target the peripheral nervous system using motor points. In this case, once I correct the gluteus maximus weakness, patients are usually totally astonished because they see what was once weak is strong again. Then I use acupuncture and myofascial release to break up adhesions and to restore joint range of motion. Then voila! Just like that, they have experienced something to-tally different than what they are used to. This sets the stage for future visits because you have explained, demonstrated and delivered. This generates confidence in the patients’ mind and they look forward to following visits. FOLLOWING VISITS Once motor inhibition is removed, it is important that you begin to target segmental regions – both at myotomal and autonomic levels – in subsequent visits. This helps maintain motor function as well as ensure perfusion to the area of injury. For instance with a shoulder injury, the myotomal target would typically be C4-C7 while the autonomic vas-cular levels are T1-T5. Secondly, it is paramount to target the peripheral trophic changes in the injured tissue. Using manual techniques to remove adhesions and reduce release of neurogenic inflam-mation from the sensory axon in the dorsal root ganglion of the spinal nerves will help promote nervous and muscle tissue healing. It is important to understand and explain to the patients the autonomic vascular system. For instance, T1-T5 are the spinal levels of the sympathetic preganglionic neurons that, via the cervical sympathetic ganglia (postganglionic neurons), will end up innervating the arterial network of the head, neck, shoulder girdle and upper extremity. If there are abnormal signals occurring at those vertebral levels – such as a long standing segmental articulo-muscu-lar dysfunction – it is believed that these abnormal signals will interfere with the normal sensory-motor-vascular in-tegration that takes place at every spinal level. Abnormal signals can contribute to all kinds of progressive undesir-able effects, including: • motor inhibition on muscles supplied by those spinal levels • abnormal proprioception on those muscles • amplification of nociceptive signals arriving at those levels from anywhere: muscle, skin, periosteum or viscera • neurotrophic changes in the somatic territory corre-sponding to the arterial levels supplied by those sympa-thetic fibers Therefore, it is advisable to make these paravertebral levels the targets of our acupuncture, myofascial release, or joint manipulation interventions in order to normalize sensory-motor-vascular integration at those levels, thus interrupting the negative effects that the abnormal neuro-logical signals from these segments may be having on the peripheral tissues. When I explain this complicated concept to patients, I point out that the muscles at the T1-T5 levels house the nerves that control the blood vessels that supply blood to the head, neck and arms all the way to the fingertips. No-tice how I have just summarized three paragraphs into one sentence? FACTORS THAT SKEW NEUROFUNCTIONAL APPROACH NEURO-STRUCTURAL TAPING TECHNIQUE KINESIOLOGY TAPING DVD SET Get step-by-step instructions and clinically relevant tips from Dr. Jardine and his team of clinical experts as they share with you their years of experience in applying kinesiology tape to manage common musculoskeletal conditions. Learn the taping applications and techniques that have been taught around the world to doctors, clinicians and therapists and find out how to improve your patient outcomes. With five hours of video content you will be able to easily integrate kinesiology taping into your practice and use The Kinesiology Taping DVD as a quick reference to help manage your patients’ conditions. Highlights: • 55 treatment protocols and clinical pearls: * 19 for the upper extremity * 17 for the spine and torso *19 for the lower extremity • Proper tape handling and removal • Skin preparation • Expert instructors • 5 hours of high quality video training At times, chronic pain, neuropathy, litigation factors and mental illness will influence the outcome of your treat-ments. Be sure to make note of the following factors that can delay or impede a positive response to your treatment: • Ongoing pain for greater than one year • Underlying systemic illnesses • Psychogenic factors • Dependence on pain medications or recreational drugs and alcohol • Neuropathic pain syndromes • Been to multiple doctors within different disciplines • Patient has financial gain at stake When approaching a patient you must remember that you as a physician have the responsibility of investigating and improving their current condition. As such, we must prepare ourselves to be consistent in the assessment, treat-ment and explanation of our services. Doing so will help our patients build the bonds of trust, security and confi-dence which they will link positively to your chiropractic care. www.canadianchiropractor.ca 24 Canadian Chiropractor July/August 2015 CHIRO june 14 book ad.indd 1 2015-06-26 1:07 PM
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