Guest guest Posted November 15, 2006 Report Share Posted November 15, 2006 Sounds like you've never had an elbow or jaw lock up on you ... if's that's not dysfunction, I need to find a new profession. Sunny Sunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7C Eugene, Oregon, 97401 541- 344- 0509; Fx; 541- 344- 0955 From: "Shad McLagan" <shadmac11@...> Subject: Welker-McLagan ModelDate: Wed, 15 Nov 2006 21:31:30 -0000 I see my past message has provoked many responses. By me stating my opinions, theories and philosophies, I by no means think that I am better than any of you nor do I mean any disrespect.Many of you have stated you do indeed treat irritation, but you also state you treat other disorders such as joint dysfunction.Joint Dysfunction: wrong/bad function. I do not believe a joint goes into a dysfunctional state. As stated in prior messages, the body works toward stabilization not destabilization or dysfunction.To me, joint dysfunction is along the same lines as misalignment (wrong/bad alignment), malposition (wrong/bad position), or fixation (wrong/bad movement). If you have any one of these three you are considered to have joint dysfunction. I believe the joint or segment is in correct joint function, given the state/irritation the segment is in. I feel that it is an intelligent adaptation to a pathological environment. Palpation is a tool used for identifying soft tissue irritation. Provocation is great tool used for identifying irritation to a disc, facet joint, capsule, etc. As stated in past journal articles given by your friend Dr. Welker, provocation has a higher interexaminer reliability than palpation.My definition of irritation depends on what the patient is complaining of. A meniscal tear of the knee is different from an infrapatellar strain. In both cases, the patient complains of knee pain. We can either call it knee dysfunction or call it exactly what it is.If a patient comes in complaining of a stiff neck, a proper examination should be done to find out where the tightness or irritation is coming from: disc, facet joint, capsule, soft tissue, mental. If pain can not be reproduce from soft tissue palpation or provocation, chances are their area of complaint is not neuromusculoskeletal in origin and requires further studies or is mental.Provocation is not done for acute inflammatory cases alone. If a patient comes in complaining of chronic low back pain, provocation of the area should be done to find the level of irritation. Even if a patient has been suffering from this low back pain for many years, his/her symptoms should still be able to be reproduced.By stating earlier that we work well with many local MD's I did not mean that I am better than any of you and did not mean any disrespect. My point was that they agree with and respect our theory and examination/diagnosis/treatment.Shad McLagan D.C. MSN Shopping has everything on your holiday list. Get expert picks by style, age, and price. Try it! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 15, 2006 Report Share Posted November 15, 2006 Shad: Thanks once again for response. But I will ask you once again to define " irritation " . You sort of gave some examples I think. It sounds like in your model " irritation " can be: trauma, stiffness, report of pain and/or antalgic response to palpation/provocation. But really, if you could just give me/us an EXACT definition of this word " irritation " I would love that. In philosophy, the first rule of order is " Define your terms " . Since we are talking 'philosophy' here I am asking you to define this term that you use quite often. Defining " irritation " would go along way to help me figure out where you are coming from. Is it trauma? Is it pain? Is it inflammation? Is it tenderness? Please advise. ;-) Thanks J. > > I see my past message has provoked many responses. By me stating my > opinions, theories and philosophies, I by no means think that I am > better than any of you nor do I mean any disrespect. > > Many of you have stated you do indeed treat irritation, but you also > state you treat other disorders such as joint dysfunction. > > Joint Dysfunction: wrong/bad function. I do not believe a joint goes > into a dysfunctional state. As stated in prior messages, the body > works toward stabilization not destabilization or dysfunction. > > To me, joint dysfunction is along the same lines as misalignment > (wrong/bad alignment), malposition (wrong/bad position), or fixation > (wrong/bad movement). If you have any one of these three you are > considered to have joint dysfunction. I believe the joint or segment > is in correct joint function, given the state/irritation the segment > is in. I feel that it is an intelligent adaptation to a pathological > environment. > > Palpation is a tool used for identifying soft tissue irritation. > Provocation is great tool used for identifying irritation to a disc, > facet joint, capsule, etc. As stated in past journal articles given > by your friend Dr. Welker, provocation has a higher interexaminer > reliability than palpation. > > My definition of irritation depends on what the patient is > complaining of. A meniscal tear of the knee is different from an > infrapatellar strain. In both cases, the patient complains of knee > pain. We can either call it knee dysfunction or call it exactly what > it is. > > If a patient comes in complaining of a stiff neck, a proper > examination should be done to find out where the tightness or > irritation is coming from: disc, facet joint, capsule, soft tissue, > mental. If pain can not be reproduce from soft tissue palpation or > provocation, chances are their area of complaint is not > neuromusculoskeletal in origin and requires further studies or is > mental. > > Provocation is not done for acute inflammatory cases alone. If a > patient comes in complaining of chronic low back pain, provocation of > the area should be done to find the level of irritation. Even if a > patient has been suffering from this low back pain for many years, > his/her symptoms should still be able to be reproduced. > > By stating earlier that we work well with many local MD's I did not > mean that I am better than any of you and did not mean any > disrespect. My point was that they agree with and respect our theory > and examination/diagnosis/treatment. > > Shad McLagan D.C. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 16, 2006 Report Share Posted November 16, 2006 Your "theory" doctor is the same as everyone elses for the most part. You might change some terms here and there, but ultimately you're talking about practicing in a way that most of us already do. I just fail to see why this is any different than the average chiropractic office and why such lengths are taken to express this presumed "New Idea" ph Medlin, DCSpine Tree Chiropractic1627 NE Alberta St.Portland, OR 97211 Welker-McLagan Model I see my past message has provoked many responses. By me stating my opinions, theories and philosophies, I by no means think that I am better than any of you nor do I mean any disrespect.Many of you have stated you do indeed treat irritation, but you also state you treat other disorders such as joint dysfunction.Joint Dysfunction: wrong/bad function. I do not believe a joint goes into a dysfunctional state. As stated in prior messages, the body works toward stabilization not destabilization or dysfunction.To me, joint dysfunction is along the same lines as misalignment (wrong/bad alignment), malposition (wrong/bad position), or fixation (wrong/bad movement). If you have any one of these three you are considered to have joint dysfunction. I believe the joint or segment is in correct joint function, given the state/irritation the segment is in. I feel that it is an intelligent adaptation to a pathological environment. Palpation is a tool used for identifying soft tissue irritation. Provocation is great tool used for identifying irritation to a disc, facet joint, capsule, etc. As stated in past journal articles given by your friend Dr. Welker, provocation has a higher interexaminer reliability than palpation.My definition of irritation depends on what the patient is complaining of. A meniscal tear of the knee is different from an infrapatellar strain. In both cases, the patient complains of knee pain. We can either call it knee dysfunction or call it exactly what it is.If a patient comes in complaining of a stiff neck, a proper examination should be done to find out where the tightness or irritation is coming from: disc, facet joint, capsule, soft tissue, mental. If pain can not be reproduce from soft tissue palpation or provocation, chances are their area of complaint is not neuromusculoskeletal in origin and requires further studies or is mental.Provocation is not done for acute inflammatory cases alone. If a patient comes in complaining of chronic low back pain, provocation of the area should be done to find the level of irritation. Even if a patient has been suffering from this low back pain for many years, his/her symptoms should still be able to be reproduced.By stating earlier that we work well with many local MD's I did not mean that I am better than any of you and did not mean any disrespect. My point was that they agree with and respect our theory and examination/diagnosis/treatment.Shad McLagan D.C. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 16, 2006 Report Share Posted November 16, 2006 Some of you are unclear on the specific definition of irritation. I use this term as a guide to define an unpleasant respose to some sort of stimulus. The stimulus could be from trauma, inflammation, tumor, bony spur, etc. Here is a difinition: Irritating/Irritation: American Heritage Dictionary ir·ri·tate ( r -t t ) Pronunciation Key v. ir·ri·tat·ed, ir·ri·tat·ing, ir·ri·tates v. tr. Physiology. To cause physiological activity or response in (an organ or tissue), as by application of a stimulus. I have also seen resposes in regards to joint locking of the jaw or elbow. Before we can treat, we must find out what is causing the joint locking. A joint does not lock without reason. Typically there is an underlying cause which is causing the joint locking: previous trauma causing free floating cartilage or bone, displaced disc in jaw, etc. In either case it is not a good idea to manipulate through just because it is " stuck " . Another response was in regards to a dislocated shoulder. A shoulder wiil not dislocate unless there has been some sort of previous trauma or severe joint laxity. A dislocation is complete failure of any joint and requires extreme measures. We have never said not to treat dislocations. With the shoulder dislocation, the body's guarding mechanism is trying to pull the shoulder back in, in order to stabilize and prevent further injury. Working against the body would cause further injury; putting the joint back into place is working with the body. We have never said to leave irritation alone, just to treat it correctly by working with the body and to manipulate/mobilize away from irritation. Shad McLagan D.C. > > Your " theory " doctor is the same as everyone elses for the most part. You might change some terms here and there, but ultimately you're talking about practicing in a way that most of us already do. > > I just fail to see why this is any different than the average chiropractic office and why such lengths are taken to express this presumed " New Idea " > > > ph Medlin, DC > Spine Tree Chiropractic > 1627 NE Alberta St. > Portland, OR 97211 > Welker-McLagan Model > > > I see my past message has provoked many responses. By me stating my > opinions, theories and philosophies, I by no means think that I am > better than any of you nor do I mean any disrespect. > > Many of you have stated you do indeed treat irritation, but you also > state you treat other disorders such as joint dysfunction. > > Joint Dysfunction: wrong/bad function. I do not believe a joint goes > into a dysfunctional state. As stated in prior messages, the body > works toward stabilization not destabilization or dysfunction. > > To me, joint dysfunction is along the same lines as misalignment > (wrong/bad alignment), malposition (wrong/bad position), or fixation > (wrong/bad movement). If you have any one of these three you are > considered to have joint dysfunction. I believe the joint or segment > is in correct joint function, given the state/irritation the segment > is in. I feel that it is an intelligent adaptation to a pathological > environment. > > Palpation is a tool used for identifying soft tissue irritation. > Provocation is great tool used for identifying irritation to a disc, > facet joint, capsule, etc. As stated in past journal articles given > by your friend Dr. Welker, provocation has a higher interexaminer > reliability than palpation. > > My definition of irritation depends on what the patient is > complaining of. A meniscal tear of the knee is different from an > infrapatellar strain. In both cases, the patient complains of knee > pain. We can either call it knee dysfunction or call it exactly what > it is. > > If a patient comes in complaining of a stiff neck, a proper > examination should be done to find out where the tightness or > irritation is coming from: disc, facet joint, capsule, soft tissue, > mental. If pain can not be reproduce from soft tissue palpation or > provocation, chances are their area of complaint is not > neuromusculoskeletal in origin and requires further studies or is > mental. > > Provocation is not done for acute inflammatory cases alone. If a > patient comes in complaining of chronic low back pain, provocation of > the area should be done to find the level of irritation. Even if a > patient has been suffering from this low back pain for many years, > his/her symptoms should still be able to be reproduced. > > By stating earlier that we work well with many local MD's I did not > mean that I am better than any of you and did not mean any > disrespect. My point was that they agree with and respect our theory > and examination/diagnosis/treatment. > > Shad McLagan D.C. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 16, 2006 Report Share Posted November 16, 2006 Dr. McLagan How about the "frozen shoulder" clinical scenario I asked about. Starts as a non-traumatic, inflammatory disorder (maybe arthritic in nature), soft tissues respond to the pain and NOXIOUS PROPRIOCEPTIVE INFORMATION COMING FROM THE JOINT (we can't keep leaving the joint out of this discussion , tighten-up, and then the shoulder--IF NOT ADJUSTED/MOBILIZED THROUGHOUT THIS INFLAMMATORY REACTION--becomes frozen. Question: Do you or do you not the HAVE to adjust/manipulate/mobilize the shoulder in order to CORRECT for the "exaggerated" soft tissue response? Thank you. RR. Welker-McLagan Model> > > I see my past message has provoked many responses. By me stating my > opinions, theories and philosophies, I by no means think that I am > better than any of you nor do I mean any disrespect.> > Many of you have stated you do indeed treat irritation, but you also > state you treat other disorders such as joint dysfunction.> > Joint Dysfunction: wrong/bad function. I do not believe a joint goes > into a dysfunctional state. As stated in prior messages, the body > works toward stabilization not destabilization or dysfunction.> > To me, joint dysfunction is along the same lines as misalignment > (wrong/bad alignment), malposition (wrong/bad position), or fixation > (wrong/bad movement). If you have any one of these three you are > considered to have joint dysfunction. I believe the joint or segment > is in correct joint function, given the state/irritation the segment > is in. I feel that it is an intelligent adaptation to a pathological > environment. > > Palpation is a tool used for identifying soft tissue irritation. > Provocation is great tool used for identifying irritation to a disc, > facet joint, capsule, etc. As stated in past journal articles given > by your friend Dr. Welker, provocation has a higher interexaminer > reliability than palpation.> > My definition of irritation depends on what the patient is > complaining of. A meniscal tear of the knee is different from an > infrapatellar strain. In both cases, the patient complains of knee > pain. We can either call it knee dysfunction or call it exactly what > it is.> > If a patient comes in complaining of a stiff neck, a proper > examination should be done to find out where the tightness or > irritation is coming from: disc, facet joint, capsule, soft tissue, > mental. If pain can not be reproduce from soft tissue palpation or > provocation, chances are their area of complaint is not > neuromusculoskeletal in origin and requires further studies or is > mental.> > Provocation is not done for acute inflammatory cases alone. If a > patient comes in complaining of chronic low back pain, provocation of > the area should be done to find the level of irritation. Even if a > patient has been suffering from this low back pain for many years, > his/her symptoms should still be able to be reproduced.> > By stating earlier that we work well with many local MD's I did not > mean that I am better than any of you and did not mean any > disrespect. My point was that they agree with and respect our theory > and examination/diagnosis/treatment.> > Shad McLagan D.C.> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 16, 2006 Report Share Posted November 16, 2006 Dr. s, " Frozen Shoulder " or " Adhesive Capsulitis " is a sign that the joint capsule has become irritated or torn. Our objective with treatment is not just to increase shoulder ROM but to increase blood flow to the capluse so that it may heal. As it heals, ROM will return naturally. Increasing blood flow can be accomplished with manipulation or mobilization in a non-painful range as not to irritate or further injure the joint capsule. If the capsule is torn badly enough, following healing, the AROM may be reduced to ensure joint stability. AROM may not become " normal " as compared to the other, non-traumatized, shoulder. The amount of AROM loss is determined by how badly the shoulder was injured. With any injury of the body, following treatment, it will never be what it once was before the injury, whether it is a 2% loss or 80% loss. Shad McLagan D.C. > > > > Your " theory " doctor is the same as everyone elses for the most > part. You might change some terms here and there, but ultimately > you're talking about practicing in a way that most of us already do. > > > > I just fail to see why this is any different than the average > chiropractic office and why such lengths are taken to express this > presumed " New Idea " > > > > > > ph Medlin, DC > > Spine Tree Chiropractic > > 1627 NE Alberta St. > > Portland, OR 97211 > > Welker-McLagan Model > > > > > > I see my past message has provoked many responses. By me stating > my > > opinions, theories and philosophies, I by no means think that I > am > > better than any of you nor do I mean any disrespect. > > > > Many of you have stated you do indeed treat irritation, but you > also > > state you treat other disorders such as joint dysfunction. > > > > Joint Dysfunction: wrong/bad function. I do not believe a joint > goes > > into a dysfunctional state. As stated in prior messages, the body > > works toward stabilization not destabilization or dysfunction. > > > > To me, joint dysfunction is along the same lines as misalignment > > (wrong/bad alignment), malposition (wrong/bad position), or > fixation > > (wrong/bad movement). If you have any one of these three you are > > considered to have joint dysfunction. I believe the joint or > segment > > is in correct joint function, given the state/irritation the > segment > > is in. I feel that it is an intelligent adaptation to a > pathological > > environment. > > > > Palpation is a tool used for identifying soft tissue irritation. > > Provocation is great tool used for identifying irritation to a > disc, > > facet joint, capsule, etc. As stated in past journal articles > given > > by your friend Dr. Welker, provocation has a higher interexaminer > > reliability than palpation. > > > > My definition of irritation depends on what the patient is > > complaining of. A meniscal tear of the knee is different from an > > infrapatellar strain. In both cases, the patient complains of > knee > > pain. We can either call it knee dysfunction or call it exactly > what > > it is. > > > > If a patient comes in complaining of a stiff neck, a proper > > examination should be done to find out where the tightness or > > irritation is coming from: disc, facet joint, capsule, soft > tissue, > > mental. If pain can not be reproduce from soft tissue palpation > or > > provocation, chances are their area of complaint is not > > neuromusculoskeletal in origin and requires further studies or is > > mental. > > > > Provocation is not done for acute inflammatory cases alone. If a > > patient comes in complaining of chronic low back pain, > provocation of > > the area should be done to find the level of irritation. Even if > a > > patient has been suffering from this low back pain for many > years, > > his/her symptoms should still be able to be reproduced. > > > > By stating earlier that we work well with many local MD's I did > not > > mean that I am better than any of you and did not mean any > > disrespect. My point was that they agree with and respect our > theory > > and examination/diagnosis/treatment. > > > > Shad McLagan D.C. > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 16, 2006 Report Share Posted November 16, 2006 You said: "My definition of irritation depends on what the patient is complaining of. A meniscal tear of the knee is different from an infrapatellar strain. In both cases, the patient complains of knee pain. We can either call it knee dysfunction or call it exactly what it is.....a proper examination should be done to find out where the tightness or irritation is coming from.... If pain can not be reproduce from soft tissue palpation or provocation, chances are their area of complaint is not neuromusculoskeletal in origin and requires further studies or is mental." Shad, (and everyone else) I think you summed-up your definition of irritation quite nicely, here. Reading your posts, and those of other DC's, I believe the diffences being discussed are more a symptom of having different views of Subluxation. I know some DC's don't even use this term....do you? I remember one of the earliest debates at WSCC in philosophy class was whether this profession should keep the word Subluxation or to replace it with Joint Dysfunction, whether that be from fixation/malposition/instability, etc. .............(Hold that thought) Another issue comes from, what I perceive to be, a difference in one's personal view of "professional scope of practice." Specifically, the biomechanical/physiological model (such as the one taught so persistantly at WSCC) vs. a model that includes the biomechanical/physiological, as well as, the emotional, mental, and individual evaluation of that hard-to-explain essence all living things posses: chi, prana, polarity, life energy, etc. I think this extended definition of "professional scope of practice" is commonly called "treating Subluxations." Like it or not, this has always been a part of Chiropractic and, unfortunately, it doesn't always hold up to the WSCC model. Are you OK with that? I am. In fact, I am encouraged by practicing DC's who have applied these concepts successfully over the years. I am glad that I am entering a profession that allows for such a vast philisophical landscape in which to practice. I think the public is better served by a profession that licenses it's individuals to use their knowledge and intuition to best serve the public's health. Dural tension....cranial bone fixation/malposition.....polarity.....these concepts were almost non-existant at WSCC....but they are pillars of belief in Chiropractic. Is there room for this in our profession? Now, I agree that a minimum standard of competence must be met by all chiropractors, no matter which state or country they happen to reside in, or no matter which philisophical light guides their hands. However, my point is, that a Competent-Diversity in our profession is a positive aspect and should not be flipantly disregarded by those "not interested." How much stock does each one of us put into Orthopedic testing vs. Palpation vs. Irritation(Pain) vs. Neurology vs. Muscle Testing vs. Nutrition? I'd wager that we would all say they were important but not equally, or in the same amount. Is that not OK? Could I simply not send my patient to another DC, perhaps more scientifically-modeled, and would that patient not be better served for it? Are these traditions not worth holding in our profession....in COMBINATION with accepted and established science? Great input, Shad. Best regards to all, , DC Thurman Street Chiropractic Shad McLagan <shadmac11@...> wrote: Dr. s,"Frozen Shoulder" or "Adhesive Capsulitis" is a sign that the joint capsule has become irritated or torn. Our objective with treatment is not just to increase shoulder ROM but to increase blood flow to the capluse so that it may heal. As it heals, ROM will return naturally. Increasing blood flow can be accomplished with manipulation or mobilization in a non-painful range as not to irritate or further injure the joint capsule. If the capsule is torn badly enough, following healing, the AROM may be reduced to ensure joint stability. AROM may not become "normal" as compared to the other, non-traumatized, shoulder. The amount of AROM loss is determined by how badly the shoulder was injured. With any injury of the body, following treatment, it will never be what it once was before the injury, whether it is a 2% loss or 80% loss.Shad McLagan D.C.> >> > Your "theory" doctor is the same as everyone elses for the most > part. You might change some terms here and there, but ultimately > you're talking about practicing in a way that most of us already do.> > > > I just fail to see why this is any different than the average > chiropractic office and why such lengths are taken to express this > presumed "New Idea"> > > > > > ph Medlin, DC> > Spine Tree Chiropractic> > 1627 NE Alberta St.> > Portland, OR 97211> > Welker-McLagan Model> > > > > > I see my past message has provoked many responses. By me stating > my > > opinions, theories and philosophies, I by no means think that I > am > > better than any of you nor do I mean any disrespect.> > > > Many of you have stated you do indeed treat irritation, but you > also > > state you treat other disorders such as joint dysfunction.> > > > Joint Dysfunction: wrong/bad function. I do not believe a joint > goes > > into a dysfunctional state. As stated in prior messages, the body > > works toward stabilization not destabilization or dysfunction.> > > > To me, joint dysfunction is along the same lines as misalignment > > (wrong/bad alignment), malposition (wrong/bad position), or > fixation > > (wrong/bad movement). If you have any one of these three you are > > considered to have joint dysfunction. I believe the joint or > segment > > is in correct joint function, given the state/irritation the > segment > > is in. I feel that it is an intelligent adaptation to a > pathological > > environment. > > > > Palpation is a tool used for identifying soft tissue irritation. > > Provocation is great tool used for identifying irritation to a > disc, > > facet joint, capsule, etc. As stated in past journal articles > given > > by your friend Dr. Welker, provocation has a higher interexaminer > > reliability than palpation.> > > > My definition of irritation depends on what the patient is > > complaining of. A meniscal tear of the knee is different from an > > infrapatellar strain. In both cases, the patient complains of > knee > > pain. We can either call it knee dysfunction or call it exactly > what > > it is.> > > > If a patient comes in complaining of a stiff neck, a proper > > examination should be done to find out where the tightness or > > irritation is coming from: disc, facet joint, capsule, soft > tissue, > > mental. If pain can not be reproduce from soft tissue palpation > or > > provocation, chances are their area of complaint is not > > neuromusculoskeleta l in origin and requires further studies or is > > mental.> > > > Provocation is not done for acute inflammatory cases alone. If a > > patient comes in complaining of chronic low back pain, > provocation of > > the area should be done to find the level of irritation. Even if > a > > patient has been suffering from this low back pain for many > years, > > his/her symptoms should still be able to be reproduced.> > > > By stating earlier that we work well with many local MD's I did > not > > mean that I am better than any of you and did not mean any > > disrespect. My point was that they agree with and respect our > theory > > and examination/ diagnosis/ treatment.> > > > Shad McLagan D.C.> >> Messages in this topic (7) Reply (via web post) | Start a new topic Messages | Files | Photos | Links | Database | Polls | Members | Calendar OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed. Sponsored Link$420,000 Mortgage for $1,399/month - Think You Pay Too Much For Your Mortgage? Find Out! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 16, 2006 Report Share Posted November 16, 2006 Dr. McLagan, You seem to be an intelligent young doctor. Many of your posts though have the color of one who has just graduated or has just been licensed. I see that you have been awarded your license this year summer of 06. (Saw your name amongst the newly licensed folks in Back Talk, and the will to explain what each condition actually is is kind of a give away) So you have been practicing for nearly 6 months perhaps? My point is that It will be important for you to keep an open mind early in your career and not to limit yourself to one way of thinking. Don't cling on to one thing sooo strongly that you lose the big picture. There will be a lot that you will learn about getting people better that you don't know yet. You will notice amazing things happen that sometimes no matter how hard you try, you won't be able to quantify or explain given the knowledge you possess. That doesn't mean that you become a "subluxation only doctor", but that you respect the power of what it is you do (chiropractic and chiropractic adjusting) . The reverse is also going to be true. You will be unable to explain why someone is in pain. You will be unable to get them better. You will also eventually notice that practice is much different than school clinic or books. The element of the human condition and dealing with people that are in pain can be very humbling at times and that humility is generally absent from the greener practitioners, simply because they havent had time enough to fail. I know you didn't ask for this lecture, but i found it important to again emphasize to you that there is very little NEW in any of this irritation, malposition stuff. Just different terms for the same thing. The chiropractors out there in practice now (namely on this listserve and Oregon) aren't practicing differently from you for the most part and you should not close your mind to their advice. Instead of re-inventing the wheel open your mind and let some of these folks teach ya something. They have been playing the game you are entering for a loooong time. We all practice differently and therin lies the art of what we do, but we all practice chiropractic. Peace, ph Medlin, DCSpine Tree Chiropractic1627 NE Alberta St.Portland, OR 97211 -- --- Original Message ----- From: Shad McLagan Sent: Thursday, November 16, 2006 11:40 AM Subject: Re: Welker-McLagan Model Dr. s,"Frozen Shoulder" or "Adhesive Capsulitis" is a sign that the joint capsule has become irritated or torn. Our objective with treatment is not just to increase shoulder ROM but to increase blood flow to the capluse so that it may heal. As it heals, ROM will return naturally. Increasing blood flow can be accomplished with manipulation or mobilization in a non-painful range as not to irritate or further injure the joint capsule. If the capsule is torn badly enough, following healing, the AROM may be reduced to ensure joint stability. AROM may not become "normal" as compared to the other, non-traumatized, shoulder. The amount of AROM loss is determined by how badly the shoulder was injured. With any injury of the body, following treatment, it will never be what it once was before the injury, whether it is a 2% loss or 80% loss.Shad McLagan D.C.> >> > Your "theory" doctor is the same as everyone elses for the most > part. You might change some terms here and there, but ultimately > you're talking about practicing in a way that most of us already do.> > > > I just fail to see why this is any different than the average > chiropractic office and why such lengths are taken to express this > presumed "New Idea"> > > > > > ph Medlin, DC> > Spine Tree Chiropractic> > 1627 NE Alberta St.> > Portland, OR 97211> > Welker-McLagan Model> > > > > > I see my past message has provoked many responses. By me stating > my > > opinions, theories and philosophies, I by no means think that I > am > > better than any of you nor do I mean any disrespect.> > > > Many of you have stated you do indeed treat irritation, but you > also > > state you treat other disorders such as joint dysfunction.> > > > Joint Dysfunction: wrong/bad function. I do not believe a joint > goes > > into a dysfunctional state. As stated in prior messages, the body > > works toward stabilization not destabilization or dysfunction.> > > > To me, joint dysfunction is along the same lines as misalignment > > (wrong/bad alignment), malposition (wrong/bad position), or > fixation > > (wrong/bad movement). If you have any one of these three you are > > considered to have joint dysfunction. I believe the joint or > segment > > is in correct joint function, given the state/irritation the > segment > > is in. I feel that it is an intelligent adaptation to a > pathological > > environment. > > > > Palpation is a tool used for identifying soft tissue irritation. > > Provocation is great tool used for identifying irritation to a > disc, > > facet joint, capsule, etc. As stated in past journal articles > given > > by your friend Dr. Welker, provocation has a higher interexaminer > > reliability than palpation.> > > > My definition of irritation depends on what the patient is > > complaining of. A meniscal tear of the knee is different from an > > infrapatellar strain. In both cases, the patient complains of > knee > > pain. We can either call it knee dysfunction or call it exactly > what > > it is.> > > > If a patient comes in complaining of a stiff neck, a proper > > examination should be done to find out where the tightness or > > irritation is coming from: disc, facet joint, capsule, soft > tissue, > > mental. If pain can not be reproduce from soft tissue palpation > or > > provocation, chances are their area of complaint is not > > neuromusculoskeletal in origin and requires further studies or is > > mental.> > > > Provocation is not done for acute inflammatory cases alone. If a > > patient comes in complaining of chronic low back pain, > provocation of > > the area should be done to find the level of irritation. Even if > a > > patient has been suffering from this low back pain for many > years, > > his/her symptoms should still be able to be reproduced.> > > > By stating earlier that we work well with many local MD's I did > not > > mean that I am better than any of you and did not mean any > > disrespect. My point was that they agree with and respect our > theory > > and examination/diagnosis/treatment.> > > > Shad McLagan D.C.> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 17, 2006 Report Share Posted November 17, 2006 Sorry you seem so defensive on this matter and that you feel that experience doesnt make one a better doctor. With experience you will know better. 5 years from now you will not be the same doctor my friend. Sorry, and yes, you will be a better one than you are today. No?? Then you intend on being as good as you're gonna get. I tell you what doesn't make one a better doctor: Thats lack of clinical experience. 6 months,7months whatever it is (splitting hairs again) it isn't much compared to people who have been doing this for 20+ or even those of 10 or yes 5years. Are there those that have been in practice for years and suck, well yes just like anything, but not usually. Even if they suck experience has improved them. Also you say " I disagree with the idea of not being able to explain why someone is in pain. If someone is hurting, there has to be a cause. If I am unable to find the cause, how could I possibly justify my reasoning for treatment? How could anyone? How would I know what I am treating? But I do agree with the fact there will be those I am unable to help. Again, lack of experience. You won't treat everyone perhaps. Sometimes that cause is impossible to determine and you treat (or not) the subluxations if present (as it is defined under your license scope) and monitor/refer as needed. I don't see why you find it feasable that you won't be able to help everyone,but will be able to diagnose everyting that comes into your office. Good luck with that. You also say comically "I do have an open mind and am always willing and eager to learn new things. By being defensive shows closed mindedness and a limited way of thinking." AMEN Hope you see the irony in this statement, as you pass off experience as not making one a better doctor, and "thanks for the Big Brother talk" etc. etc. I'd certainly say that thats defensive and limiting. Finally, you state: "I disagree "this irritation, malposition stuff" is different terms for the same thing, as I have explained in past messages. If it is the same thing, then you would agree with me theories and treatment. If you disagree with me, then terms are different." Again youre trying to make it a "one way or another" issue, when it's not. Different terms for much of the same concept doesn't equal entirely different concept. Do you really think for instance that because you term an adjustment: manipulation, that it is somehow different?? Maybe to the MD's you rely on, but ultimately not. Again i DO agree with much of your treatment as much of it is CHIROPRACTIC with some slight changes. Your theories are not new either. You did go to chiropractic shcool just like me. Remember that. You have more in common with the straightest of the straight DC's out there cuz you're a DC no matter what. Sorry to try to advise you at all. Sorry that my 5 yrs of clinical (licensed, as i was an asscociate in CA before, but running ones own practice is the real deal) experience isn't good enough for you. There was no malintent or attempt to condescend. I've pointed toward more experienced doctors because yes, I'm still learning as well and still improving. Am i the same doctor that walked out with my smile and my license in my hand 5+ years ago. THANKFULLY NOT!!! For my own good and the good of my patients. Is it ENTIRELY the 5 years of experience that have made me a good doctor? Is it the 20+yrs that makes someone good? Of course not entirely Shad, but would they be as good without it, NOT ON YOUR LIFE. ph Medlin, DCSpine Tree Chiropractic1627 NE Alberta St.Portland, OR 97211 Welker-McLagan Model> > > > > > I see my past message has provoked many responses. By me stating > my > > opinions, theories and philosophies, I by no means think that I > am > > better than any of you nor do I mean any disrespect.> > > > Many of you have stated you do indeed treat irritation, but you > also > > state you treat other disorders such as joint dysfunction.> > > > Joint Dysfunction: wrong/bad function. I do not believe a joint > goes > > into a dysfunctional state. As stated in prior messages, the body > > works toward stabilization not destabilization or dysfunction.> > > > To me, joint dysfunction is along the same lines as misalignment > > (wrong/bad alignment), malposition (wrong/bad position), or > fixation > > (wrong/bad movement). If you have any one of these three you are > > considered to have joint dysfunction. I believe the joint or > segment > > is in correct joint function, given the state/irritation the > segment > > is in. I feel that it is an intelligent adaptation to a > pathological > > environment. > > > > Palpation is a tool used for identifying soft tissue irritation. > > Provocation is great tool used for identifying irritation to a > disc, > > facet joint, capsule, etc. As stated in past journal articles > given > > by your friend Dr. Welker, provocation has a higher interexaminer > > reliability than palpation.> > > > My definition of irritation depends on what the patient is > > complaining of. A meniscal tear of the knee is different from an > > infrapatellar strain. In both cases, the patient complains of > knee > > pain. We can either call it knee dysfunction or call it exactly > what > > it is.> > > > If a patient comes in complaining of a stiff neck, a proper > > examination should be done to find out where the tightness or > > irritation is coming from: disc, facet joint, capsule, soft > tissue, > > mental. If pain can not be reproduce from soft tissue palpation > or > > provocation, chances are their area of complaint is not > > neuromusculoskeleta l in origin and requires further studies or is > > mental.> > > > Provocation is not done for acute inflammatory cases alone. If a > > patient comes in complaining of chronic low back pain, > provocation of > > the area should be done to find the level of irritation. Even if > a > > patient has been suffering from this low back pain for many > years, > > his/her symptoms should still be able to be reproduced.> > > > By stating earlier that we work well with many local MD's I did > not > > mean that I am better than any of you and did not mean any > > disrespect. My point was that they agree with and respect our > theory > > and examination/ diagnosis/ treatment.> > > > Shad McLagan D.C.> >> Check out the all-new beta - Fire up a more powerful email and get things done faster. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 17, 2006 Report Share Posted November 17, 2006 Dr. Medlin: I concur. I’ve been in practice for 18 years, and I continue to learn and evolve. A hallmark of youth is arrogance and “knowing it all”. A weakness of our profession is the lack of residency. Being thrust into the marketplace with little practical experience focuses us to quickly learn to swim or we drown. Dr. McLagan and his crew have developed their own stroke (they think). Unfortunately they don’t realize they are pretty much reinventing/renaming it instead. I wonder how much professional self-hate is going on. “We’re not like those other chiropractors, we’re real doctor’s!” As I’ve stated before, I work in an office with MD’s. With regards to MS problems there is no question I am the comparative expert. And the treat “pain” all the time; cervicalgia, lumbago, foot pain, elbow pain. Chiropractors are actually expected to dx with a higher degree of specificity. Seitz, DC Tuality Physicians 730-D SE Oak Street Hillsboro, OR 97123 (503)640-3724 From: [mailto: ] On Behalf Of deadmed Sent: Friday, November 17, 2006 9:14 AM ; Shad McLagan Subject: Re: Re: Welker-McLagan Model Sorry you seem so defensive on this matter and that you feel that experience doesnt make one a better doctor. With experience you will know better. 5 years from now you will not be the same doctor my friend. Sorry, and yes, you will be a better one than you are today. No?? Then you intend on being as good as you're gonna get. I tell you what doesn't make one a better doctor: Thats lack of clinical experience. 6 months,7months whatever it is (splitting hairs again) it isn't much compared to people who have been doing this for 20+ or even those of 10 or yes 5years. Are there those that have been in practice for years and suck, well yes just like anything, but not usually. Even if they suck experience has improved them. Also you say " I disagree with the idea of not being able to explain why someone is in pain. If someone is hurting, there has to be a cause. If I am unable to find the cause, how could I possibly justify my reasoning for treatment? How could anyone? How would I know what I am treating? But I do agree with the fact there will be those I am unable to help. Again, lack of experience. You won't treat everyone perhaps. Sometimes that cause is impossible to determine and you treat (or not) the subluxations if present (as it is defined under your license scope) and monitor/refer as needed. I don't see why you find it feasable that you won't be able to help everyone,but will be able to diagnose everyting that comes into your office. Good luck with that. You also say comically " I do have an open mind and am always willing and eager to learn new things. By being defensive shows closed mindedness and a limited way of thinking. " AMEN Hope you see the irony in this statement, as you pass off experience as not making one a better doctor, and " thanks for the Big Brother talk " etc. etc. I'd certainly say that thats defensive and limiting. Finally, you state: " I disagree " this irritation, malposition stuff " is different terms for the same thing, as I have explained in past messages. If it is the same thing, then you would agree with me theories and treatment. If you disagree with me, then terms are different. " Again youre trying to make it a " one way or another " issue, when it's not. Different terms for much of the same concept doesn't equal entirely different concept. Do you really think for instance that because you term an adjustment: manipulation, that it is somehow different?? Maybe to the MD's you rely on, but ultimately not. Again i DO agree with much of your treatment as much of it is CHIROPRACTIC with some slight changes. Your theories are not new either. You did go to chiropractic shcool just like me. Remember that. You have more in common with the straightest of the straight DC's out there cuz you're a DC no matter what. Sorry to try to advise you at all. Sorry that my 5 yrs of clinical (licensed, as i was an asscociate in CA before, but running ones own practice is the real deal) experience isn't good enough for you. There was no malintent or attempt to condescend. I've pointed toward more experienced doctors because yes, I'm still learning as well and still improving. Am i the same doctor that walked out with my smile and my license in my hand 5+ years ago. THANKFULLY NOT!!! For my own good and the good of my patients. Is it ENTIRELY the 5 years of experience that have made me a good doctor? Is it the 20+yrs that makes someone good? Of course not entirely Shad, but would they be as good without it, NOT ON YOUR LIFE. ph Medlin, DC Spine Tree Chiropractic 1627 NE Alberta St. Portland, OR 97211 Welker-McLagan Model > > > > > > I see my past message has provoked many responses. By me stating > my > > opinions, theories and philosophies, I by no means think that I > am > > better than any of you nor do I mean any disrespect. > > > > Many of you have stated you do indeed treat irritation, but you > also > > state you treat other disorders such as joint dysfunction. > > > > Joint Dysfunction: wrong/bad function. I do not believe a joint > goes > > into a dysfunctional state. As stated in prior messages, the body > > works toward stabilization not destabilization or dysfunction. > > > > To me, joint dysfunction is along the same lines as misalignment > > (wrong/bad alignment), malposition (wrong/bad position), or > fixation > > (wrong/bad movement). If you have any one of these three you are > > considered to have joint dysfunction. I believe the joint or > segment > > is in correct joint function, given the state/irritation the > segment > > is in. I feel that it is an intelligent adaptation to a > pathological > > environment. > > > > Palpation is a tool used for identifying soft tissue irritation. > > Provocation is great tool used for identifying irritation to a > disc, > > facet joint, capsule, etc. As stated in past journal articles > given > > by your friend Dr. Welker, provocation has a higher interexaminer > > reliability than palpation. > > > > My definition of irritation depends on what the patient is > > complaining of. A meniscal tear of the knee is different from an > > infrapatellar strain. In both cases, the patient complains of > knee > > pain. We can either call it knee dysfunction or call it exactly > what > > it is. > > > > If a patient comes in complaining of a stiff neck, a proper > > examination should be done to find out where the tightness or > > irritation is coming from: disc, facet joint, capsule, soft > tissue, > > mental. If pain can not be reproduce from soft tissue palpation > or > > provocation, chances are their area of complaint is not > > neuromusculoskeleta l in origin and requires further studies or is > > mental. > > > > Provocation is not done for acute inflammatory cases alone. If a > > patient comes in complaining of chronic low back pain, > provocation of > > the area should be done to find the level of irritation. Even if > a > > patient has been suffering from this low back pain for many > years, > > his/her symptoms should still be able to be reproduced. > > > > By stating earlier that we work well with many local MD's I did > not > > mean that I am better than any of you and did not mean any > > disrespect. My point was that they agree with and respect our > theory > > and examination/ diagnosis/ treatment. > > > > Shad McLagan D.C. > > > Check out the all-new beta - Fire up a more powerful email and get things done faster. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 17, 2006 Report Share Posted November 17, 2006 Dr. Medlin, Just for clarification, I never once stated I could diagnose everything, as you stated I did. I have only stated, after being asked, what I would do with certain cases or situations, given the technique I have learned. And, yes, we did both go to chiropractic school, but what I have learned was not taught in school. I meant no disrespect to those that have been practicing for years. Years of experience shows you are a good business man and perhaps a better adjuster (and maybe a good doctor). Having a high volume practice and making a lot of money shows business success, but not always success as a doctor. When is it ok for me to take on a new thought process? Must I wait 5 years? 10 years? Or as long as 20? Or should I just continue what I was taught in school because that is what they were taught and those that taught them were taught the same thing when they were in school. The point is, there is no correct time for a new thought process and it has nothing to do with experience. Shad McLagan D.C. > > > > > > Your " theory " doctor is the same as everyone elses for the most > > part. You might change some terms here and there, but ultimately > > you're talking about practicing in a way that most of us already > do. > > > > > > I just fail to see why this is any different than the average > > chiropractic office and why such lengths are taken to express > this > > presumed " New Idea " > > > > > > > > > ph Medlin, DC > > > Spine Tree Chiropractic > > > 1627 NE Alberta St. > > > Portland, OR 97211 > > > Welker-McLagan Model > > > > > > > > > I see my past message has provoked many responses. By me > stating > > my > > > opinions, theories and philosophies, I by no means think that I > > am > > > better than any of you nor do I mean any disrespect. > > > > > > Many of you have stated you do indeed treat irritation, but you > > also > > > state you treat other disorders such as joint dysfunction. > > > > > > Joint Dysfunction: wrong/bad function. I do not believe a joint > > goes > > > into a dysfunctional state. As stated in prior messages, the > body > > > works toward stabilization not destabilization or dysfunction. > > > > > > To me, joint dysfunction is along the same lines as > misalignment > > > (wrong/bad alignment), malposition (wrong/bad position), or > > fixation > > > (wrong/bad movement). If you have any one of these three you > are > > > considered to have joint dysfunction. I believe the joint or > > segment > > > is in correct joint function, given the state/irritation the > > segment > > > is in. I feel that it is an intelligent adaptation to a > > pathological > > > environment. > > > > > > Palpation is a tool used for identifying soft tissue > irritation. > > > Provocation is great tool used for identifying irritation to a > > disc, > > > facet joint, capsule, etc. As stated in past journal articles > > given > > > by your friend Dr. Welker, provocation has a higher > interexaminer > > > reliability than palpation. > > > > > > My definition of irritation depends on what the patient is > > > complaining of. A meniscal tear of the knee is different from > an > > > infrapatellar strain. In both cases, the patient complains of > > knee > > > pain. We can either call it knee dysfunction or call it exactly > > what > > > it is. > > > > > > If a patient comes in complaining of a stiff neck, a proper > > > examination should be done to find out where the tightness or > > > irritation is coming from: disc, facet joint, capsule, soft > > tissue, > > > mental. If pain can not be reproduce from soft tissue palpation > > or > > > provocation, chances are their area of complaint is not > > > neuromusculoskeleta l in origin and requires further studies or > is > > > mental. > > > > > > Provocation is not done for acute inflammatory cases alone. If > a > > > patient comes in complaining of chronic low back pain, > > provocation of > > > the area should be done to find the level of irritation. Even > if > > a > > > patient has been suffering from this low back pain for many > > years, > > > his/her symptoms should still be able to be reproduced. > > > > > > By stating earlier that we work well with many local MD's I did > > not > > > mean that I am better than any of you and did not mean any > > > disrespect. My point was that they agree with and respect our > > theory > > > and examination/ diagnosis/ treatment. > > > > > > Shad McLagan D.C. > > > > > > > > > > > > > -------------------------------------------------------------------- ---------- > Check out the all-new beta - Fire up a more powerful email and get things done faster. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 17, 2006 Report Share Posted November 17, 2006 In response to my statement: The reverse is also going to be true. You will be unable to explain why someone is in pain. you said: I disagree with the idea of not being able to explain why someone is in pain. If someone is hurting, there has to be a cause. If I am unable to find the cause, how could I possibly justify my reasoning for treatment? How could anyone? How would I know what I am treating? then I never once stated I could diagnose everything, as you stated I did. and then I meant no disrespect to those that have been practicing for years. Years of experience shows you are a good business man and perhaps a better adjuster (and maybe a good doctor). Having a high volume practice and making a lot of money shows business success, but not always success as a doctor. ??????????????????? Thanks for the dialogue doctor. ph Medlin, DCSpine Tree Chiropractic1627 NE Alberta St.Portland, OR 97211 Welker-McLagan Model> > > > > > > > > I see my past message has provoked many responses. By me > stating > > my > > > opinions, theories and philosophies, I by no means think that I > > am > > > better than any of you nor do I mean any disrespect.> > > > > > Many of you have stated you do indeed treat irritation, but you > > also > > > state you treat other disorders such as joint dysfunction.> > > > > > Joint Dysfunction: wrong/bad function. I do not believe a joint > > goes > > > into a dysfunctional state. As stated in prior messages, the > body > > > works toward stabilization not destabilization or dysfunction.> > > > > > To me, joint dysfunction is along the same lines as > misalignment > > > (wrong/bad alignment), malposition (wrong/bad position), or > > fixation > > > (wrong/bad movement). If you have any one of these three you > are > > > considered to have joint dysfunction. I believe the joint or > > segment > > > is in correct joint function, given the state/irritation the > > segment > > > is in. I feel that it is an intelligent adaptation to a > > pathological > > > environment. > > > > > > Palpation is a tool used for identifying soft tissue > irritation. > > > Provocation is great tool used for identifying irritation to a > > disc, > > > facet joint, capsule, etc. As stated in past journal articles > > given > > > by your friend Dr. Welker, provocation has a higher > interexaminer > > > reliability than palpation.> > > > > > My definition of irritation depends on what the patient is > > > complaining of. A meniscal tear of the knee is different from > an > > > infrapatellar strain. In both cases, the patient complains of > > knee > > > pain. We can either call it knee dysfunction or call it exactly > > what > > > it is.> > > > > > If a patient comes in complaining of a stiff neck, a proper > > > examination should be done to find out where the tightness or > > > irritation is coming from: disc, facet joint, capsule, soft > > tissue, > > > mental. If pain can not be reproduce from soft tissue palpation > > or > > > provocation, chances are their area of complaint is not > > > neuromusculoskeleta l in origin and requires further studies or > is > > > mental.> > > > > > Provocation is not done for acute inflammatory cases alone. If > a > > > patient comes in complaining of chronic low back pain, > > provocation of > > > the area should be done to find the level of irritation. Even > if > > a > > > patient has been suffering from this low back pain for many > > years, > > > his/her symptoms should still be able to be reproduced.> > > > > > By stating earlier that we work well with many local MD's I did > > not > > > mean that I am better than any of you and did not mean any > > > disrespect. My point was that they agree with and respect our > > theory > > > and examination/ diagnosis/ treatment.> > > > > > Shad McLagan D.C.> > >> >> > > > > > > > --------------------------------------------------------------------> Check out the all-new beta - Fire up a more powerful email and get things done faster.> Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.