A microcosm of your community is found within your neighborhood school. Each school has staff, students, and student support teams that need our attention.

Consider a walk and a short visit through the school district to review where our value lies.

Opportunities
To begin, you must bring students from home to school. A typical school district, with elementary, middle, and high schools, has a fleet of buses, each with drivers and maintenance crews. As with teachers, their physical and emotional stress accumulates and expands throughout the school year. Bus design and each driver’s physical impairments enhance driver complaints addressed best with chiropractic care. As with our patient lectures, a discussion of posture and physical stress easily outlines many of their concerns. Typical headaches, neck, shoulder, lower back, and upper- and lower-extremity pain and parathesia is not uncommon for bus drivers who deal with children, parents, discipline, and the above-average stress that accompanies it. If you call the school district office, you might be able to find out the time that drivers get together for meetings or to find out where the buses are parked. Reaching drivers via either your training class or by sending them a handout with pertinent information related to posture and stress may attract several calls to your office.

The bus fleet also needs mechanics for maintenance and repair. Their repetitive lifting, bending, and crouching accelerates their arthritis, headaches, muscle cramps, and more. As the school year progresses and wear and tear of their body begins to show, it may be the perfect time for them to know about you. The average mechanic working hard with his upper and lower back has enough trouble managing sedans and SUVs, but working on school buses and assorted other vehicles only accentuates the stress more. Every mechanic needs chiropractic care and our rehabilitative exercises. As mechanics age, wear and tear only impairs their work and social activity even more. Talk to the maintenance facility supervisor and and offer a workstation safety class; or at least provide handouts with recommended exercises, safety tips, and precautions related to posture and stress. Focus on areas affected by their typical work. Repetitive lifting, working under vehicles, lifting and maneuvering heavy tires, and assuming unavoidable positions over the hood play a role in their chronic physical wear and tear. Outlining their concerns endears you to them.

Custodial and maintenance staff come either before, during, or after school hours to either fix or clean the facilities. They probably have a maintenance or administrative office where they gather their material or have staff meetings. They, like your patients, have issues related to musculoskeletal disorders best addressed with conservative chiropractic care and proactive timely ergonomic workshops and screenings. Typical housework is outright tough on the body, but embellishing it further with multiple long tasks or repairs requiring heavy tools or being in odd positions only aggravates hidden spinal pressure. We are the experts in the area of postural stress, and they need to know about us. Focus on postural stress related to their task and how it conjoins with body function. Irritation to these areas often produces pain but always physiological stress.

Teachers prepare class lectures and spend most of their workday on their feet. They have curriculum and test-date deadlines, and they must meet the demands of local, state, and national school boards. Student and class decorum, as well as parent association demands, all add up to excessive emotional and physical tension. Is there a teacher/patient of yours that doesn’t need supportive chiropractic care, especially during the school year? Reaching teachers is less difficult, since their work environment is within the school. They may have a mailbox, or school e-mail address, that can be useful to provide timely handouts or newsletters or to mention your health and wellness classes. Conservative care after school hours helps reduce physical and emotional tension, which often accumulates and accentuates any of their physical restrictions. They may find us useful to present a class lecture concerning health, anatomy, physical education, and sports safety, not to mention how to manage their book bags.

Teachers usually work until 3 or 4 pm, and coming to your office from school is easier than rushing in after 6 pm. Orthotics may be useful for teachers who spend most of their workday standing. Orthotics vendors can offer you educational material.

Administrative services finds a cadre of employees repetitively performing data entry, filing, or sitting for long periods. Many people behind the scenes in the school offices support teachers’ work. Your typical ergonomic class addressing carpal tunnel and proper posture while seated, as well as your other topical workshops, would be a benefit for them. I recommend preparing a menu of your ergonomic workshops, such as computer fitness, stress management, avoid or manage carpal tunnel syndrome, headaches, allergies, and other sundry complaints, to name just a few. With some potential workshop dates in hand, visit the school office to introduce yourself and discuss your programs with someone there. Don’t be surprised if they take you up on a class or two.

After-school programs at most middle and high schools are either sports or social oriented. Baseball, wrestling, basketball, football, and soccer place great demands on a growing body, with every participating student needing either proactive and crisis care. Talk to the program chairperson or coach to determine if you can offer a class on safety and proper care of the body before, during, and after sport activities. A class or two addressing proactive steps to the physical demands of these specific sports would come in handy. Offering your services as a team chiropractor and having your portable table handy, or evaluating students prior and during the season, may offer them a resource for conservative care and an outlet to promote your practice as well. Be sure each student has several handouts with your address and pertinent information that may stimulate a parent or two to visit you as well.

Parent-teacher organizations have various people participating in school enhancement living and/or working within your community. Each active member is proactive for the well-being of their child and the school/community in general. These folks are more apt to have an open mind and are ready to learn more about active parenting by creating a more educated and healthy child. They have timely meetings and are often looking for speakers. This is your time to shine for student and parent issues such as book-bag safety.

Children and Book Bags
Offer to evaluate children for postural stress. Children are usually treated for preventive reasons rather than crisis management. Chiropractors adjust the spine regardless of its length. A healthier spine results in a healthier person, whether the person is weeks old or late into the 90s. Children’s visits are $10, unless their problem requires a longer schedule, when insurance is used.

A few years ago, we went to a local elementary school to evaluate the third-grade class. We took a number of posture pictures and sent them back to the parents with explanation and recommendations. Through a special computer program that you can access at www.posturepro.com, I was able to evaluate the students’ weight and the proper weight for their book bag. More often than not, bags far exceeded the recommended weight, and this was in the third grade! Most students were never instructed on the proper placement of books, weight distribution, or how best to carry it on their shoulders. Wheeled bags were best, but few used them.

Improper holding and, more importantly, packing, the book bags could be dangerous and threatening to the health. A 2002 survey reported that 55% of children were carrying more than they should in backpacks. The extra weight caused them to shift their weight forward, aggravating their necks and upper backs. We are creating health issues that will be seen years in the future. Proper adjustments of their book bag avoids crisis adjustments of their spine, but if needed, it would be best to align both now.

Book bags should never exceed 10% to 15% of a student’s body weight. Weigh the student first and then with a fully loaded bag. If the numbers are too high, begin by reducing the number of books. Check for uneven weight distribution and start rearranging. Start by placing the heavier items evenly across the bottom. Remove books that are unnecessary, and tell the students to leave them at school or carry them home only when necessary. Use both straps rather than slinging the bag on one shoulder. It may look cool, but it aggravates the spine. Padded straps are best, and an air bladder across the lower back helps greatly. Introduce your office, and volunteer to evaluate student book bags for free. I would encourage you to either create or purchase a flyer that illustrates book-bag safety and explains how a chiropractic evaluation would be most valuable. These flyers could go home with every student, distributed at PTA and faculty meetings, or sent via e-mail if correspondence is offered in this way. To extend your exposure, discuss this with your local library and neighborhood churches, offering them flyers and handouts as well as personal time for a workshop or open discussion.

Home Schools
Neighborhood schools also include private schools and home schools. Check if your community has a home-school network. These groups support home schooling with group meetings and outings. Offer your services as a lecturer on health and wellness or to evaluate children.

Look no further than your own community and the community within the school district for potential patients of today and tomorrow.

Joel E. Margolies, DC, has an active practice in Atlanta. He has written four practice-management books titled Smart Start, Chiropractic Marketing and Public Relations, Workshop Workbook and Personal Injury Workbook and he has a number of PowerPoint lecture presentations. He also sends a free weekly e-mail to more than 10,000 chiropractors in 31 countries and maintains an active chiropractic resource Web site, www.chirosmart.net. Contact him at joel3639@aol.com.