4 Types of Chiropractic Adjustments
One of the first things that most people think of when they hear ‘chiropractic adjustment’, is the ‘popping’ or ‘cracking’ sound. While this is common with certain adjustments or maneuvers, it should not define what chiropractors do. The sound is simply a by-product of bringing certain joints through it’s range of motion and creating a quick vacuum effect. Our objective is to improve joint function, not to create an interesting sound. Our spinal joints need to move, in the the way they were designed to move, in order to be healthy. Through various maneuvers we can help restore normal range of motion. By restoring normal spinal joint function, we can help decrease pain, reduce inflammation, and improve mobility. Improved posture and spinal biomechanics, balance, coordination, core strength and stability can be just as important towards optimum spinal health, but these components tend to be easier to develop when we have less pain and have normal spinal function.
Manipulation is most often defined as a high velocity, low amplitude maneuver of a joint. This is the type that is most often associated with the ‘popping’ sound. This type of adjustment is commonly for spinal joints, but is often used on joints in the upper or lower extremity as well. Spinal manipulative therapy (SMT) has been the type most often cited in the scientific literature for having benefits for certain spinal conditions. It has been theorized that it’s benefits are attributed to not only bringing the joint through it’s normal range of motion, but also doing so very quickly. It appears that a quick stretch to the joint may have a greater therapeutic benefit than one done slowly. The drawback to this type of adjustment is that it can feel a little more forceful than other types. Some patients find that they cannot relax or that they don’t like the sound it can create. I take these concerns seriously, because it is important to me that the individual is completely comfortable with their treatment. From a therapeutic perspective, I find that patients respond better when they are relaxed and don’t muscle guard during the adjustment. For most, however, manipulation is very comfortable when their concerns and comfort preferences are addressed. In my own practice, I find individuals respond faster to this type of adjustment than any other type.
Joint mobilizations cover a broad range of movement from a minimal stretch to allowing the joint to be stretched through most of it’s range of motion. Normally, mobilizations are applied more slowly and can be a little more comfortable. While they rarely cause an audible ‘popping’ sound, it should be understood that it is still a possibility. Spinal mobilizations tend to be just as or less effective than spinal manipulations for most of the common spinal conditions that they are used for. Personally, I tend to use mobilizations most frequently to prepare the joints for manipulation, if the individual is experiencing severe pain and spasm, or if the patient simply prefers a slightly less forceful maneuver. Through personal experience, I find that with mobilizations, individuals might be either less responsive to care or they might require a greater number of visits until maximum therapeutic benefit is achieved.
3. Drop Table Adjusting
I use a type of chiropractic adjusting table that allows for certain pieces to be lifted. These drop pieces can be tensioned according to patient comfort so that when the appropriate amount of force is given the drop piece drops a few inches quickly. This allows us to use momentum to cause the joint motion and thus requiring less of a push. This may sound forceful, but it is generally considered quite comfortable. Because the table has so many positional options, I have the flexibility to move the joints in a variety of different ways. While we don’t typically bring the joint through it’s full range of motion, it’s speed allows for a quick joint stretch that may have similar benefits to manipulation. Additionally, I can use the drop table to perform postural adjustments that work well to supplement the patient’s prescribed postural exercises.
4. Instrument Assisted Adjusting
I often use a common chiropractic tool to help with either preparing the joints for greater movement or as a stand alone treatment. This works well for individuals with severe pain or spasm that have difficulty with either the body position required or the amount of pressure being used for more forceful maneuvers. The type of instrument I use has three intensity settings and can be used with a singe impulse or with a burst of impulses. It is generally considered the most gentle of the types since it’s smaller surface area contact means that we need less force to provides a very quick stretch to the joints. As an added benefit, I personally find that the muscles that surround the joint tend to relax following this type of adjusting, so it can facilitate manipulation if being done on the same visit.
There are many other forms of spinal or non-spinal adjustments that are performed by chiropractors or other health care providers, but generally, the goals tend to be similar. It is my goal that we reach maximum benefit in as short of a period as possible, with minimal patient discomfort. Furthermore, it is very important to me that the patient is prepared and comfortable with the adjustments prior to them being performed. Once we are able restore spinal function and reduce pain, it then becomes much easier to work on other important outcomes, such as: core strength, motor coordination, and posture.
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Dr. Chris Enns, B.Sc., D.C. has been a chiropractor in Winnipeg, Manitoba since 2005. He is the owner of Balance Chiropractic and Wellness Centre, located at 121 St. Anne’s Rd in Winnipeg, Manitoba. Services include: chiropractic, massage therapy, athletic therapy, orthotics, spinal decompression therapy, x-ray services, and health and fitness consulting.