Dr. Mark Hastings’s Rehab Videos

How Chiropractic works

October 8th, 2007

A common question patients ask is how does Chiropractic care work, and what makes the “cracking” sound during manipulation? The answers to both questions are complicated, because the mechanisms of musculoskeletal dysfunction and disease are themselves complicated; many factors must be considered in any particular case study. The science of spinal and joint manipulation can be explained in several steps, none too difficult to understand; but the benefits of manipulation must be seen in the broad context of these steps to truly understand how it works.

When a joint is properly manipulated, it is placed into the physiologically beneficial range of motion, at the taut limits of the ligaments that hold the joint in position. When this is done correctly, the joint is stressed into the direction that most restores correct motion in that particular region. The doctor first applies an appropriate pre-stress to the joint. At this point, the patient naturally has apprehension (tenses up); when the doctor senses an ebb in this apprehension, he or she applies an instantaneous thrust into the joint plane to make the beneficial correction. The patient’s willingness to let go of their apprehension and allow the doctor to perform the technique is necessary for a speedy and successful recovery from the chief complaint. Therefore, joint manipulation is not something the doctor does to the patient; rather, it is something that the doctor and patient do together.

At the instant of the corrective thrust, the joint undergoes a radical physiologic shift by creating a rapid lessening of pressure in the joint space, activating a protective mechanism in the joint, and creating the popping or cracking sound that is audible upon manipulation. Your joints have a viscous substance called synovial fluid which acts as a lubricant and a source of nourishment to the cartilage that lines the joint surfaces. When the joint is stressed correctly, this fluid accommodates the change in joint volume by instantly releasing dissolved gases, resulting in the sound waves that we hear. During the twenty minutes or so that it takes for the gas to dissolve back into synovial fluid, the dysfunctional joint is stretched into the correct position. This is one of the first mechanisms of manipulation that is beneficial to you; in fact, there is really no other way to deal with lost range of motion at a ligamentous level in the joint, since during conventional stretching programs, the larger overlying musculature will come to tension sooner.

The next beneficial mechanism is the one that provides the immediate and noticeable relief following manipulation. Your body has a system of joint monitoring known as proprioception; it’s one of the ways your body knows where it is in space. If you close your eyes and touch your fingertip to your nose, you finger finds it way through proprioception. This system is comprised of what is known as mechano-receptors; they monitor movement and relay that information to your brain. These receptors are abundant in the musculo-tendionous regions of your body, such as where the muscles are attached to the bones. One of these receptors is known as the Golgi Tendon Organ; it monitors the rate of change of length of a muscle. If the Golgi Tendon Organ senses an excessively rapid change in length, it will trip a reflex in your spinal cord, to cause instantaneous relaxation in the muscle overlying that particular joint or region of your body. When your body has a musculoskeletal injury, muscle spasms occur around the area in an attempt to protect it. However, they can actually cause further injury to your joints, not to mention being a source of great suffering to you. If these spasms continue, they may even become self-propagating; they are then known as focal dystonias. These focal dystonias will continue until outside measures are taken to bring them back under the normal control of your body. When manipulation is directed correctly to areas plagued by spasms, the relaxation mechanism of the Golgi Tendon Organ instantly breaks these focal dystonias, and patients will see a noticeable reductions in pain. The specific nature of the complaint and the factors causing the underlying problem dictate the treatment regime and the number of times the treatments must be performed; so, the doctor needs to find the causes of the problem and treat the cause as much as the symptoms.

Chiropractic care generally helps people reduce pain in three ways. First is the severity of the pain; this is a measure of how much the pain hurts on a scale out of 1-10, with 10 being the worst pain you’ve ever experienced. The second is the frequency of the pain; this is how often you experience pain. This can be classified into seldom (25% of the time or less), intermittent, (25% - 50% of the time), frequent (50-75% of the time), and finally constant (75% - 100% of the time, including sleeping). Lastly there is the duration of the pain; this is how long the pain persists. If you are in active treatment for your complaint, Chiropractic care should reduce all these variables.

Patients’ injuries can generally be classified as acute or chronic. Acute injury patients are otherwise pain-free individuals that have very recently incurred some form of pain related to the muculoskeletal system, and will rapidly return to normal with a minimum of correct Chiropractic treatments (usually one to five treatments). Their body has not had sufficient time to undergo permanent changes from ongoing neglected musculoskeletal stress. Chronic pain suffers, by contrast, are disabled by degenerative conditions that have lead to long-term complaints that will not completely resolve. However, they can make acceptable improvement with correct care. Patients with degenerative arthritis are a prime example of this group. In these patients, changes in the joints’ internal structures do not allow for the proper functioning of the joint, and cause activation of stress responses forming frequent and continued muscle spasms. If left unattended, this cycle of muscle spasm will become more frequent to the point where pain is felt all the time. There are many systems of health care to deal with these patients, and often combinations of several health care systems are necessary to bring the patient to the highest level of functioning with the lowest level of pain. Chiropractic care uses joint manipulation in combination with exercise therapy to bring the joints to a more normal level of functionality, thus reducing the nature of suffering to an acceptable level. In these cases, it is necessary to perform several weeks to several months of proper care to retrain the muscles overlying the dysfunctional joints to return to normal service. The length of treatment depends on the seriousness of the individual pain complaint. The doctor monitors for appropriate improvement, and determines when the patient is reaching maximum medical improvement. Patients that are active participants in their treatment plans and comply with the specific recommendations by their doctor can anticipate subjective improvements of between 60% - 100% of their pain complaint. Once the initial treatment regime has delivered its maximum level of relief, the doctor notifies the patient that further improvement is not likely, and explains the need for attenuation of treatment and the need for supportive care. Supportive care is manipulation and therapy delivered intermittently to maintain the initial level of improvement, and will vary from patient to patient depending on the severity and the specific nature of the complaint. Its frequency is determined by the frequency at which the patients slip back to the symptomatic phase.
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Weight Loss

October 8th, 2007

Weight loss is something I’m asked to help with frequently. There is considerable misinformation and misconception about the mechanism of weight loss, which is actually very simple: eat less and move more. However, this isn’t enough information for most people to have success with.

The reason for excess weight is the law of conservation of mass. If you take in a number of calories and expend that same number, your body weight will remain constant. If you expend more or less calories, you will lose or gain weight at the rate of one pound of body weight per 3,600 calories. Prior weight loss techniques tried, in vain, to come up with strategies to raise your metabolic rate (the rate at which your body expends calories) to shed excess pounds. These attempts were both ineffective and harmful to overall health. The problem lay in the apeset, a part of the phylogenetically old region of the brain known as the thalamus, or your “crocodile” brain. This system is regulated by your endocrine system, which is itself controlled by the release of hormones into your blood stream when you eat food. As your digestion takes place, your intestines and other parts of your body release hormones that bind chemically in your brain to tell your body you’re not hungry any more.

The problem is, this process takes about twenty minutes. This would have been beneficial early in our evolution, when, as hunter-gatherers, we needed to travel many miles over several hours just to gather enough food to maintain even a small average body weight. Now, with an abundance of calorie-rich foods easily available, we are able to eat three to four times our daily caloric requirements in under ten minutes. By the time our appetite catches up and we feel satiated, our caloric requirements have been vastly over supplied. This problem is exacerbated by the fact that our brain registers high-caloric, high-fat foods as beneficial to our system. This also stems from our evolutionary past, when the comsumption of the excess calories found in high-caloric foods could mean the difference between life and death, especially as winters approached.

Now, thanks to Burger King, Kentucky Fried Chicken and the like, you can sit at one quick, convenient, and tasty meal and exceed your daily requirement for calories. Your body converts the excess calories into fat as stored energy for famine that never comes. The problem for modern humans is that this increased body mass significantly increases the risk for for a multitude of life-shortening diseases. Obesity is fast becoming the most serious health consideration facing Americans.

There is a simple answer to this mismatch of modern abundance and ancient physiology: Eat half of your intended meal. Take the other half and place it aside for thirty minutes. If, after thirty minutes, you’re still hungry, then, in fact, your body really needs those extra calories, and you can eat some more. The majority of the time, however, after thirty minutes, your apiset will have registered that you’re full and your appetite will have abated. If you make a habit of this, your body will eventually draw from its unnecessary excess to make up the deficit of uneaten calories and your body weight will slowly come down.

If you have weight reduction goals, it is best to monitor your weight at least once a week to make sure you’re losing between one and two pounds per week. If you lose too quickly, your body will develop strong cravings for excess food intake, and your weight will rebound. If you’re not losing quickly enough, then you need to further decrease your food consumption every meal, until you are losing at the correct rate. Once you have reached your target weight, you can use a system I call “bracketing” to maintain your new body weight. In essence, you choose a “ceiling” weight that you will not allow your body to go over before making an immediate correction. Usually this is a few pounds over your target weight. For example, let’s say you’ve chosen 160 pounds as your target weight, and have attained it. Your “ceiling” weight would then be 164 pounds. As you continue to monitor your weight weekly, if you find yourself approaching 164 pounds, make the necessary steps in your daily eating to correct this trend. After a while, you’ll gain a natural sense of your own weight and eating habits and weekly monitoring on the scale will not be necessary.

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The study of movement

June 5th, 2007

Movement Vs. Activity

I have spent over twenty-five years studying the science of human movement. I started in high school athletics, where I pursued wrestling, and track and field, with specific focuses on pole vaulting, cross-country, surfing, skateboarding, and football. After high school, I began formal training in martial arts and gymnastics. During these early years, I struggled to integrate the art of relaxation with strenuous physical activity; to master an activity, an athlete must be relaxed in its performance.

After many years, through an emphasis on flexibility and cross-training, I learned to relax at high levels of output regardless of the task. I had also begun to appreciate the importance of individual movements rather than of specific activities as a whole. This led to a breakthrough in my understanding of athletics: that relaxed body movements give one the ability to correctly complete any specific physical task.

Happiness

During this time, I began to notice people would generally be at their happiest when engaged in physical activities, and wondered why. After a while, I began to realize that it wasn’t necessarily a specific activity that brought pleasure, rather it was the fact that the person was engaged in movement. We are after all, kinetic beings, designed to move; the more we move, the closer we are to our purpose.

An ancient Eastern philosophy states that if we put equal amounts of energy into mind, body, and soul, we’ll become enlightened and happy. Many people forget the importance of the second aspect, the body. As a Chiropractor, over the years I have interviewed many patients to aid arrival at their diagnoses. In this time, I have found that those people with the most problems, both physical and emotional, are those that are the most sedentary. In fact, I know absolutely no happy people that are sedentary. This shows how integral movement is to ones sense of well-being.

All One Thing

Having been a trainer in several different athletic fields for over twenty years, I’ve begun to see a common goal to all training: to perfect the human body in motion, while being as relaxed as possible. So, in a way, all training is cross-training. A person training for running is also training for martial arts or biking or surfing; all fields require the same mastery of the fundamental principals of correct human movement. Realizing this gives you the freedom to pursue many different activities and advance in all of them, because in all of them you are simply training human movement. No matter what activity I am engaged in, it is training, including for the practice of Chiropractic.

Spirituality and Movement in Nature

One night our church pastor, Reverend Renee, spoke to a common problem with our culture: people striving with most of their time and energy toward the acquisition of material things, believing that they are necessary to happiness. He said, “God gave us everything we need to be happy. We can’t improve upon this.” He told us that nature, beautiful as a forest or the ocean, is what truly brings us a sense of pleasure and well being.

That part of nature within us, our heritage of thousands of years of hunting and gathering, shows in our bodies, designed to cover significant distances by walking, running or climbing in a natural setting: a body in motion. When we pursue athletics, especially in a natural setting, we are accomplishing our genetic purpose, and it brings us pleasure and satisfies our thirst for meaning.

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Welcome

February 25th, 2007

Hello, I’m Mark Hastings, D.C., a practicing Chiropractor in Aptos, California. I graduated from Palmer West College of Chiropractic in 1997 and specialize in sports medicine with particular focus on shoulder injuries, runners injuries, foot and hand injuries, and most musculo-skeletal injuries in general. In addition to injuries, I have extensive knowledge in athletic training and nutrition. If you have a question that you think others might benefit from, please post your questions here and I’ll do my best to answer them accurately and thoroughly. Please visit my website at www.rehabvideos.com

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