A great way to cement your relationship with your patients and to become well known in your community is to be the authority on the ergonomics of everyday living. As few doctors have studied this vital aspect in-depth, your becoming an expert in it will earn you esteem with your patients as well as more business in your community. Being an authority means that people care enough about your opinions to listen and act upon them. You don't need me to tell you the value of this for a successful practice - happy patients, referrals and sales.
"Ergonomics" is a popular buzz-word nowadays, as well as an academic field of study. Who better to teach your patients the right and wrong things about shoes, chairs, mattresses and pillows than YOU? As a structural doctor, your unique viewpoint on how bodies work entitles you to give recommendations in ergonomics. You only need a simple, easily applied approach, which is consistent patient-to-patient so that you can apply the ergonomics of everyday living routinely, with all of your patients.
A New Patient With Back Pain
While taking his history, he told me about his brand new orthotics that he had just spent $500 on. Proudly, he explained to me how they are so great because they had been molded to fit only his feet. They were supposed to take the stress off of his lower back. He had just gotten them the day before so I asked him, "How are they working for you?" He told me, "no change." His back still hurt.
As I normally do, I had him remove his shoes so that he was barefoot, stand and face a full length mirror, and then told him to let his body slump. We both could see where it was bent and leaning forward. He was also unsteady in a wobbly sort of way, which I made sure that he noticed. I had him take in a full breath and had him feel how shallow it was and how much effort it took to breathe. As with most patients, this took several repetitions until he could really feel it. I went on to review other indicators with him until we were both sure of what state his body was in prior to adjusting him.
I proceeded with the adjustment and then, when finished, stood him before the mirror once again. First, and most important to him, his back pain was gone. What I was looking for were changes in his slumping, breathing and the other things that we had checked together initially. These all showed improvement to my satisfaction but, the important thing here was to get him to notice these changes. He realized that he wasn't slumping anymore and his face had better color and looked less stressed. He couldn't really tell the difference in his breathing, even though it was obvious to me. We were both happy with the results, so he put on his shoes to leave. Then he stood up. He was hunched over a bit and his back hurt again!
I had him go back to the mirror with his shoes on this time. He could hardly believe the changes that happened to his body just that fast - and just from putting his shoes back on. He looked nearly as bad as he had when he walked into my office; and he knew it because of all the time I had spent reviewing observations with him in the beginning. The obvious next step was to take out the orthotics, which clearly were not properly measured for him.
He did this and then put his shoes back on and stood in front of the mirror. All of his previous indicators improved on the spot and his back pain disappeared! He realized instantly that these poorly designed orthotics were going to make his body worse, not better.
As he got ready to leave and picked up his orthotics, I asked him what he was going to do with them. He said he didn't know, but they had cost him a whole heck of a lot of money so he didn't want to just throw them away! I told him that I had a use for them that would be better than throwing them away, and so he gave them to me. I now use them as a visual aid to help spur conversations with patients about orthotics and how to tell if they were helping or harming the rest of their body.
Just from this patient's first visit, he knew that I was the authority on what to put in his shoes and, that he was in the right place to get his body fixed.
Thus, I became his ergonomic expert, instantly, simply because of what I had shown him. He has been a patient of mine for more than 12 years now and has referred many people to me for care.
I have made many recommendations to him over the years regarding shoes, chairs, seat cushions, beds and pillows; all of which he has followed to the letter. As usual, I felt much satisfaction from helping this man get out of pain; getting his referrals and the income from product sales were icing on the cake – I like my cake frosted.
I have seen lots of "useful" products offered by professionals and I never tell anyone that something is bad for them. I find it much more effective to show them how to test these things so they can tell for themselves. They almost always "see it" or "feel it" and make the right decisions and choices.
[pb]To be the authority, you need to be able to show that what you are saying is true and that it works this way on everyone. Then, who could doubt you? Become fully grounded in your understanding of body mechanics and what can be done to improve those mechanics with support products. This article is the first step in doing just that.
I often find in working with doctors in the field, that they simply have never been taught how to tell - definitively - what patients need in the way of support products, and the underlying science of this. There are many products you can call upon to see if they improve shoe function.
Most chairs and seats are a joke and people need to understand how sitting affects the rest of their body. Listen, there is a proper protocol for testing shoes, seats, mattresses and pillows just like there is for fixing the spine. It's a simple matter of learning the protocol and then applying it.
This protocol is easy enough to learn and, once learned, you'll have the tools to earn more income. I have taught this information to doctors at seminars as well as to patients over the course of their care, which you may also decide to do. I've designed a booklet containing these general ideas that you can give to your patients – not to teach them (you'll do that), but to reinforce the importance of your care with them, which is invaluable.
Learning To Observe And Assess Your Patients
The things you want to observe are always there to see, at any time and in any position (standing, sitting or laying down). Some are more easily observed by you than your patients, who may take several weeks before they are observant enough to notice the differences; but they do need to learn to observe their body. As you guide your patients in learning how to observe their body, keep in mind this isn't necessarily about how they feel pain-wise, but more of a functional assessment.
Exactly what the observations are and how to make them are given in detail in my booklet available form my website (Ed. note: see Dr. Porter's bio at the end of this article). These aren't difficult to begin using once you have the basic idea. Think of it this way; what do you observe about someone whose spine is in need of care?
These are a few observations you can easily make and there are many more. To determine if it's necessary to make changes in how a patient stands, sits or sleeps, you should compare various functional and observable criteria about their shoes, seats, mattress and pillow in the following way: make your observations before you adjust someone and then again afterward. If your adjustment improved their body mechanics, then the functions and observations will also improve. Only then are you ready to test some aspect of their ergonomics – their shoes for example.
If the functional and observable criteria are worse with their shoes on than with them off it's obvious that something is wrong with their shoes and affecting their body mechanics. You can now go on to figuring out if the shoes can be fixed, or should just be discarded. Many shoes can be fixed once you determine what is making them work poorly.
This has always been a fun process for me. You are making instantaneous changes in someone's body with only slightly modifying something. Your patients are very much aware, and grateful, of every change you make for them and they willingly participate in their care by following your recommendations.
If you wish, you can train your staff to do this. A lay person can learn the step-by-step approach necessary to fix shoes (for example) and thus free up your time; although personally, I enjoy this part of practice so much that I wouldn't give it up. Remember that every time you (or your staff) fix a pair of shoes for a patient or teach them how to sit in a car, your patient is happier with your care, you are reinforced as being their ergonomics expert and, your practice earns additional income. You can't beat this - a win-win-win situation.
Everyone needs support products of some kind because of bad chairs, poor shoe design, improper mattress support and faulty pillow design. Understand these ergonomics of everyday living and your level of success with your patients will improve. You will enjoy your new reputation as the local authority on the ergonomics of standing, sitting and sleeping problems.
Continuing to impress the advertising and marketing world, The Foundation for Chiropractic Progress (F4CP) has again been recognized by industry organizations for its excellence in educating consumers on the benefits of chiropractic, this time through social media, newsletters, and demonstrating thought leadership by promoting holistic well-being.
Dr. Louis Sportelli received the Lee-Homewood Chiropractic Heritage Award during the annual conference of the Association for the History of Chiropractic (AHC). During his nearly 60-year career, Dr. Sportelli has embodied the spirit of the award, given to “living individuals who have made outstanding contributions to the chiropractic profession.”
Presently there is no consensus on the best treatment for Achilles tendon rupture; and its management is still controversial. The treatment options are conservative treatment and surgical repair. With either treatment, be it conservative or surgical, Achilles tendon tears necessitate prolonged recovery and rehabilitative management.
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