What Are Adjustments?
Chiropractic adjustments, also known as spinal manipulation, is a technique that uses a high velocity but low amplitude (small movement) to move a joint. The pop that is often heard when this is performed is due to a small gas bubble that forms during the movement being released from the joint capsule. While adjustments are usually thought to be done on the spine, there are a variety of techniques to help other parts of the body including shoulders, hips, knees, and ankles. Remember, a joint is a joint, so as long as there is a capsule surrounding it adjustments may be able to help the recovery process.
Myths About Adjustments
- No, adjustments are dangerous: Adjustments are not dangerous when performed properly by a trained professional. They become dangerous when someone who has not been trained in performing them does them. Injuries usually occur when someone is performing the technique with high speed and large movement (instead of high speed, small movement). Neck adjustments do not lead directly to strokes. Most of the more significant medical issues reported with this treatment had likely been evolving over years (plaque formation in an artery). There is an extremely low risk of adverse events with adjustments.
- No, you’re not out of alignment: Despite what you have likely heard, your bones are not out of alignment. The pop you hear is not your bone going back into place. As described above, adjustments work through a complex endorphin system in the body. When the tissues begin to relax as an effect of the treatment, movement and function begin to return.
- No, you likely don’t need imaging: Imaging is being used far too frequently in the united states. It is unlikely that you need imaging unless you have a significant injury (car accident). Imaging it not an effective or reliable way to track progress in a care plan. There are too many variables affecting the quality and positioning of the image. Lastly, you are not able to visualize soft tissue structures on an x-ray. That means that if you injured a ligament, muscle, or disc), the x-ray won’t be effective in diagnosing the injury. We reserve imaging for high-risk patients who have had a significant injury indicative of a fracture, or for those who are not progressing well with conservative care
How Do Adjustments Help?
Adjustments are useful for a variety of reasons. Most benefits are short term to help reduce pain during the recovery process. Here are some of the ways that adjustments can help you reach your recovery goals:
- Reduces pain: Adjustments help to reduce pain by working with your body’s internal pain relief system. During the movement and when cavitation is felt or heard, it helps to release internal endorphins which help to reduce pain and discomfort. With this window of time that patients feel better, therapeutic exercise can be performed to get the muscles working more normally again. It can also help to allow a patient to move more normally throughout the day. Normal movement helps to further reduce pain and disability and allows the patient to get back to living.
- Proprioceptive improvement: Adjustments provide short term improvements in proprioception, which is your body’s internal picture of the body. This allows movement and muscle activation patterns to become more normalized, reducing spasm and making movement less painful. This can also help to improve the active (muscular) stability of the affected area.
- Range of motion improvements: This is a secondary effect of bullet point number 1 and 2. Due to the reduction in pain and improvements in proprioception, guarding of joints by muscles tends to decrease. When this happens, the joints and body are able to move more freely.
In our office, we usually use adjustments as a window of opportunity. This window allows our patients to move more freely without discomfort to begin the rehab journey to recovery. A comprehensive approach to care is usually necessary: Adjustments are only a tool in a toolbox to help you reach your goals.