I interviewed Dr. Zachary Ward in August 2009. To date, it was one of the most fun interviews I have done here. Instead of me emailing him a set of questions, it was more like an email conversation. Because of my post yesterday endorsing Dr. Ward’s Upper Cervical Website business, I wanted to post part of his interview for people to get to know him a little better.
Dr. Brandon Harshe: Why did you decide to become a chiropractor, and more specifically, an upper cervical chiropractor?
Dr. Zachary Ward: “Like most chiropractors, I entered chiropractic because I wanted to help people. My family had a positive experience with full-spine work, and I always reflected on that experience, and would defend chiropractic and chiropractors if anyone ever said anything bad about the profession. And I would recommend chiropractic care to people who were hurting.
The upper cervical part is a bit more complex.
Short answer: I’m an upper cervical chiropractor because I’ve been a front row witness to the amazing recuperative power of the body when under upper cervical care. A friend at Palmer introduced me to upper cervical in my first trimester, and really challenged me with her story of profound healing while under NUCCA care. It caused me to rethink the purpose of chiropractic care.
Now the long answer: I think upper cervical chiropractic offers the most clinically meaningful way to practice chiropractic as defined by the correction of vertebral subluxation. Let me explain.
Within a few months of starting at Palmer I was exposed to two lectures by two prominent NUCCA docs, Dr. Lee Yardley, and Dr. Milton Steele, both of Washington State, and both who had practiced some of the most well respected full-spine approaches, Gondstead and Activator Methods. Nonetheless, they turned to upper cervical care when the “chips were down” and they, or a family member needed a healing opportunity they weren’t getting under their full-spine practice model. (This introduced me to a common sentiment among even the most orthopedic-oriented chiropractors and students I met: when you’ve done so much you can’t do anything else, you might as well adjust the atlas and see what happens. It made me wonder…)
The lectures by Steele and Yardley were a rock that I clung to at the end of my first year of chiropractic college. I wanted to test what I was learning so far, and I began to search out the most anti-chiropractic propaganda I could find.
I wanted to know what the weaknesses of my future profession were. And all the criticisms, as over the top and ludicrous as they are, hinged on one thing: the inability to conclusively document the subluxation.
I heard a presentation from the late Dr. Jospeh Keating on chiropractic research who brought it all together into one clear sentence for me: “The subluxation may or may not exist, but even if it does, it’s NOT clinically meaningful.”
His opinion was this: The subluxation is not meaningful because you can’t measure it. You can’t define normal, so you can’t define abnormal. There’s no Gold Standard. Other than palpating bones feeling movement where there was restriction, you can’t validly measure that you’ve done anything, other than freed a restricted joint articulation. I think upper cervical doctors can agree that reducing spinal fixation is not necessarily correcting vertebral subluxation, so you can see where Keating may have been coming from. (BJ at one point said that true subluxations weren’t possible below C2.)
And, I had to agree. As I was learning about it, as I was getting care in the clinic, I was getting diversified adjustments every time I went in for an appointment. Some of my symptoms were improving. I was benefitting. But chiropractic, as strictly defined by the correction of the vertebral subluxation, was a good idea that was essentially meaningless to that good experience. After all, if you’re always adjusting, how are you correcting anything? From my patient’s point of view, I didn’t need the subluxation to benefit from spinal manipulation. The subluxation seemed to exist for the chiropractor’s understanding, not for my own.
What brought me back from delving into an abandonment of chiropractic as subluxation correction was the very fact that a core group of committed individuals were working to create that Gold Standard in subluxation measurement, documentation, and correction. They were the upper cerival doctors, and after listening to Drs. Yardley and Steele, I read about them starting in Kirk Eriksen’s the Upper Cervical Subluxation Complex, in BJ’s research, and in the Council Bulletins of the Palmer’s Standardized Chiropractors Council.
I watched a recorded presentation by the late John Grostic Jr., where he spoke about UC docs using mirrors to create low-fi three dimensional spinal imaging in the late 1930s, of chiropractors concerned with the instantaneous axis of rotation 30 years before White and Panjabi made it famous, of chiropractors being so far ahead of their time that current instructors in chiropractic colleges don’t even know about their work.
And they weren’t talked about because, to put it simply, they were upper cervical people… “BJ followers”… and that was enough to write them off entirely.
So, I began my own investigation of the upper cervical work, and found the model of biomechanics that makes the most sense to me. I found that you can plot an expected normal, and measure deviations from normal. I had upper cervical films taken in 3 different offices over the course of 18 months. These offices were 160 miles apart from docs who didn’t know anything about my care previously. All 3 of them created the same listing, with almost an identical vector. Now that’s a clinically meaningful subluxation!
So, I started sending my family to upper cervical doctors, and was blown away by the results…and how long they were holding their adjustments. And that sealed it for me. I needed to be an upper cervical doctor.”
{ 2 comments… read them below or add one }
I fully agree, the lack of quantification of the subluxation is the reason the CCE can suggest things like removing the term subluxation and most of the profession hopping on board.
I talked to many leaders in the UC profession about this quantification, and although the upper cervical people have done a tremendous job of quantifying the misalignment part, we still have a lot of work to do in determining a gold standard for nerve system interference.
I believe once we do, and we can document at the point of care how one technique does in terms of MISALIGMENT and NERVE INTERFERENCE, we will be able to measure them against each other and clean up some of the mess (read: functional rehab) out of the profession.
My two cents.
I always enjoy reading your two cents. Great points Dr. Moses!