The Science of a Chiropractic Adjustment

Chiropractors are clinically trained to perform many different types of adjustments to the spine and joints with the goal of improving body function and relieving pain by releasing pressure off the nerve system.

I’m going to start with you, the chiropractor. Please summarize the type of education and training a chiropractor receives to fully understand the human body and practice chiropractic care.

Dr. Gregg Rubinstein: Well, that’s a great question and I get asked that a lot. And when you really look at the curriculum compared to chiropractic and the medical profession, the first couple years are almost identical. You take the same course load. We take 520 hours of anatomy, physiology, pathology, chemistry, bacteriology, diagnosis one through 12, neurology, X-ray. There’s even a psychiatry class, pediatric class, obstetrics, gynecology, orthopedics. We take just about every class that they take.

Really where the education differs is once a chiropractor completes all the clinical trials and studies that you’re required to do in the clinic, you don’t have to do a residency because your clinic experience was already so specialized. So that’s the only area that it’s a little bit shorter than the medical path.

But as far as the course work, it’s exactly the same. I went to four years of college, I got a same pre-med degree which was a Bachelor of Science, and I had a major in biology and double minor in chemistry and physics, which is essentially the pre-med program. So, everything is kind of the same. The difference is when they’re working on pharmacology and surgical procedures we’re working on spinal technique, motion palpation, and the corrected adjustments.

There’s a lot of parallel I think overall. Both professions are just under 3000 hours of classwork, and it’s pretty impressive. You get a great education. You need to be able to determine what’s coming into your office, your primary portal of entry. So, people will come in with all kinds of different things that could look like back pain, so you need to know how to differentially diagnose and sometimes refer out when appropriate.

This is a three-part question. So please explain and describe what a traditional chiropractic adjustment is, why it’s done, and how it’s done.

Dr. Gregg Rubinstein: Okay. Well, that’s a pretty good question. So, a chiropractic adjustment, there could be more traditional techniques. There are newer named techniques that have come out as people have kind of honed certain skills and changed things. So there are many different types of adjustments. But the why it’s done and how it’s done…

The why is simple. The why is always going to be the same. The reason to make any adjustment is because you have a vertebrae that’s fixed or stuck in an abnormal position. When it’s out of alignment, it will pinch and irritate the nerves or create nerve interference. When that bone is stuck in that position, it needs to be corrected or adjusted. Once you make that adjustment, you put a little bit of energy into the joint, you can break up the fixation and then the body will actually move it back to where it belongs, eliminate the pressure on the nerves, and then the body can revert back to normal function because the nervous system is really just a communication system.

When you have these subluxations or misalignments, they irritate the nerves, and that can cause a host of problems, not just pain or discomfort, remembering that those same nerves are actually the same ones that control and coordinate your heart, your lungs, your kidneys, your spleen, your intestines. That nervous system runs and regulates your body. The better it communicates, the more efficient the body works.

So that’s really it. And there’s many different techniques. Some are done by hand very gently, some are using small instruments. And so there are different types of adjustments with different techniques.

Are there other types of chiropractic adjustments that chiropractors perform, and do chiropractors use any tools or devices to facilitate the adjustment?

Dr. Gregg Rubinstein: Absolutely. That question really dovetails into the one before where there are different techniques. There are low force techniques, there are no force techniques, there are moderate force techniques, and they are all designed to help different people. Now, if I have a big burly athlete, I could use probably a more force-oriented technique. If I have a 90-year-old grandmother, I might want to use a small instrument that will be much gentler and can get into the more specific places, which is called activator. There are techniques that just use gravity and a series of wedges to kind of help realign the vertebrae. So, there are many different devices and types, all depending on the different technique that the chiropractor employs. There are soft tissue techniques and there’s something called DNFT, which is directional non-force technique.

Most chiropractors should have four or five different tools in their arsenal to help the different people who come in, because technique in many cases isn’t one size fits all. There are some upper cervical techniques that really only adjust the upper cervical spine, and there are very many reasons for that. I’m not going to go into detail on that, but that also can be a very, very beneficial type of technique to use on people who have more organic type problems.

How do you determine whether or not a person’s spine or joint needs to be adjusted, and how do you know exactly where on the body to perform the adjustment?

Dr. Gregg Rubinstein: Well, there are many tools that people use, and some of them are different depending on the technique. X-ray is a great tool. We can get a static listing. I can look, and if I see the vertebrae above is straight, the vertebrae below is shifted to the left, and then the vertebrae below that is shifted more to the left, you can actually see the misalignments on X-ray.

We also use something called motion and static palpation. Motion palpation is when I’m actually pushing on the joint, and I want to feel a nice springy feel. It should kind of recoil and move and glide very smoothly. Sometimes when I push on the left side of the joint, it feels nice and springy. And then if I push on the right, it might feel blocked or stuck. And that’s how I know that joint needs to be adjusted, and then I’ll actually make the thrust, adjust. Sometimes you will hear a little bit of release from the joint, and then I can push back on it and it will kind of feel nice and springy again. And that’s how we know we completed the adjustment in that area.

You can also use thermography, which can tell you when a vertebrae is out of place. You’ll see higher levels of heat on one side due to nerve irritation and the body’s inability to manage sympathetic and parasympathetic regulation. So, you might see dysregulation of body temperature. Thermography can be helpful.

We use leg checks according to the techniques. You can see if there’s a leg that’s short or long. When they turn ahead, you can kind of locate where the listings are there.

There are a lot of different tools in every chiropractor’s chest that they should be able to use to determine where the body is misaligned and when it needs to be adjusted. The most important thing in chiropractic is really knowing when the patient is clear, because a patient might come into you and they might not need to be adjusted. And you need to have certain criteria to determine does that patient need to be adjusted today or can I leave it alone, is everything working just fine.

How does a body that is in alignment allow it to function at its best and be healthier?

Dr. Gregg Rubinstein: Well, we’ve kind of covered that on and off every time we speak. It’s really all about the nerve system. As most people would think a chiropractor is a back doctor, really we use the spine as our avenue of approach but what we’re trying to affect is your nerve system. And as I mentioned earlier in the interview that the nerve system is just a communication system. It sends messages from the brain to the body and then it gets information from the body back up to the brain, communicating across the nerve system.

If you have a misalignment that’s irritating the nerves, that communication pathway, some of those messages might not get through or they might be distorted. And then at the cellular level where your body does all its workings, that’s not enough for what the body demands. And the body can make mistakes or not be as efficient, and then it uses more energy to do the same processes. And that’s when the body will start to break down, slow down in its ability to heal, slow down in its function. And the slower it functions, it’s almost like a computer with a virus. You’re not going to get as much done and the body isn’t going to be functioning at its optimum level.

When you clear a computer from its viruses and do all the checks and defrag, your computer runs better. When the body’s computer, the brain, is interfered with, if there’s any irritation along the pathway to communication, then the body isn’t going to be as efficient and is not going to work as well. And it’s really just about that. It’s about optimizing the function of the body so you can live your best day every day.

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