Has and intersting point that the AOMSI is not part of the VSC/Subluxation if I am understanding him correctly. I agree that it is usually not a hypomobility—but we are Chiropractors have to be able to treat both—hypo and hyper. We also have to improve our understanding that we are doing so everyday.

Our Guidelines geared specifially to the VSC have listed the hyper in with the VSC that we treat everyday—here is the citing:

Here is what the CCP Guidelines State on Page 14 of the 2008 version pulished in the National Guideline Clearinghouse http://www.ngc.gov:

The American Medical Association, in its Guides to the Evaluation of Permanent
Impairment, lists the following as acceptable means to rate impairment: 82
• Impairment due to loss of muscle power and motor function,
• impairment due to abnormal motion of the spine,
• impairment due to loss of motion segment integrity,
• impairment due to disc problems,
• impairment due to pain or sensory deficit, and segmental
instability.
The above are, in fact, components of the Vertebral Subluxation Complex.83, 84

http://www.ccp-guidelines.org/guideline-2008.pdf

We also have to look to some of our most repected educators in chiropractic as far as treatment of this aspect of the VSC goes:

This is from wwww.thechiropracticimpactreport.com with Dan Murphy, DC, DABCO:

On July 29, 2010, Malik Slosberg, Dc, MS, published a review article titled (14):

How Spinal Manipulation Activates Segmental

Stabilization of the Spine

Dr. Slosberg is a full professor at Life Chiropractic College West in Hayward, California. In this article, Dr. Slosberg documents the following model of how chiropractic adjusting can improve segmental spinal instability:

Tissue injury and pain results in reflex inhibition and progressive atrophy of the segmental multifidus muscle.

The chiropractic adjustment rapidly stretches ligaments, joint capsules and intervertebral discs, stimulating stretch receptors, and initiating a ligamentomuscular reflex, which activates the segmental multifidus to stabilize and protect passive ligamentous restraints from injury.

The segmental multifidus that has been reflexly inhibited and atrophying is stimulated to contract.

This may reverse the reflex inhibition, progressive atrophy, and delayed muscle response in the segmental multifidus, and restore contractility and improve dynamic joint function.

The key concept from Dr. Slosberg is that chiropractic spinal adjusting can improve spinal segmental instability as a consequence of activating the multifidus muscle.

Dr. Slosberg is one of our most sound educators today. I am particularly grateful that he has taken on a misunderstanding (we do not treat instabilities/hypermobilities)that has plagued our profession for far to long. It never has withstands and clinical or intelectual challenges—-yet it has persisted for a long time.

We do however have to be sound in our ART, SCIENCE and APPLICATION of our procedures and those that think they cannot—should not until they have certainty otherwise. I think we can all agree on that.

Agreement provides alignment and alignment provides function and it is fortunate for all that we have a forum such a Chiropractic Resources to build alignment–through this type of interaction.

Most observant!

There’s a recent posting in the Radiology section, titled: “Accurate Prognosis in Personal-Injury Cases Using George’s Line” that discusses in detail HOW to measure that instability (hypermobility) in flexion and extension films.

The “spinal subluxations” referred to are due to damage which compromises the motion segment (and is, at minimum, a yellow flag for manipulation/adjusting of the compromised segment.)