Osteopathic Manipulation Therapy In Sports Medicine

Dr. Dominic Maneen shares insights on OMT in sports medicine, covering his AT to DO transition and OMT applications for common conditions.

Dominic Maneen
Manipulation Therapy

Q: How did you transition from an Athletic Trainer (ATC) to a Doctor of Osteopathic Medicine (DO)?

A: I transitioned to practicing sports medicine without surgery, as that field didn't align with my interests. I explored osteopathic medicine, identifying the core difference between DOs and MDs as a dedicated course in osteopathic principles. I maintained my athletic training certification to foster understanding and collaboration with ATCs, and a second course focusing on the musculoskeletal system further ignited my passion. During medical school, I also pursued an MBA, gaining insights into medical billing.

Q: Can you describe your athletic training (AT) experience at HBU?

A: I completed my undergraduate studies at UT, then worked as an ATC for baseball and softball at HBU. I entered the profession serendipitously, drawn by the phrase “sports medicine.” It required rapid maturation, as I assumed an adult role despite being only slightly older than the athletes. I collaborated with Richy Valdez and several GAs, and student athletic trainers were indispensable since it was impossible to simultaneously oversee both baseball and softball. I recall an incident involving twin softball players: one sister not playing, the other on deck, with an accidental practice swing hitting the sister, necessitating a golf cart ride to the adjacent facility.

Q: Why is low back pain a significant health concern, and how is it related to depression and lifestyle?

A: Low back pain is the second most common reason people visit the doctor, with depression being the first. Patients typically present with symptoms that indirectly lead to a depression diagnosis, rather than overtly stating “depression.” A sedentary lifestyle is often termed “the new smoking” in medicine, leading to tight, unused muscles. Hands-on manipulation therapy can be beneficial, and simple exercises like push-ups can improve posture by strengthening the neck muscles that support the head. Many individuals struggle with core muscle activation; focusing on proper technique and guiding them to engage their core will lead to increased strength over time.

Q: How do you address flat feet in patients?

A: Patients often present with concurrent back and knee pain. Structural analysis can reveal the cause, leading to recommendations for inserts or corrective devices for arch support, rather than immediate surgical intervention. Subsequent efforts focus on improving knee mechanics to alleviate symptoms.

Q: What is your approach to concussion management?

A: Myofascial release may sometimes require trigger point injections. However, most concussion cases can be effectively managed with muscle energy techniques. In older patients, some form of osteopathic manipulation may be necessary.

Q: What are the key anatomy considerations for the neck?

A: It is crucial to understand that the neck's complexity extends beyond superficial muscles like the scalenes and deltoids; smaller, deeper muscles also play a significant role in neck function.

Q: What are your tips for the Athletic Training Room?

A: Prioritize hands-on manipulation therapy and muscle energy techniques with athletes, rather than solely relying on stationary bikes or treadmills for warm-up.

Ashlyne Elliott

Leslie Bennett

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From Strain to Strength: Optimizing Hamstring Recovery For Peak Performance

Learn how to optimize hamstring recovery for peak performance with insights and key Q&A from Brian Duncan, PT, DPT, OCS, SCS.

Hamstring Recovery
Brian Duncan

Q: Is fascial length more critical than strength for hamstring recovery?

A: Fascial length is not necessarily more important than strength, but the body adapts from training, loading, and sprinting. However, sprinting alone is insufficient for optimal hamstring recovery.

Q: How can fascial length be tested in athletic training (ATR)?

A: Currently, there is no way to palpate fascial length. It can only be observed on MRI or ultrasound as imaging techniques improve. An NFL-funded trial is ongoing, examining hamstring injuries and investigating various factors with imaging across several colleges.

Q: How does adjusting knee positioning impact hamstring rehabilitation?

A: Varying the amount of knee flexion or extension can increase hamstring length and load depending on the specific area of the hamstring. Training hip extension can place more load on the proximal hamstring tendon. Most hamstring injuries occur at the myotendinous junction (proximal), while injuries within the muscle belly tend to heal better.

Q: What are the challenges in hamstring rehabilitation for high-level athletes?

A: The higher the level of competition, the more complex the situation becomes, often involving “more cooks in the kitchen.” This raises questions about collaboration between different coaches and the athletic trainer. Communication and planning can be challenging in these scenarios, impacting hamstring recovery.

Q: Is high-intensity sprinting the most important aspect of hamstring recovery, and what are the considerations for progression?

A: High-intensity sprinting is considered most important, but a lack of planning may be an issue. There is a significant load difference between an 80% sprint and a 100% sprint, with a substantial increase in eccentric load at maximum effort. The length the hamstring travels between 80% and 100% sprint is no different. A gradual progression back into previous activities is often necessary for effective hamstring recovery. Running more than nine sprints in a session can lead to further hamstring injury.

Q: Can AI, such as ChatGPT, replace athletic trainers?

A: AI is only as effective as the user and the questions asked. For example, it can build a maintenance program. When asked to include high-speed running and eccentric loading, it then asked if a weekly microcycle was needed. Hopefully, it will not replace athletic trainers' jobs but instead help them to excel at them, especially in optimizing hamstring recovery.

Q: What are the key takeaways for athletic trainers from this presentation on hamstring recovery?

A: Athletic trainers should start eccentric training early (at a pain level less than 4/10) and incorporate sprinting (running) as soon as possible. It is also crucial to communicate with coaches to target at-risk position groups with maintenance plans throughout the season and to incorporate banded Nordic hamstring curls to maximize range of motion.

Q: What is the role of maintenance programs in athletic training, especially concerning hamstring injuries throughout a season?

A: Maintenance programs are vital throughout the season to prevent recurrences and soft tissue injuries. During SAC camps, the key is to prevent overtraining and identify athletes who don't self-regulate. Sprint training should occur early in SAC camp or during the day's workout before lifting. For in-season maintenance, hamstring work should be incorporated on match day and two days after, ideally 3-4 days before the next match day.

Ashlyne Elliott

Leslie Bennett

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Limb Alignment and Leg Length Discrepancies

Limb Alignment & Leg Length Discrepancies: Key Takeaways

Guest: Brennan Roper, MD

Discussion Points:

  • Magnet-Based Leg Lengthening: Explore cutting-edge technology utilizing rods implanted in bone and an at-home magnet for non-invasive leg lengthening. This innovative approach allows for daily progress monitoring by providers, offering a minimally invasive alternative to traditional manual methods.
  • Precision in Magnet Use: Understand the critical importance of using the correct magnet, placement, and parameters for effective leg lengthening outcomes.
  • Understanding Leg Asymmetry: Learn that some degree of leg length asymmetry is normal. However, significant discrepancies warrant prompt medical attention, as early intervention can lead to less invasive treatment options.
  • When to Seek Medical Advice: Recognize the importance of consulting a physician for any concerns regarding limb alignment, especially if a discrepancy exceeds 5mm or 1 cm.
  • Specialized Care for Discrepancies: Discover why seeking a specialist for limb length discrepancies is crucial, rather than relying on general clinics or ready clinics.
  • Supplementation for Teens: Discuss the role of Vitamin D supplementation, particularly for teenagers, due to potential dietary deficiencies. Calcium supplementation may also be considered based on laboratory findings.
  • Long-Term Prognosis: Examine how the long-term impact of limb length discrepancies is influenced by the degree of the discrepancy and treatment goals. Even small differences, like 2mm, can allow for a quick return to sports after incision healing, with “guided growth” being a viable option for minor discrepancies.
  • Miserable Malalignment Syndrome: Gain insight into this condition, characterized by knee or hip pain and a feeling of being “off,” despite a seemingly neutral external appearance. This syndrome often involves internal rotation of the femur, knee valgus (knock-knee), and external rotation of the tibia.
  • Tolerance for Differences: Understand that small leg length differences (2, 3, or 4mm) are generally well-tolerated, while angular discrepancies tend to be less so.

Shortlink:SportsMedicineBroadcast.com/LimbAlignment
Website: http://utphysicians.com/provider/brennan-roper/

Tips

Current Cartilage Repair and Preservation Techniques

Advancements in Cartilage Repair: Insights from Dr. Raj Shani

Cartilage damage is a common issue, particularly among athletes. Understanding the latest repair and preservation techniques is crucial for both medical professionals and those in sports medicine. We recently had the opportunity to discuss these topics with Dr. Raj Shani, a leading expert in the field.Favorite Technique: ACI (MACI)

Dr. Shani highlighted Autologous Chondrocyte Implantation (ACI), specifically MACI, as his preferred technique due to its immediate positive impact on patients. This procedure offers a faster, easier, and less burdensome recovery for the patient. Looking ahead, advancements may allow for cartilage harvesting and growth to occur in a single setting, eliminating the current two-stage procedure.Why Athletic Trainers (ATs) Need to Know

For athletic trainers, a general understanding of these techniques is invaluable. ATs are often the first point of contact for athletes and see them daily. Their knowledge fosters comfort and trust, allowing for more effective discussions about injuries and treatment options with athletes.Exosomes vs. Gene Therapy: The Future of Growth

When considering future growth, Dr. Shani believes exosomes hold more immediate promise. The ability to directly introduce exosomes into the knee makes them a more practical option than gene therapy, which presents significant challenges in modulation.Cartiheal: A Natural Solution

Cartiheal, derived from coral, is a fascinating naturally occurring and biologically inductive material. Bone can grow into it, making it a valuable substitute for allografts, which can be expensive or unavailable.The Meniscus: Protecting Cartilage

It's important to differentiate the meniscus from the articular cartilage that deteriorates with arthritis. The meniscus plays a vital role in protecting the articular cartilage by increasing the surface area for weight-bearing. Without a healthy meniscus, the cartilage on the bone experiences less surface area for load distribution, making it more susceptible to damage and issues.

Cartilage Lesions in Athletes: Sports at Risk

Approximately 30% of athletes experience cartilage lesions. Sports involving cutting and contact, such as basketball, are particularly prone to these injuries. While data may be biased due to a higher male participation rate in sports, male athletes generally show a higher incidence of these lesions.

Contact Us

Jeremy Jackson

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VSix Athletic Training – Vander Castillo

Recovery Specialist, Club Sport Athletic Trainer, former industrial AT…Vander Castillo has created his own place to excel as an Athletic Trainer.

What is your Athletic Trainer story?

As an avid NBA follower, I saw the Athletic Trainers and wanted to be those guys.

Full-time job working with club sports…please explain.

I like wearing many hats

My office is inside of the club volleyball facility.

I have a mobile recovery unit

I see athletes one on one for a care plan

Appointment based during the week

Event coverage during the weekends.

I do a lot of education so the athletes know what they are doing.

Parents and players spend so much time on performance but neglect recovery

What drew you to club sports?

Much of my AT experience was in the industrial setting

Disney

Beer

Coca-Cola

This helped me grow into an autonomous AT

I started as VSix industrial AT but that changed.  I found a niche in hotels.

I was the MIPP program for the hotels in California.

We had bi-weekly appointments set up.

Being a business owner, what should ATs know?

Social Media is great for an AT to break off and do your own thing.

Creating your own brand is simple but not easy.

Get to know sales: yourself, your brand, your product.

I do a complimentary resume/ interview session during NATM each year.

People will pay for good care

Best growth tool? Who do you follow?

Mike Stella

ProMotion

Krystal Tyree

PTBiz

ATVantage

KCAT – Jessica 

Compex vs Marc Pro vs Twitch? Which do you prefer?

MarcPro is my favorite 

Twitch is second and more affordable. 

What makes up the majority of your business? Event coverage, practice, recovery, private evals?

About equal thirds

Tournaments

Recovery

AT services

Most underrated recovery tool?

Sleep

Contact Us

Vander Castillo – VSixAT

Marc Pro

Quiz Bowl Success

Joseph Eberhardt and Dawson Sports Medicine were preparing for a 3-peat at the time of this recording. Spoiler alert they placed 3rd in the 2025 state championships.

For those of us who may not know what is GHATS? And what is it all about?

Chris Shaddock brought me into Sports Medicine as an eighth grader

GHATS hosts a workshop for student Athletic Trainer Aides.

The workshop is to educate and expose students to the profession.

Numerous courses and rotations provide students with opportunities to learn and explore their interests.

I was uncoordinated and unathletic, and I needed people who understood me.

My sophomore year was the first year of the QuizBowl in GHATS.

Chris told them: Do not embarrass me, watch the quiz bowl, and learn.

Learn it, love it, win it.

My senior year, I wanted to keep competing and so we were doing speed drills, we acquired a quiz bowl buzzer, we did scrimmages…And we finally won.

I went on to college and came back to GHATS to recruit the student AT aides from Houston.

We won 5 championships and have been in the finals 7 times.

I began developing the program so that we as a staff, are involved.

We start studying for them in August.

As part of our student AT workshop, before school starts.

If we win this year, we will be the leading state title holders in our entire district.

We study one 30-minute session each week starting from week one.

13 students were at each of these sessions

I write 200 new questions each year so the students can not just memorize them.  I introduce them only at the scrimmage.

Region 6 has created a clause that requires the question to be fully read before the students can buzz in.

The quality of competition has increased 

What did that look like through college?

1 year at Texas A&M Corpus Christi we competed.

It was a different style quiz bowl that was more like Kahoot.

What does the state quiz bowl competition look like?

The last two years was at Tarelton State.  We came in early Sunday to settle in

Then they host the AT Olympics.

Monday morning they start the state competition like a track meet.  Multiple events and your points total place you.

This year there is a rubric that enables the student to learn exactly what is being required.

After lunch was the quiz bowl just like GHATS.

Tournament style with buzzers, head to head.

They have a skills requirement list that they must learn and have signed off on by the professionals.

How do you keep kids motivated and engaged? Are they intrinsically motivated?

Both

I push hard but it’s because they show up and want to be there.

Give us your tips for success.

ENJOY IT – the whole process

Ernest Shackleton – Difficulties are obstacles to be overcome

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Quiz Bowl Success with Joseph Eberhardt

AT in Connecticut

Jess Testani leads the Connecticut Athletic Trainers' Association and is a former AT of the year recipient.

What is your AT Story?

When did you get introduced to Athletic Training?

Where did you go to college?

Where was your first job?

How long have you been practicing?

Grew up as an injured athlete in high school

Erik Lanaes at Sacred Heart

Attended Sacred Heart Univ

Played soccer there with 2 significant injuries that left me without soccer

I took an Intro to AT course 

My mentor, Tim Spiker, told me I was an Athletic Trainer and not a PT

The ability to multitask and think outside the box.

Shenandoah University for the ELM

They were big on the challenge and immersion of the AT Program

Spent a season with Rutgers football

Then went to DC United and realized the schedule didn't fit my desired life

I found the secondary setting was my real calling

Got into the Physician practice so I could spend time with family, but still felt lacking in the depth and connection with the athletes.

You were named the CATA AT of the Year in 2019.  Tell me about that.

Have as many conversations with ATs as you can.

The then Vice president started asking me how we could change and push the profession.

From there I came to the board meeting and met the members, and the rest became history.

I became the secondary schools committee chair and worked to improve communication and connection.

What is a unique aspect of Athletic Training in your state?

I feel like our scope of practice is the best for ATs

What is a big challenge for Athletic Trainers in your state?

Similar to every other state – perceived value

Work life balance

We are a small state with smalled programs.  So there are not a lot of ATs trying to take our place.

Functional shortage = shortage of numbers available for that setting

Contact:

Jess – presidentCATA@gmail.com

Jeremy – @SportsMedicineBroadcast

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New Code: SMB

AT in Delaware

Heather Heidel leads the Delaware Athletic Trainers' Association. She has spent half of her career serving on the state association in Delaware.

Delaware ATA president Heather Heidel

What is your AT Story?

When did you get introduced to Athletic Training? During my high school sports career, I was often injured, and the AT became a mentor to me.

A surgery in my junior year led to my not playing basketball as a senior.

Did an internship as a senior

Where did you go to college? UD & Cal U of PA

Where was your first job? Tidewater Physical Therapy in Milton, DE

How long have you been practicing? 16 yrs

When did you get involved with the Delaware Athletic Trainers Association?

In my 7th year as a secretary for 4 years

The past two years, the president-elect

What is a unique aspect of Athletic Training in your state?

I know almost all of the ATs in our state

We are 1.5 hours from top to bottom

What is a big challenge for Athletic Trainers in Delaware? Turnover rate

Turnover rate

Funding for positions

The long-term hires are through the district rather than a clinical outreach.

In 2024, you had the Block grant to fund ATs in every school.  Can you talk about that?

2 million dollars annually 

It is divided among the public schools based on enrollment and is only allowed to be used for hiring an athletic trainer.

We have used a lot of the AT Your Own Risk data to educate lawmakers.

If you had to pick another state to live and work in which one would it be and why? Hawaii

They mandate ATs, and I love the beach.

You're recruiting ATs to work in Delaware…what is your sales pitch?

We have a lot of young ATs and a lot of mentors.  We are small and tight-knit

Contact Us:

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Mind Mirror Round 2

PlayPlay
Mind Mirror; Glenn Bowers

Quick overview of Mind Mirror for those who missed the first podcast.

Artificial intelligence is used to give a risk assessment of someone who potentially has a concussion.

Correlation is one element used to determine if the patient has a concussion

Coming straight in from bright light, which could restrict the pupils, but the correlation should be the same.

Light intensity, fatigue, and cold can affect pupils.

Taking Nyquil or something that makes you groggy or sluggish will negatively impact the test results.

Hit the maximum restriction in one second or less; it should not be three or more seconds.

The Athletic Trainer needs to know what is currently going on with the athlete. 

Age can also have a very slow response, which is why the app looks at other factors.

PLR – healthy score indicates a high probability that the athlete does not have a concussion.

A score lower than .8 indicates a high probability that the athlete does have a concussion.

Caffeine’s effect?

Caffeine can constrict the pupils; in Emma's case, her pupils were very constricted due to a possible combination of the caffeine and light restriction. 

You can use a light meter to help tell if the pupils are restricted.

Mind Mirror's Indoor versus Outdoor differential?

Try to do it in a shaded area or inside, and try to do it in an area that does not affect pupils

Does it matter if you do the baseline test or the after-incident test?

Exact same test, just allows them to segment the data. 

Will the administrator be able to see the results in the app?

Yes

When using the Mind Mirror app it asks test result is normal or not normal before we see the results. Should we be able to see that before?

SOAP, what did you observe? Did you observe things in a normal or abnormal state? Are things normal? They will be removed in the next version.

Clarify the colors a little more.  One of our results showed .09 and was orange.

Color scheme: green, light orange, to red

An extremely low score should have shown up in red

Will look into why it did not come up as red, yellow ,or orange is trending toward higher risk

How is the new prototype with more biomarkers coming along? 

Starting development, exposing to customers, they do their observation and send notes back, send observations ,the advance score of the risk probability, the advanced model is now currently being combined into the app

Does the environment of the test matter? 

It seemed we got different results from indoors vs. outdoors in the shade. 

Lighting does matter

Is there any more research you would like to do in the future? What do you want to prove? 

There are very few studies on female athletes and brain studies, not a lot of info, looking into studies on female rugby, looking at a lot of studies of different ages, not a lot of info on studies 

How do you intend to begin selling the product when it is ready? Will it be a monthly service? A one-time fee? Discounts for bulk pricing(multiple accounts)? 

A variety of pricing models, the goal is to get it into the hands of as many people as possible

Youth leagues and high schools are a bulk price, $5.00 for 1 year or $2.50 for 3 years

Could you ever see Mind Mirror being bought out and implemented in one of the other concussion testing systems?

Have had conversations with Sway to provide them with an objective measurement. 

Healthy Roster, incorporating MindMirror results into the system.

The goal is to add sensors to help tell if protective gear should be added, and telehealth 

The next model will have biomarkers for risk, age, and other health issues

Contact:

Mind Mirror – info@mindmirror.health

Glenn Bowers – glennb@mindmirror.health

Ben Stephenson – https://www.instagram.com/_benstephenson/

Emma Gunnin – 

Jeremy – @SportsMedicineBroadcast on IG

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Cognitive FX – Dr. Alina Fong

Cognitive FX can help your long term concussion sufferers get back to normal daily function. Imagine 8 hours per day for 2 weeks focused on restoring your cognitive function.

Explain what Cognitive FX is.

Functional MRI FMRI – use the same scanner, the process is different, and the information is different

Located in Utah

Athletic trainers are integral and 1/15 of the treatment team, a large, multidisciplinary, interconnected team

Intense approach to therapy, rather than 1 or 2 appointments, it is an 8-hour appointment for 2 weeks, patients come from all over the world 

What role does the Athletic Trainer play in CognitiveFX?  

At least 3 ATs on staff.

Athletic Trainers have not been easy to find.

We have gone to the NATA and other conferences.

We need them.

CognitiveFX will train the ATs to understand functional MRI and how the brain is connected to the body.

Cranial nerves and integration.

Use a lot of AT tools with the body mechanism 

See patients between 18-40 and they do lots of sports, ex. Skiing, sports, slipping, and falling on ice.

They do a lot of specialized training, which is connecting the brain to the body

What are you looking for in an Athletic Trainer?

Looking for someone that is willing to learn, some right out of school and some 20+ years, someone that is always curious and eager to learn, don’t know everything about the brain, cognitive fx is an exciting science, booking for curious and trainable, not focused on experience.

Every concussion is not the same

What are the statute of limitations…can we “fix” a 4-year-old cognitive deficit from a sports concussion?

every one knows 5 people that have had concussions and have lingering symptoms, they are not the same but they look normal so they get ignored, no statute of limitations, have pts from 3 months to 3 decades after injury and still see improvement, younger and closer the better, still have seen huge improvements even decades later

I appreciate that the pricing is listed on the website. How often do insurances cover some of the treatments afterwards?

Insurance reimbursement is different based on insurance companies, on average, 60-80% coverage depending on your insurance plan. The therphies are ones that people can get everywhere, so no problem with insurance.

The scans are when insurance gets iffy, the companies don't understand why we need 4 scans: 

2 Brain FMRI and 2 Neck FMRI 

Typically, insurance companies don't cover all of the MRI exams, the therapies do get covered

The costs are because so much attention is given to the patient for 8 hours a day.

24,700 price for two weeks

13,000 for one week

Athletic Trainers stay a long time

Insurance isn't timing the therapists, so they can do what they want at the clinic.

They can alter plans without having to do insurance approval. 

The first clinic was in paternship with Tom Brady and his best friend who is a Trainer, opened TB12 in Foxburrough., treat a lot of professional athletes, everyone gets concussions and they worked with the best of the best athletes, some people seem superhuman because they heal so differently, wants everyone to feel that their brain can change if given the special attention

EPIC treatment: is it like a camp where patients stay overnight?

Clinic is in utah, people from all over the world, 3 pts from netherlands, 2 from canada, rest from US all over, 2 from utah, 15 pts this week, they are there for 2 solid weeks back to back, this scan is different, using a regular MRI but lying down and doing neuro psy tasks, not looking at structures instead having them do tasks, FMRI picks up changing happening in the brain, that is when they see some parts of the brain are not working well and some are componstating for other parts

Each scan looks different, looking at how the brain metabolizes oxygen, intense program built around the patient

MD neuro neuro radiologist phd neuro scientist, neuromuscular therapist, pts, ats, neuorintergation therphist, ots, vision, cognitive, etc.

Each patient for 8 hours a day gets one on one session with each speciality, it is crazy to do all this but they support the energy levels and give them the resources to help them

Partnership with Marriott hotel that is close to clinic, even during COVID patients are still coming, nice Marriott that shuttles to clinic, and some people find their own housing, try to make it easy for the patients

2.3. EPIC Treatment

In addition to standardized test administration, normative-based assessment, and individual, image-guided measurements, our EPIC treatment exploits the latest knowledge of NVC and its role in PCS by integrating three fundamental rehabilitation facets for each patient: Prepare, Activate, Rest. Specific therapeutic activities included in each of these three phases of EPIC treatment are the product of research, clinical experience, screening, and empirical testing [29 – 34]. EPIC therapy implements a cyclical pattern of treatment where patients are rotated through therapies and activities that promote cognitive and physical rehabilitation from concussions. The preparatory stage of therapy includes varying degrees of aerobic exercise and neuromuscular therapy, based on patient capacity, to enhance cerebral blood flow in anticipation of cognitive therapy while also encouraging neurosensory rehabilitation [32, 33]. This phase of therapy lasts 50 minutes in duration and is followed by the activation portion of EPIC. We implement traditional cognitive and occupational therapy techniques for a subsequent 50 minutes of tailored treatment to target specific deficits for each patient. Complex, multistep problem solving, logic puzzles, functional and short-term memory challenges, digital therapeutic games, visual exercises, motor skill retraining, and psychosocial therapy are all implemented in this stage of treatment [30]. Additionally, DynavisionTM is incorporated into therapy as a means of Developing the Standard of Care for Post-Concussion The Open Neuroimaging Journal, 2017, Volume 11 63 treating visuospatial deficits and to enhance multitasking and cognitive processing. A destimulation period of varying duration follows to allow for recovery before another round of therapy will begin [34]. Brainwave entrainment destimulation is used promote neural wave harmonization and reduce cognitive activity [29]. This cycle is repeated for 6-8 hours a day over a typical 4-day treatment period that can be adjusted based upon symptom severity and resolution.  These therapeutic approaches address a wide range of cognitive, sensory and physical functions. The key to success, however, is not necessarily the therapies themselves, but the manner in which the therapies are applied (i.e., timing and order). For example, a carefully guided rotation between physical/cardio challenge and cognitive or sensory processing challenge is a central feature in restoring the timed pairing between rCBF and regional neural firing. Our multidisciplinary team was successful in restoring pre-traumatic NVC through the cyclical application of these rehabilitative principles supplied in tandem with the benefit of appropriately timed neurocognitive exercise [35, 36]. A multi-method approach was also employed to avoid overexertion of brain regions with severe NVU. Accordingly, cyclical brain training aimed to strengthen surrounding neural correlate systems, which, in turn, support the more severely uncoupled regions. Sustained therapy over a multi-day period was shown to promote accelerated and longitudinal restoration of pre-traumatic NVC.

Interesting story most recent, 70% are concussions, about 20% are covid long haulers, ptst hat have had a viral infection, 5% are stroke or seziure disorder, quite broad in diagnostic catergories, 

Riley Horner: big article on the news that was young with a TBI and 51st dates, kept forgetting, brought her into the clinic for 2 solid weeks, not 100% fixed, but significant improvements, came back again a few years later from teenager to older, saw huge improvements, reached out just in last month now in early 20s, she just graduated from nursing school, moms thanks for getting daughter back, now a nurse and wants to help others improve, watch inside edition improve, this is why she does what she does

Complementary consultations for anyone

Contact Us

Dr. Alina Fong – alina@cognitvefx@usa.com

Jeremy Jackson@MrJeremyJackson

Ben Stephenson –