Since I began practicing chiropractic, I've focused on the health of my patients' soft tissue as well as their spine. This premise came from my own personal experience with chiropractic long before I ever thought of becoming a chiropractor myself.

When I was 20 years old, I developed whiplash after a motor vehicle accident. I was referred to a chiropractor by a very enthusiastic patient. It was my first experience with chiropractic; I was placed on heat and an electronic muscle stimulator (EMS) unit while the doctor took notes, after which time I was adjusted. The whole process took about 20 minutes and left a lasting impression because I was nervous getting adjusted the first time. However, I relaxed after 10 minutes of heat coupled with the pulse of the EMS unit.

Warmed-up Muscles

After 5 years in practice, I've developed a unique understanding of the importance in maintaining the musculoskeletal system. When a muscle is overused, perhaps from repetitive use, it spasms in response, pulling the spinal vertebrae it's attached to out of place, leading to the all-too-common pinched nerve, a common complaint.

I perform the myofascial work myself; this keeps me informed with my patient's progress firsthand. I find that when a muscle is warmed up, the adjustment comes easier and holds longer.

I started out only using Sombra Gel for myofascial work; it's a natural pain-relieving gel that's enriched with camphor and menthol, with a scent of orange peel extract and witch hazel. I rub it onto the skin over the area of muscle on which I do deep tissue work. I prefer it over other pain-relieving gels because it doesn't stain clothing and is alcohol-free.

My second year in practice I purchased an EMS unit. It facilitates blood flow, while creating a slight contraction that fatigues the muscle, reducing spasms and the pain associated with them.

Combo Care

The turning point came in my second year, when I made the decision to incorporate the use of both products. While the patient is face down, I set up the EMS unit by placing the electrodes on the target muscle. I put a heat pack over the area, and leave the patient to relax for 8 to 10 minutes. I use that time to write their chart notes. Afterward, I do a few minutes of myofascial work using the Sombra gel; this makes a hypertonic muscle pliable, allowing for a better stretch. I finish with an adjustment, creating maximum results in treating any musculoskeletal complaint.

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Although this approach may sound time-consuming, it has proven to be efficient. Since I began applying this treatment approach, my patients are responding to treatment faster, my retention level has risen, and I've experienced an increase in patient referrals. I'm virtually all word of mouth.

My patients tell me they appreciate the attention to detail, which seems to be a break from the traditional 5-minute chiropractic visit. They feel the care of a professional. Those 8 to 10 minutes allow them the chance to relax and slow down, leaving them with a sense of physical and mental relief as well as a more precise and effective adjustment. With today's fast-paced world, people appreciate the chance to heal the body and mind. Patients often tell me that this is the reason they come back. The fact that they get better is why they refer their family and friends.

I've also found a market for selling EMS units to my patients. I sell a constant supply of replacement electrodes to patients who have purchased an EMS unit for home use. I also sell 4-ounce jars of Sombra gel. The EMS unit paid for itself in the first month of use.

Sharon Ihlefeld, DC, practices in Los Gatos, Calif. Contact her at  .