Manual Therapy Techniques Archives

July 16, 2020July 16, 2020

Should I See A Massage Therapist Or A Chiropractor?

Massage and Chiropractic Care

If you have aches and pains or an injury, you have a lot of options. The marketplace for treatment of injuries and insult to the human frame is large. If you think of this marketplace like a real supermarket you might look at the aisles and see shelves stocked with medication, patches, doctors visits, massage therapy, homeopathic remedies, acupuncture, chiropractic treatment, physical therapy, vitamins and supplements, yoga, and the list goes on.

But let us take two items off of the shelf and unpack them a bit. Narrowing the choice down between massage and chiropractic care for your problem, which do you choose?

A doctor examines a painful shoulder, will massage and chiropractic help? — Which type of practice is better suited to help relieve pain or other symptoms?

Similarities

Massage and chiropractic care are both interventions where the practitioner uses their hands to affect positive changes to irritated or injured tissue. Also, both treatments are conservative in that they do not rely on drugs or surgery to make these changes. Furthermore, massage and chiropractic are both considered very safe and non-invasive, with the most common side effect typically reported being temporary soreness following treatment.

Differences

Chiropractic care is performed by a doctor of chiropractic and often entails a full history, physical examination, diagnoses, and treatment planning before any adjustment or treatment is started. The doctor may order special tests such as x-rays or blood panels as well, depending on the history and exam findings.

Treatment in a chiropractor’s office typically involves an adjustment (spinal manipulation) or a series of adjustments. This is what chiropractors are chiefly known for prescribing as the therapeutic intervention. However, many chiropractors are also knowledgeable about and prescribe physiotherapy, nutrition, heat, cold, or electric therapies, exercises, and other modalities which can fall within a chiropractor’s scope of practice.

The Adjustment

The adjustment is the most well known aspect of chiropractic care though. So what is the adjustment, and how is it different from massage therapy? An adjustment is a fast impulse delivered to a joint, typically in the spine but also useful in the extremities at times, which stretches the joint past it’s normal end range of motion and results in a cavitation (the popping sound you may be familiar with hearing when you crack your knuckles). This fast release of joint tension often improves feelings of stiffness in a joint, pain surrounding the joint or adjacent soft tissues, and may relax tight muscles or reduce muscular spasm.

So an adjustment is most often delivered to joints in the spine or extremities, whereas massage therapy typically involves the soft tissues of muscle and fascia.

Massage therapists are licensed professionals trained to manipulate soft tissue. There are many benefits to massage therapy including increased circulation, lymphatic drainage, stress reduction, and more. However, massage therapists are not doctors and cannot diagnose or order special tests. You should still make sure to inform your massage therapist of any medical conditions you are experiencing before receiving a massage.

Massage and Chiropractic – Chocolate and Peanut Butter

As a chiropractor I have referred many patients to massage therapists for treatment. I have also personally utilized massage services for my own health. I do not believe that chiropractic is intrinsically better than massage (despite myself being a chiropractor) and will admit that for certain people and conditions massage is clearly a better tool to address some injuries and patient concerns. In fact, many chiropractors employ massage therapists in their offices and it is one of the chief adjuncts to chiropractic treatment in the United States. This is because massage and chiropractic care are so complementary.

For example, a patient may present with a bad ankle sprain with decreased range of motion and pain at the ankle. A chiropractic adjustment to the ankle resolves much of the pain and improves the available motion, but there is still much swelling and some discomfort about the joint.

The doctor prescribes some stretching and exercises for the patient to perform at home, and gives a referral to a massage therapist to address the soft tissue component of her injury. A referral for massage helps reduce the swelling and eliminates the remaining pain, and the patient is able to perform her home exercise with more ease, and is happy with her outcome and the collaboration because she knows a team is working together to resolve her presenting complaint.

I hope this post helps illustrate how massage and chiropractic are similar but different, and how they can often complement each other. Thanks you reading!

About the Author

photo of Dr. Erik Reich with his son on his shoulders — Dr. Erik Reich, Meriden chiropractor, and his son.

Dr. Erik Reich is a chiropractor in Meriden, CT. He practices at Omni Physical & Aquatic Therapy Center, Inc. located at 303 South Broad Street. Where he treats all types of patients from high school athletes, seniors, victims of trauma such as auto accidents, laborers, and desk jockeys. Spending time with his wife and son, and their Boston terrier, is something Dr. Reich also enjoys.

February 25, 2020February 25, 2020

3 Plantar Fasciitis Tips From Meriden Chiropractor

Plantar fasciitis is foot pain which is typically located on the sole of the foot. Also, this pain is typically the worst with the first step out of bed in the morning. There is debate over whether plantar fasciitis is truly an inflammatory condition of the fascia under the foot. However, pain at the bottom of the foot or under the arch, worse in the morning, and worse with activity, is termed plantar fasciitis.

Plantar Fasciitis Tips

Buy and Wear Excellent Shoes
Don’t Ignore the Calf Muscles
Begin Strength Training for Relief

Wear Excellent Shoes

There are many plantar fasciitis tips out there, most won’t matter if you wear bad shoes. Foot pain is easily exacerbated or made worse with poor footwear. Furthermore, if you are trying to reduce your symptoms and pain, paying close attention to the type of shoe you wear can have rapid benefits. A good quality running shoe that is well fitting is a must-have.

If you choose ill-fitting or non-supportive shoes such as flip-flops, flats, heels, slides, or dress shoes, it is highly likely your symptoms will be made worse, and the pain will not subside. A high quality sneaker which provides heel cushioning and improves your gait is your best option to combat plantar fasciitis pain.

Also, purchasing your shoes from a running store, even if you don’t run, can be a great choice as the staff can often evaluate your foot size, gait, and provide you with more and better information than a regular retailer.

Don’t Neglect the Calf Muscles

Secondly, although your symptoms may be local to your heel or underneath the foot, the calves often play an important role in plantar fasciitis pain. Two muscles primarily make up the calf. Gastrocnemius and soleus are their names, with “gastroc” being the larger of the two. These muscles combine into the Achilles’ tendon which inserts at the heel and is contiguous under the foot with the plantar fascia.

When the calf is tight and the muscles pull on the Achilles’ tendon, the extra tension can irritate and stretch the plantar fascia and tendon insertion at the heel, prolonged or repeated irritation can lead to pain and dysfunction at these sites. Often times stretching and soft tissue therapy is recommended for the calf muscles to reduce and eliminate this tension.

One popular method of relaxation to the calf muscles is to wear a night sock or splint while you sleep, putting the muscles and fascia on stretch through the whole evening. Many people get good results from wearing this type of support, but most people will still have some pain even with massage, foam rolling, icing, and splinting.

Passive interventions such as those previously discussed can all help. However, to have the biggest impact on your symptoms, a combination of treatments and interventions might work best. What I recommend to most patients is a multi-pronged attack plan. This includes a new pair of excellent shoes and some type of passive intervention. For example, calf massage or foam rolling. Also, joint mobilization or manipulation to any restricted joints of the foot or ankle. Then, and this is the most important aspect, gradual exposure to loaded exercise. Strength training of the affected leg.

Strength Training to Relieve Symptoms

Active interventions are those steps a patient undertakes to heal themselves. A great clinician will act as a guide to place the patient on the right path. When attempting relief from foot and plantar fascia pain, you can not ignore exercise. This tenet applies to many ills of the body, from headaches to lower back pain, sometimes the best medicine is to get moving.

In the case of plantar fasciitis, what needs to move is your lower leg, under load. Recent studies point to better outcomes with a simple progressive strength training routine of unilateral calf raises performed every other day.

Unilateral calf raise exercise is demonstrated with a towel under the toes. — This simple exercise may be the missing link to getting rid of your plantar fascia pain.

First, elevate yourself using a step or small platform. Then, roll a towel and place across the step where your toes will be located. This allows the toes to be in extension during the exercise. Lastly, with the rest of your foot hanging out in space, slowly raise and lower your heel for one repetition. Count to three on the way up, hold for a two count at the top, and then take another three seconds to lower your foot. That is one full rep.

Typically you would start a program by performing 3 sets of 12 repetitions every other day. As time goes on the exercise is progressed with added weight or increased reps and sets. Weight can be increased by wearing a backpack as you perform the exercise and gradually adding more items into the backpack each week.

Get Help for Your Symptoms

Hopefully these plantar fasciitis tips will provide you with real relief if you are a recent or long term sufferer. If you have tried these or other methods without relief, you may need a different approach. Don’t hesitate to reach out and get some help, because not every case responds the same.

About the Author:

Dr. Erik Reich is a chiropractor in Meriden, CT. He practices at Omni Physical & Aquatic Therapy Center, Inc. . Where he treats all types of patients from high school athletes, seniors, victims of trauma such as auto accidents, laborers, and desk jockeys. Spending time with his wife and son, and their Boston terrier, is something Dr. Reich also enjoys.

November 8, 2019November 8, 2019

Graston Technique and IASTM

IASTM or Instrument Assisted Soft Tissue Mobilization, Graston Technique, and other forms of soft tissue manipulation are manual therapy techniques. These treatment methods involve the clinician using an instrument or tool to affect soft tissue changes in the body. Often this involves scraping, rubbing, and massage like actions over the involved tissue and underlying fascia. As a result, more blood and nutrients are brought to the area and tissue healing is improved.

Dr. Erik Reich demonstrates IASTM for pain and restriction at the base of the thumb.

How Does It Work?

Graston Technique and other forms of IASTM work as a form of deep tissue massage. These techniques have been studied and show some benefit for certain conditions in the scientific literature. Therefore, through a process of stimulating the fascia and cellular matrix, it is potentially remodeling the tissue for increased elasticity, better organization of connective tissue, increased blood flow, and pain relief.

During IASTM or Graston Technique treatment, the provider uses an instrument or tool to glide over the skin at the involved site of discomfort or dysfunction after applying an emollient to reduce friction. After that, exercise or another active rehabilitation protocol should be employed to capitalize on any improvement in range of motion or reduction in pain to the site.

What Are The Benefits of IASTM?

Some of the benefits associated with this form of soft tissue therapy are increased blood flow and healing, pain reduction, and increased range of motion or mobility. In other words, by stimulating the fascia and connective tissue through the use of an instrument or tool, changes are made to how your brain perceives the involved area, and signals are sent from the brain to the area. Also, local changes in the fascia and cellular matrix at the site of the therapy are possibly taking place to improve circulation and improve healing time, and increase suppleness of the tissue.

Are There Side Effects to Graston Technique or IASTM?

Side effects to IASTM are rare and usually minor, typically mild soreness at the site of the therapy. You may notice small red dots appear at the surface of the skin at and around the area of treatment. However, these petechiae (red streaks) or bruising are not the goal of treatment, although they may appear after a session and cause some discomfort. Soreness can linger for 1-2 days after a treatment, and you should contact your clinician or doctor if more serious side effects are felt.

A picture of Graston Technique tools layed out on a plain background. Dr. Erik Reich, a chiropractor in Meriden, CT employs Graston Technique and IASTM protocols with his patients. — Dr. Erik Reich performs IASTM and has completed coursework in Graston Technique to better serve his patients.

If you are suffering from a recent soft tissue injury and would like to see if IASTM can benefit you, give Dr. Erik Reich a call at Omni Physical & Aquatic Therapy Center, Inc. in Meriden, CT for an appointment at (203)235-0171.