Basic Injury Recommendations to Enhance Patient Results

I talk a lot about how spinal ligament injuries are the number one cause of chronic pain and disability in the world today because they are.

Spinal instability is the number one cause of lumbar problems, cervical problems. It’s the number one cause of the headaches.

There are basic recommendations that you can do to improve your injury results with these patients.

Communication to your patient is a key factor. These injuries are the primary cause of chronic pain. They must understand that their injury recovery is not to be taken lightly.

Patients that have ligament injuries have a 50% chance of never fully recovering. According to the latest research, 30% of those patients are going to have a significant disability. These ligament injuries are the leading cause of long-term residual complaints. You cannot impress upon the patient enough how serious their injury is.

Educating them that during their recovery time, there are some general things that they could do to help themselves.  You will need their help. Their compliance with your treatment program, their active participation in their own recovery is the key to optimal results.

You are treating them, not an insurance company, or their attorney. Everything you do is geared to assist them with optimal recovery. Let them know that you use state of the art imaging procedures in order to assess these injuries. That’s how significant they are.

Tell them that you use the top board-certified medical radiologists in the world to locate and identify these injuries to assist you with what are called excessive motion tests. Let them know that this treatment plan that you created is individualized to them and to their needs. It is very important to comply with the schedule because you are trying to help them to meet the goal of recovery.

If you’ve got them under a dose schedule care, that dosing of the schedule care is very important,  If they need to change an appointment, they must work it out to come in the amount of times you put in their program.

They need to know that if something on the plan is not consistent with producing results for them, they need to communicate and let you know right away.

They may have need for supportive care. Let them know this at the very beginning while you do your initial exam. When patients have ligament conditions, ligament injuries, they can need ongoing supportive chiropractic spinal care on a regular basis.

Regular basis might be twice a year, it might be once a year, it might be five times a year, might be six times a year. But patients do better long-term with maintaining a spine. This is called supportive care because it maintains the ability to keep the symptom away.

A general and vital recommendation is proper body hydration. Proper hydration is essential in the wound healing stage.

The lack of body hydration will halt cellular migration, decrease oxygenation to blood, and vastly delay the wound treatment process. The majority of patients in the market today are dehydrated. You need to get them to drink more water. Now that sounds really, really simple, but there’s so few doctors that do it. In the Smart Injury Doctors program, we have a thing called the Smart Injury Recommendations. Those recommendations are basic things to the patient’s recovery.

Typically, the body fluctuates from 60 to 70% of the total weight is water. To maintain that positive level of hydration, you need to have no less than 64 ounces of water be consumed on a daily basis. The recommendation is half your body weight in ounces a day. Now, if a person weighs 300 pounds, that’s 150 ounces. If they weighed 400 pounds, it’s 200 ounces. If they weighed 100 pounds, it’s 50 ounces. You must get them to hydrate and be hydrated.

Another recommendation to injury recovery is proper sleep. When patients have a spinal instability, they could have neck pain, lower back pain, shoulder pain, scapular pain, pain radiating down their arms, pain radiating down the legs, numbness, tingling, sense of weakness or heaviness in the legs, numbness or tingling or a sense of weakness or heaviness in the arms, headaches, migraine headaches, facial pain, ear pain, visual disturbances, ringing in the ear, difficulty swallowing, difficulty breathing, bladder or bowel dysfunction, sexual dysfunction, severe fatigue, loss of voice, disturbances in concentration, disturbance in memory.

These are common symptoms. Some are more common than others but they all can cause, especially when we’re talking about pain, to start to reduce their ability to sleep.

Your body needs to sleep because that’s when it repairs. You must work with them to make sure that they are getting good sleep. When your body’s tired, also, it’s usually seeking ways to create more energy. This can lead to cravings for sugary, fatty foods, things that are not good for your body, things that are not good for your sleep cycle, so you got to get them to work on sleep.

When we look at an adult today, it’s recommended by the Mayo Clinic, that optimal sleep for an adult is seven to nine hours a night. If you got a 14 to 17-year-old, it’s eight to 10 hours. If you’ve got a six to 13-year-old, it’s nine to 11. Three to five is 10 to 13. Two years, it’s about a 11 to 12 hours a night, plus one to two-hour afternoon nap. 12 months, about 10 hours at night plus four hours of naps. Newborns, 14 to 17 hours a day. So, you can see as the body is growing it needs more sleep. When the body is in repair it needs more sleep.

The patients should be educated that there are three stages of correction in the body.

Phase one is called the inflammatory phase. That’s first four days, that’s when the injury is pain, painful. There’s a lot of heat, there’s swelling, it draws the healing chemicals to the area.

Then from day four to 21 we call this phase two, it’s called the proliferation phase. That where the damaged tissue is gotten rid of and new temporary tissue is being built and new blood supply lines are also being formed.

Then we have from 21 days to two years, a remodeling phase where permanent tissue is being built, replacing the temporary tissue. All tissue is then remodeled for optimal function. This is what’s occurring. Again, that is why hydration and sleep are so important.

Another recommendation is to educate the patient about an anti-inflammatory diet. Inflammation can cause injuries to be retarded in the repair process and it can cause ongoing chronicity.

What should they eat? More anti-inflammatory fats, like fish oil, flaxseed oil, avocados, fish, mackerel, salmon, sardines, olive oil, mixed nuts, seeds. They should eat fewer pro-inflammatory things like processed foods, high in saturated fat, vegetable oils like corn oil, sunflower oil, safflower oil, soybean oil, foods with trans fats, those are fried foods.

They can eat more pineapple, it has a lot of bromelain in it. They can eat more garlic, they can eat more curcumin or turmeric or curry powder, more cacao, teas and berries. These are things that are in the anti-inflammatory area. Any of your vegetables are anti-inflammatory.

Additionally, they need to eat adequate protein. A balanced diet would be one third fat intake from saturated fat, one third from monounsaturated, and one third from polyunsaturated fat.

Bottom line is you want good fats, you want great vegetables, and you want things that are anti-inflammatory. There is herbs that you can take in order to do that, garlic is one of them, curcumin is one of them, turmeric, curry, cacao.

Educating your patients on these basics things will help and assist in their long term recovery. Because remember, when you’re treating that patient, you’re treating that patient’s future, you want that patient’s future to be the best possible future for them.

There are the three general things. Hydration is excellent. Sleep and anti-inflammatory diet. These are three things that you can add to whatever else you’re doing in your clinic that will significantly improve your results and make your patients healthier.

As a result of that, they’ll get better results, you’ll have better referrals, you’ll have a better reputation These are things that are very, very easy to put into a clinic.

In the Smart Injury Doctors program, we have a form called the Smart Injury Recommendations that go over these three basic recommendations.

https://www.smartinjurydoctors.com/
https://www.thespinalkinetics.com

Three Simple Tips for Getting Better Spinal Injury Recoveries

Injury recovery, especially in the spinal ligament injury market is significant because 50% of the patients that received this type of injury will not fully recover, and 30% of them will have a significant amount of problems associated with that type of an injury.

These injuries are not the sexiest injuries in the market, but they are the most common injuries in the market. They cost the most amount of money. They cause the largest amount of personal trauma and trials and tribulations simply because so many people with these types of injuries result in a chronic outcome.  As a matter of fact, if we have 4 million auto accidents or auto injuries in this country, 2 million people every year are going to become chronic as a result of those injuries.

When you are dealing with patients, you want to get the best results.  I’m not going to get into specifics of adjusting for chiropractors or type of modality you’re going to use or anything similar. I’m going to start with some very, very general tips for you. In a Smart Injury Doctor’s Program, we call these Smart Injury Recommendations and they’re just some very, very general recommendations.

We know that when a person has a spinal ligament injury, they need to take this injury quite seriously. Your approach to that patient, your level of professionalism, your level of certainty, your level of handling the patient, will guide their response to their injury and compliance in their care.

Spinal ligament injury conditions can cause them problems. It is a fairly permanent condition. It can cause an unstable segment or segments for a long time to come. The patient needs to take their initial treatment very seriously because that’s where you’re going to try to reduce down their risks for long term residual complaints and get them a great, great result.

One of the first things that you should be discuss is dehydration. When your body is not receiving the amount of fluids and the amount of water that it needs, it takes a toll on injury recovery. It slows it down, making recovery not as swift. Remember, water is the primary way that oxygen and nutrients get delivered directly to a spinal injury. Dehydration is one of the most common reasons why cell function becomes disrupted, no matter what. Essentially if you lack fluids, you’re going to create a delay in recovery and less optimal result of recovery.

Typically the body fluctuates from anywhere to 60% of its total weight is actually water. So how much water do you want the person to consume? About half their body weight in ounces of water every single day. They will improve their injury results if they are hydrated.  If they drink coffee, they need  to offset that cup of coffee with an extra cup of water. You want them drinking water. It’s a very general recommendation that basically hits home. Hydration.

The next Smart Injury Recommendations is proper sleep. Sleep is so misunderstood. But if we look at the course of injuries and how injuries heal successfully, they have to have healthy tissue growth. They have to repair the damaged tissue and now have healthy tissue growth. According to the National Sleep Foundation, growth and repair of tissue occurs in the third and fourth stages of sleep, which after you’ve completed about 70% of your rest, that’s when those stages happen. This means that your patient needs  to get an uninterrupted night of sleep. It’s crucial.

So what’s enough sleep? According to Mayo Clinic, the optimum sleep for adults is 7 to 9 to hours. A teenager, needs 8 to 10 hours. That’s what required in order for optimal healing to occur. Optimal healing and the repair of tissue occurs in the later stages of sleep.

The third recommendation that our doctors recommend, is they need to eat a healthy diet. You want them to consume a good non-inflammatory diet. One that is reduces inflammation. Consuming more anti-inflammatory fats. These fats are fish, salmon, sardines, olive oil mix and nuts and seeds, avocados, flaxseed oil, fish oil. Staying away from processed foods that are high in saturated fats. Vegetable oils, like corn, safflower, sunflower, soybean oils, or foods with trans fats. Those are high inflammatory foods.  Also include anything that is a leafy green vegetables, highly anti-inflammatory. Anything that’s a vegetable that’s grown above the ground is highly anti-inflammatory.

There are also some spices that are anti-inflammatory, like bromelain from pineapple, garlic, curcumin, turmeric, curry powder, cocoa, tea and berries. They provide anti-inflammatory substance and they also provide a lot of nutrients. They’re nutrient dense, and that’s what the body needs when it’s going to repair.

You don’t just recommend these three, you follow up by asking about it in your re-examinations. Especially if you have a patient that’s not progressing in a manner that you deem to be appropriate for what you normally see under your care.

It is easy to just talk to the patient about better sleep, better hydration, and better diet at least while they are going through your treatment program. If they adopt these habits, you’ve created a healthier patient. You’ve created a much healthier patient. That’s one of the things that as you as an injury provider can significantly help and influence a person to become healthier and now they can also look at long term things that keep their health such as ongoing care, supportive care in your clinic.

All of us have a spine. A spine is like the teeth, if you don’t maintain it, you’re not going to get as much mileage out of it. People should take their spinal health very seriously and you as an injury provider can seriously influence that.

Three simple recommendations.

Hydration

Enough Sleep

Anti-Inflammatory Diet

In the Smart Injury Doctors Program, we call these Smart Injury Recommendations. There’s other recommendations that you can give the patient to get better outcomes, but these are three simple things that you want to go over with the patient that will improve your injury results.

https://www.smartinjurydoctors.com/
https://www.thespinalkinetics.com

Why Don’t Chiropractic Colleges Teach Standard Injury Workup?

My question is why don’t chiropractic schools in this country actually teach their students how to do a standard spinal injury evaluation?  This topic may seem a little bit controversial, but it needs to be addressed.

It not just chiropractic colleges who are remiss, it is also missing in osteopathic colleges and medical colleges. But since chiropractors are the spine specialists and trauma to the spine is the number one cause of chronic pain and disability, the market needs experts in this particular area. So why in the world would the chiropractic colleges not teach standard spinal injury assessments?

Doctors of Chiropractic are not taught how to determine the severity and location of a simple ligament injury.  They are not being taught about the fact that there are two ways to image a ligament injury, depending on what ligament is damaged.

If you have a disc herniation, you’re going to use obviously an MRI. But the fact is, there are 220 specialized ligaments that hold the spine together.

If you have damage to the supporting ligaments around the disc, shear force injuries, they cause excessive motion in the spine. That excessive motion of the spine is how you determine the severity and location of the actual ligament injuries.

If you have a C4/C5 motion unit and you have severe excessive 3.9 millimeters of translation back and forth movement, due to the supporting ligaments now being damaged due to the trauma. And at four and five we know that the fifth cervical nerve exits, we know that that would cause a possible motor problem. We would have possibly a deltoid muscle weakness. We would have the lateral side of the arm, either hyper or hypo sensitive. We want to check that dermatome so we know where the C5 dermatome is. If we knew what muscles are involved and we can test for the particular level.

For an examination procedure, we have a hypersensitivity or a hypo sensitivity at the C5 dermatome and we have a C5 muscle that’s testing weak, then we should immediately want to know, what’s the C4/C5 motion unit like? That’s the main motion unit. Could be the one above or the one below that as well. But is that damaged?

If it’s damaged, the ligaments are damaged and you’re going to see excessive motion. If there’s excessive motion, how much excessive motion is there? Is it mild, moderate or severe?

Because if we have excessive motion that causes a motor sensory or pain problem, we have in the old terms clinically a chiropractic subluxation, which means misalignment or misalignment pattern. The mismotion pattern that causes a nerve condition.

It’s also called a spinal instability in medicine, meaning excessive motion that now causes a motor sensory or pain problem.

And it’s the easiest thing in the world to do a workup on. It’s the easiest thing to image and it’s the easiest thing to standardize in injury practices across the country. But it’s not being done.

The fact is that 90% of the patients out there are in chronic pain, do not have a pathoanatomic cause.

We have experts like William Maurice, the head of the Ohio State Biodynamics Laboratory who is a leading researcher in spinal biomechanics and spinal pressures in the world. His book is called The Working Back System where he’s trying to help solve the problem of low back lumbar spine.  This is the number one cause of disability, lumbar injuries, cervical injuries are the number four and cervical injuries also lead to the number six leading cause of chronic pain and disability, which are headaches.

He cites eight out of nine, or 90% of the patients who have a low back disability, do not have an exact path though anatomic caused identified by doctors that basically are treating the patient, creating a huge expense for employers and Workers Comp., for example

One of the things that is needed in the market itself is the simple understanding of how to determine the severity and location of these ligament injuries that are so expensive to the employers. Employers should be demanding it.  

If I’m going to use a Doctor of Chiropractic, they need to know how to do a standard examination for these types of injuries.

If I’m going to use a medical doctor, or an osteopath, then they need to be able to understand, and standardly work up these injuries, because it’s the misdiagnosis or the the lack of diagnosis, that creates an environment of substandard.  

Remember, if you’re going to change something, you must get down to the cause of what it is before you’re going to get great results in changing it.

If you don’t know what the injuries are and you were not taught to standardly workup an injury, you were not taught how to determine the severity and location of a simple ligament injury.

It is not and never has been just writing a cervical sprain down on a diagnosis code.

For somebody today to say, “Well, this patient has a cervical or lumbar sprain and that’s their diagnosis.” That’s like somebody having a leg injury and having the doctor say they have a lower extremity sprain.

The first thing anybody should be asking is, “Well, where is the sprain? Where is the ligament injury? How bad is it and where is it?”

If have you had a leg sprain, you’d say, “Well, where in the leg?”

In the knee, how bad is it? Well, it’s a grade three sprain. It’s a grade three ligament problem.

This is how I identified it. This is how we imaged it. This is what we’re doing to treat it.

It is the first step to great injury results. I don’t care if you’re an employer,  a patient, or a doctor,  the first thing that has to occur in order for you to get good results is you have to identify the severity and location of the injuries.

And we have to be able to do that standardly.

Right now there are 60,000, 80,000, 90,000 chiropractors out there, my colleagues, none were trained in a one year, six month program and how to determine the severity and location of a simple ligament injury. That injury that causes the most amount of problems in the market today. So if you’re a student today at a chiropractic college, you should be asking your educators why they’re not teaching you that.

That would be like dentists coming out and not knowing how to locate the severity and location of dental decay. Of course when you go to dental school, you’re going to be able to determine the severity and location of, of dental decay of tooth decay. So why in the world would you be in a health market, in a health care educational program today, and not know how to determine the severity location of a spinal ligament injury?


It just blows my mind that that’s occurring. It occurred for me, I graduated from Palmer College one of the oldest colleges in chiropractic in the country. I graduated in 1988 and I was never trained how to do it.

 I know to this day when I asked students that are coming out of all of the chiropractic colleges and just say, “Okay, simply tell me how to determine if a ligament is damaged in the spine.” Remember the spine is the main thing that Doctors of Chiropractic deal with.

If ligament damage is the number one cause of pain and disability in the world today, how do you determine the severity and location of a patient that’s just injured their ligaments? How do you know where it is and how bad it is?

If you don’t know where and how bad, how are you going to get successful results with it? If you’re getting some successful results with it, think about how much more successful you could be if you knew the severity and location of the condition.

If all doctors were trained in it, that would change the environment in the United States.

Chiropractic, my profession is very small. When groups do research, the research of the markets about a $14 to $15 billion market. It’s a very small market. It’s like a third of 1% of the total healthcare dollars spent are spent in the profession of chiropractic.

It is very, very small. It represents less than a third of 1% of the total healthcare dollars spent. That is 14-15 billion in medicine, back problems, low back problems in 2010 we approximately $253 billion.

Medical doctors in the market today, weren’t trained either on how to determine the severity and location of a simple ligament injury. It is not occurring in the medical market either. And it needs to be occurring with every doctor.

Because the more that you understand, you will be able to accurately and swiftly know the diagnosis. Leading to the use of conservative care procedures that are highly successful for this type condition. Lessening or eliminating patients suffering from long term chronic problems that could have been prevented.


Chronic pain and problems are devastating to injury patients emotionally and financially.

It hinders their ability to work, it hinders their ability to be successful in their family, and to participate in normal activities of daily living.  

It doesn’t have to be that way. We have to get much better. We have to become Smart Injury Doctors and use accurate and objective testing for ligament injuries and diagnosis and treat quickly and with confidence.

Remember, you can’t misalign a spine. You cannot have a hyperlordotic cervical spine or reverse cervical curve, a PLRC5, without ligament damage. Therefore, you must understand about ligament damage

If you’re going to be trading in these things, particularly in the injury market, if you haven’t learned how to determine the severity and location of a simple ligament injury, that is what the Smart Injury Doctors program is for. You go to www.Smartinjurydoctor.com and you become a specialist.

We’re creating a group of doctors, chiropractic doctors, medical doctors, and osteopaths, that fully understand the urgent need for accurate objective testing and swift and accurate diagnosis.

Come in and learn about ligament injuries. We are the leading group of injury specialist.  It is where we are training doctors to have that level of understanding.

You should have been educated in this deep understanding in your basic training, so should’ve I, but unfortunately,  it’s not there.

We must get it outside of our formal education.

Become a Smart Injury Doctor and lead the way into the future of injury care.