When we watch TV today, regardless if it is satellite or cable, the public is inundated with infomercials on every type of revolutionary new exercise equipment or gimmick that will restore your health by removing excess weight, take away your chronic back pain and even grow you new hair.
The unfortunate thing is that the consumer who is suffering from one of these ailments will commonly seek out these gimmicks in search of a solution to alleviate the pain instead of seeking out chiropractic care, which may be able to find out the real cause of their problem.
Each day we hear patients comment on their weight, degenerative arthritis, fibromyalgia, constant neck or low back pain and what do we do? It is a common fact that, regardless of our patients’ complaints, they still are under hydrated, have poor eating habits, get little to no exercise, do not get enough rest, take numerous prescribed medications and countless over-the-counter remedies. We see this each time we review the case history of a new patient.
When considering this common episode, you need to ask yourself, "What types of services am I providing to help my patients achieve a real wellness style of healthcare and activities of daily living?"
We know today’s patients are more educated about their healthcare choices and want to be involved in their health care–both in the decision making, as well as how and where they want to spend their healthcare dollars. I commonly will get a new patient who comes to our office and has been under previous chiropractic care. When we ask why he is coming to our office, he says, "Every time I go to Dr. X, he does the same thing: lays me on my right side, lays me on the left side, pushes on my mid back and twists my neck to the right and then to the left, and says, ‘I will see you in a month!’" Does this scenario sound familiar? Are we guilty of doing the same thing?
There is no replacement for the chiropractic adjustment! It is what separates us from all other healthcare providers. But, our patients who have chronic pain syndromes, gait instabilities, and complaints about managing simple activities of daily living often come into our office with a soda and a bag of chips! They need more from us to develop a true wellness lifestyle.
To help educate a patient on better diet and eating habits, simply ask a patient to fill out a questionnaire or a two-week record of everything they eat and drink, then make simple recommendations. If you do not use any type of nutritional supplements in your office, I am sure you have a peer who does and can give you advice for your patients. Many times, we put all our focus on providing a great chiropractic adjustment and forget to focus on some of the additional components of the vertebral subluxation. When joints and their surrounding supporting tissue and muscles do not move in normal patterns (either from trauma, a compensatory pattern or from an injury to another part of the body) then, oftentimes, these areas need to be rehabilitated. You do not need to have the equivalent of a powerhouse gym in your office, just the use of low-tech resistance bands. A basic knowledge of how to use them can establish normal ranges of motion. This, followed by some pattern reeducation and strengthening, can go a long way in helping a patient improve his or her lifestyle. Simple things can have a huge impact, such as just teaching a patient how to correctly stand out of a chair, rise from the bed correctly, or even educating the patient on the use of a better pillow.
The use of custom-made, flexible orthotics to stabilize an abnormal movement pattern within the feet will then positively affect compensatory problems up the kinetic chain from the foot to the base of the skull. This will lead to numerous postural changes, and could help relieve musculoskeletal pains and chronic pain syndromes. Let’s take an additional look at how these biomechanical abnormalities can cause the above-mentioned conditions.
We know, during ambulation, the body goes from a heel-strike position, transitioning to midstance and followed by toe-off. This normal pattern places stresses from the rear foot through the midfoot, where weightbearing forces are accentuated when the midfoot rolls medially, or pronates. This is a normal pattern of movement. This allows the shifting of the weightbearing forces to the first and second toe for toe-off. This is, also, why most people’s big toe is longer—it’s to create a better lever. If the medial roll or pronation is excessive or not enough, the weightbearing forces are placed more laterally and (more commonly) more medially. When this abnormal pattern of movement takes place, the tibia will rotate medially more than normal. This, in turn, causes stress at the knee, hip, sacroiliac joint and throughout the spine. It sounds like the old children’s song, "The knee bone’s connected to the hip bone." Using a custom-made, flexible orthotic that is measured in the weightbearing or midstance position allows support to provide the foot with a normal pattern of movement, going from heel strike to toe-off. Allowing this normal pattern will commonly provide additional support for the musculoskeletal chain and allow better support and holding, once the chiropractic adjustment has been given.
There is no doubt: Neurologically, it is "from above down and inside out" but, biomechanically, it is from the ground up (from the feet up) and is evidenced by simple anatomy and movement patterns.
A 1980 graduate of Palmer College of Chiropractic, Dr. Kirk Lee is a member of the Palmer College of Chiropractic Post Graduate Faculty and Parker College of Chiropractic Post Graduate Faculty. He has lectured nationwide on sports injuries and the adolescent athlete, and currently practices in Albion, Michigan.