Chiropractic and gaming: the perfect match between health care and esports

Chiropractic! Many people roll their eyes when they hear about chiropractors as legitimate and viable health care practitioners. This is understandable since chiropractic has somewhat of a jaded history. However, we’re here to educate you on the evidence-based approach of our profession and why chiropractic and gaming are a perfect match.

What is chiropractic?

Chiropractic is a health profession concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, and the effects of these disorders on the function of the nervous system and general health.

Chiropractic is a form of health care that fits in the category of physical or alternative medicine. In other words, we don’t provide pharmaceutical medications, but rather we provide for our patients using physical or alternative measures.

To perform by hand

By far, the most important tools we have, as chiropractors, are our hands. In fact, the term chiropractic literally translates to “to perform by hand.”

• Chiro-: from Greek kheir, meaning hand
• -practic: from Greek praktikós, meaning of or pertaining to action

Treatments we perform by hand include adjustments (joint manipulation, often described as “cracking” of joints) and manual therapy (therapeutic techniques to soft tissue). Some chiropractors make use of tool with our hands to treat the areas of concern, a treatment called instrument-assisted soft tissue mobilization (IASTM). Each of these treatments are explained, in detail, below.

Additional chiropractic services

In addition to these treatments, we also teach therapeutic exercises, postural correction, and education patients on diet and nutrition. Each chiropractor you meet will have a particular treatment specialty, and not every chiropractor provides each of the above-mentioned services.

Therefore, you need to decide what type of treatment you’re seeking and ask questions before visiting a chiropractor!

Chiropractic treatments

Below we’re going to go a little more in-depth about the different types of treatments rendered by a chiropractor. You’ll learn a brief background of each and why chiropractic and gaming are a perfect match.

Chiropractic adjustments (joint manipulation)

A chiropractic adjustment is a joint manipulation with the goal of improving joint mobility, decreasing pain, and normalizing nerve and muscle activation. This procedure most often involves a high-velocity, low-amplitude thrust maneuver to the target joint, bringing the joint capsule beyond its elastic barrier but still within its physiologic limit.

• Active range of motion: the movement capacity of a joint under control of its own muscles (e.g., how far you can bend your wrist in all directions using the muscles of your forearms)

• Passive range of motion: the movement capacity of a joint under control of an outside force (e.g., how far you can bend your wrist using your other hand)

• Elastic barrier: the end of passive range of motion; beyond the elastic barrier is where a chiropractic adjustment (or joint manipulation) occurs and you may hear a “crack” or “pop” sound

NOTE: chiropractic adjustments are performed on any joint you can consciously move (the joints in your arms, legs, hands, feet, fingers, toes, spine, ribs, pelvis, etc.); these joints are called synovial joints, and you’ll learn more about them below

Benefits of chiropractic adjustments

The two main purposes of a chiropractic adjustment are to decrease pain and improve joint mobility. Often, an adjustment is targeted to a joint that has poor movement patterns or has otherwise become restricted.

These joint restrictions commonly become painful due to joint capsule hypertonicity or spasm along with aberrant movement.

Along with restricted joint movement, nerve and muscle function often become disrupted as well. Muscles may become hypertonic, overactive, or inhibited due to inappropriate joint movement.

Chiropractic adjustments release joint restrictions, decrease pain, and have the potential to improve nerve and muscle function.

Joint cracking or popping sensation during an adjustment procedure

The cracking or popping you hear and feel during adjustment procedures is a physiologic phenomenon called tribonucleation. It is sometimes referred to as a cavitation, which is also appropriate, but it does not tell the whole story.

• Tribonucleation: a process where opposing surfaces resist separation until a critical point where they separate rapidly resulting in vapor cavities that do not collapse instantaneously

• Cavitation: the formation of an empty space within a solid object or body

These definitions are a bit scientific and may not be abundantly clear, so we offer our easier-to-understand explanation below.

The joint capsule surrounds the joint surface and creates a seal between the internal joint space and the outside world. The joint capsule is a type of fascia—an elastic tissue that has the ability to contract, relax, and stretch.

Within the joint capsule is a fixed volume of fluid, called synovial fluid, which acts as the lubricant and nutrient-delivery for the hyaline cartilage. In normal physiology (active and passive range of motion), there is carbon dioxide dissolved within the synovial fluid.

In the instance of a chiropractic adjustment, the joint capsule is stretched beyond the elastic barrier, stretching the joint capsule and resulting in an increase in total volume within the joint capsule space.

However, as previously mentioned, there is a fixed volume of synovial fluid. Therefore, something needs to take up the additional space; there cannot be a vacuum (completely empty space) left within the joint capsule.

With the negative pressure created from the joint capsule stretch, the carbon dioxide previously dissolved in solution is pulled out of the synovial fluid to fill the additional space. This instance is what creates the sound you can hear.

A similar situation is when you open a bottle or can of soda or seltzer. Before breaking the seal, you do not see the carbonation. After breaking the seal and changing the pressure, you can hear and see the carbonation appear.

Manual therapy techniques

These techniques will provide much of your pain relief and overall improvement. Manual therapy has a vast number of techniques and treatment styles, and each of these will vary between providers, both in chiropractic as well as across health care professions.

Trigger point pressure release

A trigger point, commonly called a knot, is a focal area of increased muscle tone within a muscle or fascia (connective tissue). These areas may or may not be painful at rest, but they will generally be painful when under stress or pressure (e.g., muscle contraction, muscle stretch, or direct pressure).

Trigger point pressure release, as a technique, is pretty self-explanatory. The provider finds a trigger point and adds external pressure to initiate healing.

Although the technique sounds simple, the physiology is legitimate. The tension of a trigger point limits the blood flow through that area of the muscle, a phenomenon we call stagnation.

Pressing the trigger point acts as a pump, pressing the stagnant blood flow out and allowing nutrient-and-oxygen-rich blood to flow through. With appropriate nutrients and oxygen, a muscle can relax to its normal resting state.

Fascial manipulation

Fascial manipulation technique, as its name implies, is specific to a connective tissue called fascia. Fascia is in reference to any soft tissue in the connective tissue system that’s made up of collagen with a ground substance of hyaluronic acid and glycosaminoglycans (GAGs).

For the purpose of this post, we will focus on deep and superficial fascia as they are the most commonly treated during fascial manipulation. Also note, these definitions have been simplified, significantly.

• Deep fascia: a sheet of fascia that surrounds each muscle; think of it like a sausage casing around meat

• Superficial fascia: the fascia that makes up the under-surface of your skin

The purpose of fascial manipulation is to break apart adhesions that form between the deep and superficial layers of fascia due to densifications in its lubricating protein called hyaluronic acid.

Fascial manipulation is highly effective in relieving pain, decreasing tension in hypertonic muscles, increasing activation in inhibited muscles, and restoring overall, normal-movement patterns in the entire body.

Instrument-assisted soft tissue mobilization

Instrument-assisted soft tissue mobilization (IASTM) will use a metal, plastic, or porcelain tools to scrape an area of a muscle or fascia. This technique helps to reduce muscle hypertonicity or fascial adhesions by mobilizing the tissues around the affected area.

IASTM is somewhat similar to fascial manipulation. However, the treatment areas in IASTM tend to be more broad, treating across a body region or larger area of muscle/fascia, whereas fascial manipulation is specific to small vector points within specific fascial plane lines.

Post-isometric relaxation

Post-isometric relaxation (PIR) is a stretch technique that has both an active and passive component. Generally speaking, static stretching is passive-only, meaning the muscle is being stretched in a relaxed position through an external force (e.g., sit-and-reach hamstring stretch).

For PIR: prior to the static, relaxed-stretch phase, the patient is required to gently activate the target muscle against the resistance for 10 seconds.

After 10-seconds of active-hold, the patient takes a deep breath and holds it for 3-seconds. Then, the patient releases their breath and relaxes the target muscle as the provider increases the depth of the stretch.

This PIR technique is performed three times prior to releasing. The goal of PIR, like trigger point pressure release, is to press stagnant blood flow out of a muscle and allow nutrient-and-oxygen-rich blood to flow through and release trigger points. With appropriate nutrients and oxygen, the muscle can relax to its normal resting state.

Post-facilitation stretch

Post-facilitation stretch (PFS) is a more aggressive stretch technique that also has both an active and passive component. Different than the PIR technique, however, PFS requires a max-effort contraction or activation as its active component.

Following 10-seconds of max-level contraction, the patient relaxes the target muscle and the provider creates an abrupt, rapid elongation of the same muscle to its end-range. The goal of PFS technique is to reduce hypertonicity within a muscle.

Pin-and-stretch

This technique combines both pressure release and stretching into one modality. Similar to pressure release, the name tells you the story. To begin, the target muscle should be as short (or contracted) as possible.

With the target muscle in its shortened position, the provider will press down and pin the muscle underneath their contact. With the muscle pinned down, the muscle is then opened or stretched as far as possible.

The stretch portion can be performed either actively (the patient will create the movement on their own) or passively (the provider initiates the movement).

Each variation serves its own purpose, as active and passive muscle lengths may vary. Generally speaking, active range of motion is less-than passive range of motion. Increasing both of these types of motion are great, as long as they are done under control and within the normal movement capacity of the associated joint.

The pin-and-stretch technique can be used for trigger points, muscle hypertonicity, and even tendinosis adhesions found in repetitive strain injuries.

Therapeutic exercises and rehabilitation

Being experts in anatomy, physiology, and joint biomechanics, we are naturally experts in corrective or therapeutic exercise and rehabilitation for injuries or other pain patterns.

Along with chiropractic adjustments and manual therapy techniques, we utilize the active modality of exercise. Therapeutic exercises may be performed with the goals of activating inhibited muscles, relaxing overactive muscles, normalizing movement patterns, and creating healthy, active range of motion for a target joint or joints.

Each patient and each injury requires an appropriate assessment of joint mobility and muscle activation to determine which exercise(s) may be appropriate. Therapeutic or rehabilitation exercises may include simple movement patterns, resistance exercises, or stretches to achieve the above-listed goals.

Posture education

Posture is one of the most valuable points of education in terms of chiropractic and gaming. However, posture has been discussed at length on this page, and we will not be going into detail on this page.

Chiropractic and gaming

Combining everything described above—chiropractic adjustments, manual therapy techniques, and health and wellness education such as posture—a chiropractor is exceptionally well-versed in the cause and resolution of mechanical ailments in the human body.

The vast majority of discomfort, pain, or injuries you will experience will result from an imbalance in your mechanics—perhaps your body position is poor or you’re using your muscles inappropriately (e.g., concentric vs. eccentric or agonist vs. antagonist imbalance).

And, ultimately, none of these issues are appropriately prevented or treated with medication or surgery. Proper education on posture, exercise, stretching, strengthening, ergonomics, diet and nutrition will be what helps reduce your pain and improve your overall health and wellness.

Experts in mechanical ailments

As chiropractic physicians, we specialize in mechanical (neuromusculoskeletal) conditions of the entire body. For you as a gamer, chiropractic care should be a regular part of your health and wellness program as we are the most well-rounded providers to effectively diagnose and treat the mechanical ailments experienced during gaming.

Health care providers for your events

If you’re a tournament organizer or esports organization, you can have Esports Healthcare at your events providing all our company’s services.

Another unique aspect of chiropractic is its cost-effectiveness. In a standard chiropractic setting, there is extremely low overhead. Traditional treatments are performed by hand without the need for additional tools or gadgets, and they can be done with limited space and simple, inexpensive equipment.

• Equipment: a very limited amount of equipment is required to perform the above-listed services in full. The equipment required is a chiropractic table and a laptop/tablet for electronic health records.
  • The only other equipment that may be required is a set of portable curtains for privacy if a treatment room is unavailable—all of which will be provided by Esports Healthcare.

• Space Requirements: a small area is enough to perform all the services; for example, an area of 8ft. x 5ft. is appropriate for each treatment table

References