Decompression Summit Certification 2025 Preview

Hey there, and welcome back. I'm Dr. Vince Leone, executive producer and co-host of the Practice Builders Podcast. With my partner in crime, Dr. Kyle Pankinen, we deliver proven strategies to help you grow fast, specialize with confidence, and build profitable staff-run practices. Let's go ahead and dive into today's episode now. Hello, and welcome to the Practice Builders Podcast. My name is Dr. Vince Leone.

And I'm the co-host, Dr. Kyle Penkhanen. We're glad to have you here.

Yeah, welcome back, welcome back. And today we have, uh, a special guest for this special episode. This is the Decompression Summit Certification 2025 preview, and joining us from his 59-foot yacht is Dr. Tim Burkhardt, our co-host, uh, one of the major presenters. Dr. Burkhardt, How are you, my friend?

I'm great. Courtesy of Starlink, I'm joining you from somewhere in the Atlantic Ocean off the beautiful coast of Florida. So, thank you for inviting me. And I look forward to reviewing our topics today.

Yeah, yeah, absolutely. And so, what we were talking about, I think that would be valuable, is we'll kind of dig into the origins of how we started this 3 years ago. I think 2023 was— well, I don't think, I know 2023 was our First summit. And Dr. Kyle, it kind of started with you. I remember I was at Nordstrom shopping for some golf shirts or something, and I got a call from you about— go figure, shopping for golf stuff. But I got a call from you, and it was kind of a, you know, it was a very interesting way to start. And it was, you had introduced me to Hill DT at that time.

Yeah, it was. I felt bad about interrupting a golf potential golfing thing, but I had to do it. And no, it was in my history. I've been a client, or I've been with Hill DT. I have two Hill DT decompression tables. Dr. Burkhardt, I believe in 2016, I believe literally came to my office and from Michigan. And to my office in Southwest Minnesota and taught myself and our staff how to implement decompression, how to use the table, how to make it work. And so I'd been doing that for several years and doing quite well with it. And then in 2020, I discovered this man, Dr. Vince Leone, the guru when it comes to niches in our world and chiropractic. And so I became a client of Specialized Practice and fast forward a little bit, Dr. Vince and I did a couple of seminars together with some decompression-related themes. And but I got to thinking to myself, we need a seminar in our profession that pairs a high-end company, a decompression company with great training and great service great certification with a company that can help doctors to build and grow and implement decompression in their practice. So I thought, you know, I gotta get Hill DT and Specialized Practice. I gotta get these 2 entities together talking to build a seminar, a certification course that can go beyond just trying to sell clients, getting them to sign up for something, but we make it a world-class experience clinically and also from a business point of view. And so that was kind of the origins of it. And now this year we will be launching our 3rd year of our 3rd annual Decompression Summit certification. And it is growing from the first 2 years. And I think this year is going to be our best yet.

I would agree. Yes. Yeah, we all concur, right? And, uh, yeah, I remember getting that call. Like I said, I was at Nordstrom's, uh, shopping around, and, uh, Dr. Kyle said, you know, you should, you should speak with the gentleman over at Hill DT. So that's obviously Dr. Burkhardt as well as Jeff VanderWal. And, um, so, Dr. Burkhardt, why don't you just give us a little thumbnail on Hill DT, um, how long you guys have been working together, A little bit about, you know, your experience, you know, serving clients with the Hild ET table.

Yeah, so I agree. When I met Kyle, I knew he was a winner. I knew he was going to do great things, and it just seemed like a natural fit when he introduced us to you and all that you do and helping your clients. And I think you shared a lot of the same frustrations and really the goals that we had as far as How do we do decompression right? Not just on the outcome side, but also on the integrity side, because it seems like there's a lot of confusion out there. There's all these fluff seminars where people get a bunch of hype and all these promises with marketing, but very little of the fundamentals really on how to talk to patients, how to discern who's a candidate, who isn't a candidate, how do you get the patient to commit to the care plan, and all of these facets that seem to never— they're kind of nebulous, right? And no one had really ever put that all together. And that's how Hill DT was actually born. When back in 2008, '09, and '10, I was struggling with a growing decompression practice, and I met Howard Hill from Hill Laboratories. That's who makes the Hill DT. And he expressed his frustration with me as a manufacturer that, hey, I have doctors buying these tables. And they're calling me as the manufacturer. How do I use it? You know, and he says, you seem to be doing very well with it. Will you help us? And so, very, very good friend of mine, Jeff Vanderwall, had just sold his IT company and was looking to get something started. And I said, hey, Jeffrey, how about we put together a company and you can handle the sales and financial side of it, and I'll handle the clinical side of it, and we'll help doctors. Get the equipment, get set up, formulate some good quality training and a certification protocol. And that out of that is really, you know, this is kind of like the next natural step is connecting with someone like you with practice management and marketing concepts and putting it all together. And I love the idea of the summit because it helps us get our clients in that are just buying the table. It helps other people come in who've had a table. And have kind of struggled with how to put it all together. So, in a real short nutshell, that's kind of why we're involved and how it all kind of came together.

Yeah. And I got to say, I was a little surprised at the success of our first one in 2023. I mean, I don't know how many we had. I think we had 90, maybe 100 doctors and staff. So, this is, you know, obviously primarily for doctors, but we have a tremendous amount of staff support. And training as well. But, you know, we found a beautiful hotel in Las Colinas, a suburb of Dallas, the Omni, which is, you know, just a great venue. We have great sponsors. You know, Cutting Edge has been with us from the beginning. Elevation has been with us from the beginning. So, we really appreciate their support, especially early on when the concept was not proven. Now, it's certainly proven.

Yeah.

You know, I think, Dr. Berkner, I think this time last year we were at about 50 or 60 registered. Now we're at like 80 to 90 registered. So we'll definitely— yeah, so we'll definitely sell out this year, which I think is— did you say it's like 110, 120, something like that?

Yeah, I think that's our, our max for how the capacity that we have for the venue. And you really want it not too big because you want it to be a quality experience and Especially with the breakout sessions for the technicians and the CAs that come to learn how to use equipment. And I think that's a really strong thing to maybe mention right now is that we don't just help the doctors, we help the staff. And a lot of doctors don't even know how to train staff or want to train their staff. Yeah. So we help them out there too. We're like, hey, bring your staff down. We've got quality people that will work with them. My wife Holly, who's our lead decompression and therapy technician at our office, does a lot of the training and she has a ton of experience and it really, it really works out well.

My gosh, kudos to Holly. She's— she gets rave reviews after every summit. Everyone loves her. She just has such a wonderful way with communicating how to do it. You know, sometimes you you can know how to do something, but not able— you're not able to teach it. She really bridges that gap, and I'm excited to have her back this year as well. So, you know, just broad strokes, you know, in terms of the summit this year, we always start on Friday night. We've done this every time. So we just have a social happy hour, you know, the evening before on Friday. So this year it's September 26th through 28th. Um, we'll put the link to register in the show notes. So we start with the happy hour on, on Friday evening so everyone can just get to know each other a little bit. Um, and by the way, we got— we get a lot of returning doctors too. Of course, we have CE credits and all that good stuff. Um, and then why don't we go ahead and dive into what is Saturday? So Saturday is the big day, obviously, and then we also have Sunday morning. Um, but Let's see, let's— Dr. Pinken, why don't we start with you? What will you be covering on Saturday with your talks?

So, I have 3 talks this year, 3 1-hour talks on different topics. I'm going to do a— what's the first one is going to be decompression research, a deep dive. So, I have probably 20 to 30 different studies that I'm going to be going over. That are going to go into look at the biomechanics of what actually happens when you put somebody on a decompression table. We're going to go through several outcome studies to show what are the— what happens, what are the results that we get when we do decompression on patients. And then we're going to dig into the research and just mine some what I call clinical pearls. And we're going to— this is going to help the doctor to gain confidence, one, that this technology is good, there's good adequate research behind it, but also to communicate to patients, this is what we can accomplish, how to effectively answer the questions that patients have about decompression based upon what the research shows, and to give the patients realistic expectations of what, what that— what we can accomplish and how we can help them. So I always tell docs, If you're going to be an expert, you need to master your field. So a part of being a master of your field is you need to know what the research says about what you're claiming to be an expert at. And so we're going to give doctors a broad overview of a pretty good amount of decompression research. Secondly, that'll be for 1 hour. The second hour is going to be on non-surgical and surgical Medical options for treating spine. So we're going to contrast what decompression can do with what are some of the common medical interventions for spine pain. So we're going to do— talk about the commonly prescribed drugs. We're going to talk about epidural steroid injections. We're going to talk about spinal cord stimulators. We're going to talk about radiofrequency ablation. And then we're going to talk about surgery. And I'll show you all the latest studies about the outcomes of those interventions, and so that when you, as a doctor, are asked questions by patients, well, what do you think about this, doc, or should I go do this, you will be able to answer those from an expert point of view, because you will know the literature, and be able to give them honest answers as to yes or no, or this is what you need to consider when you ask me that question. And then finally, we're going to do, going back to what I did the first year of the Decompression Summit, which is world-class cervical and lumbar exam, but it's been updated. And you'll see kind of an innovative flow sheet that I've developed that will help the doctor really to have a nice systematic flow and then to use that exam to come to a conclusion, which is What is the primary pain generator in this patient's spine case, cervical or lumbar? And that flow sheet will also dive into all the exam or the diagnosis codes, ICD-10s will all be there as well, so that you, once you get to the end of that exam, you'll know with a high degree of certainty, this is what it is. Is it a disc? Is it facet? Is it SI pain? And so we're going to spend about an hour on that topic.

Yeah. And those, you know, that's something obviously, Kyle, Dr. Pankinen is our clinical director at Specialized Practice. And that world-class exam training on chronic neck and back has been a real hit. And I think what it really comes down to is confidence and confidence when the doctor has confidence in, you know, what the diagnosis is and what the recommendations are. That translates to the patient, right? A lot of doctors are looking for some silver bullet in the ROF, some special, you know, NLP language or some closed technique. But really what it comes down to is confidence, and then that confidence creates trust and rapport that the patient has in the doctor. So, um, shifting to Dr. Burkhardt, what will you be covering? And by the way, this is all new material from last year, so if you were with us last year. We— this is, you know, it's not going to be a rehash of everything we, we did last year. So, but Dr. Burkhardt, why don't you give us an overview of what you are covering at our summit? Sure.

We kind of changed it up quite a bit this year. I really love it that Dr. Kyle took the research aspect because I was always trying to jam that in with a lot of the other things. So I think breaking it up a little bit really helps us.

Yeah.

Cover a lot more material and more material that's gonna be at the, at the end of it, people are gonna walk away and go, wow, that was, that was totally worth it. So I'm gonna cover 3 sessions. First session's gonna be a quick review of just anatomy physiology. We kinda always start with that because we wanna understand more about the disc and just kinda review that, make sure we're all starting on the same page when we begin. And then we're going to talk about who are the candidates for this care. Dr. Kyle's going to talk about what the medical field does. Well, what do we have to offer these people, and what do those best patients look like? And then we're going to talk about who we shouldn't do the care on.

Hmm.

There's a growing list of contraindications. I get questions honestly all day long from doctors, some of them your clients, most of them our clients that are like, hey, I have this imaging finding. I have this finding or this other finding. Can I do decompression on this patient? We get a ton of that. So we're really going to drill down on that this year because it seems like the more patients grow, or the more patients come in and doctors grow their decompression practice, the more they get these one-off difficult things that they're kind of, you know, well, that's a head-scratcher. Boy, can I do that? And can I do it safely? And And a lot of times it's a good call that they didn't. And other times I'm like, yeah, you can do that. That's not a problem. So we're gonna really try to drill down on some of that. So everybody gains, like you said earlier, a lot more confidence. And then the final thing, which was kind of new last year, but we've expanded on it, is how to track the patient care, how to track their outcomes so that at the end you can hand a patient either a report or some kind of finding at the end of the reevaluation and say, hey, look. Here's where you were. Here's where you are. Look at the difference and actually measure that in a real positive way that shows, okay, you're this much better and/or you're not that much better and you can justify ongoing wellness care or that you can move them into a different care plan based on actual factual data and not just like, well, you know, I think more might help you. No, we know exactly where you need to be. In that continuum of care from the acute care to the corrective care to the wellness care and onwards. So those are my three sessions, and they're all about an hour and a half apiece. And I think people are going to really appreciate the updated information.

Hey there, it's Dr. Vince, and if you're getting value from this episode, please make sure to hit that subscribe button so you never miss an episode. And. If you know another doc who's ready to grow their practice, share this with them. It might be exactly what they need right now. Thank you in advance. And now back to the show. Yeah, absolutely. And I did have 2 speaking slots. It got whittled down to one, and I'll tell you why in a second. But my primary speaking slot is The Last Marketing Plan You'll Ever Need. Uh, how, uh, The Last Marketing Plan You'll Ever Need: How AI, Staff, and Systems Can Build Your Dream Practice on Autopilot. And that's really always been our, you know, one of our principles that, hey, we're going to use staff, systems, and technology to grow these services like decompression. Um, and that's why we have, you know, the staff training included. But, you know, marketing, you know, once you get the clinical side down and you have the staff Then it's just getting, you know, reaching people. And how do you do it? How do you create good quality patients? Because what happens a lot of times is doctors using Facebook marketing or some— something similar, they're getting no-shows, they're getting poor quality patients, people that they don't even know really who you are, what you do, and why you're an expert, and all that good stuff. And so we're going to— or I'm going to present our strategy at SP of how do we use multiple channels of marketing based on your goals to create a comprehensive strategy that will year in and year out deliver good quality patients so that you can have consistent and predictable growth. And so this is something that will be an evergreen concept. It's not going to be something that's going to, you know, work today and not tomorrow. And so I'm super excited to present that. And I gave up my other slot to, um, Brad Gibbs. So what, you know, when we were— so we tried to get Tony Robbins. Dr. Burkhart really wanted I did. But he was a little outside of our budgetary constraints. But what I felt was because I was going to do an ROF talk, but we've done that in the past. And again, we're trying— we want this to be all new material. And so, I'm in a coaching group and this gentleman, Brad Gibb, is a wealth expert. And so, he's going to give a keynote. His title is Wealth That Works: Building Sustainable Financial Freedom for Retirement and Beyond. And so, it doesn't make a whole lot of sense to build a successful practice and grow decompression and then burn through your money left and right and then be in dire straits at the end of the day. I talk to a lot of doctors and I talk to a lot of doctors that are on the tail end of their career and they do not have retirement taken care of. And so, Brad Gibbs spoke at my coaching group in January, and he did an all-day talk, but he has a formula and a model for having your target financial freedom number and then a plan to get you there. So, he's going to present that at this year's summit. I think it's going to be incredibly powerful, and I think that that will round out Our presentation, our overall summit, uh, in a really, really nice way. Um, and then of course on Sunday we'll have more, you know, that's where Dr. Burkhardt's going to do his final talk, and then we do a roundtable with all the presenters. Um, and, um, that's always, I think, very helpful for doctors because that's a Q&A session where they can actually, um, you know, ask whatever lingering questions that they have.

Um, Dr.

Pankinen, any, uh, any other thoughts on, um, you know, reasons why doctors should attend the Decompression Summit certification?

Simply, you just want to up your game. You want to be the best doctor in your field as far as clinical stuff, but then you also are interested in taking your practice to another level as far as skills but also finances. You're gonna You're gonna be able to help more people at a higher level, and you're gonna, you're gonna reap some reward for that financially as well. I had several doctors that have come up to me, uh, in between sessions and saw at the summit or after the summit, and they will say, this is in the top 2 or 3 best seminars I have ever attended. And some of these doctors have been in practice 20 and 30 years.

Yeah.

And so It's, it's robust enough clinically that the clinically minded doctor is going to get— they're going to be satisfied. They're going to be more than satisfied with it. But for that doctor that also just wants to— I know, I know I got my clinical stuff done pretty good, but I want to learn how to grow this. They're also going to get quite a bit out of it as well that way. And then you throw in the CA stuff, bring your staff, a key person or two with it. They're going to learn a lot and you're going to come away from that weekend with, this was more than— this was well worth my investment of time and a little bit of treasure.

Yeah, and I'm going to go into the mechanics of, you know, the day and go over what the CA trainings are covering as well in just a second. But just wanted to get your thoughts, Dr. Burkhardt. How do you think we differentiate ourselves from the other seminars out there on decompression?

Well, I think the, the main thing is we actually give doctors meat that they can take home.

Yeah.

I think so often I, I've been to so many seminars where about 45 minutes into it, you're just like, what am I doing here? This is just a bunch of fluff and a bunch of hype and okay, rah, rah, rah. I'm all excited, you know, connect me to the source and, you know, here's all you need is to adjust someone and they're gonna be cured and you walk away and it's like, well, how's that gonna help me Monday? Like, what can I implement on Monday that is going to impact my chiropractic career for the next, you know, several months to years? And that's what I, that's what I really want to do for doctors that show up. It, you know, it's really about handing off. I mean, I've been in practice 41 years this October.

And congrats.

There's so many little nuggets and nuances that I've captured over the years that I just want to share. And I want people to be as successful as I am. I mean, here I'm talking to you from a boat in the middle of the ocean. I, I didn't wake up with that, right? That took time to build and grow and get to. And now I'm living the life. Well, I've always lived the life of my dreams because I'm doing what I love. But as you mature and grow in your field, you should pass that on to others. And I think that's really what's great about our group is You don't have a bunch of egos getting together to just brag about what they do. You have honest people that are just trying to get together, create this coalition of success that they can hand off to you. Like you can actually physically hold it and take it home. And it's not this nefarious, oh, you know, we did this and look what we did. It's not about us. It's about you when you show up and you apply yourself to what we're trying to tell you. And if you listen, be teachable. You're going to walk away with great nuggets. Like you always say, right? I think it was you that coined it, the riches are in the niches. If you didn't coin it, you should have.

I was going to say, I don't know that I actually coined that, but I certainly borrowed it.

Well, yeah. And I love that about your approach because so many people miss it, right? They want the magic bullet, like you said, and there is no magic bullet. It's a coalescing of all these concepts that you just put into place.

Yeah, 100%. Um, and, you know, I've always said that, you know, decompression is the best first niche, you know, for, for any chiropractor to add to their practice. So even if you are not offering decompression right now, obviously, you know, if you're offering decompression, this is, in my opinion, and I'm biased, but it's the hands-down best event of the year. Um, but if you're not offering decompression yet and you are considering it, this would be a fantastic runway to come out and not only, you know, absorb information from masters like Dr. Penkin and Dr. Burkhardt, but also be around a bunch of winners. I mean, your network is your net worth. And if you can surround yourself with people that are already doing what you want to do, you will create some tremendous connections that will serve you over the next 5, 10 years and beyond. Now, just some, some mechanics of the event. Like I'd mentioned, Friday evening, you don't have to be there Friday evening, but it's nice. I mean, you know, we have hors d'oeuvres and wine and beer and all that type of stuff to just to hang out and break bread with one another. And then one thing I will note, the food there is always fantastic and you're always well fed. Now we're not going to— we don't serve dinner, obviously, but breakfast, full spread for breakfast, you know, before the event. So If you do, if you are coming, don't go out and have breakfast. Come, we have healthy, all types of stuff for breakfast. Um, at the break, there's always food. There's always food. So if you, if you like to eat like me, uh, there is always good food and beverages for you. Um, nice healthy beverages, a gourmet lunch that is like literally, you know, I don't know, what did we have? Beef bourguignon last year or something?

It was It was off the hook, really.

It was so great.

It was amazing.

Omni Hotel really, really does it right. So gourmet lunch, then we have a happy hour at the end of Saturday, just, you know, some wine and beer, that type of stuff. And then everyone's on their own for dinner. And then the next day, Sunday, like I said, we'll have another morning training. On the CA front, Holly, Dr. Burkhardt's wife, is going to be training on The table itself on the capture, which I think is, I think, one of the key things specifically with the Hildy DT table. So this is, this is, you know, getting the patient ready for decompression. Then we have another CA train on laser therapy. Drew Grinnell from Cutting Edge Lasers will be presenting there, and that's always excellent training. He's a fantastic teacher, and he's— You know, has been an expert on laser therapy for a long time. And then on the afternoon session, we're going to go into shockwave therapy. So we know shockwave therapy is the new shiny object these days in the chiropractic industry, which is great. It provides great results. So Holly will be talking there as well about shockwave therapy, best practices, helping the CAs with you know, implementing that for the doctor. And I think that's a— that's about a good wrap on this. Any closing thoughts? So September 26th through 28th, you do get a certification, right? You do an online class after— or online test afterwards, and then you'll get a certificate that you can frame. You know, these are really, really helpful in terms of patient compliance. You know, when they see that you've done the additional training to become an expert So, uh, don't, don't kind of slough that off. That's why it's called the Decompression Summit Certification, because you actually get something that means something. Um, but Dr. Paikkinen, any, any closing thoughts before we wrap this up?

I would just, I would just, not to toot our own horns, but this Dr. Burkhardt is— if you come to this seminar and you've never heard Dr. Burkhardt speak, he is a world-class doctor, a world-class lecturer. Uh, he has probably more experience in the world field of decompression than just about anybody I know, and, uh, you're gonna gain so much from that. I mean, I've been doing decompression for a number of years, but when I'm not presenting, I'm sitting listening to Dr. Burkhardt because I learn stuff, and I'm, I'm taking notes too and learning from the master. So if you want to learn from the master in decompression, that's your guy. And Dr. Leone He is, uh, he has revolutionized my practice through his business acumen and the marketing that he handles and does for me. And, uh, so with those 2 guys, you're gonna, you're gonna never regret coming to the seminar.

Well, those are kind words, um, and thank you, sir. Uh, Dr. Burkhardt, by the way, Dr. Pankinen is a true expert as well. That's why he does so well. Um, and we Every doctor I talk to that either is one of our clients or comes from the summit, the summit always speaks so highly of Dr. Pankinen. He's probably the most humble guy you'll ever meet, but with just a tremendous amount of skill sets and communication skills and clinical skills that are, you know, just phenomenal. Dr. Burkhardt, any closing Comments?

Well, I, I'd like to thank Dr. Kyle for those kind words. He's very generous. But I really look at this as a team thing. It's not about me or any one individual. It's collectively, I think we really put together a great program. And, you know, not to be discounted, there's some great state qualifying CEs for people too, because, you know, a lot of times doctors are like, oh, I'm not— I don't need one more weekend. But Hey, you're getting certified hours from National University of Health Sciences out of Chicago, which, you know, that's a pretty well-known chiropractic college. And I think the fact that they support us with continuing education, and they have all along, it really shows you the quality and the character of what this endeavor really is. And so, yeah, I'd say be there, don't miss it. Sign up soon because we're going to run out of room.

Yeah, 100%. Um, if you are wondering about the CE credits, we, we're offering 9 CE credits. And, um, on the website, the registration website, you can check your state. The vast majority of states are covered. Obviously not every single state is covered, so check there for that. If your state's not covered, who cares? This thing is going to be, uh, transformative. Um, and, uh, and, and I'd also state, some doctors— well, if I don't have a Hill table or I don't have a cutting-edge laser, will this still be applicable to me? And it will, 100%. I mean, there are trainings—

are—

it's not that they're like agnostic, but they're about decompression. So if you have a true decompression table, then this will be applicable for you. I get that question a lot. Um, and obviously, you know, it's, it's co-hosted by Specialized Practice and, and Hill DT. We're putting it on, and, you know, we would love you to use our services because we feel like we're at the top of our game. But if you have another table or another coach, that's okay. You will still get a tremendous amount of value out of this weekend. So with that, we're going to wrap it up. Dr. Burkhardt, thank you for taking the time via Starlink to, to join us from your, from your newest toy out in the Atlantic Ocean. We appreciate it.

All right. Well, thanks for inviting me. It was great to see you guys. I'm sure we'll be in touch soon.

Yeah, absolutely. Dr. Paikin, thank you for your time. And, um, and just really quick, last, I do want to thank our sponsors for this summit. Um, again, it's hosted by Hill DT and Specialized Practice, but Cutting Edge Lasers, Elevation, um, Dr. DeCesaro is a consultant for, um, Shockwave. He is a sponsor. Um, am I missing any sponsors? Neuromed's a sponsor. New Lane Finance is a sponsor. And I think, and then Backsmacks is, uh, correct. Yeah, did I, did I miss anybody?

I don't think so.

Okay, perfect. Okay guys, um, I hope everyone has a wonderful rest of their day. Thank you for listening. If you got value out of this, please share with a colleague. Uh, the goal of this podcast is to elevate our profession, um, and help more doctors, um, grow their practices. So until then, Uh, we'll see you on the next episode. Hey, it's Dr. Vince again, and hope you enjoyed that episode. And if you're ready to grow your practice fast with high-value decompression patients, then the Decompression Accelerator could be a phenomenal option for you. This is our 90-day sprint to help you scale with proven systems, staff-driven protocols, and full marketing support, and it's all guaranteed. Spots are limited. Head to Go to www.decompressionaccelerator.com to learn more.