Nathan’s Background


• Nathan Boon is a graduate of the University of Waterloo where he achieved his Bachelor's degree in Honours Kinesiology. During University, Nathan was not only a Men’s’ Varsity basketball player but also worked as a strength and conditioning coach for the Men’s Varsity basketball team. After graduating, Nathan continued his education at the Canadian Memorial Chiropractic College where he obtained his Doctor of Chiropractic degree. He is currently a Strength and conditioning coach at the Baseball Development Group in Scarborough, Ontario and is further continuing his education this coming fall where he will be starting a Masters of Biomechanics at the University of Calgary and entering the RCCSS(C) Residency program.
What is Chiropractic Medicine


• Taught to be Neuromusculoskeletal specialists and act as primary health care practitioners (first entry point into healthcare system).
• This requires a Chiropractic Doctor to have the ability to assess for redflags and be equipped with the knowledge to know if a patient is right to treat or needs to be referred out.
• Their emphasis is on the larger structural components of the body, focusing on the Nervous system and Musculoskeletal system while still acknowledging each tissue and system within diagnosis and treatment.
• They utilize Clinical experience, Evidence in research and Patient preferences in choosing the best course of treatment.
Changes in Chiropractic Medicine


• Chiropractic medicine historically has always been manual based.
• There has been a recent change into more active approaches to treatment and patient management.
• Education and exercise are main pillars in the new paradigm.
• There are more tools and skills being taught to allow the practitioner to fill the needs of the patient.
Generalist over Specialist


• The body is a dynamic and adaptive complex system that relies on all tissues, organs, and structures to maintain homeostatic and self regulating systems.
• It is difficult to look at the body under a narrow lens due to the fact that everything is connected.
• Having a generalist and holistic understanding and approach to the patient allows a practitioner to better assess and treat because the issues that arise are always all encompassing.
Nathan’s Current Approach to Assessment and Treatment


• Identifying if the patient is in the right place via red flag testing or if they need to be referred out.
• Next, doing an extensive patient history (80% or more of the diagnosis through patient history). Past history, daily activities, recent changes in function, experience with the complaint, anything that may tie into what's going on.
• Nathan likes to spend time on his “ICE” questions; ideas, conceptions and expectations of the patient. Meaning what does the patient think is going on, what they think they may need as well as their expectations of the practitioner.
• Lastly, a physical exam
• This information allows Nathan to see where the patient is now and where they want to be and develops a treatment protocol that fits their goals.
• He also stays on top of reassessment to see what issues continually pop up, how the patient responds to stimuli as well as the KPIs that are inlined with the goals of the patient.
The Key Lesion Ideology


• Within the dysfunction we see and experience in the human body there is an ideology that this may stem from a singular cause and manifest itself focally to locally to globally within the tissues and systems of the body.
• Nathan believes that due to the extreme complexity of the human body and the vast amounts of stimuli an individual experiences daily from movement, to nutrition, to sleep to stress and relationships, that this may be an oversimplification of the problems at hand.
• It is important to take a global look at the human body and the stimuli it faces so that you may improve global problems first.
• At the end of the day it is the body that does the healing, not the practitioner. The practitioner's responsibility is to create a context which allows for positive adaptations towards the intended target.
Motor vs Sensory Changes


• In the loop of the nervous system, we have sensory nerves collecting sensory information and motor nerves driving motion.
• The sensory information the Central Nervous System collects dictates the motor supply and the motions allowed (in all tissues). At the same time, the sensory nerves require motion to be able to pick up the information they need. This loop is intimately connected
• With that being said, there are two ways we can create adaptation, improve motion and improve the body's function. We can increase stimuli to encourage an adaptation on the motor end, or decrease stimuli to create a change on the sensory end.
• They both inherently impact each other. It is important to know when to use each approach. Greg Lehman has a phrase “you need to calm things down and then build them back up”.
• It is important to create a differential diagnosis to see if the problem is being dictated from the motor or sensory end, because if it is from the sensory side and we create motor adaptation we may be adding to the complexity of the compensation pattern.
• It always depends because it comes down to the patient in front of you.
The Complexities of Pain


• Due to central sensitization, seeding, sprouting and other psychosomatic mechanisms, pain can be evident in subjective findings but the structures themselves have no more damage.
• It is important to approach a patient with pain with caution utilizing exploratory active movements so they may dictate the ranges of motion and still allow for changes in sensory input.
• It is also important to understand that its true complexity is not understood. The practitioner must be humble and avoid arrogance in their understanding of the changes that they have made vs mother nature.
The Principle of Motion


• Motion is inherent in living organisms. Motion is required for all aspects of life and health.
• A loss of motion is a loss of lifeforce.
• Motion is an undeniable truth and principle that all practitioners may lean on to improve patient outcomes.
Nathan’s Advice for Young Practitioners


• Finding Mentors who you like and trust who can guide you with their experience.
• One of the toughest parts of being a young practitioner is lacking clinical experience. Finding someone who has been in the game a long time, has learned many lessons themselves and has the capability to show you how to interact with people is priceless.
• Be as coachable and passionate as you can. People are not looking to hire highly educated individuals, they are looking for individuals who are willing to learn, change and grow. Developing good interpersonal skills is crucial in this field.
• Be a good person, who is willing to listen.