Find out the answers San Francisco CA Chiropractors frequently give to patients seeking to learn more about chiropractic care at their office. Learning more about chiropractic and its benefits can help you find the best chiropractor for you. If you have a question you don’t see answered below, reach out to your team at Louis Valencia, DC, CSCS at (415) 867-2781.


“The doctor of the future will give no medicine, but will interest his patients in the care of the human frame, in diet, and in the cause and prevention of disease” – Thomas Edison

There are many ways to look at health. In chiropractic, we like to consider health as a homeostatic state composed of a “triad” or triangle of structural, chemical, and mental factors. Balance within the triad forms an equilateral triangle, thus an ideal or optimal health state. When a person experiences poor health, an imbalance in one factor of the triad is a contributor. Imbalance in two or three factors can be found in people with severe and chronic health problems. Often, a health problem starts on one side of the triad and eventually involves all three aspects. Any side of the triad can affect the other sides, both as causative factors of health problems and in therapeutic approaches. See the triad of health graphic below, which highlights each aspect of the triad of health.

Chiropractors advocate how to improve functional capacity (strength, muscle endurance, cardiovascular endurance, flexibility, and motor control such as balance and coordination), because because neuromusculoskeletal structures (ligaments, joints, intervertebral discs, muscles, tendons, and nerves) are constantly subjected to biomechanical forces such as tension, torsion, compression, and shear.

When functional capacity is less than what the work or activity demands, micro failure (fatigue) and eventual injury are the result. The distress these demands place on the neuromusculoskeletal system acts against the system’s functional capacity, and when the distress outweighs a patient’s capacity: internal resistance, then signs, symptoms, and injuries result. Maintaining neutral postures keeps demands and distress to a minimum. Maintaining ideal functional capacity keeps the body’s internal resistance up, toward ideal elite athletic ability.

Chiropractors place an emphasis on educating their patients and clients in maintaining neutral body postures while in static postures and during dynamic motion. Good ergonomics and proper biomechanics are advocated at work, at home, and during athletic activities. This emphasis on better posture helps
prevent injury and enhance performance.


The Health-Disease and Ability-Disability Continuums:

Chiropractors believe the human body is in a state of dynamic flux along a biological continuum-‘State of the Organism’. This continuum extends from optimal health to death, and each person passes through the continuum stages. From optimal health, humans move to a state that may be termed as a departure from health, then to disease, and on to the expression of a specific disease, complete with signs and symptoms.

People with mild departures from physiologic normal should be treated before they experience pathological changes. An early departure from health that is not yet expressed as illness is much less classifiable as disease. In this stage, the healthcare goal is to determine the patient’s position and direction of movement on the biological continuum by tracing the gradual deterioration, and then restoring the body’s internal resistance before disease develops.

There is also an ability-disability continuum, which has parallels to the ‘State of the Organism’ continuum described above. It is difficult to identify a discrete point within most human functions where a line can be drawn between ability and disability. Therefore, it is essential to develop a standardized reference against which function can be compared to differentiate elite athletic ability from disability and the stages in between. Within that reference, a distinction should be developed to clarify treatment for prevention and a return to optimal health and elite athletic performance, rather than just focus on the standard treatments from the continuum of dysfunction through disease to death, and from sub-normal ability through impairment to disability.

The health promotion model we advocate is that of the ‘State of the Organism’ and ‘Functional Ability’ Continuums. These two continuums’, which run parallel to each other as displayed in the graphic below, can act as a template on directing behavior toward lifestyle choices that increase our internal resistance. The goal is to increase one’s internal resistance on each side of the triad of health in order to meet the structural, chemical, and mental stressors we encounter.

Structure, with which chiropractic has always been concerned, is the base of the triad of health. Chiropractors address structural issues by treating nerve, joint, and myofascial dysfunction by removing subluxations to improve nerve, joint, muscle, lymphatic, and vascular function.

Chiropractors also address structural issues by increasing their patient’s functional capacity with active rehabilitation and functional fitness training. In addition, ergonomics addresses the structural issues by helping people maintain their neutral postures while interfacing with their workstations. The structural part of the triad of health involves the relationship between the function of locomotion and the workings of the biomechanical neuromusculoskeletal systems.


The mechanical lesion referred to by chiropractors and stated eloquently by Joseph Janse, D.C., “a subluxation is an attending complication of those chemical, mechanical, and/or environmental irritations of the nervous system which in man, the biped, produce muscle contractions sufficient to cause articular dysfunction. Once produced the lesion becomes a focus of sustained pathological irritation. It irritates proprioceptors in the articular capsules, ligaments, tendons, and muscles of the involved segment. The barrage of nerve impulses stream into the spinal cord where interneurons receive them, and then relay them to motor pathways for the conduction of muscles and glands initially in excessive amounts, but the contraction which provoked the subluxation in the first place, is thereby reinforced, thus perpetuating both the subluxation and the process it engenders”. The subluxation is typically treated with high velocity and low amplitude adjustments of the spine, pelvis, temporomandibular joints, and extremities.

The chiropractic treatment with adjustments (AKA manipulative therapy) to the spine, extremity joints, and myofascial system directed at the vertebral subluxation complex (AKA joint fixations/dysfunction), thus its crucial relationship to the spinal cord and the spinal nerve roots, is of utmost concern to the chiropractor, as is the functional capacity status of the patient.

The doctors of the future will push their patients up the ability and biological continuums toward optimal health and elite athleticperformance’. Our goal is to help increase our patient’s internal resistance by improving their bio-mechanical, bio-chemical, and bio-psychological status. In addition, keeping the structural,
chemical, and mental stressors to a minimum. In addition, it is important to avoid other risk factors for injury, illness, and disability so that our patients and clients can resist the signs and symptoms of disease and disability.

The chiropractic physician specializes in the biomechanical neuromusculoskeletal realm, which promotes ideal locomotion, neurophysiology, and good musculoskeletal function for optimal health and elite athletic ability. Orthomolecular physicians specialize in the bio-chemical electromagnetic realm, which promotes ideal combustion within the body’s energetic systems for optimal energy needs, physiology, and detoxification. The psychoneuroimmunologist specializes in the bio-ecopsychosocial realm, which promotes ideal relationships with nature, others, and oneself toward the goal of optimal health and elite athletic performance. A balanced triad of health means a balance of the human body, mind, and spirit, thus better adaptation in today’s rapidly changing society.

The patients that come into our offices are multi-dimensional and complex in their presentations. The triad of health helps us view their overall dynamic presentation and dysfunction. In addition, spinal subluxations, peripheral nerve entrapments, and dysfunction in the sacral occipital respiratory function can affect the information processing occurring within your central and peripheral nervous systems. Circulation can also be compromised, as the vessels pass through muscles that may be tight due to guarding from joint dysfunction or from prolonged awkward posture that have caused muscles to shorten. When insults to the biomechanical, bio-chemical, and bio-psychological systems within the body are managed, patients are able to heal, adapt, and experience optimal health and elite athletic performance and be hindered by neither disease nor disability. As healthcare providers, we need to convey to our patients and clients that being fit in a technological society means taking responsibility for a chosen lifestyle and making smarter choices that affect wellbeing.

Lifestyle choices that mimic our ancestors’ past, which incorporate natural physiological efficient postures, movement, nutrition, relaxation, and play can help one achieve optimal health and elite athletic performance. Active and healthy lifestyles enable a patient’s mind, body, and spirit to function at peak efficiency and better adapt to our changing world.

For overall wellness, we help our patients and clients have less distress in each aspect of the triad of health. In coordination, we
must arm our patients and clients with more factors which increase internal resistance in each aspect of the triad of health. As healthcare providers, we must also practice what we preach. Our patients look to us as model educators and our personal progress offers our patients persuasive guidance in their paths toward optimal health and elite athletic performance.


Human Adaptation to Life Stress:

Humans can adapt to and successfully function within a range of external conditions if we are given regular exposure to those conditions. Each individual possesses an intrinsic and biological dynamic that interacts with and mitigates external forces. The potential for healing is our natural heritage when we are free from vertebral subluxations, nourished with a balanced diet, and get adequate sleep, clean air/water, regular exercise, proper posture, and when stressful living is well managed.

The adaptation goal is to build the body’s internal environment (including structural, chemical, and psychological hardiness) to best resist the external environment (including traumas, toxins, microorganisms, nutrient deficiencies, temperature extremes, and stress). When the body must function through a wide range of conditions, it becomes greatly strengthened and builds an enlarged scope of adaptability. Rather than be victimized by the external world the body adapts more efficiently to its surroundings.

Each side of the triad of health (structural, chemical, and mental) has its internal resistance that copes with the physical, chemical, and psychological stressors that produce responses within the body. Conditioning factors can selectively enhance or inhibit a stress effect. Thus, conditioning may be internal (caused by genetic predisposition, age, sex, and/or other structural, chemical, and mental factors) or external (caused by treatment with hormones, dietary factors, the removal of nerve irritation, and/or stress management). Under the influence of such conditioning factors (which determine sensitivity), a normally well-tolerated degree of stress can become pathogenic and cause diseases of adaptation, selectively affecting the predisposed body area. Some good can come from physiologic challenges, if not taken beyond the limit. Evidence of a positive effect is apparent, since repeated exposure to arousing stressors may lead to physiological toughness, which is an increased capacity for responding to stress, plus the increased resistance to the potential damage that stress can produce.

It appears that the greater one’s internal resistance, the greater the ability to resist distress, and the greater potential for optimal health and elite athletic performance. When internal resistance is at suboptimal levels in the structural, chemical, and psychological realms, the chance of dysfunction is greater and there is an increase in the signs and symptoms of injury, illness, and impairment.

Chiropractic, Fitness, & the Ergonomic Model for the Structural Part of the Triad of Health:


  • Injury, structural irregularities, & awkward postures
  • Joint (i.e. motion segment) & myofascial dysfunction
  • Deconditioning & altered nerve function (i.e. slowed nerve velocity due to nerve impingement, thus compression)

Internal Resistance

  • Manual therapies & physiologic therapeutics
  • Active rehabilitation & functional training
  • Ergonomics & occupational health promotion

Orthomolecular Model for the Chemical Part of the Triad of Health:


  • Oxidative stress
  • Coagulated states
  • Deficiencies
  • Toxicities

Internal Resistance

  • Antioxidants & anticoagulants
  • Minerals, & vitamin
  • Fatty & amino acids
  • Enzymes & probiotics
  • Distilled water with electrolytes
  • Other naturally occurring physiologic substances such as herbs

Psychoneuroimmunology Model for the Mental Part of the Triad of Health:


  • Social isolation
  • Sleep deprivation
  • Addictions
  • Inability to forgive & express opinions

Internal Resistance

  • Social network & connectedness
  • Psychotherapy & hypnosis
  • Time & stress management
  • Mental & physical exercise
  • Meditation & imagery
  • Art & passion expression


Consider practicing the health promotion lifestyle strategies below to help improve your overall fitness & health status, thereby decreasing fat, inflammation, & symptoms. These lifestyle strategies will help improve your performance at work, home, & at play.

Influence the body into burning rather than storing fat by do the following:

  1. Keep insulin levels down by eating low glycemic index carbohydrates and carbohydrates should be eaten only after there is some proteins and fats already in the stomach.
  2. Keep oxidation and inflammation levels down by eating foods and supplements high in antioxidants and essential fatty acids.
  3. Keep cortisol levels down with time and stress management strategies.
  4. Keep on moving with some regular moderate to intense exercise, which will increase your functional capacity, metabolism, & muscle mass while decreasing fat mass.

Biomechanical Neuromusculoskeletal Considerations:

  1. Maintaining neutral postures while in static seated (proper ergonomics), standing postures, and while in dynamic motion by hinging at the hip when bending forward.
  2. Take microbreaks every 10-15 minutes while on a laptop or tablet, and every 20-30 minutes when on a desktop or docking station.
  3. Functional rehabilitation and functional fitness training to increase functional capacity:
    – strength and conditioning workouts 2-3 times per week
    – cardiovascular endurance training 150 minutes per week at 60-90% of max heart rate
    – after workouts use the foam roller or percussion massager prior to stretching in order to increase mobility and flexibility
    – include motor control exercises that challenge coordination and balance
  4. Recovery: 7-8 hours of sleep per day (<7 hours increases appetite, thus fat gain)

Biochemical Electromagnetic Considerations:

Hydration- half your body weight in ounces, if you’re 100 lbs. = 50 oz per day of H2O

Cut some to all of the following:

  1. Alcohol, sugar & white flour product carbohydrates (increases body inflammation)
  2. Dairy: milk, cheese, ice cream, & butter
  3. Salt, boxed, or packaged items which are more processed & eat bulk items instead

Eat small portions each meal including: from one hour of waking to every 3-4 hours.

  1. Lean protein: chicken, turkey, fish, eggs, etc.
  2. Good fats: avocado, nuts, seeds, olives, olive oil, etc.
  3. Fruits & veggies: the full color of the rainbow
  4. Legumes/ beans, & grains, such as oatmeal, buckwheat, etc.

Supplements to consider: Rainbow Grocery:

  1. Fatty acids: fish or krill oil & borage or evening primrose oil
  2. Antioxidant formula
  3. B-complex formula
  4. Multi-mineral formula
  5. Probiotics

Bioecological Psychosocialemotional Considerations:

  1. Stress management = time management which keeps cortisol levels down
  2. Deep diaphragmatic breathing for relaxation and regeneration = meditation
  3. Don’t sweat the small stuff and realize it is all small stuff
  4. Get out to nature- smell the roses & realize how interconnected we all are to it all
  5. Get full spectrum light and/or sunshine in small doses


Our health care practice is a comprehensive and therapeutic approach to managing injuries and illnesses. We strive at helping our patients maintain an active lifestyle and offer a supportive and integrated approach where personal growth and positive health changes can occur. We help our patients learn, practice, and master new skills in lifestyle choices related to exercise, good posture, diet, nutritional supplements, relaxation, play, and social connectedness for overcoming the underlying structural, physiological, psychological, emotional, and spiritual aspects of their injuries and illnesses. Ultimately our patients learn to take responsibility for their own health through their daily lifestyle choices rather than by relying on physicians to cure them.

We offer state-of-the-art evaluations, conservative treatment, and active rehabilitation for sports, occupational, and personal injuries. Our expertise is in the prevention and proper management of traumatic and repetitive motion injuries of the spine, pelvis, extremities, and soft tissues of the body. This integrated approach of chiropractic, fitness, and ergonomics offers individuals with known neuromusculoskeletal problems, those with multiple risk factors, and the healthy individual an opportunity to decrease their risk of injury and increase their athletic performance by adopting new lifestyle skills which enables our patient’s mind, body, and spirit to function at peak efficiency.

We use the reactivation approach, which consists of the following:

  1. Detailed history of your activity intolerances associated with your pain, especially those that interfere with your activities.
  2. Examination of the functional pathology related to your intolerances, so that the movement dysfunction, which is responsible for your pain, can be determined.
  3. Treatment: advice, manipulation, and exercise, which are directed to restoring function to the key link responsible for the biomechanical overload.
  4. Audit the results. Goals for functional reactivation and training are set (i.e. removal of activity intolerances) and reevaluations are done regularly to determine your status. Your goals will be adjusted as needed.


The clinical management of neuromusculoskeletal conditions involves both passive and active care services. The passive care services include the clinical use of manual therapies and modalities, while the active care services include the therapeutic procedures used in active rehabilitation and functional training.

We start off our approach with palliative care, tissue-sparing strategies, gradual reactivation advice, and provide assurance that the red flags of serious disease such as infection, tumor, and fracture have been ruled out, so that our patients do not imagine their injuries or illnesses as catastrophic.

Our passive care services: help to reduce inflammation, pain, adhesions, and restore joint, myofascial, and central/ peripheral nervous system dysfunction.

Passive Care Therapeutic Procedures: Manual Therapies

  • Adjustments of spinal and extremity joints (98940-98943)
  • Manual traction, soft tissue mobilization / manipulation (i.e. myofascial release), manual lymphatic drainage (97140)

Supervised Physiologic Therapeutics: Modalities

  • Heat and cold pack therapy (97010)
  • Electrical muscle stimulation (97014)

Our active care services: helps to restore proper movement patterns, muscle balance, posture, and functional capacity (i.e. fitness).

Active Care Therapeutic Procedures: Rehabilitation

  • Therapeutic exercises (97110): to develop strength, endurance, ROM, and flexibility.
  • Neuromuscular re-education (97112): of movement, balance, coordination, posture, kinesthetic sense, and proprioception.
  • Group therapeutic activities (97150): therapeutic exercises for 2 or more people.
  • Therapeutic activities (97530): Use of dynamic activities to improve functional performance.
  • Self-care/home management training (97535): instruction in self-care at home.
  • Physical performance testing & measurements (97750): functional capacity testing.

Taken together the passive and active care services facilitate the healing process by:

  • reducing inflammation, adhesions, and pain
  • restoring the range of motion of the joints and soft tissues
  • reactivating the neuromusculoskeletal system for the purpose of locomotion


The three aspects of conservative treatment of locomotor system disorders are advice, manipulation, and exercise. They constitute a continuum of care, which has as its goal the reassurance, reactivation, and return to your prior functional status. Advice begins with dispelling the myth that ‘hurt equals harm’. We then promote the gradual resumption of activities as a way to prevent deconditioning and improve the nourishment of the painful tissues. Finally, specific activity modification advice regarding workstation ergonomics, sleep posture/pillows, bending/lifting/carrying, and pushing/pulling is given.

Exercise helps by restoring function in a variety of ways:

  1. It may overlap with manipulation as a catalyst to recovery.
  2. It may help stabilize the dysfunctional kinetic chain by grooving appropriate movement patterns such as in agonist-antagonist coactivation.
  3. It may help prevent recurrences by reconditioning functional patterns, which mimic the challenges faced at home, work, and/or in playing sports.

It can sometimes even begin early in care particularly if a ‘functional range’ can be identified, which is both relatively painless and where motor control is appropriate. Exercises are prescribed which re-educate movement patterns that are responsible for biomechanical overload in your residence, occupation, and in your physical activities.

In summary, while relief of symptoms is always a reason health care consumers seek health care advice; modern scientific evidence indicates that the cause of most pain is functional in nature. Manipulation and the manual therapies serve as a catalyst to recovery, especially if a tissue, joint, or scar is determined to be interfering with function in a kinetic chain related to the pain generator or activity intolerance.

Functional sources of pain include decreased activity tolerance and decreased fitness, which is why we emphasize helping our patients and clients increase their activity tolerance when suffering from acute and chronic neuromusculoskeletal conditions, as well as teaching self-care skills for controlling and coping with recurrent injuries of the spine, pelvis, extremities, and soft tissue of the body. In addition, focusing on increasing fitness as a rehabilitation and preventative tool, and increasing performance capacity for all levels of athletes, including the ‘occupational athlete’!


Chiropractic Sports Care offers functional fitness training. Functional fitness training is the exercise, which actually prepares the patient or client for the functional demands of their lifestyle, occupation, and/or sport. It is the preventive approach, which should be integrated into the overall management of the patient who seeks care for a painful condition that is limiting activity, and for those athletes seeking methods for enhancing their performance.

We offer active rehabilitation and functional training services to individuals, couples, and small groups in a variety of settings:

  • Yard Gym
  • Outdoors
  • Residential

We strive to educate, assist, and motivate our patients to attain their health and fitness goals. We start out our relationship with a fitness evaluation to establish some baseline values for blood pressure, heart rate, weight, body composition, aerobic fitness, flexibility, strength, muscle endurance, and explosiveness.

During this time we discuss your health, fitness, nutritional, and lifestyle history to set some realistic goals after having reviewed the results of your fitness evaluation. An individualized program design appointment is then scheduled to design a strength and conditioning program that specifically meets your needs. In our program design meeting we determined the following:

  1. Identifying target heart zones for cardiovascular endurance and energy system development.
  2. Exercises for explosiveness, strength, and muscle endurance.
  3. Motor control exercises for stability, balance, and coordination.
  4. Flexibility stretches and foam roller methods for improving ranges of motion.

Quarterly reevaluations are done to determine if goals are being met, and to make adjustments accordingly. Performance measures are then reevaluated, and focus can be put toward weaknesses and deficiencies. We serve the general fitness needs of our patients and clients, as well as the enhanced performance needs of our athletes. We are here to help you achieve the maximum results in the minimum amount of time with injury prevention as the priority.


The initial treatment plan of two to three times per week may be needed initially to get one out of pain. Thereafter the frequency can be reduced to one to two times per week for six weeks, while restoring functional capacity, such as muscle/cardiovascular endurance, strength, flexibility, and motor control abilities such as balance and coordination to address functional deficits and joint/myofascial dysfunction. The initial visit includes a history and physical examination, and a functional capacity evaluation is typically done on the second visit, so a functional diagnosis can be made. This way care is customized to an individual’s goals, needs, and/or deficits, so one can return to their prior functional status and back to a symptom-free active lifestyle.

The active rehabilitative process begins by activating deconditioned and weaker muscles groups with exercise, stretching, and further improving mobility by addressing spinal, pelvic, and extremity joint and myofascial dysfunction with manual therapies such as, adjustments and myofascial release. Both strategies of exercise and manual therapies act on the central nervous system (CNS) and peripheral nervous system (PNS) by relieving nerve impingement and getting the neuromusculoskeletal system reactivated. The three aspects of Chiropractic Sports Care’s conservative treatment protocol of locomotor system disorders are advice, manipulation, and exercise.

Chiropractic and other manual therapies helps the communication between CNS and PNS by addressing restricted joint fixations/subluxations and myofascial dysfunction, which can impair movement, muscles, organs, and lead to nerve compression thus altered communication, as nerves pass in between vertebrae, through shortened soft tissues, and/or from spasms splinting the fixated spinal, pelvic, and extremity areas.

Exercise acts as a stimulus for adaptations of the locomotor system, thus improving functional capacity. We work on increasing your activity tolerance when suffering from acute and chronic neuromusculoskeletal conditions, as well as teaching self-care skills for controlling and coping with recurrent or chronic conditions of the spine, pelvis, extremities, and soft tissues of the body. In addition, focusing on increasing fitness as a functional rehabilitation and preventative tool, and more importantly by increasing performance capacity for all levels of athletes, including the ‘occupational athlete’!

Taken together: proper body mechanics, good posture, exercise, good nutrition/hydration, myofascial release, and manipulation of articulating fixated joints allows for better nerve function with improved motor control in our movement patterns in play, work, and at home in your activities of daily living. This way one learns how to maintain their active lifestyle and age gracefully by sparing their soft tissues and joints in a safe, fun, and efficient manner to achieve optimal results. The improved communication within the nervous system allows for better adaptation and homeostasis allows for optimal health and peak athletic performance.


Yes, chiropractors are in a unique position knowing anatomy, anthropometrics, and neutral static/dynamic postures. In addition, in practice evaluate and treat ergonomic cumulative trauma disorders of the spine, pelvis, and extremities but also to help prevent them with applied ergonomics.

Ergonomics looks at and aims to improve the relationship between people and the tools, tasks, processes, and machines they use. Improving safety and efficiency are the goals of ergonomic design and intervention. The ideal goal would be a design that eliminates injuries, poor understanding, inefficiencies, and errors without the need for operator training or diligence. Nevertheless, safety is and continues to be a shared responsibility between the employer, insurance broker, ergonomist, health service team, and worker. Office ergonomics design helps with the prevention of neuromusculoskeletal disorders for the ever growing ‘knowledge worker’ who spends a good part of their day on the computer.

There are many ways to sit and interface with your chair, keyboard, mouse, monitor, phone, and other materials around your desk. Unfortunately, most people sit and interface with the items in their workstation in ways that make their bodies’ work harder than they need to by getting out of neutral postures for sustained periods of time. Mastering successful sitting and neutral postures actually enable your body to work more efficiently, easily, and be more productive. In addition, our bodies are not designed to sit for long periods of time, especially in awkward postures or fixed positions.

There are alternate ways to counteract the hazardous effects of sitting when a workstation does fit the worker correctly, and with tissue sparing strategies such as micro breaks taken regularly.

In summary, ergonomics has to do with fitting the worker to their workstation in order to keep their joints and soft tissues in neutral postures, so that their neuromusculoskeletal systems are not overloaded and eventually damaged. Physical, perceptual, and cognitive capacities can all impact the safety and efficiency of work. Through effective ergonomic design we hope to maximize productivity while keeping human demands within established worker capabilities.


Chiropractic Sports Care is located inside the Yard Gym, a state-of-the-art fitness facility in the Pacific Heights neighborhood in San Francisco, which has two bathrooms with two showers to change into athletic clothing such as sweats, shorts, leggings, t-shirt, running shoes, etc. Athletic clothing mentioned above is sufficient to perform a physical examination and treatment.