An adjustment or manipulation is a joint treatment technique that applies a high velocity, low amplitude (i.e. quick speed and small amount of movement) thrust force to a joint within the body, whether that is a spinal joint or an extremity joint (such as the jaw, wrist, elbow, foot, ankle). It is intended to help restore range of motion and gliding biomechanics at a particular spot that has been assessed by the chiropractor and found to not been moving as well and may be tender to touch and directly contributing to your stiffness or pain. A joint restriction is found through range of motion testing, muscle and joint palpation, and other orthopedic testing. At the restricted point, the adjustment intends to bring the joint to its current end-range of motion and then the quick small thrust force helps to restore a more normal physiologic end-range of motion. 

Dr. Petropolis is trained in Diversified treatment techniques. She will often utilize drop-pieces for adjustments and occasionally an adjusting instrument (Activator) in her practice but she primarily uses hands-on techniques for both joint manipulation and mobilization. 

Joint mobilization is considered to be one step ‘down’ from a joint manipulation technique. Similar to manipulation, mobilization also aims to help address detected joint restriction or stiffness by restoring range of motion and gliding biomechanics at a particular spot. Mobilization is different from manipulation because the restricted joint is slowly stretched or moved to its end-range and then a low-grade pressure is slowly applied at end-range. It is a more globally applied treatment technique to help facilitate improved range of motion and decreased symptoms at the joint. 

There are a few common techniques used by Dr. Petropolis to address the soft tissues of the body, including muscles, tendons, and ligaments of the affected area(s). Most commonly used are manual (or hands-on) techniques which are often referred to as manual release therapy (MRT). There are also instrument-assisted soft tissue techniques (IASTT) where a stainless steel tool can be used. Instruments are especially helpful for certain muscle groups or areas of the body or for soft tissues close to and overlying bony joints. Vibration percussion soft tissue techniques can also be used for small intra-oral jaw muscles, larger muscle groups, or for decreasing nerve pain or other symptoms along a nerve pathway. A fragrance-free lotion may be applied to the skin prior to soft tissue therapy techniques to promote comfortable gliding and ease any friction on skin contact. Soft tissue therapy aims to decrease muscle tension to promote decreased pain, decreased stiffness, improved range of motion, and improve overall muscle and joint function within related movement patterns for activity demands.

With cupping, silicone or glass or plastic cups can be used to address areas of tension or taut bands within the muscles. Silicone cups are primarily used by Dr. Petropolis. When a cup is applied on the skin, a partial vacuum is created by suction and this suction creates some ‘pull’ on the skin and other layers of fascia and muscle below and draws them upwards. Cupping works to alleviate pain by increasing the flow of blood and lymph to the area in need. Cupping is also used to decrease muscle tension, decrease inflammation, and to facilitate better tissue and joint movement.  

Cups can be placed and left alone for a few minutes while the patient is still (static cupping). Alternatively, the provider might instruct the patient on an active movement, or they might perform a stretching movement on the patient for the muscle group being treated (dynamic cupping). Cups can also be moved by the provider while under this vacuum in a gliding manner along the area being treated (dynamic cupping). A fragrance-free lotion is typically applied to the skin prior to cupping to promote comfortable gliding and ease any friction on skin contact.

There are a few terms commonly used to describe how Dr. Petropolis can apply acupuncture as a clinical tool within her chiropractic treatments. These terms can include electroacupuncture, neurofunctional (or medical) acupuncture, or dry needling. 

Acupuncture is a system of diagnosis and treatment of the body rooted in Traditional Chinese Medicine (TCM) principles and a holistic approach to health and wellness and the systems of the body. The approach that Dr. Petropolis has been trained in is rooted in TCM principles but is a more Western neuro-anatomical approach to diagnosing and treating the specific anatomy related to the nervous system, musculature, joints, and specific neural pathways involved in someone’s complaint. Neurofunctional acupuncture will typically be used to treat the affected muscles, joints, and nerves, along with other aspects of the body’s systems for promoting decreased pain, decreased inflammation, improved soft tissue and joint function, and facilitating tissue healing and recovery. Treatment involves the insertion of sterile, single-use, thin needles at specific points in the body to produce therapeutic effects. Sometimes electrical stimulation is applied to a single point or multiple points together to facilitate muscular contraction, target deeper neural or joint anatomical structures, and to provide pain relief through neuromodulation of symptoms. 

Dry needling is a technique that is often very quick and its intention is to target a taut band within the affected muscle. The acupuncture needle is inserted until a ‘twitch’ is elicited within the muscle and then the needle is moved to generate multiple twitches to cause contraction and relaxation of the muscle fibers so that when it is done the muscle tension is decreased and the patient feels more relaxed. Most commonly, Dr. Petropolis uses electrical stimulation to elicit the contract-relax muscular responses for a focused muscle in a dry needling approach. 

Physical activity and exercise are part of the gold standard of care for addressing common musculoskeletal conditions, as well as part of a healthy lifestyle. Sometimes pain can affect our ability to fully participate in daily activities and our preferred forms of exercise. Dr. Petropolis works with you in the office to provide rehabilitation exercises and activity strategies and potential activity modifications that are specific to YOU and your needs. Rehabilitation given is very personalized and is based on your current abilities, where you’d like to be for your daily activity needs, and if there are any movement or activity goals that you want to work towards but haven’t achieved yet. 

Rehabilitation can integrate various combinations of stretching, mobility exercises, positions of relief. This can also include technique modifications for daily activities, walking, sports, strength training, or any other physical activities that you participate in. These strategies are used to keep you as active as possible throughout the initial plan of care within pain and activity tolerances, and then progressing your level of activities and exercises throughout the rehabilitation of your complaint.

Any advice given during treatments or that is part of at-home self-management care can be related to a variety of topics! Education is key during in-office chiropractic appointments. 

This can include education on your presenting complaint as well as what you are experiencing in terms of symptoms and why, increased postural and body awareness, pain relief, injury management, lifestyle and/or behavioural modifications, and other symptom management strategies for home, work, or with specific activities, and many other topics related to you and any questions that may arise throughout your plan of care.