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Understanding the Injury Treatment, Rehabilitation and Prevention Continuum, Pt. 1

Posted October 7, 2011 by

Chiropractors, surgeons, massage therapists, physical therapists, trainers… are they all interchangeable?  Many people seem to think so, at least to a degree. A lot of folks think that it’s up to personal preference who you should see (“I don’t trust doctors, so I choose to see a massage therapist or chiropractor for my injuries”) or simply have no idea one way or the other. I wanted to do a short write up for you guys so you can better understand the proper person to see at which time, to get the absolute best possible care.

Let’s say you are training in a fitness bootcamp one day and while performing jump squats, you land in an awkward position. Immediately, you feel an extremely sharp pain in your knee and you’re down for the count. Below are the exact steps you would want to take.

Step 1: R.I.C.E. Method

I’ve talked in-depth about the R.I.C.E. method of self-treatment (Rest, Ice, Compression and Elevation) before in previous articles, and this should always be the first thing you do if you sustain an injury, whether it’s major or minor. The sooner you apply ice and elevate your affected area, the better your recovery will be. What you do next depends on the severity of the injury.

If the injury is CLEARLY major (your bone is sticking out of your leg, your muscle is popping up looking like a golf ball under your skin, or you can’t move a part of your body due to excruciating pain) then you will want to skip immediately to step 2. However, injuries can fall more into a grey area in which it’s hard to differentiate a minor issue from a major one. The best way to identify a serious injury in this case is to continue doing the R.I.C.E. method for a few days to a week, and see if the issue subsides. If it doesn’t, you want to move on to step 2.

Step 2: See a Surgeon

Notice, that I specified to see a surgeon. Like it or not, MEDICAL surgeons are the best people to determine if you need surgery or not. They have the best equipment and the most training when it comes to diagnosing injuries. There is nothing wrong with getting a second opinion (from ANOTHER medical surgeon), but they will tell you up front if you need surgery or not. The reason this is important is because, if you DO need surgery, none of the other individuals in the injury treatment continuum will be able to help you recover—because you need surgery! Just like all other areas of the injury treatment continuum though, there ARE bad doctors out there. DO YOUR HOMEWORK. Ask your friends and family for a good orthopaedic surgeon, or look up ratings on medical review sites. As previous stated, a second opinion is a good way to minimize the risk of getting bad advice from a surgeon if you feel particularly uneasy with their prognosis for whatever reason.

Now, if the surgeon tells you that you don’t need surgery, they will tell you if the issue will get better on it’s own or not. If they say that it won’t get better on it’s own, they will often tell you that it’s something you will have to be careful for or adjust your life to avoid this issue in the future. This is where the realm of doctors ends and their limitations become more apparent. While doctors are very, very good at dealing with surgical issues and helping fix them, often they are not as aware of methods to prevent issues from happening in the first place, or how to train the body to prevent them from happening (beyond simply telling you to avoid certain actions). If you’re a professional tennis player and a doctor tells you that you won’t be able to ever play tennis again due to a non-surgical elbow injury, that doesn’t really seem like a legitimate option does it?

Therefore, if your injury is non-surgical and the doctor doesn’t tell you that it will completely resolve itself on its own, my advice is to move to step 3. If you end up getting surgery, then you should skip step 3 and go to step 4.

Step 3: See a Chiropractor

Chiropractors specialize in non-surgical injury treatment. It’s important to pick a quality chiropractor—a quality chiropractor can seem like a miracle worker when it comes to treating injuries that don’t require surgery—even issues that have plagued you for months, years or even decades! Problems that surgeons said cannot be fixed with surgery and likely will be lifelong issues have been treated effectively by good chiropractors before.

Many chiropractors, unfortunately, are prone to being complete quacks, so do your homework. Ask your doctor if they recommend a specific chiropractor, or ask around. Just as you would do your homework on a trainer you were looking to hire—do the same for your chiropractor. Do their patients see measurable results from their visits? Does the chiropractor ONLY employ methods that are scientifically-based? Do they make claims that they can treat surgical issues without surgery (totally false and usually harmful)? These are questions you need to ask before you go see them—a great chiropractor can totally help you treat your non-surgical issues, while a quack chiropractor can and probably will make your issues worse.

Keep in mind, surgery isn’t really a “choice.” People make that mistake and see chiropractors and surgeons as competitors, when the truth is they aren’t. Some situations need surgery, while others don’t. If an injury requires surgery, you’re not going to treat it by seeing a chiropractor, period. If an injury DOESN’T need surgery, then a chiropractor is probably better-equipped to help you treat it than a surgeon is. This is why a surgeon should be the first person you talk to. A GOOD chiropractor will refer you to a surgeon if they determine your injury needs surgery, and vice-versa. Chiropractors (who tend to work with athletes and specialize in sports injuries in general), along with orthopaedic surgeons who specialize in sports medicine, are more apt to give good advice on athletic injuries than may be the case with more general doctors or non-sports physicians.

Stay tuned for part 2, where I’ll discuss the last three steps in the continuum: rehabilitation and prevention.

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