|
|
RE: Whacking, Cracking, and Chiropracting
|
Logged in as: Guest
|
|
Users viewing this topic:
none
|
|
Login  | |
|
RE: Whacking, Cracking, and Chiropracting - October 30, 2007 4:01:56 AM
|
|
|
goodlooks58
Posts: 425
Joined: October 21, 2002
From: CA
Status: offline
|
Responding to OAK's post: My 14 year old finally asks me: "Dad what is the difference between Chiros and PTs" So I had to give the lay-man's version of the subluxation theory..Her immediate reaction was: Iam glad you are not going to crack my neck!
|
|
|
|
|
RE: Whacking, Cracking, and Chiropracting - November 1, 2007 12:56:47 PM
|
|
|
Lehmkuhler
Posts: 69
Joined: December 14, 2005
Status: offline
|
I find it very interesting that you continue to believe that manipulation is so very simple while at the same time painting rehabilitation as some extremely complex pursuit. One which only individuals with the super intelligence of a PT degree could possibly understand or execute.
Rehab (at least ortho rehab) isn't rocket science either...
|
|
|
|
|
RE: Whacking, Cracking, and Chiropracting - November 1, 2007 2:50:10 PM
|
|
|
jlharris
Posts: 477
Joined: April 12, 2006
From: Nebraska
Status: offline
|
Of course research (surprise) shows manipulation in nonspecific - in regards to be specific to a level -, one technique isn't neccerily better than another, and effect is not dependent on practice experience.
Rehab is different. It doesn't take years of training to teach someone and exercise or put estim on, but unlike chiropractic with manip, exercise is not the totality of PT. I actually have no problem with a chiro teaching a pt stretching or strengthening exercises. But putting someone in a MedX and then finishing with e-stim is not physical therapy.
I'll flat out laugh watching a chiro try to treat someone with CRPS, or THA from a fall d/t a CVA, or PFPS with manip and some machine a salesman convinced them to buy. Good luck with that. Just don't call it physical therapy, and I'll be sure not to call my non-specific-a-novice-can-do-it-specific-population manipulation chiropractic.
_____________________________
Jason L. Harris, PT, DPT
My PT Blog
|
|
|
|
|
RE: Whacking, Cracking, and Chiropracting - November 1, 2007 3:13:32 PM
|
|
|
OAK
Posts: 184
Joined: September 1, 2003
Status: offline
|
quote:
ORIGINAL: Lehmkuhler
I find it very interesting that you continue to believe that manipulation is so very simple while at the same time painting rehabilitation as some extremely complex pursuit. One which only individuals with the super intelligence of a PT degree could possibly understand or execute.
Rehab (at least ortho rehab) isn't rocket science either...
Manipulation is moving a joint through it's full ROM, nothing more, nothing less. While there is a learning curve, it doesn't take years to learn the techniques. Rehabilitation involves managing people, who are always complex. For instance how does one rehabilitate a chronic pain patient back to work after they have been off for 6 months? It can be done, but it is definately NOT simple or easy.
|
|
|
|
|
RE: Whacking, Cracking, and Chiropracting - November 1, 2007 9:00:38 PM
|
|
|
3.5fig
Posts: 97
Joined: July 13, 2005
Status: offline
|
Oak,
A couple of points...manipulation is moving the joint into it's paraphysiological space, not just full ROM. That is the difference between manipulation and mobilization. Yes there is a learning curve to perform manipulation and it doesn't take years to learn the techniques, but it takes more than one semester, quarter, and/or one weekend course. Just like any techinque, one needs good hands to perform properly and create as little discomfort to the patient as possible. As one who has had "bad" manipulations, trust me that the persons skill level and technique goes a long way to the comfort of the patient. Manipulation involves managing people as well, just like rehabilitation. I disagree with you that "rehabilitation is always complex"...sometimes it is, sometimes it isn't. And I totally agree with you that rehabilitating a chronic pain patient back to work after they have been off work for 6 months is not easy. I have worked in the California work comp system for the last 12 years managing these types of patients. In fact, this will answer one of your ealier questions regarding what a chiro can do that a pt can't do...I can manage the return to work status of a patient in the California work comp system. A PT is not considered physician status in the California work comp system and cannot fill out the required med-legal forms. Therefore you would not be able to manage this patient's return to work status. I for one see no problem in you managing this status. Many PTs I have worked with were just as good if not better at it then the doctors because they were more functionally inclined in treatment and spent more time with the patient. I would have to say that when someone has been off for 6 months, the physical part of their problem is usually the easiest part to manage. It is the emotional/mental aspect that is much harder to manage. The longer someone is off work the less chance they have to return to work at all.
|
|
|
|
|
RE: Whacking, Cracking, and Chiropracting - November 1, 2007 9:58:25 PM
|
|
|
OAK
Posts: 184
Joined: September 1, 2003
Status: offline
|
Paraphysiological space? Wow, that sounds like something out of Star Trek.
This is yet one more example of a Chiropractor taking something that's simple and making seem complex in an effort to confuse the public. And as long as the public is confused they will continue to seek Chiropractic care for prevention of arthritis, heart disease, indigestion and bed wedding.
|
|
|
|
|
RE: Whacking, Cracking, and Chiropracting - November 2, 2007 6:36:44 AM
|
|
|
SJBird55
Posts: 2438
Joined: May 10, 2004
From: Michigan
Status: offline
|
I was reviewing a very large document last night and was again supported in my belief that the majority of chiropractors focus on subluxations and manipulate to affect subluxations. If I am understanding correctly, chiropractors admitted that subluxations are not able to be seen via radiographs. Prior to January 1, 2000, it was allowable for radiographs to be utilized to determine a subluxation but under the BBA this allowance was disallowed because radiographs do not allow subluxations to be seen. The final physician fee schedule is being altered to eliminate the loophole that has existed since 2000 and is disallowing any medical provider to provide radiographs for a chiropractor to utilize. Quite an interesting stance and view from a federal payor. The supporting documentation can be found at: https://www.cms.hhs.gov/PhysicianFeeSched/downloads/CMS-1385-FC.pdf on page 602.
An interpretation and a view from a federal program... the use of the terms "therapy" and "rehabilitation" in their opinion only refers to physical therapy, occupational therapy and speech therapy AND the qualified professionals who provide those services. Unfortunately for chiropractors, chiropractors are not viewed as the appropriate professional to provide "rehabilitation" because chiropractors do not have the required qualifications. Hmmmm.... Again, in the above document on page 613.
If I am reading this type of interpretation from a federal payor, I am even more curious as to what state practice acts and the licensing boards have to say about chiropractors providing "rehabilitation." Even if a chiropractor does not call what is being provided as "physical therapy" and instead uses the term "rehabilitation," wouldn't the chiropractor still be practicing outside of his/her scope of practice? Which state practice acts actually have clauses in them to legally allow a chiropractor to perform more than manipulation for subluxations?
|
|
|
|
|
RE: Whacking, Cracking, and Chiropracting - November 2, 2007 11:07:13 AM
|
|
|
3.5fig
Posts: 97
Joined: July 13, 2005
Status: offline
|
SJBird55,
To answer your question....the State of California where I practice allows me to perform more than manipulation.
Oak,
Check out Scott Haldeman MD DC PhD and his book Principles and Practice of Chiropractic and you will learn about paraphysiological space and how it relates to manipulation. It is not something that I made up to confuse the public as you say. It is a well understood term in the world of manipulation/manual medicine. By your statements you betray your lack of knowledge of manipulation. Get out there and read Haldeman's book if you want a good understanding of manipulation and Chiropractic....
|
|
|
|
|
RE: Whacking, Cracking, and Chiropracting - November 2, 2007 11:21:50 AM
|
|
|
OAK
Posts: 184
Joined: September 1, 2003
Status: offline
|
quote:
ORIGINAL: 3.5fig
Oak,
Check out Scott Haldeman MD DC PhD and his book Principles and Practice of Chiropractic and you will learn about paraphysiological space and how it relates to manipulation. It is not something that I made up to confuse the public as you say. It is a well understood term in the world of manipulation/manual medicine. By your statements you betray your lack of knowledge of manipulation. Get out there and read Haldeman's book if you want a good understanding of manipulation and Chiropractic....
I realize that you did not make up the term, I am familiar with it. It is an alternative concept and I believe it does little to help with patient understanding of their injury. I am well studied in spinal manipulation and practice it regularly. Unfortunatey, most of the literature out there is not scientifically, or even logic based, and is very unreliable.
Also, sorry if my previous post offended, looking back at it, I see it comes off as rather harsh.
|
|
|
|
|
RE: Whacking, Cracking, and Chiropracting - November 2, 2007 11:32:11 AM
|
|
|
3.5fig
Posts: 97
Joined: July 13, 2005
Status: offline
|
Oak,
No offense taken....
|
|
|
|
|
RE: Whacking, Cracking, and Chiropracting - November 2, 2007 11:42:56 AM
|
|
|
orthotherapist
Posts: 218
Joined: February 6, 2007
Status: offline
|
I was not going to enter this potentially endless debate but....It really irritates me when I see chiropractors that claim they are "board certifed in physiotherapy" (as offered by the NBCE.org). Maybe PT should have a certification process where we can claim we are board certified in chiropractology or some other similar word - oh that would hurt our credibility nix that thought.
|
|
|
|
|
RE: Whacking, Cracking, and Chiropracting - November 2, 2007 6:48:05 PM
|
|
|
Jon Newman
Posts: 1707
Joined: April 24, 2004
From: Amherst, WI
Status: offline
|
For an interesting read, including some thoughts on "paraphysiologic space" see this editorial.
Interestingly, in WI the 2001 Administrative Review one can read the following:
quote:
Paraphysiological space” means the range of motion of a skeletal articulation that exceeds voluntary movement but does not exceed anatomical integrity.
and
quote:
Any procedure that causes a joint structure of the spine or pelvis to enter the paraphysiological space is a practice of chiropractic.
How do they let stuff like this get in there in the first place?
< Message edited by Jon Newman -- November 2, 2007 6:59:32 PM >
|
|
|
|
|
RE: Whacking, Cracking, and Chiropracting - November 2, 2007 10:49:28 PM
|
|
|
Lehmkuhler
Posts: 69
Joined: December 14, 2005
Status: offline
|
[/quote]
Rehabilitation involves managing people, who are always complex. For instance how does one rehabilitate a chronic pain patient back to work after they have been off for 6 months? It can be done, but it is definately NOT simple or easy.
[/quote]
You can't possibly be so naieve as to believe that DC's dont have to do the same things... Do you believe people just go to DC's without any thought as to whether or not they are achieving results. Gimme a break!
|
|
|
|
|
RE: Whacking, Cracking, and Chiropracting - November 3, 2007 4:34:44 PM
|
|
|
chiroortho
Posts: 655
Joined: February 18, 2004
Status: offline
|
JCOY, hey brother relax a little. It isn't the end of the world...we need to laugh at ourselves a little.
greg
_____________________________
Greg Priest, DC, DABCO
|
|
|
|
|
RE: Whacking, Cracking, and Chiropracting - November 4, 2007 1:03:33 PM
|
|
|
3.5fig
Posts: 97
Joined: July 13, 2005
Status: offline
|
That is a very good point Greg....you always seem to have comments that are right on the spot....
|
|
|
|
|
RE: Whacking, Cracking, and Chiropracting - November 4, 2007 10:12:16 PM
|
|
|
proud
Posts: 944
Joined: March 22, 2006
Status: offline
|
quote:
ORIGINAL: Sebastian Asselbergs
When reading this continuation of the thread, I cannot help but chuckle and think of the seagulls in "Finding Nemo": "MINE MINE MINE MINE MINE"........ 
Seb,
I agree. The sooner we establish "one expert" in the field of NMSK evaluation and treatment, the better. It is the public and the individual patient that will ultimately benefit from this clarity.
It is coming of course. Thankfully Physiotherapists are making all the correct movements both from a research and evidence standpoint, but also by association, from a political standpoint as well( example provided by SJ).
It is time to move from "who owns what" and get on with the business of providing substantiated, effective, cost efficient care that helps an already heavily burdened health care system cope with the aging population that lies ahead(recent wall street journal article is a case in point).
Debating "paraphysiological space" and its relevance to the outcomes with manipulation is dated, theory based drivel. The evidence speaks and it's time to move from theory based to evidence based.... One expert in the field of NMSK eval and Tx is the right way to go.
< Message edited by proud -- November 4, 2007 10:24:33 PM >
|
|
|
|
 New Messages |
 No New Messages |
 Hot Topic w/ New Messages |
 Hot Topic w/o New Messages |
 Locked w/ New Messages |
 Locked w/o New Messages |
|
 Post New Thread
 Reply to Message
Post New Poll
Submit Vote
Delete My Own Post
Delete My Own Thread
Rate Posts |
|
0.172
|
Printable Version
All Forums >> [RehabEdge Forum] >> Open Forum >> RE: Whacking, Cracking, and Chiropracting 
