The difference between a person with a herniated disc who has no symptoms and one who has symptoms has to do with how their body copes or stabilizes their back.

At NW Sports Rehab, we specialize in assessing the causes behind a lack of stability in your back. Then we design a program to enhance your functional ability, because when you have better supported discs, the disc bulge is not as important.

However, 90 percent of people with sciatica will improve with conservative care. Scientific study has shown that in two to ten years there was no difference in outcome between those who had surgery and those that didn’t.

Edward Caragee, an eminent neurosurgeon from Stanford University, wrote that the decision to operate is not a medical one, but rather a social one. If you are not improving within 12 weeks then you may get better quicker with surgery. But in the long run, even without surgery (if you can manage the pain), you could have the same result way.

If you do have a problem that requires an orthopedist, we will refer you to one. Most shoulder problems can be classified under two types of shoulder impingement, and are a result of minor rotator cuff strains, tendonitis or muscle imbalances. They respond very well to NW Sports Rehab’s treatment approach.

The treatment usually consists of soft tissue therapy, gentle chiropractic adjustments, ergonomic or lifting advice, traction, and rehab exercises. Often, anti-inflammatory medicine prescribed by your medical physician is important too.

About 20 percent of pinched nerve cases worsen in the first month or fail to resolve with therapy and rehabilitation in a one- to three-month period. Many times these cases require a referral to a medical provider for corticosteroid injections. Combing these injections with therapy and rehabilitation will resolve the condition. However, there are also cases that don’t respond to this treatment regime and will result in a referral for surgery. We make appropriate referrals in these cases.

The FMS generates the FMS score, which is used to target problems and track progress. This scoring system is linked to the most beneficial corrective exercises to restore mechanically sound movement patterns.

We then monitor the FMS score to track progress and to identify exercises that will be most effective. We then work to restore your proper movement and build your strength — whether you’re recovering from an injury, or if you’re an athlete wanting to do preventative work to avoid injuries or to improve your performance.

The second visit will usually last another hour and 15 minutes as we put you through an additional test, called the Functional Movement Screen (FMS). This test helps us further identify faulty movement patterns, instabilities, muscle imbalances, joint restrictions, and more. We then recommend corrective exercises to eliminate the above findings. After this we spend additional time providing you with treatment.

• Treatment visits typically range from 15 to 30 minutes.
• Rehabilitation visits usually last about 60 minutes.

Your involvement in a care plan is a very important component to successfully treating your body’s muscles, tendons, ligaments, nerves, and joints. Just like a dentist instructs you on how to care for and clean your teeth to avoid any unnecessary cavities or root canals, a NW Sports Rehab chiropractor will teach you how to properly train and take care of your body to prevent future musculoskeletal disorders like tendonitis, lower back pain, sciatica, and more.

Chiropractic adjustments improve your health by:

• Restoring your joint movement
• Relaxing your muscles
• Reducing your pain
• Reducing nerve irritation

2. Stretching tight or shortened muscles

Muscles kept in a shortened position can become very tight. A common example occurs in office workers who sit and use a computer for most of the day. The muscles at the base of the skull and in the neck become short and tight — causing headaches, a stiff neck, and pain between the shoulders. Stretching those shortened, tight muscles can reduce pain and improve the function of your neck and shoulders.

3. Rehabilitation of weak or inhibited tissues

In the office worker example, the tight muscles at the back of the neck are accompanied by deep neck muscles that have weakened over time. Specific exercises are needed to re-activate these weak and inhibited muscles. These exercises help you assume a posture that is less damaging to your body. This new posture can also help reduce your pain. Strengthening weak muscles can be accomplished with our cutting-edge Med-X machines, and with simple prescribed exercises you can perform at home.

4. Addressing scar tissue and adhesions

Areas within your muscle can develop scar tissue if they have been chronically inflamed from a repetitive stress injury or trauma. Scar tissue or adhesions in and around muscles, tendons, ligaments, fascia (covering around muscles), nerves, and joints can inhibit the proper movement of these structures. When movement is restricted it causes friction and irritation in the tissues that lead to inflammation. Other joints and soft tissue structures have to compensate for this lack of movement and they typically get overused and develop tight and shortened muscles, which can cause additional inflammation and hypoxia (less oxygen to the muscles). Our chiropractors utilize Active Release Techniques (ART) and instrument assisted soft tissue mobilization to break up scar tissue and adhesions — restoring your muscles to proper function.

5. Nutrition

The average American’s diet is pro-inflammatory, and inflammation is a major factor in muscle and joint pain. What’s more, your diet can limit your recovery from a soft tissue injury. In response, NW Sports Rehab offers an assortment of high-quality supplements and can design a nutrition program customized to fit your body’s exact needs.

Chiropractic doctors don’t prescribe drugs or perform surgery. Instead, chiropractors respect the inherent power of your body to heal itself. We also understand and respect the fact that some patients do need drugs and surgery to recover from particular conditions and we work together with your medical providers to achieve the best results possible. A chiropractor will help guide your body to health through the adjustment of your spine and other joints. Chiropractic hands-on manipulations help:

• Treat mechanical restrictions (dysfunctional joints)
• Increase your range of motion
• Eliminate excessive strain on your muscles
• Block pain impulses and increase your comfort level

Usually, several chiropractic treatments are needed to achieve long-lasting results and long-term pain relief. Yet chiropractors are like most healthcare providers — the best ones have a large toolbox of techniques they can apply in response to health issues.

Because your muscles are attached to your bones, the interrelationship between your nervous, muscular, and skeletal systems play a key role in the overall health of your body.

The relationship between these three systems is known as the neuromusculoskeletal system (NMS). A chiropractor affects your neuromusculoskeletal system by making small "adjustments" to the spine — or other articulations of the body — to improve joint, muscle and nerve function.

Athletes involved in sports that require bursts of speed (like football, basketball, or soccer) are at the greatest risk for soft tissue muscle strains. The pain caused by these strains and muscle injuries can lead to chronic muscle tightness and eventual muscle imbalance — decreasing your overall athletic performance.

And while chiropractic addresses the joints of the vertebrae in your spine, clinical massage therapy focuses on your soft tissues:

• Fascia (bands of connective tissue that hold your body together)

• Tendons (connects your muscles to your bones)

• Ligaments (connects your bones together)

Clinical massage therapy and chiropractic go hand in hand, because if your muscles are too tight, adjustments won’t last or work. As the saying goes, “Bones go where muscles put them. Bones stay where muscles keep them.”

Acupuncture promotes the proper balance and flow of qi, the vital energy behind all life forms and processes. Acupuncture involves the insertion of sterile, disposable needles to relieve pain, help with balancing hormones, improve immune system function, speed recovery following athletic events, ease nausea following cancer treatments, and many more. The acupuncture needles are very fine — usually about the diameter of a human hair.

Acupuncture can help treat the following conditions and more:

• Peripheral neuropathy
• Symptoms of MS such as neuropathy
• Digestive complaints such as constipation, diarrhea, and heartburn
• Vertigo
• Headaches
• Sinus conditions
• Allergies
• Numbness and tingling
• Stress and anxiety
• Poor circulation
• TMJ or TMD pain
• Lower back, neck, shoulder, arm, and leg pain

Typically, there is no pain or discomfort involved with acupuncture. The process is generally very relaxing. Many people even fall asleep during treatment.

Correcting any major muscle imbalances before beginning your rehabilitative exercise program is vital. Muscle imbalances prevent your joints from aligning and functioning right. Poor joint function will disrupt your ability to move — putting you at greater risk for injury, chronic muscle pain, and joint pain.

That’s why NW Sports Rehab first looks at how your body functions as a whole before prescribing rehabilitation exercises. Movement is a coordinated effort involving your brain, spinal cord, and muscles. Our chiropractic doctors assess your movement and any muscle imbalances or NMS control issues using the Functional Movement Screen (FMS), and the Functional Performance Exam (FPE).

The Functional Movement Screen and the Functional Performance Exam help pinpoint your body’s weak links — such as poor posture, lack of flexibility, decreased strength, balance, muscle inhibition, or faulty movement patterns.

Based on the examination’s findings, NW Sports Rehab designs a corrective exercise routine tailored to your exact needs. And once your body is balanced, a total fitness program can be designed to keep you performing properly.

Identifying and correcting muscle imbalance is key to preventing and minimizing injury. This process is frequently done in professional sports to keep an athlete as healthy as possible. Identifying imbalances is also vital to preventing injury or surgery recovery.

The body should be free of any restrictions and imbalances, both in the joints and in the muscles. These restrictions, imbalances, and poor movement patterns drastically distort motor learning, movement perception, body awareness, and mechanics. They rob the body of efficiency, and are very often hidden by those individuals who learn to compensate and substitute other movement patterns.

The Functional Movement Screen (FMS) and the Functional Performance Exam (FPE) are performed on all patients who are able and willing in our facility. A specific corrective exercise program is then designed for each patient based on the FMS and FPE findings.

The FMS and FPE pinpoint the weak links — such as poor posture, lack of flexibility, decreased strength, balance, and faulty movement patterns. Exercises are then prescribed to correct movement and postural deficits.

As a society we sit too much and are not as active as we should be. This tendency creates very common muscle imbalances. One of the most frequently occurring muscle imbalances is called the Lower Cross Syndrome. This imbalance occurs when the hip flexors, or psoas muscle group, become very tight due to their shortened position when we sit too much.

In Lower Cross Syndrome, the hip flexors become short and tight, and through a neurological reflex called reciprocal inhibition, tend to weaken the opposing muscle group — the hip extensors or gluteal muscles. The hip flexors attach to the lower back vertebrae and create a constant pull, while reflexively “turning off” or inhibiting your gluteal muscles.

As the normally strong gluteal muscles weaken, the lower back muscles are overused to compensate for this inhibition. The back extensor muscles then become shortened and tight. This shortening or tightening of the back extensor muscles creates a reflexive weakening of its opposing muscle group — the trunk flexors or abdominal muscles. This alteration in the length tension relationship of the lower lumbar joints creates a real problem for these important joints, as well as the spinal discs and nerves found between each vertebrae.

Lower Cross Syndrome leads to chronic tension, lack of proper support, alignment, and function to the vertebrae and discs — which can cause tearing of the ligaments, muscles, or discs. This tearing, or over-stretching, of your ligaments can lead to spinal instability. Think of it as sloppy joints that don’t want to stay in place. This creates more reflexive muscle tightening or guarding, which can cause disc bulges, protrusions — or worse yet, a herniation. A herniation occurs when the disc material bulges out and can compress or irritate a spinal nerve causing severe back or leg pain (sciatica).

These muscle imbalances are further compounded by the fact that as a nation we typically spend more time brushing and flossing our teeth each day than doing exercises that strengthen the core muscles surrounding our spine. Is it any wonder why we “strain our backs” picking up our kids or working in the yard on the weekend? This is also why lower back pain is the number one complaint seen by all doctors across America each year.

Active Release Techniques can help you resolve a variety of conditions quickly and permanently, including:

• Back pain
• Carpal Tunnel Syndrome
• Headaches
• Hip and knee problems
• Plantar Fasciitis
• Sciatica
• Shin splints
• Shoulder pain
• Tennis elbow

(The above conditions all have one important thing in common: they often result from injury to overused muscles.)

ART was developed, refined, and patented by P. Michael Leahy, DC. Dr. Leahy noticed that his patients' symptoms seemed to be related to changes in their soft tissue that could be felt by hand.

Dr. Leahy was able to consistently resolve over 90 percent of his patients' problems by observing how their muscles, fascia, tendons, ligaments and nerves responded to different types of treatment. He now teaches health care providers all over the world, certifying them in the use of Active Release Techniques.

ART uses precisely directed tension and specific patient movements to treat abnormal tissues. These treatments have more than 500 specific moves unique to ART. They allow the provider to identify and correct your specific problem. ART is not a cooker-cutter approach — it’s a uniquely individualized plan of treatment.

ART is non-invasive, very safe, has virtually no side effects, and has a record of producing good results. Treatments take about 8-15 minutes per area treated, and may require two to 10 visits. Patients usually remark that, “it hurts good.” However, keep in mind that ART is not a cure-all. Corrective exercises are necessary to make sure that your condition doesn’t reoccur, preventing you from having to be treated over and over again.

Treatments can feel uncomfortable during the movement phases as the scar tissue or adhesions “break-up.” This discomfort is temporary and subsides almost immediately after the treatment. It’s common to feel a duplication of your pain symptoms during the treatment (a good indication that the problem has been identified).

At this stage, Active Release Techniques can help enhance your sports performance by identifying and releasing soft tissue restrictions. This usually happens after the Active Release Techniques practitioner conducts a biomechanical analysis of your motion. During the biomechanical analysis and the following treatment, the Active Release Techniques practitioner:

• Evaluates your gait, motion, and posture
• Identifies the biomechanical dysfunctions currently restricting your performance
• Finds the soft tissue structures causing the dysfunction, and any affected structures along the kinetic chain
• Treats the soft tissue dysfunctions with Active Release Techniques
• Restores full function to your affected structures

Forcing your body to perform the same job over and over can irritate and inflame your soft tissues. Your body responds to inflammation by laying down scar tissue (adhesive tissue) in an attempt to stabilize the area. Once scar tissue develops, an ongoing cycle of pain, inflammation, tightness, and eventual weakened tissues begins that worsens the condition. The longer your Repetitive Stress Injury persists, the harder it is to break the cycle of scar tissue formation.

Imagine a piece of scotch tape. The smooth side is healthy fascia, while the sticky side represents scar tissue, or unhealthy fascia. Try rubbing both sides of the tape along your skin. Feel the smooth side slip easily across your skin. Then notice how the sticky side drags against your skin. That drag, the "pulling" sensation, is how an adhesion affects your body function.

You know you have an adhesion on a nerve if you feel abnormal sensations like numbness, tingling, or pain. That’s because adhesions can attach to muscles, tendons, ligaments, fascia, and nerves decreasing their ability to move and function properly.

Introducing controlled micro-trauma with these instruments causes a local inflammatory response in your soft tissue structures. The micro-trauma then starts reabsorbing the inappropriate fibrosis or excessive scar tissue. The result is a cascade of healing activities that remodel your affected soft tissue structures.

Adhesions within your soft tissue — which may have developed from surgery, immobilization, repeated strain, or other causes — are broken down, allowing for full functional restoration to occur. Applying ice can reduce your pain, while doing prescribed rehabilitative stretches and exercises increases your range of motion and overall body function.

This research shows that the majority of patients with chronic spinal pain are significantly de-conditioned. Naturally, if you're in pain, you're careful about how you walk, stand, sit, bend, and lay down. When you're in chronic pain, you’re very careful and unknownly can avoid certain movements. Over time, this leads to muscle weakness that can lead to, or exacerbate, many conditions. Herniated discs, facet syndrome, and degenerative joint disease all can be a result of this type of muscle weakness.

This provides isolation of the lumbar spine muscles, increases stability, and allows for specific, intensive strengthening in one of the body's most vital and vulnerable areas. Regular use of the Core Lumbar Strength may help prevent injuries, remedy chronic back pain, and contribute to disc hydration.

• Core Ab Isolator

Strong abs are vital to spinal support. The patented biomechanical design of the Core Ab Isolator provides the highest degree of isolation for abdominal muscles available.

Unlike other abdominal machines, the Core Ab Isolator neutralizes hip flexor muscles and restricts arching in the base of your spine. This isolates your core abdominal muscles, while eliminating lower back discomfort. The result? Superior abdominal burn.

• Core 4 Way Neck

The patented Core 4-Way Neck is a bio-mechanically precise machine that trains the flexion and extension muscles of the neck, thereby improving your range of motion.

The Core 4-Way Neck machine stretches and strengthens your cervical spinal muscles — allowing your upper spine to decompress while increasing the omni-directional strength and flexibility of your entire neck. The Core 4-Way Neck is based on the superior biotechnology of the Med-X Medical Neck Extension machine, now in use by spinal rehabilitation facilities worldwide.

• Core Torso Rotation

The Core Torso Rotation is revolutionary in its ability to isolate waistline muscles. A unique padded restraint system holds your shoulder, arm, and chest muscles in place, while another system of padded restraints locks your pelvis and prevents the hip and gluteus muscles from assisting in rotating your torso.

Core Torso Rotation increases strength and flexibility at the core of your body. Not surprisingly, it's a favorite among golf pros looking to increase club head speed.