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Part 1 of 2

October 11, 2008

Why Didn´t Rehab Help My Rotator Cuff Auto or Sports Injuries?
By Dr. William Booker, D.C. If you have successfully completed your prescribed rehabilitation program, but are still in pain, you are not alone. In fact, many patients report that the symptoms they experienced before they began their rehabilitation program, often return, and in some cases, never progressed, despite their faithful dedication to the rehabilitation program prescribed to them by their doctors or therapists. is may seem like a mystery to many, but in fact, there a straightforward explanation to this 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 is neither a formal nor an official name, this sequence is used in some form, by most integrated 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.

Dr. William Booker D.C.
Dr. William Booker D.C. holds a Doctorate of Chiropractic from the Cleveland College of Chiropractic, Los Angeles. He completed his undergraduate studies at the University of Virginia, where he graduated with a major in psychology and a minor in Biology. After completing his internship in Philadelphia, Dr. Booker relocated to Arlington to open the first Capitol Rehab inside of Gold’s Gym. Dr. Booker established Capitol Rehab-Arlington as the flagship for what would be the eventual opening of eight additional Capitol Rehabs located throughout Virginia, West Virginia and Maryland.

TREAT THE ACUTE SYMPTOMS
e first step, and a very necessary step in the road to recovery, is to reduce the effects of inflammation. You have to gain control of the swelling, the burning and the spasms, in order to switch on the body´s natural healing powers. Medical doctors, Nurse Practitioners and Physicians Assistants are very effective at reducing the acute symptoms through their prescription of medications including, anti-inflammatory, and muscle relaxants. Other commonly used modalities include, ice, vitamins, electric modalities such as ultrasound or electric stimulation, are all utilized to disrupt the inflammatory process and start the healing.

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 musculoskeletal injuries, involve a joint that has lost motion or become dysfunctional. is is most commonly seen with injuries of the spine where compressed discs, arthritis and pinched nerves are commonly diagnosed. But loss of joint motion is not solely a problem of the spine. Injuries of the shoulder, elbow, wrists, hips, knees and feet almost 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´t first have maximum joint function. Or, as I commonly say to my patients, "If I dislocated your shoulder, you would not be able to do a pushup."

Capitol Rehab of Arlington : 801 N. Quincy, Suite 130 : Arlington, VA 22203 : 703.527.5492 : @capitolrehab : drbooker@capitolrehab.com

Rotator Cuff
Why Didn´t Rehab Help My Rotator Cuff Auto or Sports Injuries?
continued

STRETCH OR RELAX, TIGHT OR HYPERTONIC MUSCLES
e third step in the rehabilitation sequence is the most misunderstood step in the process. By now, most of us are very well versed in the importance in stretching and maintaining our flexibility. But have you ever been told the difference between a tight and a hypertonic muscle? And did you know that although they feel essentially the same, you could cause serious damage by stretching a hypertonic muscle? Hypertonicity refers to a muscle that is "over excited" by the nervous system. A classic example is the "tightness" of the back of the leg, or the hamstrings, when a person is experiencing sciatica or a radiating pain from the back. People will complain that they feel "tight" in the back or legs. In actuality, the body is attempting to protect itself by "guarding" or "splinting" the injured area. e common response is to attempt to stretch the apparent "tight" area. By doing so, the person unknowingly removes the body´s natural protective mechanism, leaving the person vulnerable to exacerbations of the original injury. Remember to find a skilled practitioner who knows how to STRETCH the TIGHT muscles and RELAX the HYPERTONIC muscles. If your rehabilitation didn´t include the first three steps in the rehabilitation process, consider a second consultation with facility that utilizes an integrated approach to rehabilitation. If you continue to experience pain and discomfort, consider a second opinion from an integrated practice that incorporates the best in physical therapy, chiropractic and rehabilitation. For more information feel free to visit us at our website, www.CapitolRehab.com or call or email me directly at 703.527.5492 or DrBooker@CapitolRehab.com.

Dr. William Booker D.C.
Dr. William Booker D.C. holds a Doctorate of Chiropractic from the Cleveland College of Chiropractic, Los Angeles. He completed his undergraduate studies at the University of Virginia, where he graduated with a major in psychology and a minor in Biology. After completing his internship in Philadelphia, Dr. Booker relocated to Arlington to open the first Capitol Rehab inside of Gold’s Gym. Dr. Booker established Capitol Rehab-Arlington as the flagship for what would be the eventual opening of eight additional Capitol Rehabs located throughout Virginia, West Virginia and Maryland.

Capitol Rehab of Arlington : 801 N. Quincy, Suite 130 : Arlington, VA 22203 : 703.527.5492 : @capitolrehab : DrBooker@CapitolRehab.com