I just returned from a new certification class in Italy where I was fortunate to learn a new twist on the soft-tissue technique that I have used in practice the past 13 years, Active Release Technique. This class was refreshing and challenging. It is a good feeling to know there are still innovations in chiropractic as we start our 14th year in practice this month. Likewise, I hope to be able to continue to increase my own knowledge in helping patients attain their optimal health.

This class got me asking the question “What have I learned in 13 years of practice?” I thought I would share these things in this newsletter.

1. Active Release Technique® Is the Best
I was fortunate to be exposed to this great technique early in my chiropractic education. I was blessed to have a great mentor, Dr. Clayton Skaggs, who showed me how this great tool could be wielded to eliminate scar tissue, improve joint range of motion, and decrease pain in overused areas of the body. The stories that myself and the other ART® doctors were able to share at this past conference demonstrated just how amazingly effective Active Release is in fixing chronic conditions and sports injuries.

2. We Were Meant To Move
Traveling always reminds me that we are meant to move. Everyday for the past 13 years I have reminded patients to move more. If you sit longer than 20 minutes stand up for 30 seconds and walk in place, squat, lunge, or take a stroll down the hall. This might not always be possible but the more that you practice getting up and changing your position the better you are going to be. This doorway squat works very well.

3. We Should Eat Real Food
Traveling to Europe really teaches you that as Americans we do not eat real food. Our fast and convenient food sources have lead to decades of self created disease and health problems. In the past 13 years we have modified our nutritional philosophy from time to time but the foundation has always been to eat real food. We call it “Food By God”. Watch out for ingredients you cannot pronounce and foods that do not resemble their original source. We call that “Food By Man”. Remember chickens do not have nuggets!

4. Walk More
As Americans we do not walk much. Many cultures worldwide walk everywhere they go. We have seen this improving in America as more and more people are looking to get in their 10,000 steps each day. FitBit and other activity monitors have helped raise our awareness of how sedentary we are. Daily, I recommend patients to walk more. Short and frequent walks can consistently reduced your pain in the low back, hips, shoulders, and neck. I encourage you to increase your walking by setting goals of not just steps but intensity, frequency, and speed.

5. Do Not Eat Late
Over the years the patients that I have seen that work to eat dinner before 6pm have consistently shown better health markers. When you eat early you are more likely to make better choices for dinner. You also get to bed earlier and wake up hungry. Perfect, because those that eat breakfast are more likely to report more energy, more likely to workout consistently, and are less likely to be obese.

6. Never Use a Heating Pad
In 13 years I have seen many chronic pain patients. One thing that has been consistent with these patients is their use of a heating pad. A heating pad can create a feel good experience on a sore low back, shoulder, or neck for a short time. However, the heating pad when used frequently can create an increased sensitivity in the involved nerves. This creates an environment where minimal pressure can create intense pain. This starts the pain-spasm-pain cycle that we see with chronic patients. In short, the heating pad creates a cycle of pain that will not stop until it’s use is stopped. Please, do not use a heating pad!

7. Ice vs. Heat
Now that we have discussed the dangers of the heating pad, is all heat bad? No, sometimes heat can be helpful. A hot shower, hot tub, or sauna can be helpful when you are trying to loosen tight muscles. Most frequently this would be first thing in the morning or before a workout. If a muscle or joint is painful from use make sure you use ice. Ice calms the sore muscle, reduces swelling, and decreases the inflammatory response. Remember to always use ice cubes in a bag. Never use a freezer pack as it can burn the skin and is least likely to be helpful. Frozen vegetables while convenient and safe, are not very effective. If you are using ice, use real ice, it is nature’s most powerful anti-inflammatory.

8. Stretching Can Cause Injury
We all have been taught that we should stretch more. However, in my 13 years of experience I have found there are better ways to reduce the muscle tension than stretching. Stretching can perpetuate the pain-spasm-pain cycle and perpetuate scar tissue in overused muscles. Instead of stretching try performing some warm-up exercises for the hips and back like squatting, lunging, walking, or some of the other exercises found in our “Don’t Stretch The Hamstrings” article.
For the neck and shoulders try the Bruegger’s position that reverses the poor posture of being in front of the computer or prolonged sitting.

9. Eat Probiotic Foods
In just the past few years we have seen more and more research into the area of probiotic foods. These foods have been shown to change the balance of gut microbes to a more favorable combination of bacteria to yeast. Improvement of this balance has been shown to reduce gut inflammation, improve metabolism, and increase overall immune and hormone functions. Look for kombucha tea, kefir, sauerkraut, kimchi, and apple cider vinegar to have the best probiotic balance for your gut. Here is a video that explains how to make your own kombucha tea.

10. If Your Looking at the Site of Pain, You’re Lost
Ok, this one I learned before I started practice but I am continually reminded of it everyday. We love to diagnosis a pain problem based upon location or the structure that hurts, i.e. bursitis, tendonitis, torn meniscus, degenerative disc, etc. However, rarely does this diagnosis clue us in as to why something is painful. For example, a disc bulge identifies that nerve is being pinched and therefore why the nerve is painful. But, did you ever stop to think why is the disc bulging? It is not your age, your genetics, or even your dumb luck. It is more often your behaviors. Back pain is almost always a behavior problem. How and how long you sit, how you bend, how you sleep, how you stretch, and even how you eat. If you fix these behaviors, you have a good chance of fixing the disc bulge, even without surgery.

11. Supplements Make Life Easier, Not Cheaper
Before starting chiropractic school I did not take any supplements. I was not going to pay for a vitamin or herb, I could do it on my own. One thing I have learned in my own life and as a practitioner the past 13 years is that supplements make life easier. Yes, they cost a bit more but they allow you to enjoy life more. Whey protein allows me to get up later and still have a healthy meal. Olive Leaf Extract keeps me from being in bed sick with the latest cold virus. Glutamine allows me to exercise harder and then be able to recover faster. Fish/flax oils keep me from having to eat fish more than once a week. Supplements can cost a bit more but they are worth the convenience.

12. Things Change
In the past 13 years we have seen monumental change. Changes in insurance participation, Medicare reimbursements, and increasing co-pays. We have seen our building go from a smelly run-down gym to a bustling downtown commercial and residential space. We have seen Roanoke’s downtown go from just over 300 residents to now nearly 3,000 downtown residents. We have seen many changes in and outside our office and I’m sure we will see many more. Something that has never changed though is our commitment to serve you and your family to the best of our ability. At [Core] we strive to make your interactions with us both health and life changing.

That brings us to the best thing that I have learned in 13 years.

13. We Have the Best Patients
As we celebrate our anniversary this month I know that I am blessed with the best patients! You make our chiropractic and wellness practice fun while challenging me to learn something new each day. I appreciate your loyalty and desire to improve your own health. I trust that the next 13 years will be the same and I look forward to continually serving this Roanoke, Virginia community. If there is anything that we can do to make your time with us better please do not hesitate to let one of us know. Thank you for being a part of our [Core] family.



Daryl C. Rich, DC, CSCS, ART®