Middle Tennessee Chiropractic and Sports Injury’s treatment goal is to provide each patient with the appropriate therapy at the appropriate time. This gives that patient the best chance for a positive outcome. Patients will benefit from treatments utilizing chiropractic adjustments, manual therapies and functional rehabilitation. These therapies can restore joint function, muscle balance and stability to weak and injured areas. Treatment schedules will vary based on your chief complaint, and will be for the shortest amount of time possible, but as long as is necessary for each patient’s specific condition.
Treatment and Assessment Methods
Chiropractic manipulation is used to release restricted joints of the spine and extremities, reduce muscle spasm and decrease pain. It is essential that the joints of the spine and extremities move freely in all directions in order for the body to perform optimally. Joints often become restricted due to injury, poor muscle activity and/or improper posture. Once a joint is restricted or loses a specific range of motion, it often causes other related tissues or surrounding joints to compensate. This typically causes pain through the altered dysfunction of the surrounding tissues.
Motion palpation is a diagnostic technique used to locate restricted joints within the spinal column and extremities. Using hands-on palpation, each joint that is related to your condition is assessed for proper mobility and range of motion. The joints that are found to be stiff or hypomobile, can be adjusted using a variety of techniques, which include mobilizations and chiropractic manipulations using hands-on thrusts. Stabilization exercises will be given to those joints that are moving too much or hypermobile, in order to restore proper strength and function.
Dry Needling is a treatment technique used by medical professionals to eliminate trigger points within muscles and other soft tissues. It requires using a sterile filiform needle that is inserted into the trigger point, causing an immediate “release” of the trigger point. A trigger point consists of multiple contraction knots, which are related to the production and maintenance of the pain cycle. Dry needling decreases muscle contraction, reduces chemical irritation, improves flexibility and decreases pain. When a needle is inserted in the muscle, it will also produce a controlled lesion within the muscle fibers that will activate the immune system. It is called “dry” needling because there is no solution injected as with a hypodermic needle during a steroid injection. With Dry Needling, the needle itself and the effects it produces within the tissue is the treatment.
Instrument-Assisted Soft Tissue Mobilizations
Instrument-assisted soft tissue mobilizations is an evidence-based treatment that enables clinicians to effectively detect and treat scar tissue and restrictions that affect normal function. The technique works by separating and breaking down collagen cross-links, stretching connective tissue and muscle fibers, increases skin temperature, facilitates reflex changes in the chronic muscle holding pattern, alters spinal reflex activity, increases the rate and amount of blood flow to and from the area and increases cellular activity in the region, including fibroblasts and mast cells
Myofascial release is a soft tissue treatment method that focuses on dysfunction within muscles, tendons, ligaments, fascia, and nerves. Typically these problems develop in soft tissues after acute injuries, repeated microtrauma or tissue hypoxia. The goal of myofascial release is to stretch and loosen the soft tissue so that the surrounding structures can move more freely. By targeting the specific areas of dysfunction, myofascial release can provide pain relief for patients with restricted flexibility and movement, thus allowing them to return to normal movement and greater function.
Manual Therapy Methods
Post-Isometric Relaxation (PIR)
Post-isometric relaxation (PIR) is an effective method of dealing with acute, painful conditions involving soft tissue through the use of a graded muscle contraction, followed by passive relaxation/lengthening. PIR can often reduce a muscle spasm that is responsible for a spinal restriction, and eliminate pain points where a tendon is attached to the bone. It is very effective for patients who have difficulty tolerating any movement at all.
Proprioceptive Neuromuscular Facilitation (PNF)
Proprioceptive Neuromuscular Facilitation (PNF) is an advanced form of stretching that involves both a contraction and stretching of the muscle group being targeted. PNF is utilized to decrease muscle tension and restore proper movement patterns.
Graded Joint Mobilizations
Graded joint mobilization is a manual therapy technique using passive movements of the joint to increase range of motion, decrease pain and decrease muscle tension.
Neurodynamic mobilization is a technique that involves either passive or active movements, that focuses on restoring the ability of the nervous system to tolerate the normal forces associated with daily activities. These mobilization strategies can release nerves that are entrapped due to scar tissue. Scar tissue begins to develop during the natural healing process following acute trauma or repetitive tissue injury. Entrapments can often lead to sensations of numbness and tingling.
Functional Exercise and Rehabilitation Protocols
The goal of functional rehabilitation is to retrain muscles, restore joint function and prevent injuries from occurring again. Patients will be given the opportunity to continue their care outside of the office by participating in various rehabilitation exercises at home. Most of the exercises prescribed will require minimal equipment and empowers patients to become responsible for their pain/dysfunction. These techniques enable the patient to achieve positive results with fewer treatments.
Many patients experience pain and have difficulty performing certain physical tasks due to a lack of strength, mobility, stability, endurance and/or balance. Functional training focuses on the fundamental movements of daily life, occupation, sports, or recreation and is often performed with body weight alone. Other simple training tools, such as medicine balls, exercise bands and balance pads may be used.
Directional Preference Testing and Therapy for Spinal Pain
Directional preference describes how pain symptoms and range of motion can be made better or worse by certain active movements in a body region. The directional preference examination helps determine which adjustment and exercise should be utilized for that patient. For example, if a patient states that he or she feels better while walking or standing, and worse while sitting, this may indicate that they are flexion intolerant. If the physical examination reveals flexion intolerance, all therapies would avoid flexion and the exercises that are assigned will have an extension bias. This will help to reduce a patient’s complaint and avoid further injury or exacerbation.
Kinesiotape is applied along muscles, ligaments, and tendons to help support the tissue, prevent harmful ranges of motion and reduce strain, allowing you to remain active while recovering from injuries. Kinesiotape creates feedback to the brain that helps decrease pain and restore proper muscle function. Kinesiotape can also be applied to improve blood flow, reduce swelling and improve lymphatic flow.
Middle Tennessee Chiropractic and Sports Injury promotes an anti-inflammatory diet. The anti-inflammatory diet is composed of fresh fruits and vegetables (preferably organic), raw nuts, fresh fish and lean meats, eggs and chicken from grass fed animals. Refined and processed foods are often pro-inflammatory and are a key contributor to pain. Processed foods are also an important factor in most health conditions affecting the population today: chronic pain, arthritis, fibromyalgia, chronic fatigue, sinusitis, allergies, digestive conditions, cancer, heart disease and diabetes.