After many years of practice, I concluded that the spinal and extra-spinal adjustment does not resolve all patient problems. The use of soft tissue techniques are necessary, mostly massage, reflex points, and physical therapy modalities.
At times, I could see that I was confused, not knowing how or what to choose. Some chiropractic teachers had given up adjusting altogether and had strictly embraced soft tissue techniques. Some were more closely aligned to physical therapy than chiropractic. Others would mix adjusting and physical therapies. These practices were opposed by straights, who believed in adjusting the chiropractic subluxation, period. I respected the straights and mixers but for different reasons. The straights had a strong uncompromising belief in adjusting. In general, this belief seemed to be stronger than with mixers, yet the mixers had a flexibility to see that straight adjusting did not resolve everyone's problems.
The rest of my patient experiences have shown me that I can treat problems more effectively by mixing adjusting procedures and therapies. I saw a problem, however. By mixing, one can lose sight of the chiropractic heritage of expert adjusting. So, the trick is to mix without loss of adjustive skill or purpose. Yet, if one uses therapies, there should be a high competence and skill level.
What I saw among others and myself, however, was an approach towards therapies like those used by physical therapists. Unless the problem presented as an obvious radicular problem involving a compromised nerve, there was no relationship shown between the therapies, the soft tissue problem and the adjustive chiropractic lesion.
What I am suggesting or advocating now is a better understanding of spinal mechanics, spinal dysfunction and subluxation in relation to soft tissue strains, sprains and hypertonic states. It has been my observation that many soft tissue strains/sprains result from joint dysfunction/subluxation patterns. Thus, if I use therapies to treat the soft tissue problems, I have to use a unique approach. I must recognize that the original problem may be an articular spinal or extra-spinal dysfunction or subluxation that must be corrected first. If the articular relationship is not recognized, the chiropractor has to approach the problem as a physical therapist, a muscle worker, or rehabilitation specialist. Identity as a chiropractor is then diminished.
As previously stated, my experience has led me to recognize that many soft tissue complaints result from articular lesions (dysfunction, subluxation). I was not taught this at school, nor is this reflected in continuing education seminars, unfortunately. The educational training I received, and still receive yearly, does not reflect a strong understanding or belief in the potential of a properly determined and executed analysis and adjustment (or properly executed segmental traction, if required).
My field experience, plus basics learned through school or academic study, has been the basis for my observations and practice methods. In previous published work, I have outlined some soft tissue syndromes associated with articular lesions. I have done the same in my manual (The Connection), describing and treating these related problems. As a review, I will list again some soft tissue disorders resultant from lumbar and sacroiliac subluxations and/or dysfunctions. I call them associated disorders. They are:
If the problem has existed long enough, the soft tissues may have developed problems of their own, which cannot be resolved by adjusting alone. Adjusting can completely solve the problems presented if performed early enough. If the adjusting is performed and the complaints still remain, then soft tissue therapies can be used. Or, adjusting and soft tissue therapies may be used simultaneously and immediately just to ensure more rapid resolution.
Chiropractic is missing a great opportunity when it comes to treating professional athletes. There are so many athletic injuries which utilize a physical medicine protocol rather than a proper chiropractic one. If proper chiropractic intervention were applied in these cases, more total care could be realized. The problem could be that there are no chiropractic protocols for hip, groin, or hamstring injuries related to spinal dysfunction. There are no protocols for treating right-sided throat and head pain.
Continuing education seminars teach us statistics and therapy protocols, but not combined chiropractic articular and soft tissue treatment protocols. The schools are doing their best, but it just isn't enough. Field doctors are not getting the practical guidance needed to diagnose and treat many common soft tissue disorders and specific articular disorders. They resort to accepting protocols from sales representatives, trainers, therapists or engineers.
Another area where meaningful protocols are lacking is the treatment of hip disorders. If hip disorders are not caught early enough, they can degenerate and result in hip replacement. Soft tissue treatment should be preceded by exacting articular analysis, showing hip-joint stress secondary to lumbar and sacroiliac dysfunction/subluxation. If this cannot be done, practitioners are left with physical therapy protocols, nutrition and exercise. Nutrition and exercise are essential and important, but they are virtually useless in the face of lumbar and SI dysfunction/ subluxation. Actually, I see hip joints worsen with exercise if proper articular correction is not made.
I would recommend:
When sports chiropractors first appeared at the Olympic Games in the 1980s, it was alongside individual athletes who had experienced the benefits of chiropractic care in their training and recovery processes at home. Fast forward to Paris 2024, where chiropractic care was available in the polyclinic for all athletes, and the attitude has now evolved to recognize that “every athlete deserves access to sports chiropractic."
It is estimated that 61% of patients with CTS avoid taking surgical options due to postoperative complications and costly surgical procedures. Chiropractic care offers a comprehensive and effective treatment for carpal tunnel syndrome, addressing the condition from multiple angles. Recent studies also have unveiled a game-changing adjunct to chiropractic treatments for CTS: nerve flossing.
Some doctors thrive in a personality-based clinic and have a loyal following no matter what services or equipment they offer, but for most chiropractic offices who are trying to grow and expand, new equipment purchases help us stay relevant and continue to service our client base in the best, most up-to-date manner possible. So, regarding equipment purchasing: should you lease, get a bank loan, or pay cash?
