Conditions I Treat
Performance and recovery are the two pillars of my practice, where my non-invasive, regenerative healing approach is most effective. Whenever someone needs treatment for a physical ailment, whether it’s an injury or post-surgical healing, I can help heal them as efficiently and thoroughly as possible.
In addition, many of my patients have very active lifestyles and simply want to perform at peak physical performance. Typically, they want to increase their range of motion, play pain-free and take their game – and enjoyment – to the next level. And I can help there as well.
My clients run the gamut, from golf and tennis professionals to fitness enthusiasts, pickleball and paddle tennis aficionados and weekend warriors. In addition, I work with high school and college athletes, theater and dance professionals, marching band musicians – in short, just about anyone for whom physical activity is a central part of what they do, and who they are.
Most Requested Treatments
- Achilles tendinitis
- Adhesive capsulitis (Frozen shoulder)
- Back pain
- Bicipital tendinitis
- Carpal tunnel syndrome
- Chondromalacia patella (Runner’s knee)
- Disc injury
- Hip injury
- Iliotibial band syndrome
- Impingement syndrome of hip or shoulder
- Joint dysfunction
- Joint pain
- Knee pain
- Lateral epicondylitis (Tennis elbow)
- Medial epicondylitis (Golfer’s elbow)
- Muscle spasms
- Muscle strains
- Neck pain
- Nerve entrapment syndrome
- Overuse injuries
- Plantar fascitis
- Post-mastectomy recovery
- Post-surgical conditions
- Rotator cuff injury
- Running injuries
- Soft tissue injuries
- Scar tissue
- Shin splints (Anterior compartment syndrome)
- Sprains and Strains
- Swimmer’s shoulder
- Survivorship rehabilitation
- Thoracic outlet syndrome
“He is probably the reason I am still playing paddle…”
“He is my chiropractor who saved me from surgery for my torn meniscus last year. He is probably the reason I am still playing paddle. Even though there is pain at times, there is so much less. He makes time for me, and he shows up after matches to treat me. He’s very involved in the paddle world and just loves the sport.” – Roxy Enica, Paddle Tennis Professional, Currently Ranked #2 by the American Platform Tennis Association (ATPA).
Have a Question?
Just Give Me a Call At (203) 313-3844
Conditions I Can Help With
As your therapist, I’m fully committed to working with you for your recovery. I work with various physical therapy techniques in unique combinations to assure you get results quickly.
On Scar Tissue
Scar tissue is a natural response to the body beginning to heal itself. When you’ve had surgery, and tendons and muscles have been cut or repaired, scar tissue will develop. Scar tissue can also form in response to an injury like a hernia tear or rotator cuff tear.
Cancer and its treatment often cause physical, psychological, and cognitive problems. These problems can make it harder to do daily activities or return to work. They may also have a lasting effect on your health. Cancer rehabilitation can help with these problems, which can happen during and after cancer treatment.
On Scar Tissue
The formation of scar tissue is an important part of the body’s natural healing process.
Unfortunately, however, this protective measure can instead become an obstacle to wellness, and its mitigation via various protocols becomes necessary to both alleviate discomfort and return to full mobility.
While many people think of scar tissue as the visible indicator of a healed injury, often a laceration, the reality is that a vast majority of chronic pain and injuries are related to scar tissue.
Here’s a quick overview.
The formation of scar tissue is part of the body’s natural self defense and healing processes. In response to injuries, overuse, and even in defense of chronic use, the body produces a ‘band aid’ of sorts to protect the surrounding soft tissue – things like muscles, tendons, fascia, ligaments and even nerves. The scar tissue is, essentially, a connective tissue protein called collagen, and collagen is very strong and not easily broken down.
Often, even after the initial injury begins to feel better, some of this collagen – or scar tissue – remains in place, becoming an adhesion that restricts movement and mobility, and increases friction.
This eventually leads to the formation of additional scar tissue in response to the irritation as we continue to ‘push through’ our injuries, thus starting a cycle of entrenched and continually building scar tissue in these active areas.
With more scar tissue comes more friction, more inflammation, the creation of even more scar tissue, and increasingly restricted movement and discomfort. Over time, this can become a very painful condition that never seems to get any better.
The good news is there are ways to stop this cycle, mitigate the continual creation of scar tissue in response to the same initial injury or ailment, and get back to a largely original and healthy state.
To achieve this, and depending on the circumstance and exact nature of the injury, we can employ a variety of approaches including direct fascial manipulation and tool-assisted (e.g., Graston) techniques, Extracorporeal Pulse Activation Technologies (EPAT®) and Extracorporeal Shockwave Therapy (ESWT) designed to effectively break up ingrained scar tissue, encourage increased blood flow and promote healing in the affected area. By doing so we can break the scar-response cycle and restore the patient to a normal and pain-free state.
A Word From Dr. Nathanson
“It wasn’t long after I first began my studies that I started to see the enormous potential of applying my techniques to to aid, provide relief to and improve the lives of cancer survivors, especially those suffering from the effects of lymphedema. Over the years I have developed a series of proprietary treatment protocols which I believe have truly made a difference in the lives of many survivors, especially those suffering the trauma of breast-cancer related mastectomies. To be honest, it is possibly the most gratifying work I have ever done.”
The Physical Challenges of Cancer Survivorship
When a mastectomy is performed, many times both the breast and the axillary nodes (lymph nodes in the armpit area) are removed, and in many cases breast reconstruction takes place either immediately, or following a short post-recovery period. This has the potential to be both physically and psychologically traumatic.
One of the most commonly reported post-surgical occurrences is kinesiophobia – or a fear of movement. While this fear is, at the outset, often grounded in the very real physical restriction in the immediate post-surgical period. Later, as time progresses, the process of healing itself can compound this problem. This is because scar tissue inevitably begins to build up in the affected areas, which further restricts movement and can cause tension and discomfort. When this occurs, the initial psychological fear response is again triggered and movement is by choice decreased, without which the immobility is exacerbated.
“It’s kind of a Catch-22,” says Dr. Nathanson. “There’s a real initial reluctance to move after such an invasive procedure, which is understandable, but then over time, as the scar tissue begins to take hold and build up, the perceived restriction becomes a reality, the effects of which radiate into a number of related physical issues. Luckily, we can now attack the problem at its root by using the Graston technique in conjunction with the unique set of protocols I have been able to develop.”
Relief for Reconstructive Breast-Surgery Patients
Post-surgical reconstructive breast surgery is a common option for post-mastectomy patients who do not wish to wear a prosthesis, or who wish to regain symmetry or breast contour. While individual physical criteria determine when such reconstruction takes place, all of the reconstructive techniques involve considerable surgical manipulation which can lead to symptoms of discomfort and restricted movement.
Many techniques, for example, use the patient’s own tissue as material to construct the new breast. The majority of physicians feel that best way for the body to accept this newly-formed and relocated tissue is to make us of it without separating it from its blood supply. While this is a solid approach in terms of recovery, and a decrease in rejection, the tissue to be used is often harvested from either the patient’s abdomen (‘Abdominal Flap technique’) or trapezius muscle (‘Tram technique’) and ‘tunneled’ sub-dermally to the new location in the patient’s pectoral area. It is important to note that, although breasts are located above the pectoral muscles, reconstructed breasts are positioned beneath the pectoral sheath.
As such reconstructive techniques heal, scar tissue again forms not only in the pectoral area, but also along the ‘tunnels’ through which the tissue has been moved. As the scar tissue builds up and becomes less elastic once again, movement can be severely restricted, long with resulting tension, numbness and discomfort.
“While the results have been, in many cases, nothing short of remarkable, because of my experience in using the Graston® technique to address similar issues, I view applying it in this new and very specialized way as evolutionary, rather than revolutionary,” says Dr. Nathanson. “By applying soft-tissue procedures to the affected areas of breast reconstruction patients, and by restoring motion by breaking down the accumulated scar tissue, I have been fortunate in being able to provide relief for these people who have faced so many challenges. It is extremely gratifying.”
After Ten Years: A Difference and Hope Restored
Dr. Nathanson’s technique also is effective in relieving lymphedema, a condition of fluid retention that is a common side-effect of axillary dissection, and can lead to feelings of numbness, pressure and tingling in the extremities.
“I had a mastectomy over ten years ago, and had lost a great deal of mobility due to a build-up in scar tissue. I also had a persistent feeling of pressure beneath my arm, as well as numbness, which was largely a result of the lymphedema from the node removal,” says Maureen Gianni, one of Dr. Nathanson’s patients. “After ten years I figured that that was it; I was going to be that way for the rest of my life. But then Brian convinced me to try his technique and I’m pleased to report that the results were phenomenal! After only a few treatments I had regained much of my lost mobility, and I can also report greatly improved lymph flow. I really believe in what he’s doing and can honestly say that his techniques have made a tremendous difference in my life!”
Schedule An Appointment
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If you are a new patient, please contact me directly to discuss your situation and schedule an initial evaluation.
Thank you, and I look forward to seeing you.