ChiroMasterMind

There are do’s and don’ts for success in laser therapy. Satisfy these Ten Commandments and you will find your clinical success rates increase and patient satisfaction will soar to new heights. Now that is a pretty good deal. Here they are. Short, sweet, and to the point. Oh and if you don’t believe they are all important, try doing all ten and then take one away. Watch what happens. I dare you.

1. Proper Dosage- Yoy must get between 4J/cm2 - 10J/cm2 on tissue to have a therapeutic response. For instance 50cm2 deep tissue area will require up to 750J for proper response.

2. Wavelength-Determines penetration. For deep therapy stay in the IR (Invisible Red) range of 790-1000nm. Most common is the 800nm range. Wavelength is measured in nanometers. VR (visible red) in the 600nm range is too superficial for deep penetration. Don’t believe me, read a physics book. Get the right wavelength or results decrease.

3. Skin on skin-Laser must be in contact with the skin or exposed to skin surface. Adequate dosage cannot be obtained through objects like clothes, furniture, etc. Just use common sense. If it seems stupid, it usually is. Or better yet. Try it on skin and then through clothes. See which works.

4. Power-Higher power decreases treatment time and increases laser photon energy deeper into tissue. 500mW compared to 10,000mW is a big difference in dosage and penetration. Low powered lasers do work, but it takes longer for a session and longer to get results. (In my experience)

5. Proper Diagnosis-No laser in the world will help if you aim it at the wrong spot and simply chase pain. You should have an improvement within 3 visits or you are doing something wrong. Usually too low a dose or wrong diagnosis.

6. Nerve Root-Always treat the nerve root associated with any physical condition. For Example. Tendonitis in the elbow can be caused by nerve root adhesions which shorten the muscle and increase length tension relationships at the origin and insertion resulting in inflammation.

7. Treat Proximal to Distal-Always treat the spine first and then the peripheral area. You need to free up the lymphatics and nerves. This makes for a greater feedback mechanism of laser energy.

8. Treat enough times-Most conditions takes 3-6 visits with a high power laser and as much as 10-20 with a lower power laser. Depends on the dosage they get each session and if the diagnosis is correct. Tell the patient up front what the time frame is for healing.

9. Don’t over treat-Too much laser is just as bad as not enough. Just because you have higher power does not mean you kill the area with joules. Too much will inhibit cellular healing. You may get rid of pain, but ultimate healing is the goal. Follow the dosage rule above and you will be fine. Be wary of too much laser in one session and in one area.

10. Pick a Niche-Master a condition and become known as the “Guru’ of that injury and you will become so busy they will be turned away. For example: Be the ‘Shoulder Pain Laser Doctor’. Specialize or perish! Business 101.

Take time to learn the truth about lasers. Don’t even take my word for it. Research and see who is telling you the truth. Fancy brochures, pictures and sales tactics may make you buy a laser, BUT it will come back to haunt you and your patient’s when the results are poor. Reality speaks for itself by results!!

Dr. Perry Nickelston, DC

VP Practice Development, K-LaserUSA

1-866-595-7749 Ext. 102.

www.k-laserusa.com

Tags: Integrative Treatment Strategies, Class 4 Laser Therapy, General by Dr. Perry
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There are 6 hormones chiefly responsible for determining whether the food we eat ends up as muscle, fat or get burned as energy.  They are: insulin, glucagon, growth hormone, thyroid hormone, cortisol and epinephrine.    Over 90% of people who lose weight by caloric restriction return to their original weight within two years. This is because there is a weight-regulating center in your hypothalamus, which tries to maintain a constant body weight. (The hypothalamus and pituitary gland together represent the master endocrine gland of the body, controlling all of your hormonal responses.) It works like a thermostat by controlling your hunger level and your body’s metabolic rate. These effects are mediated by the nervous system and by hormones and enzymes involved in fat metabolism.   

If you want to change your body weight, or your body composition, you have to change the set point. The ratio of insulin to glucagon is perhaps the most important determinant of the set point. Both insulin and glucagon are produced by the pancreas, but have opposite effects. The concern of these hormones is blood sugar regulation. After eating a carbohydrate, it is digested and sent into the bloodstream as glucose. As blood glucose levels rise, so does the release of insulin, which is required to move glucose into muscle cells for use as energy or to be stored as glycogen. If blood sugar levels rise too quickly, a large insulin release results. When this occurs, some of the glucose can be converted and stored as fat instead of being stored as glycogen in liver & muscle.   

Glucagon is released when blood glucose levels become too low. This hormone prepares fat to be used for energy as well as muscle glycogen stores. The net result is to keep blood glucose levels normalized. By manipulation of the diet, you can regulate the insulin to glucagon ratio. .  Excess insulin cannot create muscle mass, but it will promote fat storage. It’s not the calories in sugar that make you fat - it’s the insulin response. READ THAT AGAIN!  When you eat carbohydrates they are digested and absorbed by the small intestine and transported directly to the liver via the portal vein. Essentially, all of the carbohydrates you eat are converted to glucose by the liver before being released into the bloodstream.

   This is why it is vitally important to detoxify and cleanse the liver before starting a weight reduction program. The liver must be functioning at 100% capacity to metabolize carbohydrates effectively. Fitness nutrition is NOT about how good you eat, it is all about WHAT nutrients your body can absorb to permit weight loss!

   Glucagon is released several hours after a meal when blood sugar levels drop. Glucagon has the effect of reducing glucose for energy and stimulating breakdown of body fat and the use of fat for energy. Glucagon also stimulates the glycogen breakdown.The net result of glucagon is to raise the glucose levels back to normal and to signal the body to begin using fat for energy since it’s running low on carbs. This is how the body acts to regulate blood sugar levels. Insulin decreases blood sugar by moving glucose into the cells, stimulating glucose burning for energy and increasing glycogen stores by shifting the metabolism from carb-burning to fat-burning.   Remember, if insulin is present, fat burning is negative! This is why you only have high amounts if simple carbs after your workout. Because you carbed up AFTER the workout when it is most important and any further influx of carbs is going to leak out of a fully carbed up muscle and go to fat.

www.K-LaserUSA.com

1-866-595-7749 Ext. 102

Dr. Perry Nickelston, DC

VP Practice Development

Tags: Integrative Treatment Strategies, Practice Tips of the Day, General by Dr. Perry
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‘Oh the economy is so bad!’ ‘How can I afford to invest in new equipment with the economy?’ ‘Our business is suffering from the economy!’ ‘It’s too expensive to advertise now with the cost of living!’ EXCUSES ALL!

If you want to be rich, successful and happy you have got to get your mindset straight right now! Thinking like this will inhibit your progress and you will attract hardship and lack into your life if you are always negative. WEALTH is a state-of-mind. You can’t get it until you believe you can get it. This is not pollyana positive mental attitude stuff. This is a Law. The Law of Attraction. Ever heard of it? If you are successful then I know you have. if you are struggling and poor then I know you have not, or chose to ignore it in disbelief. Rich and successful doctors can duplicate their status in any economy, ‘Good or Bad!’

 The time to invest in new equipment, new marketing, new employees, etc., is when the competition is NOT. They are scared too do it! But not you. You realize that competition is tough and it is the time to strike out with focused direction, innovation, and desire. Burning desire to succeed. Pain never follows the economy. What does that mean? Even in a ’so called recession’ people are still suffering and pain is a great motivator. What do you offer them that is unique and different from the competition?

So the next time you are feeling sorry for yourself and the state of the economy suck it up and realize that success is dependant on two things, YOU and ACTION!. You have to do something about it. So stop whining and start thriving.

Here are some hints to start.

1. Buy new progrrssive technology and offer it to your patients (Class 4 laser, Decompression)

2. Do more grassroots marketing to appeal to the human need for value and appreciation.

3. Spend 30-minutes a day reading positive material to improve your life.

4. Stop watching the news. Better yet the TV entirely.

5. Spend 30-minutes a day going over your goals. You do have them written down right. If not they are just wishes, not goals.

6. Call 5 old patients everyday and check up on them. YOU, not the staff.

7. Find a mentor and talk to them on a weekly basis to keep your head into success. Buy Think and Grow Rich by Napolean Hill and read it everyday. Success leaves clues. Follow the greats.

 8. Send out 5 ‘Thank You’ notes a day to exisiting patients to appreciate them.

Have fun and be the one who does not follow the recession crowd. It’s a shorter line to the front. Trust me.

Dr. Perry Nickelston, DC

www.k-laserusa.com

1-866-595-7749 Ext. 102

Tags: Integrative Treatment Strategies, Practice Tips of the Day by Dr. Perry
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If your low back pain patient is not responding to traditional therapy try to laser the Quadratus Lumborum bilaterally. I recommend 1500 joules per side for a total of 3000 joules a session. This amount of energy is necessary since 65% of this joule number is lost at the superficial layer of tissue. To reach the deeper tissue of the QL with adequate laser photon energy you need higher amounts of joules. Don’t believe me? Try it with lower dosages and then with my recommendation. See for yourself. Real world results speak for themselves. Ask the patient. They will tell you. Better yet, watch them get better before your eyes.

Make sure the patient is side lying to reach the muscle effectively. Pay close attention to he origin at the 12 rib and insertion on the iliac crest. Medial and lateral branches. Good luck and have fun. Patients will often notice an immediate decrease in pain. It usually take about three sessions for resolution of these points.

Dr. Perry

PS. Don’t forget to check satellite trigger points in the Gluteus Medius and Minimus! Always adjust POST laser. And NEVER neglect checking the bilateral psoas muscles. They are always involved with a QL problem. You can alternate laser applications and trigger point therapy from the QL to the psoas until resolved.

Dr. Perry Nickleston, DC

VP Practice Development, K-LaserUSA and Clinical Director of the Pain Laser Center, LLC in Ramsey, NJ

1-866-595-7749 Ext. #102

Tags: Integrative Treatment Strategies, Class 4 Laser Therapy, General by Dr. Perry
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