Dr. John Bickert, B.Ed., D.C. Chiropractor
Dr. Bickert emphasizes treatment of patients who suffer from biomechanical, neurological and structural problems and the various effects of nerve interference and brain lesions that can result in serious functional problems and health risk for patients. He centers on the effect the nervous system has on the health and wellbeing of his patients.
Dr. Bickert has decades of experience and has treated and helped patients who suffer a multitude of conditions ranging from very serious neurological problems such as; the residual effects of a coma, traumatic brain injury, post stroke, and spinal cord lesions to the less serious and more common biomechanical and neurological problems he encounters everyday in his practice. He uses standard, specific Chiropractic Techniques and Chiropractic Functional Neurology.
As a chiropractor, Dr. Bickert is a primary portal of entry into the healthcare field. This simply means you do not need a medical referral to see a chiropractor. Chiropractors are well trained doctors; experts at diagnosing and treating patients who suffer from a wide variety of conditions. A doctor of chiropactic in Canada studies between 4 to 5 years beyond a 4 year bachelor degree and is rigously tested before being certified in Alberta.
The emphasis in each chiropractic practice may vary and treatment protocols may be quite different from one chiropractor to the next. Although standards of practice do exist, chiropractors may differ in a technique, or various techniques they believe is most effective at producing results. Even though techniques may differ, you can be certain that each chiropractor has to comply with standards of practice laid out by chiropractic regulatory and licensing boards. While most approved chiropractic techniques are taught in chiropractic universities, some may be taught in approved chiropractic licensing seminars that are accredited by the registrar of the Alberta Association and College of Chiropractors (ACAC) for chiropractic education and accredited licensing hours. Usually, a great deal of peer reviewed research and clinical study has been done to support these various chiropractic techniques.
Some chiropractors use a variety of physiotherapy modalities to treat patients as well as researched chiropractic techniques and procedures. Dr. Bickert maintains that physiotherapists, acupuncturists, kinesiologists and massage therapists are well trained to use modalities such as; ultrasound, diathermy, cryotherapy, muscle stim, laser, range of motion and strengthening exercises, as well as massage, so he prefers to refer to these therapists, when the addition of these modalities is appropriate for the patient's condition to help speed recovery, in addition to chiropractic care and Chiropractic Functional Neurology. Dr. Bickert is trained to use a multiple of chiropactic techniques. When choosing a technique for a patient, he takes into consideration the patient’s comfort, past history of chiropractic care, reliability, appropriateness and effectiveness of the technique to help the patient improve and eventually resolve the condition and maintain health. The effectiveness of the technique is an important consideration in order to give the patient the greatest chance at producing lasting results as quickly as possible.
Chiropractors in Alberta are rigidly controlled by the Alberta College and Association of Chiropractors (ACAC) and are a listed health profession and regulated under tha Alberta Health Act. . Thus treatment standards are in place and monitored by the ACAC to protect the public from; false claims, unproven treatment practices and techniques, improper billing practices, poor record keeping and incomplete charting techniques, and the like. The ACAC strives to achieve high clinic standards and practices among chiropractic professionals. All licensed chiropractors in Alberta are regulated by this body. They are well suited and can make referrals to medical specialists when necessary. Most medical specialists will accept referrals from chiropractors and report results back to them.
- Not the same -
Chiropractors, physiotherapists and massage therapists are NOT same when it comes to treatment protocols. Patients are sometimes confused what health care professional is best suited to meet their needs for care, including those who have been referred from Medical doctors. The confusion is partly due to the a misunderstanding about the role of chiropractors and how it differs from physiotherapy, kinesiology and massage therapy. I assure you that doctors of chiropractic are best suited to judge which conditions will respond to chiropractic care, since they are specialists in biomechanical, neurological, structural conditions. Chiropractors are doctors and as mentioned earlier, serve as a direct entry into the healthcare field. You can assure yourself that if your condition cannot be treated by a chiropractor, we will refer you to the appropriated healthcare professional. Sometimes a collaborative effort is necessary where several healthcare professionals may consult each other to best resolve your issue. All of this can be quite confusing to the lay person who just wants to get well as quickly as possible. I would like to assure you that we will do our utmost to steer you in the right direction.
Physiotherapy is excellent in addition to proper chiropratic care and in most instances will not interfere with the chiropractic treatments, and under proper conditions, can be an asset and welcomed by the chiropractor to achieve functional goals. Chiropractors who do physiotherapy, do so as an adjuct to their chiropractic care. Don't be misled by a therapist who tells you that they can do chiropractic. If one states that they can; they have a serious misunderstanding about chiropractic care. A good physiotherapist will communicate with the chiropractor and will seek input into treatment protocols and Dr. Bickert welcomes their calls, inquiry and suggestions.
A kinesiologist is not a diagnostician, but can assist in the rehabilitation of a client to increase function by working with muscle leverage, tone and balance mechanisms. They work well with atheletes in training to increase efficiency of movement and performance.
Many massage therapists work with chiropractors. Massage therapists help treat muscular problems. Most concentrate on therapy, but you can find some who will do relaxation massages as well. Muscle spasms are often the secondary to underlying problems that can be solved by a chiropractor. Amassage is often a welcome addition to chiropractic care and most massage therapists are very concerned with helping patients get well and work very hard in an attempt to do so. Massage therapists are not diagnosticians. Do not expect them to read x-rays, diagnose and treat disease. Massage can have a tremendous benefit in increasing function and when used properly can help in a chiropractic functional neurology protocol, but make certain if you are being treated for a neuological condition that the massage therapist is properly directed to follow proper stimulation patterns that help and not hinder recovery. Overall, they are excellent at relaxing aching muscles and some spasms that are a component of the subluxation complex. When a patient receives a massage prior to a chiropractic adjustment, it can help the patient relax and ready them to for their adjustment.
An example of why it is best to consult a chiropractor and not be confused about the type of care best suited for your condition. A woman was referred to the clinic for massage by her medical doctor for low back pain that radiated to her thigh, knee and leg. She underwent several massages, but her pain continued to worsen. Not faulting the massage therapist who was treating her well. But I noticed her, in tears, sitting in the waiting room with her husband. She was crying from the pain and absolute frustration. I approached the two and asked if I could help. She was very emotional and in a great deal of pain. I asked if I could examine her. She agreed. After a detailed examination, I informed her that the condition would never be resolved by massage alone; only through chiropractic care could she hope for a resolution. I could see a renewed sense of hope as she agreed to undergo our outlined care for a spinal disc lesion. The problem was effectively treated through chiropractic care. I wondered to myself, how long she might have endured the severe suffering without having necessary care. She is very grateful and many of her family and friends have sought care. There are thousands of similar conditions in which people are suffering like her, not knowing that relief is available.
Acupuncture is one of several traditional Chinese approaches to health and pain relief. Acupuncturists insert needles through the skin with the intended goal to produce a change in the flow of energy they call qi (also chi or ch'i) that they theorize flows along meridians and through various acupuncture points. They believe qi forms the active principle of the living body. They map map these meridians in the body and attempt to stimulate these energy patterns with needles (sometimes using pressure points) with the goal of influencing healing.
Dr. Bickert does not practice acupuncture.
The brain and spinal cord contain the central processing units for the body called the Central Nervous System (CNS). The brain is housed in a protective bony environment of the skull and the spinal cord is also contained in a protective boney casing called the spine. The spine is made up of individual bone segments, each called a vertebra (pl. vertebrae). Each vertebra with is separated by a cushion called a disc and each pivots on top of the boney segment below it using the disc as a cushion and pivot point . Between the two vertebrae separated by the disc at the posterior portion of the disc runs a spinal nerve that exits from the spine and spinal cord to control target tissue. The spinal cord is a part of the central nervous system and connects to the midbrain and brain by means of ascending and descending pathways that act like telecommunications conduits. The spinal cord descends from the brain through a large hole at the base of the skull called the foramen magnum.
Most people do not need to be told the importance of the brain and spinal cord. The central nervous system includes the brain, cerebellum, midbrain and spinal cord. It is a control system for the entire body, including all systems that help the individual maintain life and function. Nerve pathways form a vital role in governing tissue response, organ function and ultimately the health of the individual. The brain and spinal cord communicate by receiving and sending transmissions throughout the body; whether directly through nerve transmission, or indirectly by means of nerve stimulation of glands to release chemical messengers, called hormones.
Nerves, made up of nerve cells called neurons, transmit electrochemical signals from one nerve to the next and eventually reach and stimulate target tissue. Messanges sent from the brain, mid brain, and down the spinal cord will eventually connect with spinal nerves that exit the boney spinal colum form what is called peripheral nerves. These peripheral nerves send and receive messages of target tissues which most are in turn sent back to the CNS.
The brain contains a network of billions of neurons that receive messages from the spinal cord and transmit these messages simultaneously to various parts of the brain which coordinate, inhibit, and excite other neurons ultimately responding and sometimes sending additional message back down into the spinal cord to stimulate organs, muscles and tissues. If the message is not sent, or interfered with in some way, the result may be devastating to the wellbeing of the organism leading to improper responses of target tissues, organs and systems.
Degeneration in the brain tissue, whether through a lack of proper stimulation, poor cellular metabolism, insufficient oxygen, or lesions can also cause devastating effects to the health of the individual, as in the case of dementia, stroke or traumatic brain injury.
Traditionally, many have come to believe that chiropractors only work with joints and bones. That is not entirely true. Although, chiropractors are experts in biomechanical problems and resolve them with a high degree of expertise, this does not limit what they can effectively treat. Many people suffer with joints that malfunction, fixate, or become unstable and some people may suffer for years with arthritic conditions that seemingly have no resolution. Some become depressed and discouraged due to severe pain and chiropractors are often their only source of hope. Once diagnosed with arthritis many assume that nothing can be done about it. This is not necessarily the case. Chiropractors treat many patients who have various types of arthritis in various stages. There is hope! More than 50% of Albertans see chiropractors and it is because chiropractors have proven that they are effective in dealing with many biomechanical, neurological and structural issues that arise in patients including some of the most challenging cases of degenerative arthritis. It is true that many types of arthritis cannot be cured and are managed with anti-inflamants and pain relievers, but chiropractors treat and manage many of these conditions successfully reducing the amount of pain and discomfort patients typically suffer with advanced stages of arthritis and subsequently the amount of medication they require is reduced dramatically and sometimes not necessary at all. The chiropractor is very interested in how the structure of the body can influence the nervous system and cause improper responses and pain.
Sometimes patients who have never visited a chiropractor are uncertain whether their condition is best remedied through chiropractic care. Others come to see a chiropractor as a last resort and are ready to seek care even from a provider they know nothing about. Please feel at ease. We will carefully inform you about your condition and will strive to make certain that you understand the steps necessary resolve your complaint and make certain that you are well informed about the method and time required for you to expect a positive result. I believe an informed patient will be more compliant and as a result will have greater success. You are encouraged to get involved in the process of your care and rehabilitation. Don't worry, you don't have to believe in chiropractic for it to work. It is scientific and good results are a normal clinical expectation for all patients.
It is often surprising to many that the primary concern of chiropractors is the nervous system since most often bones and joints seem to be the centre of focus. The spinal nerves exit the spine at all levels and communicate with the various organs and tissues of the body to orchestrate and coordinate functions of the body. Each nerve that exits the spine can be interfered with through compressive forces that originate from tissue surrounding the nerve leading to a fixation, nerve interference and disfunction in the spinal joint the chiropractor calls a vertebral subluxation. Although the bone does not usually compress the nerve directly; the components of the joint will swell and cause shortening and thickening of ligaments within the joint resulting in possible muscle spasm, joint fixation, vascular changes and nerve pinching. The pinching is often felt as pain, or a change in sensation around the joint, however not every subluxation results in pain. Some subluxations are not felt and as a result may cause internal organ and tissue responses that may go unnoticed for years and eventually are realized by compromises in organ and tissue response. Nerves from the spinal cord send messages to glands that control the release of hormones, the function of the kidney, stomach, heart, lungs, joints, muscles and even the movement of the small toe. The nervous system is the force behind movement, digestion, circulatory system and respiration just to name a few. If the nervous system shuts down; the organism dies.
When Dr. Bickert uses the term Vertebral Subluxation, he is referring to a complex mechanism. An imperfect simple definition for this condition will be suitable as a model. A subluxation is the misalignment of spinal segments that results in nerve interference and a loss of normal function. Note that the definition contains important elements. Misalignment, nerve, interference and loss of normal function are keys to understanding what is taking place. The nerve interference may cause problems in the motor (muscle), sensory and even autonomic (control of organs and vascular tissue) nervous systems. This in turn may return incorrect stimulus back into the central nervous system that can cause a huge impact on the health of the individual.
The World Health Organization accepts the chiropractic term Vertebral Subluxation. It defines the Vertebral Subluxation Complex as: "A lesion or dysfunction in a joint or motion segment in which alignment, movement integrity and/or physiological function are altered, although contact between joint surfaces remains intact. It is essentially a functional entity, which may influence biomechanical and neural integrity."
If someone tells you that they will do a general mobilization of bones to fix you, then they are misleading you. That is not chiropractic. Chiropractic is specific and doctors of chiropractic use many diagnostic procedures to arrive at a specific diagnosis, make corrective changes in the body, and suggest a treatment plan that may or may not include adjustments of joints. Manipulation may be contraindicated and injurious to your condition and ONLY A CHIROPRACTOR is qualified to make that decision. If an adjustment is performed, it should be SPECIFIC and not a generalized manipulation, or mobilization. The goal of an adjustment is to remove nerve interference and the root cause of your problem. Subluxations that are not corrected will eventually result in degeneration of the joint, a loss of function and possibly be a health risk.
The motor system gives rise to movement and the targeted tissues of this division are the muscles. When interfered with, the motor division can cause muscle weakness, fatigue, atrophy, and spasms depending on the severity of the interference, part of nerve compressed, length of time the interference has been persisting and severity of the pinching. The sensory nervous system inputs sensation into the central nervous system and when pinched can cause a decrease or loss of sensation, numbness, pain, or other unusual sensations like tingling, fatigue, burning sensation, crawly feelings, itch, pressure and the like. These unusual sensations, often referred to as paresthesia, are a consequence of a wide range of conditions depending on the type, location, interval, and length of time the nerve interference has been occurring. The chiropractor must also look to other causes of pain and paresthesia because many tissues and organs can mimic sensory pain and really be the result of disease or referred pain from organs not in the immediate vacinity of the pain.
In 2004 the University of National Health Sciences in Lombard Illinois fused the spine of laboratory rats in order to see the outcome of fixated joints and a loss of mobility to these joints. They found after fusing the spinal joints surgically, it caused significant degeneration in a relatively short period of time when compared to healthy mobile spinal joints. Many questions have to be asked; why did the fixation of the motion segments of the spine cause premature degeneration? Would not regular chiropractic adjustments of fixated joints in the spine reduce the chances of early degeneration? The Autonomic Nervous System sends messages from the brain, brain stem, and spinal cord along the various spinal pathways out through nerves that may also as get pinched in the same manner as motor and sensory nerves.
Autonomic Nervous System interference may cause inappropriate responses to occur in target tissues and organs eventually causing these organs and tissues to lose normal function. Would interference of an autonomic nerve produce inappropriate responses leading to organ and tissue damage? An example of this could be in the case of interference to an important nerve responsible for gastric motility which may cause digestive problems and poor gastric responses.
Some who do not support the definition of Vertebral Subluxation argue that it is hard to prove. Yes it is. It is continuing to be researched and the research supports the subluxation model. However direct impingement on a nerve by the bone in most instances is unlikely; the response of tissues to a subluxation can be accurately observed, measured and documented. Research continues to show that the subluxation model is supportable and a good analogy to describe the phenomena. Chiropractors study for years and are in most cases the best health professionals to diagnose and treat the spine. The outcome of adjustments and chiropractic treatment is remarkable. So for now, we’ll just say that the above definition of vertebral subluxation is simplified to express a demonstrable construct that chiropractors have used for years. The problem with the definition is that many in the past assumed that the bone impinges directly on the nerve root. As we have said, that simply isn’t the case in most instances. The vertebral subluxation complex involves many components including; bone, discs and supporting ligaments, mechanoreceptors, muscles, tendons, vascular and tissue response that result in; swelling, ligament shortening and thickening, swollen tissue such as blood vessels and surrounding tissue, lymphatic tissue, shunt muscle responses, supporting muscles, and the disc that can produce pressure on nerves and surrounding tissue. The body senses the impingement and interprets it to be injury and quickly attempts resolution. However the attempted resolution of the body may not be appropriate. The impingement will fixate the joint, cause swelling, pain, muscle spasm and if left unresolved will cause reduction of nerve impulses, muscle weakness and loss of function in the target tissue and eventually, degeneration and arthritis.
There is no such thing as a “slipped disc”. Discs simply do not slip without fracturing the end plates of the vertebrae. Each boney segment of the spine called vertebra are separated by a cushion called the disc. In the centre of the disc is a nucleus that acts as a pivot to allow movement between the two vertebrae that are separated by the disc. The disc consists of ringlike annular fibers called the annulus fibrosus that are similar in consistancy to ligaments and are very strong. These fibers crisscross in a pattern to strengthen the discs stucture. Vertebrae pivot over each other on the disc allowing the spine to bend, extend and rotate. The cushioning effect of the disc is very important. The centre of the disc acts much like a ball bearing to allow the vertebra to pivot on top over the one below much like a tennis ball would placed under a plate. This allows spinal movement and flexibility. One important difference. The centre nucleus is not solid. If you can imagine a jelly doughnut you might be able to visualize the mechanisim of cushioning and the role of the center of the disc. Forces that act on the disc in bending and extension of the spine put loads on the disc and the nucleus is forced in the opposite direction of the load.
The disc is composed of appoximately 90% water. Often, as we age, it dehydrates, that is it’s water component reduces. A dehydrated disc can develop hairlike cracks across the ringlike fibers and the centre nucleus can extrude through these cracks and work it’s way near the edge of the disc. If the nucleus moves close to the side of the disc, the disc can bulge. A disc bulge can become larger and strike the nerve passing in the vacinity of the disc. A large bulge can become a protrusion and is more serious than a bulge. It may, or may not cause pain, that is it may be symtomatic or asymptomatic. Many people have disc protrusions and do not notice them because the disc is not pressing against any nerve fiber and as a result is asymptomatic. If the protrusion grows, it can become a herniation. A herniation can cause severe symptoms. So severe that the patient to not be able to support themselves on their feet. Even cause a loss of bowel and bladder control may result from a severely herniated disc. Dr. Bickert has treated patients with all three of these conditions, but if you wait until you lose bowel and bladder control then the only answer is surgical intervention; in this case you will be referred to an appropriate surgeon.
For many years it was believed that brain function was confined to specific areas of the brain and mapping was done as responses were measured when stimulated with probes during surgery. A lesion in a specifically mapped area would cause dysfunction manifested by conditions relating to the brain map, and only in the rare instances of children, would the brain function related to the lesion be restored. The advent and increased use of new imaging technologies which demonstrate more accurately brain function has changed this view dramatically. Now neuroscientists have discovered that neurons and brain pathways can, and do change, even in adults. The brain functions not in one area but through coordinated pathways communicating throughout the brain. Some pathways stimulate and produce responses that terminate in other centers. Other pathways inhibit and cause a reduction in responses at the same center depending on the outcome desired. Various brain pathways are coordinated, stimulated, inhibited or assisted by other areas of the brain working together to provide a coordinated response. This is exciting news and sheds new hope on treating many conditions that were once thought to be unresolvable. The new techniques used to treat these conditions have resulted in tremendous success and have been described by the media as nothing short of miraculous.
Professor Ted Carrick, chiropractic neurologist of the Carrick Institute and founder of the Brain Center was interviewed by ABC Nightline. The interviewer asks, “Is this a miracle cure?” Dr. Carrick responds, “...I think miracles are things that happen only once in a while. What we find is that the ‘miracles’ we see, we’re seeing them frequently; every day...” Dr. Bickert works using many of the techniques taught by Dr. Carrick. He has also taken patients directly to see Dr. Carrick for additional treatment.
The ability of the brain to make changes in neuron transmission and brain pathways is called neuroplasticity, or brain plasticity. It is now accepted that neuroplasticity and brain plasticity can, in many instances, be restored when lost due to lesions and brain and neural dysfunction. The brain can find new pathways around damaged tissue even in the adult. Dr. Bickert has seen dramatic changes in patients in a relatively short period of time when treatments have been directed at returning function to the areas of the brain by targeting OTHER areas that are related to the damaged pathway to elicit changes in affected tissue and neuropathways.
Commonly in a chiropractic office we hear, “I thought it would go away.” This is after the patient has suffered for weeks, months and even years. Dr. Bickert is especially amused when he greets a new patient ready to be examined, who sits with arms folded and states, “I don’t believe in chiropractic; my wife made me come.” Dr. Bickert will remind the patient that chiropractic is not faith healing, you don’t have to believe in it to have it work for you. It is scientific. He recalls an incident of a female military flight surgeon who frequently referred patients. Her clinic staff were seeing Dr. Bickert and these patients told him that the flight surgeon was having terrible back problems, but did not want to give approbation to chiropractic by seeing Dr. Bickert. Dr. Bickert told her employees to go back and tell the surgeon to call him; he would let her in the back door. She called, made and appointment with Dr. Bickert; and not surprisingly came in the front door. She was amazed and had tremendous results. She opened the door to many in the military on base to being treated by Dr. Bickert.