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Compression therapy as in-office adjunct care

Modern compression therapy is a great option for patients waiting to see the DC, or to utilize post-adjustment for improved...

Modern compression therapy is a great option for patients waiting to see the DC, or to utilize post-adjustment

For patients with circulation issues and athletes looking to stay in peak form and maximize their training, compression therapy is a fast-rising, non-drug alternative to medication that is being utilized by chiropractors as an adjunct therapy in clinic.

For athletes it speeds up the recovery process after workouts by increasing blood flow to the limbs and reducing pain and soreness. Studies also show a host of other benefits including increased flexibility and reduced inflammation. From pros in all major U.S. sports to the NCAA, it’s difficult to find a team that does not take advantage of compression therapy for athletic recovery.

Chiropractic patients benefit from compression therapy to improve mobility, treat circulation issues including lymphedema and venous insufficiency, prevent deep-vein thrombosis, heal chronic wounds, and deal with a range of other edematous conditions. Chiropractors are integrating the technology into their practices to help improve patient outcomes with great success.

Not your father’s compression

Today’s compression therapy systems are multi-zoned and rhythmically inflate and deflate to prescribed pressures. The devices use different attachments to treat the lower extremities, upper extremities, and even target the hips and lower back.

This type of dynamic compression uses bio-mimicry designed after the muscle pump action of the legs and arms, and the newest forms of compression therapy have certainly come a long way.

Research-verified benefits of dynamic pneumatic compression therapy

Recent research has led to a deeper understanding of the benefits of compression. Jeff Martin, PhD, the assistant dean of Basic Medical Sciences and associate professor of physiology at DeBusk College of Osteopathic Medicine at Lincoln Memorial University Knoxville has helped lead multiple clinical studies on pneumatic compression therapy.

According to Martin, it is well-accepted that pneumatic compression can help facilitate lymphatic and venous flow, but evidence continues to emerge suggesting that the physiological effects of pneumatic compression are more extensive. Recent trials have demonstrated that advanced forms of pneumatic compression are associated with increased blood flow, tissue oxygenation, vascular reactivity and nitric oxide bioavailability to the treated areas.

Notably, many of these findings have also been seen in non-compressed tissue, suggesting a broader effect than simply in the treated appendage. Thus, applications may prove to be beneficial in additional situations where perfusion would address underlying pathology or physiological needs. Advanced forms of pneumatic compression used by athletes have been shown to decrease exercise-induced muscle soreness, improve flexibility, mitigate declines in range of motion secondary to exercise-induced muscle damage, and improve blood lactate clearance following intense efforts. Therefore, beyond simply improving perfusion to the musculature, it is becoming clearer that pneumatic compression can also have a significant impact on biochemical (e.g., lactate), sensory (e.g., soreness) and functional (e.g., ROM) outcomes associated with recovery.

“I would say that based on my experiences, the marked improvements in effective blood flow, soreness and range of motion would have profound effects in healing rates and functional improvements while mitigating limitations from things like pain,” Martin says. “It is notable that ‘upstream’ tissues can be affected by dynamic pneumatic compression as well, given that this may increase potential applications.”

Likewise, a Journal of Athletic Enhancement study, “An Intermittent Pneumatic Compression Device Reduces Blood Lactate Concentrations More Effectively Than Passive Recovery after Wingate Testing,” addressed lactic acid buildup and muscle fatigue. Twenty-one female student-athletes between the ages of 18-25 years old participated in a randomized-controlled clinical trial. Following a one-minute Wingate cycling test, participants were randomly assigned one of three recovery interventions:

intermittent pneumatic compression (IPC), active, or passive, each lasting 20 minutes. The IPC group had a blood lactate level significantly lower than the passive recovery groups, indicating that during the recovery phase IPC is much more effective than passive recovery.

Compression therapy and neurological chiropractic

Chiropractors are also using compression therapy for neurological cases. Mike Drzewiecki, MS, DC, DACNB, CCSP, of The Neurologic Wellness Institute in Chicago, specializes in patients with complex care needs and has found compression therapy beneficial in addressing both the physical and mental needs of his patients.

“We started using compression sleeves for our patients that have been suffering from long-term POTS symptoms leading to pooling in the lower extremities,” Drzewieck says. “The objective results have been amazing, and not only do the patients have great things to say about how their legs feel, but we have had many patients describe a significant decrease in their headaches and dizziness while using, and after using, the compression boots. It has been a game changer for our patients who have been dealing with dysautonomia and POTS.”

DCs in training learning compression therapy

A new generation of doctors of chiropractic are learning about utilizing compression in the classroom and teaching clinics as part of developing an integrated practice.

Timothy Stark, MPhil, MBA, DC, DACBSP, ICSC, CSCS, EMT, FICC, is director of the Human Performance Center at Northwestern Health Sciences University and has coordinated the postgraduate educational programs for NWHSU for the specialties of sports chiropractic and physical rehabilitation for the past 20 years.

“We have four compression systems that we use in the academic and clinical setting,” Stark says. “Academically, we introduce the systems in our Advanced Upper and Lower Extremity courses. Each student is offered an opportunity to try the systems. These courses are part of our Sports Emphasis in the Doctor of Chiropractic Program.”

In addition to allowing students to gain firsthand experience using these new modalities, students are also taught the science behind the therapy and how to effectively use this type of therapy to help their patients.

“Modern users love it for pain relief after a big workout or weekend warrior refresher,” Stark adds.

More patient choices, diversification

Patients have access to an ever-increasing multitude of choices and are looking to find providers who offer a variety of services and can provide an overall approach to wellness.

Compression devices are a great option for patients while waiting to see the doctor or to utilize post-adjustment. Sessions range from 10-30 minutes and can easily fit into existing patient flows. More and more chiropractic clinics of all kinds are implementing these types of complementary therapies. When implemented correctly they can not only treat a wide variety of patients and needs, but help attract and retain new patients.

Jay Greenstein, DC, CEO of KaizoHealth, who operates five clinics in the Maryland and Virginia area and treats a wide variety of patients, says, “We have been using compression therapy for our acute and chronic patients with outstanding results. Equally, we have our high-level athletes that are familiar with the science, and the raving reviews from their fellow athletes, lining up to receive this treatment. With evolving science, great clinician experiences, and aligned patient values, compression therapy has quickly evolved into an evidence-informed intervention that is growing our impact and our bottom line.”

Kate Kelly, DC, founder of Active Recovery Boston, a group of two clinics specializing in Active Release Techniques (A.R.T.), has found a number of benefits even with limited space in their two busy clinics.

“We use compression therapy for post-treatment recovery from our soft tissue work,” she says. “It is a great post-treatment modality for patients who may be sore from our soft tissue treatments such as Graston, A.R.T., and dry needling, because it speeds up healing and decreases inflammation, flushes lactate, and improves circulation to new areas where scar tissue was blocking blood O2. We are able to fit two chairs into the reception space. Even if a patient isn’t scheduled for compression therapy, the chairs become a spot for overflow, which encourages discussion with front desk about the benefits of our compression therapy systems.”

Kelly has also found that by marketing the same state-of-the-art compression therapy that pro athletes use, she can attract local athletes to her practice.

“Compression therapy is also a great modality to bring to an event,” she says. “It brings people over to your tent and while they are being treated you have 20 minutes to discuss the benefits of your practice with them.”

With all of the positive results that compression therapy provides, it is easy to see why so many chiropractic practices are integrating the technology. The technology is proving to be an excellent adjunct to chiropractic treatments with a manifold of benefits for patient success and as a means to grow a practice.

RICK VACH is editor-in-chief of Chiropractic Economics magazine.

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