it – Page 219 – The American Chiropractor

The Triune of Exercise

When treating soft tissue injuries, especially the chronic degenerative ones, you must be well versed in the Triune of Exercise.
I’m not just talking about athletes but about patients as well. They all suffer from some type of soft tissue injury, as well as being subluxated. In fact, why do you think their subluxations persist? Because nobody ever handled the underlying soft tissue injury correctly.
Please remember this: “The nervous system controls function, but the musculoskeletal system supports the nervous system allowing it to function”. When addressing a subluxation, it would behoove you to address the soft tissue, as well, via the Triune of Exercise.
The purpose of the Triune of Exercise is to help repair and rebuild the surrounding soft tissue to compensate for the degenerative joint; and, thus, to some degree, to remodel the soft tissue, restoring normal function to that joint, reducing exacerbations and continued degeneration. This is done through the proper conditioning of the surrounding soft tissue.

The triune consists of:

Progressive resistance training (weight training)
Stretching (flexibility conditioning)
Cardiovascular (“repetitive stamina conditioning”)

In order to condition soft tissue properly you must utilize this approach. If you do not, you cannot treat soft tissue injuries effectively.

Why Stretching is Important

As you may be aware, damaged soft tissue, left untreated, causes the soft tissue to become fibrotic. Fibrotic tissue (scar tissue) causes loss of joint mobility; thus, stretching is extremely important.

Why Cardiovascular Exercise is a Great Conditioner

We all know the importance of cardiovascular exercise for our heart, lung and circulatory tree; but, are you aware of the benefits to our stamina, or the ability to do things repetitively, which often decrease as a result of soft tissue injuries? Whereas, previously, you could run for miles, you find it difficult to walk down the block, due to circulatory disturbance to soft tissue.
Progressive resistance exercises and cardiovascular exercises are extremely important in reducing muscular fatigue and enhancing muscular stamina and endurance.

Why Progressive Resistance (Weight Training) is an Important Conditioner

I saved the best for last.
Muscles lose up to 30-40% of their strength within weeks of an injury and their strength continues to decline, as time goes on. Soft tissue loses flexibility and stamina as well. The best part of weight training is that you can accomplish all three:

Increased flexibility
Increased strength, and
Increased stamina

Weight Training

About 1984, I began to exercise, using weights. At that time, weight training was gaining popularity. I started to see professionals from all fields (tennis, golf, baseball, basketball, etc.) using a specific program that included weights to enhance their performance. Prior to this, the mentality had been (and still is, to many people) that you never wanted to exercise with weights, because you would become “muscle bound” (whatever that means). Also, when you stop working out with weights, all that muscle turns to fat.
In fact, I bet half the doctors reading this article still, to some degree, believe those statements to be true. If you think I’m exaggerating, just go to any state chiropractic convention and look at the physiques of some of the doctors attending. Your physical appearance speaks volumes about you, as a doctor. After all, are we not the doctors that state, “STRUCTURE GOVERNS FUNCTION”?
Some of us look like “LONDON BRIDGE”. You want to be a super success in practice? Start looking like the healthy specimen you are capable of being.
Your body is a billboard (like free advertisement). Your state board should make it a prerequisite that, in order to practice chiropractic, you must understand the concept, and train with weights at least three times per week.
Do you not want this very same thing for your patients? Well, if you are not well versed in the physiological and anatomical relationships between weight training and its effect on function via its effect on structural integrity, then you are missing a big piece of the pie.
I cannot, in this short amount of space, even begin to explain the fundamentals of weight training without doing it a grave injustice, so I won’t even go there. Just realize that weight training, like chiropractic, has a philosophy, science and art. It requires a great deal of understanding, on your part, to be successful using this valuable tool.

Flexibility (Stretching)
Guidelines to Follow When Stretching

When developing a program of stretching for your patients, use stretches that stretch every major muscle group/joint through the respective ranges of motion, and follow the rules below:

Stretch in the morning, or evening, or both, depending on injuries or tight areas. Each session should last 15-30 minutes.
Stretching daily helps create a routine (like brushing your teeth) that eventually will become a habit. In fact, I look forward to my morning stretches, which I also use as “quiet time” to get in touch with my mind and body. By the way, the only way to gain flexibility is to stretch daily.
Taking a hot shower before the stretch loosens the muscles.
Never perform ballistic or bouncing, hard-type stretches that are painful. These exercises are dangerous and can cause a lot of joint damage.
Always use a comfortable firm surface; and, if there are low back or neck injuries, use a roll behind your neck and/or a roll behind your knees.
Always start your stretching in the lying position, then proceed to sitting, then to kneeling, and then into your standing stretches.
Always use deep, relaxed breathing when stretching.

When stretching a muscle, you must stretch as far as you can comfortably, at which point, you must focus on two things: Breathing, and blending your mind with that muscle, with the focus on relaxing it. When you reach the point in the stretch where the muscle starts to tighten and ache from the stretch, you use breathing and mind/muscle relaxation to gain more stretch in that muscle or joint. Focus on deep, relaxed breathing, gaining a little more stretch on exhalation. In other words, as you exhale, you will be able to push the stretch a little more, and then hold that position while you inhale. Then, when you exhale, you may gain a little more, or hold that position longer. Then, repeat the cycle one more time.
At this point, you can hold the position for another 10-15 seconds, and then release the stretch slowly. Your mental focus should be on consciously relaxing that muscle or joint, by visualizing the muscle relaxing.
This process can be repeated two more times, if needed, and you will get a further stretch by the third time.
At some point, you will notice that you hit your sticking point—you cannot stretch any further. You may have pain or the muscle may start to cramp. In this case, you should stop the stretch and slowly bring the muscle or joint out of the stretch. I also recommend that you lightly massage the muscle or joint that you are working while you are stretching that muscle or joint. Always spend more time on the tight muscle or the tighter side.

Cardiovascular Exercises

Walking
Jogging
Dancing
Swimming
Cycling
Skating
Aerobic classes
Climbing
Cross-country skiing
Rowing

Progress resistance performed one set after another with little or no rest (circuit training)

Guidelines to Follow When Creating an Aerobic Program for Your Patients

Make sure that the exercise fits the patient. Overweight patients or patients with knee injuries, etc., should not jog, play basketball, etc.
Monitor and keep score of their pro-gress. When it comes to measuring your patients’ cardiovascular performance, their pulse and respiratory rates must be determined. This is what you should measure—not how much weight they are losing. It is interesting to note that most people do cardiovascular exercise for weight loss, which is not the purpose when measuring cardiovascular performance. As you condition your body properly, cardiovascular exercise will cause the weight to come off, provided you are eating right and intensifying your conditioning, using your pulse and respiratory rates as indicators. You must be able to take the following measurements:
· Resting heart/pulse rate.
· Target heart/pulse rate (approximately 60-80% higher than the resting rate).
· Resting respiratory rate.
· Target respiratory rate (approximately 60-80% higher than the resting rate)
There are three phases of cardiovascular training that patients must go through.
· Warm-Up Phase: This portion takes five-to-ten minutes, as you approach your target heart rate.
· Maximum-Effort Phase: This takes from ten-to-twenty minutes. When achieving higher levels of conditioning, you want to intensify your routine by using methods other than time (how long you work out). Grueling sessions lasting hours at a time, or working out countless hours during the week lead to burnout and poor results.
  There are other ways to intensify your cardiovascular program; wind sprints are an excellent example. This procedure is not for the beginner, but for the athlete, or someone already in good condition. Wind sprints are performed toward the end of maximum effort when you increase your speed to the point of labored breathing, which takes focus and perseverance. Sustain this level for as long as you can and then slow back down to your maximum-effort level. Once you catch your breath, you repeat the sprint two or three more times. Please note that wind sprints will take your target heart rate over 100 percent, so be careful. For those just starting out, the goal is to nudge the target rate up over time.
  How much time? That depends on your age, your condition, your diet, etc. Just continually push the envelope and reach higher target heart rates for up to 40 minutes and then you will be ready for wind sprints.
· Cool-Down Phase: This takes five to 10 minutes, as you slow your pace and come to the end of your routine.
How often should your patient perform cardiovascular conditioning? Three or four aerobic workouts per week are sufficient for most people. Any more, and you are causing too much stress on the body.
Remember, it is not how many times or how long you exercise; it is the intensity of your exercise sessions. And, there you have it: An exercise program that will support and improve sports injuries, degeneration, and joint damage. TAC

Dr. James Cima has been teaching, and writing on this subject for 20 years. Dr. Cima also teaches seminars and has created a software package for the doctors to help them assess their patients’ needs. For more information, call toll free 1-877-627-2770 or fax 561-624-3871, or e-mail Dr. Cima at [email protected].

Hamstring Strains and Orthotic Support

Hamstring injuries and athletic running seem to go together. The injuries also tend to reoccur and become chronic. Often, the recovery rate becomes frustrating for the athlete as well as the practitioner. While the etiology remains controversial, the primary causes may be considered, in order to enhance recovery and prevent reinjury.

Main Causes

Some of the most common causes of hamstring muscle strains are:

muscle fatigue
muscle strength imbalances
lack of hamstring flexibility
insufficient warm-up

Hamstring muscle strain is a non-contact injury that presents in two ways: sudden onset with acute pain (runner pulls up and grabs his/her leg), or a more insidious onset of muscle tightness. Typically the biceps femoris, with or without the semitendinosus, is involved. The area most commonly inflamed is the proximal and lateral musculotendinous junction of the hamstring near the ischial tuberosity.

Acute Phase Treatment

During the acute, painful phase, the goal is to reduce inflammation. Ice works best; don’t use heat. As a general rule, use ice for twenty minutes, every two hours (during the hours the patient is awake), until the pain is gone. A light towel or face cloth should be used to protect the skin, even though it will dissipate some of the cooling effect. This treatment may be utilized from two days to two weeks.
The injured athlete should be advised to maintain a normal walking gait, even if it means walking with a cane or crutch on the opposite side (the toe of the cane or crutch should always be in line with the toe of the injured side). Most athletes aren’t happy with this advice, but to compromise the gait into a hobble will only prolong recovery.

Rehab Protocol

Active knee extension and flexion without resistance should be performed as soon as tolerated by the patient. Some pain may be experienced during this motion, as long as it is not increased pain. When the athlete can perform knee extension and flexion with little to no pain it is usually safe to perform these two range-of-motion exercises against resistance with an at-home rehab system. Be particularly aware of pain. Initially, the range of motion and/or the amount of resistance may be limited. Set them to patient tolerance.
Do the uninvolved side first. An effective protocol is:

• 1 set to fatigue of knee extension (uninvolved side)
• 1 set to fatigue of knee extension (involved side)
• 1 set to fatigue of knee flexion (uninvolved side)
• 1 set to fatigue of knee flexion (involved side)

Repeat the sequence above two more times. This protocol should be done daily at first, and then progressed to twice daily as the patient recovers.
I recommend doing one extra set of knee extension exercises, because according to the hierarchy of strength in the body, the extensor should be slightly stronger than the flexor.
If any soreness develops, follow the rehab exercises with ice. Do not let your patients overwork themselves. Athletes have a tendency to do too much too soon and reinjury occurs. This type of protocol is designed to facilitate neurologic firing into the involved muscle(s) and initial strength gains. As muscles get stronger they will naturally be able to do more. Let pain be your guide. This type of exercise will also build up endurance levels over time.

Proper Stretching Activity

Stretching is important, but only if done correctly. Many people stretch their hamstrings by bending over a propped-up knee and curling their back to touch their forehead to their knee. This will not effectively stretch the upper portion of the hamstrings where the injury site is. Do that stretch, but arch the lower back to create anterior pelvic tilting and lean the body forward, keeping the head level.

Evaluation of Progress

To progress to activity, an athlete should be able to:

walk without discomfort
jog straight ahead without discomfort
run straight ahead without discomfort
run with change of directions without discomfort
perform the tasks of his/her athletic activity without discomfort

As with any condition involving the lower extremity, thoroughly evaluate the sacroiliac joints and the spine. Subluxation complexes can create structural imbalances, and muscular imbalances may also be playing a role.

Orthotic Support

You must also look for involvement of the knee and/or foot/ankle complex. Remember that the most common painless biomechanical fault is excessive pronation. Excessive inward rotation of the mid-foot and rear-foot can set up a serial distortion, resulting in structural misalignment and muscle imbalances. Without stabilizing this area with custom-made, flexible orthotics, reinjury will always be a concern, even with the best rehab program. Consult with an established orthotics laboratory about specialized shoe inserts for athletes. TAC

Dr. John Danchik is the seventh inductee to the American Chiropractic Association Sports Hall of Fame. He is the current chairperson of the United States Olympic Committee’s Chiropractic Selection Program. He lectures extensively in the United States and abroad on current trends in sports chiropractic and rehabilitation. Dr. Danchik is associate editor to the Journal of the Neuromusculoskeletal System and the Journal of Chiropractic Sports Injuries and Rehabilitation. He has been in private practice in Massachusetts for 24 years. You may reach Dr. Danchik at (617) 489-1220 or e-mail [email protected].

Soft Tissue Stress and Rehabilitation

The body’s soft connective tissues (such as muscles and ligaments) are generally exposed to stress throughout life. Such structures respond and adapt to the usual amount of stress exposure. Damage occurs when soft tissues are exposed to higher-than-usual stress levels. This can be a single, sudden, excessive stress, or it can be the result of repetitive stress to the muscle or ligament. In either case, the doctor of chiropractic must determine how the damage occurred, and then make appropriate recommendations (rehab following rest, for example) to help the body heal the injury and to prevent a recurrence.
Problems can also develop when these tissues are not exposed to sufficient regular stress to maintain functional health. It’s important to recognize that the soft tissues in the body are normally used in a range of intensity, and that categorizing a patient’s level of use helps in the planning of care and exercise regimens.

The Range of Soft Tissue Use

What we usually consider to be normal use is in the middle of the usage range. At one end is paralysis, where soft tissues are completely unused. Close to paralysis is immobilization, such as in use of a cast or bed rest. The difference between these is that paralysis lacks a neurological stimulus, called “tone,” which is present in immobilized (yet still neurologically intact) muscles and skeletal ligaments.¹ Next is sedentarism, when the ligaments and muscles are used only minimally. This is also called the “disuse syndrome”.² This condition is, unfortunately, becoming more common in all age groups in our rich, advanced society, which has so many labor-saving devices. Normal use can vary widely, but requires the intermittent and regular exercise and use of all muscles and ligaments. Those who are employed in active (often blue-collar) jobs and people who engage in regular, active recreational pursuits fall into the strenuous use category. And then there are the athletes, who are always trying to improve and push their limits by specifically building and strengthening their muscular and skeletal ligament tissues.³ Athletes are at the far end of the continuum, demonstrating the body’s response to progressive overload.

Damage through Overuse

The muscles and ligaments in any of the above categories can be overused and damaged. Less stress is needed to cause injury to tissues in the lower use end of the continuum. After several days of immobilization, or when someone has been on bed rest or is a couch potato, even mildly strenuous effort can be too much. Fitness protects from some injuries, especially overuse conditions of the spine. Athletes, who are regularly pushing their muscles and ligaments, are most likely to end up with either overuse or acute injuries. There are two major categories of excessive stress to ligaments and muscles—repetitive use (chronic, over time),⁴ and sudden injury (strain or sprain) with tissue tearing.
Repetitive overwhelm. When muscles and ligaments are stressed, they respond by repairing and strengthening. In some cases, however, the physical stress occurs so frequently that this process is overcome, resulting in damage. Examples include runners who quickly increase their mileage, workers who are placed in a new position which requires repetitive movement or bending, and athletes who practice throwing to the point that they injure their shoulders. Even someone taking up walking after years of standing on rigid flooring can quickly overwhelm the foot’s ability to strengthen, developing plastic deformation of the plantar fascia with arch collapse.
Acute injury. Of course, trauma to a ligament or muscle is a single episode of stress which causes damage. When a muscle or ligament is torn, there is immediate pain, followed by swelling and loss of function. Around the spine, this is often a complex injury, since it is inevitable that several layers of both muscles and connective tissues will have been damaged (a “strain/sprain” injury). Understanding of the healing response is necessary for good management of acute injuries to muscles and ligaments, wherever their location.

Healing Response

Whether damaged by repetitive overuse or by acute injury, muscles and ligaments will heal most rapidly and completely when they are cared for properly. A brief period of “relative rest” is important, the amount depending on the extent of injury. This may require a brief period of immobilization of the damaged region, followed by gradual reintroduction of movement and activity.5 Then, reactivation is necessary; this usually requires specific exercise instruction and expert guidance. The patient should be encouraged to return to the level of pre-injury, and then advised on preventing further injury, either by providing additional response time or by improving muscle strength and balance (or both). Exercise tubing (with areas targeted for rehabilitation) and a wobble board are usually helpful adjuncts.
Occasionally, ligaments become damaged and deformed to the point that full repair is not possible. In these cases modification of stress may be necessary, either through changes in activities or through the use of supports, such as knee braces or custom foot orthotics.

Conclusion

It is vitally important to understand the status of a patient’s muscle and ligament tissues prior to injury. It is also necessary to realize how these tissues became overwhelmed. Was it from an acute injury, or can a history of repetitive insult be uncovered? Once the doctor of chiropractic has the information for the “start point” and an understanding of the method of stress damage, proper care can proceed rapidly. This is what separates caring doctors of chiropractic from those providers who prescribe drugs or bed rest for ligament and muscle injuries. TAC

Kim D. Christensen, D.C., C.C.S.P., D.A.C.R.B., founded the SportsMedicine & Rehab Clinics of Washington. He is a popular speaker, and participates as a team physician and consultant to high school and university athletic programs. He is currently a postgraduate faculty member of numerous chiropractic colleges and is the president of the American Chiropractic Association (ACA) Rehab Council. Dr. Christensen is the author of numerous publications and texts on musculoskeletal rehabilitation and nutrition. He can be reached at Chiropractic Rehabilitation Consulting, 18604 NW 64th Ave., Ridgefield, WA 98642 or by e-mail at [email protected].

Helping the Most People with Homeopathy & Chiropractic

In the heart of almost every chiropractor is the desire to help people. However, our society is plagued with chronic recurring health problems not effectively treated by conventional medicine or chiropractic!
Many sincere and searching chiropractors have turned to complex, time consuming procedures to help the chronic majority in our society. These labor-intensive procedures are wonderful tools. However, these great tools can leave the doctor burned out and unable to significantly reach a sick and suffering society with the greatest good.
The problem is that labor-intensive procedures have become primary procedures for many well-meaning practitioners. These labor-intensive procedures have caused:

Physical burnout
Small practices helping only 5, 10, 20 or 30 people in a day’s work
Impairment in financial potential
Patients unwilling to commit to the time required
Patients unable to commit to the money required
Inability to significantly impact a society in great need

The doctors in greatest demand are the ones offering safe natural solutions to the common health problems perplexing our society in a timely and cost effective manner!
New contemporary breakthroughs in homeopathy now empower the chiropractor with the broadest therapeutic armamentarium to quickly and effectively correct the majority of chronic recurring health problems in our society. These new procedures have turned this once complex healing art of homeopathy into a simple and easy system for the chiropractor to effect the greatest good.
It makes far more sense to use the more streamlined time efficient, cost effective and curative procedures first, and save the time-consuming labor-intensive procedures for only when they are needed. Prioritization of these procedures empowers the chiropractor to be of the greatest value to society.
The new contemporary applications of homeopathy and chiropractic offer the most time efficient cost effective and curative procedures for the high volume, broad-spectrum practice. Properly applied, homeopathy can empower the chiropractor to effectively help 50-to-100+ patients in a day.
The ability to see high volumes of people is essential to significantly and positively impact a sick and suffering society in great need and desiring help.
The majority of the public is affected by some so-called incurable or recurring problems that neither medicine nor chiropractic has been able to resolve. These people are open to, hungry for, even hoping and praying for someone to come along with an answer to their dilemma. Dis-ease has been robbing people of their quality of life and length of years for too long. The majority of the population is seeking a doctor willing to step up to the plate and try to help them.
People are willing to step beyond the restrictions of insurance and managed care to find someone with a possible answer. The answer to their prayers can be YOU. Are you willing to break the mold and get out of the box? Are you ready to legally and ethically step out and experience the potential awaiting you?
Are you ready to be liberated as a chiropractor, and freed from the bondage of insurance carriers and managed care? Do you desire to help more people and broaden your scope of influence? Do you want to increase your value as a DC? Then homeopathy is for you!

New Contemporary Procedures

The key to our success with homeopathy is not only the product but also the procedures. We have turned what was once a complex, time consuming healing art, into an easy and accessible system for the high volume practice.
The bottom line is how many people can we most effectively help! Homeopathy, like chiropractic, works bioenergetically to correct the plethora of nerve interferences where the hands of the chiropractor cannot. Hence, homeopathy enables us to better complete chiropractic destiny by equipping us to successfully impact the whole nervous system and correct the majority of health problems we have been unable to effectively do in the past.
If this is the style of practice you want then homeopathy is for you. Enjoy the journey! TAC

Frank J. King Jr., N.D., D.C., is a nationally recognized researcher, author and lecturer on homeopathy. In addition, Dr. King is the founder and director of King Bio Pharmaceuticals, a registered homeopathic manufacturing company dedicated to completing chiropractic destiny with the marriage of homeopathy. Dr. King offers, complimentary, to all Doctors of Chiropractic his turnkey procedural system for the high volume practice called, The Chiropractic Enhancer systemTM (CES). It is so easy to use that you can successfully apply homeopathy in your practice using any company’s products in one day.
Call King Bio Pharmaceuticals, Asheville, N.C. 1-800-543-3245 or e-mail: [email protected].

Consciousness is the Key

I was recently interviewing a “chiropractor of the month” for our On Purpose tape series. She is also a Total Solution graduate and runs a very successful practice in Georgia. We got on the topic of what it had taken to build her practice, and she communicated to me that she had gone from zero to 250 patient visits per week in her first week. After I picked my jaw back up, my reflex interrogation was, “What did you do? How did you make that happen?” I knew that these were the wrong questions as they were leaving my mouth. My experience, after consulting with thousands of chiropractors, tells me that success is a consciousness and not a procedure. Give me a room with one hundred chiropractors in it. Let me teach them all the same procedure. Have them all execute it the same way. They will get one hundred different results.

Don’t get me wrong, extraordinary procedures are vital to a successful practice. Without them, a practice has no staying power and the practitioner burns out. But, extraordinary procedures void of a consciousness of success and purpose will not build a dream practice. Incidentally, when I asked the chiropractor above who saw 250 visits her first week how she had done it, she replied, “ I worked as an associate for years in a practice that saw over 1,000 patient visits per week. When I started my own practice, I didn’t expect it to be any other way”. It wasn’t her procedures as much as it was her consciousness, which created her expectations, which created her reality. It is procedures that will continue to bring her consistent, rewarding, low stress results. It is consciousness that creates the practice in which the procedures can be used.

Chiropractic is a consciousness before it is anything else. It entails a critical philosophy that creates a mindset that directs thinking and actions and provides purpose—purpose being defined as the object for which something exists. This consciousness, which provides purpose, is the very foundation on which a human life is built. Mediocrity and failure come from an undefined, contradictory philosophy, which leads to a muddy consciousness (mudhead), which leads to a lack of purpose, which leads to a constant state of survival, no matter how good your procedures are. Success, wealth, and reward come from a well defined, non-contradictory philosophy, which leads to clear consciousness, which leads to a powerful sense of purpose, which leads to a constant state of success and perpetual, never ending improvement.

For the past several years, success consciousness has been a serious cultural trend. Companies like Nightengale-Conant, Successories, and so on, are testaments to this. Unfortunately, many self help gurus have their followers try to create a success consciousness through hype and psychological means. This leads to short term benefit and, indeed, the person applying such techniques may end up in a less desirable self-circumstance due to the roller coaster effect. When you try to improve yourself based on psychological hype, you typically end up with an “adrenalin high” which is short lived and drops you hard. This creates a phenomenon I refer to as the “self help junkie”. It is kind of like people who spend their whole lives going from diet to diet, always losing weight when they start the new diet, gaining it back, and then going to the new diet, hoping for a better result, and ending up having the same experience. In chiropractic terms, these types become seminar junkies. The signs and symptoms demonstrate that the afflicted go to seminar after seminar, get pumped after each, the practice goes up for a short while, and then drops, until the next program. Don’t get me wrong. I love seminars and lecture at over fifty a year. An appropriate experience, though, would be a continual qualitative and quantitative change in your practice and personal experience as a result of attending these programs. If you are not improving or, worse yet, if you’re burning out, you are working from the wrong model and wrong consciousness.

If you are trying to deal with issues on a psychological, rather than philosophical, level, you are dealing with effect, rather than cause. This creates the “junkie’s” dependency. Psychological emotions are secondary to interpreted perceptions, which are the primaries. In other words, it is your perceptions, filtered through your philosophical constructs, which result in your emotional responses. Many people share a common experience, yet may end up with very different emotional responses. A certain event may occur, and one person may be thrilled, another horrified, and a third indifferent. The event is the same. The perception of it, based on individual philosophies, may be different, thus, leading to different psychological experiences. Therefore, if we start developing ourselves on the psychological level, without first addressing the philosophical level, we may end up in a rat’s maze. I’ve consulted with a lot of chiropractors who find themselves there. Each new technique that gets them to “change their emotional state” just sends them down another blind alley.

In summary, in order to develop a success consciousness, one must start by clearly identifying ones philosophical premises without contradiction, develop a long-range conceptual purpose (which only humans can do), and then experience the psychological and spiritual results. The cleaner your philosophy, the greater your experience and rewards. There is a great trend toward self-improvement and expanded consciousness. Without philosophy, it’s all smoke!

A 1983 graduate of Life College, Patrick Gentempo, Jr., D.C., is co-founder and CEO of the Chiropractic Leadership Alliance, in Maywood, NJ, and co-creator of the Total Solution program. An internationally renowned chiropractor, lecturer, and consultant, he has helped thousands of chiropractors achieve success and balance in their lives. For information about CLA seminars, products, and services, call 800-285-2001, or visit www.subluxation.com.

NATIONAL ASSOCIATIONS NEWS UPDATE

American Chiropractic Association
Wal-Mart, ACA Meet to Discuss
Value of Chiropractic

The ACA and Wal-Mart forged a new working relationship after meeting in December 2002, to discuss the company’s decision to drop chiropractic services from its employee benefits in 2003. Wal-Mart indicated a willingness to look at new data regarding the cost-effectiveness of chiropractic care.
The ACA was represented at the meeting by ACA President Dr. Daryl Wills, ACA Chairman Dr. James Edwards, ACA Executive Committee Member Dr. George McClelland and ACA Vice President Patricia Jackson. Wal-Mart representatives included the Senior Vice President for Benefits and Claims, and the Vice President for Benefits. Dr. Ted Morter, III, a local DC whom Wal-Mart officials know and respect also attended.
ACA presented Wal-Mart with research showing how chiropractic can reduce costs by deterring the need for drugs. “We want Wal-Mart employees to have a choice in health care, and allowing employees to choose chiropractic will benefit not only their health, but also their productivity,” explained Dr. Wills.
The benefit that Wal-Mart is cutting in 2003 impacts approximately 85% of associates enrolled in the PPO plan. The remaining 15% of associates with HMO coverage, and those with Workers Compensation claims, have chiropractic benefits intact. Although only 15% of Wal-Mart employees choose to enroll in an HMO, over a third of Wal-Mart employees have access to an HMO.
“Losing chiropractic as a core benefit will be a deterrent for employee utilization,” said Dr. Edwards. “ACA will work with Wal-Mart to ensure paid health care options for employees who choose non-surgical and drug-free care.”

International Chiropractors Association
New Coalition Organized to Defend Chiropractic Independence

According to a newly formed coalition, chiropractic is in danger of being taken over by a group of medically oriented chiropractors and organizations who are trying to change the very nature of the profession, and in the process minimizing the profession’s unique role in health care and possibly placing the public at risk.
The Chiropractic Coalition—founded in November 2002 by three major chiropractic organizations, the International Chiropractors Association (ICA), the World Chiropractic Alliance (WCA), the Federation of Straight Chiropractors and Organizations (FSCO)—cautions that several rogue groups are trying to position chiropractors as quasi-medical doctors, unnecessarily and irresponsibly blurring the boundary lines between the professions and confusing the public.
The Coalition specifically referred to the Council on Chiropractic Education (CCE) and the Federation of Chiropractic Licensing Boards (FCLB) as two of the groups, which were overstepping their authority in an attempt to control the direction of the profession.
“These groups, which are by no means representative of the tens of thousands of doctors of chiropractic active in the United States, are trying to change educational requirements and state licensing statutes to allow, and even require, chiropractors to diagnose and treat diseases and medical conditions, at the expense of the focus on chiropractic’s unique procedures,” noted ICA President Dr. D.D. Humber. “Public interest in and demand for subluxation care is growing, and their needs and concerns must be chiropractic’s first priority.”
The real danger, warns the Coalition, is that chiropractors will be forced to provide services that aren’t within the scope of chiropractic. Expecting chiropractors to act as medical doctors will not only destroy the unique character of chiropractic, but most importantly will put the public at risk, the Coalition says.

World Chiropractic Alliance

Kristina M. Collins, D.C., a member of the WCA International Board of Governors, is one of six new members appointed by the National Center for Complementary and Alternative Medicine (NCCAM) to its National Advisory Council on Complementary and Alternative Medicine. The Council is the principal advisory group to NCCAM, a component of the National Institutes of Health. Dr. Collins is a subluxation-based doctor who enjoys educating the public about the role of chiropractic in health and wellness, and about the benefits of chiropractic for children.
The WCA has issued a position paper on the duty of chiropractors to diagnose, inform patients of unusual findings, and make referrals to other health care practitioners. The lack of a standard definition of chiropractic diagnosis has resulted in numerous malpractice lawsuits and confusion among the public. “The health care landscape is dotted with malpractice land mines. The World Chiropractic Alliance’s position paper is intended to provide guidance in these matters, and support in court and before boards,” the WCA announced. The paper is posted on the WCA website, www.worldchiropracticalliance.org.
A new WCA Chiropractic Advocacy Council, headed by Matthew McCoy, D.C., has been formed to help doctors locate resources to defend themselves in court or before a board, respond to media attacks, and combat discrimination by regulator agencies, HMO’s, insurance companies, state chiropractic organizations, and other groups. The Council provides information, resources, and support on issues such as diagnosis, stroke, caring for asymptomatic patients, record keeping and chiropractic for children. For more information, visit www.worldchiropracticalliance.org/councils/advocacy.htm. TAC

“I Don’t Have Enough Time”

The battle cry of so many chiropractors today seems to be, “I don’t have enough time!” The funny thing about this statement is that everyone has exactly the same amount of time–24 hours a day, seven days a week. Why is it that some people seem to accomplish so much, and others can barely boast about completing a few small tasks? It all has to do with how you utilize your time and the results you choose to focus on during the time you have available.
You need to focus on increasing your results with the same amount of, or less, effort. One way to accomplish this is through improving your ability to complete a specific task. You can improve your ability by developing a better understanding of time management. Most people feel that they are already efficient with their time. They have absolutely no idea how they could possibly fit one more activity into an already seemingly filled schedule. The answer is simple. If you improve your ability to perform your tasks, you will find that you have created more time.
In actuality, you are just managing the time you have always had in a more efficient manner.
Two important factors to evaluate when seeking to improve your ability in any area are:
1. The organization of your systems
2. The training you possess for the specific jobs you are trying to accomplish
How would you go about improving these particular areas? Start by examining the organization of the systems you currently have in place. Look at the intended results of a specific system and determine if the system is accomplishing the task it was originally created to achieve. If not, what has changed since the inception of this system? Get back to the basic reason the system was created and take out any unnecessary steps. Only keep the systems that are producing results with the least amount of time and effort. Planning your time is critical because it dramatically reduces the chances of someone else’s planning your time with some “emergency”.
Consider your own daily system for completing tasks. Most people waste time because of the inefficient way they plan their days. The most efficient time management technique is a three-part system that includes a:
1. Master List
2. Production List
3. Top Five List
The Master List contains everything you would like to accomplish in the next month. It is a strategic overview of your projects. Your Production List is a daily listing of the specific tasks you would like to accomplish during that day. The Top Five List is the most important five tasks that must be completed today. Compile your Top Five List by taking five actions from your daily Production List and handwriting them on a large piece of paper prominently placed within easy view. Focus your energy on this Top Five List. Do not deviate from that list until all five items have been completed. Once that is accomplished, fill out another top five items from your Production List. By having a specific list of tasks, your attention is focused on the most important matters of the day. It is easier to stay on track when your activities are already planned.
The other important area of time management is training. The better trained you are at a specific task, the more efficient you will become at completing that task. The same holds true for your staff. You should hold weekly training sessions for your entire staff. Training topics should be taught and then reviewed on a regular basis. This gives each staff member an opportunity to improve their value and become better at their specific jobs, including you.
If a staff member thinks they alrea

The New Lifestyle: Chiropractic, Exercise, Nutrition & Wellness

Physical Activity and Good Nutrition

It’s a sad fact that chronic disease accounts for seven of every ten U.S. deaths, and for more than 60% of medical care expenditures. The prolonged illness and disability associated with many chronic diseases decrease quality of life for millions of Americans.
The chiropractic profession long has taken the stance that, with proper intervention and education, most chronic diseases are preventable. Physical inactivity and unhealthy eating contribute to obesity, cancer, cardiovascular disease, and diabetes. Together, they are responsible for at least 300,000 deaths each year. Only tobacco use causes more preventable deaths in the United States. Chiropractors, with a wellness orientation, teach their patients to avoid the behaviors that increase their risk for chronic diseases so that they can live healthier and longer lives.
Obesity has reached epidemic proportions in the United States where over 45 million adults are classified as obese. A disturbing trend shows that this epidemic is not limited to adults. The percentage of young people who are overweight has more than doubled in the last twenty years! 10%-to-15% of Americans ages six-to-seventeen years—about eight million young people—are considered overweight.
More and more patients are seeking the trusted advice of their doctors of chiropractic in matters of nutrition. It’s a fact that chiropractors receive significantly more hours of education in the subject of nutrition than their medical colleagues. Chiropractors must take an active role in promoting regular exercise and healthy eating.

Lack of Exercise

Exercise substantially reduces the risk of dying of coronary heart disease, the nation’s leading cause of death. It has also been shown to decreases the risk of colon cancer, diabetes, and high blood pressure. Exercise also helps to control weight; contributes to healthy bones, muscles, and joints; reduces falls among the elderly; helps to relieve the pain of arthritis; reduces symptoms of anxiety and depression; and is associated with fewer hospitalizations, physician visits, and use of medications.
Exercise does not need to be strenuous to be beneficial. People of all ages benefit from moderate physical activity, such as thirty minutes of brisk walking, five or more times a week. However, despite the proven benefits of physical activity, more than 60% of American adults do not get enough exercise to provide health benefits. More than 25% are not active at all in their leisure time.
As with obesity, insufficient exercise is not limited to adults. More than a third of young people in grades 9-12 do not regularly engage in vigorous exercise. Daily participation in high school physical education classes dropped from 42% in 1991 to 29% in 1999.

Healthy Eating

Although Americans are gradually adopting healthier diets, a large gap remains between recommended dietary patterns and what Americans actually eat. Only about one-fourth of U.S. adults eat the recommended five or more servings of fruits and vegetables each day. Poor eating habits are often established during childhood. More than 60% of young people eat too much fat, and less than 20% eat the recommended five or more servings of fruits and vegetables each day.

Vegetables without Vitamins

Even when your patients do consume the recommended servings of fruit and vegetables, often what they eat is devoid of nutritional value. When a nutritionist recently went to check out the latest US Department of Agriculture food tables, he found that some vegetables had extraordinarily low levels of vitamins. The explanation he received was that the nutrient drain should be put in context. It was explained that the 78% decrease in calcium content of corn was not significant because no one eats corn for calcium! Furthermore, he was told, the problem may not even exist at all. The apparent nutrient dips result from the testing procedures. For example, changes in the public’s perception of what the edible portion is may determine what parts have been analyzed over time. In other words, back when the old food tables were made up, people may have been eating the corncob, too, so they got more nutrients. So now you know why people need their vitamins!

Nutritional Supplements

Many chiropractors are contemplating whether or not they should offer vitamin and nutritional supplements to their patients. One thing is clear, whatever doctors think of it, your patients have already made up their minds!
Nutritional supplements are big business, and a significant proportion of the population is taking them. It’s estimated that about half of all Americans regularly use nutritional supplements not prescribed by their doctors. A quick trip to the local health food store will reveal tablets with every imaginable combination of nutrients, vitamins, herbs, homeopathic remedies, whole food products, neutraceuticals, and more, in countless doses and formulations. And it’s not just the health food store. These days, the local pharmacist and even the supermarket offer much the same spectacle. Vitamin companies spend millions of dollars in advertising hoping to convince the consumers to buy their brand. Catchy phrases and fancy buzzwords are used to entice, stimulate and often mislead the general public.
More doctors are selling health-related products and, for this reason, it is important that you select reputable nutritional supplement companies. Chose companies that use an FDA approved laboratory, conduct regular ingredient assays, and those that manufacture nutritional supplement formulas that make sense. A word of caution: Prior to dispensing nutritional supplements to your patients, you should check the scope of chiropractic practice in your state. The scope of practice varies from state to state when it comes to dispensing supplements. The chiropractic scope of practice in the state of New Jersey, for example, does not allow chiropractors to “sell, dispense or derive any financial benefit form the sale of vitamins, food products or nutritional supplements.” By contrast, the chiropractic scope of practice of the state of New York allows chiropractors to perform “nutritional counseling, including the dispensing of food concentrates, food extracts, vitamins, minerals, and other nutritional supplements.”
When prescribing supplements to your patients, be sure to perform a thorough drug and dietary history. Many supplements can produce unwanted side effects when taken in combination with prescription and over-the-counter drugs. For example, one popular herbal remedy, Saint John’s Wort, is now known to interfere with the action of a wide variety of prescription medications. To help keep you up to date about the nutritional supplement market, the publishers of the Physicians’ Desk Reference recently released the PDR for Nutritional Supplements, which provides scientific analyses of the health benefits—or lack of—for hundreds of over-the-counter products ranging from vitamins to shark cartilage.
A good relationship with the supplement company’s sales representatives can also be very helpful. An effective sales representative will keep you informed of the latest advances in their product line and will also provide you with useful patient education materials. Some nutritional supplement companies provide physicians with nutritional surveys and assessments that are helpful in determining the supplementation needs of your patients. Others provide seminars with credentialed experts on a variety of nutrition-oriented topics. Those doctors who are considering adding nutritional supplements to their practice would do well to sharpen their clinical skills with continuing education courses on the subject. Those chiropractors who become passionate about the possibilities of nutrition can also complete a 300-hour course of studies toward a Diplomate through the American Board of Chiropractic Nutrition.
Chiropractic care does not exist in a vacuum. Good nutrition plays an integral role in the maintenance of optimal health. When properly researched, and effectively managed, advising your patients to include nutrition as part of their overall approach to wellness makes good sense. TAC

Dr. Mark Sanna is the CEO of Breakthrough Coaching, LLC, the leading resource for personal coaching to chiropractic and multidisciplinary practices throughout the country.
He can be reached at Breakthrough Coaching, LLC, by calling 1-800-7-ADVICE.

Nutritional Adjustment with Coenzyme Q10

Myopathology is considered by most, if not all, chiropractors to be a component of subluxation. This is a reasonable view, as degenerative changes are known to occur in muscle after injury, during hypomobile states, and as part of the so-called normal aging process.

Most will recall that muscles, and all other cells for that matter, function properly as a consequence of mitochondrial production of ATP (adenosine triphosphate). In Dr. Janet Travell’s famous text on trigger points, she explains that TP’s are characterized as areas of “energy crisis” within muscle.

It is now known that mitochondrial dysfunction is responsible for promoting cell injury and death. For details on this relationship, see Robbins’ pathology¹ and specialty texts devoted to this subject.² Aging, neurodegenerative diseases, heart disease,² and most other chronic diseases are promoted by, or at least associated with, mitochondrial dysfunction.

Coenzyme Q10 appears to be the most important mitochondrial factor that we can use in supplemental form. CoQ10 produces several well-documented effects, including energy production and antioxidant defense, and it is now thought that CoQ10 regulates global gene expression in skeletal muscle. Consider these important functions in light of the fact that body tissue loss of CoQ10 as we age is massive.³
These dramatic losses should also be considered in the wake of “statin” drug prescriptions for cholesterol reduction. CoQ10 reductions with age can be compounded by statin drugs. For example Lovastatin can reduce serum CoQ10 levels by as much as thirty percent.³

During the aging process, a “damage mosaic” develops that is unique to each individual. During the lifetime of an individual, mitochondrial DNA undergoes a variety of mutation events and rearrangements. These mutations and their consequent bioenergetic decline, together with nuclear DNA damage, contribute to the reduced function of cells and organs⁴.

In skeletal muscle, this functional decline can be observed by means of changes with age in fiber type profile, and by the reduction in number and size of the muscle fibers. In a recent trial, human subjects about to undergo hip replacement surgery received 300 mg CoQ10 per day for 25-30 days before surgery, whereas control subjects received placebo treatment.⁴ At the time of surgery, samples of vastus lateralis muscle were taken from the same regions in both groups, and gene and protein expression patterns and muscle fiber type profiles were compared between placebo and CoQ10-treated subjects. Those taking CoQ10 demonstrated a dramatic change in muscle fiber types towards profiles of young people,⁴ in other words, myo-pathology of aging was reversed.

Nutritional replenishment of coenzyme Q10 requires a higher level than is available in most food (highest in pork hearts and chicken legs; low in fruits and veggies). The normal level in blood is around 1 mg/mL. To increase the concentration significantly requires at least 100 mg/day which increases the level in blood to around 2 mg/mL.³

An increase to 2 mg/mL in blood can be therapeutic for various conditions; this may indicate that a high blood level is needed to get coenzyme into deficient tissues. Even with large amounts of heart or herring in the diet, it would be difficult to supply 100 mg/day.³

In a more recent study publicized in the media, CoQ10 supplementation was reported to delay Parkinson’s disease (PD) progression. Patients were followed for up to 16 months, and it was determined that coenzyme Q10 was safe and well tolerated at dosages of up to 1200 mg/day. Less disability developed in subjects assigned to coenzyme Q10 than in those assigned to placebo, and the benefit was greatest in subjects receiving the highest dosage. Coenzyme Q10 appears to slow the progressive deterioration of function in PD, but these results need to be confirmed in a larger study.⁵ TAC

Dr. Seaman is the Clinical Chiropractic Consultant for Anabolic Laboratories, one of the first supplement manufacturers to service the chiropractic profession. He is on the postgraduate faculties of several chiropractic colleges, providing nutrition seminars that focus on the needs of the chiropractic patient. Dr. Seaman can be reached by e-mail at [email protected].

Alternative Healthcare

Our Often Misguided Instincts

Many of our beliefs were created by advertising. A healthy body is the best advertisement. It depicts a healthy life, which is the reality. Beliefs are acquired throughout time, starting when we are very young. We acquire a sweet tooth, and a taste for junk food. We learn most of our behaviors from our culture, including our diet. We must look at our culture—and at our entire species—and determine what effects the diet has, by watching what the diet does. Asian countries have a diet primarily of rice, vegetables and fish, while the Western diet consists mostly of meat, dairy products, bread, cereal, sugar, potatoes and over refined, killer “foods.”
Man is different from animals—animals are instinctively driven to what to eat. For example, a cat, which is a natural carnivore, would starve to death in a garden full of vegetables. Likewise, a grazing animal, such as a wild deer or a cow, would starve without plants and grains to eat, even if large amounts of meat and dairy products were available.
There has been much discussion over what the ideal foods are for human beings. Are we herbivores or carnivores? This query alone is reason enough to warrant individual dietary attention.

Life is for Living, Loving, Laughing and Learning

We must learn what works within our bodies. Some of my patients do well on a low-carbohydrate diet, some do well on a low-fat diet, some will not lose weight on a low-fat diet, and some will gain weight on a low-carbohydrate diet. We must recognize our individuality and adopt a formula that will work within ourselves. It is enjoyable to eat, we should be able to enjoy the foods that we eat.
Many of us have developed destructive thoughts and destructive habits, which originated in our childhoods. As children, we were often scolded for doing something wrong, like eating the wrong food. Since admonitions by authoritarian figures create thoughts, feelings and finally beliefs, I am asking you to put aside your thoughts and your feelings about anything unhealthy or negative and develop positive new beliefs by creating positive images.
Use your imagination. Your imagination is one of the most powerful tools you have to living a healthy, active life. The power of imagination has driven many people to good health. Close your eyes. Picture a lemon. Imagine the sharp, citrus smell. Now, imagine yourself biting into it. Feel the tart, juicy pulp on your tongue. The subconscious power of recall will give the ability to taste something that you literally imagined. Now close your eves. Picture yourself at your ideal weight. Picture yourself with the willpower to exercise. Picture yourself exercising. Picture yourself happy and healthy.
Franklin D. Roosevelt said, “We have nothing to fear but fear itself.” And, in his book, Think and Grow Rich, Napoleon Hill exclaimed, “Confront your fears, and you can make them disappear.” Napoleon Hill, who interviewed Thomas Edison, provided an enlightening perspective of what many of us call failure. Hill asked the great inventor, “Mr. Edison, what have you got to say about the fact that you have failed thousands of times in your attempt to create the light bulb?”
Edison replied, “I beg your pardon, I have never failed even once. I have had thousands of experiments that didn’t work. I had to run through enough learning experiments to find a way that did work.”
I am sure that we have all felt fear or failure sometime in our lives. But these fears or failures should not derail us on our journey toward health, happiness and success.
The human body is a perfect organism. When you understand that the heart beats approximately 72 times per minute, 100,000 times per day, 700,000 times per week and over 35 million times per year, you know it truly takes a licking and keeps on ticking. What’s more, the heart is just one component of the cardiovascular system, which is just one of eleven body systems each of us has. These systems, together with our amazing minds, give us the perfect opportunity to create the perfect homeostatic “machine”. We are self-sustaining thinkers, movers, survivors, achievers and reproducers. Our bodies are the perfect representatives of the miracle of life.
Throughout the body there are well established survival mechanisms designed to maintain a state of good health; and, there is an innate intelligence that is working in our bodies at all times (whether or not we are aware of it), which has the ability to relay signals to and from the brain and spinal chord, tissues, organs and all body systems. We do not have to tell our bodies when to digest food or when to exchange carbon dioxide for oxygen. Nor do we have to tell our hearts how to beat, tell our pancreases how much insulin to release to deal with blood sugar, or tell our sex hormones to make us look like a male or a female. Your body belongs to the union of one—and you are the one.
Your body, in its magnificence, continues to replicate, repair and regenerate itself, so that your life can continue in harmony with nature. Have you ever pondered that neither your nervous system (brain, spinal chord, nerves and sensory receptors) nor any other body system has ever taken time off—not one day, one hour, one minute or even one second of vacation time? Your body works 24/7/365 from the instant of conception until after death. Yes, even after death, parts of the body can continue activity for hours!
Throughout history, people have searched for the elusive fountain of youth or the Holy Grail of eternal health, youth and well-being. We have had to spend many decades and many billions of dollars on potions, elixirs and fad diets to finally realize that today there is a genuine alternative to disease—and it is found in alternative healthcare. The alternative holistic approaches to disease and wellness are sound, based on science, and they work. The alternative roads to travel are natural (nature’s way), as opposed to synthetic (man-made). For example, we now have proof that natural therapies—with no drugs and no surgery—can help reverse cardiovascular disease, cure cancer and slow the onset and progress of Alzhiemer’s disease. We also have learned that the road less traveled is, in fact, an avenue to the alternative healthcare world. Now we must take that avenue.

Why Study Alternative Healthcare?

We are living in perilous times, and we are constantly confronted by a dichotomy of drug care versus healthcare. At this very moment you are probably aware of someone who has had an experience of illness or disease and has gone from one procedure to another or from one doctor to another. Maybe that someone is you. A statement that should guide us in all of our endeavors, especially when our health is concerned, is, “There is only one good—knowledge—and only one evil—ignorance.” Many of us don’t have the slightest idea as to how to maintain good health. When illness strikes, we rely on our doctor (if we have one) to “cure” us.
Often we fail to realize that, “The cure comes from within.” A perfect example is the infinite resource that nature has provided us with in our immune system. It can do a great job all on its own—but it will do an even better job if we are smart enough to help. How? Start by eating intelligently; exercising regularly, avoiding places, people and things that can be sources of disease, toxins or stress; supplementing with purpose, using good quality nutrients, and reducing stress levels. These are basic steps to immune system health and overall wellness, which will also help create the critically important balance in our lives. If this sounds simple to you, that’s good, because it is. The alternative/holistic approach is both basic and simplistic—you can best achieve wellness by using the best natural methods. Our modern lifestyles have gotten us off on the wrong road. We have taken a dangerous detour to fast food, junk food, sedentary lifestyle, obesity, unsafe air and water, alcohol and drug abuse, tobacco, and runaway stress. It’s time to get back on nature’s road to wellness.
If you follow Kaplan’s commandments, you will find they will guide you on your highway to health.
Health does not come for free. There is a price we have to pay. But, this is not a complicated price. This is not an expensive price. It is a price based upon dedication to maintain your wellness. TAC

Dr. Kaplan is the CEO of MBA, Inc., one of the nation’s largest multi-specialty consulting companies. Dr. Kaplan ran and operated five of his own clinics, seeing over 1000 patient visits per week. He is the best-selling author of Dr. Kaplan’s Lifestyles of the Fit and Famous, endorsed by Donald Trump, Norman Vincent Peale and Mark Victor Hansen. He was a recent commencement speaker at New York Chiropractic College and regularly speaks throughout the country. For more information about Dr. Kaplan or MBA, call 561-626-3004.