Dr. Lisa Goodman, DC, CCSP, ICSC, CACCP, CF-L1, CF-Kids
Shock and surprise are what I get a lot of when I introduce myself as a pediatric chiropractor. Why would a child, let alone an infant need to see a chiropractor? To many people, the idea of a child visiting a chiropractor is unusual or confusing, and to others still it is downright scary bordering irresponsible! Just read some of the comments on our YouTube channel! If you have the same thoughts or are curious about pediatric chiropractic read on.
Kids need Manual Therapy
When a child has an injury or developmental condition that results in a referral to an occupational therapist or a physical therapist, we applaud it. After all, the primary goal of an OT or PT is to improve a child's mobility, muscle strength, balance, proprioception and overall functional ability. There is no argument - active rehab is good for kids. So why all of this confusion about whether chiropractic care is good for kids? A chiropractor is an expert in manual therapy, the most well known known of which are adjustments or manipulations. The primary goal of a chiropractic adjustment is to improve a child's mobility, posture, balance, proprioception as well as decrease pain and improve overall function while guiding biomechanical development. In fact, in many cases patients of all ages will be better able to perform active rehab (of a PT or OT) after they have received chiropractic adjustments. It might help to understand what an adjustment is and how it works.
The Chiropractic Adjustment
At any age, joints of the spine and extremities can become fixed (aka stuck). When this happens that joint (or joints) are unable to smoothly and comfortably move into a favorable direction. Take for example if you have ever had a 'kink' in your neck after 'sleeping funny'. You can feel a painful spot in your neck and you most definitely will not be able to rotate your head equally to both sides! This is an obvious example of a joint fixation. Another example is that of a jammed knuckle. Most of us have had the sensation of a joint in our finger jamming when playing a sport or missing a catch. The immediate sensation of pressure, pain and stiffness in the knuckle inspires us to initiate a swift pull on the finger to 'release' the jammed joint. Voila! The chiropractic adjustment. Fundamentally, adjustments really don't differ much from the knuckle example. That said, the spine is not so easy to pull on and release the joint pressure. Though that does not stop people of all ages from trying the non-specific and risky 'self-adjustment'. Interesting to me, that people would allow their kids to 'pop' their own backs, necks and knuckles but are still apprehensive about taking their child to a doctor with four years of graduate level training in doing just that.
Why do Kids need Chiropractic Adjustments?
As just referenced, people of all ages can suffer from joint fixations. Yes, even infants. Take a moment to consider the forces applied to a newborn during the birthing process. A faster labor just means more force is applied over a shorter period of time, whereas a longer labor generally means less force applied over a longer period of time. Vaginal births involve forces applied to the head into the body whereas cesarean births involve a pulling force on the spine utilizing the head as a lever. And of course, many births involve the pushing forces of labor and the pulling forces of a cesarean. All of that to demonstrate that while birth is amazing and infants are resilient, most of them do not arrive earthside without a joint fixation...or 10.
Furthermore as infants develop into crawlers and toddlers, and toddlers grow into school aged children and teenagers, the environment is ripe for joint fixations to develop. An environment that includes nursing, bottle feeding, sitting in car seats, swings and strollers, crawling, standing, plopping, falling, rolling off of beds or changing tables, tripping, stumbling, stomach sleeping, side sleeping, back sleeping, learning to ride a bike, skiing, soccer, tennis, skateboarding, falls, crashes, reading, studying, watching tv, using devices, tablets, phones, texting and well.... growing up and living life is why kids need a chiropractor.
But babies are too small for adjustments!
By now some readers are in agreement that teenagers and perhaps school aged kids could tolerate and benefit from a chiropractic adjustment. And I understand the confusion about how an infant or toddler could withstand the force of a chiropractic adjustment. The answer to that is a simple one, infants and toddlers don't receive forceful chiropractic adjustments. To that end, school-age children and teenagers are not receiving forceful chiropractic adjustments either. While, traditional, manual, chiropractic adjustments do require force it is not very much. Adjustments rely more on speed and specificity than force to be effective. (This is one reason why self adjusting does not provide lasting relief) While not a risk, most pediatric chiropractors are trained to utilize specific techniques that do not cause a 'pop' or cavitation on infants and toddlers because it is simply not necessary to achieve the same results. The younger the child is, the faster they recover from joint fixations.
What is the risk of a child not seeing a chiropractor?
One of the easiest ways to explain the risk of a child not seeing a chiropractor is in the case of a torticollis, otherwise known as a head tilt. We've probably all seen or had babies whose head preference is a tilt to one side or the other. If this is as a result of a joint fixation - which it commonly is - it can become permanent. You may wonder why we don't see people walking around with a permanent torticollis from childhood. The reason most likely has to do with the body's ability to adapt in another area. In fact, it's quite possible that a torticollis left untreated will result in scoliosis. In pediatric chiropractic, we have a saying "As the twig is bent, so grows the tree". While the body is remarkably adaptable. It would be much more favorable for the body to grow in balance. All of these adaptations can lead to pain, poor biomechanics and dysfunction ultimately affecting a child's choice of sport or other activity.
How often should a child get adjusted?
Among our patient population, it is common for infants, toddlers, school aged kids and teens to initially get adjusted when they have an obvious sign of a joint fixation. These signs may include an injury, pain, range of motion restriction, headache or asymmetry. The great news is that kids respond quickly and generally only need 2-6 treatments to fully recover. However, as kids grow, joint fixations will be part of their normal growth and development (as they are with adults!). Kids benefit hugely from routine chiropractic visit which always includes posture assessment, a search for those pesky joint fixations, a scoliosis exam and of course coaching on age appropriate biomechanical habits and posture. Each chiropractic visit ends with necessary adjustments and if needed, soft tissue therapy and taping. We even recommend massage to all ages of patients. I recommend a preventative, well-spine chiropractic visit each season or quarter (every three months) for all ages of kids. Some kids will opt to be seen for maintenance or performance care more often, such as once per month. And of course, for symptom based care, a specific treatment plan will be recommended.
For a complete breakdown by age of reasons to bring your child to a chiropractic read our list here.
I will leave you with one question to ponder. As a youth, did you ever experience an injury that was not resolved and still plagues you today? Taking it one step further, have you had an injury in your childhood that caused you to stop playing a sport? If you answer yes to this, you already know why kids need a chiropractor.
Lisa Goodman, DC, CCSP, CACCP founded Washington Park Chiropractic in 2006 in Denver, Colorado. Dr. Goodman is a Certified Chiropractic Sports Physician (CCSP) and Certified Prenatal and Pediatric Chiropractor (CACCP). She is TPI-L1 certified through the Titleist Performance Institute. She is also a CrossFit Level 1 and CrossFit Kids Certified Trainer. Dr. Goodman incorporates sports chiropractic techniques with prenatal and pediatric patients. She is a regular speaker at national events including Parker Seminars. She is part of the USGA Performance and Recovery Team. She is a member of the ACA Pediatrics Council and the ACA Sports Council. Areas of special interest include golf biomechanics, youth athletes, ankle and wrist injuries, instrument assisted soft tissue techniques. Stay connected with Dr. Goodman on Instagram @washparkchiro or @lisakgoodman