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Hi, I’m Dr. Mark Studin. And I first like to thank ChiroSecure for the opportunity for me to share information with you today. And today we’re going to tackle. It’s unfortunately become a controversial word in our industry, which has just bought baffles me. It just boggles me. I don’t understand it because it’s something we should all rally around.
And it’s the word subluxation, let’s go to the slides. We’re going to talk today about what is subluxation this subluxation exists. Is there a more accurate way to describe the core of what chiropractic treats? What is the mechanism of bono? Those are the things we’re going to be looking at today and exploring those are questions that need to be answered.
So when we look at, at, at subluxation, really it’s a philosophical origin. So when we look carefully at the vertebral subluxation complex, Leonard Fe in 1966, help develop that com that, that complex. And he described a chiropractic for people subluxation or as a complex entity that can block the open quote, close growth life forces in a biological system.
Leonard Fe actually spoke with him a little while ago. And he said he first coined that in 1963, even though the ICA had a relationship with Joe Felicia and Guy Riekeman, they really brought it around the country and Charles Lance in 89 further the concept of a chiropractor, gray, a company. Vertebral subluxation or a table subluxation complex as a complex clinical entity comprising pathophysiological changes with one or more of the following and he really furthered it.
And this is what Leonard Faber that neurophysio neuro pathophysical. Kinesio pathology, mild pathology, histo, pathology, and biochemical pathology. As a result. Now, as in everything in research in chiropractic is no different. You start out with a question and then science in the laboratory has to answer that question.
So you have philosophical questions that you need answers for. Now. I graduated chiropractic college. You needed. I studied with, a whole bunch of people and I was dying for answers and. We all we have then back in the, in the late seventies, early eighties was philosophy. There wasn’t a whole lot, but that’s a whole lot different today.
It’s a lot different. So really, and I want to put this out there. You have subluxation based schools who teach subluxation as the core of chiropractic, and then you have anti subluxation schools who don’t even allow the word on campus and, Both or absurd to an equal to an equal polarization, because the reality is we should teach subluxation.
We should teach it. We should understand it. However, we shouldn’t communicate that because it’s not truthfully, it’s not scientifically based, regardless of what people say, you go on. All the scientific sites, but there is a scientific background for what we do. And I think a better way to report that that will help us mainstream.
Now, when I say mainstream, am I saying selling chiropractic out? Oh, I say changing chiropractic. No, but you know what? I am a primary spine care provider. I want to work with. Primary care, medical providers or NFL surgeons, neurosurgeons, neurologists. I want to work with all of these people and you know what I could argue.
I don’t need them. I don’t need them in my own office. That’s great. Yes. Medicine mainstream medicine treats 98 to 99% of the population. We treat seven, eight or 9%. I want to tap into what they have so that I can have a way they was practiced. Someone coined that years ago. I, I want people to run after me.
Our school should be bulging at the seams in your office. Someone should have to know someone to get an appointment, but we’ll never do that unless we tap into that is primary spike yet provides. But let’s talk about the science, just a wee bit. Now what causes a patholo neuro biomechanical lesion. It’s pathological and as a neurological component, it’s biomechanically messed up and it’s a lesion or a vertebral subluxation complex, same thing.
So you have hypomobility high per mobile. Inactivity repetitive asymmetrical movements, macro or micro repetitive traumas, or asymmetrical, biomechanical loading due to loss of normal articulation above or below. Remember the disc as a shock absorber. We have ligaments that hold it. But your fulcrum point is that Fossette, that’s where it articulates folks.
That’s where the magic happens. Or we’re going to talk about that in a little. But that magic happens at the Fossette. And we’re going to talk about that and the ligaments, which a disc is a ligament is also critical in the model. So when we look at the Zig apophyseal joint and I’m just going to get it right out there, What happens is you’re getting sub failures of ligaments.
And by the way, I don’t have enough time in 30 minutes to explain this to you. I am giving you broad strokes. And on the second to last line, I’m going to teach. Where you can truly learn and get a real education on this stuff. But what occurs in, if we look at the Zig hypothesis joint and on an MRI, your Z join is right here on one side, and then the other on the Fossette themselves, there are no susceptive powers which help with the releasing of cytokines, which then go into an other proteins, which go into the dorsal root ganglia, which go up into the, up the spot Lubbock.
So the peri-op deduct the gray area, heading the Falmouth. They go into the entry, a single at the prefrontal cortex court and on and on and on bouncing back a fairly till it comes back that eat fairly. So the answer is, is your bone on nerve. And we’re going to talk about this again in a few minutes, there is bone on nerve.
It’s not in the nerve root. And if you understand how to interpret Mr. And an axial slice, here’s where the nerve roots come out. And this is your neuro. There is no bone on nerve and the nerve root physiologically it’s impossible, but the bone nerve occurs in the Zig apophyseal joint, which doesn’t only affect the the, the nociceptors on the facades and affects the joint capsule, which we’ll we’ll talk about in a moment.
So what occurs is, is you have a little manipulator or plica, which is a spacer, and when you have. The any one of these causative issues to create what we call a subluxation or Papo neuro biomechanical, leisure. I don’t care what you call it. Okay. Hathaway, neuro biomechanical lesion or bio mechanical leisure are all evidence based.
And I like being mainstream because I want those referrals. And by the way, on our consulting side right now, we’ve gotten I’m not going to pull up a slide because I’ll screw this whole thing up. But over one and a half million referrals. Predominantly with the referral sources are running after our doctors, additional referrals only because we’ve got after the mainstream based upon the evidence without giving up our chiropractic identity.
So what occurs is, as you get a meniscal void, it comes out and in traps around the Fossette area and the Fossette ligaments. And now you have your bone on nerve right here, but another thing happens. Another thing occurs is. The ligamentous involvement, when that Munis quarter leak is coming out and it’s going out, you’ve got the joint capsule, you’ve got these ligaments, all firing and going upside down.
And when that occurs, it creates a significant problem. So you’ve got a lot of things going on in here that are being released, but we’ve got to get to here. Because this is really where the majority of the fire occurs in that joint capsule. Remember, we’re looking at not just the meniscal area, but right here, what happens to it when the joint dislodges?
So you’ve got pacinian core puzzles, which are your crimp receptors. You’ve got. Refunding core puzzles, which are your stretcher centers. You’ve got golgi, ligament, organs, which sense what’s going on within the ligament. And then you’ve got free, free nerve endings. Not only at the Fossette level, the nociceptors, but all around, picking up thermal and chemical changes.
They all feed it into the lateral horn, every one of them and these comprise of your mechanical receptors. And proprio separate. So all of these tell you where you are. Posturally and then it shoots up into the spinal thalamic track through the peri aqueduct gray area. It hits the thalamus. And what occurs is, is it affects all of these areas.
All of these functions and we know through functional MRI, functional MRI showing where in the brain that lights up. When you have an area that’s interfered with, or you create a chiropractor it’s final adjustment. We know that it affects the cellular cortex. We know it affects the insular, the motor, the amygdala, this amount of sensory cortex.
It affects emotions, learning motivation. Ineffective consciousness, homeostasis perception, Marta control. It affects so many different things within the human body, which gives us answers. And by the way, folks, it’s on my bucket list. And I now have the technology through a a device called SIM Virta, which is a measuring tool.
We now have the technology to, to pre. And the research lab in the scientific arena that may chiropractic adjustments with effects, systemic disease, where a few years away, I haven’t found the research team. And if you have a research team that can help us, please let them communicate with, we’ve got all the pieces of the puzzle put together.
I’m on an active search right now, but all of these things are. When you have these areas firing into the different parts of the brain, it goes a fair Huntley. And then it ping pugs off of all of these regions and pink pugs off of the insula, anterior singular cortex, orbital cortex, prefrontal cortex, motor cortex, sensory cortex.
I fucked out was they ping-pong and then they go eat fairly and. Sometimes it goes E fairly to disparate areas. So if you have a problem in the lumbar spine, you’re going to have an response or pain in the cervical spine, potentially. Why? Because look at me, we have bones that are lined up, and if you have a bone that’s off kilter, because it’s, because then that clique is out of place that a meniscal void, it doesn’t line up.
Even if it’s one or two degrees. Then the body’s going to have to put curves in there. How does it put curves in there? Because the brain tells if the lumbars is out of position to the right, it’ll tell the thoracic muscles to pull on the left, then it’ll tell the cervical muscles to pull on the right, therefore giving you your compensatory curves.
That’s how the body acts. That’s why when you treat regionally, it creates a problem because you might not be, be training the primary area. You might be treating complex. And it’s a huge issue. So actually that tool we shared with you before we’ll actually show you where the primary lesion is. It might absolutely show you where that primary lesion is.
Not mine. It will show you where the primary lesion will tell you where to adjust when to adjust. It’ll tell you about ligament, laxity, LMS, but it’s the only tool out there. That’ll quantify this in an evidence-based environment to tell you what’s going on. And that’s extremely, extremely important. So what we do then from here, As we render a chiropractic spinal adjustment and high velocity, low amplitude thrust.
You have the Munis going out of place. It’s trapped in the joint capsule. When you deliver that high velocity, low amplitude thrusts, it separates the Fossette and allows that meniscal way to recede itself and stopping us from doing that. Firing there’s pressure. Now off, remember we used take pressure off of you’ve got crimp receptors and stretch receptors and golgi, ligament, organs, all of these things now normalize when these things now normalize, all of a sudden you stop that Abner and firing.
Opt into the brain. Does it go into the lateral horn anymore? So therefore when that, and by the wife, this is from Evans back in 2002, this is 20 years old. I am not breaking new ground. And I’m shocked. The majority of you haven’t heard of this before, and I know you haven’t cause I speak to so many folks, but this is really, it’s just a simple, it’s a simple concept of what occurs now, when we look at this and we talk about this the releasing of cytokines and that it stops, then the next thing you do is we go to.
Here’s your Fossette pre adjustment. This is your Fossette post, the adjustment, and it stays it gaps. You have residual gapping, which lasts for about 15 to 20 minutes. And then. That’s the only research I could find so far. And the average residual gap increases 0.7, seven to 1.3, three millimeters, and then everything.
What you’re doing is you’re adjusting. Let’s like one grain of sand at a time you’re taking a bite. You’re creating a biomechanical change. If the lumbar spine is off kilter three degrees after the, after you replaced that placate, chances are the muscles have been pattern to hold it in the wrong place.
Or you go back and do the same thing. Where do I meet woman high heels pocketbook on one side men sit on a wallet. You’re working as a dentist, always leading from one side. You’re a chiropractor, always bending. Are we delivering a high velocity thrusts? And by the way, I am a proponent of an arthro stem type device and electrical and electrically powered activators.
Y let me tell you folks. I saw in my hay day, which is by the way, everything in my life starts with, I used to, okay. I used to run fast. I used to do this, but I used to see 650 visits a week and I had to stop because I broke my back. I do the compression fractures. I lost two and a half inches in height.
I’ve had surgery on both shoulders on my hand. Let’s see, I’ve got a bunch of herniated discs. I had my hip replaced a few months ago and I attributed it all from adjusting, adjusting, adjusting, adjusting, adjusting, and I was always a hands-on adjuster. And. A few years ago, my elderly mother-in-law she was, and she loves chiropractic.
She was, antalgic like 45 degrees or more. And I couldn’t adjust her. I was afraid. I was afraid of, she’s brittle. So what I did was is I got an Arthur stem. You SIM Virta a device like that to determine where to adjuster. It was three areas. It was two times as I got together, the issue comes in there to adjust them.
And one area around T 11, two adjustments. She was a hundred percent. I was sold. It was wonderful. So you need to use leverage actually to support you so that you don’t hurt yourself. I’m the living proof of, we give our all, and I don’t want you to give as much as I did and I mean that sincerely, so folks, here’s the heaven.
And then when we go into, and I didn’t want to get into the weeds too much in this, but this is the most accurate diagnosis you could use. Biomechanical lesion, cervical thoracic, lumbar sacral pelvis. Then after that, if you want to do the five components as a subluxation complex, Kinesio pathology, mob, pathology, histopathology, et cetera, your next diagnosis can be any of those things.
Now you’ve accomplished the same thing, but you’re mainstream. You’re not fighting everyone, but by the same token, our academic institutions should absolutely teach vertical civilization complex. And the five components of subluxation, not as a scientific finding, but as the precursor. To what science has shown to be true.
All of that is true, by the way, it’s all real, it’s all a hundred percent real, but science hasn’t caught up with the literature. The coding has caught up with it and don’t say, oh, Medicare recognizes it. So it’s so it’s real. It doesn’t work like that. So matter of fact I was brought on to a case by the insurance.
On one of our devices and the device owner, whom I spoke with at length multiple times, because my goal was to keep out of a Rico case and all the doctors that use that device, he said, oh, Medicare pays for it. So we’re good. And that’s fine. And then everything is good. No, it doesn’t work like that. I promise you.
The carriers are going to take you to task don’t care either. And by the way, you have to use subluxation to Medicare. I get that, but a non-Medicare cases, I would morph over to biomechanical lesions. I wouldn’t use the other any other diagnosis for me after 41 years in the game of looking, I would start.
And then I would go onto the effect of the lesion. And by the way, I’d stay away from pain. Pain is what we call throwaway code. I work with Sam Collins a lot, and for me is possibly one of the most knowledgeable coding people in our industry. Her arguably is he’s wonderful. He calls pain and throw up.
What’s causing the bottom caterpillar lesion. If you have emphasis on empathy, do you have the strength spray primary? And you’ve got to quantify that because you can quantify secondary strain sprain in your life. And by the way, just as a side note, if you have strain sprain, that’s a permanent lesion that will never, ever, ever, ever, ever, ever get better.
And that’s evidence all over the literature. And the main research article is in the open rehabilitation journal 2013, and it talks about it and says, once these ligaments get impaired, they remain that way. And when. He’ll which is a bad word. They wound repair ligament is made up of collagen, collagen, and elastin.
You have fibroblasts that produce collagen and elastin from the neonatal all the way through puberty. Once you hit puberty, those fibroblasts that produced more ligaments, collagen, and elastin go dormant. They don’t go away. They become dormant when they become dormant, they just lay waiting to be used again.
So when you have a strain sprain, They get reactivated when they reactivate, they can only produce collagen, no longer elastin. You have a cut into a piece of steak and see Grizzle. That’s what you’re looking at. So if you have a ligament, that’s from a mature animal humans, et cetera, that’s. It’s going to wound repair only with collagen and we lasted.
And the ligament is clear about that Tozer all the way back in 2005 said there is no treatment that exists, which is true today to restore a ligament or tendon towards the normal structure. Now beyond. When you look at it. And I said before in a mature animal in province auto with 2002 found through confocal, microscopy that even in an image or a child, one year later, it hasn’t healed.
It’s going to remain permanently a mess. And then when that occurs, the ligament wound repairs, typically in an elongated position. Now what you’re doing is you’re going to determine if the joint is pathological. So you’re going to do a range. And you can look at range of motion of the spine that you’re going to say.
Is it normal and abnormal? Now when range of motion, you can only use it. Two piece inclinometer a goniometer is only for extremities and arthrodial, protractors only good for a doorstop. That’s about it. And that’s not my opinion. That’s according to the American medical association guides, the marriage and a permanent grammar, fifth edition page 400.
It’s just simple. However, when you look at cervical spine, you look at it globally. 45 degrees is. Now the problem. Isn’t too little range of motion folks because that’s usually muscle spasticity. The problem is too much is when it becomes hypermobile, you have seven segments in your neck. Almost always.
What you’re going to find is you have two or three areas. Competence. For a pathological region. So in fact, you’re going to have three, two or three hype per mobile areas for that high Paul mobile area. We have the whole course behind this, by the way. And we use again, we use that technology subverted to determine that.
So when you’re reporting normal regimen, When in fact you should be reporting, maybe one area is normal, especially if they’re spasticity in there, or even after the spasm goes away, then you could demonstrably and that’s the keyword demonstrably show. The other areas are not functioning properly and they’re pathological, there are biomechanical lesions and we could demonstrably show.
And by the way that validates long-term care. Why do you think the carriers want you to use muscle testing and range of motion? Because it stacks into the game, in their favor, they’re playing with a stack deck, muscle test range. You know what I tell my patients, Mrs. Jones, I can’t even start fixing your problem until the pain goes.
Y thinking just the muscles just fast and they’re holding everything in the wrong place. When I start relaxing that spasms, now I can start creating some biomechanical corrections and I can validate that demonstrably using technology piece of technology is wholesome verdict. So we use that technology and it could validate the necessity for ongoing care.
And it’ll tell us when it stabilized, but Mrs. Jones, we know based upon the technology, the ligaments of overstressed. That’s a permanent problem. It’s called secondary strain sprain. It’s a permanent problem. It’s not going to get better, but it can be managed just like high blood pressure is not going to get better.
It can be managed. And we’re going to manage it. It’s just easy and managing. It could mean you come in to get a chiropractic spinal injury. Maybe once a month, maybe once a year, maybe once a week. I don’t know. It all depends on how you should go, how you present, what we’re going to see, and we’re going to show it to you, but I can’t fix anything.
So that pain goes away. And when they see that they go, wow. And they get. And it works and it’s, you know what I learned how to share this stuff. It’s so funny. My three-year-old grandson brought me to preschool. They did show Intel. It dawned on me. We have to be able to show and tell in a demonstrative way to validate the necessity for care.
And it’s not muscle testing range of motion to leg length jets. You’ve got to have something that you could show and by the way, x-ray is the way to show it. Now, I don’t want to give it to this conversation. But there is no negative health effect from diagnostic. X-rays, it’s not my opinion. That is the tone.
I don’t like to talk in absolutes, but that’s the totality of the literature. Now watch according to their radiological societies and physicists and all this stuff. And that’s not what this presentation is. If you have a hundred mils serves of radiation, which is measurable, a dose of radiation, a Miller serve.
If you have a hundred milliseconds of radiation in one setting, because radiation is not cumulative, you have less than one in 100,000 chance of having any negative issues. And I’m not talking cancers that things along those lines, a lumbar x-ray is 8 million. Eight cervical is a fraction of that, but let’s just go with lumbar.
You need 56.6 lumbar x-rays in one session to have less than one in 100,000 negative health effects. How many times have you ever taken more than 56? X-rays in one session in a chiropractic setting, never, ever, ever. I’ve been doing this 41 years. Everybody got x-ray never, ever, ever, ever, ever. And if you’re using the new filtration systems with the digital systems, it’s a whole lot less.
And cervical it’s me. And half the time, a hundred x-rays of the cervical, you don’t do that. You do an Avis, the David series you’ll do an eight. Alomar complete that’s about the most you’re going to do. And now you have evidence in a safe environment. By the way of there are certain political organizations came out and said, oh, you, you, you shouldn’t do this unless there’s a red flag.
That’s absurd. How else can you see what’s going on to diagnose a biomechanical? You can’t, if not, you’re guessing you can take a good educated guess, but you don’t have the muscle bill information, red flags, which is fracture, tumor or infection. Those are your red flags. And I’m not really interested in that, even though I could tell you a tremendous percentage of our doctors and I’m talking, 10, 15% see pathology where you shouldn’t use x-ray for screening.
Screening is used for mammography. Screening is used for prostate cancer screening is used for colon cancer. Why can’t we use it for spine? It just doesn’t make sense. But now how is it going to change your treatment plan? Because when you see those biomechanical lesions, you set your treatment plan.
Now let me give you your all biomechanics. All of you. Let me tell you why you’re ready, Atlas. It’s finest right on the axis pelvis two times P I E X, that’s all biomechanical markers. You’re all treating biomechanical lesions, but if you don’t see, you don’t know. And all of those naysayers about x-ray are telling you, unfortunately to guess, and it’s just a shame because it’s not giving the entire story to the profession, but I’m going to do that a whole different time.
So folks, what I want to share with. Is subluxation is real honor to have my last slide up here. Allen, I gave you the wrong stack of slides. Oh my goodness. So folks, if you want to learn more about any of this stuff, you can always call me. My phone number is (631) 786-4253 that’s 6 3 1 7 8 6 4 2 5 3.
Or you could go to T. doctors.com, teach doctors.com and our primary spine care series teaches you all about this. We have a live symposium coming up November 5th and sixth. It’s alive in New York or live online in your living room wherever you are. It doesn’t matter. Do either one. It’s our pleasure. So if you have any questions, give me a call at six three one seven eight six four two five three six three one seven eight six four two five three.
I’d like to thank ChiroSecure for the opportunity to share. Thank you. And we’ll see you in the next chapter.