Having recently graduated from the Sherman College of Chiropractic  in the United States with a Doctor of Chiropractic degree, Dr. Ashley Liew, 29, will be starting work full-time at the Family Health Chiropractic Clinic (Singapore), this coming November.

The clinic was founded by Dr. Kelvin Ng, Ashley’s mentor.

I caught up with Ashley –  about chiropractic care, and how this may help runners. The Chiropractor is also a national marathon runner and has represented Singapore in the Marathon at both the 2013 and the 2015 editions of the South East Asian Games.

What chiropractic is all about

Explained Ashley, “Chiropractors remove nervous system interference so that the body can function to its optimum potential. The nervous system consists of the brain, spinal chord and nerves which run to every cell, tissue and organ of the body, helping to coordinate every cell, tissue and organ within the body so there is an overall balance. Any kind of stress the body is unable to adapt to, causes a ‘vertebral subluxation’ – this is a spinal misalignment that puts pressure on a nerve and interferes with the two-way nerve flow, and causing a cascading imbalance. Almost every time I lay a patient down on the chiropractic table and if they are subluxated, then one leg will indeed appear shorter before any adjustment. Which runner would want any kind of imbalance even over a small distance?”

He added, “it makes sense that prolonged imbalances potentially sets the runner up for injuries, pain, or any kind of problem. Chiropractors seek to find the root cause of these imbalances; if it is due to subluxations, then this is where we come in. In this sense, this profession is not about treating any particular sign or symptom; we correct subluxations so that the body can function to its optimum potential and the runner can do more of what he or she loves to do.”

Ashley also cited himself as an example of someone who makes use of chiropractic care and he has not suffered any injuries since he started this. He said “For me I love to run at a high level to represent Singapore and to make the most of what I have been blessed with. Since starting chiropractic care in 2010, I have been blessed not to suffer a single training injury despite high mileage; that is why when people say that injuries are part and parcel of running, I want to share that it does not have to be that way. That being said, by the time runners see me for their first chiropractic appointment, it usually means there has been some nagging issue for a while. In my experience as a chiropractic intern, I have personally witnessed my runner patients bouncing back from training injuries that could not be helped by anyone else; it is an absolute joy to play a small role in getting my patients able to do more of the things they love and perform to their best.”

Lack of awareness and misconceptions among runners – about chiropractic care

However Ashley points out that many runners may choose not to see a chiropractor due to lack of awareness. He said, “There is a lack of awareness about such an effective and holistic avenue for improving vitality – in fact, I myself had never heard about the word chiropractor prior to 2010 as well as being unsure of who is a trusted ethical chiropractor.”

As well, Ashley added that many runners many be unaware of what a chiropractor does – another reason why they may choose not to consult one. He explained, “many people think that chiropractic adjustments hurt. If they really did, why did all of my patients, from young children to senior citizens, get under regular care? My mentor has also taken care of newborns as young as four days old. We use very gentle yet specific techniques on all our patients that we take care of like our own family.”

Ashley added, “People also think that chiropractors are only to deal with pain. But our role as chiropractors is to help one function better, not just feel better. Symptoms like feeling pain are analogous to a ‘check engine’ light warning of an issue that had developed for a while, so pain is often a consequence of underlying stress.”

Ashley also pointed that that people think that chiropractic has nothing to do with non muscle-skeletal issues. He explained, “But my greatest joy as a chiropractic intern was not just seeing aches and pains alleviate with care, but with personally witnessing dramatic health transformations for example, numbness resolution, migraine resolution, anxiety reduction and bed wetting improvement – this patient had a history of nightly bed wetting to as long as a 16-day dry streak at the time of writing these answers. Again, we do not treat any conditions; but merely remove nervous system interference.”

Added Ashley, “People also say that chiropractic visits are not cheap. But one triathlete pointed out something which made sense – saying one can spend so much money on an expensive bicycle and latest equipment but hardly anything on one’s health. Health is an investment because health is wealth, as the saying goes.”

Many people, according to Ashley, are also of the misconception that chiropractic clinics tout packages. He explained, “At our clinic we believe that packages are not in a patient’s best interest. As members of the Chiropractic Association of Singapore (TCA), we adhere to a strict code of conduct that does not tout packages or fear tactics. Think about it too – since everyone is unique, how can one know how many visits to set from the start without a thorough examination?”

He added, “People also think that regular chiropractic care is just not worth it. But checking a spine for subluxations should be on a regular basis just as one would regularly service a car. The difference is that a car engine can be replaced, but not a spine.”

Ashley also feels that many people tend to believe that chiropractors are not real doctors. He says, “My programme was a rigorous one in America demanding almost four years of post-graduate education in addition to board testing and serving of patients. We are not doctors of medicine, but doctors of Chiropractic.”

Has dealt with all types of running related injuries 

As a chiropractic intern, Ashley has taken care of patients with all types of running related injuries. He said, “I have taken care of patients with running related problems such as pelvic pain, unintentional hip joint “popping” when running, osteitis pubis, lack of mental focus, foot discomfort, shin splints, knee pain, movement restrictions, muscle tightness, severe leg length difference, and imbalance when running. The common denominator was that they wanted to do more of what they love, which is running. I wanted them to all get faster, higher and stronger while functioning at their best.”

What a basic chiropractic visit involves

A basic chiropractic evaluation according to Ashley, would start with a brief new patient orientation to explain what chiropractic is. Ashley says, “This will help us to be on the same page as the patients in terms of understanding and expectations.”

He added, “Next, I would conduct a brief case history to find out more about what is going on, and after which I would inspect their posture and gait, which gives a snapshot into their inner stresses and potential subluxations. Poor posture – especially having our head down – and subluxations are like the chicken versus the egg as to which started first, but our role is to identify and correct them.”

After that Ashley added that he would have the patient do basic ranges of motion throughout their spine. He says, “Motion is lotion as the saying goes, so there is research showing that specific areas of poor spinal movement after just four weeks, starts triggering cascades of atrophy and degeneration.”

He continued “If there are specific complaints that warrant basic orthopaedic or neurological tests, I may perform them case-by-case. These tests are objective measures that are useful when benchmarking the patient’s future progress.”

Sometimes Ashley may refer patients to have x-rays as a chiropractor but he added these are not common. He says, “These are only referred if there are any potentially severe conditions to rule out.”

He added, “The final important evaluation though, would be laying the patient down on the chiropractic table. Here they just relax while I make observations of their leg lengths and palpate their spine, all while checking for specific vertebral subluxations. The frequent outcome is that the patient finds out a lot more about their own body and any underlying stresses. After which, he or she can make the informed decision on whether to proceed with chiropractic care.”

Differences between a chiropractor and physiotherapist 

There are also some differences between the work of a chiropractor and a physiotherapist according to Ashley – though some people may believe that they are the same.

Explained Ashley, “Chiropractors are uniquely trained to locate, analyse and correct vertebral subluxations to remove nervous system interference via specific and gentle adjustments.”

But according to physiotherapist Emily Lim from UrbanRehab Physiotherapy & Rehabilitation Specialists – and who has been an official physiotherapist for Singapore Athletics at the South East Asian Games and the Special Olympics – a physiotherapist is “uniquely trained to re-educate dysfunctional gait, posture and movement, and the correction of muscle imbalances via manual and exercise therapy.”

When runners should consult a chiropractor

And what is the best time that runners should see a chiropractor – before or after they are injured?

Ashley said, “Injuries do not need to be part and parcel of running. I would be happy to see runners who are recovering from injury to help them bounce back, but I wish I had gotten to them earlier so that we could have potentially avoided any damage in the first place.”

Added the chiropractor, “It is often the straw that breaks the camel’s back so my role is to make sure that the spine is as functional as it can be, before any chance of injuries happening.”

For chiropractic-related queries, consultations and appointments, you can email Ashley at drashley.liew@familyhealthchiro.sg.