Should I Ice or Not?


For decades, it has been “understood” that you should ice acute injuries because it decreases inflammation, and inflammation is BAD. The most commonly used treatment protocol for acute injuries, RICE (Rest, Ice, Compression, Elevation), was coined by Dr. Gabe Mirkin in his book titled The Sports Medicine Book in 1978. This treatment plan has been implemented for virtually all acute, non-surgical sports-related injuries over the past 30+ years; however, there have been several recent studies and literature reviews that indicate RICE may not be the best option.

A great number of articles published in well known scientific journals like the British Journal of Medicine, The American Journal of Sports Medicine, The Journal of Athletic Training, etc… have shown that there is virtually no evidence that icing an injury helps speed healing. In fact, it can actually delay the healing and recovery process. Dr. Mirkin, the guy who recommended it in the first place, has since retracted his recommendations on ice.

Inflammation is good for an injury. It’s how we heal. The more you limit inflammation, the longer it will take to recover from an injury. Studies have also shown that icing post-injury can decrease the presence of inflammatory cells called macrophages. These cells release a hormone called Insulin-like growth Factor (IGF-1) into the damaged tissues, which helps heal muscles and other involved tissues. The use of ice can decrease the release of IGF in injured tissues which can significantly delay the healing process.

Ice is good for one thing though…Pain. The application of ice has been shown to decrease sensation in the affected area. The inflammatory process can be quite painful immediately following an injury. Ice can be used to decrease pain in the first post-injury hours. Dr. Mirkin recommends icing for 10 minutes up to twice after an injury, if necessary for pain, but ice should not be used more than 6 hours following an injury.

So if I’m not supposed to use ice, should I use heat? The short answer is…sometimes. For acute injuries where there is significant swelling, heat is probably not a good choice either as it could increase the swelling and discomfort. For subacute injuries, chronic injuries, muscle tightness, and muscle fatigue, heat seems to be the best choice. Although the efficacy is still uncertain, heat, seemingly, can increase blood flow, promote inflammation for healing, and reduce muscular pain.

So the rule of thumb regarding ice vs heat is… If the injury is acute, swollen, and painful use ice for up to a few hours, if you need to control the pain. If you don’t need the ice for pain, then leave it off. Don’t heat areas with a lot of swelling, otherwise, when in doubt use heat.

America's Opioid Epidemic

It's been all over the news lately.  America has an opioid problem.  Opioids are narcotic pain medications that are derived from opium to produce morhpine-like effects.  When overused these drugs can become very addictive leading to a whole myriad of personal and social impacts.  Many that become addicted to pain killers end up overdosing and/or switching to heroin, which can be more easily obtained.  

So why do we have this problem?  Historically, physicians were told they were under treating pain, and the treatment for pain was opioid medication.  Unfortunately, that lead to over-prescribing of these potentially dangerous drugs.  

Inherently, the drug is not the problem.  It's the unnecessary use and quantity prescribed that is the problem.  As a chiropractor, it is common for patients to come to our office in so much pain that it is difficult for us to perform chiropractic treatment on them.  In these cases a medication for pain, for a few days at most, would be nice to allow us to perform conservative treatments that may be necessary to more quickly alleviate their complaints.  The reality is that most people with pain end up at their primary care physician's office and are prescribed pain killers, often a month's supply at a time.  The patient continues to take the medication longer than needed and can become addicted.  

The problem is not necessarily the prescriber, but an education history and treatment precedence.  More education needs to be presented to our primary care physicians so they can see the benefit of conservative treatment like chiropractic care as a first-line treatment instead of potentially addictive opioid medication.  These drugs should be reserved for more dire circumstances and for less standard duration.  The patients should then be monitored more closely and frequently instead of prescribed in larger quantities.  

To reiterate, we are not saying that the opioids, the physicians, or the patients are to blame.  All could be more educated and guided on their decisions to use these medications in hopes of preventing another epidemic like the one we are currently experiencing.  

There is a time and place for everything.  I hope as physicians we can utilize each other and put the focus on the patient and what's best for them in the short term as well as the long term.  

Congenital Heart Walk

Drs. Ben and Lauren Johnson will be participating at the Congenital Heart Walk in Nashville, June 4th. They will be joining the “Hudson’s Heart Warriors” team in memory of Hudson, a family friend who was lost to CHD complications at 2 years old. 

The walk is designed to help raise funds and awareness for the Adult Congenital Heart Association (ACHA) and the Children’s Heart Foundation (CHF).  Drs. Ben and Lauren will also be representing the stories of their nephew, Connor, and another family friend, Paul, as both of them continue to manage their conditions involving congenital heart defects.

It is our hope to raise funds and awareness for the ADHA and CHF through providing opportunities for our community to donate and share their stories related with CHD. 

AWARENESS: Stay tuned to our website blog and social media pages to learn more about the stories of Hudson, Connor, and Paul. If you have a personal story to share about your connection with Congenital Heart Defects through family or friends, please let us know! We would be happy to post about these moments to raise more awareness of the conditions!

You can also learn about Congenital Heart Defects and other personal stories through these links!

The Children’s Heart Foundation:

The Adult Congenital Heart Association:

Choosing Triumph Over Tragedy, Hudson’s and Friend’s Stories:


FUNDRAISING: There are two ways you can donate to the foundations!

  1. IN PERSON: Donations can be made at the Nashville Chiropractic office any time during business hours!
  2. ONLINE: Follow this link and you can donate electronically.

After donating, your name will be entered to a raffle drawing to win a set of tickets for a

Nashville Sounds Baseball Game!

We appreciate your support for Congenital Heart Foundations and thoughts for the individuals and families affected!


Anniversary Referral Promotion

In celebration of our upcoming 1 YEAR ANNIVERSARY we will be running a promotion for new patient referrals for the months of April and May.  

For every new patient you refer to our office you will receive a COMPLIMENTARY VISIT!

Just have them mention your name when they come in.  Thank you for making this a great first year for Nashville Chiropractic!

3 Exercises to Prevent Back Pain

Take a moment to think about the day of an average American.  We wake up and get ready for the day, sit in the car on the way to work, sit at work all day, sit in the car on the way home, and then spend the rest of the night sitting on the couch.  This day of sitting can lead to a lot of extra force applied to the back, specifically it increases the pressure within the discs of the low back.  In fact, sitting causes an intradiscal pressure increase of 40% compared to standing.  Sitting slouched increases the pressure by 90%. 

Unnecessary pressure and wear on the discs can cause a myriad of issues.  Most commonly it can lead to weakening of the disc causing an increased risk of disc injury.  Prolonged wear and tear can lead to earlier onsets of disc and joint degeneration or arthritis.

So how do you limit your risk for these conditions?  Try to limit your sitting throughout the day.  Having the option to switch your workstation from sitting to standing can help with prevention.  Also, work on strengthening, stretching, and stabilizing the back. 

Here are 3 exercises that can help prevent back pain:

1.  Cat and Camel:  This exercise allows the spine to be fully flexed and then fully extended.  This can cause a pumping action that can help to rehydrate the disc while providing a nice stretch to the muscles that tighten up with prolonged sitting.  

2.  Bird Dog:  This exercise is meant for core stability.  The core is built more to provide sustained contractions and stabilization and less for force production movements like sit-ups and crunches.  Your core consists of your abs, glutes, and back.  

To do this exercise, start with your hands and knees on the ground.  Extend one of your arms out in front of you as far as you can while extending the opposite leg behind you.  Hold that position for 3 seconds and then slowly return to the starting position.  Repeat this for 3 sets of 10 repetitions on each side.  

To do this exercise, start with your hands and knees on the ground.  Extend one of your arms out in front of you as far as you can while extending the opposite leg behind you.  Hold that position for 3 seconds and then slowly return to the starting position.  Repeat this for 3 sets of 10 repetitions on each side.  

3. Dead Bug:  Much like the Bird Dog, this exercise is meant to provide stabilization of the core.  

To do this exercise, start with both arms and bent legs in the air.  Slowly lower one arm and the opposite leg to just above the floor.  Hold that position for 3 seconds and return slowly to the starting position.  Repeat this for 3 sets of 10 repetitions.  

To do this exercise, start with both arms and bent legs in the air.  Slowly lower one arm and the opposite leg to just above the floor.  Hold that position for 3 seconds and return slowly to the starting position.  Repeat this for 3 sets of 10 repetitions.  

By making these exercises a part of your routine, along with seeing us at Nashville Chiropractic, you can help strengthen the core and decrease your chances of back issues.  If you have any questions or would like a demonstration, feel free to call, email, or stop by the office.  

Importance of Compliance

At Nashville Chiropractic we make it our goal to provide exceptional chiropractic care to the Nashville area. Most chiropractors are owners of their practice, therefore, offices operate at the owner’s discretion. Many chiropractic offices have various philosophies and perspectives on how to interact with patients and how to reach health goals. This will influence what techniques are used most often, if imaging is done in or out of the office, what the new patient exam protocols are, if they are in network with insurance or accept cash only, and how they present a treatment plan. 

The focus of this post is on treatment plans. Goals of a treatment plan can be separated into short term goals and long term goals. In general, short term goals often include decreasing intensity and frequency of discomfort, increasing pain free ranges of motion, and decreasing positive exam findings. Long term goals focus on increased functional mobility and how to decrease the likelihood of reoccurrence or new injury onset. Re-evaluations and patient feedback are documented to see if these goals are being reached.

The stage of the condition; and if it is defined as acute (new, recent, actively painful) or chronic (old, reoccurring, latent periods) will also influence treatment plan formats. An acute condition is actively in the stages of the body’s inflammation process. A chronic case needs to account for compensatory changes from long term failed healing conditions. 

This chart illustrates the phases of treatment and healing.  The first stage is relief care.  After this stage most patients are starting to feel better and be less symptomatic.  At time, some patients opt out of their treatment at this time.  These are the patients that are most likely to see relapses and re-occurrence of symptoms.  The goal of treatment should be to improve and restore function in the present as well as the future.  

This chart illustrates the phases of treatment and healing.  The first stage is relief care.  After this stage most patients are starting to feel better and be less symptomatic.  At time, some patients opt out of their treatment at this time.  These are the patients that are most likely to see relapses and re-occurrence of symptoms.  The goal of treatment should be to improve and restore function in the present as well as the future.  

The tissue that is injured will also influence the timeline of a treatment plan. Different tissues heal at different rates due to biological make up and external and internal stressors. For example, a ligamentous injury may take longer than a muscle injury because it has less blood flow and less nutrients available to it, at the same time a muscle is harder to rest, while a ligament can be more easily stabilized to decrease stress while healing.

The recommended treatment plan goals and visit frequency are based on researched ethical expectations that take into account stages of the condition and biology of injured tissue. Researchers, such as Perry Nickelson, author of Stop Chasing Pain, Gray Cook, physiotherapist, and Craig Liebenson,DC, have effectively defined reasonable times of the body’s healing process with conservative treatment. It can confidently be stated you should expect 80-90% of acute symptoms to be gone within 2-4 weeks of treatment, about 5-6 visits, when utilizing chiropractic care. The last 10-20% of treatment takes a bit more time, active effort, and compliance. 

Research also supports that combination care is more effective than the individual treatments alone. Chiropractic adjustments, muscle work, exercises, diet, and rest are more effective together than simply choosing one route. Long term goals, chronic pain conditions, and injury prevention are dependent on this combination. 

Of course the only way this is useful information and an effective treatment path for patients is if they are compliant. At Nashville Chiropractic we try to support easy compliance. At our office patients have the option to schedule out their appointments as far into the recommended plan as they wish. This allows for patients to consider their schedules and progress. Payment is collected at time of service to ease financial comfort for the patient and to hold our doctors accountable to the visit at hand. 

To summarize:

  • Treatment plans are designed to reach short and long term goals of being pain free and functional.
  • Stage of the condition and the specific injured tissues are two aspects that determine goals and duration of a treatment plan.
  • Research has shown what expectations a doctor and patient should have for the healing process and future injury prevention.
  • It is always the patient’s choice to comply with recommended treatment plans. Successful recovery is not guaranteed if a patient does not follow through with a credible, researched treatment plan. 

At Nashville Chiropractic, we vow to never recommend more treatment that what is reasonably and ethically necessary.  We hope to provide as much flexibility in scheduling and payment options to ensure that time and financial management are on the patient’s side to ease compliance to treatment.

Chiropractic Care Grows, and Gains Acceptance

Here is a blog post from the NY Times about how chiropractic is growing and becoming more involved in mainstream medicine. Just last week a bill passed to include more chiropractors in the VA program throughout the country. Hopefully this trend will continue, and more people can experience the benefits of honest and effective chiropractic care. Please share you chiropractic experience with anyone you think may benefit from it!

Check out the link below:

Chiropractic Physicians Urge Conservative Treatments for Pain Amid Opioid Epidemic

During National Chiropractic Health Month (NCHM) this October, the American Chiropractic Association (ACA) will bring attention to the public health crisis caused by pain, and in particular the overuse of prescription painkillers, with the theme #PainFreeNation. The campaign is part of the chiropractic profession's ongoing efforts to educate the public about the value of exhausting conservative forms of care for both acute and chronic pain before resorting to higher risk options, such as opioids.

National Chiropractic Health Month is a nationwide observance that helps raise public awareness of the benefits of chiropractic services and the profession’s natural, whole-person, patient-centered approach to health and wellness. 

"Opioid medications involve the risk of overuse and addiction. Beyond this, prescription drugs that numb pain may convince a patient that a musculoskeletal condition is less severe than it is, or that it has healed. This misunderstanding can lead to overexertion and a delay in the healing process or even to permanent injury," explains ACA President Anthony Hamm, DC. 

President Hamm notes that people in pain should be informed of all management strategies, including non-drug approaches such as chiropractic, to reduce their risk of overuse and addiction. 

"Each patient is unique, and care plans should be tailored to focus on what is the safest, most effective treatment for the individual. Chiropractic physicians stand ready to work together with medical physicians to help address this epidemic that has caused unnecessary suffering, enormous loss of human potential and massive financial and personal costs," he adds.

Fortunately, health care quality organizations have begun to recognize the value of this conservative, multidisciplinary approach. Earlier this year, the Joint Commission, which certifies more than 20,000 health care organizations and programs in the United States, including every major hospital, revised its pain management standard to include chiropractic services and acupuncture. Clinical experts in pain management who provide input to the commission's standards affirmed that treatment strategies may consider both pharmacologic and nonpharmacologic approaches. 

For updates and more information on #PainFreeNation as October 2015 approaches, go to and follow ACA on Twitter at@ACAtoday and on FacebookLinkedIn and Instagram.

The American Chiropractic Association based in Arlington, Va., is the largest professional association in the United States representing doctors of chiropractic. ACA promotes the highest standards of ethics and patient care, contributing to the health and well-being of millions of chiropractic patients. Visit

Sitting is Bad for Children, Too

An article, posted by The New York Times in their Well section, described a study to check the health effects of prolonged sitting in children.  They found that, just like in adults, prolonged sitting leads to decreased vascular dilation which can raise blood pressure and lead to cardiovascular disease in the future.  

As iPads, video games, Netflix, and other attention-grabbers have become more prevalent, kids are sitting more and more.  One researcher in the article even said, "I was surprised by how easy it was to get the girls to stay still for three uninterrupted hours."  

The study concluded that we should avoid prolonged sitting.  Getting up every hour to walk around for a few minutes can help undo the damage done by sitting.  

For more information on this study you can read the article by The New York Times HERE.  

Top 5 Chiropractors in Nashville!

We're so excited to be named one of the Top 5 Chiropractors in Nashville by Open Care!  Nashville Chiropractic won Open Care's Patient Choice Award earlier in the year, and now we have been named one of the Top 5 Chiropractors in Nashville, TN.  Please help us celebrate by spreading the news.  The best way to show us love is to tell your friends and family about our awesome clinic.  We are continuing to grow and are excited for where the future leads us!

Rib Pain: What Causes It, and How Can I Get Rid of It?

Anyone that has had rib pain can tell you it is not fun at all.  Rib pain typically presents itself as pain just outside the spine on the back; although, it can extend to the front of the chest too.  Rib issues can make also it difficult and painful to breathe.  These issues are often a result of restrictions or improper seeding of the rib head joint with the thoracic spine.  


So what causes these rib issues?  Sometimes, it can often be as simple as a hard cough or sneeze.  Another common cause of rib head issues is improper form or too much of a pushing exercise such as bench press, pushups, or punching.  When you push your arms forward and your scapulae retracts, the ribs move as well.  This produces a lever action on the costovertebral joint (the joint the rib makes with the spine).  Too much of this action or too much force, combined with weakness of the posterior muscles, can cause the rib head to push back in the joint, or in severe cases dislocate.   When the rib head is affected the muscles surrounding it tend to tighten up a lot.  This can help protect that joint, but can cause a lot of discomfort at the same time.   

So what do I do about it?  At Nashville Chiropractic we see these rib issues almost daily.  It is a very common occurrence due to people working out and neglecting the back muscles, or the back muscles becoming weak from years of desk work and sitting.  Typically, we are able to resolve these problems with a few visits.  By adjusting the rib head and promoting proper thoracic extension, usually the pain is greatly reduced after a few adjustments.  BUT that's not the end.  Ribs tend to be recurrent, so we need to address the surrounding musculature to strengthen the area around the ribs and prevent future injuries.  

If you are having, or commonly get, rib pain give us a call at (615) 620-0904.  We can address the issue and get you back to feeling and moving better.  

Healthy Weight-Loss

It's normal to want to lose weight as quickly as possible.  Everyone wants the fast results fad diets claim to provide.  Unfortunately, that usually not the way to achieve healthy and sustainable weight-loss.  

It’s natural for anyone trying to lose weight to want to lose it very quickly. But evidence shows that people who lose weight gradually and steadily (about 1 to 2 pounds per week) are more successful at keeping weight off. Healthy weight loss isn’t just about a “diet” or “program”. It’s about an ongoing lifestyle that includes long-term changes in daily eating and exercise habits.

As mentioned in the above quote, weight-loss is most effective when there is lifestyle change.  We will never have lasting results if we eat better and exercise more for a month and then go back to the pre-diet lifestyle.  

The most basic explanation of how to lose weight is to burn more calories than you take in.  One pound equates to about 3,500 calories.  If you reduce your caloric intake by 500—1000 calories per day you can expect to lose 1 to 2 pounds per week.  That is a healthy and sustainable goal.  Be wary of any diet or weight-loss program that claims you will lose much more than that.  

Nashville Chiropractic will soon be partnering with Nashville Wellness Academy (NWA) to offer successful, sustainable, and affordable weight-loss programs.  NWA will focus on everything relating to weight-loss, from mental and emotional hurdles to the physical demands required to achieve set goals.  Stay tuned for more updates!


Hudson's Day of Kindness

Recently, a dear friend lost her nephew, Hudson, to a heart condition called Hypoplastic Left Heart Syndrome (HLHS).  Kids with HLHS are born with a severely underdeveloped left side of the heart.  This left side of the heart is what is responsible for pumping blood to the body.  When it is critically underdeveloped, the right side of the heart has to take up the slack and work double time.  

Today is Hudson's birthday.  Let's give back in his honor and show that all lives, no matter how short, can make a positive impact on the world.  Do something nice for a friend, loved one, or even a stranger, and let's spread joy in his memory.  

Here is a quote from Hudson's family:

Hudson was a warrior and a miracle from the very beginning, and he lived an incredible life.  He never let his circumstances define him.  Hudson loved trains, animals, and dancing and singing at the top of his lungs.  Since Hudson will be spending his birthday in Heaven, we are asking that you bring a little of that celebration to Earth by performing random acts of kindness in honor of Hudson.

You can learn more about Hudson's life and legacy at

I Was in a Car Accident, Now What?


We've been seeing a lot of new patients who have been involved in recent car accidents.  Here are a few things to consider if you become one of the unlucky ones and get hit:  

Some of the most common injuries we see with car accidents involve the neck and upper back.  Probably the most prevalent is whiplash.  The Mayo Clinic defines whiplash as "a neck injury due to forceful, rapid back-and-forth movement of the neck, like the cracking of a whip."  This doesn't only occur with car accidents, but when it does it is usually the result of a rear-end collision.  Whiplash causes straightening of the cervical spine which can lead to pain and stiffness in the mid back.  It also stretches muscles which can cause them to tighten up.  


Whiplash is dangerous because the symptoms can sometimes take a while to show up.  It may be weeks or even months sometimes before you really see the effects.  That is why it is very important to get checked out immediately after an accident.  You wouldn't want to settle the auto claim and then realize you have chronic neck pain and degeneration from the accident after its over.   

If you are in an accident, make sure you come see us at Nashville Chiropractic.  Through a detailed history, examination, and X-rays (if needed) we can treat your current complaints and assess your risk of future issues.