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from chiropractic to physiatry

a journey towards biomechanical health

This is an article I wrote about my experience with Dr. Stefaan Vossen of Core Clinics

I first came to Stefaan in early 2012, after having him highly recommended by another practitioner who had helped me. Now, about a year and a half later, I can say that Stefaan has quite simply changed my life. Not only has he enabled me to continue to have one of my great passions, Tai Chi, in my life; but he has also changed a biomechanical path that I was on that was already starting (at the age of 30) to cause me some discomfort in my lower back, neck, hips, and knees. Had I not got this altered with Stefaan’s help, it would have continued to worsen as I continued in to later life, causing increasing pain and worsening mobility.


Over the past number of years, I think it is fair to say I have been on quite a journey in the realm of biomechanics; seeking practitioners who could help me with a number of, what I thought were, separate issues. All counted, as well as seeing some highly regarded physiotherapists, podiatrists, and deep tissue body-workers, I have seen around eight chiropractors in countries ranging from Australia and Brazil, to the UK, Spain, and Hungary. While some practitioners impressed me more than others, I had not found somebody who could fundamentally change things for me. In Stefaan I have found just that. While originally trained in chiropractic, Stefaan has left this field and started his own, termed ‘physiatry’, with the aim of setting a new standard in the practice of biomechanical healthcare. I have written this piece to give some idea of my story, and to try to put into words, from the perspective of a non-specialist, what is so different and special about Stefaan.


The first time I saw a chiropractor was in 2005 in Australia. He was offering a free assessment and first session which was sufficient to pique my interest, although I had no conscious symptoms at that time. I was only passing through, so had just a couple of sessions with him, but I was sufficiently impressed by the diagnosis and treatment that I went away with a basically positive impression of chiropractic.  


Therefore a couple of years later when I developed pain in my right hip / lower back, my first instinct was to get treatment from a chiropractor. The practitioner I saw at this time diagnosed me with the same issue as the one in Australia had, namely that my right hip was rolled back, but now it had got the point where it was causing irritation and pain in my sacroiliac joint. I went through a course of treatment that involved adjustments to the position of my hips, as well as a quite rigorous regime of core muscle exercises to try to keep the hips in their correct position. While I was relieved to have some form of management for my symptoms, I was not looking forward to having to spend the rest of my life getting regular treatment and spending 45 minutes every day doing these exercises.


Thankfully a year or so later I met a podiatrist who diagnosed me with an anatomical leg length discrepancy; that being that my left leg is physically a few millimetres shorter than my right leg. The chiropractors I had seen up to this point, as well as the ones I would see later on, had diagnosed me with a functional leg length discrepancy, meaning that the misalignment of my hips was causing my legs to seem like they were different lengths. This podiatrist was saying it was the other way around, that my right leg being longer was physically pushing my hips out of alignment. He prescribed me some orthotic insoles to correct for this leg length discrepancy, and also to correct the way my feet contact with the floor during walking, as my feet are slightly over-pronated, meaning that they turn out slightly and that the arches are a bit flat.


Using the orthotic insoles helped a great deal with my hip problem. I no longer had to do the exercises, and was no longer in pain. However, I still occasionally got symptoms if I spent too much time sitting. Also, although the orthotics seemed to be helping my problematic hip, the one on the other side started to get very tight and tense. So while they helped a great deal, and were a vast improvement on my previous situation, I still had the feeling that there was more going on and that they were not the whole answer.


A couple of years later, I started to feel that my neck was very stiff and quite painful at times. I don’t think this was a sudden occurrence, rather I think it had been building for a long time to the point where I really started to notice it. Finally in the last year or so before meeting Stefaan, I was also noticing tightness and pain in my lower back. I had also observed that my spine had a slight twist to it, which I assumed was just the way I had grown, and was now irreversible. Indeed, a couple of the practitioners I have seen commented on it in this context. Throughout this whole period I also had ongoing knee issues which prevented me from practising Tai Chi.


During this time I had continued to see chiropractors when my symptoms were worse, which was often in times of heightened stress. While I didn't go through a full course of treatment with all of them, I saw enough of each of them to say that they all had something in common. All were basically treating each issue and part of the body as isolated. My neck was painful and had poor mobility, so they would adjust the vertebrae there to loosen them. My hips were misaligned, so they would be adjusted to try and get them back to better alignment. For my knee problems, which had been diagnosed as patella femoral pain, I was given specific and isolated exercises and stretches to try and pull the knees back into optimal alignment.


And I as a patient didn’t know any better, or that there might be something deeper and more holistic going on. So to be honest, over that period of time, I felt that I had pretty good results from the practitioners I saw. I wouldn't have continued to go to them otherwise. I had symptomatic relief from the pain in my hips and neck, although no improvement in my knees. I was pretty much resigned to the fact that my body had simply grown slightly out of alignment, and this had caused my knees to be misaligned, but that there was nothing that could now be done about it. I was glad to be able to get symptomatic relief, but couldn’t see much likelihood of getting fundamental changes to the issues I had. Then I met Stefaan. 


All the previous practitioners I saw seemed to basically take the approach of ‘loosening’ stiff vertebrae, but without any real insight into why that particular vertebra was stiff. As far as I have understood, the way Stefaan works, rather than treating each vertebra as a separate entity, or even the whole spine as isolated, is to take the whole musculoskeletal system and put it through a process of re-education. Or perhaps de-education would be even more accurate.


Over the course of a lifetime, most of us have established unconscious chronic holding patterns of muscular tension, that stop our bodies functioning in their natural and most efficient manner. These can also be exacerbated by injuries and other traumatic events. These subtle muscular tensions can pull the body out of its optimal alignment, to the extent that, in my case, my spine was slightly twisted, my hips were misaligned, and as a result my thigh bones where overly rotated inwards causing the knee joints to be out of alignment.


Stefaan seems to have an understanding of how all aspects of biomechanical functioning relate to each other on a level that is far beyond anyone else I’ve come across. It appears like he is doing the same things that other chiropractors do. He adjusts my hips, he adjusts my mid-spine, and he adjusts my neck; as well as prodding at seemingly random bits of tense muscle fibre anywhere from my abdomen, to the back of my knee. But the results are totally different. Because of the depth of his understanding, these adjustments are not isolated from one another; they are intimately linked, in a way that means he is re-training my whole body musculature to carry itself in a different, more natural and relaxed way. As he describes it, he is using my body as a keyboard to have a conversation with my unconscious mind, persuading it to let go of its habitual patterns and allow the body to come to a more natural and neutral position. 


So in me all the different aspects that others had been treating as isolated problems were actually part of one global holding pattern. The places of pain and lack of mobility, not the unexplained cause of the problem, rather the symptomatic result of the whole body being slightly twisted. What Stefaan has the ability to do is follow the biomechanical pathway that leads from these symptomatic places, back all the way to the underlying causes. So, in stark contrast to the other practitioners I’ve seen, he never adjusts the most rigid vertebrae, as he knows that this rigidity and tension is in fact a protection mechanism of the body. But by coaxing the body back towards its most natural alignment, the body can let go of these nexuses of tension itself.


So over the course of six months of treatment with him, my neck and lower back stopped hurting, my hips became aligned, my spine straightened (yes, the curve in my spine actually went away!), and my thigh bones rotated out so my knees were functioning in a better way. It’s worth mentioning that Stefaan also diagnosed me with both an anatomical and a functional leg length discrepancy. He has been able to correct for the functional aspect by getting my hips aligned correctly, but I continue to wear the orthotic insoles which correct for the anatomical aspect, as well as for the over-pronation of my feet.


From speaking with Stefaan, I understood that my issues were quite ‘old’, meaning that they were patterns I’d been holding probably since my childhood. Therefore I needed to see him twice a week at first, which reduced to once a week after a month or so. Then it dropped to every two weeks, then every month. At the time of writing, about 18 months after my initial visit, I am seeing him every two months, and I understand this will eventually drop to 3-4 times a year.


Now that I have no symptoms, I could of course finish treatment with him. However, my understanding is that with all of life’s stresses and strains, the body will always be ‘pulled back’, to start to slip into bad habits again, which will eventually result in problems. So as a maintenance measure, to continue to visit Stefaan a few times a year is a no-brainer for me. Again, this compares with other practitioners whose views on what ‘maintenance’ would require varied from once per week to once per month. I think because Stefaan helps the body get to a more optimal and neutral place, much less intervention is needed to maintain that, because it is where the body naturally wants to be.


Stefaan may be unique, but he only has two hands and limited time, so eventually he will not be able to keep up with the demand for his services. Thankfully another thing that sets him apart is that he is in the process of systematising his approach, and making it teachable to others. I can only hope that over the coming years, Stefaan is able to spread his understanding and method until it becomes the standard. It is hard to imagine how much individual pain and suffering, as well as money, could be saved if everyone went through a course of treatment, and then a maintenance program, with a good physiatrist. In conclusion I would simply like to encourage anybody who is unsure to take the jump and visit Stefaan, or one of his physiatrists. It is absolutely 100% worth the money, and also the inconvenience of the travel, because the results are quite simply spectacular.

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