Chiropractor vs. Physical Therapy: Effective for the Back

Learn the difference between chiropractic and physical therapy treatments, and their effects for back problems. This article is from LIVESTRONG.com and written by Jessica McCahon. For more questions call our studio at 69-756-7500!

Chiropractor vs. Physical Therapy: Effective for the Back
Photo Credit BananaStock/BananaStock/Getty Images
Physical therapy and chiropractic sessions both treat back pain without drugs or surgery. 

Chiropractic sessions and physical therapy are two different ways you can treat back pain, but they essentially have the same end goal: to alleviate tension and nerve compression and restore mobility without drugs or surgery. Chiropractic treatment involves a trained practitioner manipulating your spine and surrounding muscles, while physical therapy involves a trained practitioner designing a program of exercises and assisting you in certain movements and massage techniques to relieve pain and restore strength and mobility. How effective each of these treatments is depends on the type of injury you have and your unique response to the therapy.

Chiropractic Adjustments

A common cause of back pain is a slipped, or subluxed, disc which can pinch the nerves in your spinal column. Chiropractic treatment involves the practitioner manipulating the slipped disc or pinched nerve back into its correct position with force and speed, says Steven G. Yeomans, DC, on the spine-health website. At the point where the tension is released, you may hear a cracking sound as gas is released from the pressure-filled joint. For this treatment to be fully effective, you need to be very relaxed, so your practitioner may massage or apply ice to the affected area before performing the adjustment.

Chiropractic Benefits and Side Effects

After just one chiropractic session you may feel reduced pain in your back and be able to move more freely, says Yeomans. This tension release can also ease compression of blood vessels and, therefore, improve the circulation of nutrient-rich blood to the injured area. It is common for the manipulated part of your back to feel sore for about 24 hours after a chiropractic adjustment, but applying ice to the treated area usually reduces these symptoms.

Physical Therapy Treatment

This type of treatment for a back injury can involve a range of techniques including heat therapy, ultrasound, massage, mobilization and exercise, says the Nicholas Institute of Sports Medicine and Athletic Trauma website. In particular, your therapist is likely to focus on strengthening and stretching the muscles and connective tissues around the affected area to improve posture and support and enhance flexibility and movement. As a result of this program, you should experience reduced pain and tension.

Physical Therapy Benefits and Side Effects

According to Dana L. Davis, MPT, on the spineuniverse website, physical therapy focuses on gradual recovery and maintaining the results. So, while the effects may not be felt as quickly as those of a chiropractic session, you may learn techniques that mean you can continue with treatment in the long term on your own. The time it takes to start feeling the benefits of physical therapy is different for every person and the type of injury you have, but Davis says two weeks is the average time it takes to notice a difference. No matter what your situation is, patience and a commitment to performing the prescribed exercises is essential for physical therapy success.

Physical Therapy for Shoulder Impingement & Tendonitis

Shoulder inflammation can be painful, and should be taken care of. It is common among swimmers, or sports where arm swings and shoulder rotation are used consistently. Here are a few exercises explained by Jessica Wellons in an article posted on Livestrong.com, to help strengthen your shoulder and thus prevent shoulder impingement and tendonitis. For questions, call us at 619-756-7500!
Physical Therapy for Shoulder Impingement & Tendonitis

The rotator cuff consists of four muscles and tendons that cover the head of the humerus and attach it to the shoulder blade, or scapula. They provide stability and strength during rotational movements in the arm. Shoulder impingement refers to mechanical compression or inflammation of the rotator cuff tendons. This occurs when the space in the shoulder joints narrows and the rotator cuff tendons or bursa, lubricating sacs located over the rotator cuff, become compressed, irritated or damaged, resulting in pain, inflammation and reduced mobility. Exercises that target the rotator cuff will strengthen the surrounding muscles and tendons, improve circulation to the joint, flexibility and range of motion.

External Rotation

Stand with your back against a wall, ensuring that your torso and shoulders remain straight. Bend your right elbow to form a 90-degree angle and bring your arm across r youabdomen, remembering to keep your thumb upright and flattening your palm against your stomach. Perform an external rotation by moving your arm and forearm away from the abdomen, remembering to keep your elbow bent. Continue this external rotation until the back of your arm is flat against the wall. Hold this position for five seconds and rotate your arm back to the starting position. Perform one set of 10 repetitions on both arms, once daily.

Supraspinatus Stretch

You will need two dumbbells to perform this exercise. Standing upright, holding a dumbbell in each hand with thumbs pointing down. While keeping your elbows straight, slowly bring your arms outward to form a 45-degree angle. Hold this position for five seconds and slowly return to the starting position. Perform three sets of 20 repetitions, once daily to strengthen the muscles and tendons in the rotator cuff, thus stabilizing the shoulders and restoring mobility.

Triceps Stretch

Stand upright and bend your right elbow to form a 90-degree angle. Raise your right hand so that your forearm forms a 90-degree with your shoulder and place your opposite hand over your elbow. Using your left hand, grab the opposite elbow and gently pull that arm down behind your head. Continue this gentle pull until you feel a stretch in your shoulders. Hold this stretch for five seconds and relax. Perform one set of 10 repetitions on both arms, two to three times daily to stretch the tendons and joints in the shoulder and help restore your range of motion.

Scapular Squeezes

Lie on your back and bend both knees. Plant your feet firmly on the ground and extend your arms away from your body, with palms up. While maintaining contact between the ground and your lower back, begin squeezing your shoulder blades together, downward and toward your spine. While performing this exercise, try to not shrug your shoulders and remember to relax your neck. As your perform this exercise, the lower muscles between your scapula should be contracting. Hold each shoulder blade squeeze for five seconds and relax. Perform one set of 20 repetitions three times a day to strengthen the muscles in the shoulders and prevent further injury.

Myths and Misconceptions: Muscle Soreness

Is it good to be sore after workouts? Check out this ACE Fit article to see if you may be over-doing it. Then come see us at San Diego Sports Physical Therapy for some great rehabilitation exercises to get you back on track. 619-756-7500

There is a common misconception that muscle soreness through exercise is inevitable and necessary to see results. For many, soreness acts as an indicator of a great workout. But this is a shortsighted view of exercise benefits and can have detrimental effects in the long run.

To clarify, this is not about the minor muscle stiffness that can be felt the day after a workout. This is about excessive soreness—the kind of soreness that lasts for a few days, has you avoiding stairs and dreading everyday activities such as putting on pants, getting in and out of a car, and even sneezing. Some people actually strive to experience this. And while a little soreness is safe and may motivate even the most sensitive among us, when it crosses the line toward debilitating movement, your body is telling you that you went too far.

The Science
In short, all muscle soreness is a result of microscopic tears that take place through workouts, followed by swelling as part of the repair and rebuilding process. This may sound like a violent way to treat your body, but it is a necessary process to stimulate changes that improve strength and fitness. But how much is enough? To answer this accurately, lets look at the available research and remove any anecdotal biases from the equation.

Cause and Effect
Many people argue in favor of soreness because they have experienced positive results and associate soreness with the results. But soreness does not necessarily equate with a cause and effect for the improvements. In fact, there is no scientific evidence that proves soreness gets better results. While there is a lack of research in this specific area, there is no shortage of research indicating that progressive challenges are responsible for improving fitness. The question then becomes, can we progress effectively without soreness? And the answer is a resounding YES.

Consider world-class athletes. No athlete, after falling short in competition, has ever said, “I should have trained to be more sore.” Yes, athletes do sometimes experience sore muscles from training. But it is neither the purpose nor the target of their training. In fact, workouts are often modified for athletes if they are experiencing excessive soreness. The measuring stick used to track success for an athlete has nothing to do with the level of soreness derived from day-to-day training and everything to do with the longer-term outcome of their training program and competition goals. In fact, too much soreness will negatively impact training and competition.

Overload
To improve fitness, it is true that an “overload” is required. This means you need to apply a challenge that is greater than what your body is accustomed to. However, this “overload” can be applied aggressively or it can be applied gradually. Many assume the more aggressively you overload, the faster you will see results. But the body is more complex than that and pain is its way of telling us to slow down with the overload.

Law of Diminishing Returns
Most improvements follow a basic premise of “the more you put in, the more you’ll get out.” However, there is a tipping point that suggests a certain level of extra work does not yield any additional benefits. In short, it means you are working overtime and not getting paid for it. This can be illustrated through the concept of exercise dosage. Much like medical prescriptions, too high of a dose does not provide additional benefits nor increase the speed of benefits. Additionally, repeated “overdosing” can invite negative consequences. Extreme soreness is often just that—an “overdose” to the body.

Why it is Important to Avoid Muscle Soreness?
The Hot Iron syndrome…
Most kids only need to touch a hot iron once. If you simply don’t like to feel pain, soreness is more likely to be a deterrent to exercise, not a motivator. In fact, it may be a subconscious reason it is so difficult to start up or get back to that first workout after a layoff.

Fitness should make everyday life easier, not harder…
Extreme soreness naturally alters choices for activity outside of workouts. If your weekly leg workout leaves you feeling sore for three days, and you choose escalators over stairs, it defeats the functional purpose of being more fit.

Tighten up those muscles…
This phrase, which is often used to describe a positive outcome, may literally mean “tighten” in this case. Consistent states of soreness can easily reduce range of motion and lead to permanent changes to your movement patterns.

Overtraining and overuse injuries…
Overtraining and overuse injuries take time to develop. Unfortunately, by the time they are noticed, you are too deep to reverse the process quickly. Aiming for and achieving soreness week in and week out is inviting either or both.

Distraction from more important goals of exercise…
Exercise and fitness success needs to have a far more sophisticated evaluation tool than the level of soreness. By aiming for soreness in the short term, we may be ignoring the true measurements of success for exercise, such as fitness, strength, functionality and longevity, among others.

How to Avoid Muscle Soreness and Still Achieve Great Results
Avoiding soreness is not the same as avoiding high intensities. High intensities and maximum effort can be reached through sensible and progressive overloading strategies. You just don’t want to start there. Gradual progressions are very effective and are a far more reasonable and comfortable way to improve fitness and reduce short- and long-term risks. This can be accomplished by understanding your current levels of fitness and strength, and applying small and frequent increases in intensities and volume according to where you are now—not the level you someday hope to reach.

Remember, fitness is built. It is not injected. Build it wisely…

By Christopher McGrath

Chris McGrath, M.S., is the founder of Movement First, a New York City-based, health and fitness education, consulting and training organization. With more than 20 years of fitness and coaching experience, McGrath specializes in a variety of training modalities including sports performance, injury prevention, post-rehabilitation and lifestyle/wellness coaching. McGrath is a Senior Fitness Consultant to the American Council on Exercise and has established himself as an international fitness expert.