Question
Good evening, Dr. Healey.  I am currently studying to become a Certified Fitness Trainer through ISSA, and as an aspiring personal trainer, I will be working closely with various health care professionals. One of my questions on my exam is to contact a Chiropractor or other occupational healthcare provider and discuss what kind of modalities they use in treatment.
Can you give me an overview of the types of therapies you use and how could I as a personal trainer work with a chiropractor in the treatment
of a client?
Thanks in advance-
DeAnna Collins

Answer
Dear DeAnna Collins,

Best of luck in your career!  I'm sure you will help bring positive change to the lives of your clients.  Also, thank you for your question.  In order to answer you properly, though, I'll first need to give you some background on the chiropractic profession.

There are two branches or schools of thought in chiropractic.  Briefly, they are differentiated by whether they deal with the limited therapeutic approach for aches and pains (commonly termed "mixed" chiropractic because it represents a mixture of a chiropractor with a non-chiropractic matter) or a non-therapeutic approach to optimum body performance (termed "straight" chiropractic because there is no mixing of chiropractic with anything else).  My expertise is in non-therapeutic straight chiropractic.

Therapeutic "mixed" chiropractic is the older approach based on a split from the founding principles of chiropractic about a century ago.

Non-therapeutic "straight" chiropractic is the more modern of the two.  It deals with a particular, common situation called a vertebral subluxation. The spine is made of many bone segments which house and protect the spinal cord and the smaller spinal nerve branches that come off the spinal cord and exit between the bones.  These nerve pathways carry information or messages between the brain and the cells of the body.  These messages are essential for the life of the cells.  Without vital brain messages, the cells immediately begin the process of dying; i.e., they can no longer function the way they should to maintain life.

Because the bones are moveable, they can misalign in such a way as to interfere with the messages and, ultimately, the ability of the person to function at their best or express their optimum potential.  People with vertebral subluxations are not able to get all they can out of life.

Vertebral subluxations can be caused by a wide variety of factors, what we'll generally call stresses.  These stresses can be physical (such as exertion, accidental trauma, sleeping posture and mattress condition, the birth process, sneezing, falling down, etc.), mental / emotional (in its many forms, probably the most familiar use of the word stress), or chemical (such as pollution, drugs, etc.), which are, unfortunately, regular parts of daily living for all age groups.  In short, a vertebral subluxation can occur for a multitude of reasons.

Tragically, vertebral subluxations are rarely obvious to the individual they affect.  They usually have no symptoms.  The reason is that most of what goes on inside you happens without your awareness.  As an example, try to "feel" your liver.  What's it doing right now?  You can't know, so you can't know if it's functioning at its best or something less.  To complicate things, nerve pathways that carry messages of control (termed "motor" nerves) have no way of transmitting ache or pain messages, so your body function may be far from perfect and you'd not have any alerting signal whatsoever.  In addition, the branching of the nerve pathways is quite complex and extensive, making it exceedingly difficult to predict or determine exactly how the person will be affected.  In order to know if someone has a vertebral subluxation, it is necessary to have that person's spine checked by a non-therapeutic straight chiropractor using a method of "analysis."  When a vertebral subluxation is detected this way, it is obviously important to correct it as soon as possible.  The term for this is 揳djustment?and can be accomplished in a variety of ways, depending upon the unique vertebral subluxation and the individual person.  

Since vertebral subluxations are caused by so many different things, people choose to go to a non-therapeutic straight chiropractor on a regular basis to enjoy the most time free of the life-robbing effects of vertebral subluxation. There's a saying that straight chiropractic is not about your back, it's not about your pain, it's about your life.  Each person has a unique potential in life.  With vertebral subluxation, it's impossible to realize that potential.

Now that you have some reference point from which to start, let's address the matter of modalities.  Note that in defining non-therapeutic straight chiropractic or in distinguishing it from therapeutic mixing chiropractic throughout this response, the focus was always upon the objective, not the method.  Whether a method fits within non-therapeutic straight chiropractic is determined by the objective ?the desired goal ?in using it.  I imagine an argument may be attempted that if a modality is used for the purpose of detecting and correcting vertebral subluxations, then it may fit within non-therapeutic straight chiropractic.  Whether it is reliable in that pursuit is another responsibility that the user has to wrangle with, of course.  From the non-therapeutic standpoint, then, an adjustment is effected by any of a number of techniques, but is solely and uniquely for the correction of vertebral subluxations because they, in and of themselves, are detrimental to the expression of life.  The exact technique used is not the determining factor in whether someone is providing straight or mixed chiropractic services.  In fact, because no two people are the same, many who are practicing non-therapeutic straight chiropractic and focusing solely on the correction of vertebral subluxations will rely on a variety of adjusting techniques.  They will employ the one best suited to the particular individual in the office at that particular moment.   Generally, modalities are therapeutic in nature ?they are used in treatment of a therapeutic concern ?and have no real place in the practice of non-therapeutic straight chiropractic.  

The way your question is phrased, regarding how a personal trainer may work with a chiropractor in the treatment of clients, may be better suited to a therapeutic mixed chiropractor.  I wonder, though, if you view your field only in a therapeutic model.  It seems to me that it could just as easily be interpreted in a non-therapeutic manner.  Wouldn't everybody benefit from exercise, and not just those with an ache or pain?  Isn't physical conditioning a positive contributor to the expression of life?  Perhaps this could be discussed further with your colleagues.  I'd be glad to be a resource for non-therapeutic model philosophy, if you wish.  As far as a personal trainer working within non-therapeutic straight chiropractic, suffice it to say that they are two different fields that could co-exist because they contribute in unique ways to the full expression of an individual's potential, but it may be of use to you in your research (and professionally and personally, since non-therapeutic straight chiropractic deals with optimum human performance) to know more about non-therapeutic straight chiropractic and the two viewpoints in this field.

DeAnna, I wish you the best in sorting out the sometimes confusing world of chiropractic and in your education and ultimately successful career.  It has been my pleasure to provide you with some information.

Sincerely,
James W. Healey, D.C.