In the second instalment of our series on stress, we caught up with Dr. Wayne Todd; author of the book and practitioner training program The SD Protocol which targets sympathetic dominance. To Dr. Wayne, the connection between chiropractic and stress is so deeply entrenched as to be inseparable, but it’s how we as practitioners deal with this that has the potential to break the cycle of repetitive subluxations and help the patient regain control of their health.
Stress And Subluxation
Long before the lightbulb moment that saw him put together the protocol, Dr. Wayne was a busy chiropractor spending long days in the clinic, returning home to a young family and still spending hours sitting up grappling with why certain patients were facing significant health problems. For Dr. Wayne, the key to moving beyond purely adjusting, and into helping people take back control of their health, lay in digging for a deeper understanding of what happens in chronic long term stress, and then translating that in a meaningful way for patients.
The result might sound like a step outside the norm, but to Dr. Wayne it takes us to the heart of chiropractic: “What are the causes of subluxation? It’s physical, chemical or emotional stress. If we look at the causes of the majority of disorders and diseases that we have, it’s underlying physical, chemical or emotional stress that creates the problem. They’re really one and the same.”
The cause of subluxation is something chiropractors are taught from the very beginning, but Dr. Wayne argues that a deeper understanding of the problems that arise in chronic stress can be transformative for both patient and chiropractor alike.
“Over the years, I’ve spent countless hours up until two and three in the morning pouring over particular cases that had significant health problems. I didn’t know why these things were going on for my patients, so I spent countless hours researching, reading, doing a two year functional neurology diplomate programme, understanding the more intricate aspects of the nervous system. I worked with a holistic GP who specialised in hormonal balancing, then looked at the digestive system, the endocrine system, and realised ‘Wow, if I had of known then what I know now, these people may not necessarily have had to go through that.’
Why Modern Life Changes The Game
Two things are immediately clear when you speak with Dr Wayne: Firstly, it’s impossible to separate chiropractic from stress or stress from chiropractic when the causes of subluxation stem from physical, chemical or emotional stressors. Secondly, its that while stress has been around since the dawn of time, the modern experience is different. Thus, our understanding needs to grow along with the demands of modern life.
“If you look at stress, how is it different now to thirty, forty, or even fifty years ago? It’s hugely different. Fifty years ago, if you needed something in business you’d post a letter off requesting that this person do something to help you. You’d then wait two or three weeks to get there or more if it were overseas, and wait for the reply to come back. Now, we have made fifty of those decisions in the first half hour of work because it’s done instantly. Our life is much more fast paced, accomplishing much more in a shorter period of time. It creates a higher level of demand. That’s how we are. I’m not saying we should go back to where we were. We are certainly accomplishing more, but at a greater cost. There’s a lot more stress and load. Often one of those situations can be seen as monumentally stressful for an individual. But you can have several of those monumentally stressful moments in one day.”
The underpinning structures have not changed. We are still dealing with nociception vs. proprioception. We will have the amygdala kicking in a stress response regardless of whether it is a public speaking stressor, a stressor downloaded with your morning emails, or a barking dog with teeth bared. We still have the adrenals responding the way they should, dispensing stress hormones and altering the function of the endocrine system to adapt to stressors. We still have a cascade of physiological responses.
It’s just that the modern lifestyle creates increased opportunities for stress physiology to occur, and decreased opportunities to allow the parasympathetic nervous system to kick in and allow recovery. Critically, in so many cases, people deal with all of this unconsciously – not knowing how to intervene and bring the body back to a state of ease: the parasympathetically driven state where we can ‘rest, digest, recover and reproduce.’
“The adrenals are your regulator of stress with regard to the endocrine system; they regulate your hormonal state during stress. There are about fifty different hormones that your adrenals produce. They’re mostly active under states of stress, and have flow-on effects in all the other organ systems of the body. That is why the symptoms or presentation of adrenal exhaustion/adrenal fatigue are so wide and varied. Because it effects multiple systems in the body when we have that locked on, constant stress response in action.”
It is clear that the amount of stress we experience in modern life is potentially much higher than in the so-called ‘good old days.’ But the types of stress are also of worthy note to patient and practitioner alike. In the old days we might have had a moment of stress followed by hours of parasympathetic recuperation. Waiting for the mail took time. Now we are hunched over the phone hitting refresh on the email app or staring down at the laptop waiting for the response to come through. It takes away the recuperation time, but also (commonly) adds an additional postural stressor. We also have the chemical stressors that can be significant enough to put one person into chronic stress by itself. “We have significant [physical and chemical] stressors in our environment that we didn’t have forty years ago,” reminds Dr Wayne.
But What Is The Chiropractors Role In All Of This?
There are, of course, those who argue that its our job to simply adjust and send people on their way; that its not our job to add on to that primary service.
“I get that,” says Dr Wayne. “It takes a lot of work, a lot of skill and a lot of knowledge to be able to do that appropriately [recommend appropriate supplements or additional tools to help the patient] and some might argue that it waters down your focus which is working on the spine and nervous system and optimising its function. But my suggestion would be that focusing on the spine and optimising its function needs to be specifically targeted to the individual’s functional neurological imbalance rather than just simply adjusting what your fingers feel. So thinking about that whole nervous system and how you might best dampen sympathetic wind-up to enhance parasympathetic function if we are talking about the stress response.
Obviously, talking about stress with patients can open up a potential juggernaut of considerations which some chiropractors may feel uncomfortable with. Should we refer? What is appropriate for us to take care of in-house? Dr Wayne suggests this is a matter for individual consideration.
“It depends on your level of knowledge and understanding in those areas of underlying stressors and causal factors, and your level of comfort with going down those paths in advising someone appropriately. You can’t advise someone appropriately on digestive membrane healing if that’s not something you’ve done a lot of work, research, or training in to develop that knowledge base, so you might refer someone out if you think that’s appropriate. If you’ve got someone with significant emotional stress that has gone on in their life, there might be someone more appropriately trained to deal with that.
But sometimes what we can do as a conduit in practice is help the patient identify that there’s a link between those things. That’s the thing that I think is really important to do – help the patient realise they aren’t going crazy, they’re not mad. There is something happening that has been created by a series of events and situations that have occurred in their life. Its’ creating stress physiology.”
Linking Stress And Subluxation – How Important IS IT In Clinical Practice?
While most chiropractors are more than comfortable talking in terms of the subluxation, often patients need to hear how the subluxation relates to them, in terms they understand. Here, stress physiology and its links to the nervous system can make all the difference. “It’s about drawing that analogy between the two of them,” says Dr Wayne.
This begs an important question: In a world full of busy, stressed out and unknowingly subluxated people, can chiropractors really afford to not be across stress physiology? While every chiropractor maintains the absolute right to practice within their own chosen protocol and paradigm, Dr Wayne is quick to present the benefits of knowing stress physiology inside out:
“If they really, truly want to get to an understanding of the underlying cause of what’s going on for the patient, and help fast-track improvement in their health outcomes, then its essential to know. You can’t afford not to.
Of course, you can choose not to. You can choose to purely adjust subluxations. You don’t have to delve into the why, the how and the wherefore. But having that understanding will help direct a targeted approach and care direction for that individual. Without it, the chiropractor could well be repeatedly adjusting recurring subluxations that are driven by an underlying stressor that’s creating that pattern of subluxation and disease for that individual.”
Dr Wayne presents a clear argument that we can’t separate stress from chiropractic in any way; that this is our heartland even if we are just purely adjusting subluxations. But laced in with this firm conviction is a gentle challenge.
“If you are a straight, vitalistic practitioner adjusting subluxations, think about what caused them? You can actually just not think about that and just simply be finding them and removing them, and that’s ok. But eventually you have to think ‘Why did that happen? And if I adjust that person every day or every week and that same thing is there, Why? Is it actually a primary subluxation or is it a secondary compensation for an underlying stress response in the body?’
We can look at it purely from a physical perspective – is that recurrent atlas subluxation there all the time because it’s the primary problem creating the tonsillitis or disturbing the nerve function to here and there, and having an influencing effect on cerebellar function? Yes, all of that might be going on, but why is that atlas subluxation there? It could be there as a primary subluxation, or it could be there as a secondary compensation to the primitive reflexive need to breathe, and scalene muscle hypertonicity is creating that secondary fixation of the upper cervical spine. We need to identify why, because if you adjust the underlying primary driver for that you’ll find the subluxation disappears almost without you needing to touch it.
“Sometimes all that is needed is for a person to make the connection that something is making them sick.”
Dr. Wayne concedes that his approach, one that has been shared with hundreds of practitioners via the training program and countless readers via his book, is not the standard approach to chiropractic despite being rooted in chiropractic philosophy, art and science. “It’s not your standard. And it makes every day in practice fun. The thing that is empowering for me is being able to empower a patient with knowledge and understanding. That’s the critical thing; it’s really cool when you can actually get people to understand what’s going on in their body to the point where they can dictate the journey rather than waiting for that next specialist appointment or scan result – from not understanding to having a much better grasp of what is going on. That’s the big thing.”
“For some individuals, the chemical side of it is their big trigger,” says Dr Wayne. For those individuals it could be just removing two or three of their trigger foods that are leaking through their digestive membrane and creating a inflammatory response in their body. For some individuals that’s their ‘aha’ moment – realising the job they hate, or the marriage or that relationship that is under pressure, is creating a stress response. Being able to look at the global picture of that individual and being able to guide them to the succinct or salient things that they might be able to change in their life can make a big difference.”
The Big Question: Has This Impacted The Time Spent With Patients In Practice?
“Yes, at multiple times and in multiple different ways. The amount of people I see in any given day hasn’t changed in thirty years. It could have, but I chose not to let that happen. There are times where I run way behind in practice, but I try to give people the time that they need when I am there with them. Some practitioners are really adamant that they’ve got to be on time. That’s their mantra and how they function. But mine is to devote that time to the patient. Sometimes I do run behind. That’s the way it is. I tend to do that a bit less than I did in the early stages of putting this all together, before I had a book that I could give people and say “here read this.” That’s the approach now. You might identify two or three things so you can connect the dots for the patient. But then you can say “This is why, but go read this book and we can talk about it next time.” Then that actually takes up a lot less time in practice.
Stress is a big topic, but what we can see clearly is that it’s a topic relative to nearly every patient at some point in their lives. The ability to recognise its profound impact on the body and simply connect a few dots for the patient can make a big difference to their sense of empowerment, and their agency in their own health journey.