insidersecretsofrockstarmanualtherapists

Allcare Physical Therapy, LLC |Insider Secrets of A ROCKSTAR Manual Therapist |Insider
Secrets of A ROCKSTAR Manual Therapist
1
A Top Expert Physio-
Therapist Reveals The
Insider Secrets You NEED to
Become A ROCKSTAR
Manual Therapist
A FREE Guide to preparing any new DPT
graduate in becoming an aspiring
Manual Therapist in the NEW Healthcare
Economy
By Ofir Isaac PT, MS, DPT, Chronic Pain Expert Clinician And
Electromyographer

Allcare Physical Therapy, LLC |Insider Secrets of A ROCKSTAR Manual Therapist| 2

Allcare Physical Therapy, LLC |Insider Secrets of A ROCKSTAR Manual Therapist |Insider
Secrets of A ROCKSTAR Manual Therapist
3
Hi, my name is Dr. Ofir Isaac, Physio-Therapist,
You're about to discover the number 1 single best secret you can use to CUT YEARS
off numerous inefficient and costly manual therapy coned courses and
certifications. This is what I call a NEW and suped up CLINICAL REASONING
operating system (OS). This new OS proposes a NEW way thinking about the
treatment of pain by applying the theories of the NEUROMATRIX to our knowledge of
NEURO-PHYSIOLOGY, NEURO-SCIENCE and NEURO-PLASTICITY to our manual
therapy interventions. It integrates the latest PAIN SCIENCE RESEARCH to produce
long term carry over in patients with musculoskeletal pain syndromes. This is totally
going to help you cut out the “white noise” of outdated “patho-anatomical models” and
help you discover how to hack into the CNS and fix patients you may have only watched
the big gurus with 15 plus years of experience help.
I believe we as DPTs are in such a unique position to create unparalleled value in the
new healthcare economy by creating efficiencies in both patient examination and long
term treatment outcomes for tremendous carryover in pain relief and function and
function. The problem is we as a profession are STILL STUCK in an old passive
framework of treatment delivery. As I talk with younger less experienced manual
therapists I hear the same story of how they are doing a biomechanical
treatment. Basically they are still under the impression that they are indeed
“FIXING STRUCTURE AND ALIGNMENT“ SOME DPTS SAY THAT THEIR–“
HANDS ON treatment”--- IS “releasing fascia, moving bones into alignment,
mobilizing joint capsules to unlock a stuck joint, and flossing neural tissue or
manipulating a“locked facet in the spine”.” I admit that I too used to think
exactly like that until I realized that there was no hard evidence to prove anything
but a neurological reset was taking place with my interventions and this changed
my approach and mindset from “passive” to “active” Physio-therapy methods.
It took me years of trial and error to notice the real difference between my patient
carryover from visit to visit. I went from the need for doing 14 visits of “grueling

finger breaking passive HANDS ON CARE” just to reset the normal mobility and
pain thresholds in a patient to 2-3 visits! This whitepaper aims to help you learn
what it takes to make a patient better almost immediately , WITHOUT 25 manual
therapy courses and 5 years experience under your belt. My hope is that you
come to your own realization so you can gain a new perspective on the power
you have into tapping into the CNS with little effort using some passive manual
therapy and lots of patient education for fantastic patient outcomes. This new
(OS) proposes the way that any pain patient can get better faster with long term
results.
At Allcare PT of Brooklyn we have embraced NEUROPLASTICITY and the
NEUROMATRIX theory way before it was a buzz word and now after years of research
using needle EMG Diagnostics and clinical applications, we have redefined these
“newer paradigms” into our unique and hybrid approach to CLINCIAL PATTERN
RECOGNITION, CLINICAL REASONING FRAMEWORK and EVALUATIVE AND
TREATMENT METHODS.
1. NEURO-SKELETAL RE-TRAINING
2. “ACTIVE” FUNCTIONAL ASSESSMENT AND NEURAL MOBILITY SYSTEMS
3. AN INTEGRATION OF THE THEORIES OF CENTRAL SENSITIZATION and
NEURO-SCIENCE MODELS
Yes, you are right in thinking that many weekend continuing education courses do teach
you the parts and pieces of these NEUROSCIENCE paradigms, but my belief and
personal experience is that most of what the weekend Con-Ed courses will teach you,
just touch upon the theoretical aspects of PAIN SCIENCE and its affects on
NEUROPLASTICITY. What I have found is that “oldschool and newschool manual
therapy systems” are still too focused on “manual techniques” or tactical training, What
most current manual therapy models are failing in showing you is the long term
STRATEGY of, HOW and WHEN and FOR WHOM to weave in these “newer
paradigms” into your current daily practice patterns to achieve better faster patient
results.. Simply put, many manual therapy systems are somewhat dogmatic and are
NOT eclectic enough.

In this whitepaper, you will learn how small levers used in your clinical exam can be
used to open BIG WINDOWS of lasting patient improvement within minutes. In other
words my hope is that you will understand that it only takes minimal evaluation time
and a short treatment time with little manipulative physical effort on your part, to yield
immediate pain relief. This system will deliver maximum patient carryover in HALF
the number of visits it normally takes other more “passive manual therapy
systems”.
In addition to this Meaty FREE report, I am also giving you an additional
opportunity to watch a few videos that I created to help the public understand
pain and what to do about it. Just Google PAIN FREE MAVERICK Brooklyn and
you can see what it takes to communicate our value in todays healthcare
environment.
PAIN FREE MAVERICK, is a compilation of what I feel is the type of education we
as DPTs must give for FREE to our community in order to help the public begin to
grasp the Nervous System as the CAUSE of their PAIN.
This report is GUARANTEED to give you the answers to these important questions and
challenges every New Graduate or Novice DPT faces today:
 Can I still achieve clinical excellence and deliver quality of care if I need
to see a high volume caseload with todays managed care environment?
 Is a manual therapy certification necessary to become a master clinician
with today’s highly competitive job market?
 How do I learn to manage complex spine and pain cases in a Direct
Access environment when I have little to no clinical experience with such
a caseload?
 What is the BEST manual therapy system out there that gets the best long
term outcomes no matter what the pain or dysfunction?
Also, if you're serious about wanting to get started right and cut through the "white
noise" of all the GURUS and SYSTEMS out there and learn foundations and
principles that will give you an edge, make sure to check out this exciting resource

right now – themanualtherapist.com. The blogs and videos alone are really great and I
believe that it will totally help you out.
Enjoy!
Ofir Isaac DPT,
Clinical Electromyographer and Eclectic Manual Therapist
Chronic Pain Expert Clinician and Researcher

How can I still achieve clinical excellence/ mastery AND
deliver quality of care in outpatient PT if I need to see a
high volume caseload with todays managed care
environment?
I get asked this question quite often by many of todays aspiring graduates of DPT
programs. You may have been reading blog posts or taking in all the “buzz” on new PT
PODCASTS about cash pay PT. Spending more “quality time” delivering “one on
one manual hands on care” in exchange for higher patient cash pay. Ahhh,. the
dream practice where you can escape the insurance company paperwork
monster and never have to deliver care in a “shake and bake” PT “mill” again!
The case for PT going towards “cash pay” is all the rage. Yes my belief is that we will as
a profession begin to shift into a more cash based environment as the OBAMACARE
TSUANAMI washes over us, we build out our brand and get closer to Vision 2020 in
the next few years. But in the mean time as you begin your climb up the path to
mastery in your chosen art of manual therapy, you must understand that in this NEW
Healthcare Economy your future employer will not measure your value by your fancy
certifications or number of continuing education courses taken, but by your ability to sell
( communicate) OUR PROFESSIONS distinct value” to the general public. PT school
prepares you for “delivering care and generating clinical outcomes”. The working world
will force you to learn how to communicate what your VALUE is especially as PT moves
more and more towards Direct Access.
“YOU DONT KNOW WHAT YOU DON’T KNOW”
This FREE REPORT will totally clear up this up for you even if you have been there
and done that already. My goal is to mentor you here and set you on the right path in
this amazing industry, and hopefully prepare you for the future now to reverse engineer
what it will take for you to become a master clinician who generates so much VALUE
you can ultimately be ready to treat cash pay.

Read on… ONLY if you want the inside scoop on making it far in this profession.
If you plan to work in outpatient private practice. This information will open your
eyes and prepare your mindset to what you can do today to cut years off of your post-
doctoral training, and aim to become the next rising star in manual therapy . This is
NOT for someone who wants to work in a Hospital System or even in an environment
that emphasizes a lot of soft tissue massage and passive body work.
Even though there is a huge outrcry and movement towards “CASH BASED PT and
OUT OF NETWORK PRACTICES”, The underlying real truth is that a HIGH VOLUME
CLINIC is a HUGE ADVANTAGE to your skill set, especially if you are a novice clinician
with under seven years of manual clinical experience and here’s the REAL WHY.
Todays newly insured patients with chronic unresolved neuro-musculoskeletal pain
syndromes simply have not had the opportunity to try Physio-therapy care ever,
previous to Obamacare most had no insurance. Now these same folks are flocking to
Physical Therapy centers for care to treat long neglected issues. Consumers are using
direct access to PT to treat their chronic NMSK pains. When working in the managed
care environment with HIGH COPAYS and LESS AUTHORIZED VISITS “ YOU WILL”
be forced to learn to manage a patents condition more efficiently and LEARN TO
SELL(communicate your VALUE). After training and mentoring over 10 new grads and
helping them achieve ROCKSTAR status in less than 2 years time I went back and
refined what was successful in my training and wrote a whole mini-residency for it . My
IMMERSION approach forces a PT to think on their feet faster, and early on in their
career and this is what helps them get huge breakthrough in their clinical reasoning. A
breakthrough in skills and clarity that only senior level PTs are able to achieve after 8
years of experience. It is my belief that the need to solve cases faster, and with
better long term results than other healthcare practioners is taught only with
IMMERSION in such an environment early on in your career.
What If I told you that YOU can learn to get any patient better within 8 minutes no
matter what that patient may have tried and no matter how long they have had their pain
or problem? It’s HARD to grasp if you have been wired to believe that you need 30
minutes with a patient to do deep tissue MFR and JOINT MOBS and NMREED on
everyone to get results. This whitepaper will open your mind to NEW possibilities…
Onward…
See RULE # 1 below, and understand it, and you will be half way there to becoming
the master you want to be.
Rule # 1: A Systematic Initial Evaluation Process Combined With DAILY
IMMERSION AND REPITITION IN HIGH PATIENT NUMBERS Is the ONLY way to
TRULY BECOMING A MASTER.

Did you read RULE# 1? if not re-read it again and again…
Here’s a great example of Rule#1 for you. I once had to pick a cardiac surgeon who
would perform a CABG on my father. Faced with this challenge I interviewed 2 great
surgeons with 8-10 years of experience and tons of letters after their name. You know
what I mean when I say “ alphabet soup”. These guys were Fellowship trained and
Board Certified up the wazoo.
You know who I ended up picking? NOT THE FIRST 2. Their practical experience was
low volume, they worked in fancy low volume research clinics their whole careers and
were professors at local Medical Schools. When I asked them to tell me how many
CABG surgeries per year they performed relative to their years of practice, they had
relatively low stats. Though these cardiac surgeons knew their stuff, their “book
knowledge” did not make up for their lack of clinical experience and technical skill.
It was then that I was referred to another cardiac surgeon who was not adorned with
letters after his name, but he was the one that showed me his HIGH STATS, and he
also knew what his “long term outcomes were” . This surgeon blurted out his “infection
and hospital readmission rates” which I thought was a great measure of his outcomes!
He didn’t have 10 years of experience either, but he had done the HIGHEST VOLUME
of CABG surgeries in town relative to years of practice and was proud of his experience
and readmission rates. Oh did I mention he was a great listener and great
communicator!
In my opinion volume helps you the clinician create Clinical Patterns And Solve
Those Same Patterns With A Small Tweak Multiple Times, Until It Turns Into A
“FLAVOR STORED IN YOUR BRAIN’S LIBRARY”
I want you to know that even I faced the same exact struggles you may be facing as
you are thinking of just starting out. I had a BIG QUESTION in my mind like every
novice graduate, and you want to know what it was?
WHERE SHOULD I START WHERE I CAN GAIN LOTS OF PRACTICAL
KNOWLEDGE IN LEARNING TO MAKE A CORRECT MECHANICAL DIAGNOSIS?

Before I tell you the single best way I know of how to master this process is to let me
take you back in time to HOW I answered this question myself . It’s a TRUE story of
what happened when I graduated from PT school in 1997. You will see how I made
tons of mistakes along the way, and so I want you to avoid those same mistakes. I was
in the last graduating class from NYU getting my bachelors degree in PT and like you I
was super pumped, excited and ready to make a huge change in my patients’ lives. I
was going to find a great learning environment where I could SPEND an hour on an
EVAL and do 1 on 1 care like they promised me in school!
MAJOR EGO SHOCKER ! LAST AFFIL OF PT SCHOOL - I WAS TOTALLY
ROCKED AT HEALTHSOUTH OF FLORIDA..MY CLINICAL INSTRUCTOR HAD ME
TREATING 5 PEOPLE PER HOUR WITHOUT ANY SUPPORT STAFF ON WEEK
ONE!! LITTLE DID I KNOW HE WAS DOING ME A HUGE FAVOR I DIDN’T EVEN
REALIZE AT THE TIME….
I made it through that final AFFIL with flying colors . It was like “bootcamp”, and now I
was a soldier ready for anything. I got so used to moving lightning fast and in my
critical thinking that after that AFFIL had my brain totally rewired to handle any Evals in
15 minutes. I felt confident in my ability to deliver really effective treatments that
worked. When I got offered my first job at a hospital outpatient center in Long Island I
was SOOO EXCITED because they promised mentoring and a slow pace because I
was “ a novice grad.”
BOY ….WAS I IN FOR A TREAT….
ON DAY 2 OF MY FIRST JOB, NOV 1997, TUESDAY, I HAD 35 PATIENTS ON MY
SCHEDULE FROM 8:00 AM TO 6:45 PM… 5 WERE EVALS AND I WAS THE ONLY
PT ON THE FLOOR!
I thought it through and stayed the path to focusing my efforts on what I could
control…. mastering my art to making myself more efficient !
It was this experience that taught to me how to get my wings and I learned that I had to
rely on myself to get better at my skills.
The first 3 months on the outpatient rehab floor were a complete haze and I didn’t
know who to turn to for advice because I didn’t have any mentors to answer my
questions, so I mentored myself by reading books after my day at work every night to
review what I had learned that day.

I SOON REALIZED THAT LEARNING TO SWIM IN DEEP WATER IS THE “BEST
TEACHER” AS LONG YOU HAVE A LIFESAVER NEAR BY, AKA (SENIOR
EXPERIENCED MENTORS TO BOUNCE IDEAS OFF OR EVEN ASK FOR A CO-
TREAT WHEN YOUR STUCK ON A CASE)
The weekly business meetings at the hospital clearly explained WHY I was seeing the
volume rise in the hospital too. Outpatient PT centers and hospital satellites were
feeling the “squeezing” of the insurance companies even back then and the “managed
care monster” was become more and more real…
EVEN IN 1997…
I HAD TO LEARN TO HUSTLE IN ORDER TO THRIVE IN WHAT WAS THEN A
DISRUPTION IN THE HEALTHCARE SYSTEM-
I REALIZED I HAD TO BECOME A BETTER AND MORE INDEPENDENT CLINICIAN
AND GET THE SAME RESULTS IN LESS TIME.. BELOW, I’M GOING TO SHOW
YOU HOW I DID IT AND MAINTAINED MY PASSION DURING HARD TIMES…
WHEN I GRADUATED I FELT EXACTLY LIKE YOU PROBABLY THINK RIGHT
NOW!
THINKING I WOULD SEE TEXT BOOK CASES THAT I LEARNED IN DPT SCHOOL
MADE ME STRUGGLE. I ATTEMPTED TO CLASSIFY EVERY SINGLE CASE INTO
A LOGICAL “PATHOANATOMICAL DIAGNOSIS” AND GUESS WHAT?
IT FAILED TO WORK.
I WENT TO TONS OF EXPENSIVE AND POWER PACKED WEEKEND COURSES
OVER THE YEARS TO LEARN GREAT MANUAL TECHNIQUES EARLY ON HOPING
TO MAKE SENSE OF WHAT I WAS SEEING IN THE CLINIC. COURSES WERE A
SAFE PLACE TO BE AND JUST LIKE PT SCHOOL IT WAS INTELLECTUALLY
STIMULATING. THE WEEKEND COURSES WERE TOOLS, ALWAYS HELPING ME
TAKE 1-2 NEW NUGGETS OF WISDOM AWAY BUT NEVER GAVE ME A FULL
REASONING FRAMEWORK TO OPERATE OF OFF.

i REMEMBER A NAIOMT COURSE A FANTASTIC CLINICAL REASONING AND
DIAGNOSTIC SYSTEM THAT I WAS STUDYING THE INSTRUCTOR STARTED TO
TALK ABOUT THE “NEURO-PHYSIOLOGICAL” EFFECTS OF MANUAL THERAPY
WHERE HE EXPLAINED THE EFFECTS OF “WHY” THINGS WORKED FROM THE
NEUROMATRIX MODEL. WE HAD A DEEPER DISCUSSION OF HOW HYPO AND
HYPERMOBILITY IN THE SYSTEM RELATED TO NEURO-PHYSIOLOGY. THIS IS
WHEN IT CLICKED FOR ME AND THE “MANUAL THERAPY” STARTED TO MAKE
MORE SENSE. I WAS PERFOMING A NEURO-PHYSIOLOGICAL RESET IN THE
SOFTWARE OF THE NERVOUS SYSTEM!
I BEGAN TO BLEND AND INNOVATE ON MY FOUNDATIONAL TRAINING AND
FURTHER DEVELOP MY THIRST FOR A MORE ECLECTIC CLINICAL REASONING
PROCESS. TODAY RATHER THAN LOOK AT A CASE LIKE A PATHOANATOMICAL
ISSUE LIKE (TENDINITIS, BURSITIS OR RADICULOPATHY) I LOOK FOR THE
HYPO OR HYPER MOBILITY IN THE SYSTEM MAY BE CAUSED BY AN ALTERED
PAIN SIGNAL FROM THE BRAIN. KEEP READING AND I WILL EXPLAIN THIS
BETTER…
I SOON REALIZED AFTER TAKING 25 CONED COURSES THAT THERE WAS NO
MAGIC BULLET “TOOL OR SYSTEM” THAT WOULD HELP ME BECOME A
ROCKSTAR MANUAL THERAPIST. I THEN STARTED LOOKING AT THE
RESEARCH ON SPECIALTESTS AND QUESTIONED WHY ONLY 20% OF THE
TESTS OF THE 100% WERE NOT REALLY SPECIFIC TO RULING IN A
STRUCTURE, SO WHY WAS I DOING CLUSTERS OF SENSITIVE TESTS ALL THE
TIME?
I STARTED TO TWEAK MY MINDSET AND SOON WHITTLED DOWN MY
APPROACH TO ONLY WHAT WAS NECESSARY. THE MOST EFFECTIVE 1-2
PERIPHERAL JOINT MOBS, 1-2 SOFT TISSUE TECHNIQUES, 1-2 MUSCLE
ENERGY AND HVLA MANIPS AND NEURAL-FLOSSING. . I ESSENTIALLY REBUILT
MY MANUAL THERAPY TOOLBOX TO BE MORE EFFICIENT.
WHY IS ASKING BETTER QUESTIONS THE KEY TO MASTERY AS A MANUAL
THERAPIST?

WHEN I STARTED ASKING MY PATIENTS BETTER QUESTIONS, AND MY
MENTORS BETTER QUESTIONS, THIS LED TO ME TO BEGIN TO
COMPARTMENTALIZE MY PATIENTS INTO RECURRENT DYSFUNCTIONAL
PATTERNS I WAS SEEING OVER AND OVER AGAIN IN THE CLINIC. I SOON
REALIZED THAT LOAD TRANSFERENCE THROUGH THE NEURO SYSTEM IS
THE FOUNDATION OF ALL MANUAL THERAPIES, I BEGAN TO DIVE DEEPER
INTO ORGANIZING MY APROACH INTO WHAT I CALL–“FLAVORS OF PAIN” AND I
MASTERED “KNOWING WHERE IN THE BODY TO START THE TREATMENT …”
AND THIS CAN BE TAUGHT TO ANYONE AT ANY LEVEL OF PRACTICE
UNDERSTANDING THE FLAVORS OF PAIN
NOW, I KNOW WHAT YOU ARE PROBABLY THINKING, AND I KNOW YOU
PROBABLY STILL STRUGGLE WITH THIS AS A NEW GRAD. “HOW DO I DECIDE
WHAT THE DIFFERENTIAL DIAGNOSIS REALLY IS IF I HAVE NEVER SEEN
THESE “FLAVORS” BEFORE? And like most new grads or early phase manual
therapists
YOU SPEND TIME IN THE EVAL SCANNING THE WHOLE KINETIC CHAIN…
1. TAKE A THOROUGH SUBJECTIVE HISTORY
2. LISTEN TO THE MECHANISM OF HISTORY
3. DOING “CLUSTERS OF SENSITIVE AND SPECIFIC SPECIAL TESTS” TO
RULE IN OR RULE OUT A DIAGNOSIS. USE EBP AND OFCOURSE YOU
ALWAYS REFERENCE “ CLINICAL PREDICTION RULES”
4. PALPATING
BUT AFTER THE EVAL, YOU STILL MAYBE STRUGGLING TO KNOW “WHERE
TO MOBILIZE AND WHERE TO STABILIZE THE SYSTEM” THIS IS TOTALLY
NORMAL AS YOU START DEVELOPING YOURSELF AS MANUAL THERAPIST.
YOU WILL BEGIN TO RECOGNIZE PATTERNS OF MOVEMENT DYSFUNCTION
BASED ON ARCHETYPES OF PATIENTS YOU SEE.
IT’S NEVER ABOUT MORE “TIME TO EVAL” YOUR PATIENT, ITS ABOUT
LEARNING TO RECOGNIZE CLINICAL PATTERNS BEFORE YOU SEE THEM IN
THE OFFICE

“CLINICAL PATTERN” RECOGNITION IS YOUR BEST FRIEND!”
ITS ALL ABOUT PATTERN RECOGNITION
IT ALL STARTS AND ENDS WITH (CLINICAL PATTERN RECOGNITION
COMBINED with a SOUND CLINICAL REASONING (OS) ) …. THIS .IS THE WAY TO
MASTERY…
YOU CAN EVEN MAKE UP AND CREATE YOUR OWN TREATMENT APPROACH
/METHOD OR TECHNIQUE, ONCE YOU CAN CATEGORIZE THE PATTERN AKA
(FLAVOR OF PAIN) !
TAKE HOME MESSAGE: You CAN ONLY LEARN CPR BY KNOWING HOW EACH
FLAVOR OR PATTERN USUALLY REACTS TO LOAD OR UNLOADING (MANUAL
TECHNIQUES}, AND THEN DOING LOTS OF VOLUME OF THE “SAME TYPE OF
CASELOAD”-, IMPROVING, REFINING AND MASTERING THE EFFECTIVE
TREATMENT PROCESS FOR THAT PATTERN!

Bruce Lee said it best “ I fear not the man who has practiced
10,000 kicks once but I fear the man who has practiced one kick
10,000 times”
At Allcare PT we have “bottled up” the concept of CPR into “Flavors of Pain” and we are
experts in teaching anyone to master it no matter their level of skill or years of
experience. As the late Kung Fu Master Bruce Lee believed, we also truly believe that
mastery is defining a CORE competence and developing that “ONE KICK” until its
deadly.
At Allcare PT we have proven that knocking out pain CAN happen in 1 swift kick
(minimal manual effort with maximum output). Other systems train combinations
of inefficient manual techniques that lead to poor patient carryover and lead to
practioner fatigue.
We are experts in helping patients recover from unresolved NMSK pain
syndromes! If this approach sounds interesting to you, go check out our youtube
channel and …Go to www.allcarept.com to read our blogs. to learn more.

Is a manual therapy certification or APTA board
certification REALLY necessary to prove you are a
master clinician in today’s highly competitive job
market?
PT, DHSc, MMSc, ATC,
OCS, FAAOMPT, CSCS,
COMT, CAMT, DIP HONS
MTC
Who is keeping track of your
CERT beside You and Your
Buddies At The Bar?

AS A YOUNG DPT YOUR FIRST REACTION IS IMPROVE MANUAL SKILLS
take as many courses as possible and be the BEST PT around right?
Ofcourse it is…
Unfortunately, being great with your hands is NOT the
answer to making it in todays healthcare system. BEING
EFFECTIVE BY DEFINING FOR THE CONSUMER
EXACTLY WHAT YOUR PLAN OF CARE WILL DO TO
HELP THEM RECOVER IS !
Patients are now called CONSUMERS, and CONSUMERS want you to sell
them the value of WHY they need to come back to PT. Consumers have zero
clue what we really do so MANY go to massage therapy, yoga, posture
correction specialists, acupuncture, pilates NASM corrective exercise
specialists, ART and certified Rolfers, Chiropratic, pop pills, or go get injections .
Sometimes consumers do absolutely nothing to solve their pain!
THAT’S WHY THERE IS SO MUCH CHRONIC PAIN OUT THERE AND WHY
WE ARE IN SUCH A UNIQUE PROFESSION TO ADD VALUE!
Having an OCS or other fancy CERT after your name is really cool and
great for bragging rights amongst your PT friends and colleagues but it
doesn’t pay the bills.
I totally agree with you that an OCS builds up your skill set and makes you
a BETTER more knowledgeable clinician because it challenges your mind
by helping you theorize and “build clinical patterns on paper” so you prime
your brain to recognize those patterns once you get into the clinic. BUT
YOU DON’T NEED THOSE LETTERS TO JUSTIFY YOUR KNOWLEDGE OR
SKILL TO ANYONE- YOUR RESULTS SPEAK FOR THEMSELVES!

Can an OCS make you more money as a clinician? In my opinion an OCS
or COMT or the likes doesn’t DIRECTLY make a practice owner like me
want to give someone a raise in pay, unless that clinician can charge the
insurance company or patient more money for that skill. I say unless your
production of patient volume goes up exponentially because of a training
system, it’s just another “feather in your cap” and a bunch of letters after
your name that give you a feeling of accomplishment which is great if
that’s your intention.
Don’t get me wrong, an OCS can help you get a job in clinical academia
that allows you to teach in a residency or mentorship program and lead
you to a path to becoming a fellow. Dips or Fellows have proven their deep
and narrow knowledge in their specialty and that alone can that can lead to
more opportunities in clinical and or teaching settings.
LETS GET BACK TO REALITY….
Your patients only value you by your ability to EXPLAIN what you WILL DO
FOR THEM in the future. They buy into your proposed plan of care if they
trust you and like your philosophy.
In my 19 years of practice patients never picked me because of my 25
course certifications on the wall or because of my EMG certification.
Patients always picked me because I am always able to actively listen to
them and COMMUNICATE my knowledge in a way that makes them trust
me on day 1. They trust me more than the 10 other “pain specialists” they
saw.
Consumers cannot “distinguish what Physio-therapists do compared to
other practioners who treat PAIN, so it’s up to the DPT to make them aware
of WHY we are the BEST CHOICE to get them to full function and recovery.
I always say that the current DPT training you have gives you a great start
to get in the clinic and deliver care competently as soon as you pass the
license exam.
You should consider investing all of your resources in LEARNING how to
sell Physical Therapy to the general public and building the BRAND of our
profession in your local market. This will be a game changer for you and
this is where your contributions will make you more money in the future.
Manual skills are a commodity in todays consumer driven healthcare
system, but being able to sell a full Plan Of Care is NOT!

Do you want to know what the key to success NOW in this industry really is? One word
says it all
C-O-N-F-I-D-E-N-C-E….
You will only develop CONFIDENCE by learning to swim in deep water (seeing
higher patient volume), treading water (iterating) by using an effective and better
clinical reasoning operating system that uses tried and true PRINCIPLES of care.
It’s all about using what you learned in PT school and TESTING and
RETESTING your assumptions until you find what works for you. More
manual certifications will NOT build your confidence to “sell”, but real
clinical experience will!
Patients, Referral sources (doctors and personal trainers) and PT colleagues will not
judge you based on the letters you have after your name because today
EVERYBODY can PAY FOR THAT. The number of continuing education courses you
list on your resume will not matter as well.
Employers and patients alike will want to see you deliver the results and those results
have to do with the way you COMMUNICATE YOUR VALUE. That’s really it.
. Mastery in any art is a long marathon that takes at least 10 years of questioning and
testing what works for YOU! It’s a life long learning journey in the PT field. Stay humble
is what I always say. Everyday is a chance to learn a new nugget of wisdom,
HERES WHAT I LEARNED IN MY JOURNEY TO MASTERY, THAT CHANGED MY
OUTLOOK AND WHY I WROTE THIS SO YOU CAN LEARN FROM MY
MISTAKES…
Lets go back to my first job at the Long Island Rehab Hospital, my mentors were all
trained by the greats like Cyriax, Brunstrum and Knott (PNF) and most trained with
Osteopathic Physicians. These guys set me straight about how to look at both the
Ortho and Neuro Systems very early on in my career This was the beginning of my
journey to mastery of Complex Chronic Pain Cases…
I got into private practice at age 24 and started in the Osteopathic Patho-anatomical
Model Based Training at Touro College Advanced Masters In Manual Therapy, and
was mentored by genious clinicians.
What I started to realize by year 10 of practicing manual therapy is that….

It’s NEVER about an approach or technique or system It was always about me! My
willingness to walk into every initial evaluation with a deep curiousity and excitement like
a novice clinician learning to take a history for the first time, and learning to really
listen and ask the right questions BEFORE touching the patient.
After 16 years into the profession is when I hit the “clinical” wall. After years using the
“Pathoanatomical Model” using mostly PASSIVE manual therapy interventions such as
correcting rotated sacrums, flexed and rotated vertebra and structural rib lesions and
releasing the psoas fascial tissue, I came to the conclusion that this Philosophy was
flawed and not reliable nor valid. Was the illium anteriorly or posteriorly after my
mechanical manual correction?.
I got depressed and stopped practicing specific manual therapy techniques, and started
practicing like a Chiro/ DO. After my third HVLA thrust manipulation course, I finally
learned from one instructor, that being specific to a segment was not valid nor reliable
It was when I finally realized that manual therapy was really creating neurophysiological
change in the software of the CNS that I changed my thinking.
I started playing around with this concept. For example I was manipulating the SI and
Pelvis on the opposite side of the forward bend test and got awesome results.
I started thrusting T5 and fixing a pelvic obliquity after I would retest.
I was confused and started to question the biomechanical (pathoanatomical model) that
I was hard wired to use in my early years…
I backed off of manual therapy courses and in 2013 I dropped out of my path to
Fellowship not because I did not love it, but I wanted to my energy to go towards
understanding the NEURO SYSTEM on a deeper level….There was all this buzz about
the Neurophysiological Resets with manual therapy interventions and I wanted to figure
out WHY this really worked…
Neuroscience always fascinated me and so I enrolled in the clinical electrophysiology
program and pre residency certification program at College of Staten Island to renew
my knowledge in the Neuromatrix.
My EMG training was the most challenging program I had ever done in all of my training
with regards to DIAGNOSIS in PT, because I had to had to master peripheral
neuroanatomy and neurophysiology and neurobiology. I realized that PAIN stems from
NEURO-SCIENCE rather than boney structure or muscle unless I know for sure there
was direct trauma or injury locally to that region of the body.

After 250 emg/ ncv studies with focus on interpretation and testing patients with
peripheral neuropathies, polyneuropathies, entrapment neuropathies and
radiculopathies and myopathies, my manual therapy thinking went to the next level. I
realized how powerful we are as DPTs with our global knowledge base of the
NEUROPHYSIOLOGY OF PAIN and how manual therapy pulls this all together
clinically.
I fused my clinical electromyography training with eclectic functional assessment tools
like the SFMA, Mckenzie Method, Pain Science and other clinical amazing tools like
Therapeutic NeuroScience Education. I began to use these new clinical reasoning
tools developing a new (OS) and a whole new world opened up for me. I had a
BREAKTHROUGH in helping more and more difficult cases.
From 2013 till now, I have had the privilege of seeing some of the most complicated
PAIN SYNDROMES around Brooklyn and Manahattan as an electro-myographer and
working directly with Neurologists and Physiatrists to come up with a plan for these
cases. My ability to evaluate and treat NON OPERATIVE COMPLEX SPINE and
DYSFUNCTIONS evolved, and finally I was making immediate changes in PAIN,
ROM, FUNCTION AND LONG TERM MOBILITY no matter what a patient may have
tried and no what how long they have previously suffered.
It’s like I had a ZOOM LENS placed on my clinical skills and I started to literally figure
out in minutes WHERE to START my manual therapy intervention. My choice of manual
technique was better, wether joint mob, manipulation or ACTIVE Mckenzie based
therapy/ or a Grey Cook Exercise progression.
That’s why I love to teach my new (OS) to newer manual therapists who can benefit
from my ability to reference my vast clinical pattern recognition library and “flavors of
pain”. I now refer to my distinct approach as a NEURO-SKELETAL clinical
reasoning framework and it’s for anyone who wants to really hone their skills, and
skip over all the “white noise” other more dogmatic manual therapy systems may offer
out there today.
If you are a DPT grad in the Brooklyn Manhattan, area shoot me an email at
info@allcarept.com with the SUBJECT NEURO-SKELETALCLINICAL MENTORSHIP
with your name and telephone number and any questions about our mentorship and I
will get in touch with you. It’s my pleasure to help the next generation of aspiring
ROCKSTAR manual therapists in pursuing their journey towards clinical excellence..


 How do I learn to manage complex spine and pain cases
in a Direct Access environment when I have little to no
clinical experience? When faced with such a high volume
caseload what is the BEST MANUAL THERAPY system out
there today that yields long term outcomes and takes the
LEAST AMOUNT OF MANUAL EFFORT to execute?
 Did you read Todd Hargrove’s Book A Guide To Better
Movement?
Well you SHOULD!
Heres Why…
Because it will totally blow your mind! No matter what you may have
learned from PT school or your CI you can pick up a “golden nugget” in
this book that will hopefully change you paradigm about what Manual
Therapy REALLY does from the perspective of the Neuro-matrix. Lets put
it this way, it was really one of my favorite reads besides Mosley and
Butlers work in PAIN SCIENCE.
My belief is this, if WE as a profession don’t change our Paradigm from a
strict “biomechanical and patho-anatomical model” we WILL work harder

and not smarter. We will also be like all the me too practioners who are
swimming upstream to “do what we do”. Yogis, Rolfers, DC’s,
Acupuncturists, Personal Trainers and Body Workers use passive
stretching and localized structural fixes and techniques to try to make
changes in pain. Only DPTs can make lasting changes in the Neuromatrix
happen. Our Neuro-Science background is underutilized and patients
don’t know the difference in what we do and what we CAN DO for THEM.
If you are serious about your career in outpatient PT, then you should
make it your personal quest to restore function quicker than those doing
PASSIVE relief therapies, AND focus on creating “maximum long term
carry over for the client in their functional restoration from visit to visit”
No, this proposed approach is not, Cognitive Behavorial Therapy
combined with Pilates or the likes. It’s NOT, some psychobabble or
quackery as you may think. It’s founded in solid theory and science of
Neuroplasticity and its clinical application to what we do as DPTs, and iI
guarantee that it will change the way you practice for the better.
Before I explain HOW this approach really works, I want to tell you that I
AM A RECOVERING OSTEOPATH…
Remember my story, I used to buy into the fact that I was actually
“releasing fascia” with my hands and “realigning a flex rotated and
sidebent lumbar facet with muscle energy” … It’s ok that was a model that
made lots of people better, and today I still use tons of these same
techniques from the old school systems because they are great “neuro-
physiological passive resets”. Freddy Kaltenborn , Geoff Maitland,
Cyriax and Paris, Mulligan, the Naiomt system and ofcourse IPA are
amazing systems and when applied within the context of
NEUROPLASTICITY and PAIN SCIENCE they even more powerful! Point
blank All Manual Therapies WORK when the technique or tool is used at
the right time and for the right “FLAVOR OF PAIN”… BUT PLEASE
UNDERSTAND THIS...

OUR HANDS HELP AS MANY PEOPLE AS THEY DON’T HELP…
I have treated many difficult cases OVER SKYPE over the last 3 years,
and made them feel 50% BETTER on day one just by using therapeutic
pain science education and clinical pattern recognition , I DID THIS
SUCCESSFULLY, WITHOUT ANY HANDS ON TREATMENT… these same
cases had tried many passive PT treatments and “hands on approaches”–
Explain that to me!
When you accept the newer PAIN SCIENCE model and use it as a
reference point, you will understand that patho-anatomical stress tests
and or special tests are really just used as a confirmation to amplify
regional mobility dysfunction. When you listen to the mechanism of
injury or history of present illness a library of clinical pattern recognition
can literally help you SKIP an exhaustive pathoanatomical dynamic
palpatory exam. WOULDN’T IT BE GREAT IF YOU CAN BE 95% certain
in most clinical cases that before even touching or palpating a patient
your outcomes will be excellent.
So to answer questions above, my proposed clinical reasoning
framework and OS can help you learn to discern differential diagnosis
faster and better in a direct access environment by setting you up to
uncover altered NEURO-SKELETAL dysfunctional patterns ( neural
tension in the system). Combining PAIN SCIENCE education, ACTIVE
MECHANORECEPTOR INPUT (Mckenzie Loaded Progressions) and Or
OMPT ( OMPT using Passive Inputs)-encapsulated in a foundation of
Clinical Electrophysiology you can aquire skills that others take years to
learn in less than 2 years time.
You will be amazed if you start your pathway to mastery with THIS TYPE
OF FOUNDATION. It’s like the difference between learning a watered down
martial art and experiencing the purest form.
You will need a foundation in pain science and neuro-science if you
aspire to become a Primary Care Neuro-Skeletal Diagnostician… THEN

you can always take additional courses and certs to learn tricks, short
cuts and hacks to improve yourself on your life long learning journey to
mastery!
So there you have it –
A FREE Guide to preparing any new
DPT graduate in becoming an aspiring
Manual Therapist in the NEW Healthcare
Economy
This meaty free report really delivered the goods when it comes to answering these
important questions and challenges every New Graduate or Novice DPT faces.
BUT, as you can also see, this is just the TIP of the iceberg when it comes to how to
CUT YEARS off numerous inefficient and costly manual therapy coned courses
and certifications!
So, if you're serious about wanting to Get Started Right and cut through the "white
noise" of all the GURUS and SYSTEMS out there and learn the foundations and
principles that will set you apart from the competition right away and you want tp
really, then you need to check out my video " right now - Click Here
Email: info@allcarept.com
If you are a DPT grad in the Brooklyn Manhattan, area shoot me an email at
info@allcarept.com with the SUBJECT NEURO-SKELETALCLINICAL MENTORSHIP
with your name and telephone number and any questions about our mentorship and I
will get in touch with you. It’s my pleasure to help the next generation of aspiring
ROCKSTAR manual therapists in pursuing their journey towards clinical excellence..

ABOUT THE AUTHOR
Ofir Isaac, MS, PT, DPT, CEMG, CNCT
Owner and Clinical Director of
Allcare Physical Therapy, LLC
Ofir Isaac, PT, MS, DPT, specializes in treating chronic pain, and he is one of the only
physical therapists in the Brooklyn area to be trained and certified in electromyography
and nerve conduction velocity testing and interpretation. These tests are a powerful
diagnostic tool to help determine the cause and location of nerve pain.
He earned his Bachelor of Science degree in Physical Therapy from New York
University in 1997, graduating Cum Laude. In 2006, he completed an Advanced
Masters of Science degree in Orthopedic Manual Therapy from Touro College with
honors.
With 19 years of experience in Manual Physio-Therapy and extensive training in
Neurology and Electro Diagnosis of the Peripheral Nervous System (EMG NCV), he
specializes and treats chronic pain conditions that may not have responded to
conventional physical therapy.

As a result of his success with the most difficult patients, for his keen diagnostic skills
and patient rapport, he is highly recommended for chronic pain solutions.
© 2016 by Ofir Isaac PT, DBA, Allcare Physical Therapy, LLC
Do not copy or reprint or we WILL prosecute to the fullest extent of the law. We're not kidding.

insidersecretsofrockstarmanualtherapists

Recommended

Recommended

More Related Content

What's hot

What's hot (7)

Similar to insidersecretsofrockstarmanualtherapists

Similar to insidersecretsofrockstarmanualtherapists (20)

Recently uploaded

Recently uploaded (16)

insidersecretsofrockstarmanualtherapists