It is often difficult to determine where to spend our postgraduate dollars. Many doctors have already attended the S1 through E1 series and might not know the changes in these seminars. The E1 seminar is by far the elite seminar in the Motion Palpation series. Although it is difficult material, it enables the doctor to be thoroughly proficient in the treatment of biomechanical disorders of the foot. The highlight of this seminar is the in-depth study of foot anatomy and anatomical movements both weightbearing and nonweightbearing. This seminar is definitely one that you will have to attend three to four times to be completely knowledgeable on the course material.
One aspect of the E1 one seminar that is relatively new is the use of a toggle board in extremity adjusting. The use of toggle or speeder boards is not new in our profession but their application in extremity work is ideal. The advantage of the toggle board is in its specificity. One can contact a single small bone in the foot or wrist and apply force in any direction of movement. The amount of force utilized with the toggle board is such that it allows adequate movement of the joint without the potential for damage of other structures. The "old" snapping or pulling movements are still taught but there is much less risk using the toggle board. Previous techniques such as Loche's maneuver, although excellent, are difficult to learn and this learning curve does not allow the doctors to quickly use the material learned during the seminar. If you live and die by the noises made during an adjustment, you won't like the toggle board, but if you enjoy painless adjusting and return of normal movement and function, you'll love this seminar.
The E1 seminar verifies the importance of proper foot, knee, and hip mechanics and their relationship to a normal and pain-free spine. Chronic low back cases and even problems in the cervical spine can have their origin in the foot or lower extremity. It is always important to remember that although we divide the spine into separate areas for nomenclature these three functional areas encase a spinal cord that is a continuous structure. The pelvis considered to be the base of the spine is actually only part of a kinematic chain that begins (at least in ambulatory humans) in the foot. Therefore, chiropractic care that does not deal with abnormal foot or lower extremity mechanics is not sufficient in restoring spinal health.
If chiropractic is more than just a musculoskeletal healing profession that deals only with backaches and headaches then we must include in our analytical procedures more than just the spine. Chiropractic is truly about treating the cause not the effect. If you are treating only the spine you may be treating the cause, not the effect. Subtalar joint dysfunction can even lead to contralateral tendonitis of the shoulder. If this sounds strange or impossible you need to attend the E1 and E2 seminars. It is always easier to treat a patient when the right structure is addressed during treatment.
Terry Elder, DC
Winfield, Kansas
Editor's Note:
Dr. Elder will conduct his next Cervicals and Thoracics (S2) seminar March 26-27 in St. Louis, Missouri and his next Upper Extremities (E2) seminar July 23-24 in Seattle, Washington. To register call 1-800-359-2289.
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
On Feb. 1, 2024, two more legislators – John R. Carter (R-Texas) and Robert “Bob” Good (R-Va.) – co-sponsored the Chiropractic Medicare Coverage Modernization Act of 2023, bringing the co-sponsor total to 155, two more than the total achieved over the entire two-year congressional cycle in which identical legislation last appeared (2021-22).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
