Vectors For "Specific" Chiropractic Adjustment and Massage Are Implausible | (Research Highlight)

The interface between the skin and fascia is frictionless. In manual therapies like chiropractic spinal adjustments and soft tissue release techniques, often it is thought that a thrust or a force is being applied to a bone or muscle at an oblique angle. It is thought that a clinician can be specific in regards to the specific direction they are pushing the targeted structure. If possible, this would be useful in attempting to mobilize a joint by pushing a bone into a certain rotation or flexion or any other specific direction. The only way that this would be possible is if the interface between the skin and the bone or muscle being targeted had FRICTION. Friction is needed to get a grip on these structures.  . . 

According to this paper, there is no friction in the skin-fascia interface. This means the only possible force vector for any manual therapy targeting structures deeper than the skin is from superficial to deep. Applying force at an angle is impossible, if the findings of this study are accurate. . . 

This does NOT mean that the therapies themselves aren't still useful, it just warrants a shift in how clinicians educate and think about what they are doing. It also makes things simpler and easier when you acknowledge the limitations of your technique.  . . 

Link to paper: https://www.lastsite.ca/wp-content/uploads/2017/10/Thefrictionalpropertiesatthethoraci.pdf . . 

Citation: Bereznick, David & Ross, James & Mcgill, Stuart. (2002). The frictional properties at the thoracic skin-fascia interface: Implications in spine manipulation. Clinical biomechanics (Bristol, Avon). 17. 297-303. 10.1016/S0021-9290(02)00014-3. . . 

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