Sunday, April 3, 2011
An Interview with Dr.Perry Nickelston
1. Perry thank for your time. Could you give my readers your background, and how you came to be a Chiropractor?
First, I would like to thank you for the invitation to be a part of your blog. I am honored to share information with your readers. So a little bit about my story huh? Well, it has been an interesting journey for sure. I became a chiropractor later in life after suffering a debilitating back injury. Chiropractic was the only thing that helped me feel better.
I had already graduated college with a degree in political science because I had plans on being an attorney. Imagine that? But, deep in my heart I knew this was not the career path for me. So I decided to go back to college and study all the sciences (chemistry, physics, biology) and become a chiropractor. It’s never too late to pursue your dreams. Thirteen years later and here I am doing what I love.
I have since branched outside of traditional chiropractic to specialize in soft tissue work and movement assessments. Once I began to focus on the muscular and fascial system first, and then integrate that into the spinal/joint component it put all the puzzle pieces together for me. I consider myself a doctor of Integrative Medicine. Meaning, I will use any and all techniques to get a patient well.
It’s not about me, it’s all about the patient. They come first. I never latch onto one paradigm of treatment or therapy. Every therapeutic approach has its benefit. But what you must do is find the system that works for what your ultimate goal is with the client. That is the key! Find a ‘system’ and master it. A system is another way to say ‘principle’. Stay true to a base foundational principle and then find the methodologies that work for you. My principle is functional movement!
2. What, in your opinion, is the biggest problem you see in the chiropractic field?
Chiropractic is definitely a fast growing professional career path. There are more chiropractic schools in the US than ever, and enrollment is at an all time high. There are two problems I see in chiropractic today.
The first is a lack of education in how to run a business. Doctors need to understand that when you graduate from school, it’s not all fun and games. They expect the money and patient’s to start rolling in because they have a degree. WRONG! You gotta put on the entrepreneur and business owner hat after you get that diploma.
Chiropractic is a service business. You are providing a service to people. In order to provide that service you must have a business to operate that service. That involves learning marketing, hiring, training, payroll, customer service, lease negotiation, taxes, etc. This also applies to personal trainers. They are also in the service industry. And unless you want to be an employee the rest of your life, you must learn how to operate a business. There are many talented doctors and trainers that never make it in the profession because they have great hands-on skills, but ZERO business skills.
The second problem I see, and one I may get some flack for, but yet it’s still the truth…is not stepping outside the paradigm of ‘subluxation’ (joint fixation). What do I mean? The medical community gets a lot of criticism for focusing on symptomatic isolation or site of pain treatment. If it hurts here, treat here and all is good. Well, not quite! In the chiropractic community this can happen too. Chiropractors (not all) concentrate solely on the spine and subluxation as the root cause of everything. Adjust (manipulate) the subluxation and the body can heal itself.
Yes, an adjustment can help….however, what about the muscle system, fascial component, movement dysfunction, and movement patterns? All of these areas contribute to spinal fixation or dysfunction. So I would like to see chiropractors embrace other treatment systems. Today, more than ever there is a shift towards this mode of thinking and I am so thrilled to see it. Chiropractic adjustments can be a powerful therapy, and if you combine them with understanding the role of human movement, you are providing so much more service to your patient.
3. Who has had the biggest influence on you as a clinician?
Oh that’s an easy one. Gray Cook. He changed my entire paradigm of how to evaluate, assess, and treat a client. When I started to evaluate the movement systems of the body via the FMS (Functional Movement Screen) and then with the SFMA (Selective Functional Movement Assessment) the medical based model, it changed the way I practice. Gray was the inspiration behind my Stop Chasing Pain brand name and logo. I saw that phrase on a slide presentation while learning the SFMA and it just all clicked for me. It was the one thing I had been searching for to tie all of my integrated therapies together. I have visited him in Danville, VA several times and we have become close friends. I actually trained him on how to use laser therapy. He purchased the same laser I use and now treats all the athletes at his University with the laser. Whatever Gray says, I do! He is my mentor.
Then I got exposed to so many other amazing individuals that have taught me to be a better doctor. Just a partial list of these individuals:
Dr. Mark Cheng
Coach Robert Dos Remedios
And the list can go on and on….. The point I stress to everyone is to never stop learning. Stay true to the principles of fitness and therapy by discovering new and better methods.
4. What are you all-time favorite books in the following areas: - Strength Training:
I love all of the books by Mark Verstegen. I have all of his Core Performance series and they were the initial ones that got my mind thinking about training outside of the traditional bodybuilding programs that I had done for over 20 years. I looked good, but could not move! I did his Core Performance routine and it kicked my ass inside and out. That sealed the deal for me.
I also love the Functional Training books by Boyle. Can’t go wrong with Boyle.
- Physical Therapy/Chiropractic/ Rehabilitation: Anatomy Trains by Myers is an amazing book. A must have. Movement by Gray Cook is my all time favorite and the one I reference all the time. I read a part every night before bed to soak up in my brain.
-Nutrition: I love nutrition as it relates to hormones, so I do not actually read many typical nutrition books because they fall really short. I reference one a lot: Natural Hormone Enhancement by Rob Faigin. I also follow Mike Mahler’s work on nutrition. He has some very interesting viewpoints that I happen to agree with. He was a guest on one of my podcasts too that you can hear by clicking here: http://stopchasingpain.podbean.com/
-Business: So many great business books out there, but I highly recommend you subscribe to SUCCESS Magazine. This is jam packed full of business and professional success secrets. Books, audios, videos, podcasts, webinars…it is a win/win of business success and one of the best investments you can ever make.
-Random: I read several books a month and never stop learning. Some of my favorites are Tribes by Seth Godin, Cardio Strength by Coach Dos Remedios, Ultimate You by Joe Dowdell and Brooke Kalanick, and anything by Jim Rohn.
5. Sometimes there seems to be a huge gap between some physical therapists, chiropractors and strength and conditioning coaches. How in your opinion can this gap be bridged?
I think the gap is closer today than ever before. I come across some wicked smart coaches, trainers, and fitness professionals that know more than most doctors about the musculoskeletal system. Go to any Perform Better Summit and you will be blown away at some of the things they cover these days. The gap expands when someone tries to be everything to everyone. You can’t do that. You must become a master at your profession and then refer or consult with others in various fields.
Sure you can learn things from each other, but you can’t blur the lines into what the client needs. If a client is in pain that worsens even when you move them in a non painful pattern during a workout, you need to consult with a medical professional who understands what you do. When a client is out of pain, the medical professional must now refer to a fitness professional who can take the client into movements that will make them better than they were before they got hurt. You just have to stay within your scope of professional services and remember the client is of utmost importance.
6. What is your opinion on the argument that Muscle Energy Techniques safer and just as effective for joint mobilization as High-Velocity Thrusts (HVTs)?
I am what you call a straight forward kind of guy. I will tell ya exactly what I think about things, and this one I gotta disagree on. Keep in mind this is my own personal opinion. Don’t want anyone sending me hate mail on this subject. There are many different techniques to use for mobilization on a joint. But comparing Muscle Energy Techniques to High Velocity mobs is like comparing a jet plane to a single engine plane. They are both planes, they both will get you from point A to point B, but the way you get there is vastly different. There are many benefits to MET. I actually use some in my office, when indicated. However if you have a locked down hip or SI joint that is not moving correctly, you gotta get in there and move some stuff. Plain and simple! As far as safety goes…in the hands of a skilled clinician who understands the proper way to deliver a HVT and the contra-indications for use, there should be no problems. There are different levels of a HVT from level 1-4. You choose a level based on area being treated, acuteness, age, history and several other factors. I use any technique that will get a client well, including MET. I also do laser acupuncture, laser lymphatic massage, and laser kinesiology. If you think something will benefit your client…do it!
7. You are a proponent of laser therapy for the treatment of pain. Could you give my readers a brief summary on what is laser therapy, how it works, and how you integrate it into your treatment methodology?
Oh I love laser therapy. But not just any laser therapy, deep Tissue Class 4 laser therapy. It is different than the Class 3 Cold Laser most people are familiar with who may have tried laser therapy. The difference is in how much power, penetration and dosage the healing light energy is delivered into the tissue. Laser therapy is the ‘secret weapon’ of my treatment program. Here is a basic introduction to how laser therapy helps with pain…
Laser Therapy or “photobiomodulation”, is the use of specific wavelengths of light to create therapeutic effects. These effects include improved healing time, pain reduction, increased circulation and decreased swelling. The FDA cleared laser therapy in 2002 for clinical use in treating pain. I use it for anything you can imagine…you name it I have seen it. Some examples include: nerve pain, disc herniations, sprains, strains, muscle tears, fractures, burns, wounds, trigger points, myofascial pain syndromes, tendonitis and more. The reason it helps everything is because it regenerates cellular tissue and it does not matter what type of cell. A cell is a cell, they all react to laser light stimulation.
During Laser Therapy, the infrared laser light interacts with tissues at the cellular level, and metabolic activity increases within the cell which improves the transport of nutrients across the cell membrane. This initiates the release of nitric oxide that leads to a cascade of beneficial effects increasing cellular function and health.
During each painless treatment, laser energy increases circulation, drawing water, oxygen, and nutrients to the damaged area. This creates an optimal healing environment that reduces inflammation, swelling, muscle spasms, stiffness, and pain. As the injured area returns to normal, function is restored and pain is relieved.
Laser Therapy is proven to biostimulate tissue repair and growth. The Laser accelerates wound healing, and decreases inflammation, pain, and scar tissue formation. When it comes to pain management, Class IV Laser Therapy is a virtually side effect free and non-addictive treatment that provides dramatic results. Combined with my soft tissue work, movement assessments, and rehab protocols I can help just about anything.
8. Last question, what advice would you give to young coaches getting into the field?
Find a Mentor. Find a Mastermind group to become a part of to guide you. The quickest way to become a success is to follow in the footsteps of someone who has already done it. Reach out to them. If you want to get involved in a certain sport, coaching career, or fitness program do some research and find out who is the top in the area. Reach out to them and ask them questions. Trust me, they are more than willing to help you. Successful people love to help others become successful. A Mastermind group is like minded individuals who will keep you focused and motivated. Stay away from the negative stinkin’ thinkin’ people out there who will squash your dreams.
And second, find a system…a system of program design and core foundational principles you will follow. Don’t try to master everything, master one thing and then add to that skill. As in the immortal words of Bruce Lee, “I fear not the man who has practiced 10,000 kicks once, but I fear the man who has practiced one kick 10,000 times.” To me that means do one thing really well and you will be more successful.
RB: Perry, thank you so much for your time. Where can my readers find out more about you?
DR. P: I am not hard to find that’s for sure. You can find me via my website at www.stopchasingpain.com and this will link you out to all of my social media content pages. Facebook, Twitter, YouTube, LinkedIn, Podcast Channel and my other Columnist media pages. Lots of things you can find on that website. I am always here to help and answer questions. Feel free to reach out anytime.