Here’s a scenario you have probably found yourself in if you’ve been under care in our office for longer than a few weeks: you come in for your adjustment, and either Krystal or Jayline (our incredible front desk duo) has stopped you as you go to sit down in our reception area, and said, “You have an assessment today,” as they grab an orange clipboard and paperwork to get your updated subjective information. The problem is that you forgot that it was scheduled for that particular day, and you’re in a rush to make it back to work, to dinner, etc. In most cases, the ladies will say that it’s okay, but we need to make sure to do it at your next appointment.
At some point, you may have wondered why these assessments are so important, why we do so many of them, and how we use them.
Feeling vs. Function
As you’ve heard our docs and team say time and time again, the most important thing to us concerning your health is how you are functioning. Only about 18% of the nerve fibers in your nervous system have the potential to feel pain. Therefore, there could be dysfunction present anywhere in the other 80% of your nervous system at any given time, and you have no pain whatsoever. Since we know that health is defined as “having 100% function of all parts of the body 100% of the time,” we prioritize how you are functioning over whether or not you still feel pain or symptoms of dysfunction.
If we say that getting you functioning better is our top priority, then we must have an objective way to measure your function, and keep up with how it progresses while you are under our care.
That is where the Insight Subluxation Station comes into play.
What does the Insight do?
The Insight technology that we use for your assessments has a few ways of giving us objective data about the function of your nervous system. The Insight is non-invasive, and is safe for use in everyone, including infants and pregnant moms. In our office, you’ve noticed that there are two features of the technology that we use each time: Advanced Thermography and Surface Electromyography (SEMG).
1. Advanced Thermography
The rolling thermal scanner is able to detect temperature differences between two sides of the spine. When subluxation is present, temperatures at involved levels of the spine can differ due to the sympathetic (“fight or flight”) response putting stress on the blood vessels in the nervous system. Using thermography, we are able to see level by level how each nerve in your system is being affected, as well as how stress and subluxation is affecting certain regions of your nervous system.
When our team is going over your assessments, there are often four different pictures that give us a look into your function at that moment; two of them are a result of the use of thermography — the NCM and the DTG.
A. NCM (Neurocalometer)
The picture that is generally on the top left of your assessment sheet is the NCM assessment. This shows us a picture of how your nervous system is functioning right here, right now, and where there is stress on various regions or segments throughout it. The stress which we see on this scan is typically in a more acute stage; therefore, it can change quickly – particularly post-adjustment, when your nervous system is working much more optimally and with less subluxation. When looking at the NCM in particular, what we are wanting to see–especially early in your care–is change; that shows us that your body is adapting differently to your day-to-day stresses in life than when you first came into the office.
While the colors on the NCM can give us more nuanced insight into your function depending on your other scans and your stage of care, generally, the way to interpret the colors is:
- White: “within normal limits”
- Green: “mild neurological irritation”
- Blue: “moderate neurological irritation”
- Red: “severe neurological irritation”
- Black: “chronic severe neurological irritation”
B. DTG (Dermathermograph)
The DTG can typically be found on the bottom left side of the page when looking at your assessment sheet. This scan shows us where there is chronic subluxation due to an ongoing sympathetic response. When the nervous system is in a sympathetic state, the blood vessels constrict, causing less blood flow to get to various levels of your system. When there is less blood flow, things show up on the DTG cooler than they should be, which is where the colors come into play. Ideally, we want to see a sliver of red at S1, and a gradual “cone” or “V” of red with each bar getting slightly longer as they go up to C1 this is because the closer to the brain we get, the more blood flow we should expect within the nervous system. When we see blue on the DTG, that tells us that there is a chronic stress response to which your body is not adapting well.
If you’ve been under maintenance care for some amount of time coming either once a week or once every two weeks, you may have had our doctors recommend you come in more frequently for a short amount of time to get momentum going in the right direction as far as your nervous system is concerned. Most of the time, that decision is based on the DTG, as it shows us a more long-term picture of how your body is doing at your current frequency. Sometimes, it may just need a boost for a few weeks; other times, it may mean that your body would do better receiving care at a different frequency.
2. Surface Electromyography
Surface electromyography shows us how much energy your body is using to keep you upright against gravity. It also shows us how well-coordinated the communication between your brain and the paraspinal muscles is. When your brain is communicating better with the muscles of your spine, we can infer that the same is likely true of its communication with the rest of your body as well.
On the top right picture on your assessment sheet you’ve noticed a few different colors that represent how much energy your body is using to hold you upright against gravity.
- White: within normal limits
- Green: two times the normal amount of energy
- Blue: three times the normal amount of energy
- Red: four times the normal amount of energy
- Yellow: indicates an area that the sympathetic response has driven to the point that it is underperforming, much like a blown fuse.
On the bottom right of your assessment sheet, you’ve likely noticed a graph with squiggly black lines and some numbers under it. The graph with the black lines is just another representation of the bar graph above it that used the four colors. The numbers underneath, however, give us the most clear picture of what’s going on with your body’s energy expenditure and coordination by putting numerical values to the sEMG graphs.
Total Energy Index: Tells us how much energy your body is putting into keeping you upright against gravity, and adapting to stress in your day-to-day life.
The ideal Total Energy Index for an adult is around 100.
The ideal Total Energy Index for a child is around 150.
Pattern: Tells us how organized your nervous system is overall.
The ideal score for this is 100%.
Symmetry: Tells us how well balanced your brain is communicating to each side of your body. The ideal score for this is 100% as well.
We use your assessments to objectively see how your body is functioning in real time, and how your nervous system is adapting to the stresses of your day-to-day life. As neurologically-based chiropractors, it is our goal to see you adapting to and overcoming the stresses that you face so that you can live a greater life. Using these tools lets us know that we are doing our job, and goes beyond relying on how you are feeling to determine if you are truly healthy.
Extra Notes for Nerds
When it comes to subluxation, there have been four dimensions proposed by Dr. Christopher Kent, all of which are measured by the Insight: dysautonomia, dyskinesia, dysafferentation, and dysponesis.
Dysautonomia refers to dysfunction within the autonomic nervous system. The autonomic nervous system is divided into two parts: the sympathetic nervous system, which controls the fight or flight response, and the parasympathetic nervous system, which controls the state of the nervous system which we refer to as rest, digest, and heal. When the nervous system is in a long-term sympathetic state, the body’s ability to adapt properly to the stresses a person deals with is hindered. This dysfunction within the nervous system over a period of time can eventually lead to dysfunction in the organs and tissues which the spinal nerves go out to control; this can eventually lead to what we know as disease.
Through specific chiropractic adjustments, we are able to help remove interference in the nervous system to help the body adapt more adequately, and be in a parasympathetic state more often, allowing healing and more optimal function of all systems.
The feature of the Insight that measures the autonomic nervous system to detect dysautonomia is advanced thermography.
Within chiropractic, dyskinesia relates to the impairment of voluntary movement, and is associated with the misalignment and fixation of structures that cause such issues. When looking at the dyskinesia often shows up on both the thermographic assessments (as neurological irritation) and the SEMG (as muscle imbalance).
Dysponesis—as defined by Dr. Kent—refers to a “reversible physiopathologic state, consisting of errors in energy expenditure which are capable of producing functional disorders.” In short, dyponesis deals with abnormal energy expenditure. Measuring energy output is the key component of using the SEMG.
Dysafferentation is the interruption of the afferent or sensory pathways that carry information from the body back up to the brain. If the brain is not receiving proper sensory input, then it’s perception of the body’s environment and how to properly adapt to it. On the SEMG, dysafferentation often presents as a region where there is “stuck” stress, or even exhaustion from stress being present for an extended period of time.
- Kent C. Proposed neurobiological processes associated with models of vertebral subluxation: Dysafferentation, Dyskinesia, Dysponesis, Dysautonomia, Neuroplasticity, and Ephaptic Transmission. Arch Neurol & Neurosci. 3(1): 2-19.
- Kent C. Models of vertebral subluxation: a review. Journal of Vertebral Subluxation Research, 1996;1(1):11.
- Gentile T. Measure what matters; thermography, HRV, SEMG. Conference proceedings at: International Chiropractic Pediatric Association, 2019; online.
200 Club Celebration
If you have received at least 200 adjustments in our office, be on the lookout for a special invitation to hang out with our team, and enjoy one of Dr. Grant’s almost world famous brisket made from grass-fed beef! We will be celebrating all of you who have made such great investments into your health with food, games, gifts, and a showing of the Super Mario Brothers movie on the green in front of the office!
AMPED Team Conference
Our team will be heading down to Atlanta, Georgia August 4-6 to gather with a group made up of some of the best chiropractic offices in the world at AMPED conference. While our doctors individually continue to pursue further education to fortify their expertise in caring for our practice members on a clinical level, AMPED conferences are a time for our whole team to gather with like-minded offices to learn how to serve you better every moment that you are in our office and under our care. We go to the lengths we do to train as a team in pursuit of not being one of the best chiropractic offices in the nation; we want to be the best for the sake of all who are under our care.