Why Don’t Chiropractic Colleges Teach Standard Injury Workup?
My question is why don’t chiropractic schools in this country actually teach their students how to do a standard spinal injury evaluation? This topic may seem a little bit controversial, but it needs to be addressed.
It not just chiropractic colleges who are remiss, it is also missing in osteopathic colleges and medical colleges. But since chiropractors are the spine specialists and trauma to the spine is the number one cause of chronic pain and disability, the market needs experts in this particular area. So why in the world would the chiropractic colleges not teach standard spinal injury assessments?
Doctors of Chiropractic are not taught how to determine the severity and location of a simple ligament injury. They are not being taught about the fact that there are two ways to image a ligament injury, depending on what ligament is damaged.
If you have a disc herniation, you’re going to use obviously an MRI. But the fact is, there are 220 specialized ligaments that hold the spine together.
If you have damage to the supporting ligaments around the disc, shear force injuries, they cause excessive motion in the spine. That excessive motion of the spine is how you determine the severity and location of the actual ligament injuries.
If you have a C4/C5 motion unit and you have severe excessive 3.9 millimeters of translation back and forth movement, due to the supporting ligaments now being damaged due to the trauma. And at four and five we know that the fifth cervical nerve exits, we know that that would cause a possible motor problem. We would have possibly a deltoid muscle weakness. We would have the lateral side of the arm, either hyper or hypo sensitive. We want to check that dermatome so we know where the C5 dermatome is. If we knew what muscles are involved and we can test for the particular level.
For an examination procedure, we have a hypersensitivity or a hypo sensitivity at the C5 dermatome and we have a C5 muscle that’s testing weak, then we should immediately want to know, what’s the C4/C5 motion unit like? That’s the main motion unit. Could be the one above or the one below that as well. But is that damaged?
If it’s damaged, the ligaments are damaged and you’re going to see excessive motion. If there’s excessive motion, how much excessive motion is there? Is it mild, moderate or severe?
Because if we have excessive motion that causes a motor sensory or pain problem, we have in the old terms clinically a chiropractic subluxation, which means misalignment or misalignment pattern. The mismotion pattern that causes a nerve condition.
It’s also called a spinal instability in medicine, meaning excessive motion that now causes a motor sensory or pain problem.
And it’s the easiest thing in the world to do a workup on. It’s the easiest thing to image and it’s the easiest thing to standardize in injury practices across the country. But it’s not being done.
The fact is that 90% of the patients out there are in chronic pain, do not have a pathoanatomic cause.
We have experts like William Maurice, the head of the Ohio State Biodynamics Laboratory who is a leading researcher in spinal biomechanics and spinal pressures in the world. His book is called The Working Back System where he’s trying to help solve the problem of low back lumbar spine. This is the number one cause of disability, lumbar injuries, cervical injuries are the number four and cervical injuries also lead to the number six leading cause of chronic pain and disability, which are headaches.
He cites eight out of nine, or 90% of the patients who have a low back disability, do not have an exact path though anatomic caused identified by doctors that basically are treating the patient, creating a huge expense for employers and Workers Comp., for example
One of the things that is needed in the market itself is the simple understanding of how to determine the severity and location of these ligament injuries that are so expensive to the employers. Employers should be demanding it.
If I’m going to use a Doctor of Chiropractic, they need to know how to do a standard examination for these types of injuries.
If I’m going to use a medical doctor, or an osteopath, then they need to be able to understand, and standardly work up these injuries, because it’s the misdiagnosis or the the lack of diagnosis, that creates an environment of substandard.
Remember, if you’re going to change something, you must get down to the cause of what it is before you’re going to get great results in changing it.
If you don’t know what the injuries are and you were not taught to standardly workup an injury, you were not taught how to determine the severity and location of a simple ligament injury.
It is not and never has been just writing a cervical sprain down on a diagnosis code.
For somebody today to say, “Well, this patient has a cervical or lumbar sprain and that’s their diagnosis.” That’s like somebody having a leg injury and having the doctor say they have a lower extremity sprain.
The first thing anybody should be asking is, “Well, where is the sprain? Where is the ligament injury? How bad is it and where is it?”
If have you had a leg sprain, you’d say, “Well, where in the leg?”
In the knee, how bad is it? Well, it’s a grade three sprain. It’s a grade three ligament problem.
This is how I identified it. This is how we imaged it. This is what we’re doing to treat it.
It is the first step to great injury results. I don’t care if you’re an employer, a patient, or a doctor, the first thing that has to occur in order for you to get good results is you have to identify the severity and location of the injuries.
And we have to be able to do that standardly.
Right now there are 60,000, 80,000, 90,000 chiropractors out there, my colleagues, none were trained in a one year, six month program and how to determine the severity and location of a simple ligament injury. That injury that causes the most amount of problems in the market today. So if you’re a student today at a chiropractic college, you should be asking your educators why they’re not teaching you that.
That would be like dentists coming out and not knowing how to locate the severity and location of dental decay. Of course when you go to dental school, you’re going to be able to determine the severity and location of, of dental decay of tooth decay. So why in the world would you be in a health market, in a health care educational program today, and not know how to determine the severity location of a spinal ligament injury?
It just blows my mind that that’s occurring. It occurred for me, I graduated from Palmer College one of the oldest colleges in chiropractic in the country. I graduated in 1988 and I was never trained how to do it.
I know to this day when I asked students that are coming out of all of the chiropractic colleges and just say, “Okay, simply tell me how to determine if a ligament is damaged in the spine.” Remember the spine is the main thing that Doctors of Chiropractic deal with.
If ligament damage is the number one cause of pain and disability in the world today, how do you determine the severity and location of a patient that’s just injured their ligaments? How do you know where it is and how bad it is?
If you don’t know where and how bad, how are you going to get successful results with it? If you’re getting some successful results with it, think about how much more successful you could be if you knew the severity and location of the condition.
If all doctors were trained in it, that would change the environment in the United States.
Chiropractic, my profession is very small. When groups do research, the research of the markets about a $14 to $15 billion market. It’s a very small market. It’s like a third of 1% of the total healthcare dollars spent are spent in the profession of chiropractic.
It is very, very small. It represents less than a third of 1% of the total healthcare dollars spent. That is 14-15 billion in medicine, back problems, low back problems in 2010 we approximately $253 billion.
Medical doctors in the market today, weren’t trained either on how to determine the severity and location of a simple ligament injury. It is not occurring in the medical market either. And it needs to be occurring with every doctor.
Because the more that you understand, you will be able to accurately and swiftly know the diagnosis. Leading to the use of conservative care procedures that are highly successful for this type condition. Lessening or eliminating patients suffering from long term chronic problems that could have been prevented.
Chronic pain and problems are devastating to injury patients emotionally and financially.
It hinders their ability to work, it hinders their ability to be successful in their family, and to participate in normal activities of daily living.
It doesn’t have to be that way. We have to get much better. We have to become Smart Injury Doctors and use accurate and objective testing for ligament injuries and diagnosis and treat quickly and with confidence.
Remember, you can’t misalign a spine. You cannot have a hyperlordotic cervical spine or reverse cervical curve, a PLRC5, without ligament damage. Therefore, you must understand about ligament damage
If you’re going to be trading in these things, particularly in the injury market, if you haven’t learned how to determine the severity and location of a simple ligament injury, that is what the Smart Injury Doctors program is for. You go to www.Smartinjurydoctor.com and you become a specialist.
We’re creating a group of doctors, chiropractic doctors, medical doctors, and osteopaths, that fully understand the urgent need for accurate objective testing and swift and accurate diagnosis.
Come in and learn about ligament injuries. We are the leading group of injury specialist. It is where we are training doctors to have that level of understanding.
You should have been educated in this deep understanding in your basic training, so should’ve I, but unfortunately, it’s not there.
We must get it outside of our formal education.
Become a Smart Injury Doctor and lead the way into the future of injury care.