Answers to the most common patient questions
Please use the links below to get answers to many of your questions about chiropractic care and healthy living. These answers are direct from Dr. Benson–not canned–and represent his distilled opinion based on his years of education and experience in the field. If you have questions not answered here, please use the contact form to submit your own question to Dr. Benson.
What is this “subluxation” that chiropractors talk about?
What Is A Subluxation?
The term subluxation refers to any disturbance in the normal function of a spinal motor unit consisting of two adjacent vertebrae. It’s Latin derivation means ‘small dislocation’- sub (less than) luxation (dislocation). It’s a medical term which has been given special meaning through its adoption by the chiropractic profession. The term is a way to indicate to the medical community at large that the underlying cause of a particular set of symptoms is a dysfunction of the spine and nervous system. The more preferred term in chiropractic these days is ‘vertebral subluxation complex’.
What a mouthful! Is there a simpler explanation?
Sure. I’ll oversimplify a bit, but in layman’s terms, a subluxation is a stuck joint.
Maybe that’s a little too simple. Why should I worry about a stuck joint?
Joints between most of the bones in the body consist of cartilage covering the end of the bone enclosed in a capsule containing fluid (synovial fluid). The cartilage does not have a blood supply of its own, so it is nourished by diffusion of nutrients from the synovial fluid. The nutrients are in turn pumped into the synovial fluid by pressure differences created by motion of the joint. This same mechanism removes metabolic waste products from the joint.
So when a joint gets subluxated- stuck- and stops moving, a nasty cascade of events begins. The cartilage of the joints is no longer being nourished properly. Metabolic waste products build up in the synovial fluid. This causes inflammation, swelling, and pain. Pain causes the surrounding muscles to tighten, which further reduces motion in the joint and puts more pressure on it, leading to more inflammation and pain. The cycle repeats.
If the joints involved in this cycle are the joints of the spine, the inflammation ends up pressing on nerves and interfering with sensation and control, as well as causing pain along the course of the nerve. The classic example of this is sciatica, where pressure on the large nerve running down the back of the leg causes severe pain.
So in the short term that ‘simple’ stuck spinal joint leads to pain, disability, and interference with the nervous system.
Leave it stuck for five or ten years, and it will degenerate into osteoarthritis and become a permanent problem.
For an extensive discussion of the effects of subluxation, and a number of related articles, click here.
What’s the popping sound when you adjust my back or neck?
There’s a gas (nitrogen) dissolved in the joint fluid. As I rapidly take pressure off of the stuck joint, the reduction in pressure causes the gas to come out of solution- like what happens when you open a soda. The gas forms a bubble, and that’s what makes the sound. It’s not harmful to the joint in any way- just the opposite. That pop is the sound of relief!
Chiropractic care corrects subluxation and restores you to full health.
An aberrant relationship between two adjacent structures that may have functional or pathological sequelae, causing an alteration in the biomechanical and/or neurophysiological reflections of these articular structures, their proximal structures, and/or other body systems that may be directly or indirectly affected by them. -American Chiropractic Association definition of subluxation
I have a bad back or neck pain RIGHT NOW. What’s the best first aid?
First Aid
The best thing you can do for an acute back pain is use ice only on the painful areas for the first 24 hours. A gel ice pack is great, or you can put frozen peas or corn in a plastic bag. Use a thin layer of cloth between the pack and your skin to prevent freezing the skin. The important thing is to get cold on the painful area. Keep the cold on for 20 minutes, then take it off for about an hour to allow blood to flow back into the area.
It’s not necessary to lie down in order to ice. You can put an ice pack inside your waistband and continue with your normal activities, or use a velcro wrap, available in the pharmacy section of stores, to hold the ice in place on any painful area.
Ice helps to control inflammation and swelling, so tissues are not further injured by the swelling. Heat may feel good, and may help relax muscles, but it will increase swelling in an injured area. The rule of thumb is to use ice on and close to the spine and sore joints, heat on surrounding muscles. You can alternate ice and heat in the same 20 minute on, hour off pattern as long as you begin and end with ice.
In general, you will feel best lying on your back on a firm surface with your knees bent. This varies depending on the exact nature of your injury, so if you find another position which is more comfortable, use it.
You will often be more comfortable standing or walking rather than sitting. If you must sit, opt for a reclined position to take some of the load off the lower back joints. If you must sit in an upright position, make sure you get up and move around at least once per hour.
If you can walk, do so. Walking keeps the spinal joints moving, and strengthens muscles in a balanced way.
If the pain persists, or if you have pain or numbness radiating down an arm or leg, see your chiropractor as soon as possible.
I’m really hurting. How can I tell whether I’m in serious trouble?
Emergency Conditions
If you are losing control of the leg muscles, or losing bowel or bladder control, go to an emergency room or urgent care facility immediately, or call 911. These symptoms may indicate an emergency situation that requires immediate treatment.
If you have pain radiating down an arm or leg, or numbness, don’t wait to have your condition evaluated by your chiropractor. These symptoms indicate pressure on nerves which can be serious if not properly treated.
Minor back pain should be gone within three days. If you are simply sore for a couple of days after doing something unusual, and the pain is gone on the third day, don’t worry about it. If the pain persists longer than this, you should have it checked out by your chiropractor. The body does a good job of compensating for problems, so the problem may seem to go away over the course of a couple of weeks, but it really goes “underground” and creates a long-term tightness in muscles and restriction in joints which result in larger problems later.
Are chiropractors really doctors?
Are chiropractors really doctors? Yes.
All chiropractors have earned the clinical degree Doctor of Chiropractic (DC) and become licensed in the state in which they practice. Chiropractic is the third largest clinical doctoral-level profession in the world, after medicine and dentistry. The same undergraduate prerequisites apply to all three, and the four-year curriculum to earn the DC degree includes graduate level instruction in all aspects of the systems of the body, diagnostic procedures, and internship in the chiropractic approach to restoring health. We pass several National Board examinations as well as a State licensing exam in every state in which we wish to practice. Chiropractors are licensed in all 50 states and many countries around the world, and are subject to the same state and federal regulations regarding standards of care, privacy and record keeping. We earn the right to call ourselves doctors!
There is a good Yahoo Answers article on this issue- click here.
On a personal note, I am periodically asked why I became a chiropractor rather than a medical doctor. I did have to make that decision- an acquaintance at Southern Illinois University really wanted me in his family practice program, and as a National Merit Finalist and Eagle Scout I was a prime candidate. As I considered the option, I had to think beyond school and on to what I would actually be doing in my career. In medicine these days, after all the diagnosis, the options for making things better are few- counseling on lifestyle changes, prescribing drugs, or removing something with surgery. The first I can do as a chiropractor; the other two I didn’t care to do. In chiropractic, I can make people’s lives better immediately using my hands and my brain, or refer people to the care they need. I have skill and talent for the chiropractic profession, and that’s what I chose for my career.
I can make people’s lives better immediately using my hands and my brain
Does an adjustment make a noise?
What Is A Subluxation?
The term subluxation refers to any disturbance in the normal function of a spinal motor unit consisting of two adjacent vertebrae. It’s Latin derivation means ‘small dislocation’- sub (less than) luxation (dislocation). It’s a medical term which has been given special meaning through its adoption by the chiropractic profession. The term is a way to indicate to the medical community at large that the underlying cause of a particular set of symptoms is a dysfunction of the spine and nervous system. The more preferred term in chiropractic these days is ‘vertebral subluxation complex’.
What a mouthful! Is there a simpler explanation?
Sure. I’ll oversimplify a bit, but in layman’s terms, a subluxation is a stuck joint.
Maybe that’s a little too simple. Why should I worry about a stuck joint?
Joints between most of the bones in the body consist of cartilage covering the end of the bone enclosed in a capsule containing fluid (synovial fluid). The cartilage does not have a blood supply of its own, so it is nourished by diffusion of nutrients from the synovial fluid. The nutrients are in turn pumped into the synovial fluid by pressure differences created by motion of the joint. This same mechanism removes metabolic waste products from the joint. So when a joint gets subluxated- stuck- and stops moving, a nasty cascade of events begins. The cartilage of the joints is no longer being nourished properly. Metabolic waste products build up in the synovial fluid. This causes inflammation, swelling, and pain. Pain causes the surrounding muscles to tighten, which further reduces motion in the joint and puts more pressure on it, leading to more inflammation and pain. The cycle repeats. If the joints involved in this cycle are the joints of the spine, the inflammation ends up pressing on nerves and interfering with sensation and control, as well as causing pain along the course of the nerve. The classic example of this is sciatica, where pressure on the large nerve running down the back of the leg causes severe pain. So in the short term that ‘simple’ stuck spinal joint leads to pain, disability, and interference with the nervous system. Leave it stuck for five or ten years, and it will degenerate into osteoarthritis and become a permanent problem. For an extensive discussion of the effects of subluxation, and a number of related articles, click here.
What’s the popping sound when you adjust my back or neck?
There’s a gas (nitrogen) dissolved in the joint fluid. As I rapidly take pressure off of the stuck joint, the reduction in pressure causes the gas to come out of solution- like what happens when you open a soda. The gas forms a bubble, and that’s what makes the sound. It’s not harmful to the joint in any way- just the opposite. That pop is the sound of relief!
Chiropractic care corrects subluxation and restores you to full health.
An aberrant relationship between two adjacent structures that may have functional or pathological sequelae, causing an alteration in the biomechanical and/or neurophysiological reflections of these articular structures, their proximal structures, and/or other body systems that may be directly or indirectly affected by them. -American Chiropractic Association definition of subluxation
Is chiropractic care safe?
Is Chiropractic Care Safe? Yes.
Opponents of chiropractic periodically trot out scares about how chiropractic care causes strokes. The actual risk is very small- various sources put it at between one in a million and one in fourteen million. For comparison, this is approximately the same risk of stroke you run getting your hair washed at a salon. Several studies about chiropractic stroke risk can be found at www.chiropracticissafe.org , a site presented by the International Chiropractors Association. The studies are done by independent researchers.
More recently, a thorough review article was published in the medical journal International Journal of Clinical Practice on 9/1/2013 to address this controversy. Their conclusion: “There is lack of compelling evidence that spinal manipulative therapy (SMT) is causally associated with stroke. …There may be some links or association with SMT and vertebral artery dissection (VAD) in untrained practitioners, but this has not been established with chiropractors.”
The risk from not having chiropractic care is significant. The pain relievers taken to deal with chronic unresolved neck and back pain have serious effects on kidneys and liver. Structural problems not corrected lead to arthritis, disk degeneration, neurological problems- the list goes on. And if your condition deteriorates to the point where surgery is your only option, the risk increases greatly.
Finally, chiropractors are aware of the risks inherent in our care; no technique in health care which is effective is entirely without risk. So we constantly refine our skills and modify our techniques to make them even safer.
Dr. Benson is very aware of these issues, and uses the safest, most advanced techniques available to keep you well and comfortable.
Do kids need chiropractic care?
Newborns and Infants
Why take the chance? I check infants for a very low fee when you bring them in with you to your visits. Get them off to an optimal start!
Younger children
We’re always amazed at the falls, bumps, and bruises that kids sustain, apparently without real injury. Kids do have great recuperative abilities. They initially have no history of injury. The small stresses do take care of themselves, but even injuries that result in altered joint motion might not be noticed. That altered joint motion- subluxation- can persist and set up long term problems if not resolved.
I modify my techniques, and use special ones for kids so it’s not scary or painful to adjust them. Under normal circumstances, if there’s no major injury, we can take care of small problems before they become big ones, then check once a year or so to keep your wonderful child in top shape for the future.
As they grow up
More bumps and bruises, athletics, school activities, backpacks that become way too heavy- childhood is not without its physical stresses. Again, the ideal approach is to check periodically and prevent problems.
If your child complains about a physical pain, have it checked out. With rare exceptions, kids don’t make up pains, and if it’s bad enough for them to mention it, it’s bad enough to be evaluated and corrected if necessary.
If your child is an athlete, the concern is not only prevention and correction of injury, but optimum performance. The muscle balancing techniques I use allow symmetrical body development and the most efficient application of strength to athletic performance. Stronger, more balanced muscles lessen the chance of injury.
The long term view
One of the most gratifying aspects of practicing in one place for so long is seeing people I treated fresh from the womb grow into strong, healthy adults. When they’re coming home on a break from college, they call their parents to make them an appointment. They get a job, get married, and bring their own kids in to continue the cycle of better health. It’s wonderful to be a part of their lives.
I’ve heard that once you start going to a chiropractor you have to continue forever. Is that true?
You don’t have to continue chiropractic care forever- but you may want to!
There seems to be a myth out there that once you start seeing a chiropractor you have to go forever- as if somehow having that first adjustment creates a need for further chiropractic care. What a screwy idea! What we’re doing in chiropractic is restoring the normal joint motion and alignment your body was born to have. We don’t make joints ‘too loose’, we don’t overstretch and damage ligaments, and we don’t make the biomechanics of the body in any way worse. Just the opposite. Besides, you’re always in charge- you can stop your care at any time.
Once you begin chiropractic care, you will experience within the first few weeks how good it is possible for you to feel. Your body will like it, and so will you. If you want just enough care to get you out of pain, there’s no requirement that you continue. But you should be aware that you’re setting yourself up to have the problem recur, since healing and full correction of the condition that caused your pain will not yet be complete. You’ll still be fragile, and prone to easy reinjury. You will probably want to continue with care long enough to fully correct the problem that caused your pain in the first place, so it doesn’t come right back and bite you again.
Taking a longer view, we all have a history written in our bodies of past injuries and insults that have left a mark, especially on ligaments and joints. This results in ‘weak links’ in our biomechanical chain where the stresses of life, bad posture, bad ergonomics, overwork, awkward lifting and computer work can cause failures that take you back into pain and disability. Every time around that cycle leaves a further mark. Many of my patients choose to work with me to find the proper interval to recheck them, whether it be monthly or a time or two a year, even if they’re feeling good to prevent problems and maintain the optimal health they’ve attained.
With the testing I do, I can find and correct problems which are building up before you’re even aware there’s a problem.
What’s the best bed? The best pillow?
Sleeping Position
It is best to sleep on your back or on your side. Stomach sleeping is hard on both the neck and the lower back. A pillow under the knees helps take pressure off of the lower back. When sleeping on your side, a pillow between the knees will make for more comfortable sleep.
You will need the assistance of someone else to look at you in your normal sleeping position. When viewed from the back while lying on your side, your neck and head should be in a straight line with your spine. When viewed from the side while lying on your back, your hip, shoulder and ear should lie in a straight line. Whatever pillow and mattress combination does this for you and feels comfortable is the one you should use. Don’t forget to reevaluate periodically- pillows compact and compress, as does any topping on your mattress. If you change anything about the bed or pillow- replace the topper, add another comfort layer- recheck your position.
My Current Bed Recommendation
Recently revised after considerable research: A well-designed innerspring mattress will give good support for 10 – 15 years. You need one which is firm enough that your spine does not sag in a U shape, but not so firm that your weight is supported only at shoulder and hip, with the spine between unsupported and sagging. Take a partner when you’re shopping, lie down as you would when sleeping, and have them look at the position. See Sleeping Position above. When you’re getting serious about buying a new bed, be prepared to spend half an hour or so on the ones you’re considering. A brief lie down won’t give you a clear sense of how the bed will work for you.
I would recommend against a pillow-top mattress. Although they feel great initially, the top material wears out much faster than the innersprings, and cannot be replaced. Better to buy a memory foam topper for softness, and replace it when necessary. What you’re looking for is quality, high count springs- the ‘lowest’ model in a manufacturer’s line that has the higher count springs. As you go up the line in a particular spring count, you just get a cushier top.
I used a King Koil Spinal Guard for over 20 years with a separate 2″ memory foam topper. The mattress was designed with the assistance of the International Chiropractors Association, and is relatively inexpensive for a quality mattress. The other major bed manufacturers also make good products. Never buy a used mattress!
I have recently purchased a Novaform “bed in a box” from Costco. We decided to take the risk on a newer form of gel/memory foam mattress, realizing that it may need to be replaced in a shorter timeframe than an innerspring mattress. So far it is quite comfortable and supportive, fitting my criteria for sleeping position, and not exhibiting the downsides of a monolithic memory foam bed like the Tempurpedic. For my opinion on longevity, we’ll have to wait a few years.
Other Types of Beds
A conventional foam bed can give good support, but only for 2 or 3 years, so I can’t recommend them. The monolithic memory foam beds (e.g. Tempurpedic) have been reported to me as being hard to turn over on, and too warm (because you sink in). Some of the new, expensive foam beds are being touted as good for 20 years or more, but I haven’t seen any such studies, nor have they been around long enough to provide the base of experience to confirm that durability.
Air beds, such as the Select Comfort, give good support and have the advantage of being able to vary firmness, even from one side of the bed to the other. The downside is that if you manage to puncture the bed you have nothing to sleep on until you can replace it. Some have also reported issues with the sound of the air pump at night.
I don’t have the money or inclination to try the very expensive ‘alternative’ beds on the market. I wouldn’t spend the money when a reasonably priced innerspring mattress will do the job. I do not recommend waterbeds of any type. See discussion below. For further reading about shopping for beds check out this article.
Pillows
Foam, fiberfill, down, ‘orthopedic’, memory foam, buckwheat, water- I’ve tried them all. The type of pillow that will work for you depends not on the type of pillow but on the position your head ends up in. I currently use a relatively inexpensive pillow I first used in a hotel, because it happens to support me properly. I won’t feel bad about replacing it when it inevitably compacts and stops working well.
A buckwheat hull pillow has the advantage of being able to change shape during the night as you switch between back and side sleeping, and provides customized support in both positions. This type of pillow takes about a week to get used to, because it’s not “cushy” like your current pillow. They provide great support, though, which can be customized ‘on the fly’ for your needs. Some don’t like the sound of the hulls shifting at night, others it doesn’t bother.
What doesn’t work
Waterbeds keep the body in a “hammock” position which is hard on the spine. They often feel great at first, partially because they’re soft, partially because they’re heated. Get the same effect (and better sleep) with a good innerspring mattress, a topper if you like the softness, and an electric mattress pad if you like the warmth.
Futons do not provide proper support. Avoid them if you can.
If your foam mattress is more than 4 years old, or your innerspring is more than 15 years old, assume it needs to be replaced.
What vitamins do I need?
This is such a huge subject that I can’t really do it full justice here, so I’ll limit myself to some general principles and comments.
Many people don’t need to take vitamins.
Crazy statement, eh? It’s true if your overall health is good and you eat a balanced diet, especially if your diet includes animal products in moderation, lots of fresh fruit and vegetables, and is composed, as much as possible, of organic foods.
If you know you’re not eating right, by all means take a good multivitamin daily!
As long as you’re taking a well-formulated multivitamin according to package instructions, and not going for ‘megadoses’, it can’t hurt and may very well compensate for nutrients you’re missing in your diet. Men and post-menopausal women should look for an iron-free supplement.
Vegetarians have an entirely different set of nutritional issues.
If you are considering becoming a vegetarian, study up- don’t just drop animal products from your diet. You must learn to combine non-meat foods in such a way as to create a complete protein, or you’ll start to waste away.
Some people absolutely need to take vitamins.
Women who are pregnant or lactating need to take prenatal vitamins, due to the tremendous demands the developing baby makes on their system. Women approaching menopause and older people of both genders should also begin taking calcium and magnesium in a one-to-one ratio. They need to be taken together in the same supplement so they are absorbed similarly. The citrate form is more easily absorbed. Vitamin D in the mix can help absorption.
If all of your food comes from large commercial farms, you may need trace minerals.
Commercial farming has leached the trace minerals out of much of our soil. Fertilizers only replace the major plant nutrients, not the trace minerals. Trace minerals are metallic ions that the body uses in very specific parts of the metabolic process. Usually a single ion is incorporated in an energy-producing cascade, and these ions are conserved by the body, but they do gradually get depleted. Consider buying organic produce when you can get it. If you can’t, a trace mineral supplement every couple of months should take care of it.
Some vitamins can hurt you.
The fat-soluble vitamins, including A and E, can build up to toxic levels in the body. Be careful of large doses over prolonged periods. Most of the others, especially the B vitamins, are eliminated in the urine if there’s an excess. If your vitamins are turning your urine orange, you are eliminating excess B vitamins. That’s good in that you know you’re getting more than enough, but you’re probably also wasting some money. Back off a little bit.
If you live up here in the Pacific Northwest, you should probably be taking Vitamin D.
We just don’t have the opportunity to be out in the sun enough to rev up our body’s ability to produce vitamin D. Deficiency causes myriad problems- see this link for the list. Latest studies suggest that the D3 form is much better for maintaining the proper levels in the body and bringing them up from deficiency.
Glucosamine and Chondroitin may help with joint pain.
Studies on these substances are coming out mixed, but a few of my patients have reported good results. The principle here is to have the substances the body needs to maintain the cartilage of the joints available at all times. You will need to give these substances (best taken in combination) a trial of at least a couple of months to see if they work for you. It’s not a short-term fix.
CoQ-10 is a coenzyme helpful in reducing the severity and frequency of migraines for many sufferers.
If you have migraines, try it for a month or so. If it’s helpful, be consistent in taking it and do not abruptly stop taking it.
Be careful (and sparing) with herbal remedies.
Melatonin supplements, for instance, work fine for better sleep temporarily, but pretty soon the body compensates by making less melatonin of its own. If you keep taking extra of something the body produces, the body (being conservative) will curtail making it. You may find yourself dependent on the supplement after awhile, and stopping may be tough. My own general orientation is to take as few medications as possible, whether they’re from Big Pharma or the vitamin store. If a herbal remedy is effective, it’s a medication, and should be evaluated by a physician- in this case a naturopath.
If you feel you are deficient in a vitamin, or are considering herbal or homeopathic remedies, consult with a naturopath.
They are the doctors with the most training in these matters. Be sure you ask questions and understand exactly why a supplement or herb is being recommended, and be a little skeptical if you’re loaded with a grocery bag full of supplements when you leave. Get a second opinion.
Some herbal remedies interact with medications and with each other
They may either interfere with or enhance the effects of medications, either of which can be potentially dangerous. If you are taking prescribed medicines, be sure your doctor and pharmacist are aware of everything you are taking, no matter how innocuous it seems.
Can you test vitamins and other substances using Applied Kinesiology?
I can, and I do, BUT- and it’s a big but- I would absolutely not have anyone who is selling you vitamins test you with Applied Kinesiology to recommend vitamins or other supplements. This is because the tester is always part of the testing mechanism, and can induce subtle, unconscious bias into the process. This need not involve any intent to deceive or anything sinister- it’s just that if the tester’s income is going to be higher if a test comes out a certain way, there is an inevitable bias introduced into the test. One reason I can trust the AK testing I do- aside from 30+ years experience- is that the results don’t affect my income.
Don’t let the person selling you the supplements muscle test you for the supplements!
I might like to become a chiropractor- what do I need to know?
I’ve had a number of requests from high school and college students who are considering chiropractic as a career to talk about how I got into the field and how I practice.
I love to encourage good people to enter the profession. This should answer many of your general questions.
The thing I like most about chiropractic is being able to help people become healthier. It’s gratifying to have someone come in to the office in pain and really grumpy, and know I have the skills to send them out the door healthier. The work is a moving meditation. People do appreciate the work, even though they may be sore for awhile after the treatment. What is people’s mood when they come in? It’s often bad. They’re hurting, and not able to do the things they find fun. Does this affect my mood? Not really. My office is the one GOOD place to complain! I can do something about it.
This leads into another question I’m often asked. I did consider becoming a medical doctor; in fact I had a friend who very much wanted me in his new family practice program at the Southern Illinois University med school. My problem with the way medicine is practiced is that there isn’t much you can do for someone other than prescribe a pill or remove something. Beyond that, it’s just counseling changes in diet or lifestyle, and I can do that with more freedom as a Doctor of Chiropractic. Plus I have a whole range of physical things I can do to enhance health and free the body to do its own healing.
My least favorite part of the job is the paperwork, dealing with insurance companies and attorneys and trying to get paid. Even that isn’t so bad with the right attitude- it’s a challenge.
My practice is scheduled so I can see up to eight people per hour, though I schedule a full hour for the first visit. On a very busy day I might see 60 people, more average might be 35-45. I find that this is enough time to do a thorough adjustment without feeling rushed- and the time allotted is only an average. If someone needs questions answered, or something special done, I make the time. We mostly stay right on time so as to respect the time of my patients, but they’re understanding about emergencies. They know they’ll get the same consideration when they need it.
I went to Life Chiropractic College- West in San Leandro, CA. At the time I went, the teaching staff was wonderful, and classes were quite small, not over 25, so I had a great experience. As far as the workload, like any med school it is FAR more intense than undergraduate study. Between classes, which are all required (with attendance 90% or better), labs, practice, and study, your time is fully committed. To do it right, you don’t have time to maintain relationships or do anything else resembling a normal life. If you have a truly committed, supportive and forgiving partner, great- otherwise plan to put life on hold for four years.
In a metro area, chiropractors sometimes specialize in a particular area of interest. I practice in a little town, so my practice runs the gamut from newborns to athletes to older folks. I have quite a bit of specialized postgraduate training- that’s where you learn the latest good stuff- so I have options for whatever problems present themselves. I have an individual practice, though I share a waiting room with an acupuncturist. As far as I know there are few opportunities to practice in a hospital, and I wouldn’t be interested if there were. Some chiropractors associate in multi-doctor practices, and there’s some attraction in having a larger shared staff to deal with administration. I prefer to keep my life simple, just me in the office, even if that means I have to do everything from seeing patients to paying bills to maintaining the computers to cleaning toilets.
I would encourage you to get in contact with as many of the chiropractors in your area as you can, and volunteer to work in a well-run office, as I did in the San Francisco Bay Area. You will learn how to do chiropractic when you’re in school, but you will get pitifully little training in how to run a chiropractic business. If you have the opportunity to see how it’s done by several different docs, by all means take advantage of it.
Selfishly, for the profession and your patients, I would encourage you to honestly evaluate your talent in work with the body. Give some massages, and see how people react to your touch. See whether you enjoy it. Massage is not the same as chiropractic, but it requires a similar base skill- the ability to see into the body with your hands. If you have that talent, and feel you’re called to the profession as a service (not just a job)- welcome.
What exercise should I be doing?
Consistency in exercise is more important than the amount or kind of exercise you do.
No one has ever gotten fit by simply buying a piece of exercise equipment or gym membership. Do what you’re going to actually do regularly over your lifetime.
I suggest that patients start exercising by walking at least half an hour per day.
When you are walking at least four days out of each seven, then think about adding other exercises. Walking gets all of the spinal joints moving rhythmically, and strengthens the muscles that support the back in a balanced fashion.
The next exercises you should add are core exercises.
Recent research has shown that several simple exercises activate the main core muscles that give your body stability. The Quick Core Workout at Sportsmedicine.about.com gives you a time-effective program for strengthening your core. You don’t have to do all the exercises at first- start with the plank, side plank, bicycle crunch, hip bridge and single leg bridge to get you started. These exercises have been proven by recent research to be most effective in activating and strengthening the core. They are simple enough for you to do at home without supervision.
Even better, find a Pilates class.
This popular form of exercise concentrates on strengthening the core muscles of the body in a balanced fashion. Do it with an instructor at first, not a book or a DVD. It’s too easy to do an exercise a little wrong and hurt yourself. The instructor can also make modifications in the exercises to account for your particular needs and restrictions.
Swimming, bicycling, and cross-country skiing are other excellent exercises.
If you don’t swim, and have trouble walking, find a water aerobics class. This will minimize stress on the joints and still give you an excellent workout.
If you are going to move on to weight training, do it in a gym with ample supervision.
You want someone to watch your body position as you do the exercises until you get the feel of the right positions. It is extremely important to use your body mechanics correctly, and until you’ve had quite a bit of good supervision you don’t have the internal feel of correct biomechanics. A trainer can also help you avoid common mistakes like recruiting your neck muscles to eke out the last repetition of an upper body exercise.
I would recommend walking over jogging in most cases, unless you are a trained runner.
The problem with untrained jogging is that heavy footfalls jar the body and put undue stress on knees, ankles, and spinal joints. If you are a trained runner and enjoy running, do it. Remember that your running shoes lose their cushioning and support ability in 3-6 months, depending on how much you run. Plan to replace them 2-4 times per year.
Not all exercise is ‘excercise’
You don’t have to have a bunch of equipment or a gym membership to exercise. Any activity that gets your heart rate up and works your muscles counts. Gardening and team sports are good examples. Just pay attention, don’t try to do too much in one day, and avoid obvious injury producers like sustained awkward positions and lift/twist combinations.
How to start a new exercise, or restart gardening in the spring
Do less than you think you can the first time out. Exercise feels so good that it’s easy to overdo it when you start. Realize that you’re using muscles in ways you haven’t for awhile, and they need time to adapt.
Start with 20 minutes of the new exercise. Stop, take a drink of water, stretch any tight muscles, and evaluate how you are feeling. If everything seems OK after a five minute break, do another 20 minutes, reevaluate, and repeat. On subsequent days, if all has gone well, you can extend the work intervals, but never beyond one hour. You should be stretching and getting a drink of water at least that often.
Consistency is key. Do exercises you like, so they will become a regular part of your life from now on.
Does Dr. Benson approve of yoga and stretching?
Warm up before you stretch!
Studies have repeatedly shown that stretching first- before you have done 5-10 minutes of exercise that gets your heart rate up and the blood flowing through your muscles- can weaken the muscles, ligaments, and tendons, and actually increase the likelihood of injury. At a minimum, if you’re hurting, walk as briskly as you can manage for 5-10 minutes and move the major muscle groups that don’t make you hurt.
Hurting Back Stretch
The best simple stretch for your back is to lie on your back on a firm surface with your legs bent, then stretch a knee gently toward your chest. Use your arms to pull the leg toward your chest, then relax into the stretch for a full minute. Do one leg, then the other, then both together, relaxing into the stretch for a minute each time.
You can add dropping the knees (held together) to one side and then the other, again relaxing into the stretch for a minute.
Don’t overdo. Twice through the above sequence, twice a day (morning and evening) is about right for a hurting back.
Yoga
It’s a great stretching routine, among many other benefits, but don’t try to do it from a book or a video. Take a class. Yoga postures are very powerful stretches, designed to be done with an Eastern sense of breathing, relaxing, and centeredness. If you do the postures with a Western, calisthenics-like sensibility, you can hurt yourself badly. Even a few degrees of change in the angle of the postures can create a wholly unintended stretch that can tear tissue. You need to have someone watch you closely at first until your body learns exactly how the correct position feels. Then you can use a video to pace you and remind you of the positions.
Get your blood moving first- before you stretch.
Is a massage all I need?
Massage is a terrific adjunct to chiropractic care, not a substitute for it.
Though I do a number of techniques to relieve the cause of stubborn, long-lasting spasm, I don’t have the time in my practice to work over the muscles in the way a massage therapist can. I love to combine massage with an adjustment so the muscles are out of spasm and don’t pull the spine back into trouble.
I don’t find that it’s critical whether your massage comes before or after your adjustment in most cases. I’m able to get the adjusting done either way. It’s a matter of personal preference whether you like to have the muscles relaxed before your adjustment or have the massage relax you and settle things in after your adjustment.
I practiced massage therapy myself before I went to chiropractic college.
What you are looking for in a massage therapist is not a specific technique, but rather someone with the talent to see into the body with their hands. A skilled therapist will be able to feel where the body needs help and go to work without your having to point out every tight spot. He or she will be able to feel just how to work with the muscles so the work is effective, without eliciting a defensive reaction from your body. You shouldn’t feel ‘beat up’ after a massage, but it shouldn’t be so light that nothing really gets done about your tight spots.
Find a massage therapist who can see into your body with their hands