Flexibility (Dr. Tucker is quoted in this article)

By Melissa Heyboer

There’s much more to rehabilitation than just improving what was once a painful injury. While recovering from muscle and joint pain is important, so is the need for improving a patient’s flexibility and range-of-motion (ROM).

Whether your patient is looking for relief from sprains, strains, disc injuries, or joint dysfunction, or if a patient simply wants to improve their overall well-being, bettering ones flexibility and ROM has unending benefits.

According to Gregory H. Doerr, DC, CCSP, ART, CKTP, developing better flexibility and greater ROM ultimately helps improve dysfunctions of the body — but it can also help prevent them.

“Inflexibility and loss of ROM leads to immobility of tissue, which leads to a number of joint and soft tissue dysfunctions,” said Doerr, “including fibrosis, tissue hypoxia, and the production of inflammatory markers including substance P and CGRP.”

Ultimately, he says, this can lead to pain and fear avoidance.

Steven Weiniger, DC, says the most important thing is that improving flexibility and ROM promotes symmetry of motion and, ultimately, helps the patient. ROM should be the first phase of rehab as you can’t advance to balance, strength and function until ROM is improved.

“Your body is made to move,” Weiniger said. “If your body is moving asymmetrically, your muscles will get strong in the way you’re training them to move.”

This creates added stress on the joints and they break down, he said.

“The chiropractor comes into the game when the person says my back or my neck keeps going out. That’s where the kinetic chain is buckling due to the asymmetric force from the muscles that have been trained to move asymmetrically.

This is where low-cost flexibility and ROM tools can come in handy.

“A person’s perception of how they are moving is often not accurate, which creates problems when performing exercises or treatment programs,” Weiniger said. “Even though the exercise is, in theory, designed to be a good exercise, it’s moving the body without symmetry. [Flexibility and ROM] tools facilitate the creation of that symmetry of motion.”

Fortunately, as a chiropractor, incorporating flexibility and ROM exercises and tools for the upper and lower extremities is not only easy, but can enhance your bottom line and broaden your patient base.

“I think providing these tools in your office can be used to differentiate yourself from other practitioners,” said Jeffrey Tucker, DC. “This type of system can help teach clients how to improve posture; and it helps neck and back pain patients.”

Tucker also suggests incorporating flexibility and ROM into a group class for your patients. “Clients want one-on-one motivation,” he said. “I sell higher quality lifestyle; it’s not about fitness. Emphasis is placed on practical, functional every day skills. It builds trust, it gives you an opportunity to have better communication with clients, and it creates value.”

Weiniger adds that with the right tools, patients can also reach their goals and improve the flexibility and ROM of both their upper and lower extremities from the comfort of their homes.

“Tools are nice because it provides structure and a point of responsibility,” Weiniger said. “They bought it, and they have it, and it lets them have an objective metric.”    

Patients need to understand that at-home flexibility and ROM exercises have the same benefit as rehab elsewhere.

“We already know that our in-office methods of manipulation, mobilization, and modalities improve pain and function,” said Tucker. “If you do not teach clients to perform corrective exercises at home, you will miss the opportunity to allow patients to ‘turn on’ the nerves and muscles prior to workouts; enhance the excitability of the neuromuscular sequence; improve the recruitment of the muscle bundles and fibers; enhance muscle sequencing and movement patterns; improve coordination; and increase ROM.”

Weiniger says that adding flexibility and ROM exercises to your practice is not only beneficial for improving motion, but it helps build the doctor-patient relationship.

“Bottom line is that we are entering a time where people are going to be more responsible for their health,” said Weiniger. “By selling the patient an inexpensive tool to help strengthen their body, the person is going to value the doctor better.

“There are some residual benefits to selling it, but the goal is to build the doctor-patient relationship so the patient can see you as a coach and teacher as well as a doctor who values the patients own best interest.”

With so many inexpensive options out there, Doerr says it’s easy for chiropractors to embrace active rehab — like the tools needed for flexibility and ROM exercises — in their practices.

“As chiropractors, we have mastered the art of passive care,” Doerr said. “It is time we evolve to match the evidence currently available and move our practices into the evidence-influenced age.

“We often fail to realize that the key to new patients and more referrals is not associated with marketing teams, coaches, or gimmicks, but with positive outcomes in a faster time period. Active protocols assist us in achieving this.”

BIO] Melissa Heyboer is the associate editor of [ITAL]Chiropractic Economics[/ITAL]. She can be reached at 904-567-1540 or

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