The Importance of a Proper Chiropractic Examination – A NYC Chiropractor’s/Applied Kinesiologist’s Take

Doing a proper examination with a new patient is of the upmost importance. It not only shows where the patient’s pain/problem is but it shows the location of the origin of the pain/problem and contributing factors.

For example, the patient may be complaining of posterior leg pain but orthopedic and neurological testing will show at what spinal nerve level does that leg pain originates from.

What muscles are weak or in spasm? For example, is the nerve being compressed by a spastic piriformis as the nerve travels down the buttock or is a weak piriformis or gluteus maximus allowing for instability in the lumbo-sacral or sacro-illiac joints.

testing rectus femoris

What is the history of this patient? A proper examination includes the filling out of an intake form which includes history of past injuries and current health problems.

Has this patient had a history of ankle injuries which may have affected their gait and caused compensation in the pelvis, hips or torso of the patient? Did that compensation set the patient up for problems down the road.

Does this patient have problems like acid reflux or breathing problems where the diaphragm is not working properly and therefore causing over-compensation in the abdominal muscles which support the low back or over-compensation in the neck muscles contributing to neck pain.

Does this patient have a history of hypertension; then a taking of the patient’s blood pressure is part of their examination. Are there white spots on their nails or do they bruise easily; patient may need certain supplements to improve oxygen flow/wound healing and cut down on chronic inflammation.

Does the patient have problems with urination or gout; these problems may show up as an energy blockage in the kidney meridian and the psoas muscles which is linked in applied kinesiology to the kidney meridian. Stimulation of acu-points on the kidney meridian may affect the psoas; part of which is located in the front of the lumbar spine and an imbalance can contribute to low back pain.

For more on use of applied kinesiology in a chiropractic examination; please see https://drvittoriarepetto.wordpress.com/2014/08/09/the-use-of-applied-kinesiology-in-a-chiropractic-examination/

Range of motion testing shows not only what movements are painful but it is also important as it gives a clue of what muscles may be involved. Range of motion after treatment is a quick test of how the patient is doing.

A proper examination (and following treatments) also requires that the patient is either wearing an examination gown (women) or down to their underwear (men). This enables me as the doctor to rule out anatomical problems such as a swollen ankle or knee as contributing to the patient’s complaint.

The doctor can also rule out health problems that cause pain that need to be referred out. For example an established patient came in complaining of posterior pelvic pain and since she was in an examination gown, I noted a rash. The rash was herpes zoster and she needed to be referred out as well as needing nutritional advice and an adjustment. If she was still wearing street clothes as in many chiropractic practices, I would have not known the “real” cause of her pain.

The above examination takes time and is geared for a chiropractic and applied kinesiology practice not for a quickie fifteen minute /3x a week practice. . Unfortunately a lot of chiropractors do not do a complete examination which I deduce when new patients who have previously seen another chiropractor ask me when I enter the examination room if they should lay face down. No I say, I need to do an examination first.

If you are interested in a comprehensive examination and treatment, please free to contact me at drvittoriarepett@aol.com or call me at 212-431-3724. 

 

© 2015-Dr. Vittoria Repetto

Want more information on Dr. Vittoria Repetto and her NYC Applied Kinesiology/Chiropractic/ NKT practice at 230 W 13th St., NYC 10011; please go to www.drvittoriarepetto.com

And please check out the Patient Testimonials page on my web site.

 Want to be in the know on holistic information and postings? 

https://www.facebook.com/wvillagechiropracticappliedkinesiologynkt/

Or join me at Twitter: www.twitter.com/DrVRepetto

 

Advertisements

How a NYC Chiropractor /Applied Kinesiologist /NeuroKinetic Therapist Treats Sciatica

First what is sciatica; sciatica is an inflammation of the sciatic nerve, the longest nerve in your body. The sciatic nerve is formed from the Lumbar 4 (L4) to Sacral 3 (S3) segments of the spinal nerves as they exit the vertebrae at the same levels.

It provides motor innervation and sensation to part of the muscles along the lower lumbar vertebrae and the muscles of your hip and pelvis, to the muscles in your thigh esp. the hamstrings the back of your knee and lower leg and the sole of your foot.

sciatic_nerve

When you have sciatica, you can have pain, weakness, numbness, or tingling in any of the fore mentioned areas. It can start in the low back and extend down the back of your thigh to your calf, foot, or even your toes. It’s usually on only one side of your body.

Causes of sciatica include a herniation or degeneration of a disc at the levels mentioned above, subluxation of the vertebrae associated w the sciatic nerve. https://drvittoriarepetto.wordpress.com/2010/07/17/the-subluxationspinal-joint-dysfunction/ or a narrowing of the spinal canal that puts pressure on the sciatic nerve root which is called spinal stenosis.

As a doctor of chiropractic, I would do a proper orthopedic and neurological examination to determine the level of spinal dysfunction/subluxation.

But before adjusting the vertebrae to remove the subluxation, I would test via muscle testing and palpation the muscles innervated by the involved spinal segments or attached to the spinal segments.

A case in point would be the testing of the psoas muscle as part of the muscle attaches to the anterior of the lumbar vertebrae; a weakness or a hyper tonicity of the muscle can cause rotation of the vertebrae and place tension on the sciatic nerve root. http://en.wikipedia.org/wiki/Psoas_major_muscle

The piriformis muscle is another important muscle that needs to be checked as the sciatic nerve passes under the piriformis; a spasm of this muscle can put pressure on the sciatic. http://en.wikipedia.org/wiki/Piriformis_muscle

sciatic-nerve

 

Other muscles that may be checked are the hamstrings, the lumbar erector, the quadratus lumborum, the gluteus maximus and the gluteus mediu

I ask,  is there a dysfunction in the coordination of muscles working in patterns. Is the above mentioned psoas or piriformis inhibited by the muscles  like the gluteus maximus or the quadratus lumborum that are compensating (facilitating) for weak or inhibited muscles, for example. or vice versa. Muscle imbalance can cause misalignment of the vertebrea they attach to. 

The muscles that are found to be either weak or hyper tonic are balanced by spindle or golgi tendon work and blood flow and lymphathic drainage to the muscle is increased by working on neuro-vascular and neuro-lymphatic points.

I would also test for problems with the illiolumber ligament and the sacrotuberous ligament which help stabilize the lumbar spine and sacrum respectively.

http://www.healthline.com/human-body-maps/iliolumbar-ligament

http://www.healthline.com/human-body-maps/sacrotuberous-ligament

I also examine the pelvis as the pelvis forms the foundation support of the human skeleton, I look to see if the patient is showing what is known in SOT technique as a Category Three pelvic problem.

Category Three occurs when the low back can no longer tolerate the physical stressors placed on it. This can be a sudden one-off event such as a lift, or it can be a pre-existing weakness that is aggravated. Category Three produces pain in the low back and sciatica. Correction involves using blocks under the pelvis in a specific direction and position. Your weight and breathing helps to gently balance the low back and take the pressure or irritation off the nerve.http://www.soto.net.au/A-patients-guide-to-the-practice-of-SOT

I also check for cranial involvement; there are cranial faults involved in low back and sciatic pain. https://drvittoriarepetto.wordpress.com/2010/05/17/cranial-sacral-therapy-in-applied-kinesiology/

The combination of all these techniques along with nutrition and specific stretches and exercises helps the patient heal faster.

 For information on specific techniques, please read:

https://drvittoriarepetto.wordpress.com/2011/07/29/how-a-nyc-applied-kinesiologist-uses-neurovascular-pts-for-better-physical-and-emotional-wellbeing/

https://drvittoriarepetto.wordpress.com/2011/02/16/how-an-applied-kinesiologist-uses-neuro-lympathics-to-improve-health/

https://drvittoriarepetto.wordpress.com/2010/06/21/muscle-balancing-in-applied-kinesiology/

https://drvittoriarepetto.wordpress.com/2010/05/06/the-art-and-science-of-muscle-testing-in-applied-kinesiology/

© 2015-Dr. Vittoria Repetto/ 2016 revised 

Want more information on Dr. Vittoria Repetto and her NYC Applied Kinesiology/Chiropractic/ NKT practice at 230 W 13th St., NYC 10011; please go to www.drvittoriarepetto.com

And please check out the Patient Testimonials page on my web site.

 Want to be in the know on holistic information and postings? 

https://www.facebook.com/wvillagechiropracticappliedkinesiologynkt/

Or join me at Twitter: www.twitter.com/DrVRepetto

 

Chiropratica NYC / Kinesiologo Applicata Che Parla Italiano

Sono Dottoressa Vittoria Repetto, io specializzato in Chiropractica / Kinesiologo Applicata

Dal 1987 ho aiutato le persone a sentirsi meglio, usando terapie naturali.

Sei alla ricerca di un medico che ti ascolta?

Sei stanco della catena di montaggio dell’assistenza sanitaria?

Sei stanco di dolore e di stress?

Sei motivato a sperimentare per ottenere una salute migliore?

Ciascuna delle mie sessioni di un’ora di benessere e’ unica e composta di terapie olistiche interconnesse.  A causa del mio approccio al benessere dell’intera persona, ho aiutato pazienti con problemi a breve termine e pazienti con problemi a lungo termine.

Io offro:

Manipolazione Spinale

Manipolazione “Extremity”

Manipolazione Mandibola

Manipolazione Cranica Sacrale
Five Element Energy/Agopressione Terapia Cinese
Vascular Therapy e Terapia Linfatica
Bilanciamento Muscolare
Bilanciamento Emotivo
Riduzione dello Stress
Terapia Galvinic
Consulenza Dietetica/Nutrizionale

Manipolazione Spinale

testing rectus femoris

Io ho aiutato pazienti con problemi muscoloscheletrici:  mal di schiena, dolore al collo, sciatica, sindrome del tunnel carpale, problemi della cuffia dei rotatori, dolore al ginocchio, dolori muscolari, Mal di testa, emicrania

Ho aiutato con mal di testa, emicrania, pressione alta, affaticamento, bassa energia, difficolta’ a perdere peso, capogiro, vertigini, scarsa memoria

Io ho aiutato pazienti con problemi digestivi: stipsi, diarrea, eruttazione, gonfiore, difficolta’ con certi cibi, bruciore di stomaco

Io ho aiutato pazienti con problemi respiratori:  iper-sensibilita’ al polline, ambrosia, difficolta’ respiratorie, raffreddori frequenti, problemi del seno

Problemi immunitari come frequenti raffreddori, influenza, infezioni

Ho aiutato pazienti con problemi immunitari:  raffreddori frequenti, influenza, infezioni, crampi menstruali, vampate di calore, cicli irregolari.

© 2013-Dr. Vittoria Repetto

Want more information on Dr. Vittoria Repetto and her NYC Applied Kinesiology/Chiropractic/ NKT practice at 230 W 13th St., NYC 10011; please go to www.drvittoriarepetto.com

And please check out the Patient Testimonials page on my web site.

 Want to be in the know on holistic information and postings? 

https://www.facebook.com/wvillagechiropracticappliedkinesiologynkt/

Or join me at Twitter: www.twitter.com/DrVRepetto

A NYC Chiropractor/Applied Kinesiologist Talks About Bad Posture & Body Pains

We’re all guilty of it. Bad posture comes with our everyday tasks, when we are not paying attention to how we are sitting, standing, lying down or driving. And our spine and the muscles associated w/ our spine take more of a beating than we realize.

Posture is not just about standing up straight, it’s about keeping your spine aligned with its natural shape and curves and the equal pull on our spines by the spinal and back muscles. Bad posture can throw off your spine’s balance, allowing your body to be more prone to injury. In an average day common incorrect posture positions can change the balance of our spine and the back muscles.

When we slouch, the natural spinal curves are either reversed or exaggerated and this puts more stress on our spine and muscles. For example, if we hang our head and neck down, we increase the strain of the muscles balancing the weight of our head and increase the strain of the muscles holding our rib cage up. Some mucles become too tight and others too loose. Such an imbalance can lead to tension headaches, mid-back pains, neck pains and shoulder pains.poor-posture-tos

Similarly, low back pain can be caused by misalignment of the spine and unbalanced muscle pull on both the front , back and sides of our torsis due to bad posture and habits.

Chiropractor and especially Applied Kinesiologists are trained to spot and test for these muscle imbalances and correct these imbalances so please do seek one out if you are having body pains and in the meantime, make an effort to be conscious of your posture.

© 2012-Dr. Vittoria Repetto

 

Want more information on Dr. Vittoria Repetto and her NYC Applied Kinesiology/Chiropractic/ NKT practice at 230 W 13th St., NYC 10011; please go to www.drvittoriarepetto.com

And please check out the Patient Testimonials page on my web site.

 Want to be in the know on holistic information and postings? 

https://www.facebook.com/wvillagechiropracticappliedkinesiologynkt/

Or join me at Twitter: www.twitter.com/DrVRepetto

No Insurance, No Problem. Reasonable Rates with Dr. Repetto – NYC Chiropractor / Applied Kinesiologist

Hi!, I’m Dr. Vittoria Repetto, a native downtown New Yorker and Doctor of Chiropractor and an Applied Kinesiologist who has been in practice since 1987. And recently a Neuro Kinetic Therapy practitioner.

I treat the whole person, not just your symptoms. I know that balancing your structure, your biochemistry and your mental outlook all contribute to your well-being.

Each of my 75 minute long wellness sessions is unique and composed of interrelated holistic therapies that work together to achieve maximum benefits.

I am not affiliated with any insurance network.

If I belonged to a network I would have to see patients in an assembly line fashion (10-15 minutes). I would not be able to take time to, for example, balance the muscle pull on your spine or extremities or to do cranial sacral work or acupressure work or talk to you about your nutritional needs or suggest exercises or lifestyle changes related to your condition.

Therefore I ask that my patients pay me directly and I fill out their insurance claim form and they get reimbursed by their insurance company if they are allowed to go “out of network” by their policy.

I charge $150 for the initial visit which includes consultation, examination and treatment and the $120 for the following visits.

The fees for my practice are moderate by New York City standards; most doctors offering similar therapies charge $ 200 to $300 for their visits and spend less time on each visit .

My fees can be paid in cash and check (no credit cards). Payment is expected at the time of service..

Services include:

  • Spinal Manipulation
  • Extremity Manipulation
  • Jaw (TMJ) Manipulation
  • NeuroKinetic Therapy
  • Cranial – Sacral Work
  • Chinese Five Element Energy /Acupressure Therapy
  • Organ Vascular & Lymphatic Therapy
  • Muscle Balancing
  • Emotional Balancing
  • Stress Reduction
  • Galvinic Therapy
  • Nutritional Consultation

Because of my Whole Person approach to wellness, I have helped patients with both short-term problems and long-term unresolved problems become free of their complaints.

And because I spend a good deal of time with you and because of my use of interrelated therapies, unlike a lot of doctors, I don’t require you to come in three times a week.

Some of the complaints that I have helped in the last 29 years are:

  • Musculoskeletal problems such as low back pain, neck pain, sciatica, carpal tunnel, rotator cuff problems, knee pain, muscle pains
  • Headaches, Migraines
  • High blood pressure, fatique, low energy, problems losing weight, dizziness, vertigo, poor memory
  • Digestive problems such as constipation, diarrhea, belching, bloating, difficulty with certain foods, heartburn,
  • Respiratory problems such as hyper-sensitivity to pollen, ragweed, etc, difficulty breathing, frequent colds, sinus problems
  • Immune problems such as frequesnt colds, flu, infections
  • Menstrual cramps, hot flashes, irregular cycles, etc

So if you  want to utilize non-pharmacological means of getting relief, please give me a call at 212-431-3724. I’m located at 230 W 13th St #1B, NYC 10011 (between 7th & Greenwich Ave)

I’m  also the writer of this  blog, in which I talk about chiropractic, applied kinesiology techniques, muscle balancing, my thoughts on nutrition and healing and as befits a foodie and a daughter of an Italian chef, even some healthy and delicious recipes.

 

 © 2012-Dr. Vittoria Repetto
 © 2016 – revised – Dr Vittoria Repetto
Want more information on Dr. Vittoria Repetto and her NYC Applied Kinesiology/NKT practice; please go to www.drvittoriarepetto.com.
And please check out the Patient Testimonials page at my  web site.

A NYC Chiropractor/Applied Kinesiologist/NeuroKinetic Therapist Talks About Spinal Stenosis

Spinal stenosis is a common finding in the spines of older patients. Spinal stenosis is a narrowing of the spinal canal.

spinal stenosis

This can develop as you age from drying out and shrinking of the disc spaces. (80% of the discs are made up of water)  Or it can be caused by scarring from chronic inflammation of the nerve roots as they exit from the spinal foramina next to the spinal canal You can feel pain anywhere along your back or leg that the nerve root supplies.

Walking more than a block can cause great leg and back pain in a stenosis patient; pain is relieved by forward bending or sitting

Spinal stenosis may be in the neck, mid-back or low back

Spinal stenosis can be treated conservatively; surgery is not always necessary or successful and over medication with pain killers can cause side effects from stomach pain, heart failure, stroke and more joint breakdown.

There is a technique founded and taught by chiropractors called Cox Technic which uses a table that provides Flexion distraction and spinal decompression and is considered spinal manipulation

Cox Technic biomechanically opens the spinal canal area by 28% and drops intradiscal pressures to as low as -192mmHg , both desired outcomes when dealing with spinal stenosis which narrows the spinal canal space.

In my office, the Cox technique is combined w other non-force techniques such as pelvic blocking (SOT) and applied kinesiology techinques such as balancing muscles that support the spine and pelvis such as the psoas, piriformis, gluteus maximus, erector muscles and abdominal muscles  and treating the lymphatic and vascular points that supply those muscles. 

I also use neurokinetic therapy (NKT) which works with the concept that movement is performed in systems or patterns.  NKT identifies muscle imbalances by using muscle testing to determine what muscles are inhibited and what muscles are compensating (facilitating) for them.

After balance is restored to the muscles, the vertebrae involved with those muscles are adjusted.

Stretches are given to the previously facilitated muscles and exercises given to the previously inhibited muscles in order to break the pattern that caused the problem.

Please see: How a NYC Chiropractor /Applied Kinesiologist /NeuroKinetic Therapist Treats Sciatica 

http://neurokinetictherapy.com/what-is-neurokinetic-therapy

I use nutrition to decrease the chronic spinal inflammation of the discs and nerves which that increases pain relief.

While spinal stenosis may not be cured due to the degenerative nature of the problem, the painful effect on the patient’s life can be controlled.

Spinal stenosis patients are often happy with  relief of the pain that allows them to take a walk or sit for a meal comfortably with their family and other daily activities. Being able to participate in the activities of daily living and family life without the use of prescription drugs with dangerous side effects is often the desired effect of any treatment for spinal stenosis.

Monthly maintenance visits are highly recommended to keep the patient pain free.

Here at Dr. Vittoria Repetto’s practice, we have the table and skills to help you with your spinal stenosis; please give us a call at 212-431-3724 to set up an appointment or just to ask questions.

Chou R et al: Interventional Therapies, Surgery, and Interdisciplinary Rehabilitation for Low Back Pain An Evidence-Based Clinical Practice Guideline From the American Pain Society.  SPINE 2009; 34 (10)

Gudavalli MR, Cox JM, Baker JA, Cramer GD, Patwardhan AG: Intervertebral Disc Pressure Changes During a Chiropractic Procedure. Abstract from the Proceedings of the Bioengineering Conference, Phoenix

A Non-Surgical Approach to the Management of Lumbar Spinal Stenosis: A Prospective Observational Cohort Study BMC Musculoskelet Disord © 2006 Donald R Murphy; Eric L Hurwitz; Amy A Gregory; Ronald Clary http://www.medscape.com/viewarticle/528906

http://www.coxtechnic.com/patients/spinal-stenosis-pain-relief-with-cox-technic

© 2012/ revised 2015/ 2016-Dr. Vittoria Repetto

Want more information on Dr. Vittoria Repetto and her NYC Applied Kinesiology/Chiropractic/ NKT practice at 230 W 13th St., NYC 10011; please go to www.drvittoriarepetto.com

And please check out the Patient Testimonials page on my web site.

 Want to be in the know on holistic information and postings? 

https://www.facebook.com/wvillagechiropracticappliedkinesiologynkt/

Or join me at Twitter: www.twitter.com/DrVRepetto