Laboratory Biomechanics vs Clinical Biomechanics

Accepted Laboratory Science is not translating to Accepted Clinical Pathways

The following was written by Panjabi in 1985

“In 1985 Pope and Panjabi in a paper entitled ‘‘Biomechanical definition of spinal instability’’ wrote ‘‘Instability is a mechanical entity and an unstable spine is one that is not in an optimal state of equilibrium. (…in the spine stability is affected by restraining structures that if damaged or lax will lead to altered equilibrium and thus instability. Instability is defined as a loss of stiffness’’. Panjabi’s views were generally accepted by basic scientists interested in this field.” 

Pope, M. H., & Panjabi, M. (1985). Biomechanical definitions of spinal instability.Spine,10(3), 255-256.

The following was written by Panjabi in 1992

“Presented here is the conceptual basis for the assertion that the spinal stabilizing system consists of three subsystems.”

1. The vertebrae, discs, and ligaments constitute the passive subsystem.
2. All muscles and tendons surrounding the spinal column that can apply forces to the spinal column constitute the active subsystem.
3. The nerves and central nervous system comprise the neural subsystem, which determines the requirements for spinal stability by monitoring the various trans­ducer signals. and directs the active subsystem to provide the needed stability. 

“A dysfunction of a component of any one of the subsystems may lead to one or more of the following three possibilities:”

(a) an immediate response from other subsys­tems to successfully compensate 

(b) a long-term adaptation response of one or more subsystems

(c) an injury to one or more components of any subsystem.

“It is conceptualized that the first response results in normal function, the second results in normal function but with an altered spinal stabilizing system, and the third leads to overall system dysfunction, producing, for example, low back pain.

In situations where additional loads or complex postures are anticipated, the neural control unit may alter the muscle recruitment strategy, with the temporary goal of enhancing the spine stability beyond the normal requirements.”

Panjabi, M. M. (1992). The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement. Clinical Spine Surgery, 5(4), 383-389.

The chiropractic profession MUST be the leader in the translation of biomechanical spine principles FROM the laboratory TO clinical practice.  There is NO other profession more qualified from a diagnosis and treatment perspective than chiropractic. This is the most basic premise to get across to the medical community in your area.