w/ Dr. Brett Winchester: Chiropractic Excellence, Inspiration, & Being The Best Evidence-informed Chiropractor You Can Be

August 5, 2021 chiropracticforward 00:59:18 0 Comments

CF 189: w/ Dr. Brett Winchester: Chiropractic Excellence, Inspiration, & Being The Best Evidence-informed Chiropractor You Can Be

Today we’re going to be joined by the illustrious potentate himself, Dr. Brett Winchester. You all are in for a real treat today folks. They say that the US Marines are the tip of the spear, well, when it comes to our profession, he’s just that. If you don’t get something out of this interview, you’re just not paying attention, my friends. Get ready for the waterfall of knowledge nuggets heading your way. But first, here’s that sweet sweet bumper music

Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

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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.

Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s an invaluable resource for your patient education and for you. It can save you time in putting talks together or just staying current on research. It’s categorized into sections so that the information is easy to find and it’s written in a way that is easy to understand for practitioner as well as patient. You have to check it out. Just search for it on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.
Then go 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.

You have found yourself smack dab in the middle of Episode #189 Now if you missed last week’s episode , we talked with Dr. Rob Pape of the Quadrant Analysis procedure as well as Practice Mechanics. Excellent discussion and plenty of nuggets dished out on that episode. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

Trucking along with the medical integration. Nothing worth doing is easy. If it were easy, we’d all be in the middle of it. But I do think that once it’s up and running, we’re going to be doing great and getting patients well. And….maybe even free up a little of my time as well. It’s a big time for me. Setting up relationships with medical supplies companies, with pharmacies, figuring out how our NP orders scripts through the EHR, and figuring out stuff that just has never been a part of my life. It’s interesting. All the while getting contracts signed and getting new accounts set up that I share with the medical director and getting cabinets put in the room to store the things I never needed stored.

I bought a damn autoclave and then bought a damn centrifuge, y’all. Seriously, it’s all new to me but I’m getting there. My biggest concern is that everything is ready to roll on day one perfectly. Which means I’ve set myself up for failure. That’s because we’re definitely going to forget something. It’s just going to happen. No doubt about it. There are so many moving parts and different supplies to get that there is literally zero chance of having it all on Day One.

But it’ll all unfold.

How’s practice going for you folks? Send me an email. I want to know how you’re all doing. I’m still hovering around about 160 or so appointments per week. That’s not much for the straights but for an evidence-based dude with therapies, exercises, and things like that, it’s quite a bit.

The joke of a chiropractor up in Oklahoma that sees like 100 patients in three hours including 9 new patients….160 wouldn’t mean much for that doctor….and I use the term loosely when I say doctor…. It takes longer than that when done properly and responsibly though, doesn’t it. Listeners of this show know that. You’re smart. You get it. We’re not where we were pre-COVID and I’m afraid the Delta-Vid has some folks scared again and staying at the casa. I don’t blame them.

Who knows if we ever totally get the VID under control but either way, it’ll become a way of life, we’ll adapt, and things will stabilize eventually. One way or another. That’s enough about me, Delta VID, and the personal happenings. Our guest is too good to waste time. Let’s get to our amazing sponsor first.

CHIROUP ADVERTISEMENT

Dr. Brett Winchester lectures throughout the world, teaching his functional approach to patient care. Combining manual therapy, including joint manipulation and neuromuscular stabilization, with therapeutic exercise, Dr. Winchester effectively treats functional pathologies and acts as a catalyst for patients working to enhance their performance. Dr. Winchester is the founder of Winchester Spine & Sport located outside St. Louis, Missouri. His current appointments include:

Advanced biomechanics course instructor at Logan College of Chiropractic
Technique instructor at Logan College of Chiropractic
Biomechanics instructor at Maryville University
Instructor and board member for the Motion Palpation Institute
Chiropractic Rehabilitation Diplomate instructor
Dynamic Neuromuscular Stabilization instructor trained by Pavel Kolar
Mechanical Diagnosis and Therapy (MDT) certified
Gestalt Performance (owner)

Dr. Winchester’s published research includes topics such as offering a multidisciplinary approach for treatment of the pregnant population and foot dysfunction.

Various chiropractic journals have also featured Dr. Winchester for his patient-driven treatment model. He also has authored two chapters for textbooks. Dr. Winchester enjoys treating professional and collegiate athletes and has gained a reputation for his sports medicine background. His expertise has placed him at the forefront of the ulnar collateral ligament rupture epidemic in professional baseball pitchers, providing insights into causation and effective treatment protocols. + Dr. Winchester served as the chiropractor for the St. Louis Cardinals from 2014-2018 and still consults with various Major League Baseball teams.

Still, his passion remains with diagnosing and treating the ailments of a diverse patient population with conservative-based protocols.

Welcome to the show Dr. Winchester! It’s great to have you with us on the podcast. Thank you for joining us.

Just briefly before we get into the meat and taters here, tell me a little about your family Everyone has the chiropractic story. Of all of the professions in the world, why are you a chiropractor?

People say they don’t know how I get all of the things done in the day that I do, reading through your bio, I can say the same about you. What does a regular day or week look like for you?

Where did you make the break from traditional philosophy-based chiropractic teaching and move firmly and confidently into the evidence, the research side of our profession?

What’s the future of chiro look like?

Why is being good at manipulation so important?

We both exist on the evidence-based spectrum of this profession.

What is your response if the more philosophy, vitalistic-based side of the profession says we are medi-practors and that practitioners like us don’t value the adjustment?

Why do people suck at joint play?

What makes for great adjusting?

What does a multi-modal approach mean?

What is it truly like to work with a professional sports team like St. Louis Cardinals? Is it worth it? Or is it just too much?

With your involvement in Motion Palpation Institute, MDT, the rehab diplomate and all of the rest, for the docs out there looking to take the next step toward being the best, what do you think made the largest leap forward for you in terms of knowledge that led to significant positive results in your patients?

What would the colleagues that are close to you say is your best attribute?

And the worst?

Tell everyone about the Gestalt Podcast, where does the name come from, and why they need to tune in?

I think that about wraps up for this episode. Tell me you’ll come back sometime.

Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus so get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.

Store Remember the evidence-informed brochures and posters at chiropracticforward.com.

Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

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 preventatively 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.

Website https://www.chiropracticforward.com

Social Media Links https://www.facebook.com/chiropracticforward/

Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/

Twitter https://twitter.com/Chiro_Forward

YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q

iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2

Player FM Link https://player.fm/series/2291021

Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through

TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/

About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Evidence based chiropractic forward podcast

American Academy of Family Physicians Warming To Chiropractic For Chronic Pain & Evidence Behind Supplements

February 6, 2020 chiropracticforward 00:29:13 0 Comments

CF 111: American Academy of Family Physicians Warming To Chiropractic For Chronic Pain & Evidence Behind Supplements

Today we’re going to talk about how the American Family Physicians may be warming up to chiropractic for chronic pain and what supplements actually have some evidence behind them.

But first, here’s that sweet sweet bumper music

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 #111

Now if you missed last week’s episode , we talked about Dry Needling vs. Massage and even more importantly, we talked about the topic of “What is your exit number?”. What are you looking to get out of it all in the end? I feel like there were points made in there that could really get you to contemplating and thinking going forward. So, make sure you don’t miss that info. Keep up with the class.

That reminds me, did you know that you can use our website as quite a resource? I do it all of the time. If you think I can keep every one of these papers in my noggin and pull them out of my brain files on demand, that’s a big nope. But I can go to chiropracticforward.com, click on Episodes, and use the search function to find whatever I 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…..

Rinse and repeat man, rinse and repeat. If you’re friends with me on Facebook, then you know life has been crazy and there’s no slow down in site.

Some really positive stuff happening though too. For example, I was interviewed for two different articles in Chiropractic Economics recently. They published an article called “Chiropractic for prevention: the latest research on maintenance care” by Michele Wojciechowski. Michele used my comments exclusively in this article and that’s just a big honor.

I remember when I was new in practice. I remember reading articles in Dynamic Chiropractic and Chiropractic Economics and thinking that would be cool to be in that one of these days. Now…..now…I’ve been fortunate enough to be in Reader’s Digest, on the ACA Blog a couple of times, and now Chiropractic Economics. It’s pretty damn exciting and it’s an honor.

Thank you Michele for finding value in my comments and sharing them with everyone else. I’ll leave a link to that article at this point in the show notes if you’re interested in giving it a read through.

Chiropractic for prevention: the latest research on maintenance care

Other than that, my family and I took a quick ski-cation to Red River, New Mexico. If you haven’t been, look it up. Here’s why we like Red River, First thing, it’s close. For a Texan to be able to just drive about 4 hours and be in the mountains, that’s pretty exciting.

Next thing, it’s just gorgeous. And, the ski slope comes right down into the town so you don’t have to drive out to a mountain which is nice.

Let’s talk about why I retired from skiing myself though shall we? This may make you think a bit about some of the stuff you do in your offtime. Maybe it won’t but it’s important to think about things which is the whole point of me bringing it up.

I used to ski a lot back in high school and junior high. I was pretty decent at it too. Then I went off to play football and be a college kid. Well, Louisiana for a bit and Dallas for a bit…..those areas aren’t very conducive to learning to snow ski. It’s too damn far. Especially when you’re still a kid and broke as hell. Skiing just doesn’t happen at that point in life unless you have parents taking you. I didn’t.

So then you start life and you’re building a business and there’s never time to go then either.

Well by the time I got back around to going skiing again, I hadn’t done it in about 20 years give or take. So, i got a private coach for a morning just to get me back on that bicycle and rocking and rolling again. I have to tell you, it was hard as hell!! It was NOT like riding a bike. Nothing at all like it as a matter of fact!!

But, I took it slow, I didn’t fall at all, and was fairly happy with my progress over the weekend. HOWEVER, I got to thinking when I got home. I went back to work and had about 45 patients that next day. What if I had twisted a knee, broken and elbow, or dislocated a shoulder while I was skiing? What would I have done?

You know this sounds stupid when you say it but, “They call them accidents because you don’t plan them.” But you can avoid them sometimes. I got to thinking long and hard enough about the risk vs. rewards for continuing to ski and……honestly, on paper, it wasn’t worth the risk.

So, I retired. Maybe if I had an associate. Maybe I could make more sense of it but, the truth is, I don’t have an associate. It’s just me although I’m thinking of hiring one just as soon as it makes sense. Anyway. I took the kids skiing while the wifey and myself enjoyed the mountains, some brewskis, and some playoff football games.

What are you involved in as far as physical activity outside of your practice that puts you at risk and puts your ability to earn a living at risk? Do you have disability insurance? Life insurance? Long term care insurance? I have all of that. Do you need it?

Start thinking about these things. Certainly, the more successful you get and the busier your practice gets. Risking an injury just might not be worth it at some point.

Before we dive into the reason we’re here, it’s good to support the people that support evidence-informed practitioners. Well, ChiroUp certainly does just that.

If you don’t take advantage of the deal I’m about to offer you, I think you just might be crazy.

Regular listeners know I’ve used ChiroUp for well over a year now. I’m going to tell you want it is and then share a way to do a FREE TRIAL and, if you sign up, only pay $99/month for the first six months. So listen up!

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, activities of daily living, & for their exercises.

This saves you so much time – no more explaining & re-explaining your patient’s care because they have access to it right there at their fingertips.

You can be confident that your patients are getting the best possible care because the reports and exercises are populated based on what the literature recommends and isn’t that reassuring? All of that work has been done FOR you by people that are deep into the research.

There are more than 1000 providers worldwide using ChiroUp to empower their treatments, patients, & practice.

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 and, to sweeten the deal, you can use code Williams99 to pay only $99/month for your first 6 months

That’s ChiroUp.com and super saver code is Williams99.

Item #1

Let’s start with this one from American Family Physician. I got this one from one of my amazing colleagues, Dr. Craig Benton down in Lampasas, TX. It’s called “Nonpharmacologic therapies can improve chronic pain outcomes” authored by Michael Devitt and was published in American Academy of Family Physicians on January 15, 2020(Devitt M 2020). Damn it’s hot…..

Not a research paper but more of an article in their publication but has plenty to do with chiropractic.

They set the stage here by pointing out that chronic pain is something that can cause people to go to extreme measures just to get the pain to go away. Or at least lighten up. They say this includes potentially harmful behaviors like drug and alcohol misuse and/or abuse.

Then this article in the American Family Physicians journal starts to highlight and promote the nonpharmacologic treatment modalities that are available to family physicians. Honestly, did you think you’d ever see the day? Ever? The battle isn’t over by any stretch of the imagination but research is gradually, inch by inch, turning the tide.

They say these modalities include simple methods like massage and heat as well as more complex therapy like acupuncture and chiropractic manipulation. They called us ‘complex’ and I’m taking that as a compliment. Lol. What we do can damn sure be complex.

They say that these nonpharma strategies aren’t only effective for decreasing pain and improving function, but can also be effective for reducing longer-term adverse effects such as substance use disorders and suicide attempts. THAT’S A BIG DAMN DEAL.

In fact, I got one word, two syllables….day-um.

One researcher, the lead author from an active-duty US Army service study said “Chronic pain is associated with adverse outcomes such as substance use and suicidal thoughts and behavior,” said Esther Meerwijk, Ph.D., M.S.N., a statistician at the VA Palo Alto Health Care System in California. She added, “It made sense that if nondrug treatments are good at managing pain, their effect would go beyond only pain relief. However, I was surprised that the results of our analyses held, despite our attempts to prove them wrong.”

Despite our attempts to prove them wrong! Haven’t they been trying to prove us wrong for generations now? Lol. I always say that with all of the powers against us, if we were wrong, if we were ineffective, we would have been wiped out years ago.

In one of her projects, they reviewed the records of more than 275,000 active-duty service members reporting chronic pain.

They combed through their files to determine whether they had received any of 13 nonpharmacologic therapies after their deployment. Those therapies were acupuncture or dry needling, biofeedback, chiropractic care, cold laser therapy, exercise therapy, lumbar supports, massage, osteopathic spinal manipulation, other physical therapy, superficial heat, traction, transcutaneous electrical nerve stimulation, and ultrasonography.

After crunching all of the numbers and outcomes here’s what they came up with:

Specifically, service members who received nonpharmacologic therapies were

8% less likely to experience new-onset alcohol and/or drug use disorders;
12% less likely to experience suicidal ideation;
17% less likely to experience a self-inflicted injury, including attempted suicide;
18% less likely to intentionally poison themselves with opioids, related narcotics, barbiturates or sedatives; and
35% less likely to accidentally poison themselves with the same types of drugs.

The researchers acknowledged several limitations in their research. For example, although most nonpharmacologic therapies were provided after service members were diagnosed with chronic pain, the authors could not determine whether those nonpharmacologic therapies were used specifically to treat that pain.

In the news release, Meerwijk also explained that her team did not study the effects of individual nonpharmacologic therapies.

“We treated them as one,” she said. “Most likely, only some of the therapies that we included are responsible for the effect that we reported, whereas others may have had no effect at all, assuming there’s no other variable that explains our findings.”

Despite these limits, the authors expressed confidence in their research methods and findings.

“Our results suggest that (nonpharmacologic therapies) provided to active-duty service members with chronic pain may reduce their odds of long-term adverse outcomes,” they concluded in the study. “Given known associations of these adverse outcomes with morbidity and mortality, providing (nonpharmacologic therapies) to service members with chronic pain could potentially save lives.”

I’ve been hearing this crashing tidal wave coming. It’s not here yet. But the roar is approaching and it sounds like sweet sweet music to me ears.

Item #2

I’m going to do everything I can to boil this sucker down and strip it to the bare bones without it getting too long or boring. This one is called “Evidence-based supplements for the enhancement of the athletic performance” by Peeling, et. al(Peeling P 2017). and published in the International Journal of Sport Nutrition and Exercise Metabolism in 2017.

The authors wanted to put together a review focusing on the available evidence based for performance supplements commonly used in sports and summarizing the when’s and the how’s around their uses.

The ysay there is robust evidence that the following supplements can enhance sports performance when used according to established protocols.

So let’s motor through this like poop through a goose, shall we?

Caffeine -There exists a lengthy research history on caffeine supplementation across a range of performance protocols, including endurance-based situations, resistance training exercise, short-term supramaximal efforts, and/or repeat-sprint tasks. Reported benefits of caffeine include benefits include adenosine receptor antagonism, increased endorphin release, enhanced neuromuscular function, improved vigilance and alertness, and a reduced perception of exertion during exercise. Low to moderate doses of caffeine (∼3–6 mg/kg BM), consumed 60 min pre exercise, appear to have the most consistent positive outcomes on sports performance in research situations, although a variety of other protocols (as mentioned above) also appear beneficial, and are practiced in real-life. Of note, athletes who intend to use caffeine as a performance aid should trial their strategies during training or minor competitions, in order to fine-tune a protocol that achieves benefits with minimal side effects.
Creatine – widely-researched supplement, with creatine monohydrate (CM) being the most common form used. Creatine loading can acutely enhance the performance of sports involving repeated high-intensity exercise (e.g., team sports), as well as the chronic outcomes of training programs based on these characteristics (e.g., resistance or interval training), leading to greater gains in lean mass and muscular strength and power. When accepted creatine monohydrate supplementation protocols are followed, the expected increase in intramuscular creatine stores is likely to enhance lean mass, maximal power/strength, and the performance of single and repeated bouts of short-term, high-intensity exercise.
Nitrate – The authors say Nitrate is a popular supplement initially found to improve oxygen uptake kinetics during prolonged submaximal exercise. Great sources are Leafy green and root vegetables (i.e., spinach, rocket, celery, beetroot, etc.
Beta-Alanine – The paper says this is one of the immediate defenses against the accumulation of protons in the contracting musculature during exercise. I can also tell you that this is just something I never nerded out on. Lol. Not my cup of tea but I like to offer something for everyone here at the Chiropractic Forward Podcast. They say it can improve tolerance for maximal exercise bouts lasting 30 s to 10 min and provide small yet significant benefits in both continuous and intermittent exercise tests. Basically, it’s used in order to augment high-intensity exercise performance ranging from 30 s to 10 min in duration.
Sodium Bicarbonate – benefits are generally seen in short-term, high-intensity sprints lasting ∼60 s in duration, with a diminishing return as the effort duration exceeds ∼10 min. However, greater benefits may be realized (>8% improvement) with a greater number of repeated sprint bouts

Go to our show notes at chiropracticforward.com if you’d like to get dosing information and all the little technical tidbits. It’s really interesting. Even to an orthopedic guy like me although, its technical enough to make my eyes glaze over as well.

There are several others listed in the paper as well but the authors point out that the evidence for their effectiveness is much less clear. They are Sodium citrate, Phosphates, and Carnitine.

Even though that stuff is not my cup of tea, it’s good to know, it’s good to have as a reference, and it’s good to pass on to you because many of you actually do nerd out on that stuff and thank God for that. That means I can call people like you and ask what the hell. On the other hand, if it’s something I nerd out on like orthopedics, you can call me and say what the hell?

Store

Remember the evidence-informed brochures and posters at chiropracticforward.com.

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 preventatively 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.

Website

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TuneIn

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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

Devitt M (2020). “Nonpharmacologic Therapies Can Improve Chronic Pain Outcomes Reductions in Drug Misuse, Suicide Attempts Reported.” AAFP.

Peeling P, B. M., Paul S, (2017). “Evidence-based supplements for the enhancement of athletic performance.” IntJ sport Nutrition Exercise Metabolism 28(2): 178-187.

Chiropractic Forward Podcast - Jeff Williams, DC

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

October 3, 2019 chiropracticforward 00:32:21 0 Comments

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

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:

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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**

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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.

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.

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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.

Chiropractic Forward Podcast - Evidence based chiropractic - Tackling the Chiropractors Cause Strokes Myth

Sports Performance / Chiropractic Care Standardization / Proprioception

August 8, 2019 chiropracticforward 00:27:12 0 Comments

CF 086: Sports Performance / Chiropractic Care Standardization / Proprioception

Today we’re going to talk about Sports Performance / Chiropractic Care Standardization / Proprioception

But first, here’s that arm like a big fuzzy coat 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 tripped into Episode #86 and when I say tripped, I don’t mean so much the LSD kind of trip but more like the I’m an idiot and fell face first in a room full of people sort of tripped. So, welcome you fools!! Lol. I kid, I joke. I’m honored to have you here today. We have some good stuff to cover.

Before we get started, let’s talk about GoChiroTV. GoChiroTV is a patient education system for your office that elminates the need for cable TV or looping the same DVDs over and over again in your waiting room. The bite-sized videos are specifically made to inform your patients about the importance of chiropractic and healthy living. To encourage referrals and to present the benefits of all of the different products and services you offer.

It works by using a tailor-fit video playlist that only promotes the products and services available in your practice. Not only that but the videos are replaced automatically on a weekly basis. There’s nothing complicated. You truly can just set it and forget it.

CF 011: With Dr. Tyce Hergert: It’s Here. New Guides For Low Back Pain That Medical Doctors Are Ignoring

Listeners of the Chiropractic Forward Podcast can use the promo code CFP19 at checkout to get 15% off all subscriptions. That’s CFP19, which also comes with a 45-day free trial to see if it’s right for your practice. Your discounted rate will be locked in for as long as you have a subscription and you can’t hardly beat that deal.

Go visit GoChiroMedia.com to check out the demo reels and get started on your free trial. Take your practice to the next level with GoChiroTV.

Introduction

We’re here to advocate for chiropractic while we also make your life easier using research and some good solid common sense and smart talk.

Personal Happenings

I always feel that, if I share personal experiences with you guys, first you’ll know me as a person better and I don’t see anything wrong with that. Second, you may identify and sympathize. Third, if you can’t necessarily identify with what I go through, you may be able to learn from it if you get to that point.

With that I’ll say that 2019 has been quite the year for us around my office. New faces, lots of new patients, and less and less time to do things outside of seeing patients. My work/life balance is out of balance at the moment and I’m afraid my health is starting to show some dents in the armor.

I think I have an undiagnosed anxiety thing and, typically, I’m very good at managing anxiety and stress and having 4 or 5 balls up in the air at the same time. I’m a juggler people. And I have been for quite a long time.

But, in January, something clicked. Something changed. I don’t say this to brag. I say this to explain. My practice numbers just started to climb during a time that we are traditionally slow. Really slow. The holidays are usually a time when you just know you’re going to have extra time to catch up on all of those things that have been piling up in front of you. Back to school time as well right? It’s always been a down time for me for one reason or another.

Yeah, well, not this year. The holidays only got busier. Much busier. The kids go back to school in two weeks and there’s been no slow down this Summer. Which is awesome. But my problem is, I don’t know what I did to cause the influx. If I knew, you better believe I’d be repeating it!! Over and over and over.

The end story is, growing is great but growing can be stressful. That’s why they call it growing pains right? Think about it: how many staff member do I need to handle the patient load? Am I over staffed or understaffed? Do I need an associate? Which one is the right one? Will they take care of things like it’s their own and they care? Where do I get good contract for one? I have a bathroom that needs tiled and I have an Air conditioner that need’s replaced. My dog pissed on the carpet this morning. Blah blah blah.

You all know how it goes. Every aspect of practice has stressors. When you’re new in practice and don’t have a heavy load, you’re sitting looking at your watch, playing on the computer, hopegully you’re out marketing, and you’re stressed about how you’re going to provide for your family.

I’m aware that being too busy is a nice problem to have. I don’t want to come off as a spoiled brat here. I’m just saying that I have been stressed and it’s starting to affect me a bit. We have been blessed and we are going to take blessings and we are going to turn them into more blessings for us and for our patients and staff.

It’s just getting through some of the mud and muck along the way. I just need to keep my anxiety under the surface a little longer. Lol. So that nobody thinks I’m insane.

I’ve fooled them this long haven’t I?

On another note, Charlie Manson. Y’all, I was fascinated by their shenanigans when I was in high school but got over it. Every now and then I’ll see something about it and I’ll perk up and listen but I went to see the new movie Once Upon A Time In Hollywood.

I’ve been seeing where some hate it and some love it and I’ve seen a bunch of ehhh comments but I gotta tell you. I’m firmly in the hell yeah category. Brad Pitt and Leo DiCaprio knocked that sucker straight out of the parking out onto the parking lot. It was funny, it was vintage, it was nostalgic, and no…..of course it didn’t happen that way but it was excellent.

If you went, shoot me an email at dr.williams@chiropracticforward.com and tell me what you thought. I can share you thoughts next week on the podcast. Or you can get on our Facebook page or our private Facebook group and we can discuss.

Item #1

Let’s get to our first item here. It’s titled “The effects of spinal manipulation on performance-related outcomes in healthy asymptomatic adult population: a systematic review of best evidence” and written by Meliss Corso, Silvan Mior, Satrah Batley, et. al. It was published in BMC Chiropractic and Manual Therapies in June 2019. Brand new…..hot stuff people. (Corso M 2019)

How To Not Miss A Dissection & De-legitimizing Complementary Medicine

Why They Did It

The authors wanted to perform a systematic review regarding the effect spinal manipulative therapy has on athletic performance in asymptomatic adults.

What They Found

They concluded “The preponderance of evidence suggests that SMT in comparison to sham or other interventions does not enhance performance-based outcomes in asymptomatic adult population. All studies are exploratory with immediate effects. In the few studies suggesting a positive immediate effect, the importance of such change is uncertain. Further high-quality performance specific studies are required to confirm these preliminary findings.”

That doesn’t mean we can’t help with pain and discomfort which aids in better performance. But it does suggest that, if a person feels great, getting spinal manipulative therapy isn’t very likely to make any difference in how fast they are or how far they can throw.

Item #2

This one is called “The Chiropractic Hospital-Based Interventions Research Outcomes Study: Consistency of Outcomes Between Doctors of Chiropractic Treating Patients With Acute Lower Back Pain” by JA Quan, et. al and was published in the Journal of Manipulative and Physiological Therapeutics in June 2015 so 4 years old. (Quon JA 2015)

Why They Did It

The aim of this study was to determine if effectiveness differs between community-based doctors of chiropractic administering standardized evidence-based care that includes high-velocity low-amplitude spinal manipulative therapy (SMT) for acute low back pain (LBP).

How They Did It

A secondary analysis of randomized controlled trial and observational pilot study data was performed with nonrandom allocation to 4 DCs.
Patients included those with Quebec Task Force categories less than or equal to 2 and acute LBP of 2 to 4 weeks’ duration.
The intervention included high-velocity low-amplitude SMT.
Outcomes assessed using Roland Disability Questionnaire (RDQ) at 24 weeks.

What They Found

The findings of this study show that regardless of the treating DC, most patients with acute LBP without radiculopathy appear to experience consistent levels of improvement in terms of BP and general PF after receiving guidelines-based treatment that include s a component of standardized HVLA SMT.

If we dive into the paper, they mention that until now, inconcsistency hasn’t been regarded as a significant barrier to chiropractors getting referrals from the medical realm. Butthere are guarded attitudeds about chiropractors when we’re talking about quality of care and that’s been confirmed in other papers.

In fact, in a survey of 487 Canadian and American orhtopedic surgeons, they found that about 71% of them held either a neutral or a negative view of chiropractors. That means only 29% of them looked at us in a positive way. 29%. Dammit

Also, when you break down that 71% of neutral or negative….you get 26% were neutral but 45% were in the negative category. Dammit.

73% of orthopedic surgeons thought chiropractors provided unnecessary treatment. Yeah, they’d probably just do better if you intubated them, knocked them completely out, and drove screws through the bones of their spine to fixate the segments on top of each other and then sewed them back up, and then sent them home with a bunch of pills. That’d probably be much more necessary. Sure thing chief.

Hell, 52% of them thought chiropractors make their patients dependent on short-term relief. I will say that it feels good to feel good and why wouldn’t a patient want to feel good as often as they can? But putting the shoe on the other foot here, let’s assume they’re right, isn’t being addicted to safe, conservative, non-invasive treatment better than being addicted to opioids or some sort of medication? Our nation’s opioid crisis suggests it is better.

The paper itself is really a preliminary study and meant to further knowledge and information for other papers down the line but I found it more interesting because of the orthopedic survey discussion. Pretty interesting. And….disappointing I’d add but that was 4 years ago. Maybe those numbers are changed a bit from then to now? Not sure.

This is a great spot to take a short break to talk about ChiroUp. If you’re a regular listener of our podcast, you I use it and I’ve told everyone how amazing it is since about June of 2018. Well now they’re a sponsor of our show and we are really excited to have ChiroUp on board the train.

Have you heard about the #1 online resource for chiropractors? Well, 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.

I’m trying to save you people some money here alright?Trust me, you’re not going wrong with ChiroUp. In fact, in studying for the Diplomate of the Academy of Chiropractic Orthopedists part two exam, I’m studying the orthopedic tests and videos from the ChiroUp website. It’s phenomenal.

Anyway, on to Item #3

It’s called “Neck proprioception compensates for age-related deterioration of vestibular self-motion perception” by G Schweigart, RD Chien, and T. Mergner. It was published in Experimental Brain Research all the way back in 2002. Bringing the old man out of the archives here. (Schweigart G 2002)

Why They Did It

Vestibular functions are known to show some deterioration with age. Vestibular deterioration is often thought to be compensated for by an increase in neck proprioceptive gain. That’s what the authors were studying here….. this presumed compensatory mechanism.

What They Found

Generally, we hold that the transformation of the vestibular signal from the head down to the trunk proceeds further to include the hip and the legs as well as the haptically perceived body support surface; by this, subjects yield a notion of support kinematics in space.

As a consequence, spatial orientation is impaired by chronic vestibular deterioration only to the extent that the body support is moving in space, while it is unimpaired (determined by proprioception alone) during body motion with respect to a stationary support.

Just to add a little sidebar here: did you know that muscle spindles are our motion detectors? Think about this. There are 16 muscle spindles per gram of muscle in our fingers. Our hands and fingers are highly sensitive with regard to proprioception arent they? Think of a musician playing with their eyes closed.

You know exactly where your fingers are without looking at them or really even thinking about them. How about typing? You don’t look right?

Now, we only have about 2 muscle spindles per gram of muscle in the traps. Which makes sense. Why do we proprioceptively need to know where our traps are? They’re attached to our axial skeleton. They’re not going anywhere. They’re not out flapping in the wind like our hands right?

Here’s the weird deal though: in our deeper cervical muscles, we have 242 muscle spindles per gram of muscle. That IS our axial skeleton basically so why so many spindles? There’s no flapping out in the wind with the upper cervical muscles either. But, it is the connection between our head and the rest of our body.

It is to the point that anatomists look at the upper cervical muscles as more of a proprioceptive organ rather than as simply muscles.

Our three proprioceptive inputs are the eys, the vestibular organ, and the muscles of the upper cervical area. When you do a Romberg’s test and you remove proprioceptive input from the eyes, and the vestibular organ….., part of what you are measuring is the input from the upper cervical region.

It’s fascinating. Absolutely fascinating when you dive off into it a bit and I encourage to do so.

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.

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.

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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 & VloggerBibliography

Corso M, M. S., Batley S, (2019). “The effects of spinal manipulation on performance-related outcomes in healthy asymptomatic adult population: a systematic review of best evidence.” BMC Chiro Man Ther 27(25).

Quon JA (2015). “The Chiropractic Hospital-Based Interventions Research Outcomes Study: Consistency of Outcomes Between Doctors of Chiropractic Treating Patients With Acute Lower Back Pain.” J Man Physiol Ther 38(5): 311-323.

Schweigart G, C. R., Mergner T, (2002). “Neck proprioception compensates for age-related deterioration of vestibular self-motion perception.” Exp Brain Res 147(1): 89-97.

w/ Dr. John Van Tassel – (Part Two) Florida State Athletics, Mentoring, & Life/Work Balance

July 18, 2019 chiropracticforward 00:38:01 0 Comments

CF 083: w/ Dr. John Van Tassel – Florida State Athletics, Mentoring, & Life/Work Balance

Today we’re going to continue talking with our guest, Dr. John Van Tassell. This is part two of our interview so, if you’ve yet to listen to part one, stop now and go back one week and start there. You don’t want to miss the sage-like wisdom of this amazing chiropractic ambassador. You are absolutely going to love listening to Dr. Van Tassel talk about Division I college sports, mentoring, and a good healthy life/work balance.

Before we get going with part two, here’s that Miami Vice-like 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 twisted and shouted your way right into Episode #83. When you have a guest from Florida, you think of gators and snakes. And Pablo Escobar and Miami Vice but we try to not get too under the table here on the Chiropractic Forward Podcast.

Before we hop into the episode, let’s talk about GoChiroTV. GoChiroTV is a patient education system for your office that will eliminate the need for running cable TV or the same DVDs over and over again in your waiting room. The bite-sized videos are specifically made to inform your patients about the importance of chiropractic and healthy living, encourage referrals, and present the benefits of all the different products and services you offer.

It works by using a tailored-fit video playlist that will only promote the products and services available at your practice, and the videos are replaced automatically on a weekly basis. There’s no need to manually update your playlist or learn any complicated software. You truly can set it and forget it.

Listeners of the Chiropractic Forward Podcast can use the promo code CFP19 at checkout to get 15% off all subscriptions, which also comes with a 45-day free trial to see if it’s right for your practice. Your discounted rate will be locked in for as long as you have a subscription.

So visit GoChiroMedia.com (that’s g-o-c-h-i-r-o-m-e-d-i-a-.com) to check out the demo reels, and to get started on your free trial. Take you practice to the next level with GoChiroTV.

Introduction

We’re here to advocate for chiropractic while we also make your life easier using research and some good solid common sense and smart talk.

Go check our evidence-based brochures out at chiropracticforward.com under the store link. While you’re there, sign up for the newsletter won’t you?

How about the previous two episodes we did with Dr. Anthony Nicholson on Chronic pain? That was basically a mini-masterclass folks. I hope you know that. If you know nothing of any substance about chronic pain, the previous two episodes are your starting points.

w/ Dr. Anthony Nicholson – (Part One) Decoding Chronic Pain

You have to listen to me here. Just go listen. Thank me later. He is the Niagara Falls of knowledge nuggets folks.

w/ Dr. Christine Goertz – Chiropractic Research, What Does The Science Say, And Where Are We Going?

In personal happenings, my family experienced some unpleasantness this past weekend. My 7 year old blue European Great Dane passed away. We got the Euro Dane because they are supposed to be heartier than their American Dane counterparts.

They think she developed some sort of tumor that zapped her weight, had her dehydrated, and just unable to walk or do anything. Not cool. It was the opposite of anything fun but, she’s not suffering and that’s the best you can ask for on that sort of deal.

Now on to our special guest today. INTRODUCTION

He is a heck of a communicator. Any discussion I have seen him take part in on the Forward Thinking Chiropractic Alliance Facebook page….he’s the most thorough, most sensible, most sage-like if you will. I’ve even sent him patients all the way from where I sit here in Amarillo, TX.

He’s the Yoda of chiropractors and I love reading his stories. If someone asks him a question, he doesn’t respond with a paragraph. He sits down and really thinks about it, considers it at length, and then responds with about a 5 paragraph guidance manual and I love it.

Not to mention the fact that he’s one of the most accomplished you’ll find in any group anywhere.

All of that is personal experience and fine and dandy but how about we give him an official introduction?

Graduating from Logan College of Chiropractic, Dr. John Van Tassel has been a chiropractor since 1991 and is the owner of Athletic and Family Chiropractic in Tallahassee, Florida.
He has been an adjunct professor at Tallahassee Community College and Florida State University.
He has been the FCA Sports Council Doctor of the Year
The ProSport Chiropractic Doctor of the Year for the Southeast Region
And has been a contributing author in various publications

What really gets one’s attention about Dr. Van Tassel is that he is the team chiropractor for the Florida State Seminoles. A perennial powerhouse of anything athletic in the SEC.

We’re going to talk about all of it and you’re going to be fascinated so here we go.

Let’s welcome to the show, the pride of Tallahassee, Dr. John Van Tassel. Thank you so much for taking the time out of your schedule to be with us today.

Let’s start with a little humor. The first thing I want to know is…..what in the heck is up with Florida? There was even a Facebook game going around for a while where you just Google your birthday and the words “Florida man…” Lol. Are Floridians just inherently crazy?

Tell me….we all have a story that got us where we are. I always like to ask this question because chiropractic is a bit of a niche choice when choosing a career. What was your story toward being a chiropractor?

Now I noticed you’re originally from North Carolina. Why the move to Tallahassee.

We became acquainted either through the evidence based chiropractic group or the forward thinking chiropractic alliance group. I can’t remember which but one of them for sure. They’re great groups. You’ll find people that are bull-headed that it’s their way or they scoff at you but that’s with any group really. Mostly….overall….they’re very friendly, very helpful, and very giving people. Giving of their experience and information as well as giving with their assistance should you need something.

I always encourage anyone that considers themselves on the evidence-informed spectrum of the profession to join both groups. I learn SOMETHING from each of them just about every week.

With that being said, I think you’ll agree that you are one of the more active members of the FTCA. Tell me about how you got involved with the Forward Thinking Chiropractic Alliance and what keeps you coming back daily.

One of the things that obviously sets you apart from the run-of-the-mill chiropractor is your involvement with Florida State. Let’s start at the beginning and just talk about that for a bit. How did you get started with a D-I program? Was it a specific certification that moved you in that direction? What’s it like day to day, month to month, and year to year? And has it morphed through the years?

In our preparation for this episode, you mentioned that you enjoy mentoring younger practitioners. With that in mind, what advice do you feel is vital for someone just starting out trying to open or build their own practice?

Continuing with the mentoring theme, what do you find to be the important aspects of maintaining a healthy work/life balance?

You seem to have a unique ability to recall things. For example, I can’t remember what I had for lunch yesterday but you can recall happenings and conversations from 20 years ago.

I really think, and I believe most of the FTCA members would agree, that you have the best stories and should probably be working on your first book by now.

With that in mind, can you re-tell the one you shared yesterday about the carpal tunnel patient that went to the GP who basically told her you didn’t know what you were talking about?

Now, the reason I asked for that one specifically, is because you’re in an arena where you commonly interact with other practitioners from the medical field. Are you experiencing this sort of bias against chiropractic in that world as well? Why do you think MD’s still don’t understand what it is that we do?

One of my favorite stories of your was about your Wall of Fame down your hallway. I’m sure there are plenty of recognizable names on that but your favorite is Mrs. Jones. Someone nobody outside of your practice and her personal circle would know. Is that a story you would mind sharing with us?

I want to close with this because this may be something that people can really use as the key takeaway from our time together today.

I was reading one of your posts that went like this, “I was just thinking about something while A plumber unclogs my system at the house. I tell people, patients and students and athletes mostly, that desire and passion and determination are key. But it’s our habits that get us where we are going. We accomplish goals by developing habits.”

Now, I don’t know how a plumber brings to mind things like goals and habits but, I couldn’t agree more. What would you say are your core habits that have made the difference in your career?

You have slithered right into Episode #82. When you have a guest from Florida, you think of gators and snakes. And Pablo Escobar and Miami Vice but we try to not get too under the table here on the Chiropractic Forward Podcast.

Before we hop into the episode, let’s talk about GoChiroTV. GoChiroTV is a patient education system for your office that will eliminate the need for running cable TV or the same DVDs over and over again in your waiting room. The bite-sized videos are specifically made to inform your patients about the importance of chiropractic and healthy living, encourage referrals, and present the benefits of all the different products and services you offer.

It works by using a tailored-fit video playlist that will only promote the products and services available at your practice, and the videos are replaced automatically on a weekly basis. There’s no need to manually update your playlist or learn any complicated software. You truly can set it and forget it.

Listeners of the Chiropractic Forward Podcast can use the promo code CFP19 at checkout to get 15% off all subscriptions, which also comes with a 45-day free trial to see if it’s right for your practice. Your discounted rate will be locked in for as long as you have a subscription.

So visit GoChiroMedia.com (that’s g-o-c-h-i-r-o-m-e-d-i-a-.com) to check out the demo reels, and to get started on your free trial. Take you practice to the next level with GoChiroTV.

Introduction

We’re here to advocate for chiropractic while we also make your life easier using research and some good solid common sense and smart talk.

Go check our evidence-based brochures out at chiropracticforward.com under the store link. While you’re there, sign up for the newsletter won’t you?

How about the previous two episodes we did with Dr. Anthony Nicholson on Chronic pain? That was basically a mini-masterclass folks. I hope you know that. If you know nothing of any substance about chronic pain, the previous two episodes are your starting points.

You have to listen to me here. Just go listen. Thank me later. He is the Niagara Falls of knowledge nuggets folks.

In personal happenings, my family experienced some unpleasantness this past weekend. My 7 year old blue European Great Dane passed away. We got the Euro Dane because they are supposed to be heartier than their American Dane counterparts.

They think she developed some sort of tumor that zapped her weight, had her dehydrated, and just unable to walk or do anything. Not cool. It was the opposite of anything fun but, she’s not suffering and that’s the best you can ask for on that sort of deal.

Now on to our special guest today. INTRODUCTION

He is a heck of a communicator. Any discussion I have seen him take part in on the Forward Thinking Chiropractic Alliance Facebook page….he’s the most thorough, most sensible, most sage-like if you will. I’ve even sent him patients all the way from where I sit here in Amarillo, TX.

He’s the Yoda of chiropractors and I love reading his stories. If someone asks him a question, he doesn’t respond with a paragraph. He sits down and really thinks about it, considers it at length, and then responds with about a 5 paragraph guidance manual and I love it.

Not to mention the fact that he’s one of the most accomplished you’ll find in any group anywhere.

All of that is personal experience and fine and dandy but how about we give him an official introduction?

Graduating from Logan College of Chiropractic, Dr. John Van Tassel has been a chiropractor since 1991 and is the owner of Athletic and Family Chiropractic in Tallahassee, Florida.
He has been an adjunct professor at Tallahassee Community College and Florida State University.
He has been the FCA Sports Council Doctor of the Year
The ProSport Chiropractic Doctor of the Year for the Southeast Region
And has been a contributing author in various publications