Chiropractic and Massage Therapy

[Maury Lindstrom]

Hello to all you Knuggledraggers out there!

I have recently been to a Chiropractor who has told me that I need some corrective chiropractic care. He figures somewhere between 12-15 treatments (session) should do it with some maintenance after that. Then I have been thinking of massage therapy as well. What I would like to know is how and when should you use these alternative health methods? Also, do any of you know why at first you need the chiropractic treatments to be so frequent? He wants to see me three times a week for the first month to six weeks. Also, I have no pain but I am thinking of doing this based on his advice from the x-rays he took. By the way, if you guys know how to best make use of these modalities that would be helpful as well. One last thing, how long do these treatments/adjustments last? Thanks in advance!

[bob_stra]

> What I would like to know is how and when should you use these
> alternative health methods?

Sorry - you're going to have to explain what you mean by that. Not clear to me.

>Also, do any of you know why at first you need the chiropractic
>treatments to be so frequent?

Couple of reasons

(1) Standard chiro protocol based on anatomical laws (ie: Wollfs Law of bone remodeling)

(2) To halt the progress of your condition and stabilize it ASAP

(3) To reduce pain (yes really. despite DC objections) and begin the long road to recovery.

6x3 tapers off to 4x2 to 2 x month to 1 x month

Think of it this way. It took x amount of time (years, months etc) to get you ill. It will take some time to get you well. The above simply presents a schedule to get you (quickly) back on the road.

I could also add (4) Some chiros like to make the bling bling, but that's a generalization.

But hell - ask him why you need so many treatments. Surely he can explain?

> He wants to see me three times a week for the first month to six
> weeks. Also, I have no pain but I am thinking of doing this based on
> his advice from the x-rays he took.

That's strange. The 3x6 protocol is used for injury intervention.

Ok. Is there an underlying condition? Some kind of spinal curvature?

> By the way, if you guys know how to best make use of these
> modalities that would be helpful as well.

Massage, chiropractic, osteopathy - all these things are great, but unless you learn how to take care of yourself the other 167 hours a week, you will have limited success. This is why I always recommend folks investigate Alexander Tech or Feldenkrais to complement chiro.

> One last thing, how long do these treatments/adjustments last

Adjustments can take from 2 minutes to 20 minutes, depending on what the chiro is doing. The actual "snap crackle pop" takes maybe 2 seconds.

As for how long you'll need to go - talk to your DC.

Seriously, talk to the guy - you're the one with questions. You're the one holding the wallet.

Other than that, try rephrasing your questions and I'll give em another crack

[Maury Lindstrom]

You're obviously educated in this area. I appreciate your comments. Also, I will attempt to be more clear in the future.

[bob_stra]

In response to PM from Maury


> Thanks a ton! Sounds like you really know what you're talking about.

Yeah, I fake it well ;-)

Re: The specific analysis your DC gave you. Phase I is really a blessing - early in the game. It goes upto Phase IV. Next time you're there, take a look at the posters around the clinic to see what I mean (the ones that show the diffs between phase I - IV)

Do you understand what his diagnosis means, or would you like me to break it down a little? I can fill in some blanks, but you will have to discuss the rest with him.

> Feldenkrais and Alexander method. When would you do Feldenkrais or > Alexander? Before, after, or during treatments?

Ok. Firstly.

Feldenkrais and Alexander are not a type of treatment per se, like ultra sound or stretching. They are educational approaches used to teach one to move "better" so as to not hurt oneself. That is a gross simplification.

Rather than reinvent the wheel, let me give you some links

On the general concept of somatic therapies
http://www.somatics.com/s-m-a.htm

Feldie specifically
http://www.feldenkrais.com/method/feldenwhat.html

Alexander
http://www.alexandertechnique.com/

Oh and look, what's this?
http://www.rmax.tv/bodyflow.html

As to when - it doesn't really make a difference. Lessons, either in group or one on one take abt 1hr. Perhaps you will have more success doing it after the treatment as your tension levels will be lower. Or perhaps doing the lessons before the treatments will allow the adjustments to hold for longer.

> Also, anything else you can tell me about massage.

Yes. Much ;-)

What would you like to know?

[bob_stra]

Another PM from Maury

> Once again thanks. I just want to be healthy.
> I feel fairly healthy so hearing reports like the one I got from the > Chiropractor is kind of a two-edged sword.

Stop and consider what healthy means. If you dig up the WHO (World Health Organization) definition you'll see it says something like "the optimal level of given functioning on a social, physical, spiritual mental and emotional level ; not merely the absence for disease".

While that sounds all hippie-skippy, consider the implication. A paraplegic, living a full, meaningful life is HEALTHY.

You dig? LEVEL of social, physical, spiritual, mental and emotional FUNCTION GIVEN that persons CURRENT CIRCUMSTANCES.

So infact, you ARE healthy already. It may not be to the absolute, *biological* peak of how healthy you *could* be, but you're on that Bell curve, just like the rest of us.

Seeing that your here, I imagine your interested in sliding a little to the right hand side ;-) (becoming "health-ier").

> I was hoping to hear that everything was fine or not know I needed
> work.

That's where you've got is bss aackwards.

Think of DC's are optimizers of health. A chiropractor is not really interested in your injury as such. He's interested in making you "health-ier".

So, unless you're the 6 million dollar man (or dead), then there's always something within that bag of flesh that can be tinkered with for fun and profit.

Moral: The news you got - not so bad! It's like saying "well, you know, you're tires are a little flat here, how abt we pump em? You'd use less fuel. Still, its upto you. Your car will work ok if you wanna leave it."

> You are right about the phases. There are three phases on the
> report that I have.

Ok, I can't be entirely sure as to what he means by them. Simply because there are 6 or 7 methods for naming things in chiropractic. Kind of like a country with regional dialects. The chief ones are CBP format, Palmer, Diversified, Medicare and Pettibon. So, where a Diversified guy might say "curvature here and here", a Medicare guy would say "oh - you mean a rotoscolosis with a focal point at such and such".

Suffice it to say, I don't speak the dialects very well.

*I've addressed the specifics in a PM to you for the sake of privacy*

> Osteopathy? You use all the big words.

Don't let that impress you. Parrots also know big words.

Osteopathy was an early relative of chiropractic. Infact, some say that the founder of chiropractic studied for 2yrs under the founder of osteopathy, then quit over an argument.

The more argumentative amongst my peers argue that because osteopathy focused on "blood" as the chief tissue of interest, chiropractic had to settle with "nerves".

In the US, osteopathy slowly integrated into mainstream medicine, losing much of its uniqueness. AFAIK, a osteopath in the US is really quite similar to a MD, except he might on occasion use spinal adjustment.

In other countries, Osteopathy has kept its unique flavor.

If I had to sum up the difference between the two, they would be -

Osteo - uses a different type of spinal adjustment technique, training is equally spread between soft tissue approaches and spinal adjustment, visits are somewhat longer (20-45 minutes).

Chiro - uses many "short lever" (specific to 1 or 2 vertebra) techniques, focus is usually on spinal adjusting, visits can be very brief (1-2 minutes) and frequent (3-4 times week).

> If you want to give me anymore advice I would be interested in
> knowing how often you would recommend getting massage therapy

Grey area. There are many types of massage, some with distinct purposes.

For the treatment of injury, the usual frequency is 1 or 2 week for
4-6 weeks. But that's a cookie cutter answer. I'd consider it a blessing if I could wrangle a free massage once a week for the rest of my days (especially after jits practice).

So, in reality, it depends whether your interest is in injury treatment, sport recoperation or relaxation.

> distinction between somatics, alexander, and feldenkrais.

I will give you my impression.

Firstly, somatics a generic term. In somatics, the focus is on FUNCTION, whereas chiropractic and massage are STRUCTURAL approaches (mostly). This means that a chiro will adjust you spine till it conforms to an idea. A massage therapist will treat a muscle until it reaches a certain quality. Gross generalizations, but mostly accurate.

Somatic approaches on the other hand are interested in how well you can function, despite structural limitations. So lets say you have a club foot. Given that your circumstances (club foot), how can you perform task xyz better?

Paradoxically, often by improving the function, the original problem is alleviated. Nevertheless, this is not the goal of somatic approaches. They set out to teach you to be function at a higher level.

Having said that, there "sub specialties" in somatics. eg: Body centered psychotherapy is interested in how the use of your body relates to your psychological function and how this can be improved through touch. You might have heard of TFT or EFT (strange kind of tapping technique used to reduce phobias) - kind of along that line. Kind of. Hakkomi method is closer to what I'm trying to describe. There are some that overlap into this area - Trager Psychophysical Integration (and of course, a little thing called BodyFlow) come to mind.

Now, between Alexander and Feldenkrais. The difference again is focus and flavor.

In Feldenkrais, much time is spent focusing on gaining a range of experiences in unusual situations. For example, a session might call for students to be on their stomach, trying to figure out a way to look at their heels without raising off the floor. The lesson is broken down into subsets - suggestions really, that each student interprets differently. See previous link I provided to you in PM. To goal of all this is to build up a level of "unconscious competence"

In Alexander, much time is spent of placing the student in familiar, everyday positions. The student is educated to prevent / inhibit poor habits and in doing so, gaining (indirect) control over one's posture.
The focus is on developing "conscious competence".

Feldenkrais believes that while initial sensation may be off, thru exploration, this can improve. In doing so, better habit develop spontaneously. Alexander believes that initial sensations are way off, and to improve them thru any means would result in further error. Thus a teacher or careful observation is required to consciously inhibit poor habits so that better ones may appear spontaneously.

Further, Alexander maintains the primary control is the head and neck, while Feldie has no real locus. (some argue its the pelvis - I disagree). Alexander believes in searching for an "optimal configuration", Feldenkrais believe in searching for novel configurations, some of which will be useful today, others for tomorrow.


> They sound all the same from the reading I did.

Well, they are AND they're not. That statement won't make a lick of sense till you try a few different ones and compare them for yourself.

Here's a bit of reading abt the commonalties -

http://somaticscenter.org/somaticsce.../htl-wis1.html


> Also, based on the information I shared with you does it sound to
> you like I would need and more important could I benefit from
> chiropractic treatments.

This is something you will have to assess for yourself. Don't be a passive recipient. Keep a journal of observations or at least be mindful of what differences you notice after chiropractic adjustment.

As to whether you could benefit from chiro adjustment.... well, that's another post, three times the length of this one. Short answer - maybe?

There are times when a structural approach is needed. There are times when a functional approach is needed. The wisdom in not to favor one over the other, but to know when each is appropriate.


Addendum: Here's a website that gives a wonderful account of clinical massage therapy.

http://danke.com/Orthodoc/

The article called "The Why and How of Posture Therapy" may be of interest to you.

[Jarlo Ilano]

Just to throw another thought into this thread (and not meant to cause too much controversy....)

But... I would be wary of engaging in a long term manipulation program such as the chiropractor wishes you to participate. Are there specific motion restrictions that you notice when you participate in activities? Are these motion restrictions unresolved despite working on movement exercises (even as simple as "stretching").

The reason I would be wary, is a bone of contention (bad pun!) between some chiropractors (and some osteopaths as well), and others who practice manipulative and manual therapy. http://orthopractic.org/guidelines.html
It is believed that repeated manipulation to a joint will cause ligamentous instability at that joint. Instability, meaning, that the range of motion of that joint will become not just more than necessary, but motion that goes beyond the "neutral zone" which can cause problems as iterated in this thread. http://www.circularstrengthmag.com/f...t=1274&start=0

My take on it is that because there are millions that have undergone chiropractic care, and not all of them are "walking wounded", is that there may be people more susceptible to having problems with repeated manipulations. These people may have some underlying hypermobilities that are just on the edge of becoming pathological. Thus manipulation exacerbates the situation.

Now this post is in no way. "Anti Chiropractic". In fact, Bob knows how much I value his insights. I admit that early in my career I was a rabid "Quack watcher". And we all have stories of how certain chiropractors hurt our patients. But I soon realized that it was the INDIVIDUAL, not the PROFESSION.

So with that in mind, you may wish to explore the other therapies that Bob mentioned in his postings. Or you may wish to continue with the chiropractic. I just wanted to add some further information into the mix.

Regards,
Jarlo

[bob_stra]

> But... I would be wary of engaging in a long term manipulation
>program such as the chiropractor wishes you to participate.

mmh! Valid point!

Yes there are some concerns to long term joint stability.

OTOH I recall reading some stuff as to how manipulation can be used to alter proprioceptors so as to make joints "stiffer". Not sure if its true (nor can I find the article - might be on chiroweb.com).

I think over-manipulation is a valid concern.

> "Anti Chiropractic". In fact, Bob knows how much I value his insights. > I admit that early in my career I was a rabid "Quack watcher".

You and me both.

> And we all have stories of how certain chiropractors hurt our patients. > But I soon realized that it was the INDIVIDUAL, not the PROFESSION.

What he said. Man, do I know some dodgey MD's, DC, PT's.....sad and frightening to think these guys are out there, "helping" people.

There are some ugly, ugly things in chiropractic, but that can be said of almost any health profession.

[SiDaiJoey]

Yea my chiropractor said that people who have underlying problems that are about to get worse sometimes don't benefit or can get worse. He said a lot of people who are already hypermobile (he gave the example of yoga fanatics) sometimes have problems and typically don't respond as well.

As a note, a typical visit I've had lately is some electrical stimulation to my right shoulder (injured/strained about 2 months ago, getting much better thanks to these guys) and to my left upper back chronic tightness and stress. After that they'll massage or do some pressure point release. Then they do some Chiropractic Biophysics and mirror image adjustments to help my posture, and they also have a PT who I will start seeing soon.

Some days I leave the office feeling awesome, some days it doesn't help as much, but that's ok. Sometimes its also a matter of seeing what works best for you in terms of the treatment regimen and modalities. It's also important to stretch, relax and self-monitor the rest of the time as well. And don't forget when you get ill to take care of yourself and see an M.D. if you need to - chiropractic manipulation won't cure pneumonia or strep throat, and if you get a broken leg, go to the ER. (This is a little tongue-in-cheek, but you get my point.)

Both allopathic medicine and chiro are great, just for different things. Allopathic is better for immediate injury bodily repair and emergencies, infections, and such whereas chiro is really good at managing chronic conditions such as body pain, postural problems, physical stress, etc. Many MDs don't know as much about rehab (unless you are a physiatrist or a rehab physician) whereas DCs don't know as much about metabolic diseases and other medical conditions. But that's OK because that's not what they're supposed to treat. However, both types of doctors are supposed to recognize the problems at hand and if need be, refer to someone who can deal with it.

[JasonE]

Great stuff!

This caught my eye:

Further, Alexander maintains the primary control is the head and neck, while Feldie has no real locus. (some argue its the pelvis - I disagree). Alexander believes in searching for an "optimal configuration", Feldenkrais believe in searching for novel configurations, some of which will be useful today, others for tomorrow.

A year or two ago I attended a BJJ seminar with Rodrigo Vaghi, one of Rickson Gracie's top guys. He spent a little time talking about how the hips are one center of movement, and the shoulders are another. He indicated that, on the ground, they are equally important in starting and controlling direction and momentum.

We have all seen how dysfunction in a leg can lead to dysfunction in the opposing arm and shoulder, demonstrating how one directly affects the other through the movement. Conversely, a shoulder injury will affect the function of the opposing leg, demonstrating that this affect is not a one-way street.

Monty Roberts, author of "The Man Who Listens To Horses" and the person "The Horse Whisperer" was based on, talks about how the configuration of a horse is judged on the relative positions of the hips and the withers (shoulders) to the spine of the horse. These 2 centers of movement are integrated and work together, yet have dramatically different (and complementary) roles to play in the everyday life of the horse. In horses, hind quarter development is an indicator of power and front quarter development is an indicator of staying power, but both are equally important in overall performance.

While humans are vastly different from horses in overall structure, I believe that the principles must be similar. Why wouldn't it make sense to say that we have 2 complementary centers of movement? Why would it make more sense to say we only have 1?

[BullOnTheBeach]

Its beautiful to see people of the same thread. I am a Shiatsu Massage Therapist (2years working) as well as a Personal Trainer (7years working).
I have worked with Chrio's, Acupun'ks, and PTs alike. Something that I would like to add in the search for holistic alignment. The soul. Its an often over looked aspect of bodywork/massage. Very few massage modalities address this part of the being, mainly do to its hard to quantify and discribe. A modality that I have found to be of great help in this is Cranio Sacral Therapy. Without writing an extreme essay to explain it (my deep understanding is minimal at best dispite having had treatments) you can check the following website:
www.upledger.com
If this is something of an interest to anyone, I strongly suggest checking it out.

And if anyone is interested in the inner workings of Shiatsu, please ask. I would love to help bring a better understanding to the art.

Travis Gordon