cervical
Proprioception - The Key to Chiropractic Care
11/05/10 20:10 Filed in: Clinical Pearls | From the Research
Since the inception of the chiropractic profession its practitioners have struggled with models of spinal dysfunction. While early notions of structural misalignment have largely given way to ‘functional’ concepts, the average field doctor still questions the exact nature of such lesions. So the question still remains, “What exactly is going on inside the spines and nervous systems of our patients?”
Clearly there are many differing clinical diagnoses that can be made when we attempt to pick a source of pain or a ‘tissue in lesion’. These might include a meniscoid extrapment, a zygapophysial synovitis or one of the various grades of annular tear/disc herniation. However, in such instances we could view any tissue damage as the result of a functional derangement that was already in existence at the time of injury. In other words, many spinal pain syndromes are a symptom of a greater deficit underneath - not simply the unlucky result of an inappropriate movement or accident.
But what ‘deficit’ might precede a spinal injury? And how would we know it was present if our patients are asymptomatic?
Read More...
Clearly there are many differing clinical diagnoses that can be made when we attempt to pick a source of pain or a ‘tissue in lesion’. These might include a meniscoid extrapment, a zygapophysial synovitis or one of the various grades of annular tear/disc herniation. However, in such instances we could view any tissue damage as the result of a functional derangement that was already in existence at the time of injury. In other words, many spinal pain syndromes are a symptom of a greater deficit underneath - not simply the unlucky result of an inappropriate movement or accident.
But what ‘deficit’ might precede a spinal injury? And how would we know it was present if our patients are asymptomatic?
Read More...
0 Comments
The Neck - A Sensory Organ for Balance
06/05/10 12:38 Filed in: Clinical Pearls | From the Research
When we operate as clinicians in the mechanical realm there is a tendency to view the neck simply as a series of linkages that enable the head to move around on top of the trunk. But it’s really so much more than that. The extraordinary repertoire of movements available to the human neck is only made possible by an exquisite neurology that ensures precise neuromuscular control over the joint segments.
To really appreciate this level of neural control, just focus your attention on your fingers for a moment. Feel how finely you can control their movements and how accurately you can perceive their position. Much of this sensory-motor prowess over your fingers is due to the sheer number of muscle spindles in the musculature - all providing a rich stream of proprioceptive information. And 16 muscle spindles per gram of muscle in the lumbricals certainly sounds like a lot...
Read More...
To really appreciate this level of neural control, just focus your attention on your fingers for a moment. Feel how finely you can control their movements and how accurately you can perceive their position. Much of this sensory-motor prowess over your fingers is due to the sheer number of muscle spindles in the musculature - all providing a rich stream of proprioceptive information. And 16 muscle spindles per gram of muscle in the lumbricals certainly sounds like a lot...
Read More...
The Vagaries of the Clinical Exam - Who Can You Trust?
29/04/10 21:27 Filed in: Clinical Pearls
It is unfortunate that the art of clinical diagnosis is exactly that - an art.
While we are fortunate to have the tools of science available to help us, the ultimate assembly of clinical data to construct a diagnosis is as much an art form as it is a science. However, the clinical decisions that we make on a daily basis must be based upon something concrete or we would be paralysed by indecision. So in the end our experience is often called upon to help us decide which of our examination procedures are really trustworthy. The trouble is, sometimes our most cherished practices may not be as reliable as we'd like.
Take, for example, the humble palpatory examination...
Read More...
While we are fortunate to have the tools of science available to help us, the ultimate assembly of clinical data to construct a diagnosis is as much an art form as it is a science. However, the clinical decisions that we make on a daily basis must be based upon something concrete or we would be paralysed by indecision. So in the end our experience is often called upon to help us decide which of our examination procedures are really trustworthy. The trouble is, sometimes our most cherished practices may not be as reliable as we'd like.
Take, for example, the humble palpatory examination...
Read More...