Blog 4: Endurance Therapeutics FAQ
Part 4: What Actually Happens in a Treatment Session at Endurance Therapeutics
Welcome back to the Endurance Therapeutics FAQ. Parts 1 through 3 covered what chiropractic care actually is, how the body heals through the nervous system and kinetic chain, and why what you do between appointments matters as much as what happens in the clinic. Part 4 answers one of the most common questions I get from new patients which is what is actually going to happen when I come in?
The honest answer is that every session looks a little different because every athlete is different. But here is the consistent framework that shapes every appointment at Endurance Therapeutics.
The Assessment Always Comes First
Before any treatment happens I need to understand what is actually going on. Not just where it hurts but how you move, what patterns are driving the problem, and what the underlying story is.
For a first appointment this means a thorough history. When the pain started, what makes it better or worse, what you have already tried, what your training looks like, and what your goals are. For returning patients it means checking in on how the body has responded since the last session and reassessing movement quality as treatment progresses.
I am watching how you move from the moment you walk in. The way you stand, sit, and transition between positions tells me a great deal before the formal assessment even begins. Movement screening, orthopaedic testing, and palpation of the relevant structures all contribute to the clinical picture that guides everything that follows.
Muscle Release Technique (MRT)
MRT involves applying precise tension to a specific muscle, tendon, or fascia while the patient actively moves through a range of motion. This combination of manual pressure and active movement breaks down adhesions, restores tissue extensibility, and normalizes the neuromuscular firing patterns that chronic tension disrupts.
If you have ever had a massage and felt temporary relief that did not last, MRT often addresses the reason why. It targets the specific tissue under load in the functional position it is actually used in rather than treating it passively at rest. For athletes this specificity matters enormously.
You will feel pressure and often a familiar achiness in the area being treated. Occasionally there is a brief intensity as adhesions release. This is normal and should feel productive rather than painful. Communication throughout the session is always encouraged.
Dynamic Cupping
The cupping technique I use involves moving the cups continuously over the skin while suction is maintained. Rather than leaving cups in a fixed position, this dynamic approach combines the decompressive benefit of negative pressure with a myofascial release effect across a broader area of tissue as the cup glides along the muscle.
This technique is particularly effective for large muscle groups like the glutes, thoracic erectors, hamstrings, and hip flexors where tension is diffuse rather than localized to a single point. It works well alongside MRT and muscle scraping as part of a comprehensive soft tissue session because it reaches the superficial fascial layers in a way that hands and instruments address differently.
The marks left by cupping are not bruises. They are the result of blood being drawn to the surface and reflect the degree of stagnation and restriction in the treated tissue. They resolve within a few days and are generally painless.
Ischemic Compression
Ischemic compression involves applying sustained direct pressure to a specific trigger point, a hypersensitive area within a muscle that refers pain or restriction into surrounding tissue. The sustained pressure temporarily restricts blood flow to the area. When the pressure is released, fresh oxygenated blood floods back in, disrupting the trigger point cycle and reducing the local and referred pain it produces.
This technique is precise and targeted. It is most effective for the stubborn trigger points in the upper trapezius, glutes, piriformis, and hip flexors that develop from repetitive athletic loading and do not fully respond to general soft tissue work alone.
Muscle Scraping (Instrument Assisted Soft Tissue Mobilization)
Muscle scraping uses a smooth edged instrument applied directly to the skin over a targeted area of tissue. The instrument detects and addresses fibrotic tissue, fascial restriction, and scar tissue by creating a controlled microtrauma that stimulates the body's healing response and promotes the breakdown and remodelling of dysfunctional tissue.
Athletes often notice that muscle scraping reaches a quality of tissue release that hands alone cannot produce in certain areas. It is particularly effective for chronic tendon presentations, IT band restriction, plantar fascia tightness, and the forearm and calf tissue that endurance athletes and hockey players accumulate significant load through across a season.
You will feel a scraping sensation and some redness in the treated area afterward. This is a normal inflammatory response and is part of the mechanism through which the technique works.
Joint Mobilization
Joint mobilization involves applying controlled, rhythmic movement to a joint to restore its normal range of motion, reduce pain, and improve the quality of movement through that joint.
In contrast to an adjustment, mobilization is a lower velocity technique that moves the joint through its range gradually rather than through a quick thrust. It is appropriate for a wider range of presentations and is often the technique of choice when the goal is to restore mobility progressively rather than release a specific restriction quickly.
I use mobilization extensively for the thoracic spine, hip joint, ankle, and shoulder in athletes who have developed restriction from repetitive loading patterns in their sport. The relief is often immediate and the change in movement quality post mobilization is something patients consistently notice.
Adjustments
An adjustment, also known as spinal manipulative therapy, is a controlled high velocity low amplitude thrust applied to a specific joint to restore its normal mechanics and stimulate the neurological response that reduces pain and improves function.
Adjustments are not appropriate for every presentation and they are never the whole of what I do. When the clinical picture indicates that a specific joint restriction would respond well to an adjustment, it is an effective and efficient tool. When it does not, I will use other techniques that are better suited to what I am finding.
The sound associated with an adjustment is not bone cracking. It is the release of gas from the synovial fluid in the joint. It is harmless and does not indicate that anything has been forced or damaged. Some patients never experience the sound at all and the treatment is equally effective.
I always explain what I am planning before I do it and consent is always sought before any technique is applied.
Exercise Prescription and Education
Every session at Endurance Therapeutics ends with education. This might be a specific activation exercise to do before training, a mobility target to work on daily, a load management adjustment for the coming training week, or a deeper explanation of what is driving the injury and how to address it.
I do not hand out generic exercise sheets. The exercise prescription that comes out of each appointment is specific to what I found in that session, what the athlete is doing in their training, and where they are in the recovery process. The goal is always to give the patient something they can use immediately that moves them closer to where they want to be.
This educational component is not a bonus at the end of the session. It is one of the most important parts of what I do. The athletes who get the best long term results are the ones who understand their body well enough to manage it between appointments. Building that understanding is a core part of every session at Endurance Therapeutics.
Up Next: Chiropractic vs. Physiotherapy vs. Massage Therapy
Now you know what happens in the room. Part 5 of the Endurance Therapeutics FAQ covers the question I get almost as often as any other — what is the difference between a chiropractor, a physiotherapist, and a massage therapist, and how do they work together? See you there.
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Ready to experience what a session at Endurance Therapeutics actually feels like? Book a free 15 minute phone consultation or a full assessment and let us get to work. Reach out to book with Dr. Keirstyn at Endurance Therapeutics today!
📍 Endurance Therapeutics | Oakville, Ontario
📞 905-288-7161
Optimizing The Endurance Athlete’s Mind, Body & Performance.