Flip Class 2

What’s that cracking sound?

The popping sound you hear when you crack your knuckles or when a chiropractor performs a manipulation or adjustment, is simply the popping of a gas bubble created by the pressure within your joints. This is the same phenomenon that occurs when you open a can of coke and get the loud crack.


How is treating a patient like going through the scientific method?

The scientific method in a nutshell involves generating a hypothesis, determining the methods by which you will test your hypothesis, performing tests and analyzing your results ultimately deciding upon an answer to the original hypothesis in the form of true or untrue. When treating a patient, particularly for the first time, the scientific method is followed exactly. The hypothesis is what you believe is wrong from the history, the methods are physical/orthopedic testing resulting in positive or negative tests that lead you to a diagnosis, either in agreement of against the original hypothesis.


Where is our entry to health?  Where do chiropractors fit in?

While chiropractors have a diverse education and can be an important part of public health, according to Dr. Triano our main very simplified goal is the normalization of movement. Chiropractors are experts at diagnosing and treating neuromuskuloskeletal problems which are either caused by or result in abnormal movement of the body.


Functional movement model – What example does Dr. Triano use to demonstrate a motion that is NOT “consistent with the task”?

Dr. Triano emphasizes the idea of movements that are not “consistent with the task” by demonstrating multiple ways to hold a pen, with the right arm wrapping around the back of his neck as the most inconsistent with the task in mind.


Dysfunctional movement model – Where does SMT affect the dysfunctional movement model?

According to Dr. Triano, SMT affects the dysfunctional movement model in three particular “boxes”: Asynchronous proprioceptive & nociceptive bombardment, Local tissue stress concentration and the connection between Spinal Cord: Asynchronous feedforward/feedback neuromotor control and Cortex: Volitional task commands.

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Reflection & Class notes

I found the flip class to be very enjoyable as per usual but also a very pertinent and important topic that should be on the mind of every student coming through CMCC. The average day for a CMCC student is filled with lectures and labs emphasizing the basic sciences and clinical knowledge that will help us become experts in our field and provide quality service to those who need it. Despite all this technical knowledge, we will all be asked questions about what we do by people with very different opinions and levels of education and in order to represent the profession and ourselves with respect and pride we must be prepared to answer them.

For example, if I had a patient today that asked me how SMT works, I would likely begin by trying to assess what level of education they have and what depth of explanation they would like, much like I would if being asked to explain an orthopedic test. In the case of the average layperson I would explain: “SMT, the adjustment, can help by allowing the joint which is currently moving abnormally to move normally again. This change may include relaxing of tight muscles in the area, increased lubrication to a joint that wasn’t moving before and may also decrease pain.”

On the other side of the spectrum, if a MD asked me about the availability and quality of evidence supporting SMT, I would take a much more scientific approach, but allow the MD to lead the conversation as much as possible. I would begin by indicating that there is a plethora of research supporting SMT from clinical trials to gold standard RCT’s published in top journals such as Spine and that many governments and medical groups are using this evidence to inform current guidelines, specifically concerning neck and low back pain. At this point I would likely try to find out what the MD knows/believes about SMT and chiropractic and end by recommending specific papers or guidelines that would benefit their own knowledge and practice.

Being comfortable talking to patients and MD’s about the profession and our hallmark treatment is essential as my two intended sources of marketing and patient referral is my current patients and MD’s. I have no intention of spending any money on advertisements or search engine optimization. My experiences and the advice I’ve received thus far has pointed to the importance of excellent care and forming relationships with the local MD’s, which is exactly what I intend to do.


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