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Physical Therapy or Chiropractic, how do you choose?

If you are in pain from a recent injury or chronic condition, how do you decide which healthcare professional will get you the best results and help you manage your symptoms independently. Below are vision and mission statements of both the American Chiropractic Association (ACA) and the American Physical Therapy Association (APTA). Both professions tout: collaborating with other health care practitioners; promoting change in public policy and legislature, giving the most value per health dollars spent on care; and access equity for the consumer.

The APTA Vision Statement however distinguishes itself by establishing what will be the primary guiding system used to achieve results (The Movement System) and focusing on Consumer-centricity (Patient/client/consumer values and goals will be central to all efforts in which the physical therapy profession will engage). The ACA’s mission statement as read below would seem to be more concerned with protecting the chiropractic profession, changing legislature and promoting the growth of chiropractic care. There is little mention of what type of system will be used to achieve optimal outcomes or mention of how a patient’s specific goals will be incorporated into an individualized plan of care.

ACA’s Mission: The ACA is a professional organization representing Doctors of Chiropractic. Its mission is to preserve, protect, improve and promote the chiropractic profession and the services of Doctors of Chiropractic for the benefit of patients they serve. The purpose of the ACA is to provide leadership in health care and a positive vision for the chiropractic profession and its natural approach to health and wellness. On behalf of the chiropractic profession, we accomplish our mission and purpose by affecting public policy and legislation, by promoting high standards in professional ethics and quality of treatment and by carrying out a dynamic strategic plan to help ensure the professional growth and success of Doctors of Chiropractic. (please go to www.acatoday.org for a complete statement).

Vision Statement for the Physical Therapy Profession: Transforming society by optimizing movement to improve the human experience. Guiding Principles to Achieve the Vision: the following principles are condensed (please go to www.apta.org/Vision/ for a complete statement).

Identity. The physical therapy profession will define and promote the movement system as the foundation for optimizing movement to improve the health of society. Quality. Collaboration. Value. Innovation. Consumer-centricity (as stated above). Access/Equity. Advocacy.

Lastly, in my over fourteen year experience as a physical therapist I believe the defining difference in ‘Chiro’ and ‘PT’ is that physical therapist from day one of treatment give our patients self-management tools to assist in treating their own symptoms/pain to include extensive home exercise programs. Our primary goal as physical therapist is to assist a patient in restoring, maintaining and enhancing their own health.

For more information or education on physical therapy and rehabilitation please contact:

Greg Sterner, Board Certified Orthopedic Clinical Specialist in Physical Therapy, Owner

San Diego Sports Physical Therapy

2750 Dewey Rd. Ste 101

San Diego, CA 92106

Protect the Lower Body by Working the Core

You can work your core a lot, but make sure you perform exercises properly to avoid injury! If you experience any pain, come see us at San Diego Sports Physical Therapy – 619.756.7500

What are the first things you think of when you hear someone talk about working the “core”?
Crunches
Sit-ups
Abs
The list could go on with similar exercises, but if these, and others like them, are the only exercises used, you may be not be working a significant part of the core. The core has been defined (Wilkerson, et al., 2012) as:
The lumbopelvic-hip complex, which is composed of the lumbar vertebrae, pelvis, and hip joints and the active and passive structures that either produce or restrict movements of these segments.

In short, or easier to understand terms, the core is more than just the abs, or the muscles on the front side of the body. The core also includes the muscles of the hips and low back. These muscles are important to the lower body as they assist in controlling the position and motion of the trunk over the pelvis and leg.
In a study by Leetus, et al. (2004), individuals who had sustained a lower body injury were found to have statistically significant differences in strength on hip abduction and hip external rotation exercises compared to non-injured participants. Another study (Wilkerson, et al., 2012), found that low back dysfunction and poor endurance of the core musculature were predictors of injury that could be modified.

By working all of the muscles of the core, individuals can increase core strength and core stability in hopes of modifying lower body injury risk predictors. A few simple exercises that you might consider adding to a workout might include:

Back Extensions on the ground or on a ball as in the picture above

Clamshells as is described below:
For this exercise, position the body in a supine position on the floor with the hips and knees bent about 45 degrees with a mini band around knees and heels on the ground. The knees should be placed beside each other while keeping the band taut.
Movement: Keep one knee stationary throughout the movement. Open the other knee to the outside of the body by performing hip external rotation against the resistance while keeping the heel planted on the ground. Slowly return to the starting position.
Tips: Do not allow the stationary knee to move during the exercise. This exercise can also be done by lying on your side if lacking stabilization in the hips to keep the “stationary”leg/knee from moving.

These exercises along with many other traditional exercises such as crunches, bridges and side bridges may help increase the motor control and muscular capacity of the lumbo-pelvic hip complex leading to increased core stability, which has been found to be a possible modifiable risk factor for lower body injuries (Leetun, et al., 2004; Wilkerson, et al., 2012). While the research is somewhat mixed on the importance of force output compared to endurance of these muscles, for beginners it appears it may be more important to start with muscular endurance.

References
Leetun, D. T., Ireland, M. L., Wilson, J. D., Ballantyne, B. T., & Davis, I. M. (2004). Core stability measures as risk factors for lower extremity injury in athletes. Med & Sci in Sports & Exercise, 36(6), 926-934. doi: 10.1249/01.MSS.0000128145.75199.C3
Wilkerson, G. B., Giles, J. L., & Seibel, D. K. (2012). Prediction of core and lower extremity strains and sprains in collegiate football players: A preliminary study. Journal of Athletic Training, 47(3), 264-272. doi: 10.4085/1062-6050-47.3.17

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Physical Therapy or Chiropractic, how do you choose?

Protect the Lower Body by Working the Core

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