Generally speaking, it is okay to exercise after an adjustment with your chiropractor, but there are some factors to take into consideration. The intention of chiropractic adjustments and of the chiropractic profession in general is to enhance and improve movement in the body. As a matter of fact, in many offices that are evidence-informed, such as our office in San Francisco, your chiropractor will demonstrate and observe you as you perform exercise specifically designed to help you with your condition. It’s the goal of every chiropractor here to not only take care of your immediate pain, but to look at all of your daily activities including exercise.
Reduce Back Pain With Exercise After An Adjustment
As peer reviewed and medical-indexed studies in PubMed consistently show that patients who exercise after an adjustment perform much better than chiropractic adjustments or exercise alone. Together, they have proven time and time again that they are great for:
- Back pain
- Neck pain
- Leg pain originating from the back
I always tell my patients, when it comes to taking care of your mechanical low back or neck pain, the formula is this. First, restore normal, smooth, and appropriate movement to your back and neck. Next, activate and condition the muscles in the area you are trying to improve. This combination of strength and stability is essential for recovery.
In the video above I demonstrate using a kickball to activate and coordinate muscle control of your neck. I show the neck’s full range of motion. This is an excellent technique to improve neck range of motion by guiding a gentle stretch through the neck muscles, guided by the ball’ rolling surface. Give it a try, and compare the feeling to a regular neck stretch. With this technique, you can mobilize your neck muscles through their range of motion. Simultaneously, this stimulates them with a constant isotonic tension through the muscles’ shortened and lengthened position.
So if chiropractic practices that practice an evidence-informed style of treatment promote rehabilitative exercises, for better outcomes, then it’s probably generally safe for you to perform them.
Spinal Deformities Repaired By Exercise After An Adjustment
If you’re a golfer, then you know that continually swinging a club over and over in only one direction can create problems for your back. Golfers experience muscle damage from overuse and repetitive training. And, their backs are the most commonly injured area, despite the elbow pain famously named “golfer’s elbow.”
Researchers published several case studies in the Journal of Physical Therapy Science on this subject. They used 3D technology to analyze the counters of their golfer’s backs. Next, they had them return to the clinic twice per week for 4 weeks. While there they receive back adjustments and complete 60 minutes of corrective exercises. The patients specifically worked on mobilization techniques, core exercises, and proprioceptive exercises.
The golfer’s improved under this kind of care. Pelvic tilt improved from 8mm to 2mm. Pelvic tilt improved from 5.5 degrees to 0.2 degrees. The lumbar lordotic angle improved from 16 degrees to 36 degrees. Even the length of the trunk showed steady improvement through the course of care. Lumbar strength in peak torque extension improved from 2.13 Nm/kg at pre-test, and ended up at 2.91 Nm/kg at the end of 4 weeks.
The studies showed the golfer’s low back pain involved both a muscular challenge and a bone and joint functional challenge. In short, performing an adjustment and exercising covers the major aspects of the challenges faced by most people suffering from low back pain. So if you are asking if it is safe to exercise after an adjustment, the answer is generally, “YES.”
What If Exercising Is Painful?
The answer is simply don’t do them. Whether you are under chiropractic care or not, your exercises that you do at the gym should not be more painful than a 2/10 on the pain scale. 0/10 is no pain. 5/10 is noticeable pain that is starting to annoy you and is interfering with your concentration at work. 10/10 is the worst pain you could ever imagine. An easy 2/10 is just about what your own body allows you to do under your own power before your body tells you to not do it any more.
For example, lets say you are at the gym and you are doing overhead presses. You start to feel a pinch in your shoulders as you go through a painful arc of motion. You should probably stop and let it rest if it is more than a simple muscle burn from activity. If it’s more of a sharp pinch, you could be aggravating it.
The same rules applies to your low back. Many patients deal with a low back injuries:
- 1/10 – If it’s a mild reminder that you have been injured there before, it is most likely safe to continue with the exercise.
- 2/10 – If it’s almost healed, but not there yet (it can take up to a year), and for example you start returning to a moderately weighted dead-lift that starts to produce pain in your spine. At that point you need to evaluate it with your chiropractor.
- If the pain intensity increases to 3/10 and beyond, you may need to lay off of the exercise a little longer. Work with lighter weights or work with your chiropractor to find a routine that is more injury-appropriate.
Foot And Ankle Adjustments Boost Athletic Performance
Years ago, I volunteered my time for the Berkeley Men’s Lacrosse team. I had a contact with their strength and conditioning coach, who offered me the opportunity to treat this fantastic group of athletes. It was a great experience.
This wasn’t my first time working with athletes of this caliber, though. This opportunity presented itself because of my experience a couple of years before that. About 5 years ago, I volunteered my time to be the team chiropractor for a Salt Lake City football team. I showed up to their team practices once a week to evaluate and correct any faults in the football player’s lower extremities duringtheir practice.
We had great feedback during this time from the players. However, the biggest success for me was when the coaches informed me for that the team had an 80% reduction of non-contact injuries.
A 2013 study in the journal Manual Therapy studied the effects of foot manipulation and dynamic standing balance. These researchers studied the balance of 20 healthy volunteers. They lined them all up to have their ankles adjusted, just like I did with those high school and college athletes. The researchers discovered that reach distance is a measure of better balance. Their subjects who got the chiropractic manipulation improved over a control group. In conclusion, they found that manipulation of the foot and ankle is a great addition to proprioceptive exercises and other therapeutic activities.
What’s Happening When I Get An Adjustment
When I was going through school and coming up in my career, they always called the popping sound in your back, cavitation. It turns out, that term was not appropriate for what is actually happening. Cavitation happens to a boat’s propellers as they are cutting through San Francisco Bay water very quickly. As the propeller blade chops through the water, bubbles form on the surface of the blade and they quickly collapse. As the bubbles collapse, they cause damage to the surface of the propeller. This is not what happens to the spine or to your knuckles.
The reality of what happens in your neck when it is adjusted is called tribonucleation. As your chiropractor moves your spine into position he is precisely contacting the segment that is not moving as it should. As he adjusts that joint by distracting the surface of the joint, surface tension is released in the synovial fluid. A popping sound happens. It’s like if you had two panes of glass, and you had water between the two flat surfaces. You would be able to glide across the surfaces of the glass smoothly with the water as a lubricant. However, if you tried to separate the two panes it would be difficult until you release the surface tension. A pop may happen.
How Long Do I Wait Before I Can Work Out?
When researchers study tribonucleation in knuckles they find that you can’t re-pop a joint for another 20 minutes. You pop your knuckles. Five minutes later, you can’t pop them. 20 minutes later, you can. (They also discovered that popping your does not, in fact, cause arthritis.)
For this reason, I suggest that after your chiropractic visit, you should wait about 30 minutes until performing vigorous exercises. In addition, warming up first is highly advised. After about 30 minutes your joints pack into a stable position again and your muscles have time to catch up.
Chiropractic adjustments help relax tight muscles via fast-stretch reflexes. They hit the reset button on your tight muscles. After these muscles relax, the muscle spindle and golgi tendon organs in the muscles send signals back to the spinal cord and cerebellum. This causes them to re-adapt to joint position. Make sure you are giving your body some time to go through this process before you perform any rigorous exercise after an adjustment.
While in college I was the seminar auditor for the continuing education department. As a result of that I was able to get paid to attend over 1000 hours of postgraduate classes in the field of automobile and sports injuries, worker’s compensation disability and apportionment, research reviews, various techniques and rehabilitation, neurology, and even a few practice management courses. Being exposed to these classes, gave me a perspective that made me decide that the best policy for myself as a doctor is to be patient centered.
Being patient-centered as a doctor means that the patient’s needs come first. I continually seek out best practices through published research in the field of chiropractic, physical medicine, and physical therapy. When new patients see me, they receive a medical history, an orthopedic and neurological examination, a differential diagnosis, and a treatment plan that combines traditional chiropractic and our latest knowledge in the field of physical rehabilitation.
I’ve called Sonoma my home ever since then. I practice in SoMa San Francisco because I want to be around the world of tech, and as I follow tech and listen to podcasts about tech, I see it all go down in San Francisco. I use to watch Apple events being reported from the Moscone Center. To me, this is where it’s all happening. However, I’m also proud to be able to live in a scenic, rural town where all of my patients love to visit.