Importance of Compliance
Most chiropractors are owners of their practice, therefore, offices operate at the owner’s discretion within federal and state scopes. Many chiropractic offices have various philosophies and perspectives on how to interact with patients and how to reach health goals. These differences will be seen in technique, office protocols, and treatment plan recommendations.
Goals of Treatment Plans
The focus of this post is on treatment plans. Goals of a treatment plan can be separated into short term goals and long term goals. In general, short term goals often include decreasing intensity and frequency of discomfort, increasing pain free ranges of motion, and decreasing positive exam findings. Long term goals focus on increased functional mobility and how to decrease the likelihood of reoccurrence or new injury onset. Re-evaluates and patient feedback are documented to see if these goals are being reached.
The stage of the condition; and if it is defined as acute (new, recent, actively painful) or chronic (old, reoccurring, latent periods) will also influence treatment plan formats. An acute condition is actively in the stages of the body’s inflammation process. A chronic case needs to account for compensatory changes.
The tissue that is injured will also influence the timeline of a treatment plan. Different tissues heal at different rates due to biological make up and external and internal stressors.
The recommended treatment plan goals and visit frequency are based on researched ethical expectations that take into account stages of the condition and biology of injured tissue. Research as found you should expect 80-90% of acute symptoms to be gone within 2-4 weeks of treatment, about 5-6 visits, when utilizing chiropractic care. The last 10-20% of treatment takes a bit more time, active effort, and compliance. Please note, this is speaking of conservative care treatment for conservative care cases!
Research also supports that combination care is more effective than the individual treatments alone. Chiropractic adjustments, muscle work, exercises, diet, and rest are more effective together than simply choosing one route. Long term goals, chronic pain conditions, and injury prevention are dependent on this combination.
Of course the only way this is useful information and an effective treatment path for patients is if they are compliant. At our office we try to support easy compliance. At our office patients have the option to schedule out their appointments as far into the recommended plan as they wish. This allows for patients to consider their schedules and progress. Payment is collected at time of service to ease financial comfort for the patient and to hold our doctors accountable to the visit at hand.
To summarize:
- Treatment plans are designed to reach short and long term goals of being pain free and functional.
- Stage of the condition and the specific injured tissues are two aspects that determine goals and duration of a treatment plan.
- Research has shown what expectations a doctor and patient should have for the healing process and future injury prevention.
- It is always the patient’s choice to comply with recommended treatment plans. Successful recovery is not guaranteed if a patient does not follow through with a credible, researched treatment plan.
We hope to provide as much flexibility in hours and payment options to encourage easy compliance for our patient’s health success!
We Are Extending Our Office Hours!
Great News!
We are extending our office hours!
East End Chiropractic will now be open Tuesdays from 8am-1pm. We hope the morning extension will complement the working schedules of many of our patients. Having these additional hours will help with appointment consistency, more availability for new patient appointments, patient compliance, and overall treatment success! At this time, only Dr. Calabra will be available at the new Tuesday morning hours. Both doctors will be available as normal for all other posted clinic times.
If you have any other recommendations or suggestions on how our office can better serve the Nashville area, please let us know!
New Office Hours will start February 2nd, 2016!
Monday: 8am-1pm, 3pm-6pm
Tuesday: 8am-1pm
Wednesday: 8am-1pm, 3pm-6pm
Thursday: 8am-1pm, 3pm-6pm
Friday: 8am-1pm
As always, stay up to date with our clinic hours in association with holidays, continuing education seminars, or personal absence by checking our website or following us on Facebook and Twitter!
Soles for Souls
Have you completed your spring running races? Started spring cleaning? Kids grown out of their school year shoes? Bring any of these shoes to our office as a donation!
We are hosting a May fundraiser at the East End Chiropractic office! Please bring any new or used shoes that you no longer need and donate them to Soles4Souls. This is a wonderful organization that helps collect and distribute shoes to people in need across a national and global level.
Click here for a link to the Soles4Souls website. Please browse around and consider bringing in your shoes for a great cause!
Thanks for all your support!
The Weather Is Warming Up. Are You?
Once you are mentally, emotionally, and physically ready to go run, it is easy to jump out the door and hit the pavement, or trails!
That is the appeal right? Running is convenient because the prep work is done quickly. However, your running times may not improve and your running seasons may be cut short if you do not consider a proper warm up and cool down routine.
So, why not do a warm up and cool down?
“I do not have enough time.”
Well, recovery from injury takes more time. Just saying.
If you start running too quickly without warming up you will expose yourself to risk of a tendon strain, ligament instability, or joint irritation.
If you do not cool down properly, you can risk a prolonged duration of muscle fatigue, increased heart rate, restlessness, and dehydration.
“I run fine without warming up or cooling down.”
True. Some people feel great when all they do is their mileage for that day.
A warm up and cool down routine does not need to be approached just to avoid injury. Adding a warm up and cool down routine is likely to serve as a missing link if a runner has plateaued on their performance level.
The beauty is that it can be personalized to cater to what your needs are to assist in improving your running abilities.
“I do not know what to do.”
You are probably closer to knowing what to do than you think. Movement is key.
A warm up and cool down should consist of movement patterns that would transition you from a rested state to a fully active state, in this case, a running state.
Most of the time you do not just jump out of bed and show up to work, you do some routine to prepare yourself to be there; standing up, getting dressed, brushing your teeth, eating breakfast, checking the news, listening to the radio. All of these tasks are engaging your mind and body a little bit at a time to prepare for your day.
Observe collegiate or professional runners. Their routines always include a series of warm up drills and an effective cool down. Your competitive side may not be at the same level, but efficient and heathy running can be accomplished at all levels of the sport.
It is easy to debunk any truth you think you hold to not warm up or cool down.
It is vital to care for your body if you expect it to perform. Runners are quick to challenge their body with increased mileage, faster time demands, frequency in races. Runners need to be just as quick to care for their body in order to reach new challenges.
The following is an example warm up and cool down routine. Try it. Tell us what you think.
Example Schedule: 5 Mile Group Run at 6PM, Beginner Warm Up/Cool Down Routine
Warm Up
5:50-5:51: Walk around- Park further away from the starting location and walk around before getting to the round-up point.
5:51-5:52: Jumping jacks- Personal favorite! Take your time with them. Jumping jacks allow for extremity mobility, core stabilization, increased ground impact force, and increased heart rate.
5:52-5:53: Arm rotations- Swing arms across the body, overhead, to the sides counter clockwise and clockwise.
5:53-5:54: Hip swings- Stand at a fence of sign and swing your legs across your body left and right and then forward and back.
5:54-5:55: 3 10-second strides with rest in between- Take full slow strides with exaggerated form to mobilize joints and mimic your running patterns
5:55-5:56: 10 lunges- Take lunge steps forward to reach a 90 degree angle at the knees. This exercise will cause muscles to be recruited for pelvic stability.
5:56-5:57: 30-secounds high knees and 30-seconds heel kicks-This pattern helps increase activation of the hip flexors and spring activation at the Achilles tendon.
5:57-6:00: Mingle with group runners, take a quick sip of water!!
6:00: START RUNNING!
Cool Down
7:10-7:12: Short jog around the block and back.
7:12-7:13: Static stretch for the calf muscles- 2 sets of 15-second stretches per side.
7:13-7:14: Static stretch for the hip flexors- 2 sets of 15-second stretches per side.
7:14-7:15: Toe walks and heels walks- 30-seconds on toes, 30-seconds on heels.
7:15: HIT THE SHOWERS!
Consider the Core Part II
The previous blog discussed what muscles the core is composed of and why it is valuable to have activation of the core. It is important to remember the core muscles listed are highly integrated to a number of other muscles and fascial coverings that expand above and below the center of the body.
How do you know if your core is strong enough?
A GOOD way to know if your core is strong enough (for you) is the absence of weak core symptoms. Some signs of a weak core include low back pain, side cramping when running, trouble breathing, difficulty picking up things, pain in the morning, and discomfort when seated.
A BETTER way to know if your core is strong is by challenging it through specific activations. Practicing specific breathing patterns, maintaining proper postures while seated or standing, utilizing bracing mechanics to lift a toddler or heavy furniture, are all daily tests to evaluate the strength of your core.
The BEST way to have an understanding of your core strength is to have it assessed by a movement professional. Chiropractors are specialists who can evaluate your core activation, stabilization, endurance, and relaxation control. Core strength can be difficult to determine on your own. Having another set of eyes to evaluate core strength can help piece together what areas need more work in order to reach valuable strength.
How can the core be activated efficiently and effectively?
Efficiency of the core is dependent on neurological feedback and mechanical control. Neurological feedback is the process to initiate, execute, react, and stop movement patterns. Mechanical control is the soft tissue response to the neurological input. Coordinating the process takes time if the system has not been executed properly.
Some activities are more effective at gaining core efficiency and strength. In the absence of discomfort or after a proper assessment, there are a number of exercises that can be completed to help increase core activation and in turn improve the strength of the area.
Top 3 Core Activations
- BRACING: Brace the midsection of the torso as if expecting a punch toward your gut from any direction.
- RELAX: Allow the midsection to relax enough such that you could push lightly on the stomach without discomfort.
- LIGHT TAPPING: At areas that will not brace or will not relax, tap lightly with your fingers to provide nervous system activation to stimulate a feedback loop for that physical area.
Top 5 Core Exercises
- Thoracic Diaphragm Breathing
- Pillar Plank
- Side Planks
- Dying Bug
- Bear Crawls
All of these exercises require core activation without flexing through the core like a sit up would demand. These are the safest and most effective core exercises to start with. Most of these exercises can be found online through professional movement sites. To learn how to complete these exercises, do not hesitate to email or call the office for instruction!
Hopefully this series has shed some light on the concept of “core”. It is a goal of our office to educate patients and the community on ways to care for themselves.
Challenge trends.
Ask questions.
Stay educated.
Consider the core.
All the best!
