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How do I know when to see a doctor vs. a chiropractor vs. a physical therapist vs. a massage therapist if I had severe joint injury?

David L Johnson
29.11.16 04:44 AM Comment(s)

In this short article you will be able make an informed decision on where to begin and how to proceed, if you have had a severe joint injury.  At the end of this article I have include a link to receive a quick reference chart to help you make a quick informed decision.

  If you have had a severe injury, you should always begin by seeing a doctor.  Only a doctor can perform or prescribe tests to determine if you have suffered from a tear in your soft tissue. (Remember a chiropractor is a doctor in many states, so if not cost prohibitive, it may be a good place to start.)  In the case of a tear, surgery may be the only option for recovery.

  If you have not experienced a soft tissue tear, the doctor may refer you to a chiropractor, if they are not one themselves, a physical therapist or a massage therapist.  Here’s a high level oversimplified overview of what each does.  A chiropractor mainly focuses spinal manipulation to relieve pain. 1  A physical therapist mainly focuses on movement and strength of a particular joint or muscle 2,  and the massage therapist mainly focuses on the holistic function of the person with a heavy emphasis on the lengthening/loosening tight muscles.3  However, there are many techniques that are used by all three professions in a very segmented unregulated fashion.  This unregulated overlap of skill sets can cause confusion and in my opinion, is one of the reasons why you can get such a wide range of care from professionals with in the same general field. Some techniques are absolutely painless while other leave you in more pain after care than before.  Sometimes this is ok and sometimes it may not be ok, it all depends on the initial problem and the technique used to address the problem. Some of these overlapping techniques are: Manual Therapy, Orthopedic Therapy, Craniosacral Therapy and Structural Integration.  All of these techniques have documented proof of providing some form of relief or improvement for different injuries and health concerns. 

How do you go about navigating your recovery, after seeing a doctor?

The doctor may refer you to a chiropractor, physical therapist or massage therapist.  A single referral is probable, but it is likely that you will benefit from more than on type of session. For this let’s use a scenario.  Let’s say your right knee is injured during a car accident and you have to be in a cast for 6 weeks.  During this time two very distinct things happen.  On the injured leg, you have no or limited movement, which means no muscle usage.  As the saying goes, “if you don’t use it, you lose it”.  So for that side of your leg you need to regain strength to regain an optimal level of performance.  However, on the other leg, that you’ve been hopping on constantly for 6 weeks, the muscles have become too rigid or tight due to repetition and over use.  Solution: you would benefit from physical therapy to aid in the process to restore strength to the injured side, and you would benefit from massage therapy to lengthen and loosen the tight over worked muscles on the non-injured side.  If you correct the injured side but fail to correct the overworked side, you are likely to experience an injury on the non-injured side in due time. Doctors often refer to only one or the other, but in reality you probably can benefit from both.




The Bigger Issue

Now that you have a very basic understanding of the three, let’s look at how you can make an informed decision to acquire a quality practitioner to help you.  Here’s my Captain Obvious impersonation: Online reviews from a reputable source are a great place to start.  Yep, obvious…but beyond that it is helpful to have some questions to be able to ask your therapist before you pay.  For example, if you have a limited range of motion issue; Manual or Orthopedic Therapy will be of great interest to you.  These techniques are generally pain free but very effective.  If you have a posture problem, Structural Integration is a great technique to help balance out your body. (By the way did you know that you may be able to regain height from specialized massage techniques?4)  If you’re having lots of headaches, Craniosacral Therapy will be beneficial to you.  This is just the tip of the iceberg as there are 100’s of techniques that a therapist can learn and use to help specific problems. If don’t believe me click here to see for yourself.   

Here’s the main point:  If you know your symptom, you can ask your therapist direct and specific questions about their training so that you can verbally vet your therapist and greatly increase your chance of getting great relief!  If you have a frozen joint but your therapist does not know Orthopedic Massage or Manual Therapy, then you may want to keep looking.  Additionally, if going to a massage therapist, you should ask if they have verifiable documentation to support their training, (transcripts or CEU certificates).  While physical therapy is heavily regulated, massage therapy is not.  In fact, some states do not even have a regulatory board for massage.  And the ones that do, the requirements range from 200 hours to 1000 hours of required training depending on the state.  (Think about the discrepancy, would choose a doctor with 2 years of training over 10 years of training, figuratively speaking of course.)

In my next few articles and flyers I will look more closely at some of the most popular and proven techniques prevalent in the industry of chiropractic, massage therapy and physical therapy. I will also help you navigate a course to finding the right therapist for your specific needs.  You may actually need a few different therapists for different symptoms and concerns over the course of your lifetime, as it is common for some therapist to specialize in specific modalities.  Scroll to the bottom of this page to sign up for my newsletter (or click here) to receive articles from me in the future and to get the free quick reference chart that I’m working on now.  I’ll send it to you with in the next few days as I am currently perfecting it.



1.  http://www.webmd.com/a-to-z-guides/tc/chiropractic-topic-overview#1

2.  http://www.webmd.com/pain-management/tc/physical-therapy-types-of-physical-therapy

3.  http://physical-therapy.advanceweb.com/Article/Comparing-Massage-Therapy-amp-Physical-Therapy.aspx?zz=0#AnchorPostComment

4.  http://www.upledger.com/therapies/articles.php

David L Johnson