The Driving Force of Function: A Tonal Chiropractic Proposal

:dropcap_open:F:dropcap_close:or years chiropractors have stated collectively that structure equals function. The structure of the spinal column gives the chiropractor a standard by which to establish clinical guidelines for therapy. This presumes that there is a structural component to the spine that is perfectly adapted for the individual patient’s immediate and long-term needs that can be imposed by outside standards. Current chiropractic theories state that small asymmetries are pathological and ineffective and that they cause disease and decrease normal physiology of humans. These negative traits of small rotary asymmetries in the vertebrae, the classic chiropractic subluxation, would naturally decrease evolutionary fitness. But to state this is also to affirm that the small rotary asymmetries at the local level in the spine were not adapted for and selected against. These theories presuppose that the spine, after 400 million years of development, has not selected for species fitness and success as a biological line. How could these small asymmetries exist for 400 million years if they did not increase fitness?
drivingforceoffunctionBasic evolutionary fitness is the probability that the line of descent from an individual with a specific trait will not eventually die out. Perhaps those small rotations may be small adaptations to the many degrees of freedom, cultivated over 300,000 generations of vertebrate existence, allowed by the hominid spine. These small asymmetries may be pathological in the short term or long term, or these small asymmetries may be the best physiological adaptation for the individual to preserve resources in the short or long term.  Perhaps these asymmetries may contain both traits.
An understanding of proper function and the analysis of patients with small rotary asymmetries in the spine reveal that many of these patients have lived to a ripe old age and reproduced effectively. If this is documented fact, it leads one to deduce that small rotary asymmetries are at least not fatal to those individuals. To state that small asymmetries are always pathological would deny the fitness of 6.2 million years of human bipedalism, natural selection and generational adaptation. If these slight rotations were always a source of inefficiency and decreased evolutionary fitness, then the rotations would have been deselected for, and they would not have survived to the present.

The original chiropractic theory of vertebral subluxation (functional anomalies) is incomplete and is as follows: The exertion of pressure on a spinal nerve produces pathology by interfering with the planned expression of Innate Intelligence. This statement is incomplete when we recognize that the vertebral column has been evolving for over 400 million years of vertebrate evolution to support the body and protect the central nervous system (CNS) in many millions of vertebrate species.
Traditional chiropractic—segmental and postural-technique classifications—evaluates abnormal function as a result of labeled abnormal structures. These labels are self-developed and described in isolation in the chiropractor’s practice or technique. Tonal chiropractic, a subset of chiropractic technique and theory, has attempted to respond to these inconsistencies by looking at the input side of structure. The abnormal structure can lead to abnormal function that continuously feeds the CNS with aberrant input. Or, the aberrant structure is the individual’s best attempt to adapt and save resources given the current immediate demands of the internal and external environment. Tonal chiropractic techniques explain that symptoms that we see in our clinics are a result of neuron-physiological partitioning. Since the CNS controls and regulates all physiological processes of the human body, optimizations must first occur at the microscopic cellular level in the nervous system. All of the changes can be explained by considering the process of energy efficiency of neural communication and neural processing. Energy, which is available ATP, is finite. It is reasonable to assume that the limiting factor for this energy resource/metabolic-efficiency-optimization process is the use of available ATP. Thus, to optimize neurological programs, the CNS will shunt and mobilize ATP to the areas of greatest physiological need in the CNS. Tonal chiropractic relies on observable biological standards.
History has proven, especially recently, that our scientific understanding of certain human physiological traits is not only incomplete but also at times plain wrong. The recent revolutions in the areas of CNS—neuroplasticity, the existence of widespread adult CNS stem cells and the “discovery” of the bidirectional communication of the CNS and the immune system—are areas of science that have changed 180 degrees from their original dogmas. This limitation of human understanding proves our generation’s descriptive limitation and the evaluation of normative function. But proper physiological function must be historical if human existence is a product of 400 million years of vertebrate adaptation and positive modifications.
Ruth Garrett Millikan, born in 1933, is a well-known American philosopher of biology, psychology and language, and she described the term “proper function” in the late 1980s.  Proper functions are the sorts of functions that biologists assign to the organs of animals and are the sorts of functions that human organs have. In the context of the philosophy of biology, the notion is introduced that proper functions are what things are for, whilst other functions of the design are not. Thus, it is possible to distinguish having the function X from merely functioning as X. Both of these linguistic distinctions can be used to mark a rough boundary for the term “proper functions.”
Function is any activity that can be produced by a structural entity. Proper functions differ from other functions in that they can explain the reason for a structure’s existence. The presence of the heart, for example, can be partially explained by its capacity to circulate blood and move oxygen into tissues. These functions provide an evolutionary and natural-selection explanation of the presence of the heart. But the presence of the heart cannot be explained by its ability to cause severe pain during a myocardial infarction event. The ability to cause pain is a function of the heart but is not its proper function; causing pain is pathological, but it does not lead to greater evolutionary fitness. The normative, or fitness, function could be said to be the heart’s proper function, but it would not be evaluative because, of course, normative definitions change with better understanding of biological functions. By definition, proper function is defined historically over evolution. For example, science used to understand that CNS glia cells were simple supportive structures; we now know that glia cells are the most important cells in the CNS for intercellular communication and neuroplasticity. Some glia cells are not supportive at all but are, in fact, adult stem cells. The proper functions of a trait are those with ancestral evolutionary fitness components. These functions of a trait are advantageous and are those selected over time. The effect is a positive adaptation. To explain a trait by alluding to its proper function is to explain it as the result of natural selection in the way with which we are all familiar.
:dropcap_open:In other words, how can we have patients who have these asymmetries and who are athletic superstars with large, socially stable families?:quoteleft_close:
When addressing the functions of the spine, one must specifically separate and define the proper functions and “foundational” functions. Proper spinal functions are functions that can best fit their place in the evolutionary fitness picture. The foundational functions of the spine must first fit in the overriding natural selection process. Function X or Y as described as a spinal function must first agree with evolutionary biology. If spinal function X or Y, though desirable, denies the natural selection process and evolutionary biology for all vertebrates, then the description of the observation must be incomplete.    The incomplete description of spinal function X or Y cannot be a proper function. Furthermore, if the function of the spine is to maintain perfect alignment with complete axial symmetry, but this “model spine” cannot be found in living or deceased humans—or in any vertebrates for that matter—and, moreover, perfect symmetry may not have evolutionary value, then perfect axial symmetry may not be a normative, or foundational function. 
There can be no statistical outliers to foundational function. If a few specimens with small rotary asymmetries are observable examples of maximum human performance and presumed evolutionary fitness—biological and athletic rock stars—then the principle of traditional chiropractic that small asymmetries lead to depressed function is visibly incomplete. Although perfect axial symmetry may exist theoretically as a spinal function, it does not supersede evolutionary drive and proper foundational function. The proper structure of the spine, as described by traditional chiropractic paradigms and colleges, cannot override examples of super normative function and faultless evolutionary fitness. If small rotary vertebral asymmetries have a deleterious effect on individual function and fitness, how can an individual have these asymmetries and have perfect adaptation traits and outstanding biological function? In other words, how can we have patients who have these asymmetries and who are athletic superstars with large, socially stable families?
So what is the proper function of the spinal column? Perhaps it is protection of the CNS and spinal cord, intersegmental flexibility that allows for great range of movement and mobility. Greater mobility adds to species fitness, or evolutionary survival ability. But again there must be an underlying principle that is true in every case when applied to all spinal functions. These functions of the spine are not the foundation function, which is, of course, evolutionary fitness. The first and primary proper function of any biological structure is energy efficiency. The proper functions must first and foremost satisfy the evolutionary fitness requirement before another function can be assessed.
Does your chiropractic technique evaluate in real time the patient’s proper physiological function that would increase evolutionary drive? High-priority physiological functions like breathing and circulation should be evaluated pre- and post-chiropractic intervention.  Can chiropractic or allopathic intervention be positive for the individual if it does not increase real physiological function despite its nociceptive effect? Increasing the body’s main physiological traits, e.g., breathing, circulation and heat regulation, should be our prime motivation for intervention. The body, after 6.2 million years of walking upright, will shift resources to maintain basic abilities. If we assist the body in prime physiological functions, the body’s innate ability developed over 400 million years will utilize the freed-up resources to improve fitness and heal local injuries and disease.
This brief article is designed to begin conversations within the chiropractic community as to what is the best physiological function to analyze in order to guide our adjusting techniques. Is it okay to have a chiropractic intervention (or an allopathic one, for sake of conversation) that may decrease pain but maintains or assists in degraded physiological function? Do we assess global physiological functions that biology and science have always proven affect every cell, such as breathing and circulation, or do we assess physiological functions on a small local level, such as segmental biomechanical function, muscle spasms and swelling, and presume they have global effects? The patient’s leg length may be even, but does that correspond to an immediate positive change in prime physiological functions like breathing, circulation, heat regulation, nutrient absorption,  CNS informational processing, energy efficiency or overall health? Is L5 right-rotated a pathological structural malposition, or is it the best adaptation that 400 million years of winning can produce to maintain efficiency and drive towards fuller expansion of our human potential? Do we evaluate physiological and pathological asymmetries? Is it always best to adjust that swollen, painful high spot, or is there a bigger game we should consider? Do we really trust that after 400 million years, the human body knows how to adapt efficiently in the short term? Or for those of other religious flavors, do we think we are divine junk?
Chiropractic is at a crossroads. For decades we have maintained that there is a perfect structure and that perfect structure leads to the best function. But that optimal structure has traditionally been a static definition, ignoring the basic principles of evolution through natural selection and energy-efficient adaptation. We have forced curves and aligned vertebrae when those apparent pathologies may be the best physiological choice at the time. It can be said that at the moment of birth, the nervous system begins to adapt to the gravity environment utilizing the structures available to it. Those structures are changed and modified over time as the efficient function drives the dynamic structures. Can chiropractic evolve at these crossroads to address those patients we have yet to reach out to? We should be reaching out to patients in wheelchairs or who are post-stroke or who have cerebral palsy, where perfect structure can never be attained. Do we pull our collective heads out of regional curves and aligned pedicles and embrace functional markers as the only objective finding that correlates to health? When the patient’s function outweighs the clinician’s biases, then chiropractic will have evolved to truly remove the interference, or inefficiency, from the patient’s nervous system. Using functional objective markers like breathing regulation, cardiovascular status, proprioceptive acuity and/or gait efficiency will dramatically change one’s practice and the clinical results.
Selected References:
  • Andre Ariew (Editor) (2002). Functions: New Essays in the Philosophy of Psychology and Biology
  • Bowler, Peter J. (2003). Evolution: The History of an Idea. University of California Press. ISBN 0-52023693-9.
  • Clary, Frederick. (2006). Functional Analysis Seminar Manual
  • Futuyma, Douglas J. (2005). Evolution. Sunderland, Massachusetts: Sinauer Associates, Inc. ISBN 0-87893-187-2.
  • David H. Peterson (Author), Thomas F. Bergmann (Author) (2002). Chiropractic Technique
Dr. Fred Clary, D.C., D.I.B.C.N. is the creator of the chiropractic technique, Functional Analysis. This technique focuses on detecting and correcting breathing inefficiencies as well as improving movement and gait patterns. He teaches the Clinical Neurology Diplomate for NWHSU. Dr. Clary holds world records in powerlifting. Contact him at: drfredclary[at]  or call  at 612-865-8430.

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