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Success Enhanced with Axial Decompression
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Written by Dr. Richard E. Busch, III, D.C.   
Saturday, 03 March 2007 11:43

Dr. Richard E. Busch III, a second-generation chiropractor, has been in practice for almost eleven years. Busch Chiropractic is a cash-based, single practitioner, blended practice of standard quality chiropractic care, personal injury and pain center, focusing on chronic low-back and cervical disc cases that are facing invasive care, such as surgery, or have had previous failed surgeries.

Many of Dr. Busch’s patients have seen two to five other doctors previous to being seen at Busch Chiropractic. They have been treated with heavy steroids and other anti-inflammatories. They are on narcotics, anti-depressants, and anti-seizure medications that are prescribed for back pain. Some have had physical therapy, more have had epidurals and many have failed back surgery syndrome.

Dr. Busch has, based on years of treating successfully with axial decompression and chiropractic care, developed a unique and customized protocol for this type of patient.

Ten years ago, he incorporated one axial decompression system into his treatment protocol, which allowed him to treat severe and chronic low back disc patients. Today, he has a total of six such systems. In an interview with The American Chiropractor (TAC), Dr. Richard Busch III (BUSCH) shares some of the secrets that have helped him develop one of the largest axial decompression clinics in the United States and, perhaps, the world.


TAC: Dr. Busch, give our readers some background information on yourself.

Busch: I attended Indiana University in Bloomington, Indiana, for undergrad work and then Parker College of Chiropractic. I graduated in January 1996 and was married to my beautiful wife, Jennifer, in March. Then, in April of 1996, we opened the Busch Chiropractic Clinic in Fort Wayne, Indiana, just a few miles from where I was raised. It was a great year!


TAC: What inspired you to become a chiropractor?

Busch: My father was a wonderful chiropractor and, from the time I can remember, I was intrigued and I knew I was going to become a chiropractor. I had the opportunity, even as a child, to have met some of chiropractic’s greats.

I have five siblings and we were all treated with regular chiropractic care, almost exclusively. We were the healthiest bunch of kids you could ever have known. We fit the study that indicates children of chiropractors have less illness.


TAC: What are the top conditions patients present with in your office?

Busch: Lumbar herniated or degenerative discs, cervical spine herniated or degenerative discs, headaches, chronic pain patients that have been everywhere, even Mayo or the Cleveland clinic.


TAC: What are your specialties?

Busch: I specialize in the treatment of chronic pain conditions.

Nothing pleases me more than working with difficult and challenging disc conditions and the treatment of the related chronic pain. I have dedicated my life and practice to this. Axial decompression therapy has extended my abilities to treat, with positive outcomes, severe and chronic low back pain and neck pain patients.

I became interested in axial decompression as the result of having the opportunity to speak extensively with Dr. Norman Shealy, a well-known neurologist. Dr. Shealy played a major role in the development of decompression therapy. I also have a great friend, Dr. Jack Ashton, who had a very large and successful decompression practice in Indianapolis.

The technology of decompression made total sense to me, and I had patients that were not responding to standard chiropractic care. I was going to refer them to an orthopedic group. Instead, I went forward with adding a DRS™ axial decompression system. The rest is history. We are now treating patients in my office with six decompression systems from various manufacturers. Over time, I developed a unique and customized low back and cervical protocol and procedure, which employs axial decompression with chiropractic care as the center.

This protocol has greatly enhanced outcomes. We have severe and chronic patients that drive or fly in from other states and stay with family, friends or at a hotel and then go home on weekends. When the chronic patient has positive outcomes, their friends, co-workers and family members also become patients.

My clinic is very strong on protocol and procedures. Even though each patient is unique and is treated with customized care, there are core components and elements that are the foundation of each patient’s care.


TAC: Which techniques do you use and why?

Busch: Diversified, Activator, Thompson.

I believe in being proficient in more than one technique because not all techniques work for all patients. I use Diversified because I just prefer to treat that way and that is the way my father treated. Activator is best for older more delicate patients and patients with extremely chronic pain. Thompson is a good technique to treat low back disc conditions with low-force and no rotation.

The majority of chiropractic patients will respond to the myriad of adjusting techniques; but I saw the real need to incorporate axial decompression for the chronic disc problems that don’t respond to standard chiropractic care.


TAC: What type(s) of diagnostic testing procedures do you use and why?

Busch: The Physical Exam is an extremely important part of every patient’s evaluation. I feel it is almost a lost art and the findings are significant in the patient’s treatment plan of care.

Also, I see a large percentage of patients who have had MRI’s and X-rays in the past, because they are coming from the typical medical low back and neck pain pipeline (i.e., general practitioners, pain medications and anti-inflammatories, physical therapy, ortho/neurosurgeons, epidurals, surgery, pain management). If the films are not current or have not been taken, I require a new set of X-rays. X-rays are imperative, because we want to be certain we can evaluate the patient’s condition completely, so that we have total understanding of exactly what the patient has going on.

I use a computerized analysis of muscle strength and range of motion, predominately in the documentation of personal injury patients, and digital motion X-ray which analyzes for soft tissue injury and ligamentous instability—also very valuable for personal injury documentation.


TAC: Tell us one or two of your most amazing patient success stories.

Busch: It’s difficult to narrow down all the success stories but the following are just a couple good examples of what keeps me inspired!

NH, a 78-year-old female, married, high school graduate, rarely used caffeine, no tobacco and no alcohol. She had a history of heart problems: a current triple bypass and two angioplasty procedures. She had a left hip replacement, right carotid surgery and right shoulder surgery. She came in using a walker and had to lie down during the entire first visit as well as the second visit which is the report of findings. Her diagnoses were intervertebral disc syndrome and degenerative disc disease with radiculitis.

The chief complaint was pain of low back, right pain the right buttocks, hip, and anterior thigh. Pain scale was 6/10 with pain medications and 9/10 without. Symptoms had been for 3-4 months and had increased in the last three weeks. She had flipped a mattress three weeks prior to being seen, and had fallen twice in the prior three weeks. Pain was decreased by pain medications and lying flat and increased when sitting and standing during the day. Previous treatment had been epidurals, pain medications, and steroid injections. She was under the care of an orthopedist who had recommended surgery.

After being treated with the low back protocol with axial decompression and chiropractic as the center of care, she no longer required any walking aid. After a normal series of treatments, she achieved 95 percent sustained improvement and was back to normal daily activities. She has maintained this improvement and is now an active chiropractic patient of ours.

Then there’s JB, a 57-year-old married man with some college education, a business owner who smokes two packs of cigarettes a day, denies using alcohol and drinks nine cups of coffee a day. He had been run over by a car in 1984 and has had three lumbar spine surgeries, over the last twenty years. There had been recurrent problems for twenty years. Recent symptoms were present for three to four weeks. Pain improved with massage, pain meds, lying down and stretching and was exacerbated by most activities such as walking, standing and sitting. Previous diagnosis had been degenerative disc disease. Previous treatment included epidural injections, pain medications, physical therapy and surgery of the lumbar spine and the then-current orthopedic doctor was recommending fusion.

The chief complaint was pain of the lumbar back and the hip. Pain in the right leg and low back had escalated in the last month. His pain level was a 7/10 with pain medications. His diagnosis was degenerative disc disease with radiculitis.

After a series of treatments with the low back protocol of axial decompression and chiropractic care, he achieved a pain-free life style and was even able to resume riding motorcycles, which was an integral part of his business life and personal life.

TAC: What has really impacted your growth as a chiropractor and that of your practice?

Busch: My strong partnership with my wife, Jennifer, and our desire to help the severe and suffering patient; and, also, our shared belief in the integration of chiropractic and axial decompression as a part of the care for chronic low back and cervical patients.


TAC: What marketing strategies do you use to attract new patients, and to keep current patients?

Busch: To attract new patients, from our statistical tracking, now a majority of our new patients have a combination of responses: They know of someone, who is or has been a patient, and they also have seen us (for years) on television or they have been referred by another physician.

Marketing is a complete subject on its own. We write our own news releases, radio and television commercials, print ads, etc. We know our practice the best. We do enlist the help of professionals on the production-side of things—that is filming and interviews. We have one of the best infomercials—I don’t mind saying—that I have ever seen. You can check it out on our website at

To keep current patients, you need to have the highest standards of care, office and employee appearance and procedures and, of course, positive outcomes. We treat our patients as if they are guests at a Five-Star Hotel. We have a patient liaison who does everything for the patient, including filling out paperwork.


TAC: What single piece of advice would you give a new chiropractor just starting out?

Busch: Be aware or beware—the new letters (D.C.) behind your name may have distorted your senses about the reality of what has to be done to generate new patients.

Yes, you are a doctor now. But the reality of that is spelled W-O-R-K and W-O-R-K is outside of your private office door and outside of your clinic.

W-O-R-K means you have to get out and do all hard things that you don’t really want to do, and you may not reap the rewards the same day!

Don’t become dependent on insurance; develop a predominately cash based practice and always be willing to recreate your practice, yourself and your life.


TAC: What general advice would you give an established chiropractor whose practice might be struggling?

Busch: Well, perhaps, just start over with your thinking. Take a critical assessment of your practice from top to bottom. This includes your employees and their thinking. Recheck your business plan and, if you do not have one, create one. Meet with others in business, even if it is uncomfortable; allow them to help you assess your position. You may not be struggling as much as you believe. It may just be a temporary "cash flow" crunch. Go back to the basics of what works to generate new patients. Even though you are an established business, you always need new patients.

Work to regain your inspiration. Listen to inspiring messages: those messages may come from your church, motivational speakers on CD’s and DVD’s, your family—and that includes your parents. Do whatever you can to get rid of "stinking thinking;" regain your love for your patients and, remember, you have the ability to improve their lives. Regain the proper motivation for your professional life: patient well-being first and "Exchange in Abundance." Again, be willing to recreate yourself, your practice and your life.


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

Busch: I see more research demonstrating even more the efficacy of chiropractic care.

Because healthcare has become consumer-directed, chiropractic should directly benefit from that. The use of the internet and the ability to research conditions and/or symptoms has empowered the patient.

The internet provides the ability for the public to research, chat and blog about the side-affects reported and/or even unreported of prescribed medications and success rates of medical procedures and surgeries. As public knowledge increases, the public’s opinion will continue to change concerning their role in their own health and their own healthcare—which positions chiropractic well. And referral rates from the medical community will increase as back and cervical pain patients demand to be seen by a chiropractor before they see a surgeon and take addictive medications.

Also, chiropractors will be strongly established in cash practices, as will many medical practices, because of managed care, reduction of fees, reduction of number of visits and the continuing increase of insurance premiums and deductibles.


TAC: Any final words for our readers?

Busch: Continue to provide the highest standards of care, strive for inter-professional relationships, and establish niche practices (do what you believe) within your practice, such as nutrition, axial decompression, personal injury, etc.

Dr. Richard E. Busch III, may be reached at Busch Chiropractic Pain Center, 5005 Riviera Court, Fort Wayne IN 46825. Call 888-DRS BACK and/or visit or


The Zen of Dr. Zinberg
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Written by Elisa Zinberg, D.C.   
Thursday, 01 February 2007 16:38

One of the top female wellness executives and consultants in America, Dr. Zinberg was an entrepreneur and private practitioner prior to joining The Masters Circle in 2000.  She also serves as the company’s director of its Chiropractic Assistant (CA) certification program and now leads day-to-day operations, overseeing coaches, seminars, and product development.

Elisa Zinberg exemplifies the spirit and dedication of The Masters Circle to empower chiropractors, wellness professionals and their assistants in creating the practice and lifestyle of their dreams. She is a true asset to the profession, widely recognized as one of the finest minds today in wellness initiatives, and admired for her ability to connect on a very personal basis with audiences as well as business colleagues.  

Complementing her position as COO, Dr. Zinberg is also a scheduled seminar speaker for The Masters Circle, who addresses a variety of cutting edge topics that are germane to professionals.  Known for her style, energy and wit, she communicates valuable information and is often sought after for speaking engagements before distinguished wellness organizations nationwide, as well as presentations for leading financial and management colloquium.

Previously, Dr. Zinberg ran a large volume, subluxation-based, cash-only practice in Manhattan for eleven years. A career at The Masters Circle enables her to assist colleagues in achieving their practice goals. This new role allows for targeted input into shaping programs and services to be of even greater value to The Masters Circle members and the profession.

Dr. Zinberg earned her undergraduate degree from Franklin and Marshall College, Lancaster, Pennsylvania, and her Doctor of Chiropractic degree from New York Chiropractic College.  She is licensed in Florida and New York, and is nationally board certified.

TAC: What inspired you to become a chiropractor? Do you have a specific story?
Zinberg: From the time that I was a teenager, I always knew that I wanted to go into healthcare and become a professional that serve the needs of individuals.  My oldest brother, Scott, is a chiropractor, and he was certainly an inspiration. My father was an optometrist, and always encouraged me to help people.  His guidance and example stirred my interest in becoming a health care professional.  

Early on, I was an athlete and always enjoyed the excitement of healthy competition.  While at college, I participated in basketball and softball, but suffered an athletic injury.  Thanks to chiropractic care, I made a great comeback and was able to enjoy these sports once again.

When I entered the profession, women were clearly in the minority, but there seemed to be no other barriers.  Nothing could hold me back from making my dreams come true.  
It is the philosophy of chiropractic that has always made perfect sense to me.  The ability of the body to heal itself as a result of its innate intelligence has resonated throughout the years, and this perception continues to drive my dedication to the profession.

TAC: Please tell us more in depth about the services and products The Masters Circle offers chiropractors and how or why those products are offered.
The Masters Circle, the largest consulting firm for licensed wellness professionals, is a highly specialized and unique leadership training and practice building organization. Its mission is to help as many doctors as possible to build the practice of their dreams and the best lifestyle they can imagine.

The Masters Circle offers a comprehensive total support program that features a persona-lized hands-on approach, utilizing a high-tech educational model that creates faster and better results. Its well-balanced, modern approach covers all aspects of personal growth, as well as every action step members will need to build their practices to the desired level.

I believe in the precepts of The Masters Circle, its proven model for helping chiropractors achieve success at every level, and its positive impact upon the profession.  I am a living example of its values and credit the personalized coaching platform for my ongoing achievements.  

Other products and services offered:

•    Seminars
•    Chiropractic coaching and consulting
•    Doctor and Chiropactic Assistant empowerment products
•    Patient education products
•    Procedural products
•    Books designed to inspire success in chiropractors

TAC: What kind of hurdles did you have to overcome as a result of being a female in a male dominated profession?

I was the first female coach hired by The Masters Circle and we now have four female coaches.  It appears that females have a keen understanding of work/life balance, a goal that we emphasize during coaching.  Women also have compassion, an ability to communicate “tough love.”  They have a heightened sensitivity to personal and individual concerns, and are able to relate to both men and women.

TAC: What are your specialties and can you tell us some more about them?
Zinberg: When I was in practice, I ran a cash, subluxation-based wellness practice in midtown Manhattan. I enjoyed a very eclectic following that ranged from administrative assistants to families, theatre personalities and CEO’s of large companies…and everybody in between.  This diversity allowed me to develop my own personal style and methodologies for addressing a wide range of patient challenges.

Because I was a member of The Masters Circle before I even started my practice, I participated in coaching and consulting before I ever opened the doors to my office.  As a result, I did not have to re-invent the wheel and simply followed the directions of my coach.  Frankly, I was afraid not to do so.  

The result of this dedication was that success came early on in the life of my practice. I was truly blessed—able to pay my bills within the first three months and able to begin saving money within the first six months.  I followed the advice of my coaches, and it paid off.

My pursuit came to an abrupt ending with a biking accident that forced me to leave active practice.  Thankfully, I was asked to join The Masters Circle as a Coach.  It has been “easy riding” since then.

My work at The Masters Circle has been very gratifying, allowing me to weave all these experiences together so that I can help other professionals.  For example, prior to my career as an active professional, I was a Chiropractic Assistant.  I know what it is like to be a CA and have been in their shoes.  

This familiarity paved the way for my professional work, and gave me the impetus to create the CA Certification program at The Masters Circle.  Today, I am thrilled to help professionals address one of the most significant challenges of practice:   recruiting, training and retaining a CA who can effectively attract new patients to the practice.  The CA program is highly valued among our members, and I am appreciative of this opportunity to assist my colleagues.

TAC: Which techniques did you use and why?

Zinberg: Throughout my career, I used whatever techniques would benefit the patient—primarily diversified, SOT, some Applied Kinesiology, and some Activator technique.  Whatever worked for the individual also worked for me.

TAC: What type(s) of diagnostic testing procedures did you use and why?
Zinberg: Over the years, I relied upon X-rays and found them to be a great tool for educating the patient.  Today, I would use the Insight Millenium Substation from Chiropractic Leadership Alliance as the optimal way to educate patients about subluxation.

TAC: Are you still seeing patients or do you plan on doing so again?
Zinberg: The answer is no and no.  I am working full time at The Masters Circle, and I love what I do.

TAC: What are your goals for the chiropractic profession?
Zinberg: I envision worldwide recognition of the profession as primary health care providers and the first choice for consumers.  I anticipate greater unity within the profession and a solidified initiative to become the wellness providers of choice.

TAC: What is the most common problem you see among chiropractors today?  
There is a lack of confidence and poor self-esteem among chiropractors.  We need a stronger chiropractic philosophy and collective dedication to build a more robust public perception of our profession.  The good news is that these deficits are easily overcome through an identity-based coaching model and enhanced initiatives that focus upon our role as wellness professionals.

TAC: What is the biggest challenge to the chiropractic profession today?

Zinberg: The most compelling challenge is that chiropractors must overcome their collective perception of personal worth and the value of chiropractic.

TAC: What single piece of advice would you give a chiropractor just starting out, or one that is in the process of building a practice?
Zinberg: Hire a coach.  That one step can carve the way for personal fulfillment and professional success.  Personalized coaching not only worked for me but has also been the key to success for thousands of chiropractors.  

TAC: Any final words for our readers?
Every person, every chiropractor should have a purpose.  Live your life purposefully and with direction.  Only you hold the master key of life.

You may contact Dr. Elisa Zinberg at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Chiropractic in the NFL
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Written by Richard R. Shaker, D.C., R.T.P., C.P.T.I., C.C.S.P., A.C.R.B., C.S.C.S.   
Thursday, 01 February 2007 16:35

For four seasons in the NFL, after having suffered a chest injury while playing my rookie year, I had not been able to breathe properly. I also had severe pain in my chest and rib cage. Previous to Dr. Shaker, I had seen every medical specialist, including other chiropractors—no one could help me. I was struggling to survive in the NFL. After two weeks of Dr Shaker’s treatments, I felt better than I had since the initial injury. I started playing like my old self and was able to split time with starting running back Michael Pittman. I am currently the starting running back for the Chicago Bears. Since then, I have flown Dr. Shaker to Chicago to treat me personally during the season.
-Thomas Jones, Running Back, Chicago Bears

Being a Sports Chiropractor since 1990, I have treated a mélange of elite pro athletes, including many past and present Tampa Bay Buccaneers players, some of whom are:

• Buccaneers All Time Leading Receiver, Mark Carrier
• Buccaneers Super Bowl XXXVII MVP and current Cincinnati Bengals Safety, Dexter Jackson
• Buccaneers Defensive Lineman, Chidi Ahanotu
• Buccaneers Defensive Back, Brian Kelly
• Buccaneers Wide Receiver, Michael Clayton
• Former Buccaneers and current Atlanta Falcons Pro Bowl Running Back, Warrick Dunn
• Former Buccaneers and current Chicago Bears Running Back, Thomas Jones

Running Back Thomas Jones came into the National Football League as the seventh overall pick by the Arizona Cardinals in the 2000 Draft, after having a stellar career at the University of Virginia. After three sub-par seasons, the Arizona Cardinals traded him to the Tampa Bay Buccaneers.

Most NFL players are referred to me by other players. This was also the case with Jones. He was referred to me by a University of Virginia teammate and free agent hopeful named Dwayne Stukes.

Stukes had chronic quadricep and hamstring injuries since college that were not being ameliorated by any other methods that he had tried.
He consulted me, and I utilized the Trigenics® treatment system and completely re-established normal function in his quadriceps and hamstrings. He was so excited by the astounding results, he referred Thomas Jones.

When I initially saw Thomas, he was the most superb example of a mesomorph that I’ve ever observed. There was one glaring problem though. I noticed immediately that his breathing was extremely labored—to the degree that one could see his left scalene muscle straining with every breath. In addition, every strained breath produced a loud, erroneous, disruptive sound.

During my initial interview, he told me that, during the third game of his rookie season, he was running through the line against the Green Bay Packers and was hit very hard in his chest area on a forty-five degree angle from his right side, by a defensive lineman. After he was tackled, he immediately started having difficulty breathing, like in an emergency state. He was carried off the field and taken by ambulance to a local hospital.

MRI’s and CT scans were performed and he was sent to a pulmonologist and a cardiologist. All of the medical tests performed were negative. The allopathic physicians could not give a diagnosis. In an attempt to heal himself, he consulted chiropractors, massage therapists, physical therapists, nutritionists, and trainers from different parts of the country. Unfortunately, he had no relief.

Thomas had two primary complaints:

1. Pain in chest that was exquisitely painful when irritated. He experienced pain every time he was hit.

2. He had difficulty breathing. He felt he couldn’t breathe enough air into his lungs and couldn’t get enough air out. He felt air was trapped inside his lungs. Obviously, he was suffering from respiratory acidosis. Respiratory acidosis occurs when the lungs cannot remove all of the carbon dioxide (a normal byproduct of metabolism) produced by the body. Because of this disturbance of the acid-base balance, body fluids become excessively acidic.

“Respiratory acidosis can be a consequence of any lung disease that prevents removal of carbon dioxide. Common lung diseases that lead to respiratory acidosis include chronic obstructive pulmonary disease (COPD), severe asthma, or airway obstruction. Other conditions that may lead to respiratory acidosis include obesity hypoventilation syndrome, excessive fatigue of the diaphragm or muscles of the rib cage, or severe deformities of the spine and rib cage (for example, severe scoliosis).”1

So we connect the dots. This young man is an NFL running back who gets hit hard on a weekly basis and he has to be able to breathe at a very high level. Both his thoracic cage and related breathing systems were failing him. As a testament to his physical and mental prowess, he continued to play while he was severely injured and thus impaired. Therefore, his production was extremely poor and the coaches and team were upset because their team physicians didn’t know what was wrong with him. Arizona considered him a bust, as he never lived up to what they expected of a player selected seventh overall in the NFL draft.

In 2003, he was traded to Tampa Bay for Buccaneers wide receiver Marquise Walker. Buccaneers’ head coach, Jon Gruden, decided to take a chance on him.

“He’s a thick and quick guy...a quick study, and we think he has some unique running skills that should make things real interesting,” coach Gruden said. He would play out the final year of his original contract in Tampa Bay, after which, he would be a free agent and able to test the free agent market. So, a good year with Tampa Bay would really help increase his value on the free agent market.

Because of my academic and athletic background, I knew that I could help improve Thomas and his condition. Through the Motion Palpation Institute and the tutelage of Dr. L. John Faye, whom I consider to be my greatest mentor in chiropractic, I learned to become an expert in costovertebral, costotransverse, and intercostal joint manipulation. Thorax function, breathing and also function of the cervical and lumbar spine are dependent on these articulations for proper functioning.

By seated Motion Palpation analysis, I discerned that his costotransverse joints and costovertebral joints on the left side demonstrated articular, capsular, ligamentous fixations with associated reactive muscular fixative lesions.

Moreover, what I deduced was that his entire ribcage was partially rotated. He was hit from his right side and that impact on that angle partially rotated his ribcage from the right to the left. That is why his left side was fixated.

So, the partial rotation of the ribcage caused a cascade of neurokinetic chain dysfunctions. The rotation stretched the scalenes, diaphragm, and intercostal muscles. All anatomy integral to breathing became dysfunctional because of the rotated ribcage.

Professional athletes are intrinsically in tune with their bodies. They can feel subtle dysfunctions about their bodies. They can perceive subtle connective tissue dysfunction in their bodies much better than the average person, because they have been training and exercising their entire lives.

Thomas felt his ribs were stuck, and the doctors and professionals he was consulting couldn’t release his ribs. That was his perception. Being an expert in rib manipulation and mobilization, I knew I could help him. I decided to manipulate his ribs using a supine technique first, in order to initially give him some hope of recovery.*

Fortunately, I was able to cavitate the costovertebral and costotransverse joints on the left side. He was extremely excited and felt a sense of relief immediately after those manipulations. He noticed he could breathe a little bit better and he had less pain in his thorax than he had had in the past three years. That was just after one adjustment.

From a manipulation perspective, the left first rib manipulation was also significant, as Thomas’ pectoralis major was involved as a result of the intercostal, costochondral, costotransverse, and costosternal joint dysfunction. “When the first rib is fixated, the following muscles can be involved: anterior scalene, middle scalene, iliocostalis cervicis, levator costorum, and the sternocleidomastoid, indirectly, through its attachment to the clavicle. Scalene involvement also causes a couple of motions of the cervical spine to become fixed and painful as well as initiates occiput C-1 pathomechanics to occur. The levator costorum, as a result of scalene hypertonicities, now places undue stress on the upper thoracic rib cage and then we have a positive feedback loop: anterior structures causing fixations in the posterior structures, and the posterior structures perpetuating the anterior fixations.”2

The pain will present almost anywhere and will cause self-generating mechanisms of decreased mechanoreceptor input, resulting in unchecked nociceptor input and an out-of-control sympathetic nervous system. “The sympathetic nervous system output results in vasoconstriction, reflex muscle spasm, and eventual disuse of the involved structure: a self-perpetuating cycle.”3 This is a good description of part of Thomas’ clinical presentation.

“Chest wall syndromes are definitely a sports-related event, obviously not the only cause, but certainly a common one. The following sports have a component of either trunk flexion alone or trunk flexion coupled with axial rotation. The positional stresses and strains that accompany such activities as golf, tennis, baseball, triathlon, mountain biking/cross-country/trail riding, volleyball, football, soccer, rugby, etc., are a common cause of the subluxation complex being initiated by thoracic cage dysfunction.

The pain from the above thoracic cage dysfunctions may not be at the actual location of the segment in question, as pain is referred to a site either proximal or distal to the actual lesion. If the intercostal nerves are involved, the pain might be referred secondarily to a traction effect by the intercostal muscles, or by the numerous biochemical mediators liberated by the inflammatory response. The pain, in this case, would most likely be referred along the space occupied by this intercostal nerve and not above or below that level. If the dysfunction involves the costochondral junction of the ribs 3-5, then the pectoralis minor could be involved as well, with resultant shoulder joint dysfunction and pain secondary to scapulothoracic rhythm abnormalities.”4 The pectoralis major, if involved as a result of intercostal sprains, costochondral, costotranverse, and costosternal dysfunction, could impair the external oblique muscle’s ability to function as a prime rotator of the lumbar spine, thus causing lumbar pain.

From a Trigenics® perspective, I discerned that the scalenes and diaphragm muscles were the primary source of his breathing difficulty. Initially, I taught Thomas cerebropulmonary biofeedback breathing both utilized in the Trigenics treatment system as well as to re-teach him how to effectively breathe outside of the office. At the time of his presentation, Thomas displayed marked paroxysmal breathing. I decided to start applying the Trigenics® Lengthening (TL) procedures to the left scalenus anticus and medius muscles. I also applied the Trigenics® Strengthening (TS) procedures to the same muscles as well as the intercostal muscles, and diaphragm.

I estimate that the combination of chiropractic manipulation and Trigenics® treatment system application achieved a ninety-five percent success rate over the course of twenty-four treatments. Thomas had an abundance of aberrant afferent and eventual efferent dysfunction, because he had been breathing erroneously for three years, not just as an average person, but as an NFL running back. That is profound: forcing air through a dysfunctional system and trying to exhale air through the same dysfunctional system. He was declining physically and, eventually, was set to be out of the league. It was Trigenics® that helped to re-establish all of the neurokinetics.

After joining the Buccaneers and regaining his health through my intervention, he enjoyed the best season of his career and shared the starting position with Michael Pittman. He then became a highly valuable and coveted free agent and signed a lucrative four year contract with the Chicago Bears that included a signing bonus. The deal was finalized just minutes into the free-agency period.

As a testament to his resurrection, one merely needs to observe the following stats:
In his first 2 seasons with the Bears:

He has produced the best two seasons of his NFL career during his two years with Chicago.
Since joining the Bears in 2004, has rushed for 2,288 yards—the best consecutive seasons by a Bears RB since Neal Anderson gained 2,333 yards from 1989-90.

Recorded 9th best single-season rushing total in franchise history, while establishing a career-high in rushing yards in his fifth-straight season.

Averaged 1,427 yards from scrimmage over last two seasons, which is 36.0-percent of Chicago offense, the second-highest rate in the NFL during that time. (Tiki Barber, NYG, 42.7%)

Dr. Richard R. Shaker is a licensed chiropractic physician and graduate from Life University School of Chiropractic 1988. He was an all-state athlete from Flint, Michigan, and was offered scholarships in both football and baseball. He started the Shaker Chiropractic and Sports Injury Center in 1990. He specializes in a wide variety of neuromusculoskeletal conditions and sports injuries. You may contact Dr. Shaker at 813-876-9552.

For further information on Trigenics®, visit, call 1-888-514-9355 Ext. 1, or email This e-mail address is being protected from spambots. You need JavaScript enabled to view it .


1. MedlinePlus Medical Encyclopedia: Respiratory acidosis
2. What if… by Dr. Keith Innes, D.C., Dynamic Chiropractic, June 17, 1994, Volume 12, Issue 13
3. What if… by Dr. Keith Innes, D.C., Dynamic Chiropractic, June 17, 1994, Volume 12, Issue 13
4. What if… by Dr. Keith Innes, D.C., Dynamic Chiropractic, June 17, 1994, Volume 12, Issue 13

Nutrition - Adding Value to a Chiropractic Practice
Cover Stories
Written by Freddie Ulan, D.C.   
Friday, 01 December 2006 14:24
Dr. Ulan earned his Doctor of Chiropractic degree at the Chiropractic Institute of New York, completing the 4500-hour, nine-semester program in thirty-six consecutive months. He graduated with honors in 1965.

Ulan Nutritional Systems (UNS) is a training center where nutritionally-oriented practitioners gather to learn, and attain mastery of the clinical and practice management techniques Dr. Ulan used in building his highly successful nu trition practice in upstate New York. While chiropractors comprise better than 80 percent of the UNS clientele, the professions of medicine, acupuncture, naturopathy, and even veterinary medicine are liberally represented in his seminars.

UNS got its start ten years ago in the offices of Dr. Ulan’s million-dollar, all-cash nutrition practice in Glens Falls, New York. With the help of his wife, Dana, he opened his doors to chiropractors and like-minded practitioners from all over the United States, instructing them in detail on the theory and nuts-and-bolts practical details needed to duplicate his success. Delivered monthly, the three-day seminar was officially titled Patient Management Secrets of a Million-Dollar Nutrition Cash Practice.

Wasn’t he, at least, a little bit worried about competition?

Far from it, he says. Swamped with patients from all over the country and even abroad who had heard about his techniques, he realized that it would take a veritable army of clinical masters to satisfy the demands of the public once they began to realize the truths about nutrition—and malnutrition—published as early as 1943 by Dr. Royal Lee and his pioneering colleagues.

Incorporated in 2005, Ulan Nutritional Systems has grown to a staff of thirty-five, including six doctors of chiropractic. The "Million-Dollar Workshop," as attendees have affectionately dubbed it, continues to be a mainstay of UNS’ training lineup. Flanking it are basic and intermediate workshops in Dr. Ulan’s pioneering Nutrition Response Testing work. Dr. Ulan’s vision of an army of clinical masters finds its realization in his Advanced Clinical Training program (ACT), a 150-hour postgraduate-level course that shares everything that he and his New York clinic partner, Dr. Lester Bryman (a chiropractor for forty-seven years) evolved over decades of experience dealing with nutritional patients. ACT produced its first fifty-two graduates in 2006.

All the courses are taught in Clearwater, Florida, with the exception of basic Nutrition Response Testing workshops, which are offered in cities all over the country. UNS also provides doctors with test kits, equipment, and a wide range of educational DVD’s by Dr. Ulan, to augment their practices.

In an interview with The American Chiropractor (TAC), Dr. Ulan shares how he went from a straight practice to a million dollar nutrition cash practice.


TAC: Dr. Ulan, what inspired you to become a chiropractor? Do you have a specific story?

Ulan: My father owned his own business and was a weekend athlete. A devastating injury to his knee sidelined him from the sports he loved to play every weekend. Three different medical specialists told him he needed knee surgery and would probably never play ball again. He took a friend’s advice and consulted a chiropractor. After two chiropractic visits, his knee was normal and it’s been normal ever since. From that time forward, he became a chiropractic zealot. No matter what occurred or what condition anybody had, a chiropractor was called in. As a teenager, I’d get together with my friends to play cards and would end up practicing the chiropractic techniques I’d learned as a patient.

I switched from engineering school to chiropractic college when I realized that, although mechanics was my subject, engineering wasn’t. I was much more interested in dealing with people than with objects. Chiropractic made perfect sense. I graduated in 1965 with the highest degree in proficiency and diversified techniques conferred by the Chiropractic Institute of New York.


TAC: What types of patients do you generally treat or attract?

Dr. Bryman and I have associates doing most of the active clinical work these days. Apart from the doctors I check at my seminars, I haven’t seen patients routinely in about three years.

I always tended to attract patients who were suffering from ill health, as opposed to personal injury cases. I would say the conditions I’ve most commonly treated are chronic fatigue, chronic immune dysfunction, chronic pain, weight problems (under- or overweight), and hormonal dysfunction.


TAC: What are your specialties?

Ulan: Since 1993, I have specialized in Applied Clinical Nutrition, which I had determined to be the missing component to restoring health naturally through chiropractic. That was when I had put the pieces together enough to realize that at the heart of all chronically recurring subluxations—and the loss of health that inevitably follows those chronic subluxations—is the nutritional deficiency or imbalance component, which is then exacerbated by toxins, environmental stressors, and endogenous poisons.

Our specialty evolved into the most efficient and accurate analysis to determine the real underlying causes of each patient’s condition, and a system that guided us into the creation of the most effective, extremely personalized protocols that would correct the causes and eliminate any factors that would prevent the Innate Intelligence of the body from doing its job of fully restoring health.

As an integral part of this, we had to determine how to develop patient programs that were affordable, lowest possible pill count, that would be so easy for the patient to comply with that the program would then do all the work and the patient would get the results sought. Looking back on this, these were all major accomplishments, and—without losing any of the unique individuality of each patient’s program—resulted in totally standardized procedures that opened the door to helping more people than we had ever helped before, with less stress and more satisfaction, and then being able to train others to achieve the same results routinely in their own practices.

TAC: Is your Nutrition Response Testing like Contact Reflex Analysis or muscle testing? Perhaps you could give us a brief description of the process.

Ulan: While all analytical systems which utilize muscle testing have muscle testing in common, there are several key factors that make Nutrition Response Testing truly unique.

First, it is the only system that is based entirely on the actual structure and anatomy of the body, and which assesses the functional status of the autonomic nervous system directly, discovering whether or not the body is even capable of benefiting from any therapeutic intervention—and, if not, what needs to be done to correct that situation rapidly.

We have identified the most common factors that can prevent the body from healing itself, and how to deal with these, when present, as the first step toward optimal health recovery. This one discovery opened the door to the most effective, most economical, easiest-to-comply-with, lowest-pill-count program ever. And THAT is the key secret to our success. Once these factors have been identified and handled, our system prioritizes each succeeding step, not based on any pre-determined flow chart, but strictly on the basis of our extremely effective reassessment procedure that enables us to monitor the exact progress of each patient in a series of brief follow-up visits that bring them through one or more "Healing and Observation" cycles, until they are truly ready for graduation onto a maintenance program for life.

TAC: What percentage of your practice is made up of the following: men, women, children, families, elderly?
Ulan: One of the purposes of my practice is to create a healthy next generation. We learned a long time ago that the way to help the most children is to help the mothers. So, our clinics are designed to attract mothers—especially working mothers in the thirty-five to fifty-five age bracket. These are the people who carry the biggest burden in this society. They’re more concerned with how they’re functioning than how they’re feeling. They know that, if they go down, everything goes down. How many husbands know how to take care of the kids and keep the family going if Mom gets sick?

 All of our marketing is directed to the working mother. She deserves the most help. The majority of our clients are women and the rest are their families and friends.

TAC: Which techniques do you use and why?
There is an abundance of chiropractors with effective techniques for handling subluxation and muscular-skeletal problems. The scarcity is in nutritional support, so we specialize in that. Very little spinal manipulation is done in our offices today.

 But, obviously, every patient needs the benefits of chiropractic adjustments, and I have learned, over the years, that there is an enormous number of effective chiropractic techniques that are valid in well-trained and competent hands. 

 I graduated from the Chiropractic Institute of NY with honors for having obtained excellence across a wide diversity of techniques. I have enormous respect for my colleagues who have honed their skills and specialized in specific techniques, and I have seen every technique produce miracles in the hands of those who had mastered them. Over the years, I have concentrated on different approaches ranging from Upper Cervical Specific to Cranial Sacral Technique, to various full-spine approaches and, as a result, I tend to fall back on my wide experience and determine what to do regarding structural correction on an individual basis. 

 Interestingly, in my small town in upstate New York, there are approximately thirty-five chiropractors within a short driving distance of my office. Since many of our new patients are referred to us based on the miraculous results we have gotten through our unique nutritional systems, I long ago adopted a policy of determining if a patient already had a chiropractor they liked to work with, and encouraging them to continue with that chiropractor for structural support while we worked on the nutritional aspect.

 Regardless of what technique each of those good doctors was using, many of them reported that their patients were now holding their adjustments much better since embarking on the nutritional program we had designed for them. Per D. D. Palmer, each factor of the subluxation complex needs to be addressed. The spinal adjustment addresses the subluxation directly and is most effective in dealing with primary subluxations while, by addressing the nutritional component, one can often eliminate the visceral-somatic reflex that constantly re-creates the “secondary subluxation.”

TAC: What other therapeutic modalities do you include when treating a patient?
Ulan: In our own practices, we concentrate on nutrition, but many of our clients integrate Nutrition Response Testing into their chiropractic, acupuncture, medical, or veterinary practices.

TAC: What type(s) of diagnostic testing procedures do you use and why?
We do not diagnose as such. We do an assessment of the functional state of the autonomic nervous system using a combination of Nutrition Response Testing and Heart Rate Variability assessment.

TAC: We understand that your Nutrition Response Testing reveals nutritional imbalances that keep people from staying healthy. Could you tell us a little bit more about your experiences?
Ulan: Dr. Royal Lee forecasted, in 1943, that modern mass food processing techniques would lead to a sharp decline in American health and a sharp upswing in the rate of degenerative disease. That’s the trend I began to observe in the early decades of my chiropractic practice. The structure wasn’t sound enough to heal itself. The body’s innate intelligence had been driven into apathy by poisons.

 Dr. D. D. Palmer talked about the nutritional component and the various causes of subluxation: primary subluxation by injury or accident, secondary subluxation caused by toxicity, nutritional deficiency and stress.

 The majority of the patients that we see today have recurring subluxations. This is not because chiropractic doesn’t work—on the contrary, it is far more effective than ever in correcting subluxations. What we have today are secondary subluxations caused by autonomic nervous system stress, caused, in turn, by nutritional deficiencies, imbalances, and toxicities.

 Our mentors—Drs. Royal Lee, Francis Pottenger, Melvin Page, and Weston Price—discovered that the autonomic nervous system determines the person’s health status. We have discovered how to consult the autonomic nervous system and find the key departures from optimum functioning. We then strengthen and rebalance the autonomic nervous system with nutrition, providing genuine replacement parts for the body through very high-quality nutritional supplements derived, primarily, from organically grown whole foods.

 “Routine miracles” in chiropractic are no longer a thing of the past.

TAC: Tell us two or three of your most amazing patient success stories.
Ulan: A middle-aged woman came into our office with her hands wrapped in gauze. Her hands had been seeping and she’d literally lost all the outer skin off her hands, even the fingerprints. This had been going on for well over a year. Many doctors had tried many different things on her. 

 Our Nutrition Response Testing analysis revealed a minor parasitic situation that we were able to correct in a matter of weeks. The seeping and pain in her hands stopped. After six weeks, she was carrying her granddaughter—something she’d only dreamed of ever being able to do.

 Then there was Andrew Oldham, the original producer of the Rolling Stones rock group, who had been addicted to cocaine for twenty-five years. He was consuming five packs of cigarettes a day, several pots of coffee, and more than a dozen medical and psychiatric drugs, not to mention other street drugs and alcohol.

 Andrew called a music business friend to say goodbye—he’d be dead in a couple of weeks, the doctors said. 

 At his friend’s urging, he flew a great distance to visit us in Glens Falls, New York. He arrived in great pain and barely strong enough to walk. He, literally, couldn’t go four hours without a cocaine fix because of the withdrawal pains. It took us three to four days of intensive nutritional work to get him through the cocaine withdrawals, primarily, vascular collapse. His hands and fingers and feet would go into very painful gripping spasms. It took us a few days to get him through that.

 He was loaded with multiple immune dysfunctional states. We had to rebuild his immune system, his cardiovascular system, his muscular system. All along, we were providing nutrition for his endocrine system, guiding his diet, slowly tapering him off cigarettes and coffee. Over a period of two years, we were able to get this guy totally operational and back to work. He’s back in the music business today, totally drug-free.

 In another case a woman came to our clinic who was overweight and in a lot of pain with continuous headaches. She was also suffering from depression and anxiety. She was so loaded with psychiatric drugs and pain pills that she could hardly function. We addressed one problem at a time in the exact priority that our testing procedure indicated and, over a period of six to nine months, she had gotten herself off all the medications.

TAC:  What has really impacted your growth as a chiropractor and that of your practice?
Ulan: I grew up seeing chiropractors who were true holistic healers, and I was very fortunate to go to a school that had several brilliant chiropractors on staff.

The most significant thing to the expansion of my practice was learning that success depended 20 percent on being a great chiropractor and 80 percent on knowing the actual technology for managing a practice—specifically, the Hubbard Management System, which contains all the basics of practice management.

The next thing was my own life falling apart because I was not paying enough attention to nutrition. I had an active life, traveled a lot, but was eating fast foods. My health deteriorated from 1986 to 1991. I hit rock bottom and literally did not know if I would survive another year.

I was in bed with chronic pneumonia. Nothing would fix; couldn’t hold adjustments. How do we reverse this? 

When Dr. Bryman and I asked that question often enough, our eyes were opened to a whole new universe. Before this, straight chiropractic was the answer to all our health problems. We had to teach ourselves nutrition.

We searched relentlessly, refusing to accept answers that were not workable until we got the common denominators (which took us back to the four great nutritionists mentioned earlier). Their teachings, when combined with our wonderful chiropractic training and our ability to assess the autonomic nervous system, took on immense practical significance.

Today, I bicycle six to ten miles every morning, just to celebrate being alive. I’m far younger now, physiologically, than I was before. That is what led us to expect the extraordinary, rather than the ordinary, in terms of practice results. I had discovered the missing component in a chiropractic practice, and felt I had to get the word out.

TAC:  What marketing strategies do you use to attract new patients and to keep current patients?
First, we identified the correct public to promote to. Through extensive surveys, we found that this was the working mother. We found that we could reach her most effectively through public education workshops at clubs, functions, and organizations. 

The true key to our marketing is simply great results. With a precise nutritional program the patient can easily afford, we put her health—and the health of her family—back under her control.

We survey doctors at our seminars. Typically, they rate their health less than optimum. It’s not uncommon to find that they have an unresponding physical condition. After they’ve been working with us a while, nutritionally, their health has markedly improved. They become zealots (like me!) in their practices. Patients respond to a doctor who exemplifies the kind of health improvement they hope to attain for themselves, and who truly walks the walk.

TAC:  What single piece of advice would you give a new chiropractor just starting out?
First, I’d ask his purpose for going into chiropractic. If it is to get patients well, he needs to add a nutritional component that will reinforce the effect of chiropractic adjustments. He’d also better learn how to manage the nutritional patient correctly from day one. The road to his success is already paved; he just needs to take the first step and then keep going.

TAC:  What general advice would you give an established chiropractor whose practice might be struggling?
Ulan: Again, learn how to add a viable low-stress nutritional component to your practice. It will improve chiropractic results, compliance, and referrals. It will greatly improve your success financially and clinically. Our programs are set up so that the doctor gets the tools to implement nutrition in his practice the next day.

TAC:  Where do you see the future of chiropractic headed?
Insurance has played itself out. I see a growing awareness in the population concerning nutrition. They’re tired of drugs, side effects, no results, and chronic illness. I see the future of chiropractic with nutrition as laid out clearly by Palmer in 1914. He said it was a holistic system of healing that includes what you put in the body. We feel we have realized his vision in the combination of chiropractic and Nutrition Response Testing.

TAC:  Any final words for our readers?
Ulan: Nutrition isn’t “the wave of the future” anymore; it’s headline news. Newsweek recently devoted thirty-five pages to the subject. Supermarkets are adding entire organic foods sections, not just a shelf or two. These are unmistakeable signs of growing public demand for what we, as practitioners, have to offer: better nutrition, better information, and better health.

You may contact Dr. Ulan at Ulan Nutritional Systems, 1170 NE Cleveland St., Clearwater, Florida 33755, (866) 418-4801. Website:

The Landmark Victory for Surface EMG
Cover Stories
Written by TAC Staff   
Tuesday, 14 November 2006 16:59

In January of 2005, David Marcarian and his company, PBI/MyoVision, defeated a group representing most of the major insurance companies and the State of Florida, who questioned the validity of surface EMG.  The case was appealed to the Superior Court of Florida, with an attempted appeal to the Supreme Court of Florida. Marcarian and MyoVision again prevailed with a unanimous decision, proving the validity of the surface EMG technology Mr. Marcarian developed twenty years earlier.

It was a landmark decision causing reverberations throughout the chiropractic profession as well as other healthcare professions. This definitive case evaluated the scientific literature and determined that the equipment is capable of differentiating injured patients from those who are not.

In an interview with The American Chiropractor, David Marcarian talks about the victory that surface EMG won for chiropractic and how surface EMG proves chiropractic efficacy.

TAC:  What is the behind-the-scenes story regarding MyoVision’s formation?
  After developing a surface EMG technique at NASA in the mid-80’s, I was awarded a $450,000 grant from the National Institutes of Health (NIH) to design what is known today as the MyoVision. Precision Biometrics, Inc., (MyoVision) is the oldest and most respected supplier of surface EMG equipment in the world. 

TAC:  How did you become involved in the chiropractic profession?  What inspired you?
  What inspired me was that, in 1988, a DC who had been the bottom gunner on the B-17 Flying Fortress in World War II called me and told me that he had read about my experience at NASA and thought that the technology I developed under the NIH grant could be helpful to chiropractors.

He had never flown since WW II, so I agreed to fly to his office, as he was sixty-five at the time. He was one of the kindest souls I have ever met. His name was William McIlvaine, DC, and he was known throughout Oregon as one of the best chiropractors in the state. 

Anyhow, I flew to his office, and tested all his patients one day.  I was shocked to see that their muscle tension patterns correlated completely with their complaints and that their muscle tension dropped significantly post adjustment.  There was one exception: a patient who had very even, very low levels of muscle tension. 

I said, “Dr. McIlvaine, there is only one problem.  This one patient has no issues at all that I can find.”

He said, “He is a friend without any issues, and I threw him in to see if your machine was foolproof or not.”

After that, I was hooked on both chiropractic and proving the value of it.

TAC:  What are your goals for the chiropractic profession? 
  My goals are to offer the chiropractic profession a new way to solve three major problems: ethical marketing, tracking progress and protection against insurer’s attempts at refunded payment due to lack of documented justification for care. My goal is to encourage doctors to use objective data, instead of clever marketing techniques, to obtain new patients and grow their practices in an ethical, scientifically sound manner with the resultant improved public perception of chiropractic.  There has been a sudden increase in the number of cases where insurers are actually going after doctors for back pay for cases lacking documented proof of the need for care.  Insurers are actually reviewing patient records and demanding a refund of payment for care where the doctor cannot prove objectively that the patient needed care. Recently, a MyoVision owner reported winning such a case, saving $50,000 in payments and $20,000 in legal fees, because she documented the need for care with her MyoVision. 

The need for documentation should be a requirement for practice.  How many of us would see a dentist that selects the tooth to drill into by intuition?  Or a medical doctor that prescribes a level of thyroid medication without blood tests?  All other health care professionals use objective data for determining treatment, and so should we.

In the past, we used to go to dentists when in pain.  Now, we go to prevent pain.  What changed dentistry?  They began using those little red tablets (disclosing tablets) that “show” plaque, proving the need for care.  I am offering a tried and true marketing method, similar to the dentists’ disclosing tablets, which may replace questionable marketing techniques with the use of objective data. Surface EMG provides this visual proof for chiropractic in the same manner the disclosing tablets do for dentists. 

By using the simple-to-understand visual, graphical representation of subluxation, you no longer have to waste your time with a futile attempt to convince people of their subluxations. As the color graphics, which correlate with subluxation (you cannot measure subluxations directly) do the job for you. Furthermore, this objective data makes you a much better doctor, since you are relying upon solid outcome measures, and not just your intuition.

So many doctors have told me how surface EMG has prevented the loss of patients, because they alter their adjusting technique if they are not seeing improvement in the tests.  To add to it, patients get very involved in their own progress by using the scans as a means of tracking their own personal progress.

The appealing color graphics lead patients to refer friends and family for testing as a secondary benefit.

The main reason instrumentation is so effective is it focuses the patient on function and not symptoms. We all know that symptoms are not the most effective way to determine spinal dysfunction.

I also want DC’s winning major legal victories for their patients.  Through proper use of instrumentation, you can win Personal Injury and Workers Comp cases without ever appearing in court.  By presenting objective data using the combination of dual inclinometry range of motion and surface EMG, attorneys are much more likely to settle cases.  The last thing they want presented to a jury is the objective evidence that a patient is injured. 

But, to be fair, it also benefits insurers. I, personally, was involved in three cases where a total of 2.5 million was being sought. All three cases were dropped after testing, as the patients turned out to be symptom magnifiers.  But, the bottom line is that the purpose in using objective data is to get the truly injured the care they deserve/need, and those that are not injured removed from the system; so it truly makes the entire system function more fairly for everyone. 

The reason that it is so effective in the legal arena is the same reason I have never lost a case in court:  The opposition presents their “opinion” (with no data) that the patient is not injured almost as policy; and I present objective data, proving the presence or absence of soft tissue injury. Objective data (dynamic sEMG and ROM) always wins over opinion. When doctors utilize it properly, they regain control of patient management, and their decisions cannot be questioned because they have the data to back them up. 

TAC:  Tell us about your victory in the Florida Superior Court case.
  The state of Florida determined, based partially upon doctors who were trained to focus on the use of the sEMG for marketing purposes only (using static sEMG and not dynamic), that the device was not medically valid and, therefore, made it illegal to bill personal injury for it (PIP insurance).

TAC:  Can you give us a summary, or the highlights of that case?
  The most interesting thing about the case was that I was the only person out of all the sEMG companies to show up in court!  It was me against nine attorneys and, I believe, eight expert witnesses. Their star expert witness was an individual with an MD/PhD who specialized in surface EMG.

The big surprise was the Florida Chiropractic Association. When I arrived in court, I believed that the FCA would be on “our” side, there to help the chiropractors; but, instead, their representatives testified on behalf of the insurance companies and the State of Florida, that there was no validity to sEMG.

Why was I the only person to show up?  After reviewing the literature that was considered admissible in court, it became quite clear.  MyoVision was the only multifunction sEMG system with research that met all the quality standards/requirements requested by the court.  Furthermore, there were no direct financial ties between the publishers of the research and my company. This made it impossible for the attorneys to attack the validity of the research I presented in court.

In court, the attacks on me, personally, were brutal. The nine attorneys did everything they could to destroy my credibility; but each time they attempted, my credibility was further bolstered, and they eventually backed down.

Perhaps the most fun interaction was when an attorney “threw down” an advertisement in front of me, and raised his voice (just like on TV), implying that this advertisement proved my actual goal for my company.  The advertisement had a headline, which stated something to the effect: “HOW TO DRAMATICALLY INCREASE YOUR INCOME WITH SURFACE EMG.”  He was so excited, as he felt he had finally nailed me. 

Well, unfortunately, he had not read the ad carefully, and the ad turned out to be from another company!  I believe the judge asked him to sit down after that.
Another major highlight for me, personally, was how the judge, in my opinion, relied heavily upon research performed with my equipment in making her decision.  It was a wonderful feeling to know that this device I invented was given so much respect.

The bottom line is that I presented, in a completely unbiased manner, the scientific literature in as pure a form as possible. The judge agreed with my interpretation of the literature, and the case was won.

TAC:  What is the impact this has on the chiropractic profession as a whole?
  Impact?  This case will have a monumental impact on chiropractic in so many ways.  It gives chiropractors the power to determine when and how to care for their patients, and the power to prove to insurers the need for care by simply performing dual range of motion testing and dynamic surface EMG.  We now have a court-validated, research-validated tool which can be used to show that chiropractic is effective, to document injury or the lack thereof, and a precedence-setting case which can be used to establish the validity of surface EMG in any court in the country, if it is questioned.  

No longer will a doctor be called in for review with only his or her opinion for justifying why a patient is a chiropractic patient. No longer will chiropractors have to fear going to court, as they have the security, when owning unbiased court-validated instrumentation, that the tool can be used to support their position.  Chiropractors now have objective data to PROVE that what they do really works. 

But the main achievement here is that now chiropractors can proudly practice as professionals, and use instrumentation that helps them focus on patient care.  By using instrumentation, there is no need for clever marketing schemes, as patients will provide referrals for spinal screenings and doctors can build their practices based upon doing a good job and simply proving it with objective scientific data. 

To continue development, we are currently in the middle of numerous major research studies with famous researchers who have selected MyoVision as the “tool of choice,” due to its proven record of reproducibility and quality.  I am confident that these studies will further prove the value of chiropractic.

TAC:  How is this victory important to chiropractors on an individual basis?
  There has been a major shift in the world of insurance and workers compensation:  If you cannot prove through objective documentation that the patient needs to be cared for, you can forget about payment.  This case effectively establishes a manner by which doctors can protect themselves against the scrutiny of insurers and worker compensations boards by having the established objective data required to prove need for care. 

In addition, winning this case helped lead another major insurer, American Specialty Health Network, to alter their policy on surface EMG.  Up to this point, any users of surface EMG equipment were excluded from their extremely fast-growing provider network.  I presented the research to their extremely well qualified Technology Assessment Committee (TAC) and their policy was reversed the following week. This means that thousands of doctors who were not formerly eligible as ASHN providers can now re-apply and begin seeing patients almost immediately.

TAC:  What is the most common problem you see among chiropractors today?
  The gap in utilization of high tech instrumentation between the chiropractic profession and all other health care providers is the biggest problem.  Patients have become accustomed to determining the doctor’s credibility based upon the technology they have.  Dentists have digital X-ray, medical doctors use all kinds of high tech tools, and we need to also utilize technology, if we are going to be viewed as credible health care providers.  Patients expect it and, if we don’t respond, we are going to lose credibility.  Use technology, and everyone will know the value of what we do and how well it works.

TAC:  In the most recent Best Practices Low Back draft document written by the Council on Chiropractic Guidelines and Practice Parameters (CCGPP), the authors sited two studies, Haldeman, et al., {Haldeman, S., Chapman-Smith D., et al., 1993 1369/id} and Henderson, et al., {Henderson D., Chapman-Smith D., et al., 1994 526/id}, that led the CCGPP to the conclusion that there was insufficient evidence available to recommend the use of the surface EMG.  Is there any evidence you can provide for them in support of this technology?
  What a great question.  All one must do is look at the dates on their references and the names of the authors to recognize the lack of validity to their claim. First of all, these are not two independent reviews. The same author is on both papers, meaning that it is their opinion and, without two completely independent authors, is lacking the scientific scrutiny one would expect from a truly scientific review. It is typical, when attempting to prove one’s theory, to rely upon multiple independent researchers, not the same researcher.  The biggest issue with their viewpoint is the fact that they are relying upon papers published sixteen years ago to support their position. If we were to rely upon information sixteen years ago, we would still be using antibiotics to treat ear infections.
You have to ask the question, “Why would they ignore the most recent literature on the topic?” 

Perhaps, because this new literature supports the use of surface EMG, which makes you question their motives in ignoring data which support the use of it.
Since the year 2000, there has been an explosion of research supporting the technique for sEMG evaluation provided by dual range of motion combined with surface EMG, and this is summarized best by reviewing the papers I presented which lead to winning the Superior Court case in Florida and, by simply reading the paper which summarized all this research, authored by Geisser, et al., 2006, titled “A Meta-Analytic Review of Surface Electromyography among Persons with Low Back Pain, and Normal Healthy Controls,” published in the Journal of Pain, November 2005.  This paper summarized, quite nicely, forty-four studies, and up-to-date research (beyond 1993), and is, therefore, a more reliable source of information with regard to the validity of surface EMG.  As stated in the abstract: “SEMG measures of flexion-relaxation appear to distinguish LBP (low back pain) patients from controls with good accuracy….” 

It was after I presented this new evidence to ASHN that they altered their policy. For ASHN’s Technology Review Committee to alter their policy on sEMG, as I mentioned earlier, makes us further question the CCGPP’s motivation and conclusions with regard to surface EMG. 

It is actually quite simple: In the court case, the State of Florida and all the major insurers threw the absolute best expert witnesses at me and I still proved the validity of surface EMG in court.  If they could not win this case, it was purely due to the fact that surface EMG is, in fact, valid when performed properly.  If the CCGPP were to, instead, state that properly performed, surface EMG is valid, I would agree with this statement, as it applies to any diagnostic equipment. That is what I believe they truly wanted to make clear but, obviously, they threw out the baby with the bathwater.

Perhaps the most unfortunate result of their conclusions, contradicting the most recent scientific literature, is that CCGPP’s guidelines have no credibility and appear to be more of a political statement, rather than a set of guidelines based upon science and logic. I would love the opportunity to present some of the literature that has been published in the sixteen years since the publications they referenced, so that their guidelines more accurately reflect the scientific validity of surface EMG.

TAC:  Where do you see the future of chiropractic headed?
  Chiropractic is on the verge of a major breakthrough. Through the integration of technology and high tech tools, the public’s perception of chiropractic will improve dramatically, and it will turn into a field, like dentistry, where people visit their chiropractor to prevent illness rather than treat it.

TAC:  Any final words for our readers?
  One of the unfortunate aspects of a profession filled with such passionate individuals is that we sometimes make decisions, not through the use of critical thinking but, instead, by “following” what those we want to believe in as our leaders tell us.  I have proven myself in a major court of law, which gives me AND my equipment a proven credibility with regard to instrumentation.  It is important that you purchase equipment from individuals with similar experience, since you are eventually going to need them to support your use of the equipment, if questioned by insurers, your board, or workers compensation boards. 

Drop the emotion.  Avoid sub-standard equipment by doing your research. Does the device have a dual inclinometer?  It is required by the AMA to bill insurance.  Was the device designed to perform the sEMG’s test properly? Remember the test must be performed properly to be considered valid. Does the device have a separate probe for dynamic sEMG?  Does the thermography device have tubes at the end of the sensors to push the hair out of the way for a measurement above the hairline?  

Too many doctors have called me pleading with me to take a trade on a three-month-old machine they purchased impulsively from another company I can’t help them.  Take your time; learn everything about a tool before jumping on the bandwagon. There are no silver bullets or instant solutions, so do your research before you buy. 

Remember that philosophy is wonderful and is the backbone of the profession, but you can’t take it to court. Let your thorough research findings be what guides your equipment selection decisions.

David Marcarian, M.A., is founder and president of Precision Biometrics, supplier of the MyoVision sEMG and Thermoglide systems. He lectures for Palmer College of Chiropractic, Life Chiropractic College East and all U.S. chiropractic associations that mandate sEMG training endorse his course. He has personally instructed more than 6,000 chiropractors on proper sEMG use.

Mr. Marcarian can be reached at 800-969-6961, by email at This e-mail address is being protected from spambots. You need JavaScript enabled to view it , or visit his company’s website at


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