CHIROPRACTIC

This page is dedicated to the questions I get asked a lot.  I have tried to cover some of the key topics that make chiropractic and movement fitness such an important part of a healthy lifestyle. 

I JUST BENT DOWN TO PICK UP SOMETHING AND MY BACK WENT...

Symptoms which have arisen without a specific incident are likely the result of movement dysfunction. 

Movement Dysfunction can be defined as the inability to maintain stability through movement.  So how is this dysfunction created?!  The body is always adapting to the environment.  When we left school many of us did not maintain the exercise routine that the few hours of compulsory PE gave us and so our conditioning has gone down. If you haven’t run for 5 years and then you do a 10k run, the chance of you getting shin splints is much higher because your tibialis anterior muscle has weakened from the lack of strenuous use. But it is not only the amount of strength we may have lost, but also the amount of mobility.
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Physical trauma such as a sprained ankle will also lead to similar changes.  A sprain will create inflammation and swelling causing the joints affected to become restricted.  This localised immobility leads to compensatory changes in movement and coordination. These changes often remain even after the injury has healed and as a consequence muscle imbalances, tissue remodelling and changes in joint centration occur.  Consequently the next time you attempt to perform a movement outside of your adapted range tissue damage occurs.
Prolonged postural stress and physical trauma can further affect the amount of mobility we have.  Sitting at a desk for long periods will cause muscle fatigue and deformation of the spinal tissues. These changes in muscle activity decondition the spinal stabilisers and thus decrease the protection of the lower back. Secondary stabilisation mechanisms, such as muscular tightness, develop and the joints that are not given diverse positions will decrease their range of movement.  This further increases stiffening and decreases the ability to achieve more complex movements. 
 
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Flexibility

Flexibility is the ability to achieve a range of motion passively, without activating muscles to achieve that movement. Yoga is a fantastic way to become flexible but practitioner often lack the control (stability) to maintain some of the movements.

Stability

Stability is the ability for the body to remain supported or aligned in the presence of changes in forces acting on the body. This requires balance, reliable muscle contraction patterns, and muscle endurance.

Mobility

Mobility is the joints ability to perform a wide range of movements without sacrificing stability or control; allowing muscles to work synergistically to perform that movement. This means strength combined with flexibility.

CAN I REVERSE THESE CHANGES BY DOING A LOAD OF DIFFERENCE EXERCISES?

As discussed previously your body is always adapting to the environment so to a certain extent you can use exercises to counteract some postural-induced changes, and I encourage everyone to try to do so.  However, in my own experience and from working with a multitude of athletes over the years the truth is: it is difficult to know which areas require greater strength or mobility without objective testing from a qualified practitioner.  It is also essential to keep in mind that if a ligament or joint capsule has tightened it is very difficult to target these areas solely through exercise.  
It is a good time to reflect that rehabilitative exercises that cannot be performed well should not be performed at all!  Repeating a movement that is faulty is not going to rehabilitate the movement back to function but integrate the faulty movement further and fail to target the immobile area needing addressed.  As the great movement specialist, Grey Cook, states: First move well, then move often.  It is a primary goal of chiropractic to help you get back to moving well.
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Chiropractic is a healthcare profession concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, and the effects of these disorders on the function of the nervous system and general health. 

World Federation of Chiropractic
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WHY DO CHIROPRACTORS CRACK MY BACK AND WHY IS THE FOCUS ON THE JOINTS AND NOT THE MUSCLES?

Serge Gracovetsky in his book Spinal Engine, found quadruple amputees could “walk” on the base of their pelvises without any 'practice' needed.  He reasoned spinal rotation was the foundation of human locomotion.  A concept that has been developed in the scientific literature to include all movement.  This means that movement begins at the spine and restoring any movement must involve good spinal function. 

As an example, when working with an athlete who performs racket sports, the elbow often becomes symptomatic because of the repeated stress from the weight and impact of the racket on the joint.  The repeated movement causes muscle imbalance around the elbow and shoulder that change the way the movement is performed.  And as stated above, all movements begin at the spine, and so all compensatory movements will involve changes in how the spine functions.  Therefore, when treating these athletes the area under stress, the elbow, needs to be addressed first, but the spine cannot be separated from the rehabilitation process. 

...WHY IS THE FOCUS ON THE JOINTS?

Muscles respond to the amount of movement available at each joint. The greater a joint’s mobility the greater functional range it has to perform a desired movement.
Decreases in mobility from lack of use, posture, or trauma prevent more complex movements from being achieved, or at least being achieved well.  By increasing the range of movement at the joint (often by manipulation or mobilisation) the potential for more complex movements is attained.  E.g. a tight hamstring will always remain tight if the movement at the hip and knee has been reduced.
Although joint mobility is the foundation of movement it is sometimes essential to target muscles that have become maladapted.  Muscles that have been under tensile or compressive forces over long periods of time or have undergone fibrotic stiffening due to metabolic stress may need to be addressed so certain movements can be performed. 

Once function quality movement has been established focus will shift to mobility / strengthening exercises that will focus on more complex movements and the increase of adaptive range.
 

WHY DO I NEED 'MAINTENANCE' WHEN I FEEL FINE?

As discussed previously, the body is always adapting to the environment and we generally do not incorporate enough variety of movement into our daily lives.  (It is likely that our ancient ancestors had a much more diverse way of moving and our spinal evolution is not accustomed  to modern life.)  Therefore, we lose strength and mobility (stability) due to modern living / environment.  In other words, poor adaptive range from a lack of varied movement patterns coupled with compensation mechanisms make us vulnerable to injury when we go beyond our normal movement range. 
The term "Adaptive Range" or "Functional Capacity" is a concept that represents the varying degrees of physical performance an individual can endure without injury, or the extent to which their body can adapt to the environment.  It represents how chiropractic and physical therapy reverses movement dysfunction and improve physical health.  At Marshall Chiropractic all clients are assessed using functioning testing prior to each treatment session.  This is of vital importance when trying to determine where someone is on their movement range and where improvement is required.
I should mention here that although I am an enthusiastic exponent of 'maintenance' care, you may not need to get your back adjusted too regularly.  Instead once the adjustment has helped reclaim a functional movement, a movement pattern should then be developed to maintain that function.  Depending on circumstances and physical conditioning maintenance sessions are often recommended 2-3 months apart.
 
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Low Range

Everyday simple tasks such as walking lead to discomfort.

Reduced Range

Light exercise can lead to injury or pain.  This means recurrent injuries and pain syndromes.

Moderate / Good Range

Able to perform some advanced movements without injury. Complex movements may still cause issues.

Excellent Range

Unphased by a wide variety of physical stresses, essential in those who participate in athletics.