SPONSORED CONTENT CONTENTtly ation: A case of mistaken identity?bser Changes in Bone Size and Structure R vations in a new light L . George Rothlux Clinical Implications By Dr. George Roth, DC, ND, CMRP searched the Internet for scientific Startling Observations: Bone Enlarges with Injury! nce to support chiropractic. Unfortu-y , most of the references emphasized While studying radiology in chiropractic my on own practice. In order to achieve that, Surprising Observations ack of scientific validation or measur-comes school, I noticed that the size of within a structure felt that there had to be a universal principle, As a chiropractic intern, noticed something that often I different to support the basic tenets of I one side of the body was than which would explain the Hypothesis underlying seemed to a be a studies mystery to my instructors in other the side. ession. At best, there are few its counterpart on the For example, A Testable for structure a Molecular of Origin of Fracture Resistance Figure 3, Pre-treatment: Femoral and monstrate a modest advantage for chi-c the studying proximal femoral or humeral head, or the the body and its response to injury. Eventually, radiology department. While radiograph-tibial epiphyses enlarged, approximately 5 A to explore developments in the manipulation over some tibial plateau on I one side was noticeably larger my search led me ic images of prescription hips, shoulders and knees, often ob-mm. compared to the right. *Note relative ions for certain conditions, such as than the opposite side in the same individual. narrowing of the medial joint space.NSORED served that an epiphysis (the end of a long bone) fields of cellular and molecular biology. Emerging Before impact in. However, the overall impression is professors were unable to shed any light on on one side of the body My was often enlarged, as science regarding the cytoskeleton and the extra-ropractic science is still relatively un-and these findings. As an anatomy lab instructor at compared to its counterpart on the other side. No cellular matrix, as well as the developing field of that chiropractors are only mini-cepted the college and from subsequent observations the shape of the bone is possible and appears t electrobiology, me to develop a form of one seemed to have explanation. It was not as part of the health care team. an of cadaverous specimens, I was able to confirm inspired B allow for the restoration of the joint space an therapy, based on these concepts. The result is a until almost thirty years later, that these obser-e been a chiropractor for over 40 years, these differences. At the time, these facts were As an impact biomechanical function, resulting in improve begins to system, which appears to be congruent vations were validated independent y in my career, I became convinced that by filed away, and it research. was only many treatment years later that healing of the entire joint complex. separate fibrils ot achieving the of results prom-en these early observations came to with be viewed in scientific a these principles, and which I have It is kinds my contention that these bone changes are I attended school. to I also new of light, on my ba-clinical research. Subluxation: been teaching to practitioners from around the crucial our witnessed understanding the based structural my colleagues becoming disheartened By carefully examining a better quality skel-C A Case of Mistaken Identity? sis of injury and its implications for therapeutic world for almost three decades. g in practice. They had come into this etal model, which is cast from a real skeleton, The subluxation theory and the idea that bone intervention. on with high expectations and a sincere you can verify many of these same discrepan-“go out of place” has long been questione The Molecular/Cellular Basis of Injury: o help their fellow humans, but the cies for yourself. Besides the examples of the However, I believe that the entire premise ma Happens to Bone with Injury? In 1992, I was fortunate enough to encounter a bril-treatments What they were taught did not femur, tibia and humerus mentioned earlier, be a matter of mistaken identity. By this, I mea orthopedic Objective evidence from the University of of Califor-o these expectations.many a close inspection the spine liant can be very re-surgeon, Dr. Stephen Levin, who that the palpatory impression of “misaligne Ded_Content_DPS_Dec19_EJS.indd of you, I pursued a long vealing. Note the powerful differences in the size (width, on the importance of the intercon-was lecturing nia published in search 2005, revealed by the vertebra” reveals may be the the result of enlargement o Figure 2: High powered microscopy protein tional modalities to improve results, depth and height of direc-the articular processes) at of the vertebral segment (see Figure nected framework of tissue, as reflected in the in the framework Atomic Force my Microscope (AFM) under the within the cell part (cytoskeleton), which determines After impact my outcomes and me the Paul confi-various 1 levels throughout the spine. Figure 1 above). fact that to many is over its structural properties and tion of give physicist Hansma , has clarified the cellular structure, which he refers to as biotenseg-how it The may respond injury. patients achiev be able to find and resolve my patient’s demonstrates these differences in the size of Ingber, through MD, PhD. chiropractic adjustment ma structural effects of injury within bone, resulting in rity 2 . Cellular research conducted by Donald Ing-*Photo: Courtesy of Donald benefit ns. In this search, I was blessed to meet the articular processes of the atlas. I contend be due to its influence on the actual structur persisting enlargement 1 palpation, below). these areas of ber, M.D., Ph.D., has 2: since established that all Figure Microscopic Evidence of Bone researchers and clinicians from other (Figure that on enlargement of the osseous enlargement, albeit inadvertentl Expansion with Injury, Paul Hansma Lab, living cells consist of a molecular/protein frame-cell biology, biomedical engineering, may be easily mistaken for a relative rotation or University of California, Berkeley, 2005. (With on the part of the practitioner. In my opinion, 3 work (see: referred as the cytoskeleton Putting the Puzzle Together (see: Figure 2 dic medicine, osteopathy and physical Pieces translation of the vertebral segment Sub-to permission from the author) practitioners were made aware of the fact tha e). They were making luxation: a A wide Case of Mistaken below). below). In addition, the cytoskeleton of each cell is Over the amazing years, I discov-ar have explored range of Identity, injury alters the shape and size of bone in th ding the underlying effects of injury evidence from the University of adjacent Cal-male hockey player, who had matrix been suffering linked to cells via the extracellular approaches within the field Recent of structural therapy. spine and throughout the body, they woul mechanical dysfunction at the cellular, revealed by the powerful Atomic Force a from knee pain for which several I refer months, be eager to apply methods that would mor (ECM), forming continuous fabric, to which Each technique provided ifornia, a theoretic framework trical and even the molecular level. I microscope, under the direction of physicist prevented him from playing. The injury also precisely target these areas and thus achiev to support its tenets but, to my frustration, none 1 as the biotensegrity matrix. This provides mechan-ed that for a system of therapeutics Paul Hansma and his team , has confirmed the caused considerable pain during normal daily even better results. continuity throughout the body, of them appeared to agree with each other. I ical and electrical alid, it had to be congruent with this activities, such as climbing stairs, which he presence of certain protein structures within which is essential to the maintenance of optimal knew that something was missing. For the past g science. the bone that expand with an injury. These was only able to accomplish in a slow, hob-Neurological Evidence 4 cellular function 40 years, I have been on a quest to more . Fortunately for me, orthopedic bling manner. findings are achieve consistent with my clinical health obser-and One of the major factors, which drew me t surgeons were due monitoring the of size of the bones vations, which were first made over 40 years consistent, objective and measurable results When an injury occurs, to many life’s chiropractic in the first place, was its emphasi at the knee as with a high degree of precision, ago (see Figure 2). Figure 3: Model of C1, cast from central a real importance skeletal spec-unforeseen events, such strains, falls, sports on the of the nervou imen. of the This right articular process to an collisions, underlying physics genetic condition. a Note the enlargement system. made absolute sense to me, as injuries or motor due vehicle teach-As and measured 2 mm. larger in to any are result, they took consistent measurements to the spinal canal, which Restoration of Bone Size disruption of neurological signals es us that the mechanical energy is absorbed by every dimension. within one-hundredth of a millimetre. They and Joint Healing of the body, could lead to serious functiona the densest structures of the body, namely bone were all surprised when the femoral condyle One of the significant clinical breakthroughs consequences and even threaten survival. Th and the to fascia associated certain the tibial with plateau of the visceral left knee, which that my colleagues and I were able ac-and unique anatomical structure of the spine i structures. Water is been the densest substance the than ten the structural had approximately 5 mm in larger its a detailed paper on complish was that bone size appeared to be exquisitely designed properties to afford substantial pr body, and we thus impact injury be absorbed by shrunk of bone as they relate tection to the to biomechanics of while the still allowin counterpart on can the right, had suddenly restored to normal with treatment. At first, the spinal cord, by that amount of after only a few treatments (see questioned these results and followed them up compartments the fluid-filled the body, namely entire body 7 . for mobility and flexibility. However, it was a Figure 3 and This 4). Subsequently, the with precise measurements using callipers and the ways a mystery to me why skel-there was never an the trunk and cranium. often results in young in-man’s Better quality skeletons, cast from a real Model of C1, cast from a real parents noted that he was once again “flying tape measures. Inter-tester validation appeared specimen. Note the enlargement mention in the chiropractic literature regardin ternal injuries to the liver, kidneys, spleen or heart, eton, will allow you to verify many of these same ght articular process and the spinal up” the stairs with absolutely no pain. This case to confirm our findings. the most significant concentration of neuron as well as concussion affecting the fluid contents discrepancies for yourself. For example, you may which measured 2 mm. larger in Several years ago, I treated a 15-year-old verified my contention that normalization of in the body, housed in the equally protectiv mension. 18 2-3d Figure 1: Microscopic Evidence of Bone Expansion with Injury Paul Hansma Lab, University of California, Berkely, 2005. of the cranium, including the brain. Thus, injury (impact or strain) is transferred to the densest components of the body, which in turn, leads to expansion of the molecular structure within the cell (cytoskeleton). It has been demon-strated that when the cells expand in this way, they become rigid and their electrical properties are altered 5, 6 . This combination of deformed tis-sue structure and electrical disruption has far‐ reaching clinical effects, causing a wide range of symptoms. This molecular/cellular response to injury is also consistent with the expansion ob-served in injured bone, as observed by Dr. Hans-ma’s team of researchers. Dr. Levin has also writ-be able to notice these differences in the spine (width, depth and height of the vertebral body, ar-ticular processes, lamina or transverse process-es). Figure 3 demonstrates these differences in the size of the articular processes of C1. On pal-2019-11-21 AM areas of enlargement may be easily pation, 9:01 these mistaken for a relative rotation or translation of the vertebral segment. Case Study Allie* is a teenage girl who has struggled her whole life with a debilitating structural bone con-dition. Her issues began at approximately 1 year of age when she broke her right tibia, near the
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