physical activity

Postoperative Acupuncture & Activity And Depression

CF 268: Postoperative Acupuncture & Activity And Depression

Today we’re going to talk about Postoperative Acupuncture & Activity And Depression

But first, heres 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!

Chiropractic evidence-based products

Integrating Chiropractors

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  OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, 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 com

  You have found yourself smack dab in the middle of Episode #268   Now if you missed last week’s episode, we talked about Pain Reprocessing Therapy & Meditation-Based Therapy For Chronic Pain.  Make sure you don’t miss that info. Keep up with the class.  

On the personal end of things…..

Things are steadily picking back up here at Jeff Central. One of our new hires is having a Zoom meeting with our social media crew from the UK this week to get their heads together on TikTok stuff, YouTube ads, and all of that fun stuff.   Some of the older guys will fondly remember the days when all you had to do was place an ad in the YellowPages, an ad in the town newspaper, and if you were really fancy, an ad on the radio. Then join Lion’s Club or the Rotary Club. From there…..you were pretty good to go. No other effort really required.  

Not only that but reimbursements were better, co-pays cheaper, deductibles less, and premiums cheaper. It’s just dumb to be a healthcare provider these days when you think about it sometimes. You damn well better be in it for the right reasons. That’s for sure. If it’s all about the money, you’re in the wrong place, pal.   Now, we have social media, podcasts, content marketing, website SEO, keywords, Google ranking, and all of the other BS that comes along with it. It’s a bunch of crap. But, it’s a bunch of necessary crap if you want to compete and build a business in 2023. Damnit.  

Those that have better systems and better people helping them with it all are just naturally going to do better. I’ve tried doing it myself for years. I’m an early adopter. But, it’s gotten too difficult. I’m trying to gather a team of helpers because, honestly, my practice can be so much larger with the right team in place.   We’re working on it. Stay tuned. And, in the meantime, if you know of an associate that wants to come to Amarillo and is certified in acupuncture, or can be, send them my email and tell them to get hold of Ol’ Uncle Jeffro at creekstonecare@gmail.com      

Item #1 Speaking of acupuncture.  

The first one today is called, “Wrist–Ankle Acupuncture as Additional Therapy for Postoperative Multimodal Analgesia in Orthopedic Surgery: Systematic Review and Meta-Analysis” by Ning Xu and published in Pain Medicine on 28 April 2022. Dayum. That’s hot.    

Why They Did It   The present meta-analysis analyzed the efficacy and safety of wrist–ankle acupuncture (WAA) as an additional therapy for postoperative multimodal analgesia after orthopedic surgery.    

How They Did It  

  • Electronic databases, including Cochrane Library, PubMed, EMBASE, Web of Science, CNKI, SinoMed, Wanfang, and VIP, were searched to identify randomized controlled trials and cohort studies that reported details of WAA as an additional therapy for postoperative multiple analgesia in orthopedic surgery before October 1, 2021.

 

  • Analyzed outcomes included time points of the visual analog scale, use of patient-controlled intravenous analgesia (PCIA), and postoperative adverse events. Subgroup analysis was performed according to time points and complication type.

 

What They Found  

  • Eleven randomized controlled trials and one cohort study were included in the meta-analysis. Among a total of 845 patients, there were 422 patients in the wrist–ankle acupuncture groups and 423 patients in the control groups.

 

  • The wrist–ankle acupuncture groups showed a better analgesic effect, lower use of patient-controlled intravenous analgesia, and lower occurrence of postoperative adverse events than did the control groups.

 

Wrap It Up   Wrist–ankle acupuncture as an additional therapy for postoperative multimodal analgesia in orthopedic surgery showed advantages over control treatment in terms of pain relief, use of patient-controlled intravenous analgesia, and occurrence of postoperative adverse events.    

Item #2   Our last one this week is called, “Association Between Physical Activity and Risk of Depression” by Matthew Pearce, PhD and published in JAMA Psychiatry on April 13, 2022. Hot potato!    

Why They Did It   To systematically review and meta-analyze the dose-response association between physical activity and incident depression from published prospective studies of adults.  

How They Did It  

  • They used information from PubMed, SCOPUS, Web of Science, PsycINFO, and the reference lists of systematic reviews retrieved by a systematic search up to December 11, 2020, with no language limits. The date of the search was November 12, 2020.

 

  • They included prospective cohort studies reporting physical activity at 3 or more exposure levels and risk estimates for depression with 3000 or more adults and 3 years or longer of follow-up.

 

  • Data extraction was completed independently by 2 extractors and cross-checked for errors. A 2-stage random-effects dose-response meta-analysis was used to synthesize data. Study-specific associations were estimated using generalized least-squares regression and the pooled association was estimated by combining the study-specific coefficients using restricted maximum likelihood.

 

What They Found  

This systematic review and meta-analysis of 15 prospective studies including more than 2 million person-years showed an inverse curvilinear association between physical activity and incident depression, with greater differences in risk at lower exposure levels. Adults meeting physical activity recommendations (equivalent to 2.5 h/wk of brisk walking) had lower risk of depression, compared with adults reporting no physical activity.    

Wrap It Up   This systematic review and meta-analysis of associations between physical activity and depression suggests significant mental health benefits from being physically active, even at levels below the public health recommendations. Health practitioners should therefore encourage any increase in physical activity to improve mental health.     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 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 (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  

  • Ning Xu, M., Lu-lu Liu, BN, Wei Rong, MD (2022). “Wrist–Ankle Acupuncture as Additional Therapy for Postoperative Multimodal Analgesia in Orthopedic Surgery: Systematic Review and Meta-Analysis.” Pain Medicine 23(10): 1654-1669.
  • Pearce M, G. L., Abbas A, (2022). “Association Between Physical Activity and Risk of Depression: A Systematic Review and Meta-analysis.” JAMA Psychiatry.

 

Vertebrogenic Pain – A Thought Shift & Leisure Time Physical Activity Effects On Mortality

CF 249: Vertebrogenic Pain – A Thought Shift & Leisure time Physical Activity Effects On Mortality Today we’re going to talk about Vertebrogenic Pain. Time for A Thought Shift & Leisure time Physical Activity Effects On Mortality 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!

Chiropractic evidence-based products

Integrating Chiropractors

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OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, 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.   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 #249 Now if you missed last week’s episode , we talked about steps per day and how that’s related to dementia and we talked about vets and chiropractic. What a wonderful combination.  Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

Ugh, slow Monday man. I hate it and it give me anxiety but I’m using the extra time to make things happen, my friends. Yes indeed. This is being written on September 19th so we are still in the middle of the yearly back to school slowdown.  When back to school gets us down, what’s the best way to handle it? Frist, as I’ve mentioned in recent podcasts, you get stuff done! Start through all of the things that have been piling up. Get that stack knocked out.  Secondly, marketing wise, what has been successful for you in the past? Have you slowed down on your posting frequency on social media? Pick it up and get to posting. Has it been any community outreach or direct marketing?

Time to re-engage, right? Thirdly, settle the hell down. You didn’t pee on the mayor’s dog and the whole town is not mad at you. Or me. I think this is me talking to me by the way. Lol.  Marketing is the most effective thing we can do for our clinic so we are spending this time calling and checking on patients that are more recent but have not really kept up with their schedule. Not in a bully or harrassing kind of way but a ‘staying top of mind’ kind of way and showing concern.  What are the big things that speak to people? For me and my practice specifically, I think it can be boiled down to 10 things. 

  1. No long waits
  2. Evaluation and treatment on the same day
  3. New patient appointments within 48 hours
  4. They will know the cost before their visit – at least as close as we can get to the cost
  5. Not everyone gets x-rays
  6. No pills and no surgery
  7. Online scheduling
  8. No long treatment plans
  9. Treatment by a Board Certified Orthopedic specialist
  10. Fast and efficient first appointment

These go for our medical side as well as for our chiropractic side. I think hammering these points consistently is an effective strategy. And, they aren’t talking points. It’s how we do things.  Here’s another thing I’ll share with myy patients when appropriate; when I have a difficult decision to make as far as recommendations or treatment, I fall back on one principle. That principle is ‘what would I do with this person if this person were an immediate family member?’ That is a guiding principle that will get you the closest to every right answer out there that you can make.  Alright, that’s enough of the personal side of things. Let’s get to the meat and taters. 

Item #1

The first one is called “Vertebrogenic Pain: A Paradigm Shift in Diagnosis and Treatment of Axial Low Back Pain” by Conger et. al. (Aaron Conger 2022) and published in Pain Medicine on July 20, 2022. Hot sauce coming up!

  • Clinicians and researchers have long recognized that better subgrouping of individuals with CLBP is necessary for more targeted and effective treatments. Commonly described sources of CLBP include the zygapophyseal joints, sacroiliac joints, and intervertebral discs (often termed “discogenic” pain)
  • Historically, the term “discogenic pain” has been associated with disc degeneration and internal disc disruption with the presence of fissures in the annulus fibrosus and associated nociception via branches of the sinuvertebral nerve 
  • Previously, it was thought that pathological neurovascular ingrowth penetrated into annular fissures, leading to increased sensitivity and nociception via the sinuvertebral nerve
  • However, more recent evidence appears to refute the occurrence of such neurovascular ingrowth in many cases
  • In the late 1990s, a team of researchers led by Dr. Heggeness reported that vertebral bodies were richly vascularized by vertebral capillaries and innervated by nociceptors that traced back to a single source, the basivertebral nerve. Basivertebral nerve. Let’s call it the BVN, please and thank you. 
  • It’s a branch of the sinuvertebral nerve and it densely innervates the endplates. 
  • With progressive segmental degeneration or acute injury, altered force transfer and endplate stress can result in changes to endplate morphology and composition with concomitant impairment in permeability and transport 
  • Vertebral bodies demonstrated endplate nociceptor densification in areas of damage that were associated with increased disc degeneration. 
  • They also found that only 30% of annular tears in degenerated discs had pathologic neural ingrowth, compared with 90% of adjacent endplates (which were twice as densely innervated) 
  • This distinction between annular and endplate innervation is likely due to differences in nerve ingrowth potential. For the annulus, nerve ingrowth is inhibited by physical pressure and proteoglycans whereas nerves can easily proliferate in fibrovascular bone marrow adjacent to sites of endplate damage 
  • Accumulated damage to the discovertebral complex may result in chemical and mechanical sensitization of endplate nocioceptors 
  • These histopathological findings led to exploration of an “endplate-driven” model of discovertebral pain, with nociception largely occurring via the BVN to a greater extent than the sinuvertebral nerve
  • This research supports an “endplate-driven” model of anterior column degeneration and existence of a fourth distinct structural source of low back pain, popularly termed vertebrogenic pain

The rest of the article goes on to talk about the research and the benefits of BVN nerve ablation. Of course, that’s not where our minds go immediately when we’re looking at a disc issue, endplate or annular.  We’re looking at movement, functionality, and things of that nature.

But, I thought it was interesting because I have been taught over the years, even more recent years, that when an annulus cracks, it’s easier to become painful again because the nerves grow into that fissure and are deep toward the nucleus pulposus upon healing than they were prior to injury.  So, for that reason, we have assumed that’s why the biggest predictor of future pain is the presence of prior back pain. This updated information seems to, for the most part refute that information. And I’m OK with that. I love new knowledge.

I love updating my education and staying on top of the cutting edge when I’m able to. 

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

The last one this week is called, “Association of Leisure Time Physical Activity Types and Risks of All-Cause, Cardiovascular, and Cancer Mortality Among Older Adults” by Watts et. al. (Watts EL 2022) and published in JaMA Network Open on August 24th 2022. That’s slapy ya mama hot!

Why They Did It

  • Higher amounts of physical activity are associated with increased longevity. However, whether different leisure time physical activity types are differentially associated with mortality risk is not established.. 
  • They wanted to answer the question, “Are different types of leisure time physical activity differentially associated with mortality risks among older adults?”

How They Did It

NIH Cohort study of 272 550 older adults

What They Found A total of 272,550 participants age at baseline, 70.5 years provided information on types of leisure time activity, and 118,153 died during follow-up of 12.4 years. 

  • In comparison with those who did not participate, 7.5 to less than 15 metabolic equivalent of task hours per week of racquet sports and running were associated with the greatest relative risk reductions for all-cause mortality, 
  • Followed by walking for exercise, 
  • other aerobic activity 
  • golf 
  • swimming
  • and cycling 

Each activity showed a curvilinear dose-response association with mortality risk; low metabolic equivalent of task hours per week of physical activity for any given activity type were associated with a large reduction in mortality risk, with diminishing returns for each increment in activity thereafter.  Associations were similar for cardiovascular and cancer mortality.

Wrap It Up

This cohort study of older individuals found differences between different types of leisure time activities and mortality risk, but there were significant associations between participating in 7.5 to less than 15 metabolic equivalent of task hours per week of any activity and mortality risk. There you have it go jump into some tennis, racquet ball, or pickle ball and then go for a run. You future self with thank your current self.  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 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 (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

Aaron Conger, D., Matthew Smuck, MD, Eeric Truumees, MD, Jeffrey C Lotz, PhD, Michael J DePalma, MD, Zachary L McCormick, MD, (2022). “Vertebrogenic Pain: A Paradigm Shift in Diagnosis and Treatment of Axial Low Back Pain.” Vertebrogenic Pain: A Paradigm Shift in Diagnosis and Treatment of Axial Low Back Pain 23: S63-S71.  

Watts EL, M. C., Freeman JR, (2022). “Association of Leisure Time Physical Activity Types and Risks of All-Cause, Cardiovascular, and Cancer Mortality Among Older Adults.” JAMA Netw Open 5(8). s

Thoracic Adjustments For Neck, Not Headache & Physical Activity In Children

CF 229: Thoracic Adjustments For Neck, Not Headache & Physical Activity In Children Today we’re going to talk about T-sp Adjustments For Neck, Not Headache & Physical Activity In Children 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!

Chiropractic evidence-based products

Integrating Chiropractors

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This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg

This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg

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 a great resource for patient education and for YOU. It saves you time in putting talks together or just staying current on research. It’s categorized into sections and written in a way that is easy to understand for you and patients. 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 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 #229 Now if you missed last week’s episode , we talked about Exercise For Depression & Manipulation For Tendinopathy. Make sure you don’t miss that info. Keep up with the class. 

 

On the personal end of things…..

I’ll be honest with you all…..I always am anyway…..I feel like I’m as busy as I’ve ever been but when I look at the numbers, they’re down a bit still. I’m not fully recovered to the numbers that we saw prior to the pandemic setting in in 2020. I know many of you are. I’m not yet. I’m not far off. But I’m not there dependably month after month yet.  As a result of my involvement in Dr. Kevin Christie’s Florida Mastermind that you’ve heard me mention, and at Kevin’s suggestion, I read a book called Who Not How by Dan Sullivan and Ben Hardy. I highly suggest it. This book is telling us to quit looking for how you do things and start looking for WHO can help you accomplish your goal.  This isn’t really a new concept but really sheds some light on the topic.

We need a team. We need helpers. We cannot ever hope to do it all ourselves and do it a high level. To start looking at bringing on team members as investments rather than costs.  It’s eye-opening for sure. Give it a try and see what you think. As a result, I’m looking for Whos. I have some Whos already. I make good use of virtual assisstants. I have one in Pakistan, one in Nigeria, and one in India.

They help me with marketing voice over, with my Chiropractic Forward website, with a website I’m trying to build for another business, and with stat keeping and monthly balancing and close outs in my chiro business.  But I’m still doing a lot of tasks weekly that can be farmed out to a Who. What daily and weekly worker bee tasks are you doing yourself that can be farmed out while investing in a new Who? My biggest one is an associate. I’m on the hunt. If you or someone you know is interested in interviewing with me for a potential position here in my clinic, I’d love to speak with you.

The Texas Panhandle has pros and cons like everywhere else but I will say that one of our biggest draws is our incredible people. We are kind, friendly, and helpful. That, and hey, we have the second largest canyon in the nation called Palo Duro Canyon. It’ll knock your socks and your shoes off.  Anyway, send me an email at creekstonecare@gmail.com if you’re intersted and we’ll connect. 

Before we get to the research, I recently connected with a personal injury attorney and as a result, I have a gift for you!  I’m going to turn you on to a system that will result in your getting tons of PI cases from attorneys.   Yes, getting these referrals can be done. Paul Samakow, a veteran PI attorney, put this system together.  He knows what attorneys want to hear – inviting them to lunch doesn’t work, folks.   His system, delivered to you in both written and video form, is insightful and hits the mark. 

Over 25 concepts on how you can not only get attorneys to refer to you, but endear yourself to them. Samakow’s system costs $997 and he guarantees satisfaction or your money back. You have to check this out.  Even if you only get one case, you’ve made at least 4 or 5 times the investment. Go to gettingpicases.com/cs That’s gettingpicases.com/cs One more time so you get it right:   gettingpicases.com/cs

Item #1

The first one today is called, Thoracic spine thrust manipulation for individuals with cervicogenic headache: a crossover randomized clinical trial by McDevitt et. al. (Amy W. McDevitt 2022) and published in the Journal of Manual and Manipulative Therapy July of 2021. Shazam….it’s steamy. 

Why They Did It

To determine if thoracic spine manipulation (TSM) improves pain and disability in individuals with cervicogenic headache (CeH). Now, let’s take a step back just a bit and I’ll share some knowledge from the Neuromusculoskeletal Diplomate program about where Cervicogenic headaches lie in terms of prevalence.  Tension-type headaches are the overwhelming winners.

They make up about 40% or more of the headaches that present to just about any clinic.  Second place goes to migraines. True migraines make up only about 10%. Not nearly as much as you might expect. Since Tension type and migraine live on the same continuum of headaches, they can share some characteristics of each other so, many times, a tension type can behave like a migraine and vice versa.  True migraines, however, are only about 10% of cases.  Then comes cervicgenic headaches at only about 4% of the cases of headaches you see in clinic.  The good news is that tension type and cervicogenic are the ones we really have a lot of success with since they typically come from the suboccipital and/or neck region and that’s our bread and cinnamon butter, baby. That’s hero territory right there because we can turn someone’s life around muy pronto, mi amigo. 

How They Did It

  • It was a randomized controlled crossover trial 
  • It was conducted on 48 participants with cervicogenic symptoms. 
  • Participants were randomized to 6 sessions of thoracic spine manipulation or no treatment and after 4-weeks, groups crossed over. 
  • Outcomes were collected at 4, 8 and 12 weeks and included: headache disability inventory (HDI), neck disability index (NDI), and the global rating of change (GRC). 

What They Found

  • Comparing no-treatment group to the active treatment group, the Headache Disability Index outcomes were not significantly different between groups at any timepoint; 
  • The Neck Disability Index outcome, however, was significant at 4 weeks.

Wrap It Up

Thoracic spine manipulation had no effect on headache-related disability but resulted in significant improvements in neck-related disability and participant reported perceived improvement. Muy bueno, muy bueno. Don’t forget to adjust the T-spine for the neck pain.  Before getting to the next one, I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! It’s live again.

Use the code HOTSTUFF upon purchase at droprelease.com to get $50 off your purchase. Y’all, it makes a world of difference. 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. My patients love it and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it. Hear me now and believe me later.

Item #2

This one is called, “Physical Activity In Children” by Michel et. al. (Michel J 2022) published on April 25, 2022….brand spankin new in the skillet. It’s burns! This is an article really rather than a research project so lets summarize this bad boy. 

They start by saying “The US received an overall grade of D− for physical activity in children, with only about 1 in 4 children meeting the daily recommendation of 60 minutes or more per day.

With the recent COVID-19 pandemic, this has worsened because children are even less active, missing out on daily activities and group sports, and increasing screen time.” “Being inactive has numerous harmful effects on health and well-being. It is linked to many chronic diseases and conditions, such as obesity, diabetes, high blood pressure, heart disease, cancers, and early death. In contrast, there are numerous benefits to physical activity for children, including decreased risk for developing all of these diseases and conditions.

Physical activity can also help to decrease stress and improve school performance, sleep, and mental health.” “US physical activity guidelines recommend that children aged 3 to 5 years be physically active throughout most of the day and that children aged 6 to 17 years have at least 60 minutes of moderate to vigorous physical activity daily. Moderate to vigorous activity means the heart rate is raised higher than the normal resting range and is associated with sweating and deeper breathing.” “How can you help your child meet these goals? First, be an example.

Children copy you, so if you make exercise a part of your routine, they are more likely to follow in your footsteps. You can also help by making physical activity a part of your whole family’s daily routine by setting a time every day, especially when your children are young. In addition, try to make activity fun. If your child enjoys physical activity from an early age, this will likely continue as they grow older.

It can also be helpful to make a list of physical activity options, both for outside and indoors for when the weather is not appropriate. “ These are recommendations for us as parents but also as providers that can guide and encourage out younger patients toward more activity.

Do you do anything outside of your office to encourage your patients to get active? What if one of your staff members wanted to host a walk in the park? A hike in nature? Or something similar?  Good for your patients and good for practice building.  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. 

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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.

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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  

CF 053: Healthy New Ideas For Physical Activity

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

Integrating Chiropractors

Introduction

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. 

Talking DACO

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. 

CEs

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. 

Newsletter

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[1]. 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. 

Walking Paper

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[2]. 

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.”

Social Prescribing

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[3] 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[4].”

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. 

Integrating Chiropractors

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!

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

https://www.smithsonianmag.com/smart-news/british-doctors-may-soon-prescribe-art-music-dance-singing-lessons-180970750/?utm_source=facebook.com&utm_medium=socialmedia&fbclid=IwAR1etMZiV8oe-JbUwgUYmP2gxR5pinJcbLS2W1u1QlMBNISVIxTpFBRmubc

https://jamanetwork.com/journals/jama/fullarticle/2712935?utm_source=silverchair&utm_campaign=jama_network&utm_content=weekly_highlights&cmp=1&utm_medium=email

https://chiromt.biomedcentral.com/articles/10.1186/s12998-018-0179-x?fbclid=IwAR3aJGZBcmMSscPoibtAzIRHok9_RpsMvJDbvx76MnzRJY9YU0x_JMY5FK0

https://www.ncbi.nlm.nih.gov/m/pubmed/30448632/

 

Bibliography

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).