ChiroMasterMind

Ok Perry. What the heck are you talking about this time? You have officially lost your mind. Yes, while that is true, it still does not take away from the power of this question. What do I mean by this question? Let me tell you a story…

One of the most influential marketing consultants in sports had the job of turning around the dismal attendance at NY Nets basketball games. I mean, you could not give these tickets away and season ticket holders were not renewing in droves. They were losing millions! They had to find a way to get season ticket holders interested enough to open up a letter with new offers for the Nets upcoming season. Problem was, most fans were so disgusted with the team they just threw out the letters whenever they arrived in the mail. What to do? This consultant said, “I know, rubber chickens!” He sent full size rubber chickens via Fed-Ex to all season ticket holders and wrapped the season ticket offers around the leg of the chicken. Was that insane? YES. Was that outrageous? YES Did it work? YES. They were certainly curious and opened up the letters. Mission accomplished. 80% renewed for the season.

What is the moral of this story? You have to find your rubber chicken. What can you do that is crazy, outrageous and nuts in regards to marketing your services? Something that will get potential patients to take notice of you. Maybe you can have a Chiropractic Weenie Roast inviting families to attend. Sponsor a Hot Dog eating contest. Host a roller skating rink party-Skate for Your Spine. Sounds nuts? Good. Then it will probably work. Beats a newspaper ad anyday of the week. Get creative. If you don’t your competition will.

Dr. Perry Nickelston                                                                                           

VP Practice Development for K-LaserUSA

www.k-laserusa.com

1-866-595-7749 Ext. 102

www.painlasercenter.com

Tags: Integrative Treatment Strategies, Practice Tips of the Day, General // Add Comment »

At your core, there’s an incredible athlete. Lean and powerful. Strong, but still flexible. Use your core to transform your body—and your life, turn back the clock, speed up your metabolism, trim your waistline, build muscle, permanently rid yourself of nagging back pain and gain unlimited energy.  Sound good?  It can become a reality for your patient’s with a ” Core Regeneration Program!” 

So what is the core you say?  Good question. Lets start learning. 

The major muscles of your core include:

• Transverse Abdominis (TVA)-The deepest of the abdominal muscles, this lies under the obliques (muscles of your waist). It acts like a weight belt, wrapping around your spine for protection and stability.

• External Obliques-These muscles are on the side and front of the abdomen, around your waist

• Internal Obliques-These muscles lie under the external obliques, running in the opposite direction.

• Pelvic Floor- These muscles are responsible for support of your internal organs and abdominal contents.

• Multifidus-Responsible for stabilizing the spine and pelvis directly prior to limb and trunk movement.

Why should you care about the core?
Core strength enhances your overall fitness level. Your body moves more efficiently and gracefully. You gain more power in athletic moves and other exertion. And you’re less prone to injury and muscle pain. When your core muscles are weak, other muscles compensate by doing work they’re not intended to, and you’re more likely to wind up with chronic debilitating back problems and injuries to the knee joint.

Weak core muscles contribute to all kinds of problems in the body, the most prevalent of which is lower back pain. By strengthening the muscles that help support the spine and improve posture, you can dramatically decrease the symptoms of lower back pain. Picture your spine as a column of soda cans stacked one on top of the other. If you wanted to keep that column standing up under stress, what do you think would work better: a “tenser” bandage (as is used for wrapping injured ankles) or Scotch tape? Sure the tape would keep the cans together but the cans wouldn’t receive a whole lot of support, would they?

When you strengthen the muscles of the core, you are in effect turning that Scotch tape into a nice, tight “tenser” bandage, increasing the amount of support that your spine gets. Core training also has the potential to greatly improve sports performance. The core is the one area of the body that will always give you a great return on your investment.

So how do I train my core muscles?
Exercises that work the abdominals and the lower back are the staples of core training. Also, exercises that target the stabilization and power-transfer duties of the core muscles are very effective.  Here is brief exposure to the beginning of core training.  (A personalized one-on-one program is designed for patients.)

The exercise is known as the Abdominal Sit-Up. It uses a sit-up-like movement but focuses directly on the abdominal muscles rather than the hip flexors (which a regular sit-up does). It is also very safe for your lower back. Another advantage it has over the standard crunch is that it targets the stretched (arched back) range of motion of the abs, which is totally missed in standard floor crunch.

How To Do It:

Lie on your back on the floor. Roll up a towel or mat and slip it underneath your lower back, just above the waistband (the size of the towel affects your body position during this movement - use a fairly large towel). Your knees should be bent about 90 degrees. Keep your feet close together and knees fairly wide apart. This prevents the hip flexors from having a direct line of pull, helping to minimize their involvement. Do not anchor your feet or have someone hold them down. This automatically activates the hip flexors. You will get the most out of this exercise by minimizing their involvement.The difficulty of this exercise depends on where you hold your hands. The hardest position is above your head at arms-length, then beside your head, then across your chest, then straight down between your legs or at your sides. You are now ready to begin. (Do 3 sets of 12-15 reps)

• Keeping your torso straight and stiff, start the sit-up by tightening your lower abs then lifting your upper body off the floor.

• As you continue up, imagine trying to push your face up against the ceiling (think up, not around).

• When you reach about 25 to 30 degrees above horizontal, hold there for a second or two and squeeze your abs hard.

• Keep your lower back in contact with the towel at all times and always maintain tension in the abs.

• Lower yourself down slowly and under control. Do not just drop back to the ground. The negative portion of this exercise is extremely effective. Take at least 3 seconds to lower down!

• Remember to adjust your arm position depending on the strength of your abs

If you were to ask me which muscle group in your entire body you could work to get the greatest benefits in the shortest amount of time, I would tell you without hesitation, “the core.” Strengthening the core can realize tremendous benefits to anyone regardless of his or her training experience and can do so very quickly.  Have fun with the exercise above.

Dr. Perry Nickelston, DC VP of Practice Development for K-laserUSA.www.painlasercenter.comwww.-k-laserusa.com

Tags: Integrative Treatment Strategies, General // Add Comment »

What do you do for a living? What is your profession? Most people will answer with the name of their job title; “I am a Chiropractor, I am an Accountant, I am a Painter.” Wrong! Wrong! Wrong!. You are a MARKETER first. You can’t BE a chiropractor unless you have a patient to care for. They have to be in your office for you to do that, get it? So stop trying to become a better doctor, that’s easy. Become a better marketing professional. That takes time, commitment and LOTS of failures. Here is a list of some of the marketing essentials you need to know and implement for lifeling practice and business success. So do it already…

Think outside the box. Have fun and enjoy.

Dr. Perry Nickelston, DC

1-866-595-7749 Ext. #102

www.k-laserusa.com

www.painlasercenter.com

Tags: Integrative Treatment Strategies, Practice Tips of the Day, General // Add Comment »

“I can’t close my bra in the back.” “The pain in my shoulder is terrible when I turn on it in bed at night. “It hurts like hell when I try to put on my T-shirt.” “The pain starts in my shoulder and goes down my arm to the elbow.” “The pain is so bad, that I can’t workout without pain.”  “Just thinking about exercise makes my shoulder hurt Doc!”

These are typical of the things I hear from patients consulting me about shoulder pain. Most ailments afflicting the shoulder have a gradual, often imperceptible onset. We keep thinking it’s going to get better, but our range of motion decreases progressively because of our natural avoidance of moving into pain. Muscles and tendons shorten, joints tighten and movements are more limited, until daily activities become so difficult we finally have to scream for help.

The shoulder is not a biomechanically efficient joint, nor is it one single joint. The head of the upper arm bone (humerus) sits rather insecurely in an extremely shallow cup at the outer upper angle of the shoulder blade (scapula) called the glenoid fossa. Essentially, it is held in place by the muscles and ligaments attached to it. Extreme movements in any direction, but particularly overhead and/or to the back, subject those tethers to stretching which eventually results in slight tearing of ligaments and tendons. The body attempts to protect these structures and sets up a reaction called inflammation. The inflammatory response is associated with swelling due to increased blood flow, further restricting motion and increasing pain.

MOST COMMON INJURIES FOR PEOPLE WHO EXERCISE

Rotator Cuff Injury. Tears in the rotator cuff can result from the progressive worsening of tendonitis, repetitive strain through overuse, or trauma- especially as a result of athletics. The gradual tearing of the rotator cuff is a process similar to a shirt wearing out- it gets more and more threadbare until the edges fray or a hole appears. This sort of rotator cuff injury can be difficult to repair surgically, and conservative treatment under the direction of a professional is often the best course of action.  A “clean” tear to the rotator cuff (due to trauma) can often be repaired surgically. Whether or not surgery is indicated, Sports Medicine treatment will almost certainly be involved in all stages of recovery.

Bursitis/Tendonitis go hand-in-hand. Inflamed bursa sacs and muscle tendons may become thickened and reduce the “free” space in the joint, thus restricting movement. In extreme cases some of the bursa sacs can be removed surgically; otherwise, the therapeutic approach to treating bursitis and tendonitis is similar.

Impingement refers to a condition, sometimes painful, in which the shoulder joint lacks enough room to function properly. Structural impingement is a “built-in” organic condition, e.g., a bone spur in the shoulder joint. This situation is usually the result of years of tendonitis, rotator cuff injuries, and wear-and-tear. It is important to note that structural impingement usually requires surgical intervention.Functional impingements often result from repetitive motion situations (such as pressing movements overhead with weight training). Stretching and rotator cuff exercises, along with proper CORE muscle balance training, can help prevent and alleviate functional impingement.

Trigger Points are “knotted” up muscles in the shoulder that cause significant debilitating pain and restricted movement.  The most effective treatment for these points is aggressive Orthopedic Sports Massage.      

TRAINING SECRETS   ********    TRAINING SECRETS

Balance your upper body workouts

A good way to avoid shoulder injuries is to make sure your upper body strength sessions are balanced. This means that every push or press exercise must be balanced with a pull or row exercise. Too many athletes and weight trainers focus on developing the ‘mirror muscles’, the upper trapezius, anterior deltoid and pectorals. As a consequence, the ‘non-mirror muscles’, lower trapezius, rhomboids, latissimus dorsi and rear deltoid, are underdeveloped. This leads to a muscular imbalance about the shoulder, which results in poor scapular stabilization. since the non-mirror muscles are the ones that work to stabilize the scapula. In addition, over-developed mirror muscles can lead to a round-shouldered posture, which incorrectly places the scapula up and forward. Redressing this imbalance is very important for the prevention and rehabilitation of shoulder impingement injuries

Limit your range of movement, and take it easy

Often this means avoiding certain ranges of motion where the shoulder joint sub-acromial space is compressed the most. The impingement zone to avoid is between 70 and 120 degrees of shoulder abduction (when you move the arm laterally away from the side of the body). To start training the non-mirror muscles, begin with the seated row, because the shoulder joint is not abducted in this exercise. Once the pain is completely gone, then introduce the overhead exercises such as pull ups and lat pull downs. You should be even more careful when it comes to the mirror-muscle exercises. I would avoid lateral raises, upright rows and shoulder presses completely for a while. However, incline bench press with arm abducted to 45 degrees would be a good choice to start again. Slowly build up to the normal bench-press range as strength improves.

Correct scapula positioning when performing exercises

The correct position for the scapula (shoulder blade) is back and rotated down. Essentially, this means maintaining a good ‘military posture’, with shoulders back and chest out. A round-shouldered or hunched posture is to be avoided at all times. To achieve the correct position, you need to use your rhomboids, mid and lower trapezius muscles to retract the shoulder and pull the scapula down.

When you perform any upper body weight training exercise, always get into the habit of starting with good upper body posture and pinching the shoulder blades together. You should feel that the scapula is a solid platform which keeps the shoulder correctly positioned while you perform the exercise. As mentioned last issue, a good way to learn the correct position is during the seated row exercise by keeping your scapula back and down while you move your arms. During the exercise, you should feel that the rhomboids and trapezius muscles are statically contracting to hold the scapula in place, and the latissimus is working to perform the movement. Once you have the feel for maintained scapula stability during the seated row, try to achieve it during all upper-body exercises. What you might find is that exercises such as the press up or front raise, where the shoulder may become impinged, will not be painful if you stabilise your scapula correctly. In effect, by using the scapular muscles you can achieve better shoulder mechanics and avoid injury.

Correct scapular stability is difficult to learn and demands a great deal of practice and concentration during your training sessions. You first need to understand what the correct position is, and often this requires a professional to guide you. Instruction and observation can help you achieve and maintain the correct shoulder position.

Avoid too many consecutive training days

The more consecutive training days you have, the higher your chances of getting hurt.  Consecutive days are counted as follows: if you train on Monday, Tuesday, Wednesday, and Friday, you are training on three consecutive days each week (Friday doesn’t count because it has a rest day before and after it). Studies show that reducing the number of consecutive days lowers the risk of injury. This means that if you train for one hour every day from Monday through Friday (five consecutive days), you could reduce your risk by completing 75- minute workouts on four days per week (Monday, Wednesday, Friday, and Saturday, for example). Your total training time (and gain in fitness) would be the same in each case, but the second strategy would reduce your consecutive days from five to two, giving you much more average recovery time between sessions and a lower risk of injury.

PROPER Stretching

Stretching to increase flexibility should never be done prior to training or competition, but instead done during ‘down’ times in the week. This is because of the suppression of the ‘stretch reflex’ that takes place during sustained passive stretching of muscle tissue (i.e., repeated holds of 20-30 seconds). If one were to do rapid forceful movements such as lifting weights straight after such passive stretching, there would be an increased chance of muscle and tendon tears. For flexibility every muscle needs to be stretched three to four times at 20-30 seconds each, and repeated three to four times per week. The best way to learn how to stretch the above areas is to be taught by a sports physiotherapist, sports conditionist or personal trainer. It is important not to stretch the ligaments of the shoulder, which in due time can cause laxity of the joint and potential instability.

If you have a shoulder injury and would like to try to treat yourself, please remember:

It would be wise to visit a Sports Medicine Specialist to rule out structural damage first, via X-rays, CT-Scan, US Scan or MRI, particularly if your shoulder joint experiences sharp catching pains, locking sensations, clunks, pins and needles or numbness, looseness or laxity, or the history of the injury was in any way traumatic, involving body contact or a fall.  The length of time it took to develop your problem will give you some indicator of how long you will need to persist with correcting the faults before the results will be felt. Don’t forget, that the pain is often only the tip of the iceberg, directing you to the real issue.

Dr. Perry Nickelston, DC VP of Practice Development for K-laserUSA.

www.painlasercenter.com

www.-k-laserusa.com

1-866-595-7749 Ext. 102

Tags: Integrative Treatment Strategies, General // Add Comment »

I have the distinct honor to care for Ms. Graziella Baratta, the current reigning Ms. New York.  She has done fantastic with laser therapy care on chronic injuries that have plagued her for years. Being a dancer, she suffered countless micro-traumatic injuries to her body that makes it difficult to perform at full potential sometimes. I actually contacted her via her website (Which I will list below and recommend you visit) and asked her to see me for complimentary Class 4 laser treatments. Why? I knew the laser would help. Guess what? She called and the rest is history.

 Now Graziella gets weekly K-Laser sessions combined with chiropractic and soft tissue trigger point therapy. She has never felt better. Check out these links to Graziella and stop by for a visit. Tell her you found her through my blog. She will be glad to hear from you. Graziella is more than a patient, she is a dear friend. I respect her drive, ambition, and desire to help others. She is a very successful businesswoman and entrepreneur that all of you could learn from. I don’t respect and admire many people, but Graziella I DO. She knows what it takes to thrive in today’s marketplace. It’s all about visibility my friends!

www.graziellablog.com

Ms. New York Blog: http://blog.msnewyorkus.com

www.GraziellaBaratta.com

www.G-volutionDance.com

www.Byouneek.com

www.MsNewYorkUS.com

Why is this story important? Building your practice is about building relationships. Reach out and initiate contact with new people. The movers and shakers in life! They are anxious to help you. Step outside of your comfort zone and do it. If I had not taken the initiative to contact Graziella she would still be suffering and I would not have such a dear friend. It’s not about you Doc, it’s about them. Start today. Pick up the phone and call one new person to network with today. It could be another chiro, just pick one. The more you do, the better you get. Trust me I know. Until next time. Everything in life you desire, lies just outside your comfort zone!!!

Don’t forget to tell Graziella Dr. Perry says hello.

Dr. Perry Nickelston, DC

VP of PRactice Development for K-laser, USA and Clinical Director of The Pain Laser Center, LLC in Ramsey, NJ.

www.k-laserusa.com

www.painlasercenter.com

1-866-595-7749 Ext. 102

Tags: Class 4 Laser Therapy, General // Add Comment »

Patient Education! It can mean the difference between practice success and failure. Making money or starving. Before your patient leaves the office after your Report of Findings and during their care plan, they MUST know and understand the following 12 points. These are in no paticular order, but each one is an integral part of the success formula. Practice. Practice. Practice. Everyday.

1. Chiropractic care is SAFE!

2. The condition they have

3. They should get rid of the problem

4. Condition is caused or related to ’subluxation’

5. Chiropractic CAN HELP!

6. As treated, symptoms will disappear

7. Symptoms gone-Still have an underlying condition

8. Drop out of care too soon-Symtoms WILL return

9. Differnce between Relief Care vs. Corrective Care. (Which do THEY want?)

10. Status of Progress Reported during care. They need objective feedback

11. Treatment Plan-They need a roadmap and a plan to follow. Commitment required.

12. Insurance and Financial responsibilties-No surprises!

If you fail to educate you fail to retain! You have failed to deliver value for the patient’s investment. No one turns down a ‘Good Investment!” You never get a second chance to make a first impression.  Keep your attitude in check. An attitude can be more important than facts. It can make or break a doctor. You can’t change many things in life, but you can always change your attitude! Invest your time and effort into learning more about education and communication. Have a plan and follow it! Until next time…

Dr. Perry Nickelston, DC

VP of PRactice Development for K-laser, USA and Clinical Director of The Pain Laser Center, LLC in Ramsey, NJ.

www.k-laserusa.com

www.painlasercenter.com

1-866-595-7749 Ext. 102

Tags: Integrative Treatment Strategies, Practice Tips of the Day, General // Add Comment »

Depends on the success rates you want to obtain in laser therapy. Higher power allows for a greater range of clinical applications, leading to patient satisfaction. Not to mention, your financial satisfaction. Next to an accurate diagnosis and proper clinical training in laser therapy application, dosage is the single most important parameter for a successful outcome in laser therapy. Too little energy produces no effect. The primary factor in lasers that determine dosage is power. 

DOSAGE = Power x Time 

While power is the amount of energy measured at the source of the beam, dosage is the amount of energy delivered to the skin. Dosage may also be referred to as energy density or fluence. Its unit of measure is the Joule. Higher power gives a higher power density, which very often is beneficial.  Insufficient power cannot be compensated with more treatment time!  Positive results require more than increasing time. By itself dosage cannot adequately describe laser treatment. One must ask several questions. What is the depth of the target tissue? Is the laser power strong enough to reach this target? 65% of laser energy is absorbed by the subcutaneous tissues, so you must take this into account when determining the laser power options. 

Example:

Given enough time a 500mW laser could administer a dosage equal to that given by a 2 watt instrument. Yet results will be very different. The higher power density of the 2 watt laser will penetrate far more deeply and with greater effect. 

Dosages and power at higher ends typically provide better results, as long as treatment intervals are not too close together. 

I often meet doctors who do not know what type of laser they should purchase. When asked, it is not unusual for them to respond 3B. Make sure to investigate the option of Class 4 lasers too. Trust the science, not the sales brochures!

Perry Nickelston, DC

www.k-laserusa.com

www.painlasercenter.com

1-866-595-7749 Ext. 102

Tags: Integrative Treatment Strategies, Class 4 Laser Therapy, General // Add Comment »

Here is a secret! Not many people know it, and it is the key to success. Read carefully and soak up this knowledge. Dale Carnegie had it right when he wrote “How To Win Friends And Influence People.” He knew that the best way to become successful is to MASTER communication skills. If you have not read this book, get off your butt and buy it, read it, and live it! Neglect this skill at your own business and personal peril. Here are 30 quick snippets from the book to get you started. Enjoy!

1. Don’t critisize, condemn or complain.

2. Give honest, sincere appreciation.

3. Arouse in the other person an eager want.

4. Become genuinely interested in other people.

5. SMILE (This is a big one!)

6. Remember that a person’s name is the sweetest and most importatn sound in any language.

7. Be a good listener. Encourage others to talk about themselves.

8. Talk in terms of the other person’s interests.

9. Make the other person feel important-and do it sincerely.

10. The only way to get the best of an argument is to avoid it.

11. Show respect for the other person’s opinion. Never say, “you’re wrong.”

12. If you are wrong, admit it quickly and emphatically.

13. Begin in a friendly way.

14. Get the other person saying, “yes, yes” immediately.

15. Let the other persaon do a great deal of the talking.

16. Let the other person feel that the idea is his or hers.

17.Try honestly to see things from the others person’s point of view.

18. Be sympathetic with the other person’s ideas and desires.

19. Appeal to the nobler motives.

20. Dramatize your ideas. (Tell stories and give testimonials)

21. Throw down a challenge.

22. Begin with praise and honest appreciation.

23. Call attention to people’s mistakes indirectly.

24. Talk about your own mistakes before critisizing the other person.

25. Ask questions instead of giving direct orders.

26. Let the other person save face.

27. Praise the slightest improvement and praise every improvement. Be ‘hearty in your approbation and lavish in your praise.”

28. Gi ve the other persona a fine reputation to live up to. Compliment them in front of other people.

29. Use encouragement. make a fault seem easy to correct.

30. make the other person happy about doing the thing you suggest.

Americans are far more likely to turn to friends, family and others for advice than to rely on advertising. Communication skills is what you and your staff can do well that makes patient’s want to tell others how good you are! Study communication everyday! Read and learn. Your financial statement will reflect the effort.

Perry Nickelston, DC

www.k-laserusa.com

www.painlasercenter.com

1-866-595-7749 Ext. 102

Tags: Practice Tips of the Day, General // Add Comment »

“I’m already busy, why do I need to add a Class 4 Laser to my practice?” First let me say how absolutely stupid this statement is! Yet I hear it all the time when trying to convince doctors to become progressive and add laser therapy technology to their practice. When you get busier, hire an Associate or a laser therapy technician. Case closed!

The mistake most doctors make is not looking at their business from the point of view of the patient (customer). If you try to think from their point of view, what can you see about your business that is fascinating, helpful, unique, or different? You’re looking for a WOW factor that sets you apart. Class 4 Laser therapy offers a Unique Competitive Advantage in the marketplace. When a patient is looking to buy your kind of service they are facing certain risks; It might not work. They might look bad. They might lose and nobody wants to lose. What you want to do is find a way to reverse the risk to the client. You remove risk with quality laser equipment that is guaranteed to deliver results. After all, helping more people is what it’s all about! Help people and you make money. Simple really. 

Money is the instrument of exchange for valued production (i.e. results). Money is earned only by the producer. The accumulation of wealth is accomplished only by applied effort and discipline. Money tends to flow toward those people who can use it in the most productive ways to produce valuable goods and services.  To succeed, you have to do something, buy something, or start something. What you focus on expands. Your field of focus determines what you find in life. Take responsibility for the results in your life. Poor doctors hesitate on purchasing/leasing a laser because they believe they “can’t afford it.” This is classic either/or thinking. “I can’t afford to buy a laser and operate my clinic; the overhead will be too high.” Rich doctors know they can’t afford NOT to purchase a Class IV laser. The return on investment will be astronomical in the long run. Until you can show you can handle what you’ve got, you won’t get any more! 

Dr. Perry Nickelston, Dc www.painlasercenter.comwww.k-laserusa.com

Tags: Practice Tips of the Day, Class 4 Laser Therapy, General // Add Comment »

Tags: Integrative Treatment Strategies, Practice Tips of the Day, General // Add Comment »