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Winback Therapy June 29, 2023

Tyler: All right. All right. Welcome, everyone. We’ll wait a few seconds to let everyone join in, then we’ll go ahead and get started. All right. I guess we’ll go ahead and get started. All right. Hello, everyone, and welcome to the Tuesday webinar series. My name is Tyler Mikson with Chiropractic Economics. And in today’s webinar, Chris Koultukis will discuss the science behind Winback therapy, and how to better manage chronic lower back pain and build your practice. Dr. Koultukis has 38 years of private practice experience, and is a certified fascial manipulation specialist. He is a member of the ACA Rehab Council, enrolled in International Fascial Manipulation School, and is a consultant for manual therapy, ESWT, and therapeutic exercise rehabilitation programs. Winback therapy is a method that will help your patients feel better faster, and experience in your hands a powerful, gentler chiropractic session. Welcome, Dr. Koultukis.

Dr. Koultukis: Thank you. Great to be here and to talk about this wonderful therapy, which I’ve had the privilege of working with for the past couple of years. What I love about when Winback is that I could use this therapy in any fashion of my techniques and implement my chiropractic work, my acupuncture work, other modalities, exercise therapy, manual therapies, as a way of amplifying the treatment. The science behind the radio wave therapy is fascinating in the sense that it stimulates on the cellular level all the necessary components in the various phases of healing in the acute, chronic, and rehabilitative phase. We could move on to the next slide. I’m not seeing the slides. Tyler, are you there?

Tyler: Yep. Can you see them?

Dr. Koultukis: No, the slides are not… I just see your name up there. I don’t see the slides.

Tyler: Okay. Let me pull ’em up. My apologies.

Dr. Koultukis: That’s okay.

Yeah. So, while we’re waiting, I will just further elaborate on the transfer of energy therapy with Winback. You can target the various different tissues, so you can work in a very superficial fashion from the skin, going all the way down to the tendons, joint capsule, bone, by making various adjustments on…

Here we are. Okay. So, we could go to the next slide. Okay. What causes muscle spasms? Well, several factors. And we could go back one. Or we could move along. That’s fine. It’s age-related. Obviously, as we age, the tissue gets thicker. We don’t have the same type of lubrication due to the changes in the hyaluron, overuse, injuries, poor posture, and even disease processes like ankylosing spondylitis.

The main thing here in this slide is we’re showing the relationship between the muscle spindle and the Golgi tendon organ, and how these stretch receptors have to communicate with each other. One can come from the higher centers or the gamma motor fibers, and then the other from the annulospiral fibers, the flower spirals that are 1A and 1B. Everything has to be integrated in the fascial tissue, which is sensory tissue, to get quick responses to various different types of phenomenon. For instance, if you’re a baseball player and you’re up at bat and, you know, maybe in your mind you’ve programmed your body, you know, you’re gonna swing the bat, but your eyes as receptors are picking up various different signals and things are changing so rapidly. And the only way that can take place at this speed is through the whole fascial system and how the nervous system is integrated through this fiber optic highway.

We could go on to the next slide. Okay. So, here, this slide’s pointing out, in medicine, they have various ways to disrupt this cycle. This, I feel, is like, you know, you’re cutting off communication. In chiropractic acupuncture, all holistic type of modalities, what you’re looking to do is try to keep the organism in its whole state and then work to correct these maladies. So, introducing botulism into your system, I just came across an article today on how this gets right into the brain cell, these nerve blocks, intrathecal baclofen, CSN suppressants. I think that these, you know, they’re focusing on the wrong thing, just eliminating pain. I mean, obviously, in some cases, this might have to be done. But for the most part, or at least most patients I see, athletes, dancers, marathon runners, triathletes, you know, they wanna try to keep their system intact.

Now, when you utilize Winback with various different chiropractic techniques, myofascial techniques, acupuncture techniques, you’re looking to reestablish this pattern, and what you’re going to do utilizing these therapies, you’re gonna help to open up the pathway. Number one, hyaluron is going to respond to heat. This type of heat that is emanated from the Winback therapy is probably the most effective endothermic heat out there on the market. Not only does it feel good, but it’s so effective in reducing pain. I see, like, cases that respond so quickly. It really does cut treatment time in half. We could go on to the next slide.

Okay. So, I kind of was talking about this a little bit. With an increase in the extracellular matrix viscosity. Obviously, there’s hyaluron that’s present in the extracellular matrix. We have fibers, elastin fibers, collagen fibers, and ions. Now, what happens is that there’s a thickening, a glue-like type of phenomena that takes place as muscles age or there’s injuries. And in this state, it’s a little easier to make that shift into the tissue. There’s a plasticity that’s present within the fascial system, within the hyaluron.

Okay. Thank you, Tyler. Just getting a little message. I will ask questions, okay, as needed.

And we have another phase when this actually can turn into fibrosis, and this takes a little bit more effort. Used to be thought that that might be an irreversible process, but it’s actually with a little bit more effort. And this is where Winback, again, could come in because you might have to get a little bit deeper onto those fascial densifications to break up those adhesions. There could be a little bit more soreness involved in the treatment. So, using something like Winback, and the beauty of this, I’ve never seen an instrument like this before, where with the wrist bracelets, you can actually, the therapy is coming through your hands. So, you are, like, right there and in the moment breaking up that adhesion feeling. So the feedback is quite, quite quick and very responsive in real-time. Okay. We can move on to the next slide.

So, looking at the muscular architecture, the fascial system envelopes every single organ, muscle, bone in the body, nervous system in the body. Looking over at the right here, we see the extracellular matrix, which is that area that’s outside the cell, but very important. In acupuncture, we refer to stagnation as being one of the causes of disease. There are more studies that are being done looking at this phenomena and looking to address therapies into the extracellular matrix to actually make a change and make the person healthier. I know that they’re working with this in the oncology world as well, but I’m gonna stay focused right now on the musculoskeletal issues.

So, here we see an example of a muscle. We have that everything is nice and sectioned and broken down. The epimysium covers that, will lead into the tendon going onto the bone. Then you’ll have the perimysium and the endomysium, which are tissues that wrap every vesicle. And this is kind of dividing all these little units of muscle fibers. And if we were to take the muscle out, it would kind of like look like a well-organized honeycomb. And we have the motor unit going in there with different parts of the muscle doing different functions in different planes. And everything is so nicely controlled through this fascial system. Okay. We could move on to the next slide.

Okay. Let’s talk a little bit about the hyaluron here. Okay. So, hyaluron, it’s a fascinating molecule. We could talk for days about this molecule, but let’s just kind of give, like, the basic science. It’s a very long sugar molecule. It has the ability to attract a lot of water about 1000 times its weight. And what happens is, when things start to break down and you can see this on MRIs too because the bound and the unbound water is gonna indicate the changes to the hyaluron.

So, the hyaluron is present in the extracellular matrix. It’s present in the loose connective tissue that lines like the aponeurosis. It’s laying on top of the epimysium between the aponeurosis. And it allows a gliding to take place. And so, there’s like separations of functions. So, when you look at the thoracolumbar fascia, there is going to be three planes, which kind of like work into the way our body moves through the whole spatial plane system.

And in between each plane, each is angulated at a specific angle and wraps around the body in various different types of formats, some in spirals, some in diagonals, and in sequences. And this material is extremely important because without it, we wouldn’t be able to move. So, with Winback therapy, like I said, we can direct that therapy to help to restore the hyaluron into a healthy state, thereby helping to improve movement. Okay, we can move on. And just what I was talking about, there’s, like, some overlap between the slides, so we could kind of move on to the next slide.

Okay. So, when you’re looking at various different components of the extra site… Excuse me. I’m checking to see if [inaudible 00:12:29.794]. Okay. Let’s just go over some of the functions about the hyaluron. It is the most abundant gamma-amino glycan, which is present in, like I said, loose-connected tissue, doesn’t have any sulfate groups. It’s a long chain, about several thousand sugars. It holds up to about 1000 times its on weight. And it functions as a hydrophilic macromolecule. It’s found in the cartilage, the brown substance. It’s a lubricant, like I said. It’s in the aponeurotic fascia. Protects the muscles. It supports recovery from issue. It changes in concentration based on pain, inflammation, and loss of function. And it’s plentiful during repair and regeneration. The turnover of the hyaluron turns over about every two to four days and must remain active, or therefore, there’s a risk of reducing the quantity. With the Winback therapy, the angiogenic, the inflammatory, immunostimulatory type of effects that can be induced with this help to restore any type of mechanical distortion to the system. Okay. We can move on.

Okay. So, here we’re just showing that there’s a change in the hyaluron, in the viscosity based on the concentration. So, as the concentration goes up, then there’s going to be an increase in the viscosity. Obviously, we wanna try to reduce that to bring that to its ideal behavior on the blue line. Okay. We can move forward.

Okay. Like I said, the hyaluron in higher concentrations will act like a glue, and this is something that you will palpate as you’re going into the various different muscles, fascia, various different regions. You’re gonna be able to pick up and compare where it’s becoming stiffer, where you can feel the skin gliding over the tissue easier. And this, I just wanna diverge to the use of the Winback therapy again, where you can direct that therapy. If you are picking up there’s a lot of restriction within the superficial regions, you can apply the C-reactive probe, the capacitive probe to this, and help to open up the circulation. If there is a lot of restriction, obviously, more force is gonna be generated, like I told you before, and therefore we’re going to require something just to help to alleviate some of that discomfort, and I think that the Winback is a wonderful tool to do that. Okay. We can move on.

So, again, a lot of this is reiterating what we’re…bringing up, what we already discussed. But the most important thing here is that even though there’s degradation to the hyaluron, there is that plasticity, and that is something that is extremely important, and it allows us to achieve our goals of restoring normal movement patterns back to the individual, reducing their pain, and helping them, not only with their musculoskeletal injuries, but other visceral injuries and maladies as well. Okay?

And this is just a little drawing. It is showing that there is definitely a thickening, a change, as the muscle changes in its ability to move from normal into a fibrotic state. Like I said, you can still make changes even with the fibrosis, but in scar tissue, that’s something that is permanent and that needs to be…you know, it requires a lot more work. You can modulate the tissue, but it’s never ever gonna go back into a normal state. But with fibrosis, you can help restore that. Okay?

Okay. We’ve talked about the increase in the extracellular matrix viscosity. So, a lot of the fascial densifications, this is where it’s taking place. You identify the various different points that you’re gonna work on. As a chiropractor, I would first focus in on the skeletal system to see where there’s restrictions in the arthrodial joints. Then I’m going to evaluate the fascial system, and I’m going to work within a specific plane. I feel that I have a little bit more control when I do that and help to understand the malady much better. And then, we’ll go back after I’ve worked on those points with my Winback therapy and my manual therapy, and go back and assess to see what type of changes have taken place to the spinal structures as well as the extremities. Okay. Next slide.

Okay. So, radio frequency and fascia. Okay. So, this picture on the right is a beautiful demonstration of what the fascia looks like. It’s in constant movement. Dr. Gian Bateau, [SP] a French orthopedic hand surgeon has done some very nice video endoscopies, and you could actually see this live, I would look him up, just to look at these pictures. But I’m gonna focus right now on the Winback therapy and how this affects the hyaluron. When you are applying the therapy, like I said, you can direct it to any level of tissue that you need to get to.

And you have the ability to adjust the temperature on here. And you could work with temperature ranges between 95 degrees up to 104. Obviously, you would not be using this with someone that had some type of inability to sense heat, but that I find is such a rare condition. We’ll talk about some other contraindications later on. But within that range, you can make a change to the hyaluron. And by using a manual therapy in there, you can break those adhesions up and set the body into motion to set it on a course for healing. Next slide.

Okay. A little bit about how the radio frequency works. So, we have a very high frequency that is passing through a cell membrane. And when these vibration types of alternating current starts, it starts these ions that start oscillating. And it makes the cell membrane slightly more permeable, so you’re able to move the sodium and potassium ions across this membrane. So, it’s accelerating the whole healing process. So, if someone comes in, there’s some inflammation, you can set the parameters on the Winback therapy for that phase of treatment, and you get the ball moving. It also is gonna help with lymphatic peristalsis, and it’s going to also calm their nerves down. So, at the same time, you’re decreasing pain. So, a lot of different functions in this therapy. Next slide. Okay. I believe this one has the video with this too.

Tyler: Not on this side. We’ll get…

Dr. Koultukis: Oh, not it. Okay. Okay. So, I have, like I said, or as I was introduced, I’ve been doing this for 38 years. I never stopped trying to engage myself in programs of learning more. I feel that when I approach conditions, I like to look at it as I have a toolbox, and I’ve got many different types of tools, obviously treating patients, each one’s an individual, and each one is gonna respond differently to the type of therapy and type of therapist. So, I have found that with Winback, because it just feels so good during the treatment, it’s so easy to use and it’s so creative.

Like I said before, no matter what type of therapeutic principles that you practice or a technique that you practice, I feel this is some type of therapy that would just dovetail in nicely to what you’re doing. I could speak for myself with the various different techniques that I do. I’m able to do acupuncture, cupping, I could use grasping technique, I could use extracorporeal shockwave therapy while I’m doing it. It’s just such a adaptable therapy. I also use this quite frequently in exercise therapies, manual therapies, massage therapies. It’s just a wonderful, applicable instrument. And the main thing, it feels good in the process, and it gets the job done faster. Okay. Next slide.

Okay. Like I discussed before, we can use this through all phases of treatment in the inflammatory phase, in the proliferation phase, and the remodeling phase. You could adapt the treatment to help to boost this process. Next.

Tyler: All right. Now we have a video. I’m gonna switch screens so that we can get it shared.

Dr. Koultukis: Okay.

[00:23:00.261][silence][00:25:28.116]

Tyler: All right. We’ll switch back to the slides.

Dr. Koultukis: Was there audio? I didn’t hear anything.

Tyler: Not on that video, no.

Dr. Koultukis: Okay.

Tyler: All right.

Dr. Koultukis: Okay. All right. The mission of Winback is to get this therapy out there to help our patients. I feel that everybody treating someone should have a mission statement. This is, I feel it’s important because it sets your direction as to what your objectives are and how you are going to utilize your skills in helping people get better. Okay.

Okay. A little history of TECAR. As you can see, this goes all the way back to 1890 when these waves were discovered. They found that below 100,000 hertz, the plasma membrane acted as an insulator with that low frequency. But as things started to move to faster frequencies, they were able to actually stimulate getting this into the plasma membrane and stimulating the cell in a non-invasive way. And I have to say, when I went to school, I got out in ’84, the diathermy machines that they had back then were these very large-headed devices.

You just kinda just placed them over the injured tissue. But when you look at the Winback device, there are so many different, as you had seen in that video, so many different applications that can be used in the various different phases of care, which for me, it’s very exciting, and again, you could apply that in almost any type of situation. I have not had any type of issue where I was not able to use the therapy even with implants, which we unfortunately come across so often to the hip replacements, knee replacements, and such. You’re able to use this type of therapy over these areas. Let’s move on. We’ll talk about contraindications later on.

Okay. And then here we go, you know, through the years, things are just getting better and better. And I think even since I got my unit, I think we’ve made some changes that are present in the new one, which are very enticing, and we’ll have to visit that very soon. Okay, next slide.

All right. We kind of talked about TECAR therapy. Let’s kind of sum it up. There’s three phases, the analgesic phase, the diathermy, the cellular metabolism. The analgesic phase, what the waves are doing is they’re actually blocking the nociceptors. They’re actually changing their input so you can reduce that pain. The diathermy, like the endotherapy, is the best type of way of heating the tissue. You’re using the body as a resistor to get into that deep tissue to make the necessary biological changes to the tissue. You’re getting more oxygen into the tissue. You’re releasing that tension. You’re changing the vascularization rate and the drainage of the area. Like I said before, you’re stimulating lymphatic peristalsis, you’re stimulating collagen synthesis, elastin synthesis, and hyaluronic acid synthesis. Okay, next phase.

And here are some of the components. There are different units. This is one of the portable units that’s out there. All work fine. The unit that I have not only can you treat the musculoskeletal issues, but you can treat lymphatic issues. Some patients, if you’re interested, you know, they’re looking for cosmetic type of treatments. I prefer not to do those. With all the plastic surgeons we have here in New York City, I keep my focus to the musculoskeletal. Very simple to operate. You have a capacitive probe, which is coated. It’s black. The resistive probe is just as the stainless steel. And then a return point, just to complete the circuit. You have the ability to change the frequencies.

So, in the capacitive phase, you can use it to direct it more onto the superficial fracture. If you wanna get down into the lymphatics and blood vessels, you might put it on the CET+. If you feel like, “Hey, I wanna work on both of those areas at the same time,” you could have a setting where you put it on dynamic and you could address both of those areas. It’s important that while applying this therapy, you’re just using very, very small movements, circular movements, and the body is basically kept still. When you’re using the resistive mode, you can hold the probe over the side of pain or the joint that’s involved that’s not functioning properly and apply that therapy there. You could have movement into the area whether passive or active. Let’s go to the next one.

And here we are showing here on the depth of penetration between the capacitive mode and the resistive mode, and the various type of tissues that they treat. So, for instance, if you have an individual, but they have an acute muscle spasm, you might wanna start off with capacitive mode while they’re lying on the table, working in that at the site of pain area and around that area for two or three minutes. Then you could go to the resistive mode and go right over the swollen joints, tendons, ligaments to start helping the body to reduce the inflammation and to create like a healing effect. Next slide.

Okay. Here on the right, we’re showing the various different types of intensity that we can adjust to the therapy. And we could adjust that during the CET phase as well as the RET phase. So, when you’re dealing, like, with pain, with a lot of inflammation, obviously you wanna keep it about like 10% in the acute phase, that’s indicated with the blue. With the gray, you’re keeping it about like 20%. Here, you’re gonna start to introduce some microcirculation, oxygenation, and maybe about like, you know, five minutes or so of treatment. That depends on the condition, the amount of inflammation that’s present in there.

You know, when you’re in the orange phase, you’re keeping it about like 40%. And here you’re just gonna get in the more arterial and venous system, vascularization, circulation, going on. Going over 40, the hypothermia, more collagen synthesis, and enhanced vascularization. So, you could see, like, as you’re going through your various different phases of treatment, you just adjust the intensity accordingly. And then you could just like change, you know, from a CET to CET+, or RET to RET+, which is gonna help you to get easier to the different depth of tissue. Okay.

And here’s just a slide showing the various different frequencies and going from superficial to deep. When in that RET phase, you are using the body’s tissue as part of the circuitry. And with more resistance, the heat is going to build up in there. So, always be astute to your patient’s feelings, so you can adjust it accordingly. Like I said, when I’m holding the RET probe, it can start to heat up. If I have a plate, the RET plate while they’re doing exercises, I constantly check in with ’em to make sure it’s not getting too hot, and then I adjust it. I find that most of the time I might start off at like a level of 30%, and then I’ll drop that down to 20%. And it takes about 5 or 10 minutes to heat up. Okay. Moving on.

Okay. And this, again, is just showing some of the various different apparatus that they have, the bracelets, the adhesive electrodes, and the fixed pads. And what’s really nice is they have a SWAP, a program on here, which allows you to do the CET and the RET simultaneously. So, I can set my plate on, let’s say, I’m from working on the lower back, on the stomach, I’ll set the RET plate. Let’s say it’s an ascending type of low back issue, so I want to go down to the extremity where this might be coming from a previous ankle strain that had changed the structure of the tissues in the ankle, and I’ll put that plate down below there. So, now I’ve got the RET therapy coming in, and then the CET therapy I would have with another plate right over the area or close to the area of injury. Then I could just set my various different intensities, allow that to work. And I could work hands-free now. I could just get in there and do whatever type of work I need to do, whether I’m gonna do some cupping work or acupuncture work, or electrical shockwave therapy, or Graston Technique. Again, you have so many different variables that you can put into this. Okay. Next slide.

And I love this slide because Winback tecartherapy amplifies your skills, and that it does. So, here it’s showing the various different types of phases of treatment. On the slide to the left here, we’re holding actually the fixed pad, which is in the therapist’s left hand, and then the right hand, the resistive pad. And you can move these around. So, in this particular instance, you can really target the injured tissue. A lot of times you might come up in your examination that you just have to focus on a certain segment of the muscle, and this is a really nice way to do this. It’s also very good working around the shoulder joint, the elbow joint, the hip joint, knee joint.

Here, the therapy in the middle picture here, the therapy is literally coming through the patient’s hands. These bracelets are attached to you, and the therapy is going right through your body, right into the offended tissue. So, you have a great way of staying in current time with your patient. And by using all your manipulative skills, you can actually go through different ranges of motion and assist them in your manual therapy.

And the last slide over here, while the patient is exercising, this helps to open up the pathway along the whole joint complex, the whole myofascial chain, which I feel you get a much better response in your treatment. And it just is just a wonderful, pleasant, comfortable feeling. I do this typically at the end of the week after my long work week, and it’s just a great way to kind of work out all the kinks. Another thing that I would use this therapy too, like I say, after a myofascial therapy, and if there’s a little bit of soreness, I’ll focus just using the Winback therapy to help. It’s more of like a palliative type of treatment, just to help the lymphatics and vascularization, kinda move things along, and kind of, like, empty out all those waste products that are causing irritation to the tissue. Next slide.

Okay. So, a lot of the focus is getting people back into their desired sports, getting them back into their life in a pain-free manner. And I have to say that Winback has proven to me time and time again how easily and comfortable this process takes place. Okay, next slide. And again, as a kind of a recap of what we’re talking about here, we’re using the therapies while at the same time, we’re doing instrument-assisted soft tissue mobilization, dry needle, acupuncture, shockwave therapy. Sometimes with shockwave therapy, it can be a little uncomfortable, but using the combination together, it makes it much, much more easier type of delivery of the treatment. Because number one, you’re working on the lymphatics, you’re working on the nervous system, you’re working on the vascular system. So, you’re putting everything into play that the body needs to get amplified. Okay, next phase.

Okay. Contraindications. So, not that many contraindications. And the other nice thing, especially when treating a lot of athletes, some are getting ready to do a triathlon or marathon or performance, you can use this daily. Like other contraindications with other therapeutic devices, deep vein thrombosis, people who have sensitivities, numbness, fevers, and infections, obviously, the person should be in your office at that moment, pacemakers, insulin pumps. Treating minor patients, I don’t wanna treat minor patients with this, and cancer, and pregnancy. Okay, next slide.

You can review the literature and look at all the science behind TECAR. I have found that it’s still in its infancy. It needs to, you know, get a lot more research. I think that would be very helpful to get more practitioners involved in it. But my experience over the past couple of years has been nothing but positive. Okay. Next slide.

And the platform, the Winback Academy platform is great. You have a question about how you would set up a treatment outside of the manual, you could just sign up on the platform, do a little search, and you’ll have various different videos with material that you can read to help you target the particular malady that you’re dealing with. Very helpful. And also, the community. You can get in there and you got questions, put the question there, there’s thousands of people on here looking to help out. So, I think it’s a wonderful way to stay abreast of all the changes that are taking place with Winback. Next slide.

Tyler: I have your videos here. We can pull them up if you wanna narrate over them or we could just play them as is.

Dr. Koultukis: Okay. So, we could go to the top left?

Tyler: Yep. I’ll get that right now.

Dr. Koultukis: Does it play that one?

Tyler: I think this one is… Yep. I’m gonna just… Can you see it?

Dr. Koultukis: Yep.

Tyler: Okay.

Dr. Koultukis: It’s not moving yet.

Tyler: Moving now.

Dr. Koultukis: Probably loading. Okay. So, here we’re doing a closed kinetic chain amount, getting the whole myofascial chain, getting the spine to start undulating from the cervical all the way down to the lumbar spine. Here we have the fixed pad is located on the back, excuse me, on the front. And I have the active pad, the resistive pad on the back, and we go through various different movement patterns before we do undulation. Now we’re going to the squats. So many people when they perform squats, they do them wrong. So, I feel I have a lot more control in helping my patients and direct them into the proper posture, so they’re relieving the stress and getting a much better movement. The other wonderful component with this, while I’m doing these exercise therapies is that we’re putting the focus on the trunk, so everything becomes like a core resistive type of exercise. Okay. Next slide.

Tyler: Yeah. Do you wanna play any other videos or you just wanna move on to the next slide?

Dr. Koultukis: Depending on time, we might have, I think it’s 15 minutes. Let’s leave time for questions and we could talk about various different therapy applications. Okay. So, I have to say, it really lives up to its statements here. It is maybe even faster, especially, you know, they’re just looking at the pure application of using Winback. I think when you start to incorporate the various different manual therapy techniques, acupuncture, and such, that you could probably even increase the curve a little bit. I would say at least with pain relief, I’m seeing like, you know, maybe 90%, 95% pain reduction. And it can last for several days, which is really helpful in your management of patients.

Tyler: All right. Awesome. So, we’ll go ahead and head into the Q&A session. We have a few questions from the chat, so thank you all for throwing them in there. You’re welcome to ask more questions as we get to it. We do have a question here. Considerations when administrating Winback to a patient receiving Synvisc injections?

Dr. Koultukis: Oh, as to my knowledge, there’s no issue at all. In fact, I think it’s going to be more beneficial because of the effect that the Winback therapy will have on the hyaluron. In fact, I was at the TOBI Conference, where they were doing all regenerative medicine, and I sat in at the master’s meeting at the conclusion of the seminar. I have to say, I think the research is pointing more towards using these type of therapies and being very effective in the regenerative process. And some of the docs were even saying maybe even more so than some of the stem cell work in bone marrow transplants that they were doing. So, that was very reassuring, the type of therapy that we have in our hands on what we can offer our patients.

Tyler: All right. Awesome. Got another one. Does TECAR increase HA production or release dissatisfactions, or densifications?

Dr. Koultukis: Oh, it’s going to help to break up the densification, but while I’m using the TECAR therapy, I am actually doing a manual therapy over that point. It’s the combination, if you look on that study, it was the manual therapy along with the increase in the heat to the area to help to break up that densification.

Tyler: Fantastic. And how does Winback therapy empower you as a doctor of chiropractic?

Dr. Koultukis: Well, like I’ve been saying all along, not to steal their word, but it does amplify my treatment. It’s such a comfortable modality. It’s very easy to use. There’s a lot to be learned, so there’s a learning curve because you have so many different applications with this. But just take it one step at a time, you’ll be able to fit all of that into your treatment toolbox.

Tyler: All right. Awesome. And what has been patients’ response to Winback therapy in your practice?

Dr. Koultukis: Okay. To give you an example, I was treating a track and field individual. He ran the 440 hurdles. He came in on a Monday with crutches. He was treated, you know, with his athletic trainer. And when he came in, I immediately started with the Winback therapy. He was very upset because he had a competition that Saturday. He competed that Saturday. I treated him every day and he was able to compete, and he took a third. He probably, if he didn’t have that injury at all, he probably would’ve won that.

Tyler: That’s great. It’s great to hear. Do you have a favorite condition to use Winback?

Dr. Koultukis: Oh, I kind of like go through phases, like I gave into, like, treating shoulders, and all of a sudden, I don’t know if this happens to the other docs out there, but all of a sudden, like, I’m treating about like five, six more new shoulder injuries for that week. So, I kinda get into working on that and doing a little bit more research in the areas that I’m treating. You know what it is, it’s the response that you get back from your patient, regardless if you’re treating low back, shoulder, hip, knee, plantar fasciitis. The fact that they’re feeling better, and you could just sense it in their voice, their tone, that to me is the most satisfying type of compliment that I receive. And I really feel that the Winback is a very helpful tool in managing that.

Tyler: Awesome. How does Winback therapy contribute to your practice’s bottom line?

Dr. Koultukis: Okay. So, you know, unfortunately, it’s not recognized, you know, through insurance, so patients pay. But if you set up, you know, a pay scale structure for your area, just by adding in, let’s say, you’re seeing 100 patients a week. If you add the Winback therapy into your protocol and you charge $25 in addition to the copay that they’re paying if you’re in network. If you’re out of network, obviously you would set up in a different way. But that increase of $25 for, you know, hypothetically each patient, not everybody will be at that 100, will be in there. You could just, you know, do the math and you could just see the return on your investment. But like the main thing, it’s like we’re treating people, we’re out there to help them to get better as naturally as possible, and to stay better.

Like in my mission treating patients, my goal is to, and it’s not that I’m against surgeries, but to try to limit the amount of surgeries that are being done, to limit the amount of medications. I think that the good that they have done, they also, you know, they have done harm as well, and I’m sure, like I said, I’ve been around for 38 years doing it, unfortunately, with some surgeries, that’s the last time I ever see that patient, and not because they’re not coming back, it’s because of the unfortunate outcome. So, it’s something that, you know, if we could keep people off the knife and keep people off the medications, we are doing a major service to that individual and as well as to society. So, this is one of the instruments that I feel is helpful in achieving that goal.

Tyler: Awesome. And has Winback increased your referrals, word of mouth, and popularity of your practice?

Dr. Koultukis: Absolutely. Absolutely. You know, my whole practice is built all on word of mouth. I don’t use any type of other means of introducing patients to the office. It’s just I try to do the best I can and I’m waiting for that referral.

Tyler: Fantastic. And we have one more question. Out of all modality investments you have made recently in your practice, how would you rate Winback therapy?

Dr. Koultukis: Oh, they get an A plus.

Tyler: Awesome. All right. Well, I wanna thank you first, Dr. Koultukis, for sharing us your expertise. And I also would like to thank everyone for joining us on this busy Tuesday. I know it’s a busy day at the office for all of us. So, I also would like to let everyone know that this webinar is being recorded and it will be available on Chiropractic Economics, and you’ll be able to watch the recording. We’re also gonna transcribe it as well, so all that information will be uploaded usually within 24 to 48 hours, so stay tuned for that. You also have a QR code on screen where you can book your demo for Winback therapy. And there’s also a 10% off code on the screen, but we’ll also send this to you in an email that’ll come from Zoom, so you’ll be able to get that information. Dr. Koultukis, do you have anything else to say?

Dr. Koultukis: I just wanna thank you for having me on. I’m more than willing to make myself available for any questions. If anybody would like to contact me, my email is [email protected]. Feel free to contact me anytime and I’ll be more than happy to answer any of your questions.

Tyler: All right. Well, thank you very much and I hope everyone has a great rest of your Tuesday.

Dr. Koultukis: Thank you, Tyler.

Tyler: Bye, everyone.

Dr. Koultukis: Bye.

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