In the past few years, patients have consistently asked my opinion about Chiropractic adjustments they have seen on many social media portals. Some of these videos are harmless and show how an adjustment is performed, which I have no issue with. Some are sensationalism to the extreme and are about getting likes and attention, my focus will be on the latter types of videos seen on the web.
The information/questions listed below are specific to Chiropractors that chose to put a strap around the base of a patient’s skull while they are laying on their back, then apply a quick jerk to the patient’s head and neck. In no way is this article a personal judgement of any provider who chooses to do this, but this article is meant to educate the public about the potential risks associated with this type of adjustment, versus a more traditional Chiropractic treatment/adjustment.
The adjustment performed with the use of a strap is not specific. The neck region has 7 bones in it; and most techniques taught in Chiropractic school focus on adjusting one segment at a time. Performing these adjustments where everything pops makes it more difficult to be precise in my personal experience, and may increase the likelihood of injury as this study discusses: Rushton A, Rivett D, Carlesso L, et al. International
framework for examination of the cervical region for
potential of Cervical Arterial Dysfunction prior to
Orthopaedic Manual Therapy intervention. Man Ther.
2014;19:222–228.
Was this technique taught at a Chiropractic school or a Post graduate seminar? I attended Palmer College of Chiropractic in Davenport Iowa, and we were not taught how to adjust in this manner in our core curriculum. However, other Chiropractic schools may have included this as part of their course of study—ask where the doctor went to school, and was this an elective they may have taken. The Pettibon technique utilizes a Y-strap to perform more subtle/gentle neck traction. Here is a link to that technique, which has been taught in Chiropractic schools: The Pettibon System
Possible Increased risk of injury. The neck is the most fragile part of the spine, and to pull on it with that much speed/force may increase the likelihood of sprain/strain of the neck region— similar to a quick force going through the spine during a rear end car crash that you are not braced for. Here is some research that discusses these forces: Neck strain in car occupants: injury status after 6 months and crash-related factors - PubMed (nih.gov)
If you are injured with this type of adjustment, the Chiropractor in my opinion has very little to stand on credibility wise unless they have been trained or certified by an accredited College or University. If the Chiropractor is performing a technique without proper training/certification it may fall beneath the standard of care for a DC to perform a treatment in which they have no graduate or postgraduate training in their state.
How thorough is the history and exam—Prior to having this maneuver performed, ask the doctor where they received their training to perform this type of adjustment, and have they encountered any adverse reactions personally, or read of any in the literature? Do they take a comprehensive history and perform a thorough exam to rule out contraindications to neck manipulation prior to this maneuver or any adjusting technique that involves the neck region. Here is an article that discusses how to perform risk assessment on neck manipulation: A risk-benefit assessment strategy to exclude cervical artery dissection in spinal manual-therapy: a comprehensive review - PubMed (nih.gov)
In closing, there are good and bad representatives of any profession, and Chiropractors are not immune to this. The public needs to be adequately informed about practices and techniques that could stray from the norm and realize that most Chiropractors do not use these types of maneuvers. Here is a link to further discussion concerning this technique—https://www.chiroeco.com/y-strap/