Welcome to ACTIVE REST, the latest addition to Only The Strong Fitness! This is a new section consisting of interviews with intelligent and experienced members of the health and fitness community. This section may eventually be turned into a podcast, when I figure out how to do that, but until then my humble paraphrasing and editorial skills will have to suffice. For the first installment of ACTIVE REST I sat down and spoke with Dr. Crystal A. Joseph, D.C. Dr. Joseph is a Certified Chiropractic Sports Practitioner and a Certified Applied Kinesiologist. She has a background as an All-American high jumper, and is also a dancer. She was kind enough to answer my questions during some time on the stationary bike!
OTS: To be honest, I usually refer to you guys as “chiro-quack-tors”, no offense. Can you flesh out your background for us and what makes you different? What the heck is an Applied Kinesiologist??
DCJ: People don’t necessarily know what a “chiropractor” is or can be. They may only be familiar with the stereotype of “cracking backs” and having to endlessly return for more appointments without a foreseeable resolution of the problem. There are some old school doctors still stuck in this approach who do things by rote and are not actively continuing their education or digging deeper for the root of an issue. I believe in taking an integrative approach, which is what applied kinesiology is about. It’s not just about the spine – I take into account all body systems. In addition to a physical evaluation or adjustment that will include posture/gait analysis, breath assessment, full body neurological tests, deep tendon reflexes, blood pressure, and muscle testing, you will be asked to fill out a nutritional questionnaire and we will delve into the level of stress in your life, your level of activity, and so on. This is all to determine which system or systems should be addressed in your treatment for a total body resolution of the problem.
OTS: Yes, too often it seems like practitioners are just treating symptoms, not the underlying causes. I like the comprehensive approach and try to apply it when dealing with clients. Is there any body system you don’t touch on?
DCJ: Often patients come in for a musculoskeletal problem and I find other issues in the evaluation, especially in the case of athletes. They tend to feel everything is just physically based, but stress can put other body systems “out of whack”. I also frequently have patients referred for non-musculoskeletal problems, like PMS or indigestion, and I am able to help them because of my training in applied kinesiology and in naturopathic medicine. In kinesiology there is a belief that the body speaks a language and thus the relationship of the muscles to the functionality of systems and organs have been mapped out. For instance, during lingual testing of supplemental vitamins and through the nutritional questionnaire, I may find that a patient is lacking in a certain nutritional need and that is causing a body system to malfunction, which is then causing a musculoskeletal discomfort that can cascade through the body.
DCJ: Let’s look at a patient that comes in with a complaint of neck pain. A visual exam shows they have a forward head posture with rounded shoulders and need to stand up straighter and spend less time hunched over their computer.
DCJ: I know, I know… So, upon further physical exam, I find that they have very tight quadricep muscles, pulling their pelvis into anterior tilt and causing hyperlordosis and hyperkyphosis (increased curves) in the spine – the end result of those being forward head posture and neck pain. Without the addition of information from other biological systems, I might just have them work on their muscle flexibility. But tight quads may not just be a stretching issue. Your quadricep muscles are also affected by the level of absorption of minerals in the small intestine. Delving into their eating habits and stress levels may determine they are not getting what they need nutritionally. For instance, as our age increases, our level of stomach acid production decreases, meaning we break our food down less and have less opportunity to get the vitamins and minerals needed. This patient may need to supplement their diet with probiotics or HCL (hydrochloric acid supplement to help break down food in the stomach) to better absorb the minerals they were missing. There is then less effect on their quadricep muscles, which will have increased flexibility, allowing their pelvis to realign correctly, ridding them of hyperlordosis in their lower back and hyperkyphosis in their upper back. That makes it easier and more effective to use corrective exercises or manual adjustment to realign the forward head posture and relieves them of their neck pain!
With that said, I do refer patients to outside sources if necessary. Besides biological systems, I find it very useful to stay in touch with those who can help the patient deal with mental and emotional issues that may be causing a physical complaint. In the case of an athlete, that will be the athletic trainer, the coaches, a personal trainer, or possibly a school counselor. These people are in constant contact with the patient, know them very well and may be close with them, and can assist in reducing or removing the cause of the stress. It’s often a team effort.
OTS: Agreed. As an athletic trainer I am in constant contact with PCPs, orthopedists, and other specialists, including school counselors. Athletes especially tend to ignore the effect mental and emotional stress can have physically. As a personal trainer, I need to pay close attention to a client’s work and home balance and it is often difficult to convince them to re-balance.
DCJ: For me, that’s what it is all about: knowing what a person does or is trying to do and breaking down what they are saying into what their hindrance is. Then, it’s up to us guide them and get them to BALANCE themselves, whatever that may mean and by whatever means necessary. I like to impart to them some wisdom that was given to me by my mentor, Dr. Eugene Charles, which was that “health is a process, not an event”.
OTS: Very true. In fact, I think I’m going to steal that quote for future use! Too many people are under the influence of commercial media, where everything has a quick fix and problems are solved in 30 minutes or less. 10 minutes for abs, etc. I spend a good deal of time helping clients and athletes understand the process and why we may be starting our route in an unexpected or seemingly unrelated body area. It’s good to have another voice in the mix passing on the same idea.
DCJ: It’s great to have personal trainers to refer patients to that “get it”. It’s also great to have you guys on the team as extra guidance for myself. I’ve had Personal Trainers help me planning my own workouts, targeting the real roots of an issue and adding functionality, and that is a large part of what has helped me continue as a competitive runner. I transfer those ideas to my patients, especially the functionality of an exercise. I have worked with personal trainers to have a new mother exercise with off-centered weight loads to help her get better at handling the shifting weight of a baby. It’s not just “crunches”; it’s a real, useful, and safe core/trunk exercise that will really translate for her. You guys keep up-to-date on all of that stuff and are a good conduit of that information for me. It’s key as a professional to sometimes have outside guidance and be integrated as a team with professionals in related fields. We each add a layer of expertise for the patient/client to be able to achieve a higher level of accomplishment that he or she can’t do alone. It may be a nutritional aide, a stretching technique, an agility drill, or a balance and proprioceptive technique that will assist them in accomplishing an activity of daily living.
OTS: Absolutely true. When I saw you for my hamstring issues and was handed a nutritional questionnaire, it was rather eye-opening, and now it seems pretty silly that I hadn’t thought much about that stuff before. So thank you for that. And thank you for your time answering my questions and helping OTSFitness Readers get more familiar with the ideas behind good chiropractic medicine and Applied Kinesiology. I’ll let you get on with your workout now. Thanks so much!
DCJ: You’re very welcome!
Dr. Joseph is located at 200 West 54th St, between Broadway and 7th Aves, in NYC. She can be reached at 917-828-6733 or DrCrystalJo@gmail.com for appointments.