Tag Archive for: chiropractic

What Makes a Good Chiropractor and a bad Chiropractor?

Thanks Danny for an excellent blog! Please read on…

As a practicing Chiropractor I have made 2 brief lists of things to be aware of when visiting a Chiropractor for the first time. The lists are also good to see how your current Chiropractor compares.

All professions have good and bad practitioners, as you can imagine people’s abilities to treat differ just as a persons abilities at sport can differ. Some people are naturals, some take time to improve and others well… the less said the better. There can also be differences in how one practitioner views a patient as a human being similar to how people in general life have different views on individuals in the human race. One practitioner may run a clinic with a patients health in mind whilst a minority would put the business overwhelmingly first and see patients as number rather than a person.

Here are some bad things that from my experience I would recommend to watch out for when you go to see a Chiropractor:

  1. Treatment times less than 15 minutes long.
  2. Offering of a full spinal x-ray on consultation rather than an x-ray of a specific area, an x-ray is only required in 10% of patients and is often not necessary straight away.
  3. A “spinal scan” that miraculously highlights areas of the spine that need “correcting” or “re-aligning”. A spine with graph like projections coming out to the sides may be seen on the print out of one of these.
  4. Being told you have a “subluxation” or “subluxations”. This is an old Chiropractic term that is in the process of being phased out in the UK due to its misuse by a minority of the profession and the confusion it causes to the public. I do not have a problem with the term when it is used correctly (rarely), however it has been abused and used as a scare tactic by a minority of individuals.
  5. Treatment ‘pre-payment packages’ or ‘set number of treatments’, for example: “buy 10 treatments for the price of 9!” or “book all 20 treatments now and save 10%” or “you need 22 treatments for this problem” These are sales tactic, no practitioner can per-determine the number of treatments required for an injury as everyone heals at different rates. I tell my patients that it will take anywhere from 4-16 treatments. Post treatment the patients then usually books in the next 1 or 2 to ensure they get the times they want for the next session. I find on average 6 treatments is sufficient for most simple spinal problems with occasional management options to prevent injury in the future.
  6. Not doing any soft tissue work. Chiropractors that only manipulate and mobilise joints are considered lazy and their treatment outcomes will be less effective as a result. A good practitioner will do soft tissue work whether it be with or without manipulation or mobilisation or they provide some one else such as a masseuse to do it for them.
  7. Not providing home exercises or rehab. Again considered lazy as home exercises are great for the patient to maintain the benefits felt in clinic and to get involved with their treatment plan.

Here are some good things I would recommend to watch out for in a good clinic:

  1. Treatment times 15 minutes or longer.
  2. Recommendation by a trusted friend, family or colleague.
  3. A clean, open friendly practice environment centered around the patient.
  4. Soft tissue work before/after treatment with or without manipulation or mobilisations as manipulation and mobilisation are not always used whereas some form of soft tissue almost always has a use even in very acute patients.
  5. Prescribed exercises or stretches at the end of the consultation, checked regularly and progressed in following treatments.
  6. Accessible staff by phone and e-mail in case of complications.
  7. Chiropractors registered with the British Chiropractic Association (BCA), the BCA is considered the “original and best” association to be a member of, they are currently leading the profession and are striving to further Chiropractic in co-ordination with the best chiropractic international and encourages the profession to better itself based on high quality research and interaction with other professions.
  8. A PPQM (Patient Partnership Quality Mark) or a CMQM (Clinic Management Quality Mark) these are a sign that clinics have met high standards set by the “College of Chiropractors” in the UK. The clinic I am currently working in does not have these yet as the clinic is relatively new. Though we are in the process of applying for both of these for the first time, they are very long application forms!!. You can see if your clinic has these awards as they will be up on Bronze plaques in the clinic.
  9. Look for the membership certificates for the associations and awards I have mentioned. If you cannot see them out on display, then ask to see if they have them.

I have to say, as you might expect, that the clinic I work at here in Longlevens, Gloucester is a very good clinic but hey! What do you expect me to say?!?! We advocate good practice within the profession and try to lead by example. Some practices put the business before the patient, this is wrong, the patient experience and treatment outcome should always comes first.

The standard of Chiropractic practice is constantly improving as the governing body clamps down hard on practitioners not adhering to the strict guidelines that are updated and handed out regularly.

A great piece of news I saw recently was that the The College of Chiropractors (a group dedicated to educating and furthering the profession) recently released a document. This document suggests guidelines of good practice for Chiropractors to follow regarding what is considered best practice during the management of a patient that has presented with an episode of acute lower back pain (back pain with an onset within 6 weeks). Though they are not strict rules to follow I feel this is a big step toward the profession locking down an identity as to what the public should expect from the Chiropractic profession. Feel free to read the document as it will give you a good idea of what to expect and what you should expect when consulting a good Chiropractor if you or those you know suffer from Acute lower back pain. It is available here: Chiropractic Quality Standard for the management of Acute Low Back Pain

If you have any questions regarding this topic please comment or feel free to e-mail me on danny@longlevenschiro.com

Fantastic Corporate Event

Danny’s Latest Blog  details his experience of one of our very successful corporate events, that are a roaring success.  Free 20 minute assessments are provided on-site at a local employer to any employees who want to find out how chiropractic could help – whether it’s with a long standing sporting injury, back pain, repititive strain injury, bad desk posture or headaches, the chiropractors are there on-site, free of charge, to  provide short term advice and to inform as to how they can help.

The corporate Occupational Health Team at one of our most recent visits was very happy with how the day went, the employees welcomed the opportunity to talk to a qualified chiropractor free of charge, managers were  happy that less time off sick could result and Danny and Simon had a great day out meeting lots of lovely people and interesting cases.

Please do contact me if your employer or your company could benefit from such an event.  We only need a meeting room – we bring our own portable benches and spinal models.  We are happy to raise awareness of our profession and can help with many workplace related injuries.

01452309372

leah@longlevenschiro.com

Happy Easter!

Happy Easter from all the team here at the Longlevens Chiropractic & Sports Injury Clinic.  After a very busy build up to the Easter weekend we will be making available some extra appointment times next week.  In the meantime, we will be catching up with family and eating too much chocolate and we hope that you do plenty of the same!  Enjoy your break.

Danny’s Blog: Neck Pain, Chiropractic & Exercise = The Perfect Relationship?

An interesting study…

The results below are from a study, funded by the National Institute of Health, that tracked 272 patients with recent-onset neck pain who were treated using three different methods: Medication, Exercise or a  Chiropractor.

After 12 weeks the patients who used a chiropractor or exercised were more than twice as likely to be neck pain free compared to those who relied on medicine. The patients treated by a chiropractor experienced the highest rate of neck pain relief with 32 percent saying they were neck pain free, compared to 30 percent of those who exercised. Only 13 percent of patients treated with medication said they no longer experienced neck pain.

A Chiropractors View

As a Chiropractor myself, I always recommend Chiropractic treatment along with a personally prescribed exercise plan. Part of your chiropractic treatment is to receive advice on which stretches and exercises to perform. The exercises are designed to train areas of your body so that it is less likely to re-injure itself. I also give ergonomic advice, advice for around the house and advice on the correct nutrition to aid you in healing faster. Exercises are usually given after one or two treatments once a patient is out of pain and can move a bit better. You must be careful as exercise during the acute phases may increase the pain levels and actually hinder progression. This is because the inflamed areas can get further irritated by the compressing, stretching and pulling movements aggravating the injury.

What to expect

It’s crucial for everyone to know that Chiropractic is more then just hands on treatment, Chiropractors assess all contributing factors and give you advice to correct each possible factor that may have led to the injury onset. Once out of injury or even before they get injured many people see their Chiropractor for a regular spinal and body check up. During these visits a Chiropractor will check to see if any part of the body could lead to future discomfort and to see if their patient has been performing their exercises correctly to prevent injury or re-injury.

This Chiropractor’s ‘Dream’

Chiropractic and exercise go hand in hand, on their own they are OK, but together they are unbeatable. In a perfect world everyone would see their Chiropractor on a regular basis for regular check ups, this is the dream as back pain is one of the leading causes of work absence. Think about it!! if we all saw our Chiropractor regularly we would have less days off work as a country due to back pain which would lead to a boost in the economy and decrease our taxes!!… what do you think? it’s a nice dream, make it happen ;-) .

Remember

“prevention is better than cure”.

References: Forer, B. (2012). Neck Pain: Chiropractors, Exercise Better Than Medication, Study Says. Available: http://abcnews.go.com/blogs/health/2012/01/04/neck-pain-chiropractors-exercise-better-than-medication-study-says/. Last accessed 22nd March 2012.

 

How Can I Avoid Back Pain This Spring?

Winter is gone, spring is here!, the time for new life, flowers blooming, the smell of fresh-cut grass and for those unlucky few… time for back pain, unless you listen close!

The main activities we find that cause back pain at this time of year are Gardening, Spring cleaning and DIY. You know the usual chores, “the garden is overgrown and needs a good looking after”, “the gutters are full up with leaves left from last autumn”, “the attic, shed and garage all need a good sort out”. Classic situations that can lead to back pain, in this post I am going to give you some really helpful tips to help you prevent injury.

Tip 1.- Be sensible and know your limits! I am sorry to sound like a nag but this is definitely one for those of you that have suffered from previous episodes of back pain or have had previous operations that may limit your ability. Start any job by first thinking ‘is it really worth causing all that pain and potential loss of earnings for the sake of doing something a much fitter, possibly more experienced and capable person could do?’. Remember, assess the job that needs doing and make a sensible decision about it, it is your body, look after it, ask yourself, ‘is it capable?’ and ‘is it really worth the risk?’

Tip 2.- Co-Contraction. Sounds funny doesn’t it?, don’t worry, its sooo simple! and sooo effective! Co-contraction is simply tucking in or contracting the lower part of you belly by just 10-20%, your belly button should tuck in a little when you do this. Holding this contraction will cause a belt of support around your waist and spine, its like those belts weight lifters use but its built-in!, great hey?. Hold this whenever you are attempting to bend over or pick up anything (i.e lifting boxes, mowing the lawn, using the vacuum cleaner, climbing a ladder, pretty much all the time if you can!). It is great, the best part is, that if you keep doing this for 2 weeks constantly it becomes automatic. So what I tell my patients is “co-contract, co-contract, co-contract!!”, the more you think about using it now, the less you will have to in the future.

Tip 3.- Bend from your hips, not from your back! I know, I know, someone has told you something similar already but its time to mop up the nonsense and explain exactly how and why everyone needs to do this. If you need to lean forward (i.e mowing grass or working at a workbench) or bend down (picking up a box or some leaves) then use your hips and knees to lean forward or get lower and keep your back as straight as possible, remember to co-contract!! :D . You have been blessed with hips and knees, so use them!, your back is not designed to lift loads while flexed, your hips and knees are. Another way you can get lower is opening up your stance so your legs are further apart and then bend from your hips. Also, try keeping your head up once you have a good grip as this helps you keep your back straight. Look at you body, have you ever wondered why your bum is so big? (sorry to those offended :-P  ), it is designed to keep your top half upright and help you and your hips in lifting weight. Bending from the hips will take off a huge amount of strain from your back which will lead to an increase in back support and decrease the risk of getting back pain.

One last piece of advice, your spine is weakest when it is flexed and rotated, so please, remember not to bend and twist your back this spring! enjoy the sun everybody.

I hope this has helped you understand a bit more about your body and Chiropractic, If you have any questions on this topic send me an e-mail at danny@longlevenschiro.com  To view more of my blogs visit www.chirobeans.wordpress.com

If you live in Gloucester or surrounding areas and are interested my Chiropractic services and what I can do to help you, then book an appointment to see Danny at the Longlevens Chiropractic and Sports Injury Clinic on 01452 309372

So, How Can A Chiropractor Help Treat My Headache?

There a variety of different headache types, evidence shows that chiropractic can help treat two of the most common types, these are migraines and cervicogenic headaches. During a consultation a chiropractor will assess you and form a working diagnosis as to which type of headache he thinks you are suffering from. They will then inform you as to whether they feel you would benefit from chiropractic treatment.

Treating ‘Migraines

Although migraine attacks affect a significant number of people, the triggering processes for the headaches are not fully understood. Many different triggering processes have been noted by sufferers in the past and finding the one that affects you may be the key into helping you prevent them reoccuring.

What is known about Migraines are that they have been found to be due to changes in the function of the blood or nervous systems in specific areas of the brain as well as due to changes in chemical balances within the body. With Chiropractic care, migraines may not be cured completely, though the frequency and the severity of the headaches has been found to be reduced (Ruegg, Shaw and Descarreaux et al, 2011), the mechanism of why this happens is currently unknown though there are theories.

One high quality research paper suggests that the relief of stress as a result of chiropractic care may be one of the reasons chiropractic treatment helps migraines they found that “83% of participants reported stress as a major factor for their migraines.” they then continue “It appears probable that chiropractic care has an effect on the physical conditions related to stress and that in these people the effects of the migraine are reduced.” (Tuchin, Pollard and Bonello, 2000)

Treating ‘Cervicogenic headaches

Cervicogenic headaches are headaches that are as a result of pain and restriction within the neck. Cervico- means cervical region of the spine (the top 7 vertebrae that make up your neck) and -genic means the beginning (as in genesis). The second most commonly treated problem by chiropractors after lower back pain is neck pain and dysfunction. By using a variety of techniques a chiropractor can help treat your neck’s joints and musculature which in turn can have a profound effect on relieving cervicogenic headaches by treating the true cause.

If you suffer from pesistant reoccurring headaches, try arranging an assesment with a chiropractor. You may be very surprised as to the difference chiropractic treatment can make to your quality of life.

References:
Ruegg R., Shaw L., Descarreaux M., Sorra K., Bryans R., Duranleau M., Marcoux H., Potter B., Watkin R., White E.. (2011). Evidence-based guideline for the chiropractic treatment of adults with headache. Clinical Chiropractic. 14 (4), 173-174.

Tuchin P.J., Pollard H., Bonello R. (2000). A randomized controlled trial of chiropractic spinal manipulative therapy for migraine. Journal of Manipulative and Physiological Therapeutics. 23 (2), 91-95

I hope this has helped you understand a bit more about your body and Chiropractic, If you have any questions on this topic send me an e-mail at danny@longlevenschiro.com

Why Do I Need to Use Ice?

Its amazing… amazing how many times I have asked patients during our first meeting and consultation if they have iced their injury before coming in to see me. The answer 90% of the time is, “I haven’t” or “I have been using heat but not ice”. In mine and a lot of others opinions, Icing is by far and away the best thing you can do to get yourself back on the road to recovery as fast as possible in the early stages of a muscle or joint injury. Here in this post I explain why…

Probably your whole life you have been told if you have burned or bruised yourself that “you need to put ice or ice cold water on it to stop the swelling”. Well the same rule applies for your muscles and skeleton, this includes your spine by the way!, they all respond to ice in the same way as if you bruise your arm. Let’s take back pain for example, a similar thing is occurring with an episode of back pain that occurs with a bruise. Something in your back has been damaged as a result of weakness or poor function and the body is reacting by trying to protect itself using inflammation. The same as if you had bumped and subsequently bruised yourself.

Inflammation has 5 components; pain, heat, redness, swelling and loss of function. All five are reduced as a result of icing. Ok, now think about what I have just told you and consider this: If you just bruised your arm, would you put heat on it to try to make it better while it is still sore and hurting? (oh dear god, please say no…) Remember the 5 components of inflammation??, that’s right, heat was one of them!, therefore you would be encouraging inflammation if you used it, not good. This again also applies to your back, if your back is in pain it is usually due to inflammation, so don’t use heat!. The only time I recommend the use of heat is during a warm up before performing strenuous exercise and certainly not for someone in pain. Once a person is out of pain and functioning correctly I only encourage heat in the form of giving your muscles a good rub to make them more pliable if you know they are noticeably tight.

Right, now I want you to apply what I have just told you to your day-to-day life. If you had just suffered an episode of back pain, would you now consider it a good idea to have a hot bath?? or a hot shower??, or go in the hot jacuzzi down at you leisure club??. I hope you can see what I am saying here (and no, I am not saying don’t wash, that wouldn’t help any of us!). What I am trying to say is that you may be applying heat to your back pain without realising it, by performing day-to-day activities like those I just mentioned. What I would like you to consider when in an episode of back pain is turning down the temperature. When you have a shower or bath, reduce the temperature a bit (not too much!) and make sure you ice your back straight after for 10-15 minutes or find a cooler alternative to cleaning yourself, like using wash towels.

To conclude, wrap up some ice cubes in a damp cloth or wrap an ice pack in damp paper towels or a cloth and apply to the problem area. Perform 10-15 minutes of icing every 2 hours, five times a day or as close to that as possible. This is the perfect routine to help get yourself through the early stages of injury. I would also recommend seeing your Chiropractor or other manual therapist as there are some instances where the pain may in fact not be coming from the parts of the body you suspect. In which case your Chiropractor or other manual therapist will help you identify the correct place to apply your ice pack whilst also providing treatment, information, advice and guidance to aid the healing process and help prevent it happening again!.

When to use ice: Acute sprains and strains, Acute inflammatory processes: arthritis, bursitis, tendonitis myositis, and neuritis, Acute trauma, Acute and chronic muscle spasm.

When not to use ice: Cold hypersensitivity (test a small non-painful area first if worried), a vasospastic disorder (Vasospastic disorders are conditions in which the vessels of the extremities do not dilate properly.), Systemic complications, Raynaud’s Phenomenon or Certain malignancies (seek advice). Do not apply if you are a weakened individual; Old age, Infancy, Cachexic. Or if you have severe varicose veins, myocardial weakness or high blood pressure.

I hope this has helped you understand a bit more about your body and Chiropractic, If you have any questions on this topic send me an e-mail at danny@longlevenschiro.com

If you live in Gloucester or surrounding areas and are interested my Chiropractic services and what I can do to help you, then book an appointment to see Danny at the Longlevens Chiropractic and Sports Injury Clinic on 01452 309372

http://chirobeans.wordpress.com/2012/02/23/why-is-icing-my-back-so-important/

Preventing Injury on Matchday: A Chiropractor’s and a Footballer’s Perspective

Warming up, as every footballer should know its an absolute necessity to a footballers game for these reasons, i) to prevent Injury, ii) increase performance, iii) prolong your playing career, iv) reduce delayed onset muscle soreness (DOMS). From my 17 years of playing for and working with numerous teams I strongly feel the importance of a warm up is not emphasised enough by teams to their players at pretty much all levels of the game. This post is here to highlight the most common problems I have experienced and my tips on how to correct them;

  1. Number one, ‘not increasing blood flow before stretching’, if you fail to do this, you are just asking for an injury, especially on those cold winter mornings when everyone is feeling cold and tight. You need to get your heart rate up and blood flowing to the muscles of your limbs so that they warm up, loosen and receive enough oxygen and nutrients ready for the stretching and skills aspect of your warm up. I’d recommend having a run back and forth across the pitch while performing actions that encourage blood flow to the muscles of your limbs. Actions such as jumping, bending to touch the ground and rotations while running are a few that are great to get the blood flowing round your body. Try to involve your upper limbs as well as it will all contribute to the effect of increasing your heart rate and encouraging blood flow to the limb muscles.
  2. The number two problem I have seen at pretty much every team I have played for is too much ‘Static stretching’. ‘Static’ stretches are stretches that are performed while not moving, a common example is sitting on the floor with the soles of your feet together to stretch out your groin. There is some confusion in football teams about the use of static stretching. here is what I recommend, make sure almost, if not all, al the stretches in your routine are dynamic, ‘dynamic stretches’ are basically just repetitive movements that replicate the most common action in which the muscle will be elongated during a match. A well-known example is repeatedly kicking through the air to stretch the back of your leg ‘The Hamstrings’. The reason for using mainly dynamic stretching is because research suggests ‘static stretches’ surprisingly “do not improve muscle length once the muscle is in motion“, such as during a match (Silveira et al, 2010). Another study suggests that static “stretches may decrease your ability to sprint repeatedly“, therefore affecting your acceleration and performance (Dawson et al, 2009). If however, you are intent on including static stretches in your warm up prior to a match, there is evidence to suggest that your performance should not be affected as long as you “follow-up your stretch routine with a moderate to high intensity skill based sport specific activity” (Taylor et al, 2009). an example of a ‘skill based sport specific activity’ for football would be something like a ‘piggy in the middle’ passing routine. If you need ideas or examples of dynamic stretches for football I’d highly recommend consulting a fitness instructor or manual therapist.
  3. Number 3 is ‘poor stretching technique’. As the old saying goes: “if your going to do something, you might as well do it properly!“. Therefore make sure you are performing your dynamic stretches correctly!. A common mistake I see even the best professional players making when warming up is performing a kick through with the intention of stretching their hamstrings but getting the technique incorrect. What they fail to do is isolate the hamstring by not ensuring they keep their knee extended straight enough. Any good manual therapist can tell you that when you test a hamstring’s muscle length you must keep the knee straight otherwise you are also assessing the gluteus maximus length. Try it yourself, perform a kick through stretch allowing your knee to bend and then perform it again but with an almost completely straight knee (bent slightly to about 5 degrees), feel the difference?. I would recommend performing sets of the kicks twice, one lot of sets with and one lot of sets without a straight knee so that you stretch both your hamstring and gluteus maximus. If everyone focused on their pre-match stretching technique then maybe hamstring tears would be less common in football. Remember the saying, “Fail to prepare, then prepare to fail”, well the same saying applies to your muscles as well!. If you need technique advice, I’d recommend consulting a fitness professional or manual therapist.
  4. Number 4 is the amount of time spent stretching, over stretching can in fact lead to a decrease in performance, one study suggests any longer than 4 minutes stretching one muscle group can lead to a decrease in its performance (Taylor et al, 2009), I would recommend around 2 minutes per muscle group during your routine.
  5. Time for number 5, ‘the importance of a cool down’, after many studies there is in fact very little evidence supporting the theory that you should perform a cool down. As an alternative, I would recommend an ice bath or a very cold shower/bath for around 20 minutes. Only do this if you do not have any other major health concerns (see bottom of post) as it is quite an extreme (but effective) option. Or you can apply ice/cold packs when and wherever the body is sore. This will ensure any inflammation occurring in your body (which is guaranteed after 90 minutes of football) will be reduced, and trust me, if you can bear the cold it is worth it in the long run. You should notice a marked decrease in muscle soreness and tightness in the days following a match. I would also recommend statically and dynamically stretching muscles regularly in your own time. Commonly tight muscles to be aware of in footballers are your hamstrings, hip flexors and calves. The more you do when you’re not playing, the better your performance will be when match day arrives.

It’s never too late to change your warm up routine, just because the team is being told to do something, you don’t have to!, it’s your body!. Now you have read this post you should be able to make an informed decision as to whether what you are being told to do is correct. Take ownership of your body and make sure you are well aware of your it’s needs so that you give yourself the best opportunity to perform well and without the risk of injury.

I would also like to suggest, for all you parents with young stars in the making, that you take the time to make sure your children are being told to warm up properly. Mistakes made during the growing years can adversely affect their performance and injury susceptibility in future years at a time when they should be reaching their peak. There is nothing worse than having a career in sport fail due to something that could have been avoided if small changes such as these had been made earlier.

Who ever said that football was just a game eh?…

  • When NOT to use ice/cold packs, ice/cold baths/showers: Cold should not be applied to weakened individuals, Infants, people with circulatory disturbances, Raynaud`s disease, peripheral, vascular disease, severe varicose veins, myocardial weakness, high blood pressure.
  • Never apply cold (or heat) to: Areas of reduced sensation, infected areas, potential malignancy

References: Dawson B., Sim A., Wallman K., Guelfi K., Young W.. (2009). Effects of static stretching in warm-up on repeated sprint performance. Journal of Science and Medicine in Sport. 12 (supplement 1), S60. Silveira G., Sayers M., Waddington G.. (2010). Effect of static and dynamic stretching on hamstring flexibility in the warm-up. Journal of Science and Medicine in Sport. 12 (supplement 2), e10-e11. Taylor, K.L., Sheppard, J.M., Lee, H., Plummer, N.. (2009). Negative effect of static stretching restored when combined with a sport specific warm-up component. Journal of Science and Medicine in Sport.12 (6), 657-661.

I hope this information has helped you understand a little more about your body, If you have any questions on this topic send me an e-mail at danny@longlevenschiro.com

To read more of Danny’s Blogs visit www.chirobeans.wordpress.com

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