Chiropractic biophysics helps Lars Eric Larson, DC, improve patients’ posture

For Lars Eric Larson, DC, chiropractic is a corrective method aimed at improving posture and, with it, the overall health of a patient. The Burlington, Vt-based chiropractor has built his entire practice, Discover Chiropractic and Wellness Center, on the use of chiropractic biophysics (CBP), a technique used to correct the curvature of the spine as opposed to simply adjusting it.

Larson says the method—developed in 1980 by Donald Harrison, PhD, DC, MSE; Deanne Harrison; and Daniel Murphy—is a bit different than the more conventional approach. “The goal [with CBP] is to correct posture, and to create a change that’s visible and measurable,” he says. “You can show a patient that their spine is out of alignment with their x-ray.”

Larson discovered CBP at Life Chiropractic College. It was a technique that resonated with him. “After studying it, [the technique] made so much sense to me,” he says. “Many chiropractors don’t take posture into account enough. [With CBP], I have seen patients’ health skyrocket.”

Building an entire practice with a method that, at first glance, seems to be highly specialized may seem risky, but Larson says that about 90% of patients who come through his door have some level of posture distortion. And not all of these distortions are indicated by pain. In some cases, patients may not even know that they have poor posture until Larson examines them. In other cases, those in pain may think the cause is related to an injury, but it is actually caused by poor posture.

No matter the cause, Larson uses CBP to evaluate patients and develop a plan of care to get them standing straight again (or for the first time).

By Degree
Larson sees several species of poor posture every day. These include lateral flexions; translations; and rotations of the head, torso, and pelvis in relation to one another. During the initial visit, Larson examines the patient from foot to head and sees how the patient’s feet align with the pelvis; how the pelvis aligns with the shoulders; and how the shoulders align with the head. If the patient has good posture, then each of these parts of the body will form a straight line from the feet to the head when looking from a lateral view. “The first thing I do is make patients aware of their poor posture,” Larson says. “When you have awareness, then you can correct it.”

The first visit also includes x-rays and possibly an adjustment. When the patient returns for the follow-up visit, Larson reviews the x-rays with him. Larson then draws on the x-ray with black and red pencils—the black showing how the patient’s spine should curve and the red showing how it is actually curving, noting the degrees of separation between them. This separation forms the basis of the treatment goals. He also uses x-rays of patients with a normal spine in comparison to the new patient’s as another way to illustrate the severity of the new patient’s posture problem.

Each patient is reassessed after every 12 visits and is re-x-rayed periodically. With the new x-rays, Larson draws another set of lines and measures the degree of correction, giving the patient and himself a benchmark of progress.

Depending on the severity of the patient’s posture distortion, treatment can last between 3 to 12 months. Larson says there is no “typical” treatment plan, but, using the maximum 12-month cycle as a model, the patient will come into the office three times per week for 3 months, then two times per week for 2 months, then one time per week for 6 months. At the end of the 12-month cycle, the patient will be enrolled in a wellness program.

Though the adjustment is an integral part of correcting posture and spinal curves, two other elements are necessary as well: traction and exercises.

Mirror, Mirror
The adjustment typically requires a drop table and is performed in the mirror image of the posture distortion. The adjustment helps alter the position of the spine and improve nerve integrity, but since CBP is corrective, there needs to be a way to cement this alteration. It is for this reason that Larson and other practitioners of the CBP technique use traction. It retrains the spine to be in the new, correct position. “The adjustment is a big one for the spine and nervous system,” Larson says. “And it needs to be followed up with traction and exercise.”

Numerous traction devices are on the market, some more elaborate than others. Larson uses an ambulatory cervical collar for neck- curve changes that the patient uses while in the office.

CBP patients are also given exercises to perform that retrain the spine. These are called “mirror-image” exercises because they have the patients move in the opposite direction of their normal spine position. For instance, a patient who carries his head forward will be given exercises that retrain the head to be held in a more backward—mirrored—position. A typical exercise for this translation is to stand against a wall and use a small ball to do resistive pressure to get the patient’s head into the opposite position.

Exercises are performed during every treatment session, though they are also prescribed for home as well. Larson says the reason for doing the exercises in the office is that he has a better level of control in the office setting. “At home, you may lose some focus,” he says.

Larson does not rely on spreading the message of good posture in his office to those who are already seeking treatment. He is proactive. He heads out into the community to continue getting the word out about posture. And among his primary targets for conversion are children.

Back to School
Larson typically visits local schools twice per year—in the fall at the beginning of the school year and in the winter—to teach students how to carry and pack their backpacks. He admits that many school administrators are typically wary about his visit, but his goal is simply to educate the students, their parents, and teachers about “this self-created, giant health problem,” Larson says.

The first thing Larson does is weigh the backpack and then the child. For an elementary-school-age student, a backpack should weigh no more than 10% of the child. For a high-school-age student, the backpack can weigh up to 15% of the student’s total weight. Though he focuses primarily on the dangers of an overloaded backpack, Larson notes that many students are also overburdened with gym bags and musical instruments.

His seminar covers the basics of backpacks. He encourages the students to wear the pack with both straps, instead of the typical “cool” one-strap way. If the pack has a belt feature, he encourages them to use this as well. He also advises the children, parents, and teachers about how to load the backpack with heavier items and closer to the child’s body.

He encourages the children to bring just what they need to school, advising that they leave any extra toys, books, and other non-school items at home. He also recommends that, when possible, teachers assign homework in the form of lesson plans and that the students not bring home heavy books. No matter the cause of the bad habit, Larson does not point the finger at a single cause. “There is a shared responsibility between the parents, the teachers, and the kids,” he says.

Larson does not sell backpacks in his practice, but he will make recommendations. “There are some good backpacks out there and some that are subpar,” he says.

The school visits are a staple of Larson’s practice, but he has never gotten a patient from a school visit. “They are part of my community outreach.”

He does have pediatric patients, however. These come through parents who are under Larson’s care. “We encourage all families to have their kids come in,” Larson says. “If they do, we’ll check the kids at their first visit for free.” The children are treated in the same way as the adults with the exception that they are not typically x-rayed. Larson explains that younger children do not necessarily need x-rays to fully evaluate their spine and posture.

School visits are not the only way that Larson proactively interfaces with the public. He is a regular fixture at public events.

Posture Talk
Larson sets up “posture booths” at various locations, such as county fairs, health fairs, and private businesses. He has been solicited and has sought inclusion at these events. For instance, he has volunteered for the March of Dimes, and health-fair organizers have contacted him to be an official vendor.

The posture booths include information about Larson’s practice and the correct way to sleep, work, and drive, among other topics. Those who stop by the booth receive a posture evaluation. Larson usually waits for attendees to approach the booth before engaging them. “We’re there, and we will talk with them,” Larson says. “I’ll ask them if they want to have their posture checked, explaining that it only takes 5 minutes.”

Larson also visits the University of Vermont on a regular basis, setting up in a campus recreational room and evaluating the college-age students.

He visits businesses, evaluating workers and their work spaces. He notes that sitting behind a computer is one of the worst things a person can do. That is primarily because it is usually antithetical to good posture with the screen position typically set in a way that causes workers to look down instead of up.

He recommends that sedentary cubicle workers get up every 15 minutes and readjust their positions.

Talking about posture has been good for business in another way. It is an accessible topic, Larson says. “People understand this—they get posture—and it’s a good way to break the ice with potential new patients,” he adds. “I’ll say, ‘look at your posture; it’s terrible,’ and they’ll agree with me.”

But posture is just a component of Larson’s larger view on chiropractic. For him, correcting posture is just the entry point to good health.

Wellness Focus
Like most chiropractors, Larson sees chiropractic as a wellness practice. He says that he breaks down wellness into two broad categories—nutrition and motion, or remaining flexible throughout one’s life.

His use of CBP is aimed at keeping patients physically active and not in pain, but he notes that other problems are associated with poor posture. For instance, a forward-slumping posture can cause numerous health problems, such as compression of the rib cage, which can compromise the heart and lungs.

Larson uses his time with his patients to educate them. He regularly gives in-office talks, covering such topics as power nutrition, “fit while you sit,” stress, carpal tunnel, and proper lifting techniques.

C.A. Wolski is a contributing writer for Chiropractic Products.