While the manual adjustment has long been the basis of chiropractic, there are now a number of hand-held adjusting or massage tools that can greatly improve the quality of care without compromising standards for both patient and practitioner safety.
Many first-time chiropractic patients often are not quite sure what to expect. They may have done a bit of research beforehand or asked about the experiences of friends and family members who have been to a chiropractor, but despite all of this preparation, prospective patients still may not have a complete picture of what to expect from their first visits.
One of the more common misconceptions about chiropractic is that the chiropractor will only use the hands in order to make adjustments to the various joints of the body. However, there are in fact several hand-held tools that a chiropractor might choose to use, depending upon the location of the problem, as well as whether it involves joint stiffness and pain, or soft tissue or muscle pain. Such instruments allow the chiropractor to focus on the problem area and provide safe, effective relief.
There are several types of adjusting instruments, ranging from very simple ones that use a spring and trigger mechanism, to more high-tech computer-assisted devices that come with software on board. Whatever the type of adjusting instrument, the basic premise is the same—they deliver a high-velocity low-amplitude (HVLA) adjustments to the joint and surrounding ligaments and tendons. This means that an instrument-assisted adjustment will not require as much force as a manual adjustment (using the hands) to produce the same effect.
An instrument-assisted adjustment will result in less wear and tear on both the patient and the chiropractor.1–3 Some research has shown that instrument-assisted adjustments have a clinically favorable comparison to HVLA manual adjustments.4 The other main advantage to instrument adjusting is that it takes less time per patient, so a chiropractor is able to see more patients in a given workday, thereby adding to the practice’s bottom line.2
One large consideration with adjusting instruments, particularly the more sophisticated devices that come with computer software, is the potential learning curve. When investing in the equipment, doctors should consider the extent of training, certification, and support offered by their company of choice.
There are also certain tools designed specifically to work on the muscles and soft tissue (as compared to the joints, ligaments, and tendons). These tools can include foam rollers, which are rolled along the length of the muscles (most notably down the length of the back) to help break up restrictions and adhesions. Other examples include instruments that are used to target specific areas of restricted muscle movement. Both foam rollers and mobilization techniques are particularly useful in treating athletic injuries, as well as maintaining peak performance.
While there is a lack of large research studies on the value of soft-tissue tools, there are some small case reports that show promise for these techniques.5
1 Beychok T. “Instrument adjusting versus manual adjusting, Part 1: Physics.” ChiroEco.com. https://www.chiroeco.com/news/chiro-article.php?id=14828&catid=2044&title=instrument-adjusting-versus-manual-adjusting-part-1-physics. Published January 2014. Accessed April 2015.
2 Beychok T. “Instrument adjusting versus manual adjusting, Part 2: Bottom-line benefits.” ChiroEco.com. https://www.chiroeco.com/news/chiro-article.php?id=14850&catid=2044&title=Instrument%20adjusting%20versus%20manual%20adjusting,%20part%202:%20bottom%20line%20benefits. Published January 2014. Accessed April 2015.
3 Beychok T. “Instrument adjusting versus manual adjusting, Part 3: Patient benefits.” ChiroEco.com. https://www.chiroeco.com/news/chiro-article.php?id=14851&catid=2044&title=instrument-adjusting-versus-manual-adjusting-part-3-patient-benefits-. Published January 2014. Accessed April 2015.
4 Huggins T, Luburic Boras A, Gleberzon BJ, et al. Clinical effectiveness of the activator adjusting instrument in the management of musculoskeletal disorders: A systematic review of the literature.J Can Chiropr Assoc. 2012:56(1);49–57.
5 Looney B1, Srokose T, Fernández-de-las-Peñas C, Cleland JA. Graston instrument soft tissue mobilization and home stretching for the management of plantar heel pain: A case series.J Manipulative Physiol Ther. 2011:34(2);138–42.