Advanced Training

Dr. Rob DeMartino

Advanced NRCT

Treatment

Dr. Robert DeMartino, D.C., Q.N.

Master Trainer for NRCT

Superior Health Solutions

Henderson, NV

X-Ray Evaluation

A more precise way to improve diagnosis.

A visual for patients so they can understand.

Allow for a higher level of diagnosis code.

Explains why some patients will get changes on Anterior and Posterior testing.

Explains why the lateral technique works.

Helps get more specific with treatment giving you a more exact line of drive.

Adds another component of care with cervical stabilization techniques necessary.

George’s Line

Case History

66 Year old female

3 Strokes within the last five years

Left side of the body weakness

Balance problems

Pain in both legs

Neck pain

Middle back pain

Cervical Lateral View w/ Extension

What was her listing?

C4 is retro unstable on C5

Bilateral Posterior!

It makes sense, because if the ligament

instability in her spine is on the posterior

aspect, than the translation of the bones

will be in a posterior position.

Therefore, the force of the NRC treatment

should be applied Posterior to Anterior.

Case History

24 year old female

Diagnosis of Still’s Disease (essentially

Juvenile RA with associated high fevers).

Chronic whole body pain.

Onset when she was 16 years old

following a “routine” surgery on a knee

injury.

Cervical Lateral View w/ Flexion

What was her listing?

C3 is unstable on C4 anteriorly.

Less so C2/3 and C4/5.

Bilateral Anterior!

Since the ligament damage is occurred in

the anterior position, it would make logical

sense that the nervous system would

respond to the Anterior to Posterior line of

drive.

But here is where it gets interesting…

The New X-Ray Angle

It is a twist on taking an AP open mouth cervical x-ray.

You set the patient up the exact same way, but you take the x-ray with the patient laterally bending their neck bringing their ear directly to the shoulder.

Take it with the bend to both sides.

You are looking for an overhang of the C1 lateral mass over the body of C2.

AP Open Mouth w/ Lateral Bend

Normal Example

Case History

16 year old

Diagnosed with fibromyalgia

Onset of symptoms came after she

crashed her bike into a light pole and

fractured her collarbone

Here are her APOM Lateral Bend X-rays

APOM w/ Lateral Bend

Case History

55 year old woman

30 years ago her car was T-boned by a

semi-truck that broke multiple bones in her

body.

Her pain was controlled with traditional

chiropractic for a long time, but within the

last few years she has gotten little to no

relief with any modality.

APOM w/ Lateral Bend to Left

APOM w/ Lateral Bend to Right

Patient Evaluation

Raglands Before and After

Muscle Testing

Leg Length evaluations

Neurologic testing

Therapy Localize

Lower Myotome Evaluations

Lower Body

S1:

Peroneus Tertius

Supine with foot in eversion

L5:

Toe Extensors

Supine with the toes in extension

L4:

Tibialis Anterior, Hamstring

Supine with foot inverted/ Supine with knee and hip at 90

degrees

Lower Myotome Evaluation

L3: Sartorius

Supine with knee/hip at 90 degrees and externally rotate the femur to cross the patient’s leg.

L2: Quadriceps

Supine with hip/knee at 90 degrees

L1: Illiopsoas

Supine with hip/knee at 90 degrees

Upper Myotome Evaluation

T1:

Finger Abducters

Fingers spread out

C8:

Finger Flexors (Grip)

Fingers flexed around your curled fingers

C7:

Triceps, Wrist Flexion, Finger Extension

Arm at side, elbow bent at 90 degrees, palms up

Upper Myotome Evaluation

C6:

Biceps, Wrist Extension

Arm at the side elbow bent at 90 degrees

C5:

Deltoid

Arms abducted 90 degrees or to patient ROM,

Elbow at 90 degrees and palms down

Upper Myotome Evaluation

C4:

Cervical Rotation

Have patient “Turn into your hand:

C3:

Lateral Flexion

Bringing ear to shoulder

C1/C2:

Flexion and Extension

Make sure you post and have square resistance