palpation
What Are You Adjusting? Hyper or Hypo?
03/06/10 11:22 Filed in: From the Research | Clinical Pearls
To most chiropractors quality of spinal motion is a prerequisite for spinal health. We have an intrinsic understanding that a joint must move normally to be normal - or at least to stay that way. As such, our examinations are heavily geared towards assessing and quantifying the relative motion of each segment. We then give it a rating: 'normal', 'hypermobile' or 'hypomobile'.
Most of the time chiropractors tend to focus upon finding areas of limited motion - segments of greater stiffness that would benefit from an adjustment. Indeed, the majority of definitions of joint dysfunction suggest that reduced mobility is a cardinal sign, and that we should try to stay away from any hypermobile segment.
But is this really what's going on? Is it truly the stiffer joints that are the prime source of pain in most of our patients? And is it the stiffer joints that benefit the most from manipulation? Or could it actually be the hypermobile joints that should be the target of, and beneficiaries of, the neurological effects of an adjustment?
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Most of the time chiropractors tend to focus upon finding areas of limited motion - segments of greater stiffness that would benefit from an adjustment. Indeed, the majority of definitions of joint dysfunction suggest that reduced mobility is a cardinal sign, and that we should try to stay away from any hypermobile segment.
But is this really what's going on? Is it truly the stiffer joints that are the prime source of pain in most of our patients? And is it the stiffer joints that benefit the most from manipulation? Or could it actually be the hypermobile joints that should be the target of, and beneficiaries of, the neurological effects of an adjustment?
Read More...
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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...
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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...