For the past several years, around the same time that the American College of Sports Medicine publishes the results of its annual survey of fitness trends, I've discussed what I think are the chiropractic trends for the year ahead. Here are my top chiropractic trends, followed by the top 10 ACSM trends – many of which are extremely applicable to chiropractors.
1. Integrated and Patient-Centered Care
My No. 1 sense is that we will see the continued integration of chiropractic care with traditional medicine, using your knowledge and experience with sound clinical judgments and the current scientific research.
Patients are looking for practitioners who help formulate a proper diagnosis, whether it is mechanical or medical, because every patient deserves a proper diagnosis. The doctor as a teacher is definitely trending, especially those who explore individual patient goals and discuss healthy lifestyle principles, including nutrition, diet, energy balance, and chiropractic-based postural and ergonomic principles.
2. Manipulation
I don't think we can stop the physical therapists from learning manipulation, but we as chiropractors must be the best at manipulation. The trend here is making sure the public knows that manipulation is our specialty because of training and philosophy. This is a trend we must continue to lead.
3. Assessment and Other Tools
Outcome assessment tools (OAT) being regularly used along with review of tests for the diagnosis, manipulation in conjunction with exercise training and the use of taping. This is the current model of care; not a fad, but a trend. Learn the latest practical information on OATs, orthopedics, neuro testing, and the best exercise and taping interventions to offer patients.
4. Cannabis
Patients are going to ask you about CBD and THC for pain relief and many other conditions. Popular in several states are hemp seed or CBD creams, edibles with THC, and the actual weed to smoke. I was issued a United States patent for a process to make cannabis topicals. Patients are going to have to try various topicals to see if it does have an analgesic and/or anti-inflammation effect on them.
Note: While hemp is an industrial variety of the marijuana plant, it contains extremely low levels of THC, the substance that gives you a high.
5. Posture Education
Every patient I check is educated about and made aware of their standing and sitting posture. My entire physical examination still starts with static postural analysis. You need to learn to integrate posture training into your care.
Other Trends in Chiropractic
Other chiropractic trends I see for 2018 include being the doctor to guide weight loss or "cleanses," especially to help decrease inflammation and chronic diseases; focusing on doing specialized blood work and other tests to optimize health; and using cryotherapy chambers along with laser, shockwave therapy, massage and vibration therapy (together with skilled manipulation) to help manage sports injuries, prevention therapy and difficult chronic pain cases.
I also have always advocated bringing supplement and equipment vendors into your office on a monthly or quarterly basis to help provide education on the latest products and services that can help better serve your patients and practice. This should be a definite trend in 2018.
The ACSM Fitness Trends
Unfortunately, getting "adjusted," "manipulation" and "chiropractic" weren't included in the ACSM Worldwide Survey of Fitness Trends for 2018. No. 12 is "exercise for medicine" – why not "chiropractic adjustments for sports performance," "chiropractic for healthy aging" or "chiropractic manipulation trained professionals?" Could it be the people who vote for the trends don't know us? I doubt it because we treat players in every sport, from kids to professionals, and we are in hospitals and health clubs around the world.
1. High-intensity interval training (HIIT) typically involves short bursts of high-intensity exercise activity followed by a short period of rest or recovery, and typically takes less than 30 minutes to perform. You should have the skill set to understand and write these types of programs for patients
2. Group training. This involves leading, teaching and motivating a group of 3-4 individuals through intentionally designed exercise classes. I suggest offering group exercise classes in your office to create community and social support, and to help keep the costs down and increase office revenue.
3. Wearable technology includes fitness trackers, wearable cameras, smart watches, heart rate monitors, GPS tracking devices, and smart glasses (designed to show maps and track activity). I just returned from teaching in China and it was obvious that wearable technology is being integrated into daily life.
4. Body-weight training is still my personal favorite. I expect my patients to demonstrate using their own body weight effectively before I teach other strength training methods.
5. Strength training for me starts with "motor control" and then "progressive overload" training. Patients want doctors who can help them chose which exercises to perform in the gym or at home. The right exercises will help them become more durable and injury resistant.
6. Educated, certified and experienced fitness professionals. In chiropractic, we have sports and rehab educational programs that can help you become more appealing to the public. You can learn to offer new services (rehab, exercise training, soft tissue, taping, functional nutrition coaching, etc.). Look to your local chiropractic college or association for diplomate / certification programs.
7. Yoga continues to trend with "What is old is new." Chiropractors – listen up: I think it is a great in-office therapy to offer. I have done yoga on and off for years, but this year I plan on taking more structurally integrated types of yoga classes and passing that information on to my patients. If you have extra space in your office, consider yoga for breath, flexibility and strength.
8. Personal training is my domain as a rehab specialist. We should work closely with trainers and help them assess movement (function vs. dysfunction), prescribe and select the actual corrective exercises.
9. Fitness programs for older adults. Why shouldn't this include chiropractic for healthy aging or chiropractic for regenerative fitness? Can we at least make this a research agenda goal for the public to understand and appreciate?
10. Functional fitness is everything chiropractic – improved balance, coordination, force, power, and endurance to enhance the patient's ability to perform activities of daily living.
As 2018 unfolds, I hope this is the year we become known as the profession that helps patients slow down the degenerative aging process. Remember, your choices today contribute to shaping the future of the profession. Cheers to 2018 being a happy and healthy year to you and yours.
Some doctors thrive in a personality-based clinic and have a loyal following no matter what services or equipment they offer, but for most chiropractic offices who are trying to grow and expand, new equipment purchases help us stay relevant and continue to service our client base in the best, most up-to-date manner possible. So, regarding equipment purchasing: should you lease, get a bank loan, or pay cash?
Some pundits say that the upcoming presidential and congressional races, and many local races, might be the most consequential in our country’s history. We do not have the choice of sitting on the sidelines and hoping our patients will carry our water. Unlike other medical professions such as physical therapists, podiatrists, nurses, etc., the health care class (AMA) will not protect us. We must be in the game.
The most common condition affecting the shoulder is rotator-cuff disease. From acute tears to chronic tendinopathy, it’s common and needs a thorough workup. In fact, even asymptomatic shoulders can have full-thickness rotator-cuff rears in up to 40% of instances. Let’s look at additional conditions that can present to the office with weakness, loss of motion and pain in the shoulder beyond rotator-cuff tears.
