Categories of Treatment
Active Release Techniques®
Active Release Techniques® (ART) is a hands-on movement-based
technique to treat both acute and chronic soft tissue injuries. Soft
tissue injuries occur when a muscle, ligament, tendon or nerve
become overly tight and motion becomes limited, often causing
pain and decreased function. The treatment decreases trigger
points and adhesions within the muscle, leading to improved
ROM, proper joint mechanics, and decreased pain.
ART is a perfect complement to chiropractic adjustments.
Providing ART either before or after the adjustment helps to
facilitate the healing process to get patients out of pain quicker,
significantly helping to reduce treatment time.
Chiropractic adjustments are used to restore motion in restricted
joints of the spine and extremities. Motion palpation of the joints
is used to find areas that are restricted and need treatment.
Adjustments often creates an audible cavitation
(popping/cracking) when applied to an area of joint restriction.
This leads to relief of painful areas and relaxes surrounding tight
muscles. Joints often become restricted from poor posture, lack
of movement or injuries.
Specific corrective exercises are given to every patient to improve
movement dysfunction and/or limit pain. This active component
by the patient is what maintains the improvements from the hands-on care and bridges the gap between treatments. The exercises are performed both during a treatment session and then at-home to create long lasting results.
The goal – to limit future injury through self-managed rehab.
About the Doctor
Michael Meersman DC, CCSP, MS, ART®
Dr. Meersman is a certified Chiropractic Sports Physician and full-body ART® provider. He completed his Doctor of Chiropractic degree at Logan University in Chesterfield, MO, where he concurrently obtained a Masters of Sports Science & Rehabilitation.
Dr. Meersman focuses on the treatment of the spine & musculoskeletal injuries. His modern evidence-based approach to chiropractic care and sports rehab is patient-centric and straight forward. He meets each patient where they are at and gives them the best treatment possible. He has attended numerous seminars focused on manual therapy and functional rehabilitation, utilizing the best from each to incorporate in his treatment approach.
Dr. Meersman is an official team chiropractor for the Chicago Bears. He has worked with athletes at all levels, including the NFL, MLB, NBA, WNBA, PGA, NHL & NCAA athletes.
What We Treat
We use safe, comfortable, evidence-based treatments to provide relief from a number of conditions including…
Headaches range from tension headaches to migraines, often due to neck dysfunction and trigger points in surrounding muscles. Consistent headaches are not normal and complicating factors include diet, poor sleep, & stress.
Neck pain is one of the most commonly treated areas by chiropractors. Neck pain often occurs from restriction of the joints in the neck and upper back, leading to compensatory muscle tightness. Focusing on improving range of motion and properly loading the neck are the keys to reducing persistent pain. The cervical spine always needs to be ruled out a potential cause as a potential referral source for shoulder, arm or hand symptoms.
Golfer’s elbow is pain felt along the medial aspect of the elbow. Repetitive motion from activities stress the inner aspect of the elbow, creating tension in the muscles of the forearm that refers into the elbow. Golf and throwing sports can lead to this pain, often being associated with involvement of the shoulder and spine, which lead to altered biomechanics.
Carpal Tunnel Syndrome
Carpal tunnel syndrome primarily involves the compression of the median nerve. The result can be referred numbness/tingling felt in the hand and fingers. Multiple possible compression sites can be involved, where palpation of the muscles of the forearm and wrist need to be evaluated. Surgery may be unfavorable if the compression site is not in the wrist. Using a brace at night is often helpful to relieve symptoms. If symptoms are persistent over time and unresponsive to treatment, a EMG is the golf standard for accurately diagnosing carpal tunnel syndrome.
Hip impingement, or FAI (femoral acetabular impingement), is pain felt in front of the hip. Pain is typically felt with the hip fully flexed or internally rotated. A lack of hip range of motion can contribute to lower back discomfort that is persistent and need to be assessed together for treatment. X-ray may be needed to determine any bony overgrowth causing the impingement.
Knee pain, unless from an acute injury or direct trauma to the knee, is from a combination of altered biomechanics of the ankle, hip and pelvis. A lack of mobility in the ankle and hip can cause referral of pain to the knee due to a lack of ability to properly load the joints of the lower extremity. Working to restore mobility in the ankle/hip and then strengthening the lower extremity together will drastically reduce mechanical knee pain.
Shin splints are often referred to as medial tibial stress syndrome. Pain is felt along the inner aspect of the lower leg bone (tibia) most often. Runners are commonly dealing with this injury, especially high mileage runners with low arches. Rest, along with cross training, with progressive return to sport helps manage the injury. Soft tissue of the lower leg and adjustments of the foot/ankle, along strengthening exercises are needed during the rest period as well.
Ankle sprains are very common and most often occur from an inversion sprain (rolling the ankle inward). Predictors of ankle sprain include prior ankle sprain, being overweight, high arches, impaired arches and tight calves. Soft tissue treatment and re-establishing ankle range of motion and stability are important early in the recovery. Often using K-tape or an ankle brace to maintain ankle position is helpful as well.
Shoulder pain is most commonly due to a mechanical source of pain, often including posture, movement or poor biomechanics. Mechanical shoulder pain is made better or worse based on position/movement in the shoulder. Overuse of the shoulder is a more direct cause in overhead athletes, such as baseball, tennis and volleyball players. The cervical spine often refers pain into the shoulder and needs to be assessed to be ruled in/out as a potential cause of shoulder pain. Stabilizing the shoulder joint and shoulder blade are very important to maintain long-term improvements.
Shoulder Blade Pain
Patients often complain of pain along the inner aspect of the shoulder blade, describing a knot felt in the mid to upper back. This could be a trigger point of the surrounding muscles or a restriction of a rib. There may also be a referral of nerve-like pain from the neck, where treating the neck may resolve the pain. Stabilizing the shoulder blade, upper back and neck are crucial to reducing a reoccurrence of pain.
Lower Back Pain
Lower back pain is very common, with over 80% of people having at least one episode in their lifetime. A majority of the pain is disc related, with the pain causing movement being flexion. This can be made worse by sitting, driving, forward bending, deadlifting, etc. Chiropractors are experts in treating LBP and should be part of the initial assessment for patients prior to any other intervention.
Tennis elbow is pain felt along the outside of the elbow. It is an overuse problem that is common in racquet sports, golfers and workers who primarily use their hands (mechanics, electricians, etc.). It is due to a combination of tightness/compression of the forearm extensor muscles, as well as general muscle weakness in the forearm. Poor posture can be a contributing factor and stabilizing the shoulder blade, elbow and wrist are often part of treatment. Appropriate eccentric strengthening and lengthening of the forearm muscles resolves pain and allows faster returns to sport.
Sciatica refers to pain experienced along the length of the sciatic nerve, which travels from the lower back, the buttock region and down the back of the thigh into the foot and toes. The cause is typically from the lower back, possibly involving a disc herniation or nerve root irritation. Arthritic changes or overuse of the joints can also be involved. Sitting will prolong recovery and removing the cause of pain is essential. The piriformis muscle is often involved and treating it helps take stress how the sciatic symptoms down the leg.
Calf strains are caused due to improper loading of the muscle and tendons of the lower leg. A trigger point is often felt in the medial aspect of the calf. Restricted range of motion in the ankle/feet, knee and hip can all be involved, decreasing biomechanics efficiency with running and sprinting. Eccentric exercises to both strengthen and lengthen the calf muscles can be done early in treatment to manage pain and create faster healing. The lower leg muscles are often undertrained in runners and focusing on those can re-balance the forces distributed around the lower leg. Gradual re-introduction to running/sprinting in sports is important to manage the load the calf receives and decrease chances of re-injury.
Achilles pain is felt along the back of the heel and into the insertion of the calf muscles. The calf muscles unite above to form a single thick Achilles tendon. Injury typically occurs from overuse, often in runners. The tendon also weakens as we get older. Proper loading of the tendon, exercises & soft tissue treatment build long term resilience of the tendon.
Mid Back Pain
Mid back pain is typically due to a lack of mobility. The postural position of the mid back feeling flexed is common and more likely to be present is people working at their desk and sitting for long periods of time. Improving thoracic extension with both adjustments and mobility exercises are important to reduce the forward posture. A disc herniation in the mid back is very uncommon. Mobility in the mid back is important for all athletes, especially those involved rotational sports, such as baseball, tennis, golf and hockey.
IT Band Syndrome
IT band syndrome is a common overuse issue seen with runners and bikers, with a burning pain felt primarily at the outer (lateral) aspect of the knee. It comprises about 25% of running-related injuries in runners. The repetitive knee flexion and extension in running/biking causes friction of the IT band that leads to the pain on the outside of the knee. The muscles at the origin and insertion of the IT band will need to be treated, as they act to maintain the tension the IT band creates and become tight when the pain is present. Strengthening the glute muscles are essential for full resolution of the discomfort and enhancing proper lower body biomechanics.
Hamstring strains are common in any sports that require top-end sprinting, with sprinters being especially susceptible to this injury. Hamstring strain have a high rate of reoccurrence and strengthening of the hamstring is critical to avoid it from happening. Inflexibility is often considered a potential cause but little evidence supports that. The most lateral hamstring muscle (biceps femoris) is the most frequently injured in runners. Soft tissue work of the damaged tissue stimulates muscle repair and won’t affect the muscle strength.
Jaw pain, or TMD (temoperomandinular disorder), is pain felt in and around the TMJ. Assessment of the neck during treatment of TMJ is important as ~50% of cervical spine cases have an origin in the orofacial system. The TMJ is one of the most unstable joints in the body and both sides of the jaw are often involved. Treating the muscles of the jaw and reducing tension is the first step to resolve discomfort. Clenching of the jaw is a common cause of the pain and often times you won’t even realize you are doing it. Re-grooving proper mouth opening and closing will help reduce the tightness jaw and establish correct muscle tone.
What does a chiropractor do?
- A chiropractor is trained to treat the spine & musculoskeletal complaints conservatively. This involves the chiropractic adjustment, soft tissue treatment and corrective rehabilitation exercises. Restoring proper joint range of motion and decreasing pain allows the body to function more optimally. The nervous system is then better able to respond and process information from all areas of the body.
Will I have to come forever?
- No. A focused treatment plan will be provided after the initial assessment to set the expectation on the length of care. After completing the treatment plan there are several options as to how to precede – including performance care, maintenance care, etc. This is usual dependent on patient’s activity levels and lifestyle. Occasionally this may involve imaging if indicated as we begin care.
- Patient education and self-care are also essential components of treatment at MSM and will be the tools to avoid continual care over a long period of time.
Why do I have at home exercises?
- Spinal hygiene! This refers to the daily routine of exercises for your back, neck and extremities. This involves movements for exercise recovery and those for existing daily motions, such as sitting or walking.
- MSM is also focused on getting the most out of every treatment. Specific exercises are provided to every patient to be done by the patient out of the office. These are given to bridge the gap between treatments and prove valuable when a slight reoccurrence of pain may occur.
What happens if the pain comes back after completing care?
- Having a reoccurrence of pain or discomfort after release from care is not uncommon. Initially you should start by doing the at-home exercises given. If they are not working or pain gets worse, an appointment will be the best option for further assessment.
What is ART® (Active Release Techniques) and how is it used in treatment?
- Active Release Techniques is a hands-on treatment approach to diagnose and treat soft tissue injuries. Soft tissue refers to muscle, tendon, fascia, or nerve. When applied to the soft tissue, ART® can unload pain-generating structures and facilitate the rehab of functional deficits. This often involves treating “trigger points” within muscles, when reduced often decrease pain and allow for proper movement.
- ART® is used with every patient and is incredibly effective in reducing symptoms and improving function. This technique is very popular with athletes as a means for recovery and injury treatment, as well as people who have jobs involving repetitive motions (i.e. hair dresser, computer work, manual labor, etc.)
Why should I go to you first instead of my medical doctor for my joint or muscle pain?
- At MSM, the chiropractor is highly trained in conservative, non-invasive spine & musculoskeletal assessment and treatment. The doctor will assess and determine the reason for your pain and provide the appropriate clinical decision going forward.
- While medical doctors help with many problems/diagnosis, most do not have much training in the conservative treatment of joint or muscle pain. Often the steps of imaging and prescriptions to deal with pain can be avoided.
Am I able to return to playing my sport?
- Chiropractic care is a great way to drastically reduce symptoms and get you back to your sport in a short amount of time. Depending on the severity of the complaint/injury, a general re-introduction to sport should be considered. Managing the load and strain on the body after an injury is very important to not have re-injury occur. Jumping right back into your previous level of competition or exercise increases these chances.
- Strengthening the body, either through PT or a trainer, are important steps to return to sport. MSM works to communicate with those working with athletes to ensure your return to play is as smooth as possible.
How often should I expect to come after I start treatment?
- Treatment plans are typically 6-8 sessions over a 4-6 week period. The treatment plan could be shorter or longer depending on the complaint. The more recent the complaint, usually there is a faster result. For a long standing complaint, it may take more time to achieve the desired outcomes.
- If progress is not being made, an appropriate referral or co-treatment with another provider will be considered. MSM is focused on the best outcomes for every patient and working with other medical professionals allows for this.
Do you accept my insurance?
- We are currently accepting BCBS PPO and AETNA insurance plans. If you are not enrolled with this plan, we have affordable self-pay options. Payment will be required at the time of service.
Do I need an x-ray or MRI of my spine? Do you take x-rays?
- X-rays are not provided at the office and are not depended upon for treatment. MSM focuses on a movement-based approach and x-rays don’t provide value to determine clinical outcomes in this setting, avoiding an unnecessary step during treatment.
- Given the appropriate situation imaging is an invaluable tool. Patient presentation either initially or if symptoms change/get worse may indicate imaging and the appropriate referral will be given.