VOL 38 | ISS 2 | 2017

THE MAGAZINE OF LIFE CHIROPRACTIC COLLEGE WEST

When Science Met Subluxationwith Dr. Heidi Haavik

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BY Mary Lucus-Flannery, DCILLUSTRATION BY Laura Johnston Bratt

DR. HEIDI HAAVIK WASN’T ALWAYS A CHIROPRACTIC RESEARCH GURU.

Heidi was once a young chiropractor who was curious about how and why things worked. There was little scientific evidence that could explain WHY adjusting

the spine would impact the body as she was observing in practice. She simply had to know more.

After graduating from New Zealand College of Chiropractic, Heidi began a post-graduate course in adult education at the University of

Auckland, simply for fun. She bumped into her chiropractic instructor, Dr. Bernadette Murphy, who talked her into doing post-graduate papers in neuroscience across four different departments.

Heidi did not see herself as smart enough to do a PhD, but with Bernadette’s encouragement and top grades in all four departments, she

started a PhD anyway. Once she began, she was bitten by the “science and research bug” and fell in love with the pursuit. What could be more exciting than discovering

the mechanisms of chiropractic care?

It was clear to Heidi that we were missing a biologically plausible mechanism for why adjusting the spine could make people feel and function better. She wanted to understand what happens within the central nervous system when we adjust the

spine — especially when we adjust dysfunctional segments called vertebral sublux-ations. Heidi wanted to figure out why spinal function was so important to brain function.

Heidi did not care what the results of her research would be. She only cared that chiroprac-tors could better understand HOW chiropractic works through careful, systematic, high quality, basic science research experiments. She wasn’t trying to prove or disprove any-thing. She sought only to understand.

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THE RAPIDLY EVOLVING WORLD OF CHIROPRACTIC RESEARCHAs her work progressed, Heidi began to see how we can use research to understand and better explain what we do. In the past, chiropractors have considered research boring and of little use in practice. As a research fanatic, Heidi makes it her personal mission to demonstrate how fun, exciting and useful research can be.

Most practicing chiropractors don’t read or use research much. Aside from the odd publication that gets shared on Facebook, most chiropractors do not see chiropractic research articles. For Heidi, this is a shame. The public loves solid science and research – and they deserve to be told about the latest research by their family chiropractor.

Heidi’s team has created an online monthly program where members are given the latest information and resources to help them do exactly that. By staying up to date with the latest science (on a variety of topics) chiropractors are able to easily share this information with their patients, the public and with other health care providers.

“I believe that chiropractic care is currently under-valued and under-utilized. Our history has been a turbulent one, and rightly or wrongly, we remain marginalized and on the fringe of conventional health care. We have survived as a profession for two main reasons. First and foremost because of our great clinical results. Also because of our unique philosophy. With-out our philosophy we probably would have lost our identity and been swallowed up by the medical profession.”

Heidi believes that chiropractors have incredible opportuni-ties right now to integrate with other health care profession-als, for the benefit of our patients.

“By integrate, I don’t mean that we should just see the back pain patients that other professions don’t want to see. We should work with other professions in integrated settings, providing chiropractic care so our patients can better adapt, self-regulate and heal, irrespective of what condition they may have.”

HOW TO DESCRIBE A

USING

A subluxation is when the brain is not moving things properly in a portion of the spine given the task at hand.

For example, the spine may be moving when it should not (e.g. while lifting), or not moving when it should (e.g. while running), or not reflexively responding to help us maintain balance and prevent falls.

Because we cannot see our spine, the brain relies on the messages it gets from the small muscles close to the spine and skull to be able to ‘see’ what is happening in the spine.

When parts of the spine are not moving properly this affects the way the brain perceives what is going on in our bodies and the environment around us, making our brain’s knowledge of what is going on less accurate.

When we are subluxated — we may notice this as clumsi-ness. We may notice we keep hitting our head getting into our car, or knocking our elbow on door frames, or tripping over our own feet. This can also manifest as back pain, neck pain and headaches, as well as other musculoskeletal pain.

Even more interesting, is that it can also manifest as other symptoms, such as colic in babies, bedwetting trouble in kids, hypertension in adults and/or altered emotional and/or immune responses.

Based on the research findings, when we adjust dysfunc-tional areas of the spine (chiropractic vertebral sublux-ations) we affect parts of the brain known as the control or command centers (such as the pre frontal cortex and the cerebellum).1,2

When the brain does not get adequate or accurate infor-mation from the spine, it can make the brain confused, and it can end up thinking (and therefore manifesting) that it has a problem, even when it does not. Sometimes when we adjust the spinal subluxations and suddenly the brain realizes it actually does not have that problem, the symp-toms ‘miraculously’ disappear.

REFERENCES1) Lelic, D., Niazi, I.K., Holt, K., Jochumsen, M., Dremstrup, K., Yielder, P., Murphy,

B., Drewe,s A. M., & Haavik, H. (2016). Manipulation of dysfunctional spinal joints affects sensorimotor integration in the prefrontal cortex: A brain source localization study. Neural Plasticity, 1.doi:10.1155/2016/3704964.

2) Daligadua, J., Haavik, H., Yielder, P., Baarbe, J. & Murphy, B.A. (2013). Alter-ations in cortical and cerebellar motor processing in subclinical neck pain patients following spinal manipulation. Journal of Manipulative and Physiolog-ical Therapeutics. 2013;36:527-537.

We live in a time where evidence-informed patient care is highly valued. Evidence-based means making decisions about each patient based on three equally important factors:

1} The best available evidence

2} Your own clinical experience

3} The patient’s own values and wishes

Awareness about the best available research is both important and practical for chiropractors to pay attention to. It’s not the only thing you should base your care plan on, but is one of the three important pillars of practicing in an evidence-informed manner.

However, this also places the emphasis on us as a pro-fession to create the evidence that chiropractors will use to make day to day decisions about best care for each unique patient encounter.

THE CASE FOR EVIDENCE BASED CHIROPRACTIC

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MODERNSCIENCE

VOL 38, ISS 2 | LIFE STYLES

THE FUTURE IS NOWHeidi sees a very bright future for chiropractic, both in research and in practice. Luckily more and more young, bright chiropractors find chiropractic research interesting and valuable.

We have only just scratched the surface of what we need to know about chiropractic care. Chiropractic needs more than basic science neurophysiology research. We need clinical research, epidemiology research, and qualitative research. Heidi hopes that in 30 years we will have far greater insights into how spinal dysfunction impedes the brain’s ability to positively adapt, grow and heal.

We all have much to gain from doing this research. We will have a far greater understanding about those who respond to chiropractic care and those that do not. We could assess, up front, for objective markers to identify who is likely to benefit from our care, and what type and frequency of chiropractic care will best help them. The potential protective nature of chiropractic care will be better understood.

“For example, I’d love to know the impact on development for a child who receives chiropractic care vs. kids that don’t. All we have so far is our own observations from our own children who have received chiropractic care all their lives, and the positive stories we hear from patients in our practices. But we need to run a proper large prospective study exploring the ef-fects of chiropractic care on children’s development and disease/disorder/injury prevention.”

Heidi sees much more work to be done in relation to sports performance and function. And due to all the evidence that we have of the impact on brain function, we also need to continue to explore the science behind chiropractic care for people suffering from different brain injuries (such as stroke or con-cussion) or chronic neurodegenerative conditions (such as Parkinson’s, Huntington’s or Alzheimer’s Disease).

The benefit of research snowballs from there. The more we understand the benefits of chiropractic care and the more we share this information world-wide, the more demand there will be for our services. Heidi is convinced that as we better understand how chiropractic works that this will have a signifi-cant positive impact on all of us, from scientists to clinicians to the public.

“The way we explain chiropractic care now absolutely has to change. Gone are the days where it was ok to talk about a bone out of place squashing a nerve! This is not accurate. We impact brain function. We enable the brain to more accurate-ly perceive and appropriately respond to both internal and environmental cues. And these changes are most likely due to changes in the movement pattern of the vertebrae (after an adjustment) due to changes in the signaling from the deep paraspinal muscles.”

WHAT CAN EVERY CHIROPRACTOR DO NEXT? Heidi implores all chiropractors to learn about the new re-search in chiropractic and to understand and communicate

the science behind the adjustment. Our new understanding about the mechanisms of the adjustment is far more profound than the old ‘bone out of place’ theories.

“When we adjust a subluxation we don’t just relieve pressure off that particular nerve root - we change the master control system of the body! We change the brain! We change the brain’s awareness of not only what is happening in the spine, but it also appears to influence how accurately the brain can ‘see’ what else is going on in the limbs as well as the environ-ment around it.

This can explain all kinds of other observations chiropractors see in practice. Because we influence the brain - this could be why patient’s moods change, or immune function is improved or why visceral problems get better. If the brain sees more clearly what is going on with these systems then it would ex-plain why these things improve as well as aches and pains.”

The chiropractic profession benefits from a new conversation about our science and about our future. Now that we better understand how chiropractic care works, we have an incred-ible opportunity to change the way we communicate and interact with our patients, the public and the rest of the health care community.

Heidi envisions a united team, which works together to share the science of chiropractic and enlighten the world with this knowledge.

“We can do this by communicating chiro-practic using simple language to everyone. If we keep harping on about bones out of place squashing nerves - the public will not listen. They know this is not true. We need to fully own our science and share an updated current understanding about chiropractic – the neuroplasticity model!”

LEARN MORE ABOUT WHAT TODAY’S SCIENCE TELLS US ABOUT CHIROPRACTIC. Heidi is so passionate that all chiropractors have access to the latest research that she is offering her ebook for free at www.therealitycheck.nz. She has also put together a free webinar www.chiropractic.how on how to run a successful awareness campaign.

Heidi’s enthusiasm for science and research is contagious. She has become one of the most highly sought speakers and leaders in chiropractic. Heidi didn’t start her chiropractic ca-reer as a research guru but her passion and understanding of the science of chiropractic is influencing chiropractors and pa-tients around the globe in ways she never dreamed possible.

It’s time for us all to step up and communicate the profound science of chiropractic with as much clarity and passion as we do the philosophy of chiropractic, using the very latest in chiropractic research.

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“ When we adjust a subluxation we don’t just relieve pressure off that particular nerve root — we change the master control system of the body! We change the brain!” — DR. HEIDI HAAVIK