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A physical therapist's take on PT versus chiropractic

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Fitness conscious client Raymond A. Billica, left, works out in the "MOG" at Grand Island Physical Therapy earlier this month under the watchful eye of owner and physical therapist Russell Certo. (Robert Kirkham/Buffalo News)


By Scott Scanlon – Refresh Editor

Grand Island Physical Therapy owner Russell Certo, 53, subject of today’s In the field feature in WNY Refresh, had a lot to say during our recent interview about how health care is changing with the Affordable Care Act.

There will be a greater emphasis in the coming years on wellness and prevention, and Certo told me he believes his “medically oriented gym” business model will fit in well with the new dynamic.

We talked about a number of different treatment methods when it comes to chronic disease.

I included an interesting exchange on painkillers in the print version of Refresh, but also asked him some questions about chiropractic.

Let me disclose that I’ve seen a physical therapist twice in the past to deal with tendonitis, and it was helpful both times. I’ve also seen a chiropractor for a couple of years and he’s helped me keep some chronic gastrointestinal issues and back pain in check.

Here’s what I asked Certo:

How does what a chiropractor does differ from what you do?

Their understanding and their theoretical philosophy on how pain is generated is different than most physical therapists that I know. So they’re talking in terms of it’s all based upon the nervous system and the change in the pressure against nerves. It can cause not only pain, but dysfunctions in systems, so they manipulate spines to alleviate pressures and adjust how your spine is aligned. I just come from a different viewpoint. They also believe in maintenance adjustments.

... If we’re talking about the spine, they think back pain is caused by pressure on the nerve but most times in patients we see, it’s disc-related, not from a misaligned bone. So a lot of what we do is take care of that disc problem – traction, exercise, stretching – but the big part of what we do is educate them to maintain their flexibility and good body mechanics so that it doesn’t come back. And when it does come back, make sure you get back to doing this program and maybe you don’t need to go see your doctor or come and see me, or see a chiropractor.

Do you think it’s helpful or hurtful to see both a chiropractor and physical therapist?

It’s individual. I find it confusing for the patient when they’re doing it at the same time. They’re getting one thing from the chiropractor, and they obviously are very successful at what they do, and most physical therapists are very successful at what we do. I recommend to patients, ‘Pick one or the other. Try that, and if it’s successful, good for you. If it’s unsuccessful, don’t stick with one of them forever. Try something else.’

Here are some other questions I asked Certo:

What is the most remarkable recovery you’ve seen in your business?

We have some really, really good stories. As a therapist, what we do in therapy is selfishly rewarding. We’re able to take people who have something and return and restore their lifestyle. When we added the MOG component – it didn’t take long to figure it out – we were helping people not only restore their life but we were transforming their lifestyle. We were giving them stuff they never had.

Here’s my best story: 29-year-old, young guy. He was a truck driver. He drove a truck from Pennsylvania to San Diego every week and had two days off. Lived here on Grand Island. Because of that job and that lifestyle, he was very obese. And one day he stepped out of the truck and fractured his ankle. Had the surgery, got the cast, referred to therapy, came here. As part of the rehab, we got him onto an elliptical for the motion it would provide him and his ankle joint. He fell in love with the elliptical. He started losing weight. He joined a gym. He lost 150 pounds. He went to his trucking company and said, ‘I want to stay working for you but I’m not going to San Diego anymore. It interferes with my healthy lifestyle. I need a truck route that’s local.’ And they gave him one.

At that point, he was on blood pressure meds, was diabetic. He lost all that weight, became very healthy, off all the medicines. He was only 29. Imagine those downstream savings. At the time, I wasn’t even thinking about those things. I’m thinking, ‘How cool is this? We fixed his ankle, got him back to work and then he changed his life.’

What are the most typical physical issues your patients or MOG members are dealing with?

If they’re here as non-traditional referrals, they’re going to be post-cancer referral, they’re going to be obese patients. They’re going to be diabetics. They’re going to have hypertension. Metabolic syndrome encompasses all of that. While they’re patients, they’re patients. When they’re ready to transition to the MOG side, they become members.

What are some of the typical physical issues for your patients and members?

They’re physically deconditioned for the most part. The difference is that the patient has a specific medical condition that has either come on because they weren’t active or they’re not active because of (the condition). It’s all the same stuff. They’re a little bit weak, their BMI is a little bit high. Their weight is a little bit high. They might have a hypertension issue. It’s worse this year than it was last year and they’re just generally moving along the deconditioned trail and they’ve reached point where either they’ve decided it’s time to do something, or a physician has recommended it, or they’ve come to the conclusion together.

Are they’re certain conditions that are more common?

The chronic disease stuff that are most appropriate for dealing with both sides of the service and that makes sense, because chronic disease is the most costly thing in health care. And if you can prevent or slow down that process ... you can assume anecdotally that if you can catch a prediabetic patient and prevent the diabetes from coming on, 10 years down the line, you’ve changed a boatload in health-care costs.

What is the most challenging injury you’ve suffered personally, and how did you address it?

From a rehab standpoint, I ruptured my ACL in my left knee and had ACL reconstruction. I had surgery – Dr. (Paul) Lapointe did my surgery – and I was a patient right here. It wasn’t very long ago, so I knew what I was in for. I was a good patient. I let them do what they needed to do and was back playing hockey within five months of the surgery.

email: [email protected]

Twitter: @bnrefresh

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About The Refresh Buffalo Blog

Scott Scanlon

Scott Scanlon

Scott Scanlon is an award-winning reporter and editor who has covered various topics in his quarter-century as a journalist in South Florida, Syracuse and Buffalo. He is aiming to pass along what he is learning these days about health, fitness, nutrition and family life.

@BNRefresh | [email protected]

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