The person who referred me to you says you are different from most chiropractors.  How so?

I think the biggest thing that sets me apart from other providers are the various treatment modalities I employ and the extra training I have pursued.  I am one of only two Active Release Technique providers in the state, one of only a handful of Certified Sports Chiropractors, and the only one that I know of who has both credentials.   Traditionally people think of chiropractors as manipulating the spine.  While I love being a chiropractor and find great value in spinal manipulation, it is just one of the tools I use to help get people better.  I treat knees, shoulders, and other sports injuries as commonly as back and neck issues.  I put a great deal of emphasis on muscle work and rehab concepts; in a typical appointment I will spend twice as much time performing muscle work as manipulation.  The half hour time slots I book are longer than normal for a chiropractor, but it is what I feel is necessary to adequately get to the root of most people’s problems.

I favor a hands-on approach in the treatment of musculoskeletal problems.  While medications, electrical stimulation, ultrasound, etc. have their place, they do nothing to fix the issue, let alone its source.  Most musculoskeletal problems follow a common pattern: pre-existing muscle imbalances (tight vs. weak,) causing joint dysfunction and further muscle irritation.  Typically it is the joint dysfunction and muscle irritation that causes the pain and brings people in for treatment.  This is the depth of intervention of most chiropractic treatments and muscle techniques such as massage therapy.

However to truly solve most musculoskeletal problems you have to identify and correct the underlying factors that created the problem in the first place.  My approach is to incorporate the best treatments available to effect quick pain relief but also to put together the whole biomechanical puzzle as early as possible to start correcting these underlying factors.

This may sound like mumbo-jumbo so I’ll give a classic example.  A common complaint I see in the office is upper back pain that radiates up into the neck, limiting its range of motion.  Typically the source of the actual pain is a rib joint that has become fixated, causing some associated muscle spasm.  Chiropractic manipulation is relatively unique in ability to quickly resolve the rib issue.  Coupled with a little muscle work we can usually resolve the pain and restore range of motion fairly rapidly.  However in the absence of trauma it is rare for a rib to just decide on its own to become fixated.  Usually there is an underlying muscle imbalance present in the shoulder causing the muscles that attach to the rib to become tight and thus predisposing the individual to have this type of injury.  Until you resolve this muscle imbalance the rib is very likely to continue to continue to be a problem.  Active Release Technique is very effective in identifying and correcting these older muscle issues.  To take it even one step further, part of the muscle imbalance may stem from a hip issue on the same side that has inhibited a key shoulder stabilizer (latissimus dorsi for those keeping score.)  So ultimately until this hip issue is corrected and the lat turned back on, you won’t effect a true “cure.”  This whole pattern becomes more pronounced with athletes; obviously in swimmers, but even the cyclist with recurring one-sided neck pain after two hours bent over the handlebars, or a golfer with a hitch in his swing.

What can I expect during treatments?

The first treatment will typically last about one hour.  I will take a thorough medical history and conduct an examination, and then let you know what I’ve found, whether I think what I have to offer is the right fit for you, and if it is, how many visits it would likely take to resolve your problem.  My average treatment plan is typically pretty short (i.e. 4-8 visits.)  Patients are often surprised by this.  My focus is truly on finding and fixing the source of your problem quickly, and giving you the tools and information to be pro-active in your recovery and in prevention.

We will usually provide a brief treatment on the first visit if appropriate.  Subsequent treatments are generally about one half hour.  It is difficult to say what an “average” treatment is like.  I custom my approach to the individual, the injury, and to any other factors affecting the injury.  I have a lot of different treatment options at my disposal, and will use whatever is most appropriate on that day.

With that being said, most treatment will include some amount of chiropractic manipulation and a fair amount of muscle work.  The amount of each really depends on the problem.  I also typically prescribe exercises as we progress through our treatment plan, preferring to give one or two at a time instead of over-whelming you with a bunch at once.

During our time together I may discuss, and you should feel free to ask about, other factors affecting your injury.  Topics might include posture, appropriate footwear, sport-specific technique, mattresses, ergonomics, etc.  We may also talk about other factors not specifically related to your injury but that play a big role in general health such as nutrition, stress, sleep, breathing, etc.  Again feel free to ask.  I don’t know everything but do get asked about these topics often and have done a lot of reading over the years.  I can usually give decent advice or at least point you in the right direction.  You can also check out the “Articles” section of our site for discussions on various health and athletic topics.

Once the pain is gone, desired function has returned, and you are satisfied with your progress, we will usually discharge you from active care.

Once I start seeing a chiropractor will I need to keep coming indefinately?

This is a common stereotype associated with chiropractors. I attribute it mostly to the fact that once people realize they don't have to live with the aches and pains that they associate with “getting older,”  or as just being inherent in their sport, they are happy to return. I treat every individual differently.  My focus is on alleviating your pain, educating you on what caused the injury, and helping you to be pro-active in preventing its return.  Once we have accomplished this I will usually discharge you from active care and tell you to return if and when you feel like you need to.

Most people find that they can use the occasional “tune-up” visit.  A healthy body, and life in general, is all about balance.  But who amongst us is completely balanced?  I know the ins and outs of taking care of yourself, and try to practice what I preach, but I still find I feel best when I see my chiropractor every month or so.  For some people, for example athletes in contact sports or pregnant woman, it makes sense to schedule maintenance visits ahead of time knowing that we will always find something to work on.  For the average person or athlete though I leave it up to you to decide when you need to return.

Do you treat people who aren’t necessarily “athletes?”

Absolutely.  I enjoy working with a variety of people from all walks of life.  The training and experience I’ve had in working with athletes helps me treat everyone better.  We all have the same basic body design.  Athletes may use their bodies more than the average person, but the same biomechanical principles apply whether you’re swinging a baseball bat or just swinging a rake in your back yard.

Do you treat kids or senior citizens?

Yes I do.  In fact working with the young and the old can be very rewarding as they often have the most dramatic results from the type of work I do.  I have treated babies (including my three) as young as several days old.  I find there a few times with babies when it makes sense to have them checked by a chiropractor, starting soon after birth.

Having watched my three kids enter the world I realize how much physical stress a baby can go through during the delivery process.  It’s not uncommon for them to need an adjustment sometime after birth (and mom too for that matter.)  Around three months, when the baby is starting to hold his or her head up, there is a lot of new stress on the mid back to support that big head, and they will often have mid back issues.  One specific condition with babies I have had good luck treating is reflux.  Often times babies with reflux have mid back (thoracic) issues that, when treated, resolve the problem.  As kids get older and more active, it’s not a bad idea to have them checked out every so often, say after every third fall from the couch, etc.  The great thing about kids is that they heal so quickly; it usually only takes one or two treatments.

Senior citizens, being from a generation where you didn’t complain about things and when alternative medical care wasn’t as available, often times just learn to live with musculoskeletal issues and attribute it to “getting older.”  You may accept not being able to turn your head fully to one side.  You may accept that after tennis or gardening your right knee is going to be sore.  It doesn’t necessarily have to be that way though.  Quite often we can make a difference.  I can’t tell you how many times we have resolved a musculoskeletal problem that was previously diagnosed as or chalked up to “arthritis.”  The secret to a long healthy life is staying active; I can help you to continue doing the things you like to do with less pain.

I am interested in Active Release Technique but am wary of chiropractic manipulation.  Will you do one without the other?

Yes.  I am not here to force anyone into anything they are uncomfortable with.  I will say two things on this subject though.  First, most musculoskeletal problems are just that: they involve both the muscles and the skeleton.  Quite often you won’t obtain the best results if we don’t incorporate work on both, even in some seemingly straight-forward muscular issues.  I will let you know if I think this is the case.  The second thing I would point out is that I have seen dozens of people who were pretty adamant about not being manipulated, usually in one part of their body such as the neck.  Invariably, after they allow me to perform one trial manipulation, they realize that it’s not really a big deal, and they wind up feeling the results they obtained were worth over-coming their anxiety.  Manipulation doesn’t usually hurt; most people find that if they can get past the noise it’s really pretty benign.

Having said all that, if you were still entirely opposed to manipulation, we will skip it.  Everything I do is contingent upon your consent, and I would never do anything that you specifically don’t want.

What is that “cracking” noise that accompanies a chiropractic adjustment?

An adjustment is usually targeted at a specific joint, causing that joint to rapidly gap open.  When this happens a vacuum is temporarily formed within the joint which then fills with gas from the surrounding area.  When the joint closes back down the gas is released causing a “popping” sound.  There is no pain associated with the noise.  Most manipulation is relatively painless.

What type of clothing should I wear?

Generally the only types of clothing that are problematic are dresses or skirts for woman or really tight fitting pants.  Other than that don’t worry too much about what you are wearing.  We will usually have you take off eyeglasses, tight belts, shoes, and larger necklaces and earrings.  If we are seeing you for a knee problem we will often give you a pair of athletic shorts to wear.  Feel free to bring in your own.  If we are seeing you for a shoulder problem it is sometimes helpful to wear a tank-top underneath your regular shirt.

Do you take X-rays of every patient?

I only order X-rays if I feel they are medically warranted to rule out fractures or pathology.  I would estimate that I order X-rays on around 10-20% of incoming patients.

Will my insurance cover this?

Most insurance companies in Maine cover chiropractic care.  We will be happy to bill your insurance for you. Normally, even with HMO's, you can self-refer without prior approval from your primary care physician.  We will call your insurance company on your first visit to let you know what your benefits are.  It is not a bad idea to call your insurance company to verify your coverage before coming in for your first visit. We are a contracted provider with every major insurance company that we know of.

Will my insurance cover seeing the massage therapist?

Generally not, unless they specifically cover massage therapy as rendered by a licensed massage therapist.  You can ask your insurance company this question or we can let you know when we call to verify your benefits.