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Combining adjustments with deep tissue therapy
The chiropractic profession was built on the skill of practitioners who could find misaligned bones and "set" or adjust them back into proper alignment with the neighboring bones. Ask anyone who has had an acute neck or back problem resolve with an adjustment--these misalignments can be painful and problematic.
Most of us have scarring in the muscles because of previous injury. Scar tissue in muscle is tough, sticky, and pain-sensitive. The stickiness of the scar is what leads us to call the scars adhesions. The tough, sticky scars cause the muscles to function poorly, creating instability and misalignment in the bones and joints.
Deep tissue therapy is similar to massage in that it works directly on muscles, usually using oil to help lubricate the skin and allow the practitioner's hand to glide over the area of treatment. However, where the goal of massage is to relax and improve circulation, the goal of deep tissue therapy is to release adhesions, remove excess scar tissue, and restore function to muscles and comfortable mobility to joints.
My preferred method of deep tissue therapy has the patient move the problem area while I use my hands to mobilize and loosen the adhesive scar tissue. A typical treatment to an area consists of two or three sets of five or six movements. If we are successful, we can restore a great deal of comfort and mobility to a joint in just a few treatments. The longer the area has been dysfunctional, the longer it takes to fix the problem.
Muscles don't show up on x-rays and scars don't look any different from muscles on MRI. The only way to find them is through physical examination. A skilled practitioner can observe a patient's movement and identify the areas where the adhesions may be, and then feel for the scar. Scar tissue has a very distinctive feel. Most of the time, when I put my finger on the adhesion, the patient feels it, too, and often confirms that it feels like the source of the problem.
At times it is. Often the adhesive scar tissue is deep within a muscle, in a hard-to-reach area, or in a spot like the calf or the chest where most people are normally sensitive anyway. Also, scar tissue has more nerve endings than normal tissue, so it is more pain sensitive. I do my best to keep my contacts soft and keep the discomfort to a minimum. The most common feedback that I get from patients during deep tissue therapy is that it hurts, but it's a good hurt; "it feels like it needs to happen."
I am not generalizing when I say just about everybody. I find adhesions in most circumstances, the most common of which are:
Adjusting a joint through a tough, tight, and short muscle is hard. It takes more force, which makes it less comfortable and less safe for the patient. Once you mobilize the muscle, the area usually softens and relaxes, making the adjustment much easier.
In addition, the newly scar-free muscle is now better at supporting the joint, which means alignment is maintained for longer and adjustments "hold" better.
Good evaluation and treatment must account for scar tissue embedded in myofascia as well as bone and joint alignment. To adjust the bones without repairing the supporting tissues is to address only half of the problem.
I can't speak for everyone, but I can attest to two facts. One, it makes patient visits longer. Many chiropractors feel they have to see a patient every five or ten minutes. Our treatments are twenty to thirty minutes long. Two, it's not easy. It takes a lot of skill to find, feel, and release these problems. To stay proficient with deep tissue therapy, a practitioner has to do it every day and take refresher courses from qualified instructors at least once a year. For whatever reasons, many of my colleagues do not have the aptitude or interest to do this.
You may or may not need either an adjustment or deep tissue therapy. Just be sure that any providers you work with are ready and able to address your problems completely and efficiently!
If you have any questions about deep tissue therapy, or would like to discuss your problems with me to see if my approach might be helpful, feel free to call me at 503-688-1219, or click here to send me an email.