Understanding how structural and functional patterns contribute to predictable clinical presentations allows DCs to design more full-service effective care plans and identify when orthotic intervention, custom cervical support and rehabilitative exercises are appropriate.
Understanding how structural and functional patterns contribute to predictable clinical presentations allows DCs to design more full-service effective care plans and identify when orthotic intervention, custom cervical support and rehabilitative exercises are appropriate.Caring for patients in the chiropractic profession has evolved from the earliest days of providing chiropractic adjustments only, to making other recommendations that supported the adjustment as the patient progressed. Diet, exercise and supplementation as well as in-office modalities.
Improving knowledge and skill is an important component of the promise made by a DC at graduation. As early as 1948, Palmer College of Chiropractic had the foresight to comment on advancement in the profession as part of its oath. It is the graduates’ responsibility to their patients to remain contemporary in academic and clinical knowledge to best serve them.
Continuing education is where we are exposed to new ideas, research, clinical competency and technology as it relates to patient care. These are also the components we use to contribute to a successful business model. Success of a chiropractic practice must begin with clinical competency that provides successful patient outcomes, but it can be supported using technology and products that enhance the patient’s experience.
Speaking from my own experience, upon graduating from chiropractic college, my “toolbox” did not contain very many tools. I adjusted my patients, but for many of my patients, the recurrence of pain after temporary relief made me think there was something else happening that wasn’t being addressed.
My journey
As part of my continuing education, one of the first postgraduate seminars I attended was a national technique convention that hosted a myriad of vendors. It was exciting to see the mix of adjusting equipment, administrative tools, diagnostic equipment, rehab items and exercise systems, but what caught my eye was a vendor with the image of a foot on the table cover. My first thought was, “What’s a foot company doing at a chiropractic convention? Our focus is spines.”
I approached the vendor to inquire and was soon reminded of things I learned studying architecture before my chiropractic journey. The feet are the foundation of the pelvis and spine. They influence minute changes in balance, posture and functional movement of the entire body through the sensory organelles in our muscles and tendons. If there are differences between the functional architecture of the feet, compensatory changes take place to ensure our fundamental ability to seek food, shelter and community. That is the primary desire of the brain, and it doesn’t really care how crooked, slumped or unstable you are. These compensatory changes create mechanical, physiological and neurological stress in the lower extremities, pelvis and spine, creating subluxation patterns that show up in our office as pain, postural imbalances and spinal decay.
This made complete sense to me based on my knowledge of construction principles and the fact I had developed persistent low back pain by the time I was 25 years old. Chiropractic care provided me relief, but it was temporary. If my feet were a contributing factor, custom stabilizing orthotics might be an appropriate adjunct to support my chiropractic care. My feet, which no one had ever evaluated, were indeed a contributing factor to my foot, knee and spine connection. I was on a path to developing chronic low back pain and if family history was a predictor, lumbar disc herniations.
Within one week of adding custom orthotics to my regimen of care, my back pain was gone and my “football knee” was stable. At this point, I accepted the obligation to look at my patients differently, to see if their feet were contributing to the subluxation patterns, posture, gait and pain. I promised to provide a regimen for the good of my patients according to my ability and judgement, and the custom flexible orthotics I prescribed were a significant contributing factor to the success of my patients.
Take advantage of tech tools
Technology has given us many tools to improve our diagnostic abilities, patient communication and treatment. 3D laser scanning technology for the feet and custom cervical pillows, AI-assisted posture, range of motion and functional movement assessment and digital X-ray all contribute to creating effective patient care plans. Using these tools to assess the need for adjunctive therapies and complementary interventions has enhanced the business side of our practices. Research has shown the structural and functional patterns our patients present contribute to predictable outcomes that include degenerative changes, chronic pain and an increased risk for unintentional falls due to aberrant postural changes.
A full-service patient care plan may include custom orthotic interventions for posture, gait, balance and functional movement. It can also incorporate therapeutic exercises to support and retrain balance and postural patterns, as well as custom cervical pillows to provide postural support during sleep. In addition, appropriate modalities or nutritional protocols may be used to address acute pain and inflammation. Together, these elements create a comprehensive regimen designed “for the good of your patients.”
Final thoughts
Comprehensive chiropractic care plans work together with our new understanding of the principles of neuroplasticity. Integrating chiropractic adjustments with custom orthotics, cervical support pillows and postural rehabilitation with the appropriate frequency and intensity over a long enough period will create predictable, measurable, meaningful outcomes for our patients and business success for our practices.
Brian Jensen, DC, is a graduate of Palmer College of Chiropractic and the owner of Cave Spring Chiropractic in Roanoke, Virginia. He has been in practice for more than 35 years. As a Foot Levelers Speakers Bureau member, he travels the US sharing his knowledge and insights. For more information, visit footlevelers.com.
