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The Different Upper Cervical Techniques with Dr. Ian Bulow

5 years ago

More and more people get curious about the upper cervical technique and its healing wonders. Blair Upper Cervical doctor, Dr. Ian Bulow, gives further knowledge about the different upper cervical techniques which can help restore health to the entire body. He explains the goal of structural alignment and neurological integrity and how this is important as it’s not just about the neck but the whole nervous system.

We have a recurring guest, Dr. Ian Bulow. He is a Blair Upper Cervical doctor at Pittsburgh, Pennsylvania. He also has a podcast called Staying Connected. If you enjoyed this episode, feel free to check that out. Dr. Bulow is a wealth of knowledge on all the different upper cervical techniques. On this episode, we are going to go over the handful different upper cervical techniques and the similarities and differences between them. Some doctors out there say they’re doing upper cervical chiropractic, but there are definitely some qualifications that need to be established to make sure you’re getting high-quality upper cervical care, which Dr. Bulow also goes over. We also go over what might be the best technique for you, where students can learn the upper cervical work and how to find an upper cervical doctor near you. Please welcome, Dr. Ian Bulow.


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The Different Upper Cervical Techniques with Dr. Ian Bulow

We have one of my favorite Blair Upper Cervical doctors, Dr. Ian Bulow. He is an Upper Cervical Chiropractor at Pittsburgh, Pennsylvania. Dr. Bulow, how are you?

I am doing well.

I’ve been getting a couple of requests from the audience about the different types of upper cervical techniques and chiropractic. You are probably one of the most perfect guests for this because you’ve done the Upper Cervical Diplomat, which goes into great detail of all the upper cervical techniques. You’re able to learn from all of them. You are able to meet all the different doctors in that field. You’re not a technique basher, which I also like about. You’re open to everything. It’s a great episode to have you on. It might even make more sense if we backed up a little bit to why upper cervical chiropractic even started and then how it even trickled down from there and how it’s evolved into what it is now?

We’re blessed to be in the profession that we’re in helping people that we do every day. Upper cervical is one of the purest versions of the principle of chiropractic that we have. I grew up with the understanding that life is intelligent and life is a miracle. When you look at human beings and you look at animals and you look at life, it’s all intelligent. In human beings, we have a brain and the nervous system that controls that life. If we can help that run better without any interference, we expect that the body can run at a higher potential. One of the first areas that the brain and the nervous system can be negatively affected is their misalignment of the spine. If you think of how important it is to not have high blood pressure, imagine how important it is to not have high nerve pressure. Arteries and blood vessels have to go through these arteries. All your nerves have to go through channels as well. They have holes inside of your spine and one of the first and biggest holes are one at the base of your skull.

When I was going through chiropractic college, I was looking at the spine as being one of the most important things to maintain in proper alignment and subluxation-free. Free of any misalignment, creating disturbance or neurological interference. These doctors that exclusively look to maintain a healthy and clear subluxation-free upper neck, they make sure that where the head sits on the neck, that there’s no misalignment that’s affecting negatively the quality of information going between the brain and the body. My initial reaction was that it sounded too good to be true and it didn’t make sense. How would that help someone with low back pain? How would it help someone with neuropathy in their hand? What does my neck have to do with my foot? I came to find to be true, the same thing that the developer of chiropractic came to find to be true. DD Palmer founded the profession in the late 1800s and his son BJ took it over.

After years and years of research, BJ found that because the spine is incredibly strong and stable with the cushions of the discs, the ribs, the big muscles and all that, as a whole unit it’s hard for individual parts to not stay in alignment. The body’s got a lot of checks and balances for everything. That makes the body so incredible. In the upper neck though, the checks and balances are a little bit more complicated. If the upper neck goes out of alignment, the neurology that is there to correct that misalignment is affected by the misalignment. It’s inherently incapable of auto correction the way the rest of the spine is. Then you’ve got a ten-pound head on a little bone that could fit in the palm of your hand so the leverage to auto correct is hard. It’s much easier to fix a crooked head by the big strong shoulder muscles, leveling off the eyes and ears because the brain wants the eyes and ears level. If my head’s crooked, my eyes and ears are crooked so then my shoulder muscles have to pull that head back so the eyes and ears get level but my shoulders are tight. If my shoulders are tight, my back gets tight.

After a while, I realized it’s not just about the neck. It’s about the whole nervous system and it’s about the whole spine. We’re just using the head as a steering wheel to correct the alignment of the rest of the spine. For me, that’s what it was about that. That was all like the analytical side of things that combined with the amazing stories I was hearing. You talk about every time you do a podcast is the miracles that we experienced and the life-changing power of correcting that, opening up the channels and blood flow in and out of the head. That made me go all in on this thing called upper cervical chiropractic. Over the last few years, I went from being a practitioner, being an instructor and educator to where I am now the President of the Council on Upper Cervical, which is international guidance body for education, research, politics and things like that. I’ve been able to look across over the fences and talk with the different upper cervical procedures that are out there. To your point, there are many actual bashers but there are people that are misinformed. They haven’t had a full-rounded education like we all were.

We were educated by our mentors, but our mentors came from a generation where there was a lot of ego and a lot of dogma. Our generation, we’re a little bit past the dogma and I’d like to think that we’re past the egos as well. We’re way more inclusive and way more communicative. It’s a good principle to live by. It’s not about pointing out what someone’s doing wrong. It’s about finding out what they’re doing right. Everybody can’t be wrong. One of my favorite principles is what makes us amazing in certain areas of our life is what makes us vulnerable in other context or areas. In our technique systems, what makes us strong in the wrong patient, it might be a weakness. Maybe we need to look at this other technique, this other procedure because their strengths may in fact be my weaknesses. That’s the Council on Upper Cervical is all about. It’s about learning about this stuff, researching it. We have our diplomate program, which is a 300-hour, three-year program where doctors can get certified in their techniques system, their protocol or procedure. Also get their diplomate, which means you start to learn about the conversations that are happening all around the profession. That’s why I do it and that’s what I’ve been up to.

EM 90 | Upper Cervical Techniques Upper Cervical Techniques: Upper cervical is one of the purest versions of the principle of chiropractic.

We all have the same overall objective is to clear out all the interference between that craniocervical junction so people can function to their optimum potential. That is the goal across the board.

Restoring life from above, down, inside and out. That’s what it’s about.

How many different upper cervical techniques are there that are recognized?

We have a lot of different techniques. I can manipulate my own neck if I tried hard. I could push on my chin, I can crack my neck. Because I cracked the upper neck, I moved it like cracking your knuckles. You pop a joint, you increase its range of motion and all that. Does that mean I administered an upper cervical adjustment to my neck?

It could, technically.

I can fall down a flight of stairs. Was that an upper cervical? It’s like The Simpsons, the trashcan technique. You throw them over the back, you hear a lot of popping noises. How do we define what is an upper cervical chiropractor versus a full-spine chiropractor? Considering that upper cervical affects is full spine. How do we distinguish between adjustments versus manipulation? How do we do all these different things? The Council’s working on that. My definition of an upper cervical chiropractor is someone that is looking near exclusively at the upper neck. That’s where they’re going to intervene pretty well exclusively.

We’re not going to make it a regular practice to manipulate joints of the body other than the upper ones. We’re not manipulating, we’re aiding in the restoration of alignment something we call an adjustment. We’re doing that pretty much exclusively to the upper neck. I could manipulate my own neck exclusively but if I did that, I wouldn’t consider that being an upper cervical chiropractor if I just fell down a flight of stairs and cracked my upper neck. It requires more than the exclusive attention to that area. It requires a very thorough analysis, a very conservative analysis, postural, thermographic and palpatory exam findings, not always adjusting, checking to see when adjustments are needed. There should be visits where you don’t get an adjustment because you’re stabilizing, that’s a common thing.

That can be mind-blowing to people that have ever gotten the upper cervical care. It’s like, “What do you mean I’m not getting adjustments? We’re ecstatic.” We’re like, “Everything’s already in place.”

You were talking about how the idea of holding the alignment is a new concept for some folks. The way I explained that is let’s pretend I had a broken arm and I had it put in a cast. I go to the doctor, I have it set in a cast. Then I go back the next week and they do some evaluations, maybe they take an X-ray and they say, “Everything indicates that the bone in the cast is in perfect alignment. It’s our policy in this office to remove your cast two times a week, reset the bone and then we’ll reset it next week. We’ll cast it again, we’ll reset it and we’ll cast it.” If you were that patient, you’d probably run for your life because that seems very traumatic. It seems like it would hinder the healing. In the same way in upper cervical, what we would expect to be a normal experience would be that you would need to be realigned in the beginning and then you would need to be checked to see if you’re holding that realignment. If you are holding that realignment, you should be left alone. If you’re continuing to be realigned or adjusted without holding, then a reassessment needs to be done because something’s wrong. You should hold, otherwise there’s no justification to back off on your visits.

Upper cervical chiropractors tend to be very analytical, very conservative and the actual upper cervical adjustment usually is determined or formulated by some advanced images. We’re taking very specific X-rays. We’re reviewing MRIs. We may even review CT scans. We’re doing some very analytical work. Those three things in my opinion are what classify someone as an upper cervical chiropractor which is the exclusivity to the upper neck. The very thorough and conservative analysis before and after adjustments, the resting after the adjustments and then the image guided adjustments. We’re not going in adjusting off of palpation, we’re going in and adjusting off of objective measurements that will be as least invasive as possible to that patient and as gentle.

Would you also throw in the Tytron scanning to measure nerve interference? Do you think that’s a staple for an upper cervical doctor?

I would say within the world of upper cervical in terms of analysis, you have about four or five ways of analyzing the integrity of the spine. You can do a postural structure once standing straight up and see how the head and shoulders are tilted and twisted. You can do the same thing lying down but you’re looking at if the hips are higher because one leg will appear shorter. It’s the same as standing, it’s less information because you’re only looking at the feet binary, if the hip is short on one side.

You’re taking gravity out of the equation.

It is binary, which makes it very repeatable and very reliable. I can look at the feet and measure it with a measurement, it’s a millimeter, it’s two millimeters, it’s a quarter of an inch and it’s three-eighths of an inch. I can get that where measuring standing posture could do that, you need some special equipment; the Anatometer, the GSA, Gravity Stress Analyzer. My point is you can look at the structural integrity both standing and lying down. We can palpate the muscle tension, the swelling of the nerve endings in there and then we can do thermography through CSS. How the sympathetic nervous system is? How much stress is on your autonomic nervous system? We know the lower part of your brain, which is right above your neck is the governance driving system of your autonomic nervous system. I would suggest out of those three types of analysis, you need at least two.

An upper cervical chiropractor may only do leg check and palpation or standing and palpation. They may only do thermal scanning and a leg check or thermal scanning and a palpation, but you need at least two of those three to be thorough. I would argue that I like to do all three. There is a justification for doing all three. I’d like to see us as a profession do all three but as long as people are doing two out of those three, we know that they’re being very conservative. They’re using tests that have been proven to be related, that are valid and reliable. There’s reliability and validity to all of those tests but in my mind, you’ve got to be doing two of those three. You should be doing them before and after the adjustment to assess whether or not you did your job, whether you had a change. That’s all part of it. It does set the ground work to where we can talk about what you want to talk about.

The amount of procedures that are doing that by definition, doing those two or three checks and are doing advanced images to figure out how to then move forward. I would say there’s probably about a half a dozen different organizations out there that are certifying people. They are slowly coming into the fold with the Council and being what we call affiliate organizations, which is saying they’ve been vetted. As a Council, we’ve reviewed them. The council is made up of board members that are a part of all of these different techniques. It’s a multidisciplinary, as much as it can be nonpartisan, nonpolitical body, nonprofit all that stuff. We’re reviewing them to say, “You are teaching that. Yes, those are good, valid, reliable processes.”

EM 90 | Upper Cervical Techniques Upper Cervical Techniques: You’ve got a ten-pound head on a little bone that could fit in the palm of your hand.

You also get the people that say I do upper cervical and then you watch a YouTube video and you’re like, “What was that? I’ve never seen that before.” Those are definitely very important checkpoints for patients and for doctors be like, “That’s not upper cervical.”

It’s quality control but it’s also sustainability, this is important. It’s not just quality control, it’s sustainability. If you were certified by a given procedure, what happens if that procedure is only one person’s word and say, they might change with the wind, number one. Number two, what if they die? We want your patients to be under a procedure that has longevity, reproducibility and sustainability. This is about quality patient care but it’s also about the sustainability and progression of our profession. We want everyone to do well. We want to help these organizations as a council, we want to help them grow. Maybe they’ve never had a board before, maybe they never had a research project that’s done. We’re going to give them the tools to do that. My point is there’s about a half dozen techniques that I would say are upper cervical. I would say there are about four that are affiliate organizations within the council and that is growing.

If anyone wants, there’s a great resource out there called [].(,-94.94497417499997,5z) Dr. James Beadle came up with a referral map. To be listed on that map, needs to be certified in one of those half-dozen or so techniques. It’s at least some filter. They may not be affiliate organizations. The council may not have vetted them but at least the organization purports to be upper cervical and the doctors listed are certified in those techniques not just members but certified. It’s a good way, a good litmus to see who’s in your area that’s at least trying to be advanced and is working on it and getting certification and all of that.

That’s one of the reasons why a couple people have been requesting this because they hear a couple of upper cervical episodes like, “I want to try it.” You get on Google and it’s like, “I got NUCCA. I got Blair. I got Atlas Orthogonal. What do I choose? What’s going to be the best for me?”

With that, I’ll give my best explanation. We’re all after the same goal for the most part, is structural alignment. We want the alignment of the bony structures and neurological integrity. When you have that, that’s what we call running clear or being in balance. The brain and brainstem are doing as best they can running without a chiropractic subluxation. I would put the assessments aside because those three assessments that we went over, I happen to think that thermography is the most important. Someone else might think that posture is the most important. We can probably have a nice debate about that. For the purposes of this conversation, we can say, “Let’s put that aside for now.” We can debate that, we can do all that but assuming that the doctor that you’re seeing is good at what he or she does, then those differences shouldn’t matter as much. We’ll put the assessments to the side. We all should be doing all of them. I don’t think those are differentiators. At the end of the day, everyone should be doing all three of those. I’m going to set them over here.

There are some differences. Some people do more scanning, somebody will do more posture but we’re going to move that to the side. With that said, the main differences then are in the type of imaging that’s done to see if you need to be realigned or not or adjusted. If you have a subluxation and if you need to be adjusted, then it’s the actual technique. What kind of impulse or procedure is done to your spine and your neck to bring about the correction of this condition known as an upper cervical subluxation or misalignment that’s affecting the neurology in the area? I’ll go over both. The type of imaging is a pretty big difference. If you were seeing an expert in each field, it shouldn’t matter as much. It’s different if they’re doing their job right, it doesn’t matter as much. The way I explain it is like this, half the profession is looking at your neck like looking at a crooked finger. If you make your index finger crooked like a shrimp, they look like a hook, Captain Hook and you say, “This finger should be straight but it is crooked.”

Half the profession is going to look at that curve and they’re going to say, “If we pull on the tip of the finger and flattened the whole thing out, that will achieve the goal of straightening the finger out.” The other half of the upper cervical profession says, “It’s this knuckle that’s causing the problem. I need to fix that knuckle and then maybe fix this other knuckle over here and the whole thing is going to straighten out.” You’re after the same goal. One is looking at a global correction not worrying about the knuckles and the other one is trying to fix the knuckles and assuming the global will take care of itself. They both have their assumptions. That leads to the difference in the corrective procedure, if my procedure is more global in nature and my goal is to globally correct things, then my procedure is going to be more global. I’m going to put an impact into the neck that’s going to affect all the structures at one time. Maybe it might be slow and gradual like stretching the hamstring. We might put some pressure on the neck to unlock, stretch and restore alignment of the weight of the head over the neck all at the same time.

Those are what we call orthogonal procedures where you’re on a table that tilts your head a little bit and tilt your shoulders a little bit, then there’s a single impulse with an instrument or a slow gradual pressure with your hands. Those techniques usually are going to look at your posture standing up. They’re usually going to look at your posture lying down. They’ll sometimes do the thermal scans but they’re more concerned with your posture. The assumption is when I get your head straight over your shoulders and hips in line, I’ll be able to stand against gravity so I’ll have less structural problems. If I do my job right, I’m probably going to release the pressure on the nervous system. The nervous system is what controls the tension in my hips anyhow. It also has been shown to control blood pressure, digestion and all of these things. That technique, whether it’s the hand adjustment or the instrument adjustment, you barely feel it. That’s what we call the orthogonal upper cervical techniques. You have NUCCA, Orthospinology, Advanced Orthogonal, Atlas Orthogonal, EPIC, Grostic and you even have this technique on QSM3.

I’m not sure QSM3 if they take X-rays or not. I know they’re very global. They looked at the whole spine and they look at muscle tension. How do we define these things but either way they would purport to be upper cervical? They would all be looking at the global realignment of the axial skeleton and that’s what we call orthogonally-based techniques. The definition of orthogonality is like the cross hairs in a scope of a rifle. We have a line straight down and a line straight across and 90-degree angles between those two lines. That’s orthogonality. If you drew a line down my forehead through my mouth, that’s a straight line and a line down my neck, that’s another line. The top bone in the neck is the atlas, it’s a line straight across that makes cross hairs between your head, your neck and the C1 bone makes a big giant plus sign. Orthogonal techniques are trying to achieve as close to orthogonality as they can like straightening that finger out nice and straight, that’s the ideal.

It’s important to know that some of those techniques you named do have the instruments involved and some of them are done by hand. Which of those techniques are done by hand, what are done by the instrument and maybe pros and cons of hands versus instrument?

When it’s done right, I would say that it shouldn’t matter. The pros and cons should be a wash. If it’s done with a high level of practitioner, I would say it should be awashed. If it’s a new practitioner, there are some pros and cons but either way what I would say in terms of defining it, NUCCA is exclusively done by hand. The National Upper Cervical Chiropractic Association, the doctors go through this painstaking process to train and turn their bodies into machines essentially. That’s done by hand. Orthospinology is an extension or an evolution of what’s known as Grostic. John F. Grostic is the godfather of all the orthogonal techniques for the most part. There’s some debate there but for the most part he is. When he passed away, NUCCA started. John D. Grostic also used an instrument on occasion that was John F. Grostic’s son. When John D. Grostic passed away, some of the family continued the Grostic tradition. Some of the instructors, it’s a long story how and why but there was some that stuck with the Grostic name.

Then there were some that went a little bit of a different direction.

The bottom line is a lot of instructors out of necessity, to be honest is the truth of the matter started the Orthospinology Organization. It wasn’t that they wanted to, it was one of these situations which is out of necessity. It was the best thing for the profession. My point is Orthospinology is essentially Grostic and their doctors for the most part use instruments. Although they do know and there are trained in the Grostic hand adjustment, which is similar to NUCCA. There’re some changes but it’s similar but most of the time Orthospinology is going to be an instrument that’s going to percuss. You’re going to feel a little pressure about six pounds of pressure, it will feel a lot like the hand adjustments. It was specifically designed to feel like the hand adjustments. That’s Orthospinology and then you have the sound wave percussion instruments. QSM3 is a hand adjustment as well. That’s another one.

You have NUCCA, Orthospinology, which is hand and instrument and then you have QSM3, which is hand, which is very light. You barely feel it from what I understand. Those three are on their own. Although Orthospinology does some instruments or does a lot of instruments, but there is a difference in the instrument. In Orthospinology, instrument extrudes out. It will dimple the skin. You’ll feel that a little bit. The other orthogonal techniques are called soundwave percussion instruments. Soundwave percussions are very fascinating. If you’ve ever seen a Newton’s cradle, the steel balls that are held up by strings and there are five of them in a row. When the one clicks the three in the middle, don’t move. No one on the other side kicks away and when it comes back it clicks. Three in the middle don’t move and the other one goes back away, it clicks back and forth. It’s called a Newton’s cradle. There’s a lot of physics involved in that.

Imagine you have these five balls in a row and you take the three balls in the middle. You replace them with a steel pencil rod, like a steel rod the size of a pencil. You have a rod in the center and you have a ball in each side. You raise the ball up on one side. It clicks the rod, the rod doesn’t move. It transfers that vibration to the other side. That vibration is translated into the other ball and the other ball kicks away and then like before. The steel rod in the center does not move. Now take that steel rod, put it on your neck and take another ball and hit that steel rod, the rod doesn’t move. There’s a transfer of force of vibration that goes through that rod into your body. The steel ball went away before but there’s no steel ball there. There’s your atlas bone. There’s your anatomy. That anatomy is going to absorb the force transfer but do you feel it? No, that’s what makes it fascinating. You don’t feel it. It’s just vibration, the sound wave that resonates through your neck and sets the structures. They have before and after X-rays, like everybody else in the orthogonal techniques. They take X-rays before and after and you can see the structures realigning. You can’t argue that it doesn’t work because it has an effect.

We’ve got to do the research and say, “How much of it is vibration? How much of it is the headpiece? How much of it is the doctor? How much is it the setup?” There are a lot of variables we have to do but at the end of the day, the bottom line is does it get the job done? The answer is yes. When it’s done right by a professional that’s highly trained, it should get the job done. The pros and cons of the orthogonal techniques are all extremely gentle. You barely feel a thing there. They’re very safe and very gentle. I would argue that because there are assessments, whether they feel they’ve made a successful change or not, is based on your structural posture that they may have a slight advantage on structural issues. They’re not going to be satisfied until your hips and shoulders are perfectly level. People who scan more are satisfied as long as the neurology is clear and your shoulders and hips will come along. That’s a cultural thing. There’s a little bit of an advantage if your primary complaint is a structural one. I get this chronic tension in my neck, shoulders and back. The orthogonal ones have a little bit of a leg up because they’re paying attention to posture, they’re looking at it. Assuming that they’re good, that’s what they’re obsessed with.

EM 90 | Upper Cervical Techniques Upper Cervical Techniques: Restoring life from above, down, inside and out, that’s what the goal is about.

When we go to the other techniques, what’s called Knee-Chest upper cervical, Blair upper cervical and Toggle-Recoil upper cervical usually those doctors are more concerned with your thermal Tytron scans. They want to see changes in your thermal patterns, which is essentially a change in your autonomic nervous system. The advantage there in my mind is if you have a functional issue, if you have blood pressure, acid reflux, seizures, migraines or vertigo but guess who did the blood pressure research study, the NUCCA people looking at posture and they saw it drop. That’s what I’m saying, we’re all doing the same thing but if I was to say a difference, I would say that the Knee-Chest, Blair and Toggle, they tend to scan a little bit more and do less of the standing postural assessments. Should we be doing standing posture? Yes, we probably should.

With that being said, what do they do that’s different? The X-rays are a little different. Instead of looking at the crosshairs like the straight finger versus the hook finger, we’re looking at the knuckles for the most part. We’re looking at which individual bone is the offending bone. I’m not so much concerned about the rest of them. I want the one that’s the most crooked and I want to fix that one period, end of story. The adjustment’s a little different too. The adjustment instead of lying down, a little bit turned and a little bit bent, we lie you in a perfect neutral. The other techniques or close to that but it’s a single impulse and it’s usually a very lightning quick impulse. When you’re trying to move one bone it’s hanging out over there, it’s pretty fast. You’re lying on your side with Blair and Toggle, it’s a single impulse. The headpiece is probably the biggest difference. The headpiece drops a fraction of an inch, it’s very quick. It’s like if you were sleeping in the back of your car and the driver hit a pothole. You hit that bump, you wake up and you say, “Did we hit a pothole?” You almost forget it even happened because it’s so fast and it’s so light, you barely feel it as well. There’s a little impulse there that you do feel but it’s so fast and light that ten seconds after it happened you forget what it felt like.

That’s Blair and Toggle and the only difference between Blair and Toggle, Toggle is like using a hammer where others are using a screwdriver. There’s a little bit of a difference in the tool that’s being used. As a patient, you don’t feel those differences. You feel the impact but barely. There is a little bit of difference in the type of tooling that we’re using. Knee-Chest is in a totally different field of its own where the head is rotated and supported by a table. If you’re sleeping on your stomach with your head turned right, you’re in that position and then the table also does not move like an orthogonal table, it doesn’t move. The adjustment is more like a Blair and Toggle. It’s like both with your head turn. It’s a little bit faster of an impulse like, Blair and Toggle. Since the headpiece doesn’t move, then your neck absorbs that and you may hear that popping noise in your neck like having your knuckles cracked. You may not, but you usually do and so it will wake you up a little bit more. When it’s done right, you should barely feel it, it shouldn’t hurt. We’ve done some research on them in the Council and almost all of the techniques are about six to eight pounds of pressure within a fraction of a second. It’s all similar force involved when it’s done right.

The pros and cons for me, the Blair and Toggle because there is that drop mechanism. If someone’s in the middle of a pretty bad migraine, it doesn’t feel great. If you’re driving down the road and you hit a pothole and you have a Migraine, it doesn’t feel great. If you have swollen discs and you hit a pothole, it doesn’t feel great. It’s not the adjustment that’s doing that to you. It’s your problem that needs to be fixed that’s doing that for you. The adjustment is still gentle and safe and great. That’s the only limitation that I know of. The advantage to Blair is that we adjust people on either side of the neck, where we don’t have to adjust on the side that the seesaw is high, so to speak. We can go to the low side and lift the seesaw up and get it level. Knee-Chest benefit is that as a doctor you can feel the segment move under your hand. It’s a different feeling. The downside is that the patient can also feel it move. Sometimes it’s not as comfortable of an adjustment but when these are done correctly, they’re all safe. As long as we clear that neurology, if we clear the thermal scan and we balance out the head, shoulders and hips, you should be on your way to recovery. Living a life to your fullest potential.

My encouragement to everybody, no matter what type of issue you’re having or none at all, is to get your spine cared for from the top down by a certified specialist that can take care of you and your family. There are plenty of options out there. There’s usually a dozen or half-dozen around every major city. If you’re in super rural areas, it’s a little harder to be honest. You can go to You can go to You can go to Looking up upper cervical chiropractor in your Google map is risky but you can do that and then you can look through their websites if you want to take the time and see if they are certified in their techniques system. I can go on from there but it will be more about what makes us separate than what makes us together. That probably answers most of it. If any specific questions that you may have, Kevin, I’m going to check. Anything else that you wanted to follow up on, I’d be happy to address.

How are people going to know which technique to do and where, what search engine do you use? That is being put in place so everybody can look up those sites and find the nearest upper cervical doctor near you. I had a girl fly from Vancouver. She was seeing a NUCCA guy up there. She was home for college, she wanted to get checked. I did my analysis and complete respect with his, it was the same objective. I have no problem referring to any of the other upper cervical techniques. If they’re good in their field, it shouldn’t matter.

The clues will be the certifications. You want to see that they’re actively pursuing certification. will be a resource for that. This is a growing specialty that diplomate in upper cervical. UC Referral added that as a differentiator, so you can look to see where is the closest NUCCA doctor or Blair doctor or just anybody that’s certified. Then you can say, “I want to see if there are any diplomates in my area.” If you don’t know, there are all varieties in your town, you can choose any of them. I’m a preferential with Blair. I love Blair. You could probably choose any of them as long as they’re certified. You may want to look on the UC Referral website. If they’re a diplomate, that’s nice because then they have that. I don’t want to disparage anyone that’s just out of school because there are advantages to docs coming out of school. They know the latest greatest stuff, but there is a skill to this work.

If it’s someone that’s been doing exclusive upper cervical over the last 40 years, that’s probably a decent upper cervical chiropractor. They’ve seen it all. For me, in my own personal journey, I was trained very well in school. I did exclusively upper cervical chiropractic college. Coming out, I would like to think that I was pretty decent, but honestly it took about five years to get the swing of things. I wouldn’t think twice about going to a new grad at all. If they were in my town, I wouldn’t think twice. If I had the options and they were all equal, then I might tend to go to the doc that’s been out for longer. If it was differences of five to ten to twenty years, I may do that because there is something to be said. This is an art form and it does take time. Otherwise, if there are other things, if the new grad is closer or if you just liked their office and their vibe, then go for it. If they’re certified, go for it. It’s totally fine.

*If people were looking for opportunities to learn from people or practices for sale or just to get mentored, is there a site where you can see if a practice is for sale, somebody is looking for new associates or anything like that that the students can get a head start on? * There are a couple of resources. Number one, the Council on Upper Cervical Care is where you belong. If you are an upper cervical practitioner or planning on being one, I would tell you that you need to become a member of the Council on Upper Cervical. That’s where all of these resources are. If they’re not made public yet, that’s where the resources are being created. You can help to form these things if they are not yet formed. Believe me, we are going to have that. We are working on laying the groundwork for a new website that’s going to have all of that. That being said, a gentleman by the name of Billy Doherty has been involved with the upper cervical world for a very long time. He’s not an upper cervical chiropractor. He’s more of a support business to our profession. He owns, which is another place that people can go to find doctors. They’re not all going to be certified, but they’re probably going to be involved in their upper cervical organizations.

I believe that for students, the website is Billy has a calendar and he wants everybody’s technique weekends to be in that calendar. All the seminars, all the annuals, that would be in one place. The Council’s going to do the same thing. Our website is That’s where you can register for the symposium every year, the diplomate program, all of that. We’re going to be expanding that but it may not happen for another year. Then there’s the individual techniques. If you going to, you can see all the seminars. I’m sure if you go to or, you probably can see theirs. Orthospinology and all the other organizations, Knee-Chest upper cervical, the Knee Chest institute. There are all kinds of different ones. You just have to look at their individual sites. The one store house will be We want you to be a part of it if you’re a student. The membership is $50 for your entire student career that you’re a member. That allows you to be a part of the conversation. We want you to be on committees. We want you to be involved.

I’m going to announce this to reward the people that have been a part of this blog this whole time. I’m going to ask that if you hear my voice say this, you keep it under wraps and you don’t tell anybody. I’m going to tell people in June at the Upper Cervical Symposium in Denver, that’s an annual conference. Advances in Spinal Care is what it’s called. For patients, there once was an organization called the International Upper Cervical Advocates Association, IUCPAA. That was where patients learn about this stuff that we’re having conversations. They can join chapters like support groups and they can help support their doctor. They can learn about upper cervical and they can learn about other things that are helping. We may also need the help of an ophthalmologist or a dentist or a massage therapist.

That organization was started by James and Rhonda Tomasi, who inspired me to become an upper cervical chiropractor by Greg Buchanan, who started the Upper Cervical Branding Movement. These people were part of the reason the Council exists now. The Patient Advocacy Association hasn’t been active for the last five years. Rumor has it that a devilishly handsome upper cervical diplomate president of the Council on Upper Cervical is going to be assuming responsibility and directorship of that advocacy association. In the future, that advocacy association will be available for patients to plug in in all of these ways as a resource. The best resource you got is to go to the individual techniques systems. That’s the best thing I can advise right now.

Dr. Bulow, thank you so much for coming on. I enjoyed this episode. I’m definitely going to have you back on again soon. Thank you for all your knowledge and your dedication to the field. I appreciate it.

Thank you.

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