Unlike massage therapy, chiropractic is open to interpretation by the public. Massage therapists have done a great job defining themselves in the public as a profession that relaxes muscles and calms the mind. Therapeutic massage helps many people overcome pain and regain function. Their work is understood for the most part by the public and it is trusted. Even though we do the same exact thing as MT's, some do not equate DC's in this manner.
Chiropractic is misunderstood. Many people feel as though the only thing we can do is fix lower back problems. This misunderstanding forces practitioners to sell chiropractic to people. Hence, the reason people adhere to questionable marketing tactics. That being said, massage therapists fill in the gaps of our profession and having an MT in our office would be a very smart idea.
Going back to the case I spoke of earlier. This person does not understand chiropractic and when I tried to explain what we could do to help, it was like a door was slammed in my face. Rejection! The patient chose massage therapy because there was a misunderstanding as to what chiropractors actually do. It was a very frustrating moment. Had the person known that we relax soft tissues, free restricted joints and guide patients through rehab, as well as address nutritional factors, I believe more good would be done. Will this patient feel better after the massage? Definitely. Will the problem be resolved completely? I don't think so.
In the long run, the person will get some relief from the problem. As far as rehabilitation goes, the patient will not get the care needed to rebalance the muscles and the potential for re-injury is there.
We are in a peculiar situation as fresh doctors in a society that does not understand our work. I propose we take control of the situation by taking the effort to be the go-to doctors for musculoskeletal care. We have to own what we do so that it is not taken from us. Not only are we competing against MT's, but we have DO's and PT's, even MD's to think about. These professions are just as good as our own and for the most part, more understood by the public.
If chiropractic was thought of as the place to go to for all musculoskeletal problems, we would be elevated in society to a new level of professionalism and trust. I do believe the ACA is doing a great job helping the profession succeed, but it would be nice to see the colleges and practitioners do something to educate the public.
All for now
Nice blog and thanks for sharing with us.
ReplyDeleteThanks for reading.
ReplyDeleteAs an RMT myself, I find your blog interesting. Tell me, how do you address fascial restriction and adhesion, fibrosis and scar tissue within the muscles? Do you work directly with muscle spindle fibres and GTO's? Since approximately 90% of all subluxations are caused by forces exerted on the vertebrae by muscle, fascia and soft tissue, do you not think that the subluxation becomes primarily the symptom of a soft-tissue dysfunction?
ReplyDeleteJust curious...
Hi there,
DeleteI agree with you in regard to muscles being the main culprit to causing joint restrictions. However, there are times when the joints are the real issue due to excessive laxity in musculature. A lack of stability to an area can cause the deeper layers of joints and ligamentous attachments to become fibrotic and restricted, therefore an adjustment or mobilization is the best treatment choice along with a rehab program.
In practice I look at things as layers. Once pathology and serious illness has been ruled out, I look at what could be causing the restricted range of motion and pain. Fascia, muscles, joint capsules, ligaments and tendons all can cause reduced mobility, so it is wise, in my opinion, to start superficial then work deep. The "less is more" analogy comes in quite handy using this approach. At least from my experience in the clinic.
I hope that helps.
Thanks for reading!
Dr. Spangler
I find it quite interesting myself, while I believe Chiropractics have there place in medicine, I still cant justify the ripping and tearing of musculoskeletal tissue in order to realign the neck. 80% of neck injuries are a common result of the continuous small rips and tears you make that build up adhesion's. What I seriously can't figure out is why a chiropractor wont tell there customers that this is only a temporary fix and that the muscles are going to pull the bones back to the fixated state they were in before, which is why they continuously, obliviously, keep coming back.
ReplyDeleteI don't think you have this completely correct. As I stated, the adjustment is a useful tool when used properly. To state that it rips and tears muscles and relieves symptoms temporarily is in an overstatement and quite false.
DeleteI've had several patients respond to a high-velocity adjustment quite favorably where other less aggressive therapies such as, Graston, pin and stretch and PNF stretching did nothing for them.
You can't generalize chiropractors in this manner because it is not what 80% of us do. More often than not, the consensus is to treat the tissue that is causing the symptoms through a wide array of therapy choices. The high-velocity adjustment is a nice addition to this package of therapies and blends nicely when the muscles are treated as well.
Another thing to think about is the many causes of pain. This should scare you a little, as it does me daily. Chiropractors are trained in diagnostics in both general medicine and musculoskeletal medicine. We form differential diagnosis lists and check them off as we rule in and out issues. The approach we are trained in is to start with the scariest issue the complaint could be then do tests to confirm it. If the test is negative, we move to a less scary issue until there is enough information to justify a conservative treatment.
Massage therapists are not trained to do this, yet they treat clients with body work aimed at reducing musculoskeletal tension (ie. conservative care). Is this safe for the client who comes to them solely without being diagnosed previously?
Of course, I will side with diagnostics any day because I have personally seen serious issues that cause muscular pain that need surgery, pharmaceuticals and the like which will worsen and not improve with conservative therapies as time drags on without proper intervention.