Spinal Decompression

TMJ The Best Way & Axial Traction For Lumbar Disc Herniation

CF 120: TMJ The Best Way & Axial Traction For Lumbar Disc Herniation
Today we’re talking about TMJ the best way and we talk about axial traction for the lumbar disc. But first, here’s that sweet sweet bumper music

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OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. 

We’re the fun kind of research. Not the stuffy, high-brow kind of research. We’re research talk over a couple of beers.

I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

If you haven’t yet I have a few things you should do. 

  • Like our facebook page, 
  • Join our private facebook group and interact, and then 
  • go review our podcast on iTunes and other podcast platforms. 
  • We also have an evidence-based brochure and poster store at chiropracticforward.com
  • While you’re there, join our weekly email newsletter. No spam, just a reminder when the newest episodes go live. Nothing special so don’t worry about signing up. Just one a week friends. Check your JUNK folder!!

Do it do it do it. 

You have found yourself smack dab in the middle of Episode #120

Now if you missed last week’s episode , we talked about chiropractic business opportunities and how chiropractic solves the opioid issue.

Make sure you don’t miss that info. Keep up with the class. 

While we’re on the topic of being smart, did you know that you can use our website as a resource? Quick and easy, you can go to chiropracticforward.com, click on Episodes, and use the search function to find whatever you want quickly and easily. With over 100 episodes in the tank and an average of 2-3 papers covered per episode, we have somewhere between 250 and 300 papers that can be quickly referenced along with their talking points. 

On the personal end of things…..

I decided to start recording the episodes the week of at this time because things are changing so quickly right now, it didn’t make sense to record something that would be heard in two weeks and would likely just be irrelevant and maybe somewhat detached from the realities of the current events. 

Besides, it’s not like I don’t have the time, right?

First thing’s first, please check with your accountant before you do anything but, it looks like the PPP loan is the way to go for a lot of the employers. I want to be honest, I have the luxury of my wife handing this for us because she is wise in thing financial, record collecting, filing….that sort of stuff. 

But my rudimentary understanding of the PPP loan is that it acts more like a grant and if the money was used to continue to pay employees, then the loan is forgivable by that amount. Now, you folks smarter than I on these matters, please correct me but that is my initial understanding of the process. 

It is worth calling your accountant right now, today, and finding out if that’s the way to go. I’ve seen so many questions about the SBA loans and this and that and what should I do and which direction should I go. Look, we are stressed and worries to the max right now. We can all agree on that. 

So, how about we lessen the stress and just ask the people that know what’s going on. That would be the accountant. Some are better than others. If you have a crappy one, find a good one! We have confidence in ours.

So far, this week, at this point, we are still paying our employees as if we are still working. We closed our office on 3/23/20 to try to do our part and help flatten the curve. When you start looking at every patient as a potential point of danger, well….that’s not the way it’s supposed to be so, it was time to close for a bit. 

I plan on beginning to treat emergency patients only on Monday April 13th. Now, honestly, if we’re being honest, that might only be 3 or 4 a week. If even that. 

Some of the things I’ll have in place. We have some gloves left over. I have an N95 mask leftover from my woodworking. No, I do not have a stockpile. I spoke with a nurse practitioner friends of mine and they are down to only one as well. They are using diluted Barbasol to disinfect the masks. Is that ideal? Well hell no. Is it something and is something better than nothing? Yes, indeed. 

I have purchased small desk fans to place in each room in order to keep the air moving and not allow any virus to hang around in aerosol form. We, of course, will be wiping, checking temps, spraying, and all of that good business but, knowing that asymptomatics can carry and spread it, well, that puts us in a precarious situation doesn’t it? So we will be requiring patients to arrive with wearing a mask, 

     the thing I’ve found particularly irritating is uneducated folks finding some humor in fake coughing. Well, that’s a quick way to get booted from my office so there will be a sign in the lobby stating that “Fake coughs are not funny at this time”. Hopefully, that will get the message across so we don’t have to deal with any of that. 

Before we closed, we even had a less than thoughtful patient trying to be funny by rubbing hands all over the door frames and mock any safety protocols. Well, it goes without saying that this just isn’t the time for the tom foolery and shenanigans. 

We will begin slowly with only one person in the office at a time and a scaled-back workforce. I don’t want a bunch of people in the office at once and, honestly, we don’t need a bunch of people in the office at once. The workload is probably not going to be back to 100% for several months. I’m not being pessimistic, I’m being realistic. 

People don’t have the confidence to go out in public. They’re scared and it’s going to be that while for some time going forward. That’s just the facts. June into July is going to look better for us all if the models hold up and are accurate. They’ve been pretty spot on so far so hopefully, it stays that way.  

If you’d like a good model to check out, I’ll put the link in the show notes. 

https://covid19.healthdata.org/projections

For most areas, it looks like June is going to be a better month for everyone involved. At least in America. But when do things return to normal? I don’t think anyone knows what’s going to happen. Assuming this is not a seasonal issue, then I’d suggest September or so before people start gaining the confidence to really go out. 

If this has a resurgence, is seasonal, or the models don’t hold up, well that changes the story. On the plus side, as you know, if they come up with a dependable and highly effective means of treating this dude, we get back to normal, with confidence, faster. Or a vaccine but the shortest time table I’ve seen ever mentioned was 12-18 months. 

If you want some good news and some confidence in a return to what we once considered normal, please go to the show notes and check out the prediction model link I provided. 

Stay strong, stay faithful, take good care of yourselves physically and mentally, and take care of your neighbors. 

Item #1

Let’s get started with this one called “Effect of Manual Therapy and Therapeutic Exercise Applied to the Cervical Region on Pain and Pressure Pain Sensitivity in Patients with Temporomandibular Disorders: A Systematic Review and Meta-analysis” authored by La Touche, et. al(La Touche R 2020). and published in Pain Medicine on March 17 of 2020 – I cannot hold this for it is too hot at this time….

Why They Did It

To assess the effectiveness of cervical manual therapy (MT) on patients with temporomandibular disorders (TMDs) and to compare cervico-craniomandibular manual therapy vs cervical manual therapy.

How They Did It

  • The first thing that jumps out at me on this paper is that it is a systematic review and meta-analysis which means it’s at the top of the food chain……or research pyramid…..when it comes to reliability. Meaning, this is great information. 
  • They searched PubMed, EMVASE, PEDro, and Google Scholar with and end date of February 2019
  • Two independent reviewers performed the data analysis and assessed the relevance of the randomized clinical trials 

What They Found

  • For cervical manual therapy, they included three studies that showed statistically significant differences in pain intensity reduction and an increase in master pressure pain thresholds, with a large clinical effect
  • Also the results showed an increase in temporals pressure pain thresholds with a moderate clinical effect
  • The Meta-analysis included two studies on cervical manual therapy vs. cervico-cranialmandibular manual therapy and showed statistically significant differences in pain intensity reduction and pain-free maximal mouth opening, with large clinical effect. 

Wrap It Up

The authors wrapped their thoughts up by concluding “Cervical manual therapy treatment is more effective in decreasing pain intensity than placebo manual therapy or minimal intervention, with moderate evidence. Cervico-craniomandibular interventions achieved greater short-term reductions in pain intensity and increased pain-free motion over cervical intervention alone in TMJ/TMD and headache. Low evidence.”

Item #2

Our second and last paper this week is called “Effectiveness of Traction in Young Patients Representing Different Stages of Degenerative Disc Disease” authored by Kuligowski, et. al(Kuligowski R 2019). and published in the journal of Orthopedics, Traumatology, and Rehabilitation on June 30 of 2019. It’s warm but not quite hot… Dangit. I don’t get to use my beloved sound bit. But, it’s still less than a year old so listen up!

Why They Did It

The authors say that traction techniques are a popular method of treating lumbar disc herniation. The type of lumbar disc herniation (protrusion, extrusion) in young people appears to determine patients’ clinical status, necessitating diversification of treatment methods with regard to the type of damage.

How They Did It

  • They enrolled 37 people aged 22-35
  • The subjects had MRIs, which determined if they went to the protrusion group or the extrusion group
  • During treatment, patients were in the supine position
  • They were given three-dimensional traction using a manual therapy belt – I’m going to admit ignorance on what exactly constitutes 3-dimensional traction. In a search for a definition, you find all kinds of belts and contraptions, table, you name it. So, if you know the answer to exactly what they’re talking about here in this paper, shoot me an email so we can be clear on it. Email me at dr.williams@chiropracticforward.com
  • Oswestry questionnaire, MRC scale, Numeric Rating Scale, SLR test, Passive Lumbar Extension test and measurements of lumbar segment mobility were used for clinical evaluation. 

What They Found

  • An analgesic effect was noted with regard to the Oswestry and the Numeric Rating Scale. There was statistically significan differences observed in the case of parameters reflecting the subjective evaluation of disability and pain levels on the Outcome Assessments. 
  • These differences were clear and statistically significant with more pronounced changes observed it the group of patients with the protrusion group. 
  • The subjects improved clinically with regard to the Passive Lumbar Extension and the Straight Leg Raiser
  • A statistically significant result was observed with regard to subjective pain levels on the NRS, again, with a better result in the protrusion group. Which I think is to be expected. Both groups improved in most measures with protrusion having the best results. But also keep in mind on the extrusions, outside of this paper, we know that an extrusion with migration is more likely to be self-absorbed by the body so it’s not all doom and gloom even for the extrusion group. 

Wrap It Up

  1. The type of intervertebral disc damage determines the functional status of young people with degenerative disc disease. 
  2. The study demonstrated and confirmed a positive effect of traction on the functional status of subjects with lumbar disc herniation. 
  3. Traction techniques are safe and can be successfully used in the treatment of LDH.

Key Takeaways

Store

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The Message

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 rather than chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few.

It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. 

And, if the patient treats preventativly after initial recovery, we can usually keep it that way while raising the overall level of health!

Key Point:

At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints….

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes. 

Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms. 

We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. 

Connect

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

Bibliography

  • Kuligowski R, D.-B. A., Skrzek A, (2019). “Effectiveness of Traction in Young Patients Representing Different Stages of Degenerative Disc Disease.” J Orthop Tramuatol Rehabil 21(3): 187-195.
  • La Touche R, G. S., Garcia B, (2020). “Effect of Manual Therapy and Therapeutic Exercise Applied to the Cervical Region on Pain and Pressure Pain Sensitivity in Patients with Temporomandibular Disorders: A Systematic Review and Meta-analysis.” Pain Med.

Forward ’19, Decompression Research, Curveball or Pitch Count?

CF 094: Forward ’19, Decompression Research, Curveball or Pitch Count?

Today we’re going to talk about my Forward ’19 experience, we’ll talk about decompression research, and we’ll cover some new research on whether it’s the curveball or the pitch count that injures young players on the baseball diamond. 

But first, here’s that sweet sweet bumper music 

Chiropractic evidence-based products
Integrating Chiropractors
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OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun and accessible while we make you and your patients better all the way around. Welcome, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

You have rattled and rolled into Episode #94

Now if you missed last week’s episode on the bigger the disc the better and what early improvement in treatment tells you, make sure you don’t miss that info. Every episode offers some good take-aways so make sure you’re up to date and not falling behind the rest. 

I like to look at this podcast as an ongoing, fun way of learning and making each other just a little bit better every week so don’t just hop in for one episode. Stack them up one after another and, before you know it, you’re going to start retaining the info and you’re going to start recalling something we talked about down the road when you’re interacting with a patient and they ask you a question. 

You’ll see. Even though I’m the host, it happens to me. Someone will ask me a question and I’ll remember an episode we did on that topic and BOOM!! Pow!! There it is, the answer comes to me. Pretty cool. 

Forward ’19 – For you newbies here you’re probably wondering what the hell Forward ’19 is. A quick rundown is that it is a yearly seminar/conference that was born from an online Facebook group called the Forward Thinking Chiropractic Alliance aka FTCA. They have a website as well. 

The group is very much evidence-based or evidence-informed. Whichever is your preferred verbiage. The group has about 7800 or so doctors in it and they are interacting on a daily basis mostly to try and make each other better. Overall, it’s a good group. I’ve heard people griping because they see griping here and there in the group but, in general, it’s a very positive, very smart, and very helpful group. I encourage you joining it if you’re a doctor or student. 

Anyway, Forward 19 – What an event. The group puts on several events through the year but this is the key event put on by the FTCA every year. This is year #2. It was in St Louis at the campus of Logan Chiropractic College.

First thing is, holy smokes what a campus man. I bet they pay a fortune just to mow the grass. Just wow. The landscaping, the tower in the middle, and Purcer Center where it was all held. Just gorgeous. Having gone to Parker, that was the Chiro campus I’d been on and don’t get me wrong, Parker is impressive. I’d say Logan most definitely is as well. Kudos.

Speakers:

Gray Cook SFMA – SFMA stands for Selective Functional Movement Assessment – I have to admit that this was my first exposure to Gray Cook but it won’t be my last. I had heard of SFMA but was not all that familiar with it. I really enjoyed his talk and some of the concepts he puts forward. I can’t wait until I get through with my Diplomate program – hopefully in November – so that I can dive into Gray Cook’s stuff and just keep building on the knowledge pile. 

Greg Kawchuk – He is the Research Chair for the World Federation of Chiropractic. 

So, outside of the FTCA, I had little knowledge of Greg Kawchuk. But, Greg gave a speech at the World Federation of Chiropractic last year in Berlin that got some people a little fussy and some people elated. It definitely got the attention of chiropractors around the world to say the least. He gave the same speech last weekend in St. Louis and it had people on the edge of their seats. 

Backing up a bit, Greg is a dynamic speaker. One of the more humorous and engaging speakers I’ve seen in maybe forever. He’s immediately like-able and that make for a good speech from the top. The talk was all about putting the ACT back in Chiropractic. A play on the way the philosophy guys use the TOR and the TIC garbage. You know….the principled vs. un-principled hoohah. 

I happened to think that evidence-informed docs are the principled ones and if you need more info on why I think that, just go back about 3-4 episodes and listen to my podcast on the topic of Closing Patients. A principled, ethical person doesn’t carry themselves in that manner and the philosophy folks are much more likely to be out there closing patients than offering responsible treatment plans that are based on commonly accepted guidelines. In my experience at least. It’s always made me a bit hot under the collar when someone asks whether another chiropractor is principled or not. 

Makes me want to principle them in the forehead…..with a mighty slap. 

Anyway, putting the ACT back in chiropractic: he asked what are we doing right now? What are you doing right now to move the needle forward? To bring chiropractic into this current century we are in? He suggests we do a lot of sciencing and consume at least 1 science per day and I agree with him. 

Hell, here at the Chiropractic Forward podcast, we distribute about 3-4 sciences per episode so we almost got you covered for the whole week if you’re a regular listener. 

I think the part of his presentation that some took exception to was the part where he feels the evidence group may, at some point, consider a divorce from the philosophy geared group. He said it may not be an official divorce but could be very much a divorce in the way we act, carry ourselves, communicate with our patients, and things of that nature. 

He says, at the end of the day, it could be something similar to….. we went out for a pack of smokes and…..just never came back. 

Now, as you sit in your car or truck or your office hearing me say that, you can take that all in as you will. I’m going to tell you that, as a doctor that considers himself very much on the research end of things and very little on the philosophy end of it, and as a doctor that does everything he can to be ethical, honest, and all that…..it is so hard to sit and hear patients talking to me about being forced to sign of on a contract for thousands of dollars for a year long schedule for umpteen visits based on a curve correction that research suggests isn’t that big of a deal. 

It’s hard to hear about the knuckleheads in Oakland claiming they can reverse degenerative spurring by seeing someone 3x/per day for 3 weeks. It’s hard to watch Mr. man bun top not from the coffee house talking about fixing kids with no research to back his claims. 

It’s hard to hear about chiropractors scaring the crap out of patients with x-rays and convincing them that they are somehow damaged and in a dire circumstance unless they undergo 60 visits and another 3 sets of x-rays….

These are just a few of the stories. There are so so so many of them and at some point, I just don’t want to be associated with that anymore. At all. If that’s not understandable and that makes no sense to you and that makes you mad at me, well….I’d say I’m sorry but I’m just….I’m just not. 

Even though I don’t smoke in the physical meaning of the word, I think I went out for a pack of smokes and never came back about 15 years ago. 

Christine Goertz – If you are a regular listener of our podcast, you know Dr. Goertz has been on our show before and you know I’m a nerdy fan of her and her contribution to our profession. Any chance to listen to Dr. Goertz is a chance that should be seized upon. She’s a giant in our industry. 

Annie O’Connor – World Of Hurt – OK, I’m admitting something again. I wasn’t familiar with Annie O’Connor. Annie is fun and vivacious and really another very dynamic speaker but she is full of knowledge nuggets. The kind that you can really put to use. She spoke on how words can harm so how key communication can be for some patients. She talked about yellow flags and she talked about classifying pain patients so that we can help them with more efficiency. You can believe that World Of Hurt is on my reading list after Forward ’19. 

Greg Friedman – documentation  documentation. Greg is Greg. Smart, laid back, fun, and just likable immediately. It was great to get to meet him in person and share a good discussion prior to his documentation class. He’s full of excellent information and not just on documentation so, if you get a chance and you need the hours, search out a class. He’s flying all over the nation every weekend. 

Mike Massey – he shared teaching duties with Greg on the documentation class. He told me he’s a listener of our podcast and he’s an active member of the FTCA so I’ve been a fan of his for a while now. It’s always a cool deal to put the online world into a 3D context and it was sure nice to meet Dr. Massey. Hopefully next time I’ll get to sit and speak a while with him. I think our personalities probably match up pretty closely from what I can tell. 

Some of the others I got to see and speak with are Brandon Steele

Kevin Christie

Jon Morrison

Robert Jones, President Of The ACA was there the whole weekend sitting in on the classes himself. What a super guy.

Budweiser tour

Meeting people

Kris Anderson

Chris Howson

Rob Pape

Bobby Maybee

Bobby Mozafari

Mike Massey

Greg Friedman

Dale Thompson

Kevin Christie

Anne Maurer

My biggest regret is that I didn’t get any real one on one time with very many of these folks but That’s OK. All’s well.

If I didn’t come up and speak with you but you saw me there, please don’t take it personally, believe it or not, I have a bit of a shy streak. Once I’ve had a conversation with someone, it’s all good. But, if I don’t know you yet….ugh….I have a podcast. I was a traveling musicians for 7 years. Why would a guy like me be shy at all? Yeah I don’t know. I’m in control in those other situations. Maybe it’s when I’m not in control or I’m a newbie….who knows?

Anyway, if you ever see me at an event, regardless of the event, please come say hi. I’d love to meet you.

We are about to get to our two articles. One is new research on traction/decompression information for low back discs and the other is on young baseball pitchers and how the curveball isn’t the culprit. 

First though, we have backed off and rather than having two show sponsors, we have one and it’s a company you all know how much I love. 

If you’re a regular listener of our podcast, you know I used it since about June of 2018. Let me tell you about it. 

ChiroUp is changing the way we practice by simplifying patient education and here’s what I mean: 

In a matter of seconds, you can send condition-specific reports to your patients with recommendations for treatment, for their activities of daily living, & for their exercises. 

You can see how this saves you time – no more explaining & re-explaining your patient’s care, because they have access to it at their fingertips. 

You can be confident that your patients are getting the best possible care, because the reports are populated based on what the literature recommends and isn’t that re-assuring? All of that work has been done FOR you. 

There are more than 1000 providers worldwide using ChiroUp to empower their treatments, patients, & practice – Including myself! **Short testimony**

If you don’t know what it’s all about or you’d like to check it out, do yourself a favor and go to Chiroup.com today to get started with your FREE TRIAL – Use code Williams99 to pay only $99/month for your first 6 months

That’s ChiroUp.com and super double secret code Williams99

Item #1

The first article today is called “The effect of mechanical traction on low back pain in patients with herniated intervertebral disks: a systemic review and meta-analysis” by Cheng, et. al(Cheng Y 2019). and published in Clinical Rehabilitation in August 28, 2019. Smoking hot folks. Stand back. Watch your eyebrows!

First thing, recognize in the title there, this is a systematic review and meta-analysis. That’s at the top of the research pyramid. 

Why They Did It

To evaluate the effectiveness of traction in improving low back pain, functional outcome, and disk morphology in patients with herniated intervertebral disks.

How They Did It

  • They did a big time search PubMed, Scopus, Embase, and the Cochrane Library and they did this search from the earliest record all the way up to July 2019. 
  • They included RCTs that involved adult patients with low back pain associated with herniated disc confirmed by MRI or CT
  • RCTs that compared lumbar traction to sham or no traction
  • RCTs that provided quantitative measurements of pain and function before and after intervention. 
  • The initial search came up with 3,015 records which they whittled down to 7 involving 403 patients.

What They Found

Compared to the control group, the patients that had traction showed significantly greater improvements in pain and function in the short term

The differences were not significant enough to support the long-term effects on pain and function, nor the effects on herniated disc size. 

Wrap It Up

Compared with sham or no traction, lumbar traction exhibited significantly more pain reduction and functional improvements in the short term, but not in the long term. There is insufficient evidence to support the effect of lumbar traction on herniated disk size reduction.

Here’s where I’m at on that. I use decompression. I just need to know more about this study. Did they do simple traction? Did they do a cycling pull phase from a pull to a rest phase? How much weight was the pull? How long did they do each treatment and how many treatments did they do?

There’s also patient preference and clinical experience factoring into using decompression.

Reading down through this sucker, it’s just too varied to make any assumptions. The intervention programs differed among the studies from 10 sessions to 60. The treatment protocols varied from 2 weeks to 10 weeks. Some of the studies included had no information on the weight of the pull while a handful went up to 50% of the body weight. Some of the studies used continued traction while others had intermittent traction. Some even used self-suspended, inversion table type traction. 

Are you getting a whiff of what I’m dumping here? 

Out of the 7 studies they included, only 2 measure the disc height and one measured the disc ratio. 

Overall, when you read through the paper, these authors freely admit, this is a tough one but they wanted to start somewhere. They suggest several ways to go forward and say that there are a couple of studies out there that show a trend toward long-term decompression reducing the size of a disc herniation but no longer papers have been done to investigate it. 

It’s anecdotal as hell but I’m going to go ahead and anecdote the hell of you. Right to your face. Or….to your ears as it may be. I’ve been doing decompression for about 7 years and I’ve yet to see anything as effective. Including exercises, McKenzie, all of it. In some cases, it has absolutely amazed me. But, like I said, that is anecdotal but I hope some of these really super smart researchers out there in the profession start to dial down into it and figure it out. Mostly because I know it works. I’ve just seen it too many times. 

Item #2

This last item is called “Effects of a Simulated Game on Upper Extremity Pitching Mechanics and Muscle Activations Among Various Pitch Types in Youth Baseball Pitchers” by Oliver et. al(Oliver G 2019). and was published in Journal of Pediatric Orthopedics in September of 2019. Wait, it’s September of 2019 right now right? Steaming pile of fresh knowledge nuggets, big platter, sizzling. 

Why They Did It

The purpose of this study was to examine differences in pelvis, torso, and upper extremity pitching mechanics and muscle activations between the fastball, change-up, and curveball pitches in youth baseball pitchers following a simulated game.

How They did It

  • 14 youth baseball pitchers with no history of injury were included
  • All major muscles and mechanics were measured
  • The pitchers were instructed to throw with max effort during a simulated game that provided random game situations
  • They were limited to 85 pitches
  • Data from 3 fastballs, curveballs, and change-ups thrown in the first and last innings were selected for analysis

Wrap it up

The principle findings of this study revealed that pitching to the age-restricted pitch count limit did not result in altered pitching mechanics or muscle activations, and no differences occurred between the 3 pitches. These results support previous research that indicate the curveball pitch is no more dangerous for youth than the other pitches commonly thrown. This is supported by the pitcher’s ability to maintain a proper arm slot during all 3 pitches and indicates that they are obtaining the spin on the ball from their grip and not by altering upper extremity mechanics.

So….it is not the curveball it seems but, rather, it’s the pitch count in young pitchers, it’s treating them like professionals when they’re still developing, it’s that they tend to play only one sport aka specialize, and that they need to be treated like developing children and human beings rather than the Dad’s lost glory or a future paycheck for the whole family. 

Store

Part of making your life easier is having the right patient education tools in your office. Tools that educate based on solid, researched information. We offer you that. It’s done for you. We are taking pre-orders right now for our brand new, evidence-based office brochures available at chiropracticforward.com. Just click the STORE link at the top right of the home page and you’ll be off and running. Just shoot me an email at dr.williams@chiropracticforward.com if something is out of sorts or isn’t working correctly. 

If you’re like me, you get tired of answering the same old questions. Well, these brochures make great ways of educating while saving yourself time and breath. They’re also great for putting in take-home folders. 

Go check them out at chiropracticforward.com under the store link. While you’re there, sign up for the newsletter won’t you? We won’t spam you. Just one email per week to remind you when the new episode comes out. That’s it. 

Chiropractic evidence-based products
Integrating Chiropractors
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The Message

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!

Key Point:

Patients should have the guarantee of having the best treatment offering the least harm.

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Help us get to the top of podcasts in our industry. That’s how we get the message out. 

Connect

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. 

Website

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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

Bibliography

  • Cheng Y, H. C., Lin Y, (2019). “The effect of mechanical traction on low back pain in patients with herniated intervertebral disks: a systemic review and meta-analysis.” Clin Rehabil.
  • Oliver G, P. H., Henning L, (2019). “Effects of a Simulated Game on Upper Extremity Pitching Mechanics and Muscle Activations Among Various Pitch Types in Youth Baseball Pitchers.” J Pediatr Orthop 39(8): 387-393.