION

Too often in our society a well balanced diet has been replaced by manufactured sweets, snack foods, TV dinners, and other “junk” foods. While four fifths of our daily foods should consist of alkaline-forming vegetables, raw salads, and fresh fruits, most American tables display four fifths acid-forming concentrated proteins, starches, and sugars.

Autointoxication, which weakens natural resistance forces, results from an accumulation of acidic by-products of digestion, metabolism, and cell decomposition. Most pathogenic microorganisms prefer an acidic environment, and calcium will not abnormally deposit in tissues (eg, arthritis, gallstones, kidney stones) except in an acidic environment. Thus, anything that burdens the body’s alkaline reserves depletes its functional potential.

Moderate exercise helps to speed metabolism and to oxidize and eliminate excessive amounts of protein by-products. However, the products of muscle fatigue from excessive exercise are acid ash. Also, comparatively speaking, many people avoid regular exercise because we are twice as efficient mentally as we are physically. While a diet rich in fruits and vegetables would be beneficial, processing and cooking minimize its potential. The doctor is therefore confronted with adapting his advice from the ideal to the life-style the patient chooses to live.

      FOOD ALTERATION

Although all natural foods contain the nutrients necessary for their metabolism, they seldom have their original spectrum of vitamins when they reach the table. While caloric values and the quantity and quality of protein, carbohydrate, and fat are relatively unchanged, at least six vitamins can be lost or partly destroyed by steaming, frying, roasting, boiling, freezing, drying, storage, or irradiation. Industrialized food processing often results in a deficiency in vitamins and elements necessary for metabolism. Other factors are also involved. Many trace elements that were once plentiful in American soil and necessary for optimal health and resistance, have been grossly depleted by the use of commercial fertilizers. Dietary supplementation is the price we must pay for wide distribution of purified, stored, and processed foods. Without supplementation, we run the risk of unbalancing the diet in terms of essential nutrients.

While meat is the common source of protein, remember that meat is commonly ingested with an array of antibiotics, hormones, and scores of additives designed to preserve, age, cure, tenderize, color, flavor, season, and scent to satisfy the consumer’s interest and producer’s profit. Fruits and vegetables commonly purchased at the corner supermarket contain a degree of pesticide residue. Without question, many common food processing techniques and additives have a nefarious effect on our natural resistance and recuperative powers.

      PHYSIOLOGIC NEEDS

Maintaining cellular homeostasis of biochemical equilibrium by supplying proper nutrients is the purpose of nutrition and a primary basis of good health. Yet, a number of authorities claim that Americans are the most overfed and undernourished people in the world. Thus, dietary management under chiropractic care is often necessary to see that a patient’s diet provides balanced meals of proteins, carbohydrates, fats, and other nutrients necessary for proper metabolism.

The subject of nutrition is an important part of the curriculum at each accredited chiropractic college. It is unfortunate for the public that most medical schools do not list the subject in their catalogs.


Posture and Physical Fitness

Americans lag behind many countries of the world in physical fitness. Easier living caused by space-age developments have encouraged a life-style of minimal physical effort. A society of button pushers neglects its physical fitness, however. Nature is not wasteful; what is not used, degenerates. Physical fitness is no exception. Table 3.3 lists the major systemic changes associated with physical inactivity.

Since its development, the chiropractic profession has offered national and community leadership in encouraging parents and teachers to support physical fitness programs in schools. Youngsters should be encouraged by their parents to develop good fitness and health habits at an early age. Fitness is a family affair.

From birth, the biped human being enjoys an architectural opus magnum that allows for agility, leverage, mobility, and balance against gravity’s constant pull. When biomechanics are disturbed through stress and strain even slightly, distortion results because of the close interrelationship of our structural and functional systems: the body is a whole. Posture not only has a direct bearing on comfort and work efficiency, it is also a factor determining resistance to disease or disability.

The chiropractic profession is uniquely attentive to the importance of nerve integrity and body mechanics for good health. The doctor of chiropractic is most concerned with the effects of and prevention of spinal defects affecting physical fitness. He is skilled to treat health problems, and his treatment is aimed at maintaining joint integrity by correcting spinal and extraspinal mechanical defects and postural distortions.


     Table 3.3. Systemic Changes of the Inactivity Syndrome

SystemPathophysiologic Manifestations
CardiovascularDecreased cardiac reserve
Postexercise angina
Excessive adrenal reaction
Sympathicotonia
Increased BMR
Central nervous Altered sensory perception from decreased sensory input
Demoralized personality
Disturbed sleep patterns
Anxiety/depression syndrome
Impaired learning ability
Autonomic imbalance leading to poor exercise level adaptation
DigestiveAltered eating habits
Decreased GI motility
Constipation
Decreased GI secretions
ImmuneDiminished resistance
MusculoskeletalActivation of latent trigger points
Muscle mass atrophy
Fatigue (general)
Osteoporosis
Fibrositis
Reduced coordination
RespiratoryDecreased respiratory muscle strength
Dyspnea upon mild exertion
UrinaryBacteriuria Hypercalcemia
Urine retention
Urgency


The need for good posture is far more significant than an attractive appearance. To assure health our bodies must be free from structural distortions and our functions must operate at peak efficiency. Any activity in which the structure of the human frame is thrown out of normal balance can cause distortion of the spine. The spine not only supports the weight of the entire body above the pelvis, it also protects the spinal cord which connects the higher brain centers with nerves to and from the vital organs.

Too often we think of our spine as a flexible rod that moves only on the command of our will. Yet man is a dynamic creature, structurally as well as functionally. Movement never ceases. Motion is constant. With every breath the spine, ribs, and their attachments are in motion. Add this small movement to the gross movements of daily living and we can appreciate the persistent motion, constant stress, and necessity for proper alignment.

When disorders occur to the normal musculoskeletal system, we see the rise of sore backs and stiff necks, aching joints and easy fatigue, headaches and nervous tension, and scores of other complaints so common to our time. Such structural abuses and their frequently painful effects are an important area in chiropractic counsel and care for both prevention and treatment.

As early as 1930, the White House Conference on Child Health recognized the importance of spinal integrity and body mechanics in relation to health. The report showed that correct posture is essential to proper development, balance, coordination, rhythm and timing—body efficiency. Distortions not only affect comfort but also the function of major organs and systems. Thus, there is an undisputed relationship between good posture and health, and poor biomechanics and the ability to cope with a variety of diseases. Again, this shows how the body operates as a complex yet synchronized unit, how structural defects may result in functional disturbances, and how functional disorders may result in structural impairment.

To be physically fit is to bring the efficiency level of the body to a point where it can meet the demands of everyday living. This requires the building of stamina. The rewards are greater energy, greater resistance to disease and disability, and greater mental potential. People with good posture are generally more physically fit, mentally alert, and emotionally adjusted —three characteristics that lead to happier and more productive lives.

A spinal injury or mechanical defect that may occur may not have dramatic effects initially. It may occur subtly and grow worse with time. Unless trained in the health sciences, most people do not usually recognize subtle health problems. Rather, they learn to adapt and suffer in silence. As a result, many spinal defects are unknown until the problem grows more serious and pain is felt. To add to the mystery, symptoms often occur in a part of the body not ordinarily associated with the spine. For this reason, chiropractic care is attentive to the cause.

The spinal subluxation and the extraspinal mechanical lesion are yet only partially understood. Because of their observed importance in degenerative diseases and functional disorders, the chiropractic profession has sponsored and will continue to sponsor research in this area so that we may know more of the implications involved which have been demonstrated successfully with millions of patients in chiropractic offices since the turn of the century. It is unfortunate that the subluxation, and its attendant soft-tissue trauma, is one of the most commonly missed diagnoses within the healing arts. It is not only a mimic of many diseases, it also can be a causative or contributing factor in a variety of disorders.

Mechanical disorders and their functional alterations are probably the most common of man’s ills today. Yet, this is not unusual when we consider that the body’s response to gravity is a constant strain in the upright posture. Such stress must have a negative effect on the healing powers of our nature. We should be ever mindful that the musculoskeletal system comprises more than 60% of our body’s total mass, yet this 60% is often overlooked within other healing arts.



     COUNSELING:   THE ART OF PREVENTIVE THERAPY AND ENHANCEMENT

In our era of rapidly advancing technology, we have attempted to adapt to both mental and physical stresses unknown by our forefathers. While it is commonly agreed that emotional disturbances may cause structural disorders, clinical observations verify that the reverse is also true. Structural faults may lead to a low stress threshold resulting in a variety of emotional illnesses.

It was the Father of American Psychology, Professor William James of Harvard, who insisted that while emotional disturbances can cause structural and functional disorders, so can structural and functional disorders also cause emotional disturbances. Thus, the structural neurologic approach of chiropractic may often benefit associated behavioral disorders. Several chiropractic papers report excellent results in handling many types of emotional disorders such as certain forms of hyperkinesis, anxiety, and depression. A monograph titled Nervous and Mental Cases Under Chiropractic Care describes 400 cases. This paper was written by a former president of the Council on Mental Health of the American Chiropractic Association, H. S. Schwartz, DC, in collaboration with G. W. Hartman, PhD, professor of psychology at Columbia University.

Increasing evidence of the serious consideration now being given to the chiropractic somatopsychic approach to many emotional illnesses can be found in scientific literature. Several authorities have shown a distinct relation- ship between mental illness and vitamin deficiencies; others between mental illness and overconsumption of refined sugar or food additives. Still others show a definite relationship between the ingestion of lead or copper (with use of lead or copper plumbing) and zinc deficiency (with decreasing soil content). With these dietary factors removed and treatment directed to somatopsychic structural correction, a greater promise arises for the reduction of our nation’s increasing mental health problem.



     GENERAL PRACTICE AND SPECIALIZED INTERESTS

While chiropractors emphasize the importance of the correction of spinal and extraspinal mechanical lesions, no practitioner believes that these are the sole causes of disease. However, clinical chiropractic has shown repeatedly that neurologic aberrations originating from mechanical lesions are a contributing or inducing factor in many more dysfunctions than commonly realized. As has been shown, when combined with poor nutrition, pollutants, physical and emotional overstress, germs, trauma, drug-related weaknesses, poor habits and addictions, and other common debilitating factors, such mechanical lesions become an important consideration far too often overlooked.

Pain and Preventive Care

In matters of health, a warning signal matters a great deal. Pain is such a warning. As nature’s early warning signal, it is a message that tells us that our body is not functioning properly—that something serious may be wrong with our health. Pain of any kind is an alarm that nature uses to signal where there is a health problem deserving attention. It is just as foolhardy to do no more than kill the pain with a pill or injection as it would be to silence a fire alarm and fail to seek its cause. To affect proper care, the cause must be treated—not just the symptom.

      COMMON COMPLAINTS

Headaches are the most common complaint encountered in the healing arts today, and a common cause of headaches originates from a vertebral articular disorder in the spine. It is important that such mechanical lesions be recognized by a trained chiropractic physician. Unfortunately, sufferers of headaches are too often offered a generalized diagnosis such as sinus trouble, migraine, cluster headaches, and so forth. Because chiropractic care is attentive to the neurologic implications involved, headache sufferers have frequently found relief under chiropractic care where other forms of therapy have failed.

The second most common complaint is that of backache. Here again, lumbago, sacroiliac strains, and disc injuries are usually of a musculoskeletal nature having neurologic overtones. It is important that the cause be recognized and cared for before permanent damage is done. Because chiropractic care recognizes the structural/functional relationships involved, the profession has earned a respected reputation in handling cases of both acute and chronic back pain.

Remember that many pains remote from the spine originate from a spinal disorder. In the same manner, many pains that appear to be situated within the spine originate in some distant tissue. Differential diagnosis in such conditions requires a thorough holistic approach—an approach demonstrated under modern chiropractic care.

      RESISTANCE TO DISEASE

Health science would be much simpler if a single disease could be attributed to a single cause. But this is not so. We all live in an environment of potential bacterial and viral invasion, but only a small minority of us become infected. Even many of the most virulent strains of pathogenic organisms do not infect every person exposed. Bodily resistance, acquired or inherited, and many other factors combine to decide whether an invading organism will result in noticeable infection.

Human ecology and economy are complex considerations. The cause of disease is not singular, neither is the response to disease singular. Thus the logic of a health care that considers a person as a total being. Any illness affects the total person, and any disease is multicausal. The total person is affected because illness is not a thing, it is a process.

Chiropractic’s emphasis on the importance of body resistance is a contribution that has yet to realize its full potential. Every person is an individual from his fingerprints to his structure, functions, responses, adaptability, habits, and addictions. All logical theory and therapy should be directed to recognition of individual differences and supportive of one’s peculiar nature.

It is unfortunate that the health sciences traditionally have not emphasized the importance of the nature of health as it has the nature of disease. In recent years, L. J. Rather, MD, a Stanford University pathologist, reminded the International Congress of Logic, Methodology and Philosophy of Science that: “If we measure interest by activities rather than by protestations, physicians have been and are, for the most part, as little interested in health as soldiers in peace.”

Sports Injuries

Because of chiropractic’s emphasis on structural/functional relationships in health and disease processes, it is logical that there is much attention within the profession given to therapeutic kinesiology. One purpose of the ACA Council on Sports Injuries and Physical Fitness is to seek improvement in the prevention and correction of sports and recreational problems. Because of chiropractic input, counsel, and ingenuity, several contributions have been made regarding protective gear and shoes in contact sports, athletic health maintenance, and therapy and enhanced rehabilitation after injury.

While chiropractic contributions in this area have been made for many years, the public press has brought increasing attention to the profession’s unique approach. Much publicity surrounding chiropractic care with Olympic and professional athletes has been given in recent years. Football, baseball, basketball, tennis, golf, volleyball, and most other sports can be thankful for chiropractic’s advanced approach to the care of sports injuries.

Prenatal and Postnatal Care

During pregnancy, there is a natural change within the mother’s pelvic structure along with an accompanying change in weight distribution. Health disorders such as headache, backache, leg pains, and lower extremity circulation disturbances often can be attributed solely to the strain on the portions of the neuromusculoskeletal system involved. In association with regular obstetrical care, periodic chiropractic spinal analysis and adjustments throughout the course of pregnancy show excellent clinical results in either reducing or eliminating such disorders as well as easing the labor of delivery.

Spinal examination and necessary correction after delivery is a positive step toward preventing potential lower back and sacroiliac disorders that may have been initiated during pregnancy or delivery. Correction of these often minor disorders at this time may serve as a positive deterrent against possible structural/functional gynecologic problems of later years.

Pediatric Care

The strain of delivery plus the disproportionate weight of the child’s head upon yet to be fully developed neck structures may result in insults to the child’s upper cervical vertebrae, effecting a variety of dysfunctions. Chiropractors recommend a spinal examination of the child shortly after birth so that proper correction can be made if problems exist. Only a chiropractic physician has been trained to make such determinations. Clinical records show that chiropractic pediatric examination and care during the postnatal period have positive influence on reducing the possibility of colic, digestive sensitivities, allergies, and other common dysfunctions in the newborn—as well remove predisposition to common childhood diseases.

Since it is impossible to restrain a normal child from participating in the many activities that may cause stress and strain, the correction of faulty body mechanics early is important. Active children are particularly prone to spinal subluxation because they are energetic, impatient, and have an innocent disregard of caution. Spinal disorders often are the result of twists, sudden turns, awkward lifts and postural positions, and shocking body contact and jolts during play and sports. If not corrected, spinal problems may lead to interference with normal function and body mechanics contributing to severe illness.


Professional Groups

Various professional organizations are available in which a DC with a special area of interest may keep abreast with the latest research in that field. These groups are called councils, and members are encouraged to devote many hours of postgraduate study to prepare themselves, by examination, for diplomate status.

Professional councils on diagnostic imaging, orthopedics, rehabilitation, and chiropractic diagnosis and internal disorders strive to keep the field abreast with the latest scientific and technologic advancements. Councils on nutrition, neurology, technic, physiologic therapeutics, and mental health also are continually investigating efficient methods. Some objectives of the Council on Sports Injuries and Physical Fitness have been described earlier in this chapter.



     CLOSING REMARKS

Chiropractic is an exciting profession, and serving as a chiropractic assistant offers a stimulating and challenging career. This chapter has briefly described an overview of chiropractic health care. Most briefly, the profession’s implementation of diagnosis, therapy, rehabilitation, and counseling have been explained. In addition, some important aspects of general practice and specialized interests have been defined so that the reader will have a better understanding of the profession. This will serve as a foundation for further study. In the next chapter, the language of the health-care professions will be explained.

***********************************************