Want to learn about new advances in chiropractic care? Sure you do I promise that it won’t be too dry. First of all there are many misconceptions about chiropractic care. Many of these misconceptions are perpetrated by the medical profession who view chiropractic as less than favorable substitute for physical therapy. Chiropractors work to remove nerve interference that causes pain in the musculo skeletal system of the body. That may be over simplifying it but that is the best explanation I can provide. Physical therapists provide a broad range of services like post surgical rehabilitation, stroke care, and ambulatory help. There is some overlap of what chiropractor and physical therapists treat. We each have our purpose and different ways to treat the overlap conditions.The most important thing is for the patient to get better as fast as possible. Not every low back case responds to chiropractic care. The same can be said about physical therapy, sometimes patients would be better served by seeing a chiropractor. Put the patients needs first should be the order of the day. There should be no difference of opinion there.
I am excited that there are some great ways to help people with chiropractic care. You may not be aware that chiropractors treat extremities. What this means is that your arms and legs can subluxate. The subluxation occurs when the bone is misplaced and it blocks the nerve nearest to it. The brain uses the nerves to communicate with the rest of the body. When a subluxation exists there will be pain and loss of the brains ability to communicate via the affected nerve. The chiropractors main job is to locate the subluxation and remove it relieving the painful nerve pressure as well as the nerve blockage.
To further explain extremity subluxations. Lets use the elbow as an example. There are 3 bones that make up the elbow. The radius and ulna which are side by side in the lower arm and the humerus in the upper arm that connects to the shoulder. Any one of these three bones can subluxate and cause the elbow to be in pain. If the subluxation is the problem then physical therapy will not help it. By adjusting the humerus, radius or ulna you will have the subluxation removed. This will relieve the pain and restore the brains’ ability to communicate with that body part. But what happens to the surrounding soft tissue? If the subluxation has existed for an extended period of time the muscles, tendons and ligaments are likely to be involved. The soft tissue needs to be addressed to fully resolve the condition.
There is an excellent technique called Graston that is sweeping the chiropractic profession right now. It involves releasing adhesion’s that form in the fascial plane usually around subluxated joints. When a bone has been subluxated for an extended period of time the surrounding soft tissue adapts to the instability created by the misplaced bone. If a bone is 3 cm. out of place the connective tissue is stretched and will accommodate the subluxation. The protective covering of the muscle is called fascia. It is smooth and slippery allowing the muscles to glide over each other as they perform their functions. The increased surface tension arising from the subluxated bone causes the fascia to become gritty instead of being smooth and slippery. The gritty tissue is known as adhesion’s. If you were to think about a pound of hamburger meat in a ziploc bag and then consider a pound of hamburger meat in a bubble wrap bag you can envision what I am trying to convey. The bubble wrap is more like the adhesion scarred fascia whereas the ziploc is like normal fascia. If you were to rub two bubble wrapped bags of meat against each other you would have more friction. The greater the friction the more pain you would have in the area. Fascia which is a type of connective tissue has nerve innervation and is quite sensitive. When it gets irritated the tissue becomes more and more painful every time it moves against other fascia creating more adhesions.
Graston is named for a British Osteopath who probably learned the technique from an Oriental Medicine practitioner. It involves lubricating the surface of the skin where the pain is located. Adhesions are hard to palpate so it is best to just go for a large area surrounding the pain. After applying the lubricant we take a surgical stainless steel instrument that is shaped for certain ares of the body. Then we glide the Graston instrument across the surface area we just lubricated. It is important to use the instrument firmly and go in all different planes. The patient will let you know if you are pressing to hard. This will be painful when you are on an adhesion. You will be able to feel the adhesions thru the instruement. There is a gritty feel as you glide the tool over the problematic area. Continue to do this to the patients tolerance. You may have to back off if the pain becomes to great. Follow with 15 minutes of ice over the affected area.
Why Graston works so well. The Graston procedure erases the adhesion’s from a conceptual stand point. The process abrades the adhesions in the fascial plane. The cells die off from the abridgment. New cells will grow back but will not have the subluxated bones needing additional support. The new fascia cells will grow back and not have the physical stress of the subluxation on it so it can grow back normally. The fascia that re grows will be more like the ziploc bag filled with hamburger meat. That is good for the patient.
The idea I like the best is that chiropractors must do a better job of treating connective tissue. Too often we dig our heels in and only address the subluxation. Then we have our physical therapist friends treating only the muscles. The connective tissue connection is being missed and by addressing it we can help our patients with extremity problems just as much as we can help our patients with low back pain. Better and faster service for our patients should always be our goal. They will like us more for it. Thanks for reading. If you would like to share it please feel free.