In working with the human frame the various techniques can be roughly subdivided into ones that work with the bones, ones for the joints, ones for the soft tissues (muscles, tendons, ligaments etc.) and ones to improve the nervous system’s control of the whole affair. There is overlap in these but it’s a useful way to learn the major focus of techniques.
In this blog I will take on methods of changing bone alignment, the relative position of a bone to the ones beside it. Of course that means a change in the joints also because that is where bones meet one another, however, these techniques focus more on the bone position rather than the joint relationships. (I will write about the joint relationship techniques in the next post.)
The most familiar to people is having the bones of the spine moved, the stock in trade of Chiropractors. Technically it is called manipulation or mobilization and involves putting a force directly to the bones of the spine, or vertebrae, to move them. How much force and in what direction is where various techniques differ. Some will use a high velocity thrust to “crack” the back and often times an audible “pop” or “crack is heard and/or felt. (There is no good proof of what causes the actual noise but it probably comes from a variety of causes depending on the situation.) Other techniques use grades of mobilization which involve various degrees of a softer force applied to the area of concern. This is applied repeatedly until the movement of the bone is achieved. Still lighter and more focused force can be used with a small tool called an Activator. This is a small spring loaded hammer used to put gentle but focused mechanical force on a small area (about ½ inch across) to push on a specific part of a vertebra. All of these involve the practitioner actively applying force to move the vertebrae while the client is passive. The techniques are fast and can frequently provide quick pain relief. Because they are passive techniques they often require the client to be seen several times before the changes stay with the client for prolonged periods.
Muscle Energy is an Osteopathic technique in which the practitioner positions the client in a specific alignment and then the client performs a gentle contraction against the resistance of the practitioner. Due to the positioning and the direction of the contractions the bones are then pulled into a better orientation. This results in the bones moving as well as retraining the muscles to help it maintain the improved orientation. This takes more analysis and skill on the part of the practitioner to do well than mobilization but often requires fewer sessions to maintain the desired changes.
All of these techniques can be applied to the other bones of the body and are very useful in restoring full function in areas with many small bones such as the hands and feet. Each of these techniques has its advantages and shortcomings and the challenge for the practitioner is to know which the best is for the client.