Thursday, May 22, 2008
A Tonal Chiropractic Manifesto
The Driving Force of Function:
A Tonal Chiropractic Manifesto
For years chiropractors have stated collectively that structure equals function. The structure of the spinal column gives the chiropractor a standard into which to establish clinical guidelines for therapy. This presumes that there is a structural component to the spine that is perfectly adapted for the individual organism’s immediate and long term needs that can be imposed by outside standards. Current chiropractic theories state that small asymmetries are pathological, ineffective, cause disease, decrease normal physiology of the human. These negative traits of small rotary asymmetries in the vertebra (the classical chiropractic subluxation) would naturally decrease evolutionary fitness. But to state this is also to affirm that those small rotary asymmetries at the local level in the spine were not adapted for and selected against. These comments presuppose that the spine (after 400 million years of development) has not selected for species fitness and success as a biological line. How could these small asymmetries exist for 400 million years if they did not increase fitness?
Basic evolutionary fitness is the probability that the line of descent from an individual with a specific trait will not eventually die out. Perhaps those small rotations may be small adaptations to the many degrees of freedom (cultivated over 300,000 generations of vertebrate existence) allowed by the hominid spine. These small asymmetries may be pathological in the short term or long term or these small asymmetries may be the best physiological adaptation for the individual to preserve resources in the short or long term. Perhaps these asymmetries may contain both traits?
An understanding of proper function and the analysis those patients with small rotary asymmetries in the spine reveal that many of these patients have lived to ripe old ages and reproduced effectively. If this is documented fact this leads one to deduce that these asymmetries are at least not fatal to those individuals. To state that small asymmetries are always pathological would deny the fitness of 6.2 million years of human natural selection and generational adaptation. If these slight rotations were always a source of inefficiencies and decreased evolutionary fitness these rotations would have been de-selected for and they would not have survived to the present.
The original chiropractic theory of vertebral subluxation (functional anomalies) -the exertion of pressure on a spinal nerve which by interfering with the planned expression of Innate Intelligence produces pathology-is an incomplete statement. This is an incomplete when we recognize the vertebral column has been evolving for over 400 million years of vertebrate evolution to support the body and protect the central nervous system in many millions of vertebrate species.
Traditional chiropractic (segmental and postural technique classifications) evaluates abnormal function as a result of labeled abnormal structures. These labels are self-developed and described in isolation in the chiropractor’s practice or technique. Tonal Chiropractic, a subset of chiropractic technique and theory, has attempted to answer these inconsistencies by looking at the input side of structure. That abnormal structure can lead to abnormal function that continuously feeds the CNS with aberrant input. Or that aberrant structure is the individual’s best attempt to adapt and save resources given the current immediate demands of the internal and external environment. Tonal chiropractic techniques explain that symptoms that we see in our clinics are a result of neuron-physiological partitioning. Since the CNS controls and regulates all physiological process of the human body, these optimizations must occur at the microscopic cellular level in the nervous system first. All these changes can be explained by considering the process of energy efficiency of neural communication and neural processing. Energy (available ATP) is finite. It is reasonable to assume that the limiting factor for this energy resource/metabolic) efficiency optimization process is the use of available ATP. Thus, to optimize neurological programs, the CNS will shunt and mobilize ATP to the areas of greatest physiological need in the CNS. Tonal chiropractic relies on observable biological standards.
History has proven, especially recently, that our science’s understanding of certain human physiology traits is not only incomplete but can be plain wrong. The recent revolutions in the areas of CNS neuroplasticity, the existence of widespread adult CNS stem cells, the ‘discovery’ of the bidirectional communication of the CNS and the immune system; these are areas of science that have changed 180 degrees from their original dogmas. This limitation of human understanding proves our generation’s descriptive limitation and the evaluation of normative function. But physiological proper function must be historical if human existence is a product of 400 million years of vertebrate adaptation and positive modifications. .
Ruth Garrett Millikan (born 1933) is a well-known American philosopher of biology, psychology, and language described the term “proper function” in the late 1980’s. Proper functions are the sorts of functions that biologists assign to the organs of animals and the sorts of function that human artifacts have. The notion in the context of the philosophy of biology is introduced that proper functions are what things are for whilst other functions of the design are not. It is possible to distinguish having the function X from merely functioning as X. Both these linguistic distinctions can be used to mark a rough boundary for the class proper functions.
Function is any activity that can be produced by a structural entity. Proper functions differ from other functions in that they can be cited to explain the reason for the structures existence. The presence of the heart can be partially explained by its capacity to circulate blood and move oxygen into tissues. These functions enter into an evolutionary and natural selection explanation of the presence of the heart. But the presence of the heart cannot be explained by its ability to cause severe pain during a myocardial infarction event. The ability to cause pain is a function of the heart (pathological abet a function) but not its proper function that leads to greater evolutionary fitness. The normative (fitness) function could be said to be its proper function. But it would not be evaluative because of course normative definitions change with better understanding of biological functions. By definition proper function is defined historically over evolution. For example, science used to understand that CNS glia cells were simple supportive structures, we now know that glia cells are the most important cells in the CNS for intercellular communication and neuroplasticity. Some glia cells are not supportive at all, but are in fact adult stem cells. The proper functions of a trait are those effects of a trait which ancestral evolution has determined have fitness components. These functions of a trait are advantageous and are those selected over time. The effects are a positive adaptation. To explain a trait by alluring to its proper function is to explain it as the result of natural selection, in the way with which we are all familiar.
When addressing the functions of the spine one must specifically separate and define the proper functions and foundational functions. Proper spinal functions are functions that can best fit its place in the evolutionary fitness picture. The foundation functions of the spine must first fit in the overriding natural selection process. Function X or Y as described as a spinal function must first agree with evolutionary biology.
If spinal function X or Y, although describable, deny the natural selection process and evolutionary biology for all vertebrates, then the description of the observation must be incomplete.
The incomplete description of spinal function X or Y can not be a proper function. If the function of the spine is to maintain perfect alignment with complete axial symmetry but this “model spine” can not be found in living or deceased humans (or any vertebrates for that matter) and more over that perfect symmetry may not have evolutionary value, then perfect axial symmetry may not be a normative function, or be the foundational function function. There can be no statistical outliers to foundational function. If a few specimens with small rotary asymmetries are observable examples of maximum human performance and presumed evolutionary fitness (biological and athletic rock stars) then the principle of traditional chiropractic that small asymmetries led to depressed function is visibly incomplete. Although ‘perfect axial ‘symmetry may exist theoretically as a spinal function, it does not supersede evolutionary drive and proper foundational function. The described proper structure of the spine (as described by traditional chiropractic paradigms and colleges) can not override examples of super normative function and faultless evolutionary fitness. How can an individual have perfect adaptation traits and outstanding biological function and have small rotary asymmetries if these small rotary vertebral asymmetries have a deleterious effect on individual function and fitness? For example, how can we have patients that are athletics superstars, have a large socially stable families and have small rotary asymmetries if these asymmetries are always deleterious?
So what is the proper function of the spinal column. Perhaps protection of the CNS and spinal cord, Intersegmental flexibility that allows for great range of movement and mobility. Greater mobility adds to species fitness (evolutionary survival ability). But again there must be an underlying principle that is true in every case when applied to all spinal functions. These functions of the spine are not the foundation function, which ids of course, evolutionary fitness. The first and primary proper function of any biological structure is energy efficiency. The proper functions must first and foremost satisfy the evolutionary fitness requirement before another function can be assessed. Does your chiropractic technique evaluate (in real time) the patient’s proper physiological function that would increase evolutionary drive? High priority physiological functions like breathing and circulation should be evaluated pre and post chiropractic interventions. Can a chiropractic or allopathic intervention be positive for the individual if it does not increase real physiological function despite its nociceptive effect?
Increasing the body’s main physiological traits (e.g. breathing, circulation, and heat regulation) should be our prime motivation for intervention. The body after 6.2 million years will shift resources to maintaining basic abilities. If we assist the body in prime physiological functions, the body’s innate ability developed over 400 million years will utilize the freed up resources to improve fitness and heal local injuries/disease.
This brief article was designed to begin conversations within the chiropractic community as to what is the best physiological function to analyze that guides our adjusting techniques. Is it okay to have a chiropractic intervention (or an allopathic one for sake of conversation) that may decrease pain but maintains or assists in degraded physiological function? Do we assess global physiological functions biology and science have always proven effect every cell(breathing, circulation) or do we assess physiological functions on a small local level (segmental biomechanical function, muscle spasms and swelling) and presume they have global effects? The patient’s leg length may be even but does that correspond to an immediate positive change in prime physiological functions like breathing, circulation, heat regulation, nutrient absorption, CNS informational processing energy efficiency, or overall health? Is L5 right rotated a pathological structural malposition or is it the best adaptation 400 million years of winning can produce to maintain efficiency and drive towards fuller expansion of our human potential? Do we evaluate physiological and pathological asymmetries? Is it always best to adjust that swollen, painful high spot or is their a bigger game we should consider? Do we really trust that after 400 million years the human body knows how to adapt efficiently in the short term? Or for those of other religious flavors; do we think we are divine junk?
Very Selected References:
Andre Ariew (Editor) (2002). Functions: New Essays in the Philosophy of Psychology and Biology
Bowler, Peter J. (2003). Evolution:The History of an Idea.
Futuyma, Douglas J. (2005). Evolution.
David H. Peterson (Author), Thomas F. Bergmann (Author) (2002). Chiropractic Technique
Dr. Clary has been practicing in