This week's topic is chiropractic. My goal for this stream is for you to come away with just a better understanding of the ways in which chiropractic could be beneficial to you, and potentially just have a deeper understanding of what it can accomplish and when. It should not be used in cases when it could be potentially harmful. And there are cases like that. I'm an example of that. I have a history with chiropractic. I have a big, long history with chiropractic, and I've used it beneficially, and I've also been harmed by chiropractic as well. So we'll get into that story later. And here we go. Most people probably think of chiropractic as either, you know, cracking the back or getting an adjustment. And so that's what we're going to focus on today is that side of chiropractic. I recognize that there's more in, you know, under the scope of practice of a chiropractor so they can do more than crack a back or adjust a back. But we're probably not going to get too much into that. We're going to focus on the cracking, the adjustment of the spine. And from a clinical perspective, that also falls under the scope of practice of a physical therapist. So I am trained in what someone might think of as chiropractic. And so the type of adjustments that we give to a spine are what's called a high velocity, low amplitude adjustment. Or it's under the scope of manual therapy. And so what that means is we want to adjust the spine extremely high force but low amplitude, very small amount of movement. And that would be called a thrust. And that would be the highest level of adjustment. And there are grades below that that are much, you know, a scale of more gentle adjustments. But like I said, we're focusing on the full adjustment. That's what people think of as chiropractic. And so I'm going to start with a story, a personal story that I've experienced going to a chiropractor back when I was probably around twenty three years old. And then we'll lead into why in situations like that, chiropractic could be harmful. And I will say that I have used chiropractic since several times, potentially many times, and and used it successfully. And so that's what I want for you to come away with is how can you Use chiropractic if you need it and if you could benefit from it. How could you use it in the best way for you and and potentially avoid, you know, getting caught up in this cycle that some people fall into where you either become dependent on chiropractic or like in my case, you can actually get worse if something is being thrusted a joint or a disc in the spine that shouldn't be getting thrusted, shouldn't be getting adjusted. So why don't we get into the story and then we'll break it down? Why that might have happened to me. So like I said, I was about twenty three years old and my back had been hurting for probably about seven years at that point. So I was not a new sufferer. I was well experienced and I had lots of physical therapy, somewhat successfully. You know, physical therapy tends to help, but it wasn't having a lasting effect for me. And so I never really got out of the cycle at that point. And so my mother, she suggested a chiropractor to me in Irvine, California, and I didn't really know I had had chiropractic before, but nothing really remarkable. No, you know, nothing to talk about experience wise. So I was open to it. And so I went there, and I remember he adjusted my spine and he had a lot of trouble getting it to crack. So he was focusing on my lower back, which was where the pain was. And he was doing something called the lumbar roll, which I'm trained in now, but I had no idea what it was back then. I was probably like most people going to the chiropractor and just saying, you know, move my body, twist my body. Do what you're going to do. I have no idea what you're doing. I hope I feel better when I leave. Right. So he was having trouble. He was doing this twisting maneuver on my lumbar spine. It's a pretty common one. Most of you, if you've been to a chiropractor, have probably received it where you have one leg up and your upper body is twisted one way and the legs are twisted the opposite way, and then they come down with their body weight on your legs and twist your torso into. Hopefully, I think that their goal is to get a cavitation or a pop. And so my back wasn't popping and so he would go with a harder thrust. And he I remember had several unsuccessful attempts. And eventually um, he was successful with an extremely hard crack. You know, I felt like he was throwing all his body weight into my into mine, into twisting mine. I remember this was a long time ago, right? Thirteen years ago. So I remember feeling like, wow, that was forceful. But nothing really abrupt happened. I didn't experience instant pain. I just just remember feeling a little bit of like, uh, maybe surprise. And that's it. So I leave the chiropractor and I had plans to go to a baseball game with my friends. Immediately after, I think I was actually late. This was an angel game. Or, you know, the the local baseball team in Orange County is the angels. So I drove there myself. My friends were already there. I was late and parked and I parked quite far from the stadium. So I remember I decided I'm going to jog to the game. I'm going to jog from my car to the stadium. I remember feeling, for the first time in my life, this shifting feeling in my lumbar spine. Like like this type of feeling. Every step I took, every time I took a step in jogging and I felt, I thought, wow, that's really strange. I feel like my spine is loose and it's shifting. And it didn't feel good. It also didn't really hurt, but it was an unsettling feeling. And so from that point forward, for a matter of years, probably three, two to three years, I had an instability in my lumbar spine. I had an unstable joint, and that would be specifically l5, S1. It's the most common one to have degeneration and instability. And so with instability, there's a lot of friction and wear and tear degeneration. And I really went down a spiral at that point. And so that was one experience out of millions of chiropractic experiences that people have had. But it was an example of how chiropractic treatment may not always be the best idea. And I'm going to Oreo cookie sandwich this by saying that, like I said before, there are many cases in which chiropractic can be beneficial. And so this is just one case. And I believe this is applicable to many people. So we're going to talk about why this may have happened and if it may be applicable to you. And then you can ask your questions. But first, if you can just imagine the spine and my focus is going to be L5, S1. That's the most common disc of degeneration. And you can imagine almost any spinal condition, any diagnosis. So we have herniated disc, bulging disc stenosis, degenerative disc disease you name it, it doesn't really matter. All of those are in some form related to degeneration, the degeneration of tissues, body tissues in some form. And so when you are thrusting a joint that's been degenerated, that would be an abrupt movement in that joint. And it causes a little bit of friction. Right. That's what happens with movement. Naturally. Friction happens, it's unavoidable. And so if we think about why degeneration happens in the first place, it's the same cause it's friction. Our discs become degenerated because typically because of repetitive trauma. And so we can get into the different reasons why repetitive trauma happens. We can talk a little bit about that in a minute, but let's just recognize the fact that repetitive trauma causes friction, and friction causes degeneration for the most part. There may be some diseases or infections that can cause degeneration, but in the vast majority of cases of chronic lower back pain, it's simply repetitive trauma. And so it doesn't make a whole lot of sense. If you have degeneration and the tissues are worn down and potentially a little bit slack, a little bit loose to treat that with a thrust, with more friction, because that's the cause of the problem in the first place. So what we would actually want to do is the opposite. We want to provide support and stabilize the joint, just like you would if you sprained your ankle or broke your wrist. You want to put a cast on it and you want to stabilize it. And in those cases, those are acute traumas. So a cast or a brace is very effective. The bone will heal and you can take it off. But with chronic lower back pain you don't want to put a brace on it if you don't have to because it's not an acute trauma. This is a chronic thing that goes on. And so, um, it may help temporary healing, but the muscles that you want to provide that support will get weaker. And so, um, we want to try and create that brace with our core muscles. And so that is the general idea that I want to portray to you is that if you have degeneration in your spine, then you probably don't want to get an adjustment at that level. Okay. So that is the no no. And it applies to most conditions. Most diagnoses of the lumbar spine would be something I personally this is my opinion would avoid getting an adjustment on by a chiropractor. Okay I hope that's clear to you. And so on. The other end of the spectrum would be when would it be good to get an adjustment and get manipulation to the joints of the spine. And so these would be the joints that we want to get manipulated, cracked, adjusted, whatever you want to call it would be the ones that are stiff, the ones that are not moving enough. And those joints typically don't have a lot of degeneration because they don't have a lot of movement and friction and repetitive trauma. They're just stiff. And it would be usually beneficial to get adjustments in these levels of the spine. And typically the pattern would be just above the lumbar spine. So if your problem area is say L4, L5, L5, S1, those are the degenerative levels, most common ones, then you most likely have stiffness in the levels above those hypermobile or unstable levels. So in the upper lumbar levels like L1, L2, L2, L3, those might be stiff And the thoracic spine is usually stiff. That's part of the predictable pattern. And so personally myself, I still do use chiropractic. I don't often go to a chiropractor anymore because I have physical therapist friends that are trained in manipulation. So, um, I'll go to my friend and I'll say, hey, can I get an adjustment on my my upper back? Because I know that that area is stiff and I don't have degeneration there. I don't have, you know, beyond normal aging. I don't have a lot of pain there, but it's very stiff. And so those are the areas I want to get adjusted. And so it seems really simple. Uh, it seems almost obvious. I hope that you see the logic in this, but it becomes a little more difficult to implement in real life. When you go to a professional, a doctor, and you go to their office and you're in their environment, and they may be wearing a white coat, which is a symbol of, you know, power. And to be able to tell them that you don't want a certain treatment that they want to give you. And that's what you have to do, because there are chiropractors that may not follow these principles that I'm talking about. And there are chiropractors that do follow. There are good chiropractors and there are not so good chiropractors, just like every profession. So we can think about whatever profession you have if you have one. Are there people that are good at what you do, and are there other people that are not so good, or maybe even bad at what you do? It's the same for physical therapists. It's the same for doctors. It's the same for chiropractors. And so I don't know which chiropractor you're going to. I hope that you find a good one, but you might benefit from setting some boundaries when you go to the chiropractor. If it's your first visit or even not, and just say, hey, I would like to get your treatments, but don't touch. Don't adjust my l5 s1. I don't adjust my lumbar spine at all because that's not why I'm coming to you. I'm coming to you to get the stiff parts of my spine adjusted so that they can get more mobility and take a little load or a little pressure off of the hypermobile parts of my spine. So that's actually a teaching point that I can educate you about. It's maybe a little bit too deep into biomechanics, but I'll break it down as simple as possible. Anytime you have a hypermobile or a joint that moves too much, you can say unstable, but unstable is a certain level of hypermobility. That is, it's a grade. It's a classification. So hypermobile just means that the joint moves too much. Anytime you have a joint like that, you're most likely going to have the joints above and below that joint are stiff or hypermobile. And so that's kind of a general rule. And so you have stiff and then hypermobile moves too much and then stiff. And that's the pattern. And that's what causes the joints in the middle to remain unstable or hypermobile, because there's not enough movement in the joints above and below. And so we can benefit from chiropractic or, you know, as Tim, I saw you mentioned Tim in the chat that you can do self manipulation. And yes, that's a good thing to do. I recommend that if you are trained in it, if you know how to manipulate the hypermobile, the stiff joints, and by doing that and getting more movement, more motion in these joints, you're taking pressure off of the lumbar spine to have to move so much. Same thing with the hips. The hips typically become stiff, not flexible, especially the muscles in the front of the hips. They become tight. And so we can improve the lumbar spine by getting more mobility here in the hips, so that the lumbar spine doesn't have to do so much work doing, getting, taking all the mobility in our movements. We can put some of that mobility, we can spread it out more. And so if you know your body well enough, you can guide a chiropractor to treat the areas of your body that are stiff, and avoid the areas of your body that you know have degeneration and potentially could be harmed by a thrust maneuver. So that's really what I wanted to portray. I, I think it's a very simple principle, and it will just require you to have a bit of a boundary if you're going to use chiropractic. All of this applies to the neck too. If you have neck pain, the neck is another area of the body that tends to become hypermobile. Certain parts of the neck. The cervical spine. And so I would not let a chiropractor adjust my neck or thrust my neck. And I know they do that one rotation maneuver and that would scare me. I wouldn't want them to do that to my neck because I have a history of neck pain too, and so I want to protect and support those discs. But again, it fits the pattern perfectly. What's immediately below the neck? The thoracic spine. The thoracic spine gets stiff. It has all that rib cage support. And the rib cage is attached to every level of the spine. So it's very supportive. And it gets stiff. Well, just above that is hypermobile. Too loose. Right. And then you have the head above that which doesn't have joints that move really besides the jaw. Right. So it's the pattern is consistent throughout. Hypermobile hypermobile neck hypermobile thoracic hypermobile lumbar hypermobile hips. And so we want to focus on getting more mobility in the areas of the body that become stiff. Chiropractors can be very beneficial. Highly skilled professionals at and helping us to treat those areas. But you want to be careful about putting all your trust into a chiropractor if you don't know that, how good they are. If you know, maybe it's a reputable chiropractor and they're well respected, highly knowledgeable, and experienced, maybe you can be a little bit more, um, you know, have less boundaries with someone like that. But if it's like in my situation where I was recommended a chiropractor by my mom and I didn't know anything, and she probably didn't know him either, I don't think this chiropractor that hurt my spine for years was would be considered a good chiropractor, and I can be grateful to him because he led me on the path that has brought me here. And I'm very happy to have taken this path. And, you know, I had a lot of problems and, you know, traumatic experiences with my back and forced me to dedicate my life to this stuff. And I've helped myself and I'm now helping other people. So ultimately, I'm grateful to this chiropractor. But my goal would be to prevent something like that from happening to you, and hopefully you understand that. So let me know in the chat. I'm going to start addressing the chat and we'll answer some questions and then maybe we'll wrap it up. Holly I'm going to address you first. So it says you went hiking at the Grand Canyon and your back was fragile. Now you have a herniated lumbar disc and four bulging and you want to know if you'll ever be normal again. So. One hundred percent. You can be normal again. It depends how you define normal. I don't know that you'll have perfect discs again, but what you can have is a normal life where you have full function of your body. And I believe you've been attending my previous live streams, so if you attended two weeks ago, you would know from the imaging stream that like ninety percent of people without back pain with no symptoms have degeneration in their spine. They have bulging discs, they have some form of a bulging disc or degeneration or stenosis. It's extremely common. And so you can be a normal person with no back pain and have bulging and herniated discs. So yes, you can have a normal person's life. And on that note, I could say that having a bulging or four bulging discs is not so abnormal. Holly, hopefully that answers your question. You said you followed up with your chiropractor when you got back, and your doctor thinks your chiro ruptured your disc. Wow. Okay. How relevant is that to the story that I just told? So maybe I could have read that earlier and applied everything I was talking about to your story as well, if your MD is correct. But yeah, if you have a herniated disc, do not allow the chiropractor to manipulate the herniated, uh, level of your spine as much as they might want to. Knowing what I know, the education, the experience, I would set a hard boundary, a hard no on that. And so you would hope that a chiropractor would already, uh, subscribe to that school of thought. They go to a lot of schooling. They're very knowledgeable, but they're, you know, I think that Someone who is an expert in something. You know, a carpenter sees everything as a potential nail. Right. That's what they do for a living. And a chiropractor might see everything through the lens of a potential opportunity to adjust. Even if it's an injury. The good news is your body can heal. And here I am after the story. If you heard the story I told. I live a normal life. I have a full function of my body. I don't have back pain unless I mistreat my body. You know, if I go for a long car, drive or sit all day long. Yeah. My back's going to hurt. I'm human, and I think that's healthy. That's normal. That's your body communicating to you that you shouldn't do those things. So I'm grateful for that. But my spine is probably pretty messed up and I feel proud of where I've gotten to the point I've gotten to through lifestyle and training and and learning how to use my body in a healthy way. And last week we talked about pain, and we talked about how it's not always in alignment with damage. Holly. Holly, we are back. We're down to your part, making small adjustments. Uh, yeah. So Pts can do adjustments. And actually not all Pts but Pts like in my case, I went to a manual therapy school. Our fully trained in everything that a chiropractor. Well, maybe I can't say everything, but what a chiropractor is best known for doing um, manipulation. We're fully trained in it. You can get manipulation from a PT, most Pts, but not all of them. And that may be a bit of a safer bet because we don't see everything as an opportunity to adjust. Right. So there are cases in which we don't want to adjust. We want to stabilize lots of cases. I would say most cases. That's my bias. Holly, you you said clunky loose. Yes. That's how I would have described my the feeling in my spine after, uh, in my story I told earlier when I was twenty three years old running to the Angel game, I was feeling a clunky, loose feeling in my spine that was the spine moving. It was exactly what it felt like. Your intuition about what's going on is usually pretty accurate. Let's see. Tim, you can self adjust your thoracic spine in the child's pose. Yeah that's great. I have no problem with that child's pose. Especially if you're trying to target like right between your shoulder blades. T4 drop that down into child's pose. Try to let that drop all the way down to the floor, but don't let that go into the lower back, you want to protect the lower back, keeping the core tight. Stay connected to your anchors. You're in the program, so you know what that means. That will protect the lumbar spine. And then you can get that motion into the thoracic spine. It's hard to do. It's hard to force motion into the stiff area when there's a loose area right adjacent to it. And so you have to have a lot of mental focus to hold that adjacent loose area, to hold it stable with your muscles, to kind of target the movement, to go into the stiff area. So, um, yep. Child's pose. And then in the program we teach self adjustment through the foam roll, not foam rolling the way that most people think of it on the muscles, but using the foam roll to manipulate and bring motion into the thoracic spine because it's so common. It's very effective. I do it all the time. Holly, I'm reading the deep regret comment. Don't live in that space of regret. Just think next step forward. It's something that you can recover from, and there are steps you can take to bring your body back into balance, to heal the part of your spine that may have been damaged. And absolutely, there are steps you can take. And so that's where I would encourage your mind to be. And so the past has already happened. And we accept it. And we we learn from it. And we we take what we learned to help guide our decisions moving forward. So you're smarter, you're more experienced, more knowledgeable. You're wiser now. And so there are good things that can come out of these tough experiences. Yevgeny, I see your question. lower back. If your lower back hurts, the chiropractor shall adjust upper and if upper hurts, he shall adjust lower. Uh, no, I wouldn't. I would say no to that second part. That's not a rule. You don't want to just assume that the part that hurts is the hypermobile part. You would want to go by the predictable pattern, or your history, or your your intuition, your feeling of your body. Okay, so you say someone was in a car accident and the seatbelt held them to the seat, but just above the seatbelt, they had a big jolt in their spine that could create a hypermobility in the thoracic spine. And so if I had that history, if I had hypermobility or instability in my thoracic spine from from a history of trauma, then I would want to protect that area. So there is no absolutes with these rules, like never adjust the lumbar spine or always adjust the thoracic spine or anything like that. The pain can be where the stiffness is or the pain can be where the looseness is. And so you got to use your own judgment based on what you know of your body. If you intuitively know that you have a lot of degeneration in your lumbar spine and maybe even feel it's a little loose, then that would be a reason to not get it adjusted. But I wouldn't say that would be the reason to get the thoracic adjusted. Because what if you had the history of an injury to your thoracic spine and it was hypermobile you still, you wouldn't want to get that adjusted? Yeah. I can't give you any rules. The only rule is don't manipulate, don't thrust a hypermobility or an instability. That's the only rule. And you got to know where those might be. Typically they're in the areas of degeneration. And usually those areas are surrounded by stiffness. And those are the areas that could be benefited by a thrust or a manipulation. Hopefully that makes sense. Follow up with questions if that doesn't make sense. Holly, I know you're asking about a CBT plan. Have you seen the masterclass? Because that would be the first place to go. I would want everybody who's interested in the program to watch that get get that knowledge. And then if you if that makes sense to you, then to do the free trial and see if it's a good fit. Try it out. It can't hurt you. Even if you have this acute situation that you're talking about. This stuff is extremely gentle in the beginning of the program, and so it's not going to hurt you. And I'm in there every day coaching the students. So that's where we would be able to connect. And I would suggest that path. You know the masterclass. Take the assessment and see if you qualify for the trial. And if you do then do the trial. And if if you have other questions that you need that aren't addressed through that path, then you can send me an email. Just hit reply to any of the emails that you get from Core Balance Training, and I'll see that and I'll be able to address your questions. So let's keep going down in this chat. Chris Manhart. Hi Ryan, this is off topic, but what are your thoughts about running with spinal stenosis? I'm a runner but was diagnosed with severe spinal stenosis l4, l5. Uh. It's doable. So this is in perfect alignment with the kind of the whole philosophy of core balance training. It's not about what you do. It's about how you do it. And so yes, you can run, but it's going to matter how you're connected with your core, how you're connected with your body and how your spine is supported while you're running. And so you couldn't just across the board, tell anyone that they'll never run again, or that they can absolutely run no matter what just because of, you know, a diagnosis like that, like a stenosis in their spine. It's not the activity is not the factor. It's how you relate to your body while doing the activity. There's only a couple activities that I would say that you shouldn't do that, I wouldn't. You know, I'll speak for myself. There's only a couple activities that I wouldn't do because I know of my history, and I just. I don't know, they're not. They don't interest me that much. So I'd rather be a little preventative. But I don't think becoming an avid horseback rider would be the best idea because of just the inherent amount of compression. Repetitive trauma to the lumbar spine. I don't think that would be the best idea. And the other one I can think of is like a regular avid off roader going off roading. Same, same kind of idea, right? Just constant vibration and compression. But other than that, I think that you can get back to pretty much any activity that you want to do on the planet, save for a couple of those activities that aren't even really, you know, they're more going for a ride, if you ask me, than Doing something with your body. Horseback riding. You could argue that, but. So, yes, you can run. Chris. Are you a student? Because if you are, then that's what I would recommend to you, is continue in the program and you're going to learn module six is going to be highly relevant to you. It's called Walking Week and it just teaches you how to connect your core during walking and support your spine. And so that walking can become good for you. And then that same exact concept would be applied to running. Running could be looked at as a progression of walking. So you'd want to be able to master that with walking first. Um, you know, we get into this stuff as early as module four, where we connect all three anchors together and form this kind of support around the spine. I call it the anchor triad. That happens in the beginning of module four. And yeah, you can pretty much do do the life that you want to do when you can make that connection. So it's super powerful. Okay. So good question Chris. All right Linda, do the vibrating machines that you stand on hurt or help your joints and spine? I have a bulge and a degenerative disc. Uh, vibration typically is irritating for the lumbar spine. For degenerative discs. You mentioned you have degenerative disc. So vibration is typically going to irritate that. And you can imagine why it's a bunch of little micro friction happening into an area of the body that is experiencing degeneration from microtrauma, from friction, from repetitive trauma. So I don't personally seek vibration. I know those vibrating massagers are getting really popular, but I wouldn't want a whole lot of vibration and any injured part of the body. That's just not what it wants. It wants to be hugged, right? It wants to be held and wrapped and supported, and vibration is kind of the opposite of that. Chris Manhart. Yeah, you're in the program. Awesome. And I'm glad you are enjoying the program and learning something new. Keep going. It's super rewarding and it's just it's my passion. So I'll be in there anytime you need support. So keep it up and you're out. Keep investing in yourself. Uh, Holly, you can get back to those things. Hiking, teaching, yoga. And, Linda, I do recognize your name. You're in the program starting week three. Awesome. I love to see the students showing up, so thank you all for being here. I am super happy to be able to provide a little bit of support and just share some of what I've learned in my long, long journey in the back pain universe. Hopefully you took away something from my message today. Chiropractic is a valuable tool that can be used to help you, and it just takes a little bit of education and knowledge about your body to prevent it from potentially harming you. And so it seems like we have at least one person in the chat who has recently experienced trauma to their spine from a chiropractor. So don't be the next person to go through that. It's not fun. I've been through it. I told my story and the main takeaways are you don't adjust a degenerating, injured part of the spine. You don't. You want to set the boundaries there and you don't let somebody manipulate or thrust those parts of the spine. You want to get your manipulation. If you go to the chiropractor, to the stiff parts of the spine, that's typically the thoracic spine, but not always. Eighty percent of people fall into the predictable pattern. And so most likely you could benefit from thoracic spine adjustments. That's what I would do if I went to the chiropractor. I would say don't touch my lumbar spine. And that's totally okay. Even if they're wearing a white coat, it's okay to be the boss of your body and your temple. So thank you again for being here, everybody. You know, as we leave the stream, whatever you go do next, make sure it's something for your body, for yourself, because our bodies do so much for us. So if that means getting down on the floor and doing some core balance training, then go do that. So thanks again for being here and I'll see you next week.
