By Dr. William Booker, D.C.

If you have successfully completed your prescribed rehabilitation program, but arestill in pain, you are not alone. In fact, many patients report that the symptomsthey experienced before they began their rehabilitation program, often return,and in some cases, never progressed, despite their faithful dedication to therehabilitation program prescribed to them by their doctors or therapists. is may seem like a mystery to many, but in fact, there a straightforward explanation tothis all too common occurrence.In order for a patient to go from a condition of injury to a condition of wellness,their treatment plan must include an orchestrated progression through a series of steps that we are going to call "e Rehabilitation Sequence." Although this isneither a formal nor an oﬃcial name, this sequence is used in some form, by mostintegrated healthcare facilities. As I describe the rehabilitation sequence, ask yourself how many of these steps did you complete, and more importantly, how many steps were never addressed.

TREAT THE ACUTE SYMPTOMS

e first step, and a very necessary step in the road to recovery, is to reduce theeffects of inflammation. You have to gain control of the swelling, the burning andthe spasms, in order to switch on the body´s natural healing powers. Medicaldoctors, Nurse Practitioners and Physicians Assistants are very effective atreducing the acute symptoms through their prescription of medicationsincluding, anti-inflammatory, and muscle relaxants. Other commonly usedmodalities include, ice, vitamins, electric modalities such as ultrasound or electricstimulation, are all utilized to disrupt the inflammatory process and start thehealing.

MOBILIZE FIXATED SEGMENTS

e second step in the rehabilitation sequence is the step most commonly skipped with rehabilitation. It is important to remember that all musculoskeletalinjuries, involve a joint that has lost motion or become dysfunctional. is is mostcommonly seen with injuries of the spine where compressed discs, arthritis andpinched nerves are commonly diagnosed. But loss of joint motion is not solely aproblem of the spine. Injuries of the shoulder, elbow, wrists, hips, knees and feetalmost always have some form of joint dysfunction associated with them.Chiropractors and osteopaths are skilled in addressing abnormal joint motion.Always remember, you can never achieve maximum muscle function if you don´tﬁrst have maximum joint function. Or, as I commonly say to my patients, "If Idislocated your shoulder, you would not be able to do a pushup."

Part 1 of 2

Why Didn´t Rehab HelpMy Rotator Cuff Auto or Sports Injuries?

Dr. William Booker D.C.

Dr. William Booker D.C. holds aDoctorate of Chiropractic from theCleveland College of Chiropractic,Los Angeles. He completed hisundergraduate studies at theUniversity of Virginia, where hegraduated with a major inpsychology and a minor in Biology.After completing his internship inPhiladelphia, Dr. Booker relocatedto Arlington to open the ﬁrstCapitol Rehab inside of Gold’sGym. Dr. Booker establishedCapitol Rehab-Arlington as theﬂagship for what would be theeventual opening of eightadditional Capitol Rehabs locatedthroughout Virginia, West Virginiaand Maryland.