In most cases, non-surgical treatment options are the solution to ending your pain and bringing you back to a full and healthy life. Dr. Herman will guide you through your best options for treatment, and if surgery or another form of care may be needed, he will refer you to the appropriate provider.
Below is a list of the conservative procedures he specializes in:
Chiropractic manipulation has been demonstrated by research to be an effective treatment for musculoskeletal-based conditions. The intention is to restore motion to restricted joints. When we move better, we tend to feel better. Joints may become restricted because of a single traumatic event, such as improper lifting of a heavy object, or through repetitive stresses, such as sitting in an awkward position with poor spinal posture for an extended period of time. While most think of this treatment for spinal conditions, manipulation can be applied to any joint in the body, such as the foot. There are many ways to employ this treatment. Dr. Herman will select the technique that is right for you based on your presentation and your preferences.
Flexion distraction is a technique that is most often utilized for lower back complaints such as disc herniations with or without radiculopathy (pain, numbness, tingling, or weakness in the leg). With the patient lying face down on a specially designed table, Dr. Herman applies a gentle force with his hand to the patient’s back while the lower section of the table is slowly moving up and down. Dr. Herman will discuss your condition with you, will educate you on your options, and will determine if this treatment is indicated.
ACTIVE RELEASE TECHNIQUES
Active release techniques (ART) is a specific and advanced soft tissue system that treats problems with muscles, tendons, ligaments, fascia, and nerves. Headaches, back pain, carpal tunnel syndrome, shin splints, shoulder pain, plantar fasciitis, knee problems, and tennis elbow are just a few of the many conditions that can be resolved quickly and permanently with ART. These conditions all have one important thing in common−they are often a result of overuse.
How do overuse conditions occur? Over-used muscles and other soft tissues change in three important ways:
- Acute conditions (pulls, tears, collisions, etc.)
- Accumulation of small tears (micro-trauma)
- Not getting enough oxygen (hypoxia)
Each of these factors can cause your body to produce tough, dense scar tissue in the affected area. This scar tissue binds up and ties down tissues that need to move freely. As scar tissue builds up, muscles become shorter and weaker, tension on tendons causes tendonitis, and nerves can become trapped. This can cause reduced range of motion, loss of strength, and pain. If a nerve is trapped, you may also feel tingling, numbness, or weakness.
For many, once a soft tissue injury occurs, the pain and dysfunction can occur and reoccur for years. With ART, however, because the texture, tension, and movement of the tissues are restored, your new or old pain that was thought to be permanent can be resolved and your function can be restored.
Dr. Herman uses his hands to evaluate the texture, tension, and movement of the tissues. Abnormal tissues are treated by combining precisely directed tension with very specific patient movements.
ART is not a cookie-cutter approach. There are over 500 specific treatment protocols unique to Active Release Techniques. Dr. Herman is able to identify and correct the specific problems that are affecting each individual patient.
Graston technique (GT) is a protocol that uses stainless steel instruments to specifically detect and efficiently and effectively treat areas exhibiting scar tissue and fascial restrictions, resulting in improved patient outcomes. The use of GT instruments, when combined with appropriate therapeutic exercises, leads to the restoration of pain-free movement and function. The instruments are also used diagnostically to assess the kinetic chain in an efficient manner, using the principles of regional interdependence, which means that seemingly unrelated impairments in other body parts may contribute to, or be associated with, the patient’s primary complaint.
FUNCTIONAL DRY NEEDLING
Functional dry needling (FDN) is a technique that involves multiple advancements of a solid, thin filament needle designed to be inserted into muscle to target trigger points. Trigger points are typcially tight bands in skeletal muscle, more commonly referred to as "knots", that cause pain and impede function. By releasing these knots, we help to decrease pain, improve muscle activation, and improve movement impairments. Functional "dry" needling denotes no injectable solution.
How is functional dry needling different from acupuncture?
FDN and acupuncture are not the same. The only similarity they share is the solid, round tipped needle. The evaluation, assessment, application, and intended purpose are all different. Acupuncture is a form of traditional Chinese medicine that aims to restore the flow of energy, or chi, through the body. FDN is based on the treatment of musculoskeletal and neuromuscular deficits identified during a physical exam to improve pain, movement, and strength. In FDN, the needles are inserted into muscle tissue rather than the superficial insertion to redirect the body's energy flow as used in acupuncture.
Cupping therapy creates a vacuum inside of a cup that is positioned over the surface of the skin, using local negative pressure to promote blood flow. Cupping therapy is used to decrease pain, improve circulation, and enhance performance. This technique became popular during the 2016 Rio Summer Olympics, as several athletes were seen with visible “red dots” that were left behind from cupping therapy; these dots do disappear within several days, however.
Personalized Blood Flow Restriction Rehabilitation
This is the future of rehabilitation. We offer an innovative exercise approach to speed up your recovery. The use of personalized blood flow restriction (PBFR) allows us to offer an alternative way to strengthen weak muscles without the normal stress to your joints.
How Does PBFR Work?
PBFR is performed with a medical grade, FDA-approved tourniquet that is placed on the upper arm or upper thigh. We use the Personalized Tourniquet System (PTS) manufactured by Delfi Medical Innovations, Inc., a world leader in tourniquet technology and safety. This computerized tourniquet establishes the minimum amount of pressure, Limb Occlusion Pressure (LOP), it takes to restrict blood flow. LOP is regulated and monitored continuously for patient comfort and safety. The cuff accounts for different variables such as your systolic blood pressure, cuff design, cuff width and application, limb size and shape, and tissue at the cuff site. All of these features ensure that your pressure stays consistent and safe. Once your individual LOP is established, the actual treatment can begin. Treatment consists of performing rehabilitative exercises while restricting blood flow to the working limb. Your Personalized Tourniquet Pressure (PTP) is established by restricting 80% of blood flow to the leg or 50% of blood flow to the arm. You will be monitored throughout your appointment.
By restricting blood flow to a limb, the muscles aren’t required to work as hard in order to strengthen and hypertrophy. Using PBFR, patients who used to be limited by the body’s natural healing process can now start strengthening earlier, and as a result, get back on the field or back in life faster.
NormaTec Pulse Pro Recovery Systems
NormaTec gives a competitive edge to the world’s elite athletes, coaches, and trainers. Normatec’s goal is to establish recovery as an integral part of every athlete’s training. The NormaTec Pulse Recovery Systems are dynamic compression devices designed for recovery and rehab. We utilize Normatec’s Pulse Pro Recovery Systems, allowing athletes to rehab and recover faster between training sessions and after competitions.
Normatec systems include a control unit and attachments which go on the legs, arms, or hips, and because we utilize the Pulse Pro System, we are able to customize settings to your individual needs. This device uses compressed air to massage your limbs, mobilize fluid out of the extremities, and speed recovery with its patented NormaTec Pulse Massage Pattern. When you use this system, you will first experience a pre-inflate cycle, during which the connected attachments are molded to your exact body shape. The session will then begin by compressing your feet, hands, or upper thigh, depending on which attachment you are using. Similar to the kneading and stroking done during a massage, each segment of the attachment will first compress in a pulsing manner and then release. This will repeat for each segment of the attachment as the compression pattern works its way up your limb.
Marc Pro Plus
Marc Pro is a cutting-edge electronic muscle stimulation device that helps muscles recover faster and reduces pain, allowing professional and everyday athletes to perform and feel their best. Marc Pro utilizes patented technology that takes active recovery to the next level with non-fatiguing muscle activation, flushing out waste and delivering nourishment to any target area with ease. This is the foundation of recovery, conditioning, and feeling your best. We utilize the Marc Pro Plus model in our office.
Why Recovery Matters
Whether you’re a professional athlete or just staying in shape, you might be doing more than body can handle. You may or may not actually feel sore, but you’re likely starting each day with a recovery deficit. When you’re not fresh, you don’t feel like yourself, your performance suffers, and you increase the chance of injury.
It’s also important to realize that during strenuous exercise or activity, muscles are breaking down, not getting stronger. It’s during the recovery phase that muscle builds and strength gains occur. If you’re training more than a few days a week, you’re likely not fully recovering, and therefore not getting the most out of each workout.
Rehabilitation exercises are a necessary component to bouncing back from an injury and then reducing the risk for recurrent injury and pain. The goal of rehabilitation exercises is to decrease pain and restore movement by improving strength, endurance, power, flexibility, stability, and balance.
Initially, the focus is on selecting exercises that will allow the damaged tissue to heal. From there, progressive loads and functional exercises and drills are incorporated to ensure the body is ready to handle the stresses of everyday life and sport. Continuing to perform these exercises once healthy is often an important component to remaining healthy.
Kinesiology tape is used by practitioners throughout the world to treat injuries and improve sports performance. While the use of kinesiology tape is often associated with athletes, providers have been using this tape to alleviate a wide variety of ailments, not just sports injuries.
Dr. Herman prefers to use RockTape, a specific kind of kinesiology tape. RockTape has three primary functions−to cue form (especially in athletics), reduce inflammation and swelling, and minimize pain. RockTape accomplishes this by microscopically lifting the skin away from the muscle and fascia, which decompresses the area and reduces swelling. RockTape also signals the central nervous system through the skin’s nerves, which provides powerful feedback to minimize pain and cue form. RockTape can be worn for up to 5 days and can be worn while swimming or in the shower. The adhesive is hypo-allergenic, acrylic-based, and contains no latex.
If you’re a runner, it’s likely that you have, are, or will experience some kind of pain in your hips, knees, and/or feet. Dr. Herman will work with you to resolve these issues. However, whether a running injury or non-running injury, our approach is often to remove a negative before adding a positive. That means that if your running form is a contributing factor to your pain, not correcting the cause (bad technique) and only resolving your pain may not yield long-term results.
To the runner without pain, by improving running technique, you can become a more efficient runner and that means faster times, more enjoyment, and bragging rights after races.
Running evaluations not only include an analysis of your running, they also include an evaluation of your shoes and some discussion on your nutrition and training plans. Recommendations will be made based on findings.
FUNCTIONAL MOVEMENT SCREEN
Functional movement screen (FMS) is a screen of seven movements that we all perform throughout our daily lives. This screening tool is used to identify limitations or asymmetries in fundamental movement patterns that are key to functional movement quality in individuals with no current pain complaint or known musculoskeletal injury. Once identified, faulty patterns can be corrected and movement can become more efficient.
For the athlete, by identifying and correcting weak links in the chain, sports performance is improved. In fact, this screen is performed on all football players at the NFL Scouting Combine.
For the everyday person, getting in and out of a chair more easily or picking up your children more easily can finally be accomplished.
If you’re a coach or involved in a team and would like Dr. Herman to come to you to provide group screenings, please call the office to schedule. Individual appointments at the office may also be scheduled.
SELECTIVE FUNCTIONAL MOVEMENT ASSESSMENT
Selective Functional Movement Assessment (SFMA) is an assessment of seven movements (different from FMS) that we all perform throughout our daily lives. This movement-based diagnostic system is for those with known musculoskeletal pain who are seeking relief. By evaluating movement, Dr. Herman can efficiently and systematically find the cause of symptoms. Sometimes your pain is caused by the body part in question, but sometimes the cause of your pain is in a different body part that is contributing to your primary complaint, a concept known as regional interdependence.
For many of you, you have tried popular diets, perhaps with some success. But all too often, the weight is regained and your body image and self-esteem take a hit.
Weight loss is about a change in how you approach life−for the rest of your life. That’s right, for the remaining days on planet earth, you must approach life differently. Weight loss is about discipline, diligence, tenacity, sacrifice, durability, and a long-term approach. Weight loss can often be achieved with short-term modifications in one’s diet and exercise routine, but maintaining that weight loss takes an educated approach.
At this office, you will not get a concoction of pills or a 1-2-3 approach to losing weight. Instead, Dr. Herman will learn about your life−the way you view food, how you determine what to put on your plate at dinner, what foods you view as healthy and non-healthy, how you approach a grocery store, timing of meals, your approach to physical activity, and the list goes on. Dr. Herman has learned that when we better understand why we make decisions, we are better equipped to meet life’s challenges.
With you playing an active role all along the way, together we will discover new ways to eat, new ways to become physically active, new ways to combat a negative self-image, and simply, new ways to approach life. Along with your goals, Dr. Herman’s goal for you is to not only lose weight and then maintain that weight loss, his goal for you is to explore a whole new chapter of your life that may not be possible at your current weight. He wants you to thrive, not simply survive.
If your child plans to participate in sports this year, we encourage you to schedule an appointment for a sports physical examination with Dr. Herman. Be sure to pick up your school’s Preparticipation Physical Evaluation form and complete the “History Form” on the first page before you come in. We appreciate each and every opportunity to serve you.