Chiropractors in England partake in 4/5 years of University training, including topics of Neuroanatomy, Orthopedics, Histopathology, Physiology, Diagnosis (musculoskeletal and other systems e.g. cardiovascular), Research, Imaging, Psycho-social, Molecular Nutrition, Functional Management and practical skills such as manipulation and soft tissue therapy.
What we treat...
The types of problems most commonly seen by Chiropractors are:
Headaches arising from the neck (cervicogenic)
Shoulder pain including rotator cuff tendon issues
Hip and knee issues including osteoarthritis
Plantar fasciitis and ankle sprains
Other minor sporting injuries.
We treat a wide variety of individuals from adolescents to elderly, weekend warriors to professional athletes!
How we treat...
Chiropractic treatment often involves a range of techniques to reduce pain, increase mobility and improve function.
Treatment may include:
Manipulation (spinal and extremity joints):
There are a number of techniques used by Chiropractors in terms of manipulation, from Gonstead to Activator to Diversified. I personally mainly use what is called Diversified Technique. This consists of a controlled thrust at a specific joint/region, in a specific direction. This is also known as a high-velocity low-amplitude (HVLA) thrust. The manipulation is often associated with an audible 'pop/click'. Once manipulated we will recheck the joint mobility and/or recheck muscle function/tone to ensure we have achieved the result we wanted. (It doesn't always have to 'pop/click', so long as we have got the intended response).
For more about the mechanism behind spinal manipulation, see my Blog Posts.
If patients are not as keen on Diversified adjustments or the 'pop/click' sound, I use techniques such as Activator (a tool which delivers a gentle but quick movement into a joint) or Mobilisation (moving a joint through it's range of motion, without a HVLA thrust).
Sacro-Occipital Technique (SOT) is another Chiropractic technique that I use. This involves the use of pelvic blocks.
Massage and trigger point therapy
Often within treatment I will use deep tissue massage and soft tissue release techniques, trigger point therapy and stretching. Muscles and joints work hand in hand so I believe that using both joint manipulation/mobilisation and soft tissue work is key. If I feel patients could benefit from longer massage sessions and different techniques such as scar tissue work, I refer to one of my massage therapist colleagues.
Kinesiotaping is another technique I use for certain conditions.
Dry Needling (/Acupuncture)
Dry Needling involves the placement of needles into muscle trigger points (contraction knots). Acupuncture involves the use of Chinese Medicine Meridian points throughout the body to treat certain conditions and pain. Often some of the traditional Chinese Acupuncture points and Trigger Points overlap. I have personally done extra courses involving both but tend to predominantly use Dry Needling for muscular trigger points and tendinopathies, alongside a few Acupuncture based points for conditions such as knee osteoarthritis.
Alongside hands on treatment, I believe exercise is key in achieving optimal pain relief and function. Currently, we use a great home exercise App called PhysiApp to create individualized home exercise programs, which can be sent directly to people's phones via the App, or made into a sheet for patients. I often talk through and demonstrate exercises during treatment sessions.
Exercises may involve diaphragmatic breathing, stretching and gradual strengthening/plyometric training to aid return to normal daily activity or sport.
Advice on other lifestyle factors such as nutrition, stress and sleep may also be given.
If I feel you need any more specific support in other regions such as nutrition, psychology, exercise or sleep, I am lucky enough to work with some amazing Nutritionists, Counsellors/Hypnotherapists, Personal Trainers, Massage Therapists, Reflexologists, Sleep Consultants and more.
I am able to refer on for X-rays and Ultrasound Imaging, private MRI scans and Shockwave Therapy.
I am often in contact with GPs on top of this regarding patient management.