Why do all the chiropractors I’ve been to and all the ones my clients go to still cross you over and hold down your shoulder while jumping on your leg to see how many cracks they can get in and effort to fix your alignment?
1. My understanding is that there are 2 camps of chiropractors: Traditional and Non-Traditional. The traditional chiropractor is of the belief that reducing subluxations in the spine can fix anything. Non-traditional chiropractors are still trained with that in mind, but they are not attached to manipulating the spine will cure cancer approach. Neither of these categories speaks to the ethical boundaries that we often see chiropractors cross, but without a doubt, physical therapists, physicians, strength coaches, and trainers also cross these boundaries. My opinion is that the traditional clinicians cross boundaries just as much as chiropractors, but because the general public typically think they understand what those clinicians are doing, so it is not thought of as an awful act when a PT charges for an hour of wasting your time, or a D1 strength coach programming crunches after crunches. All specialties are on the hook for not following contemporary trends or science.
2. In regards to manipulation techniques, these are not isolated to chiropractors. They are well taught and practiced by physical therapists and osteopathic physicians as well. Some very prominent physical therapy programs such as McKenzie’s, Maitland’s and Paris’ continuums both teach the same manipulations you see typically from chiros. Maitland would call it a Grade 5 mobilization.
3. The physical therapy literature also has a very solid set of articles that support the use of manipulation in the presence of back and neck back. A recent trend (5-7 years) in rehab literature is the development of clinical prediction rules (CPR). These rules are evidence-based programs that give the clinician a roadmap that if you see xyz, and you do B, you will get desired response. In fact, manipulation in flexion/rotation if performed with a certain presentation of acute low back pain will increase a valid outcome measure by at least 50%. Manipulation is very efficacious in some populations.
4. Something else to consider is that where much manual therapy has its genesis is in New Zealand and Australia. I am told that they are very few “chiropractors” or “physical therapists” in those countries. They are all collectively known as “physios,” and they do what you would expect a combination of the two to do with their patients.
5. Lastly, the notion of segmentally mobility should not be dismissed. I would trust that there are few members of this Website that speak louder against training outside of a neutral core. I have 3 slides in my Advanced Joint by Joint presentation that lists as many problems that can go wrong when you train mobility in the lumbar spine. It is wrong and unacceptable. However, by means of what many have heard me coin as the Core Pendulum Theory, it is also quite mandatory that lumbar vertebrae have the 12-15 degrees rotation and 30-40 degrees of flexion that is kin to the normal spine. If you don’t have that inherent mobility, there is a potential loss of proprioception needed to reflexively stabilize the spine. Now I am not suggesting these wackadoo clinicians are evaluating and correcting with this in mind; they probably aren’t. But mobilization of the spine to access segmental mobility is a very important link in ultimate performance in my opinion. Keep in mind manipulation is just 1 way to get it, and I am not of the belief that I need a battering ram to break through a locked door. There are other ways, but the original posts’ concern about adding spinal mobility is the topic at hand. It’s okay to get it, and great core training that 95% of the sportsrehabexerpt.com Website supports is how you keep it.
