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.