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December, 2013

The Quality of Individual Care is Key to Treating Nagging Sports Injuries


Have you ever broken from your busy office schedule to take a long, hard look at your patients? We're not talking about demographics, gender or even age. This is more about the faces of each and every person who enters your facility expecting and, often demanding, the very best care.

Unfortunately, given our active work lives and the amount of people we must now see on a daily basis just to make ends meet, it's become far too easy to forget the individual and focus solely on the ailment and the treatment almost as if they were parts of a mathematical equation. Although we're all scientists in a way, dependent on the research of medical science to continually expand and update our levels of care, we must never forget our expertise alone is not enough to create irreparable patient bonds that last for years or even decades. A personal dedication to individual care is mandatory for establishing a professional reputation of excellence that saturates the community and produces thousands of lifelong, loyal patients.

No Two Patients Are Alike

sports injury - Copyright – Stock Photo / Register Mark The treatment of nagging sports injuries starts with this philosophy. No two patients are alike. Despite the similarities between similar individuals, no two will respond the exact same way to a chiropractic technique and the manner it is administered. So, treatment must begin not only with an assessment of the physical injury and its causes, but also the mindset of the individual. This is the only way to develop a rapport with the patient that will take them from the initial treatment phase through rehabilitation to ongoing wellness.

With three decades of sports chiropractic experience that includes the treatment of tens of thousands of athletes at hundreds of events, I am often asked, "What is the hardest part of treating world-class athletes competing on an international stage?" The answer is that the quality of care and concern must be consistent, no matter what; whether it involves nationally recognized ice skaters, wrestlers or triathletes moments before a gold medal competition; or baby boomers who visit the office occasionally and only after taxing themselves after a particularly strenuous weekend.

However, the difficulty in treating these vastly different individuals again lies in the mindset. Professional and amateur athletes most often listen and ardently pay attention to even the simplest of instructions. Although they are often superior specimens with pain thresholds far exceeding the norm, they know their very careers, and possibly the next payday, are many times dependent on the directions and subsequent results that improve optimal performances.

As a result, top-tier athletes are quite amenable to instruction once you've gained their trust. Oftentimes, this is because they are far more knowledgeable about sports injuries, treatments and outcomes than the normal weekend warrior. They can also distinguish the difference between good and bad soreness and thoroughly value the additional training and competition time that could be lost trying to "play through the pain."

On a 10-point grading system, a 1-point ankle, knee, elbow, shoulder or wrist sprain, which is the mildest of conditions, will normally take anywhere from a few days to several months to heal depending on the age, level of fitness and the treatment regimen that is both prescribed by the doctor and followed by the patient. And, this is the tricky part. Education, compassion and time are all key ingredients for treating the average person, no matter their age and gender, relieving them of nagging aches and pains and placing them firmly on the path to lifelong physical wellness.

The truth is that many 20-somethings think they are invincible, while baby boomers are now more involved in activities ranging from biking, golf and tennis to jogging, aerobics and weight lifting than ever before. Unfortunately, wisdom doesn't always accompany the desire to stay fit and trim, which has led to our older and middle-aged populations heading for treatment and emergency rooms in ever-increasing numbers.

Consequently, the handling of the initial consultation and exam are essential for not only determining injuries and their severity, but also outlining ongoing practices that will eliminate their repeat. It is also imperative for instilling confidence, especially in first-time patients. Everything you do from the time the person enters the examination room through the moment they walk out the door must be explained in clear, understandable terms. This proceeds from clinically interpreting the injury, physically reproducing the pain and then confirming the type of ailment through diagnostic testing.

Furthermore, individuals must be made to understand that they are likely not suffering from the same problem as a neighbor or family member because they have similar symptoms. Just as every individual is unique and different from the next, so too are the health conditions they suffer and the treatments they require. Never treat the symptom alone. This cannot be emphasized enough – take the time and patience to talk to the patient and to help them to identify the underlying cause of the injury.

For example, you'll sometimes see a good athlete with bad form, but you'll almost never see a bad player with good form. Proper form is not only integral to improving athletic performances, but also alleviating undo stress on the spine, neck, joints, ligaments and tendons. Anyone who has ever played the game knows golf is a sophisticated sport that includes a wide range of motions. A good swing can result in a 250-yard drive straight down the fairway, while a bad one can easily slice or hook in the wrong direction. On the medical side, bad form can also result in a host of injuries ranging from muscle strains, herniated discs and separations to shoulder tendinitis, bursitis and impingement syndrome.

Messages to Emphasize to Your Patients

So, it's not enough to treat symptoms and ailments to help patients overcome the nagging injuries that have likely plagued them for years. Essentially, you must diligently partner in each person's wellness in order to become a valuable and trusted resource to the community and a lifelong mentor for better health. As an example, here are some valuable insights every individual should know before they leave your office:

  • Pain is one of the last signs of a problem. Be aware of the initial signs of discomfort, especially as it progresses and becomes more frequent.
  • Don't wait to seek treatment. It's important to treat an injury within the first four to six weeks of its occurrence. Otherwise, scar tissue will develop and the chances of continually aggravating the problem with greater levels of severity will increase over time.
  • Subsequently, newer injuries, if treated appropriately and immediately, tend to respond to fewer visits assuming that major tissue injury has not occurred. Many of these first-time injuries can be effectively managed in as little as three to four visits. Conditions that have been present for greater than three months and recurring conditions are generally more stubborn and difficult to manage. Resolution may require 12 visits or more.
  • Stay fit and active. Warm up before doing anything strenuous. Be smart. Don't spend several months idle and then expect to perform or work out at peak levels. This is especially true for weekend warriors and baby boomers, who continue to view the past as the present.

Finally, you don't need to be great at everything, although it helps to provide proficient, ongoing care to patients. But you should strive to be the very best in at least one or two osseous and soft-tissue techniques to establish your credibility and become a very valuable resource to your patient's wellness. Don't forget that most of your patients live within a five- to 10-mile radius of your office. So, the circle is relatively small and the news surrounding your practice, whether good or bad, does not have to travel far to impact the perception of your services – and ultimately its bottom line.

Dr. Ira Shapiro has been the director of the Plaza Chiropractic Center in Old Bridge, N.J., since 1984. He is a two-time member of the U.S. Olympic Medical Team and the recipient of numerous professional awards and distinctions. For more information, visit

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