Manipulative Therapies Flashcards
Chiropractic medicine
treatment based on the belief that the nervous system, skeletal system, and muscular system interact, and if that interaction is blocked, disease and/or pain will occur
Belief that body has inherent ability to heal itself if nerve impulses can travel freely between brain and rest of body
Chiropractic method of treatment
relieve blockage by using spinal manipulations or adjustments
Subluxation
1+ bones of the spine that have moved out of position and cause pressure on or irritate the spinal nerves
Adjustment/spinal manipulation
manipulating misaligned vertebrae or other joints in the body back in place
Adjust the spinal vertebrae that surround the spinal cord to release pressure on spine/nerves that connect to and innervate body
Bonesetters
people who set the broken bones without conducting surgery
Practiced in Europe, North Africa, Asia
Western folk medicine contains references to bonesetters; said to be early chiropractors
Daniel David Palmer (1845-1913)
1895 - founded chiropractic medicine
Manipulated misaligned vertebrae into place to cure patient of deafness
1898 - Palmer School of Chiropractic
Many problems; jailed for treating without license
David Daniel Palmer believed spinal manipulation could heal ~____% of all diseases
~95%
chiropractors believe good health is determined by a healthy nervous system, particularly a healthy ______ ________
spinal column
Primary belief
= using natural and conservative methods of health care and to allow the body to heal itself without the use of surgery or medication
3 Camps of Chiropractic Philosophy
- Chiropractic Straights
- Chiropractic Mixers
(3) Reform Chiropractic (offshoot of mixers)
Chiropractic straights
~15%
1. Objective straights:
- sole focus is correction of vertebral subluxations
- Do no claim subluxations cause any disease
- more modern than traditional
- Traditional straights:
- adjustments are a plausible treatment for a wide range of diseases
- Believe in innate intelligence = criticism
- Follow Palmer’s doctrine (subluxations cause/contribute to most disease)
- Use only spinal or joint manipulations to cure every sort of disease (no heat)
Chiropractic Mixers
- majority of chiropractors
- Believe that disease is caused by pathogens
- Subluxations cause lower resistance to disease or cause neurological imbalance
- Use spinal adjustments + other adjuncts (heat, light, vitamins, physical/mechanical adjustments)
reform chiropractic
- Offshoot of mixers
- Considered most biomedical of group
- Rejected Palmer philosophy, avoiding alternative medicine
- Chiropractic care only for musculoskeletal disorders
- Did not believe spinal joint dysfunction is the cause of disease = did not focus on subluxations only
- Aimed to create “orthopractic group” = failed
Vaccination
Historically opposed to vaccination and water fluoridation
- belief that all diseases were traceable to causes in the spine, and therefore could not be affected by vaccines
- body is conditioned to fight off disease and that vaccines may be lulling people into a “false sense of security
Many do not promote the use or nonuse
Fluoridation
more controversial
Many countries rejecting because they believe drinking water is not the appropriate vehicle for delivering medication
- believe ingesting is less effective than topical application
Known toxic effects
- Children developing dental fluorosis, discolored teeth
- before units filtered out fluoride, people on dialysis were developing bone disease
_______ are a major diagnostic tool for chiropractors
X-rays
Diagnosis
○ X-rays are a major diagnostic tool
○ Physical examination of injured area
○ History is taken
Treatment plan formulated
Chiropractic Techniques
- Basic Chiropractic Adjustments
- Thompson Chiropractic Technique
- Cox Flexion/Distraction Chiropractic Technique
- Gonstead Chiropractic Technique
- Basic Chiropractic Adjustments
= most common
*Velocity (high or low speed)
*Force (high or low)
*Lever (short or long)
*Recoil
= Most used = high velocity, short lever, low force
- Thompson Chiropractic Technique
AKA drop-table technique
- Analyzing the length of the leg and using a drop table for adjustment
- Gentle thrust is applied to joints, setting drop table into motion
*high velocity, low force
- Cox Flexion/Distraction Chiropractic Technique
- Restore range in motion in joints and muscles
- Uses special table that flexes and bends various joints
- Restore herniated discs, reduce headaches, and improve posture
*Low velocity, low force
**uses activator sometimes
- Gonstead Chiropractic Technique
- Application of different levels of pressure to address subluxations
- Increase muscle and joint mobility
- Short lever, high velocity, low force
- Use different types of tables and often patient is sitting up
Chiropractic Activator
- Mechanical chiropractic aid
- Small tool that delivers a light and measured force to correct a misalignment
- Gently and painlessly moves the vertebrae
Adjuncts
- massage therapy
- Active release technique (ART)
- Dry needling
- Hydrotherapy and heat therapy
- Cold therapy
- Immobilization therapies
- Electrotherapy
- Galvanic stimulation
- Radiofrequency rhizotomy
- Transcutaneous electrical nerve stimulation (TENS)
- Interferential current (IFC)
- Ultrasound
- Diet and nutrition counseling
Contraindications to having chiropractic adjustment
- advanced osteoporosis
- bleeding abnormalities or being on anticoagulants
- having spinal malignancy/other spinal inflammatory disease
Adverse Effects
temporary headaches, tiredness, or local discomfort
Although rare, some serious side effects have occurred
- Upper spinal manipulation could cause arterial dissection and stroke
- lower spinal manipulation could cause cauda equina syndrome
Training of the Doctors of Chiropractic (DC)
- Undergraduate Bachelor’s Degree (3 years, emphasis in science courses)
- Graduate Dr of Chiropractic Degree
- National Board Exam
- Canadian Chiropractic Examining Board (CCEB) - Register with Region’s Board
Critics’ Thoughts
subluxation and spinal manipulation are not based on sound science
Pros of Chiropractic care
- Effective for back and neck pain
- Decrease frequency of headaches
- Does not require drugs
- Considered a natural treatment
Chiropractors can develop close relationship with patients
Cons
- stem from those chiropractors who adhere to a philosophy that spinal manipulation can cure diseases
- not been scientifically proven and could deter people from seeking medical advice
Massage therapy
manipulating soft tissue and muscles using a variety of physical methods, including applying fixed or moveable pressure, holding, vibrating, rocking, applying friction, kneading and compressing, and/or causing movement to the body
T of F: massage therapy includes therapies such as healing touch (Therapeutic Touch), Reiki, acupressure, and reflexology
F: excludes, uses touch
Origins of Massage
Hippocrates (460-370 BCE)
- Reported that anatripsis (act of rubbing up) was most effective for massage
Per Henrik Ling (17761839)
- Developed the Swedish massage and Swedish gymnastics
- Swedish Gymnastics Included calisthenics, stretching, and massage
- Physiotherapy was based on these methods
1970s - movement to establish massage as a treatment for stress and maintain health outside medical practice
Massage therapists are not allowed to:
- diagnose conditions
- prescribe drugs
- conduct spinal or joint manipulation
Western vs Eastern massage
- Western:
- tend to focus on stretching and are more soothing and calming
- addresses the body through anatomy, physiology and pathology
(Swedish, myofascial, esalen, holistic) - Eastern: use direct and focused pressure and are more stimulating
- based on energy flow and balance between mind and body
- massage used to help Qi flow through body
(ayurvedic, tuina, lomi lomi, shiatsu)
Western
a) Swedish Massage
- firm but gentle pressure to promote relaxation, ease muscle tension, and create other types of health benefits
- May include deep tissue massage: deeper pressure on specific areas of muscle tension
b) Esalen massage
- Developed in California; done near cliffside natural geothermal (hot) springs
- If not at the Institute, incorporates the sound of waves in the background, and if not close to water, uses recordings of waves breaking onto a beach or rocks
- ocean provides a slow-moving rhythm said to be similar to the internal rhythm of our bodies
- wellness/stress management type of massage
c) Holistic massage
- Claims to deal with the person as a whole
- attempt to address the underlying cause of the symptoms
- client completes a detailed health history; what they have eaten and eliminated
- Kneading strokes on tight muscles to aid lymphatic drainage
Eastern
a) Ayurvedic massage
- Uses mat not table
- provide relaxation, help circulation, and rid the body of toxins
- based on the Ayurvedic doshas and marmas (pressure points)
- Using Ayurvedic massage oils
b) Tuina
- Bodywork therapy using the theory of the flow of chi through meridians
- Chi flow is increased and allows body to heal itself
- uses hand techniques that massage soft tissues, muscles, and tendons, and uses acupressure to directly move the flow of chi
c) Lomi lomi
- Hawaiian massage therapy
- Increases energy flow in body
- Hawaiian healing philosophy: Huna = everything seeks harmony and love
d) Shiatsu
- Gain relaxation
- Acupressure techniques to unblock meridian points where chi energy is blocked
- Client has to change positions during massage
- Watsu: form of shiatsu given in therapeutic pool of water
Massage techniques
- Effleurage
- Petrissage
- Percussion
- Tapotement
- Static pressure
- Deep sustained pressure
- cat stroking
- fan stroking
effleurage vs petrissage
Effleurage: stroke that can blend all strokes
- hands are placed across the body with fingers together and thumbs slightly stretched
- stroke should be smooth, initially without pressure
Petrissage: kneading using the whole hand, with fingers together and thumbs outstretched so that the rounder contours of the body are squeezed
percussion vs tapotement
Percussion: lightly striking the body using different parts of the hands, keeping the wrists loose
- begin slowly and increase to moderate speed, then build to a crescendo and stop abruptly
Tapotement: tapping the body or face
done by cupping, hacking, and pinching
static pressure vs deep sustained pressure
Static pressure: good for releasing tension in the neck, shoulders, back, and feet
- thumbs are placed on the skin and the therapist leans into them, increasing the pressure
Deep sustained pressure: full length of the sausage-shaped muscles on either side of the spine
cat stroking vs fan stroking
Cat stroking: placing hands at the top of the area that is being massaged and, with very light pressure, gliding the hands down the body
Fan stroking: placing hands palm side down and smoothly sliding upwards by leaning into it with a straight back
– Fingers fanned on both sides, slowly releasing pressure
Training of a Massage Therapist
- high school diploma
- massage therapy program
- complete required training hours
- mandatory certification examination
(college of massage therapists of Ontario = CMTO)
Benefits of massage
- eliminate waste products such as lactic acid from overworked muscles
- improve circulation, bringing fresh oxygen to body tissues
- stimulate the lymph system to rid the body of toxins
- enhance a sense of well-being
- reduce stress
- improve mood and sleep patterns
- decrease lower back pain
- increase range of motion
What does research show?
*geriatric massage
*infant massage
*pregnancy massage
*reasons for massage
*back pain
*geriatric massage
- age-related illness (Parkinson’s, arthritis, diabetes) benefit due to improved circulation of lymphatic fluid
- touch may aid with depression, loneliness, isolation
- improves mobility and stiffness
*infant massage
- sleep better, cry less, less stress
- nothing on physical attributes or social/mental development
- helps bonding
- satisfaction among caregivers
*pregnancy massage
- conducted by someone trained in pregnancy massage to avoid pressure points causing uterine contractions
- relaxing anxiety, relieving back pain, promoting sleep, relieving edema
*reasons for massage
*back pain
reflexology
form of massage that involves applying pressure to points on the feet, hands, and ears
in relfexology, body is divided into ____ energy loops that start at and then return to the ____ and _______
10
hands and feet
○ By stimulating the origins of these loops pressure will cause a response in any of the organs found within particular loop
Pressure on certain points of the feet, hands, and ears are thought to heal parts of the body that correspond to the
pressure points
origins
17th century: tribes practiced zone therapy or reflexology to cure themselves of various diseases
1900 - William Fitzgerald - introduced zone therapy to the United States
zone therapy
the body is divided into 10 vertical zones, running from the tips of the toes to the top of the head
Eunice Ingham
renamed zone therapy as “reflexology” and mapped out the feet’s reflex zones in charts
discovered that applying pressure to reflex points could have a much wider effect on the body than just pain relief
T or F: Reflexology is a gentle, non-invasive technique with no known side effects
T
T or F: oil is used in feet reflexology
F: Oil is not used, instead a light dusting of talcum powder on foot
what does it mean when reflexologist feels tiny crystals under the skin and will record those on a piece of paper
= particular area of body needing special attention
Becoming a Reflexologist
There are no licensing laws requiring special reflexology training, but it may allow a practitioner to be more effective
Massage therapists receive some reflexology training
future of reflexology; most favorably received among ________ ________, ________ ________, and ________ profession
physical therapists, massage therapists, and the nursing profession
