Chiropractic Care vs Physical Therapy: The Difference Based on Personal and Professional Experience
If you have spent any time in the fitness world, you may hear whispers of debate regarding chiropractic care and physical therapists. Actually, this is not just in fitness but really in all aspects of health care as chiropractic treatment is becoming a force to be reckoned with as more is learned about chiropractic care and results of that care.
Your previous trainer may have recommended you see a physical therapist, but your current trainer may be recommending a chiropractor to work on that shoulder or knee that has been bothering you and is affecting your lifting or running.
Chiropractic Care vs Physical Therapy
As someone who has not studied exercise science or is not certified in personal training, how do you know what the difference is between a physical therapist and a chiropractor? How do you know which is right for you? The point of this article is to help answer those questions based on my personal and professional experience.
Personal Experience: I’ve been involved in sports my entire life
I’m never the star of the team, but I work and train hard to still be a strong player. In junior high (or middle school for some places), my knees started to become incredibly painful whenever I was running or jumping. Then they swelled up to the point that you could not see any of the muscles surrounding the knees. I went to an orthopedic surgeon who told me the tendons and ligaments designed to hold the patella in place were longer than normal leading to my knee-cap being able to slide around to almost the back of the joint! I was sent to physical therapy several times in high school, specifically for my knees. I have maxed out on Cortisone shots for life because of my knees. My senior year, no one would clear me to play my last year of sports…except that surgeon who signed the waiver with the understanding that I would go to physical therapy throughout volleyball season and have bilateral knee replacement surgery (by now, they were bone on bone) after my senior trip.
Up to this point, I wanted to be a high school history teacher. In this last round of physical therapy, however, I became fascinated with all the posters and books about how the human body works together. If one little joint is out of place, everything is thrown off in ways you would not think. It was at this time that I decided I wanted to become a physical therapist specializing in tactical injuries. It was also during this last round of physical therapy that the Physical Therapist told me my hips were not even. I had taken a hard hit when scrimmaging against our varsity boys basketball team freshmen year. That was the point where my knees went downhill fast and my back pain started. Apparently, that hit (and the PT could tell because of how the muscles had grown around the bone) actually caused my tailbone to get stuck in the pelvis, which is what contributed to the worsening knee problems, the painful running, being unable to to ride horses using a saddle, etc. The PT said he could adjust it back into the proper spot right then during the initial assessment. Not knowing any better, my mom and I said ok. He kind of twisted my hips to where I felt a pop, but nothing else… until I tried to move. I hit the floor from all my back muscles fighting their new position. That was it. We then focused on strengthening the muscles around the knees, but never touched the back muscles.
Fast forward a few years. I have since decided that I don’t want to have my knees replaced at the ripe old age of 18 and pretty much avoided that doctor – who is brilliant and good at his job, I just did not want surgery. I became an Emergency Medical Technician to put myself through school for pre-physical therapy and exercise science. I worked full-time nightshift for a private ambulance company as well as joined my local fire department. After less than a year of constantly lifting patients anywhere from a newborn to over 750 pounds (with no fewer than 8 other EMTs for safety), I realized my knees were shot. Now my back was hurting worse even with proper lifting technique as were my hips. I had resigned myself to needing surgery when my mother – an old-school ER nurse – recommended a chiropractor. I rolled my eyes a LOT, but finally caved and made the initial appointment.
After only a month of the treatment plan – which I will discuss more in-depth later in this article – my partner noticed we were able to lift heavier patients easier. (Standard protocol is to automatically receive a lift assist if the patient is 300+ pounds.) I was able to work out more often and lift heavier weights which led to our truck joining the other trucks on our shift in not needing a lift assist unless we were going up more than 2-3 steps or the patient was over 350 pounds. After another month, my back pain had decreased, my chronic knee pain had been reduced to the point where sharp pain was actually a painful surprise. In addition to the reasons I initially sought treatment, my neck was adjusted so that headaches I thought were normal vanished. A rib injury I suffered in high school was adjusted. Any time I fell out of the back of the squad, my knees and left shoulder (the one used to catch myself on the door) were adjusted. These are just ways that chiropractic care has helped me! My mother (this is posted with her permission) has cardiac issues. Adjustments help to immediately reduce the acute vaso-spasms she was experiencing on a regular basis that had been landing her in the hospital on a nitro drip. The adjustments did not get rid of the problem; she was still exhausted the rest of the day from that battle her body went through. However, the immediate danger was eliminated if she got adjusted quickly. Witnessing one of those episodes being stopped was actually the point where she finally convinced me to do the initial consult, as I stood with my jaw on the floor and 911 dialed on my phone when I realized a squad was not necessary as in times past.
Professional Experience: In school, I realized that pre-physical therapy was not for me
I dropped that part of my major and picked up a minor in Health Promotion and Education to supplement my Exercise Science major. Working in that private transport, I saw many, many people – including those in my own age group – who were facing chronic illnesses that could have been reduced in severity level if not prevented completely with lifestyle changes. When I had to do an internship in order to graduate, I picked my chiropractors’ office.
Chiropractors have gotten a bad rep over the years due to those, that I like to say, do a “crack and go.” They do not usually do x-rays to show you what needs to be corrected via adjustments. They do not give you exercises and stretches to help the muscles adjust to the “new” movement pattern. They do not give you mobility and strengthening exercises for the muscles most directly effected by the adjustments.
The chiropractic office where I began as a patient, where I completed my internship, and was my first job out of college employed not only chiropractors but also a medical doctor and a physicians assistant in addition to those of us with various degrees certifications in exercise and fitness. X-rays are done with every new patient of every complaint they have. For example, I went in complaining of low back pain and knee pain. Full spine x-rays were done, essentially because of chain reactions. A problem in the thoracic spinal region may have been affecting my lumbar spinal region, or the cause of pain in my lower back could have a negative impact on the upper back. Treatment plans or care plans are determined by the doctors and physician assistant. Warm-up exercises are given to each patient with modifications as necessary. There is protocol for each area of the body which are modified to be specific to individual patients and their problems. Rehab floor technicians, which was my official employee title, update the doctors and PA on how the patients are doing with their exercises and stretches so changes can be made as necessary after the doctors talk with, assess, and observe the patients in regards to those updates. As patients progress, their visits typically become less frequent. This is the style of chiropractic care not only at the office at which I worked and still visit as a patient but is also the style of several other chiropractic offices to which I have referred friends, family, and clients. One of the clinics actually has a Physical Therapist and Physical Therapy Assistants on staff to handle all of the rehab, still in partnership with the chiropractors, MD, and PA but without needing direction or protocol like the certified trainers or Exercise Physiologists at other locations.
So. What’s the difference between physical therapists and chiropractors? Why do I refer my clients to chiropractors and not to specific physical therapists?
Physical therapists deal with body movements and problems a person may have with movements (1). Chiropractors look at both the musculoskeletal system and the nervous system (2). As an Exercise Physiologist, if I have a client who is struggling with a movement, let’s say their shoulder is acting up, I will refer them to a healthcare professional who can not work on improving their shoulder but can also give their immune system a boost among other full-body benefits to help my client on their way to being in the best state of health they can be. I have seen patients who were previously struggling with not only movements but also battled consistent illnesses improve due to my training complementing the treatment of the chiropractors to whom I referred the client (they had signed my name on the HIPAA waiver allowing the employees at the chiropractic office and I to talk about their diagnosis and treatment plan).
Other fitness professionals have their opinion on the matter
Some are die-hard pro-physical therapy and have that instinct to roll their eyes upon hearing the option of chiropractic care the same as I did when it was first mentioned to me. They may have gone to one of the less reputable chiropractors and have no desire to see a client go through whatever they experienced. The long and short of it is: both chiropractors and physical therapists typically choose their field in order to help their patients better their quality of life, whether that is decreasing pain without the use of pain medications or increasing mobility and strength thus increasing independence.
This betterment of one’s quality of life is typically the motivation of any fitness professional in the field as well and should lead to partnerships that may lead to you as the client being referred to either a physical therapist or a chiropractor. You do have the right to refuse that referral if you do not feel it is right for you, but you definitely will want to discuss the reasoning behind that decision with your trainer.
More information can be found with the sources cited in this article (1,2) as well as the third source of information listed below:
Unknown. Benefits of Physical Therapy.Ameri can Physical Therapy Association. 2018. 10 Feb 2018. Online; http://www.moveforwardpt.com/Benefits/Default.aspx
Unknown. What is Chiropractic? American Chiropractic Association. 2018. 10 February 2018. Online. https://www.acatoday.org/Patients/Why-Choose-Chiropractic/What-is-Chiropractic/Chiropractic-Frequently-Asked-Questions
Molly. Are There Limitations to Being a Physical Therapist Versus a Doctor of Chiropractic? Ask Palmer Blog. 17 May 2016. 10 February 2018. Online. https://blogs.palmer.edu/askpalmer/2016/05/17/physical-therapist-versus-doctor-of-chiropractic
