A chiropractic care routine always starts with an initial examination to check the health of the spine and follows with regular checkups at least twice per month, to correct misalignments that might occur due to accidents, injuries or the regular stresses of life.
If someone had an accident and is suddenly in pain seeking chiropractic care, what would a typical chiropractic treatment schedule be like?
Dr. Gregg Rubinstein: Well, there’s no such thing as a typical chiropractic treatment schedule. It’s a great question and something that people always want to know, but they can be difficult to answer because everyone’s a little bit different. As a matter of fact, we’re as different on the inside as we are on the outside. So, the questions can be a little difficult to answer. But if we’re talking about someone from an accident, well, the amount of forces. How fast were they going? How big was their car? How big was the other car? Were they a pedestrian versus automobile? So, the amount of forces that are involved in the accident are definitely going to have a significant effect on how badly they are injured.
Typically, the more injured they are and the more stress and injury to the spine, the longer something like that’s going to take to correct, and probably more frequency might be required, especially in the beginning. Then the person’s individual state of health when they had the accident. Are they a 98-year-old osteoporotic 100-pound woman, or is it a 30-year-old ex-football player who’s thickly muscled and in really great shape? Is it a seven-year-old kid who is super flexible and more malleable than the 80-year-old person? If they’re both exposed to the same accident and the same forces, well, it might be enough to cripple the older person and the younger one might escape with only minor cuts and bruises. So, it’s truly dependent on the age of the patient, the health of the patient, their physical status, their current level of fitness, the severity of the accident, how fast they were traveling. So, it’s always multifactorial and no two cases are exactly going to be the same.
In general, if you take your average 35-year-old guy in an average automobile car accident, they walked away, most of them are going to make a pretty full recovery inside of three months. Sometimes their frequency will be started out as twice per week, sometimes it might be three times a week. Sometimes these people also concurrently need to go to physical therapy to rehab other types of injuries. But a lot of times we’re starting off somewhere in the range of two to three times a week, and that can be anywhere from four to six weeks or up to three to six months depending on if they’ve ever had care before, their general health. It’s so multifactorial.
So, there’s no one-size-fits-all. It’s not all cookie cutter, but there’s a lot of factors that go into it. The age, the health, the physical stamina, if they’ve had accidents before, if they have arthritis, all these things are going to contribute to different types of care plans. So, I would say it’s never cookie cutter. We do a detailed examination and history, and we usually take X-rays to determine the health of the bones. And then once we look at all those factors, then we’ll come up with a care plan. But it can be really anywhere from six weeks to six months and sometimes even longer.
For your typical patient under regular chiropractic maintenance care for overall healthy body function, how often would they see a chiropractor?
Dr. Gregg Rubinstein: Again, I typically don’t ask patients to do anything that I wouldn’t do myself or I wouldn’t be willing to do for my family. So once a patient has gone through that initial corrective care, the corrective adjustment plan, and their spine is about as healthy as we can get it, usually what I recommend and what I do for myself, my staff, my family, and anyone that I love is I recommend usually getting checked twice per month. Now that’s every other week. Some people don’t do that well and need to be seen weekly. Other people decide that they only want to be seen once per month, but I never recommend once per month because that’s not what I do for myself.
Remember, chiropractic care isn’t based on symptoms. Just because you don’t have pain doesn’t mean that you’re not subluxated. When you’re subluxated, you can irritate the neural structures, but when you think about it, only really 10 to 15% of your nerve system is dedicated to sensing pain and moving the muscles. The other 90% is controlling all your internal organs, your digestion, your heart, your lungs, your kidney, your spleen. It controls your immune system. So, the nerve system has a really big job, but very little of it senses pain and moving muscle. You can be a very healthy person and have pain. You can also be a very sick person and have no symptoms at all. So again, it’s different.
Again, I wish people had a little button on their forehead that lit up red when they were subluxated and said tilt, but they don’t have that. So, the only way to really know is to check. And so sometimes people will come in, they’ll get checked. If they’re not subluxated, we don’t adjust them, we send them home. Some people get a little upset and they’re like, “What am I paying you for?” You’re paying me to check you. It’s just like if you went to the dentist and he said no cavities, you wouldn’t be mad that he didn’t take out the drill.
Do you factor in the age of the patient when determining how often they receive chiropractic treatments, such as infants or seniors?
Dr. Gregg Rubinstein: Absolutely. The age of a patient does have a lot to do with how much care they will need, but it’s typically related to how long you’ve been on the planet and how you’ve treated your spine. Someone who works in a coal mine every day and doesn’t exercise or stretch and just goes down there and grinds it out every day for 30 years, well, their spine is going to be a little more difficult to manage and probably need more care than a brand new infant because the infant just born hasn’t been exposed to stress, tension, poor posture and all those different things, right? Their spine is extremely malleable. But an older person who’s used their spine hard, the spine’s more brittle and it’s more misaligned and has been used harder and degenerates more so they’re going to need more care.
It also depends though, when you started care, because I know I have quite a few seniors that have been with me for the entirety of my practice, and I’ve been at this for 33 years and I’ve seen kids growing up in chiropractic care that need less care when they get older than people who never had care. So, if you’ve never had care, you’re going to need more care. The older you are probably going to need more significant care. And the younger you are, if you just do the periodic checkups and never let the spine get out of control and degenerate, well, they’re going to have much less care and they’re going to do better. So, it’s definitely going to be a brand new baby is going to need less care than a 65-five-year-old person who’d never been to a chiropractor and had tons of accidents and led a life full of stress, tension and poor posture.
For athletes and people looking to improve their sports performance, what would a typical chiropractic schedule of visits look like?
Dr. Gregg Rubinstein: And again, this is going to vary because who are we talking about an athlete? Is it the weekend warrior or is it Joe Montana? So, Joe Montana, I know the last thing he did before he ever took the field and put his shoulder pads on was get adjusted by a chiropractor. So, he did it for performance, right? So that improved performance. And another interesting fact is that horse racing has the highest level of chiropractic care in any other sport out there. The highest percentage of athletes in horse racing are using chiropractors. And those athletes are not the jockeys, it’s the horses. And the horses aren’t in pain. They’re not looking at their trainer and saying, “Hey, my neck hurts. Can you get a chiropractor over here?” They’re adjusting those animals to optimize the nerve system and optimize performance.
So, there are a lot of people who used chiropractic and were big touters that it helped improve their performance. And Joe Montana was certainly a big one. And Tiger Woods used chiropractors a lot. He’s not the greatest example because he’s struggling these days. But it’s so common in athletics to improve performance. So, if an athlete never had chiropractic care and they played football for 20 years in high school, college and pro, and they’re showing in my office, well, they may need more care than the 10 or 11-year-old kid who’s just starting their basketball career. So, a seasoned veteran versus a weekend warrior, again, different things, and it’s always up to the individual.
Typically, it’s going to depend on several factors. It’s never cookie cutter. We always do a proper examination and very often we’ll take X-rays to determine the health of their spine. So, depending on how long they’ve been subluxated or how much they’ve mistreated their spine or if they played a contact sport or a relatively low force non-contact sport, all those things come into play. So, it’s never cookie cutter and it’s always going to be different. But again, most of our standard corrections usually start off in there twice per week and usually for somewhere between anywhere from six weeks to three to six months.
What should someone new to chiropractic expect during their first few visits and what is recommended for their treatment schedule as a new patient?
Dr. Gregg Rubinstein: And again, new patients are going to come in with various degrees of pain or discomfort or different conditions, and everyone invariably has treated their spine differently. Some people will come in just because they have a little stiffness and a soreness in their neck. Other people will come in because they’ve heard chiropractic can help boost immune system and help with things that look like organic disease by getting pressure off the nerve system. Other people will come in because they had a major car accident or a sports injury. Some people will come in just because they’re not sleeping well or have digestive issues.
What happens with every new patient every time is we do a complete detailed consultation, examination, which includes orthopedic and neurological testing as well as our chiropractic analysis for subluxation. Since that subluxation pattern and the presence is directly dependent on how long they’ve had the problems and how hard they’ve worked on that body and what they’ve done, their care plan and results will often be age and degree dependent, depending how old they are and how long they’ve had the problem. The more severe it is, typically we’re going to spend more time correcting the spine and getting it back to a healthy a state. Once it’s healthy, then it’s always wise to maintain the correction and not wait for it to break down again.
Periodic checkups or wellness visits are encouraged, usually on the order of twice per month depending on what your chiropractic truth is and what your understanding is. So, some periodic checkups are wellness visits. Some people still get recurring pain and need the care to mitigate that. But a lot of times people will come into my office, and we’ll get started on care and they’re like, “Hey, doc, when am I done? When can I stop coming into the office?” And I usually make a joke and I tell them, “The only reason that we should stop seeing each other as chiropractor and patient is if one of us dies.” And I make that joke, but in reality, it’s true. Getting checked regularly rather than waiting for your body to break down is a much better idea. I don’t wait for my engine to seize and then say, “Gee, I should change my oil.” By maintaining the engine and doing periodic maintenance on it and changing the oil frequently, that engine is going to run more efficiently with less friction and less breakdown. And the body is no different.
Staying ahead of the curve and maintaining your health is a much better option than waiting for it to break down. I think it was Frederick Douglass who said it’s better to raise healthy children than to try and repair broken men.
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To speak with Dr. Gregg Rubinstein, visit www.ChiropractorMidtown.com or call (212) 977-7094 to schedule an appointment.
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