Smart chiropractors are adding exercise groups to their practices, and finding health and business benefits
By Randy Southerland
Dr. Rob Francis is presenting his report of findings to a new patient in his
Pasadena, Texas, office. The man, 50-ish and graying, listens intently as the
chiropractor describes his care plan. It includes the usual—a prescribed
number of visits for regular care and adjustments; then there’s the kicker.
“We’ll schedule you for one of the evening yoga classes,”
says Francis. He tells him to stop by the front desk to pick up a schedule.
At this chiropractic office, patients are getting up off the table following
adjustments and into yoga poses as part of their care plan. In fact, Dr. Francis
requires every patient to not only get adjusted, but also practice this ancient—and
to many westerners—decidedly different form of exercise.
Putting chiropractic patients in yoga classes is part of a growing trend among
doctors who realize that regular physical exercise of some form can work wonders.
These DCs maintain that as their patients become fit they require less care,
hold their adjustments longer, and in general tend to be much healthier than
those who continue to follow a sedentary life style.
The results can be striking.
Dr. Stacey Davis, who practices at Chiropractic Physicians of Scottsdale in
Scottsdale, Ariz., provides each patient with some form of exercise to follow
even if it’s not covered by insurance plans as part of a rehabilitation
program.
One of her Medicare patients had been getting care for low back pain and radiating
pain down the leg. While he usually experienced some relief from chronic pain
following each adjustment, it quickly returned. She instructed him in the use
of a wobble chair and a series of simple back stretches.
“When he came in for his last visit he said, ‘You know, I’m
pain free for the first time for an entire week,’” she recalls.
“I know the adjustment is paramount, but the exercises helped him tremendously.”
A licensed massage therapist prior to entering the chiropractic field, Davis’
approach to enhancing patient fitness includes various simple devices for increasing
mobility along with resistance training and stretching exercises.
Many doctors follow the tried and true approach to getting their patients into
a regular regime, but a number of doctors are following Francis’ approach
by offering more out-of-the-ordinary fitness programs. Among these approaches,
yoga classes are probably the most popular.
Nearly every city has at least one yoga studio and it is becoming increasingly
accepted by mainstream America. The word yoga, from the Sanskrit word, “yug,”
means to yoke or bind, and is often interpreted as a means of uniting, or a
method of discipline. The Indian sage Patanjali is credited with collecting
the various practices of yoga into the Yoga Sutra more than 2,000 years ago.
Today, there are many different styles of yoga that can range from the slow
and meditative to high-energy brands that resemble aerobics.
While many people may be a bit leery of yoga’s roots in Eastern philosophy,
participants are quickly won over by the strength and flexibility that regular
practitioners experience after doing exercises with names like Pasasana or Noose
Pose, and Adho Mukha Svanasana, better known as Downward-Facing Dog.
While yoga may have overtones of the mysterious East, Dr. Francis has some very
practical reasons for getting his patients to learn the discipline.
“Yoga is much more complete in terms of physical rehab, and what people
are able to do with yoga is a lot more comprehensive in terms of the muscles,
tendons and ligament structures,” he says.
While most rehab programs tend to focus on just the injured area and one muscle
group, yoga emphasizes balancing all the muscles.
“There are a series of postures in yoga that balance the trunk muscles
in the front and the back as well,” he explains.
Dr. Francis, who holds medical staff appointments with several Houston area
hospitals and works with a team of MDs, has long been a proponent of yoga for
patients—whether they present with a specific complaint or are simply
interested in wellness.
In fact, his practice at Texas Yoga & Ayurveda Institute is primarily wellness-based.
Patients often come in knowing that something is wrong with them, but often
aren’t sure exactly what, or how to make it right.
At first, he referred patients to local yoga studios, but as they began reporting
back their experiences he realized that not every teacher had the proper level
of training in anatomy and physiology to tailor programs to every patient’s
needs.
“So we began to develop that component of the practice,” he says.
“Over the course of two or three years, it became a significant part of
the practice to the point that we have a yoga school now where we train teachers.”
The yoga school and studio are led by Francis’ wife, Tracie Brace-Francis,
and is accredited by the Reading, Penn.-based Yoga Alliance. Class attendance
is an integral part of patient care plans, and each patient must agree to attend
class on a weekly basis. For those who aren’t interested in this holistic
approach, Francis says he makes referrals to two other nearby DCs who have more
traditional practices.
Doctors who have used yoga as a means of helping their patients achieve greater
health and fitness say that the programs benefit nearly everyone.
“From when I practiced in another office that did not have (yoga available
to patients), I would say that most of my patients are improving with half the
care,” says Dr. Wendy Noffke, director of Namasté Yoga & Chiropractic
Center in Puyallup, Wash. “A lot of the time they begin to feel more responsible
for their health. They can see that they do have some control over things.”
While Dr. Noffke doesn’t require patients to attend the yoga classes taught
at her office, she does encourage everyone to engage in some form of exercise.
Currently about half of all patients are taking yoga on a regular basis.
“It’s good for most people,” she says. “With most of
my patients we take a look at what other things—in addition to chiropractic—we
can do to improve their health holistically. So we work on diet and nutrition
with them. We work on exercise.”
Dr. Francis, who has recommended yoga for about five years, agrees that patients
recover much faster from injuries when yoga is combined with chiropractic care.
In addition, this form of exercise also brings other benefits in the form of
stress reduction and greater relaxation.
For many patients, an injury is not simply physical, but carries a strong emotional
and psychological component as well, say the doctors. Moodiness and even depression
often go hand in hand with injury and chronic pain. A regular yoga practice
fosters healthier emotional states and a more positive outlook.
“A large percentage of my patients had a lot of stress in their lives
and many times they were not aware of it,” he explains. “I found
that after they came back from taking yoga for six weeks they would tell me
their marriage was a lot better or their job was better or their relationships
were a lot better.”
Both chiropractors offer their patients Hatha yoga, the most popular and recognizable
form of yoga. They also are careful not to push the philosophical tenets of
yoga on patients who may not be receptive to them.
“There’s still some stigma in this area,” says Noffke. “The
town where I live is not necessarily the most progressive city in Washington.
So most people are coming in and doing this because we present it as a program
that works with coordinating movement, breathing and exercise and relaxation.
We only push into the spiritual realm of it if that tends to be where people
want to go with it.”
Presenting ancient knowledge to a modern and perhaps skeptical audience has
kept other doctors from finding new uses for these exercises. At the office
of Woodstock, Ga., chiropractor Tali Cluxton, patients are learning how to cope
with the ailments of modern life using techniques supposedly first developed
by ancient South American shaman more than a thousand years ago.
The Toltec Indians—who inhabited in the 10th century A.D. what is now
present day Mexico—developed a series of exercises designed to strengthen
muscles, improve posture and breathing and bring greater overall vitality. One
of the great pre-colonial empires of that region, the Toltecs reigned over much
of Mexico prior to the Spanish conquest, practicing human sacrifice and building
great stone temples to the feathered-serpent god Quetzalcoatl.
Cluxton teaches her patients a system called tensegrity, a modern version of
a technique originally attributed to the Toltecs and given new life by a growing
population fascinated by all things New Age. Based on the mythic writings of
Carlos Castaneda, it is a system of energy-invoking movements called magical
passes, developed by Indian shamans like the Toltec.
Castaneda claimed that a mythical character, who he referred to as Don Juan,
taught him that these ancient Indians were able to discern the universal flow
of energy using these techniques. Since then numerous other authors and entrepreneurs
have taken up the “Toltec way” and built a thriving business teaching
these techniques to other eager truth-seekers.
A word originally invented by the architectural community, tensegrity is a combination
of “tensional integrity.” It is a reference to the architectural
principle stating that “the property of skeleton structures that employs
continuous tension members and discontinuous compression members in such a way
that each member operates with the maximum efficiency and economy.”
“Their (Indian shamans) definition of tensegrity may differ from that
of a modern chiropractor’s definition of tensegrity,” she explains.
“Basically they did a series of exercises almost like a Tai Chi exercise
or Tai Chi pattern. It was designed to rebalance all the joints of the body
and basically energize them the way we would drink a cup of coffee in the morning.”
She adds that these exercises “involve movement and breath and tension
and all those things.”
Requests for her patients to do conventional stretching exercises in between
visits to her office frequently went unheeded. Many didn’t realize just
how poor their posture was until the DC presented them with results of biomechanical
tests.
While not a martial art like Tai Chi, tensegrity is a highly effective means
of improving posture through strengthening the muscles and connective tissues
around the joints. For those patients who practice the exercises, the results
are often renewed vigor and greater freedom from pain. Those kinds of results
have gotten their attention and compelled many to continue practicing them.
She teaches the exercises at Spinalright Chiropractic during a weekly class
that is open to all her patients. Her version of tensegrity—which she
learned from another practitioner who had been trained in California—emphasizes
the movements and their healthful benefits rather than the mystical properties
practiced by ancient shamans.
While the forms and names may differ all of these doctors are teaching their
patients how regular physical activity can give them new life and vitality,
and help expand doctors’ practices.
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