Cervical Curvature & Lumbar MRI Findings In Asymptomatics – New Stuff

CF 259: Cervical Curvature & Lumbar MRI Findings In Asymptomatics – New Stuff Today we’re going to talk about Cervical Curvature & Lumbar MRI Findings In Asymptomatics – New Stuff 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, look down your nose at people 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.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, drive, smart, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com 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 excellent educational resource for you AND your patients. It saves you time putting talks together or just staying current on research. It’s categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 
  • Then go Like our Chiropractic Forward Facebook page, 
  • Join our private Chiropractic Forward Facebook group, and then 
  • Review our podcast on whatever platform you’re listening to 
  • Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com
You have found yourself smack dab in the middle of Episode #259 Now if you missed last week’s episode , we were joined by Dr. Anthony Houssain and had an amazing discussion on how to choose a good practice location, on the clinic/gym hybrid model, and one why masterminds are so important for you growth. Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. First thing, if you haven’t had enough of my podcast, or you just want to hear my thoughts in a different context and setting, Dr. Jay Greenstein and Brad Cost interviewed me for their podcast called TechTalk and we had a great chat about life, practice, and all things in between. Go check it out. It aired just a week or two ago so it’s one of their newest episodes.  So, if you’ve been listening lately, you know I’ve been in a slump. I’m not a slump type of guy. I don’t know what ‘take a step back’ even looks like. It’s not in my vocabulary. All I know is progress, growth, win, win, win. I’m an old college football player and won state here in Texas in the discus. Competition, initiative, and growth are engrained in the very fabric of my being.  It’s just how I’m built.  So, being slower here in the clinic this year has been challenging for me. A bit financially but also big time mentally. I don’t have mental health issues. That’s now what we’re talking about. Mentally as far as trying to figure it out. Putting the puzzle together so that I can fix it and get back to growing.  Part of that has been fixing my outlook day to day. Embracing the suck. Meaning, when I show up on a Monday morning and there’s 48 on the schedule and there are 5 in the lobby before we even open…..instead of being defeated before I even get into my office space, my personal area, instead of being defeated, I need to embrace the stress and anxiety, thank God for our blessings, and get to work making people feel better.  So, I wanted to fix that first. Then, what else could be the issue. Well, I used to be #1 on the google search. For years I was the top one because nobody else had figured out the importance at that time so I had a step ahead.  But, an internet company I was with screwed up my site, Google changed their algorithms, and boom, I started dropping. So I switched companies. They set up a great site but no real SEO. So I started blogging every single week. New, fresh, completely original content. Guess what, no help at all. Not even a little. I was falling like a rock.  So I think website SEO is a big issue so I’m addressing that now too. You all know I’m in the Florida Mastermind with Dr. Kevin Christie. Well Kevin works with Darcy Sullivan of Propel. So, I contacted Darcy and she’s taking me on as a client and a big project I can only assume. Lol.  I’m going to be talking every week or so about my experience so you’ll know how it’s going in real time and we’ll be able to see where I started and where I end up with Darcy’s help. It’ll be a learning project we’ll do together.  Stick with me for the next 4-6 months on the website SEO thing because this should be interesting. If all works out well, you may be contacting Darcy and Propel as well. Time will tell.  Alright, let’s get to the research shall we? Item #1 Our first on his called, “Lumbar spine MRI findings in asymptomatic elite male academy footballers: a case series: by Carmody et. Al. (Carmody S 2022) and published in BMC Sports Science Medical Rehabilitation on October 24th, 2022 and that’s brand new and it’s hot too! Why They Did It
  • Understanding common MRI findings may allow clinicians to appreciate the sport-specific effects on the lumbar spine, and to discern clinically significant pathology. 
  • Prevalence data regarding radiological abnormalities seen during the surveillance of asymptomatic elite footballers is, therefore, important to help understand injury mechanisms and to prevent associated injuries. 
  • The purpose of this study was to evaluate the magnetic resonance imaging (MRI) findings in the lumbar spines of asymptomatic elite male adolescent footballers.
How They Did It
  • A prospective case-series study was carried out. 
  • MRI was performed in 18 asymptomatic male elite adolescent footballers recruited from a professional academy in England 
  • The images were independently reported by two consultant musculoskeletal radiologists to achieve consensus opinion. 
What They Found
  • Fifteen players (83%) showed one or more abnormalities, that included facet degeneration, synovial cysts, disc degeneration, disc herniation, and pars injury. 
  • One player had mild (Grade 1) facet joint arthropathy at L4/L5
  • 3/18 showed evidence of bilateral facet joint effusions. 
  • Three synovial cysts were identified in 2 players, 
  • 4 presented asymptomatic pars injuries, 
  • 4 had a grade 2 subtotal stress fracture and 
  • 1 player had a grade 4 chronic stress fracture 
  • Disc degeneration at one or more levels was demonstrated in 7 fo the 18. 
  • Disc herniation was present in 5 or 27% of the players.
Wrap It Up A range of unsuspected findings on MRI of the lumbar spine are common in elite adolescent footballers. Folks, all of those scary words used to send my patients straight to a surgeon for a second evaluation. Now I know better. These are all asymptomatic. No clinical issue whatsoever and these players ranged from 17 years old to almost 19 years old.  No pain and almost 30% of them had disc herniations. We can manage these cases. If there is no progressive neurological deficit with regard to bowel and bladder function, DTRs, dermatomes, or motor function, why are you sending them anywhere? Don’t do it. Pain is not a reason for surgery and we can manage them if you are educated and know what to do. If you do not know, get smart and get educated. Good starting points are:
  • Stu McGill’s book called Back Mechanic
  • Craig Liebensen
  • McKenzie Certifications
  • FMS/SFMA
  • DNS
  • Donal Murphy’s Spine Practitioner program and his CRISP Protocol books. 
Just that group of stuff right there will put you heads and shoulders beyond what the majority of your colleagues and yes…competitors are able to do. You immediately differentiate yourself and then you lengthen the road between yourself and the others more and more with each cert you get. Then look at Diplomates to solidify a canyon between yourself and the rest.  Stop sitting on your ass if you don’t know anything about this stuff. Get on it and make this profession what it should be.  Bam. Pow. Smack. Kachunga, Slap! Wowza! Tough talk and tough love. But hopefully motivating works from you Ol’ Uncle Jeffro. You’re welcome.  Before getting to the next one, Next thing, go to https://www.tecnobody.com/en/products That’s Tecnobody as in T-E-C-nobody. They literally have the most impressive clinical equipment I’ve ever seen. I own the ISO Free and am looking to add more to my office this year or next. The equipment you’re going to find over there can be marketed in your community like crazy because you’ll be the only one with something that damn cool in your office.  When you decide you can’t live without those products, send me an email and I’ll give you the hookup. They will 100% differentiate your clinic from your competitors. I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! Use the code HOTSTUFF upon purchase at droprelease.com & get $50 off your purchase. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. I love it, my patients love it, and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it. Item #2 Our next one is called, “Does Improvement towards a Normal Cervical Sagittal Configuration Aid in the Management of Lumbosacral Radiculopathy: A Randomized Controlled Trial” by Moustafa et. al. (Moustafa IM 2022)published in Journal of Clinical Medicine on September 29, 2022 and that’s a hot tamale with jalapeños atop of it.  And as a side note, I’m still trying to figure out how I got stuck with a boring name like Williams while you got guys walking the Earth with the last name Moustafa. It’s just not fair.  Why They Did It
  • to investigate the effects of sagittal head posture correction on 3D spinal posture parameters, back and leg pain, disability, and S1 nerve root function in patients with chronic discogenic lumbosacral radiculopathy
How They Did It
  • A randomized controlled study with a six-month follow-up
  • 80 (35 female) patients between 40 and 55 years experiencing chronic discogenic lumbosacral radiculopathy with a definite hypolordotic cervical spine and forward head posture (FHP) and were randomly assigned a comparative treatment control group and a study group
  • Both groups received TENS therapy and hot packs, additionally, the study group received the Denneroll cervical traction orthotic.
  • Interventions were applied at a frequency of 3 x per week for 10 weeks and groups were followed for an additional 6-months. 
  • Radiographic measures included cervical lordosis (CL) from C2-C7 and FHP; postural measurements included: lumbar lordosis, thoracic kyphosis, trunk inclination, lateral deviation, trunk imbalance, surface rotation, and pelvic inclination.
  • Leg and back pain scores, Oswestry Disability Index (ODI), and H-reflex latency and amplitude were measured
What They Found
  • Statistically significant differences between the groups at 10 weeks were found: for all postural measures, 
  • No significant difference for back pain, leg pain and ODI at 10 weeks were identified. 
  • Only the study group’s improvements were maintained at the 6-month follow up while the control groups values regressed back to baseline. 
  • At the 6-month follow-up, it was identified in the study group that improved cervical lordosis and reduction of FHP were found to have a positive impact on 3D posture parameters, leg and back pain scores, ODI, and H-reflex latency and amplitude.
OK….a dude who sells the Denneroll did this paper. It’s funny how other researchers find no big deal when it comes to the cervical curve. However, literally ALL of this guy’s ‘papers’ somehow make a big deal out of C-sp decreased curvature. Hinky, huh? It’s so odd.  It’s like Firestone doing research and finding out how amazing their tires are.  Hey everyone….McDonald’s did a research project and they found out how yummy their food is!! Yay McDonald’s you’re so amazing and thank you for doing your own research on your own company for the rest of us dumbasses. Thank you for being so awesome and kind.  Blah.  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. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. 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!

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 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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Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter 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 (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger  Bibliography Carmody S, R. G., Mitchell A, Kryger KO, Ahmad I, Gill M, Rushton A, (2022). “Lumbar spine MRI findings in asymptomatic elite male academy footballers: a case series.” BMC Sports Sci Med Rehabil 14(1): 184.   Moustafa IM, D. A., Harrison DE (2022). “Does Improvement towards a Normal Cervical Sagittal Configuration Aid in the Management of Lumbosacral Radiculopathy: A Randomized Controlled Trial.” J Clin Med 11(19): 5768.      

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