Chiropractic Tools
Sometimes an injury or physical problem or dilemma can seem overwhelming. Breaking a physical injury or limitation down into a list of issues you may be experiencing can help you create a strategic plan or solution. For example, if you are having issues with a movement, you can ask yourself if it is a problem with strength, pain, mobility, endurance, coordination, etc. Once you know what exactly is limiting you, then you will know what tools to apply.
The opposite can be said for looking at a set of tools and then really digging into what and how they help. If you hammer a screw, you will be frustrated and never achieve what you are trying to achieve. If you try to screw in a nail, you will also be frustrated, unable to get what you want. Both look pretty similar from a distance but up close you realize that if you just took the time to evaluate the problem and the solution, you might actually get the right pairing.
If we apply this to physical injuries and goals, then let’s start by looking at the tools of a Chiropractor. To make things easier, let’s lump them into three categories: Manual Therapy, Rehabilitation, and Modalities.
Manual Therapy is hands-on treatment addressing muscles, fascia, tendons, ligaments, and joints (cartilage and capsule). This can be active where the patient moves during the treatment pass, or passive where the movement is done by the practitioner only. There are two types of manual therapy typically offered, soft tissue, and joint.
Soft tissue mobilization can be done manually with the practitioner's hand or elbow, or it can be done assisted with an instrument, like a guasha tool or a smarttool/graston tool. What exactly does soft tissue mobilization do? Soft tissue mobilization improves mobility by reducing adhesions in fascia. It also improves blood flow hence improves healing. It also helps improve the mind-body connection simply by providing stimulation physically.
The other side of manual therapy is for joint health. Your joints can be mobilized or manipulated (high velocity low amplitude adjustments). Joint manipulation reduces pain by stimulating mechanoreceptors in the joint, and restoring motion to the joint. It reduces muscles spasms by stimulating muscle spindles and Golgi tendon units with the quick stretching mechanism. It increases range of motion by reducing adhesions within the joint. It also reduces pain by releasing any potentially trapped meniscoids within the joint space. It also improves joint health by providing nutrition and lubrication with restored motion.
Manual therapy has many benefits, and helps us so much, and the above may be why. When considering manual therapy, ask yourself, will the benefits of manual therapy help me with my issues and provide a solution to my problems? If so, go for it! Remember though to find a licensed practitioner who knows how to look for contraindications to care!
The next category of therapy would be rehabilitation. This would be prescribed movements combined with information to educate, empower, and potentially reference and comanage with other healthcare professionals. With rehabilitation and education being so closely interconnected, let’s look at both separately.
Exercise improves function and independence, improving confidence and ability to perform activities of daily living (dignity). It also helps improve overall quality of life. Exercise reduced risk of injury for athletes and for elderly (fall risk). Exercise also improves performance in many categories such as strength, endurance, balance, proprioception, coordination, and plyometrics.
Education can help improve prognosis (getting an idea of what the diagnosis is, and potential referrals more quickly). The reassurance is huge with mental health and prognosis as well. Education can also help reduce injury risk improving biomechanics and posture. It can also reduce pain with at-home care strategies.
Finally we move to Modalities. There are many modalities on the market, so starting with evidence-based modalities is always your safest bet.
Modalities are often passive, and can help with a variety of issues. Modalities include any physical agent (different form of energy) applied or adjunct tools utilized.
Acupuncture is one of the most commonly offered modalities. Acupuncture has been recommended by the evidence-based community for decades. Acupuncture helps reduce pain by taping into the gate control theory, hormone release, endorphin release mechanism, and the HPA axis.
Another modality commonly offered is electrical stimulation or transcutaneous electrical neurostimulation. This reduced pain by using the pain-spasm-pain cycle, gate control theory, and the endorphin release mechanism.
One modality that has a lot of evidence behind it is the cold laser or class IIIb laser therapy. Laser therapy such as this reduced pain by increasing nociception thresholds, endorphin/serotonin release mechanism, blocking C Fibre polarization, and the inhibition of prostaglandin release. Laser also improves healing by increasing collagen synthesis, DNA/RNA synthesis, increased growth factor, and capillary growth, and improved local immune cell function.
Percussion (like vibration or massage gun) can help reduce pain (specifically DOMS), improved blood flow and thus healing, improves mobility by reducing adhesions, and of course the vibration provides stimulation, improving the mind-body connection.
Although the research for tape isn’t great, kinesiotaping can stretch your skin as you move, thus providing proprioceptive feedback. This feedback is thought to help correct biomechanics and motor patterns.
Heat is also another common modality offered as the increased blood flow leads to improved healing.
Finally, topicals are often offered. Depending on what you use, a topical like Medistik provides a counter-irritant capsaicin, thus reducing pain, as well as a vasodilator increasing blood flow and improving healing.
Hopefully by setting back and evaluating the different tools, what they help and how they help will assist in deciding what is right for you at different times, with different problems and goals. Save yourself time, energy, and frustration by seeking out what you need, when you need it!
