Congratulations! You came to Cornerstone for your low-back pain, showed up to all of your appointments, practiced your prescribed home exercises, and met your goal of being able to play the baritone kazoo for three hours without tweaking your rotator cuff. If the pain returns when you surpass those three hours, your condition has improved but the dysfunction remains, and you should update your goals in a new round of care. If you’re feeling fine, though, your Cornerstone provider will likely recommend performance care.

Active care and performance care

Active care is the therapy you receive to resolve a current problem, usually one that is caused by pain or discomfort. Maybe it’s the aforementioned three-hour limit on the kazoo; maybe it’s an ache in your lower back after walking more than a mile or vertigo after six hours of working at your desk. Insurance often covers active care.

Performance care is provided when you are between active-care problems or are at the tail end of their resolution. Whereas active care resolves dysfunction, performance care keeps it from returning. The techniques used in active and performance care are often identical: if your active care consisted of certain adjustments, soft-tissue work, and exercises, your performance care will likely feel familiar but be scheduled less frequently, perhaps just a monthly fifteen minutes.

One important difference between active and performance care: the latter is not liked by insurance. The obvious question then arises: is performance care worth the potential out-of-pocket expense?

The evidence

Five years ago, 328 patients with low-back pain were provided with chiropractic adjustments and soft-tissue work. After six visits, their reported pain levels dropped from 5.2 out of 10 to only 2. The patients were then divided into two groups, one that regularly received performance care for the next year and the other that was simply dismissed from care. A year later, the first group had 13 fewer days of significant lower back pain–yet an average of only 1.7 more office visits. This was because members of the second group often reinjured themselves and needed to resume active care. That’s right: with performance care, patients experienced two fewer weeks of significant pain with barely any difference in the number of office visits. 

Note that this study covered chiropractic adjustments and soft-tissue work only–no exercises. At Cornerstone, rehab is a fundamental component of nearly every patient’s active care. For performance care, we encourage our patients to enroll in our Foundational Fitness program.

Foundational Fitness

Foundational Fitness (FF) is Cornerstone’s program to help you train efficiently and safely. We offer classes at beginning and intermediate levels and a specialized barbell class. Each sixty-minute workout consists of four phases.

1) Activate: full-body mobility warm-up

2) Accelerate: safe movements that get your heart rate to the optimal level

3) Enhance: full-body circuit training, employing both body weight and free weights

4) Elongate: full-body cool down and lengthening

You’ll begin your FF experience with a no-sweat intro. One of our trainers will get to know you and learn about your past experiences with fitness and which activities you enjoy. We’ll then work with you to determine your health and fitness goals, how close you are to reaching them, and the steps that will bring you to success.

For more information about FF and to get started, let us know you're interested here!

J.  McCrackan DC, CMT

J. McCrackan DC, CMT

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