For those unfamiliar with HIO , let me give you some background.
HIO, or "hole in one" is a chiropractic technique that only adjusts the Atlas vertebra and no other segments of the spine. The philosophy behind the approach is based on sound principle, but, in my opinion falls short of the pin.
The underlying principle is that if you clear the upper cervical spine of subluxation, specifically at the first vertebra of the spine, everything will fall into place below it, as the body uses its innate ability to heal itself and seek balance.
Sounds pretty good... kind of along the lines of unclogging the screen at the beginning of a hose pipe to allow the flow to be restored to the whole length of hose.
But, what happens when the restored water pressure can not overcome a kink further down the line?
Some would have us believe that is the best that can be achieved. They hide behind the reasoning that there is a limitation of matter that can not be overcome and that any pain that might still be felt by the patient is not relevant. I agree that pain in and of itself is not an indicator of subluxation, but I do believe that it is a part of the equation that we must not neglect. In fact, our Sherman College Health Center Daily Check Sheets (that are filled out when a patient comes in for a visit) makes notation of areas of edema and pain. Of course, that is not justification for adjustment, but it does play a part in assessing the overall health of the spine and the surrounding soft tissues.
If the hose is kinked and the garden is in "pain" , would you not undo the knot? or would you say, "it's as good as it can get, the tomatoes are smaller than normal but, at least, we are getting some tomatoes?"
I think that clearing upper cervical subluxation is truly the most important focus to have in caring for someone's spine, as everything downstream can be affected if the nerve impulses are diminished or agitated. In many (probably most) cases, adjusting atlas truly does unlock the spine and the ripple effects are seen throughout the entire spine as it seeks to restore homeostasis.
In the chiropractic golf bag, atlas adjustment is definitely the Driver.
But what happens when you end up in the rough?
Here is a potential sand trap:
You have a patient with a compound surgical fusion of the cervical spine.
The vertebrae have healed from the surgery, but they are not aligned to allow for proper nerve transmission. You find a C1 subluxation. So, you adjust atlas.
Maybe C2, C3, and C4 below it are able to realign themselves, but wham...the nerve impulse hits the fusion and there is a subluxation at C5. Uh oh: C6 is not subluxated, but it has been fused to C5. One segment of the fusion will always be subluxated. What happens to the signal below that?
Compensations.
The spine compensates and tries to achieve the best position it can to protect the cord and its nerve signals. Again, we see the limitations of matter.
The patient continues to come in for weeks. Atlas is holding pretty well, but they continue to complain that they have excruciating low back pain. Upon examination, it is found that they still have subluxations in their lumbar spine and hips.
But atlas is holding adjustment.
Perhaps, just maybe, the compensation has become a subluxation, independent of atlas. The same could apply to a spine that has suffered trauma or a disease process. What to do then?
A compassionate care giver would hopefully adjust the other subluxated segments to relieve the pressure on the affected nerves. That is the job of a chiropractor, after all, to remove subluxations from the spine.
This is the Sand Wedge in the chiropractor's golf bag.
If the patient's chief complaint was low back pain and you have done a great job of stabilizing atlas, but the lumbar spine and hips are still subluxated and the patient's original complaint has not improved, the Mercy guidelines would suggest a change in strategy or a referral to a chiropractor that is willing to address the other subluxations.
I believe that many chiropractors and chiropractic students have put their blinders on and have placed themselves upon a pedestal, passing judgment on those who "dilute the purity of their chiropractic" by acknowledging that atlas might not always be the only piece in the puzzle.
This is America, where everyone is entitled to have an opinion as to what is correct and what is not. Please don't run down the majority of chiropractors that believe Atlas is of the utmost importance, but recognize that the entire spine must be maintained for optimal life expression.
I think that everyone wants their patients to get better. Some just have a little bit different idea of how to get them there...and quite possibly a few more patients in their waiting rooms who know that it's better to play at the Masters than to hang out at the driving range.
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