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Chiropractic adjustments can be customized to treat every patient demographic including children, pregnant women, athletes and senior citizens. Varying the use of force and using handheld instruments and special tables are just some of the ways chiropractors treat patients gently and effectively.
Let’s start with the young demographic. Why would a child need chiropractic care, and what type of treatments would you provide?
Dr. Nick Angione: Typically, with children, most of the time they shouldn’t have any pain, so at first we have to make sure that this child is not having any pain for any bad reasons such as other diseases or anything like that. Once we clear that out and make sure there is nothing bad going on, generally it is just musculoskeletal pain. I now currently treat a 10-year-old girl who is an avid softball player. She plays quite a lot of games so she just comes in with some regular old back pain. I did have her sent out for x-rays and found that she was developing a scoliosis, so that’s another thing that is common in adolescent females.
Most of the time, when children have pain we’ve got to usually treat them pretty normally as if we would treat adults, but we just modify our force. Chiropractic uses an HVLA adjustment. It’s just a short, abbreviated version for high-velocity low-amplitude adjustments, meaning that we put a good amount of force in to a joint, but we do it in a very short and quick manner so that we don’t push through the joint very far, but we do move it very quickly. This allows the joint to move, allows the muscle to not spasm up when we do the adjustments, and for children we just modify our force, so we just use gentler forces.
For patients with scoliosis, it is usually a little more specific and a little different. We can use different techniques like flexion distraction tables, where the table itself twists and flexes to unload the spine, unload the curve of the spine, so generally that’s what we do. It doesn’t really change much from an adult, but it is just modified slightly. Everything is pretty much consistent with adult treatment; it’s just modified forces.
How does chiropractic care help athletes? What are some common treatments and therapies that chiropractors perform on athletes?
Dr. Nick Angione: With athletes, these are the people that I like treating the most, I have to say. They’re usually more active, and they want to get better. That is one of the best things about a patient is when they want to get better.
In terms of treating the athletes themselves, a lot of times they come in with, similar to like I said with the adolescents, playing a sport. It’s an overuse injury or sprain or something like that with athletes. Usually repetitive motions are what cause the problem, so when we do treat the athletes, we address the muscles themselves. When they’re used constantly, or repetitively used a certain way like throwing a ball or something, certain muscles will get tight because they’re getting used all the time, so we make sure those muscles are treated and released and manually worked on. We also can adjust the joints to make sure that they are properly moving and have full range of motion.
The one special thing about athletes compared to an everyday person is that, like I said, they always want to get better faster, so we also need to get them better faster, so we might see them a little more often, but more or less the treatment is pretty similar to an everyday person.
What type of chiropractic adjustments and techniques are used on pregnant women?
Dr. Nick Angione: Pregnant women are a little bit of a special case. Depending on how far they are in the pregnancy, it is going to change their treatment. Early on in the first trimester or even early in the second trimester, you can adjust them pretty normally. You just also need to modify your force. A lot of times, when you have pregnant women, their ligaments are more lax. The reason for this is due to the increase in hormones. One of the major hormones in increasing ligament laxity is a hormone called relaxin. Oddly enough, it is easy to remember, but it does cause all the ligaments in the body to loosen and have an extra laxity.
When we adjust them, we make sure that we modify our forces, and we’re compliant or we try and arrange them in a way that it is not pushing on their stomach too much depending on how far along they are. A very common technique used for pregnant women is Webster Technique. It uses a lot of drop table, which is a table that you lay on and it raises up about a half an inch, and when you push down on it with the person on it, it abruptly stops so you don’t have to put as much force in, but it still, because of the abrupt stop, it allows for a good amount of force to be put in to the joint.
Along with that drop table adjustment, the Webster Technique also utilizes massage of the round ligament, which is a ligament that attaches from the uterus to the pubic area, and it has a lot to do with the alignment of the uterus and alignment of the baby prior to delivery and birth, so that’s very important and can have big impact. Chiropractors are not supposed to be shifting the womb around, but if you do massage the round ligament and you correctly use Webster Technique, you can allow the pelvis to shift in a way that allows for more room for the baby, so that the baby can get into a proper birthing position a little easier. It is not like we are manipulating the baby itself inside the stomach. We are just allowing the muscles and ligaments around it to relax and properly align the baby for delivery. Besides the drop table technique and the modified force, it’s not much different, but there are some differences.
How do senior citizens benefit from chiropractic care, and what type of adjustments and techniques are used that they are comfortable with?
Dr. Nick Angione: With older people, generally they, not everyone, but some of them do have a skewed view of chiropractic. That is something that is a challenge every day, but it’s definitely turning around. I have to say, with geriatric patients or just elderly patients, once again we modify our force, though lot of times due to their age and the wear and tear on their body, we can’t manipulate them with those HVLA adjustments that I was talking about earlier. We have to find a different way, and the way we do that is through a technique called Activator.
Usually it’s just a handheld device that delivers a very short impulse. It has a rubber tip on the end, and it just pinpoints places on the body, and it quickly adds little jolts to the joint, gets some motion in there, and helps the body move a little bit easier. There is a whole technique behind Activator. It’s heavily researched actually, and there are some very good things about it. We use a different style. We don’t follow Activator specifically here, but we do use a gun very similar to what Activator is, but it delivers multiple impulses as opposed to the standard Activator that just delivers one impulse.
We don’t really follow the technique of Activator, but we do use, it is a mild form of adjustment, and most of the time patients love it. We don’t even just use it on elderly. We use it on anyone that doesn’t like adjustments, but most of the time with elderly patients, they have other things going on where we can’t necessarily adjust very harshly. Not harshly, but very forcefully into their spine or extremities, wrists, ankles, knees. We just modify our force, modify our technique, and usually everyone leaves happy. A lot of things that we do have to worry about with elderly patients is things like osteopenia, which is thinning of the bones, and with the Activator, we can totally handle that and it makes it nice for everybody, easy for us and it is easy for the patient to handle too.
For healthy, active adults, what are some reasons they should visit a chiropractor for a check-up?
Dr. Nick Angione: This question is a great question, and I believe that just like anyone goes to the dentist for a regular check-up and just to make sure that everything is good in their teeth, it’s a good thing to come to a chiropractor and make sure your back and joints are moving properly. A lot of times, we don’t know that we’re actually misaligned or we’re having dysfunctional joints and stuff like that or we’re lacking motion, we’ll just feel a little stiff, nothing hurts too much, but you’ll be surprised how many times people will come in and say, “That didn’t hurt until you pushed in on it.”
Those things are often found in everyday people, people that are active, healthy and usually when muscles are sore or there’s pinpoint tenderness in areas, it leads to a misalignment of the back or a joint in that area. It would be great for any everyday person without pain to be coming in just to get screened, because you do things every day of your life that you don’t realize, but they’re very repetitive. Sitting at a desk and looking at your screen, if your screen is not centered, you’re going to be looking to the left or to the right constantly every day, so even though it doesn’t start to hurt immediately, over time it could. It will develop tighter muscles on the left if you’re looking to the left or vice versa.
You may not have pain, but there’s probably a misalignment somewhere, and the goal is, if you come in before you’re in excruciating pain, we can make sure to manage it and make sure it doesn’t get out of control. That is the beauty of chiropractic. Even though our world today is probably a rehab world where we have to deal with things after they’re exacerbated and hurt, it is great to be able to be proactive and get in here to get screened to make sure you’re not misaligned and to stop things from getting bad, stop your back from getting thrown out or your neck from spasming up. It’s definitely great for anyone who is an active and healthy human being to be getting checked by a chiropractor, make sure everything is moving properly and pain free.
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