Why Rationing Out Your Conservative Care When You Have an Active Problem Is Not a Good Idea

By PPSM Staff

Many people now have insurance coverage that includes conservative care benefits for their ailments. This has opened up a window of opportunity for many to explore avenues of health that they may not have even heard of before. While there are some newer methods of treatment two staple conservative care options that have been around the longest are chiropractic and physical therapy. At Performance Spine and Sports Medicine not only are these two avenues of care offered, but they operate in tandem and do so at exceptionally high rates of success. However, this success is not haphazard. The collaborative effort between our medical doctors, physical therapists, and chiropractors is elaborately made with the ultimate goal of providing the correct and most efficient care for each individual patient that comes through our doors. The recommended treatment plans given are crafted for each individual based on a set standard that is proven and rooted in consistency and maximum efficacy for results and following said treatment recommendation is key to seeing those results. There are times, however, when some patients feel that breaking up their treatment recommendation, in terms of frequency, will fare them better because of the perception that it is better for them if their care lasts a longer overall period of time. Clinically this is untrue and here’s why.
Three times per week is a pretty common standard set in the conservative world, this number is not arbitrary. Care recommendation is based on achieving the best clinical outcome possible for the individual. Plainly stated, we want to put together a plan that is going to get you to your goal, being pain free, as quickly, safely, and efficiently possible. Liken this to working out. When you start a workout plan/regimen you typically have a goal in mind; even if it is as general as “wanting to get into better shape overall” and not as specific and particular as “train for a 5k” or “lose 25 pounds.” If you are following your training regimen but only going to the gym once a week you likely feel good afterward each time you go, but once a week isn’t doing very much to help you reach your goal as efficiently as possible. You’re sacrificing the efficacy of your program for little to no therapeutic/physical benefit.

When you’re a patient at PSSM, clinical necessity spearheads the recommendation we’ve given you. So, when we tell you that three times per week is what we are recommending it is because that is what is necessary to see results in the short time frame we are trying to get you better in. Remember, that number is not arbitrary. Conservative care is a cumulative process; meaning the results and effects of the care add up over a defined period of time. We want to protect you from wasting a lot of energy swimming upstream by only getting a third of the care you need each week; therefore significantly slowing your overall progress and many times staving it off altogether. You simply won’t get the results you’re looking for that way.

Time is a factor here as well. Most problems that patients come in for, that aren’t a result of a directly traumatic injury, have actually been developing over a longer period of time than they realize. This can range from months to even years. When you’re undergoing physical therapy and chiropractic care we are trying to reverse that problem in a matter of weeks. This adds another layer of difficulty to the mix when a patient purposely cuts their visits down by more than half. A lot of times it will take longer to get better; much longer, but most of the time you will just plateau faster and stay there longer; meaning you’ll improve to a certain point and then your progress will slow to a halt, remain there, you’ll get stuck and in many cases get worse again. The other reason this is true is the activities of daily living factor. Depending on what you do for work and/or hobbies these activities will begin to counteract the care you’re supposed to be getting 3x a week but are only allowing yourself to receive 1x per week. If you are working out once a week with a goal of getting stronger, or fitter, would you reach your goal in one year? Not likely. Relatively, if you are coming in for care once per week will you be better within 8 weeks? Not likely. So take the time to get better. It may feel tedious and painstaking in the process but it really is your best chance at getting better and staying that way. You’ll thank yourself when you come out on the other side.

Soda is a Four Letter Word

By Matthias H. Wiederholz

America has an obesity problem.  And it seems the rest of the developed world is following suit.  A question that many people wonder is whether soda consumption increases the likelihood of weight gain. The short answer is YES.

Soft drink consumption has increased globally from 9.5 gallons per person per year in 1997 to 11.4 gallons per person per year in 2010.  Simply a 1% rise in simoft drink consumption contributes to an additional 4.8% overweight adults, 2.3% obese adults, and 0.3% adults with diabetes.1  If this trend of increased consumption of caloric beverages continues, it is clear that these rates will rise drastically.

There is an alarming statistic. Consumption of sugar sweetened beverages (SSB) in the United States is increasing.2,3  About half of mothers with children age 2 reported that their children drank SSB’s at least one day per week.  Moreover, there is a much higher likelihood that children who drink the highest amount of SSB come from low-income families.  These families are the same families that likely have limited access to quality healthcare.

So what does this mean for society in general?  Well, SSB consumption is increasing and the obesity epidemic is worsening.  Insulin resistance is becoming commonplace.  Based on the studies outlined above, we can conclude that soda consumption is certainly contributing to this problem.  In fact, as mentioned earlier, soda consumption predicts weight gain.

Therefore, if you don’t want to gain weight, don’t drink soda!

don’t drink soda


  1. Basu S, et al. Relationship of Soft Drink Consumption to Global Overweight, Obesity, and Diabetes: a Cross-National Analysis of 75 Countries. American Journal of Public Health. Nov 2013; Vol 103, No. 11: pp. 2071-2077.

Treat Your Migraines (and your wrinkles too)

By Matthias H. Wiederholz

Do you suffer from migraine headaches? Migraine headaches can be debilitating and some people have more headache days than non-headache days. Migraines typically start as a dull ache and progress to a throbbing pain. You may have sensitivity to light or sound with this headache. Some people even get nausea/vomiting with this headache. The headache typically lasts between 4-72 hours and interferes with daily activities.

If you suffer from migraine headache at least 15 days of the month that last at least 4 hours per day, you may be a candidate for treatment with Botox. Yes, I said Botox. Botox is FDA-approved for the treatment of chronic migraine. If you have tried multiple medications that have failed you are likely frustrated with the lack of pain relief. In fact, sometimes taking too much medication can actually worsen your headaches!

Botox is a simple injection technique for the treatment of chronic migraines. It involves injecting the medication into specific sites in the face, head and neck. It relaxes the muscles and relieves the headaches. In patients with 15 headaches per month or more, Botox reduced the headache days by 9 or more.

The best part… Your wrinkles will disappear too! Seriously. Many of the injection sites to treat migraine also happen to be the same sites that we inject when using Botox for cosmetic purposes.

If you have more headache days than non-headache days, consider calling for a Botox consultation today.

PPSM Overview Video

By PPSM Staff

PSSM Wellness Overview

Performance Spine & Sports Medicine, LLC, is a premier non-surgical orthopedic institute providing a team-oriented approach to optimize your health and wellness.

PSSM sponsors Shady Brook Farm’s *Holiday Light Show*, a Bucks County tradition

By PPSM Staff

PSSM has partnered up with Shady Brook Farm as a Top Sponsor for their annual Holiday Light Show, Bucks County’s most anticipated community event of the year!

annual Holiday Light Show

Experience the magic of millions of lights illuminating acres of farmland at the Shady Brook Farm 2013 Holiday Light Show!”

This event makes a wonderful holiday tradition for families and friends. There are incredible new displays this year, including the ‘Seven Wonders of the World’….and our very own PSSM customized light display!!

Our PSSM light display is located upfront by the ticket booth entrance. You can’t miss it, at 18′ high by 60′ wide – also seen from highway I-95! We couldn’t be more thrilled of our awesome display and, of course, our partnership with Shady Brook Farm!

Our display design pays homage to a keyword at PSSM; Performance. Its aesthetic correlates to our 3 significant graphic rings shown on the PSSM logo – our performance rings of service & achievement, acknowledging the state-of-the-art non-surgical multidisciplinary platform we offer. Our logo is lit with the animation of a flaming torch, representing PSSM’s promise to serve, treat & help heal our patients. “Our Patients Results are our Goals”.

New Sponsors of the Holiday Light Show

Here is an excerpt from the Bucks County Courier Times special edition Holiday Guide, handed to all who attend the light show:  New Sponsors of the Holiday Light Show, by correspondent Sandi Pachuta:

Percy Naranjo, Chief Executive Officer of Performance Spine & Sports Medicine, said he is excited that his medical practice is a new light display sponsor for Shady Brook Farm this year.  Naranjo’s practice is one block down the road from the farm, and he is pleased they are neighbors.  “We are in step with Shady Brook and how they interact with the community,” said Naranjo.

“We are so glad Shady Brook is having us as a sponsor for the community-oriented event of the light show; Shady Brook Farm provides a great environment for the family all year long,” said Naranjo.

Naranjo has been taking his children, now ages 5 and 7 years, to the light show ever since they were babies. “The light show is awesome, and we have been attending the show ever since we moved to the area six years ago,” said Naranjo. 

Performance Spine & Sports Medicine ( is slated to open its third location in Bordentown, NJ, in December.  The practice began in 2009 in Lawrenceville NJ, followed by the Newtown location in 2011.”

After visiting the light display show, we encourage everyone to enjoy all that the farm has to offer, including the market for their selection of nutritious fruits and nuts for added holiday health!  PSSM brochures are available all year long in the Farm Market and Garden Center, also handed out together with the Holiday Guide on special evenings during the light show event.  Spread the word; PSSM is at your service.

The Holiday Light Show is on display now through January 5, 2014 from dusk to 10PM.  Visit for prices.

Shady Brook Farm is celebrating 100 years in business and we couldn’t be more proud to be associated with this farm’s iconic heritage, commitment and service to Bucks County.  Enjoy some holiday light show magic ~ Doctors orders.  😉

Happy Holidays from PSSM!

Platelet Rich Plasma Injection

By PPSM Staff

Platelet Rich Plasma Injection

Platelet Rich Plasma Injection involves injecting your own blood platelets (special cells in your blood that heal tissues) into joints like shoulders and fix rotator cuff tears.

Acupuncture at PSSM

By PPSM Staff

Acupuncture at PSSM

Dr. Michael Rizkalla, MD – Discusses acupuncture treatment at Performance Spine and Sports Medicine. Here our interdisciplinary clinic and approach allows us to coordinate your care and tailor make a customized treatment plan for you.

Chronic Pain Solutions

By PPSM Staff

Chronic Pain Solutions

Dr. Matthew Wiederholz, M. D., Board Certified – Speaks about chronic pain and advanced pain treatment.