CHIROPRACTIC - TREATMENT OPTIONS
Dr. Christa Mallay BA, DC &
Dr. Jeff Marshall BScKin, DC, CSCS
Chiropractic Spinal Manipulations are probably the most recognized and used technique of chiropractors which is usually what separates Chiropractors from other health professionals. It is a technique where a joint is brought to its end range and then a very small, quick movement is directed to further move the joint. This allows the joint capsule and surrounding tissues to be stretched allowing for a greater range in motion. As well, this quick thrust creates a neurophysiological effect to the surrounding area to help reset and relax the muscles in the area leading to improved motion, decreased tension, and decrease stiffness. This quick thrust has been shown to be the key mechanism in producing the overall feeling of decreased tension, decreased stiffness, and decreased pain immediately following the manipulation.
What is that "cracking" sound? Chiropractic Spinal Manipulations may or may not create a “cracking” sound heard when a joint is manipulated. It is the same sound that is heard when someone "cracks" their knuckles, their back, their hip, their foot, etc. The joints in your body are pressurized and contain fluid with dissolved gases, and when the joint is gapped, these gases are rapidly released out of the fluid. A common example is opening a champagne bottle or pop bottle. Both are pressurized and when opened, release gases creating the popping sound. Within 20-30 minutes, the gases go back into the fluid.
Chiropractic Mobilizations are gentle techniques, and can be used in addition to or alternatively to manipulations that take a joint to their end range of motions and give a small rhythmic stretch to the joints of the spine. This helps to stretch the joint capsule to do numerous things. First, to allow a greater and easier range of motion of the joint, second to help flush out and remove any fluids which have built up within the joint (ie, inflammatory chemicals causing swelling and pain), and thirdly to decrease the amount of tension or compression through the joint which may be putting an aberrant amount of force through the structures of the joint or surrounding tissues.
Myofascial release is a soft-tissue massage based technique that treats problems with muscles, tendons, ligamnets, fascia, and nerves. Myofascial release is extremly useful in treating conditions which involve overuse of muscles.
Overused muscles change in three important ways:
1. Acute Injury (Pulls, Tears, etc.)
2. Build up of Small Injuries (micro-trauma)
3. Not Getting Enough Oxygen (hypoxia)
Each of these factors can cause your body to produce tough, dense scar tissue in the affected area. This scar tissue binds up and ties down tissues that need to move freely. As scar tissue builds up, muscles become shorter and weaker. Increased tension on tendons can cause tendonitis, and nerves can become irritated. This can cause reduced range of motion, loss of strength, and pain. If a nerve is trapped you may also feel tingling, numbness, and weakness.
Myofascial release is used to break down this scar tissue to restore the proper function of injures soft tissue.
Extremity Joint Manipulation/Mobilization
Manipulations and Mobilizations are used to affect the joints of the upper and lower limbs to maintain your joints range of motion and flexibility. The range of motion of these joints can become reduced due to scar tissue buildup, capsular contractions, muscular contractions or spasms, arthritis, etc.
Conditions such as plantar fasciosis and hip osteoarthritis usually involve joints which have become stiff and have lost a certain degree of movement causing altered movement patterns leading to tissue injury and pain. These manipulations and mobilizations allow for an increased range of motion though these joints and allow improved shock absorption (in the case of plantar fasciosis), improved flexibility, and overall improved function.
Rehabilitation exercises are an important aspect of any treatment. Rehabilitation is used regain lost strength, flexibility, balance, etc. These are either done during treatment or given as exercises to do at home. These exercises help to restore previous function and help retrain proper muscle firing patterns.
A common example is a recurrent inversion ankle sprain, where someone keeps "rolling over on the outside of their ankle". Because of the first or subsequent ankle sprains a person sustains, the muscles that help to stop your ankle from "rolling over" might be weak, or might turn on too late if the original injury is not rehabbed properly. The ligaments of the ankle will probably not be as strong and you might have increased motion in the ankle. This leads to the ankle losing its ability to know exactly what position it is in (called proprioception).
Most therapists stop treatment once the ankle is pain free and the swelling has reduced and most people think the ankle has healed, which usually is not the case. Ligaments can take up to 6 months to fully heal and reorganize to proper strength. If you do not rehab the ankle properly with specific exercises (ie., targeting the weak muscles, stretching the tight muscles, and balance or proprioceptive exercises), then the chances of re-injury are greatly increased.