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Please join us in welcoming Dr. Etai David Gamliel to the Premier team! Dr. Gamliel is a passionate sports performance physical therapist, former collegiate athlete, and Certified Strength and Conditioning Specialist. He also serves as an Assistant Coach with the Calvert Hall Freshman/Sophomore Football Program, injury consultant, and personal trainer in the Baltimore, MD area. Dr. Gamliel graduated from one of the top physical therapy programs in the country, The University of Maryland Baltimore. Prior to joining the Premier team, Etai worked in sports oriented clinics in Manhattan and Baltimore, During this time, Dr. Gamliel worked with clients from a variety of demographics (ages 4-96), including active military, wounded warriors, and high school, colligate, and professional athletes. In Etai’s free time he enjoys reading, playing guitar, singing, exercising, playing football, basketball and spending time with family and friends.  Local to the Towson, Lutherville-Timonium, Cockeysville, or Hunt Valley area? Friends & Family receive a FREE
Discovery Session at Premier!
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Most times when people are rehabbing from surgery, dealing with repetitive injuries, or experiencing persistent pain, they start to feel like their body is "out of balance." But how does it get that way?  The body feels and looks out of balance when the length tension relationships between muscles has changed. For instance, in the picture above, the client's hips are shifted to his right in resting standing position. This has occurred as a result of changing length-tension relationships. The muscles responsible for moving the hips to the right have determined it is safer to be in a shorter, more active state, which creates additional tension in that direction. As an effect, the muscles responsible for pulling the hips to the left will be stuck in a lengthened (or stretched) state. These changing relationships cause the body to look and feel out of balance. They also place the body in a slightly more vulnerable, injury prone position. For example, because the hips have naturally learned to shift right, more body weight will fall on the right side of the body with every day movement. Over time, the right side of the body is forced to absorb more and more force, which may result in additional "wear and tear." This is just one of many examples of how being "out of balance" can put us in more injury prone positions. Optimally, the body's resting state would be in a neutral position that equally distributes body weight. The natural next question is "why do length-tension relationships change in the body?" Length tension relationships change in the body for a number of reasons including:
In all of these cases, the body adapts to a new normal resting position and learns to utilize muscles in a less than optimal way. In order to correct the issue and restore balance to the body, it is important to have an understanding of what "proper" (or a balanced) position looks like. With that understanding in mind, you can practice reintroducing the body to its proper resting state. With continued and disciplined practice, the body will restore balance. It is also important to understand exactly where the root cause of the changing tension relationships are coming from. This can be a challenging task for even the best movement specialists. One of the most impactful benefits of utilizing Neuro Therapy technology is that the "search" process pinpoints exactly where the most significant length tension relationship problems exist. After pinpointing where those problems exist, the technology can be utilized to efficiently restore proper length-tension relationships and balance in the body. The picture below was taken after a session with Neuro Therapy technology - it's clear to see that his body is much more balanced in resting standing position than before the session (pictured above). If you are interested in learning more about supplementing your existing rehab program with Neuro Therapy technology, click the blue button below to arrange a time to talk to a member of our team.  This week’s post highlights the success of one of our Premier Family clients, Steve. I met Steve at one of the best CrossFit gyms in the area, Outsiders Crossfit. At the time, Steve was dealing with persistent pain in both the shoulder and hip that were forcing him to scale back and modify his workouts. Local to the Towson, Lutherville-Timonium, Cockeysville, or Hunt Valley area? Friends & Family receive a FREE Discovery Session at Premier! While he was excited to be a member at Outsiders, he was discouraged that this persistent pain was keeping him from continuing to build on his level of fitness. Because the problem has been going on for 6 months, and he had tried many other conservative means (like resistance band exercises, stretching, and resting), Steve was convinced surgery would be needed to fix the problem.  If surgery was required, it wouldn’t only affect his ability to stay fit, but it would also inhibit his ability to stick to his busy travel schedule for work. He was concerned that surgery and/or physical therapy would take so long that his work would start to be affected. Working around Steve’s busy travel schedule, we were able to find 2 weeks to work on his shoulder together. By the end of the two weeks, all of Steve’s hard work at Premier allowed him to work out at Outsiders and feel much more confident in his shoulder. The need for surgery was off the table. After going on a trip for work, Steve returned several weeks later to work on his hip, with similar, successful results. He's back in the gym at 100%, continuing to improve his fitness levels each day. Before Steve and I met, he admits he had very limited knowledge about Neuro Therapy. Even now, he maintains it is just one of those things you have to experience to understand how it can work for you. Because many people have expressed this to us, we offer the ability to experience Neuro Therapy completely for free. You can learn more about the process and go through a full session at no cost to you: Just click here to sign up go.premierneurotherapy.com/apply Check out the video below to see Steve’s full story and find out what his favorite part of the Premier Neuro Therapy experience was. Local to the Towson, Lutherville-Timonium, Cockeysville, or Hunt Valley area? Friends & Family receive a FREE
Discovery Session at Premier! Diabetic Neuropathy Overview Diabetic Neuropathy is a debilitating complication of diabetes. It's estimated that 50% of people with diabetes have some degree of diabetic neuropathy. The condition starts as minor pain or numbness in the extremeties, but has the potential to become a much more serious issue. Eventually, people sufferering from diabetic neuropathy may end up with loss of sensation in the feet, which predisposes them to a variety of foot injuries, including ulcers. If an ulcer develops, the risk of negative outcomes increases significantly, and the condition may even require amputation of the limb. Outside of the personal costs associated with diabetic neuropathy, the condition costs the US helathcare system between $4.6 and $13.7 billion each year. Up to 27% of the direct medical cost of diabetes may be attributed to diabetic neuropathy. How Does Diabetic Neuropathy Develop? Diabetic Neuropathy occurs when hyperglycemic conditions in the blood stream cause decreased blood supply to nerves. Blood carries necessary resources, like oxygen and nutrients, to the nerves. Thus, when blood supply is decreased to the nerves, the nerve becomes starved, inflamed, and eventually damaged. When the nerve becomes damaged, either pain or numbness start to set in. The longer the body is exposed to hyperglycemic conditions, the more diabetic neuropathy escalates. In order to manage the condition, a community based approach is needed which includes programs that address both the hyperglycemic condition (for example, dietary factors) and decreased blood supply. How Does Premier Neuro Therapy Impact Diabetic Neuropathy? Premier Neuro Therapy works to minimize symptoms, such as pain and numbness, associated with diabetic neuropathy via 4 pathways:
Conclusion Diabetic Neuropathy is a serious condition that must be taken seriously. The longer your body is exposed to hyperglycemic conditions, the greater the risk is of debilitating diabetic neuropathy leading to ulceration and potentially amputation. In order to slow the progress of diabetic neuropathy, a two pronged approach is needed that both manages the hyperglycemic condition and increases blood supply to the affected nerves. If you're interested in finding out if Neuro Therapy can help slow the progression of your diabetic neuropathy, click the link below to schedule a time to talk with a member of our team; Click here to schedule time to talk with a member of our team If you have additoinal questions regarding Neuro Therapy and Diabetic Neuropathy, feel free to shoot me an email at: [email protected] Local to the Towson, Lutherville-Timonium, Cockeysville, or Hunt Valley area? Friends & Family receive a FREE
Discovery Session at Premier! The other day, a new client mentioned that she had been on our website, and initially thought that Neuro Therapy was only for professional athletes. It's an understandable stance, based on the information on the website, and it's true that I initially worked primarily with professional athletes all over the United States. However, as more and more athletes sought out Premier’s services, cases became more and more complex. The Premier team was no longer just helping athletes who suffered acute injuries to get back on the field efficiently, but also athletes who were struggling with repetitive injuries, delayed recovery from surgery, and persistent pain. The latter group of athletes had been through months of physical therapy, and sometimes even surgery, but still could not perform without the lingering effects of injury including severe pain, decreased range of motion, decreased strength, and decreased overall daily function. We started to wonder... if Neuro Therapy can have this kind of impact on those lives, who else can it help? Today, Premier serves a population of people consisting of all ages, genders, and races ranging from the 8 year old gymnast who's hoping to get back on the mat to the 84 year old grandmother who wants to keep up with her grandkids. Local to the Towson, Lutherville-Timonium, Cockeysville, or Hunt Valley area? Friends & Family receive a FREE Discovery Session at Premier! If you asked me to sit down and define who Neuro Therapy is for, I would boil it down to 5 main groups: Group #1: You’ve tried multiple other forms of therapy (massage, chiropractic, in-home exercises, traditional PT, painkillers) and are starting to think surgery, a lifetime of medication, or “just living with it” are your only options. Group #2: You’ve already had surgery and it hasn’t done much to improve the way you are feeling. The recovery is slower than expected, has stalled out, or actually has you feeling worse and worrying more than before. Group #3: You’ve just had surgery or gotten injured and are feeling like it will take forever to get back to the activity or performance levels you were at before (and maybe worried about the risk of re-injury). Group #4: You experienced an injury and re-injured it when trying to return to high activity levels. Now, you want to recover as quickly as possible but are concerned it could happen again. Group #5: A friend who’s already experienced Neuro Therapy told you this is the best way to recover and you 100% need to try it. Recap If any of these sound like you, I want to hear about it. Click the link below to tell us a little more about what's going on and apply for a FREE Discovery Session: https://go.premierneurotherapy.com/apply The discovery session is designed to give you all the information you need to make a decision about whether or not Neuro Therapy is a good fit for you. During the discovery session, you'll have the chance to tell us more about your problem, learn more about Neuro Therapy, and go through a full session from beginining to end. It is a 100% risk free opportunity to see if Neuro Thearpy is something that can change your life and get you back to doing what you love, so don't hesitate to apply! Local to the Towson, Lutherville-Timonium, Cockeysville, or Hunt Valley area? Friends & Family receive a FREE
Discovery Session at Premier! You’ve just been injured or started feeling a weird pain in one of your joints. You get online and start googling things like “knee pain,” “elbow pain” or “sprained ankle.” Immediately, you’re hit with search results and ads advocating for the use of a “brace.” It’s an attractive solution, because it seems easy and low risk. What’s a couple bucks? If it doesn’t help, no biggy. If it does help, you’ve found a solution that will allow you to keep going about your normal day to day life – that’s great! Right? Well… potentially.  It is definitely great that you’ve found a temporary solution to relieve pain and keep you moving, but there are a few important questions you must ask yourself before calling the problem solved. Before we dive in to the questions, let’s start with the basics of the function of a brace. A brace decreases pain by restricting mobility and limiting range of motion in the affected joint. By restricting mobility, a brace may cause a couple of long term problems for the joint, as well as other joints in the body.
 With those thoughts in mind, it may start to seem like a brace isn’t such a great idea. However, they aren’t completely bad. It just means that they aren’t always the long term solution people think they are. Here’s 3 questions to ask yourself before jumping at that opportunity to throw on a brace and see how it feels. 1) Is my safety at risk if I don’t wear the brace? In some cases, an injury or movement disorder may be so bad that a brace is needed to stabilize the joint. Without a brace, it’s possible that simple movements like walking or standing up would cause more damage to the joint. If that’s the case, it’s likely a brace needs to be a part of your solution. 2) Do I want to wear the brace long term? If you’re perfectly ok with wearing a brace long term, maybe it can be a solution for you. Just remember that the longer you wear it, the more you’ll increase the risk of developing dependence on it and other injuries down the road. 3) Do I have a brace exit plan? If you do not want to wear the brace long term, you need a brace exit plan. There must be a plan in place to address the underlying causes of the injury or condition – a qualified strength coach, physical therapist, or neuro therapist may be able to help develop this plan. My take? Braces aren’t all bad – they play an important role in the recovery process if the affected joint is in legitimate risk of additional harm. However, I would not recommend using a brace (other than for safety reasons) if you don’t have a parallel plan in place to address the underlying cause of injured joint. Local to the Towson, Lutherville-Timonium, Cockeysville, or Hunt Valley area? Friends & Family receive a FREE
Discovery Session at Premier! Our local community partner, the Arthritis Foundation, is hosting their annual Baltimore Walk to Cure Arthritis on Sunday, June 9th! We see clients from all walks of life, and I’ve seen first-hand the impact arthritis can have on someone’s life.  At the end of 2018, we had the pleasure of working with one of the most well known Baltimore area members of the Arthritis Foundation. He grew up with Juvenile Arthritis and continues to live with Rheumatoid Arthritis. When he came to us, his goal was to walk the entire Jingle Bell Run For Arthritis (a 5K). It was a lofty goal, given that the arthritic pain and fatigue had never allowed him to complete the 5K, and we only had 1 month to help him prepare. However, using Neuro Therapy, we were able to help him pull it off. He continued to work with us in to the first few months of 2019 to manage the inflammation around his joints, prevent muscle atrophy, and improve his overall quality of life, and has since accomplished his second goal of being able to work 30 hours/week!   Arthritis is the nation’s #1 cause of disability, and it is the mission of the Arthritis Foundation to fight for a cure, while providing educational tools and resources, along with community connections, for the 54 million Americans who are diagnosed. The Walk to Cure Arthritis is a FREE wellness event where the Arthritis Foundation raises awareness and funds to support their mission. At the event, we will hear from Young Adult Honoree, Nia Phipps, who has been living with Juvenile Arthritis since she was 5 years old. Nia credits the Arthritis Foundation’s Juvenile Arthritis Camps for helping her make friends and learn to live life beyond her diagnosis. It costs the Arthritis Foundation $1,000 for a child to attend a Junveile Arthritis Camp each summer. Our goal is to raise $1,000, and send a child like Nia to one of the 42 Juvenile Arthritis Camps across the US so they finally have a chance to be a kid.  We have a team for the Walk and would love to walk with you on June 9th. Visit https://events.arthritis.org/team/premier to register, or create your own team to walk with your family and friends! If you’re able to donate, even just $5, it will make a difference. Thank you in advance for all your support. To learn more about the Arthritis Foundation and how you can get involved, contact Lexi Evans, [email protected], 443-948-6657. Local to the Towson, Lutherville-Timonium, Cockeysville, or Hunt Valley area? Friends & Family receive a FREE
Discovery Session at Premier! One of the toughest parts of the recovery journey that we see day in and day out is day 1 of what we call “force absorption testing.” I would imagine this concept isn’t unique to Neuro Therapy – there are similar moments during the recovery process for everyone, whether they are just “resting” their injury until it gets better, going through traditional physical therapy, or have recently undergone a surgery. It’s that moment when you get to test the activity that’s most important to you and see how the injury feels. Whether it’s just going for a walk, jogging, biking, or getting back on the field, you finally get to see how you’ll feel going at a little higher intensity than what you’ve been allowed to do in therapy so far. So what makes it so tough? Surely, this is a joyous occasion. All the hard work and time you put in to therapy is about to pay off! Except when it doesn’t (at least not on day 1…)  In 90% of cases, that first day of testing isn’t about being 100% pain free or to feel like you’re performing at your best again. Day 1 of testing is about starting to acclimate your body and more specifically the nervous system, to the forces that are required to do that activity again without any hesitancy or guarding. Because it’s been so long since you last performed that activity without pain, it’s extremely likely the nervous system will still be guarding. And when the nervous system is guarding, it causes the brain to send off signals like pain, stiffness, and “this feels weird.” It takes repeated exposure to the activity over the course of several days in order for the body to “take the guards off” and realize the activity can be completed without any resistance. When the nervous system realizes this, it eventually allows the activity to be performed without pain, stiffness and the feeling of “this feels weird.” In other words, to put it shortly: You should expect there to be pain or some level of discomfort on Day 1 of testing – do not let it discourage you!  The goal of day 1 of testing is to establish a baseline. How much activity can you do before feeling discomfort? If you’re a runner, maybe its ¼ mile and you start to feel that nagging pull in your hamstring at a 2/10 pain level. In general, we look at pain levels of 1s and 2s out of 10 as a warning signal sent by the nervous system. They aren’t there to indicate you’re doing harm – just to let you know “hey, we’ve been down this road before, and past experience tells me we might be doing an activity that can cause damage.” We’ll encourage you to keep running through that 1 or 2 out of 10 until one of two things happen: 1) The discomfort goes from a 1 or 2 out of 10 to a lesser value (maybe none at all). That’s fantastic – it means the nervous system has realized there isn’t actually a threat present and has started to ease up on the guarding mechanism. 2) The discomfort goes from a 1 or 2 out of 10 to a greater value. That’s great as well, because now we know and can start gauging progress as you continue with the recovery process. Our goal will be to continue working at it to extend the amount of work you can do without discomfort levels elevating to a more alarming level. Primary message of this post? Don’t get discouraged on day 1 of testing your body with your favorite activity! It’s only purpose is to establish a baseline for where you’re at in the recovery process. The recovery process is a journey with ups and downs along the way, but you will reach the end goal! Local to the Towson, Lutherville-Timonium, Cockeysville, or Hunt Valley area? Friends & Family receive a FREE
Discovery Session at Premier! If you’ve been through the Neuro Therapy process, you’re well accustomed to the following send-off after sessions (perhaps even as you’re walking out the door). “Don’t forget your protein, water, and sleep!” Whether you are recovering from a sport/exercise related injury or doing what you can to put years of persistent pain behind you, all 3 play a vital role in the recovery process. Out of these 3 recovery factors (protein, water, sleep), the protein is the one we get the most questions about. “Do I have to eat protein?” (Yes!) “It makes me so full!” (That’s a good thing!) “Won’t I gain weight?” (No!) We know – Optimizing your lifestyle to increase the body’s ability to repair isn’t easy. But as anyone who’s experienced it knows, the point of Neuro Therapy isn’t to be easy. It’s to get better.  So why do we constantly preach protein when clients offer so much resistance to the idea? Here’s 4 reasons hitting your protein target is crucial to reaching your Neuro Therapy goals: 1) Protein is the essential building block required to repair muscles, bones, and nerves. If you’re injured, your body is damaged, or suffer from nerve pain, your body literally cannot repair itself without sufficient amounts of protein. Hoping that Neuro Therapy can help you recover without hitting your protein targets is like trying to build a house without wood or brick (ask the 3 Little Pigs how that worked out…). It just won’t happen! After writing this, I’m starting to think just this reason alone should be sufficient to convince you protein is needed…but we’ll continue with the other 3. 2) Protein helps to prevent muscle atrophy associated with injury. Injuries often cause a state of anabolic resistance in the affected muscle, which decreases the ability of the muscle to create protein. This causes immediate losses (atrophy) in muscle size and strength, sometimes in as little as 5-7 days. Hitting your daily protein targets will decrease the effects of anabolic resistance, and thus decrease the chance of muscle atrophy in the affected area (boosting your ability to recover quickly). 3) Protein helps to decrease muscle soreness between Neuro Therapy sessions. One of the reasons Neuro Therapy is so effective is because it directly targets muscles and ranges of motion that the body is not accessing properly. Often times, re-introducing the body to correct muscle activation and movement patterns causes muscle soreness – something we keep an eye on throughout the Neuro Therapy process. While muscle soreness is expected (and generally is a good sign of progress), if the muscle soreness becomes too intense, it may limit our ability to be as effective in Neuro Therapy. So how can we prevent the onset of soreness and optimize the Neuro Therapy process? Hit your protein targets! Protein will help to repair and re-vitalize muscles between sessions so you can arrive at your next session ready to get to work!  4) Protein increases your capacity to do work during Neuro Therapy sessions. In order for Neuro Therapy to be the most effective, you must arrive every single day ready to get to work. If you’re coming in hungry or malnourished, your body will start to reserve energy for vital functions, meaning you won’t have as much energy to put into your session. There’s nothing worse than having to deal with a growling stomach and a max tolerance set of Neuro Therapy. Hunger will limit your ability to push yourself to higher output powers, meaning your results will be limited. Hit your protein targets, and I can promise you, hunger will not be on your mind during sessions, allowing you to put all of your energy into pushing yourself and driving results. Local to the Towson, Lutherville-Timonium, Cockeysville, or Hunt Valley area? Friends & Family receive a FREE
Discovery Session at Premier! What is Neuropathy? Neuropathy is characterized by decreased or improper neurological communication to the peripheral nerves. The peripheral nerves are responsible for neurological communication throughout the body. The brain uses them to communicate with the muscles to make them move and also to receive sensory information from the environment, like the sense of touch. When these nerves are damaged, it can affect either (or both) functions of the peripheral nerves. If communication with the muscles is disrupted, you may find it more difficult to move and experience decreased coordination, decreased balance, muscle weakness, and/or stiffness. If neuropathy affects the nerves responsible for the sense of touch, you may also start to experience numbness, tingling, and/or burning. When the brain senses it has lost communication with the peripheral nerves, neuropathy often starts to become painful. Local to the Towson, Lutherville-Timonium, Cockeysville, or Hunt Valley area? Friends & Family receive a FREE Discovery Session at Premier! Why does it occur?
Neuropathy occurs for a number of reasons, but the primary reason is that the brain has a lost the ability to communicate with the nerves in the affected area. Whether it is because of a previous trauma to the area, head/neck injury, nutrition deficiency, or biochemical imbalance (like Diabetes Mellitus), the nervous system has a diminished ability to communicate effectively, resulting in the symptoms listed above. In order for the problem to be addressed, the nerves need appropriate resources (oxygen, nutrients) to repair themselves and re-establish appropriate communication. However, often times, the problem is compounded over time. Because neuropathy causes people to use the symptomatic area less, the brain starts sending less resources that way. The nerves become inflamed, scar tissue can develop, and blood supply is restricted, meaning the nerves receive less oxygen and nutrients to repair themselves. Additionally, muscles in the area become weaker, so the nerve becomes likely to become even more damaged. How can Neuro Therapy be a part of the solution? Neuro Therapy was designed to re-establish proper neurological communication throughout the body. When proper communication is established, the brain can start to communicate with the damaged nerves appropriately again and symptoms may start to decrease. Through its unique, targeted approach, Neuro Therapy also helps to bring needed resources (blood flow, nutrients, oxygen, etc). back to the affected area, so the nerves can begin to repair themselves. During the process, clients also work to re-educate the nervous system and muscles around the affected area to work properly, to improve movement patterns, increase range of motion, and limit the chances of future damage to the nerve. If you or a friend are experiencing symptoms consistent with Neuropathy, it's possible Neuro Therapy can help. We've designed a 3 step assessment process to determine whether or not Neuro Therapy can help relieve your Neuropathy symptoms... and for a limited time, it's 100% free. If you're interested, just click the blue button below to apply for the free assessment. Once you've completed the form, a member of our team will reach out to learn more about your problem and determine if you are a good candidate for the assessment: |
About the AuthorEvan Lewis is a nationwide leader in Neuro Therapy and founded the Baltimore area's only specialist Neuro Therapy facility. 
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About
Premier Neuro Therapy specializes in helping people overcome nagging pains and injuries, avoid surgery and injections, and transform the body to a state of peak performance.
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Monday 8am-6pm
Tuesday 8am-6pm Wednesday 8am-6pm Thursday 8am-6pm Friday 8am-6pm Saturday Appointment only Sunday Closed |
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Our home base is just outside of Baltimore, MD, but we serve clients virtually throughout the United States!
15 miles north of downtown Baltimore, MD
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