Work with patients to choose the ingredients to connect rehab & PT with wellness and longevity and open up new chiropractic physical therapy rehab potential
My wife owns restaurants, and she would say we are therefore in the hospitality industry too. It’s all in the point of view and what you want to accomplish. If you practice acute care, call it sports injury care. If you practice auto injuries, call it personal injury specialization. I practice it all, from sports injuries to rehab to performance to regenerative medicine to longevity, all rolled into one to broaden the chiropractic physical therapy rehab potential for patients.
Can I see the menu?
Think about it from the patient’s point of view. Do they want to have a dine-in experience, takeout or delivery? What does this patient want? Do they want to build an omelet, a sandwich or a salad? I have to help them see what they need.
My menu is pain relief, weight loss, wellness and longevity. One of my top ingredients is movement. I will be creative and build a personalized exercise program. Patients can choose one or more from:
- Flexibility
- Stability
- Strength
- Weight Loss
- Cardiovascular
- Balance
Building a rehab & PT sandwich
The outer-layer tools are the bread of this sandwich, the Italian Crisp Baked Baguette, or Multi Seeded Grain Roll, or Whole Wheat Tortilla Wrap. These tools are bodyweight, CLX bands, free weights, kettlebells and sandbags.
Be creative and build your own:
One protein — Turkey, ham, burger, egg. My one meat is always related to gait. This means something related to better walking ability and getting even a little out of breath.
One cheese — Provolone, white, cheddar, feta. My one cheese is going to be in the balance category. That means one legged “something” exercise. Using BOSA (sounds like a cheese) is a good tool.
Veggies — Iceberg lettuce, spinach, mushrooms, olives, romaine, fresh basil, alfalfa sprouts. You need lots of these for variety, to offset boredom and add flavor. Target stretching certain muscles and strength movements.
Condiments — Horseradish, mayo, mustard. What is your special sauce? Mine happens to be a great ability to customize sets and reps that are palatable for patients to do daily. These movements are usually a little challenging to do, but once these become easy to get down, I change to another movement progression.
Extras — Remember, extras cost more money. Avocado, extra meat, extra cheese. My extras are the in-office stack of shockwave, laser, TECAR, lab tests, stool tests for microbiome, and a few others.
My message: Movement consistency beats inconsistency. Let’s die trying what leads to longevity.
Wholistic chiropractic
What do you call chiropractic care when you add in weight management (diets, intermittent fasting), all-inclusive exercise, creating good sleep, creating good digestive health (microbiome), decreasing risks for and improving cardiovascular health, hormone optimization, stress and inflammation reduction, balancing detoxification pathways, aesthetics, and brain health (avoiding dementia, Alzheimer’s)? Something that extends chiropractic physical therapy rehab potential.
It’s beyond just blending rehab and physical therapy. I’m feeling it as a “wholistic chiropractor” – what I was originally taught in school over 40 years ago. My sandwich is blending it all together – acute pain relief, chronic care, biohacking, regenerative medicine and longevity planning. I can be methodical yet innovative.
As a chiropractor my most sought-after hack has been helping people get out of pain, correcting posture, and improving and maintaining range of motion. Most people are losing range of motion as they age. This physically and emotionally hurts, and makes patients feel old when they are still young or relatively young. Improve poor posture and restore lost range of motion, and your patients will feel young.
Chiropractic physical therapy rehab potential and the top biohacks
Five top hacks for my patients are sleep, hydration, weight optimization, sun and light optimization, and oxygen optimization.
Here’s an example of the top hacks:
- Sleep optimization — Help patients get seven hours and understand REM, light and deep sleep.
- Hydration optimization — Make water your favorite drink! Show me on my body composition device that you have good intracellular water amounts.
- Oral and dental optimization — Stop using mouthwash. It messes with your microbiome.
- Light optimization — Look outside at the sunrise (natural light signals hormones) every morning. Let’s figure out screens at night.
- Oxygen optimization — Encourage nasal breathing, diaphragm breathing, meditation, short bouts of high-intensity cardio to force breath in and out.
- Movement optimization — I bring awareness to tight areas and weak areas of the body and get patients thinking about regaining movement for longevity.
Most patients need some flexibility and strength to build the choice they picked (less pain, a better body, better brain function). In order to build muscle, you must work hard enough to trigger muscle hypertrophy. Start learning about blood flow restriction (BFR) training.
Understand this
All systems eventually cease delivering results. I’ve met many doctors and patients who become stagnated. This eventually and inevitably occurs, so we need to be ready with another equally effective approach (such as the ingredients in the sandwich) to extend the chiropractic physical therapy rehab potential.
I have many ingredients: resistance training, diet regimens, modalities, and other biohacks to change it up. I created choices that contrast dramatically to the approach being used.
For exercise and rehab practitioners, start light and build technique, as this will keep you safe. Ninety percent of weight training injuries are attributable to two causes: too much poundage or straying outside the technical boundaries of the lift. Use realistic poundage for the rep range that you select.
Answer three key questions and you can construct a customized training regimen for longevity:
- What are your realistic goals? Pain related? Add muscle? Reduce body fat? Performance related? Live longer?
- How much time and how many days do you have to dedicate to these goals?
- What length periodization timeframe can you commit to? Get good at determining a timeframe and break down the long-term goal into weekly benchmarks. Start using testing to hold you and the patient accountable (gamification works).
Synchronize care for greater progress
I synchronize nutrition, recovery, fascia care and cardiovascular exercise with resistance training to accelerate progress. Fascia and skeletal muscle is the most abundant tissue in the human body. Connect these and the brain as constantly being the most adaptable within the body.
Consistent and vigorous training with the proper diet, fascia care and weights (even with blood flow restriction) can double or triple a muscle’s size. A muscle can become more massive only when its individual fibers become thicker.
For the starters in rehab and PT, or whatever you want to call it, get good at training patients with a barbell, dumbbells, a sturdy exercise bench that inclines, and a primitive set of squat racks.
There are nine basic free-weight exercises that can and will deliver all the results a serious individual can expect from a progressive resistance routine. On the top tier are the three most important free weight exercises: the squat, bench press and deadlift. The 2nd tier is occupied by the overhead press, curl and triceps press. The 3rd tier contains the Romanian deadlift, single-leg calf raise and abdominal exercises.
Integrating rehab and PT in your practice can start simple and advance at the needs of patients. Make some “wellness sandwiches,” and make hospitality a longevity journey that is fun.
JEFFREY TUCKER, DC, practices in Los Angeles, Calif. Sign up for his newsletter on his website at DrJeffreyTucker.com.