The Death of Various Theories of How to Improve or
Effectively Change Spinal Configuration to Improve Health
About Chiropractic and Effectiveness
By Dr. Jesse Jutkowitz
Engineers have it a bit different in this world than do doctors. If a doctor works on ten patients and only four are better, the docs keep doing the same things saying it was some variation in living things that caused the other six not to respond and people are satisfied. If an engineer builds ten bridges, ten cars, or ten anything and only four of them work, he is quickly out of a job.
To be effective, in healthcare as in the rest of the physical sciences, one must look to actual physical results in the evaluation of theories and methods of treatment and not make excuses when the desired outcomes are not attained.
It is important to note that this is especially true when examining various theories of how the body works. Remember that experiment we were taught? The idea of the time was that meat spontaneously generated maggots. Keep in mind that the scientific method is not the magical thing some scientists have turned it into. It is just isolating factors to determine which is the causative factor. If you remember your grade school lessons Francesco Redi doubted that idea about meat spontaneously generating maggots so he put some meat in an open jar and some in a covered jar. No maggots in the covered meat though there were plenty in the uncovered meat.
Two important points: 1. Isolate the factors. 2. One example of a theory not working means it is wrong -- you cannot prove a theory by example but you can disprove a theory with one example of it not working. (Keep in mind this does not mean the effect you are theorizing about does not happen, just that it does not happen with the mechanism you proposed.)
So keep in mind the fact that one example of some theory not working is demonstration that the theory is not true as a basic fact.
Given that, to find the basics of how something works one must look at more and not less of the body. Since the 1970s, Chiro Boards of Examiners and others have been trying to lessen the ability to measure body structure changes by attempting to restrict x-ray pre and post treatment. Some of us have ignored the restrictions and continued the research.
I used sitting and standing full spine AP and lateral films to measure changes in many techniques for about 20 years despite much criticism and attacks.
The reason for standing and sitting is that a body can do a great deal of compensating with the feet, legs and pelvis when standing. When sitting you remove the ability of the body to use the feet and legs for any but minimal compensation. Thus looking at standing upright films of the spine and comparing them to sitting upright films you are seeing the mechanics of the body compensated and much less compensated. This lets you analyze the mechanics much better than just standing or just sitting because you can see what changes rather than having to guess – you would not believe how incorrect the so-called “experts” are in their guesses of what changes sitting to standing. Try a few – even sectionals.
Do not do this now but later you can view standing and sitting film here.
With the observational data from those films and application of engineering analysis rather than chiropractic drivel, anatomic observations and methods that isolate what has been missing from chiropractic to make it work consistently and predictably have been discovered. I realize this is a large statement and arrogant if you do not follow along and do the mechanical analysis and discover for yourself it is true.
Here is what one doctor says about that statement:
These statements may seem far-fetched or overblown. I well remember how put off I was by hearing similar statements before I met Dr. Jutkowitz and began to learn ABC™ years ago.
Now, after having delivered ABC™ care to thousands of patients from around the world, the concepts and instructions in this manual are no longer theory to me. They are the rock solid steps needed in restoring stability and ease to the human frame. They work because they act to reverse the very steps the body took to compensate for things it could not self-correct, and in the process, twisting itself into structural instability and dysfunction. Every patient who presents in front of you, no matter the outward manifestation or severity of their symptoms, is just waiting to be set free.
With Advanced BioStructural Correction™ you now have the tools to do so consistently and predictably.
Given that, I offer here a few of the observations toward something better:
The first is that DD Palmer stated bones go out of place affecting the nerves. That means that structure is key not nerves (despite what followers-on have said). Through the years, there have been several deviations from this course due to inconsistency of results. The largest deviation from that basic truth came after mechanical research by x-ray in the 1960s and 70s by chiropractors. It did not confirm chiropractic’s bone out of place pinching a nerve theory due to faulty research methods and faulty mechanical analyses. (The main fault was not looking at the spinal column as a single synchronized working unit but taking things in sections - not looking at the entire spine as a single synchronized unit but just looking at the positions of one bone compared to the bones immediately next to it.)
To explain the failure, Dr. Homewood came along with his book/thesis, THE NEURODYNAMICS OF VERTEBRAL SUBLUXATION. Though this book is the direct source of the current band of “nerves are not working so the muscle is weak and letting the bone go out of place theories” there have been previous attempts at this theory in several disciplines of structural healing. None of the nerve-based or muscle-based theories, chiropractic, PT or other, has ever given a consistent set of results and so are suspect.
I am not knocking the generation of these theories for they are an attempt to search and find something better. However, there is something better, that works consistently and predictably, available right now.
Given that preamble I present the following anatomical observations:
Regarding displacement of a vertebra: If a vertebra displaces to the left, there are muscles in the body to pull it to the right and reposition it. (At this point, we are just considering the anatomical observations. We are not now concerned with the fact that the muscles often seem not to do so or the reasons they do not do so.)
Likewise, if a vertebra displaces to the right, there are muscles in the body to pull it to the left to reposition it.
If a vertebra displaces posterior, you have muscles in your body to pull them anterior and reposition them. – In the lumbars, you have the psoas to pull it anterior and reposition it every time you stand from sitting. In the midlumbar to midthoracic region, you have the diaphragm to pull it anterior every time you breathe. (Test this by pinching your nose shut, closing your mouth, sucking in and noticing the effect of the diaphragm on your spine.) Above that, you have various muscles to pull the cervicals and upper thoracics anterior. (Test this by putting your head half in flexion, putting a palm on your forehead and then attempt to flex against the resistance of your palm. Notice the pull of the muscles.)
You can therefore see that if a vertebra displaces anterior ----- there are no muscles that pull posterior to reposition it.
The muscles of the back are oriented vertically and horizontally. They pull inferior-superior, left-right and on all sorts of angles between those two; BUT THEY DO NOT PULL POSTERIOR. To pull posterior there would have to be a muscle that attaches from the vertebra to something stable behind the vertebra. (Just skin back there for me.)
Many would object to that observation, stating the erector spinae, longissimus, multifidus and other muscles pull posterior but they are not looking at the orientations of those muscles and their directions of pull.
People who do not exactly observe the orientations and directions of pull of the muscles are misled by what the back muscles seem to do. Those muscles pull down on the back of the vertebrae rotating them into extension. This tilts the body posterior and seems to bring the vertebrae posterior, but it does not. (see diagrams below)
Since the muscles attach to the posterior parts of the vertebrae and pull inferior-superior it seems they can pull vertebrae into extension tilting the vertebrae above backward to counter-balance any anterior slippage. However, you will note that the vertebra extended is actually pushed anterior at its inferior aspect. (see right below) There are other factors missed that make this even more of a mistake but this is the first one.
Other factors include that there is not just that one muscle. There are a SET of muscles that attach to the vertebra above as well as the vertebra below. In doing these analyses you have to take into account ALL the muscles and exactly what direction they pull or exert force.
Besides needing to know all the muscles involved and the exact angle and direction of the force of those muscle pulls, you have to take into account which vertebrae move. In this case the vertebra below the one you want to move backward is not stable. It also moves when the muscles contract. That yields a different result from what many think occurs. See below.
The arrows represent those muscles at rest here. The middle vertebra is shown to have displaced slightly forward.
The idea some have is that contraction of the muscles will pull it backward. However. since there is free motion at ALL the vertebrae. That is not what occurs as shown on x-rays.
As you can see in the diagram below with the arrows representing those muscles contracting the motion that occurs is extension of all the bones with nothing moving backward.
Keep in mind x-rays show this so it is not just an idea but a physical reality.
As you can see, because of the anatomical realities, the physiological result is not quite what some people, including doctors, expect on a quick and simple look. There are no muscles that pull vertebrae in a posterior direction.
There is no theory here.
This is a huge anatomic and physiologic fact omitted from the education of anyone doing manipulation, physical therapists, chiropractors, osteopaths and every other method of structural healthcare. It means that the twisting, tilting and malpositioning of vertebrae in directions other than anterior (which the body could self-correct but does not) is to compensate for vertebrae displaced anterior. Because the body cannot self-correct the positions of those anteriorly displaced vertebrae it must twist others to counter-balance and compensate the body.
This observation, now made, leads to a single statement that describes what practitioners need to do to correct bodies:
Correcting body structure consists of repositioning bones displaced in a direction the body cannot self-correct because it has no muscles pulling in the direction needed to bring the bone or bones back into its/their proper position(s)
This statement is much more important than one might think at first glance because it also covers the other side of that same coin.
If you move or correct the position of a bone out of place that the body can
self-correct because it does have muscles pulling in the direction
needed to correct its position you will decompensate the
body and worsen the condition for which that bone
placement was compensating.
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