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Chiropractor Shenanigans?

I have a question for all you practitioners out there. When you go in to do an inital assessment on someone, you will have them “hold” a certain position (be it leg or arm or whatever) while you apply pressure on it and move it out of position easily. After an adjustment and stuff, you will then repeat the process yet this time the joint/muscle has magically improved and can support the foce you are applying to it.

Is this a ruse? Or is this a legitimate quick way to assess how progress is going? I have been to a couple chiros that have done this now and I don’t know if they are legitimate or the equivalent of quack docs (hold these vitamins to your belly button to determine which ones your body needs…)

Sorry if I am asking you to give away magic tricks here, but I am genuinely curious.

It is based on applied kinesiology. This has been refuted by all that is science or anyone with common sense. Even manual muscle testing by physical therapist serves no clinically relevant purpose except to keep private insurance companies happy (in the USA of course).

Any test should be performed utilizing an objective test or validated patient self report. Not one determined by unreliable and non-validated testing.

In the end these tests have not correlation to improved outcomes.

[quote]olifter1 wrote:
It is based on applied kinesiology. This has been refuted by all that is science or anyone with common sense. Even manual muscle testing by physical therapist serves no clinically relevant purpose except to keep private insurance companies happy (in the USA of course).

Any test should be performed utilizing an objective test or validated patient self report. Not one determined by unreliable and non-validated testing.

In the end these tests have not correlation to improved outcomes. [/quote]

Can you expand on this? Specifically " Even manual muscle testing by physical therapist serves no clinically relevant purpose " . Are you saying muscle testing for muscle/tendon inflammation dysfunction does not work, or is invalid?

@VTBalla
Are you asking about specific joint testing (ie. testing the ligament/tendon strength of a sprained joint) or muscle testing (where they ask you a question and tell you to hold your arm out to get the answer from your subconscious)?

As someone who has a Chiropractor (and a damn good one) as a mother, and whom has been treated since the day she was born. I can attest that this is definitely not a ‘ruse’. I believe it is definitely a technique to shock and awe a new patient, but I feel it is factual. I now see a different chiro, as I live 3000 miles away from my mother, and he has done some similar tests.

_Mel

melanie,

Using terms like ‘believe’ and ‘feel’ mean you don’t utilize or except science and research. If you did, you would understand these are tests without any scientifically defensible theory, supporting evidence or pragmatic use. The x-rays utilized by chiros are of no use in the absence of a ‘red flag.’

[quote]olifter1 wrote:
melanie,

Using terms like ‘believe’ and ‘feel’ mean you don’t utilize or except science and research. If you did, you would understand these are tests without any scientifically defensible theory, supporting evidence or pragmatic use. The x-rays utilized by chiros are of no use in the absence of a ‘red flag.’[/quote]

Muslcle testing, as in assesing for muscle/tendon inflamation and trigger points is most certainly scientific. You can apply the scientific method of scrutiny to this form of assesment as well as orthopedic testing. Muscle testing, as in testing whether or not a certain vitamin is good for you is interesting, but definitely not scientific.

If you could elaborate and provide a reference for the reliabilty and validity of manual muscle testing I would appreciate it. If you could provide me with a research article for the reliability of identifying trigger points, validity of trigger points and finally a research article that suggests treating ‘sore spots’ improves outcomes I would also appreciate it.

Scientific? Have you read the research in rehabilitation? Less than 10% of special tests for orthopedic conditions have any clinical utility based on sensitivities/specificities/Likelihood ratios and satisfactory QUADAS scoring.

So to answer your statement; manual muscle testing and ‘sore spot’ assessment provide little to the clinical picture let alone improving patient outcomes…

[quote]Most Major wrote:
@VTBalla
Are you asking about specific joint testing (ie. testing the ligament/tendon strength of a sprained joint) or muscle testing (where they ask you a question and tell you to hold your arm out to get the answer from your subconscious)?[/quote]

LOL no…I mean they have you hold your arm out and push down on it to see how much force you can resist…it always seems like they are putting more force on it to start with, and less after the “adjust” you to make it seem like you’ve gotten stronger from the adjustment (removing the impingement, loosening you up, etc.)…seems kinda bullshit to me, but my chiro seems to always do it and is happy about it

Your chiro is in sales and marketing…

[quote]olifter1 wrote:
If you could elaborate and provide a reference for the reliabilty and validity of manual muscle testing I would appreciate it. If you could provide me with a research article for the reliability of identifying trigger points, validity of trigger points and finally a research article that suggests treating ‘sore spots’ improves outcomes I would also appreciate it.

Scientific? Have you read the research in rehabilitation? Less than 10% of special tests for orthopedic conditions have any clinical utility based on sensitivities/specificities/Likelihood ratios and satisfactory QUADAS scoring.

So to answer your statement; manual muscle testing and ‘sore spot’ assessment provide little to the clinical picture let alone improving patient outcomes…[/quote]

You are kidding right? What is your definition of scientific? I define it as stating a hypothesis with variable but consistent and reliable outcomes, performing objective and universally applicable procedures, then producing consistent and verifiable results. As objective, universal, and consistent as human beings can be, all of your requests can be, and have been fulfilled meeting those requirements . We are not talking polarity therapy, disc bulges, or waving crystals here.

Go to Pubmed and do your own research, there is plenty of evidence of clinical evaluation and identification on TrP’s as well as methods treating them. Read Dr. Travell, M.D. The manuals she spent decades researching, compiling and testing are available at amazon. Read David j. Magee’s orthopedic assesment manuals. I mean really come on. You are not the guy who thinks Janda was a quack?

By the way I am not interested in debating here, it is not me you are debating. You can waste your time arguing against decades and thousands of hours of clinical practice with yourself, or whoever else it appears to have an agenda against. Good luck.

[quote]VTBalla34 wrote:

[quote]Most Major wrote:
@VTBalla
Are you asking about specific joint testing (ie. testing the ligament/tendon strength of a sprained joint) or muscle testing (where they ask you a question and tell you to hold your arm out to get the answer from your subconscious)?[/quote]

LOL no…I mean they have you hold your arm out and push down on it to see how much force you can resist…it always seems like they are putting more force on it to start with, and less after the “adjust” you to make it seem like you’ve gotten stronger from the adjustment (removing the impingement, loosening you up, etc.)…seems kinda bullshit to me, but my chiro seems to always do it and is happy about it
[/quote]

Oh, well yeah that kinda seems like shenanigans.

An adjustment aims to free up nervous communication, so I guess it could make a joint stronger if there was severe impingement? But what you’re describing sounds a bit kooky. Honestly I love getting adjusted and I always feel better afterwards, but there are some chiros out there who are just not doing it right.

[quote]VTBalla34 wrote:

[quote]Most Major wrote:
@VTBalla
Are you asking about specific joint testing (ie. testing the ligament/tendon strength of a sprained joint) or muscle testing (where they ask you a question and tell you to hold your arm out to get the answer from your subconscious)?[/quote]

LOL no…I mean they have you hold your arm out and push down on it to see how much force you can resist…it always seems like they are putting more force on it to start with, and less after the “adjust” you to make it seem like you’ve gotten stronger from the adjustment (removing the impingement, loosening you up, etc.)…seems kinda bullshit to me, but my chiro seems to always do it and is happy about it

[/quote]

Is it the same test they do for the wrist magnets?

What you described sounds like a gimmick to me. I mean you could make a reach and say that the mobilization has reduced the passive resitance of an atagonist muscle, but that is a serious reach, and i have never heard of it occuring. There are a barrage of strength tests to screen for shoulder dysfunction/trauma done in a similar manner but these are used as indicators of injury, not an assesment of a procedure. Those tests also test one arm relative to to the other, as attempting to perceive strength off feel is far too subjective.

We will often strength test several weeks after the onset of treatment, but that is done with computerized equipment that can read force output with tangible numbers. Doing a strength test after each daily procedure is redundant in my opinion. I’m not trying to discredit anyone or any proffesion’s integretity, but that method of evaluation seems like an extremely flawed way of quantifying results. However if you have expierienced less discomfort and easier movement since seeing the chiropractor, then by all means stick with it, but perhaps approach claims of miraculous strength gains cynically.