CF 072: Kids Need A Rest, Chiropractic In Europe, & Exercise For Chronic Pain.
Today we’re going to talk about a surgeon that says let kids slow down, the shape of chiropractic in Europe, how exercise affects chronic pain.
But first, here’s that bumper music
OK, we are back. Welcome to the podcast today, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.
You have collapsed into Episode #72
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Let’s talk a bit about the DACO program
If you hear something here that you really like and would like it in written form rather than spoken, just hop onto chiropracticforward.com, find the episode, and just scroll down to copy and paste it. If you’re using it for content or on your website for some reason, just be cool and give us some credit please. I’d sure appreciate it and I’m sure the researchers we discuss would too.
“Noted surgeon Dr. James Andrews wants your young athlete to stay healthy by playing less” by Dennis Manoloff of the The Plain Dealer(Manoloff D 2013). It was posted back in February of 2013 so a little old but has been making the rounds here lately in the private groups and with several colleagues. And it’s right up our alley when you consider we are also trying to keep kids out of surgery.
Some highlights are when Dr. Andrews says they have worried for too long about patching people up rather than preventing the injury in the first place. Amen brothers and sisters.
When asked why kids are getting hurt more and more these days, he says there are really two factors. One being that kids specialize too much now and what he calls professionalism.
Specialization means kids are just playing one sport these days instead of being well-rounded athletes with a wide array of different activities and skills. When they’re only doing one thing and they’re doing it over and over and over…..well, that’s a recipe for surgery due to overuse.
He says ‘professionalism’ is taking these young kids that are 12 or 13 and working them like they are professional athletes with year-round training and activity.
Advice he would give parents that can help us guide our conversations with patients and parents was
- Use proper mechanics in any sport.
- Don’t play year round. Their kiddo needs at least two months off each year to recover from a specific sport. Ideally, 3-4 months.
Basically, sometimes we have to look at mom and dad and say, cut it out or a surgeon will be cutting something out.
I just made that up but you can use it if you like it. You don’t even have to give me credit for it unless you make money from it. Lol.
Alright, Item #2, comin’ through.
Before the DACO course, chronic pain (while it should have been) was not on my radar at ALL as far as something I was interested in and something I wanted to learn to solve. It sure it now though and this next paper fits right in.
It’s called “Exercise-induced hypoalgesia: A meta-analysis of exercise dosing for the treatment of chronic pain” by Anne Polaski, Amy Phelps, Matthew Kosted, and more(Polaski A 2019). It was published in January 2019 and I’ve cited it in the show notes.
Why They Did It
As more and more studies are showing the effects of exercise as a first-line treatment for “nearly all forms of chronic pain,” things like dosing for different treatment modalities has not been explored just yet.
What They Found
As you can deduce from the title, this was a meta-analysis.
They say in the abstract, “increasing the frequency of exercise sessions per week is most likely to have a positive effect on chronic pain patients.”
In the end, as is always a part of the conclusion, more research is needed but there is a modest effect.
This one was in BMC Chiropractic & Manual Therapies in April of 2019. Hot stuff….comin up! It’s called “The shape of chiropractic in Europe: a corss-setional survey of chiropractor’s beliefs and practice(Gislason H 2019).” It was written by Halldor Gislason, Jari Salminen, Linn Sandhaugen, and other names I refuse to attempt at this time.
Why They Did It
Considering the ongoing split in the profession, the authors were looking to report an adherence to unorthodox descriptiions of chiropractic and the types of chiropractic practice in Europe.
How They Did It
They sent out an online survey amongst European chiropractors in 2017. They sent it out through social media and through the different membership associations.
What They Found
- They got back 1,322 responses back representing about 17.2% fo the profession.
- The responses were boiled down to fit into 2 different groups of practices.
- The two groups were categorized as orthodox and unorthodox.
- The orthodox group made up 80% of practitioners
- The unorthodox group made up 20%
Some Key Differences
- 23% of the unorthodox chiropractors x-rayed over 50% of their new patients while the orthodox chiropractors x-rayed only 5% of theirs.
- The amount of unorthodox chiropractors seeing over 150 visits per week was more than double the amount seen by the orthodox chiropractor.
- Then, of course, there’s info demonstrating how unorthodox hates vaccines while orthodox chiros are fine with them.
They concluded by saying, “in parallel with other research, this survey suggests that key practice characteristics in contravention of national radiation guidelines or opposition to evidence based public health policy are significantly more associated with non-orthodox chiropractic paradigms.”
Now, what does that mean exactly? Well, for those of us on the evidence-informed end of the spectrum, it means that we are in concert with 80% of the profession in Canada and in Europe. From what I recall, about 80% of the profession in America is either evidence-informed or somewhere in the middle. Basically, agnostic.
It’s not my place to argue if subluxation is a real thing or is not a real thing because I believe people define it differently. My opinion, not research because there is none to my knowledge….but my opinion is that if one defines a subluxation as something that can be removed thus fixing cancer, infections, and things like that…..well, my opinion is that that definition puts you in the unorthodox category and puts you in the 20%.
That’s my opinion anyway and that’s worth diddly squat in the unorthodox community so, take as you may.
We can also discuss the x-rays. I honestly have no problems with initial x-rays. I realize that flies in the face of a lot of newer guidelines but I believe that we get gut feelings that don’t fit into the definition of a ‘red flag’ per se. You damn well better get x-rays on those deals.
I’d also say, if you have a history of x-raying every single patient that comes through the doors, that’s also putting you in the 20% that is defined as unorthodox and it’s also meaning that you’re considered an outlier.
Outliers MUST keep an eye out if you have contracts with insurance companies. If you’re going to be an outlier, you’d best be a cash practice. Whether it be right or wrong in your opinion, insurance companies do NOT like outliers and unorthodox practitioners. And, honestly, who can blame them?
If I’m writing a bunch of checks and I have 80% of the profession over here mostly following guidelines, seeing people a reasonable amount of visits, I’m going to be cool with that 80%. If I have 20% of guys and girls over here seeing people 100 times per year when they have absolutely zero pain and taking repeated x-rays through the year, well…..if I’m writing those checks, I’m going to have a problem with that 20% at least 100% of the time.
Do whatever you’re going to do but you should give at least SOME consideration to what I’m saying.
I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment instead of chemical treatments like pills and shots.
When compared to the traditional medical model, research and clinical experience show that many patients get good or excellent results through chiropractic for headaches, neck pain, back pain, joint pain, to name just a few.
Chiropractic care is safe and cost-effective. It can decrease instances of surgery & disability. Chiropractors normally do this through conservative, non-surgical means with minimal time requirements or hassle to the patient.
And, if the patient develops a “preventative” mindset going forward from initial recovery, chiropractors can likely keep it that way while raising the general, overall level of health of the patient!
Patients should have the guarantee of having the best treatment offering the least harm.
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We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward.
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About the Author & Host
Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger
Gislason H, S. J., Sandhaugen L, (2019). “The shape of chiropractic in Europe: a cross sectional survey of chiropractor’s beliefs and practice.” BMC Chiro Man Ther 27(16).
Manoloff D (2013). “Noted surgeon Dr. James Andrews wants your young athlete to stay healthy by playing less.” The Plain Dealer.
Polaski A, P. A., Kostek M, (2019). “Exercise-induced hypoalgesia: A meta-analysis of exercise dosing for the treatment of chronic pain.” PLoS One.