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Herniated Discs and Conservative Treatments
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Written by Jay Kennedy, DC Michael Schneider, DC., PH.D David Seaman, D.C.   
Friday, 21 August 2009 13:59

 

HDCT
DTTTDH

 

Dr.-Jay-KennedyDr. Kennedy is a graduate of Palmer College and has been in both private and MD/DC practices in Berlin, PA, for over 23 years. He is a leading authority in North America on decompression and rehabilitation procedures and has successfully treated tens of thousands of patients. He has pioneered decompression therapy technique since 1993. Dr. Kennedy is also a renowned product designer and holds multiple patents. Dr. Kennedy is a frequent guest lecturer at leading chiropractic colleges and decompression therapy certification seminars throughout the US. For more information email This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Decompression, a.k.a. traction therapy, as a primary treatment modality for herniated lumbar and cervical discs is well known in physical therapy (PT) and chiropractic. Over 50% of PT’s report using traction therapy as a primary treatment for herniated discs, especially conditions showing nerve tension signs. I believe up to 15% of DC’s now utilize decompression with 70% using Flexion/Distraction, primarily to affect disc and nerve conditions. Cervical traction is far more prevalent than lumbar traction, in both PT & DC practice, according to a recent survey by Hartte et al. However, both cervical and lumbar traction therapy tend, at least in the PT world, to be directed toward nerve encroachment syndrome (A condition with few other safe and utilitarian options).

Interestingly, lumbar traction has been completely usurped by disc decompression, even though they are one and the same. It is not far fetched to suggest advertising and marketing slogans are the primary differences. Decompression is the potential disc related outcome achieved during axial traction. The prime contingency being that the disc must be intact and hydrostatic (pressurized fluid). When axial tension is applied, a centripetal effect can enhance osmotic renewal. Movement of fluid and nutrients can expedite healing in many cases. This is typically referred to as molecular solute transport and the hydrophilic property of the proteoglycan molecules affords the nucleus its pressure deformation and resiliency characteristics. Keep in mind, decompression isn’t ‘table dependent’, it is an inherent action of axial elongation applied to an intact (hydrostatic) disc.

The primary clinical question is; why Decompression does not always work and why, if so theoretically valuable does it so rarely demonstrate dramatic efficacy in controlled trials? (see Cochrane collaboration; traction review 2006) That remains one of the most puzzling questions for those of us regularly using traction and convinced of its efficacy.

Traction (axial tension) apparently affords 3 potential outcomes:

1. Decompression...if the above mentioned criteria of disc patency hold true.

2. Stretch...creating pain modulation via mechanoreceptor/nociceptor pain gate mechanisms.

3. Directional preference...a range-of-motion that tends to centralize referral pain based on a potential migration or stress-shielding effect of the disc.

These actions-of-traction allow a theoretical answer to why a clinical outcome is attained from treatment. However, we don’t as of yet have the ability to know with certainty what is actually causing the pain and how traction is affecting it specifically. It remains largely theoretical and its benefits largely empirical. My experience through 15 years of clinical use and study of traction tells me it does offer improvement, often dramatically, in disc herniation conditions, with or without nerve involvement. I believe, it will become a primary treatment modality in chiropractic and is fast approaching a tipping-point acceptance.

 

RHD

 

 

Dr.-Michael-SchneiderDr. Michael Schneider has been a practicing chiropractor for 27 years. He has a PhD in rehabilitation science from the University of Pittsburgh where he presently is an Assistant Professor in the School of Health and Rehabilitation Sciences. Dr. Schneider has obtained a five-year Federal grant from the National Institutes of Health to conduct chiropractic research on low back pain

Rehabilitation involves the use of therapeutic exercises and activities to stabilize the spine. The evidence based approach to rehabilitation of herniated discs has two basic components:

1. Directional preference exercises to directly affect the disc

2. Stabilization exercises to improve function in the muscles around the disc

Direct treatment of the disc requires that the chiropractor pay careful attention to how various movements affect the patient’s lumbar and leg symptoms. McKenzie was the first to describe the centralization phenomenon, in which repeated movements cause a receding of leg symptoms proximally toward the spine. Old time chiropractors used the term "retracing" to describe the same observation of pain leaving the foot and slowly retracing back to the spine. When a particular movement causes centralization of symptoms, this is called a directional preference, and is thought to be mechanically causing movement of the herniated nucleus pulposis back toward the center of the disc. When the disc has herniated posteriorly, often repeated extension movements will drive the nuclear material anteriorly and reduce the sciatic symptoms. In patients with a lateral shift or antalgia, repeated lateral bending movements into the same side of pain will cause centralization. This concept was called "closing the open wedge" by some old time chiropractors.

Once directional preference exercises have helped to reduce the disc herniation and symptoms are centralizing, the next step is to stabilize the spine with rehabilitative exercises. Patients should first be taught the postural cat-horse exercise in order to be able to sense their "neutral position", which is the normal lumbar lordosis. Next, patients should learn how to tighten their abdominal muscles as if someone were to punch them in the stomach. This reflexive tightening of the abdominals is known as an abdominal brace, and immediately stiffens all of the muscles surrounding the spine. Finally, McGill talks about the "big three" exercises for spinal stabilization which consists of training these key muscle groups:

a) Partial crunches: Activates the rectus abdominis without flexion of the spine

b) Side bridge: Activates the oblique abdominals without rotation of the trunk

c) "Dog Pointer": Activates the erector spinae muscles without hyperextension

Most patients with herniated discs need to be careful not to aggravate their condition with exercises that are beyond their ability. This mistake is made in many physical therapy clinics who take a "no pain – no gain" attitude. McGill has shown that most disc patients do not require intensive strength training to stabilize their spines, with his research showing that only a 5-10% improvement in muscular strength is needed to greatly improve spine stability. Chiropractors can easily incorporate these directional preference and stabilization exercises into their practices without expensive equipment, and help many disc patients to improve.

NTDH

 

Dr.-David-SeamanDr. Seaman is an Adjunct Associate Professor at Palmer College of Chiropractic Florida, has a part-time practice in Ormond Beach, and is the Clinical Education Director for Anabolic Laboratories. He has written numerous articles on the treatment options for chronic pain patients, with a focus on nutritional management. He can be reached at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

For many years, we have known that the presence of disc herniation does not equate with the presence or severity of back/leg pain.1 It is also known that, substantial disc degeneration associated with a grade II spondylolisthesis can be pain-free.2 Thus, the first treatment technique should be to reassure the patient that disc degeneration, internal disruption, and herniation are common and often remain painless throughout one’s life. Reassurance, as a treatment, is important because we know that there can be a negative effect on outcomes when patients view images of their degenerated spine.3 The second treatment technique involves the realization that no treatment technique fits all patients and so there is no specific technique that is responsible for reducing herniations. Interestingly, if a patient does not have progressive neurologic changes and they can withstand the pain of discopathy, most herniated discs will resorb on their own within two to twelve months.4

In terms of managing patients with herniated discs, the goal should be to reduce the pain to a tolerable level, while the natural resorption process occurs. In addition to traction, manual procedures, and rehabilitative exercises, both dietary and nutritional supplementation may be helpful. While there is no specific "nutrition" technique for discs, it is important to realize that the pain process with herniated discs is no different than any other pain. Foods known to reduce inflammation in general include omega-3 fish, vegetables, fruit, and nuts. Lean meats and skinless chicken are also acceptable. Tubers such as potatoes are also anti-inflammatory, so long as they are consumed with the aforementioned low glycemic index/load foods. Foods that are less anti-inflammatory are whole grains, legumes and dairy. And foods that are overtly pro-inflammatory are refined grains, grain/flour products, sugar-rich foods, deep fried foods, trans fat-containing foods, and dressings/foods that contain omega-6 fatty acids from oils derived from corn, safflower, sunflower, cottonseed, peanuts, and soybeans. Ensuring adequate digestive function is also an important consideration. Bearing down during a bowel movement increases intrathecal pressure and can dramatically increase back and leg pain in those with disc herniations. In addition to eating anti-inflammatory foods, supplemental fiber such as psyllium husks can dramatically improve bowel habits. Meals should be spiced with ginger, turmeric, oregano, and other spices, and/or these can be taken as supplements. Not well known is that these spices have anti-inflammatory actions that are similar to NSAIDs. Three key supplements that can influence inflammatory and nociceptive processes include magnesium, vitamin D, and EPA/DHA, which are omega-3 fatty acids from fish oil.

These nutritional recommendations are known to reduce levels of inflammatory mediators in humans, and so should be considered in all of our pain patients.

 
Spinal Decompression and Traction- What Is The Difference?
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Written by Dr. David Bass, DC:, D.A.A.M.L.P.   
Friday, 21 August 2009 13:51

In the 20th century, the electric motor became part of our culture. The creation of intermittent power traction became a reality. This remained unchanged until Dr. Allen Dyer introduced decompression therapy in 1991.1

Dr. Dyer felt that, to reach the inner disc core, traditional traction needed modification.

Although intermittent traction is an effective therapy for elasticity, circulation, inflammation and facet movement, it did not adequately address the internal needs of the disc. In other words, to more effectively treat the intervertebral disc, the pull-release ratios needed to change. Dr. Dyer discovered and developed a unique pull-release pattern that proved more effective to the disc than traditional traction.

This was the creation of the "logarithmic pattern." Although it is technically a traction pattern, it is the only traction pattern classified as decompression.

Figure 1 represents the logarithmic pattern. Simply defined, it is a unique 100-second cycle comprised of a 60-second loading of the pull-force, followed by a 30-second unloading of the pull-force, and finishing with a 10-second rest. The cycle repeats itself for the 30-minute session.2

Logarithmic-Pattern 

Currently there are as many as 14 decompression systems. About half the systems are manufactured by independent companies. The others are manufactured by "outsource" manufacturers who cosmetically re-badge them to look different and retail under private labels as unique machines.

Pricing for the larger sophisticated systems ranges from $65,000 to $149,000. They all claim superiority but, in many respects, they are the same. However there are some distinct differences you should be aware of.

 Pull-Release Forces: All decompression systems create their pull and release forces using one of two available systems. They either use a modified "cable-winch" motor, or the more sophisticated "actuator" motor.

So what’s the difference?

The winch motor system is comprised of a cable wrapped around a spool like a fishing reel. Function wise, the cable-winch provides a satisfactory pull but it has very little control of the release value other than to simply unreel and "let go."

The actuator motor is a more sophisticated system, comprised of an internal gear attached to a long threaded axel shaft. The gear and shaft provide extreme accuracy in both the pull and the release. In addition, actuator motors can be manufactured with internal sensors that provide feedback to locate the position of the actuator shaft. This means the actuator has the capability of setting its pull-release forces by poundage (like cable systems) and by distance (only actuators can control distance). On a clinical note, patients with elongation limitations, i.e., post surgical, tissue sensitivity or geriatric issues, can be treated more safely using distance values. It is an excellent safety feature that should be consider when researching your system.

 Postures: There are three postures currently used in decompression. They include supine, prone and reclined sitting.

 

Postures

Because back pain is generally relieved in a reclined position, the majority of traction systems have been designed to treat patients either prone or supine. As equipment improved, there was little thought that went into improving or changing the reclined posture.

In the 1980’s, manufacturers began to improve their creativity by providing the ability to adjust the location or position of the pull-source. For example, tables with the ability to raise or lower the pull source, or shift the pull source to the left or the right, were introduced. Doctors began to realize that pulling the spine in directions other than straight had clinical advantages.

Flexion-distraction systems modified the pull-source position by adding the ability to move the lower extremities "along with" and "in the same direction" as the pull source. This was accomplished by hinging the source of the pull-force under the pelvis.

However, in 2005, the FDA cleared the first system that could treat the spine in a reclined "sitting posture." This was the first major change in patient treatment posture since the introduction of traction.

Science has proven that postures affect disc pressure. The vertical bar chart in Figure 2 shows how.

The bio-mechanical theory behind "reclined sitting" is based on vertebral-disc positioning. "When sitting in an upright weight bearing posture, the vertebral bodies are flexed onto the disc. This increases disc pressures more than standing. Therefore, if we can decompress the spine in a reclined "sitting" posture, we can create stronger disc vacuums than supine or prone.3

Simply stated, the postures that create the greatest disc pressures under gravity produce the greatest disc vacuums under decompression.

 Range of Motion: Range of motion refers to the motion capabilities of a joint. With respect to spinal decompression, range of motion refers to the ability to adjust and vary the spine’s posture during the decompression. The ability to vary and change the posture of the spine as you decompress the spine changes how and where the pull-forces move through the spine.

Combining spinal range of motion (ROM) with decompression is the newest addition to decompression. The ability to articulate the spine through its ranges of motion adds a new and sophisticated dimension to decompression.

If you are researching range of motion, the following planes need to be included:

• Vertical elongation of the spine,

• Flexion and extension of the spine,

• Lateral flexion of the spine,

• Rotation along the vertical axial plane,

• Translation anteriorly and posteriorly.

ROM features or articulating features provide three methods of treatment.

Pre-Postured decompression: This is where the spine is strategically pre-positioned based on X-ray or MRI to vary and improve the effects of the pull-forces through the spine. It can succeed where straight linear pulling fails.

ROM therapy: This is a therapeutic procedure that involves actively moving the spine through a series of postures while the spine is distracted, to restore or improve spinal ranges of motion.

Antalgic Decompression: This is where the patient is positioned into the posture of "least pain" prior to beginning of the decompression cycling.

Regarding axial rotation, the postures used with conventional Flexion-Distraction tables limit rotation because the patient is lying straight. Conversely, the flexed hip and knee posture of reclined sitting enables 90 degrees of lumbar-pelvis rotation because the posture simulates the lumbar side-posture adjustment.

Conclusion

There are many traction-decompression systems to choose from. With so many systems to consider, you must choose wisely. Look for the following features:

• Are the pull-forces created by actuator?

• Can the pull-forces be set by poundage AND distance?

• Can the ROM features provide at least 10 planes of motion?

• Does the system have "built in" patient safety features?

• Does the system have report writing software?

• Are there research studies on the system?

Dr.-David-BassDavid Bass, D.C., LAc, DOM, invented the articulating ROM Antalgic-Trak and is current President of Spinetronics the manufacturer of Antalgic-Trak. You can reach him at This e-mail address is being protected from spambots. You need JavaScript enabled to view it  or visit www.Spinetronics.com.

 
Achieving Longevity Through a Healthy and Drugless Lifestyle
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Written by Dr. Eric Plasker, D.C.   
Tuesday, 21 July 2009 17:27

 
Dr. Eric Plasker D.C

 Through the family practice, dr. Eric plasker helps chiropractors grow their practice and become life-style leaders in their community

Dr. Eric Plasker is a graduate of Life Chiropractic College and former owner of two highly successful family practices, where he practiced for 16 years.

In 2000, he founded The Family Practice, a personal coaching company that offers marketing and patient education programs which helped thousands of doctors grow their practices. As the author of the best selling book The 100 Year Lifestyle and, soon to be released, The 100 Year Lifestyle Workout, Dr. Plasker has defined a new health care model that includes chiropractors as leaders.

He is an official media correspondent for The American Chiropractor, who has generated over 70 million media impressions and counting for chiropractic through The 100 Year Lifestyle.

 

In an interview with The American Chiropractor, Dr. Eric Plasker tells us about his path to success in chiropractic and life.

TAC: Why are you so passionate about chiropractic and the message of lifetime care?

PLASKER: Chiropractic saved my high school football career and, through ongoing care, I was able to continue playing and excel in sports. My family has experienced incredible quality of life because of the chiropractic lifestyle.

From a practice perspective, the principles of lifetime care helped me to build two highly successful family practices that provide an incredible life for my family. And, through The Family Practice, I have seen thousands of doctors duplicate this success with their clinical results, their practice growth, and their financial success. I get nice letters from doctors and their patients all the time expressing their gratitude. This is very rewarding and fuels my passion.

TAC: Why do you think chiropractors are so successful with this model of practice?

PLASKER: Their success is very exciting. The doctors who we track are growing by a collective $20 million per year and they are becoming Lifestyle Leaders™ in their community. One doctor saw 52 new patients last month, without spending a penny on advertising. Several doctors just reported that, in the first quarter of 2009, they were up by over $25,000 compared to the first quarter of 2008, even in this down economy. That’s $100,000 increase for the year.

One reason for this is that these doctors are filling a very important void in our heath care system. There are no family doctors in the world of medicine anymore and people are searching for healthy, drugless solutions. Chiropractors who are practicing this model are meeting the demands of the public who are starving for answers.

You’ve heard the expression, "You should practice what you preach." Chiropractors need to do just the opposite. We need to start preaching what we practice. Most chiropractors are under regular chiropractic care, and so are their families and their teams. When doctors focus this practice around their truth, they begin to attract five, ten or even twenty new patients at a time, instead of just one at a time, because they are attracting families. This could be the traditional family which includes mom, dad, kids, parents and grandparents or it can be the inner circle family, which includes your patient’s friends, co-workers, sports community or religious affiliations. This leads to immediate and lasting growth for a practice. These patients stay for life. They value their care and are willing to pay you, regardless of third party involvement. You become their primary care doctor and they will pay you for life, so you don’t have to worry about new patients all the time. This gives many doctors the stability that they have been so desperately searching for, and it sure beats accumulating an office full of inactive files.

TAC: The 100 Year Lifestyle has become a bestselling book that has gained incredible media exposure for chiropractic and for chiropractors. Why did you write it?

PLASKER: To the world, The 100 Year Lifestyle is a book that people love to read, share with their families and use as a reference guide for healthy living. I am honored by its success and I love that it is changing so many people’s lives. This is one reason why I wrote it. The second reason was as a strategy, and that strategy is to create a brand new health care model, in a world of extended life span, that includes chiropractors as leaders.

Many people are unaware that 100-year-old people are one of the world’s fastest growing segments of our population. Unfortunately, they were blindsided by their extended life. They are outliving their life expectancy—which was only 50-years-old when they were born—by a staggering five decades and they are suffering because of it. Our generation is the first generation in history that is getting the advance notice that we will probably live longer than we ever thought, whether we want to or not.

There are 79 million Baby Boomers who are seeing their aging parents and grandparents deteriorate and end up in nursing homes and they are thinking to themselves, "Wow, I have their genes, but I don’t want to be like that when I am that age." The 100 Year Lifestyle uses what we call this Leverage of Longevity to motivate Baby Boomers to make lifestyle changes now, in the present, for themselves and their families, so they can age differently than their parents and grandparents, and make the most of their extended lives. Obviously this includes chiropractic care to keep their spines and nerve systems healthy for life.

TAC: When you work with families, do you have a hard time getting everyone involved?

PLASKER: If families are an afterthought for you and your team then, yes, you may struggle with getting everyone involved. However, if it is a core part of your procedure, your marketing, and your clinical skill set, you will attract them naturally.

The target market of The 100 Year Lifestyle is Baby Boomers and, in particular, Baby Boomer women. Women buy more books and make the health care decisions for their families. When you get the Baby Boomer women plugged into this model, you will get the entire family under care right away.

TAC: Can you tell us the significance of The 100 Year Lifestyle brand and how doctors can utilize it?

PLASKER: Over the past 2 years, The The 100 Year Lifestyle has generated over 70 million media impressions through television, including CNN, TBS, Movie and a Makeover, FOX, ABC and NBC, hundreds of radio interviews and print media ranging from small local newspapers to Family Circle and Women’s World magazines. Doctors are co-branding with The 100 Year Lifestyle through our licensed marketing and training programs to build their practices and become Lifestyle Leaders in their communities. Co-branding is a very important business strategy, especially in this economy. Think about FedEx Kinko’s, Microsoft/Intel, Delta/American Express, Apple/ATT, and the NFL/United Way, to name a few. The list of strong co-brands goes on and on. Co-branding with The 100 Year Lifestyle helps doctors stand out in the health and wellness crowd.

Since wellness has become such a confusing mess and, in the mind of the public, includes everything from cancer treatments, wonder drugs, massage, beds, nutritional supplements and chiropractic care, just to name a few, The 100 Year Lifestyle brand gives chiropractors the edge ahead and provides them with turn key co-branded marketing and training resources to help them grow. All of the co-branded marketing is very high integrity and includes simple implementation strategies such as newsletters and very creative patient handouts to power point presentations, flyers, gift certificates, media campaigns, ads and more. We often use themes to target specific groups of people including families through our Healthy Generations Campaign, corporations through our Stress Less, Live More Campaign, women and men through our Go Girl and Stand Strong outreach programs, athletes, kids and so on. These campaigns are extremely effective and are producing great results for doctors. It saves them hundreds of hours and thousands of dollars that it would take to put marketing like this together, plus they get to capitalize on the media impact of The 100 Year Lifestyle brand. This Family Practice Program also includes training and implementation support and can be viewed on our website.

TAC: You have developed a Certification Program which is being implemented by the California Chiropractic Association, with many other associations considering coming on board as well. What is the purpose of this Certification Program?

PLASKER: We created a brand new health care model for a world of extended life spans that includes chiropractors as leaders. I am excited about this program because, in working with the state and national associations, we are creating clinical excellence in this model which, combined with the co-branded marketing, can cause social change. We will not only train doctors to deliver chiropractic care through this model but we will also be able to raise the resources through the associations that will enable us to pass laws for our profession and cause social change. I have traveled around the world for the past ten years helping chiropractors grow and have been very fortunate and successful. Now, for the next go around, we will, through this growing and very recognizable brand and our collective efforts, elevate social consciousness around the issue of longevity, human performance and chiropractic. The best part is that it is working across the board.

TAC: Do you have any plans for building your brand in the future?

PLASKER: I believe that, for chiropractic and chiropractors to be relevant during this time of rapid health care transition, we must be leaders in the areas of longevity, fitness and human performance. The soon to be released 100-year Lifestyle Workout will tell America and the world that, if you want to live an active, healthy, long life, then you must Get Your ESS in Shape. The ESS stands for Endurance, Strength and Structure, and all three are essential if you want to have quality of life as you age. The fitness industry is poised and positioned to lead health care. They have all the research. The structural component of the ESS, which obviously includes the spine and chiropractic, is a critical piece and is at the core of this model. The chiropractors who are implementing this in their practices now are booming and building relationships with fitness centers, personal trainers, nutrition companies, corporations and municipalities to deliver this very effective, fun and important message.

TAC: So, you mentioned that several figures have endorsed your program; could you mention some of them?

PLASKER: Everyone. This has been very exciting and humbling. In addition to being endorsed and utilized by thousands of chiropractors and endorsed by doctors in nearly every chiropractic association and college, it is being endorsed by individuals such as Jack LaLanne, Stedman Graham, NFL Grammy Winner Great Roger Craig, Olympian Terry Schroeder, and Usher, as well as companies and associations such as Foot Levelers, Gold’s Gym International, Les Mills International (creators of BodyPump), and the National Academy of Sports Medicine, to name just a few. The list is growing every day as chiropractors spread the word and attract business and community leaders in cities around the world.

TAC: What is your ultimate vision?

PLASKER: My vision is to create a healthier world through this new health care model. Through the public relations and media capabilities of The 100 Year Lifestyle and the on-the-ground delivery of chiropractic care through doctors, we will reach the masses. I believe that the combination of these elements is essential to the success of the individual doctor and our profession. I am very grateful to The American Chiropractor for their leadership in bringing this message to the profession.

Dr. Eric Plasker can be reached at www.thefamilypractice.net, www.100yearlifestyle.com and www.twitter.com/Drericplasker or 1-866-532-3327 x109.

 
Dr. Lester Bryman & The 50 Year Evolution of Nutrition Response Testing
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Written by Susan Karnovsky   
Wednesday, 24 September 2008 16:37

In 1958 he was the Only One….

Fifty years ago, when Dr. Lester Bryman began his career, he felt like he was the only practitioner in his field that thought or talked about a nutrition oriented practice: No one he knew ever wondered about the therapeutic value of eating, let alone that whole foods (non-processed products) were healthy and non-foods were bad.

In 1959, he moved into his first small office in the Bronx, which he shared with his older brother, Dr. Larry Bryman. Together, they practiced straight chiropractic. It was simple and straightforward. People came in. They got an adjustment. They came back. They got great results…and he experienced many miracles. But he still felt something was missing.

One afternoon—he remembers the exact moment—he made a decision to introduce nutrition into his practice. "I was looking at two identical cases," he said. "One was doing great and the other was very similar—but with no results at all.

 "I questioned both patients. One ate only really good foods. The other was on a diet of soda, candy, cake, and ice cream, etc. I thought, no wonder no results. So I got the sugared-up patient to gradually cut the sugar out of his diet, and the positive results came right alongside."

Bryman applied this simple solution to all his cases that were failing or not moving ahead fast enough. Almost all started to improve.

In 1968 he found the key: Combining Nutrition and Chiropractic

In 1962, Bryman added Parker Chiropractic Procedures to his practice. "Simply put," he said, "Parker showed me how to present a report of findings to my patients which gave them a choice of treatments; they chose one which they would agree to do and, then, they’d get well."

That simple procedure boomed Bryman’s office. In 1965, he bought a beautiful building down the street which was set up to see a hundred people a day, very easily. He was still doing straight chiropractic, still no insurance cases, and still intensely interested in nutrition.

However, Bryman began to see a problematic pattern in the chiropractic preventive care he was providing. During the first decade of his practice, his adjustments helped his patients; almost one for one made excellent gains. But, by 1968, it became obvious to Dr. Bryman that preventive chiropractic care was becoming less effective. The adjustments would not hold quite as well as they did years earlier. He knew that there was something missing, and he was certain that combining nutrition and chiropractic was the key.

In 1967, Bryman opened another practice in White Plains, New York. He was still a straight chiropractor, but was always seeking to learn from other successful chiropractors who were older and wiser. He noticed a common thread: They all had a prepayment system that required their patients to buy a package of care (basically offering twelve visits for the price of ten). This plan allowed the patients enough time and opportunity to get real results—and, by doing so, Bryman discovered he now had time to help his patients with their diets. His practice boomed.

By 1978, Solutions Were Revealed: Helping the Body Heal Itself

In 1970, Bryman attended his first nutritional-chiropractic seminar, Dr. Herbert Anderson’s Applied Kinesiology. He said, "I was very impressed with the theory and application of muscle testing and experienced personal gains as well. The instructor noticed that I had a sty in my right eye. He gave me three Thymex tablets from Standard Process," the company he still uses to this day. "He asked if I would take them for my sty and report back to him the next day.

"My sty had been there for three months and I really did not expect that it would go away in one day. However, it disappeared in 24 hours, just from taking the exact right nutritional product. Well, that really got my attention and, from that moment, I never looked back. I knew I was on the right path."

By 1988: Working with the Technology of Nutrition Response TestingSM

Bryman sold his White Plains office, gave his Bronx office to his older brother as a gift, and sought to work with the very best in the field. George Goodheart, DC, and Dr. Herbert Anderson, DC, both outstanding Applied Kinesiologists, shared their knowledge openly; Frederick Keck, DC, taught Bryman about upper cervical technique. He met Dr. Herbert Smith, DC; Dr. Ray Behm, DDS; and Dr. Freddie Ulan—the one individual who has taught him the most. Together, he and Dr. Ulan set up a practice in Glen Falls, NY, where they developed Nutrition Response Testing.

Bryman describes Nutrition Response Testing as "a system that any clinician can learn and apply with great results. It is completely duplicatable. It identifies ‘neurological switching’ and ‘blocked Autonomic Nervous system malfunction,’ the two primary states that prevent the body from working normally to allow healing to occur. This opens the door to nutritional handling at a NEVER before level of healing ability.

 "Additionally, due to Nutrition Response Testing’s workable technology, doctors in training are continually improving on the healing processes through nutritional handlings. For example, on a visit by visit basis, one can handle metal detox and chemical detoxification to verify detoxification, not only if it is happening but at what rate and speed, for complete controlled handling with no adverse reaction."

1998 and Onward: Creating a Healthy Future

A valid and effective system to determine nutritional needs is needed today more than ever. The vast majority of people no longer buy nor eat real foods purchased fresh from Mom and Pop stores, like Bryman’s dad’s Kosher Butcher shop. Back at the start of his career, Bryman remembers, "Folks bought enough to eat for just three days or so, everything fresh. Over the years, food has progressively degraded, to the point where, today, everything you get is packaged, filled with additives and preservatives that actually make you sick."

There are fewer healthy foods available now. Also, people have been progressively indoctrinated into eating the new fast foods, like McDonald’s, Pizza Hut, etc. Bryman says, "They do not know the difference between foods and products. Sadly enough, people think this food is better, or they don’t even give it a second thought.

"That’s why children today, as a result, are getting weaker and weaker and more susceptible to dis-ease, (a word coined by D. D. Palmer, meaning lack of innate healing ability which manifests as abnormal function). So, a body gets a normal reaction to an abnormal processed product which is dis-ease."

2008 and Beyond… Nutrition Response Testing’s Workable Solution

"It was clear to me, at that time," Dr. Bryman says, "that there were few, if any, nutritional courses that had components that permitted direct application of a technology which one could use immediately to get results. The answer was Nutrition Response Testing."

Nutrition Response Testing is taught in an extremely well organized and thorough training program, available in seminars around the country. These programs enable practitioners to immediately apply what they learn in order to restore their patients’ own innate healing ability.

Bryman says "There are training DVD’s and CD’s available that present specific cases that clinicians can study in their own homes and become better and better. After all, it is a Science and an Art; therefore, it must be practiced and studied.

Nutrition Response Testing is clearly at the forefront of today’s chiropractic wellness movement.

For more information on Nutrition Response Testing, contact Dr. Bryman at Ulan Nutritional Systems, Inc., by calling 866-418-4801 or e-mailing This e-mail address is being protected from spambots. You need JavaScript enabled to view it . "NUTRITION RESPONSE TESTING is a Service mark owned by Freddie Ulan."

 
Sports Chiropractor Specialist Gerald R. Mattia, D.C. Shares his Secrets to Success
Cover Stories
Written by Gerald R. Mattia, D.C.   
Wednesday, 27 August 2008 10:09

With over 175 professional athletes under care (as well as the CEO’s of major corporations such as Tupperware and Harris Corp.), Dr. Gerry Mattia shares his secrets to success.

Gerald R. Mattia, B.S., D.C., has thirty-one years of experience as a chiropractic physician. He earned his chiropractic degree from New York Chiropractic College in 1977, and has been a member of the International Chiropractic Association for more than thirty years and a member of the Board of Directors of the ICA for twenty years. He was named Chiropractor of the Year and Sports Chiropractor of the Year and was appointed to the Board of Chiropractic Examiners by the Governor of New Jersey. He is presently serving as President of ICA’s Council on Fitness and Sports Health Science.

Dr. Mattia describes his clinic as high tech where the adjustments are the core procedure in the office with a good percentage of the practice geared toward maintenance chiropractic care. In his practice, he utilizes several chiropractic techniques, including decompression therapy, specializing in disc problems in the low back and neck. He travels the country speaking on this subject.

Dr. Mattia practices at Mattia Chiropractic Wellness Center with his wife, Paulette Mattia, D.C., and their nephew Brian Moriarty, D.C.

In an interview with The American Chiropractor (TAC), Dr. Gerry Mattia talks about his history and practice particulars that have helped him achieve such a successful practice.

TAC: What was it about chiropractic that got you interested in the profession?

Mattia: Chiropractic saved my life. I was born with Aortic Stenosis of the heart. My parents were told that I would live to about the age of seventeen. The first seventeen years of my life, I spent many hours in St. Michaels Hospital in Newark, NJ.

In 1968, doctors wanted to perform open heart surgery on me; the success rate at that time was one percent. My cardiologist told my mother to cancel the operation. He thought, at least she would have her son another six months.

I also had allergies. Our neighbor told my mother that her son went to a chiropractor and his allergies went away.

 I started chiropractic care three times a week for six months with no results. Finally, my allergies cleared. I was still alive and feeling better than I had in the past. I kept going to the chiropractor. A year later I had another cardiac catherization, and the results confused the cardiologist because my aortic valve stopped closing. I knew that day that I was going to be a chiropractor. Chiropractic saved my life.

TAC: What type of patient makes up the majority of your practice?

Mattia: The professional athlete is a major part of my office as is chiropractic maintenance care for all ages. Over the last couple of years, we’ve developed a reputation in spinal decompression. We now have patients flying in from all over the world to have decompression on their lower back and cervical region. Most of our patients, today, have some sort of disc problem. We specialize in difficult cases.

 

TAC: Is Sports Chiropractic something you envisioned yourself doing when you started?

Mattia: When I first went into practice, the last thing on my mind was sports chiropractic. I was interested in becoming successful. Back in 1977, chiropractors were not well accepted. My partner, Dr. Susan Guarino, and I wanted to change that. We did patient education classes every week and rented a hall once a month to educate people in chiropractic. The athletes came later in the practice. I never forgot, however, what it was that got me into chiropractic in the first place, and for the first twenty-five years of practice, I had a policy in which I’d treat all patients fifteen years old and younger at no charge. That was my way of giving back.

 

TAC: Could you tell our readers how exactly you have been able to tap into the professional athlete market so effectively?

Mattia: I have a passion for sports. I enjoy watching and playing sports. I never tried to get professional athletes as patients. I tried to be the best in chiropractic. I always worked on referrals. It happened one referral of an athlete lead to another, to another, to another, which has led now to several hundred professional athletes, from Major League Baseball, NFL, NBA, PGA, LPGA, European Golfers, to professional wake boarders. This is great for our profession that athletes such as Johnny Damon, Duane Clemons, Barry Larkin, and Trevor Immelman, 2008 Masters Champion, recognize our profession and its value to their health. But, let us not forget the value of every mother, child and father that has chosen chiropractic as their choice of health care. Those are the people that make our profession successful.

 

TAC: Do you prefer one technique over another? If so, why?

Mattia: All techniques work, but not all patients accept each technique the same. Diversified, Gonstead, and Thompson Terminal Point have been used the most. For patients who come in with an antalgic lean, SOT Cat 3 is used. Activator and Toggle Recoil have been used. The techniques which allow me to put my hands on patients have been used the most. An innate sense instills in me that we’re on right path to their health.

 

TAC: Do you see value in Spinal Decompression?

Mattia: When Vax-D came out in the early 1990’s, I saw little value because of the low success rate. With the development of new decompression companies, like other technologies, as time passes results have improved. Using decompression for the past several years led me, along with Dr. Eric Kaplan, to develop protocols for greater results. With our success rate on bulging, protruded, herniated and degenerative discs, my practice has drastically changed. We have patients fly in from all over the world for decompression. Right now, our farthest traveled patient has come from New Zealand. With a favorable success rate using decompression, we have treated people from England, Spain, Australia, South Africa, Germany, Netherlands, India, France, and Italy.

 

 

Decompression, along with the adjustment, has also given us an edge with athletes.

 

TAC: Is there any mentor or one specific person that has really shaped you to be the doctor that you’ve become?

Mattia: First, I would have to say my parents. They were my teachers in life. They inspired me to always do my best, taught me right from wrong but, most of all, they instilled in me a passion to help other people. My parents gave me values. Values are everything.

In chiropractic, Dr. Tom Whitehorne made me understand the philosophy and principles of chiropractic. His passion for chiropractic was great.

 Next, was Dr. Bill Remling. I worked for Dr. Remling when I was a student. He finished his office hours late every night. He would then stay and teach me techniques and talk over office situations and how to handle them, so I could learn. I thank God every day that He sent these people into my life.

 

TAC: What are you plans for the future?

Mattia: I would like to develop equipment that will aid chiropractic practice. I believe we have to embrace technology yet keep the chiropractic adjustment as the core of the practice. I presently work part time four afternoons a week. Over the next three years, my nephew, Dr. Brian Moriarty, will take over more and more of the operations of the office. He has been working with us since he graduated and has been welcomed by our patients.

Our patients have come from different areas of the world to experience our office. I would like to travel with my wife, Dr. Paulette Mattia, and visit some of the places they have come from. I would like to speak on chiropractic and share my story.

 

TAC: What is the most common problem you see among chiropractors today?

Mattia: I love chiropractors and chiropractic. What troubles me is the lack of confidence some of the chiropractors have today and what chiropractic can do for the world. There needs to be a passion for the profession. Too many treat it as a job. Unfortunately, the insurance industry is not favorable to chiropractic, so we cannot base our practices anymore on reimbursement. Health care is turning back to the responsibility of the consumer. More and more chiropractors must become non-participants in reimbursement plans or they will not have the freedom to practice as they choose.

 

TAC: What is the biggest problem or challenge you see in the chiropractic profession today?

Mattia: Doctors of chiropractic embracing technologies and becoming independent of the reimbursement networks and insurance industry. Patients are willing to pay for something they believe to have value.

 

TAC: Can you think of one change that a chiropractor can do to significantly impact his/her practice’s growth immediately?

Mattia: Market your office and your profession. Most other professions and industries do this. We have done it with spinal decompression in our area. We have used infomercials with professional athletes. We have a valuable commodity to offer people. We must market our value.

 

TAC: Do you have any recommended marketing strategies that chiropractors can do to attract new patients and to keep current patients?

Mattia: Get out in your community. Be the doctor that everyone is talking about. Use marketing to your advantage. Dare to be different. Make sure your skills as a chiropractor are fine tuned.

Just as an athlete trains and practices before an event, we must prepare to take care of our patients. Believe what you do for your patients cannot be done anywhere else.

 

TAC: Dr. Mattia, I understand that you’re very hands on with the equipment utilized in your practice and that you’ve assisted with the development of several different tools. Can you tell us about that?

Mattia: Yes. Over the years, while looking for the right tools to better serve my patients, like many chiropractors, I’d find that sometimes the right tool just didn’t exist yet. While working with professional athletes, I’d find that doing the right thing isn’t enough, but you need to have the right technology and documentation to show the clients just how much they are improving with care. Athletes are goal-oriented people and like to have a plan from start to finish to show their progress. This is what led to my work with K-Health in helping to develop the R.O.M. device that I use on my athletes. With athletes, of course, rehabilitation and exercise are important components, which is why I do rehab geared at the core muscles and connective tissue with protocols and equipment which I helped to develop. My most recent involvement has been with Disc Force for decompression therapy. I got together with the engineers of the Disc Force company and they were very receptive to making changes to improve the equipment for better patient needs and standards. From my experience, working with my own decompression tables, it is an undeniably beneficial treatment method for spinal conditions which has helped me with patients of all kinds, not only athletes, but CEOs, and all patients.

So, maybe I’m a bit of an overachiever, but I believe in being the change you want to see in the world. If the tool doesn’t exist, then make it! If you don’t have the time to make your own tools, then at least look within chiropractic to build off the work of other chiropractors before you, so you don’t have to start from scratch.

 

TAC: Where do you see the future of chiropractic headed?

Mattia: I wish I could look into a crystal ball and see where chiropractic is headed. With the healthcare industry changing, I cannot really say. However, with the value chiropractic has for its services and results we get for our services, the public will be ready to pay. The reimbursement system has changed.

Will socialized healthcare be part of our future? I never understood how healthcare could be part of the government. Medicare is not the panacea for seniors that it was envisioned to be. Chiropractic has withstood many challenges for over 100 years.

 

TAC: Thank you, Dr. Mattia.


To contact Dr. Gerry Mattia, you may call his clinic at 407-909-4788 or email him at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

 

 
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