Pollack Rehab

11/09/2025

SPINAL MANIPULATION – WHAT’S REALLY HAPPENING

There’s this ridiculous idea floating around that a simple thrust can “realign” your bones. Let’s be clear — that’s not what’s happening. You cannot push vertebrae back into place with your hands. The spine isn’t dislocating and relocating every time someone cracks your back. If it were actually misaligned the way some claim, you’d be in hospital, not on a treatment table.

When a practitioner performs a spinal manipulation, the movement is extremely small — a few millimetres at most. The joint surfaces briefly separate, creating a rapid change in pressure within the synovial joint. That change causes gas (mostly CO₂ and nitrogen) to form and collapse inside the joint fluid — the audible “pop.” That’s all the noise is. It’s not bones moving back into place. It’s cavitation — a pressure change in the joint capsule.

Physiological Effects

Manipulation affects the body mainly through neurophysiological responses, not through physical repositioning of bones. The quick stretch activates mechanoreceptors within the joint capsule and surrounding tissues. These receptors send a flood of sensory input to the spinal cord and brain. This temporary barrage can reduce the sensitivity of nociceptive pathways (pain signalling) and alter muscle tone via reflex mechanisms. That’s why after a manipulation, patients often feel “looser,” “lighter,” or notice an improved range of motion — it’s not because their bones were realigned; it’s because their nervous system has momentarily adjusted how it’s interpreting movement and pain.

The effect can also increase local blood flow and help restore normal joint motion if it’s been restricted by protective muscle guarding. Again — that’s a functional change, not a structural one.

Why the Realignment Myth Persists

The “realignment” myth continues because it sounds dramatic and easy to sell. It gives people the impression something was out of place and the practitioner fixed it. It’s a neat story — but it’s nonsense. The vertebrae are held in place by strong ligaments, discs, and deep stabilising muscles. A single thrust cannot overcome that structure and magically shift things back.

11/08/2025

10/08/2025

🌳 There is a lot of wisdom here, despite the gimmicky headline.

My daughter rolls her eyes every time I say it. She’s the one with the $200 yoga mat, the smartwatch that buzzes when she’s been sitting for more than an hour, and the shelves full of protein powders.Me? I’m 75, and my version of exercise is walking Lottie, my dog, around the park and gardenin...

10/07/2025

Dynamic and enthusiastic, Jill embraces all life has to offer. So far in her journey she’s been a holistic esthetician, arctic adventurer, business owner, gardener extraordinaire, ice castle raver, friendly live wire, solo world traveler, kundalini yogi, and unpaid roadie.

09/15/2025

⚠️ FAQ: My knees make noise, should I be worried?

Short answer: No.

Self-reported knee crepitus — an audible crackling or grinding noise during knee movement — did not predict worsening osteoarthritis (OA) features in either the patellofemoral or tibiofemoral compartment over the next 5 years, according to a 2025 study published in Arthritis Care & Research.

Joints are designed to make noise. Crackling is normal. Although this study found that crepitus was a bad sign after anterior cruciate ligament (ACL) reconstruction, there is probably nothing to worry about for the general population. Movement is medicine for mechanical knee pain, with or without crepitus.

Knee crepitus after anterior cruciate ligament reconstruction is tied to cartilage damage and worse patient-reported symptoms 1 year after surgery but doesn’t predict worsening joint damage over time.

09/08/2025

09/03/2025

🗣️ Language matters: Health is determined by biological, psychological and social factors (the biopsychosocial model).

Diagnosing “wear and tear” is biologically wrong and psychologically disempowering.

It is always important to emphasize that function trumps structure for things like knee osteoarthritis or shoulder tendinopathy.

“Take good care of yourself and your body will do the rest!”





📊: RunningPhysio

09/03/2025

Shawn Thistle (RRS Education): Kerry and colleagues outlined a contemporary framework for teaching and applying manual therapy, including spinal manipulative therapy and mobilization. Rather than relying on traditional concepts like clinician-centered assessment, pathoanatomical reasoning, and highly specific technique selection – which generally lack strong support in the scientific evidence; the updated model emphasizes three key humanistic dimensions for both patients and practitioners: safety, comfort, and efficiency. This approach shifts the focus toward a truly person-centered style of care, where shared decision-making, clear and positive communication, and a supportive clinical environment are central to the therapeutic process.

Blog: Dr. Shawn Thistle reflects on the recent series of papers on chiropractic spinal manipulation published in CMT.

08/27/2025

🩻 Question: Do older adults with back-related disability require an x-ray before receiving chiropractic care?

Answer: No.

"Like grey hair or wrinkles," common degenerative changes of the spine (otherwise known as normal aging) do not correlate with symptoms of back pain or disability.

For example, lumbar spinal stenosis is a finding estimated to be present in 1 out of 5 adults over 60 years old and increases with age. Notably, more than 80% of these cases are asymptomatic. However, most people with back pain and spinal stenosis will be referred to an orthopedic surgeon. Most of those referrals are unnecessary.

The good news: In this study, after 12 weeks of treatment, 42% of the older adult participants achieved a clinically important response to chiropractic care (30% improvement in back disability), regardless of severity of radiographic findings.

"The result of this study suggests imaging may not be helpful for predicting who will be a responder to chiropractic spinal manipulation and home exercise, and that spinal manipulation may reasonably proceed without imaging on older adult patients in the absence of red flags or suspected contraindications to care," according to a 2025 study published in Chiropractic & Manual Therapies.

Background Some chiropractors use spinal x-rays to inform care, but the relationship between radiographic findings and outcomes is unclear. This study examined the association between radiographic findings and 30% improvement in back-related disability in older adults after receiving 12 weeks of chi...

08/25/2025

As a general rule, tendinopathy should be managed with exercise and education on load management.

Unfortunately, passive modalities such as laser therapy, electrotherapy, ultrasound and shockwave are common despite a lack of supporting evidence.



📊: RunningPhysio

08/25/2025

🥩 Medscape: Chefs and restaurants say all kinds of things, but the real definition is simple: Mammals are red meat, and birds are white meat.

Now, there’s another thing we need to explain. We have red meat, but we also have processed red meat. Processed red meat is when red meat is transformed in some way — and that doesn’t mean cooking. If you just take a piece of steak and cook it on your barbecue or in the oven, that’s not processed meat. Processing is doing things like salting the meat, smoking it, or curing it. Processed meat includes items like bacon, sausages, hot dogs, salami, corn beef, and smoked meat.

So, when we talk about red meat and health risks, we are primarily talking about processed red meat.

All this to say, if you eat hot dogs every day of your life, your risk of getting colon cancer goes up by 1 percentage point on the absolute scale. Now, on first instinct you might say, "Pfff, that’s nothing. Pass the bratwurst." But 1% on the absolute scale is not trivial. That’s thousands of cases per year. Millions of cases over the course of your lifetime in a country of 300 million people. It has some important public health implications.

The WHO has declared red meat a carcinogen. So, Dr Christopher Labos asks the question we're all thinking: Is a hot dog really as bad as a cigarette?

08/15/2025

🪜 No more graffiti in our parking lot!

When the owner refused to remove offensive graffiti from the back of their building, Kevin Darrah - Fredericton Ward 7 Councillor & Downtown Fredericton stepped up to support small business and the downtown community.

Thank you!