UPFRONT | Columnist BUSINESS TALk A 10 things I didn’t learn in school, part 2 of 2 Real life lessons from one practitioner to another By Anthony LoMBArdi fter part 1 of this article was pub-lished, I received a very kind e-mail from a fellow colleague who wrote this: “Anthony, I am deeply touched by reading your article. Not everyone is willing to help others and openly discuss the inside of their business and techniques.” This short note made me feel very special. I feel that willingness to share valuable informa-tion with one another is an attribute that en-hances our profession. Some may feel that sharing such things gives “secrets” away, which can hurt our own prac-tice, but that is simply untrue. I once read somewhere that by teaching we learn and by learning we teach. At the best of times the utilization rate of chiropractic services in Can-ada is about 15 per cent. That leaves a pool of over 24 million potential chiropractic patients. With prospects like that, helpful tips, or “se-crets,” will not endanger the future of their practices. So let’s continue where we left off from last issue, identifying some of the things I didn’t learn in school that have revolutionized my practice today. The first five things were dis-cussed last issue. What follows are the remain-ing five points. 6. Understanding trophic changes Many of us have probably heard the terms “trophic changes in soft tissue” or “trophic soft tissue changes,” but very few of us have a firm grasp on the clinical meaning and the mechanism of the concept. On a surface level, trophic changes are simply changes in soft tissue (skin, fascia, muscle), resulting from in-terruption of nerve supplyThis interruption does not have to be a discal lesion, nerve compression or axonometis. It can simply be an interruption caused by microcirculatory changes at autonomic spinal levels (T1-T5, T10-L2), overuse of a par-ticular muscle or group of muscles, or effects of degenerating joints, which contribute to the neurogenic inflammation that triggers trophic changes in segmental and local tissue. Anthony lombArDi, DC, is consultant to athletes in the NFL, CFL and NHL, and founder of the Hamilton Back Clinic in Hamilton, Ont. He teaches his fundamental EXSTORE Assessment System and conducts practice-building workshops to health professionals. Visit www.exstore.ca for information. 20 Canadian Chiropractor December 2013 For example, in musculoskeletal cases we may notice clin-ical signs such as knots or tight bands in subcutaneous tissue over an injured muscle as a result of a combination of motor inhibition and changes in capillary circulation to that region. I’ve learned the key to clinical treatment is to reverse the stimuli that trigger the noxious chemical and the mechanical stimuli that cause the neurogenic inflammatory response. Manipulation of joints, manual muscle treatments and inter-ventions that directly target the nervous system, such as acu-puncture and electro-stimulation, are key allies in the minimi-zation of trophic changes and the acceleration of soft tissue healing. Photo: fotolia.com 7. You never get a second chance to make a first (clinical) impression The world today is moving at a fast pace with countless stim-uli occupying the attention of your potential patients. So, making a habit of creating a positive, lasting first impression www.canadianchiropractor.ca
Chiropractic + Naturopathic Doctor December 2013: Page 20
