What It Takes to be Precise (For the Doctor: How To Be Precise)

Precision in anything involves the TWO C’s:

1. Carefulness (in Observation + Action), and

2. Comprehensiveness (knowing and applying all factors involved).   

#1 above starts with taking care to observe what you are observing. It involves intention to see and understand what is happening.

A patient is asked to breathe in and out while standing still. The doctor observes this from the side of the patient. What does the doctor see?

Well, the doctor knows that rib cage moves up and down like the handle on the side of a bucket – the “handle” moves up from the bottom on the breath in and descends back down on the out-breath. Just pretend that there is a bucket handle on the side of your own rib cage, and pull it up, then let it drop down again.

If the breath in has hesitation on the way up, there is something wrong with the ribs movement, somewhere in the middle, right? The Ribs are supposed to move smoothly from bottom to top.

Or, if the body slumps at a specific spot on the way down, there might be some kind of misalignment of a spinal bone somewhere in the middle, right? The Bones of the spine hold the body UP in good posture IF they are in the right positions.

Think of stacked boxes – someone can stack them well, each of them having their box corners lined up with those below and above. Now they are more stable and upright! Or someone can stack them badly and they end up falling over quite easily.

Also, the popular game of Jenga illustrates this concept of stacking and stability!

When a Doctor gets good at observing what you are observing, they can improve the precision of treatment – knowing where and what to treat!

#2 above, Comprehensiveness, has to do with not missing any important data about the subject of Structural Correction and applying all of that data in the correct sequence.

Multi-concept Example: the 1^st rib is the highest rib of the Rib Cage. It forms joints with the last bone of the neck (Cervical #7) and the first bone of the Upper back (Thoracic #1). If this rib is out of place on either or both left and right sides ~ then the neck and head are going to slump forward. Is this even considered in Standard Chiropractic Practice?

Furthermore (on the 1^st Rib),…

There is a type of Lever System which the combined weight of the Head and Neck are held up (naturally with an aligned structure) with a mechanical balance point. The 1^st Rib IS that balance point. If it is out, the Lever System fails and the weight of the Neck and Head now rely on the MUSCLES to hold itself upright.

It might be said, ‘Well that’s ok, that’s what the muscles are for!”, or something more sophisticated like “There are 10 balance points in the body and you must do something with the muscles to balance these out”.

Hmmm, when did Chiropractic become about Muscles? And muscles are NOT FOR HOLDING UP the Neck and Head and the rest of the body. They are for MOVING/stabilizing for the purpose of MOVING the head and Neck and body – see the difference?

When either or both of the 1^st ribs are chronically out, MUSCLE HOLDING over time will develop a tight neck and eventually Headaches, among other very non-optimum conditions.

Better to Correct the 1^st Rib into a stable position which does not rely on Muscles.

Furthermore still (on the 1^st Rib),…

The 1^st Rib will NOT have a stable position unless you FIRST correct the REST of the rib cage below it, AND the Low Back. One must properly stack all the supporting structure below before the top 1^st rib will keep its normal stable position.

Much like making sure one stacks the boxes well from the bottom to the top. Or Jenga once again!

Conclusion: The 1^st Rib and its various clinical aspects is a great example of Comprehensive knowing and application.

A Doctor of Chiropractic has the responsibility to know ALL the Mechanical and Bio-hydraulic importances to Structural Correction, and how these two relate to each other. [Also read “Importance of Bio Hydraulic Concepts in Chiropractic Practice].

Lastly, a much better way to practice Chiropractic is to separate out each Structural Correction Factor, and to treat EACH with Precision. Be the Best Chiropractor that you can be!

Simply putting your hand on the spine and pushing hard may get a lot of things to move, but it is not the definition of “PRECISE” - the multiple One-shot Adjustment techniques may move a lot of bones at once and produce short-term relief of the patient…So, Do you want “Let’s see what happens” or Precision with Long-term Correction? 

[Dr. Dan Riesling is a co-developer of Bio-hydraulic Sciences in the Practice of Chiropractic]