I am a chiropractor because I have had back problems from the time I was eleven. We lived at Hickam AFB, on Oahu, when my back first began to hurt. I was in the 5th grade. The doctors we consulted were ones assigned to the base dispensary. The 3rd one finally got around to taking x-rays, a precaution the 1st one might have reasonably taken. Number Three could not see any blatant fractures or gigantic tumors, though, so he asked me how I was doing in school. Even at age 11, I understood that he suspected I was either malingering or psychosomatic and I was infuriated by his implication. I answered him rather rudely. As he was a grown-up and an officer (although junior in rank to my father), I got a reprimand from my mother, but in fact, she was as irritated with him as I was. In the doctor's defense, after 30 years looking at x-rays, I can understand why the base doctor came off as a dullard: the human spine is a puzzling landscape for general medical practitioners. It's full of lumps, bumps, shadows, and lines that course right through the middle of things - all of which look like they might be malevolent. Chiropractors feel that way about lung fields: gray, nebulous expanses of film concealing fatal goblins that only radiologists can spot.
After doctor number three, no more medical doctors were consulted and I grew into manhood with periodic pain. The first manipulative treatment I ever received was when I was 18 and attending Western Washington University, (State College at the time). I don't remember what set off the episode but I could barely walk. The campus health center sent me downtown to an osteopath. I had a car and why I didn't use it that day I don't recall. What I do recall is that the trek was so painful I had to stop and lean against buildings every few yards and wondered at times if I was actually going to make it to my appointment. After my osteopathic manipulation, I felt better and the walk home didn't require leaning against buildings. I saw the osteopath four times, but although I had periods where my back hurt and pain even went down my right leg, I didn't suffer the debilitation I had during the incident in college and I didn't seek treatment for another 10 years. Working in they hay fields produced another severe bout and I began seeing a chiropractor in Ferndale. I was so impressed with what he was able to do for me that it was not much of a leap for me to embrace his suggestion that I go to chiropractic college and become a chiropractor, myself.
Candidly, I admit that I've never been an athlete but throughout my lifetime I've engaged in athletic endeavors that probably should have involved some athletic conditioning, just for my own safety. Swimming, sailing, handling cattle, riding horses, and other activities were approached in the manner of an evening or weekend warrior and I was rewarded with the injuries that came with my foolishness. Only in karate did I follow a fitness program and I was pushing 40 by the time I started that. Now, looking back on it all from the end of middle age (63), I'm convinced that both chiropractic and exercise, together, are essential for a healthy, active life.
I tell you why I say this. We will talk about illness vs. wellness in terms of stuck vs. movement. We move every day, mostly doing chores or work, and these activities (we convince ourselves) give us adequate exercise. I am as guilty as anyone else in this lazy rationalization. This exercise, however, doesn't always "do the trick". Have you ever noticed how one task that you are fit for does not always make you fit for another? This is because our chore and work activities are not balanced from a muscle-use perspective. The chore and work movements do not equally utilize all the muscle groups in our bodies. The muscle groups we overuse complain from wear and tear, and the muscle groups we underuse complain when they have to deliver more effort during activity we normally don't engage in. To achieve a balance, which will optimize movement and maximize health, we all should take advantage of the synergism of chiropractic and exercise. What is synergism? It is "the action of discrete agencies whose combined effect is greater than their separate and individual effects," or "the whole is greater than the sum of its parts."
I want you to understand how chiropractic works. Most people don't - even the ones who have received chiropractic treatments for years. Chiropractic is joint mobilization: the articulation of a patient's spine or peripheral joints by the doctor. Many different disciplines practice joint mobilization and claim it as their own by giving it a proprietary name. Chiropractors mobilize joints by "adjusting" them, either by hand or by instrumentation. Within the profession, many different techniques are practiced, "different strokes for different folks." Diversified Technique is a grab bag of manual manipulative moves that are generally perceived by the public as - good, 'old time chiropractic' Activator Technique, and "Toftness Technique" are rendered with instrumentation. In the former, a light rapid force is delivered; in the latter, a light prolonged force is applied. Receptor Tonus Technique is the axial "milking" of the belly of muscles to reset their tension neuropathways.
To speak of neuropathways permits a segue into why joints become demobilized. Most people think chiropractic addresses bone alignment. You may be surprised to learn that nothing could be farther from the truth. Bones only do what muscles direct. And muscles only do what the nerve system commands. The commands are sent by impulses going out or coming in over neuropathways. Joints become stuck because the nerve system wants to demobilize an injury by means of a neuromuscular splint. Neuromuscular splinting occurs to some degree in every illness or injury. Chiropractors most commonly treat sprain/strain injuries. Although the terms are used interchangeably in conversation, sprain and strain are clinically different. A sprain is ligament damage. Ligaments attach bone to bone; the intervertebral discs are ligaments; the rotator cuff is, in part, a ligament. A strain, on the other hand, is muscle/tendon injury. Tendons attach muscle to bone or to ligaments.
Both types of injury generate a clinical entity called 'the inflammatory response'. The inflammatory response occurs in all illness and injury. Its components are Redness, Heat, Swelling, and Pain. (We learned them in Latin: Rubor, Chalor, Turgor, and Dolor.) Nerve receptors responsive to these four elements around an injury or an infection send signals which cause splinting by muscles to immobilize the area. These nerve receptors are the end organs of neurological pathways leading to and from the brain in feedback loops. There are two types of feedback loops: one governs motion, the other inhibits it. The two feedback loops oppose one another. In health, they are balanced and work together to produced normal movement and maintain normal posture. In injury or illness, the balance is altered to favor inhibition and splinting. Chiropractic adjustments reduce inhibition and splinting by jumpstarting the motion neuropathway. As nerve signals are repeatedly sent along a neuropathway, the signals move increasingly easier with repetition. It's a little like the cutting of the groove in an old-time phonograph record when the record is being made. So when the chiropractor moves the joint during an adjustment, he is shifting the neurological balance between the two pathways back to the motion side of the equation. Also, the chiropractic adjustment reduces inflammation. Redness, Heat, Swelling, and Pain are chemically mediated. That is, chemicals in the tissue act upon nerve endings to produce these responses. By introducing and increasing joint movement, these chemicals are literally pumped away from an injury, allowing components of the immune and repair systems to come into the area, a bit like an army displacing an enemy.
And this is the conceptual point at which chiropractic and exercise are synergistic. In the acute phase of an injury, chiropractic treatment should be complimented by exercises which duplicate the chiropractic adjustment and extend the benefit of the treatment. The motion pathway facilitation that the doctor imparts with the adjustment is continued by the patient doing exercise; and the pumping-away activity is repeated. In chronic or long-term care, exercises specifically selected to balance the entire musculoskeletal dynamic are prescribed.
In work and play, some joints and muscles are underutilized and some are overutilized. Overutilized joints always have underutilized neighbors, and vice versa. An exercise program designed for long-term or chronic care should address this inequality and even out the activity spread. That is why exercise often looks a little silly: one has to engage in movements that are not normally done. Balancing the activity spread is best managed by chiropractic and exercise combined. This is because we sometimes ignite inhibition neuropathways by carrying exercise or activities a little too far. We re-injure ourselves, a little or a lot. It's then that the motion neuropathways have to be re-engaged chiropractically to return nerve and muscle performance to balance.