Bartlett - Palmer College of Chiropractic
Transcription
Bartlett - Palmer College of Chiropractic
Summer Quarter 2016 THE BARTLETT A publication of Palmer College of Chiropractic’s West Campus “Corporate Chiropractic” panel-session features alumni from tech-based health centers. Page 10 Palmer speakers top the line-up at CCA Sports Symposium. Page 23 SHOWING LEADERSHIP THROUGHOUT THE PROFESSION! Meet the new ASG officers! Page 20 Highlights of Palmer-Life softball/soccer games! Page 6 Sports Council helps walkers “go the distance” (and raise $4.5-million for breast-cancer support-programs) at Avon 39 event in San Francisco Page 10 1 From your Editors... H ello there, Palmer! Welcome to the 2016 Summer edition of the Bartlett! To start off this edition, we, Jeff Wong and Nav Sohi, would first like to introduce ourselves as your new co-editors of the Bartlett! We’re honoured to take on this role, and will do what is needed to bring you an enjoyable read! In addition, we welcome Alexandra Andersson as our new supporting writer! Summer quarter had its fair share of events. This was the first quarter for our new ASG council; our Sports Council helped treat nearly one fourth of the 1,900 walkers at the Avon walk for breast cancer; we held a corporate chiropractic panel; and the Rio Summer Olympics happened! Jeff Wong Co-editor Within this issue, you’ll find a wide variety of material! From information about FAKTR, to an interview with Dr. Ti Pence, to a recap of the AVON 39 walk for breast cancer. Hopefully there is something within that will stimulate you! A special thanks to Chuck Bustillos for being a key part of the Bartlett over the past few years and really capturing the essence of what it is to be part of Palmer San Jose West family. Keep your head up and hope you enjoy the read! Nav Sohi Co-editor Good luck on your finals!! Table of Contents 1 - From your Editors... 14 - Inspiration 2-3 - Welcome Summer 2016! 15-16 - Sports Council AVON 39 Walk 4 - Results of Gallup Study 17-18 - Interview with Dr. Ti Pence 5 - Palmer on YELP! 19 - Note from your ASG President 6 - Palmer West Vs. Life West 20 - New ASG Officers 7 - Intra-Abdominal Pressure? 21-22 - Keys to being a Successful Clinician 8-9 - FAKTR 23-24 - Strong Palmer Presence at CCA 10-12 - Corporate Chiropractic Panel 25- Movement Variability 13 - Comic Relief 26 - CONGRATULATIONS! The Bartlett welcomes your comments, articles, etc. Please send to: pccw.thebartlett.ca@palmer.edu Alexandra Andersson Writer Chuck Bustillos Publication Advisor 2 Welcome Summer 2016 1st Quarter Class! Raymar Adams Los Angeles, CA Trevor Agnitsch Benecia, CA Ilan Green Mill Valley, CA Joanna Holleran Chester Springs, PA Mary-Kathryn Brazil Salinas, CA Nicole Kasper Calgary, Alberta Olivas Galapon Salinas, CA Montre- Ti Liu 3 Mat Mancuso Denver, CO Molly McFarland Costa Mesa, CA Sean McTarggart San Mateo, CA Todd Morgan Bartlett, IL Nicolas Muhn Morgan Hill, CA Micheal Risher Palatine, IL Erik Sanchez San Jose, CA Shantai Watson Adrossan, Alberta “Foster an environment that breeds a culture of sympathy, empathy, and respect towards fellow peers” Tim Windsor Reno, NV Coln Yan San Mateo, CA 4 5 6 Palmer West Vs. Life West! Jennifer Gordon (7Q) ASG Sports Director Jennifergordon11@live.com “Battle of the Bay” with Life West on Friday, July 29th and Saturday, July 30th was just that - a battle! Friday night at Twin Creeks Sports Complex in Sunnyvale: The Men’s softball team fought hard but ended the game with a loss. The co-ed softball team worked together and dominated the field to trying to bring home a win, but inevitably leaving it a tie. Saturday at Bladium Sport and Fitness Club in Alameda: The Men’s team sprinted hard, keeping it neck and neck the whole game but unfortunately ended with a loss. The coed soccer team then stepped onto the field and finished the weekend off with a big win! Overall, the Palmer teams went out, played hard, and enjoyed competing against our cross bay rivals. We will have to settle the score next quarter, showing Life West what we’re made of! 7 Intra-Abdominal Pressure? I’ve Heard of it -- But what is its Purpose? Jeff Wong (8Q) Bartlett Co-editors Jeffrey.wong1217@gmail.com I’ll start off by saying that this is not a DNS (Dynamic Neuromuscular Stability) article, but will use concepts from DNS. Now with that established, I’m going to try and simplify the why, the what, and some of the how of intra-abdominal pressure. Let’s start off with… The What: The core is made up of musculatures surrounding the abdominal region. It’s easiest to think of the core as a barrel that is surrounding the spine in a 360 degree direction. Anteriorly and laterally the big players are the transverse abdominous and obliques (external and internal), as well as the rectus abdominous. Posteriorly (and slightly lateral) is the quadratus lumborum and the back musculature (erector spinae, multifidus…ect). The bottom of the barrel is made up of the pelvic floor, and the top of the barrel is the diaphragm. Now on to… The Why: If you think of the human spine, you have a lordotic cervical and lumbar portion with a kyphotic thoracic portion in-between. The curvatures of the C and L spine are the same (or similar), but the muscular attachments vary greatly. If you think about the anatomy, the cervical spine has muscles attaching directly to the anterior aspect of the vertebrae (deep neck flexors: longus colli and capitis), and directly to the posterior aspects of the vertebrae (splenius capitis and cervicis, multifidius…etc). Now with that said, any flexion in the cervical spine will be counterbalanced directly by extensors, and any extension counterbalanced by the flexors. This keeps the cervical spine STABLE through both movements. Now if we travel down to the lumbar spine, things are a little different. Here, muscles attach directly to the posterior aspect (and lateral aspect: Psoas) of the vertebrae, but no muscles attach directly to the anterior aspect. Thus extension in the lumbar spine has nothing on the anterior aspect to counterbalance the movement and keep stability. THIS IS THE REASON WHY WE NEED INTRA-ABDOMINAL PRESSURE… It’s a counterbalance to the posterior musculature of the lumbar spine, and help keeps neutrality through extension and through hip flexion (no intra-abdominal pressure can result in an anterior sheering created by the psoas; think about gait). And now finally… The How: So now when you take a breath in, the diaphragm moves from its domed, resting position, into its flattened, active position. This (if the core is functional) causes a reduction in volume creating an increase in abdominal cavity pressure. This pressure is only maintained if the muscles surrounding are working correctly. The surrounding muscles SHOULD NOT be contracting CONCENTRICALLY to increase the pressure. The only type of This diagram from Frank, C., Kobesova, A., & Kolar, P. (2013). Depicts the pressure contained within “the barrel” AKA the core. The blue arrows show how the summation of pressure acts upon the lumbar spine to create stability of the segments. Reference: Frank, C., Kobesova, A., & Kolar, P. (2013). Dynamic Neuromuscular Stabilization & Sports Rehabilitation. The International Journal of Sports Physical Therapy, 8(1), 73. muscle contraction here should either be ISOMETRIC or slightly ECCENTRIC. To sum this up, essentially the diaphragm flattening creates the pressure in the inside of the cavity, and causes a reflexive isometric contraction of the surrounding muscles causing them to resist the pressure that is trying to travel outwards. Dysfunction of this system can occur in many different ways, but that’s a story for another time. A quick, chiropractic relevant, side note: the end result of this dysfunction is not always, but can be low back pain. Anyway’s, I’ll admit that this way of thinking is DNS biased, but hopefully this gives you a good starting point, and a very general idea of the why, the what, and the how of intra-abdominal pressure. 8 An Introduction to FAKTR Alexandra Andersson (8Q) Bartlett Writer Alexandra.andersson@1897.palmer.edu It was down the street, another convenient luxury of Silicon Valley. A quick lunch outing to refuel our brains for the next round in an amazing weekend-long educational deluge. Whole Foods in all of its glistening and gleaming (and mostly over-priced, i know BUT) goodness. Dr. Greg Doerr D.C., makes his way around the food court animated, looking at this and that, here and there, hands in his pockets, and a big beaming smile with an exuberant radiating energy. It was refreshing. He was willing to take on any question, including unrelated, personal and completely adorable! He met his wife on a train on the east coast when she started up conversation with him; being as it was New Jersey he assumed she couldn’t possibly be sane starting up casual conversation with a chance stranger. He quizzically and amusingly asked her where she was from and she claimed to be an east coast native. The spell had been cast; they spent the entire train ride unable to pull their loquacious selves apart from one another. And, to top it off, it turned out she wasn’t from the east coast after all… she hailed from the exotic land of South Africa. They arranged to have dinner together and the rest is, as they say, history. Dr. Greg Doerr is a very amiable and approachable guy. Add to that highly intelligent, knowledgeable, relatable and well-spoken and you’ve got yourself a first rate instructor. Go to an ACA Sports Symposium; Dr. Greg’s presentations are regularly overwhelming popular. Go to an MPI seminar; they regularly give Dr. Greg an acknowledging shout-out. Graston? Dr. Greg was one of the original instructors. Functional and Kinetic Treatment with Rehab (FAKTR) was co-developed by the highly reputable and respected Dr. Greg Doerr and Dr. Tom Hyde in 2002, both of whom have an impressive collection of alphabet soup after their names. Seriously. Up to the point in time before FAKTR had come into being, these two docs had gotten their hands dirty with just about every technique imaginable. Though they appreciated and embraced a lot of what they had learned over the course of their careers, they also recognized that there was something they wanted but still had not been taught. There was a niche to fill and they wanted to fill it for themselves and for the advancement of the profession. Thus, FAKTR was forged. Dr. Doerr and Dr. Hyde each created Dr. Greg Doerr, co-developer of the FAKTR technique their own similar, yet distinct, ideology under the FAKTR umbrella. FAKTR is a marriage of evidence-based soft tissue techniques, the latest research and a ridiculously impressive accumulation of clinical expertise. The seemingly endless scope of FAKTR in treating neuromusculoskeletal issues is appropriately summed up by its acronym: Functional and Kinetic Treatment with Rehab. As the name implies, FAKTR is a malleable approach to treatment, not a predetermined checklist. A patient walks through your door with this, that or the other thing. What do you do? Where do you start? What’s your road map look like? What are the clues to help you get through the case? As students, these are the sorts of questions that cause us to hit the panic button, regress 20 years and pee our pants! These are the sorts of questions Dr. Doerr wants to help us learn how to answer quickly, confidently and effectively and in a way that creates trust and compliance with our patients. 9 An Introduction to FAKTR Over the course of a weekend with FAKTR you will learn immediately applicable strategies for how to approach everyday ailments such as tendinopathies, sprain/strains, nerve entrapments, shin splints, diaphragmatic release and TOS. You will be expertly trained in the different applications of IASTM. We will constantly be working through assessing whether we’re dealing with a primary mobility or stability issue. Movement assessment will be pervasively present through the course. Critical thinking will constantly be used to simplify what we see and why we see it. Over the course of the weekend we will treat the entire body, and not just statically but we will treat through functional movement! We will learn to assess and recognize when the patient needs rehab before our soft tissue work is going to have any effect for them. And we’ll even get a sneak peek at some of Dr. Greg’s innovative taping methods! We will also dispel some widely misunderstood concepts regarding IASTM, like: did you know petechial bruising should only occur in the first 1-3 visits? Or that the appropriate use of soft tissue instruments requires different methods based on presenting condition? Or that soft tissue therapy has instantaneous effects NOT because we’re breaking up scar tissue or adhesions but because we’re using afferent stimulation to reset the neurological system. If this isn’t enough for you, FAK- TR has placed the nitty gritty didactic material online. On there you will find not only references for what we cover over the weekend course but you can also take an illuminating dive into the more intricate physiological details for why we do what we do. If you’re looking for a fun weekend of constructive hands on learning, come join us! This is a clinical course that looks at the big-picture and is designed to teach you impeccable skills in critical thinking, assessment and treatment. As Dr. Greg likes to say, “sometimes you need to build the road before you can pave it.” Come hungry to learn and you will leave with more skill and knowledge than you bargained for. To learn more, go to: www.faktr.com Corporate Chiropractic PanelSession Shows Palmer’s Leadership in Growing Field of Care 10 Chuck Bustillos Palmer Marketing & Communication Chuck.bustillos@palmer.edu With more and more companies emphasizing wellness in the workplace in the form of corporate-based health centers, students at Palmer’s San Jose campus had a unique opportunity to learn about the unique skills required to be the chiropractic member of the multidisciplinary team when Palmer alumni from the campus-based health centers for several top companies in the Silicon Valley recently participated in a special “Corporate Chiropractic” panel-program presented by the San Jose campus Student Ambassadors of the Palmer Center for Business Development (PCBD). Panel-members included: Rhiannon Dickison, D.C. (San Jose, ’12), Google; Daniel Lord, D.C., (San Jose, ’08), Facebook; Patrick Lum, D.C., (San Jose, ’98), Google; Matthew McCormack, D.C., (San Jose, ’14), Motiva Health; Kale Ptacek, D.C. (San Jose, ’14); and Morgan Young, D.C. (San Jose, ’07), Cisco Systems. “The Palmer Center for Business Development aims to ease the transition from student to graduate through guest-speaker presentations, and other skill-building resources,” said Jennifer Nathan, Student Services Specialist, and staff advisor to the PCBD Student Ambassadors at Palmer’s San Jose campus. “Our campus-location in the Silicon Valley provides a unique opportunity for our students to learn about the growing opportunities in the field of corporate-chi- Acknowledging photo includes speakers, PCBD Student Ambassadors for West Campus, and Jeniffer Nathan Student Service Specialist ropractic care, and we’re grateful to our distinguished alumni currently practicing in several of the tech-based clinics for sharing their knowledge and experience with students who aspire to practice in similar multidisciplinary settings.” Clinical and cost-effectiveness (along with convenience to the employees) are among the major reasons for the rise in the number of corporate-based clinics, which a recent report by the Foundation for Chiropractic Progress stated are expected to grow annually by approximately 15-20 percent. And based on statistics (and patient-demand), the availability of chiropractic care is a big reason for overall efficacy – and why the appointment of additional chiropractors at each location has grown at a more rapid pace than other health care providers. “We’re here today, standing on the shoulders of the greats, like the Souzas and the Updykes of the profession, who’ve done an amazing job in giving us the opportunity to be part of an amazing and growing way to reach a segment of the population who otherwise may not have been introduced to, or benefited from, chiropractic care,” said Dr. Lord, appointed to the Facebook Health Center in 2012, where he is now Physical Medicine Lead, who, in addition to management of the team of chiropractic doctors (which includes San Jose campus alumna Danielle Correa, D.C., ’12) also has oversight of acupuncture and physical-therapy services. When he joined the Facebook health-center team four years ago, Dr. Lord said the number of chiropractors at other Silicon Valley-based health centers was relatively small. He now estimates approximately 30 DCs are currently involved with the delivery of some type of on site care – which is having an impact well-beyond the company-communities they serve. (Continued on page 11) 11 Corporate Chiropractic PanelSession Shows Palmer’s Leadership in Growing Field of Care “At each of our clinics, we’re exposing a percentage of the general population who otherwise may never have gone to a chiropractor – and when the patient experiences positive outcomes, it’s a real game-changer, because the ripple effect of that experience ultimately touches the entire profession,” said Dr. Lord, a past president of the San Jose Sports Council, and featured speaker at the most-recent San Jose and Davenport Homecoming programs, who is involved with the expansion of the new Facebook Health Center scheduled to open at the Menlo Park headquarter-campus in November. When Dr. Young was appointed Cisco Systems “LifeConnections Center” team in 2010, he brought the experience of working in a multidisciplinary setting, as a result of serving as the chiropractic consultant for Kaiser Hospital in San Jose – which has served him well in his role at Cisco. “Getting exposed to other disciplines, and understanding other health care professions, is very important for anyone who aspires to a position in a mul- tidisciplinary clinic, because it fosters the necessary understanding of each providers set of skills, and their respective roles, in the patient-care process,” said Dr. Young, a San Jose campus faculty-member since 2008. Dr. McCormack said he was grateful for Palmer’s VA/DoD Internship program, and appreciated the experience for providing him with the first-hand perspective of a multidisciplinary team-dynamic. “My (VA) internship was invaluable, because it enabled me to see other providers in an active setting. I came away from the experience with an incredible level of understanding and experience, which benefits the provider, and the patient,” said Dr. McCormack who graduated as class valedictorian, with Summa Cum Laude honors. Dr. Lum encouraged students who aspire to work in a corporate setting to take advantage of seminars, and broaden their scope of health care mentors. “Look outside the box – in addition to seeking strong chiropractic mentors, shadow some medical doctors, to see how a medical office operates – it makes you that much stronger of a candidate to work in a multidisciplinary clinic,” said Dr. Lum. Dr. Dickison works with Dr. Lum (and several other San Jose campus alumni, including Rob Murray, D.C., and Nicole Chan Murray, D.C.) at Google – and she, too, emphasized the importance of mentorship. “Surround yourself with a good group of mentors, who are diverse in how they practice, and who help build your confidence – I think that’s huge,” said Dr. Dickison, who has served as a clinician at multiple Sports Council events, and in addition to her participation in the Corporate Chiropractic panel-program, participated in the alumni-panel session at the San Jose Homecoming prospective student event earlier this year, and was the special guest-speaker at the Summer ’16 “Welcome Back” assembly. (Continued on page 12) (From left) Rhiannon Dickison, D.C., Google; Patrick Lum, D.C., Google; Daniel Lord, D.C., Facebook; Mathew McCormack, D.C., Motiva Health; Kale Ptracek, D.C., Motiva Health and Morgan Young, D.C., Cisco Systems Corporate Chiropractic PanelSession Shows Palmer’s Leadership in Growing Field of Care “I’m humbled and thankful to be starting my career in a corporate setting. I love my job. It’s incredibly gratifying. I didn’t think I’d have an opportunity like this for 10 or 15 years. But we get a great education at Palmer, which provides multiple opportunities to gain valuable experience. And when you present all that experience in a strong CV, you can find yourself in a position similar to mine, just a few years after graduating.” small to medium-sized companies in the Silicon Valley to forge on site relationships that yield equally positive outcomes as the care provided at the Google, Facebook and Cisco-sized companies. “Our goal with Motiva is to position chiropractors as the ‘gatekeepers of musculoskeletal care’,” said Dr. Ptacek, whose company serves as a “chiropractic broker” of sorts, looking to help these companies enjoy healthy profits With their company “Motiva Health”, Drs. achieved by the larger Silicon Valley McCormack and Ptacek are targeting firms, in part, due to a healthy workforce. “We are aiming to fill a niche not just here in the Silicon Valley, but with the infinite number of companies throughout the U.S.,” added Dr. Ptacek, who with Dr. McCormack provides on-site care for a company of 300 employees in South San Francisco. “We’re trying to position chiropractic as their first-thought process. You start by showing what a couple of days of treatment can do for their staff – and if you’re able to extend that to five days, and show what you can truly offer, the potential is limitless.” Palmer In the Community! SPEAK Club co-president Jessica Young (8th Q) discussed health benefits of chiropractic care, and promoted the services of the Palmer Chiropractic Clinics, at the Festival of Arts & Musique in San Jose on Aug. 27. Fellow SPEAK club member Nikita Predtechensky also participated Palmer students enjoying a day off with a watermelon eating contest! Thank you West Chapter Foundation for Chiropractic Progress (F4CP) for providing prizes! Winners were: 1st – Mike Risher, 1Q (Chipotle gift card & Theraband stability disc) 2nd - Ismeil Hachem, 7Q (Theraband stability disc) 3rd - Dustin Johnston, 8Q (Palmer water bottle) 12 13 Comic Relief 14 Inspiration Dr. Souza being an inspiration to us all! Photo courtosy of Dr. Therresa Whitney, If you have a photograph you wish to share to the barlett please email us at thebartlett.ca@palmer.edu! 15 Sports Council Helps AVON 39 Walkers “Go the Distance” Palmer-team interns included Sports Council members: Christina Goulart, Jeff Grykuliak, Daniel Hopper, Will Lee, Danny Louie, Brittni Melnychuk, Dixon Mosseau, James Perry, Tyler Poland (Sports Council co-president), Tanya Simard, Erica Yu, and Courtney Wilson (Sports Council co-president). Chuck Bustillos Palmer Marketing & Communication Chuck.bustillos@palmer.edu the availability of Palmer sportscare services, and more than 350 received chiropractic treatment. Doctors and interns from the Palmer Chiropractic Clinics in San Jose played an instrumental role in helping several-hundred participants “go the distance” and raise nearly $4.5-million at the AVON 39 Walk to End Breast Cancer in San Francisco, July 22-23. Ti Pence, D.C., (San Jose, ’06), served as captain of the Palmer team, and was assisted by fellow clinicians Rhiannon Dickison, D.C. (San Jose, ’12), and Richard Robinson, D.C. (San Jose, ’96). AVON 39 San Francisco (the fifth of seven events across the country) drew 1,900 participants from 37 states and Washington, D.C. — including 222 breast cancer survivors — who walked a total of 39.3 miles over two days along a course route that began near the “base camp” at Fort Mason, crossed the Golden Gate Bridge, passed through scenic Sausalito, and concluded in the countryside of Marin. The Palmer team initiated their event-care services at the “base camp,” and then moved to different spots along the course. Nearly 500 participantsbenefitted from “I was very impressed with the commitment and dedication of each and every Palmer team-member who was involved in this event,” said Dr. Pence, who has served as a clinician at multiple Sports Council events, including the Silicon Valley Turkey Trot. “These interns worked all day, in extreme heat, doing everything possible to help the walkers reach the finish line. Several worked 13 hours, until nearly 11 p.m. on Saturday evening, were up by 4 a.m. on Sunday morning, and treated walkers at the finish line until after 3 p.m. The Palmer team really showed what they were made of at this event – and their efforts were well appreciated.” Student-assistants included: Alix Boyer, Troy Davis, Corey Diamond, Christopher Duong, Alex Fonseca, Jacob Friedman, Marc Gusse, Jackson Hymphrey, Jong Kim, Amy Jones, Bradley Kufske, John Lin, Angelica Malek, Ledia Mati, Vanessa Ng, Dane O’Brien, Nikita Predtechensky, Monica Rizkalla, Dianna Rocha, Robert Sanders, Michael Simele, Molly Sparks, Danielle Walsh, and Brian Wang. “Working the event was very inspiring and moving to hear the stories of so many strong women,” said Anne Marie Vicencio, Sports Council event coordinator, who had a particularly memorable experience with a breast-cancer survivor who finished eighth overall, and credited her achievement to the care she received from the Palmer team. “I’m lucky to say that I was able to help these women walk 39 miles -- and it’s incredibly rewarding when they tell you that without us, they wouldn’t have finished.” “For me, the AVON 39 walk was a unique event, unlike any other I have attended throughout my three years of involvement with the Sports Council,” said Courtney Wilson, Sports Council co-president. “It was an extremely proud moment for me looking up between adjustments to see my peers relentlessly treating patients, their passion for chiropractic and helping patients reach their goal (Continued on page 16) 16 Sports Council Helps AVON 39 Walkers “Go the Distance” “The enthusiasm, energy, and determination of the walkers was indescribable. It was an experience I will never forget, and an absolute highlight of my chiropractic career thus far!” “Avon 39 was an amazing event, and an amazing experience for our Sports Council team,” said Tyler Poland, Sports Council Co-President. “To be able to help the participants who were giving everything they had for an amazing cause reach the finish line, and to help them benefit from chiropractic care when many of them were physically breaking down, was truly a special experience for everyone involved.” “I heard nothing but great things about how incredibly helpful the Palmer team was to ensure the wellbeing of our participants,” said Daniel Sanchez, crew and volunteer manager for the Avon 39 event in San Francisco. “You guys rocked it out there both at Base camp, and at the Finish festival. After walking a long 39.3 mile journey, our walkers and crew were able to relax under the care of Palmer Chiropractic!” Since the AVON 39’s launch in 2003, more than 220,000 participants have raised nearly $590,000,000. Funds raised are distributed to local, regional and national breast cancer organizations. 17 Q&A: Dr. Ti Pence Reflects on his Rotation at Olympic Training Center Chuck Bustillos Palmer Marketing & Communication Chuck.bustillos@palmer.edu Ti Pence, D.C., is a 2006 graduate of Palmer’s West campus. Dr. Pence has maintained practices in Colorado and California, and also enjoyed the unique experience of working in a multidisciplinary clinic in Susuno, Japan. In addition to his role in the Palmer Chiropractic Clinics, Dr. Pence, appointed to the West campus faculty 2011, has served as a Sport Council clinician at multiple events, including the Silicon Valley Turkey Trot and the Avon 39 breast-cancer fundraiser-walk (for which he was the Palmer team-captain). An avid martial-arts and sports enthusiast, Dr. Pence recently experienced one of the highlights of his chiropractic career: a two-week clinical-rotation providing care at the Olympic Training Center in Chula Vista, Calif. Dr. Pence reflects on his OTC experience in the following “Q&A” discussion: What inspired you to pursue an OTC rotation, and when did you begin the application process? I received an invitation to apply for the rotation, which I completed and submitted immediately. The longest part of the application-process was waiting on the security check, which takes a little while. Soon thereafter, I received a message that I had been selected for a rotation. What are the requirements for OTC-rotation consideration? At minimum, candidates applying for an OTC rotation must have earned their CCSP. Experience working with teams also is a plus . What was your reaction to the news that you’d been selected? Total elation. I’ve wanted to do an OTC rotation since I heard about the possibility while completing my CCSP. I had to read the acceptance letter a number of times before I believed it was actually happening! Do applicants have a choice in the location of the OTC (California or Colorado) at which they’d prefer to complete their rotation – or, is the assignment determined by the sport(s) in which you have an interest, or the sport(s) in which you have experience with providing care (such as martial arts)? This one I am not sure of -- I think assignments may be determined partially by which of the two locations is closer to the doctor. What team(s) did you work with during your OTC rotation in SoCal? I was there at a very unique time. The Paralympians were preparing to go to Rio, and many of the Olympians were returning to the center after winning medals at the Summer Games. I spent most of my time with the Paralympian track team. They were truly inspiring – which inspired me to do all I could to help keep these amazing athletes competing at the top of their game. What was a typical day dur ing your OTC assignment? The day began with breakfast in the OTC cafeteria, where we’d often meet and eat with the Olympians we would treat that day. This provided an informal way to prepare for the type of care we’d provide. The clinic opened at 8 a.m., and we’d see a number of the athletes before training. Once we got all the athletes ready for practice, we would head down and see what help we could provide for the Paralympic track team. As soon as practice was over, we would head back to the clinic, where we would continue treating the athletes until 6 p.m. After we closed the sports medicine department, I would meet with one of the Paralympians, to do their gym workout with him. Then we would head back to the cafeteria for dinner. We had a short period of time for rest and hanging out before it was time for bed -- so we could wake up and do it all over again! (Continued on page 18) 18 Q&A: Dr. Ti Pence Reflects on his Rotation at Olympic Training Center How would you describe the dynamic of the camaraderie among the team of providers involved with the delivery of care? The best way to describe the camaraderie is the comments we received from the many athletes who received care from me, and other team-members. They continually asked if we were friends, and came down here to treat together. They all thought we had been working together for years! Meggie, my physical-therapist teammate, had limited experience with chiropractors. She had never been treated by one, nor really referred anyone to a chiropractor. Within the first day, we figured out a groove, and were working out team-treatment plans for the athletes. By the end of the first week, we were great friends. The experience made it very clear how much benefit there is to working with other professions to provide a ‘team’ approach to health care. As far as what drew the athletes to me, it was my skill at adjusting both the spine and extremities. I didn’t need to do much muscle work or rehab. I allowed the physical therapist to shine in her skills in these areas. I would help, if needed, but focused on the adjusting. What is the process by which athletes can request/receive chiropractic care? If they are a medal-contender for the Olympics, or if they (or their coaches pay) to have the sports medicine as a service, then the athlete is allowed to be seen by us. The athlete can either call or make an appointment in sports med to see the provider of their choice. We would also try and accommodate walk-ins, as best as we could. For any student/doctor considering an OTC rotation, what do you see as the most important skill or attribute to achieve a similar goal? Be a ‘team player’ and learn the mind of a high level athlete. Second, get your CCSP and start working with athletes whenever you can. Third, try to do all you can to learn to work with other professions, and learn to play to each other’s strengths. It can get a bit intense at times, and having faith and trusting your sports med team is a vital component. How does this experience rank among your collective chiropractic-career achievements? I have had the unique privilege of being a part of many amazing experiences within my career. I have been mentored by some of the great minds in chiropractic like Drs. Bart Green, Claire Johnson, Mark Charrette and Dan McClure. I have worked in a spine-surgery clinic in Japan. I have helped breast-cancer walkers finish the Susan G Komen 3-Day walks, and was the captain of the Palmer team at the recent Avon 39 walk for breast-cancer research – experiences for which I am truly grateful for all. However, my OTC rotation was truly was the most intensely gratifying experience of my career. The Paralympians changed my view of athletes, and how I look at life in general. There is no way to truly express my gratitude for what it meant to be a part of this team for two weeks. Is your ultimate goal to provide care at an Olympics (or similar international athletic event)? Ultimately, I would love to provide care to these Paralympians at the next Paralympic games in Tokyo. It would, of course, be an honor to work at the Olympics -and I would consider myself very lucky to be a part of the team. However, working with the Paralympians is vastly more challenging, and ultimately more rewarding. In reflecting on your collective career achievements and activities, how would you sum up your decision to become a doctor in the chiropractic profession? I have been proud to be a chiropractor since the day I walked across the graduation stage. I have never wanted to be anything but a chiropractor. If someone gave me the option to trade my chiropractic degree for any other degree, I would turn them down. We truly stand on the shoulders of giants who came before us, and made possible all of the opportunities that I, and many others, are now able to enjoy as chiropractic doctors. I just want to be able to pay it forward, like so many did before me. 19 An Insightful Note from your ASG President you towards becoming the chiropractor that is woven into your genetics. Everybody is unique, it becomes your own path in which you will find some things more difficult and stressful than others, while also finding things easier and more exciting! Keira Fika (7Q) ASG President Fika@ualberta.ca First off, I would like to begin with welcoming the 1st Quarters! This is the beginning of a challenging, eye opening, and rewarding graduate program! Since beginning my journey to become a chiropractor I have learned this experience is so individualized and unique. I cannot think of another profession that has so many avenues, streams, and trails that you can pursue, all directing Throughout your adventures here, upper quarter students will love to give you advice. Which classes should you actually pay attention in, who writes difficult exams, and what clubs and seminars to attend. In my experience you need to take this information in with a grain of salt. Like I mentioned before, everybody sees things in different ways, and every quarter has a particular difficulties that are relevant to your own level of experience. First quarter is hard because you’re the newbies, so is sixth and seventh when you take your first round of boards with over 34 hours of classes; Eighth and ninth you’re preparing for clinic; Tenth you’re trying to find patients. You need to remember, this is a graduate program and it should be demanding! The best way to grow is to be thrown into the deep end and be challenged to teach yourself swim. You must learn to adapt, learn from yourself, and make mistakes! Mistakes show us we are human and no one is perfect nor has the perfect advice for you or themselves. This program will test you mentally, physically and emotionally. Half way through my second quarter I had health issues arise and had to fly home to Canada in the middle of the quarter to run some tests. I was stressed with missing school, paying for a flight, and not knowing what those tests would say. Everything turned out fine, but without the support of my friends and family I don’t think I would have got through it so well. The people you’ll meet and the relationships you build here will be life changing. They will help you become a better person and an amazing chiropractor, and will open you up opportunities you never thought possible. So enjoy these next three years! Immerse yourself in your education and learn from others. Go explore California, go hike and get lost, learn to surf, go wine tasting, just fall in love with this place and never want to leave. “Every accomplishment starts with the decision to try” - Gail Devers 20 Meet the New ASG Officers Officers Alissa Banns is a native of Vancouver, B.C., and earned her B.K. (Bachelor of Kinesiology) from the University of Fraser Valley, Abbotsford, B.C., Canada, where she played on the women’s and co-ed soccer teams. Jordan Bryson served as social director for the 2015-2016 ASG. A native of Calgary, Alb., Canada, Bryson is a graduate of the University of Calgary, where she played on the women’s soccer team. Chuck Bustillos Marketing & Communication Chuck.bustillos@palmer.edu Palmer College of Chiropractic’s San Jose campus recently conducted elections to select the Associated Student Government (ASG) officers who will serve for the 2016-2017 term. The new ASG executive council taking office effective Summer Quarter ’16 (which begins in July) will include: President: Keira Fika, 7Q Vice President: Jordan Bryson, 8Q Secretary: Brad Kufske, 8Q Treasurer: Dustin Johnson, 8Q Athletic Director: Jennifer Gordon, 7Q Social Director: Alissa Banns, 7Q Community Service Director: Tim Haynes, 8Q Keria Fika: “I am so happy, and grateful, to be selected as the ASG president by the student body,” said Fika, who attended the University of Alberta, and has achieved Dean’s List honors in each of her first five quarters at Palmer’s San Jose campus. Jennifer Gordon is a native of “It means so much to be chosen, and Hemet, Calif., and earned her B.S. I cannot wait to make a difference with (kinesiology) from California State our student government, and provide University-Sacramento. support for my fellow ASG officers.” Tim Haynes is serving his second In addition to ASG, Fika also is a Sports term as ASG Community Service diCouncil officer who has assisted at rector. A native of Jonesboro, Ark., several events (including the Sea Otter Haynes earned his B.S. (biology) from Classic, Double Road Race, and San Arkansas State University. In addition Jose State rugby). She has also repre- to his role as an ASG officer, Haynes sented Palmer’s San Jose campus at also serves as one of the membership the Chiro Games, and helped carry The representatives for the San Jose camPalmer Spine at the 2015 Silicon Valley pus student chapter of the American Chiropractic Association (SACA), vice Turkey Trot. president (and cofounder) of the Disc “I have been treated by chiropractors Golf Club, and president of the San since I was three-months-old, which Jose campus chapter of the Foundahas helped me through many sports-re- tion for Chiropractic Progress (F4CP). lated injuries, and daily life issues,” said Fika, who played on the University of Brad Kufske is a native of Abbotsford, B.C., Canada, and earned his Alberta ringette team. Bachelor’s in Human Kinetics (BHK) “I chose to pursue a career in the chi- from Trinity Western University, where ropractic profession because of the he played on the men’s volleyball amazing care that I have received, team (which won two national chamwhich has helped get me back on my pionships). feet. This made me realize how much I want to help people maintain their over- Dustin Johnson is a native of Edall health and wellness, and provide monton, Alb., Canada, and earned his B.S. (biological science) from the them with the best-possible care.” University of Alberta. 21 10 Keys to Being a Successful Clinician Kevin Hendry Khendry@innovativefittnes.com About the author: Based in Vancouver, BC, Kevin Hendry is the Director of Education for RAD Roller as well as an author, Practicing Kinesiologist and Strength & Conditioning Coach. He is currently pursuing a graduate diploma in Osteopathy while working in the trenches helping people to move and perform better. Kevin has a decade of experience coaching NCAA Division 1 athletes, CFL football players, Canadian National Team athletes and BC Hockey League players, While his athletic background is in baseball, basketball and soccer his adventures have taken him all over the world - covering 30 countries on 6 continents. I get asked the following question all of the time: How can I ensure that I’ll have success as a clinician? My answer is quite simple: find an amazing mentor, get outside of your comfort zone, never stop learning and offer something unique that is unlike any other service that is already being provided. I would also like to share with you RAD Roller’s Educational Guiding Principles. There will always be new trends emerging that can make your role as a chiropractor very confusing but if you remember these 10 points and apply them with your own personal flair you will never be lost. 1. Information is changing and so should our approach. You should reserve the right to change your approach because we reserve the right to learn. As new evidence emerges and better strategies are developed your approach should evolve. 2. Patient values, wisdom from field experts and research guide our direction. We are guided, but not bound, by an evidence based approach which includes client/athlete/patient values, best research evidence and clinical expertise. The patient brings to the encounter their own personal preferences and unique concerns, expectations and values. The best research evidence is usually found in clinically relevant research that has been conducted using sound methodology (Sackett, 2002). Clinical expertise refers to the coach or clinician’s cumulative experience, education and skills. 3. Principles before techniques. We act out of principles instead of executing magical techniques from a recipe book. Those principles are very few in number and include: create body awareness, build people’s confidence, have a convincing therapeutic narrative, meet people’s expectations, provide novel input to the body to allow the individual’s nervous system to positively adapt, get people moving, support behavioral change and motivation to take responsibility for their own outcome. 4. The body has a hierarchy when it comes to function and structure, follow it. When we perform manual therapy it is often advisable to operate in a proximal to distal manner. In other words, address the mid-line of the body before the extremities (ie. the cervical spine before the forearm). The nerve root for the muscles in the forearm are located in the neck as well as the anchor of the fascial line that runs down the arm. Similarly, work on the ‘container’ before the ‘contents’. Address the superficial structures including muscles, fascia, tendons, joints and sensory receptors before addressing the organs. 5. The whole is greater than the sum of the parts. The body is an ecosystem in fine balance. It is not a collection of individual structures that need to be ‘fixed’. We pay attention to the complex systems in the body including the nervous, immune and autonomic systems which are very sensitive to even minor inputs and have a great influence over how we move and feel. We follow the Biopsychosocial (BPS) Model of Health that attributes ailments to intricate, variable interaction of biological factors (genetic, biochemical, etc), psychological factors (mood, personality, behavior) and social factors (cultural, familial, socioeconomic, medical, etc. (Continued on page 22) 22 10 Keys to Being a Successful Clinician 6. Chase prevention, not pain. We do not ‘chase the pain’ and simply address the part of the body that hurts. Pain is incredibly complex and is summarized well by the Pain Neuromatrix (Katz & Melzack, 2011). The following factors all come into play if your hip flexors are tight and ‘hurt’: memories of past experience, attention, meaning, anxiety, sensory signals from skin/muscles/fascia/organs, and finally emotional mechanisms related to homeostatic and stress mechanisms. Pressing into the hip with a tool does not magically make the pain go away. 7. When dealing with pain or dysfunction the body requires a progressive continuum of stimuli. Continuum for Better Movement: assessment-> education -> awareness -> manual therapy -> active mobility -> motor control/stability -> neuroplasticity trigger -> loaded movement -> locomotion integration. The entire sequence needs to be executed in the right order at the right time. Any one element alone is not enough. 8. The human body is incredibly durable and robust, not weak and fragile. It needs to move and be continually (eu)stressed. We do not treat the body as something that is fragile and is in need of fixing. Or that the body is inherently weak and can only work well when optimally aligned with free of trigger points and adhesion. The body has the ability to self-regulate and express health from the inside out but sometimes it needs a little external push in the right direction. If you are not careful with your words and overall message you may be doing more harm than good. Be sure you are not creating a nocebo which is the opposite of the placebo effect. 9. After trauma or repetitive stress the body may move and feel different. By targeting the nervous system through the body’s tissues we will have the greatest impact. Muscles are connected via fascia, fascia is the body wide tensional force transmission system that facilitates coordinated motion, motions move joints, joints drive the nervous system. The fascial web of myofascial chains can provide valuable insight into the health and balance of the body’s presentation. After trauma, repetitive stress or simply due to genetics, the body can manifest with excessive workload in different structures and the following is listed in ascending order in terms of importance to treat. muscles (least important to address) fascial lines joints nervous system sensitivity (most important to address) 10. Treat every individual like a unique case that you’ve never come across before and assess to see what they need. It is imperative to take an individual’s history and to assess their static posture, presentation through palpation, passive movement and active movement in order to fully appreciate what they will benefit from. No two individuals on this planet or exactly alike so your approach should be slightly different in every instance. “It’s not about the breadth of tools in the toolbox, it’s about the depth of understanding of how to use them in the simplest fashion.” - Brett Bartholomew 23 Strong Palmer Presence at CCA at CCA Sports Symposium Sports Symposium Chuck Bustillos Palmer Marketing & Communication Chuck.bustillos@palmer.edu the chiropractic consultant for the Oakland Raiders and president of the Professional Football Chiropractic Society (PFCS), was another Palmer-associatWith six speakers on the program, and ed speaker at the CCA Sports & Rehab many alumni and students in atten- Symposium. dance, Palmer College showed its leadership in the field of sports chiropractic As an “MVP Sponsor,” Palmer’s in a significant manner at the third-an- high-profile presence extended into the nual California Chiropractic Association Marketplace vendor-area, featuring the (CCA) Sports & Rehab Symposium, three California chiropractic colleges Aug. 19-21, at Disney’s Grand California and various chiropractic-product compaHotel and Spa in Anaheim, Calif., which nies. The Marketplace provided Palmer was attended by attended by nearly 150 alumni and students an opportunity to chiropractic doctors and students. network and discuss current trends in the field of sports chiropractic. Palmer-alumni speakers included: Nick Athens, D.C., Davenport ’82; Steven “It’s not surprising to see so many West Capobianco, D.C., DACRB, CCSP®, alumni at an event like this, since so West ’03; Tracy Cole, D.C., West ’89; many of us were active in the Sports Jeffrey Langmaid, D.C., Davenport ’06; Council, and many of our patients seek and David Paris, D.C., San Jose ’01 our care for sports-related injuries, or (who serves as CCA vice president). to improve athletic performance,” said Ed Green, D.C.., CCSP®, West ’01. Dr. Kyle Prusso, D.C., CCSP®, director of Green’s Moorpark, Calif.-based practice Clinics at Palmer’s West campus, who is received “Readers Choice Favorite” rec- ognition from the Ventura County Star newspaper in 2015. “It’s nice to connect with other Sports Council alumni, and to speak with current students, to see how the program has grown since I graduated,” Dr. Green added. “Many of us chose to attend Palmer’s West campus because of the Sports Council, and as graduates we share a mutual interest in continuing to advance the field of sports chiropractic,” said Robert Fife, D.C., West ’10, who maintains a Lafayette, Calif.-based practice. “The West campus has a tradition of graduating progressive-minded doctors, who are ‘outside the box’ thinkers, which is why you find so many of our alumni leading the way in sports care, and other fields within the profession.” In addition to many alumni, several current West campus students also attended the Symposium. They included Ryan Rubin, who’s completing his 13th Quarter field-training assignment with Eric Blum, D.C. (Team chiropractor for the Los Angeles Dodgers, Dr. Blum was one of the featured speakers at the CCA Sports Symposium.) “Not only did Palmer have the most alumni-speakers and doctors at the Symposium, we had he most students present at the seminar, too,” said Rubin, a member of the Summer ’16 graduating class. Kyle Prusso, D.C. West campus director of Clinics, spoke about his role as team chiropractor for the Oakland Raiders at the CCA Sports Symposium (Continued on page 24) Strong Palmer Presence at CCA at CCA Sports Symposium Sports Symposium Several other West campus alumni and faculty have presented at the CCA Sports Symposium since the program debuted in 2014, including Tony Kearns, D.C., ’07; Ed Feinberg, D.C., DACBR, ’84; and Terry Schroeder, D.C., ’86, along with Thomas Souza, D.C., West campus dean of Academic Affairs. perience with great satisfaction. When I have a chance to meet with current Sports Council members at events such as these, and see how they’re ‘raising the bar’ that pride grows, which shows why Palmer West is the place for any prospective student who has an interest in sports chiropractic.” “Through its Sports Council program, Palmer West has established a reputation for graduating some of the best sports doctors in the profession,” said Dr. Capobianco, who in addition to serving as medical director for RockTape, also is the owner of Project Move, sports specific rehab and performance institute in Colorado. “I’m proud to be a Palmer West graduate, and look back on my Palmer ex- Several West campus students attended the CCA Sports Symposium Study Break! 24 25 Movement Variability Nav Sohi (8Q) Bartlett Co-editor Navsohi3@gmail.com Introduction Movement variability is defined as the normal variations that occur in motor performance across multiple repetitions of a task (Stergiou & Decker, 2011). An everyday example of this would be if we analyzed multiple jump squats with the focus of determining the variation in knee valgus of every jump. How far from the normal does the knee vary for this individual? If a person tries to repeat the same movement twice, the two actions will never be identical. Bernstein described movement variability quite eloquently as “repetition without repetition” (Lockhart & Stergiou, 2013). Relevant Information When we look at movement variability in young athletes, those that begin to specialize in one sport too early are at greater risk for injury in their formative years. Studies have shown that children who are raised on a multi-sport model are set up for greater success later in life in the categories or performance, motor learning and risk for decreased injury. Clinical Significance What is the clinical significance of movement variability and how does it apply to us? A therapist’s role is to rehabilitate an athlete back from injury and decrease the risk for future injury. This is done through challenging the athlete in different situations, forcing them to adapt. When the athlete is exposed to enough variations, this would allow them to have a repertoire of movements for any new situation. If not, then the athlete may be at a greater risk for a future injury. We can externally influence movement variability by changing the environment of the athlete, for example, stable vs unstable surface; barefoot vs shoes; resistance vs no resistance; fatigued vs non-fatigued. What happens when we change the surface from stable to unstable? We get an increase in variations of the original movement and this is where learning to adapt occurs. Therefore, we increase the movement variability of the task. As the athlete learns to adapt to the new surface, their movement variability decreases and therefore they become more proficient at executing the task. Three categories can be externally influenced to create variable movement patterns: 1) Body Constraints – mobility, stability, strength, power. 2) Task Constraints – initial/final, ROM. 3) Environmental Constraints – sand, rocks, logs, gravity, weighted vests, sleeves. Dosage Relating to exercise prescription, when and where should we be using movement variability? As always, every individual is different and each case should be evaluated on its own merits. However, a general rule is to follow the period- ization phases. Early in the season, movement variability is encouraged and as the athlete adapts, progressively increase the variability. Late in the season, closer to competition phase, variability in a program should be maintained or decreased. This is because movement variability and execution of a task are inversely related. Conclusion In conclusion, we can say that in populations where the individual has a high movement variability will be better equipped to handle challenges allowing for greater success. While populations where the individual has a low movement variability will be poorly equipped in handling challenges leading to a lower chance of success. Discussion Some of the BEST athletes understand how to match their biomechanics with a changing environment. This can be defined as an athlete’s ability to gauge the spectrum of variability within an environment and accurately adapt their biomechanics to the variability of movement required to that environment. “Before I learned the art, a punch was just a punch, and a kick, just a kick. After I learned the art, a punch was no longer a punch, a kick, no longer a kick. Now that I understand the art, a punch is just a punch and a kick is just a kick.” - Bruce Lee 26 Congratulations! Palmer’s Newest Interns: Summer 2016! Summer 2016 Graduates! 12TH ANNUAL EVENT! THANKSGIVING MORNING THURSDAY, NOV. 24 It’s time to “Trot” again! Help carry The Spine at SVTT 2016 on Nov. 24! The Palmer Spine has become a big part of the SVTT tradition, and 2016 marks the eighth year in a row that The Spine Will provide “the backbone” of the Thanksgiving-morning event, which has raised more than $5-million for local charities. SVTT registration fees paid for everyone who helps carry The Spine – plus, a souvenir shirt! For additional information: Denise Miller, President’s Office The puck is ready to drop! PALMER PRIDE HOCKEY: SEASON XXIII Good Luck San Jose Sharks Adult Hockey League Division-champions: 2009-2010-2011 to the West Campus athletes competing in the 2016 ChiroGames! Watch for details about the 2016-17 season! Games played at Sharks Ice of San Jose (located at 1500 S. 10th St., across from Spartan Stadium) November 5-6/Cocoa Beach, Fla. www.chiropracticgames.com For information about the Palmer Pride 2016-2017 season, contact: Annelies Wentzel or Michael Sydoryk FALL QUARTER 2016 “DATES TO NOTE” … Monday, Oct. 3: Classes begin Wednesday, Oct. 5: “Welcome Back!” Assembly Thursday, Oct. 6: Fall Quarter “Spizz Night!” Thursday, Oct. 13: Women’s Forum Wednesday, Oct. 19: ASG Mtg./Admin. Update Friday, Oct. 28: All-Intern Meeting Thurs./Fri., Nov. 24-25: Thanksgiving holiday Wednesday, Nov. 30: Wassail Bowl (Café.) Thursday, Dec. 8: Fall ’16 graduation ceremony December 17 – Jan. 8, 2017: Winter Recess