By Dr. Anthony Cipperoni, chiropractor and co-founder of Function Rx
I noticed it as early as my training. A good adjustment, a client who felt better, and then the same client back with the same problem.
In practice it looks the same. People come in again and again for one complaint. The adjustment works every time, and it doesn’t last.
If you’ve wondered why adjustments don’t hold for some of your clients, here’s what I’ve learned → and what finally changed it in my own practice.
Three Reasons Adjustments Don’t Hold
Here’s the breakdown, in the order I see them.
1. The muscles around the joint are dysfunctional. You restore motion to the joint. The muscles around it are still working in the old pattern, so they pull it back. The adjustment was sound. The muscles undid it.
2. Nothing is happening at home. You have the client for a few minutes. Their body spends the rest of the week in the same positions that created the problem. Without work between visits, there’s nothing to hold the change.
3. The home exercises are generic. Many clients do get exercises. A National Board of Chiropractic Examiners survey found that 98% of chiropractors use corrective or therapeutic exercise, as reported by Foot Levelers. The trouble is that a standard sheet of stretches treats every low back the same, and it doesn’t address why this client’s body keeps returning to this pattern.
All three point the same way. The adjustment isn’t the weak link → the support around it is.
What I Tried First
I did what most of us do. I handed out general exercises and stretches.
They didn’t work. Clients did them for a week, felt little change, and stopped. The ones who kept going were stretching muscles that were tight for a reason, so the tightness came straight back.
More frequent visits kept people comfortable. They didn’t change the pattern.
It took me a while to see why. I was giving the same exercises to different bodies, and none of it was aimed at what was pulling each adjustment out.
The Crane
When a client asks why the relief keeps fading, I give them the crane.
Think of a construction crane. The arm can swing, lift, and extend. It can do all of that only because the base is locked in place.
Loosen the base, and everything changes. The arm gets wobbly. Other parts of the structure take on load they were never built to carry.
Your body works the same way. The deep stabilizing muscles are the base. We call them the Postural Chain. The bigger surface muscles are the arm. When the base is weak, the surface muscles stop moving you and start holding you together → and they pull your joints out of position while they do it.
I can adjust the arm all day. If the base isn’t stable, it won’t stay.
How to Spot It in the Exam
You can usually see it before you put your hands on the client. I look for two things together.
A weak Postural Chain. The body is sinking with gravity:
- Posterior pelvic tilt
- A flattened low back
- A rounded mid-back
- A head that sits forward
- Collapsed arches
Compensation on top of it. Surface muscles are bracing to hold the body up:
- Anterior pelvic tilt
- An exaggerated low back arch
- Heavy, visible muscle tension
- Joints that feel rigid
A client with both is the client whose adjustment gets pulled back out. The weak base can’t hold the correction, and the compensating muscles drag the joint toward the old position.
This is also where the kinetic chain comes in → the linked system of joints and segments that force travels through. When it’s broken at one point, load collects there. We cover how to find those breaks in our guide to postural disconnects.
What Helps an Adjustment Hold
Let’s keep it simple. The fix for all three reasons is the same thing: specific corrective work, done at home, built for that client’s body.
That’s posture therapy. It differs from a generic exercise sheet in three ways:
- It starts with an assessment. A set of posture photos shows where this client is weak and where they’re compensating.
- It’s built for the individual. Two clients with the same sore neck can get very different work.
- It runs in a set order. The exercises come as a sequence, and each one sets up the next.
The client does one sequence a day, about 20 minutes, with a new sequence each week.
Here’s what I see in clients who do both. Their adjustments hold longer. Their pain eases sooner. I see them less often while they’re in posture therapy, with some adjustments along the way.
Those are my observations from practice, not a guarantee. Every client responds on their own schedule.
Go Deeper
This page is the starting point. These guides take each piece further:
- Understanding Postural Disconnects: where the kinetic chain breaks, and what clients say when it does
- Range of Motion Testing: What It Misses: what posture photos add to a standard exam, and their limits
- Home Exercise Compliance: why clients skip their exercises, and what gets them to follow through
- Posture Therapy and Chiropractic: how I combine the two, with a client example
- Practice Revenue Without More Hours: how the model works for a practice
Two more are written for your clients, so you can send them before a first assessment:
How Function Rx Fits
I co-founded Function Rx because building this kind of work for every client takes time most practices don’t have.
Here’s how it runs, for chiropractors, personal trainers, and workplace wellness providers, in person or remote:
- You take the assessment photos and submit them.
- Our posture therapy team builds four sequences around what the photos show.
- You review and approve them before they reach your client.
- Your client follows them in the app at home.
- A reassessment shows what changed, with add-on sequences for clients who continue.
A clinic subscription puts it in one place, and our trainers can run virtual appointments when your team is stretched. You stay the practitioner your client trusts. It’s expert-guided care, with you still in charge of it.
It can mean fewer visits per client. In my practice it has also meant more referrals, because clients who finally hold their results tell people.
See how it works for practitioners → functionrx.health/practitioners
If you’re a client reading this, ask your chiropractor about posture therapy, or contact us and we’ll connect you with a clinic.
From the same client with the same complaint → to adjustments that finally hold.
