Develop a plan for extending your practice life.
It’s a problem DCs are aware of, but also one seldom discussed: getting hurt on the job. Too often, work-related injuries reduce the time a chiropractor can spend in active clinical work. But how do you overcome the aches and pains of adjusting to extend the life of your practice?
My own experience is an example of struggling with—and solving—this very problem.
When I started out as a chiropractor, like so many others, I used my hands.
As a Logan University graduate, I began with the Basic Technique. For those unfamiliar with this procedure, you hold a thumb contact under the sacrotuberous ligament until you feel the patient relax, and then make the adjustment. It isn’t a physically taxing move, but it can take too much time.
The Van Rumpt technique, also known as Directional Non-Force Technique (DNFT), was next for me. This method calls for using one’s thumb—with a quick flick of the wrists and elbows—to accomplish the thrust.
After three years of consistent physical effort, I had created a daily ritual: Each night at home, I soaked my elbows in ice water to take down the swelling and ease the pain. The next morning, it took a soak in hot water to loosen up and get going again.
A new way to adjust
I had to do something to take that terrible strain off my wrists and elbows. My solution was the creation of the first adjustment instrument. It was crude compared to the tools we have today (the first Activator was a dental mallet fitted with a brake shoe rivet and a blunt rubber tip), but it worked.
Before the Activator, I had to limit my patient load based on how my elbows were feeling. Now, I could see more patients and create better results for them, while preserving my own body and practice. The moral of the story is that less force can mean a longer practice life.
Research supports this assertion. A study published in Chiropractic and Osteopathy suggests injuries begin while students are still in school, with problems most commonly arising when adjusting the lumbosacral spine with the patient in the side-lying position (the “lumbar roll”).1 Another study arrived at similar findings, suggesting that as many as 40 percent of practicing doctors have been injured while performing an adjustment.2 Most injuries occur early in a doctor’s career and require a change in technique.
Extending your practice life can also involve expanding the scope of your practice to include more geriatric patients. This growing population can be less familiar with and more frightened of chiropractic, yet can benefit greatly from a low-force adjustment.
My favorite example is a 104-year-old patient of mine. For 15 years she had a stiff neck and headaches, yet she avoided chiropractic out of fear of having her neck “popped.”
Fortunately, her daughter had been successfully treated with chiropractic and eventually convinced her mother to come in for a visit. After just one Atlas adjustment, she finally found relief.
Even now, as doctors today use various low-force adjusting instruments, we hear concerns about pain associated with frequent use. That issue can be resolved thanks to the invention of electronic adjusting instruments that call only for the pull of a trigger and suit every kind of practice.
It makes sense to extend the life of your practice by giving the best care possible to your patient and taking care of your own body. By choosing your technique wisely, you can avoid career-limiting injuries and still give the best care possible to your patients.
Arlan W. Fuhr, DC, is credited with developing the Activator Method Chiropractic Technique, a widely used instrument adjusting technique, and the associated Activator Adjusting Instrument. Recognized worldwide for his contributions to the chiropractic profession, Fuhr is also the co-founder and CEO of Activator Methods International. He can be reached through activator.com.
1 Bisiacchi DW, Huber1 LL. Physical injury assessment of male versus female chiropractic students when learning and performing various adjustive techniques: a preliminary investigative study. Chiropr Osteopat. 2006;14:17.
2 Holm SM, Rose KA. Work-related injuries of doctors of chiropractic in the United States. J Manipulative Physiol Ther. 2006;29(7):518-23.