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.
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.
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.
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 firstname.lastname@example.org 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.
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)
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.
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.
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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.
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.
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 email@example.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.
I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment instead of chemical treatments like pills and shots.
When compared to the traditional medical model, research and clinical experience show that many patients get good or excellent results through chiropractic for headaches, neck pain, back pain, joint pain, to name just a few.
Chiropractic care is safe and cost-effective. It can decrease instances of surgery & disability. Chiropractors normally do this through conservative, non-surgical means with minimal time requirements or hassle to the patient.
And, if the patient develops a “preventative” mindset going forward from initial recovery, chiropractors can likely keep it that way while raising the general, overall level of health of the patient!
Patients should have the guarantee of having the best treatment offering the least harm.
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 & 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.