Lunch with: Dr. Allan Martin

Hey there, time traveller!
This article was published 12/05/2012 (4895 days ago), so information in it may no longer be current.

Part of my motivation to do this interview was I’m a big fan — at least, I WAS a big fan — of Two and a Half Men. But poor Dr. (also Alan!) Harper takes so much abuse as a chiropractor! And yet I’ve heard those same sorts of comments from other sources: ‘You’re not a real doctor.’ How do you respond to that?

Well, I think today we’re very, very fortunate — certainly there are still some misunderstandings and prejudices, but nothing like the pioneers of our profession, where they were, in some cases, persecuted for practicing medicine without a license and thrown in jail and all kinds of terrible things.

I think patients who have come to use chiropractic understand what’s involved, and it’s not witchcraft or voodoo or any of those other strange conceptions some people may have. And acceptance has been getting much better both inter-professionally and through public awareness. So we’ve been very fortunate in our generation.

You obviously have to study anatomy and physiology and all that kind of stuff. So why do you think the disparaging commentary continues?

I think it’s probably more historical, where educational standards back at the turn of the century, both for medicine and for chiropractic, were pretty abysmal — they were still doing blood-letting and all kinds of weird things.

But if you look at our hospital, for example — you’re surrounded by millions of dollars of diagnostic equipment and nurses and blood tests and all manner of diagnostic imaging. So how can these chiropractors diagnose when all they really have is a reflex hammer in their hands?

People think they’ve got to have a test or nobody can really figure them out. ‘I have to have an MRI’ or ‘I have to have a CT scan.’ Why? Research shows most back patients don’t need these tests. But I think people today really are enamoured with high-tech medicine. So I think a chiropractor is obviously going to be viewed as something a little less. And I think that’s why some of my colleagues are getting more into some of these so-called diagnostic testing devices that are reading heat and reading this and reading that, just to kind of show patients more high-tech imaging.

In chiropractic, you seem to be able to look at a patient, or touch them, and find exactly the right place and know just what to do. And that astonishes me!

I guess that’s where the education diverges a little bit — certainly we take all the anatomy, physiology, histology — all those other courses. But our training tends to be focused more on spinal joint mechanics, where for hours and hours ad nauseam we’re palpating spines, learning to feel the proper movement — or what should be proper movement — and where you have areas where it’s not moving properly.

So it’s like anything else: if you spend enough time doing that type of analysis, your sense of touch and your perception and your knowledge base just grows and grows. So it may seem strange that just from palpation and few other orthopedic and neurologic tests, we can arrive at a diagnosis. But for the most part, back pain is just that — it’s a mechanical problem. It’s an area that’s too tight, it’s been injured or it’s a postural thing or whatever, but it’s not too difficult to analyze the area and then make the appropriate corrections.

What happens when you do an adjustment?

To put it very simply, usually a bone is out of place — it’s pinching a nerve, so we pop that bone back into place. And there’s usually a click, a pop, a snap. The joints are encapsulated by a capsule that has fluid inside, and when you stretch that area quickly, there’s a drop in pressure, a little nitrogen gas bubbles out, and it pops. So any normal joint can be made to pop. It doesn’t hurt, it doesn’t do anything — no good, no bad.

In areas where the joint’s not aligned or not moving properly, that pop is sort of our guideline that we’ve been able to create enough movement and correction to have, hopefully, a positive effect.

When the bone gets moved rapidly like that, not only does it reduce pain and increase the range of motion, there’s a muscle stretch that helps to take away some of the muscle tension and reaction. There is a muscular component to all of these treatments, of course, but the actual adjustment is done on the bone or vertebrae.

We’re our own worst enemies, too, right? I mean we sit badly, like I’m doing right now …

Postural things, an awkward lift, a slip, a car accident — the gamut of trauma that can happen is endless. And not all traumas require treatment. Sometimes we just get better. But when things are starting to drag on for weeks and weeks with no improvement, then probably it’s a little deeper than just a muscle strain.

For people who have never seen a chiropractor, if you have an injury that maybe you’ve gone through before, usually a week to 10 days is pretty typical for a strain/sprain to come around — at least you know it’s improving. But if you’re starting to go two weeks and it isn’t getting better, or perhaps getting worse, then I would suspect it’s probably time to have it assessed at least.

So many of these things are, as you say, historic, but there’s an old presumption that ‘chiropractors like to keep you coming back.’ Well, no! You want us to get healed just like any other doctor would, right?

Correct! And that’s a very good question. My style or philosophy of practice has always been ‘you find it, you fix it, you give patients whatever education and advice so they can help themselves, and then you leave it for as long as you can.’ And I think what happens, at least in my practice, is that patients begin to realize the benefit of perhaps coming in periodically to keep ahead of recurring problems.

And in some cases, it really and truly does help some patients control their chronic symptoms from old injuries and things that perhaps just exercise alone and postural changes won’t help. They’ve got a problem. It’s like having diabetes — you’ve got to keep taking your insulin. You may feel great, but if you don’t take it, it’s going to get out of control again. So in my style of practice, that’s what happens.

There are some practitioners who firmly believe everyone should come in for a monthly adjustment. Personally, I think that’s a little excessive. I run an acute-care practice — if you’re hurt, come on in, we fix it, and you’re done, as long as things go well. But there are others who feel that, no, you should have regular adjustments all the time to maintain your health and well-being and alignment. And that’s the wonderful thing about having choices in different practitioners — you can choose whichever approach appeals to you or works for you.

Is there a ‘most common cause’ for back problems?

Every season brings its own problems. But there’s a fairly finite list of things that contribute to back symptoms. Posture, weight, lack of exercise, stress, smoking. Most of the time, it’s our lifestyle. When they do research in Third World countries — there’s no chairs, there’s no cars, there’s no computers, there’s no cushy anything — chronic back pain is almost zilch. They walk everywhere, they eat simple foods, they have no aspirations to keep up with the Joneses. So it’s obvious that our lifestyle is what contributes to this epidemic of headache, neck pain and back pain. Our bodies were not meant to sit at computers with the only exercise being using the remote control. And eating fast foods and job dissatisfaction and all these other stressors — something has to overload. And everybody reacts to stress differently. Some get ulcers, some get skin rashes, some people’s necks tighten up and they get headaches, or their backs lock up. So I think if we look at our lifestyle and we make reasonable, simple changes — walk every day, try to watch what we eat, watch our posture, and do some stretching exercises — I think — well, I know — a lot of this chronic back pain would not be an issue.

You’ve been doing this for 37 years. What keeps you interested? What’s the reward for you?

It’s an extremely fascinating field because although we see the same types of problems, every problem is a little different. But it’s my patients who keep me coming back. They’re wonderful people and you develop a bit of a rapport and relationship with them. It’s kind of like going to the coffee shop — you have 30 of your best friends there, and I just kind of chit-chat while I’m doing my work. I really don’t know what I’d do if I didn’t have my practice to come to every day. It’s just extremely rewarding and interesting. And to be able to hopefully help patients in kind of a different and unique way, and maybe keep down the use of meds and surgery to some extent. And they’re extremely appreciative. So that’s what keeps me motivated. And it’s fun. I just love it.