It has been said that Chiropractic is a philosophy, science and art. What is the ‘art’ of Chiropractic? A lot of people associate the word ‘art’ with music, dance and visual compositions. The art of Chiropractic though does not involve paints, leotards or musical instruments. 

Art is one of those words that has many different applications and definitions. Especially depending on who you ask. Any abstract principle such as art is bound to have many definitions. 

Art can be defined as a “skill acquired by experience, study, or observation.” Art can also be defined as: “a branch of learning.” Furthermore, art is “an occupation requiring knowledge or skill.” And finally, art can be defined as “the conscious use of skill and creative imagination especially in the production of aesthetic objects”

What does this have to do with Chiropractic? In its most simple form, the art of Chiropractic is the technical skill of the adjustment. This simple definition can lack substance. R.W. Stephenson D.C., who literally wrote the book The Art of Chiropractic,  understood that the Chiropractor is “not only a scientist” but “should be an artist; skilled with mind and hands.” 

To me, that is a crucial point to be made about Chiropractic. It is the coupling of mind and hands. In a broader understanding, it is the merging of the concrete and the abstract, the material and immaterial back together. This is what makes Chiropractic, Chiropractic. It is our unique philosophy that helps bind science and art together. But I will leave explaining the ‘philosophy of Chiropractic’ for another blog. 

Now before I pontificate too much, my goal is to try and simplify the art of chiropractic. An acronym for the A.R.T. of the Chiropractic adjustment is: A for action, R for reason and T for time. The technical skill of the adjustment requires a specific action, for a specific reason at a specific time. Let’s tease this out a little. 

Action

The action is the specific movements needed to obtain a proper adjustment. The three main actions that are needed for an adjustment are toggle, torque and recoil. Toggle and torque are actions made by the Chiropractor and recoil is the action made by the patient. 

A toggle action involves two levers of unequal lengths joined together by a hinge joint. The mechanical advantage of a toggle joint is that a small force applied at one end can create a much larger force at the other end. The human body just so happens to have toggle levers found in each arm. 

The upper arm (which is slightly longer than the forearm) is hinged to the forearm at the elbow. This creates a natural toggle joint. This means that the Chiropractor needs only to apply a small amount of force to the vertebra to overcome its subluxated nature. Little does much and less is more. 

The torque is often considered the “secret sauce” of the adjustment. The torque creates a “twist” in the toggle mechanism. This provides the third dimension to the adjustment. 

Torque also provides a mechanical advantage by creating more efficient use of power. Most corkscrew wine openers utilize torque to increase the efficiency of power to make it easier to open the bottle. The torque is created at the elbow and travels down through the forearm. It is then concentrated at the contact point found on the small pisiform bone of the hand. 

For every action, there is an opposite and equal reaction. The recoil is the reaction to the toggle and torque actions. This reaction is created by the patient. 

The recoil action is what makes the adjustment. There is a misconception that the Chiropractor makes the adjustment. What actually happens is that the body of the patient reacts to the specific force applied to the spine by the Chiropractor and adjusts to it.

The more specific the toggle and torque, the more specific the recoil. The more specific the recoil, the more specific the adjustment. The Chiropractor determines what vectors and angles are needed with the toggle and torque predominantly through X-ray analysis. The X-ray provides a “blueprint” for the specificity of the adjustment. 

Reason

What is the reason for a specific adjustment? An adjustment helps restore proper mental impulse communication to the Nerve System. This is done by correcting a vertebral subluxation. 

The main objective of the Nerve System is to control all movements, sense everything we fell, regulate all body organs and relate us to the outside world. The mental impulse is the main driver behind these objectives. Without a proper functioning Nerve System, the sensation, perception and behavior of a Mental Impulse can get disrupted.

A disruption in Nerve function results in a disruption in health and well-being overall. The reason then for a specific adjustment is to improve overall health and well-being. 

Health is a cornerstone of life. Without health, many other aspects of life fall short of their full potential. Chiropractic wants everyone to live at their greatest potential. The greater potentiality we have, the greater actuality we can express. And great action can produce great work. 

Time

More elusive to define than art is time, but I will try my best. The time aspect of the adjustment carries with it a few applications. Time can refer to the rate of speed needed to provide an adjustment. 

The actions of the adjustment (toggle, torque, recoil) rely on the rate of speed. For a proper, specific Chiropractic adjustment, quick speed is crucial, not brute force. A 100-pound female can give a better adjustment than a 300-pound male if speed is utilized. 

Time can also relate to duration. A vertebral subluxation is not a vertebral subluxation at all times of the day. A subluxation is similar to a fever in that the characteristics of each can ebb and flow throughout the day and are dependant on the situation. 

The NeuroCaloMeter instrumentation was designed to help answer the question: When is a Subluxation? There is a specific time to give an adjustment. 

The time to give an adjustment is when a vertebral subluxation is present. To give an adjustment when a vertebral subluxation is not present is a contradiction. The X-ray helps give us a snapshot of WHERE the subluxation is. The NCM gives us a non-invasive real-time measurement of WHEN the subluxation is.  

Chiropractic is like a three-legged stool. It is supported by its philosophy, science and art. If one leg is weak, the rest of the stool becomes unstable. As a Chiropractor, I must embody that dynamic if I am to provide a skilled adjustment. 

- Jarek Esarco, DC, CACCP

Jarek Esarco, DC, CACCP is a pediatric, family wellness and upper cervical specific Chiropractor. He is an active member of the International Chiropractic Pediatric Association (ICPA). Dr. Jarek has postgraduate certification in Pediatric Chiropractic through the ICPA. Dr. Jarek also has postgraduate certification in the HIO Specific Brain Stem technique through The TIC Institute. Dr. Jarek is happily married to his wife Regina. They live in Youngstown, Ohio with their daughter Ruby.