Plantar fasciitis is one of the most common heel-pain complaints I see at the clinic. The classic version sounds like this: sharp pain on the bottom of the heel with the first few steps in the morning, eases after walking around for a few minutes, then returns after long sitting or at the end of a long day on your feet. Sometimes it’s been going on for weeks. Sometimes it’s been going on for over a year and you’ve started compensating without realizing it.
This post explains what plantar fasciitis actually is, how I assess it, what treatment looks like at the clinic, and what you can reasonably expect from the recovery process.
A note before we get into it: this is general information about how I approach plantar fasciitis clinically, not specific medical advice for you. Heel pain has multiple possible causes — actual diagnosis requires assessment in person.
What plantar fasciitis actually is
The plantar fascia is a thick band of connective tissue that runs along the bottom of your foot, from the heel bone forward to the base of your toes. Its job is to support the arch and absorb load with every step.
“Plantar fasciitis” technically refers to inflammation of that tissue, but the more accurate term in many cases is plantar fasciopathy — chronic degeneration of the fascia rather than acute inflammation. Histological studies of long-standing cases show that the tissue often has the structural changes of chronic overload, not the cellular signs of active inflammation. Practically, this matters because anti-inflammatory approaches alone tend not to fix the underlying mechanical problem driving the pain.
The pain itself usually shows up at the medial heel — the inside of the bottom of your heel where the fascia attaches to the heel bone. That’s the spot that hurts when you press on it, and that’s where the morning-step pain originates.
Why the foot isn’t always the problem
One of the things I look for early in any plantar fasciitis assessment is whether the foot is the actual driver of the problem, or whether it’s the place that’s paying the price for dysfunction further up the chain.
The foot is the end of a long kinetic chain. Restricted ankle dorsiflexion, tight calves, hip mobility limitations, glute weakness, and even old low back issues can all change how load travels through the lower extremity with every step. Walk 10,000 steps a day with a slightly off-pattern landing, and the fascia ends up absorbing more than it’s designed for. That’s the version of plantar fasciitis that doesn’t respond to “ice and stretch the foot” — because the foot isn’t where the problem started.
So the assessment looks at:
Local foot and ankle mobility, particularly ankle dorsiflexion
Calf and Achilles tightness
Hip and glute function on both sides
Pelvic position and lumbar mobility
Walking pattern and gait mechanics
Footwear, training surface, and recent changes in activity
Sometimes the foot is the whole story. Often it isn’t.
How I treat plantar fasciitis at the clinic
Treatment is always individualized to what the assessment actually shows, but the typical components are:
Manual therapy to the foot and ankle. This includes joint mobilization of restricted tarsal and ankle joints, soft tissue work to the plantar fascia itself, calf muscles, and any associated trigger points. Manual therapy and stretching for plantar heel pain has reasonable supporting evidence, particularly for soft tissue mobilization techniques.[1]
Addressing dysfunction up the chain. If the assessment shows hip, pelvic, or lumbar contributions to the problem, those get addressed too. Adjusting only the foot and ignoring the rest of the chain tends to produce short-term relief without lasting change.
Loading and stretching protocols. Plantar fascia-specific stretching, calf flexibility work, and progressive loading exercises are core parts of recovery. The current evidence supports stretching, heel raises, and graded loading as foundational components of conservative treatment.[2] The specifics depend on what your foot needs and how irritable it currently is.
Footwear and activity guidance. Sometimes the most important intervention is changing what you’re doing during the other 23 hours of the day — different shoes for work, a different surface for your runs, an activity-modification plan that lets the tissue actually heal between loading sessions.
Shockwave therapy when indicated. Extracorporeal shockwave therapy (ESWT) has the strongest evidence base of any single intervention for chronic plantar fasciitis, with high-quality systematic reviews showing meaningful effects on both pain and function.[3] Shockwave isn’t always the first thing we use — but for cases that have been going on for a while or aren’t responding to manual therapy and loading, it’s a useful tool. (Shockwave is currently available at our Stittsville clinic, Nobility Performance, with plans to bring it to Smiths Falls as well.)
What recovery actually looks like
Realistic expectations matter here, because plantar fasciitis recovery isn’t always linear and the timeline depends a lot on how long it’s been going on.
Early stages (first few weeks): Morning pain often improves first. Sharp first-step pain typically eases within 2-4 weeks of consistent treatment plus home work. This is encouraging but it isn’t the finish line — the tissue is still vulnerable, and stopping treatment at this point is the most common reason it comes back.
Middle stages (4-12 weeks): The fascia and surrounding structures are loading better. End-of-day soreness fades. We’re typically working on returning to fuller activity, addressing whatever drove the original overload, and progressing your loading program.
Longer-term (3-6 months for chronic cases): Stubborn cases that have been going on for a year or more sometimes take this long to fully resolve. The fascia regenerates slowly. The good news: even chronic cases generally do respond to conservative treatment given enough time and the right inputs.
Most plantar fasciitis cases resolve with conservative care over 3-6 months. A small percentage don’t and require escalation — surgical consultation is sometimes part of that conversation, but it’s a last resort, not a first option.
What you can do at home
Some of the highest-leverage things you can do between visits:
Calf stretching, multiple times per day. Tight calves are a major contributor to plantar fascia overload. Both straight-leg and bent-knee versions cover the gastrocnemius and soleus.
Plantar fascia-specific stretching. Pulling your toes back toward your shin, especially first thing in the morning before you stand up, can dramatically reduce that first-step pain.
Roll the bottom of the foot. A frozen water bottle or a lacrosse ball under the arch for a few minutes a day. Combines tissue mobilization with cold for soreness.
Manage load. If running or walking volume has crept up recently, dial it back temporarily. The fascia needs time to recover between loading sessions.
Avoid going barefoot on hard surfaces while symptoms are active. Supportive footwear in the morning before you stand up makes a real difference for some people.
Show up for your sessions and do your homework. The clinical work and the home work compound each other. Doing only one cuts the result roughly in half.
When to come in
A few situations where booking an assessment is the right move:
Heel pain that’s been around for more than 2-3 weeks and isn’t improving
Morning first-step pain that’s affecting your daily routine
Pain that’s started limiting your training, walking, or work
An old plantar fasciitis episode that keeps coming back
Heel pain that doesn’t quite fit the typical pattern (worth ruling out other causes)
Not all heel pain is plantar fasciitis. Stress fractures of the heel bone, fat pad atrophy, nerve entrapments, Achilles tendon issues, and a few other conditions can all cause heel pain. Part of the value of a proper assessment is making sure we’re treating the right thing.
Common questions
How quickly will I notice a difference? For most people, morning pain starts easing within 2-4 weeks. Full recovery from a recent case is typically 6-12 weeks. Long-standing cases take longer — sometimes 3-6 months. Improvement isn’t always linear; some weeks you’ll feel a clear change, others will feel stuck.
Do I need imaging? For a typical presentation, no. Plantar fasciitis is diagnosed clinically — history and physical exam are sufficient in most cases. Imaging becomes relevant if the presentation is atypical, the pain isn’t responding to conservative care, or there’s reason to suspect a stress fracture or other diagnosis.
Can I keep training? Usually yes, with modifications. Total rest isn’t typically the answer — the fascia responds well to graded loading. The plan we’d build for an active patient usually involves dialing back the most aggravating activities while maintaining conditioning through movements that don’t load the foot the same way (cycling, swimming, strength work that isn’t standing-heavy).
What about orthotics? Sometimes useful, especially during the active recovery phase. Off-the-shelf supportive insoles work for many people. Custom orthotics make sense for specific situations but aren’t always necessary. We figure out what’s right based on the assessment, not based on a default protocol.
Will it come back after I’m better? It can, particularly if the underlying contributing factors aren’t addressed. The work we do during recovery on calf flexibility, hip and glute function, footwear, and load management is also what reduces the chance of recurrence.
What about Applied Kinesiology for this? AK assessment is part of how I work and is particularly useful here for identifying inhibition patterns in the foot intrinsics, calves, and hip stabilizers that contribute to fascial overload. (For more on how AK fits into clinical assessment, see our post on Applied Kinesiology.)
Booking an assessment
If you’re dealing with heel pain in Smiths Falls, Lanark County, or the surrounding region, a thorough assessment is the right starting point. We’ll figure out what’s actually driving the pain, build a treatment plan around your specific findings, and give you the homework that supports the clinical work.
Charles R, Fang L, Zhu R, Wang J. The effectiveness of shockwave therapy on patellar tendinopathy, Achilles tendinopathy, and plantar fasciitis: a systematic review and meta-analysis. Front Immunol. 2023;14:1193835. doi.org/10.3389/fimmu.2023.1193835
If you train hard on weekends but grind at a desk during the week, your workstation can either support recovery—or sabotage it. This step‑by‑step setup reduces neck, shoulder, and low‑back strain while keeping you ready for sport.
Low back/hips: Prolonged flexion = hip flexor tightness, inhibited glutes, achy lumbar. Key idea: Your “next posture is your best posture.” We aim for neutral setup + frequent, small position changes.
10‑minute workstation setup checklist
Chair setup
Seat height: Sit so knees and hips are level or hips slightly higher. Feet flat on floor.
Seat depth: 2–3 fingers between the seat edge and the back of your calf.
Lumbar support: Support the natural curve; if none, add a small cushion or rolled towel.
Armrests: Height so shoulders relax (not shrugged). Elbows near 90–110° and close to body. Common fix: If your feet don’t reach the floor, use a footrest or a firm box.
Monitor position
Height: Top of the screen at eye level (or 1–2 inches below if you wear progressive lenses).
Distance: About an arm’s length (50–70 cm). Move closer if you lean forward to read.
Centering: Align the primary monitor with your nose; dual monitors used equally should be centered; if one is primary, center that one and angle the secondary.
Keyboard and mouse
Placement: Close to the body so elbows stay by your sides; forearms parallel to floor.
Keyboard tilt: Flat or slightly negative tilt to avoid wrist extension.
Mouse: Same height/plane as keyboard. Keep wrist neutral—move from shoulder, not just the wrist. Consider a larger mouse if you death‑grip a tiny one.
Desk height
Ideal: Around elbow height when shoulders are relaxed. For most, 25–30 inches; adjust to you, not the spec.
Standing desk: Set the same elbow‑height rule. Keep screen height consistent with sitting.
Laptop users
Use a laptop stand to lift the screen to eye level + external keyboard/mouse. This is non‑negotiable for daily use.
Lighting and glare
Place monitor perpendicular to windows to reduce glare.
Use a task light to keep the screen dimmer than your paper/keyboard.
Cable and reach management
Keep daily‑use items within the forearm “easy reach” zone.
Move the phone/headset to the non‑mouse side to alternate load.
Micro‑breaks and mobility plan (2 minutes per hour)
Timing: 30–60 seconds every 30 minutes; 2 minutes every hour. Set a timer or use software nudges.
Movement snacks:
Chin nods + retractions x10 (small, gentle)
Shoulder blade slides: elbows at sides, squeeze down/back x10
Thoracic extension over chair back x5 breaths
Hip opener: stand, lunge stretch 30s/side
Calf raises x15 or brisk walk to water
Standing rotation drill for golfers/pickleball/hockey: hands across chest, slow trunk rotations x10 each way.
Common mistakes (and easy fixes)
Perching on front of chair → Slide back and use lumbar support.
Shrugged shoulders at the keyboard → Lower armrests/desk; bring keyboard closer.
Monitor too low → Stack books or use a riser; stop craning the neck.
Wrist resting on sharp desk edge → Add a soft desk mat; keep wrists neutral.
All‑day standing → Alternate: sit 30–45 min, stand 15–20 min; change positions often.
Footrest: A stable box works; adjustable footrests add comfort.
FAQ
Q: What is the correct monitor height?
A: Top of screen at eye level; arm’s length away; adjust for progressive lenses.
Q: Is a standing desk better?
A: It’s a change tool, not a cure. Alternate positions and keep elbows at desk height.
Q: What if my feet don’t touch the floor?
A: Use a footrest to keep knees/hips level and reduce low‑back strain.
Q: Do I need an expensive chair?
A: Adjustability matters most. Add a lumbar roll before upgrading.
When to get help If you’re dealing with recurring neck/shoulder headaches, numbness/tingling, or stubborn low‑back pain, a targeted assessment can identify mobility or motor‑control gaps your setup can’t fix alone.
Ready for a personalized ergonomic tune‑up?
Book an assessment with Nobility Chiropractic & Wellness in Smiths Falls. Online booking via Jane, or call/text 343.801.0094.
Whether you’re a competitive athlete, weekend warrior, or just love staying active, injuries and setbacks can be a frustrating part of the journey. At Nobility Chiropractic & Wellness in Smiths Falls, our unique approach helps athletes recover faster and prevent future injuries—using a technique called applied kinesiology.
What Is Applied Kinesiology?
Applied kinesiology is a specialized assessment and treatment method that evaluates muscle function and movement patterns. At our clinic, we combine muscle testing, neurological assessment, and manual therapy to identify imbalances in the body. This approach allows us to pinpoint the root cause of pain or dysfunction—whether it’s a muscle weakness, joint restriction, or even nutritional deficiency.
Why Is Applied Kinesiology Ideal for Athletes?
Athletes demand more from their bodies. Whether you’re training for a marathon, playing hockey, or hitting the gym, your muscles and joints are under constant stress. Applied kinesiology at Nobility Chiropractic & Wellness supports athletes by:
Identifying Weak Links: Through muscle testing, we find areas of imbalance that might not show up on standard exams.
Personalizing Treatment: Your care is tailored to your unique movement patterns and sport-specific demands.
Preventing Injuries: We correct dysfunctions before they cause pain, helping you avoid common athletic injuries like strains, sprains, and overuse issues.
Enhancing Performance: Optimized movement allows you to train harder, recover faster, and perform at your best.
What to Expect at Nobility Chiropractic & Wellness
At our Smiths Falls clinic, Dr. Bryan Pankow is one of the only chiropractors in the region using applied kinesiology for sports injury recovery and prevention. Here’s how we support your recovery and performance:
Comprehensive Assessment: We start with a detailed history and movement evaluation, including applied kinesiology muscle testing.
Hands-On Treatment: Sessions may include chiropractic adjustments, soft tissue therapy, corrective exercises, and lifestyle or nutrition advice.
Personalized Care Plans: Every treatment plan is designed for your sport, your goals, and your body’s needs.
Ongoing Support: We provide education and self-care strategies so you stay injury-free long after you leave the clinic.
Real Results for Local Athletes
Our evidence-informed approach has helped athletes from Smiths Falls, Perth, Carleton Place, and beyond recover from injuries and get back to doing what they love—faster and stronger than before.
Ready to experience the difference? Book your appointment online or text/call us at 343.801.0094 to learn how applied kinesiology can help you reach your athletic goals.
Applied Kinesiology (AK) is a biomechanical and neuromuscular assessment framework I’ve trained in for the better part of a decade. Used well, it’s one of the more useful tools I have for figuring out what’s actually going on with an athlete’s body — particularly when conventional assessment hasn’t given clear answers.
The short version: AK uses manual muscle testing to detect inhibition and facilitation patterns — muscles that aren’t firing properly because the nervous system has dialed them down, often in response to old injuries, joint dysfunction, or compensation patterns that have been running for years. Once those patterns are identified, treatment can be targeted at what’s actually driving them rather than at where the pain happens to be felt.
This post explains how I use AK in practice, the underlying neuromuscular concepts the work is built on, and where the evidence sits.
A note before we get into it: this is general information about how I practice, not specific medical advice. Whether AK assessment is useful for your particular situation depends on what you’re dealing with — and that’s a conversation in person, not on the internet.
What “muscle inhibition” actually is
The core concept under AK is that muscles can be neurologically inhibited — not weak from lack of training, not torn or injured, but turned down by the nervous system. The muscle is structurally fine; it’s just not getting the signal to fire properly.
This isn’t a fringe idea. It’s a well-established concept in sports medicine and physiotherapy — particularly under the term arthrogenic muscle inhibition (AMI). The classic example is what happens to the quadriceps after an ACL injury: the muscle is intact, but neural signals from the swollen, painful joint suppress activation. Athletes can lose 30-50% of their quad strength even when the muscle itself is uninjured.[1]
A 2018 scoping review in the British Journal of Sports Medicine identified arthrogenic muscle inhibition as a critical factor limiting recovery after ACL reconstruction, and reviewed evidence-based interventions for addressing it.[2] This is mainstream sports medicine, published in one of the most-cited sports medicine journals in the world.
The same neurological mechanisms — joint inflammation, faulty proprioceptive input, altered reflex patterns, central nervous system adaptation — produce inhibition in less dramatic situations all the time. Old ankle sprains affect glute activation. Chronic low back pain alters core firing patterns. A history of shoulder impingement can dial down rotator cuff recruitment for years after the original injury healed.
None of that shows up on an MRI. None of it shows up on a strength test where you ask someone to push with maximum effort against a hand dynamometer. But it shows up on assessment when you know what you’re looking for — and it directly affects how an athlete moves, performs, and gets injured.
How I use AK in practice
What an AK assessment session actually looks like at the clinic:
1. History and movement screen. Same as any assessment — current complaints, training history, prior injuries, what you’re trying to accomplish.
2. Muscle testing as part of the physical exam. I assess the strength and recruitment quality of muscles relevant to your complaint and your sport. The test is: can this muscle hold against a controlled force in a specific position, with the right timing and quality of activation? I’m not looking for raw strength — I’m looking for inhibition, asymmetry, and recruitment patterns that don’t match what your body should be capable of.
3. Identifying drivers. When I find a muscle that’s inhibited, the next question is “why?” Sometimes the answer is local — a joint restriction, a fascial adhesion, a trigger point in a synergist or antagonist muscle. Sometimes the answer is upstream or downstream — a hip problem creating compensatory patterns at the knee, a thoracic restriction altering shoulder mechanics. AK gives me a real-time framework for testing these hypotheses rather than guessing.
4. Treatment with retest. If I think a joint restriction is driving an inhibition pattern, I’ll address it and retest. If the muscle now activates properly, that’s confirmation. If it doesn’t, I look elsewhere. The test-retest cycle is what separates AK from “I think I know what’s wrong, let me try this and hope for the best.”
5. Homework matched to findings. The exercises and self-care I recommend are based on what the assessment actually showed, not on a generic protocol for your complaint.
What the literature supports — and where it’s mixed
Worth being honest about the evidence picture:
The mechanism of muscle inhibition is well-established. AMI is a real, measurable, neurologically-mediated phenomenon. The literature is clear that joint pathology, inflammation, and altered afferent input can produce profound inhibition of surrounding musculature, and that interventions aimed at restoring normal joint function and afferent input can help reverse it.[1][2]
Spinal manipulation produces measurable changes in muscle activation. A 2018 RCT in elite athletes showed significant increases in maximum voluntary contraction and corticospinal excitability after a single manipulation, persisting 30-60 minutes.[3] A separate study found 44-54% increases in motor evoked potentials following manipulation, suggesting changes happen at the level of cortical drive — exactly the kind of effect AK practitioners describe clinically.[4] When AK assessment leads me to deliver an adjustment and I see immediate facilitation of a previously inhibited muscle, the underlying neuromechanism is supported.
Manual muscle testing reliability is the honest weak link. A 2020 study examining force profiles of testers performing manual muscle tests found significant differences between experienced and beginner testers, and even experienced testers showed inter-tester variability and partial intra-tester reproducibility issues.[5] Older research on traditional manual muscle testing in clinical populations also showed reproducibility problems compared to instrumented testing.[6]
The honest interpretation: MMT is a tester-skill-dependent tool. Done by someone with significant training and standardization, it produces consistent results. Done by someone untrained or inconsistent in their force application, it doesn’t.
This is part of why I’ve invested 400+ hours of additional training beyond the initial ICAK certification — including multiple 100-hour AK course series, clinical pearls work with the late Dr. Wally Schmitt, and instruction with Dr. David Leaf at ICAK international meetings. The certification covers the basics; proficiency comes from deliberate practice, study with senior practitioners, and consistent recalibration. It’s also why MMT is best used as one component of a comprehensive assessment, not the sole basis for diagnostic conclusions.
Where AK earns its keep
The honest version of where this approach pays off:
Identifying neuromuscular inhibition patterns that don’t show up on standard strength testing or imaging
Real-time test-retest assessment to confirm whether an intervention actually worked
Untangling complex compensation patterns where pain in one location is being driven by dysfunction elsewhere
Building an individualized treatment and homework plan based on what your specific body needs, rather than a protocol
Performance work with athletes whose strength on paper doesn’t match how they actually move and generate force in their sport
For anything outside the musculoskeletal scope — bloodwork, imaging, allergy testing, nutritional analysis, or specialist medical care — the right answer is referral to the appropriate professional. I work within my scope.
Why this approach matters for athletes
Most assessment systems for athletes rely on either subjective complaint (“my hamstring feels tight”) or maximum-effort strength testing (“can you push as hard as possible against this”). Both have value, but both miss the layer where most performance-limiting dysfunction actually lives.
The athletes I see most often aren’t catastrophically injured. They’re partially inhibited. The hamstring that’s “tight” is often actually under-recruited. The shoulder that “feels off” has a serratus anterior that’s not firing properly. The knee that “doesn’t track right” has a glute that’s not doing its job.
You can train through these patterns for a long time before they become an injury — but they cost you in performance, and they raise your injury risk over time. AK gives me a way to find them earlier and address them more precisely.
Common questions
What does an AK assessment add to my visit? It adds a structured, testable framework for figuring out what your specific body needs on the day you come in. Muscle testing gives me real-time information that informs which interventions to use, in what order, and whether they actually worked before you walk out the door. The treatment itself — adjustments, soft tissue work, exercise prescription — is similar to what you’d see in any sport-focused chiropractic visit; the assessment is what makes the plan more individualized.
Do I need to “believe in” AK for it to work? No. AK isn’t a faith-based system in how I practice it. The muscle either tests strong or it doesn’t. The intervention either changes the test or it doesn’t. You can be skeptical of the framework and still benefit from it, the same way you can be skeptical of “core stability training” and still benefit from learning to brace properly.
Is this covered by insurance? The chiropractic care itself is. There’s no separate “AK fee” — assessment is part of how I work, not an add-on service.
How long does an AK-informed visit take? About the same as a regular chiropractic appointment. Initial assessments run longer (45-60 minutes) because of the comprehensive movement and muscle screen. Follow-ups are shorter (15-30 minutes) since we’re working from a known baseline.
Do you do AK on non-athletes? Yes. The framework is just as useful for desk workers with chronic pain, post-surgical patients managing residual deficits, or anyone whose body has compensation patterns from old injuries. It’s not athlete-exclusive — that’s just where the gains are most visible.
What does an AK assessment actually feel like? Mostly like a thorough orthopedic exam. I’ll have you in different positions — supine, prone, standing, sometimes mid-movement — and apply controlled force to various muscles while you resist. It’s not painful, it’s not strenuous, and you don’t need to be at maximum effort. The goal is to feel how your body responds, not how hard you can push.
If you want to try it
I’m an ICAK-certified Applied Kinesiology practitioner with 400+ hours of additional AK training beyond the certification, including study with the late Drs. Wally Schmitt and David Leaf. I see athletes, tactical professionals, and active people across both Nobility Chiropractic & Wellness in Smiths Falls and Nobility Performance in Stittsville.
If you’re an athlete dealing with persistent issues that haven’t responded to conventional approaches, or you want a more individualized assessment than a generic protocol-based visit, this is the work.
Pietrosimone B, Lepley AS, Kuenze C, et al. Arthrogenic Muscle Inhibition Following Anterior Cruciate Ligament Injury. J Sport Rehabil. 2022;31(6):694-706. doi.org/10.1123/jsr.2021-0128
Sonnery-Cottet B, Saithna A, Quelard B, et al. Arthrogenic muscle inhibition after ACL reconstruction: a scoping review of the efficacy of interventions. Br J Sports Med. 2019;53(5):289-298. doi.org/10.1136/bjsports-2017-098401
Christiansen TL, Niazi IK, Holt K, et al. The effects of a single session of spinal manipulation on strength and cortical drive in athletes. Eur J Appl Physiol. 2018;118(4):737-749. doi.org/10.1007/s00421-018-3799-x
Haavik H, Niazi IK, Jochumsen M, et al. Impact of Spinal Manipulation on Cortical Drive to Upper and Lower Limb Muscles. Brain Sci. 2017;7(1):2. doi.org/10.3390/brainsci7010002
Bittmann FN, Dech S, Aehle M, Schaefer LV. Manual Muscle Testing—Force Profiles and Their Reproducibility. Diagnostics (Basel). 2020;10(12):996. doi.org/10.3390/diagnostics10120996
Escolar DM, Henricson EK, Mayhew J, et al. Clinical evaluator reliability for quantitative and manual muscle testing measures of strength in children. Muscle Nerve. 2001;24(6):787-93. doi.org/10.1002/mus.1070
The honest answer is “before” most of the time — and the second answer is “it depends, here’s how to decide.”
Most chiropractic content on this question hedges. “Either is fine, talk to your chiropractor!” That’s not wrong, but it’s not useful. If you train hard and you’re scheduling care around real performance, the evidence and clinical reality both lean in a clear direction.
This post takes a position, walks through the research, and tells you when the position flips.
A note before we get into it: this is general guidance based on published research and what I see clinically. It’s not specific medical advice for you. I haven’t assessed your body, your training, or your history — and the right answer for any individual depends on all three. If you want a recommendation tailored to you, that’s a conversation we have in person, not on the internet.
The default: adjust before you train
For most healthy, regularly-training athletes, scheduling a chiropractic adjustment before your workout is the better-supported choice.
Two reasons:
1. Better mechanics going into the session. Adjustments improve range of motion, joint mobility, and movement quality. Going into a training session with restored mobility is a better starting position than going in restricted and hoping to “warm out of it.”
2. Increased neuromuscular activation post-adjustment. This is the part most chiropractic content underplays — and it’s the part that genuinely matters for performance. There’s a growing body of research showing that spinal manipulation produces measurable, immediate changes in how the nervous system drives muscle contraction:
A 2018 randomized controlled trial in elite Taekwondo athletes found that a single session of spinal manipulation produced a significant increase in maximum voluntary contraction (MVC) force in the plantar flexors, alongside increased corticospinal excitability. The MVC effect lasted 30 minutes; the cortical excitability effect persisted for at least 60 minutes.[1]
A 2016 study using transcranial magnetic stimulation found a 54.5% increase in maximum motor evoked potential in the upper limb and 44.6% in the lower limb following spinal manipulation, suggesting the effect is driven by descending cortical drive rather than spinal cord-level changes.[2]
A 2018 study showed shortened cortical silent periods and increased motor unit excitability following spinal manipulation, providing further evidence that the changes happen at the level of the brain’s motor control, not just at the joint.[3]
A 2021 motor unit study found altered recruitment patterns following manipulation — specifically, increased recruitment of lower-threshold motor units, suggesting more efficient force production at submaximal loads.[4]
Translation: in the hour or so after an adjustment, your nervous system is driving your muscles more effectively. For most people, that’s a window worth training in — better activation patterns, better mechanics, lower likelihood of compensating into an injury.
It’s also why you’ll occasionally feel surprisingly sharp at the gym after an adjustment. That’s not in your head.
The honest caveat: the research is mixed
A 2019 systematic review of 20 low-bias studies on spinal manipulation and performance outcomes in healthy adults concluded that the overall evidence for performance enhancement is inconsistent, with most studies showing only immediate effects and uncertain clinical importance.[5]
That’s worth knowing. The neuromuscular activation findings are real and reproducible, but whether they translate to meaningfully better squat numbers, sprint times, or sport performance is a harder question. Some studies show effects, some don’t, and the effect sizes vary.
The honest synthesis: if you’re chasing a 1% performance edge in elite sport, this isn’t a guaranteed lever. If you’re a recreational or competitive athlete training regularly and want to get into your sessions feeling well-organized, well-activated, and moving cleanly — the literature plus clinical experience both support adjusting before the session.
It’s a meaningful tool, used in context. It’s not magic.
When the answer flips: adjust after, or skip the session
There are specific situations where adjusting after a workout — or scheduling the adjustment for a non-training day — makes more clinical sense.
1. First-time visits, or a complaint we haven’t worked on before. If we don’t yet know how your body responds to an adjustment in a particular region, scheduling it post-workout (or on a rest day) is the safer call. The first few sessions tell us how reactive your tissues are. Once we have that information, the standard pre-workout pattern usually applies.
2. Pre-competition, especially with a new approach. Competition day is the worst possible time to find out you’re one of the rare people who feels achy for 12-24 hours after an adjustment. If we’re trying something new before a race, match, or event — wait until after.
3. Acute injuries or active flares. If you’re in the middle of an acute flare-up, dealing with a fresh injury, or your tissues are visibly inflamed, adjusting before training is asking for trouble. Manage the flare first; train later.
4. Patients who reliably get short-term soreness post-adjustment. This is uncommon — somewhere in the 10-15% range of people I see — but it’s real. If your body consistently gets a bit sore in the first 12-24 hours after an adjustment, schedule your adjustments for after training or on rest days.
5. When the goal of the visit is recovery, not performance. If you’re coming in specifically because you’re sore, beat up, or post-event — that visit is a recovery visit. Recovery visits work fine post-workout, and often that’s the more sensible scheduling.
A practical note: most of the cases above need an actual assessment, not a guess from a blog post. If you’re dealing with an acute injury, an active flare, or you’re not sure whether the soreness you’re feeling is normal post-training fatigue or something more — book in. Don’t try to figure it out from a website.
Practical scheduling for athletes
Strength session today, adjustment in the morning? Good. Train in the activation window.
Sport practice tonight, adjustment at lunch? Good. Same logic.
Big game / race / event in two days? Adjust today, not tomorrow. You want a buffer if your body has any reactivity, plus the neuromuscular effects are largely settled within 24 hours anyway.
Big game / race / event tomorrow morning? Skip the adjustment unless we have a long history of pre-competition adjustments going well for you. Don’t introduce variables right before competition.
Just played / lifted / raced and you’re sore? Recovery visit. After is fine.
Acute injury or flare? Get assessed first. Don’t book a regular adjustment until we know what’s going on.
How we approach adjustment timing at Nobility Chiropractic
The default at our clinic is pre-workout adjustment for athletes and active individuals — informed by both the neuromuscular literature and clinical experience watching what works.
But “default” doesn’t mean “always.” Every patient is different. Some people are unusually reactive; some have specific injuries or flares we’re working around; some have competition schedules that shape when adjustments make sense. We work that out in your visits.
If you’re not sure what makes sense for your training, mention it during your first appointment. We’ll talk through your schedule, your goals, and how your body has historically responded to manual care, and we’ll build a plan around that.
How long after an adjustment should I wait before training? For most people: not long. The activation effects begin almost immediately and persist for roughly an hour, which is exactly the window you want to be training in. If you’ve had a particularly intensive session — a lot of mobilization, a new region addressed, a manual technique you’re not used to — give yourself 30-60 minutes before max-intensity work.
Will an adjustment make me weaker for my workout? The research consistently shows the opposite — increased force production and motor unit recruitment in the hour following adjustment. The exception is rare individuals who experience post-adjustment soreness; for them, the temporary discomfort can affect performance.
Can I get adjusted on the same day as a competition? Generally we recommend against introducing chiropractic care on competition day unless you have an established history of pre-competition adjustments going smoothly. The downside risk (any unexpected reactivity, soreness, or unfamiliar feeling) outweighs the upside on a day where consistency matters most.
What about Applied Kinesiology specifically? The same logic applies. AK assessments and adjustments produce similar nervous-system effects to standard chiropractic care, and the timing recommendations are the same. (For more on AK specifically, see our post on Applied Kinesiology and athletic performance.)
What if I’m just doing cardio or yoga? Same answer — pre-session is generally better. The activation and mobility effects support quality of movement regardless of training modality.
Does this apply to youth athletes too? Yes, with the same caveats. If we haven’t worked with a youth athlete before, we’ll often schedule the first few visits independent of training so we can establish how their body responds.
Building chiropractic into your training
For athletes who train consistently, regular chiropractic care can be a meaningful part of staying healthy, moving well, and getting more out of the work you’re already putting in. The timing detail above isn’t a hard rule — it’s a starting framework that we adjust based on how your body actually responds.
If you’re an athlete in Smiths Falls, Lanark County, or the surrounding region and you want a sport-focused chiropractor who actually thinks about how care fits into your training, we’d be happy to work with you.
Christiansen TL, Niazi IK, Holt K, et al. The effects of a single session of spinal manipulation on strength and cortical drive in athletes. Eur J Appl Physiol. 2018;118(4):737-749. doi.org/10.1007/s00421-018-3799-x
Haavik H, Niazi IK, Jochumsen M, et al. Impact of Spinal Manipulation on Cortical Drive to Upper and Lower Limb Muscles. Brain Sci. 2017;7(1):2. doi.org/10.3390/brainsci7010002
Haavik H, Niazi IK, Jochumsen M, et al. Chiropractic spinal manipulation alters TMS induced I-wave excitability and shortens the cortical silent period. J Electromyogr Kinesiol. 2018;42:24-35. doi.org/10.1016/j.jelekin.2018.06.010
Robinault L, Holobar A, Crémoux S, et al. The Effects of Spinal Manipulation on Motor Unit Behavior. Brain Sci. 2021;11(1):105. doi.org/10.3390/brainsci11010105
Corso M, Mior SA, Batley S, et al. The effects of spinal manipulation on performance-related outcomes in healthy asymptomatic adult population: a systematic review of best evidence. Chiropr Man Therap. 2019;27:25. doi.org/10.1186/s12998-019-0246-y
