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Law #2 Of Laser Therapy Success

Law (noun); a statement of a scientific fact or phenomenon that is invariable under given conditions.

Success (noun); the achievement of something planned or attempted.

Law #2: Proper Training and Diagnosis.

A laser is only as good as the clinician behind its appication and the proper diagnosis. Point the best laser in the world at the wrong spot and you get minimal results at best. To obtain phenomenal success you MUST have sufficent training and knowledge of laser applications.

Unfortunately, after a sales rep hooks you in with a laser purchase their job is done. Their only priority is usually selling you a laser, meeting a sales quota, and keeping a job. Subsequent training usually involves showing you how to turn on the equipment and wishing you good luck. I see it all the time!

Doctors are left to follow pre-programmed settings with the misunderstanding that a “point and shoot” method of treatment is adequate. The success rate in laser therapy is directly related to the clinician’s ability to diagnose the true cause of a patient’s problem.

Pointing laser light at a painful area is not enough to get the spectacular results that properly trained physicians can achieve. Corporate sales reps spewing back to you “statistics” and research articles on laser therapy cannot compare to a skilled practicing clinician who uses successful techniques everyday in real world practice. Which would you rather get your training from? I know my answer! What about your patient’s?

Many companies organize courses and “training” events of markedly varying quality. A serious importer or manufacturer takes pains to ensure that his equipment is used in a qualified way, and makes sure that the customer receives some training in its use.

What are the trainer’s background and qualifications? Has he or she published anything? Is there a course description? Is a training course included in the cost of the equipment? Is the training material included?

Your training should involve at a minimum the following:

Laser Operational Instructions

How to set up the Laser

Proper Fiber Handling and Storage

Using the different laser tips. Understanding the difference between CW and Modulation Laser Safety: review manual Laser Contraindications review manual: Eyes, do not treat thyroid, Cancers, Pregnancy, patients that have had a steroid shot within 7 days of treatment, patients that are taking photosensitive medication.

Risks of treatment Protocols: Presets, and Manual settings Techniques: Sweeping technique, and contact methodConditions: Go over different conditions with doctor and how to treat them.

How to treat Shoulder, Knee, Cervical, Wrist, and Low Back. Integrating muscle work into treatment (ART, MRT, TPT, MFR) Kinetic Chain assessment techniques Understanding chronic cases and secret problem areas to search for Biomechanical compensation syndromes (Avoid common treatment mistakes)

Available for support anytime via personal phone calls Understanding adjusting power settings and frequency changes Make sure your trainer is available for future consultations and continued support. Once trainers walk out the door after your purchase-they can be impossible to reach for help. Marketing, PR, patient education, reimbursement, and other value added material should be provided. Public relations and instructions on public speaking with “Patient Education Lectures”, “Open Clinic Nights” and “Lunch & Learn Programs.”

Before your purchase a laser ask other doctors what their training involved. Were they happy with the results? Was the trainer a doctor too? What type of conditions have they had success treating utilizing laser therapy? Do they use laser therapy alone or do they use other treatments with it?

These are very important to know before making a purchase decision. Never go by the fancy brochures created by the laser company telling you how great their support and training is. Results speak for themselves!

Dr. Perry Nickelston, DC

VP Practice Development, K-Laser,USA

1-866-595-7749 Ext. #102

www.k-laserusa.com

Quit Smoking With Laser Therapy

So the newest and hottest rage going in the world of low level laser therapy is it’s use in helping people to quit smoking. I’m sure you have heard all the radio commercials and seen all the print adds boasting high success rates. Should you get into this type of therapy? How successful is it? How does it work? All great questions that I will attempt to answer.

The laser stimulates acupuncture points in the ear, face and hand that release special hormones called “endorphins.” These endorphins are the body’s natural “feel good” hormones that are produced whenever someone smokes a cigarette. By stimulating a surge of endorphins the individual no longer has physical cravings for the addictive behavior.

There are 5 major nerves that innervate the ear. 

1.   Vagus Autonomic is a branch of the PNS

2.   Trigeminal Nerve goes to the facial muscles, nerves and bones

3.   Facial Nerve controls facial m uscles and taste.

4.   Cervical Plexus innervates head, neck and shoulder.

5.   Glossopharyngeal innervates the mouth and throat 

Laser auriculartherapy is applied to acupuncture points in the ear and meridian points of the body. It does not focus on the acupuncture meridians but on the use of the ear as a localized reflex technique that modulates the central nervous system and endocrine system.

Auricular therapy points (AT) emerge only when there is pathology. These AT points correspond to anatomy and neurology. AT points have lower skin resistance and this is helpful in locating points. The ear contains tissue from all 3 germ layers from embryological development; endoderm, ectoderm, and mesoderm. Success rates can be very high depending on the type of laser you have for the procedure. For example: A 500 mW Invisible Red Laser with Wavelength of 820nm will give you different success rates than a 200mW Visible Red Laser with a Wavelength of 635 nm. The physics of the laser stimulation are totally different despite having the same doasge applied. It can be frustrating to learn a protocol because there are so many variations, and people will recommend their own lasers for use. Be careful where you go and what laser you use. All protocols are not the same. They can be hugely different. If you want to know my recommendations you may call me directly or e-mail me for the information.

 It is important for the patient to realize that Laser Therapy for addiction control can only be effective if they psychologically want to give up their addiction.  No amount of hormone stimulation can override their mental habitual cravings.  Laser therapy is not a quick fix program. There is a degree of self responsibility that comes with overcoming any addiction. It takes about 20-minutes for the procedure.

Dr. Perry Nickelston, DCVP Practice Development, K-Laser,USA

1-866-595-7749 Ext. 102

www.k-laserusa.com

pnickelston@k-laserusa.com

Attitude Determines Success

Every great leader knows the value of a positive Attitude. In short ATTITUDE IS EVERYTHING! Talent is not enough to ensure success in chiropractic. There are a lot of very talented doctors who graduate from the top of their class, and yet they never become successful in business. Why? You would think that they of all people would be ensured of success. There are one of two reasons why. ONE: Zero business and communication skills TWO: Wrong attitude! Your attitude and your potential go hand in hand. Attitude is an inward feeling expressed by behavior. That is why an attitude can be seen without a word being said.

Attitude determines your ability to deal with people. The Stanford Research Institute says the money you make in any endeavor is determined only by 12.5% by knowledge and 87.5% by your ability to deal with people. Let’s do some math now.

87.5% people knowledge (attitude) + 12.5% product knowledge = Success

Where do you think you should be devoting your time after you graduate from school? Better yet, where should you be investing time WHILE still in school? Get ahead of the pack. The key to having a good attitude is the willingness to change. You are either the master or the victim of your attitude. It is a matter of personal choice. Who we are today is the result of choices we made yesterday. Tomorrow will become what we choose today. To change means to choose change. If you want to have a great attitude then make the following choices.

Choice #1: Evaluate Your Present Attitude-What is your starting point?
Choice #2: Write A Statement Of Purpose-Write specifically what you desire to accomplish, verbalize it everyday and take action!
Choice #3: Have The Desire To Change-Do you really want it?
Choice #4: Live One Day At A Time-Take it day by day and make subtle changes. The thought process will become a habit.
Choice #5: Change Your Thought Patterns-Thoughts become things. You are what you are because of your dominating thoughts.
Choice#6: Choose To Have The Right Attitude-You are the only one who can determine what you will think and how you will act.

The greatest battle you wage against failure occurs on the inside, not the outside. Every successful doctor in practice makes the following words a part of their vocabulary. Do it and you will too.

I can…I will…Expect the best… I know…I will make the time…Positively…I am confident…I do beleive…(promote) You…All things are possible.

Dr. Perry Nickelston, DC
VP Practice Development, K-LAser,USA
www.k-laserusa.com
1-866-595-7749 Ext. #102

Is Laser Wavelength Important?

In one word, YES! Wavelength is critical to the success of your intended clinical application. Therapeutic lasers require deeper penetration to stimulate various tissue layers to promote optimal healing. Infrared wavelengths penetrate deeper by the laws of physics and science. Visible red lasers do not. Lets learn more.

The wavelength of light is measured in billionths of a meter, or nanometers (nm). The shorter the wavelength, the greater the energy carries. As wavelength becomes longer, the energy carried is less. Some wavelengths work better than others. Wavelength is the prime determinant of tissue penetration. 

The wavelength is very specific for cell absorption. In the IR (Infrared) spectrum, the longer wavelengths penetrate deeper and a greater percentage of the laser light will be transmitted in a forward direction. This means less scatter and better results!

 Laser therapy wavelengths vary from 630nm up to 1100nm depending on the manufacturer and your desired effect. The wavelength chosen for therapeutic laser must be capable of reaching its intended target.  Skin is permeable to light between 600nm and 1300nm. This is referred to as an ‘optical window”, and most light therapy is between these wavelengths.The wavelengths most commonly used for therapeutic purposes are 633 nm (HeNe lasers), 635 nm, 650 nm, 660 nm, 670nm (InGaAIP lasers), 780 nm, 820 nm, 830 nm (GaAIAs lasers), 904nm (GaAs lasers),  

Lasers that do not penetrate as deeply (630 - 740nm) are suitable for acupuncture point stimulation and wound healing but have not proven their clinical efficacy with deep musculoskeletal conditions. Infrared lasers (750 - 1500nm) penetrate deeper tissues and stimulate trigger points, ligaments, joint capsules, and intra-articular structures 

In my experience, Gallium-Aluminum-Arsinide (GaAlAs) lasers are effective over a wide therapeutic range and have very good depth of penetration. Laser treatment at more than one wavelength is likely to enhance results. Combining multiple wavelengths during the same session, one is likely to trigger additional biochemical/energetic pathways and a total higher dosage can be given.  CLINICAL PEARL:Ask your laser manufacturer what the wavelengths are and if the laser has multiple wavelengths from the same optical fiber. Very important to determine if you will need to purchase multiple wands and fibers. (Multiple wands can be EXPENSIVE) 

 Dr. Perry Nickelston, DC

VP Practice Development K-LaserUSA

Director of the Pain Laser Center, LLC in Ramsey, NJ

www.k-laserusa.com

www.painlasercenter.com

1-866-595-7749 Ext. #102

What Is Your Rubber Chicken?

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

Core Secrets to Stop Back Pain

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

1-866-595-7749 Ext. 102