The question of whether a physical therapist can perform a chiropractic adjustment is complex, primarily due to differences in professional terminology and legal scope of practice. Both Physical Therapists (PTs) and Doctors of Chiropractic (DCs) are licensed professionals who utilize manual techniques to treat musculoskeletal conditions. While their physical actions may appear similar to the public, the specific language used to describe the technique and the underlying philosophical approach differ significantly. The ability of a PT to perform a technique similar to a DC’s is determined by state law and professional designation.
Manipulation Terminology and Professional Distinction
The core of the distinction lies in the difference between a “Chiropractic Adjustment” and “Spinal Manipulation.” A chiropractic adjustment is a term legally and professionally reserved almost exclusively for Doctors of Chiropractic. This term often implies a specific philosophical approach, historically tied to the correction of a “vertebral subluxation” to restore nerve function.
In contrast, “Spinal Manipulation” is the clinical term used by Physical Therapists, osteopaths, and other practitioners for the physical technique itself. This technique is defined as a high-velocity, low-amplitude thrust (HVLAT) directed at a joint to restore mobility or reduce pain. Physical therapists are trained to perform this type of manual therapy, but they refer to it as spinal manipulation, not a chiropractic adjustment.
Physical Therapist Scope of Practice
Physical therapists are legally permitted and trained to perform high-velocity, low-amplitude thrusts (HVLAT) as a form of manual therapy. These techniques result in the audible joint cavitation, or “popping” sound, which is a common feature shared with chiropractic adjustments. The goal of a PT’s spinal manipulation is to achieve clinical improvements within the neuromusculoskeletal system, such as restoring joint mobility, reducing pain, and improving muscle function.
The training for these techniques is integrated into the Doctor of Physical Therapy (DPT) curriculum and often augmented through post-graduate education. Many PTs pursue specialized training to enhance their skills in manual therapy, including HVLAT. The American Physical Therapy Association (APTA) supports spinal manipulation as an evidence-based intervention within the PT scope of practice. PTs utilize these manual techniques as one part of a broader rehabilitation and exercise framework, focusing on diagnosis and prognosis to optimize physical function.
Regulatory Oversight and State Law Variations
The final determination of what a physical therapist can perform is heavily influenced by jurisdictional law, which is established by each state’s practice act. State practice acts govern the legal scope of practice for all licensed healthcare providers, including PTs and DCs. This means that the answer to the user’s question is often geographical, varying significantly from one state to the next.
Some states explicitly allow physical therapists to perform spinal manipulation and may require specific, advanced training or endorsements to do so. Other states have laws that either restrict the use of HVLAT techniques by PTs or prohibit them from using terms like “spinal adjustment” or “spinal manipulation” in their advertising. These legal differences explain the ambiguity the public faces, as a technique permitted in one state may be restricted or prohibited in another.
Educational Foundations of Manual Therapy
The educational models for Physical Therapists and Doctors of Chiropractic provide context for their differing approaches. Both professions receive extensive training in anatomy, biomechanics, and manual techniques during their doctoral programs. However, the emphasis differs significantly.
The Doctor of Physical Therapy (DPT) curriculum focuses on integrating manual therapy within a comprehensive rehabilitation and exercise-based treatment plan. In contrast, the Doctor of Chiropractic (DC) curriculum places spinal manipulation as a primary modality, often dedicating significantly more hours to the technique and its associated diagnostic principles. This difference in educational focus contributes to the distinct professional identities, despite the overlap in the physical application of high-velocity, low-amplitude thrusts.