Most chiropractic manipulation is done using the “high velocity, low amplitude” (HVLA) approach, which consists of quick, short movements to bring the spinal column back into alignment. However, there are times when other methods may be more appropriate.
Patients who have suffered recent trauma and elderly patients are two common examples. So are young children and those who are new to chiropractic treatment. Whenever a patient’s body may be fragile or a patient is particularly nervous about receiving a chiropractic adjustment, low-force techniques reduce the likelihood of accidental injury and may make treatment more effective by minimizing the defensive tensing of muscles.
Palpation is a technique which uses the hands to assess the degree of tension and range of motion in a patient. In many cases, the chiropractor will take the joint to the furthest end of movement but by then it may already be causing pain. Chiropractors practicing low-force palpations feel for the first barrier to movement and stop there, which is gentler for the patient.
Similar to low-force palpation, low-force adjusting begins slowly in order to find the minimum force needed to make the desired adjustment rather than immediately using full force. Low force adjustments do not give the same “buzz” to patients as HVLA techniques (which often cause neural receptors in the joint to fire), but this is not always a bad thing. This is especially true for those who are especially sensitive or already in a state of nervous tension or excitement.
Low-force techniques also include soft tissue methods such as post-isometric relaxation, which involves gently contracting a target muscle for a short time (5-10 seconds) while the patient resists it. Following the resisted contraction there is a 10-15 second period in which contraction is “switched-off” and the muscle can be manually lengthened with little resistance. Myofascial release is another low-force technique that is routinely used by chiropractors and other manual therapists to passively relax and lengthen muscle tissue through palpation and massage. Trigger point therapy, which focuses on identifying and stimulating specific points of muscular tightness to produce a relaxation response and release of tension, is also low in force but still very effective.
Although low-force techniques are particularly appropriate for patients who have recently experienced trauma and for patients who are especially sensitive, nervous or excited, there also may be other times when they are preferable to HVLA adjustments and other full-force techniques. If you’re wondering whether chiropractic care may be right for you or have questions about our approach to care, please call or visit our office. We’ll be happy to help!