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Save Your Body
By Katie K. Bell

Four exercises that protect you from the wear and tear of performing adjustments.

After 26 years in practice, Vince Erario, D.C., reluctantly closed his practice because of a wrist injury he sustained while working. “I had to stop practicing, I really had no choice.” The pain he was experiencing at the end of a full day adjusting patients was terrible and ultimately, he adds, “the quality of my work was being reduced.”

Indeed, one of the ironies of chiropractic care is when the healer becomes the injured. It happens all too often, and doctors are often forced to make more significant adjustments—not the DC kind, but the lifestyle kind, involving career change and modification.

Erario was by no means an out-of-shape practitioner. “I always exercised. To me prevention is foremost, especially strength conditioning for the upper back and shoulders, but my wrist ended up being my weak link.” His initial injury occurred in November of 1983, while performing an anterior thoracic move where the doctor’s hand becomes a fulcrum and a patient’s spine releases over it.

“I did this with a 300-pound patient and my hand just twisted under his body, that’s when the tear (in the triangular fibro cartilage of his hand) occurred. In addition, I consistently used a technique called toggle recoil adjustment, which added stress to my wrist joint.”

After the injury, Erario sought advice and treatment from fellow chiropractors, even pursuing acupuncture, eventually consulting with an orthopedic surgeon and submitting to surgery. “Of course they finally found out they couldn’t repair the damage, as there was no material left to sew anything together; they could only clean the jagged edges,” he notes.

Practicing DCs can incorporate a series of stretches and strengthening exercises to avert potentially disastrous injuries. We asked Dr. Pete Gratale, the creator of PowerCentering with 21 years of chiropractic experience and TV fitness host on ESPN’s “Body Shaping” to suggest several exercises that can be done at work—between patient appointments—to prevent injury.

Gratale advises doctors to first go through the PowerCentering process of getting connected to your core, “Regardless of whether you are a martial artist, an athlete or a chiropractor, if you do something physical you can be much more effective if you have a good mind-body connection. I urge practitioners to treat adjustments like an athletic event—you have to be well conditioned and centered to perform adjustments correctly,” he advises.

Erario also offers his own tips for modifying techniques after a strain or an injury.

He suggests doctors try to do things with the uninjured arm or hand. “I often used my forearm (rather than my hand) to adjust low back pain, essentially putting stress on the other parts of my body.”

He also advises doctors to pay careful attention to form. “When we make a correction we should have the best form—the patient should be in the correct placement, as should the doctor. It is no different from lifting weights and using the correct form.”

Also keep your core strong. “Have good core strength; this is essential to chiropractors because we are bending over patients all day long.” he explains.

Despite being forced into retirement, Erario has remained busy. He is presently serving as the chairman of the Governmental Relations Committee of the Georgia Chiropractic Association.

Exercises:

The Exercises
Dr. Pete Gratale (pictured) demonstrates four exercises—you can do at your practice—that can save your body from the physical stresses of caring for patients. Before starting this sequence of exercises, take a moment to focus your attention to your center, your inner core. Gratale suggests visualizing your breath going down into your center, as energy comes in through the breath. “A centered doctor and a centered patient creates great rapport,” he says.

Bicep stretch with Shoulder blade Squeeze
There is a prevalence of extremely poor posture in DCs while performing adjustments. The chest, anterior shoulder and biceps get tight and pull the shoulders and traps forward. We want to open up the anterior chest and shoulders. Bring your arms to side about shoulder level with your palms face up to supinate the biceps. The arms should rotate up, back, down and around. As you do this, be sure to squeeze the shoulder blades together. These arm circles will create balance between front and back, stretching out the anterior muscles and contracting and strengthening postural muscles. This is much like arm circles, but with the palms facing up. This is a pose you simply cannot overdo. Do at least 15 to 20 reps throughout the day.

Horse Stance
This leg strengthener can actually be done while adjusting patients. The whole idea is to get your body down low enough, so that when you place your hands on the patient you do so without bending over and putting strain on your lower back. Begin by taking a wide stance with toes pointed out about 45 degrees. Spread your legs out and bend your knees while keeping upper body erect. Check your knees to make sure that they stay over ankles (or the toe at the very least). This pose is good for giving stability and power to the groin, hamstrings and thighs. Practice maintaining this position while giving adjustments, turning your feet as appropriate to maintain balance and centering.

Spinal Cord Breathing
Begin in a standing position, bend knees (crouch down a bit) and bend forward into a standing fetal position, tuck tail under like a scared dog, bring chin to chest, form your spine in a ‘C’ shape, pull navel back toward spine. Your body should have the appearance of a ‘C’ shape from a side view. Be sure to exhale as you are getting into the position.

To Reverse: Knees should remain slightly bent, begin to extend spine backward from the waist up, lift hands up to the sides, squeezing the shoulder blades back. Be careful to maintain an elongated posture.

Swami
Use this as a good wrist stretch and strengthening exercise. Press palms together in prayer position and begin to roll hands forward. As you roll forward, your forearms will be parallel to the floor and the fingers will begin to point down. As you turn your hands in toward your chest, rotate palms so that the backs are touching and bring your hands up and around again to prayer position.