Spinal Injections Can be Back Breaking

Spinal injections have been shown to increase your risk of spinal fracture.

Did you know that recent research says that treatments like spinal injections can dramatically increase your risk of a cracked, or broken back? The scary part is over 9 million of these injections are given every year for spinal pain! New research has shown a 21% increased risk of a spinal fracture after every epidural steroid injection.

Lumbar epidural steroid injections are frequently given by pain management doctors for the treatment of radiculopathy or neurogenic claudication arising from compression of spinal nerves. However, there is evidence suggesting that corticosteroids can negative affect bone strength by diminishing new bone formation and increasing bone resorption.

The findings suggest that steroid injections can lead to increased bone fragility. The added exposure to glucocorticoids resulting from these injections may carry a greater risk than the medical industry previously thought.

“Of greater concern, the definable fracture risk as documented by Mandel et al. should be set against the best available evidence regarding the long-term efficacy of these interventions, which is admittedly less than robust.” - Andrew J Schoenfeld, MD

Why it Matters:

As you can imagine, spinal fractures hurt. They require further medical treatment and sometimes even result in surgery. By staying conservative with your healthcare, you can reduce your risks and get the relief you desire. Research shows spinal adjustments as one of the best forms of care to reduce your pain, increase your function and improve your overall quality of life.

Chiropractors are focused on correcting the cause of your pain. Problems with your spine can put pressure on your discs and nerves causing irritation, swelling, and a lack of spinal motion. A shot does not correct the cause of the pain, at best it only temporarily masks it. With the risks of spinal fractures, the smart decision is to get well and stay well using conservative, natural healthcare.

▪ Research has shown a 21% increased risk of spinal fractures after injections

▪ A fracture, or broken back, can cause tremendous pain and even result in surgery

▪ Natural healthcare, such as chiropractic, is recommended before moving on to riskier treatments such as spinal injections

Next Steps:

Share the science. Being well informed comes with the responsibility of sharing what you know with others who don’t. That doesn’t mean you should argue with those who are already convinced by their prejudices. It says that we encourage you to share what you know with others who are curious and can benefit from understanding the Research That Matters.

Science Source:

Spinal Manipulation Postepidural Injection for Lumbar and Cervical Radiculopathy: A Retrospective Case Series. Journal of Manipulative and Physiological Therapeutics. September 2004

Symptomatic MRI-Confirmed Lumbar Disk Herniation Patients: A Comparative Effectiveness Prospective Observational Study of 2 Age- and Sex-Matched Cohorts Treated with Either High-Velocity, Low Amplitude Spinal Manipulative Therapy or Imaging-Guided Lumbar Nerve Root Injections. Journal of Manipulative and Physiological Therapeutics. May 2013

A Retrospective Analysis of Vertebral Body Fractures Following Epidural Steroid Injections. The Journal of Bone & Joint Surgery. June 2013

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What is Foam Rolling and why does it hurt so good?

Chiropractic, foam rolling, and your body.

Foam rolling has exploded in popularity over the past few years. No longer used only by athletes and trainers, foam rolling (or myofascial release) is now used by people with all levels of fitness. The goal of foam rolling is to improve muscle function, performance, and range of motion. When a tight muscle or trigger point is released, you are able to move freely, with less pain, and improve your overall performance.

Why it Matters:

Activity, age, and injuries can cause your muscles to lose flexibility which in turn creates adhesions and pain. Foam rolling allows you to place deep compression on these areas reducing pain and adhesions while creating an improved joint range of motion. Using a foam roller during your warm-up routine may provide additional benefits beyond stretching alone. New research has discovered that foam rolling can improve flexibility more than static and dynamic stretching.

- Foam rolling is designed to release tight muscles and trigger points

- Researchers have found increased flexibility and reduced pain after foam rolling

- Proper movement patterns are thought to improve performance and reduce injury

Next Steps:

Using a foam roller on tight muscles and trigger points has been shown improve flexibility and help maintain proper movements patterns. If you have questions on whether foam rolling is right for you, just ask! We believe this type of at-home care is a great way to support the adjustments and care you receive in our office.

Science Source:

Acute Effects of Foam Rolling, Static Stretching, and Dynamic Stretching During Warm-ups on Muscular Flexibility and Strength in Young Adults. Journal of Sports Rehabilitation 2017

Differences in pressure pain threshold among men and women after foam rolling. Journal of Bodywork and Movement Therapies 2017

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How to Get Your First 1K Instagram Followers- Chiropractic Edition

Instagram- a great place for pictures of food and selfies or a great place for business?

As a chiropractor, it's a GREAT place for business and building an audience of people who know, trust, and like you.

Today we're going to break down five things you can do starting today to get your first 1,000 followers on Instagram. We all know to be an influencer you need to be on Instagram. There are over a billion active users! So regardless of what demographic your targeting of your specific healthcare niche, Instagram is a place where you should be to build, connect, and ultimately grow your brand.

And there are five things that you can start implementing right now to get on your journey to that first 1,000 followers.

1. Consistency Wins

The first step is to post consistently. Consistency wins the game whether you are posting once a day, or even if you only have the time twice per week. Staying consistent with your post is a great way to start expanding your brand and expanding your message on Instagram.

2. Tagging People and Places

Your second step is to tag people and places. If you stop by a healthy restaurant; tag that restaurant! If you're hanging out with a colleague, be sure to tag that person! Tagging others can accomplish a couple of different things. First, if you tag a specific business or place it "geo-targets" your location which means people searching for that business or place will be able to see your post — more opportunities for exposure= more followers. So tagging the places you visit is crucial.

It not only helps people find you through research, but it is much more likely that those businesses are going to share your post/content across their platform which will further amplify your message and get more new eyes on your channel, your content, and your profile. So be sure to tag people and tag places.

3. Collaborations

Collaborations with influencers can really explode your follower count. Search out the popular people in your community and reach out for a collaboration. Perhaps it's a post that both you appear in. Maybe it's a story, or it could be just sharing content back and forth. And remember micro-influencers matter. You probably won't be collaborating with Jay-Z or Beyonce anytime soon- so but that doesn't mean it isn't worth it. Micro influencers in your community 5,000-20,000 followers will be happy to do collaborations with you because they are also trying to grow their audience and profile. So find collaborators do collaborative stories and host to help expand your message.

4. Engage With Others Content

Number four engage with other people's content. The more engaged you are on the platform, the more likely it is that people are going to notice you, recognize you, and follow your profile. So engage with other people's content. One way to do this is to find five hashtags that are relevant to your industry and add a comment onto the top 10 posts with that hashtag each day. Once you do that for 30 days, I can guarantee you boost your follower count and be "known" in that circle of influence.

You will become somebody that everybody recognizes by name, and in turn, you will have people coming back to your profile following you and engaging with your content. So take five to 10 minutes at the beginning or end of each day, search up you hashtags that are relevant to your business, your industry, your circle of influence comment and engage on that content.

5. Hashtags

Number 5 is hashtags. Hashtags are not dead; they are a great way to search out relevant content that you can contribute on and also for other people to find the content that you are putting out. So one best practice that I've seen lately is to create the first comment on your post and load it will up to 30 individual hashtags. You don't need to do 30 every single time, but if you choose appropriate hashtags, it helps amplify your message people will see your content and again more people will follow you.

Those five steps will help you get as quickly as possible to 1000 Instagram followers. It's how I've done it. It's how thousands of other people have done it. When you get started on Instagram, it can seem daunting to get the first 50 or first 100 but if you follow these five steps- post consistently, tag people and places, do collaborations with other influencers, engage with other people's content, and use hashtags; you will be well on your way, and you will be smashing a thousand Instagram followers before you know it.

How to Negotiate an Awesomely Fair Chiropractic Contract

You made it through school. Now the real fun begins...negotiating your first chiropractic contract.

Most of us have heard the adage that chiropractors "eat their young." Well, I hope that by reading this article you can avoid some pain and negotiate a fair chiropractic associate contract.

via GIPHY

I wanted to give you three crucial pieces of information that I wish I knew when I "negotiated" (aka- took the first offer thrown at me) my first contract.

I know for many people of us the thought of going through a contract negotiation or a salary negotiation is about as comfortable as a root canal. But having a few key things clarified before you go into that conversation can make a world of difference in making sure you strike a mutually beneficial arrangement.

The 3 Keys to Negotiating a Fair Chiropractic Contract:

1. know your role- understanding what you are going to do within that clinic is crucial

2. new patient acquisition- who is responsible how are they going to do it and who is paying for it

3. identifying your long term goals

1) Know Your Role

First, let's dive into knowing your role in the clinic/practice. Are you merely performing exams? Or are you responsible for exams and treatment? What about modalities? That is very important to understand. Get clarity around your split or percentage on all revenue generating responsibilities. But, don't stop only with the revenue generating pieces of the clinic. If you are responsible for taking care of some administrative items that don't produce revenue then get a feel for how much time that will take each week. Your great asset is time, and time spent away from revenue producing activities has the potential to reduce your income.

Let's use an example of how your role may also be dependent on the organizational structure of the business. Perhaps this clinic has six locations with ten positions and is growing quickly by spending a lot on advertising. That's a lot different than a single doc with a single front desk person that's been in practice for 25 years. Keep in mind that knowing not only your role but the context of that role within the organization can help you tremendously when negotiating your salary. It will also help you be a lot more realistic.

Just because one clinic is in the ideal location doesn't necessarily mean it's the best place for you- so keep that in mind. Location, Location, Location- isn't always accurate for working for another chiropractor.

2) Who’s Getting the Patients?

Number two is all about new patient acquisition. Are you driving new patients into that practice or are you taking care of existing patients? Who is responsible for that lead generation? Patient acquisition is the number one area where I see new docs get tripped up with that initial contract negotiation. If you are expected to go out there and get patients, then you should be compensated for it and make sure that you have that built into your contract.

If you don't address it up front and after your first week or your first month your boss starts asking you to get out there and generated patients you are going to be unhappy. That type of friction can be a very uncomfortable position to be in.

3) Long-Term Goals

And finally, number three is knowing your long term goals. Is this an area where you're hoping to get experience? Is this a clinic that you eventually may want to take over and become a partner or owner?. And most importantly understanding your goals will help drive your contract negotiations. For instance, if you don't intend on being their long term, maybe you can take a slightly less salary for the opportunity to practice there. Otherwise, if you want to be there long term, you may add various reviews and share "buy-ins" that allow you access to more ownership in that company.

Understanding what you want to do, and what you want to achieve being a doctor in that clinic, is crucial to identify the steps to get the most out of your experience.

Keep in mind the organizational structure with all contract negotiations. If you're talking to a hospital or a large multidisciplinary group you might have salary on the table, plus paid vacation time, continuing education credits, and additional perks such as food and much more. However, if you are in a local clinic owned by a single individual, it might be a lot more difficult to get any of those perks or those guarantees.

Neither of these organizational structures is necessarily wrong or right, better or worse.

The key is to understand your goals, getting a clear view of new patient acquisition, and your day-to-day role in the practice. By doing so, you will be on the right path to negotiating a fair contract for both the clinic and yourself!

Chiropractic Postcards- Are They Worth It?

Sending postcards may seem a bit old-school, but you shouldn't underestimate their effectiveness at driving new patients and re-activations.

Today we'll break down the three important types of postcards that you need for your chiropractic practice. Typically I talk a lot about social media and online marketing (because it's SUPER important) because it's the best way you can grow your practice quickly. But there is something to be said for the physical nature of mailing a postcard. And there are three postcard types I would recommend starting immediately which all have an extremely high return on investment.

Chiropractic Happy Birthday Postcards

So postcard type number one is the good old fashioned "Happy Birthday" postcard. We all know getting physical mail carries way more perceived importance than just an email. Think about it yourself. When it's your birthday, you open up the mailbox you'll see a card there. It makes you feel good! You should, of course also send a happy birthday email to your patient but sending a physical postcard at somebody's birthday has that little bit extra pizazz. It's a little bit special, it's a little bit over the top, and I think it delivers a very high return on investment through goodwill and caring.

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Chiropractic Reactivation Postcard Set

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The second type of postcard you should be sending is a re-activation postcard. The goal of this postcard is to engage with your past patients, let them know you've been thinking about them and that you care.

Over time you will have an inactive patients list in the hundreds, if not thousands. Sending a physical postcard and reminder of your practice thorugh direct mail is a compelling way to stimulate re-activations. Incidentally, you should also be sending these reminders consistently through email, but mixing in a physical postcard every few months is a great way to deepen your relationship and add another touch point.

A reminder that you exist is an excellent opportunity for your in-active patients to pick up the phone and call your office. How many patients leave your practice happy and healthy? Probably more than 90%. So think about it, you have a plethora of "fans' of your practice out there in your community. Don't hesitate to remind them with a physical postcard that you are part of their healthcare team and you are ready to help when they need you.

Chiropractic Holiday Postcard Set

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The third type of postcard you should consider is a holiday card. Around the New Year is a great time to send a physical piece of mail to your patients and let them know you are thinking of them. Pro-tip- the timing of your holiday card can vary. If you are looking for a boost in the new year, then it may be beneficial to wait until after the 1st to send. If you are looking for a little practice uptick before the close of the year (and as your patients are looking at their deductibles) then sending the holiday card towards the beginning of December may be a better idea. It's up to you!

These three postcards will give you touch point practically every quarter with your patients.

I'd encourage you to explore sending postcards in 2019. Test it. See what kind of return on investment you can get. I think you'll be happily surprised with the results.