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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Chiropractic is the third largest healthcare profession after medicine and dentistry.  Although chiropractic is characterised by joint manipulation other techniques such as soft tissue release and home exercises are often prescribed to restore the body back to a state of health and function.

The Role of Chiropractic

This page was created to try and shed light on the purpose of chiropractic and give insight to the nature of musculoskeletal health.  If you would like to jump to a specific topic discussed please choose from the titles below.

Symptom Management

The first role  your chiropractor will perform is to destress any tissues that are damaged and encourage a healing response to take place.  The way this is achieved is through a variety of soft-tissue techniques and joint mobilisations. 

Symptoms are often the end result of a chain of dysfunction and therefore, we can think of this initial stage of treatment as peeling away the foremost layer of dysfunction.  To take a closer look at a specific symptomatic area and how healing may be encouraged please select from the body map below.

 

Symptoms are the Result of Movement Dysfunction

One of the most important aspects in understanding musculoskeletal health is symptoms which have arisen without a specific incident are likely the result of movement dysfunction.  Many clients often focus on pain relief and fail to see that the problem may still remain even after the pain has gone.

 

Therefore, after encouraging the damaged tissue to heal a chiropractor must build a clinical picture of what biomechanical issues may have led to the symptoms being experienced.  Understanding how well the body is able to perform different functions can shed light on why a person is prone to injury or have recurrent problems.  Functional tests are used to identify where instability exists, mobility has decreased, and where flexibility is required. 

 

Dysfunction in the musculoskeletal system is the inability to maintain stability through movement.

 

The first stage of restoring global function and stability is by increasing mobility in the correct places.  The way this is achieved is through:

  • Joint manipulations and mobilizations.

  • Soft tissue release of ligaments, joint capsules and muscles.

  • Mobility exercises.

 
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Flexibility, Mobility and Stability

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

How Does Mobility Relate to Stability?

To best understand how increasing mobility can help produce stability is by an example: 
 
If the hip is unable to achieve an externally rotated position effectively then other areas must compensate to achieve that movement.  Decreased mobility in the hip forces the lumbar spine, pelvis, knees and other areas to move more, sacrificing stability to attain movement.  This leads to muscle imbalances, tissue remodelling and loss of joint centration.  (This is often the reason why people who have knee pain or pelvic instability often lack mobility in the hips). 
 

           The greater the joint’s mobility the greater functional range it has to                                                         perform a desired movement.
 

By improving the hip’s ability to externally rotate the compensatory patterns can be reduced allowing for better movement.  Forces acting on the body can thus be transferred appropriately, without causing other areas to be under stress or lose stability. 

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Why Target Joints and Not Muscles?

This question is often asked and the answer is that both are targeted at the right time.  Muscles respond to the amount of mobility at the joints.  However, in order to achieve greater mobility at certain joints it is sometimes essential to release specific muscles and ligaments; this is especially evident when there are long standing dysfunctional movement patterns.

 

How Do We Lose Our Mobility Over Time?

Although there are quite a few specific ways that mobility is lost the most common ones that are easy to identify are trauma and posture.
 
When you fall and sprain your ankle there will be immediate inflammation and swelling.  This will cause the mid tarsal joints of the foot to become immobilised.  This localised immobility to the tarsal joints, coupled with being unable to put pressure through the foot due to pain, 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 lack of mobility at other joints pursues. 

                         
                     The body is always adapting to the environment.
 


Another example is postural stress.  Being in one position for extended period of time adapts how the body functions.  Creep deformation is the term used for when a soft tissue very slowly starts to change or stretch due to the forces being applied to it over time.  Sitting in a car or at a desk for a long period will cause muscle fatigue and creep deformation of the spinal tissues.  The changes in muscle activity that are produced lead to a deconditioning of the spinal stabilisers and diminished protection in the lower back.  As a result secondary stabilisation mechanisms develop such as muscular tension in the anterior and posterior chains and stiffening of the joints.  Once again poor movement patterns develop.

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Developmental Stages of Movement

We all go through the same developmental stages of movement.  We begin with head and neck control and progressively move to rolling, crawling, kneeling, squatting, standing, stepping, walking, climbing, and running.  Once fundamental movement is managed, other factors like strength, endurance, coordination and acquisition of skill can be developed. 

 
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Developing Movement Control

This 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.
 
Only once mobility and function of the involved joints and associated soft tissues is produced should the next stage of working on movement patterns be undertaken. 
 
                                            First move well, then move often.
 
Movement patterns such as functional squats, controlled articular rotations, and intrinsic foot muscle strength are all useful in improving movement control once the body is ready.  This if often when individuals can be taken from “rehabilitative” exercises towards optimal performance.

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The Role of Chiropractic is to Improve Adaptive Range

In musculoskeletal health the term "Adaptive Range" or "Functional Capacity" is sometimes used.  This concept represents the varying degrees of physical performance an individual can endure without injury, or the extent their body can adapt to the environment.

It is a good way of representing how chiropractic reverses movement dysfunction and improves physical health.

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Low Adaptive Range

A very narrow adaptive range means that even light exercise or doing light manual work can lead to injury or pain.  

When a patient presents like this the aim of chiropractic is to destress the area that is injured and induce a healing response to the damaged tissue.  

Reduced Adaptive Range

 

Owing to life-style and work stresses an individuals functional capabilities are reduced.  This means recurrent injuries and pain syndromes.

 

A clinical picture will be created from the presenting symptoms and an assessment of how well the individual performs basic functional movements.  

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Moderate to Good Adaptive Range

Individual should be able to perform all everyday tasks and some more advanced movement patterns such as running without risk of injury. Movements that are more difficult may still cause issues.  

Chiropractic should further the functional capacity of the individual by looking at a wider range of functional movements.  Focus is usually placed on mobility exercises in troublesome areas. 

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An Excellent Adaptive Range

The body is unphased by a wide variety of physical stresses.  This is essential in those people who want to participate in high performance athletics.

Chiropractic session will focus on complicated movements with the desire to help fine tune any areas needing worked on.  Mobility exercises and advanced movement patterns may be prescribed along side advice on nutrition.