Barrett L. Dorko, P.T.

          I understand that in Japan there are 200 seismographic reporting stations continuously monitoring and analyzing the earth's activity. In January 1995 they told the people of Kobe: "Hey, you guys just had a major earthquake." And the people of Kobe responded from beneath the rubble: "No kidding?"

          Often a patient will recount the visit to the doctor that preceded coming to see me. "He examined me very thoroughly, poked all around my spine, checked my reflexes, and asked a lot of questions. Then he told me I had a backache."

          I know that preventive care is a popular and logical way to use our current medical knowledge. Studies have long shown that certain behaviors help us withstand future stresses on our body or retard the growth of unhealthy processes. But the distinction between prevention and prediction becomes obvious in a situation like the one in Japan.

          All of the effort put into building things that could theoretically withstand the stresses of internal disruption and all the monitoring of activity beneath the surface did not help to predict when some significant change would occur. This is as true of our bodies as it is of the earth beneath us.

          Nor does prevention necessarily mean we will easily withstand future injury. Illnesses can expose our inherent weaknesses like the earthquake destroyed entirely the wooden houses of Kobe. Each of us has vulnerable parts that are unique to our lives and impossible to strengthen or constantly protect. Achilles remained vulnerable at his heel because that is where his mother continued to hold him (read the story) and there was no escaping that.

          Can we predict a future backache? Well, a recent study by Newton and Waddell suggests that even the most sophisticated isokinetic testing has proven unreliable when used in pre- employment screening. Of course, certain manufacturers will take issue with this, but they must be reminded of their vested interest in any evaluation of their product. Newton's analysis of 108 articles, many published by proponents of isokinetic trunk testing, reveals what most researchers know: What we see and report depends partly on what is there and partly on who is looking.

          I wonder what would happen if the people who sold earthquake insurance were also in charge of interpreting seismographs? Something tells me the tendency to predict trouble would become more frequent. The postural screening booth I see a local chiropractor set up in the mall might have a similar effect.

          Maybe our attempts at predicting backache are connected to our very human desire to know something about the future. With science, we have accomplished this with eclipses of the sun and the gender of our unborn children. But when it comes to the future of human behavior and our subsequent health, we haven't been as successful. It looks like the earth's future behavior is as much a mystery, and the absolute absence of warning in Japan proved that again.

Selected Reading
Newton M., Waddell G.    Trunk strength testing with iso-machines.
Spine, 1993: 18(7).