Finding the right professional to help you with your pain and injury can be a challenging and confusing task. After all, resources (a.k.a your money!) are limited, you are in extreme discomfort, and you desperately want to get back to your favorite sport. Who should I visit for my hamstring strain? What about an ankle sprain? Low back pain? Tennis elbow? Fractured wrist? Deconditioned cardiovascular system? These are common questions I hear at the gym all the time. Although there isn’t always a clear cut answer, let’s compare a few health professions and you can decide which one is most appropriate for you!
Chiropractors go through 4 years of intensive schooling after an undergraduate degree (typically in kinesiology or human kinetics), with their first two years focusing on basic sciences (e.g. anatomy, physiology, nutrition) and the latter two years in clinics and laboratories refining practical skills. They are experts in the spine and are taught to see the human body holistically, identifying how muscles, joints, and other bodily structures interconnects with one another. They are the only healthcare professional trained vigorously to perform “low amplitude high velocity” manipulations where they “crack your back” to adjust your spine and optimize nerve impulse transmission. They are also arguably more knowledgeable than many other professionals in nutrition and supplement counselling, as their philosophy is one which emphasizes using natural means to help the body heal itself.
Physiotherapists go through 2 years of rigorous training, also after their undergraduate degree (almost always in kinesiology or human kinetics). The first year focuses on learning rehabilitation principles and the neuromusculoskeletal system. The second year is spent in hospitals rotating at different departments to gain clinical exposure and familiarize themselves with the hospital setting. Physiotherapists are uniquely qualified to use exercises, education, and physiotherapy modalities (e.g. electric stimulation, ultrasound, dry needling) to help patients recondition muscles, fix imbalances, and regain motor functions. Because they are trained in a hospital environment, they are generally more suited to communicate and collaborate with your GP.
Interestingly the fine line between their roles, training, and techniques have been significantly blurred within the past decade. Chiropractic schools nowadays frequently teach its students about basic physical therapy techniques and theories, whereas many physiotherapists also take continuing education courses in spinal adjustments after they have obtained their degree. It is also not uncommon for many chiropractors and physiotherapists these days to pursue further schooling to become concurrently qualified for massage therapy, orthotics, and other treatment modalities.
Generally speaking, if your problem is pertaining to your extremities (e.g. ankle sprain, hamstring strain, tennis elbow), a physiotherapist will be more suitable to treat your problem. Physiotherapists are specialized to work with soft tissues and have the appropriate equipment in their clinic to treat you. Chiropractors, on the other hand, are extremely helpful for issues related to the spine and postural alignments (e.g. back pain, neck pain, postural check-up). For weight loss, cardiovascular reconditioning, and muscle hypertrophy, a kinesiologist or personal trainer would be better choices. However, there isn’t a clear line to distinct the professions anymore, as there is such a large overlap between what these professions can provide. Finally, with suspected bone fractures and other urgent care such as ligament tears, without a doubt you should seek help from a medical doctor ASAP.
But there are many other factors to consider. Even within the profession, there is considerable variability in terms of experiences, qualifications, approaches, and specialties. A sports chiropractor would presumably be more equipped at treating athletes than a general chiropractor. Similarly, a physiotherapist focusing on car accident rehabilitation will likely produce superior results for motor vehicle accident patients than one focusing on post-stroke rehabilitation. It would be wise to spend some time researching the practitioner- What kind of continuing education courses have they had? Which area do they specialize in? Do they refer you to another practitioners when they are unable to help you?
Empathy has been an important component in the training of healthcare professions for good reasons. Patients comply better with the orders and prescriptions when they perceive that their practitioner cares about, connects with, and relates to the patient. Is the practitioner someone who takes the time to listen to you? Do they teach you home remedies or exercises you could perform to help with recovery or alleviate your pain?
Finally, if your insurance plans or work benefits cover their services, that’d be a big bonus. Although you cannot put a price tag on health and wellbeing, these costs definitely can add up. Check with your practitioner of interest to see if these services are partially or fully covered.
People have their own inherent biases. This is why in this article I try to be as objective as possible with the intention of keeping you informed to make a decision for yourself.
I would like to acknowledge Dr. John Lin DC, a current practicing sports chiropractor, and Ms. Shannon Chou, a senior physiotherapy student for generously sharing their insights.
Kevin Cheng is a rehabilitation specialist, personal fitness trainer, and physician-in-training. He specializes in sports and car accident injury rehabilitation, physique and figure training, and powerlifting. For more information about him, please contact at [email protected].