Let’s create new chiropractic diagnostic tests and therapeutic protocols best for patients
When we hear the word technology, we think of our smartphones, iPads and Bluetooth devices. As chiropractors, we should be thinking digital laser foot scan, digital X-ray, MRI, cold laser therapy and spinal decompression. These are the technologies and new chiropractic diagnostic tests that will help any chiropractor become a better diagnostician and healer.
I’ve lectured for years that the chiropractic scope of practice in every state is far broader than that of any other profession, both diagnostically and therapeutically. Many chiropractors who are practicing today, however, fall victim to the restrictions and guidelines of their academic teachings, insurance guidelines, and a totally miseducated public who is taught to take a pill because they haven’t got time for the pain. The opioid crisis is the result of that thinking.
New chiropractic diagnostic tests, new guidelines
Let’s create new guidelines. Let’s set our goals and objectives to use the diagnostic and therapeutic protocols that are clinically, emotionally, physically and economically best for your patients regardless of insurance coverage or medical opinion.
The digital laser foot scan — The human being is an architectural structure and the feet are the foundation. Ask any architect if they’re comfortable with an imbalanced foundation.
The human being must be looked at the same way. The feet are a critical part of the exam as most people have moderate to severe pronation of the feet.1 The kinetic chain will compensate to find balance. If we don’t correct the feet/foundation when collapse is present, we’ll never correct the compensations.
An adjustment may temporarily alter the mechanics; however, the abnormal loading will cause fixations and subluxations to quickly return starting when the patient stands upright.
Digital X-ray — The industry today discourages the importance of X-rays. This has much to do with the fact that medical opinion doesn’t see the benefit of X-rays for musculoskeletal problems and biomechanics is not part of their concern — it’s primarily-only pathology.
That’s why most of the time medical doctors take X-rays, the patient is told the X-rays are negative. They are never negative for biomechanics, and it’s the biomechanical information of these chiropractic diagnostic tests that is most likely causing the condition that brings the patient to the provider. Findings such as abnormal centers of gravity, vertebral rotation or wedging, femoral head height difference (fhhd), sacral base angle, Ferguson’s center of gravity line, bone quality and disc integrity are seen on X-ray.
I do a two-view cervical and two-view L-S standing while barefoot as the baseline series for every patient, even the uninjured 12-year-old. Research shows that 64% of the population have fhhd >3mm when X-rayed barefoot, while 42% have >5mm fhhd.2 You can’t know this without X-rays.
MRI, the other 50% — X-rays show 50% of a patient’s musculoskeletal system and MRI shows the other 50%. Most chiropractors are guessing at what the actual diagnosis is, and then are not equipped to provide the proper care for the actual diagnosis.
Case in point, a 38-year-old athlete with right-sided sciatic pain. The chiropractor doesn’t do a foot scan, doesn’t X-ray and doesn’t order an MRI. The patient comes in for adjustment after adjustment after adjustment and always goes home hoping to feel better. The problem is, they are missing the root of the problem.
When the appropriate chiropractic diagnostic tests are done, the findings might show a moderate collapse (pronation) of the feet, and 47% weight distribution on the right and 53% weight distribution on the left. On X-ray, a femoral head height difference of 12.4mm is shown. On MRI, there is a disc extrusion at L5. This diagnosis requires so much more than 12 adjustments, and chiropractors have the scope to both diagnose and treat this condition better than anyone else.
Custom 3-arch orthotics — Chiropractors fail to understand the magnitude of importance in recommending custom orthotics to their patients.
Increased Q angles, unlevel knees, unlevel femoral head heights, pelvic rotations, uneven weight distribution, fixations and subluxations all originate with collapse of the feet. You must recommend custom orthotics as the very first step in correcting any of the above and more.
Cold laser therapy — Cold laser therapy, in my opinion, is the therapy of the future. Light therapy has gained a very high level of awareness and understanding, and from a clinical perspective and patient satisfaction perspective, I can’t imagine any office not having laser today.
From pain to injuries, bruises to fractures, bone marrow and soft tissue edema, and many other patient complaints, cold laser is the treatment of choice. It’s easy, it’s safe and it’s unattended. I have seven lasers in my clinic.
Spinal decompression — When you realize that almost all humans develop MRI findings from the age of 30 on, findings such as degeneration, desiccation, stenosis, edema and disc injuries, you realize this modality is invaluable to help patients reach their highest level of potential.
We live a compressed existence with aging and gravity, so decompression makes sense for virtually everyone. This computerized traction and release therapy allows many of these conditions to heal, not just provide symptomatic help as medications, cortisone shots or surgeries do.
I have three systems in my clinic and we use decompression on 40% of all patients. Patients absolutely love it and respond extremely well.
Utilize technology for better care
When you do an examination that provides visual evidence on a patient, including a digital laser foot scan and standing digital X-rays, you have a much greater influence over appropriate decision-making by the patient.
In my office, it doesn’t matter whether they have insurance or not. When your exam has visual evidence and it makes sense, people will gladly pay to get well. Every human wants a high quality of life until the day they die, and this technology reigns superior to all other exams and treatments available today.
TIM MAGGS, DC, still practices full-time and specializes in sports biomechanics. He is the developer of The Concerned Parents of Young Athletes™ Program (CPOYA) and participated in the development of Foot Levelers’ CPOYA custom orthotic. He can be reached at DrT@DrTimMaggs.com.
