Sunday, August 26, 2012

Why 3 times a week?



Why 3 times a week?  This is a question I often get. This question often turns into a patient "skipping appointments" once they are out of pain. So,...why?

Actually it's a very good question. Why come when you're feeling "GOOD"? No need right?
WRONG...and here's why.

For the patient that comes regularly, they will remember the first 2-4 weeks, the adjustment sometimes holds for 1-2 days. In fact, I have had patients where the the first week, the adjustment was lasting "hours",.....not even a day. So, what increases TIME for the adjustment.

1) TIME....simply that. Healing is by momentum, and healing takes time.
2) Patient's ability to RELAX during an adjustment. It sometimes takes a few weeks for the patient to become "trusting" to the doctors hands. The more the doctor can move the bone without patients  creating a muscle restriction, the longer the adjustment will hold, and the faster the healing process will begin.
3) Muscles, ligaments, soft tissue ;.... Often there is some type of damage or repair that has to occur in order to progress further in that patients health. Here is an example.
e.g. Patients often come to me with tight Iliopsoas muscles and when I look on x-ray I will often see a shadow of the Psoas Major and Minor attachment to the vertebral bodies. So, when the muscles are extremely tight, they will pull on their attachment sight as well as their origin sight.
e.g.#2 I had a patient with that very issue that went and played tennis........"Oh,...no".  In tennis, the amount of transverse leaning of the body with extension of the legs happens as a person stretches out to try and get a ball out of their reach. an overactive muscle (tight muscles) will cause pain,...and in this person's case, it caused a temporary postural distortion....we had this patient come into clinic for 6 times in 3 days as the patient iced for an acute injury and did postural training. By the end of the week, the patient had returned to their original posture.
4) Postural distortion: Many patients have this issue. Pre-posture training (primary curve lordosis laxity training...or in clinic we call it the "towel exercise"), posture training (mirror image and proprioceptive repetition) will enhance posture. If a persons posture is not well, the possibility of an adjustment holding for an extended period of time,... is "Slim to NONE".
5) Injury (trauma). This is often in conjunction with point #3. However, this can also include bones that have been seriously realigned. Sometimes in a permanent fashion. Therefore the chiropractor has his/her hands tied because the limitations of success decrease due to injury and the amount of damage done to the body.
6) Ergonomics: Huge problem. We get patients who sit in front of a computer 8-12 hours a day. How successful is the patient going to be if they keep putting their body in this mechanical malposition for hours upon hours, and then don't do anything to correct it. In addition to WORK stress, the ergonomics are often poor. (bad position of keyboard, keyboard promotes Carpal Tunnel Syndrome, hand on the mouse for hours, the height the arm is positioned in most of the day may create tingling/numbness in the arms/hands/fingers, type of chair may promote Low Back Pain, the height of the chair may promote slouching, may promote other mechanical stress issues).
7) Patient is NON-compliant. This is generally the case. Even if a patient comes 3x a week, but doesn't do things to improve their ergonomic stress, doesn't do their at home exercises and stretches to decrease recurrences, etc..., this patient then is on a treadmill and the progress is slowed down.
Patients deciding on their own to decrease their care time because "they don't feel pain anymore", will start to put themselves on this rollercoaster of pain vs. no pain.

The amount of time a patient is in clinic is dependent upon their ability to heal and HOW FAST they're healing. Each patient is different, and each injury is different. Let your body do it's magic. Your body is a healing mechanism and the chiropractor is acting like the mechanic of your body. If you feel tightness and stiffness after exercising your body,...the chiropractor will note that,...but often expect that from patients who are going through a body structural transference. THIS IS NORMAL. That brief period of feeling "tight" or "stiff" or even "pain". Ever go to the gym and lift weights? How did it feel the first time you lifted weights? Feel sore the next few days? Of course you did. You're going from non-use to use and your body needing those few days to heal again. It's perfectly normal for your body to feel that way right? Of course it is,...therefore it's as normal to feel stiff, soreness, tightness, and even recurrences of pain when you exercise and go to chiropractic clinic. But,...here's the good news. The ability for the body to heal faster also happens. These patients usually are my successful patients, for they are willing to put in that little bit of sacrifice and they get amazing results.

I tell my patients this. " THE MORE YOU PUT INTO THE WELLNESS OF YOUR BODY,... THE BETTER RESULTS YOU WILL GET IN THE OUTCOME".  Meaning, if the doctor says "10 minutes a day of exercise is the minimum you should be doing..." and you perform 1 hour a day,....these patients will end up  with better results than the person who does the bare minimum.

Let's start putting the emphasis where it belongs...YOU control your own health's ability to heal. So,...leave the excuses at home, and come in to clinic with that wonderful "get well" attitude, and you'll marvel at how well you can do.

To good health,....
Dr. G