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Ask Doctor Donohoe - how long should I wait ?

Ask Doctor Donohoe

I’ve been in practice now for 16 years. Over all those years I’ve been asked to answer LOTS of questions. Neighbors Newspaper has graciously agreed to open up their publication to me and YOU! We will be accepting questions on all subjects health related. As readers of my column already know, I specialize in pediatric and pre-natal chiropractic care. However, my office is a family practice. I take care of patients young, old and everyone in between. We invite your questions on health and fitness, diet and nutrition, kids care, adult care and any alternative medicine issue. Please email your questions to I will try to answer one every month in this column.

Question: Submitted by Theresa J.
I am the mother of 3 very active little ones all participating in various sports/activities. I have been a long time chiropractic patient and understand the need for maintaining optimal functioning through chiropractic adjustments. My question is about the kids. With their participation in sports and dance they will often come home complaining of some new ache or pain. How do I know when it’s one that will pass or one that will require treatment?

Thank you for your question Theresa! That’s a very good question indeed. As the father of 4 kids all active in their own sports, I can relate! My own kids experience the same thing. They come home from practice and it seems like each night I hear something to the tune of “dad, my shoulder has been aching since volleyball practice this afternoon” or “dad, I tweaked my back at football practice” or my personal favorite, “dad, I’m all snapped up and I need an adjustment!”

The human body is a remarkable miracle of design and function. It can sustain mild to moderate injury and recover relatively quickly and completely. The majority of injuries sustained on the playing field or dance floor are of the type that will take care of themselves. However, those that need treatment shouldn’t be ignored or they could end up delaying significantly your child’s return to their activity, or worse, further injury.

Dr. Battie Videman of Helsinki, Finland published a study that showed how even minor traumas to the spinal joints can result in scar tissue formation in and around those joints within two weeks. Two weeks!

Your spine houses and protects your spinal cord and the nerves that exit your spinal cord in between your vertebrae are the communicating pathways from your brain to all parts of your body. Your nervous system controls and coordinates the function of every cell, tissue and organ of your body. Any breakdown in the communicating pathways can detrimentally affect your nervous system’s functioning and ultimately affect other systems of your body. Scar tissue formation after an injury is what leads to reduced motion in the joint, inflammation, pain and possible nervous system compromise.
So within two weeks, after even a minor injury, your spine can begin to develop scar tissue that can lead to interference in your nervous system and compromise your health in any number of ways! Now let’s get back to these active children and their sports injuries.
Most of these injuries are simply soft tissue in nature. Meaning they are muscle strains or mild ligament sprains. Along with muscle and ligament injuries, contusions, bruises and abrasions are among the most common types of sports related injuries. These are the types of injuries that simply require rest, ice, compression and elevation. Remember the acronym RICE. Those injuries that affect joint alignment and function will require additional evaluation and management.
So how do you determine which is which? I tell my patients to follow what I call the “3 day rule”. This, of course, applies to injuries that are not the obvious ones which require immediate attention. Injuries that result in severe pain, limited range of motion, bruising and excessive swelling need immediate attention. The 3 day rule is for those that fall into the gray area. Here’s how it should be applied:

The injury should be treated conservatively with RICE for the first day or two. A mild to moderate injury that will resolve without lingering effects will do so within 3 days. That means that by day 3 the affected region is back to full activity with little to no pain and complete range of motion. An injury that is still painful, prevents full range of motion or continues to demonstrate swelling past 3 days will require attention.

A doctor of chiropractic is qualified to evaluate, diagnose and treat these types of injuries that may require specific adjustments to restore joint alignment and function. Physical therapy can also be guided by your chiropractor in the form of prescribing necessary stretches or strengthening exercises and the use of therapeutic modalities such as electric muscle stimulation, ultrasound or traction.

I believe that it is the goal of every parent to see their kids having fun with sports and other physical activities. Don’t let the questionable injuries linger or become something that could continue to cause your child problems for months or even years to come! Follow the 3 day rule and your children will learn how to manage these injuries better on their own in the future, prevent them form getting worse and get in the game ASAP!

Thanks again for the question Theresa! Please get more questions in to and let’s keep this column active!

Dr. Donohoe is a family practice chiropractor who specializes in the unique needs of pregnant women and children. His office is located at 41880 Kalmia St., Suite 135 in Murrieta. He can be reached at 951-677-6500 or through his website at


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