The Heritage Approach to Treating Overuse Injuries

How Do Overuse Conditions Occur?

Over-used muscles (and other soft tissues) change in three important ways:

• Acute conditions (pulls, tears, collisions)

• Accumulation of small tears (micro-trauma)

• Not getting enough oxygen (hypoxia)

Each of these factors can cause your body to produce tough, dense scar tissue in the affected area. This scar tissue binds up and ties down tissues that need to move freely. As scar tissue builds up, muscles become shorter and weaker, tension on tendons causes tendonitis, and nerves can become trapped. This can cause reduced range of motion, loss of strength, and pain. If a nerve is trapped you may also feel tingling, numbness, and weakness.

What is an ART Treatment Like?

Every ART session is actually a combination of examination and treatment. The ART provider uses his or her hands to evaluate the texture, tightness, and movement of muscles, fascia, tendons, ligaments, and nerves. Abnormal tissues are treated by combining precisely directed tension with very specific patient movements.

These treatment protocols – over 500 specific moves – are unique to ART. They allow providers to identify and correct the specific problems that are affecting each individual patient. ART is not a cookie-cutter approach.

Why don’t Doctors of Chiropractic prescribe drugs?

The chiropractic approach recognizes that only the body can heal itself and the role of the doctor should be to remove interferences to this inborn ability. While aspirin, muscle relaxers, and other drugs with analgesic properties have the effect of blocking pain, the underlying structural problem remains.

Doctors of Chiropractic recognize the importance of structure and that the headache or pain is not the result of an aspirin “shortage”. Your doctor respects the homeostatic balance of cause and effect and looks for the underlying cause of the patient’s complaint.

How long does it take to start feeling better?

Some patients find they start feeling better with the very first adjustment. Others discover progress takes weeks or months. As with any healing process, every person responds differently. Children usually respond quickly. Adults often take longer because most spinal problems are the result of years of neglect. A patient’s lifestyle, diet, exercise and kept appointments all affect their progress.

I feel fine. Why do I need to be checked?

Our busy lifestyles continue to cause spinal problems. Improper lifting, long periods of sitting, emotional trauma, alcohol and other so called “normal” activities can interfere with normal spinal function. Because of the body’s adaptive abilities, many spinal problems get started without any associated symptoms. Like many diseases, early detection can prevent problems from becoming more serious. Patients who wait for obvious symptoms, especially after an accident or those who have a history of spinal-related problems, often require more visits and take longer to show improvement.

Are subluxations painful?

They can be, however the body can accommodate some spinal distortion without pain or other obvious symptoms. Damage to the spine is cumulative, so the degenerative effect of uncorrected spinal problems worsens with time. Generally, pain doesn’t result from this condition unless there is massive trauma or the body can no longer adapt. Ill health, fatigue and many other disorders can result long before “back pain” becomes obvious.

Will I need chiropractic care for the rest of my life?

That depends upon how long the patient wants to experience the benefits of chiropractic care. Some spinal problems, neglected from early childhood, may require a lifetime of supportive care for optimum spinal function. Chiropractic care can be a conservative form of long-term health management and prevention, like regular dental and eye examinations.

What’s the best adjustment technique?

A great deal of controversy surrounds this subject, with each technique having a sometimes vocal following within the profession. Each Doctor of Chiropractic has chosen several different techniques and has become highly adept at their delivery. Most chiropractic patients report their symptoms are relieved and better health is experienced after spinal biomechanics are improved, regardless of the adjusting technique used.

What is the sound the adjustment makes?

Not all adjustments make sounds. Nor can the presence of sound be an indication of the quality or effectiveness of the adjustment. Since bones don’t touch each other, the sound is created by quickly shifting the normal fluids and gases in a joint. When these fluids and trapped gases move in response to the spinal bones regaining a more desirable position, sounds are made. Similar sounds are made by popping your knuckles. Because dense bone transmits sound so easily, adjustments delivered near the head and ears can seem louder or more intense.

Do adjustments hurt?

While it might seem logical to assume that if a joint hurts, moving bones would cause more pain, the reverse is often true. An adjustment is often like removing the weight of a heavy box that has fallen on your toes. When the box is removed, there is often an instant feeling of relief. Most patients find the actual adjustment to be quite pleasant. Often there is an invigorating “aliveness” that is felt as the function and integrity of the spine is returned to a more normal state.

It is helpful for patients to be relaxed during the adjusting procedure. If the supporting muscles of the spine are tensed, it can make the job of repositioning spinal bones more difficult.

The few patients that indicate discomfort, often report feeling this way later in the day or the next morning after their first adjustment. They often describe a soreness in the muscles supporting the spine near the area where the adjustment was made. Correcting many long standing spinal conditions can require retraining and repatterning supporting muscles. Like the day after raking leaves, shoveling snow or other vigorous exercise, these supporting muscles can become tired. It takes time to strengthen them and become accustomed to supporting the spine in a more normal fashion.

Can the spinal bones be moved too much?

It’s highly unlikely. The accuracy of chiropractic adjustments and years of training and practice make chiropractic adjustments specific. Doctors of Chiropractic use the least amount of thrust necessary to restore normal biomechanics.

Every joint of the body has a range of motion through which it can move. There are generally two ways the joints of the spine malfunction that cause patients to investigate chiropractic. Either a spinal joint is stuck, “locked up,” fixated, out of position and not moving enough (hypomobility). The purpose of a chiropractic adjustment is to apply just the right amount of energy at the precise angle so the offending spinal joint can return to its proper function.

Can I adjust myself?

No. Certainly it is possible to make popping sounds by turning one’s head in a certain way or bending or twisting the body, yet, these are not adjustments. Chiropractic adjustments are specific procedures delivered to only the area(s) of the spine that are not moving properly.

Besides the risks of self-inflicted damage, patients who attempt to manipulate themselves often cause these joints to become too loose and hypermobile. The resulting damage to the ligaments and other supporting tissues can cause permanent problems. Even your doctor must look to another chiropractic doctor to be adjusted.

Why may I need more than one adjustment?

Chiropractic adjustments are designed to help restore a more normal motion and position of individual bones of the spine. It is common for these bones to return to their abnormal position after being adjusted.

This is due in part to changes in the muscles that support the spine. If there has been a long passage of time (months or years) since the event causing the loss of normal motion or position, supportive muscles and connective tissue are damaged. Muscles on one side of the spine can become overdeveloped while the other side of the spine weakens. This is often seen in patients whose jobs cause repetitive motion with one side of the body, like hammering nails, lifting and twisting in the same direction, or propping the telephone between the ear and shoulder.

Eventually these malfunctioning muscles are infiltrated with fibrosis, a form of scar tissue. This fibrotic tissue is a lot like the gristle in a cheap cut of meat. This scar tissue significantly alters muscle elasticity and muscle tone (myopathology), interfering with the muscles ability to assume proper support of the spine.

Interestingly, pain or other obvious symptoms may not be present to indicate these malfunctioning muscles. Yet, reduced ranges of motion, nervous system interferences and other problems may be occurring.

Note: Excerpts taken from Bill Esteb’s “What Every Chiropractic Health Assistant Should Know” pages 28 to 35.