Pregnancy and Chiropractic care in Tokyo

Since working in Okinawa for the last 2 years we have had the privilege of assisting many women through the pregnancy process providing english speaking low force chiropractic care to primarily the military population down there. There is a running joke down there most of the SOFA members in okinawa are here for their ” 2 baby tour ” . Well at least I used to think it was a joke.



Reflections from Chiropractic experience in  Okinawa

Lower back pain is very common in pregnancy and usually peaks in the middle of the 3rd trimester with as many as 75% of women reporting pain in either the lower back area or lower down over the joints of the sacrum ( 1). Most women reported on average that this pain was rated as around 4/10 on a visual analog scale so it’s fair to say it hurts, and can make life pretty uncomfortable.

Post partum pain is also very common with 24.7% of women reporting lower back pain that persists after birth (4) . In fact we would argue Post partum issues are not given their fair share of attention or research.

What causes low back pain in pregnancy

Surprising it’s not as well understood as you think.

One of the pain factors is the obvious one of the weight gain of a little human now growing inside your belly but its not just the weight but the way your posture changes that also causes more stress on your joints and ligaments.

There are also some hormonal changes at play. As your body prepares for pregnancy a hormone called relaxin readies the body for birth and soften the ligaments around our joints, particularly the sacro-illiac joints on either side of the sacrum.

Interesting the relaxin levels actually spike around the 1st trimester but it takes a few weeks for the effects to be fully translated in the body. The graph below is handy reference for the various hormones at play.

Then there are are also some genetic and individual variations. If you already have a history of low back pain you are in more of a high risk group.

Talking about weight

One of the best predictors of pain in pregnancy seems to be one when you carrying over 15Kg of extra weight over your normal healthy weight (2) so if you are planning on getting pregnant or in the very early stages and are overweight it may be well worth your time to consult with a health profession on coming up with plan to address this.

Carrying a kilo’s was also associated with a much higher risk of developing pain that lasts months to years after birth. Interestingly researchers found that just a few extra kilos ( under 10 ) was so significantly related to low back pain so you don’t have to go crazy just try to set the goal that you are not carrying more than the 10-15gk of extra weight.

Exercise is medicine

There is also some good evidence that exercise therapy can reduce pain over pregnancy’s. The jury is still out on what seems to be most effective. Is it yoga or piliates or core work ? Crossfit ? Even from a good review of the literature published this year we still don’t know ( 4).

There was some weak findings that work on ” core ” was better than general exercises but What does seem to be most important is that you do something and that it’s safe. Try and find a qualified fitness instructor that really takes the time to understand your needs and most importantly pick something that you enjoy.

Manual therapy

Lastly I we should talk about the role of manual therapy. Many women report great results with Chiropractic or physio interventions right up to the birth. Whilst most of a chiropractors job is to get stuck joints moving again often in pregnancy we are faced with joints that may be too mobile.

As such the approach tends to change a bit from traditional chiropractic techniques to more lower force joint mobs and muscle work to increase comfort levels although I do find chiro adjustments can still be very helpful in the mid thoracic spine throughout pregnancy.

I guess I also have to bring the often misunderstand Webster technique. Webster is a chiropractic technique that has a system of analysis that involves leg length and SI joint checks and then some specific release work around the pelvic ligaments and the round ligament of the uterus. The Webster technique is not an ‘external cephalic version ” were the pressure is applied over the uterus itself.

Yes there is some anecdotal evidence from Chiropractors, proponents selling or teaching the webster technique ( major conflict of interest ! ) and mothers themselves that a potential breech birth was corrected soon after a webster procedure sadly this has not yet been verified in a well designed randomized controlled trial and it makes me slightly angry and disappointed that this study has yet to be done all these years later. It’s impossible to say from a research perspective how many of these births may have resolved by themselves and how many were directly helped from the Webster protocol.

Most of the benefit of Webster in my humble opinion is simply increased comfort around the pelvis and less pain levels.

So I think as Chiropractor webster is one tool of many for the evaluation of a pregnant patient we must be guarded in what we can state with certainty as to what it can and can’t achieve and I truly hope that in a few short years we have better published data in the research literature.

Is Chiropractic safe for pregnant women ?

This question was addressed in a comprehensive research review in 2016 of multiple studies and they concluded that manual therapy and manipulation was safe for the pregnant population. To date not single case of adverse events to relating to the pregnancy itself has been published (4).

The only rare complications of manual therapy where in line with the sort of risks that would be still be present in non pregnant population.

That being said our experience is that once the hypermobility of late stage pregnancy is reached there are simply better lower force techniques to reach for to support pregnant women such as side lying ligament release work and activator.

If you would like to schedule an appointment with an English speaking Chiropractor in Tokyo to assist with your pregnancy you can book online at 






How did Tokyo international Chiropractic come about ?

Like many things, completely but accident.

In 2018 my Japanese wife and I sold everything we owned and moved from Australia to Japan to try something exciting and create a new life in Japan after being in private Chiropractic practise for nearly 15 years in the hinternaland just behind Byron Bay. We had already visited Hokkaido several times with my wife’s family being from Sapporro and decided Niseko was an obvious choice.

We were lucky enough to be able to purchase some land there before the interest in Hokkaido real estate and built our first house in Niseko in 2020 looking up to the magic dormant volcano of Mount Yotei.

Working and living in Niseko was a life changing experience and it was a blessing to be able to meet people from all over the world keen to experience their own winter wonderland. Certainly living in Japan has had it’s challenges. I really miss my good Cheese, Aussie wines and my family ( probably in that order ) and underestimated the little things, like not being able to read anything but all the whole living in Japan has really opened so many exciting doors and cultural experiences that I would not swap it for the world.

In 2019 Niseko Chiropractic was established that provided Chiropractic consultations to injured skiers, snowboarders and tourists to Niseko.

Sadly this all came crashing down in 2020 when covid closed Japan’s international borders. Fortunately work was found remotely on the Island of Okinawa assisting SOFA personal based near Kadena and Camp foster. In a moment of panic in July 2022 it seemed like Japan’s borders where never going to open up so another remote operation in the heart of Tokyo commenced.

The start of our Tokyo operation

The Tokyo college of Chiropractic where kind enough to allow us some consulting space in their teaching clinic which over the last few months has allowed us to build a clientele large enough to justify a new premises. Again in another stroke of good luck Sato-san from Physic Chiropractic allowed us some space to consult from in Ebisu just walking distance from Shibuya station.

Working in Tokyo has been a really exciting and eye opening experience after growing up in the quite suburbs of Sydney Australia and living most of my life in the countryside. It’s amazing to see the scale of nightlife and options available for everything interest, even it it means not always making the healthiest of choices !

With your support we aim grow this business, hire some more internationally qualified experienced Chiropractors and provide an english speaking Chiropractic service full time in the crazy city of Tokyo.

Our style is more of a modern multi-modal approach utilising soft tissue work, rehabilitation exercises  as well as some of the more traditional Chiropractic techniques.

If you are seeking an english speaking Chiropractor in Tokyo we hope you can may give our service a try 🙂


English speaking Chiropractor for

SOFA personal based in

 Yokota air base and Yokosuka Navel base


After working with SOFA members based  Okinawa for the last 2 years Brent Verco has now expanded to Tokyo and there has already been a pleasing level of interest from Yokota and Yokisuka.

Whilst we do appreciate Ebisu city is not exactly ” next door ” we do hope that perhaps if some SOFA members wish to let their hair down in Tokyo’s nightlife or combine it with some of the great activities and shopping there there may be some interest from US personal in visiting our Tokyo clinic.

Both our current Shimbashi clinic and our new permanent clinic in Ebisu are really close on the ” Tokyo line ” so it’s really easy to grab a train up.

Having worked with SOFA crew down near Kadena and Camp foster for the last 2 years we have learnt about about the unique stresses and challenges of a military career and we hope you may have give us a try whilst you complete your tour in Japan.

If you would like to book an appointment in Tokyo please go to 





Simple health tip

What if there was one simple thing you could do from tomorrow that would dramatically improve your health, drop your weight and even lighten your mood ? Well there is. All you need to is swap out soft drink for sparkling water.

Why ? Well read on

Imagine you are meet a good friend at your local cafe. You order coffees and then they reach for the sugar cubes and slide one into there latte. You would not care to notice.

Now imagine they put it 2. It might cross your mind to think, wow quite the sweet tooth, remember that if I ever make coffee for them at home. Now imagine they start to put 3 then 4 then 5 then 6… . by around cube 7 You might be thinking Wow, this person got a bit of a problem here. Once they got to cube 9 you might wonder if they have gone mad.

Well that’s how much sugar is in a 250ml can of coke. 39 grams to be precise which accounts for 9 teaspoons of sugar. (1) and that info is from Coca cola themselves. Nobody bats an eyelid if somebody orders a coke with their lunch.

Commercial soft drinks first appeared in the US with a drink called ” Moxie ” and by 2018 the world was producing 1 billion litres of soft drink per year with a value of 60 billion dollars. In 1776—at the time of the American Revolution—Americans consumed about 1.8 of sugar per person each year. By 1850, this had risen to 9kg , and by 1994, to 54kg (4)  . Move aside big pharma and make way for ” Big sugar ” . The issue with soft drinks is they are simply packing an energy density we are not evolved to handle. Soft drinks alone are estimated to account for up to 47% of added sugars in a typical modern diet (3).

In the US alone 64% of the population is now considered overweight with 30% considered obese (3). Whilst Japan’s figures are not as alarming it’s clear we are headed in worsening direction.

If you are looking to drop a few kilo’s dropping soft drink is going to be easiest and simplest thing you can do for yourself to dramatically cut your sugar intake.

And it’s not just the weight. Drinking just 500ml of soft drink per day  for 6 months induced features of the metabolic syndrome and fatty liver and type 2 diabetes (4). Drinking just one serve day is thought to raise your blood pressure by at least 2 mm of Mercury (5).

Your mood is also affected by increased soft drink intake. It might give you that ” buzz ” whilst you are consuming it but just like any recreational drug when abused in can affect your mood. When controlled for other factors soft drink intake correlates with an in increase in depression and anxiety scores. ( 7).

And if all that is not enough consider your teeth. Coca cola tops the list with an acidic PH of 2.3 (6) which puts has a pretty nasty effect on the quality of your tooth enamel (6). It’s crazy to think teenage kids are needing regular trips to the dentist for fillings.

So if there is just one easy thing you are willing to try to get healthier, give up the soft drink.






Tokyo International Chiropractic research review


There has been a been a lot of talk about the risks of sitting lately. Some commentators have coined the term ” Sitting is the new smoking ” and certainly the research does support the large health risk of sitting too much correlates with poorer health outcomes (1).

But the plot thickens when we start to look further.

How much of the health risk is due to the sitting itself and how much is just because people that sit more tend to exercise less ? What about to standing workstations ? Do they actually help reduce our risk or are they just a fad ? Once again we need to turn to the research to cut the wheat from the chaff.

The dangers of sitting too much

In 1953 Morris (2)  published a paper in the prestigious medical journal ” The lancet “.

Morris noted that bus drivers in the 1950’s had far more heart disease than bus conductors. This was interesting. They both worked identical hours and shared almost identical work environments and backgrounds. The main difference seem to be that one group was sitting and one group was standing. Was sitting causing their heart disease ?

Fast forward to 2016 and several papers did some large meta analysis and it seems yes that too much sitting was associated with a range of problems from Heart disease, to type 2 diabetics and obesity (3).

But the interesting question still remained. Is it the sitting itself that causes the problem or is it the lack of physical activity associated with the sitting that causes that leads to poor health ?

Maybe both ?

Well the research at this point is divided with some experts claiming that doing exercises does not offset the dangers of sitting whilst others claiming daily exercise can mitigate a lot of the the dangers of sitting.

Dr. Alter and colleagues conducted a meta-analysis ( where they study other studies ) of 47 studies that tracked groups of people who reported data on how often they spent sitting and on how much exercise they took.

They found that people who were the most sedentary were more likely to be diagnosed with type 2 diabetes, cardiovascular disease and various cancers, including breast, colon and ovarian cancers. The most sedentary people were also 24% more likely to die during the studies than participants who spent the least amount of time sitting.

Although this association was much stronger among people who spent little time exercising, the study also found that too much sitting time was associated with poor health outcomes, regardless of physical activity (4)

Alter was of the opinion that exercise alone does not reduce the health risks of sitting. He believes we actually need to sit less.

In 2016 a much larger study was published by Owen et al (5) in the reputable journal The Lancet that found that moderate activity ( about 60 to 75 minutes a day ) does seem to offset the health risk of sitting in regards to death rates. They did find however that if you watched more than 3 hours of TV a day then even moderate to heavy exercise did not offset the health risks of the sitting.

So they researchers are still a little divided about whether sitting itself is the issue or if is sitting is a co-founding variable associated with the real culprit, lack of enough activity.

I think it’s safe to say that we should all be aiming to try to get an hours walking in more days than not and also minimizing or at least having breaks with the amount of sitting we need to do over the day. A short walk to the water fountain to bitch about a c0-worker may be healthy.

What about standing workstations

It seems like an obvious solution. If sitting is causing the problem then why not just stand ? The sitting/ standing workstation became an overnight sensation in the corporate world with some pretty hefty price tags too.

The interesting thing here is the jury is still out on weather standing workstations make much of a difference. Surprisingly little research has been done to date on whether a standing workstation is really a viable alternative to combat the risks of sitting.

A Harvard study found that when you sit you burn about 80 calories an hour and when you use a standing workstation you use about 88. Over a 3 hour period this relates to about the same energy difference from eating a carrot ( 6). The authors concluded you would be far better off doing a short walk in your lunch break.

And just to make things even more spicy…….

Maybe standing still all day at a workstation is not that good for your either ! One study find that finding that occupations involving predominantly standing were associated with an approximately 2-fold risk of heart disease compared with occupations involving predominantly sitting (7). With all the media attention on the dangers of sitting some authors noted a gap in the research knowledge on looking at the risks of standing.

Again it seems like gentle daily exercise may be worth implementing first before you worry about rushing out to purchase a standing workstation.

In conclusion it’s probably safe to say that an doing a job where you sit all day is a risk to your health and this becomes far more serious when you are not doing enough exercises.

So get out there and move more !



  2. Morris JN, Heady JA, Raffl e PA, Roberts CG, Parks JW. Coronary heart
    disease and physical activity of work. Lancet 1953; 265: 1053–57.
  3. Ekelund, U., Steene-Johannessen, J., Brown, W. J., Fagerland, M. W., Owen, N., Powell, K. E., … Lee, I.-M. (2016). Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women. The Lancet, 388(10051), 1302–1310.doi:10.1016/s0140-6736(16)30370-1


We did it !


Some exciting news to share for our Tokyo clients.

Tokyo international Chiropractic ( TIC ) is  very grateful to the Tokyo College of Chiropractic for allowing us to consulting space to test the market over the last few months. We were very heartened by the level of demand.

Tokyo international Chiropractic is proud to announce that we have now secured a permanent location in Eibusu just a short walk from the station and only a 10 minute walk from the Shibuya station.

Many thanks to Sata-san who has invited TIC to share his beautiful clinic ” Physic Chiropractic ” and we look forward to being able to continue to offer Chiropractic services to the english speaking expatriate community of Tokyo.

If you are seaking an English Speaking Chiropractor in the heart of Tokyo we hope you can consider our services. For the direct link to our online calender and booking service please go to

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Google maps link of new location ( after 3rd October 2022 )



Tokyo International Chiropractic Research update- The best exercises for chronic low back pain


So what exercises work ?

A very interesting article was recently published in the British Medical Jounal.

They examined the important question of which type of exercises work best for chronic lower back pain ?

Should we be doing yoga, pilates strength training or Mckenzie extension exercises to help our lower back pain. We don’t have time for everything so what works the best ?

Lower back pain that last more than 12 weeks ( Chronic lower back pain ) is a huge burden to society. Although chronic lower back pain only makes up 20% of cases that present to us practitioners it makes up over 80% of the costs for the direct costs of low back pain and if you have chronic lower pain you know you would be happy to try anything for meaningful result.

Each week there seems to be a new ” miracle cure ” or celebrity exercise program that is going to cure all and make all our flabby bits go way. Should we be doing kettle bells squats or swiss ball situps ? what is really going to help ?

And The Answer ?

Well according to authors the good news is that almost all exercise programs that you can choose from tend to make a significant improvement but not 1 thing seems to be so much better than anything else (1) .

So if you already drawn to pilates and yoga and enjoy the social aspect of these programs then pick one of those and stick to it.

Stretching by itself seemed to have very little improvement so if you are trying to treat your back pain just with stretches you watched from youtube you may have work cut out trying to get a good result.

The Mckenzie method which seemed to be darling child of rehab for few years got poo pooed in the study (1) My thoughts on this is that the Mckenzie method really seems to shine when you are dealing with a disc issue and much of non specific lower back does not really have a firm diagnosis so perhaps we may be making the sample size a little to general here. (1)

And The Winner ?

This study seemed to indicate that the pilates method seemed to yield the highest results but only by small margain against the others. The authors also sound significant improvements for mental health so if we can get off just looking at pain for a moment there are far higher reaching benefits to choosing an exercise activity that works for you.

Just my hunch but one reason I think the mat classes do so well is the social interaction and support you get from them. There is a big plus to exercising where you have friends waiting your attendance and have somebody to share a coffee with afterwards.

Even simple old arerobics seemed to get some positive results so even joining a fitness class or taking up light jogging my useful.

Us manual therapists also received a kick up the bum. It’s hard when research does not always agree with your clinical experience but if you are going to have some faith in the science then we are going to have to eat humble pie sometimes. As therapists we must try harder to incorporate exercise therapy into our treatments and also help hold the patients accountable for commitment to their chosen exercise program.

We must be a little cautious here. the beauty of the meta-analysis is that it allows a bit more power in finding what really works but the downside is that by throwing so many studies everything can get so generic that it can loose relevance to the actually condition.

This study only looked at ” non specific lower back “. If your therapist is confident of a structural diagnosis for your symptoms then some of the conclusions here may not be relevant for you. I’m thinking disc herniation or chronic SI ligament problems etc.

So the take home message for those in Niseko experiencing chronic lower back is that what is important is to pick an exercises intervention that works for you and stick to it.

In conjunction with a trial of manual therapy you will be well positioned to give yourself every chance of an active and enjoyable recovery.

If you would like to make an appointment with an English in speaking chiropractor in Tokyo Japan you can do so on the link below

Tokyo Chiropractor Appointments 








How important is training to failure ?

I have a confession to make first.

I have not been back to the gym since the Corona Virus shutdown my favourite little weights room at the Kutchan gym. You can see updated status on the Kutchan public gymnasium on the link below


When I was training last summer season there was a school of thought going round the gym and probably every gym that you really need to keep pushing your reps until you fail, until you are not able to squeeze out even one more press. That was the point that you had a short rest, then repeated the movement. It was based on the idea that by pushing to failure you are more likely to cause the micro-damages necessary to cause muscle hypertrophy and also help train your nervous system to better at muscle recruitment.

Here is the interesting thing. that theory has not been tested by science as much as you think it would have by now. A brilliant study was just published by Lacerda et al ( 2020) that looked at the effect of weight training to failure verses just doing an equal amount of reps overall but not pushing up to the point that you simply can’t perform one more press.

And what did they find ?

The good news is they both work.

If you start training regularly you will get stronger. This is also suits the findings or other research looking at number of reps verses amount of weight etc. Whatever you end up doing. If you do resistance training regularly you will stronger and the difference between various methods may not be as much as we think.

What Lacerda’s study did was divide the group of 10 untrained me in to 2 groups. Over 35 training sessions one group pushed right to failure the other just did the same amount of reps but with a little more rest. Interesting for about 50% there was no difference whilst some individuals found a small difference with some getting better results with going to failure, others getting better results just doing the volume.

But the take of the home message of this study has to be that it’s really the volume and number of training sessions that seems to be more important that if you go to failure or not. This is certainly new news to some gym folk law that is still passed around. The caveat here is still need to be putting in a hard effort however, please don’t misinterpret this message as ” working hard doesn’t matter ” it’s just we are trying to tease out just how important it is if go right to point that we simply can’t perform the last rep.

The findings of this study may be particularly interesting to you if you rehabing an injury. Obviously by pushing to failure there is much high chance of loosing good form in our lifts and also becoming unstable and risking further injury.

So if you are comfortable training to failure and can maintain your good lift form even at failure you are probably just fine to keep on going the way you are, but if you are new to weights, nursing through an injury or worried you may slip and fall then you can pull back from this brink and know you are still getting a great workout.

For an appointment with an english speaking chiropractor in Tokyo please go our appointments page 


Lacerda LT, Marra-Lopes RO, Diniz RCR, et al. Is Performing Repetitions to Failure Less Important Than Volume for Muscle Hypertrophy and Strength?. J Strength Cond Res. 2020;34(5):1237-1248. doi:10.1519/JSC.0000000000003438

Pubmed link:


English Speaking Chiropractic now in Tokyo

We are very proud to announce the launch of Tokyo International Chiropractic from the 15th of August 2022.

After 4 years in Japan Niseko Chiropractic is now proud to expand to the busiest city in the world and we feel there is an exciting space in the market for a native english speaking chiropractic service in Tokyo.

We are currently operating from our office in Shimbashi but will have some exciting announcements on a more permanent location soon.

Here is a pic of the U-max building in Shimbashi.

Tokyo international Chiropractic would love to hear from you

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