How
does this differ from Physical Therapy, Chiropractic or Swedish Massage?
This is a question we are asked often. Let's start with Physical Therapy and how it got started as a modality in the treatment of pain and dysfunction. It used to be the case that during and after wars our injured veterans were sent to hospitals to heal from the wounds suffered in combat. Many of them spent months, even years in those hospitals getting weaker by the day as they lay virtually motionless in bed. Physical Therapy was born out of the need to rehabilitate these veterans and get them back on their feet and productive again.
They needed to get stronger from the injuries suffered but also from the weakness caused by being so inactive for so long. Therapists did gate training and exercises designed primarily to get these guys walking again...and it worked! Even though many still had a limp or some other dysfunction and may have still had some pain they lived with, they were able to walk and function in society.
The problem is that the paradigm Physical Therapists were operating under then is the same one they are still using and applying to athletes with pain, active adult workers with pain, kids with pain and recently hospitalized patients with post surgical pain. They are still attempting to STRENGTHEN contracted, tight muscle tissue. IT CAN'T BE DONE. You cannot strengthen a contracted muscle! When you attempt to do this you will strengthen the area around the injury so the symptoms in that area may subside...but will not be completely resolved.
For those of you who have had physical therapy your experience went something like this. The therapist did a muscle strength test assessment which checked the injured area against the same muscles groups on the opposite side. You were then given a set of exercises to strengthen the 'weaker' side or area. Along with the exercises you may have received ultra sound, e-stim, heat and a few moments of light massage. You started gaining strength for a time and then plateued. The original pain still lingered. You were then probably discharged because the therapist could not justify further treatment because of lack of progress. This process took a matter of weeks or months. You may then have been referred to a pain management clinic which attempted to teach you how to live with the pain you would never be rid of.
This process is as frustrating for the patient as it is for the physical therapist. Physical Therapists have done everything they've been taught in the best schools in the country. It is ridiculously difficult to get into PT school and almost as tough to stay in and graduate. These, in most cases ARE the best and the brightest. Why doesn't what they do to eliminate pain work? They are working from a basic flaw in theory. They need to substitute the word "weak" with the word "tight" to get on the right track. The patient isn't in pain and "weak" because some area(s) need to be strengthened. The patient is in pain and weak because some area(s) are too "tight" and need to be lengthened to correct soft tissue imbalances. When you do this, pain is eliminated.
Chiropractic
This is a little easier to describe. Generally speaking, Chiropractors, (many of whom are friends of mine), are taught that the skeletal system is the horse and the muscular system is the cart...that the bones affect the nerves and muscles, not visa-versa.
Again, generally speaking, we believe that the skeletal system is the CART and the muscular system is the HORSE. The skeleton cannot move unless muscles pull it. If the spine is out of place some muscle(s) or muscle group(s) have pulled it out of place. If you lengthen the muscle(s) or muscle group(s), relieving pressure on the nerves, the spine will go back into place, eliminating the pain and dysfunction the patient is feeling.
Is Chiropractic useful? Sure it is, in some cases. Is Physical Therapy useful? Sure it is, in some cases. Are both of these over utilized as a means to reduce physical pain and dysfunction? I don't think there is any question but that they are. When nearly 60% of the adult population in this country is in chronic pain AND EXPECT THAT THEY WILL ALWAYS BE, according to a recent study, it is clear that these two modalities alone have not been getting the job done. We can, and must do better.
Swedish Massage
Okay, to be fair I'll hit massage here as well. Nearly every massage school in the country teaches it's student that "you should NEVER hurt your client! If you are hurting them you are going too deep!" It is no wonder then that traditional Swedish Massage is not getting the job done either.
I'll really catch some grief over this one but, oh well. The truth is that if you don't get into the tissue that is injured, shortened, tight and constricted you'll never get the problem resolved. I believe the reason for the stance of the schools is fear of law suits and liability. To be fair, for the most part they are teaching light touch massage but even in advanced training workshops dealing with injury rehab most of what I've heard is the same warnings about not hurting people during their treatment sessions.
There, now I think I've offended everyone!