Importance of Rehabilitation

If one wants to maximize one's health, one needs to play an active role in its' achievement. Exercise rehabilitation is the key to a full recovery. Of course, correcting the cause of body imbalance is essential; whether it be misaligned spinal vertebra resulting in interference to normal body function (subluxation) or nutritional deficiencies due to poor dietary intake. Our experience shows exercise rehabilitation, in addition to chiropractic treatment, is an essential ingredient in achieving a more complete recovery from any musculo-skeletal condition or injury.

To better understand why rehabilitation is so important, we must first distinguish between two basic types of muscles. The first type is known as "fast twitch" (anaerobic). These muscle fibers are designed for short spurt activity (sprinting), not endurance. They predominantly burn sugar for energy and when they fatigue, they produce lactic acid; a well known tissue irritant causing pain and muscle spasm.

Another type of muscle is known as "slow twitch" (aerobic). These muscle fibers are designed for endurance. They burn fat for fuel, withstand fatigue and help the body resist gravity.

When normal motion becomes reduced in a joint, whether it be from injury, postural or occupational stresses and strains, the endurance muscles take on the characteristics of the short spurt muscles. This means that you are now using short spurt muscles for endurance tasks. This results in excessive lactic acid build-up which causes blood vessel constriction leading to muscle spasm and pain. It also inhibits muscle function and reduces its' frequency to contract. Even higher brain centers are affected.

When this happens, muscle protein is lost; resulting in muscle loss (atrophy). As these muscles atrophy, they lose their aerobic ability to stabilize a joint; they lose their capacity to endure. The longer these muscles are allowed to deteriorate, the more problems can result and the longer it takes to fix them. Considering that it takes only 6 to 10 days for a muscle to lose half of its ability to work, in a mere 30 days up to 90% of the muscle function can be lost.

As a general rule, due to gravity, occupational and postural habits, we tend to develop the flexor (bending) muscles of our bodies disproportionately to their counterpart extensor (straightening) muscles. Above the waist, the flexor muscles are mostly on the front of the body and below the waist, they are predominantly located in the back. Flexor muscles include: chest muscles, abdominals, biceps and hamstrings; extensor muscles include: back extensor muscles, lats, triceps and quadriceps. In normal spines, extensors should be 30% stronger than their counterpart flexors. If you could lift 50 pounds performing a leg curl (hamstrings), you should be able to lift 65 pounds performing leg extensions (quadriceps). The same ratio applies between the stomach and the back extension muscles. Remember, as the endurance muscles take on the characteristics of the short spurt muscles and produce excessive lactic acid, the extensor muscles become inhibited. This tends to allow for a one-to-one ratio between flexors and extensors, and posturally, most people become an injury waiting to happen. These factors support the fact that you cannot consciously correct posture.

Take the case of a person with a neck problem who spends his/her day looking down at a desk or computer keyboard. This places a tremendous amount of strain on the neck muscles, usually resulting in pain as the day wears on. Over time, these muscles become less able to sustain this endurance activity and their ability to provide spinal joint stability diminishes. As this progresses, joint cartilage (disc) breaks down which ultimately leads to joint degeneration (arthritis). Without active exercise rehabilitation, this cycle is difficult to break. The same scenario applies for the lower back musculature.

Imagine, if you will, a shelf on a wall. The shelf is two inches thick and made from solid oak. The brackets attaching the shelf to the wall are made of steel. First impression is that this is a very strong shelf. However, the shelf and the brackets can only be as strong as the wall supporting it. The wall in this analogy represents your spine and postural muscles. Most of the exercise that people participate in tends to strengthen the shelf and bracket, but does little to strengthen the wall. This adds to the instability of the joints of the spinal column. Hence, the reason that a lot of people begin exercise programs, only to conclude quickly from injury.

In order to break this negative cycle, strengthen the wall and return atrophied endurance muscles back to normal, rehabilitation of the spinal joints is required. This is done with progressive resistive firing of the "wall" muscles of the spine. The more stimulation these muscles receive, the more work they can do. The more muscle strength created, the more tension can be produced and the more binding sites can be developed. This leads to an increased stability of joint function, hence improved posture and allowing for a more complete recovery and an ability to maximize your health.

Our complete exercise facility is one of the few Nationally Certified Chiropractic Rehabilitation Facilities in the Metropolitan area recognized by the National Chiropractic Rehabilitation Association in Ridgefield, Washington. Dr. Weinstein is a Board Certified Rehabilitation Doctor.

Our expertise affords our patients faster recovery and improved health. As always, we try to stay on the cutting edge of the latest innovative methods to afford our patients the best available health care.

Copyright © 1999 Dr. Ronald A. Weinstein. All rights reserved.

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