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Back to Basics

From injury to performance

In my practice I see a mixture of acute and chronic injuries with my patients. Having been in practice for several years now in Kelowna, I have had the pleasure of seeing many patients who enjoy more dangerous pursuits on a repeat basis for different injuries. When dealing with acute injuries there is an established routine that should be followed in order to best reach full recovery. This can be a frustrating process for the patient who understandably wants to be fixed as soon as possible. Sometimes it is my job to temper patient enthusiasm in order to avoid further injury. Often times too much, too fast results in a delay in recovery.

Step 1: Pain Relief and Range of Motion

When a patient presents with a new, acute injury the first task is to examine him/her to make sure that further investigation such as X-rays or a CT scan is not required. Once this has been established, decreasing pain symptoms and increasing pain free range of motion is the first order of business. Depending on the location of injury, this is achieved by joint manipulation, soft tissue mobilization, heat or cold and other modalities such as ultrasound. Combined with this, is encouraging the patient to slowly increase range of motion in the affected area. This should be a relatively pain free activity, although some stiffness is to be expected. The sooner you can have a patient actively move an injured area without an increase in symptoms, the quicker they will recover.

Step 2: Full Range of Motion, Endurance, Strength

Once pain free range of motion has been achieved, then you can start loading and strengthening the area (One caveat with this; with low back pain patients I will often start some core strengthening exercises earlier as long as it is a pain free activity for the patient. That is part of a movement re-education that I feel is important to start as soon as possible). With the strengthening it is important to first establish some endurance with the muscles. Therefore the load may be light and the repetitions high. The endurance helps with daily movements and also to build confidence in the patient that they can progress on to bigger and better things. Once strengthening exercises are prescribed, range of motion is full and pain is minimized, I will usually let the patient go and follow-up in a few weeks to ensure that everything is progressing normally.

Step 3: Performance Training

With athletes, there is another step. This is the bridge between rehabilitation and performance. Most offices are not designed to really offer the performance training that athletes need to get back on top of their game. That can be best accomplished by do sport specific drills, plyometrics and practice. Fortunately there are places in Kelowna where this can be achieved. Okanagan Peak Performance in Kelowna and VO2 Max in West Kelowna are 2 such places where the conditioning to return to sport can be achieved.

The road to recovery is often not linear and can often be 2 steps forward, 1 step back. Mixing appropriate manual treatment such as Active Release Techniques and chiropractic with smart rehabilitation is the tried and true method to best manage acute injuries. Your chiropractor is an excellent choice to consult with following an acute injury.

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About the Author

Dr. Nimchuk is one of a few full body certified Active Release Technique practitioners in the Okanagan Valley.  It has become known as the gold standard treatment for soft tissue injuries in athletics with almost every professional sports team in North America retaining the services of an ART certified Chiropractor.  Dr. Nimchuk has had the opportunity to work with many professional, Olympic and Ironman athletes.  ART is a patented, state of the art soft tissue system/movement based massage technique that treats problems with muscles, tendons, ligaments, fascia and nerves. Headaches, back pain, carpal tunnel syndrome, shin splints, shoulder pain, sciatica, plantar fasciitis, knee problems, and tennis elbow are just a few of the many conditions that can be resolved quickly and permanently with ART.  Dr. Nimchuk employs many different chiropractic techniques including manual and instrument adjusting along with ART.

In addition to private practice, Dr. Nimchuk is a frequent speaker and consultant to business organizations on topics such as ergonomics and workplace health.  Dr. Nimchuk is also registered as a Certified Exercise Physiologist with the Canadian Society of Exercise Physiology and has worked in many high performance and rehabilitation settings.

As part of his ongoing commitment to health and fitness, Dr. Nimchuk is a clinic instructor for marathon and 1/2 marathon clinics at the Kelowna Running Room and is also the Okanagan evaluator for the RCMP Physical Abilities Requirement Evaluation (PARE test).

To learn more about Dr. Nimchuk's treatments or to schedule a consultation, visit his website at or call 250-860-2212.


The views expressed are strictly those of the author and not necessarily those of Castanet. Castanet presents its columns "as is" and does not warrant the contents.

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