Specialized Treatment Plans at 57th Street Chiropractic

57th Street Chiropractic offers specialized treatment plans for prenatal and pregnancy chiropractic care, infant chiropractic care, and headache and allergy relief. All treatment plans focus on clearing the nervous system of any interference to allow for improved nerve and body function.

Pregnancy chiropractic is a specialty of your practice. Could you please describe the components of a specialized treatment plan you implement for pregnant women?

Dr. Gregg Rubinstein: Pregnancy care is kind of similar from mom to mom. They all come in with similar conditions and similar complaints and they have similar outcome goals that they’re all looking for. The first step in determining what you’re going to do with any patient or what type of treatment plan you’re going to apply is basically taking a careful history. You want to find out what experience they’ve had, if this is their first birth, if it’s their second or third, because things can be different with each different pregnancy. The first one can be the most difficult or the easiest and then sometimes the other ones become more difficult, depending on the experience and the birth history. But we’ll take that complete history and find out what’s going on, see if there are any contra indications to anything that we might want to do.

Then we do complete chiropractic analysis and that chiropractic analysis is done just like anybody else, right? We’re looking at the same structures, the neck, the middle back, the pelvic girdle, the spine so the analysis for chiropractic is the same.

We also do some orthopedic and neurological testing to rule out any other conditions like herniated discs or any instability that we may find in the spine that might require us actually to modify care. And sometimes we might even have to refer a case out if we find something that is not within the scope of our practice.

If everything looks clear on the orthopedic, neurological, and the chiropractic analyses, then we do the Webster Analysis.

The Webster technique is that specific analysis that really focuses a little bit more on the pelvic girdle and really is designed to help ease the discomfort associated with pregnancy. We keep the pelvic girdle moving with more range of motion, to allow a little more spread through the pelvic girdle when the baby is delivered. That can ease the amount of discomfort and help the baby come out through the birth canal with a little less discomfort and even actually increase the speed of delivery. There’s a lot of research pointing in that direction.

The Webster technique, the protocol, typically we would like ideally to get the moms in early, but very often the moms will be coming in on the later side. Typically, if they’re coming in towards the latter part of the second trimester, that is the most common time to see them. Typically, we’ll start a mom off usually at about twice a week. Then we’ll be looking and checking the pelvic alignment to see if there’s a reduction in that, the pelvis stays clear or properly aligned. So, we usually start out about twice a week and then it’s usually after we complete the initial push, it’s usually about once a week until they deliver.

And that is irrelevant, whether they’re having pain or not. We’re just trying to keep good alignment and maintain great flexibility through the pelvic girdle. Those are the important things that we focus on in those stages of pregnancy. It’s really all about just making sure the mom is comfortable and then the plan is usually twice a week for about a month or maybe more, sometimes a little less, and then once a week until they deliver. But it really depends on what time they’re showing up and if there are any other issues that they’ve had prior with their spine.

A neonatal care examination is another specialized treatment you offer. Could you describe what a neonatal care exam is and what a treatment plan would be like for an infant?

Dr. Gregg Rubinstein: The infants are a little bit different. Again, we always take a careful history, want to find out where was the birth? Was it a home birth? Was it done in the hospital? Was it a birthing center? What type of birth was it? Was it vaginal, was it C-section, were there any procedures performed like a vacuum extraction or forceps delivery? So, we start to look into those things early.

And then we also want to check history if there was a fall or any type of accidents or any type of difficulties during the birth. Also, we want to find out if the kids are on any prescription medication. A lot of times they’re putting kids on antibiotics and a lot of different things very early in life to try and deal with other things. So, we want to get a careful history.

We also want to then examine the baby. And when you do an examination on a child, they can’t really talk back. You’re really relying on the parent’s history and you want to make sure that you examine the child’s spine. It’s very gentle. I explain the exam first to the parents, and then I demonstrate what things look like and what specific issues children have. We talk about the mechanics and how to look for flat spots on the child’s head. Are they sleeping with their head turned completely to one side? If I turn the head to one side, will it stay there or does it automatically go back to the other side? We show all these findings to the mom or the dad, whoever’s with us, checking the range of motion, the general alignment, and then where we find any alignment issues we do adjustments on these children.

The adjustments on infants are very, very gentle. I’m using essentially pinky pressure. They don’t even know that they’re getting checked or adjusted. They’re just usually lying they’re cooing if they’re happy and in a good place. Chiropractic care is actually safer to do on children than it is in adults because they don’t have stress, tension, or things developing in the spine. They haven’t been on the planet very long, so there hasn’t been a lot of trauma. And since their spine is mostly cartilaginous, it takes very little effort to adjust a child.

Now, the actual treatment plan, how often you see that child, will vary depending on what type of condition the parents brought them in for. So, there’s no cookie cutter answer for an infant or a child. But wellness care, which is a big proponent where you’re just checking the children periodically to make sure everything stays healthy, in my office I recommend usually about twice a month that they get these kids checked. You might need some additional checks when they’re learning to walk because they fall a lot more and as they get older and start to participate in sports. Generally speaking, you’re going to make your clinical decisions based on what you see on the examination, the history and anything else you find.

It’s not so cookie cutter with the neonates but again, there’s a lot of different factors that go into it. Just really want to make sure that you asked the question about a neonatal examination and not specifically the treatment, but the examination is different from the treatment. But the treatments are very gentle and very effective in a host of conditions that people bring their kids in for.

Could you describe your specialized treatment plan for treating and rehabilitating sports, dance and gymnastics injuries, that involve the joints and soft tissue?

Dr. Gregg Rubinstein: You know, Liz, that’s a really great question. Chiropractic focuses on detecting and removing the misalignments to the spine or what we call vertebral subluxations. When those bones misalign, there can be irritation to the nerve and then when the nerve is irritated, we can see tightness in the muscle and things like that. But to be honest with you, that’s a difficult question because I’m not really an infant rehabilitation specialist. So, I’m not going to be really rehabilitating sports injuries, dance injuries, or gymnastic injuries. I will see these kids after those injuries, but the rehabilitation is typically done by a physical therapist or a physiatrist. That’s really not the sweet spot of our office. I know there are chiropractors who try to do those rehabilitation things, but really it’s not my favorite thing to do. And honestly, I think some physical therapists are better equipped to do the rehab.

So, I will check their spines and adjust as needed because that’s what a chiropractor does. And there might be increased need for chiropractic care after a sports, dance or a gymnastic injury. But really what I would stress is that it’s more about prevention and maintenance while the kids are performing those sports, dance, and gymnastic activities. Because again, there’s always stress and strains. If you miss the tumble, if you don’t land perfectly, those things over time can accumulate. And it’s that repetitive stress to the spine that’ll create the misalignments. So, getting those young athletes checked and adjusted will make sure that small injuries don’t become big ones, enhance performance and hopefully extend their careers and give them high level performances. You know, Joe Montana would never take the field without getting adjusted and a host of other professional athletes, Harry Carson, Tiger Woods, not the greatest example these days, but really these are high level athletes that all use chiropractors just to maintain their health and make sure they optimize their performance.

That’s really the biggest thing I see, getting checked throughout life and not waiting for problems to develop will keep these athletes going and make sure that small problems don’t become bigger ones. And that’s really what I see as the highlight and the main reason to be checking these young athletes.

I know you treat a lot of people suffering with headaches from a variety of causes. What is involved in your specialized treatment plan for headache relief?

Dr. Gregg Rubinstein: I do a lot of focus on what we call upper cervical technique, where typically a lot of headache sufferers get relief. The Atlas is the top bone of the body and they call it Atlas because Atlas sits right underneath the globe. If you remember the Greek God, Atlas, if you see him over there in Rockefeller Center, he’s got the world on his back. So, since the Atlas, that top cervical vertebrae supports your head, it’s the most important bone in the body because number one, it’s the most freely movable. Think of all the movement we get to see from that first top bone. It spins around and allows you to say no and there’s some forward and back motion. So, it’s very movable, therefore, it’s the most likely to get misaligned or what we call subluxate. Since every nerve in your body coming right off the brainstem down through the spinal cord passes through the ring of Atlas, it is so important to check that. Even minor alignment issues at that top cervical bone can put pressure and irritation to the spinal nerves and even sometimes the brainstem itself, where all the cranial nerves come off of. Any alignment issues there, are usually going to put pressure and cause headaches and different types. You can see the migraine headaches, you can see the tension headaches, you can see cluster headaches, all these different things.

I’m not going to sit here and tell you that chiropractic is a panacea for every type of headache. You’ve got to figure out what’s going on. You need to screen and make sure that they’re not having any cardiovascular accidents like a stroke or anything like that because typically those people are going to come in with headaches. So, you do your full examination. You make sure that there’s nothing else more significant going on and then you determine where the misalignment is. Typically, I’m always going to be looking at C1. When we get that bone moving properly and lined up better, a lot of these people do better with their headache symptoms. Some people get complete resolution, other people it’s 90% better, 90% of the time. And occasionally I’ll get a stubborn case that maybe they get a little bit of relief, but it doesn’t fully go away and sometimes we need to refer those out.

It’s really important and the treatment plan for them is really determined on how severe the headaches, how often they come and how misaligned they are. So, we’ll take an x-ray and determine if they’re phase one, phase two or phase three of degeneration. The more degenerated the spine, usually the more corrective work is needed. But on average, we can usually start those cases and usually they’re under care for about two to three months for the initial phase, and then we talk to them about maintenance or preventive care after. So, it varies a little bit depending on the level of headaches and how severe they are and how chronic they’ve been. But once we do the examination, we send them on their way and many patients do wonderfully with headache care. It’s one of the things that I get most excited about when they come in, because usually by eliminating those headaches, you can really improve their quality of life.

Could you describe the specialized treatment plan you use to help patients with allergy relief?

Dr. Gregg Rubinstein: That’s a really good question. I don’t particularly treat allergies in my office. I treat people with allergies. It’s the same thing, I get asked, “Oh, can you help someone who has MS, multiple sclerosis?” And I’m like, “I can’t treat MS, but what I can treat is a person who has MS.” In chiropractic the basic tenant is about increasing nerve function and nerve flow because when the vertebrae misalign, they will pinch and irritate the nerves, which can create static and almost slow down the function of the nerve system.

In the example of someone who has MS, their nerve system is already slowed down by the demyelinating process of MS. If you already have a nervous system that’s being slowed down, and then you add subluxation interference to that, that can effectively cause more interference. You don’t want that interference on top of the already existing part of MS. So, if I can get 5% or 10% improved performance out of the nerve system by clearing it out and getting pressure off the nerves, well, that’s going to help that person who has MS because they’re going to do better because they’ll have better nerve function that’s already in a system that’s kind of impaired.

And it’s really no different when you look at someone who has allergies. What’s happening is the nerve system controls your immune system. Allergies are a hypersensitivity to things that are normal in our environment. I’m not allergic to cat dander, yet I know people who are. And when me and someone who is allergic walk into a room, why does their immune system go bonkers and have this hypersensitivity and this overreaction to something that’s there and mine does not? The main difference is probably the way your nervous system works and the way your nerve system views that allergen or that stimulus.

Treatment plans are truly based on the subluxation pattern that we find in the body. It’s not about how bad their allergies or what they’re allergic to, it always goes back to checking the alignment pattern, looking at their subluxation pattern, reducing the subluxations to get the pressure off the nerves and allow the nerve system to function more efficiently and really look at things.

When people are in stress and the nerve system is amped up and the immune system is hypersensitive, then you’re going to see these overreactions where your body cranks out all kinds of histamines, and then your nose runs, your eyes water, all those different things. But these things are normally in our environment. So, person A’s nerve system is working different than person B’s and if we can level that playing field by relieving any pressure building up on the nerve system, that’s truly what chiropractic is about and how you might be able to help someone with allergies.

Again, I don’t treat allergies. I don’t treat MS. I don’t really treat anything. But I treat people who have those conditions and by improving nerve system function and removing interference, in essence, they should get better, function at a higher level, and those things should be less of an issue for them.

Learn More

To speak with Dr. Gregg Rubinstein, visit www.ChiropractorMidtown.com or call (212) 977-7094 to schedule an appointment.

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