Return to Wellness - Coral Gables, Coconut Grove CHIROPRACTIC PHYSIOTHERAPY ELECTRODIAGNOSIS MASSAGE THERAPY ACUPUNCTURE NUTRITION

Chiropractic
Active Care
Graston Technique
Physiotherapy

Chiropractic Adjustments
By definition chiropractic is a health profession concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, and the effects of these disorders on the functions of the nervous system and general health. There is an emphasis on manual treatments including spinal adjustment and other joint and soft-tissue manipulation.

Chiropractors are the Spinal Health Care Experts in the Health Care System

Since its inception in 1895, chiropractic care has always had multiple approaches in rendering chiropractic care to its patients. Return to Wellness offers traditional as well as advanced chiropractic techniques, were ultimately you will get a comfortable adjustment with great results.

Chiropractic Care:

Ability to improve function in the neurological and musculoskeletal systems, and overall health, wellbeing and quality of life.
Specialized approach to examination, diagnosis and treatment, based on best available research and clinical evidence with particular emphasis on the relationship between the spine and the nervous system.
Tradition of effectiveness and patient satisfaction Without use of drugs and surgery, enabling patients to avoid these where possible.
Expertly qualified providers of spinal adjustment, manipulation and other manual treatments, exercise instruction and patient education.
Collaboration with other health professionals.
A patient-centered and bio-psychosocial approach, emphasizing the mind/body relationship in health, the self-healing powers of the individual and individual responsibility for health and encouraging patient independence.

Adjusting techniques reduce spinal and extremity joint fixations, establish normal movement patterns, promote proper biomechanics, and reduce pain. Traditionally, we utilize techniques with years of efficacy such as Diversified Adjusting, Activator Methods, Palmer Toggle Recoil, Gonstead Technique, and Thompson Technique. For more advanced cases we utilize relatively newer techniques like Cox Flexion-Distraction Technique for herniated discs, The Webster Technique for the pregnant patient, The Pettibon System for structural corrections or The CLEAR Institutes protocols for scoliosis correction.

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Active Care (Rehabilitation)
Rehabilitation in conjunction with chiropractic care has been shown to provide incredible results with more long term stability. At Return to Wellness you have the opportunity to receive chiropractic care and active rehabilitation under the same roof.

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Graston Technique (Soft Tissue)

"Graston Technique® is an advanced form of myofascial release. Soft-tissue dysfunction, which includes scar tissue, adhesions and restrictions, results in pain, weakness and functional limitation for the patient. Graston Technique® uses patented stainless steel instruments, which are contoured to complement the body's shapes and curves.... The instruments are designed to facilitate a clinician's hands, not replace them."

"The Graston Technique® was inspired when a tool and die maker sustained a knee injury during a waterskiing accident. Three ligaments were ruptured, requiring extensive surgical repair. The resultant scar tissue caused unresolvable range of motion limitations and strength deficits preventing full rehabilitation.... Through research, as well as treating hundreds of clients, the Graston Technique was developed as an effective rehabilitation program for a wide variety of diagnoses. It is important to understand that the Graston Technique® is only one part of the total therapy program. It is not meant to be used alone, but to be used as a component of an overall treatment program."

"The Graston Instruments, much like a tuning fork, resonate in the clinician’s hands allowing the clinician to isolate adhesions and restrictions, and precisely treat them. When explaining the properties of the instruments, we often use the analogy of a stethoscope. For, just as a stethoscope amplifies that can be heard by the human ear, so do the instruments increase significantly the information which can be detected by the human hands."

"The Graston Instruments, while enhancing the clinician’s ability to detect fascial adhesions and restrictions, have been clinically proven to achieve quicker and better outcomes in treating both acute and chronic conditions." Graston Technique is being used by more than 35 professional and amateur sports organizations. It is used by the New England Patriots, winners of the 2004 and 2005 Superbowls. In addition, Graston Technique® is being taught at four colleges, including Indiana University, where it is part of the graduate kinesiology course curriculum for athletic trainers.

Conditions that can Benefit from Graston Technique [More]

Clinical Studies

Rat Tendon Morphologic and Functional Changes Resulting from Soft Tissue Mobilization: Science and Sports Exercise. Vol. 29 No. 3 1997. Pp 313-319.

Traditional Physical Therapy vs. Graston Augmented Soft Tissue Mobilization in treatment of lateral epicondylitis: Journal of the American College of Sports Medicine.Vol. 27 No. 5 1995. Rotator Cuff Tendinosis: DC Tracts. Vol. 14 No.1 2002. Pp 3-6.

The Effects of the Graston Technique on Electrodiagnostic Testing, Objective clinical Measures and Subjective Measurements on individuals diagnosed with Carpal Tunnel Syndrome: Midwest Automotive Manufacturing Facility.

Case Reports

Instrument-assisted Soft Tissue Mobilization for the treatment of Carpal Tunnel Syndrome, Laura K. Sweney, MS, PT.

The Use of Instrument assisted Soft Tissue Mobilization for the Treatment of Plantar Fasciitis, Mike Ploski, MS, PT, ATC, OCS.

The Use of Instrument assisted Soft Tissue Mobilization for the Treatment of Low Back Injury, Terry Carey, MS, PT, MTC.

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Physiotherapy

Return to Wellness, utilizes common physiotherapies such as: Electrical Muscle Stimulation (EMS), Therapeutic Ultrasound (US), Combination Therapy (EMS and US Combined) and Mechanical Traction.

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Manupulation Under Anesthesia (MUA)
Cooperation Between Medical Physicians And Chiropractic Physicians Has Made The Technique Of Manipulation Under Anesthesia (MUA), A Viable Option For Patients.

Manipulative treatment of the spine is the science and practice of the non-operative restoration of the function of the bones, joints, muscles, tendons and ligaments. The overall objective of MUA is to relieve the patient's pain and disability with a minimum amount of expense to the patient and loss of time from work and other activities.

In acute back pain when there is severe pain and muscle spasm, an anesthetic may be desirable to aid with the manipulation. In chronic pain when the patient has received regular manipulative treatment over a long period of time and has not had a major improvement in the level of pain or an increase in spinal or extremity joint flexibility, MUA may be effective.

What kinds of conditions respond well to manipulation under anesthesia?
Migraine headaches, chronic neck and back pain, chronic disc changes, chronic myositis, chronic fibrositis, restricted motion following trauma including old compression fractures, acute muscle spasms associated with segmental dysfunction, arthritis, frozen shoulder, hip joint motion restrictions and other conditions.

Why Anesthesia?
The joints are supported by the muscles and ligaments. Muscles serve to move the joints and ligaments serve to limit the joints. When the muscles are in spasm or ligaments are scarred over, the Chiropractic Physician may not be able to put the joint through its normal range of motion. Under anesthesia the postural tone of the muscles and the muscle spasms are abolished. This allows the Chiropractic Physician to gently manipulate the joints by putting the joints through their normal range of motion, reduce the restrictive adhesions in the ligaments and muscles, and reduce the fixations of the involved vertebrae. This procedure works well for many patients who have pain and do not wish to undergo surgery. Some patients are in too much pain or have muscle spasms that are too severe and chronic to benefit from chiropractic care without anesthesia.

An intravenous sedative is administered by a Medical Physician (anesthesiologist), who also monitors the patient's vital signs and levels of consciousness. The patient is not subjected to the dangers of general anesthesia and the patient is awake enough to preserve protective reflexes. The patient is sedated for 5 to 10 minutes, rather than for hours as during back surgery. Two Chiropractic Physicians perform the manipulation or fibrous release procedures so that the patient can be stabilized throughout the procedure. The nurses, medical physicians, chiropractic physicians, physical therapists and hospital staff work closely together as a team.

How do you know if you can benefit from Manipulation Under Anesthesia (MUA)?
First, an orthopedic and neurological examination is performed by Chiropractic Physician specifically certified to perform MUA. There are only a few Chiropractic Physicians in Florida qualified to do so. Additional necessary studies may be ordered. These may include X-rays, lab tests, MRI, CT scan, and Nerve Conduction Studies including EMG when appropriate. A Medical Physician will also perform an examination to be sure the patient can be safely anesthetized and is a good candidate for MUA. This is truly a team effort between Medical Physicians and Chiropractic Physicians working together for the benefit of the patient.