CF 053: Healthy New Ideas For Physical Activity
Today we’re going to talk about updated guidelines for physical activity as well as some research that the more vitalistic in the profession may not dig too much. Don’t kill the messenger people.
But first, here’s that delicious 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 toppled into Episode #53, the first episode of year #2. I am committing to doing a second year as long as we show continued growth. If we stop growing, I may change my approach at some point but, I absolutely want to do a second year to see where this thing of ours can go.
Let’s talk a bit about the Diplomate of American Chiropractic Orthopedist program also known as the DACO. I’m just keeping you apprised of my progress. At this point, I have 68 online hours down and 40 live hours done. So, I’m 108 hours into the 300 I need.
I have literally knocked out 24 hours online in the last two weeks. That’s a gob of information. It is literally changing how I practice every single week. It’s almost indescribable but, I see patients coming in every day now that have something I would have missed without having gone this far into the DACO.
The more recent classes I’ve been through include plantar heel pain, Diagnosing idiopathic scoliosis and assessing the risk of progression, anterior knee pain in an adolescent, lateral knee pain and th IT band, as well as recognizing meniscus tears and essential of reading knee MRIs.
I honestly wonder how on Earth I’ve gotten anyone well over my 20 years in practice without the knowledge that I’m gaining here. In the end, I guess doing SOMETHING is always going to trump doing nothing and, it’s not like I’ve been a dummy for 20 years.
I’ve always been a big proponent of continuing education and have consistently gotten 30-50 CEs every year rather than the 16 required so, I’m not going to beat myself up over it but, sincerely here, this information you get in the DACO program is beyond anything I’ve gotten in any seminar anywhere.
Now, with that being said, I haven’t been to one of McGill’s or Liebenson’s talks so I need to make that clear. By the way, both of those giants will be at Parker Vegas in February if you are ready for some learning of the highest caliber.
Right now, while you’re thinking about it, go to chiropracticforward.com and sign up for the weekly newsletter. It’s just once per week, it’s easy and fast and I’m in the process of making some pretty cool stuff that I think can be useful in helping you in practice.
When it’s ready to roll out, you’ll save because you were cool enough to be on the list, cool enough to be an early adopter, and cool enough to basically be a founder of what we’re trying to build here. I’ve never believed that I can build it by myself. It has to be a team of like-minded, motivated individuals.
If you are evidence-based I’d love to have you on the team. Reach out and let’s talk about what we can do to build build build.
Meat n’ Taters
Alright, onto the meat n taters today. Let’s start with this paper that just came out in the Journal of the American Medical Association. It’s authored by Dr. Katrina Piercy et. al. and is called The Physical Activity Guidelines for Americans. It was published on November 20, 2018. It doesn’t get a whole lot more recent than that does it?
The 2018 Physical Activity Guidelines Advisory Committee conducted a systematic review of the science supporting physical activity and health. They came up with recommendations strictly based on evidence graded as strong or moderate.
Here’s what they decided:
- Preschool-aged children from 3-5 need to be active throughout the day
- Children and adolescents from 6-17 should do 60 minutes or more of moderate to vigorous activity daily.
- Adults should do at least 2 1/2 hrs to 5 hrs per week of moderate intensity, or 1 hr 15 minutes to 2.5 hours per week of vigorous aerobic activity, or an equivalent combination of the two.
- Adults should also do muscle-strengthening activity on 2 or more days per week.
- Older adults need a multicomponent physical activity that includes balance training as well as aerobic and muscle-strengthening.
- Pregnant and postpartum females need at least 2.5 hrs of moderate activity a week.
- Basically moving more and sitting less will benefit nearly everyone.
See? And you didn’t even need a trainer to figure it out. You’re welcome. You are so welcome, folks. It’s what I do. I give give give.
Let’s move on to a paper that was in Spine Journal in November 2018 called Walking more than 90 minutes/week was associated with a lower risk of self-reported low back pain in persons over 50 years of age: A cross-cross-sectional study using the Korean National Health and Nutrition Examination Surveys.
Again, very new stuff. Only a month or so old.
They did this one because, while strengthening and aerobic exercise is well-documented and well-founded, there isn’t a lot of information on walking and it effects for low back pain.
This was a cross-sectional study which means they looked at people differing on one specific characteristic at one specific point in time. The data they collected was from the Korea National Health and Nutrition Examination Surveys from 2010-2015.
What They Found
The authors wrapped it up by saying, “Our study showed that longer walking duration was associated with a lower risk of LBP. Regular walking with a longer duration for more than 3 days/week is significantly associated with a lower risk of LBP in the general population aged over 50 years.”
I wanted to discuss a pretty neat article I came across last week from the Smithsonian. This article is called British Doctors May Soon Prescribe Art, Music, Dance, Singing Lessons and it was written by Meilan Solly published November 8, 2018. Yet again….the newest stuff here this week.
The article discusses a new initiative on the part of British Health Secretary Matt Hancock and they’re wanting to allow the country’s doctors to prescribe art or hobby based treatment for all sorts of issues. From dementia and psychosis to lung complaints and mental health complications.
They’re calling it “social prescriptions” and I have to say that I’m a big fan of the idea. For instance, just listening to Otis Redding sing Sittin’ On The Dock of the Bay does something good to me inside and out. One of my all time favorites and you all clearly have good taste because you’re listening to our little podcast here so I’m sure it’s one of your favorites too. If it’s not one of your favorites then you clearly haven’t listened to it yet.
The health secretary has an excellent quote here when he says, “We’ve been fostering a culture that’s popping pills and Prozac when what we should be doing is more prevention and perspiration.” “Social prescribing can help us combat over-medicalizing people.”
And the heavens opened up and all God’s people said, “Amen.”
The only problem I have with the idea is that they’re not looking at having it up and running until 2023. Which, honestly, isn’t as far away as it once seemed is it?
Still, you’d think they have that rocking and rolling quicker but look who’s griping? We’re still here in America where our medical profession is still trying to figure out how to get more people on medication and into surgery rather than think out of the box just a tad for a second or two.
But, back to the point, I think it’s an amazing idea. Music, singing, creating art, and experiencing art in whatever form possible is good for the body and soul. Not one or the other but all of it. Every inch. Laughing too. Laughing is so good for you.
Richard Pryor, Rodney Dangerfield, and Eddie Murphy for children of the 80’s such as myself. Dane Cook and Kevin Hart for the 2000’s kids. Laughing your butt off fixes a lot of stuff.
‘Principled’ May Not Be So Principled
And to our last paper by Guillaume Goncalves, et. al. published in Biomed Central on April 5, 2018 called “Effect of chiropractic treatment on primary or early secondary prevention: a systematic review with a pedagogic approach.”
The authors start out by saying that the chiropractic vitalistic approach to the concept of ‘subluxation’ as a cause of disease lacks any validity nevertheless, some in our profession still claim to prevent disease in general through continuous chiropractic care.
Don’t send me crappy emails. That’s what the authors said here.
They go on to say that, if some are going to continue with this model of practice, there must be evidence that it is effective and that’s the reason for the research here.
How They Did It
They searched PubMed, Embase, Index to Chiropractic Literature, and some specialized chiropractic journals, from inception to October 2017.
They scrutinized 13 articles. 8 were clinical studies and 5 were population studies
They dealt with various disorders of public health importance like blood pressure, blood test immunological markers, and mortality.
Wrap It Up
The authors concluded the paper by saying, “We found no evidence in the literature of an effect of chiropractic treatment in the scope of primary prevention or early secondary prevention for disease in general. Chiropractors have to assume their role as evidence-based clinicians and the leaders of the profession must accept that it is harmful to the profession to imply a public health importance in relation to the prevention of such diseases through manipulative therapy/chiropractic treatment.”
Now look, don’t kill the messenger. I know that some of you are just going to do what you want to do and what you believe no matter what is thrown in front of you. I know that. Honestly, those people probably aren’t listening to an evidence-based podcast to start with because we won’t confirm that bias. We’ll challenge it from time to time.
People don’t typically like that. In fact, they may attack those that challenge their bias.
The information is more useful to confirm the bias of evidence-based chiropractors and to further educate those that are being fed information to the contrary whether it’s by friends or even at school.
Regardless, for every chiropractor and patient, it’s food for thought.
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.
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.
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:
Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger
1. Piercy K, T.R., Ballard R,, The Physical Activity Guidelines for Americans. JAMA, 2018. 320(19): p. 2020-2028.
2. Park SM, Walking more than 90 minutes/week was associated with a lower risk of self-reported low back pain in persons over 50 years of age: A cross-sectional study using the Korean National Health and Nutrition Examination Surveys. Spine J, 2018. 18: p. S1529.
3. Meilan Solly, British Doctors May Soon Prescribe Art, Music, Dance, Singing Lessons. Smithsonian.com, 2018.
4. Gonclaves G, Effect of chiropractic treatment on primary or early secondary prevention: a systematic review with a pedagogic approach. BMC Chiro Man Ther, 2018. 26(10).