The HARSH reality of Health Insurance and Chiropractic Care

As you know, we here at Health-Fit try to keep you informed and up to date on all things health related through our emails, mailed newsletter, social media and blog posts. Today is no different, just a different type of topic. 

The continued decision whether to be in or out of network is increasingly becoming more difficult due to the ever changing environment of health insurance. 

We continue to stick with the insurances that still are somewhat fair to us, but that has left us with only a couple that we can afford to be in-network with and provide our level of care our patients deserve and expect. 

Health insurance companies are forcing Chiropractors between a rock and a hard place. Many Chiropractors have had to choose only provide care that the insurance company pays for. And many times, the chiropractic adjustment is the only thing they will perform. 

 As our patients know, we do a lot more than just adjust our patients. The adjustment is important, but not the end all be all too really fixing your pain and injuries. Don’t get me wrong, for some of our patients, the adjustment is all they need and gets wonderful results. But many need more to really get quick and effective results. And the bottom line is, results are what matters most.  

To give you a brief history of Health insurance and Chiropractic (and many other medical fields), the reimbursement has been slashed by considerable amounts. For instance, let’s take the year 2000. A total office visit reimbursement used to be about twice as much as it is today, with the patient having a very small copay and the insurance paying the rest. Fast forward to now, Insurance companies are reimbursing Chiropractors (and many other doctors) half of what they used to and now putting the majority of the burden on the patient. 

So not only has the total reimbursement been basically cut in half, the insurance company is putting the vast majority of the bill on you. What the end result has come in most Chiropractic offices is a lower level of treatment and more out of pocket cost to you, and for lesser care! It is a frustrating and vicious cycle that has occurred. 

In light of the ever changing (not for the better) insurance environment, we continue to attempt to provide you the most VALUE for your care. Our Doctors have spent a lot of time and money being certified in Active Release Techniques, Graston Technique, sports rehab modalities and more.

We have made the EASY decision not to bend under the immense pressure of insurance companies and lower our standard of treatment given to our patients. We have made the decision that we will continue to offer the best conservative care available to our patients. 

We completely understand that cost of healthcare is always an important decision for you and your family. We all have to make those same decisions in our personal healthcare too. That is why we are striving to always offer the most VALUE for your care. We can’t control the COST, because unfortunately, the insurance companies control that. But we can control the Value of care you receive out our office. 

So, when making decisions on your care, whether it is Chiropractic or Medical, always seek out VALUE and not necessarily the COST. Sometimes Value isn’t related to cost. Sometimes the price tag may be a bit more, but the value is extremely high. Many times the cost is low, but the value is non-existent. It is an interesting dynamic. 

Sometimes, if you choose a Chiropractor solely based on being In-Network, and the insurance doesn’t reimburse Chiropractors fairly, you may find that you only get a quick adjustment and you are in and out of the door without the true care needed to address your pain and symptoms.

It unfortunately becomes a numbers game. They will need to see 50 patients in a day instead of 20. Seeing 20 allows the Chiropractor to offer the value and care needed to address your pain and conditions. 

So, to wrap up this little “rant”, we want to assure you we are continuing to find the best and latest methods of musculoskeletal care to get you feeling better the fastest possible way. Therefore, the value of your care will be high and ultimately allow you to save money in the short, medium and long term. 

That is the key in the new healthcare environment.

A Trend in Sports Recovery for the CrossFit® Community?

Just as in many sports and activities, CrossFit® is physically demanding on the body. There is no denying that and that doesn’t make it right or wrong, it’s just a fact as it is in many sports and challenging activities. That’s why we do it. That’s why we gain so much satisfaction out of it. Physical challenges to the body have so many positive aspects. 

With that being said, just like in any other sport or activity, once you decide to join CrossFit® or any high demand activity, you need to understand that body preparation, self-care, treatment, and sports recovery modalities are vital in maintaining health and performance. 

We can all agree that CrossFit® would be considered “overwork” to the body. That’s the whole point. Stress the body and watch the body make adaptive changes such as strength, power, conditioning, aesthetics, etc. However, with this stress and overwork to the body, there are potential ramifications if not careful. Dr. Michael Leahy who developed Active Release Techniques® has done a great job in depicting how over-use injuries occur with this diagram representing The Cumulative (Repetitive) Injury Cycle.

 

In Overwork situations such as Fitness, Sport and even things like sitting too much, your body will develop muscular imbalances. Some muscles will tend to become tight, and others will tend to become weak. The glutes tend to become weak. The hamstrings tend to become tight. Abdominals weak. Calves tight. So on and so forth. 

The tightness and weakness then develops friction, pressure and/or tension in the area and leads to a decreased circulation or hypoxic state (lack of oxygen due to lack of optimal blood flow). Once this hypoxic state occurs, you end up with scar tissues and adhesions in the muscle, ligaments, and/or tendons. This, in turn feeds the muscular imbalance even further. The Cumulative Injury Cycle then keeps on turning and turning--lying dormant until finally, the body sounds the alarm system, which is pain! Now we have an injury. 

Below I am going to break down each aspect of the Cumulative Injury Cycle, then I will reveal how certain Sports Recovery aspects can help reduce this cycle and aid in injury prevention and optimal recovery.

Weak & Tight Muscles

Repetitive effort makes the muscles tighten. When a muscle is overly tight it also tends to become short. When a muscle is weak it tends to become tense.  If certain muscles become tight, then the antagonist muscles may become weakened. For instance, tight hip flexors can lead to weakened Glutes. Tight Low back can lead to weakened abdominals. This phenomena is call Reciprocal Inhibition. This furthers the muscle imbalance issues in the body. 

Friction- Pressure -Tension

As a result of weak and tight tissues, the internal forces acting on the tissues rise. Friction, pressure, or tension are examples of internal forces, and can all be present individually, or all at the same time. A couple examples of this are the tension you get in your Upper Trapezius or the friction an IT Band causes at the lateral knee, which cause an inflammatory response and pain.  If one or more of these factors is high enough, an acute injury and inflammation can result even without outside forces being applied. 

Decreased Circulation-Swelling

The effect of increased forces on the tissues is to decrease circulation. If pressure is applied over one of the low pressure lymphatic channels the result is swelling. Outside forces in the form of constant pressure may also have the effect of decreasing circulation or causing swelling.

Adhesions-Scar Tissue

Cellular hypoxia (lack of oxygen) from restricted circulation causes adhesions and scar tissue to occur in and between muscles.

Result: Repetitive Strain Injury

 

The cumulative-injury cycle is self-perpetuating. It worsens the symptoms and syndromes of cumulative- trauma disorders with a downward-spiral effect. The result is pain, decreased recovery times and/or altered biomechanics of the body.

Typically if we are suffering from the effects of this cycle and do indeed have an injury and an inflammatory state, some sort of treatment is instrumental in alleviating that pain. Once the pain levels subside (or during treatment to achieve pain relief), we can target the muscular imbalances through strategic corrective exercises and movement pattern correction. In addition, we can do manual therapy techniques to address the scar tissue/adhesions. By applying manual therapy techniques, you will not only address the scar tissue/adhesions, but also restore blood flow and oxygen to the area which is vital to healing any tissues in the body. Once that occurs, you will relieve much of the pressure, friction and tension to the muscle, tendon and/or ligaments. So, by combining the manual therapy with corrective exercises, you can restore the body to the pre-injury cycle status.

Well, what if I am not injured, but I want to prevent this cycle from exacerbating itself into pain you ask? Preventative measures can’t be stressed enough. CrossFitters are great at doing body work and other self-care work to improve muscular balance, function, motor control and tissue quality. CrossFitters are always looking for the next best thing to improve performance, prevent pain, and enhance recovery. 

In my experience, the one piece of the puzzle that CrossFitters, along with many other athletes, has been optimal Recovery from their sport. What am I referring to when I say “Recovery”? My use of the word for the purposes of this discussion, and in our Sports Recovery Center in Boca Raton is the ability of the body to return to full function and homeostasis after hard training or competition. When the body is not recovered you may suffer from loss of performance in key aspects such as endurance, movement control, strength, power, and proprioception. A decrease in these factors will not only decrease your overall performance, but may also lead to increased over-use strain to the body. 

The term Sports Recovery can be very general, and there are many faces to Sports Recovery. In our facility, we have many CrossFitters who come in for treatment for recovery from an injury. However, in our facility we also have a Sports Recovery Center, and these modalities are mainly geared towards athletes who are not suffering from injury or pain per se, but are looking to improve their recovery times in between training sessions and competitions; Or to prepare the body for competition. Many of our CrossFitters are using Whole Body Cryotherapy, Recovery Boots and Hyperbaric Chamber for their recovery needs. Other aspects of Sports Recovery may include massage therapy, deep tissue laser, Active Release Techniques®, foam rolling, etc.

         

Why do I like the trio of the Whole Body Cryotherapy, Hyperbaric Chamber, and NormaTec Recovery Boots for CrossFitters? Simply put, it does the best job in targeting what I find to be the biggest recovery issues and also repetitive injury causes. That is the decreased circulation/swelling aspect/Hypoxic state that occurs in the body when Overwork causes muscular imbalances. Lack of oxygen and blood flow in the body is the biggest hindrance in recovery and injury prevention in my opinion. We can argue how the body gets to this state, such as poor Biomechanics, past injury, bad form, etc., but restoring properly enriched blood flow to the tissues is instrumental in healing and recovery.

Whole Body Cryotherapy

Whole Body Cryotherapy can help professional and recreational athletes help their bodies be at peak performance, recover more quickly from intense training and break the cycle of nagging chronic injuries. The whole body lower temperatures that occur in the cryosauna helps enrich the blood and supply it to all internal organs and peripheral muscles in the body. It does this by the body’s natural reaction to extreme cold environments to shunt the blood from the extremities into the vital organs and core of the body. Once you get out of the cryosauna, the blood that is now freshly enriched by the vital organs hyper-profuse the extremities. See MMA Star Anthony Johnson using WBC

Hyperbaric Chamber

Hyperbaric oxygen therapy delivers oxygen to tissues up to 25 times normal levels. This stimulates the production of body stem cells, decreases swelling and inflammation, promotes regeneration of injured tissues, and increases healing rates. In our office, we do not use the Oxygen Concentrator with pumps pure O2 into the chamber. That needs to be in a more controlled, medical environment to do to the effects of pure O2. See Pro Boxer Wes Nofire discuss Hyperbaric Therapy

NormaTec Recovery Boots The removal of waste products may help to reduce injury risk and the phenomenon of delayed onset muscle soreness (DOMS). Recovery boots provide benefit in terms of abating performance reduction following high intensity exercise and reduces soreness shortly after exercise as well as 48 hours later.

I wanted to spotlight the above few aspects of our Sports Recovery Center, but as I had mentioned previously, there are many faces to Sports Recovery. You can experiment and choose which sports recovery options are best for you. We even have developed The Sports Recovery Audit™ to help our athletes and others choose their best path to recovery. To reiterate, the main differentiation from treatment of pain/injury from Sports Recovery, is that our goal is to decrease recovery times, reduce injury risk and improve performance. As for the purpose of this article,  we are not examining, diagnosing and treating conditions. Don’t get me wrong, we have had many athletes use our Sports Recovery Center to aid them in reducing their pain, inflammation and over-use strain injury, as well as a great treatment plan to decrease recovery time, reduce injury risk and improve performance. But again, every athlete has different needs and having different options is serving the athlete best. We always recommend aligning yourself with a great manual therapist, chiropractor or physical therapist. If you have any questions pertaining to Sports Recovery modalities, please email me at drchristie@healthfitchiro.com.

Take Your Sports Recovery Audit