What are chiropractic adjustments?
Chiropractic adjustments are specific thrusts into synovial joints. Adjustments are also known as manipulations, grade V mobilizations, or HVLA (high velocity low amplitude) thrusts. Chiropractic adjustments employ a variety of techniques depending on the location and amount of fixation of the deranged joints. The effects of spinal adjustments have been proven to reduce musculoskeletal pain, increase passive range of motion, shorten the duration of acute back pain (RAND Study), and positively affect the central nervous system.
When are chiropractic adjustments indicated?
Chiropractic adjustments are indicated when joints have become fixated and locked up. This is often accompanied by inflammation and pain, commonly found in disc bulges, herniations, facet joint arthropathy, sacro-iliac dysfunction, and more. This also happens in other joints of the body as well, including your thumbs, wrist, elbows, shoulders, feet, knees and hips. Chiropractic adjustments aim to restore vertebral as well as extremity mobility, thereby reducing inflammation and pain.
What is Active Release Technique (ART)?
Active release technique is the gold standard for soft tissue techniques utilized today. Essentially, it is a simultaneous stretch and massage technique used to break adhesions, reduce trigger points, and soften contracted tissue. It is very well suited in a chiropractic setting as the adjustments mainly address the joints and ligaments, whereas the ART will address the muscles, tendons, and fascia.
ART can produce Delayed Onset Muscle Soreness (DOMS) which usually creeps in 1-2 days following a treatment, similar to that felt after working out after a long hiatus. The benefits typically outweigh the side effects, and the combination of therapies plays a synergistic role, being more effective that just the sum of either therapies alone.
Does it hurt to be adjusted?
It typically does not hurt to be adjusted. If the joints are too swollen and painful, a chiropractic adjustment may not be indicated at the time. Whether or not to use a chiropractic adjustment is something that will be discussed between you and the doctor. More gentle techniques such as using a table with a fall-away bottom called a Drop Table, or a pen-like tool which delivers a very mild thrust called an Activator(Tm) may be employed instead of a manual adjustment.
Even when joints are swollen and painful, if a chiropractic adjustment is indicated and performed, the relief is usually instantaneous.
What should I expect after a chiropractic adjustment?
You should expect to feel good. You should have greater mobility and range of motion.
When your back or neck is hurting, the muscles and fascia are in a very contracted state; the joints are locked up and inflamed. The treatment aims to free up those joints, and the ART aims to soften the muscles and fascia. Unfortunately, when injury and inflammation are present, the muscles and fascia revert to it’s previous contracted state. The joints become locked up again. And pain and stiffness are returned. This is the reason why multiple chiropractic treatments are often indicated with a treatment plan. The ultimate goal of the manual therapy is to retrain the muscles and fascia, and to keep the joint mobility as optimal as possible.
What is Icing?
Instructions: PLEASE READ AND FOLLOW CAREFULLY
Nearly all pain systems in nearly every part of the body can be explained by inflammation; this is particularly true in musculoskeletal arena. Ice is one of the simplest, safest, and most effective self care options you can do.
Never ice directly prior to activity, as it will stiffen the muscles and joints (this is caused by vasoconstriction of the blood vessels) and may lead to further injury. A good rule of thumb is to make sure the skin is back to normal temperature (before if it is necessary) to return to activity, which usually takes about an hour depending on the body part.
There are four phases to icing:
Aching (which can be more intense than the pain)
You must get through all stages for icing to have a therapeutic effect. Icing causes vasoconstriction of the tissue, flushing away the metabolic waste and cellular debris found in injured tissue. The therapeutic effect of icing, however, is not just in having the ice applied, but also when the ice is removed. When the ice is removed, in a process called reactive vasodilation, blood then rushes in and delivers key nutrients to help the tissue heal. Therefore, you must ensure proper warm up of the tissue before re-icing. This is also why, beyond getting frostbite and the like, you should never ice for more than 20-25 minutes, depending on the body size and patient body mass.
What is Heat Therapy?
Heating can also be used to reduce pain as well, however, as expected the mechanism is different. With most pain symptoms, there is a certain degree of muscle tightness as well as inflammation. The decision of whether to use ice or heat is determined by the the acuteness and severity of the injury (or re-injury). Typically, in the first 24-48 hours following an injury, ice is almost always more indicated than heat. After that, both can be therapeutic,
Moist heat is significantly superior to dry heat (i.e. an electric heating pad). Moist heat can be accomplished in a number of ways. Most physical therapy offices provide a hydrocollator, where a sand bag is immersed into hot water. This is typically not applicable in the home setting. A good alternative to a hydrocollator is a microwavable pad with silica beads. These are often found in pharmacies or online, with a brand called ThermalOn being a preferred. These silica bead pads draw moisture from the air, and when heated, transmits the moist head to your tight muscles. If this is not available, a hot water bottle can be an effective substitute.
Heat can be applied for 20 to 45 minutes...and can be used approximately every hour as needed.