Introduction to the Dynamic Chiropractic Paradigm
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Chapter 1: INTRODUCTION TO THE DYNAMIC CHIROPRACTIC PARADIGM
Overview of the Dynamic Chiropractic Approach
This chapter presents an overview of the background and basic concepts of Dynamic Chiropractic. The normal motions of spinal and related articulations, general considerations of spinal fixations, the different types of fixations, the significant physiologic mechanisms associated, a comparison of traditional and modern definitions of the vertebral subluxation complex, and other basic concepts are summarized.
In 1936, a small group of Belgium chiropractors began what was to be a long research project. Its aim was to study what chiropractors refer to as a subluxation, which is traditionally defined as an incomplete dislocation, a displacement in which the articular surfaces have not lost contact, or a partially reduced (spontaneously) dislocation.
Outstanding within the Belgium group were Drs. H. Gillet and M. Liekens. These investigators, who have been involved in this study for more than half a century, soon found that the clinical phenomenon of subluxation was a great deal more complicated than the effects of the oversimplified picture of “a bone out of place” that has been commonly proposed since the turn of the century. Their findings reported in the Belgium Research Notes are a testimony to their skillful observations. Although the theory of “a displaced vertebra” contained enough truth within it to constitute a basic therapeutic approach that could be justified by large numbers of positive benefits witnessed empirically, it was not sufficient to serve as a scientific hypothesis.
This investigative group did not have the advantage of any but personal funding and their own office facilities, it was decided to concentrate their studies on the normal and abnormal mobility of articular segments, especially those of the vertebral column and pelvis. As the findings of their investigations were reported, some basic assumptions of the profession were confirmed and others had to be discarded in light of the new knowledge obtained. For example, it was found that two basic concepts withstood the assault of the knowledge obtained year after year. These concepts involved vertebral position and motion:
It was determined that a subluxated vertebra has not “slipped out of place.” It is not displaced from its physiologic boundary, nor has it exceeded its normal limits of motion. Thus, when a “subluxation” is adjusted, it is not really replaced, relocated, or reduced in the same context as would be a complete or partial dislocation for it is usually “freed” to function normally (made mobile).
1. Facts of Position.
2. Facts of Movements. Vertebral movements describe an arc around a center of motion, from one extreme to the other. It was found that the basic move- ments of spinal segments are rotation about the longitudinal axis, lateral flexion (side bending, tipping) toward the right or left, posterior-anterior flexion, anterior-posterior extension, and long-axis distention. Factors may arise that can inhibit movement within any one or more of these directions, setting up a state of abnormal biomechanical translation and rotation leading to biomechanical and subsequent physiologic dysfunction.
Introduction to Fixation Terminology
The design of the spinal column’s bony processes and its ligaments tend to stop the zygapophyses from exceeding their inherent range of motion. When this range is exceeded (eg, severe trauma, predisposing gross pathology), the articular surfaces lose contact and are in a state of dislocation.
Bones Do Not Subluxate
A single vertebra cannot become subluxated or fixated. Only an articulation can subluxate or become fixated. As fixation-subluxations occur between two normally articulating surfaces, we speak about adjusting or mobilizing vertebral motion units (two apposing vertebral segments), not a single vertebra. Thus, articulations subluxate, not bones.
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