Does Chiropractic work? Sometimes? Not really?

[Mabouya]

I've been rowing a bit for the last few months (C2 erg) and want ramp things up, but as I started to do that a week or so ago my shoulder's started to bother me. I sent some of the folks in the local rowing club an e-mail (got the addresses from the contact list on the web site) asking if there were any orthopedic surgeons in the area who were familiar with rowing-related issues.

I received a response from one of the coaches who happens to also be a chiropractor. I've never been to one before, so I'm not sure what to expect, but as we all know they have a bit of an iffy reputation, and if you go to this guy's web site it has it's fair share of "feel the energy" type of stuff that tends to turn me off.

On the up side, I do believe my insurance at work will cover it. (not 100% sure)

Any thoughts on whether or not this is likely to be worth my time and money?

TIA

[Eric Estlund]

I'm not an expert, was a long time skeptic, and have had some negative and positive experiences. Good ones not only look at skeletal alignment, but other issues that may be causing concern (like how you are using your shoulders and body).

I will say that if you are ramping up you may be over training a specific set of muscles resulting in either discomfort of possible injury. I spend a little time on a C2 myself, but also balance all the pulling exercises with pushing and stabilization stuff. You may be interested in seeing a trainer, coach or other sports med. practitioner before jumping straight to an orthopedic surgeon.

[doomridesout]

Backing out to the initial complaint-- even if you don't find that chiro is your thing, the fact that your shoulder is bothering you only a little indicates that finding an ortho surgeon is probably overkill. Orthopedic surgery is for when you run out of other options or have seriously injured yourself. It's one thing if you want an ortho to refer you to somebody who can do physical therapy, it's another to go get cut up for some nagging injury. I would only consider surgery if there's a definitively diagnosable and otherwise permanent injury.

The upshot for chiropractic care? There are plenty of quacks out there and if this guy wants to do "manipulations" on you, and doesn't provide any homework in terms of strengthening/stabilizing exercises, he may be one of them. On the other hand, I've had extremely positive experiences with the type of practitioner who is willing to give you a list of exercises to do daily or nearly daily. This type of issue takes some work on your part to resolve, but outcomes seem to be better across the board compared with orthopedic surgery.

[Mabouya]

To clarify, I'm a gazillion miles from surgery.

They call themselves "orthopedic surgeons" but I wouldn't be seeing one for surgery, just a diagnosis and treatment.

[Polyglot]

I went to college in Toronto and the only Chiropractic college in Canada (Canadian Memorial Chiropractic College) at the time shared our residence because they did not have their own. As such there were many chiro students that were endlessly looking for volunteers to practice on. Over my 4 years of college, I got adjusted by about 100 different students and later by many different graduate chiros. Let me say that a good chiro is worth their weight in gold. Unfortunately, a poor chiro is little use at all and can actually be negative. Since I now work in hospitals on a regular basis, I have also witnessed the work of orthopedists and osteopaths. I find the percentage of very good orthos or osteopaths is about on a par with the percentage of good chiros. My local chiro is a former president of the ethics panel of the local board of chiropractics and he is wonderful. I must however caution that he was the fifth chiro that I visited before feeling well-served. Where I last lived, I had another chiro and she too was wonderful and there I was lucky on my first try.

As far as rowing goes, my mother has been rowing for close to 70 years and won 4 gold medals in the 80+ category at the last masters world championships in September 2015 and she visits a chiro from time to time for relief. She hasn't been to see a surgeon since have her carpal tunnels repaired over 30 years ago. Personally, I would not go to a chiro that presented himself in a club setting. I would instead ask then to refer you to a colleague of theirs and then make sure that the referral is returned by the chiro that you are referred to.

[Mabouya]

Personally, I would not go to a chiro that presented himself in a club setting.

It's been over 24 hrs since I sent the e-mail and so far he's the only one who's responded. I find it interesting that not a single other person to whom I sent the message (9 total, including him) replied with something like "Talk to Joe Smith, he's both a coach on the club and a chiro - he ought to able to help." That might not mean anything, and maybe the others aren't good about checking their e-mail, but still, I can't help but wonder if that's a sign.

[Mark Kelly]

"Subluxation" has never been shown to exist.

I find it hard to believe in a therapy based on a non-existent phenomenon.

A favourite quote from Tim Minchin's : "You know what they call alternative medicine that's been shown to work? Medicine."

[Matthew Strongin]

I've been rowing a bit for the last few months (C2 erg) and want ramp things up, but as I started to do that a week or so ago my shoulder's started to bother me. I sent some of the folks in the local rowing club an e-mail (got the addresses from the contact list on the web site) asking if there were any orthopedic surgeons in the area who were familiar with rowing-related issues.

I received a response from one of the coaches who happens to also be a chiropractor. I've never been to one before, so I'm not sure what to expect, but as we all know they have a bit of an iffy reputation, and if you go to this guy's web site it has it's fair share of "feel the energy" type of stuff that tends to turn me off.

On the up side, I do believe my insurance at work will cover it. (not 100% sure)

Any thoughts on whether or not this is likely to be worth my time and money?

TIA

When you say your shoulder is starting to bother you, was there an event that caused an injury or did it come on gradually as you ramped up the rowing? If gradual, have you tried rest and ice to see if that causes the pain to subside? I'm not a medical professional, but I have extensive experience in effing up my shoulders. Broken and dislocated clavicles, separated shoulder, dislocated shoulders and a torn labrum. With each injury my orthos have ordered rest, mild anti-inflammatories and ice. It was a good lesson that sometimes just giving the body time to do it's thing can make a huge difference. And considering the collection of injuries the fact that I have pretty normal shoulder function on both sides tells me that there's something to this. That and, as Eric said, doing work to balance the rowing and increase stability is key to avoiding overuse injury in the first place.

If it was an acute injury, I'd start with an ortho for a consultation and go from there. You could do the same with a chiro if that helps you feel like you're keeping your options open. Keep in mind, a consultative visit is a way for you to get more information on what could be causing your pain and a way to assess the practitioner; and if your insurance covers it, it is not terribly expensive. My main advice to avoid making things worse would be to make sure you are 100% confident in the diagnosis and the doctor before starting down a course of treatment.

[SeanEasley]

To clarify, I'm a gazillion miles from surgery.

They call themselves "orthopedic surgeons" but I wouldn't be seeing one for surgery, just a diagnosis and treatment.

This is like saying you want to take your car to a vacuum repair shop to diagnose the problem and fix it.

You should see a PT for a proper diagnosis of an overuse or movement-based problem (which is what this sounds like).

If you fell on your shoulder and it hasn't been the same since or something like that, then the case for surgeon is stronger. An ortho specialist PT is always a good first stop for anything like this.

Full disclosure: yes, I'm a PT

[deano]

No dog in the fight here except a couple of good pals who are PTs. I believe in PT; chiropractic, I'm skeptical, but some folks I know and love swear by it; BUT, this I believe:

don't do anything, chiropractic, surgery, etc., without a buncha PT before and after. Anything we do to/for our bodies is useless without actually strengthening the muscles and joints to prevent or improve our foibles; PT is going to be the narrow gate through which you must pass no matter what.

[deano]

PS - recent MTB wreck and I thought I had a broken clavicle. Doc says everything a-OK with the bone but I likely bruised it and pulled my trap somehow causing the pain. Gave me a muscle relaxer! PT took one look at it the next week and accurately diagnosed my AC separation. These folks know muscles and bones like gangbusters. lotta PTs now have a doctorate too.

[Tom]

There are good chiros and useless ones, as stated. If they want to start adjusting without checking any diagnostic information first run, do not walk, to the nearest exit. It doesn't work in isolation, either. It'll get something that is screwed up back in line but if you don't do the work to maintain strength and alignment on your own you're wasting your time and money.

[summilux]

A good chiro is worth seeking out and I am very happy with the ability of mine to alleviate some moderate chronic back and shoulder pain issues. That said, I went through 5 useless ones before I found my current one. If you've got insurance, why not?

[teleguy57]

To clarify, I'm a gazillion miles from surgery.

They call themselves "orthopedic surgeons" but I wouldn't be seeing one for surgery, just a diagnosis and treatment.

Nope. They are trained to "fix" things and their view of the world is surgical. True story: took an 87-year old friend to a follow visit to a neurologist regarding a potential Parkinson's diagnosis. Several weeks before he had fallen and broke 2 vertebrae. He was telling the neurologist about the poor beside manager of the ortho who saw him in the ER. Her response "Surgeons are trained to do surgery. When you need them you really want the technically best one -- and your guy is one of the best. But you don't see an orthopedic surgery unless you're looking for surgery. "

I look other places for primary diagnosis and treatment; for me it's all about the quality of the provider. I have a great PT who is also a cyclist and who has introduced me to dry needling as part of my treatment. I also have visited 4 different DCs over time. All have helped with acute SI/L4-5 issues. The current/best one also has helped me think upstream/downstream to look at root cause vs symptom. Turns out my SI stuff often is a response to restrictions in my upper thoracic region. He also is trained in accupuncture (same tools as dry needling, much different approach and intent) and that's been helpful at times too.

[Matthew Strongin]

Nope. They are trained to "fix" things and their view of the world is surgical. True story: took an 87-year old friend to a follow visit to a neurologist regarding a potential Parkinson's diagnosis. Several weeks before he had fallen and broke 2 vertebrae. He was telling the neurologist about the poor beside manager of the ortho who saw him in the ER. Her response "Surgeons are trained to do surgery. When you need them you really want the technically best one -- and your guy is one of the best. But you don't see an orthopedic surgery unless you're looking for surgery. "

This was definitely not the case with the ortho surgeons I visited. I'm not saying it isn't common, but I don't think it's universal. When I broke my collarbone the ortho wanted to see me regularly for a couple weeks to make sure it was reconnecting on its own. Once that was confirmed he actually talked me out of surgery because he felt it wasn't necessary to regain full function. He was right. And when I had the pleasure of a dual SC dislocation and AC separation, a different surgeon once again recommended time and PT. Neither of these guys had any interest in cutting me open if I didn't need it.

[donevwil]

I say have an open mind and be willing to try more than one chiropractor. Your chiropractic experience will most likely hinge on the quality and skill of the chiropractor. I've been going to the same guy on and off for 20 years and he's good, but my experience has also proven that there are many mediocre ones for every truly skilled one. That said a PT visit would also be in order, they'll teach you some stretches, exercises and probably tell you to buy a foam roller to work out the persistent kinks.

Good luck.

[Bewheels]

Another way to determine whether you are onto a good chiropractor or not is to ask what to expect. How long is a sessions? How many sessions could you expect? What would take place during a session? etc.

If you are told that there sessions will be 10 minutes and be weekly for months...run away.

My wife is an ex-chiropractor and had her own business. She was one of the good ones (says her husband) and focused on elite athletes. She saw a patient for 30-60 minutes at a time and had a policy that if she could not substantial improve the situation in 3 visits she referred you out. This referral might have been to PT or other medical professionals.

The chiropractic field is also a chiropractic industry in which schools and seminars are 100% focused on running a business and making money. Which is fine except it overly promotes the money making side. We would receive countless solicitations for these things.

I could go on....

But the main thing is to find out what to expect. What you are looking for is a person who will spend at least 30 minutes with you and there is an expectation that the issue will be resolved in a reasonable amount of time. And what type of other medical professionals do they work with.

[defspace]

This was definitely not the case with the ortho surgeons I visited. I'm not saying it isn't common, but I don't think it's universal. When I broke my collarbone the ortho wanted to see me regularly for a couple weeks to make sure it was reconnecting on its own. Once that was confirmed he actually talked me out of surgery because he felt it wasn't necessary to regain full function. He was right. And when I had the pleasure of a dual SC dislocation and AC separation, a different surgeon once again recommended time and PT. Neither of these guys had any interest in cutting me open if I didn't need it.

+1
Somewhat recent collarbone break here. Ortho initially suggested we let it heal on its own. I went in a few weeks later for a follow up and the break had shifted (I could see the difference on the X-ray). At that point we started talking surgery and got the feeling I was more interested in surgery than he was.

Re: PT's - I've been working with one for my shoulder. Geez, they're great. They really know their stuff. No feel the energy nonsense here. It's amazing how much they can make you hurt with light weights! I can't comment on chiros. I've never visted one.

[EricKeller]

I was always a skeptic, but I finally gave in because of too much back pain. I know it's due to stress, but that doesn't really matter to me. My wife is a D.O., which means that she has training similar to a chiropractor, only combined with medicine. Of course, most D.O.'s don't do manipulation because they can't get paid for it. So my wife isn't very good at it any more. She finds chiropractors that aren't quacks. From what I can tell, if they have an X-ray machine, it's a sure sign of quackery. Our chiropractor retired a year ago, unfortunately. The thing that gave me confidence in him was that he would find the places that hurt without any help from me. I know that there are PT's that will help the same conditions with their own techniques, but that seems problematic from an insurance viewpoint. When I had regular chiro appointments, my back pain was much better most of the time.

One thing that I have considered is yoga, I'm pretty sure that would fix my problems. Only thing is that it's hard for me to keep up yoga on my own and I have had problems because of continuity with yoga instructors.

[Mabouya]

I agree that ortho + PT is a more mainstream approach than chiro. In this case I'm wondering if a chiro who's intimately familiar with rowing and the issues associated with that may potentially be more helpful.

I haven't decided yet what I'm going to do. If I wait long enough this will resolve itself because it will be too warm to row inside and I'm be shifting over to cycling outside.

One thing I have noticed is that I used to be able to the stretch below on both sides (one was super easy, the other took some work). Now I can't come anywhere close, L or R. I haven't done any shoulder stretches in months, and that may be part of the problem.