Essential techniques to learn as a doctor of chiropractic
One of the key questions that students ask when choosing a chiropractic college is, "What techniques will I learn at your school, and how will they help me succeed as a doctor of chiropractic?" Many colleges try to answer that question with a core curriculum covering a multitude of techniques.
At Northeast College of Health Sciences, rather than pursuing a "jack of all trades" approach with a broad overview, we concentrate on producing graduates who qualify as what we like to call expert adjusters. This more focused approach ensures that students acquire the hands-on experience to master essential techniques, so that upon graduation they are ready to effectively practice on day one.
Creating better chiropractors through an amplified core curriculum
Northeast College has developed a core curriculum that lets students learn key osseous and soft tissue techniques in-depth: Diversified, Flexion and Distraction, and ConnecTX. That core expertise is amplified by the exceptional range of technique electives offered, such as Drop Technique, Gonstead, Nimmo and Activator, to name just a few.
This "core + elective" approach allows students to excel with the art, science, and philosophy behind high velocity, low amplitude thrust-adjustive techniques. At the same time, future chiropractors can explore additional techniques via required elective coursework and may even decide to pursue credentialing with organizations that govern those techniques. Often, credentialing can be done through Northeast’s own Frank J. Nicchi School of Continuing Education.
In this article, and others that will follow, we explore the unique way Northeast College teaches each technique, beginning with Diversified Chiropractic Technique (DCT). We sat down recently with Dr. Brett Carnevale, chair of the Integrative Chiropractic Therapies Department at Northeast College of Health Sciences, to get an inside look at this mainstay of the core curriculum.
A fresh look at diversified chiropractic technique
We first asked Dr. Carnevale to define the DCT. He said that, while the term encompasses a variety of manual adjustment types, "a general definition would be an adjustment with a high-velocity, low-amplitude impulse."
Noting that chiropractic practice involves, for the most part, hands-on, manual therapies, he added that "this high-velocity, low-amplitude impulse works to restore a motion within the area that we're contacting, or adjusting. This restoration of joint motion promotes optimal spinal function and promotes pain reduction and healing in the associated tissues." While that area is most commonly the spine -- typically the focus of chiropractors -- Dr. Carnevale was quick to point out the broader applications, saying, "The Diversified Technique can be utilized throughout the body, including the joints of the upper and lower extremities, and not solely the spine."
The philosophy behind chiropractic technique is as important as the physical application
Given that instruction in Diversified Chiropractic Technique is offered at most chiropractic colleges, we asked Dr. Carnevale if there are substantive differences between how it is taught and how it is practiced. He spoke immediately to the importance of the philosophical focus of one's chiropractic education and how that philosophy eventually guides practice.
"You'll notice," Dr. Carnevale said, "how I used the phrase 'restoring proper motion in the spine.' That reflects what we at Northeast College call a motion-based philosophy, versus those that take a more static approach. Under a static model, the assessment of the patient is based primarily on the alignment of the spine. If a misalignment is found, an appropriate adjustive technique would be performed. Often referred to as having 'a bone out of place,' this approach emphasizes a specific vector to correct the misalignment and push it back into the normal position. Although our students will learn that approach, our focus in adjusting with the Diversified Technique is to look at it from a motion perspective.
At Northeast College, we teach our students to assess the patient relative to motion. As we assess the different joints of the body, we're looking for a joint that isn't moving as well as the joints around it or compared to the other side. When we find a joint that doesn't have sufficient motion, that's what we like to adjust -- that's where we like to apply the Diversified Chiropractic Technique."
Accurate assessment is as essential as skilled adjustment
Dr. Carnevale went on to explain that, while people outside the profession may primarily associate chiropractic care with "that pop or cracking of the spine, effective use of the Diversified Technique involves a thorough process of discovery to determine what type of adjustment should be used where -- or even if a different type of therapy is called for in a specific case."
"I always tell students that the adjustment is the icing on the cake," he said. "From their first trimester on, our students are trained to identify different structures of the body and to assess the motion within the body. Then they learn how to best determine whether a patient needs an adjustment, or if one of the other techniques we teach may be more applicable. For instance, some patients may have underlying medical conditions that are contraindicated for a chiropractic adjustment. So, our students learn the appropriate steps that must be taken before application of an adjustment, to ensure that adjustment is the best treatment, and the patient is ready for it."
Early hands-on learning is key to mastering the Diversified Chiropractic Technique
Of course, chiropractors must be "ready for it," too -- ready to skillfully apply manual therapies from the very first day of their professional lives. Dr. Carnevale explained why doctor of chiropractic graduates from Northeast College can so confidently step into practice.
"What we do very early in the program, especially compared to other institutions, is to immediately make learning hands-on. In the first 15 weeks of the program, students have 60 contact hours of hands-on skills training. That includes palpation, some assessment, and training in techniques needed to apply a particular adjustment. Though they don't adjust each other yet, students instead use speeder boards, which are mini chiropractic tables that allow practice of all the different hand contacts and thrusts."
Dr. Carnevale continued, "The second 15 weeks, during the second trimester of the program, our students have one technique course that includes 90 contact hours. By the fifth week of that course -- roughly week 20 of their education -- they apply their first adjustment to one of their fellow classmates.
By getting students hands-on early into the program, they get used to that touch, they get used to applying these forces, and it allows our instructors to have more time to critique and fine tune the basic techniques that students learn. By mastering these skills early in the program, more advanced techniques can be taught as the students progress through the curriculum."
Learning chiropractic beyond the basics
The Diversified Chiropractic Technique is central to what students learn at Northeast College, but still only part of a comprehensive, evidenced-informed education encompassing advanced techniques and specialized therapies. To learn more, explore our Doctor of Chiropractic Program, and watch for the upcoming article, "Specialized Chiropractic Techniques Taught at Northeast."