Our Approach

            PHASES OF CARE

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Phase #1

THE CONSULTATION

This will be direct one on one contact with Dr.Katz. During this time he will listen to your complaints and ask a series of very specific questions to help direct us towards the possible areas that may be causing your pain. The importance of this time cannot be overstated. One of my mentors and a brilliant diagnostician, Dr. John Mennell, would say, “Listen to your patients, they are telling you the diagnosis”. He was a master at arriving at a probable diagnosis based upon the consultation and then using the exam as confirmation. It is that model that we try to emulate.

"The Consultation drives the Examination"

  

phase2.png Phase #2

THE EXAMINATION

The examination starts with questions and ends with answers. The goal is to determine where the pain is coming from. It is divided into many parts, namely postural, orthopedic, neurological and biomechanical. The sum of these parts will help us arrive at a diagnosis. It is very important to recognize that where the pain is, is not necessarily where the problem is. Spinal nerves, through a very complex series of branches, run through the entire body. The significance of this cannot be overstated. What this means is that any pain in the body can be caused by spinal nerve irritation secondary to a herniated disc, stenosis or arthritis. Through a comprehensive examination, we will be able to differentially diagnosis the source of your pain and determine the appropriate course of treatment needed to help to resolve your condition. 

"We will only accept patients whom we sincerely believe we can help"


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Phase #3

THE DECOMPRESSION

Spinal Decompression Therapy is an extremely safe, very effective method of treating spinal lumbar (lower back) disc herniation, spinal stenosis, sciatica and spinal arthritis

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The decompression system that we utilize will allow patients to be treated in either the prone (belly down) or the supine (belly up) and even the recumbent (side lying) positions. In other words, the table will adapt to the patient rather than forcing the patient to adapt to the table. This is an extremely important feature because it will allow us to take advantage of gravitational forces to assist disc reduction. For patients that are being treated for spinal stenosis or arthritis, it may be painful to lay one way or the other, thus severely limiting treatment. By having this patient positioning option, treatment is more comfortable and therefore, more effective. Our table allows for comfortable positioning that is "dialed in" and customizable for any patient height and weight.

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Neck as well as Lower Back
Spinal Decompression Therapy can also be very effective for cervical (neck) disc herniation, cervical stenosis and cervical arthritis.

"Compression results in pain, decompression results in relief"

 

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Phase #4

THE ACTIVATION

Neural Activation

Your nervous system controls and coordinates every bodily function, not the least of which, the muscular system. The strength of our muscles depends upon the heath of its specific nerve innervation. If that particular nerve has been damaged or irritated, pain will result that may or may not include muscle weakness. However, if this condition is not resolved quickly, the pain may lessen but the weakness will start to manifest itself or, if it was present at the onset, it will likely get worse. The more chronic the condition the more the nerve becomes inhibited and the muscles continue to weaken. This is an example of a known cause and effect. It is very important to realize that many people have subtle underlying muscle weaknesses, secondary to poor nerve function that often goes completely undected. This poor nerve function can be the result of an old injury that, on the surface looks to be completely healed, but underneath, the nerve remembers the trauma and in an effort of self-preservation, essentially, “turns off”. Simply doing various types of weight-resisted exercises will only lead to failure and frustration because the nerve was never re-activated or “turned back on”. Through the use of light therapy (particularly red and infra-red) and physical mobilization/manipulation, we are able to re-activate nerves and turn them back on. Our bodies use light to communicate and stimulate function. For example, we absorb sunlight to create vitamin D. Our cells emit light when performing certain cellular functions. Light therapy is well documented for the stimulation of ATP (cellular energy) production, lymphocyte activity (cellular detoxification), increased circulation and tissue oxygenation. Light therapy has been researched and in use since the 1960’s. It has been used alone and in conjunction with surgical and medical procedures for many years. While the video below is an example of a patient whose sciatic nerve “turned off” as a result of ankle surgery, the principle is still the same, in that the sciatic nerve had to be “turned on” or activated. In spite of all the exercises she had been doing, the calf muscle remained weak. Months of frustration, was replaced by satisfaction as her strength completely returned in a matter of weeks using our neural activation treatment.

"You cannot strengthen a muscle whose nerve has been turned off"

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Phase #5

THE REHABILITATION

Core Muscle Activation

core_muscle1.png One of the most common questions that patients will ask is “What exercises can I do to get rid of my pain?” My response is “What makes you think that your pain is coming from muscle weakness?” The initial puzzled look is soon replaced with one of understanding when I explain that, while it is certainly possible that the pain is secondary to muscle weakness, it is far more likely that the pain is secondary to poor core stability. Muscles may become inhibited when pain signals from an injured area are present. This inhibition can lead to destabilization and ultimately to muscle weakness. It was been well documented in the literature that “patients with lower back pain exhibit trunk muscle recruitment patterns that differ from those in healthy controls.” What is the core? Your core is located between the diaphragm, pelvic floor, abdominal wall and back muscles. 


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Research has found that retraining the timing of contraction (synergy) of these muscles is important for the ability to maintain/re-gain lower back stability. Retraining neural pathways for using this system automatically and efficiently is the initial goal. If you begin a core strengthening program without first addressing the ability to activate the core muscles and you ignore the sequencing and timing of these muscles that you are attempting to strengthen, you will only reinforce the non-optimal patterns that you already have. In other words, if you keep doing what you’ve always done, you are going to keep getting what you’ve always got.

"Activation before Rehabilitation"





Core Stability Strengthening

Through a series of very specific spinal stabilization and muscle grading tests, we will be able to determine whether the need for spinal exercises exists and most importantly, the type of exercises to be performed. We will tailor this program to the patient, not the patient to the program. In other words, someone who is relatively sedentary will need less strengthening than someone whose job requires heavy lifting. A weekend athlete will not need the same level of exercise intensity as compared to a highly competitive athlete. These exercises can consist of a combination of floor, exercise ball, proprioceptive, and strength training exercises. You will not need to join a health club or buy any expensive machines, as all of these exercises can be done in the comfort of your home. It is crucial that you perform each exercise correctly, taking extra care to isolate the specific target muscles. We will watch you very closely and once you have mastered the movements and can perform all the exercises independently, they can/should be continued to ensure a complete and lasting recovery.

 

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                                                                 "It is not the quantity; it’s the quality of the exercise that matters most"



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