27 May 2020   |   By : Daryl David Ho

The explanation of MIX-FIX-SET

The explanation of MIX-FIX-SET

Understanding about chiropractic adjustments

Much like how a dentist addresses issues with your teeth and bite, or how an ophthalmologist focuses on eye and vision care, chiropractors focus on the spine and the associated nervous system, its functions and biomechanics of the muscles and joints. Chiropractor at All Well Scoliosis Centre perform treatment such as posture rehabilitation, pain management, and scoliosis treatment using specific equipments that aid including chiropractic adjustments. “What is chiropractic adjustments?” It is a specific chiropractic manipulation by hands and/or specific instruments that may produce The “cracking” noise around the joints and they are being done specifically to your joints in your spine and limbs to address the issues that you face. The adjustments are implemented to help improve the alignment of the spine to create an unobstructed pathway for messages from the brain to reach the rest of the body and vice versa. Similar to how squeezing a water hose tightly would limit the amount of water that can flow through, misalignments in the spine could place pressure onto the spinal cord housed within the spine, limiting the amount of messages that can pass between the brain and body. The brain and the spinal cord is the command centre of the body called Central Nervous System(CNS), receiving and sending out instructions to allow us to perform our everyday activities, and even vital things like breathing and keeping our heart pumping to help us stay alive. When the pathway by which these messages travel is blocked, it creates confusion in our body and could manifest itself in the form of generally feeling unwell, headaches and pain. It might also lead to problems in other organ systems like indigestion and constipation just to name a few.

Contrary to popular belief, chiropractic is not just about “cracking” your spine. Besides providing adjustments, chiropractors may also address your posture and any associated chronic condition that related to the spine and its function. For example, a large portion of people spend long hours hunched-back and straining their neck forwards while using the computer. For those of you who are guilty of this, you have something called a forward head posture. Such a posture would be having a rounded shoulders, stiffed neck, back, and reduce joint mobility. Overtime, step by step, spine in the neck becoming stiffed and a forward head posture places heavy loads on your neck that may lead to persistent headaches and spinal degeneration in the neck. The further your neck is strained forward, the greater the load and strain experienced by the neck.1 Your chiropractor would therefore propose certain posture rehabilitation that include X-rays, thorough examination, spinal and posture rehabilitation drills to help you to correct your posture and at the same time, learn what a proper posture is. Therefore, chiropractic treatment involves much more than just adjustments to the spine that produce the “cracking” sound. Chiropractors may also use other tools to complement the treatment process to ensure you, the patient, receives the best possible care to address the root causes of your problems.

What to expect during your visit to our clinic?

At All Well Scoliosis Centre, we adopt CLEAR approach for chiropractic patients care and in particular scoliosis patients. CLEAR scoliosis treatment approach was developed by CLEAR Scoliosis Institute, founded by Dr. Dennis Woggon, D.C., an American chiropractor. CLEAR Scoliosis Institute serves as the leaders of scoliosis rehabilitation within the chiropractic profession and CLEAR scoliosis treatment approach was designed with providing the best possible care to scoliosis patients in mind. Furthermore, CLEAR scoliosis treatment approach can also be adopted when providing care to non-scoliosis patients as well. The CLEAR scoliosis treatment approach can be broadly divided into three phases – MIX, FIX & SET.2

First phase of the treatment represents the MIX phase and is designed to prepare the body for treatment. Much like how we often warm up before participating in any sporting activity, the MIX phase serves the same purpose. Most patients with poor posture and especially scoliosis patients have muscles especially deep muscles and ligaments that are really tight. Therefore, it is important that we help these deep muscles and ligaments relax, especially those muscles and ligaments around the spine, so that specific chiropractic adjustments can be performed more easily later on and the patient themselves feel more relaxed. The MIX phase for scoliosis patient consists of the following steps:

1) The Active Rehabilitation Chair – A specially designed chair that has a seat which pivots 360°. This chair is used to create movement in the hips and lower back. By creating movement, it helps to increase blood flows, re-hydrate water and nutrients inside the discs that are located in between the spine, and also loosen up the tight muscles and ligaments. Scoliosis patients would also use this to perform side bending exercises, specifically bending away from the scoliotic curve to increase flexibility of the tight muscles and strengthen ligaments on the concave side of the curve.

2) The Cervical Traction – A simple tool designed to reduce forward head posture and improve cervical curve. We loose our cervical curve can be due to trauma or accident, or overtime, it may develop slowly through studying in school, working in front of computer or prolong use of mobile phones that require us to hold our head downward. Eventually, this causes the spine to misalign, little by little, until the muscles become tight and tense. The body then begins to use these tense muscles more than the weaker ones, causing change into compensated posture. With the loss of the curve in the neck, the nerves that travel through the spinal cord to every single cell in our body begin to suffer. In a straight neck, the spinal cord is stretch by 10% and if the neck buckles completely, this can increase as high as 28%. Imagine if somebody pulled your finger until it was 28% longer, you’d probably complain about it. The Cervical Traction is a simple, and efficient way to keep your spine and the nerves that run through it on their way to the rest of your body at the optimum level of function. To use this device there is a strap like device is place under the chin and back of the neck while the patient is standing. The patient then performs a squatting motion whilst looking straight up. As the device is also attached to the ceiling, the strap performs a gentle traction on the neck while the patient is performing the squat. The patient is in complete control over the amount of traction applied and the gentle traction helps to relax the muscles of the neck, while also creating motion in the spine to promote spinal disc health also improve spinal curve.

3) Vibrating Traction Therapy – The vibration causes a “pumping” action to take place in the intervertebral discs, drawing water and nutrients to help the disc staying healthy, while simultaneously breaking up fires scar tissue and removing waste. Resulting in improved ranges of spinal motion and reduction of the symptoms of spatial neglect. The procedure is patient lays on a table with a roller beneath the neck, additional weight will be place on the head to traction and creating lordosis in the neck. Vibrating Traction device is also useful for shoulder injury, knee injury, foot, and scoliosis with rib humps.

4) Core Muscle Stimulator – Just like the device called a core stimulator is a percussive device with purpose of releasing prolong muscle guarding that can adversely affect stance, posture, and gait with a direct correlation to decreased health and longevity. The centre or core of the human body is the spinal column. The vertebrae, discs, ligaments, tendons, muscles, and hard and soft tissues all work together as a functional synergistic unit. Most percussive instruments function only for muscle stimulation and relaxation, the CMS has been designed to work on both muscle stimulation and soft collagen, ligaments, tendon and discs stimulator. CMS has a variable speed control and research has suggested that a frequency of 270 strokes per minute has a highly relaxing and beneficial effect upon the soft collagen tissues of the body such as ligaments, tendons and discs. At the lower speed, The CMS can reach this frequency, the muscles however respond at a much higher frequency which is roughly at 2,800 strokes per minute. Patients with more severe muscle guarding may experience more benefit with the higher setting of this instrument.

5) Motorized Flexion-Distraction table – The ultimate goal of flexion distraction table is to induce motion into the spine to aid in disc rehabilitation, create “mirror image” of the patient’s posture to stretch the compressed soft tissues along the concavity and relax the elongated along the convexity of the spine. Utilize the lateral traction straps and lateral flexion feature to create a fulcrum at the apex of the scoliotic curve and apply additional lateral traction forces above and below the fulcrum point to induce lateral deviation in the patients’s spine in the opposite direction (the goal is to go beyond a simple straightening of the spine). Three dimensional de-rotation into the spine through the hips and the ribs. patient lays down on their stomach on an Eckard or Hill table and, depending on the patient’s x-ray, straps may be used to counter any curvature observed in the spine. For scoliosis patients, straps will have to be used and are placed at specific locations depending on your scoliosis curves. When the table is active, the lower half of the body will be moving up and down, providing a gentle flexion-distraction movement. This creates movement in the spine and promotes spinal mobility. If straps are used, they complement the flexion-distraction and help to bring the spine into proper alignment.

The next phase of the treatment is the FIX phase. Once the muscles more flexible and ligaments are loosened up, they will move on to the FIX phase. This phase is where the chiropractic adjustments occur to help reset the spinal function and place the spine into the proper alignment. Every patients is adjusted according to their unique x-rays configuration. X-rays that we are taking is usually a 3 dimensional type of X-rays. We will look into the position between the head, neck, mid back and lower back, as well as the hip joints. We will see the position from the front, back, side, and top of the spine. X-rays is like a map of human body, it will give Doctor of Chiropractic the understanding of patient’s spinal history and its impact after prolong chronic problems and/or injury that happened in the past. Chiropractic adjustments are implemented very specific to the segment of the joints either manually or using an adjusting instrument, both methods delivering precise impulses to specific areas of the spine the nudge it back into alignment.

SET is the phase following the adjustments phase. During this phase we will need to improve each patients Neuromuscular understanding between the brain and body biomechanics and its functions. The process is called Neuromuscular Re-education. Imagine if we walk tilted to the left side and always locking one of our knee when we are standing. This habit becomes natural especially for scoliosis sufferers because the brain does not understand how not to lean and to stand whilst engaging the core muscles and not compensate and locking the knees. This is done through specific deep subconscious exercises called Sensory Motor Re-integration. In other words, this phase purpose is to reboot the understanding of ones brain and build a better understanding with patients daily activities of sitting, standing, walking, running, jumping, lifting, and so on. SET phase consists of the following:

1) Scoliosis Traction Chair (STC)– The STC is a chair designed by CLEAR Scoliosis Institute to specifically helps improving lateral bending, compression of the discs and spine, and rotational component of the scoliosis in a sitting position by eliminating the compensation of the legs during standing position. The STC is unique with use of straps and neck traction help to decompress and de-rotate the coiled scoliotic spine and discs while the concurrent use of a specific frequency of Whole Body Vibration motor helps to stimulate bones, muscles, ligaments, collagen, and around the spine. Only CLEAR certified doctors are permitted to use the STC as improper usage may have adverse effects on the spine. For a more detailed understanding of the scoliosis traction chair, you may refer to our other article titled “Scoliosis Traction Chair”.

2) The Vibe – Whole Body Vibration has many functions, some of the functions are aiding in relaxation, waster dispersion, pain management, and blood circulation. The Vibe when it is use properly will be beneficial to postural muscles to maintain proprioception (balance), and in turn speeds blood and lymph circulation throughout the body. It will also increase collagen that makes up ligaments, tendons, and discs and make them more fluid, improving ranges of motion and flexibility. Patient will be tasked to stand on an imbalance surface placed on a vibration platform. The purpose is to create proprioception activation of the deep muscles and it’s ligaments, tendons, and discs to train the brain to activate the necessary postural and stabilising muscles to maintain balance.3 When the postural and stabilising muscles are active, our posture will be corrected, and balance can be achieved. For scoliosis patients, additional weights and cantilever devices will be implemented as well to help the body react in the opposite direction from the weight. Similar to how carrying a heavy luggage on your right would cause your body to lean to the left, the weights and cantilever devices function the same way and are strategically placed to help activate the correct postural muscles, shifting your body into the proper posture. The use of the vibrating platform helps to activate and strengthen the weak postural muscles of the body.3

3) Exercise – On top of MIX-FIX-SET, we are also design exercises specifically based on the patient’s posture, biomechanics, and X-rays structure and positioning to help building stronger posture. aving a poor posture would suggest some form on muscle imbalance in the body; certain muscles are weak and inactive while others are tight and overpowering the weaker muscles. Thus, specific exercises will be recommended to help the patient learn to activate their muscles to achieve a more balanced muscular activity and improve their posture. For scoliosis patients especially, the muscles in their body are significantly imbalanced. Therefore, they would have to go through a series of scoliosis-specific and individualised list of exercises to help activate and build strength in their muscles; so as to gain the necessary strength to hold their spine in the correct alignment. These exercises are designed as additional specifically based on the patient’s posture and Spine structure and to be performed while at the clinic and also at home as well.

4) Denneroll and Scoliroll – The Denneroll and Scoliroll are additional treatment that we at All Well Scoliosis Centre added as treatment plan. These blocks specifically designed to help release muscle tension around the cervical region, lumbar region, and tension around the apex of the scoliosis curve on the convex side. The specific shape of the Denneroll helps to re-create the natural curvature found in the neck. Scoliosis patients would also use either Thoracic or Lumbar Scoliroll by lying sideways on it, placing the foam block specifically at the apex of the curve either in the lower or upper back region. The scoliroll helps to gently push the curve in the opposite direction to help releasing deep muscle tension and help with spinal alignment.

At All Well Scoliosis Centre, the “cracking” is just a small part of the entire comprehensive treatment process. The treatments are not randomly designed but instead modelled on the CLEAR approach which has been proven to achieve remarkable progress through extensive research in addressing scoliosis curves. Furthermore, non-scoliosis patients are also treated using the same approach, albeit with certain elements of the Mix-Fix-Set approach removed or modified since some elements are scoliosis specific only. Seeking treatments with us is an ongoing process and is not limited to the confines of the clinic but also to your own homes as well. Not only do we provide treatment to our patients but we also teach them how to strengthen their body, maintain their postures and ensure that whatever issues that affected our patients never return again. Our goal is to find the root cause of the problem, not just to get rid of the symptoms. The process can be long and tedious however, by trusting the process greater and positive outcome will follow.


1) Bonney RA, Corlett EN. Head posture and loading of the cervical spine. Applied ergonomics. 2002 Sep 1;33(5):415-7.

2) https://clear-institute.org/treating-scoliosis/alternative-treatments/clear-scoliosis-treatment/typical-treatment-session/

3) Marin PJ, Hazell TJ. Effects of whole-body vibration with an unstable surface on muscle activation. J Musculoskelet Neuronal Interact. 2014 Jun 1;14(2):213-9.