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The youngest of the 77 million baby boomers turned 40 last year, the oldest turned 60, and as a group they have one thing in common: They will be proactive in their quest to age well. Studies show they anticipate aging better than their parents, with 79 percent expecting to be active past age 70, and half expecting to be active past age 80.1 And according to the business magazine Fast Company, their numbers and disposable income make aging boomers "the next American gold rush"2 as entrepreneurs attempt to satisfy their needs and desires. One of the first rules of business is to provide what the market demands. Baby boomers' demand to keep moving has already given rise to a number of different providers offering various treatment modalities: • Pharmaceutical companies sell new and improved drugs for arthritis. They are spending billions on research and development, searching for the next "big cure." • Orthopedic surgeons sell increasingly high-tech surgery, with fast recovery times. • The number of knee-replacement surgeries among 38 to 56 year olds doubled from 1996-2001.3 New procedures such as cartilage-cell transplants, arthroscopic procedures, and artificial knees, hips, and discs contribute to a growing $26 billion industry. • Retailers sell ergonomically engineered products, such as beds, chairs, shoes, and sports gear, engineered for comfort and marketed for wellness. • Physical therapists initially sell one-on-one passive care, followed up by exercise and lifestyle advice. An astounding 93 percent of boomers say they plan to go to a physical therapist when they feel themselves slowing down, according to a Rehabilitation Institute of Chicago study.4 And while our profession was not mentioned in the study, filling this growing market defines a chiropractic opportunity. THE OPPORTUNITY Chiropractors provide spinal adjustment/manipulation, along with some ancillary support procedures and health counseling. As a profession, our generation's opportunity for chiropractic to achieve cultural relevance is to do more for the growing middle-aged patient population. We can do this by providing a combination of active and passive care. Posture-focused practices catering to boomers' desire to "keep going" can take us from being perceived as "back doctors" to "motion specialists" for aging well. In the public eye, chiropractic has focused on a passive therapy — adjustments. Studies show that in addition to strong positive neurologic effects, adjustments stress joint ligaments and so show better outcomes than passive therapies that stress primarily muscle and lack sufficient force and/or velocity to affect joint function. So, chiropractic helps people move well, but we can strengthen chiropractic's appeal by synergizing with the growing interest in exercise and fitness programs such as yoga, Pilates, and other core-strengthening programs. By itself, active care has been shown to be effective. Randomized clinical trials, a standard of research, have shown better outcomes and less disability for people with neck and back problems who receive exercise therapy than for those who don't.5, 6
A posture practice combines active and passive therapies and can show excellent results in acute and wellness cases. Studies show the combination gives better subjective improvement on VAS and other pain and lifestyle instruments, as well as better objective improvement when measured by the ability to accurately know when the head is straight and level.7, 8 Creating a posture practice is the key to shifting patients' goals from pain relief to moving well. Chiropractors who operate a posture practice educate patients about maintaining motion and strengthening posture, both of which "everyone knows" deteriorate with age. They teach patients how the neuromusculoskeletal system choreographs every motion a person makes and explain its three subsystems: Contracting muscles; connecting ligaments, tendons, bones, and fascia; and controlling brain, spinal cord, and peripheral receptors and proprioceptors that together control conscious and reflex motion. The big gun in the chiropractic tool chest is the adjustment, which affects the contracting, connecting, and control subsystems of the neuromusculoskeletal system on a more fundamental level than any other therapy. The ideal active-care therapy to incorporate into a rehab or wellness practice is a core-stabilization program with an exercise ball. These large, inexpensive, but sturdy, inflatable balls are excellent for active care because the body is forced to balance as it exercises. This creates a high demand on the motor control system, which changes both the level of muscle activity and the way muscles coactivate to stabilize the entire body.9, 10, 11 POSTURE CONSCIOUSNESS Exercise and posture-awareness programs that first use a ball and then add other low-tech tools create "posture consciousness." Posture exercise protocols structured in progressive, short-interval encounters fit well into most chiropractic practices as doctor and patient work together to retrain and promote symmetrical, coupled motion and improve balance — first for rehab, and then to help people move and age well. Ball rehab protocols also help DCs work synergistically with other fitness professionals and help them target athletes, because restoring full-range motion and creating posture consciousness improves form. The combination of active and passive care (with passive care consisting of therapies designed to maintain muscle function as well as joint motion) may ultimately prove to be the most clinically and cost-effective way of initially treating people and then keeping them moving well as they age. Just as cholesterol, blood pressure, and LDL/HDL ratios have become part of the national health consciousness, many middle-aged Americans will embrace the wisdom of keeping a body moving as it ages. The opportunity is to integrate chiropractic, muscle therapy, and posture exercise into boomers' lives so they perceive us as a "magic bullet" for moving and aging well. The irony of chiropractic may well be that a late-19th century monocausal philosophy of health may become the vital link in 21st century wellness biomechanics for aging baby boomers. Steven P. Weiniger, DC, developed the "Integrating Chiropractic and Posture Rehab Exercise" seminar, being presented nationwide in 2007. Along with teaching seminars, Weiniger is managing partner of BodyZone.com, an online resource that works to help people move naturally. He can be reached at DrWeiniger@BodyZone.com. References |
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