Question
Hi there,

My father is 62 years old and has just suffered from a very painful herniated disc. He has been rendered almost immobile for around 5 weeks now, and only now is he starting to show significant signs of recovery, being able to sit for short periods of time and exist without painkillers (previously he could only lie down and stand for short periods). He was an intense athlete up until about the age of 50 in cycling and tennis, and he recognises he has somewhat let his body go since then, he always eats well but just stopped working out almost completely and so has a lot of muscle wastage. His chiropractor and the back specialist he has seen since suffering his condition have told him he needs to strengthen his core area - his back and stomach - in order to prevent this from occurring again in the future. He was wondering what good exercises are for this, as he is wary about doing anything too much while recovering from such a debilitating condition.
If you have any websites with safe exercises or recommended advice, or if you have any yourself, I would be most grateful if you could advise me. I appreciate your time and recognise you must be busy. Thanks again.

Answer
Dear Anna,

Thank you for your question about you father's situation.  In order to answer you properly about exercises, though, I'll first need to give you some background on the chiropractic profession.

There are two branches or schools of thought in chiropractic.  Briefly, they are differentiated by whether they deal with the limited therapeutic approach for aches and pains (commonly termed "mixed" chiropractic because it represents a mixture of a chiropractor with a non-chiropractic matter) or a non-therapeutic approach to optimum body performance (termed "straight" chiropractic because there is no mixing of chiropractic with anything else).  My expertise is in non-therapeutic straight chiropractic.

Therapeutic "mixed" chiropractic is the older approach based on a split from the founding principles of chiropractic about a century ago.

Non-therapeutic "straight" chiropractic is the more modern of the two.  It deals with a particular, common situation called a vertebral subluxation.  The spine is made of many bone segments which house and protect the spinal cord and the smaller spinal nerve branches that come off the spinal cord and exit between the bones.  These nerve pathways carry information or messages between the brain and the cells of the body.  These messages are essential for the life of the cells.  Without vital brain messages, the cells immediately begin the process of dying; i.e., they can no longer function the way they should to maintain life.

Because the bones are moveable, they can misalign in such a way as to interfere with the messages and, ultimately, the ability of the person to function at their best or express their optimum potential.  People with vertebral subluxations are not able to get all they can out of life.

Vertebral subluxations can be caused by a wide variety of factors, what we'll generally call stresses.  These stresses can be physical (such as exertion, accidental trauma, sleeping posture and mattress condition, the birth process, sneezing, falling down, etc.), mental / emotional (in its many forms, probably the most familiar use of the word stress), or chemical (such as pollution, drugs, etc.), which are, unfortunately, regular parts of daily living for all age groups.  In short, a vertebral subluxation can occur for a multitude of reasons.

Tragically, vertebral subluxations are rarely obvious to the individual they affect.  They usually have no symptoms.  The reason is that most of what goes on inside you happens without your awareness.  As an example, try to "feel" your liver.  What's it doing right now?  You can't know, so you can't know if it's functioning at its best or something less.  To complicate things, nerve pathways that carry messages of control (termed "motor" nerves) have no way of transmitting ache or pain messages, so your body function may be far from perfect and you'd not have any alerting signal whatsoever.  In addition, the branching of the nerve pathways is quite complex and extensive, making it exceedingly difficult to predict or determine exactly how the person will be affected.  In order to know if someone has a vertebral subluxation, it is necessary to have that person's spine checked by a non-therapeutic straight chiropractor using a method of "analysis."  When a vertebral subluxation is detected this way, it is obviously important to correct it as soon as possible.  The term for this is 揳djustment?and can be accomplished in a variety of ways, depending upon the unique vertebral subluxation and the individual person.  

Since vertebral subluxations are caused by so many different things, people choose to go to a non-therapeutic straight chiropractor on a regular basis to enjoy the most time free of the life-robbing effects of vertebral subluxation. There's a saying that straight chiropractic is not about your back, it's not about your pain, it's about your life.  Each person has a unique potential in life.  With vertebral subluxation, it's impossible to realize that potential.

Now that you have some reference point from which to start, let's address the matter of exercise as a modality.  Note that in defining non-therapeutic straight chiropractic or in distinguishing it from therapeutic mixing chiropractic throughout this response, the focus was always upon the objective, not the method.  Whether a method fits within non-therapeutic straight chiropractic is determined by the objective ?the desired goal ?in using it.  From the non-therapeutic standpoint, then, an adjustment is effected by any of a number of techniques, but is solely and uniquely for the correction of vertebral subluxations because they, in and of themselves, are detrimental to the expression of life.  The exact technique used is not the determining factor in whether someone is providing straight or mixed chiropractic services.  In fact, because no two people are the same, many who are practicing non-therapeutic straight chiropractic and focusing solely on the correction of vertebral subluxations will rely on a variety of adjusting techniques.  They will employ the one best suited to the particular individual in the office at that particular moment.   Generally, modalities, including prescribed exercises, are therapeutic in nature ?they are used in treatment of a therapeutic concern ?and have no real place in the practice of non-therapeutic straight chiropractic.  

A key question to ask for your purposes, then, would be, Is someone with disc damage, such as your father, better off with vertebral subluxation / nerve interference or free of subluxation / with the nerve channels open?  It is easy to see that having all the available nerve messages getting through is better than only some of them getting through, regardless of the person's situation otherwise.  It's not that he should see a non-therapeutic straight chiropractor FOR his disc herniation or back pain ?he should visit one in an effort to be free of vertebral subluxations, even WITH such symptoms.  Non-therapeutic straight chiropractic is not about diagnosing and/or treating this or any therapeutic-model or medical condition.  It is entirely separate in its goal.  

As I mentioned earlier, not all chiropractors adhere to this and it is important that you be able to distinguish which ones do if you're going to seek this type of service.  You need to understand very clearly that the practice objectives of therapeutic mixed chiropractic and non-therapeutic straight chiropractic are quite different, as described above.  What I can tell you must not be interpreted from the mixed viewpoint.  

It is likely, from the information in your question, that the chiropractor your father has visited is of the therapeutic mixing viewpoint and that his recommendations about strength and exercise was for a therapeutic objective.  That said, it would certainly be wise to have your father's spine checked for vertebral subluxations by a non-therapeutic straight chiropractor even if you still elect to have therapeutic attention for your reported injury or therapeutic exercise needs.  Remember, the two objectives are not the same and a therapeutic mixed evaluation will not replace the evaluation of a non-therapeutic straight chiropractor for vertebral subluxations.  

If you are interested in finding out how to locate a non-therapeutic straight chiropractor in your area, please contact me at this site again or at [email protected].  You may also visit www.gschiro.com, a site that represents non-therapeutic straight chiropractic organizations on a state level.

Anna, I wish you the best in sorting out the sometimes confusing world of chiropractic.  It has been my pleasure to provide you with some information.

Sincerely,
James W. Healey, D.C.