Health Care Services

·  Chiropractic

·  Acupuncture

·  Soft Tissue Therapeutics

·  Custom Orthotic Prescription and Casting

·  Exercise Prescription

·  Massage Therapy

Many of our patients have additional questions about chiropractic, acupuncture, custom orthotics, or massage therapy.   If you are one of those individuals, please see our Frequently Asked Questions page.

Chiropractic

Chiropractic is one of the largest primary-contact health professions in Canada with over 6,000 practicing chiropractors. Approximately four and a half million Canadians use the services of a chiropractor each year (1). 

Chiropractic is a regulated health profession recognized by statute in all Canadian provinces and American states. The benefits of chiropractic have been well studied, and well recognized by other health professions. Medical referrals to chiropractors are common for treatment of musculoskeletal condition (2).

Chiropractors are trained to assess, diagnosis, and treat patients for disorders related to the spine, pelvis, nervous system, and extremities. Chiropractors practice a drug-free, manual treatment approach, utilizing a variety of techniques and modalities. This may include spinal manipulative therapy, soft tissue therapy, deep myofascial release, therapeutic modalities such as ultrasound, TENS, and interferential current. Further, the inclusion of therapeutic exercises prescription,  ergonomic, and lifestyle counseling are common components in a comprehensive treatment/management plan.

Many people associate chiropractic with spinal manipulation/adjustment. Spinal manipulative therapy is a carefully controlled, precise procedure that utilizes the highly-refined skills developed through four years of intensive chiropractic education. Primary goals of adjustments include improving areas of decreased movement in the joints and supporting tissues, particularly of the spine, and decreasing muscle tightness or spasm through restoration of normal mechanics and improved functioning of the spine, extremities and supporting soft tissue structures (3,4,5).

 Spinal manipulation, as performed by trained professionals, can cause immediate or delayed relief of symptoms and correction of underlying biomechanical conditions. Rarely an adjustment can cause discomfort, such as mild short term achiness.

The vast majority of patients who seek chiropractic health care do so for musculoskeletal complaints, particularly of the spine – low back pain, neck pain, and headaches. Extensive scientific research has demonstrated, with clarity, the effectiveness of chiropractic treatment for these conditions (6,7,8,9). Legislative bodies across Canada, as well as governments around the world have also conducted extensive reviews of the chiropractic profession and have consistently recommended chiropractic services (10, 11, 12, 13, 14, 15, 16, 17, 18)

References:

1.        Miller W. Use of Alternative Health Care Practitioners by Canadians. Canadian Journal of Public Health 1997; 88(3):154-58.

2.        Verhoef MJ, Sutherland LR. Altenative Medicine and General Practitioners: Opinions and Behaviours. Canadian Family Physician 1995; 41:1005-1011.

3.        Bronfort G, Evans R et al. A randomized clinical trial of exercise and spinal manipulation for patients with chronic neck pain. Spine 2001; 26(7):788-800.

4.        Hoving JL, Koes BW et al. Manual therapy, physical therapy, or continued care by a general practitioner for patients with neck pain. Annals Int Med 2002; 136:713-722.

5.        Mior SA. Manipulation and mobilization in the treatment of chronic pain. Clin J Pain 2001; 17(4 Suppl):S70-6.

6.        Aker PD, Gross AR et al. Conservative management of mechanical neck pain: systematic overview and metaanalysis. BMJ 1996; 313:1291-96.

7.        Hurwitz EL, Aker PD et al. Manipulation and mobilization of the cervical spine: a systematic review of the literature. Spine 1996; 21:1746-60.

8.        Bronfort G, Assendelft WJ, Evans R et al. Efficacy of spinal manipulation for chronic headache: a systematic review. J Manipulative Physiol Ther 2001; 24(7):457-66.

9.        Spitzer WO, Skovron ML et al. Scientific Monograph of the Quebec Task Force on Whiplash-associated Disorder: Redefining Whiplash and its Management. Spine 1995; 20:8S.

10.     Coulter ID, Hurwitz EL, Adams AH et al. Patients using chiropractors in North America: who are they, and why are they in chiropractic care? Spine 2002; 27(3):291-6.

11.     Manga P, Angus D, Papadopoulos C, Swan W. The Effectiveness and Cost-effectiveness of Chiropractic Management of Low-Back Pain, Commissioned by the OCA. Funded by the Ontario Ministry of Health, 1993.

12.     Wells T et al. Chiropractic Services Review, An Internal Review. Commissioned by the Ontario Ministry of Health, 1994.

13.     Epidemiology Review: The Epidemiology and cost of back pain. Clinical Standards Advisory Group. 1994 HMSO.

14.     Back Pain. Report of a CSAG Committee on Back Pain. 1994 HMSO. 19 New Zealand Acute Low Back Pain Guide. New Zealand Guidelines Group, 1997.

15.     Waddell G, McIntosh A, Hutchinson A, Feder G, Lewis M, (1999). Low Back Pain Evidence Review London: Royal College of General Practitioners.

16.     Danish Institute for Health Technology Assessment: Low-Back Pain. Frequency, Management and Danish Health Technology Assessment 1999; 1(1).

17.     Koes BW, Assendelft WJJ, van der Heijden GJMG et al. Spinal manipulation and moblisation for back and neck pain: a blinded review. BMJ 1991a; 363:1298-1303.

18.     Assendelft WJJ, Koes BW, van der Heijden GJMG et al. The effectiveness of chiropractic for treatment of low back pain: an update and attempt at statistical pooling. J Manipulative Physiol Ther 1996a; 19:499-507.

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Acupuncture

Acupuncture is a therapeutic intervention involving the insertion of fine needles into specific points in the body.

Many health care practitioners use acupuncture in their clinical practice, including chiropractors, physiotherapists, and medical doctors.  Not surprisingly then, there has been a clear trend of the integration of acupuncture into a Western medical model.  Coupling ancient concepts of Chinese medicine with modern biomedical concepts, Western health care practitioners of many disciplines are now incorporating acupuncture treatment both as stand-alone therapy, and as an adjunctive, complementary treatment modality to other conservative treatment techniques.

Dr Mueller trained in Contemporary Medical Acupuncture (CMA) at McMaster University.  This training is only made available to health care professionals such as Chiropractors, Medical Doctors, Physiotherapists, and Naturopaths.  Acupuncture is a powerful adjunctive treatment as utilized by health care professionals to treat conditions of the neuromusculoskeletal system.  The WHO supports recognizes the benefits of Acupuncture for conditions including but not limited to the following:

Soft Tissue Therapeutics

Dr Mueller has training in a number of soft tissue techniques including but not limited to Trigenics, myofascial stripping and release, trigger point therapy as well as various stretching techniques such as PIR (post-isometric relaxation).  These techniques are used an a powerful adjunct to spinal manipulation, acupuncture, and exercise to help patients to help patients recover from conditions of pain and neuromusculoskeletal dysfunction.   

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Custom Orthotic Prescription and Casting

Custom orthotics are custom made orthopedic devices that fit comfortably into your shoes.  They are designed to correct faulty foot and lower limb mechanics as well as to treat a wide variety of musculoskeletal conditions.

Many individuals who work for many hours on their feet, work heavy manual labour, and/or participate in sports may have pains in their toes, arches, heels and ankles, or even knees, hops and low backs which may be aided by the use of custom orthotics.

Common conditions that people seek orthotics for include, but are not limited to:

Every patient seeking custom orthotics will undergo a thorough history, a physical exam and a biomechanical assessment to see how their feet work when standing, walking and some common movement patterns to assess whether or not they may benefit from custom orthotics.  If they are appropriate, we can create an impression of your feet using either foam or traditional plaster casting methods.  They are then sent to the Ontario Orthotic Lab to be manufactured relative to the specific design that we request to best support your needs.

Patients may choose to order quality shoes with or without special orthopedic modifications, or request that we fit their new custom orthotics into a pair of shoes that they have purchased elsewhere.  Some orthotics are easily moved from one pair of shoes to another, while others are designed to sit primarily in one pair of shoes.   These are all things which can be customized to your specific requirements.

Most conditions that will benefit from custom orthotics will also benefit from some degree of manual care and/or exercise prescription.  Fortunately we can offer you all of these services in our clinic.

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Exercise Prescription

Specific exercise prescription may be as simple as advice on how to incrementally increase cardiovascular activity (beneficial for achieving diverse goals from weight loss and decreasing blood pressure to modulation of depression and decreasing cancer risk), to specific exercises and techniques to decrease stress and strain on the job, core stability, or rehabilitation from sports injuries. 

One example of a set of exercises especially utile to chiropractors is core stability exercises due to their benefit for low back pain.  Dr Mueller has developed a program based on the research of McGill, Jull, Richardson and McKenzie and protocols developed by  Dr Craig Liebenson complemented by Dr Mueller's experiences as an athlete, educator, and health care provider.  This program is ideal for patients with back pain, or those looking to improve general core stability to improve athletic performance.

Similar protocols can also be offered to current patients as a part of their normal treatments along with take home information handouts.  The exercises are taught in logical and incremental fashion to be sure that participants and patients are able to perform the exercises in the class properly as well as to use critical thinking skills to integrate new exercises safely into their exercise regimes in the future.  Core stability and postural education can also aid patients in dealing with the stresses of the modern workplace.  

Massage therapy is a regulated health profession in Ontario and as such should be performed by a Registered Massage Therapist (RMT). 

Massage Therapy is an enjoyable and effective treatment for many conditions that cause stress and muscle or joint discomfort.

Massage therapy uses a variety of hands on techniques that apply stretch and pressure to soft tissues to relieve pain and maintain or improve physical function of muscles and joints.  

When we perform daily tasks and physical activities, our muscles are contracting repeatedly by way of nerve signals sent from the brain and chemical reactions within the muscle tissue.  When you strain a muscle, part of the muscle fiber is damaged through rupture of the muscle cell membrane which releases an excess of chemical mediators for muscle contraction, and the result is continued contraction of the muscle, even after activity/movement has stopped.  Muscles shorten and lengthen with joint movement but the sustained shortening after strain causes decrease in flexibility and decrease in blood flow and elimination of metabolic waste products through the muscles.  This creates an uncomfortable stiff and sore feeling, strain on joints, ultimately making you more susceptible to muscular injury/re-injury.  The same thing occurs after prolonged activity, even if you do not think you have strained a muscle.  The prolonged use of muscles shortens them and does not allow for sufficient blood flow/oxygen flow/removal of metabolic waste, which leads to formation of painful muscle knots.

Massage Therapy relaxes the nervous system to decrease muscle tension.  As well, the techniques used during the treatment place a stretch on soft tissues to re-lengthen shortened, tight areas, and allow for better blood flow and lymphatic drainage.  The result is improved flexibility and decreased pain because your muscles will more easily contract and relax, and shorten and lengthen during activity.  Through decreasing tension and decreasing muscle tightness, massage therapy enables your body to heal with improved circulation and to return to normal function.