4 Chiro/rehab beliefs I’ve changed my mind about in 16 years of practice
Posture causes pain
I used to believe rounded shoulders, forward head posture (Kim et al., 2016), and pelvic tilt were major contributors of pain. Research shows surprisingly little correlation between “perfect posture” and pain for most people: humans are far more adaptable than we once thought!
Usually the issue isn’t just slouching, it’s staying in the same position too long.
While chasing PERFECT symmetry is often a losing battle, addressing significant imbalances can be a useful tool for improving movement efficiency and distributing mechanical stress evenly across your joints. It’s less about fixing a "defect" and more about expanding your body’s toolkit so you aren’t over-relying on a single pattern of movement. An asymmetry is simply a physical variation, NOT a diagnosis of dysfunction; you aren't a machine that needs to be perfectly calibrated to run, but a biological organism that has successfully adapted to the unique demands of your life.
Adjustments put things back into alignment
In Chiropractic school we’re taught to locate spinal misalignments and fix them with a force in a very specific direction. While this is the case SOME of the time, much more often it’s less specific. Manual therapy works much more through the nervous system, decreasing sensitivity, improving movement options, and helping the brain feel safer with movement again (Jupin et al., 2025) What’s great about this, is while Chiropractic is a GREAT way to “get back to factory settings” the fastest, your body can do this with other tools: massage, movement, stretching, correcting ergonomics, etc.
Tight muscles need more stretching
Tightness doesn’t always mean a muscle is physically short. Often, it’s a protective response from the nervous system.
I see this all the time with low back disc herniations where the hamstrings feel insanely “tight,” but part of that feeling may actually be the nervous system guarding because the nerve root is irritated or sensitive (Zhu et al., 2006). In those cases, aggressively stretching can sometimes make the body even more protective.
One of the best ways to make muscles feel safer, and often feel “looser,” is through loading, resistance training, and controlled movement.
I still love yoga, foam rollers, massage guns, and mobility work. What’s fascinating is that many of the short-term improvements from these probably come less from physically lengthening tissue and more from changing sensitivity, improving blood flow, reducing threat, and helping the nervous system relax its protective response.
There’s ONE problem causing pain
I used to spend so much energy trying to find the one perfect diagnosis or magic orthopedic test. Now I see pain as much more nuanced and multifactorial. Structure matters, but so do stress, sleep, previous injuries, fear, conditioning, recovery, and nervous system sensitivity. The longer I practice, the less interested I am in convincing people they’re broken, and the more interested I am in helping them feel capable again.
Sources:
Kim, E., & Kim, J. (2016). Correlation between rounded shoulder posture, neck disability indices, and degree of forward head posture. Journal of Physical Therapy Science, 28, 2929 - 2932. https://doi.org/10.1589/jpts.28.2929.
Jupin, C., Aibar, V., & Sarhan, F. (2025). Short-Term Effects of Spinal Manual Therapy on the Nervous System in Managing Musculoskeletal Pain: A Systematic Review. Journal of Clinical Medicine, 14. https://doi.org/10.3390/jcm14113830.
Zhu, Q., Gu, R., Yang, X., Lin, Y., Gao, Z., & Tanaka, Y. (2006). Adolescent Lumbar Disc Herniation and Hamstring Tightness: Review of 16 Cases. Spine, 31, 1810-1814. https://doi.org/10.1097/01.brs.0000226047.83475.e4.