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Rehabilitation
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Rehabilitation
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Written by Kirk Lee, D.C.
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Tuesday, 19 July 2011 17:52 |
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 Now that we are in the middle of summer, many of our patients ask us about outdoor activities and what they should do and not do. We usually instruct our patients to warm up a little with some walking and some simple range of motion stretches involving the major muscle groups before starting their outdoor projects. For our more sedimentary patients, we may even tell them to take time every 15 minutes to stand up and stretch after they have been in one specific posture for a period of time. For many people, spring and summer bring on a new resolution of getting out and exercising more frequently. This commonly is in the form of walking, jogging, and for some, running.
Besides recommending specific stretches to our patients, there are other concerns we should discuss with them to help support them as they begin to exercise. They may seem like common sense tips but, for many patients who do not regularly exercise, these tips will be a good reminder to them to be safe and healthy as they exercise.
Discussion points to have with patients who are starting exercise routines:
• How to stay hydrated—A safe recommendation is drinking at least 50 percent of their body weight in ounces over a given day.
• Wearing appropriate workout clothing—This includes reflective clothing if patients are walking in the early morning or once the sun is beginning to set. Rain gear can be helpful to keep them on their regime and not using bad weather as an excuse to skip exercise.
• Use of adequate sunscreen or wearing a hat when appropriate.
6 S’s of Running/Walking
I like to keep most of the focus on what is called the “6 S’s of running/walking.” These include stretching, speed, strength, surface, shoes and structure. Paying attention to each of these six points makes a world of difference for patients to stay healthy while beginning an exercise regime.
We already mentioned stretching earlier, but it is important that even the casual walker do some stretching, especially in the lower legs. Stretching of the gastrocnemius and Achilles are crucial, because these are common areas of cramping for beginning walkers and runners. The older our patient is, the more vulnerable he or she is to Achilles strains and sprains, which can be very slow healing and interfere with normal gait pattern movements. One very important aspect of stretching is to remind patients to stretch again after they have exercised to help loosen up the muscle groups and reduce lactic acid build ups.
Speed can mean different things to many people. Our focus should be on developing a comfortable pace for patients. They should not start out going too fast or too far too soon. Building up speed and distance on a weekly goal can be achieved by most people. Many overuse injuries are caused by simply trying to do too much before the body is ready to handle the pace or distance the runner is trying to achieve.
Many patients use strength as an excuse not to exercise. We have all heard it a million times, “I do not have enough strength to do....” The important thing here is just getting the patient to do something. They need to understand that strength will be gained by being active, not inactive.
Where people live can decide how and when they walk or run. The important factor in surface is staying on a level and fairly smooth surface. For more experienced walkers and runners, adding hills, unlevel surfaces (grass, dirt roads or paths) can make a walk or run more challenging. For our beginners, the smoother and the flatter, the better. It is common today to see people walking in shopping malls, schools, etc. The goal is to just get out there!
The last two S’s—shoes and structure—are very important, regardless if our patient is a beginner or a seasoned veteran. Wearing the correct shoe can make all the difference between enjoying a good experience or a bad experience. The last thing we want is our patient to be discouraged due to blisters or sore feet. Your recommendation of the correct shoe is vital. If you are not comfortable making a recommendation, then recommend that your patient go to a running store to get correct information on what shoe is best for them. Running shoes are designed on three types of foot structure: the supinator, neutral and hyper-pronated foot. The supinator, or high-arched foot, is usually demonstrated as a C-shaped shoe. This shoe is usually more flexible and has additional shock-absorbing support. The neutral foot shoe is semi-curved with adequate support and shock absorbing capabilities. The flat foot, or hyper-pronated foot, requires a shoe that is referred to as a motion control shoe. It is designed to add additional support on the medial side of the shoe to assist with pronation. This shoe is usually straighter in its appearance.
I am often asked by doctors when I am lecturing, “If we place a patient in a motion control shoe, do we still need to recommend an individually-designed, flexible orthotic?”
The answer is YES! Remember, the individually-designed orthotic is designed to balance the three arches of the foot to allow a symmetrical heel-to-toe transition. If you put your hand inside the shoe, you will find that the shoe is usually flat on the inside. The additional stability to the shoe is placed in the medial side for additional support as the weight bearing forces go medial. They are not designed to correct a fallen or dropped arched.
The last of our six S’s is structure. No one does structure better than the doctor of chiropractic. Because of our education, philosophy and the art of the adjustment, we continue to be the leading profession that the consumer seeks for manipulative therapy. We must continue to keep it that way. The use of individually-designed orthotics can be essential to help stabilize the kinetic chain to allow the chiropractic adjustment to hold longer in correcting or stabilizing our patients’ neuro-musculoskeletal conditions that result from the different types of subluxation. We must also consider posture of our patient when we recommend rehabilitative procedures to help with strengthening muscle imbalances. The right nutrition is key in assisting to reduce inflammation and improve healing. All of these are important aspects to think about when giving exercise recommendations to our patients.
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.
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Rehabilitation
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Written by A. Joshua Woggon, D.C.
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Saturday, 25 June 2011 03:10 |
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O steoporosis and obesity are important health concerns in the United States. Whole-body Vibration (WBV) therapy has the potential to make a significant impact upon musculoskeletal health and wellness in the coming decade.1,2 It also has the potential of causing significant musculoskeletal harm, and becoming a significant source of doctor liability, if improperly applied.
Many educated readers may recall the lawsuits that arose in the 1990’s regarding the use of decompression therapy in chiropractic clinics, who utilized the literature provided to them by the companies supplying the decompression therapy equipment and were, ultimately, found to be culpable in lieu of the company who wrote the recommendations for the equipment sold. In today’s litigious society, the buck stops at you, Doc.
It is the responsibility of the doctor to ensure that the equipment in the clinic is incapable of causing musculoskeletal harm.
Whole-body vibration therapy equipment has this same potential to result in “open-and-shut” litigation in the 21st century chiropractic office. It is the responsibility of the doctor to ensure that the equipment in the clinic is incapable of causing musculoskeletal harm.
Unfortunately, there is a doctor reading this article who is providing their post-menopausal osteoporotic patients with a WBV device designed for healthy athletes. According to Rubin, this doctor—by following the manufacturer’s guidelines for using their equipment—is providing patients with WBV dosage that exceeds the safe limits for WBV exposure as established by the International Standards Organization (ISO), Section 2631-1.3
Research suggests bone remodeling occurs best within frequencies around 25-45 Hertz.
WBV is the perfect adjunctive therapy to chiropractic when applied properly. Be sure to ask the right questions when purchasing a WBV platform for your office: Is it safe? Is it effective? Just as an AM/FM radio must be “tuned-in” to the ideal settings for maximum musical enjoyment, so must WBV therapy be “tuned-in” to the ideal frequency and amplitude for the maximum targeted physiological benefit. As an example, to-date, research suggests bone remodeling occurs best within frequencies around 25-45 Hertz.4 If you are utilizing a WBV platform that operates outside these frequencies, your patients should not expect to achieve improvements in bone mineral density from their use of WBV therapy. Also, frequencies ≤ 20 Hz or ≥70 Hz may not be effective and may, in fact, be harmful; they should be avoided.5
Whole-body vibration has the potential to provide chiropractors with a significant source of professional revenue, while positively impacting their patients’ long-term outcomes. It also has the potential to expose doctors to liability for inflicting permanent musculoskeletal harm. Choose wisely!
Dr. A. Joshua Woggon, a 2010 Graduate of Parker College, is the Director of the CLEAR Scoliosis Treatment and Research Clinic in Dallas, Texas (www.clearscoliosisclinic.com), and the Director of Research for CLEAR Institute, a Non-Profit Organization dedicated to advancing chiropractic scoliosis correction (www.clear-institute.org). He can be contacted at
This e-mail address is being protected from spambots. You need JavaScript enabled to view it
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Research & References
1) Rubin C., Recker R., Cullen D., Ryaby, J., McCabe and K. McLeod: Prevention of postmenopausal bone loss by a low-magnitude, high-frequency mechanical stimuli: a clinical trial assessing compliance, efficacy, and safety. J. Bone Miner. Res. 19 (3) (2004), pp. 343–351.
2) V. Gilsanz, T.A.L. Wren, M. Sanchez, F. Dorey, S. Judex and C. Rubin: Low-level, high-frequency mechanical signals enhance musculoskeletal development of young women with low BMD. J. Bone Miner. Res. 21 (9) (2006), pp. 1464–1474.
3) Rubin: Contraindications and potential dangers of the use of vibration as a treatment for osteoporosis and other musculoskeletal diseases. April 2007.
4) Prisby, et al: Effects of whole body vibration on the skeleton and other organ systems in man and animal models: What we know and what we need to know. Ageing Research Reviews 2008;7:319-329.
5) Totosy de Zepetnek, Giangregorio & Craven: Whole-body vibration as a potential intervention for people with low bone mineral density and osteoporosis: A review. Journal of Rehab. Res. & Dev. 2009.
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Rehabilitation
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Written by Burl Pettibon, D.C., F.A.C.B.S., F.R.C.C.M., Phd. (Hon)
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Wednesday, 11 May 2011 20:32 |
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I s it possible to walk through a doorway when the door is closed? That strange question is a metaphor that can be used to describe the difference in research-based rehabilitation to prepare the spine for corrective procedures with little to no pain versus no preparation at all or, worse yet, substituting bilateral strengthening exercises for rehab to prepare the spine for corrections that are often both painful and ineffective.
Gym type exercises are often called rehabilitation exercises. However, the two have little in common. Gym type exercises are isotonic that work and shorten muscles, thereby opposing positional changes. Phasic muscles are enervated by a1-motor fibers and are consciously controlled and, when totally fatigued or injured, become flaccid. Postural muscles are enervated by a2-motor fibers and are autonomic nerve controlled. The strengthening of these muscles requires isometric exercises. When they are fatigued or injured, they become spastic. It is critical to understand that postural muscles dominate one’s spinal position and function as well as posture, stance and gait.
What is rehabilitation and why is it necessary for quality patient care? Dorland’s Medical Dictionary 26th Ed. defines rehabilitation as:
1. “The restoration of normal form and function after injury or illness.”
2. “The restoration of an ill or injured patient to self-sufficiency or to gainful employment at the highest attainable skill in the shortest period of time”.
The profession of chiropractic claims that the adjustment is for the restoration of normal form and function of the spine through correction of spinal displacement subluxations. We can agree that abnormal/subluxated spinal forms cause abnormal functions.
Surveys show that the clinical procedures taught in chiropractic colleges and practiced by 84% of the profession involve the use of a sudden applied force into the subluxated spine, referred to as an adjustment or treatment.
What do the adjusting forces actually do? Is it possible to physically correct spinal displacement subluxations without first preparing the spine to welcome the force through rehabilitating the soft tissues that hold the static spine upright while in a normal or abnormal (subluxated) position?
We can agree that abnormal/subluxated spinal forms cause abnormal functions.
Research published in 1996, by JMPT, titled “Lasting Changes in Passive Range of Motion after Spinal Mobilization,” a Randomized, Blind Controlled Trial, tested spinal changes produced by diversified and toggle recoil adjusting. Their findings were that these adjustments caused about a 5% increase in mobility and the changes lasted for about 7 days. A more recent article published in the Spine Journal demonstrated with pre and post MRI studies that the same kinds of adjusting resulted in the spine becoming measurably more displaced than before it was adjusted. Chiropractic adjusting, without first performing rehabilitation to prepare the spinal soft tissues for change, typically has shown little success in making gross structural spinal and postural changes. This also was tested and published in JMPT. The authors were Harrison, et al in 1997, and Lantz et al, in 2001. In 1975, Jowett and Fidler published research in Orthop. Clin., N. Amer. that proved the body changes phasic fibers into postural muscle fibers on the convex side of spinal displacement subluxations; hypo mobility and nerve root compression were also noted.
Neuro-muscular research has proven that the dynamic stretch reflex guards all body parts including spinal position, even if it is in a subluxated position from being changed by sudden applied forces. Guyton’s Physiology 5th and 6th Edition, explains how the dynamic stretch reflex causes muscles to replace body parts after a dynamic force has displaced them. Muscles intercept sudden applied forces of up to .3 of a second in speed. The phasic muscle fibers can contract fast enough to counteract these sudden applied forces. This reflex protection is automatic, unless the force is faster than .3 seconds or so great that they tear the muscles and then the ligaments, thereby causing spinal subluxations.
The protective energy of the muscles can be greatly reduced by slowly stretching the phasic and postural muscles rather than attempting to exercise them. To be effective, stretching should last at least 40 seconds and include all muscles involved.
Hysteresis can temporarily remove up to 95% of the ligament’s holding energy and lasts for approximately six minutes.
Ligament research has proven that to instantly change a vertebrae’s position, the adjusting force would have to overcome 40% of the ligament’s resisting force. Such high forces are impossible for a doctor to produce and could crush the vertebrae before the ligament entered the plastic range necessary, before instant positional change of a vertebra can occur. However, rehabilitation procedures that cause disks and ligaments to go through full range loading and unloading cycle’s for 2 to 5 minutes produces a condition called hysteresis, which gradually lowers the resistance of spinal disks and ligaments, thereby making changes in spinal position possible, easy and pain free. Hysteresis can temporarily remove up to 95% of the ligament’s holding energy and lasts for approximately six minutes after loading and unloading cycles are discontinued. Within 15 to 20 minutes after loading and unloading cycles are discontinued, the ligaments regain all of their holding energy.
Loading and unloading cycles in the cervical spine requires slow, intermittent traction, while effective loading and unloading cycles in the lumbo-sacral spine require full range, figure 8 cycles that are slowly applied, requiring 4 seconds to complete one cycle after the ligaments are completely stretched. The figure-8 cycles also mix and re-mix the protoglycine aggregate of the disk’s nucleus necessary for making and maintenance of a perfect jell. Like fluids, the jelled nucleus is non-compressible. When perfected, it equally transfers body weight from the vertebrae above to the vertebrae below, thereby providing a foundation for maintenance of the corrected spine’s form and function. In addition, the figure-8 motion pumps the cerebral-spinal fluids necessary for the metabolic interchange of glucose to feed the brain, thereby giving the patient a feeling of mental and physical well being—an additional benefit of the rehab procedures! Home care instructions work in tandem with clinical care and will include the use of deep, diaphragmatic breathing in coordination with specific rehabilitation procedures. These procedures take into account the fact that the thoracic spine is approximately 13 times less flexible than the cervical spine and approximately 3 times less flexible than the lumbar spine; therefore, thoracic loading and unloading cycles require more time and concerted rehabilitation procedures. Patients are taught to prepare their spine both in the clinic before being seen, as well as at home before daily activities and rest.
Change is inevitable for the growth of any profession; without it, stagnation and eventual decline is the end result. Through the use of clinical research and documentation with new and more efficient methodologies, we grow in our knowledge and our abilities. The Pettibon Biomechanics Institute has published several retrospective as well as blinded studies, proving through pre- and post- X-rays that permanent spinal corrections are possible after the spinal soft tissues have been prepared through our holistic rehabilitation procedures. Research can be found at www.pettiboninstitute.org.
Burl R. Pettibon, DC, FABCS, FRCCM, PhD. (Hon) has guided The Pettibon Institute’s direction, continuing education offerings, and research since the Institute's inception as the Pettibon Spinal Bio-Mechanics Institute in 1981. As a teacher, inventor, and researcher, Dr. Pettibon’s influence and contributions to the science of chiropractic are legendary. Dr. Pettibon has been an extension faculty member and lecturer at Palmer College of Chiropractic for more than 35 years. He has also been an extension faculty member at Life University, Logan College of Chiropractic, Parker College of Chiropractic, and Cleveland Chiropractic College—where he received his degree in 1956. Dr. Pettibon has written more than 65 papers and books on chiropractic care and research. Over the course of his career, he has developed 25 clinics. At the present time, the profession is using the more than 50 rehabilitative products that he has invented to make the detection and correction of vertebral displacements both easier and more accurate. He currently holds four patents. Papers and books are also available through www.pettibonsystem.com.
References
1.Morningstar MW, Strauchman MN, Weeks DA, Spinal Manipulation and Anterior Headweighting for the Correction of Forward Head Posture and Cervical Hypolordosis: A Pilot Study, Spring 2003, Number 2, Volume 2, Journal of Chiropractic Medicine.
2.Horseman I, Morningstar MW, Radiographic disk height increase after a trial of multimodal spine rehabilitation and vibration traction: a retrospective case series, 2008 7, 140-145, Journal of Chiropractic Medicine, 2008.
3.Schwab MJ, Chiropractic management of a 47-year-old firefighter with lumbar disk extrusion, 7, 146-154, Journal of Chiropractic Medicine, 2008.
4.Saunders ES, Woggon E, Cohen C, Robinson DH, Improvement of Cervical Lordosis and Reduction of Forward Head Posture with Anterior Head Weighting and Proprioceptive Balancing Protocols, J. Vertebral Subluxation Res., April 27, 2003.
5.Morningstar MW, Cervical curve restoration and forward head posture reduction for the treatment of Mechanical thoracic pain using the Pettibon corrective and rehabilitative procedures, Summer 2002, Number 3, Volume 1, Journal of Chiropractic Medicine.
6.Morningstar MW, Cervical hyperlordosis, forward head posture, and lumbar Kyphosis correction: a novel treatment for Mid-thoracic pain, Spring 2003, Number 3, Volume 2, Journal of Chiropractic Medicine.
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Rehabilitation
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Written by Clayton Stitzel. D.C. and Joshua Woggon, D.C.
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Monday, 21 February 2011 12:20 |
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 Now that genetic pre-disposition testing for scoliosis progression risk is available, An Early Stage Intervention Program has also been developed to provide scoliosis patients a non-bracing, non-surgical treatment option that allows them to take immediate action in the prevention of the next stage of the standard treatment process.
The three medically-sanctioned methods of scoliosis treatment—observation, bracing, and surgery—have been around for decades. A great deal of research has been done on the risks and benefits of each option. However, the general conclusion of this research suggests that a new paradigm is desperately needed, as there are many conflicts and inadequacies present in the current model.
Observation Only or the “Watch & Wait” Stage
Once an individual has been diagnosed with scoliosis, no treatment is initially prescribed, and no action is immediately taken, until the cobb angle has progressed to 25 degrees. At this point, bracing is typically prescribed. This period, which is termed "watch & wait," consists only of regular visits to an orthopedic.
Spinal brace treatment (generally recommended for curvatures 25 degrees and larger)
If there ever was a time when a patient could benefit most greatly from chiropractic, therapeutic exercise, or non-surgical intervention, it would undoubtedly be during the mild stages of the disease—before the muscles and tissues of the body have been deformed by months or even years of compensating for the abnormal twisting and bending of the spine.
Bracing dates back to approximately 650 AD, when Paul of Aegina suggested bandaging scoliosis patients with wooden strips. The first metal brace was developed by Ambroise Pare in the 16th century. Today, there is a bewildering assortment of braces in use, ranging from the venerable and bulky Milwaukee brace, to the traditional TLSO braces such as the Boston and the Wilmington brace. There are "part-time" braces, designed to be worn at night: the Providence brace, and the Charleston brace. There are also "dynamic corrective braces" (SpinCor), which may use soft, elastic materials and claim to be able to do more than simply stabilize the progression of scoliosis.
This dizzying variety is further complicated by the fact that not every doctor prescribes the braces to be used in the same manner, and not every patient may follow their doctor's recommendations to the same extent. As a result, research is often conflicting in regard to the true effectiveness of bracing in scoliosis treatment. Some studies have shown very little difference between patients who wore the brace for the prescribed time. In every case, all corrective benefit is lost very quickly once the patient stops wearing the brace.
Spinal fusion surgery (Generally recommended of curvatures 40 degrees and larger)
Those patients for whom bracing fails to prevent the progression of their scoliosis are left with only one option: surgery. Those who are confronted with this choice may be told that having a metal rod fused to their spine will not impair their daily activities, and will reduce the rib arch and improve their cosmetic appearance. However, research has consistently shown that surgery—which primarily focuses upon the sideways bending, and does little to address the rotation of the spine (and hence the rib protrusion)—will actually cause the rib arch to worsen (Chen 2002, Goldberg 2003, Hill 2002, Pratt 2001, Weatherly 1980, Wood 1991, Wood 1997).
The rate of hardware failure is virtually 100% over the course of a normal lifetime. It may occur immediately after the surgery or several years later, but one or more components of the hardware placed inside the body is highly likely to fail or break. The author of one study stated, "One would expect that, if the patient lives long enough, rod breakage will be a virtual certainty". Another study found that, amongst seventy-four patients who underwent the surgery, failed fusion occurred in 27% of patients within a few years after the procedure.
The truth of the matter is that scoliosis is an abnormality of the spine which involves much more than merely a sideways curve. Yet the "effectiveness" of surgery is measured only by the degree to which it can reduce the lateral deviation through the application of brute force, and a fused spine is every bit as abnormal and dysfunctional as a scoliotic spine.
We can alter the natural course of this disease by identifying which patients are at the highest risk for severe progression via genetic testing (Scoliscore) and by implementing an aggressive, non-invasive Early Stage Scoliosis Intervention program that re-trains the brain’s involuntary postural controls centers before the spinal curvature reaches the 30 degree "buckling" point.
Dr Stitzel graduated from Palmer College of Chiropractic in 2002. Dr Stitzel practices in Lititz,PA and specializes in scoliosis rehabilitation. Dr Stitzel is a former director of the CLEAR-Institute and lectures both nationally and internationally on the topic of scoliosis rehabilitation.
Dr. A. Joshua Woggon, a 2010 Graduate of Parker College, is the Clinic Director of the CLEAR Scoliosis Treatment and Research Clinic on the campus of Parker College of Chiropractic in Dallas, Texas (www.clearscoliosisclinic.com), and the Director of Research for CLEAR Institute, a Non-Profit Organization dedicated to advancing chiropractic scoliosis correction (www.clear-institute.org). He can be contacted at
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Rehabilitation
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Written by Dr. Joe Ventura
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Monday, 21 February 2011 00:00 |
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As if the prospect of morning sickness, constipation, rashes and changes in hormone and wardrobe weren’t daunting enough, 80% of pregnant women will develop back pain and almost 100% will develop poor posture. The pain can last up to three months past the delivery date. Typically pain is experienced in the following areas:
Unfortunately, the poor posture can become permanent.
It’s easy to see why. First there are the hormone changes that help relax ligaments and joints throughout the body. Next is the extra weight. Here is a breakdown of weight gain for a woman of normal weight.
The Body’s Balance System
The human body has a magnificent system of adapting to keep us upright under many different conditions. This “Balance Control System” is comprised of two parts; Sensory (Where am I) and Motor (What am I going to do). But this adaptation comes at a price. As the extra 25 or so pounds are added to the woman’s general mid-line area, the initial reaction is for the Center of Gravity and Center of Mass to shift forward. However, the body’s Balance Control System kicks in and begins a slow but steady realignment of the pelvis, spine, head and shoulders to act as a counter-balance for the extra weight of pregnancy. Eventually the Center of Gravity shifts backward. This short term solution can have long lasting consequences.
The spinal changes are very predictable.
- Pelvis tilts forward
- Mid back drifts backward
- Head/Neck assume a position in front of the shoulders (know as Forward Head Posture)
How This Affects the Spine
The natural “S” shape curve of the spine is created from the attachment of muscles and ligaments. Any changes in the curves of the spine will cause some muscles to stretch
and some muscles to shorten, both situations contributing to instability in the spine. This instability leads to chronic tension in certain muscle groups and increased strain on joints.
The study of Physiology tells us that a muscle kept in a stretched position will eventually elongate its fibers and become weak (Stretch Weakness). Conversely, a muscle held in an over-relaxed position will shorten its fibers and also become weak (Short Weakness). Because the postural changes are so predictable, it is clearly understood which muscle groups are involved and whether they have become stretched or shortened. Unfortunately after delivery and the loss of the extra weight normally gained during pregnancy, the mother’s posture does not “snap” back into place. The stretched and shortened muscles stay that way until there is an intervention. That Intervention is known as Posture Reprogramming™.
The Shear Truth
 As if all this wasn’t enough, other forces come into play to create a low back that is less stable and more prone to create chronic pain and discomfort. Shear forces to be exact. In a person with normal posture, downward Gravitational and directional shear forces work with the body to “lock” joints into position under load, thereby providing strength and stability to the spine. In a pregnancy posture, the Gravitational forces remain essentially the same, but the shear forces change direction in such a way as to open the low back joints, providing less stability in the spine. The body’s exquisite feedback system senses this and the muscles in the low back become tighter in an effort to take up the slack.
First the bad news: Poor posture is NOT self-correcting.
Now the good news: Poor posture can be corrected in as little as four weeks!
Identifying Poor Posture Through the Use of the Posture Number™
Correcting posture begins with a simple non-invasive digital analysis to establish the patient’s Posture Numbertm. This number is used to identify and quantify the extent of the poor posture, and provide guidelines for the cost of posture reprogramming.
Next a series of gentle spinal mobilization sessions will be started and a set of custom stretches and exercises will be assigned. A special therapeutic cushion may be prescribed. These protocols are designed to reverse spinal muscle changes and reprogram muscles back to their original positions. This process takes about four weeks.
About the Posture Reprogramming Stretches and Exercises
Because the pelvic and spinal changes are so predictable, it is possible to map which muscles will undergo “Stretch Weakness” and  which will exhibit “Short Weakness”. With that knowledge, a Posture Reprogramming professional can create an exercise program to strengthen the muscles that have become stretched, and a stretching program for the muscles that have become shotened.
In addition to these maneuvers, a new therapeutic cushion that helps reduce the effects of Forward Head Posture may be recommended. It’s called Posture Blocks™ (Patent Pending).
Gravity Works Against You All Day Long. Now, Make It Work For You!
The special contours and foam density of the Posture Blocks cushion causes the person’s body weight, along with the pull of Gravity, to stretch muscles that need to be stretched and relax muscles that need to be relaxed. Imagine an exercise program that works simply by doing no more than lying on the floor!
Here are some of the innovative features:
- Adjustable Headrest allows the head to assume a neutral or slightly backward position simultaneously stretching the muscles in the front of the neck and relaxing the muscles in back.
- The soft neck bridge encourages a normal curve in the neck.
- Special cut-out encourages external rotation of the shoulders.
- The upper back bridge exerts a gentle forward force that relaxes the back and expands the chest area.
- The upper back bridge has a gentle decline to the low back area.
The special features of the Posture Blocks cushion are so unique the company was awarded a Patent Pending designation by the USPTO.
Reimbursement for Posture Reprogramming
Although there is an ICD-10 code for Abnormal Posture (R29.3), third-party reimbursement for abnormal posture is rare and is generally considered an out of network service, Most insurance companies will allow its use as a compound or complicating code. This essentially means that Posture Reprogramming is a cash based service. The fee is based on the results of the posture exam. The Posture Pro software will generate a Posture Number™, which is the accumulation of deviations from normal. The general fee guideline is $50 for every Posture Number unit of deviation. For the average patient that would be in the $500-$1,000 range for the Posture Reprogramming.
Using the Posture Reprogramming System a doctor of chiropractic can market this service directly to pregnant patients or to local OB/GYN clinics.
Conclusion
Back pain and postural changes from pregnancy are both inevitable and manageable. If started early, a prescribed exercise and stretching program can help reverse muscle changes and improve posture during and after the pregnancy. A new therapeutic cushion, the Posture Blocks, shows great promise in helping with this universal problem.
Joseph Ventura D.C. is owner of VenturaDesigns, a 32 year company that develops software and marketing strategies for the chiropractic profession. Dr. Ventura can be reached at (888) 713-2093 or at
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