The role of chiropractic by Dr. Richard Hunter Chiropractors are underutilized in the field of spinal cord injury. The altered movement patterns seen in SCI commonly contribute to bio-Richard Hunter mechanical prob-lems of the kind chiropractors regularly see in their practices. Restoration of nor-mal joint and soft-tissue function is par-amount to help reinstate ability, and to reduce joint and nerve pain syndromes. This is accomplished with the use of cor-rective chiropractic techniques. Joint and muscle proprioceptors are also affected by partial and complete spinal cord lesions. Afferent messages to the cord and brain are affected. Some proprioceptive input is reduced or ab-sent, whereas other input is excessive or aberrant due to the altered biomechanics of the joint, muscle and overall locomo-tor system. When deprived of the usual stimulus it normally receives, the cortical map of the body in the brain can cause the cen-tral nervous system to promote secondary pattern changes. These mixed messages may have an influence on the brain and the spinal cord’s neuroplasticity, causing adaptations that may have negative be-havioural consequences. It is essential, then, that proper joint and body motion be restored as quickly as possible follow-ing a spinal cord lesion in order to keep the nervous system stimulated and pro-mote proper reorganization and mapping of the neural pathways. Active and passive forms of therapy, including chiropractic, are very helpful at this stage of healing. As long as the lesion and spinal injury is sta-ble, many forms of restorative techniques and exercise can be used. Chiropractors have excellent skills in observation and palpation that enable them to detect alignment issues as well as subtle joint, nerve and muscle problems that cord injured patients have. These problems can be detected and helped with the skills chiropractors have. I be-lieve that early intervention using chiro-practors will improve the early treatment results and the long-term management of spinal cord injured patients. 12 • CANAdiAN CHiROpRACTOR | MAY 2011 PREVENTION, THE ONLY CURE Formidable advances have been made to mitigate some of the catastrophic se-quelae of spinal cord injuries, and more is being learned from year to year. How-ever, at this time, an actual method for reversing the effects of an SCI has yet to be determined. For this reason, preven-tion still really is the best and only cure. Prevention of injury may, of course, be discussed between practitioners and patients in the clinic setting. Chiroprac-tors may also choose to talk about this in the health classes that many of them hold for their patients and/or within their communities. Furthermore, many DCs are involved with organized sports, both at the amateur and professional levels. This is an area where many in-juries may occur, and thus, an opportu-nity for DCs to incorporate prevention education into their role with the team. Chiropractors may also become in-volved in existing organizations that are dedicated to public education re-garding spinal cord injury prevention. (Initiatives for the prevention of spinal cord injury are often paired with brain injury prevention education.) As spi-nal specialists, chiropractors are well versed in spine health – as holistic practitioners, they understand the im-portance of maintaining one’s lifestyle by not shying away from activities but lear ning to undertake them safely. notion that prevention efforts should begin as early as possible in a person’s life. From that premise, ThinkFirst Canada was born. Interview with Dr. Charles Tator ThinkFirst Canada (www.thinkfirst. ca) is one example of an organization that is dedicated to spine and brain injury prevention, but its approach has been somewhat Dr. Charles Tator different from that of similar groups. The organization was founded in the United States and brought into Canada by Dr. Charles Tator. Dr. Tator is a neurosurgeon, scientist and educator in the area of spinal cord injuries and their pre-vention. He has been the face of “ThinkFirst Smart Hockey”, as well as injury prevention initiatives in other amateur and professional sports on the local regional and national lev-els for a number of years. Dr. Tator found himself aligned with ThinkFirst’s (US) ThinkFirst centres its efforts on educating children of all ages about the advantages of playing safe while having fun. “ThinkFirst is involved in programs to reduce the incidence of spinal cord and brain injuries through school and community-based injur y prevention initiatives,” Dr. Tator tells Canadian Chiropractor, from his office at the Krembil Neuroscience Centre of the University Health Network in Toronto. “The latter include many sport-specific programs and are focused on a variety of sports and recreational activities, including hockey, football and diving. Shallow water diving is still the most common cause of spinal cord injur y among the sports and recreational activities in Canada. We tr y to teach activity-specific strategies and tr y to work in a coalition with other organi-zations such as the Red Cross.” ThinkFirst, a not-for-profit organiza-tion, designs and develops its programs and operations based on research that explores the impact of prevention pro-grams in decreasing the incidence of injuries in various situations. “One of the exciting findings [of this research] is that prevention programs do make a difference,” continues Dr. Tator. “For example, there are fewer broken necks in hockey as a result of a number of injury prevention strategies, including education of players, coaches and train-ers, as well as through rules changes and enforcement. Seatbelts and airbags have Continued on Page 34 www.canadianchiropractor.ca
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