I recently wrote a letter to the Maryland Board of Chiropractic Examiners on the topic of allowing us to use mild Hyperbaric Oxygen Therapy (mHBOT)  in-office. I had been exposed to patients/doctors utilizing it with great results over the years when I worked at various sporting events and I wanted to add this amazing technology to my office to help my patients.  I am happy to say that at the June 2014 meeting, the Board determined that Hyperbaric Oxygen Therapy can be included under the scope of practice for chiropractors in the state of Maryland. I’m so excited my patients can now benefit from it and you should be excited too!

I was going to write a lengthy blog on the topic of mHBOT but I realized that using the major bullet points I addressed in the letter that I wrote to the Board (and tweaking them a little) would work to help you understand what mHBOT is, how it works, its benefits, its safety, etc…  So, here we go…

Mechanism of Action:
Mild HBOT is a safe method of delivering oxygen to the body at a cellular level. Using filtered and pressurized ambient air, around 21-24% Oxygen, the mild HBOT chamber is filled to about 4 pounds per square inch (1.3 ATA). This pressure is equivalent to being 11 feet below sea level. Applying Henry’s Law of Physics, the increased pressure allows the blood plasma and other bodily fluid compartments to absorb additional oxygen. This process increases oxygen uptake by the body’s cells, tissues, glands, organs, and brain (cerebrospinal fluid). Simply put, the more utilizable oxygen we have in our body, the faster we heal, the better we feel, and the better we perform.  Being we are about 60% water, there is a lot of tissue that will absorb that Oxygen!

Clinical Applications:
Increased oxygen uptake via the mild HBOT chamber is systemic and therefore advantageous for all types and etiologies of damaged tissues.  There are many claims made about the positive effects of HBOT for a variety of medical conditions, but as a Sports Diplomate chiropractor, the areas that most interest me are its effects on neuromusculoskeletal injury, mild Traumatic Brain Injury (mTBI)./concussion, and reduction of oxidative stress (which in the studies is linked to a plethora of diseases).

For musculoskeletal injury, mild HBOT serves as an extension of  existing chiropractic protocols and modalities for soft tissue pathology. Allowing for increased circulation to areas of inflammation, increased oxygen under pressure hastens recovery from injury. There is growing evidence for the benefits of mild HBOT for musculoskeletal injuries; anecdotal accounts from professional athletes can be found many places on the web (it’s well known that Hines Ward and Terrell Owens are big proponents of mHBOT).

Many consider Hyperbaric Oxygen Therapy best utilized several hours following acute injury (Hatch; The Oxygen Revolution; Hatherleigh, 2010), but there are also benefits for more chronic musculoskeletal problems.  I was fortunate enough to spend a large amount of time at the USGA U.S. Open 2014 at Pinehurst, NC with Bill Schindler.  Bill is a pioneer in this field and he opened the first Hyperbaric Oxygen Therapy office in the nation.  He works with high level medical specialists, including Dr. Jeff Bradstreet.  I have spoken with Bill over the years at various events and although I was highly skeptical when I was first introduced to mHBOT, I continued to read and learn from those who had chambers in their offices and it soon became apparent that to optimize patient health and recovery, I had to have a chamber.   I am very grateful to Bill for spending time with me over the years answering my questions and educating me about the benefits of Hyperbaric Oxygen Therapy.  It was a great experience to spend time with him teaching me how to properly use the chamber.  Much of the paperwork I use in my office is an adaptation from his.  He is a huge advocate for using hyperbaric therapy and I hope to share great stories with him soon!

For mTBI, HBOT is widely accepted as an effective and safe treatment, as summarized in this editorial about chronic post-concussive syndrome: .

Safety Concerns:
Like many of our chiropractic treatment modalities, mild HBOT is non-invasive, non-pharmaceutical, and without significant reported side-effects. The actual chamber can be depressurized and opened from the inside. In addition, there is a large portal that enables visual contact with the doctor or staff, and the patient may use a phone or walkie-talkie to communicate while receiving the therapy.  In our office, we do give you a walkie-talkie to communicate with us.  Sessions tend to be one hour-long and most people relax or sleep while in the chamber.  The chamber is 100% USA made and only one add-on part comes from overseas…an inside filter and noise suppressor that is made in England.

I hope this has provided a nice synopsis of what mild Hyperbaric Oxygen Therapy is all about.  If you are interested in going for a ‘dive’, please contact our office and we can schedule you.