By Guy Grundy

After a very serious injury, Dr. Carmine Gangemi “The Bodybuilding Chiropractor” brought Guy close to 100% recovery without surgery.

There’s a good reason that Carmine Gangemi is the chiropractor of choice for bodybuilding’s elite. He’s a bodybuilder! You might go to him for an adjustment in the morning and then check out his heavy deadlifting session at Gold’s Gym (located across the street from his office) in the afternoon. Carmine believes that this has helped him succeed where other chiropractors might fail. “I’m successful with bodybuilders because I understand what they’re subjecting their bodies to,” he says. “I understand how muscles function, what sort of stress is being applied to the spine and associated joints and what’s required for adequate recuperation between training sessions.”

Dr. Gangemi discovered firsthand what harm aggressive manipulation can cause. While in college, he was seeing a chiropractor for a problem with his lower back. The aggressive technique the chiropractor used actually aggravated his problem. This experience almost made him drop out of the chiropractic field altogether, until he was exposed to a different technique, Cox® Decompression Adjustment & Manipulation. “The Cox® Decompression Manipulation safely takes stress off of the intervertebral discs,” he explains. “Keep in mind that bodybuilders and strength athletes frequently place huge compressive loads on their discs. The Cox technique is the perfect remedy for counteracting these training stresses.”

A good chiropractor must address the functional capacity of muscles with exercise rehabilitation as part of a course of care. “If a chiropractor is just trying to ‘move bones,’ he’s only doing part of his job and may be doing more harm than good.” He also thinks that sound nutritional supplementation, such as glucosamine products, “should be part of an athlete’s dietary regimen.” There are three approaches to Dr. Gangemi’s program of care:

1) Restore and enhance a muscle’s capacity for work.
2) Enhance the joint’s ability to function in a stable and predictable manner.
3) Include a natural supplementation to provide the tissues with nutrients they need for proper function and to speed healing.

Having worked with bodybuilders for so long, Carmine has seen many injuries and ailments. Most bodybuilding injuries are caused by overuse; however, most of the nagging problems bodybuilders experience are a result of frequent fluctuation in bodyweight. Bodybuilders often experience muscle spasms in the lower back caused by rapid weight gain. “Another common lower-back problem occurs when bodybuilders go into the heavy-training part of their cycle,” he says. “A good approach is to ensure that the low back is strong. Do exercises that target the core muscle groups and gradually build up to heavier weights.” Bodybuilders also have problems when they ramp up their cardio before a contest. Elliptical machines seem to irritate some bodybuilders’ sacroiliac regions. “The only clear answer is to avoid the culprit machine and to apply therapies that ease the swelling.”

Carmine feels that bodybuilders don’t approach stretching as they should. “Muscles are active tissues, therefore your approach to stretching should be active. You should use PNF stretching techniques,” he says. “Proprioceptive neuromuscular facilitation, or PNF, is a technique whereby you contract a muscle for about six seconds, then relax that muscle and stretch by contracting the opposing muscle group.” This type of stretching is especially beneficial for the bodybuilder, because standard stretching has the potential to irritate tendons.

According to Dr. Gangemi, there are two exercises bodybuilders should avoid. The first is the stiff-leg deadlift. “I know that many bodybuilders like this exercise, but a problem occurs when you are hanging with the weight,” he explains. “In this position, your lower back muscles have a tendency to ‘shut off.’ Then, in the absence of muscular contraction, the weight is literally hanging by the tendons and ligaments.” The other exercise to avoid is the sit-up. “If you come all the way up, you are activating the psoas major muscles – in other words, the hip flexors. The psoas originates at the front of the lumbar vertebrae. When you do a sit-up like this you cause a compressive force to occur in your lumbar spine while it’s being flexed. This can lead to a severe intervertebral disc injury.” It’s best to reduce the range of motion and isolate your abs with crunches and other exercises.

Of course, there are times when an athlete simply must deal with a severe injury that may put a dent in his training season. “This can spook some bodybuilders,” says Dr. Gangemi. “They are set in a routine. They don’t want to modify. But the athlete has to realize that an injury can go from being a nuisance to being career-ending if it’s not managed properly.” Also, many bodybuilders don’t seek help with minor injuries. “I’ve seen athletes with old injuries that were never brought to the attention of a doctor, and sometimes these injuries turned out to be quite severe.” Dr. Gangemi suggests giving an injury three days. If it isn’t better after three days, get it checked out. During those three days, use the RICE principle: Rest, Ice, Compression and Elevation.

Carmine is revered for his rehabilitation work with surgical patients, and I can attest to his superiority in this area. “Three things occur following surgery that can slow or complicate healing,” he explains. “The first is inflammation, or swelling. The second is the formation of scar tissue, and the third is muscle weakness. Rehab should address all these factors, especially scar tissue.” He says that scar tissue can be forced to align itself in response to stress, making tissue stronger. If the scar tissue is not forced to develop in the proper area, it occurs randomly. This puts severe limitations on the potential for the restoration of proper tissue function.