There are basically two types of chiropractors: those concerned with correcting spines and those who aren’t. Truthfully, the latter group probably won’t even bother reading this article. Since you’re here, I’ll assume you have at least some genuine interest in trying to deliver real and lasting structural corrections to your patients. As you’ve probably found out, it’s kind of hard to do, isn’t it?
Almost every chiropractor has experienced the frustration of adjusting patients and seeing the symptoms improve, only to see the spine stubbornly stay the same. Many docs will switch to a new technique only to have the same result. I get calls every week from doctors having problems correcting spines. The call usually starts with the doctor explaining, somewhat apologetically, which technique he/she uses. I hear statements like, “I’ve been meaning to take some ABC seminars, but just haven’t done it yet,” or “I used to do XYZ technique, but I’ve kind of gotten away from it.” And, of course, what that indicates is a tendency to view their poor structural outcomes as being due to some shortcoming in their adjusting technique. Well, I’m here to tell you, it’s not true.
I used to hear in chiropractic college that “all techniques work.” And that’s true…depending on how you define “work”. The beneficial effects of all manner of chiropractic adjustments have been studied relative to a wide range of human ailments. And the jury is in. Spinal adjusting, using just about every technique has been shown beneficial for just about everything from simple back pain to infantile colic to webbed feet. Seriously, there’s lots of evidence that spinal adjusting is pretty good stuff for any number of symptoms and complaints. So pretty much all techniques do “work” in terms of making folks feel and function better. We should all feel good about that. But when we start studying how well our adjustments perform in terms of actually correcting spines, we start to have a real problem.
There’ve been a few research papers indicating that adjustments alone are somewhat effective at producing small, intersegmental improvements in vertebral position. Unfortunately, posture is a completely different thing entirely. Posture is the “big picture.” And, essentially, every method of adjusting studied has fallen short in terms of making significant changes to overall spinal alignment. Certainly there are some studies which tout the benefits of a particular technique system to correct global spinal posture. But they tend to all have one big problem. In almost every case, the researchers only looked at the effect of their unique brand of spinal adjustments combined with other therapies such as traction, exercise, stretching, vibration, head weighting, etc. And, of course, the problem when you combine different therapies into the treatment groups is that you never really know which treatment is actually producing the results.
When you read way too many research papers, like I do, you might start to get an uncomfortable feeling about how some projects are designed. For instance, if you were a technique guru, out there promoting the beneficial effects of your particular methods, wouldn’t you want to prove just how effective your adjustments were? Boy, I sure would! The very first thing I would do is draw up a project where one of the treatment groups got ADJUSTMENTS ONLY using my brand new, ultra whiz-bang methods. (All properly patented and trademarked, of course.) Then, when I had proven, once and for all, that my technique was the best thing since shirt pockets, the world would literally beat a path to my seminars. (Somebody call the Nobel Prize committee please!)
Only thing is, the various gods of the technique universe never do that. Instead, they combine all manner of treatments into their studies and, not coincidentally, some mixture of adjusting, rehab, traction, postural reeducation or whatever tends to be effective. You might almost get the idea that they were avoiding the subject a bit. Call me cynical, but I’ve got a sneaking suspicion that it will be a long time before most technique gurus are willing to test the efficacy of their adjusting methods in isolation. A few famous techniques have done this in the past and the results were a bit embarrassing!
So, before anyone fires off a hateful letter defending their favorite guru, I’ll lighten up just a bit. Most of these guys are smart, innovative doctors. Their constant desire for better results drives progress in the profession. It’s generally a good thing. Just realize that most of their great corrections are typically the result of a potent combination of rehab methods, not just their unique brand of adjusting. Truthfully, very few of us totally isolate patients to only one treatment method when they are in our offices anyway. Instead, we generally throw everything but the kitchen sink at the problem. It’s certainly true in my office. Adjustments, ice, traction, exercise, trigger points, stretching…the list goes on.
The point of all this is that, the “world’s best technique” doesn’t really exist. There’s not one whit of evidence to suggest your tried and true adjustments should take a back seat to the newest and hottest technique of the decade. It’s just easy for us as a profession to look at our technique whenever we experience difficulties correcting spines. After all, we’ve got a hundred year heritage of visualizing subluxation as a bone out of place, pressing on a soft nerve. And sometimes old thought habits die hard.
Certainly, every modern chiropractor understands that vertebral subluxation is almost always more involved than a single segment in need of being pounded back into alignment. And, yet, the old paradigm continues to lurk somewhere in the back of the chiropractic mind. Why else would our perception of the importance of “technique” be so strongly engrained in us? It’s this attitude which leads many of us to incorrectly conclude that our clinical failure(s) could have been avoided, if only the proper adjustment had been given.
Well, Doctor, you can relax, because it just ain’t so. Save your seminar money. Spend the weekend at home with your family. And, if you really want to understand how the best doctors in the country are making great corrections, then pay attention to the ancillary procedures they are using to address postural alignment. Consider implementing active care procedures which focus on correcting postural alignment, like reverse posture exercise, extension traction methods, spinal remodeling. Yes, those conveniently happen to be related to items that my company sells. But you might also want to take a look at other tools and methods my company doesn’t manufacture, like head and shoulder weighting, wobble chairs, rocker boards, or vibration therapy. There are lots of tools out there for doctors who are genuinely interested in correcting spines…just don’t get caught in the trap of thinking you need to change adjusting technique. According to the best evidence I can find, one technique is just about as good as another. You can rest easy knowing that whatever you are already doing is tied for first place as the “World’s Best Technique.”
Dr. Mark Payne is president of Matlin Mfg., a manufacturer and distributor of postural rehab products since 1988. Doctors interested in learning more may call 334-448-1210 or go to www.posturalrehab.com for a FREE SUBSCRIPTION to our newsletter Postural Rehab where we discuss a wide range of subjects relevant to structural rehabilitation.