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5 Reasons Not to Be Skeptical of Chiropractors

You've thought about seeing a chiropractor before, but have hesitated because you:

  • Heard it was "BS" or "quackery"
  • Thought that once you start going, you'll have to go for life
  • Were afraid of being adjusted
  • Thought they just won't be able to help
Let's first address the reality that all chiropractors are not the same. While "chiropractic" refers to the profession as a whole, what many people experience - from one chiropractor to the next - can be quite different. There are numerous techniques and specialization within chiropractic that enable chiropractors to do more than "just crack necks and backs".

In fact, chiropractors have the ability to successfully treat a number of common musculoskeletal problems. Below you will find five reasons why you shouldn't be so skeptical of chiropractors and why finding a great chiropractor can prove to be a priceless investment to your health and well being.

1. Solve joint and muscle pain without unnecessary medication or surgery

Let's illustrate the significance of this point with an all-too-common experience for many of us. You begin to experience joint (neck, back, shoulder, knee, etc.) pain seemingly for no reason at all. Your pain has just appeared and you are puzzled as to why.

What do must people do first?

Most commonly, they start in the medicine cabinet with common over-the-counter (OTC) medications like Tylenol, Motrin, Advil, or Aleve. They may ice the area or apply pain-relieving gels. Others may just give it time and play the waiting game to see if the pain goes away on its own. If OTCs, ice, pain-relieving gels or time don’t do the trick, then they pay a visit their primary care physician only to receive a script for either anti-inflamatories or muscle relaxers and a referral for an orthopedic consult. The orthopedist will likely perform a physical examination along with possibly ordering imaging studies such X-ray, CT scan, or MRI. Based on your examination and imaging results, one of two recommendations is often made - physical therapy or surgery.

Too often surgery can be recommended before more conservative approaches are given a chance. Disregarding the risks associated with surgery, what happens when the procedure fails? Surgery is not a great choice when pain is associated with a positive — often incidental — finding on an MRI. These incidental findings are well document and often times structural adaptations to functional problems.

When assessed properly by a trusted conservative musculoskeletal care specialist, whether a chiropractor or physical therapist, many muscle and joint problems can be resolved without the need for surgery.

Seek conservative care first. If you don't respond to care within 6 weeks, then it wish to consider more invasive procedures if they are indicated.

2. Manage complicated disorders

Remember when I said all chiropractors are different? It's true.

Just like the medical profession, there are many areas of specialty in chiropractic. Those who specialize as a sports injury & rehabilitation chiropractor (such as Dr. Gallagher) have undergone the traditional education on joint manipulation or adjustments. However, in addition to their core curriculum, sports injury & rehabilitation complete hundreds of hours in continuing education learning about exercise and sport-related injuries, manual therapy, and functional rehabilitation methods.

Chiropractors who utilize a sports injury & rehabilitation approach incorporate joint mobilization/manipulation, soft-tissue treatments, various manual therapies, and functional rehabilitation techniques to provide a gold standard of care in treatment for individuals with exercise and sport-related injuries. This combination of complementary approaches uniquely positions sports injury & rehabilitation chiropractors to manage complicated disorders that other specialists may have difficulty in treating.

3. Prevent future episodes of pain by changing function

Imagine a world where patients get the advise, education, and treatment they need. Imagine doctors who:
  • Make sense of what a patients says
  • Know exactly what a patient needs
  • Confidently provide gold standard advice and treatment interventions
This world is obtainable, but it must first begin with better quality, order and structure to our thinking patterns. One of the fundamental challenges with healthcare is that the human body is amazingly complex and adaptive. In response to the complex nature of dealing with the human body, doctors and therapists may have the tendency to routinely provide services that serve their own skill set better than appropriately addressing the patient’s needs. Often times this leaves both the patient frustrated with lack of response to care.

As ac chiropractor it's my job to educate my patients and help them problem solve. I have to help them understand not just what their problem is, but more importantly why it started.

In understanding why their problem started, we aim to change the function of their body. If patients don't commit to changing their behaviors and habits that got them into pain in the first place, then how can they expect to find a solution to their problem?

4. Enjoy a healthier lifestyle

As stated in the point above, chiropractors should be educators. As educators, we teach individuals how to live their best life and do so in a model that promotes our patients's have a sense of independence, capable of making informed, intelligent lifestyle choices.

Regardless of specialization, a universal truth to chiropractors is that they generally practice a “holistic” approach to patient treatment. Meaning chiropractors view the individual as a whole, identifying and focusing on more than just physical symptoms such as pain. By employing a combination of manual treatments, ergonomics, postural education, exercise prescription, nutritional interventions, lifestyle advice, and other strategies (practitioner dependent), chiropractic is more than just cracking backs to reduce pain. Chiropractors want their patients to enjoy a healthier lifestyle.

5. Enhanced performance

We put our bodies through the ringer daily (some more intensely then others). Periodic treatment from a qualified chiropractor will help keep your body running like a fine-tuned machine, improving your ability to perform and progress in your training programs by optimizing the body’s ability to function at it’s best.

How?

By combining chiropractic with functional rehabilitation and strength and conditioning principles.

It's exactly why we do what we do at Gallagher Performance.

Almost every case involving muscle or joint pain requires some level of strengthening exercise progression and education. We will make sure you are doing the most appropriate exercises for your situation and your level of ability. By clearly educating each patient on why they are performing their prescribed exercises or stretches, the focus becomes about patient empowerment and providing them with a sense of what they can do for themselves to keep pain from returning.

Regardless of the number of treatments you receive, the goal remains the same – to make a lasting change in your body through posture and movement re-education.

Wrapping Up

There are many great reasons to visit a chiropractor. Every chiropractor is different, so just because one didn’t work for you it doesn't mean that all chiropractors are useless. You just haven't found the right one for the job and that can prove to be a difficult task. Yes there are some bad ones out there (like any profession), but there are plenty of good ones that can be trusted.

No matter who you see, keep in mind that it is critically important that you understand your problem, your treatment plan, your expectations for recovery, and how to manage your problem during as well as after treatment.

At Gallagher Performance it is our intent to get you back to what you love doing and as quickly as possible. We create clarity by helping you understand your problem, why it behaves they way it does, and apply the right tool to make a lasting change in the way your body functions.

 
More related reading:

https://gallagherperformance.com/dynamic-duo-chiropractic-dns/

https://gallagherperformance.com/busting-chiropractic-myths-misconceptions/

https://gallagherperformance.com/are-you-promoting-independence/

 
https://gallagherperformance.com/before-you-go-to-a-chiropractor-read-this-first/

https://gallagherperformance.com/when-should-i-see-chiropractor/

What Makes a Sports Rehabilitation Chiropractor?

Chiropractors have traditionally been known for treating patients suffering from acute or chronic pain related to the neck and back. Chiropractic treatment that involves spinal manipulation is regarded as a standard for treatment of cervical spine (neck) pain and acute lower back pain. Not only is it safe, but it has also shown tremendous health benefits for improving range of motion and reducing pain in patients during the rehabilitation process.

However, chiropractors are also capable of helping patients rehab and recover from injuries suffered in an accident or sports. The role chiropractors play in rehabilitation and sports medicine has grown substantially in the last 10 years. Almost all professional sports teams in North America utilize chiropractic services because of the recognition chiropractors has received in their ability to help athletes perform at their highest possible level. Apart from this, many rehabilitation clinics include chiropractic care as part of the services offered to patients.

Consider for a moment that the Managing Director for Sports Medicine for the United States Olympic Committee is Dr. Bill Moreau....a chiropractor!

Holding a position as a sports rehabilitation chiropractor is growing in popularity and, just like an athlete, a sports rehabilitation chiropractor must possess many tools or skills to be both effective and efficient in treating patients who are active and athletic.

Below is a list out 5 critical elements you should find when looking for a chiropractor who will be capable of treating you from a rehabilitation or sports injury perspective. Consider that these are not simply just my opinion, but rather this list has been compiled based on the insight of several of my colleagues and mentors, their clinical experience, as well as my own clinical experience.

  1. Palpation & Adjusting Skills. The heart of chiropractic is the ability to assess, diagnose and treat (heal) with our hands. Our hands truly are the greatest diagnostic tool available to us. I've had people say to me that what I do as a chiropractor is "easy" and that "anyone can adjust". There is some truth to that. Adjusting is easy. You can make a joint "pop" real easy. The challenging part is palpation and finding exactly what joint needs corrected, what motions are limited, and determine exactly how you will adjust the dysfunctional joint(s). Palpation is a skill and takes years to refine. You would be wise to find a sports rehabilitation chiropractor who is very skilled with their hands and capable of determining appropriate application of chiropractic adjustments.
  2. Functional Approach to Evaluation and Treatment. The use of functional evaluations is another critical skill of the sports rehabilitation chiropractor. The ability to assess movement and identify hidden causes to injury and pain become invaluable to helping patients find relief and optimize performance. If your chiropractor isn't taking time to assess your movement and helping identify how it may be playing a role in your pain or injury, you may be miss reasons why your pain is recurrent or why you just can't seem to get better.
  3. Functional Rehabilitation. A sports rehabilitation chiropractor should incorporate rehabilitation and active care into your treatment plan. Almost every case involving muscle or joint pain requires some level of strengthening exercise progression and education. The functional approach to rehabilitation includes identifying joint dysfunction, muscular imbalances, trigger points, and faulty movement patterns. These are often the hidden causes of injury. Observing how a patient moves and functions allows us to identify improper movement patterns that become contributors to pain and poor sport performance. By placing an emphasis on strategies to improve movement and function, functional rehabilitation is effective in improving qualities of endurance, strength, stability, balance, agility, coordination, and body awareness.
  4. Dynamic Neuromuscular Stabilization (DNS) and Vojta Therapy. DNS and Vojta Therapy are advanced approaches used to not only treat a variety of neuromuscular conditions but also used by athletes worldwide to elevate performance. By applying principles and techniques rooted in the study of child development, DNS and Vojta Therapy aim to improve and restore the activation ideal movement patterns. These techniques are used to promote the ideal postures, movements, and degree of body awareness that is essential not only to athleticism, but to also treating the underlying causes of several pain syndromes that are commonly treated by sports rehabilitation chiropractors.
  5. Myofascial Release & Manual Therapy Techniques. Myofascial release targets adhesions that develop either within a single muscle or between adjacent muscles and other forms of connective tissue such as fascia, tendons and ligaments. Sports rehabilitation chiropractors commonly use myofascial release & manual therapy techniques such as cross friction massage, active release, instrument assisted soft tissue mobilization, muscle activation, PIR, and PNF. Many athletes and patients experience accumulative or overuse trauma (ex: plantar fasciitis due to running or carpal tunnel syndrome due to prolonged computer/desk work). The goal becomes to work a muscle to remove adhesions and restore neuromuscular function to decrease pain while increasing range of motion, strength, and coordination of movement.
 
More related reading:

https://gallagherperformance.com/prevent-re-injury-integrated-training-rehabilitation/

https://gallagherperformance.com/before-you-go-to-a-chiropractor-read-this-first/

https://gallagherperformance.com/fascia_muscular-adhesions_how_they_relate-_to_pain_and_overuse_injuries/

3 Exercises for Athletic & Mobile Hips

Please watch: https://www.youtube.com/watch?v=RRZL6Y6gtZI

In this video, we discuss exercises aimed at training proper hip dissociation - an often overlooked and undertrained function of the hips. Poor hip dissociation is commonly a reason for pain and poor performance.

Some key points discussed in this video:

  • What hip dissociation means. Hip dissociation is the ability to independently move the hips without compensations from the rest of the body.
  • Why poor hip dissociation and compensations are often a reason for low back pain, hip pain, and even pain within the knees and feet/ankles.
  • How poor hip dissociation is related to increased risk of injury.
  • Why the inability to move properly though the hips limits athletic potential and will negatively impact your performance.
  • And most importantly - what to do to improve your ability to move your hips independently with simple exercises that you can perform at home, at the gym, or basically anywhere with just a few simple tools.

Thanks for watching and as always, let us know your questions or comments.

More related reading:

https://www.gallagherperformance.com/blog/advanced-training-for-elite-athletes

https://www.gallagherperformance.com/blog/2-exercises-for-groin-and-knee-pain

https://www.gallagherperformance.com/blog/the-solution-to-long-term-improvement-of-back-pain

https://www.gallagherperformance.com/blog/pistol-squat-or-skater-squat-which-is-better

https://www.gallagherperformance.com/blog/how-dns-solves-pain-and-improves-performance

https://www.gallagherperformance.com/blog/a-powerful-innovative-approach-to-improving-how-the-body-functions

When Should I See A Chiropractor?

[embed]https://www.youtube.com/watch?v=1aaE3CIouTU[/embed]

In this video we discuss some important points to consider when to see chiropractor or why to see a chiropractor, especially one that has a sports injury and rehab specialization and practices in a functional movement model.

Some points to consider:

  • How important is your health to you? Health is an investment and requires a proactive approach rather than be reactive.
  • Do you want to get out in front of rather muscle tightness and joint range of motion/mobility restrictions before they get more serious or painful?
  • Most people are unsure of who to see for back pain and joint pain, even muscle tightness. They may see their PCP, but not receive the answers or solutions they were hoping for. They are looking for a provider they can trust.
  • Those that have a positive experience with a chiropractor or have one they trust, turn to them when they start to "feel off" or they feel their body is moving as it normally does or they start to feel pain.
  • Ideally, chiropractors who have a specialization in functional rehab, sports injury, and movement are the experts you should see for the most musculoskeletal conditions that we commonly deal with.
  • When, or if, you see a chiropractor is ultimately your choice and one that can prove to be beneficial and a worth while investment.
 
More related reading:

https://gallagherperformance.com/the-importance-of-functional-evaluation/

https://gallagherperformance.com/low_back_pain_treatments_that_just_wont_help/

https://gallagherperformance.com/solving-pain-influence-czech-rehabilitation-techniques/

https://gallagherperformance.com/powerful-innovative-approach-improving-body-functions/

https://gallagherperformance.com/effective-treatment-shoulder-pain/

https://gallagherperformance.com/solving-movement-problems-entertainment-vs-effective/

Chiropractic, Rehab & DNS Treatment

https://www.youtube.com/watch?v=ceIcoreYu8o&t=4s

This video illustrates how we integrate chiropractic, rehabilitation and dynamic neuromuscular stabilization (DNS) into patient treatment. For the purposes of this video, these techniques were used to speed up post-workout recovery, ensure structural balance and improve how the body functions. Similar to fine-tuning a race car, the human body can benefit tremendously from fine-tuning to keep body prepared for high performance.

Key take home points:

  • Treatment is directed at patient-specific goals and outcomes. There are different levels of care that may need, ranging from symptomatic (i.e. painful conditions) to more performance-based therapy or fine-tuning.
  • Chiropractic manipulative therapy (i.e. adjusting) was not filmed but utilized for the spine and hips.
  • Soft-tissue work was done manually and instrument-assisted to mobilize muscle and connective tissue to improve recovery.
  • Dynamic neuromuscular stabilization (DNS) was used to fine-tune motor patterns and muscular activation. Proper muscular activation and stabilization function of muscles helps to ensure proper muscular coordination while minimizing stress on the joints.
  • This all adds up to optimizing performance while keeping the body as healthy as possible.
More related reading:

https://gallagherperformance.com/fascia_muscular-adhesions_how_they_relate-_to_pain_and_overuse_injuries/

https://gallagherperformance.com/dynamic-neuromuscular-stabilization-advancing-therapy-performance/

https://gallagherperformance.com/powerful-innovative-approach-improving-body-functions/

https://gallagherperformance.com/solving-pain-influence-czech-rehabilitation-techniques/

Solving Movement Problems: Entertainment vs Effective

The value of movement is undeniable. But the industry of movement has become a bit of a circus.

I have seen some doctors, therapists, and trainers using the label of “movement provider” lately and while I’m not quite sure what that means, I can speculate as to what they are trying to communicate. Yes there are many universal truths when it comes to human movement, health and performance, but the true pioneers of movement are few. Social media has created a tool for spreading quality information and education. I understand leveraging social media can become incredibly valuable to a business. However, when it comes to movement, exercise, and fitness, social media has become more entertainment than substance.

It’s become a sea one can easily become lost in, caught up in the wow factor of challenging movement drills and variations while others are less likely to engage with more of a simplistic focus. Movement providers from licensed healthcare professionals to run-of-the-mill trainers pop up all over the worldwide web and social media sending messages that may seem conflicting. There’s more information than ever yet many people searching for solutions are more confused than ever. The industry seems to thrive on confusion more than any other. Confusion creates dependence and the industry loves confusion because someone has to have the answers. They want to build an audience.

But are you building an audience based on your information being entertaining or effective?

Sadly it seems that he who yells the loudest, gets the most followers and gets the most attention must have the answers right? I mean they do have 62,000 followers, they must know their stuff? Not necessarily. Entertaining may score you points on social media, but effective scores you points with patients and clients. Yes there are extremely effective movement experts with massive followings, but I doubt they exist in the real world in the masses like they do on social media. If you’re chasing entertainment yet don’t know how to effectively get someone from point A to point B, it’s all smoke and mirrors.

While overhead lateral rotational lunges with hanging bands may score thousands of views on Instagram, does it have any significant relevance? From a clinical perspective, those who treat patients regularly know the majority of what entertains on social media has little transfer to patient care. The reality is that the majority of patients with musculoskeletal issues have lost the ability to perform basic human movement. There is a reason why the lumbar disc patient is a disc patient. Most of them are deconditioned and lack adequate strength, motor control, mechanics and proprioceptive awareness not only in their low back, but likely in their feet and hips as well. They need the basics. The fundamentals. Problem is the basics aren’t sexy and don’t get you likes or follows on social media. Advanced progressions of basic human movements make up 90% of what’s on social media, yet in the office 90% of our patients only need the basics. The same can be said for the population that works with a personal trainer or strength & conditioning professional. They often need the basics and just building off them.

The majority of patients and clients need to master the basics without the need of external resistance. For most, simply working against the resistance of their own bodyweight is sufficient. Problem is, if you take away the bands, the barbells, the kettlebells, the dumbells, the cables and sliders from some doctors, therapists, and trainers, they will struggle to think of exercise progressions/regressions to yield better movement by simply using one’s own body. The really good movement providers can achieve improvement without the need of equipment. This may be incredibly simplistic and not score big points on Instagram or Facebook, but you’d be surprised at how challenging the basics and their variations will be. So if you are using social media as your reference library on how to rehab your own injury, rehab a patient, or create a workout for your next training client, I would be incredibly cautious.

Sure the squat may be basic, but how many are actually capable of a proper bodyweight squat? The answer may surprise you. Yet how many are capable of a proper squat before heavier and heavier loads are introduced or they try an overhead, band-resisted, anti-rotational squat? I’m gonna bet not many. If you’re capable of performing an overhead, band-resisted, anti-rotational squat with ideal form, great. You’re part of less than 1% of the population that is capable. The other 99% need more of the basics and arguably may never need to do that advanced of an exercise. Most won’t even have the desire as they won’t see the relevance.

The basics may be boring, but they are incredibly effective. We all need them. The basics serve as the foundation. What kind of basics are we talking about? If I was to build a short list of basics to ask yourself, it would look something like this:

  • Are you able to breathe without excessive chest or shoulder movement?
  • Are you able to balance on one-leg for at least 60 seconds?
  • Are you able to balance on one-leg (eyes closed) for at least 30 seconds?
  • Are you able to hold a plank for at least 60 seconds?
  • Are you able to hold a side plank for at least 30 seconds on each side?
  • Are you able to perform a lunge with ideal form and control?
  • Are you able to perform a squat with ideal form and control?
  • Are you able to raise your arms overhead with ideal form and control?
  • Are any of these movements painful?
  • Are any of these movements difficult to perform due to tightness or restricted range of motion?
If you have answered, “Yes”, to one or more of these questions, you are lacking the basics. Lacking of these basics has been correlated with increased incidence of back pain, neck pain, hip pain, knee pain, foot/ankle pain as well as reduced athletic ability. And believe it or not, no equipment is needed to help someone achieve these basic standards. All you need is your body and the ground. This is what the really good movement providers understand and it’s all they need to work with.

Why are the basics so important?

People want to exercise to get in shape and improve their health yet most of us aren’t in shape to exercise. When we loose the basics – the fundamentals to human movement – more complex or more demanding activities will take a toll on our body. If the basics are challenging yet you wonder why you have knee pain after running or why your back kills after leg day, you now have some possible answers. Our body will eventually pay a price when higher and higher demands are placed on an inadequate foundation. Make a point to master the basics and never loose them. Your movement provider should be capable of helping you achieve the basics. In doing so you’ll realize a quality of health and physical ability that may have previously seemed impossible to achieve.

More related reading:

https://gallagherperformance.com/prevent-re-injury-integrated-training-rehabilitation/

The Best Exercise

Often I am asked, "What is the best exercise?" or "What is the best type of exercise?"

To answer that question, let's set the stage of what exercise really is - movement.

Teaching patients not only about chiropractic but how to move better all comes back to function and understanding how all the intricate parts of our body make up a highly complex movement system. But here are some key points to understand:

1) Function determines movement. Chiropractic and rehabilitation seek to restore proper movement function. Functional examinations determine WHY movement is painful or problematic. Utilizing the functional model of movement helps to determine who is at risk for injury, which movement patterns or body regions are dysfunctional, and what treatment or exercise strategy is needed to address those issues in combination with chiropractic/manual therapy methods.

2) Function is critical to movement and movement is critical to our health. Our bodies are designed to move. The growing list of chronic diseases and immense burden on the healthcare system associated with an overly sedentary society clearly demonstrates one conclusion – we need to move more.

3) Movement is exercise and exercise is medicine. The medicinal benefits of exercise are numerous. There is a reason why exercise and proper nutrition is being labeled as "lifestyle medicine".

For those who wish to start an exercise program, the public is told to “see your doctor” before starting an exercise program. Most patients are cleared to exercise after history and vitals are considered “normal”. Sure your organ system may be healthy enough for exercise, but nothing is mentioned about seeing a doctor to determine how well you move or how well your muscles and joints are functioning. Why wouldn’t this be considered? Why wouldn’t seeing a “movement specialist” before considering an exercise program be equally advocated?

So, in typical fashion, most of us embark on an exercise program believing we will be healthier for it. We are told to exercise and practice sound nutritional habits, but what do most of us do for exercise? How about go to the gym, sit on a machine and pull or push weights while hunched over with lousy posture. Or, after sitting for 40-60 hours per week, let’s go out and put staggering amounts of stress on our bodies through recreational activities like weekend skiing, Thursday night softball league, rec league hockey, golf, or basketball.

There's nothing wrong with those activity choices, yet what happens when pain or injury come into the picture? Most of blame the exercise or blame the activity when, in most cases, we should be blaming our own body.

When it comes to pain and injury, the reality is what our body is capable of performing cannot meet the demands we are placing upon it. The overall function of our body must be ready to handle a specific task or movement otherwise problems will eventually arise. Problems that may range from mild (muscular tightness/stiffness, joint aches) to more severe (pain and/or injury).

The beauty of the functional model is that those regions that have mechanical sensitivity (pain) and/or abnormal motor control can be identified and solutions are discovered. Exposing these compensations and correcting them plays a huge role in not only getting patients out of pain, but improving how their body functions.

Why is changing how our body functions so important?
While pain is why most people seek care, the reality is if we only change pain and fail to change how a patient’s body functions, we have our reason why so many patients relapse. But if we get them out of pain and improve how their body functions then we are doing what we need to do to keep the pain from returning.

Whether we need mobility (improved range of motion) or stability (motor control), that can be addressed with a proper functional examination through movement. After a functional examination, it just makes sense to reinforce functional movement patterns with specialized exercise to build a foundation of proper movement coordination, strength and skill. Now we are beginning to get somewhere to build form, function and fitness. Now we are getting people to move better through better exercise!

Correct movement is the best exercise
Once people learn better movement, how to project their joints and what exercises they should be performing, their bodies are much healthier for it. There is less risk of injury and most will ultimately start feeling better instantly. Rather than beating their bodies up due to poor movement, movement becomes healing. Correct exercise is the answer. Correct movement is what we need to get out of pain, feel capable and feel healthy.

That’s the essence of the functional model. It’s about promoting health and healing through therapy, movement, and patient-centered education. That’s what we pride ourselves on at Gallagher Performance as our model is truly unique in the services we provide and the results we achieve.

More related reading:

https://gallagherperformance.com/prevent-re-injury-integrated-training-rehabilitation/

https://gallagherperformance.com/powerful-innovative-approach-improving-body-functions/

https://gallagherperformance.com/do-you-really-need-more-mobility/

https://gallagherperformance.com/the-truth-about-functional-exercise/

Post-Surgical Rehab Success is All About Team

Recently, Shannon Perrine of WTAE Channel 4 News in Pittsburgh featured a story on a patient of ours, Karla White. The focus of the story being Karla's same-day hip replacement surgery. It was a short, yet informative piece on the work of her surgeon and the rehabilitative process with special attention to the factors that played a role in a very successful outcome. If you have not seen the story, head to our Facebook page and check it out. All of our social media links are here on the website. You'll find them at the top of the page.

After the story aired yesterday, I had a number of thoughts that came to mind. Primarily these thoughts centered around how many medical professionals and the general public have a misunderstanding of the training and qualifications of chiropractors and strength & conditioning specialists. Especially as they relate to rehab, be it from injury or surgery. Many may find it unconventional and, at times, silly that one seeks out the professional help of a chiropractor or strength coach for the oversight of their rehabilitation.

Traditionally, once a patient is ready to begin post-surgical rehab, this process is guided by a physical therapist. It’s conventional thought and accepted practice. You have surgery, then you go to physical therapy.

That said, there are post-surgical patients who will seek out a chiropractic rehabilitation specialist to manage their rehabilitation. And, depending upon the setting and patient, strength & conditioning specialists may be involved as well.

Now there may be a few thoughts running through your mind right now. Maybe thoughts such as:

“Wait….chiropractors aren’t qualified to do post-surgical rehab!”
“Why would you use a strength & conditioning specialist for a rehab patient? Those are only for athletes!”
This news story has opened up the opportunity to help educate, so let’s address these questions or concerns.

Are chiropractors qualified for post-surgical rehab?
The reality is, when patients seek a provider for their post-surgical rehab, they may choose to seek a professional who is not a physical therapist. Some may not have the flexibility to make their own decision, but for those patients are looking for the best person for the job and they will exercise their right to make that decision. Regardless of title (PT or DC), patients must be in the hands of a provider who has the professional training and expertise to handle their rehabilitation appropriately. Providers must be competent and efficient for the sake of minimizing post-surgical complications and improving outcomes.

I’ve highlighted this before in previous writings, but my residency truly provided professional training very few chiropractors ever receive. During my 3+ year residency, I managed or co-managed numerous spinal, shoulder, hand/wrist, hip, knee, and foot/ankle post-surgical rehabilitation programs. Our department at Palmer College of Chiropractic worked with local orthopedic and neuro surgeons to co-manage routine as well as highly complicated surgical cases within the Quad City area. Meaning, we saw everything from athletic injuries to total joint replacements.

I don’t stress this to simply pump my own tires, but to convey to our audience that I’m not new to post-surgical rehabilitation and there are chiropractors out there that have similar training and expertise as well. We don’t exist on the level of physical therapists nor are we claiming to be physical therapists. Physical therapists have their own unique training and skill set. The ones I know do outstanding work for their patients.

The point I’m trying to make is that it is possible for chiropractors to have a background in functional and post-surgical rehabilitation. These chiropractic rehabilitation specialists are qualified and are capable of successful post-surgical rehab outcomes.

What is the value of Strength & Conditioning during post-surgical rehab?
For all those that want to be evidence-based, exercise and strength training literally helps more musculoskeletal conditions that all other treatments. The same can be said of post-surgical rehab as it is all about regaining range of motion, strength, and functional capacity. If you have the privilege of having a knowledgeable and qualified strength & conditioning specialist in your corner, they will provide enormous value to the post-surgical recovery process.

Yes, the involvement of strength coaches may be more commonly used in the athletic world, within the collegiate, professional and international ranks. But, when available in the private sector, they add an immense advantage as the rehabilitative process is very time sensitive and it’s critically important no time is wasted. The more quickly a post-surgical patient can regain adequate strength and movement quality through gradual exposure to the functional demands of strength training, the more quickly they are able to return to their activities of daily living, job, or sport with confidence and minimal complication.

Strength coaches are experts in what almost all musculoskeletal conditions will benefit from: exercise and strength training. Keep in mind, they must have the appropriate qualifications. Not all strength coaches are created equal and those that are capable of being involved with a post-surgical patient are rare. I can't stress that enough. These professionals understand their role and the best results are seen when they work together with the rehabilitation specialist to ensure ideal outcomes for the patient.

Post-Surgical Rehab Success is All About Team
The success of the post-surgical rehab program is not solely dependent upon any one specific individual involved in the process. Successful post-surgical outcomes take on a team dynamic. In this case, the surgeon, rehabilitation specialist, strength & conditioning specialist, and patient all had critical roles.

The Surgeon
For Karla, she had a tremendous orthopedic surgeon in Dr. Julius Huebner. Due to a congenital condition and progressively worsening degenerative joint changes to the left hip, Karla underwent direct anterior approach total hip replacement in late May 2016. This surgical approach is essentially a “surgical strike” as described by Dr. Huebner in the video. His surgical procedure resulted in no damage to adjacent tissues and structures. The procedure was a precise as you can get, enabling same-day hip replacement surgery and a faster recovery.

The Rehabilitation and Strength & Conditioning Specialists
In preparation for her surgery, she worked with the team at Gallagher Performance during the months prior to her surgery to improve her post-surgical rehab outcomes. Her pre-surgery rehab program enabled Karla to remain as functional as possible during that time. Pre-surgical rehab programs are never easy and quite challenging. However, Karla is a tremendous patient who demonstrated nothing but commitment and patience, knowing that the work she did prior to surgery meant having that much less to do post-surgery.

Likewise, during the course of her post-surgical rehab program, Karla worked one-on-one with either myself or Ryan. I managed the early phases of her rehabilitation recovery, implementing manual therapy and exercise. This continued as she progressed to more strength training focus in her rehab. That's when Head Performance Coach, Ryan Gallagher, designed and implemented her strength & conditioning program. The collaborative focus was on developing ideal movement patterns to spare her joints, thus improving the health and relative function of her legs, hips and spine. Exercise selection and progressions were based on post-surgical guidelines, tolerances, and functional capacity all while ensuring adequate strength and movement control were demonstrated.

The Patient
As for Karla, she was the ideal patient. She was compliant and motivated throughout the entire process. Karla loves to be active and workout, which only added to her motivation. A motivated patient is so refreshing to work with for countless reasons. The rehabilitative process can be frustrating at times, with obstacles and ups-and-down marking the road. As challenging as rehab can be physically, rehab can be even more challenging mentally. To her credit, Karla was always willing to work, even when she was frustrated or progress was slow. She always worked hard and focused on the little details. It’s because of her attitude that she demonstrated and her drive to regain the quality of life she desired that she is where she is today.

Summing Up
The combined team effort was the key to the success of this post-surgical rehab story. This theme must be present to ensure a patient has the outcomes they desire. It’s a privilege to be involved, providing our services to complement the team effort required during the post-surgical process as we recognize our role in the rehabilitative process. We thank Dr. Huebner for his medical expertise, Karla for being outstanding to work with, and WTAE’s Shannon Perrine for her excellent coverage of the story.

At Gallagher Performance, our focus is on developing the resilience of our clients and patients. We are committed to utilizing cutting-edge, patient-focused progressions to help every individual we work with not only achieve but also exceed their goals. With our extensive training and knowledge in chiropractic, manual therapy, sports injuries, rehabilitation, and performance-based training, we work with all individuals who are interested in living healthy, active, and pain-free lives.

More related reading:

https://gallagherperformance.com/3-simple-steps-to-reduce-your-risk-of-sports-injuries/

Solving Pain: The Influence of Czech Rehabilitation Techniques

As physical medicine becomes increasingly specialized, chiropractors and therapists must remain educated and capable of offering the highest quality in their professional services, knowledge, and examination abilities. Regardless of whether you are entrusted with the care of an athlete, chronic pain syndrome patient, or post-surgical rehabilitation, we have the job of reaching successful outcomes for each individual we encounter.

We must find their real source of pain, their true sources of dysfunction. Even if it means identifying sources others do not know exist.

We should be able to perform orthopedic, neurological, and also functional assessment to not only diagnosis problems, but also determine how to prevent any future problems.

One such country that has encouraged this level of thinking among it’s doctors and therapists is the Czech Republic.

The emergence of Czech ideas within the United States has grown over the last 15-20 years. My mentor and residency director, Dave Juehring, DC, DACRB, CSCS and director of the Sports Injury & Rehabilitation Department at Palmer College of Chiropractic in Davenport, IA has one of the most extensive backgrounds in Czech approaches to manual medicine and rehabilitation within the United States. In my opinion, there is no brighter mind in the chiropractic rehabilitation world. He may not be well known by industry standards, but those that know him know his knowledge and skill set is second to none.

The knowledge and expertise he is able to share with his residents, rehabilitation interns, and students has a profound impact on our professional development.

Among many lessons, he really has helped us understand the approach taken within the Czech School of Manual Medicine as well as the Prague Rehabilitation School. The intent of this article is to share some of this knowledge and highlight how these Czech methods can improve rehabilitation outcomes and athletic performance.

Alternative Thinking
The Czech School of Manual Medicine truly has revolutionized the management of musculoskeletal pain. Early in the 1950s, neurologists by the names Vladimir Janda, Karel Lewit, and Vaclav Vojta took a special interest in the rehabilitation of the motor (aka movement) system. As western medicine became progressively more technologically driven, Janda and Lewit focused on the value of manual approaches such as chiropractic, joint mobilizations, and neuromuscular rehab techniques, such as PIR (post isometric relaxation) as critical pieces of the rehabilitation plan. Janda was instrumental in the assessment of muscle imbalances, Lewit’s in joint dysfunctional. Vojta was instrumental in the discovery of global reflex locomotion patterns.

Collectively, their research focused on joint dysfunction, muscle imbalance, and the assessment of faulty movement patterns.

These concepts became components of identifying “Functional Pathology of the Motor System”. In other words, identifying why someone has developed pain or a movement related problem. In contrast to traditional medicine, which had a growing emphasis on medical imaging (X-rays, CT scans, MRIs) to identify structural pathology as the cause of pain.

Developing Ideas and Techniques
The work of Janda, Lewit, and Vojta influenced the work of Pavel Kolar and his work now represents a very innovative and powerful approach to how the central nervous system not only controls but expresses movement. This approach is known as Dynamic Neuromuscular Stabilization (DNS). The application of DNS has value from the neurologically impaired child to adults dealing with musculoskeletal pain to elite athletes. Kolar’s knowledge and skill set has landed him jobs with the Czech national teams in soccer, hockey, and tennis.

DNS has become highly effective in speeding recovery from injury, rehabilitate the body’s function as a unit, and enhance performance. Even the Czech President relies on his unique skill set. Kolar has worked with some of the world's best athletes, such as Jaromir Jagr, Roger Federer, and Novak Djokovic to name a few.

Thanks to the influence of these Czech clinicians, we are now able to look for predictable patterns of dysfunction within the human body and correlate them with pain or injury. It is in the Czech model we are able to piece together the clinical relevance of local, segmental joint treatments (mobilizations, manipulation), muscular imbalances, and central nervous system coordination of movement to optimize how the body functions and performs.

Read more on DNS here:

Dynamic Neuromuscular Stabilization: Advancing Therapy & Performance
The Hidden Causes of Sports Injury
https://gallagherperformance.com/chiropractic-rehab-dns-treatment/

https://gallagherperformance.com/sports-chiropractic-rehabilitation-massage-therapy/

Understanding Concussions and How Chiropractors Can Help

In light of recent news from the Pittsburgh Penguins regarding Sidney Crosby sustaining another concussion during practice last Friday, the hockey community is a buzz. Crosby’s concussion history is well documented of recent, having sustained three in less than six years. Discussions and speculations of what this means for Crosby's season, and even career, are populating the Internet and sports talk shows.

Despite the advances in sports medicine as it relates to concussion diagnosis, management, and return to play guidelines, concussions remain a challenging condition for all involved.

The reality is concussions are truly challenging. Despite measures to "prevent concussions", concussions are not preventable. There is no such thing as concussion prevention. There is no single piece of equipment, be it a helmet or mouth guard, that is capable of preventing a concussion. Rather than prevention, the focus is on minimizing concussion rates through proper identification, management, and education.

Consider that within the United States, there are over 300,000 sport-related concussions per year and research suggests concussion rates are on the rise. If your child is in contact sports, there’s a risk of concussion. Thus making this is an extremely relevant conversation and one that shouldn't be taken lightly. That said, the goal of this article is to offer insights into what a concussion is, how they should be managed, and the chiropractors potential role in the process.

What is a concussion?
A concussion is a traumatic brain injury defined as a short-lived loss of brain function due to trauma that resolves spontaneously. With a concussion, there is no structural damage to the brain. Simply put, only brain function is altered.

Encased within the the skull, the brain floats in a pool of fluid, known as cerebrospinal fluid. These protections allow the brain to withstand many of the minor injuries that occur in day-to-day life. However, if there is sufficient force to cause the brain to bounce against the bones of the skull, then there is potential for injury. It is the impact of the brain against the inside of the skull that cause the brain to be injured and interrupt its function. This impact is often due to rapid acceleration and deceleration movements of the head and neck. Rapid acceleration and deceleration of the head and neck can be created from a direct blow to the head or from impact that results in whiplash injury common in motor vehicle accidents and falls.

How are concussions diagnosed and treated?
First and foremost, anyone suspected of having a brain injury should seek evaluation by a neurologist trained in concussion evaluation.

The signs and symptoms of concussion may be obvious or very subtle. Most concussions are sustained without the individual losing consciousness or "blacking out". In several cases, the individual may not be aware they have sustained a concussion or may not connect their symptoms with a head injury. Complicating the picture is the fact that some individuals may have delayed onset of their symptoms, not presenting with concussion symptoms for several hours or days after the initial injury.

Typical symptoms of concussion include:

  • Headache
  • Difficulty concentrating or feeling “foggy”
  • Poor recall or memory of recent events
  • Changes in mood or personality
  • Slower reaction times
  • Dizziness, lightheadedness
  • Nausea or vomiting
  • Low tolerance of bright lights or loud sounds
  • Irritability
  • Changes in sleep patterns, such as being unable to sleep or sleeping more
 
In some cases, chiropractors can be the first point of access for individuals who recently sustained a head or neck injury, such as those occurring in sports, car accident or fall. Chiropractors, especially ones who are certified by the American Chiropractic Rehabilitation Board, regularly manage athletes who suffer sports injuries, such as concussions, and are trained in proper diagnosis and understand the importance of referral for additional medical evaluation. Gallagher Performance offers such quality in their chiropractic services and has been part of the co-managment team in a number of concussion cases.

An effective tool chiropractors may use to assess the severity of a concussion is called the Sport Concussion Assessment Tool 2 (SCAT2). The SCAT2 is used to evaluate, assess, and manage concussions in athletes 10 years and older with the end goal of safely returning the athlete back to the sport.

How are concussions treated and what is the Chiropractors role?
After evaluation, rest is the best treatment. Depending on severity, most symptoms resolve relatively quickly while treatment is directed at symptom control for headaches, nausea, dizziness, and sleep problems. Rest does not simply mean physical rest. Brain rest is equally important as physical rest. Exposure to television, computers, and smartphones and other devices can stimulate the brain and aggravate symptoms. Limiting use of those devices may be helpful in allowing the brain to recover more quickly. Brain rest may also involve student-athletes being held out of the classroom and encouraged not to read, study, or taking exams as this mental effort can aggravate symptoms and possibly delay healing.

When it comes to management and, for athletes, return to play guidelines, often a team of medical professionals are involved. Chiropractors may find themselves as part of this co-management team.

Chiropractors may not be the first medical professional you imagine when it comes to concussion management and treatment, but sport and rehabilitation chiropractors are trained to support the patient during the recovery process. Largely this is due to their focus on treating spinal joint dysfunction present in the head or neck, myofascial techniques to restore muscular and connective tissue function, and sensory-motor based exercise protocols to restore ideal neuromuscular function. For further consideration, two recent literature reviews outlined how chiropractors can effectively manage athletes with concussions (1,2).

Ultimately, the brain will recover at it’s own pace. For athletes, return to play guidelines are established to ensure they are safe to return to sport competition. This involves the close observation of the athlete to ensure no symptoms are present during gradual exposure to increased cardiovascular demands all the way to more intensive and sport-specific measures.

Dear Patient, Be Patient
While 80 - 90% of individuals who suffer a concussion will recover within 7 - 10 days, some will experience symptoms for weeks or months. The length of recovery is not necessarily related to the extent of the initial injury.

Employers or school officials should be informed of the concussion diagnosis and aware of potential issues of poor performance due to difficulty with concentration and comprehension. Return to sport is fully dependent upon complete resolution of concussion symptoms and this decision should come from the neurologist overseeing care. Remember to be patient. The brain is a delicate structure and will heal with time. Don’t rush your recovery process. Returning too quickly can put you at increased risk for worsening your previous condition. Let the brain recover and reboot.

Gallagher Performance has extensive training and experience in evaluation and co-management of patients and athletes who have sustained a concussion. Our experience allows us to assist in providing gold standard care when it comes to concussions.

This blog post was written by Sean Gallagher, DC, DACRB, PES
To schedule your appointment, call (724) 875-2657.

References
Johnson, C.D., et al. Chiropractic and concussion in sport: a narrative review of the literature. Journal of Chiropractic Medicine 2013 (12):216-229.
Shane, E.R., et al. Sports Chiropractic management of concussions using the Sports Concussion Assessment Tool 2 symptom scoring, serial examinations, and graded return to play protocol: a retrospective case series. Journal of Chiropractic Medicine 2013 (12): 252-9.
 
 

Understanding Methods and Application in Training and Rehab

It seems, inevitably, we get weekly questions wanting our insights or thoughts on some training or rehabilitation method.

Regardless of the whether its the fitness industry or physical medicine profession, methods come and go all the time. Some interventions have staying power as they provide lasting results. Some trends are just a flash in the pan. The more recent or more intriguing the trend, the more it seems to generate questions.

When it comes to rehabilitation, this can be seen in a wide range of modalities and procedures from electromuscular stimulation (EMS) to low level laser therapy, machine-based exercises to the functional approach, stretching to myofascial release techniques, and kinesiotaping to cupping.

In the fitness and training industry, there is an equal (likely greater) amount of options and trends to get hung up on. From kettlebells to TRX, Curves to Crossfit, bodybuilding methods to Olympic weightlifting, and unstable surface training to over-speed training just to name a few.

While the question, "What do you think of....," may be seem to be a simple question in nature, it's a difficult question to answer without understanding the context of it's application.

Unless the application is understood, the results one gets from a specific method is left in question.

If you severely sprain an ankle during a basketball game, sure taping and bracing will help in the early stages of healing. As healing and rehabilitation progress, manual therapy and exercise begin to take more focus. Single-leg balance and sensory-motor stimulation have demonstrated successful application in the rehabilitation of certain injuries, such as ankle sprains. But if you get on a BOSU ball or unstable surface too soon - and you re-injure your ankle - is the problem the unstable surface or just poor application?

Similarly, there are many people who take on a fitness or sports training program but end up worn down and banged up because their application of certain principles is just wrong. This may be due to joining a group exercise class or working with a trainer that provides poor advice and application of training principles. Or it could be due to an individual attempting to structure their own exercise program without proper knowledge of training method applications.

We all could benefit from someone who we can trust for sound advice who it comes to applying the principles of rehabilitation or exercise. They will be able to inform you on what methods may be best for your specific goals and your unique individual considerations. You need someone who can help guide and educate you, who is able to critically think and problem solve. This is what the best trainers, coaches, and therapists are able to do for their clients and athletes.

What we do at Gallagher Performance is exactly that. We critically think and problem solve for our clients and patients. We aim to educate them and implement the most appropriate applications for their desired goals and outcomes.

Despite this, the reality is our philosophy, our approach, or our applications may not be for everyone. We won't sacrifice long-term sustainability for temporary results. We take pride in quality over quantity. We won't focus on the latest trends or what other people are doing. We aren’t concerned with this.

Our primary concern is offering the best training and therapy to the people we work with while educating them on understanding sound application so they are able to make informed decisions. And we will always educate, even if that means people have to hear the hard truth. But hopefully in hearing the hard truth, they learn lessons that provide better guidance in the pursuit of their goals.

More related reading:

https://gallagherperformance.com/prevent-re-injury-integrated-training-rehabilitation/

https://gallagherperformance.com/powerful-innovative-approach-improving-body-functions/

https://gallagherperformance.com/the-benefits-of-performance-therapy/

Summer Grind, Summer Blast

Lately it’s hard to find time to keep up with our blog. Life and business have a way of keeping you busy. Ignoring our social platforms may happen for a period of time, but we always revisit them. If there is one thing I’ve always hoped is that our blog would be informative, educational, and entertaining (at times).

The summer months bring on increased work load. Once May rolls around, we take it up a notch or two at Gallagher Performance. Summer is a grind, but it’s also a blast. We love the grind, love the process. With the volume of high school and collegiate athletes training for strength and performance, along with the patients we see ranging from acute care to rehabilitation to return to play, summer provides tremendous learning opportunities.

Reflecting back on the past several weeks, there are some friendly reminders and lessons learned or re-learn that I wanted to share:

  • Power-speed athletes thrive on power-speed drills and exercises. Just because one can squat or deadlift 500+ doesn’t mean they are explosive and fast. Yes athletes need strength and for many they will need a primary focus on strength training. However, those newly acquired strength levels must also be displayed in more power-speed dominant means such as sprints, jumps, throws as they have greater specificity to athletics than anything barbell related.
  • Athletes need to rapidly absorb force and rapidly generate force and do it on a level of unconscious activation. That brings me to another point of muscle activation. Muscle activation is a craze nowadays and rightly so. The overwhelming majority of the population will benefit tremendously from learning how to activate and integrate muscles such as their tibialis anterior, glutes, and scapular stabilizers to name a few. A lost art in muscle activation seems to be the use of isometrics. There is always an isometric contraction during the amortization phase of movement. Even during the most explosive movements, there is an isometric contraction. Isometrics are also awesome for reprogramming and generating a powerful mind-muscle connection, making isometrics a great tool for performance as well as rehabilitation. We have been utilizing a select few isometric drills for uprighting, motor control, and priming for improved force/strength generation. In a relatively short period of time, they have more than demonstrated significant value.
  • There is a right way to go about training and a wrong way. The right way will always be dependent on the needs of individual and their specific goals. Don't get caught up in hype, trends, and empty promises. Trust the tradition. There is magic in the basics of the barbell, free weights, sprints, jumps, and bodyweight drills. They have stood the test of time. Fads and trends come and go, the basics remain. Using these exercises is one thing, understanding how to structure them in a training plan is another animal in itself. Find a trainer/coach that understands training specificity or else you are simply wasting your time and money.
  • We are problem solvers. Either as a clinician or trainer/coach, the heart of what we do is problem solving. Maybe it’s a matter of ability or effort, but clinicians or trainers either have the ability or they don’t. The ability to problem solve comes from knowledge and experience and even instinct. When it comes to effort, frankly some are just lazy and don’t care to think hard as it complicates their job. Whether it is listening to what a patient/athlete is telling you or just simply watching, you’ve got to process the source of the problem and how you’re going to solve it. When it comes to performance or rehabilitation, everything makes sense. If it is happening there is good reason for it. If we don’t understand it, it doesn’t make sense to us, but it always makes sense. Never dismiss a client or patient as not making sense. Make the effort to make a change. Change your perspective. Learn more.
  • We all need a coach. No one gets through life all on their own. We all have needed mentors and coaches at some point in our life. These may have been parents, family members, close friends, teacher, professors, bosses, etc. If we pursue something of significance, chances are someone helped us along the way. We need the help of others than have more knowledge, more experience, more accomplishments. I have had a number of mentors and coaches. For everything they did for me, I hope I can pass that on to those that I work with in the role as a coach.
  • Take time to get to know your clients and athletes. Show you care about them. We do more than just simply get kids bigger, stronger, or faster. We have an opportunity everyday to connect with our clients and athletes and hopefully make a positive impact. The reward goes far beyond cash flow. It’s about making a difference for the better.
That’s all for now. Thanks for reading and enjoy the grind!

More related reading:

https://gallagherperformance.com/do-you-really-need-more-mobility/

https://gallagherperformance.com/faqs-frequency-avoided-questions-of-strength-conditioning/

Prevent Re-Injury with Integrated Training and Rehabilitation

The majority of us will not get through life without sustaining some degree of injury. The joints of the back, shoulder, hips, knees and ankles are all very common injury sites for not just athletes, but the general fitness population as well.

Most injuries that develop over time tend to have one thing in common, a breakdown in the human movement system. Meaning it could be that you are performing specific movements with sub-optimal technique or perhaps muscle imbalances are responsible for your symptom presentation. Regardless of the reason for injury, the goal is the same; to make movement more efficient to ensure that once training or competition resumes, the chance of re-injury is minimal.

Efficiency of movement is rarely a goal achieved in therapy. Incomplete rehabilitation in athletes and the general fitness population has lead to a re-injury epidemic. The problem is rooted in either the push to return athletes to the field as quickly as possible or rushing patients through the rehabilitative process.

With the ever changing landscaped of health insurance, the overwhelming majority of athletes and patients deal with increasing out-of-pocket expenses and limited number of therapy visits. Ultimately, many patients never complete their rehabilitation process.

This may be for a number of reasons, but in most cases athletes or patients are discharged once specific objective and ADL (activities of daily living) measures are satisfied. Sure you may have minimal to no pain, full range of motion and seemingly adequate strength resorted, and basic activities are easy to perform, but this does not ensure you are ready to resume training and competition.

And this is exactly where most get stuck.

They are lead to believe they are ready to resume sport training or their exercise program, but soon after resuming they realize they aren't as ready as they thought they were.

The transitional period between rehabilitation and performance-based training is the most critical period to ensure complete rehabilitation and that the transition back into training and competition carries minimal risk of re-injury.
Sadly, due to points made previously about the state of healthcare, many personal trainers and strength coaches are finishing off the rehab process.

Why do I say sadly?

Frankly, the majority of personal trainers aren’t educated enough to be overseeing such a delicate process, yet many position themselves as psedo-therapists. I’ve lost count of how many personal trainers I’ve seen giving “massage” or performing “joint mobilization” during their training sessions. They have no training or qualifications to perform such work and ultimately the person at most risk is the individual they are working on. Word to the wise: if your personal trainer is performing such work on you and has no license to perform such work, run the other way and seek out a qualified professional.
Within the fitness industry, there has been a large growth in facilities that blend rehabilitation with prevention strategies within strength and performance based training programs. Done well and overseen by qualified professionals, this is a great way to manage what is seen both in a rehab and training setting. This process should not be handled improperly. Implementing “corrective” or therapeutic exercises strategies into a performance-based training program should be lead by qualified professional(s). There used to be a gap between the professionals in the therapy and strength & performance world. Progressively though, that gap is slowly closing as more therapists crossover into the world of strength & conditioning.

Returning from injury isn’t and shouldn’t be a quick process. It’s far better to train smarter through the process. Improving on the function of the body while adding qualities such as endurance, strength, reactivity, power, etc. will help ensure successful outcomes. It’s less about isolation and more about training systematically to re-groove movement patterns. For anyone who has suffered an injury, they all want to get back to their previous level of function while also building the confidence they will not re-injure themselves. It can and will be a detailed process that involves rest, manual therapy directed at specific joints and soft tissues, as well proper exercise progressions. And yes, this means regressing, substituting, and even just slowing down exercises until they are owned.

Once movement and exercises are owned, it opens the door to further progressions in a performance-based setting to help ensure a more complete rehabilitation resulting in reduced risk of re-injury. This has become a huge part of what we do at Gallagher Performance as we successfully help our athletes and patients resume an active, pain-free lifestyle.

More related reading:

https://gallagherperformance.com/technique_and_performance/

Before You Go To A Chiropractor, Read This First

Imagine a world where patients get the advise, education, and treatment they need. Imagine doctors who:

  • Make sense of what a patients says
  • Know exactly what a patient needs
  • Confidently provide gold standard advice and treatment interventions
This world is obtainable, but it must first begin with better quality, order and structure to our thinking patterns. One of the fundamental challenges with healthcare is that the human body is amazingly complex and adaptive. In response to the complex nature of dealing with the human body, doctors and therapists may have the tendency to routinely provide services that serve their own skill set better than appropriately addressing the patient's needs. Often times this leaves both the patient frustrated with lack of response to care.

Improving the Quality of Physical Medicine Care
The last 15 years have been great for musculoskeletal healthcare. There are several new treatment procedures and we have developed a deeper understanding of how the body works and how it breaks down. This has had tremendous impact on the world of physical medicine care, and chiropractic profession is no exception. The advancement of musculoskeletal care education has fueled a growing speciality within the chiropractic profession, sports injury & rehabilitation.

While physical therapy is often the first choice for medical doctor referrals in rehabbing an exercise or sports-related injury, there is a growing trend among athletes and individuals who enjoy an active lifestyle to turn to sports injury & rehabilitation chiropractors.

You may be thinking, “I thought chiropractors were only good for treating low back and neck pain and headaches.”
Just like the medical profession, there are many areas of specialty in chiropractic. Those who specialize as a sports injury & rehabilitation chiropractor have undergone the traditional education on joint manipulation or adjustments. However, in addition to their core curriculum, sports injury & rehabilitation complete hundreds of hours in continuing education learning about exercise and sport-related injuries, manual therapy, and functional rehabilitation methods.

What's so special about a sports injury & rehabilitation chiropractor?
Chiropractors who utilize a sports injury & rehabilitation approach incorporate joint mobilization/manipulation, soft-tissue treatments, various manual therapies, and functional rehabilitation techniques to provide a gold standard of care in treatment for individuals with exercise and sport-related injuries.

If you choose to visit a sports injury & rehabilitation chiropractor, you can expect a comprehensive examination before treatment begins. These examinations generally include:
  • A detailed history, orthopedic and neurologic examination, and functional based examination to create a working diagnosis.
  • Functional based examination to focus on the spine, shoulders, hips and feet, as these joints and their respective functions serve as the "key joints" of the human body.
  • Joint and muscle palpation to assess the quality of your joint movement, trigger points, and muscular imbalances.
Once the examination is completed, we want to discuss your specific goals in order to create a customized treatment plan for your road to recovery. The more accurately we assess, the more accurately we can apply treatment. Four types of treatment used at Gallagher Performance for exercise and sports-related injuries are:
  1. CHIROPRACTIC MANIPULATIVE THERAPYGallagher Performance provides the latest techniques, including joint manipulation (adjusting), designed to treat musculoskeletal complaints. The purpose of joint manipulation is to release restricted joints of the body, primarily in the spine and extremities. Joint commonly become restricted as a response to poor posture, imbalanced muscle activity, and/or trauma. By releasing a restricted joint through manipulation, improvements in the quality of motion of the joint are gained that may not be possible with exercise or other interventions. Manipulation also serves to reduce pain and relax tight muscles.
  2. FUNCTIONAL REHABILITATIONIn addition to providing relief through manipulative therapy and treating muscular adhesions, it can prove to be incredibly valuable to identify the source of a patient’s symptoms. The functional approach to rehabilitation includes identifying joint dysfunction, muscular imbalances, trigger points, and faulty movement patterns. These are often the hidden causes of injury. Observing how a patient moves and functions allows us to identify improper movement patterns that become contributors to pain and poor sport performance. By placing an emphasis on strategies to improve movement and function, functional rehabilitation is effective in improving qualities of endurance, strength, stability, balance, agility, coordination, and body awareness.
  3. DYNAMIC NEUROMUSCULAR STABILIZATION (DNS)By applying principles and techniques rooted in the study of child development, DNS aims to improve activation and neural control of muscles and ideal movement patterns. DNS promotes the ideal postures, movements, and degree of body awareness that is essential not only to athleticism, but to also treating the underlying causes of several pain syndromes.
  4. MYOFASCIAL RELEASEGallagher Performance offers a number of soft tissue approaches to treat painful or tight muscles, tendons, and ligaments. We have extensive training in identifying and treating muscular adhesions that compromise quality of motion and contribute to pain symptoms or reduced sports performance. Many overuse or repetitive use conditions respond well to treatment of soft-tissue structures, including back pain, shoulder pain, shin splints, runner’s knee (IT band syndrome), and plantar fasciitis.
If you have any questions or have been struggling with pain related to your activities, exercise or sport, Gallagher Performance offers customized treatment plans to get you our of pain and performing better.

To schedule your appointment, call (724) 519.2833

More related reading:

https://gallagherperformance.com/options-dont-take-insurance/

https://gallagherperformance.com/powerful-innovative-approach-improving-body-functions/

https://gallagherperformance.com/resetting-bodys-function-post-injury/

Welcome to Gallagher Performance

[embed]https://www.youtube.com/watch?v=dzaixhJKgnQ[/embed]

Hi. I’m Dr. Sean Gallagher. Welcome to Gallagher Performance. I’d like to tell you about what we have to offer and why it might be a right fit for you to come check us out.

We offer chiropractic, functional rehabilitation, massage therapy, nutritional programs, as well as sports performance and personal training programs.

To begin with, my approach to chiropractic is different from what most have come to expect or have experienced in the past. As a chiropractor, my focus is on returning you to proper function and teaching you what you can do to keep pain from returning. Rather than spending 5 minutes with my patients, I usually spend 30 -60 minutes.

New patient evaluations are an hour long, as this allows me the opportunity to listen and understand their history as well as their desired goals and outcomes from treatment. All new patients receive a neurological and functional-based evaluation as this serves to create a working diagnosis and treatment plan recommendations.

Our functional-based evaluation and treatment plans are focused on looking at how you move so I can figure out strategies to help you move better and ultimately help you understand what could be causing your pain and what you can do to keep it from returning. The process is truly focused on you as the patient and your desired outcomes.

In addition to chiropractic adjustments or manipulations, I perform soft tissue treatments to improve the integrity and function of the muscular system. Massage therapy is offered here as well as it is extremely effective in treating painful or tight muscles and assisting in the healing process. Additional rehabilitation work focuses on improving movement qualities such as endurance, strength, stability, balance, agility, coordination, and body awareness.

When it comes to training, Gallagher Performance is all about individualizing the training process. That’s because we understand each person responds differently to training due to a multitude of factors that must be accounted for. We take time to understand your injury history, training experience, primary sport(s) played, and several other factors. Regardless of whether training occurs in a private or semi-private setting, clients are all closely coached through the entirety of their program to maximize results. This is what separates us and makes us unique from area competitors.

So if you’re looking to improve your performance, whether in sports, the achievement of your health and fitness pursuits, or you just need a tune-up to get your body feeling better, whatever the reason, come see us at Gallagher Performance. We are committed to you achieving your health and fitness goals and would love to be of service to you. Thank you.

Low Back Pain: Causes and Treatment Recommendations

Low back pain is not an uncommon condition among the American population. Several studies have supported data that demonstrates up to 85% of the population will experience at least one episode of low back pain during their lifetime. Low back pain is responsible for millions of dollars in healthcare costs every year.

In most cases, low back pain is relatively self-limiting condition, meaning it reduces naturally over a period of a few days. That said, it is not uncommon for many to experience severe pain. For this reason, it is important to begin treating low back pain conservatively with interventions such as chiropractic, manual therapy, therapeutic massage, and/or proper exercise prescription. All these conservative interventions have demonstrated their ability to successfully treat low back pain and its causes.

Some common back pain causes that respond well to a combination of chiropractic, manual therapy, massage, and/or exercise include:

Sprain/Strains: Injury to muscle and/or connective tissue, such as tendons or ligaments, suffered during activity, accidents, or lifting with poor form. Sprain/strains are extremely common and most range from mild to moderate (little to no tearing of tissue) and respond well to conservative treatment such as chiropractic, manual therapy, and progressive rehabilitation. Severe sprain/strains are characterized complete tears of ligaments or tendon ruptures. These may require surgical intervention.

Sacroiliac Joint Dysfunction: These pelvic joints usually produce pain as a result of alter joint mechanics from lifting or straightening up from a stooped position. The pain is usually relieved with sitting or lying down. Muscular tightness in the low back and hips is common.

Facet Syndrome: Pain in the low back that is localized, sharp and provoked with either extension (arching of the low back) or a combination of extension and rotation of the spine.

Sciatica: Radiating pain into the lower extremity on the posterior thigh/calf/foot. Sciatica can be caused by central issues (disc herniations) or peripheral issues (piriformis syndrome, nerve entrapment).

Disc Herniations: Low back pain which may also radiate pain into the hips or legs. Typically worse in the morning; worse with bending forward; usually better standing than sitting. Because of the disc injury, muscle spasms are not uncommon. These muscle spasms serve to limit movement in order to protect the disc from further injury.

Piriformis Syndrome/Nerve entrapment: Radiating pain on the posterior thigh and leg caused by tightness in the piriformis muscle. This muscle is deep within the hip lays underneath the glutes. Tightness in the piriformis can create irritation by entrapping the sciatic nerve, thus creating the radiation of pain. The sciatic nerve can be entrapped within the hamstring and calf musculature as well. Low back pain may also accompany hip pain.

Myofascial Pain Syndrome: This is a chronic form of muscle pain caused by trigger points. These trigger points are often present within muscles of the low back and hips due to any combination of joint dysfunction, postural imbalances, and/or poor stabilization/support function of the core musculature.

Spondylolishthesis: A fracture of the vertebrae resulting in pain with extension. Similar to sprain/strains, spondylolishthesis is graded in severity. Mild forms for spondylos can respond well to chiropractic manipulative therapy (CMT) and rehabilitation programs. This condition is frequent in athletic populations who perform repeated extension movements, such as gymnasts, football players, wrestlers, and weightlifters.

In many cases, several studies support that low back pain responds exceptionally well to the combination of chiropractic care, manual therapy, massage, and proper exercise instruction. If you are suffering from low back pain, whatever the cause, consider Gallagher Performance for your evaluation and treatment. Our goal is to relieve your pain while teaching you what you can do to keep the pain from returning. Please contact us as we have every expectation that our chiropractic and rehabilitation programs will help you Experience the Difference.
 
This blog post was written by Dr. Sean Gallagher.

Gallagher Performance offers customized treatment plans. Visit our website for complete contact information.
To schedule your appointment, call (724) 519-2833.
 
More related reading:

https://gallagherperformance.com/why-stretching-wont-solve-your-tight-muscles/

Fascia & Muscular Adhesions: How they relate to pain and overuse injuries

What is Fascia?
The soft connective tissue, located just under the skin, is a white membrane that wraps and connects muscles, bones, nerves, organs, blood vessels of the body.

This soft tissue is known as fascia. Think of fascia like the white fuzz inside an orange peel connecting and wrapping around the orange and the individual sections or slices.

At times, muscles and fascia are can become stuck or tear, resulting in soft tissue injuries or adhesions. Adhesions restrict movement and the quality of muscular contractions resulting in either soreness, pain, and/or reduced flexibility.

For a quirky take on fascia or "the fuzz", watch this video by Gil Hedley, PhD. The video provides great visuals as to what fascia looks like, how our muscles have to slide while we move, and what muscular adhesions look like and how they limit movement.

[embed]https://www.youtube.com/watch?v=_FtSP-tkSug[/embed]

How do you treat Fascial/Muscular Adhesions?
Treatment of fascial/muscular adhesions through manual or instrument assisted techniques have clinically proven to achieve successful outcomes in many acute and chronic conditions. Gallagher Performance offers a number of soft tissue approaches to treat painful or tight muscles, tendons, and ligaments. We have extensive training in identifying and treating muscular adhesions that compromise quality of motion and contribute to pain symptoms or reduced sports performance. Many overuse or repetitive use conditions respond well to treatment of soft-tissue structures through myofascial release, including back pain, shoulder pain, shin splints, runner’s knee (IT band syndrome), and plantar fasciitis.

Myofascial release is a manual or instrument assisted therapy targeting soft-tissue structures to reduce the presence of adhesive/scar tissue. Adhesive muscular tissue is arguably the most common yet most underdiagnosed condition in the entire human body. Muscular adhesions act like glue among muscles, fascia, tendons, ligaments, and even nerves. As a result, this reduces flexibility, strength, and stability to the body by altering movement control patterns. Adhesive tissue along nerves can cause numbness, aching, tension, tingling, and in some cases weakness. This is condition is called nerve entrapment and can happen in an estimated 150+ locations throughout the body.

How does adhesive tissue develop within the body?
Often adhesive tissue develops in result to acute injury or from overuse/repetitive trauma injury. Overuse injuries are caused by repetitive stress on the muscle and skeletal system without enough rest to allow the body to adapt. Studies show these overuse injuries account for more than half of pediatric sports injuries and often happen due to intensive focus on a single sport with an intensive practice and competition schedule. Unrecognized and untreated, they can sideline athletes from play and lead to more serious injuries.

Who is qualified to diagnose and treat fascial/muscular adhesions?
Sports medicine experts are advocating a greater role for therapists who can help athletes or active individuals recover without incurring lasting damage or hampering their activities. Specialists such as chiropractors, physical therapists, and massage therapists who specialize in sports-related injury and rehabilitation are often the first line of defense in managing and treating overuse injuries. These licensed professional are best for identifying muscular or fascial adhesions as they related to overuse injuries and movement disorders. With specialized training, these professionals are able to detect and treat muscular adhesions, expediting the healing process and minimizing downtime due to overuse injuries.

This is exactly why at Gallagher Performance we have a team which includes a massage therapist and a board certified chiropractic rehabilitation specialist. We strive to offer our athletes and patients the latest treatments and evidence-based soft tissue and rehabilitation techniques. Helping our athletes and patients achieve and sustain their best level of health and performance is our goal.

More related reading:

https://gallagherperformance.com/tendinitis-changing-treatment-and-improving-recovery/

https://gallagherperformance.com/why-stretching-wont-solve-your-tight-muscles/

https://gallagherperformance.com/3-benefits-of-integrated-training-and-therapy/

Painful Back? You May Be Hurting It By Stretching

What you need to know:

  • Many healthcare providers and trainers poorly understand how movement of the nervous system relates to several common pain syndromes and musculoskeletal conditions.
  • Dealing with neural tension is not as simple as just stretching. While stretching may feel good, it very easily may aggravate symptoms.
  • Once appropriate treatment of neural tension begins, patients often normalize their movement very quickly and experience pain relief. Often this pain relief is instantaneous.
What is Neural Tension?
Neural tension is rather unheard of yet it often plays a significant role in many pain syndromes and musculoskeletal conditions. We all understand for movement to occur in the body, joints must move and your muscles must contract. But did you know that your nervous system tissue must also move freely and unimpeded during movement?

Neural tension is commonly mistaken for muscle tension. Your nerves were not designed to stretch, but rather to glide and give during movement.
If some form of obstruction (soft tissue or bony) impedes your neural tissue then pain or restriction of normal nerve movement is a common result. This normal nerve movement may only be a matter of millimeters, but nerve tissue is highly sensitive and does not like to stretch. Thus if too much stretch is placed on a nerve, the result is adverse neural tension and that can create pain, limited range of motion, as well as other classical symptoms associated with nerve tissue (numbness, burning, shooting pain, etc.)

Neural Tension Treatment
The movement of your nerves, or neurodynamics, can be assessed by a licensed chiropractor or therapist trained in the process of detecting and treating neural tension. Screens or tests commonly used to identify neural tension help identify not only which nerve(s) have adverse neural tension but also where the nerve is being obstructed during its movement. Identify where the nerve is being obstructed is critically important because treatment is tailored to the site of obstruction.

Again, this highlights the importance of an accurate assessment as treatment can be more accurately applied to the structure(s) creating adverse neural tension. Once treatment begins, patients often normalize their movement very quickly and experience pain relief. Often this nerve pain relief is instantaneous.

What Conditions Commonly Involve Adverse Neural Tension?
Some common conditions that adverse neural tension often plays a role in or is a complicating factor that must be treated include:
  • Neck Pain
  • Shoulder Pain
  • Tennis Elbow
  • Carpal Tunnel Syndrome
  • Low Back Pain
  • Hip Pain
  • Sciatica
  • Plantar Fasciitis
Stretching vs Nerve Mobilizations
A common misconception in the treatment of back pain and associated muscle tightness is the idea that one must stretch to get relief. Stretching may bring temporary relief, only for one to experience the tightness come back once again or, worse yet, an increase in their pain.

Interestingly, when neural tension is identified as the underlying reason for muscle tightness, the treatment of neural tension doesn't actually involve stretching. Excessive stretching can actually irritate your nerves and increase pain. Excessive stretching may potentially damage your nerves as well.

This should make the message pretty clear - stretching may not be the best thing for your back when it's giving you all the signs that it isn't responding favorably.

Rather than stretching, restricted nerves and the surrounding muscles require a different approach known as nerve mobilizations or nerve sliders. Qualified chiropractors and physical therapists will utilize nerve mobilizations to help entraped nerves slide better during movement. They will also treat the surrounding muscles or tissues that is obstructing your normal nerve movement. After treatment, they will retest your neurodynamics and repeat the process until your full neural movement is restored. This process may take a few treatments to clear up, or take several, depending on severity.

Research Supports Neurodynamics
The concept of neurodynamics or neuromobilization is originally based on the research of Michael Shacklock and David Butler. Over the past several years, further research has added to the scientific support of the concept that your nerve tissue requires full freedom of movement to remain pain-free.

The following excerpts are from Michael Shacklock’s book Clinical Neurodynamics: a new system of musculoskeletal treatment:
"Neurodynamics is an innovative management tool involving conservative decompression of nerves, various neural mobilising techniques and patient education techniques. Neurodynamics offers a fresh understanding and management strategies for common syndromes such as plantar fasciitis, tennis elbow, nerve root disorders, carpal tunnel syndromes and spinal pain."

"Essentially the entire nervous system is a continuous structure and it moves and slides in the body as we move and the movement is related to critical physiological processes such as blood flow to neurones. This movement is quite dramatic and it is not hard to imagine that fluid such as blood in the nerve bed, a constricting scar, inflammation around the nerve or a nerve having to contend with arthritic changes or proximity to an unstable joint could have damaging effects, some of which could lead to pain."
Final Words
Neural tension can be present with many common musculoskeletal conditions, such as back pain. Very often neural tension is easily mistaken for muscle tension, leading many to want to stretch in order to find relief. Stretching can be counterproductive and may aggravate pain symptoms. In order to treat neural tension, it must be examined accordingly. At GP, we are trained in detecting and treating adverse neural tension and why it is present.

If your pain is not resolving with other interventions, consider your pain may be associated with neural tension and you may benefit from the most appropriate course of treatment and client education.

More related reading:

https://gallagherperformance.com/why-stretching-wont-solve-your-tight-muscles/

 

Gallagher Performance - Staff Bios

For many of our readers, you may not be aware of the specialized background that Gallagher Performance has in personal training, athletic development, chiropractic rehabilitation, manual therapies, and sports-injury care.

Whether you are pursuing professional services for personal/performance-based training or you’re thinking of seeing a health professional about a sports injury, Gallagher Performance has two board-certified specialists who are capable of addressing your goals and needs.

Meet the Staff

Ryan Gallagher LMT, NASM-CES: Head Performance Coach
Ryan Gallagher is the Head Performance Coach and a Licensed Massage Therapist at Gallagher Performance. Ryan has quickly established himself as a highly sought after coach for athletic development, helping athletes achieve new performance bests while implementing specialized strategies along with manual therapy to keep his athlete’s healthy during their competitive and off-seasons.

Ryan has been involved in the fitness and sports performance industry since 2007. During that time, he has worked extensively with youth, high school, collegiate, and professional athletes. He has also worked with competitive strength athletes in powerlifting and Strongman, as well as physique athletes (bodybuilding, figure, and bikini).

Ryan is certified as a Corrective Exercise Specialist (CES) through the National Academy of Sports Medicine (NASM) and is also a Nationally Certified Licensed Massage Therapist (LMT) through the National Certification Board for Therapeutic Massage and Bodywork. Ryan holds a bachelor’s degree in Sports Management with a concentration in Wellness and Fitness from California University of Pennsylvania.

To compliment his educational background, Ryan is an accomplished athlete in the sports of ice hockey, bodybuilding, powerlifting, and Strongman. HIs diverse athletic and educational background provide Ryan with an highly extensive and unique skill set that allows him to efficiently and effectively help his clients achieve their goals while staying healthy in the process.

Sean Gallagher DC, DACRB, NASM-PES: Director of Sports Therapy, Performance Coach
Dr. Sean Gallagher is the Director of Sports Therapy and also serves as a Performance Coach at Gallagher Performance. In 2009, Sean earned his Doctor of Chiropractic degree from Palmer College of Chiropractic in Davenport, IA. Prior to attending Palmer, he earned a bachelor’s degree in Exercise & Sports Science from Ohio University.

After graduating from Palmer, Sean entered a residency program in Palmer College of Chiropractic’s Sports Injury & Rehabilitation Department. The residency is the only one of its kind within a chiropractic college in the United States. Under the direction of former Olympian, Dave Juehring DC, DACRB, CSCS and Ranier Pavlicek DC, ATC, DACRB, CSCS, the residency provided Sean the opportunity to further the development of clinical skills in the realm of diagnosis, treatment and management of sport-related injuries. During this time, he received extensive training in manual therapies and developmental stabilization methods influenced by the German and Czech rehabilitation schools.

Sean graduated from his residency and completed his board certification in 2012, making him one of a select few chiropractors in the country that have successfully completed a rehabilitation and sports-injury residency. He is a board certified rehabilitation specialist through the American Chiropractic Rehabilitation Board (ACRB) that abides by the standards set out by the National Commission for Certifying Agencies.

To compliment his clinical training and experience, Sean also serves as a Performance Coach with years of experience working with athletes of all abilities and is a certified Performance Enhancement Specialist (PES) through NASM. He is an accomplished athlete in the sports of ice hockey and Strongman. During his time at Ohio University, he was part of the 2004 ACHA D1 National Championship team. In 2001, he was named to the NHL’s Central Scouting Service “Top 10” High School players in the US and was ranked among the top players in North America (US and Canada). As a competitive amateur Strongman, he has won or placed in several NAS sanctioned competitions since 2010 and was a National qualifier in 2010, 2011 and 2012.

Our staff welcomes the opportunity to get you back to 100% and help you reach your fitness or performance-related goals. When you think of sports performance training and chiropractic rehabilitative care in the Pittsburgh area, remember the team of experts at Gallagher Performance.

 

Are You Promoting Independence?

As a chiropractor, I often treat people who have already exhausted all of their insurance money from seeing other chiropractors and/or physical therapists. They come to me out-of-pocket and immediately expect me to do significantly more in one or two visits than the previous professional(s) did after the 12-20 visits that drained their insurance benefits.

I’ve routinely accepted the challenge and many times I’ve closed their case in 2-4 visits by having them listen to advice, advice that addresses underlying issues previously missed or ignored by other providers. Yes, I am a chiropractor and I will adjust and perform manual therapy as needed. But the difference maker time and time again has been the time focused on education directed at independence. Promoting independence on the patient’s behalf is a game changer. This is why I feel so strongly that empowering a patient should be the focus behind therapy and prescribed home programs. As patients discover how they are able to better themselves, their compliance becomes a non-issue and outcomes drastically improve.

The opportunity to educate others is a responsibility that should never be taken lightly. As a provider, the methods utilized to accurately assess a patient’s condition and direct treatment must also serve to improve provider-patient education and accountability.

Gray Cook places this perspective into words very well:

“Our current medical and physical cultures are wasting a lot of time and not creating independence in our clients or our patients. Do we want them to be well and go tell others about their experience or do we want them to keep returning as continual consumers? At what point does wasting time conflict with an oath to do no harm?”
Are you wasting your patient’s time?
One of the fundamental challenges within healthcare is that the human body is a complex adaptive system composed of several interacting parts that are continually changing in response to the stimulus from the environment. This complexity makes understanding the human body a difficult task. Unfortunately, some healthcare providers find reality too complex and would rather repeat the same routine evaluations and treatment over and over again to fit their own skill set rather than truly diagnosing a patient’s condition before administering treatment. This is where providers should question their principles. Are you doing the same thing over and over? Are you so ritualized that your care lacks individualized attention? Are you wasting your patient’s time because you keep missing their problem?

The very essence of what we do is problem solving. Before you can solve a problem, you first must identify what is relevant. On most patients, you can find any number of problems, but it is the relevant problems that are the key. To find relevant problems, you must have a reliable method. The foundation for any method is knowledge and experience. Knowledge and experience that is rooted in understanding how basic science (anatomy, physiology, biochemistry, etc.), pathology, assessment (orthopedics, technique, imaging, etc.), and treatment all integrate.

I’m continually shocked and disappointed when speaking with a new patient who has been told by previous providers that their symptoms “Don’t make sense.” When it comes to musculoskeletal (MS) care, everything makes sense. It may be extremely complex, but it makes sense. If something doesn’t make sense to you, then you don’t understand it well enough. Make changes. Take a more detailed history. Change your perspective. Perform a more detailed assessment. Expand your knowledge base. Do something different.

Never dismiss a patient as not making sense.

As a physical medicine provider, it is your job to have a knowledge base that is large enough to encompass the overwhelming majority of MS problems and conservative interventions. If you don’t, chances are you will suffer along with your patients because your knowledge base is not sufficient enough to diagnose their problems.

Diagnosis must have accuracy and completeness. It must include a pain generator and the relevant problems or dysfunctions. These must be put into context for the patient so they can understand how they came to be the way they are. This is critical as it provides the framework for the education and advice you provide your patient.

Ultimately, that very same framework serves to empower your patients to become more independent. The process is about transitioning them from dependence on you as the provider to an independent patient who truly understands their problem, how to go about fixing it, and the steps needed to prevent recurrent issues in the future.

Final Words
I’m not trying to do anything in my work at Gallagher Performance that is unheard of, but it is still rather uncommon. For my conscience, I would rather create independence than be routine. I also feel that this conscience is growing among healthcare providers and that it is a mindset patients desire to see from their provider.

Promote independence. Your patients will thank you.

More related reading:

https://gallagherperformance.com/stress-overload-and-injury/

https://gallagherperformance.com/relief-care-vs-regular-chiropractic-care/

https://gallagherperformance.com/before-you-go-to-a-chiropractor-read-this-first/

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Contact

  • 4484 William Penn Highway

  • Murrysville, PA 15668

Hours of Operation

  • CHIROPRACTIC
    Monday-Thursday: 9am-1pm, 3pm-6pm
    Friday: 9am-1pm, 3pm-5pm
    Saturday: by appointment only
  • MASSAGE & TRAINING
    Hours are by appointment only