tag:typepad.com,2003:weblog-1250480 %ISSUE_DATE%T09:25:32-07:00 Working with muscle and other soft tissues. TypePad tag:mpamedia.com,2008:post-55569 2011-10-07T12:00:32-07:00 2011-10-07T12:00:07-07:00

Iliotibial band syndrome (ITBS) is the most common cause of lateral knee pain in runners. It is described as an overuse injury caused by repetitive friction of the iliotibial band over the lateral femoral epicondyle, with the maximal zone of impingement at about 30 degrees of knee flexion.

By Warren Hammer, MS, DC, DABCO Iliotibial band syndrome (ITBS) is the most common cause of lateral knee pain in runners. It is described as an overuse injury caused by repetitive friction of the iliotibial band over the lateral femoral epicondyle, with the maximal zone of impingement at about 30 degrees of knee flexion. tag:mpamedia.com,2008:post-55517 2011-09-09T12:00:32-07:00 2011-09-09T12:00:07-07:00

Many of us focus primarily on adjustments, others are primarily soft-tissue chiropractors, and still others focus on rehab. What gets the best results? Since this is my soapbox, here is my answer: Use the right combination of all of your tools for the specific patient and their specific problem.

By Marc Heller, DC Many of us focus primarily on adjustments, others are primarily soft-tissue chiropractors, and still others focus on rehab. What gets the best results? Since this is my soapbox, here is my answer: Use the right combination of all of your tools for the specific patient and their specific problem. tag:mpamedia.com,2008:post-55492 2011-08-26T12:00:32-07:00 2011-08-26T12:00:07-07:00

One of the most exciting things about manual methods such as Graston, active release, fascial manipulation, friction massage and others is that mechanical loading stimulates the proliferation of fibroblasts. Fibroblasts are the most common cells of connective tissue. These cells, among many other functions, synthesize the extracellular matrix and collagen, which represents the structural framework for our tissues. Lest we forget, the extracellular matrix (ECM) represents everything outside of the cells. Besides providing a structural support to our cells, within the ECM are gels of polysaccharides and fibrous proteins that fill the interstitial spaces and provide a compression buffer against all loads.

By Warren Hammer, MS, DC, DABCO One of the most exciting things about manual methods such as Graston, active release, fascial manipulation, friction massage and others is that mechanical loading stimulates the proliferation of fibroblasts. Fibroblasts are the most common cells of connective tissue. These cells, among many other functions, synthesize the extracellular matrix and collagen, which represents the structural framework for our tissues. Lest we forget, the extracellular matrix (ECM) represents everything outside of the cells. Besides providing a structural support to our cells, within the ECM are gels of polysaccharides and fibrous proteins that fill the interstitial spaces and provide a compression buffer against all loads. tag:mpamedia.com,2008:post-55457 2011-07-29T12:00:32-07:00 2011-07-29T12:00:07-07:00

Fascial manipulation (FM) is a systematic approach to soft-tissue work evolved over 30 years by Luigi Stecco, an Italian physical therapist. I'll start out with my thoughts on this treatment approach in the format of a Web review. My rating is 4.5/5 stars; very good.

By Marc Heller, DC Fascial manipulation (FM) is a systematic approach to soft-tissue work evolved over 30 years by Luigi Stecco, an Italian physical therapist. I'll start out with my thoughts on this treatment approach in the format of a Web review. My rating is 4.5/5 stars; very good. tag:mpamedia.com,2008:post-55456 2011-07-29T12:00:32-07:00 2011-07-29T12:00:07-07:00

An interesting article in the sports section of the New York Times blamed the "yips" on the buildup of scar tissue in the forearms. The yips represent a nervous / tension reaction while attempting to make a short putt in golf and has been defined as a motor phenomenon of involuntary movements. Most people blame it on psychological factors.

By Warren Hammer, MS, DC, DABCO An interesting article in the sports section of the New York Times blamed the "yips" on the buildup of scar tissue in the forearms. The yips represent a nervous / tension reaction while attempting to make a short putt in golf and has been defined as a motor phenomenon of involuntary movements. Most people blame it on psychological factors. tag:mpamedia.com,2008:post-55414 2011-07-01T12:00:32-07:00 2011-07-01T12:00:07-07:00

Bill Clinton used the campaign slogan, "It's the economy, stupid," to help defeat George H.W. Bush in the 1992 presidential election. The sooner the chiropractic profession recognizes the importance of fascia and its treatment in the world of soft tissue, the sooner will we receive the recognition we rightly deserve.

By Warren Hammer, MS, DC, DABCO Bill Clinton used the campaign slogan, "It's the economy, stupid," to help defeat George H.W. Bush in the 1992 presidential election. The sooner the chiropractic profession recognizes the importance of fascia and its treatment in the world of soft tissue, the sooner will we receive the recognition we rightly deserve. tag:mpamedia.com,2008:post-55328 2011-05-20T12:00:32-07:00 2011-05-20T12:00:07-07:00

Osteoarthritis (OA) is the most common form of arthritis, affecting approximately 27 million Americans. Causative factors are thought to be overweight, aging, joint injury or stress, and muscle weakness, among others. Clearly there are many theories of causation, but still no definitive etiologies.

By Warren Hammer, MS, DC, DABCO Osteoarthritis (OA) is the most common form of arthritis, affecting approximately 27 million Americans. Causative factors are thought to be overweight, aging, joint injury or stress, and muscle weakness, among others. Clearly there are many theories of causation, but still no definitive etiologies. tag:mpamedia.com,2008:post-55277 2011-04-22T12:00:32-07:00 2011-04-22T12:00:07-07:00

Most clinicians in the soft-tissue world work on some type of point. It could be a tender point, a myofascial trigger point (active and latent), an acupuncture point or what are currently being called "Stecco" points. Some of the many techniques used to treat these points include friction massage, Graston technique, active release, ischemic compression, myofascial release, fascial manipulation, Nimmo, dry needling, gua sha, structural integration (Rolfing), active isolated stretch, pulsed ultrasound, low-level laser, mechanical vibration, reciprocal inhibition techniques, and varieties of massage, to name just a few. These points are found in and even define conditions such as myofascial pain syndrome, fibromyalgia, fibrositis, regional pain syndrome, chronic pain syndrome, chronic fatigue syndrome, tendinopathies, temporomandibular joint syndrome, migraines and many others.

By Warren Hammer, MS, DC, DABCO Most clinicians in the soft-tissue world work on some type of point. It could be a tender point, a myofascial trigger point (active and latent), an acupuncture point or what are currently being called "Stecco" points. Some of the many techniques used to treat these points include friction massage, Graston technique, active release, ischemic compression, myofascial release, fascial manipulation, Nimmo, dry needling, gua sha, structural integration (Rolfing), active isolated stretch, pulsed ultrasound, low-level laser, mechanical vibration, reciprocal inhibition techniques, and varieties of massage, to name just a few. These points are found in and even define conditions such as myofascial pain syndrome, fibromyalgia, fibrositis, regional pain syndrome, chronic pain syndrome, chronic fatigue syndrome, tendinopathies, temporomandibular joint syndrome, migraines and many others. tag:mpamedia.com,2008:post-55254 2011-04-09T12:00:32-07:00 2011-04-09T12:00:07-07:00

In my opinion, quality chiropractic care begins with combining soft-tissue techniques with joint manipulation and rehabilitation exercise. Muscles move bones. If you are not addressing the dysfunction in the muscles, your adjusting is much less likely to have long-term success. This article, the first in a series on soft-tissue techniques, reviews some of soft-tissue methods I have been introduced to over the past 35 years.

By Marc Heller, DC In my opinion, quality chiropractic care begins with combining soft-tissue techniques with joint manipulation and rehabilitation exercise. Muscles move bones. If you are not addressing the dysfunction in the muscles, your adjusting is much less likely to have long-term success. This article, the first in a series on soft-tissue techniques, reviews some of soft-tissue methods I have been introduced to over the past 35 years. tag:mpamedia.com,2008:post-55134 2011-01-29T12:00:32-07:00 2011-01-29T12:00:07-07:00

For years, we have read about and experienced the reduction in tissue viscosity that occurs when we create pressure on tissues, whether by hand, instrumentation or the use of modalities. Many thoughts have been expressed about tissue release regarding temperature, the effect of pressure, the change in fascia from a gel to a solid, intercellular matrix changes, etc. The problem is that no one has expressed the underlying possible histological reason for tissue change based on evidence.

By Warren Hammer, MS, DC, DABCO For years, we have read about and experienced the reduction in tissue viscosity that occurs when we create pressure on tissues, whether by hand, instrumentation or the use of modalities. Many thoughts have been expressed about tissue release regarding temperature, the effect of pressure, the change in fascia from a gel to a solid, intercellular matrix changes, etc. The problem is that no one has expressed the underlying possible histological reason for tissue change based on evidence. tag:mpamedia.com,2008:post-55078 2011-01-01T12:00:32-07:00 2011-01-01T12:00:07-07:00

Almost all of the major anatomical textbooks - Netter's Atlas of Human Anatomy and Gray's Anatomy, for example - show beautiful photos and illustrations of muscles attached to bones. Unfortunately, based on this type of muscular description, they are describing only part of a structure and giving the impression that this represents the muscle in its entirety. What is being left out is the part of the muscle that transmits its force and even more importantly, the part of the muscle that allows it to function.

By Warren Hammer, MS, DC, DABCO Almost all of the major anatomical textbooks - Netter's Atlas of Human Anatomy and Gray's Anatomy, for example - show beautiful photos and illustrations of muscles attached to bones. Unfortunately, based on this type of muscular description, they are describing only part of a structure and giving the impression that this represents the muscle in its entirety. What is being left out is the part of the muscle that transmits its force and even more importantly, the part of the muscle that allows it to function. tag:mpamedia.com,2008:post-54773 2010-07-15T12:00:32-07:00 2010-07-15T12:00:07-07:00

"Addressing the Myofascial Component of Musculoskeletal Pain," a two-day conference held at the University of Pittsburgh on May 7-8, marked a historic first for the chiropractic profession. Over a year ago, four doctors of chiropractic got together and decided that with interest in soft tissue beginning to permeate our profession, why not create a conference and invite scientists and clinicians from all professions interested in soft-tissue research and treatment? Why not invite representatives from all areas of the soft-tissue world that have clinically proven successes? In short, this was a conference conceived by DCs who decided that they had enough of the petty bickering between professions as to who could achieve the best results.

By Warren Hammer, MS, DC, DABCO "Addressing the Myofascial Component of Musculoskeletal Pain," a two-day conference held at the University of Pittsburgh on May 7-8, marked a historic first for the chiropractic profession. Over a year ago, four doctors of chiropractic got together and decided that with interest in soft tissue beginning to permeate our profession, why not create a conference and invite scientists and clinicians from all professions interested in soft-tissue research and treatment? Why not invite representatives from all areas of the soft-tissue world that have clinically proven successes? In short, this was a conference conceived by DCs who decided that they had enough of the petty bickering between professions as to who could achieve the best results. tag:mpamedia.com,2008:post-54549 2010-03-26T12:00:32-07:00 2010-03-26T12:00:07-07:00

Before I decide whether to attend a conference, I ask myself two important questions: will the information be beneficial to my understanding of the subject and will I be instituting any permanent changes the following Monday morning? It is often said that if a conference is able to give the practitioner one significant thing they will find useful for the rest of their career, then the weekend is worthwhile.

By Warren Hammer, MS, DC, DABCO Before I decide whether to attend a conference, I ask myself two important questions: will the information be beneficial to my understanding of the subject and will I be instituting any permanent changes the following Monday morning? It is often said that if a conference is able to give the practitioner one significant thing they will find useful for the rest of their career, then the weekend is worthwhile. tag:mpamedia.com,2008:post-54447 2010-01-29T12:00:32-07:00 2010-01-29T12:00:07-07:00

This past November, I was privileged to speak on Graston Technique at the 2nd Fascia Research Conference in Amsterdam. There is much to report about the new material that was presented at the conference, which I will do in this and future articles. I became especially interested at the final day of the six-day conference when I attended a workshop titled "The Fascial Manipulation Technique and Its Biomechanical Model - A Guide to the Human Fascial System." The course was presented by Carla Stecco, MD, an orthopedic surgeon and assistant professor of human anatomy and movement sciences, University of Padova, Italy; and Julie Ann Day, a physiotherapist also from Padova.

By Warren Hammer, MS, DC, DABCO This past November, I was privileged to speak on Graston Technique at the 2nd Fascia Research Conference in Amsterdam. There is much to report about the new material that was presented at the conference, which I will do in this and future articles. I became especially interested at the final day of the six-day conference when I attended a workshop titled "The Fascial Manipulation Technique and Its Biomechanical Model - A Guide to the Human Fascial System." The course was presented by Carla Stecco, MD, an orthopedic surgeon and assistant professor of human anatomy and movement sciences, University of Padova, Italy; and Julie Ann Day, a physiotherapist also from Padova. tag:mpamedia.com,2008:post-54422 2010-01-15T12:00:32-07:00 2010-01-15T12:00:07-07:00

At a recent seminar, I was teaching how to correct the adductors. As I circumducted the supine patient's left hip joint, she experienced pain at the pubic ramus when the thigh was adducted medially and moved from superior to inferior. One of the doctors standing nearby blurted out that the patient had a labral tear. This opened the opportunity for discussion about acetabular labral tear signs and symptoms.

By Todd Turnbull, DC, CCSP At a recent seminar, I was teaching how to correct the adductors. As I circumducted the supine patient's left hip joint, she experienced pain at the pubic ramus when the thigh was adducted medially and moved from superior to inferior. One of the doctors standing nearby blurted out that the patient had a labral tear. This opened the opportunity for discussion about acetabular labral tear signs and symptoms. tag:mpamedia.com,2008:post-54394 2010-01-01T12:00:32-07:00 2010-01-01T12:00:07-07:00

Before employing rehabilitative exercise in the office or counseling a patient on rehabilitative exercises to be performed at home, you must have a basic understanding of soft-tissue injuries. This understanding will help in all aspects of rehabilitation including stretching, aerobic exercise and strength training.

By K. Jeffrey Miller, DC, DABCO Before employing rehabilitative exercise in the office or counseling a patient on rehabilitative exercises to be performed at home, you must have a basic understanding of soft-tissue injuries. This understanding will help in all aspects of rehabilitation including stretching, aerobic exercise and strength training. tag:mpamedia.com,2008:post-54348 2009-12-02T12:00:32-07:00 2009-12-02T12:00:07-07:00

An anatomic study that appeared recently in the American Journal of Sports Medicine1 identified – for the first time – the cross-sectional anatomy of the iliopsoas tendon at the level of the labrum. Several authors have implicated iliopsoas impingement on the anterior labrum as a cause of labral tears. They have stated that a tight iliopsoas tendon could cause compression over the anterior capsulolabral complex, leading to labral lesions. Labral tears at the 2 o’clock to 3 o’clock position of the acetabulum (see image on page 20) are directly under the iliopsoas tendon. This labral tear is considered an anterior tear, while most labral tears caused by trauma, femoroacetabular impingement, capsular laxity/hip mobility, dyspla

By Warren Hammer, MS, DC, DABCO An anatomic study that appeared recently in the American Journal of Sports Medicine1 identified – for the first time – the cross-sectional anatomy of the iliopsoas tendon at the level of the labrum. Several authors have implicated iliopsoas impingement on the anterior labrum as a cause of labral tears. They have stated that a tight iliopsoas tendon could cause compression over the anterior capsulolabral complex, leading to labral lesions. Labral tears at the 2 o’clock to 3 o’clock position of the acetabulum (see image on page 20) are directly under the iliopsoas tendon. This labral tear is considered an anterior tear, while most labral tears caused by trauma, femoroacetabular impingement, capsular laxity/hip mobility, dyspla tag:mpamedia.com,2008:post-54149 2009-10-07T12:00:32-07:00 2009-10-07T12:00:07-07:00

It appears that the validity of almost all of the shoulder tests we perform on a daily basis are in question.

By Warren Hammer, MS, DC, DABCO It appears that the validity of almost all of the shoulder tests we perform on a daily basis are in question. tag:mpamedia.com,2008:post-54040 2009-08-12T12:00:32-07:00 2009-08-12T12:00:07-07:00

It is very doubtful that a cure for osteoarthritis (OA) will be discovered in our lifetime. However, based on present-day information, there are definite ways to reduce its consequences. Three definite risk factors include being overweight, excessive musculoskeletal loading at work and injuries. According to Felson, et al., losing weight would reduce OA by 27 percent to 53 percent; eliminating squatting, kneeling and carrying heavy loads during work would reduce OA in men by 15 percent to 30 percent; and preventing ligamentous or knee meniscus rupture injuries would reduce OA another 14 percent to 25 percent.

By Warren Hammer, MS, DC, DABCO It is very doubtful that a cure for osteoarthritis (OA) will be discovered in our lifetime. However, based on present-day information, there are definite ways to reduce its consequences. Three definite risk factors include being overweight, excessive musculoskeletal loading at work and injuries. According to Felson, et al., losing weight would reduce OA by 27 percent to 53 percent; eliminating squatting, kneeling and carrying heavy loads during work would reduce OA in men by 15 percent to 30 percent; and preventing ligamentous or knee meniscus rupture injuries would reduce OA another 14 percent to 25 percent. tag:mpamedia.com,2008:post-54036 2009-09-09T12:00:32-07:00 2009-09-09T12:00:07-07:00

There is an old saying that "movement heals." It is readily accepted that exercise benefits many musculoskeletal conditions by promoting repair and remodeling of tendon, muscle, articular cartilage and bone. This occurs by way of mechanotransduction, a physiological process wherein cells sense and respond to mechanical loads.

By Warren Hammer, MS, DC, DABCO There is an old saying that "movement heals." It is readily accepted that exercise benefits many musculoskeletal conditions by promoting repair and remodeling of tendon, muscle, articular cartilage and bone. This occurs by way of mechanotransduction, a physiological process wherein cells sense and respond to mechanical loads. tag:mpamedia.com,2008:post-53981 2009-08-12T12:00:32-07:00 2009-08-12T12:00:07-07:00

As most of you know, fascia is a component of pretty much all structures. The practice of Rolfing, or structural integration, is a popular form of bodywork and purports to be directed at balancing the fascial structures in the body, leading to optimal structural health. However, like most practices, there is little evidence to support this concept.

By Geoffrey Bove, DC, PhD As most of you know, fascia is a component of pretty much all structures. The practice of Rolfing, or structural integration, is a popular form of bodywork and purports to be directed at balancing the fascial structures in the body, leading to optimal structural health. However, like most practices, there is little evidence to support this concept. tag:mpamedia.com,2008:post-53978 2009-08-12T12:00:32-07:00 2009-08-12T12:00:07-07:00

I first began investigating lasers in May 2000 after I returned from working with cyclist Lance Armstrong in preparation for the second of seven consecutive Tour de France victories that Lance, his team and I would win together. Ironically, the laser would ultimately end up playing a major role in Lance's victories.

By Jeffrey Spencer, MA, DC, CCSP I first began investigating lasers in May 2000 after I returned from working with cyclist Lance Armstrong in preparation for the second of seven consecutive Tour de France victories that Lance, his team and I would win together. Ironically, the laser would ultimately end up playing a major role in Lance's victories. tag:mpamedia.com,2008:post-53935 2009-07-15T12:00:32-07:00 2009-07-15T12:00:07-07:00

Manual muscle testing is used to determine if a muscle is injured or causes pain, if weakness is associated with the pain or if there is weakness without pain. When the tendon is involved, there usually will be more of a full range of motion than if the belly is involved, due to possible muscle belly rupture and protective spasm limiting the range of motion.

By Warren Hammer, MS, DC, DABCO Manual muscle testing is used to determine if a muscle is injured or causes pain, if weakness is associated with the pain or if there is weakness without pain. When the tendon is involved, there usually will be more of a full range of motion than if the belly is involved, due to possible muscle belly rupture and protective spasm limiting the range of motion. tag:mpamedia.com,2008:post-53894 2009-07-01T12:00:32-07:00 2009-07-01T12:00:07-07:00

A great deal of effort has been applied in chiropractic toward understanding and treating functional disturbances of the cervical spine, whether the cause of the dysfunction is trauma, as in whiplash dynamics, or of unknown etiology, as in many cervical-cranial syndromes. While considerable research has been conducted detailing the mechanical nature of the neck, the functional nature of cervical muscle action - responsible for the biomechanics and kinematics of the neck - is more limited.

By Scott Cuthbert, BA, DC, BCAO A great deal of effort has been applied in chiropractic toward understanding and treating functional disturbances of the cervical spine, whether the cause of the dysfunction is trauma, as in whiplash dynamics, or of unknown etiology, as in many cervical-cranial syndromes. While considerable research has been conducted detailing the mechanical nature of the neck, the functional nature of cervical muscle action - responsible for the biomechanics and kinematics of the neck - is more limited. tag:mpamedia.com,2008:post-53806 2009-05-20T12:00:32-07:00 2009-05-20T12:00:07-07:00

Every technique that creates compression or tensile stretch to soft tissue creates a mechanical load that is necessary for tissue change. Gua sha represents another form of mechanical load on soft tissue that claims healing results and, like all other soft-tissue methods, begs for research to prove its value.

By Warren Hammer, MS, DC, DABCO Every technique that creates compression or tensile stretch to soft tissue creates a mechanical load that is necessary for tissue change. Gua sha represents another form of mechanical load on soft tissue that claims healing results and, like all other soft-tissue methods, begs for research to prove its value. tag:mpamedia.com,2008:post-53621 2009-01-29T12:00:32-07:00 2009-01-29T12:00:07-07:00

A recent article in the AJSM discusses a surgical release for the proximal hamstring syndrome. Conservative treatment for this condition has included shortwave diathermy, ultrasound, electrotherapy, stretching, muscle exercises, anti-inflammatory drugs, muscle relaxants, corticosteroids and local analgesic injections.

By Warren Hammer, MS, DC, DABCO A recent article in the AJSM discusses a surgical release for the proximal hamstring syndrome. Conservative treatment for this condition has included shortwave diathermy, ultrasound, electrotherapy, stretching, muscle exercises, anti-inflammatory drugs, muscle relaxants, corticosteroids and local analgesic injections. tag:mpamedia.com,2008:post-53426 2008-09-23T12:00:32-07:00 2008-09-23T12:00:07-07:00

People don't like pain. It seems like every other commercial on TV is for this or that pain reliever – tablet, gelcaps, mineral rub, thermal patch, easy-to-swallow liquid, and even the special herbal formulary translated from an ancient stone tablet somewhere in the Himalayas. The focus on alleviating pain is enormous. Please note, I said the focus is on alleviating pain, not fixing the problem. As chiropractors, we often focus on fixing the source of the problem – that is all well and good, but most people on the street are only worried about getting out of their pain now.

By Douglas R. Briggs, DC, Dipl. Ac. (IAMA), DAAPM and Kymberlie S. Combs, LMT People don't like pain. It seems like every other commercial on TV is for this or that pain reliever – tablet, gelcaps, mineral rub, thermal patch, easy-to-swallow liquid, and even the special herbal formulary translated from an ancient stone tablet somewhere in the Himalayas. The focus on alleviating pain is enormous. Please note, I said the focus is on alleviating pain, not fixing the problem. As chiropractors, we often focus on fixing the source of the problem – that is all well and good, but most people on the street are only worried about getting out of their pain now. tag:mpamedia.com,2008:post-53319 2008-07-15T12:00:32-07:00 2008-07-15T12:00:07-07:00

Have you ever treated a plantar fasciitis that did not respond? It might be a nerve entrapment.

By Warren Hammer, MS, DC, DABCO Have you ever treated a plantar fasciitis that did not respond? It might be a nerve entrapment. tag:mpamedia.com,2008:post-53217 2008-05-20T12:00:32-07:00 2008-05-20T12:00:07-07:00

The effect of mechanical load on soft tissue is receiving increased attention from researchers around the world. This was most evident at the recent Fascial Research Conference held at the Harvard Convention Center. It was emphasized that all types of soft-tissue mechanical loading including exercise, injury, manual muscle treatments such as fascial release, stretching techniques and instrument-assisted soft-tissue mobilization methods (IASTM), such as the Graston technique (GT), affect the fibroblast.

By Warren Hammer, MS, DC, DABCO The effect of mechanical load on soft tissue is receiving increased attention from researchers around the world. This was most evident at the recent Fascial Research Conference held at the Harvard Convention Center. It was emphasized that all types of soft-tissue mechanical loading including exercise, injury, manual muscle treatments such as fascial release, stretching techniques and instrument-assisted soft-tissue mobilization methods (IASTM), such as the Graston technique (GT), affect the fibroblast. tag:mpamedia.com,2008:post-53144 2008-03-25T12:00:32-07:00 2008-03-25T12:00:07-07:00

We constantly try to prove that chiropractic care is preventative and that maintenance visits are necessary. While the absolute proof of this premise is not yet substantiated, one area to evaluate

By Warren Hammer, MS, DC, DABCO We constantly try to prove that chiropractic care is preventative and that maintenance visits are necessary. While the absolute proof of this premise is not yet substantiated, one area to evaluate