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Episode 91

Testing MSK Vs Neuro Before Treatment Clinical Neurodynamics With Michael Shacklock

SHOW NOTES I attended Michael Shacklock's Upper and Lower Quarter Neurodynamics course in Spring of 2018 and it was one of those seminars that completely changed the way I looked at my patients on Monday morning. Michael presented for four days on some awesome ways we can test to see if a patient has a neuro component to their symptoms. Surprisingly many conditions that have a partial neuro aspect don't require radiation or pins/ needles! Here's a few types of cases I've found neuro aspects within (at least a percentage): Subacromial Impingement Cases Ankle injury diagnosed in the training room as a deltoid ligament grade 1 Medial Epicondylitis These types of cases would have fallen through the cracks in my eval and I would have been treated them as pure musculoskeletal conditions, but the truth is when I implemented some corrected to the neuro findings, the person improved past that plateau we sometimes find in patient care. I feel very fortunate to have Michael on to share some wisdom with the rest of the sports medicine listeners. Quotes: Spinal cord movement is a looking glass into lumbar nerve root behavior There's a 66% reduction in spinal cord movement with disc protrusions Flexion will open the foramen and reduce pressure on the nerve Across joints the nerve is more extensible, unrelated to amount of connective tissue Bio: Michael Shacklock: Michael received his graduate qualification at the Auckland School of Physiotherapy, New Zealand, in 1980. He worked in public hospitals in the medical, surgical, paediatrics, orthopaedics, geriatrics, intensive care and burns areas around New Zealand before being employed in private practices, treating spinal and sports injuries in Nelson with Michael Monaghan and Auckland with Margaret Franklin. In 1985 he moved to Adelaide, Australia, working at the Royal Adelaide Hospital and private practices around Adelaide. He completed a Graduate Diploma in Advanced Manipulative Therapy in 1989 and converted this to a Masters degree at the University of South Australia in 1993. He was awarded a Fellow of the Australian College of Physiotherapists (Australian Physiotherapy Association) for his monograph and international best-seller text book, Clinical Neurodynamics, Elsevier, Oxford, 2005. In addition to his neurodynamics book, he has published two other books, Moving in on Pain (Elsevier) and Biomechanics of the Nervous System: Breig Revisited . He also authored, co-authored and mentored numerous research studies, editorials, commentaries and clinical papers in international peer reviewed journals articles which have garnered many international awards, including Visiting Professor of the Faculty of Medicine, Barcelo University, Buenos Aires (see academic activities on ResearchGate ). He was a member of the International Advisory Board of the journal Musculoskeletal Theory and Practice (formerly Manual Therapy), United Kingdom and is an Associate Editor of the Journal of Manual and Manipulative Therapy, USA. Michael presents keynote addresses and invited conference lectures, trains staff at elite sports medicine facilities and sports clubs, universities, hospitals and private seminars around the world. His special interests are neurodynamics, measurement of mechanical function of the nervous system, pain and the nervous system and musculoskeletal function. His most valued interest is how to synthesise science and clinical practice using evidence and reasoning. Michael is an active clinician, has 35 years of experience in treating patients and is recognised as an international leader in the diagnosis and treatment of musculoskeletal disorders with a neural aspect. Website: https://www.neurodynamicsolutions.com/ Sebastian's Youtube Channel Attention Docs and Fitness Professionals: Access your client educational products, banners and posters here. Dr. Sebastian Gonzales is an expert in trouble shooting sports injuries and overuse conditions. This podcast is intended for sports medicine topics to become easier for patients and athletes to understand. Don't get confused by what your doctor told you in your appointment. If you like in Orange County CA, book an exam with Dr. Gonzales, your Huntington Beach Chiropractor.

71 Minutes – Jun 13, 2018

Episode 90

Unspoken Miscommunication Between Patients And Doctors

SHOW NOTES Based on my observations working with patients for the past 8+ years, I found there are a few recurring conversations I have with patients. They often bring these points up well after the first exam date. I believe these points to be their unspoken objections or beliefs about their body/ injury. When we believed the world was flat, people didn't want to sail too far… because of the unspoken "truth" that the world was flat. I'm going to address the following "truths" patients and the public believe. Warning: Not all healthcare providers are going to agree with me on these, but many of them will. I'm ok with that. These are my beliefs that I've formed through experience, reading research and success with the patients I see. Here's a link to the hip video I mentioned: https://youtu.be/OiAJ8Hsr1nQ Enjoy! Here's the 9 points: "My XYZ is from my age… I'm just getting too old" "My problem is from my knots" "So are you going to 'work on' me?" "My XYZ is out" "My back pain is from XYZ, posture has nothing to do with my pain" "My problem is from scar tissue" "Can we do something to workout my arms?" "I don't understand why I'm in pain" "I have no time to learn about my injury/ pain etc" Sebastian's Youtube Channel Attention Docs and Fitness Professionals: Access your client educational products, banners and posters here. Dr. Sebastian Gonzales is an expert in trouble shooting sports injuries and overuse conditions. This podcast is intended for sports medicine topics to become easier for patients and athletes to understand. Don't get confused by what your doctor told you in your appointment. If you like in Orange County CA, book an exam with Dr. Gonzales, your Huntington Beach Chiropractor.

54 Minutes – Jun 6, 2018

Episode 89

Listener Questions Hip Pain (FAI & Hip Flexor Tightness) And Knee Pain (Meniscus, Pes Anserinus, Patellofemoral Pain)

Session 89: Listener Questions: Hip Pain (FAI & Hip Flexor Tightness) and Knee Pain (Meniscus, Pes Anserinus, Patellofemoral Pain) SHOW NOTES In this podcast session, I go through some of my emails and comments from listeners. There seemed to be a lot of questions about knees and hips so I took the best ones… I apologize to anyone's questions who won't be answered but I'm attempting to address all questions through these cases. Case 1: Torn Knee Meniscus Exercising Case 2: Intense Knee Pain with negative X-rays Case 3: FAI Hip Pain with lots of PT Case 4: Brazilian jiu jitsu Knee Pain Case 5: Grading Muscle Injuries in the Shoulder Case 6: Hip Flexor Pain after a Hamstring Injury (Runner) Dr Sebastian Gonzales is an expert in trouble shooting sports injuries and overuse conditions. This podcast is intended for sports medicine topics to become easier for patients and athletes to understand. Don't get confused by what your doctor told you in your appointment.

69 Minutes – May 30, 2018

Episode 88

Defeating The Take 3 Weeks off Healthcare System With Quinn Henoch

SHOW NOTES Dr. Quinn Henoch DPT is an innovator in the sports medicine world… why? He has an awesome vision of the future of sports medicine. Often times athletes leave their doctor's office frustrated with the prescription to "take 3 weeks off." That's needed sometimes but it's very individualized to the person and the injury. Quinn understands athletes because he is one, but how can you find someone like him in your area? He created a network of clinicians who are athletic clinicians. They understand when rest is needed and when we can modify activity. Listen to this podcast about some sports medicine theory and the creation of the network. When I contacted Quinn, I asked if he would be willing to talk to me about the concept of rest for injuries… he agreed. Listen up! Quinn Henoch Bio: Quinn Henoch has a Doctorate of Physical Therapy from the University of Indianapolis and is head of sports rehabilitation at Clinical Athlete Laguna Niguel in Orange County, CA; where he manages athletes of varying levels and sports. He is also the founder of Clinical Athlete, which is a network of healthcare professionals who understand the performance-based needs of athletes. Quinn played football at the Div 1-AA level at Valparaiso University as a defensive back. Since 2011, he has trained exclusively for the sport of weightlifting, having competed at the national level. Reach him: Website Instagram: @ClinicalAthlete & @ quinn.henochdpt Book: Weightlifting Movement Assessment & Optimization: Mobility & Stability for the Snatch and Clean & Jerk Sebastian's Youtube Channel Attention Docs and Fitness Professionals: Access your client educational products, banners and posters here. Dr. Sebastian Gonzales is an expert in trouble shooting sports injuries and overuse conditions. This podcast is intended for sports medicine topics to become easier for patients and athletes to understand. Don't get confused by what your doctor told you in your appointment. If you like in Orange County CA, book an exam with Dr. Gonzales, your Huntington Beach Chiropractor.

62 Minutes – May 23, 2018

Episode 87

Fix Your Own Back, Dermal Traction And Facebook Live With Phillip Snell

SHOW NOTES I met Dr. Snell in Colorado this year while he was presenting at the Rehab to Performance Symposium on the topic of back pain and clinical reasoning. Seems like a general enough topic for a chiropractor right? The funny thing is that many healthcare providers don't have a systematic way to resolving back pain because they've never dug deep enough to uncover the main reason of the patient's condition. Dr. Snell took us all through an amazing workflow of how to identify the root case of low back pain (based upon some McGill and McKinzie works) and then how to reduce the person's pain quickly. He has a website called Fix Your Own Back that you should definitely check out. Dermal traction, formally known as YAP, is also one of his original ideas (along with Justin Dean, a past guest) and he goes over the concept of using it for high patient buy in today. SHOW NOTES: https://www.p2sportscare.com/fix-your-own-back-dermal-traction-dr-phillip-snell-dc/ Phillip Snell Bio: A cum laude graduate of Western States Chiropractic College (now University of Western States ) in Portland, Phillip also received extensive post-graduate training in the diagnosis, treatment, and case management of automobile-related spine trauma. His practice is focused on sports medicine, using functional assessment and rehab prescription, and supported by cutting-edge myofascial techniques like Graston Technique and Stecco Fascial Manipulation . He also has served as part-time faculty at University of Western States in their manual therapy department and Sports Medicine Masters degree program. Phillip keeps up to date with emerging scientific literature to improve his clinical practice, a process known as evidence-based practice. He also travels extensively each year, teaching these methods to other doctors—and continuing to add to his own toolbox as he in turn learns from the best researchers and teachers in the world. Using a biomechanics mindset, Phillip enjoys the detective work that gets to the bottom of stubborn, painful conditions. He then turns his attention to teaching patients how to use corrective exercises to manage their own conditions. His focus on finding the key movement patterns that need correction led him to launch MyRehabExercise.com in 2011. Health care professionals around the world use the website to help teach their own patients functional rehab methods. As a long-time athlete, Phillip has a special appreciation of the needs of athletes as they age and the conditions that keep them from being as active as they would like. Patients can expect not only chiropractic adjustments, but also treatment to address the surrounding muscle and fascial tissues, followed up with thorough rehabilitation exercises. Treatments are tailored to each patient's needs, with special attention to educating the patient in how to reduce future injuries. Phillip enjoys wintertime snowboarding and during the warmer months can be found in his garden or hiking and running the beautiful trails in the Portland area with his wife and son. Reach him: https://www.fixyourownback.com/ Disclaimer - I'm now an affiliate. Quotes: Muscle Protects Nerve In school we are taught to assess tight muscles but we need to ask why they are tight The way we treat back pain should be an ordered process Deadlifting is the basenote of what we do at the Fix Your Own Back Program Sebastian's Youtube Channel Attention Docs and Fitness Professionals: Access your client educational products, banners and posters here. Dr. Sebastian Gonzales is an expert in trouble shooting sports injuries and overuse conditions. This podcast is intended for sports medicine topics to become easier for patients and athletes to understand. Don't get confused by what your doctor told you in your appointment. If you like in Orange County CA, book an exam with Dr. Gonzales, your Huntington Beach Chiropractor.

69 Minutes – May 16, 2018

Episode 86

Starting Workshops, Podcasting & Educating the Public With Ryan DeBell (The Movement Fix Podcast)

SHOW NOTES I reached out to Dr. Ryan DeBell DC, of The Movement Fix, to help young clinicians, trainers and students develop businesses similar to his… if they desired. Dr. DeBell started a solo practice on his own. During his first few months of practice, he was able to successfully make $4000 in one day teaching at a seminar. Wow! This popularity lead to speaking engagements, workshops, podcasts, videos, and online content creation. Sky's the limit. During our conversation, he mentioned he has been able to grow his online business so much that he had to choose if he wanted to practice full-time or spend more time online. He picked online… why? Because he would rather help more people with understand the basics of having a health life. If you're a young doc who posts half-heartedly on instagram or facebook, you need to listen to this podcast. Enjoy. Quotes: "I learned to draw to improve my creativity" "A lot of times when we are talking to patients, we talk to them like they're Picasso." "When other people make content I think, I'm glad these people are putting themselves out there." "The people who are going to criticise you are the ones who are afraid to do it themselves." Ryan DeBell's Bio: "I was born a skeptic and a cynic. I question everything and challenge the status quo. I have a passion for helping people become strong, pain free, and take ownership of their bodies. I believe being pain free and moving well is a fundamental human right. Information shouldn't be kept a secret when it can benefit so many people in such a large way. I graduated from the University of Washington's Foster School of Business. After realizing I didn't enjoy the work I was doing (and sitting there writing excel macros thinking about how much more I would enjoy teaching people how to become strong, pain free, and move their body) I decided to make a change. The switch lead me to the University of Western States where I earned two degrees: A master's degree in exercise and sport science and a doctorate in chiropractic. I actually have an identity crisis at times. I don't identify well with one particular group of people based on how I was trained. My job is to help people become strong, get pain free, and move their bodies well. However I achieve that is not important (through hands on therapy, exercise instruction, a video on the internet, an e-book, a podcast, etc.). I care about helping as many people as I can in whatever way possible." Quotes: "I learned to draw to improve my creativity" "A lot of times when we are talking to patients, we talk to them like they're Picasso." "When other people make content I think, I'm glad these people are putting themselves out there." "The people who are going to criticize you are the ones who are afraid to do it themselves." Sebastian's Youtube Channel Attention Docs and Fitness Professionals: Access your client educational products, banners and posters here. You can access the show notes at https://www.p2sportscare.com/86 Dr. Sebastian Gonzales is an expert in trouble shooting sports injuries and overuse conditions. This podcast is intended for sports medicine topics to become easier for patients and athletes to understand. Don't get confused by what your doctor told you in your appointment. If you like in Orange County CA, book an exam with Dr. Gonzales, your Huntington Beach Chiropractor.

84 Minutes – May 9, 2018

Episode 85

Fascial Manipulation: How it Works, and What It Can Do With Warren Hammer

SHOW NOTES Warren Hammer authored some of the first articles and books I read as I was starting into grad school. He's been practicing using various soft tissue methods since the 1960's… he landed on Facial Manipulation as his main tool. I couldn't help but reach out to him to see what he has learned over the past 50 years of soft tissue work, clinical experience and research. You'll enjoy his passion! Here's some topics we hit: What kind of injuries or cases can fascial work assist with? What is Fascia? Does fascia have pain receptors? Why does fascia get restrictions and what is the physical "sticking?" How is Fascial work any different than foam rolling, massage, ART, graston etc Explain the receptor system How can fascial manipulation assist in movement patterns? Research surrounding fascia work Take the seminar by Warren Hammer here . Warren Hammer Bio: In Chiropractic practice since 1960. Subsequently obtained an MS degree and a diplomate in Chiropractic Orthopedics. Realizing the importance of soft tissue with respect to the treatment of joints I took many courses in soft tissue methods. Since 1985 I have lectured nationally and internationally on soft tissue methods. Some of the soft tissue methods taught were Cyriax's Friction Massage, Strain/Counterstrain, Post Facilitation Stretch, Myofascial Release, Muscle Energy, Graston Technique, Mattes' Active Isolated Stretch, Mulligan methods, Voyer's ELDOA technique and others. Authored and edited three editions of a text "Functional Soft-Tissue Examination and Treatment by Manual Methods" and more than 300 articles on soft tissue subjects, some of which are peer reviewed. Became a certified FM instructor in 2013. Invited Antonio Stecco to the U.S. about 5 years ago to teach FM and the rest is history… Sebastian's Youtube Channel Attention Docs and Fitness Professionals: Access your client educational products, banners and posters here. Dr. Sebastian Gonzales is an expert in trouble shooting sports injuries and overuse conditions. This podcast is intended for sports medicine topics to become easier for patients and athletes to understand. Don't get confused by what your doctor told you in your appointment. If you like in Orange County CA, book an exam with Dr. Gonzales, your Huntington Beach Chiropractor.

72 Minutes – May 2, 2018

Episode 84

The Proper Pitcher Stereotype With Brett Winchester

SHOW NOTES Brett Winchester was recommended by Dr. Richard Ulm (#67) , to speak about all things throwing. Dr. Winchester is a sports medicine clinician for the St. Louis Cardinals and has a true passion for the health of his pitchers. He has a unique was of keeping them healthy, strong and performing well. On our initial call about the podcast, he told me about how most pitchers (MLB, college, high school and younger) are taught the wrong pitching mechanics, or what he called "pitching stereotype." What does that mean? I think about how I loved to see Ken Griffey Jr swing a bat so I attempted to model my at bats around what he did… I mean he was great right?! Brett says that each person has the idea mechanics for them… currently at the younger levels our kids are being taught to pitch in a way that verifies the spikes in UCL injuries. It al starts with when your player separates their hands... Dr. Brett Winchester's Bio: When not practicing at Winchester Spine & Sport, Dr. Winchester teaches around the globe. In 2013, Dr. Winchester lectured in six countries conducting 30 seminars for doctors, students and therapists. Dr. Winchester currently teaches for Logan University and its College of Chiropractic, the Motion Palpation Institute, Dynamic Neuromuscular Stabilization, and The Chiropractic Rehabilitation Diplomate, to name a few. Dr. Winchester's studies and lectures have taken him to England, Prague, Chile, Sweden, Norway, Canada and across the United States to teach the latest manual therapy research and techniques. In his free time, Dr. Winchester enjoys spending time with his family, including wife Cheri Thornhill Winchester, a longtime resident of Lincoln County, and his children Grace and Wade. His hobbies include cycling, snow and water skiing, soccer, tennis and reading. Dr. Winchester received his Doctor of Chiropractic degree from Logan College of Chiropractic Quotes: "In all throwing sports it all comes down to timing" "We've had an epidemic level of UCL injuries (since the first one in 1974)" "I was awesome at RBI Baseball (Nintendo)" "Ask me about the Cap Boso Slant (Tecmo Football)" "As long as there's Intra-Abdominal Pressure maintained it's ok (lumbar extension)" "If you watch a Little League World Series, none of those kids will be pitching in major league baseball" Musculoskeletal Ultrasound Article Email: [email protected] Website for Pitching mechanics as mentioned at the end of the podcast: Gastal Performance Sebastian's Youtube Channel Attention Docs and Fitness Professionals: Access your client educational products, banners and posters here. Dr. Sebastian Gonzales is an expert in trouble shooting sports injuries and overuse conditions. This podcast is intended for sports medicine topics to become easier for patients and athletes to understand. Don't get confused by what your doctor told you in your appointment. If you like in Orange County CA, book an exam with Dr. Gonzales, your Huntington Beach Chiropractor.

72 Minutes – Apr 25, 2018

Episode 83

Proper Diagnosis And Kettlebells With Michael Fanning

SHOW NOTES Are you a young doc treating patients with back pain, hip pain, groin pain or IT Band Syndrome? Did you know often times patients will be given a misdiagnosis, they hold onto dearly, before they walk into your office? That's right! People are being misdiagnosed… I've done it, you've done it, we've all have done it and it's mainly from lack of knowing what to look for, what to test and what to ask. I was there… I'm still learning everyday. Dr. Michael Fanning DC, came in to chat with me about proper diagnosis. Dr. Fanning and I have a friend in common, Tom Fletcher, who you heard in the last podcast. Some of the topics we covered in this podcast are: IT Band Syndrome vs Lumbar "Pinched Nerve" Radiculopathy Hip Impingement vs Hip Flexor Tendonitis How to use Kettlebells in rehab How to wear pink speedos when biking Dr. Michael Fanning Bio: Michael is a Rhode Island native, OIF Veteran (Operation Iraqi Freedom) and endurance athlete. He is a Chiropractic Sports Medicine resident, and specializes in diagnosis and conservative management of neuromuscular skeletal injuries. He lives in southern California with his beautiful wife Jen, and great dane, Bear. Quotes: "When a Crossfit athlete complains of IT Band Syndrome, I know already they probably don't have IT Band Syndrome" "Stiffness in the morning with IT Band Syndrome is from imbibition (disc fluid increase)" "The L5 nerve goes right over the IT Band location" "It's really important for all trainers to be able to recognize hip impingement" "People with hip impingement may have pain with squatting" Sebastian's Youtube Channel Attention Docs and Fitness Professionals: Access your client educational products, banners and posters here. You can access the show notes at https://www.p2sportscare.com/ 83 Dr. Sebastian Gonzales is an expert in trouble shooting sports injuries and overuse conditions. This podcast is intended for sports medicine topics to become easier for patients and athletes to understand. Don't get confused by what your doctor told you in your appointment. If you like in Orange County CA, book an exam with Dr. Gonzales, your Huntington Beach Chiropractor.

75 Minutes – Apr 18, 2018

Episode 82

Hip Pain In Endurance Populations With Tom Fletcher

SHOW NOTES Dr. Tom Fletcher shares some of his observations about hip pain in endurance populations. Runners, cyclists and triathletes will be interested in this podcast session. Tom and I met years ago, working at an Ironman Triathlon. He is a triathlon junkie himself and is a great example of a treating doctor who gets into the culture of his patients. He practice in Sandy UT, just outside of Salt Lake City. Some of the topics we go into are: Hip Flexor Tightness Upper Quad Tightness Muscle Strains Hip Impingement Hip Labrum Tears Corrective Exercise And what day is the best to have a long ride in Utah. I've known Dr. Tom for years. As you will be able to tell on the podcast we have fun chatting. Dr. Tom Fletcher's Bio: Dr. Tom Fletcher was raised in the Salt Lake Valley with his two brothers by his parents. He attended Brighton high school where he was involved with Rugby and as many Lake Powell trips as possible. After high school Tom moved on to the University of Utah. While at the University of Utah, Tom met his wife Delilah and continued his love for team camaraderie and athletics. It was not till Tom had nagging rugby injuries in college that he then sought out chiropractic care. The rest, as they say, is history. Tom attended Palmer College of Chiropractic West in San Jose, California. While in California, Tom excelled in academics and patient care for a variety of conditions. He was able to further his education by attending post-graduate programs such as Active Release Technique , Graston Technique , and HandsOn Muscle Therapy. California also offered the unique opportunity for Tom to volunteer in many events as a student intern. These events included: Escape from Alcatraz Triathlon, Cal Bearathon Triathlon, Bay Area 24-Hour Bike Race, Nami Walk for Multiple Sclerosis, Los Gatos Ballet, and many more. California also helped Tom develop his love for triathlon. During his first race he thought his lungs were going to explode as he climbed the Berkeley hills. Since then Tom has tried to compete in as many races as time allows. Races such as Stanford Treeathlon, Cal-Poly Triathlon, Wildflower Triathlon, Cal Bearathon, and the San Francisco Marathon to name a few. Upon returning to Utah Tom has continued his athletic and post-graduate academic goals by working with chiropractic mentors to improve his skills in patient-based care. Tom has also had the unique opportunity to work with fellow Ironman triathlon doctors. One of Tom's proudest accomplishments is being on staff with fellow IRONMAN doctors at the IRONMAN World Championship in Kona, Hawaii, IRONMAN Coeur D'Alene, and IRONMAN Arizona. Dr. Tom Fletcher's Contact: Website Instagram: @WasatchHealth Sebastian's Youtube Channel Attention Docs and Fitness Professionals: Access your client educational products, banners and posters here. You can access the show notes at https://www.p2sportscare.com/82 Dr. Sebastian Gonzales is an expert in trouble shooting sports injuries and overuse conditions. This podcast is intended for sports medicine topics to become easier for patients and athletes to understand. Don't get confused by what your doctor told you in your appointment. If you like in Orange County CA, book an exam with Dr. Gonzales, your Huntington Beach Chiropractor.

67 Minutes – Apr 11, 2018

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