WEBVTT
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Factor spelled FA k t R stands
for Functional and Kinetic Treatment with Rehabilitation.
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Over the past decade, this unique
approach to treating pain and dysfunction has been
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utilized by healthcare providers on six continents, serving as a framework that guides clinical
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decision making and patient visits around the
globe on a daily basis. With this
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podcast, our goal is simple to
bring the best and brightest in clinical education
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to the forefront and empower practitioners with
cutting edge, evidence based content that improves
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patient outcomes and inspires healthcare providers to
continually evolve their approach to treatment. In
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each episode, we will feature a
training or interview with some of the top
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minds and healthcare in a short format
that is easy to digest, with actionable
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information that you can implement into practice
right away. Let's get started, guys
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A Welcome to the Factor podcast.
I'm your host, Jessica Riddle. If
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this is your first time tuning in, welcome and thanks for listening. In
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today's episode, we finish up our
two part training with doctor Michael Lovick titled
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Muscle Memory. How your brain uses
muscle tone to map the world. Now,
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muscle tone or muscle memory rather is
the ability of muscles to perform actions
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without neuronal input. It's related to
the brain's ability to map out the body
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using muscle tone and integrates with vestibular
and visual inputs. Today, Doctor Loovic
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will discuss the importance of understanding the
innerplay between the brain and body to help
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determine the root cause of seemingly unrelated
symptoms in your patients. We will also
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chat about the relationship between muscle memory
and chronic pain and how reflexogenic systems can
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be used to treat musculoskeletal cases that
are not responding to care. Today's guest
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speaker helping us navigate this topic is
doctor Michael Lovick, a Board certified chiropractic,
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functional neurologist and Board certified chiropractic sports
physician. He holds Masters of Science
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in sports Medicine with additional training in
brain based functional medicine and functional movement based
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rehabilitation. He has served as medical
director and a member of the medical staff
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for various organizations and events in professional, amateur, collegiate, and high school
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athletics. He specializes in integrating the
physical aspects of sports medicine and chiropractic care
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with the brain's neurological and physiological systems
that are often overlooked. He's a partner
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of Delta S Performance Functional Neurology and
Sports Medicine with clinics in the Denver and
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Boulder metro areas, and clinical adjunct
faculty for Evidence space, concussion Management and
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care for the University of Western States
Sports Medicine program. All of that being
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said, with all of the accolades
and the functionalrology designations that doctor Lovic has
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earned over the years, we are
super excited to have him tackling this very
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important and very cerebral, may I
say, topic for us today, So
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let's cue the intro music and get
started. So we talk about a couple
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of these artificial compensations that happen,
so balance and hypertenicity. If you have
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an issue with vestibular input through your
vestibular spinal tract to your core muscles,
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no matter how much balance training you
do, it's not going to fix the
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vestibular issue, So you're going to
constantly be fighting against vestibular systems are always
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paired. Right, you have your
right end to your left post here and
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now give your left horizontal and your
right horizontal. Now if the left horizontal
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isn't working well, your right one
relative to it will be overfiring, which
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use the term escaping, which means
that you're going to get the constant perception
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of your rotating to the left if
you're always rotating to the left, even
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if you're physically not, but your
brain thinks you are. Because remember,
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vestibular drives into appropriceptive. That means
all the muscles on the right post to
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your side of your body are going
to be pulling back and you're going to
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be creating muscular imbalances, and that
is home. So you can have pain
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in patterns associated with that, and
you can do it yourself. Slightly turn
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your body to the left and then
rotate your trunk to the right and find
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the areas in your body. You
can feel a little bit more tension building
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and next time the patient comes in
with a pain in that area, start
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to think, hey, maybe there's
a vestibular component. How can I test
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for this or how can I co
manage someone who contest for this muscle splinting.
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We talked about that pretty straightforward joint
dysfunction. So if you work in
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any sort of pt or chiropractic mindset, where you're using mobilizations or manipulations.
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The whole concept of joint dysfunction in
an area might not be due to an
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area due to a problem in that
area could be especially if it's post whiplash
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or post concussion or developmental if they've
had it forever. It could be due
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to that increase in hypertenicity in that
localized segmental area because it's a segmental sensory
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apraxia, which means the brain can't
feel it well enough, so forgets how
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to move it, which locks it
down, creating a restricted area. So
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when you motion palpated or you try
to say, oh is this working,
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how's that doing? And you start
moving things around, adjust in that area
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may not be the most appropriate thing
to do, because it could be coming
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from an area where the brain is
needs that to figure out where the body
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is in space. So what do
I recommend if it's on the same side.
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So let's say you're looking at it
from a cerebellum perspective and you're like,
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Okay, the right cerebellum's not like
I found that seems to be doing
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a little bit rougher, And I'm
finding all these areas on the left side
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of the body that are hypertonic.
Maybe hypertenicity is more of a compensation.
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I want to put input through to
that right cerebellum instead, I'm going to
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only hit the stuff on the right
side. I'm only going to move and
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motion palaply this stuff on the right
side of the body, and so the
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left side of the body I'm just
gonna leave alone and see what happens.
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More often than not, if you're
using this approach, you'll find that hey,
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like two three days later, that
just kind of like quietly disappeared,
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and the patient when you ask them
about it next time, you're like,
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oh, yeah, I guess that's
gone. But you can use this through
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this sort of concept through a number
of different ways. And this is where
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I put all those reflexes down there. For people who like to read up
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on things will read up on all
these reflexes and you'll start to say,
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like, oh wait, there's a
connection there. There's a thing there that
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might be causitive correlated that where my
more musculo skeletal based approach might stop and
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not be able to go that far, because essentially we're just kind of beating
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it into submission. One of the
problems is so, especially like with like
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deep tissue, is you're creating a
ton of sensory stimulus into an area that
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might be one of those compensations.
And if you're putting sensory stimulus into the
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brain on the opposite side of where
you find the deficit, you might be
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furthering that deficit. Where they'll feel
better in the moment they'll get up off
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of the table. The muscle is
longer because you've manually made it longer,
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But what's going to happen as soon
they try to use it, It's going
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to shrink back up again because the
brain still needs that compensation to navigate the
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world appropriately. So I hope this
created a little bit of a paradigm shift
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for some people to think maybe there
is a little more of the brain to
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look into. I always offer consoles, case reviews, anything like that with
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anybody was interested. I'm always happy
to chat about it. It's the goal
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is I feel like patient, but
I want patients to have the best patient
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care they have. And if somebody
needs to ask a question, doesn't want
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to feel like it's a weakness to
ask for help that I'm always there to
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help. So for anybody who wants
to refer a patient my way go to
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contact us page on our website and
click under new patient info have them fill
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out to get started for him.
For everybody else, anybody who's a practitioner
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of any sort has questions, I
wants to have hop up a phone call
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with me to go over something you're
working with, or at least to ask
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a question of like, Hey,
this is I'm trying to figure this system
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out. How do I figure it
out? Practitioner referrals and case reviews.
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And then if you want to come
shadow in office, either in Massachusetts,
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Rhode Island, or Colorado, fill
out the form under shadowing our offices and
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we're more than happy to have you
in here. And that's all I got.
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I've tried a lot of different rubs
and different types of ointments and lotions
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before I used to use other top
goals and never had the success that I
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now have with China Gel. China
Gel is my pain reliever of choice.
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We use it in the office because
of its consistency and the response that I
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get from the patients is what my
goal is. I want to get people
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better. China Gel allows me,
as the practitioner to use instrument assisted techniques
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me as the practitioner to do ultrasound
and do many different techniques that I've learned
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over the years in conjunction with China
Gel to get the maximum benefit for a
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patient. It's the combination of my
skills as a chiropractor and what China Gel
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has in it that allows the patient
to get better, faster, and more
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effectual. Thank you so much,
doctor Levic. If you have questions,
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please chat those in through the chat
feature there. We would love to hear
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from you, and we'll start kind
of the live Q and A portion here.
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Going back to what you saying earlier
about your practice, could you give
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us kind of a little idea about
what your intensives look like. I know
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sometimes you work with patients in these
intensive programs and do a lot of different
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things. Could you tell us first
what type of patients are better suited for
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and intensive and then walk us a
little bit through like what that process looks
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like in your office in terms of
length of time, zams, things like
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that. So when you're looking at
it, intensive actually gets a little complicated
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because you look at more psychosocial factors
as well. So let's say ideal,
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which means no financial concerns, no
time concerns, and we can get a
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person better. If we want to
create neuroplasticity and your brain, the best
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way to do that is intensity and
repetition. Right when you're working with the
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brain, you don't have to rest
as long as when you're working with a
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muscle. So let's say it ideally
or a ton of hand waving gear,
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we'll go when doing a workout with
like two A days. If you do
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two A days every day for a
while, five days straight, that's pretty
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like the body typically needs to recover. People are usually pooped that evening and
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hopefully sleep well that night. When
we're talking about neurological rehab, if you
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give them ten fifteen minutes of actual, like full on rest, like hey,
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you lie down, you get naptime
in the dark, close your eyes.
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I'll be back in fifteen minutes.
We do thirty minutes for most intensives
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here. Then we can continue to
build neuroplasticity at a rate where we have
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a controlled environment so that they don't
go back into the world, move weird,
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do things weird, throw off the
stuff that we worked on, and
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then they come back and say,
all right, I felt better, and
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then it came back. We can
continue them rehabbing and getting better and better.
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I had a patient in here this
week. So what an intensive is
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is two hour examination, twenty eight
rehab sessions, and then a one hour
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reexam Monday through Friday. And so
I have a patient in here from the
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Los Angeles area and came in thinking
like it might be some sort of disononomia,
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some sort of pots, some sort
of weird thing that just creates muscule
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scaltle issues, including like some sort
of cog wheel rigidity in the legs where
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you're like, okay, there's some
weird nerrow stuff going on. And as
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we started working on it, we
realized it was a vestibular issue. There
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was a left postier canal, or
we'll call it a right end tier canal
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escape that was really like creating a
lot of haywire right endtier canal escape.
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You think that you're constantly falling forward, what is your body going to do
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the compensation it's constantly going to pull
your backwards into the left. Your left
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post or a hip is gonna be
super tight. What also counts as a
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posterior muscle your soas and so you're
going to be creating these artificial compensations where
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if I went in there and I
tried it a couple of times, I
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was like, all right, I'm
just gonna loosen up your so as.
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I'm gonna loosen up your glutes.
We're gonna do some glute activation type stuff
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and do all like the functional movement
rehab type stuff and say, hey,
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if we we're just gonna see what
happens. I even did one single drop
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on a drop table, separately,
not all at the same time, to
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say I'm going to do this,
throw you on a balance platform and see
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what happens, see what changes.
And every time we did anything with the
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muscles, it destabilized it, which
created an increase of symptoms until I was
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like, okay, well we're going
to move your leg out like this a
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few times to activate those left glued
stabilizers and like, oh, pain went
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away. So we were going through
this cycle and we realized that there was
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a vestibular issue that had to be
taken care of first and foremost, and
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we got that knocked out in like
a day and a half. That was
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easy, but then we spent the
rest of the week incorporating more of a
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functional movement thing. How do you
relearn how to use your hips, how
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to use your lower core, how
do you turn it into the appropriate motor
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and grams? And for people who
don't know what an end gram is,
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it's a code of your brain that
says this is how you move and coordinate
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a group of muscles to to do
a certain function. So we're trying to
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do is create a new motor and
graham And what's the easiest way to do
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that? Repetition and intensity where we
have her doing more fundamental movements and you
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can go to like DNS in that
kind of style, And I did,
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but I was using it, but
I was changing the exercise to bias.
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It based off a vestibular input,
so we can continue winding left post your
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canal into lower brain stem activation into
motor court of a spinal output. Does
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that make sense at all? Yeah, I know that's interesting. And I
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think another important question too is like, if I'm a doc in practice and
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I have a patient that might need
to be referred for further neurotreatment than I
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offer in my practice, what does
that typically look like? When should their
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kind of red flags start going off
where they say, hey, this is
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something that might be outside of what
we can off here. That's the toughest
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part right now, because a straight
up algorithm is at a functional model of
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when you draw this line, that's
when this is functional neurology. And before
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that can be we'll call it functional
movement. I would say when there are
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neurologically related symptoms, easy way to
know if it's a neurologically related symptom,
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go to the subjective symptom and out
with the subjective symptom form on the SCAT
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five. Any of those things,
including neck pain, could be neurologically related.
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And so when you see anything there, first step is to start putting
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a little closer eye on there and
say, okay, is there something deeper
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happening? Do I want to start
looking for things? So what you want
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to look for is ocular movements.
Can they keep their eye on a target
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when they're looking at you or do
they jump their eyes all over the place.
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And if you ask them to look
at something like a thumb, make
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sure it's outside of their convergence on
this. Number one error that I see
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in most people doing rehab is they
put the thumb right here or even here.
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You want the thumb to be further
than they could reach, because you
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want their eyes to be as at
least converged as possible within reason. Have
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them look at your thumb. If
they can keep their eye on a target,
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that doesn't mean that they have ocular
stability, because that's where these things
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come in. When you can keep
your eye on a target, you can
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use your frontelobe to inhibit the vestibular
error. So there's two ways to look
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into this, and they're a little
bit tough to do. You can throw
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them in goggles like that which put
them in the dark, and you can
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see how the eyes move when they
don't know where they are in space,
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they don't know where the world is, and you can see ocular instability.
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Or you can use an opthalmoscope and
you can look in the eye and you
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can have them cover the other eye. The light blocks out, the hand
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blocks out, so you can see
a spontaneous pystagmus. Sometimes you can see
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a bunch of ocular instability, like
if you're like, if you practice your
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up homoscope and you're having trouble getting
into the eye, it might not be
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your error. It might be their
eyes moving all over the place that they
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can control it. And then The
other thing you can do is have them
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line their back and then close your
eyes and you can put your like I
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use my thumbs like this. You
can put your thumbs on their eyelid and
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you can feel the lens as a
differentiation. You can feel the motion of
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the eyes. So there are ways
that you can look at ocular stability without
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having them look at something where they
can use their frontelope to suppress all the
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issues that are going on. One. I think you made an important point
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there too. You don't have to
have complicated equipment sometimes to make these determinations
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or to do these exams, which
is some people use a vibra pastor that
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costs fifteen hundred bucks. I'd take
a gilette raisor and take the sharp part
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off. That's a great way to
do that. Someone else wrote in with
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a question and said they're curious if
there's a neurocomponent in scoliosis cases. They
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said, the point you made to
work on the opposite side of the symptoms.
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Do you think or know if there
is a relationship to idiopathic scoliosis without
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clear structural ediology with the compensatory mechanisms
you mentioned, Yes, so scolios I'm
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not going to talk about congenital scoliosis, or we're not going to call about
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a structural scoliosis, but let's talk
about a functional scoliosis where everything is not
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structurally asymmetrical. They just have that
Remember what I was talking about before,
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where you could have structural asymmetry in
just the angle in which the interior is
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sitting. If you think of walking
as a series of controlled falls moving constantly
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throughout the world, You're constantly getting
more input into one side than the other,
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which is going to create differences in
neuroplasticity along the appropriate path associated pathways,
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which is going to create changes in
head tilt, which is going to
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create changes in rotation. It's going
to create changes in your cortical stability.
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If you have less will call approp
receptive awareness of the left side of your
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body, you make collapse into that. It can also change based off of
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your comfort and balance. For example, me personally, I have less awareness
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on the left side of my body
based off of like concussions and stuff.
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And so now is it less awareness, Like you can do a neuroexam on
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me and be like, oh,
yeah, there's a deficit. No,
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it's when you take all these like
real functional things and you put it under
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stress, that left side of the
body is just not going to be as
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aware. So if I was going
to default to a more stable side,
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I'm going to default to my right
side. Where are all my sports injuries?
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Right shoulder, right hip, right
knee. I tore my PCL skiing
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because I lost the ski on the
left side and I defaulted to the strong
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side and all the four went through
it. So these injuries that use sports
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related injuries you can get may be
associated with a vestibular or visual deficit,
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and for me, it was a
vestibular deficit that created changes with that.
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So yes, when you have these
neurocomponents, they can be related to a
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more of a functional scoliosis because they
just think that this is home because their
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heads like this make your eyes level
to the horizon. It's fascinating. It's
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really fascinating to think about. And
I think you made a very salient point
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there as well, Like, if
you're seeing athletes who continue to have injuries
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on one side of their body versus
another, is that something to look at?
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Is that something to kind of dig
a little bit deeper with? But
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if you're seeing all the athletes with
the injury on the same side of the
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body, and you start rehabbing and
really doing a ton of soft tissue work
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or joint manipulation on that side of
the body, and it's due to the
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other side of the body not having
the appropriate activation. You could be creating
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further brain and balance which is going
to create other issues. So if you're
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working on one thing and you're like, oh, now I'm getting less like
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headache coming out of nowhere, there
might be a time to look back and
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say like, Okay, do we
have multiple problems going on? Do we
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need to rehab a neurocomponent, which
for our office, like when we get
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referrals from other practitioners, they're usually
back in the other doctor's office within two
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to four weeks because we work what
we do works quick. We do many
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intenses with people where we see people
like three sessions in a day. We
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said three times a week, We'll
see him three times in a day,
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and we'll stack them and put them
all in a morning. So it works
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quick. But that but going along
with that same idea is they gets sent
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to us for more of that neuro
rehab perspective, and then we send them
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back for the muscile skeletal because we
don't need to do everything, and it's
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also a little more expensive, so
there for the patient to pay our prices
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for something that they can get quality
someplace else. But from back to a
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clinical perspective, yes, if you
start seeing injuries all on the same side
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of the body, start looking at
the other side. I have a story
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about this. A colleague of mine, Tyler, out in Idaho, he
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called me once because he had a
violinist who was having a bunch of forearm
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pain and he did he did,
like he went to school with me,
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so he did factor, he did
a number of other techniques and he was
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like trying to work on it and
he was like, nothing's changing. And
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I was like, do the same
exact thing, but on the other side
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of the body and it went away. He was like mind blown. Yeah.
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Yeah. He called me with more
expectives than I'd ever expected to set
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say in his life, and I
laughed. That's fascinating though, And it's
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it's interesting because we do talk about
this in our soft tissue courses as well
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in terms of what we're doing to
the body. And obviously doctor Riddle can
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speak much more eloquently about this than
I can. But there is so much
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input that's being You're inputting into the
CNS, affecting the central nervous system with
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what you're doing every time you touch
the body. And I think you're right
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if you just stop and only think
through the muscular skeletal, but then don't
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even consider the entire nervous system that's
also a part of that, you're really
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kind of missing the boat on some
things there. That was my favorite part
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actually, what I was like entire
proctic school learning about because I was learning
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neurostuff at the same time because apparently
I don't like having a life. But
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while I was going through it,
we were I remember going to class and
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being in class that we all palpated
the yes side. We had a one
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person and everybody went through and palpated
it. We all were talking about what
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side do we think restrictions were on? What did we think we were was
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going on? And I'm sitting there
thinking about it as I'm watching this,
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I was like, every time we
palpated, we're creating motion in there,
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and that motion is creating sensory awareness
to the brain, which is changing the
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activation which is going to send back
down and change where the restrictions are.
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And I think the purpose of it
was very good, which was there's variability
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just to what people feel. But
I'm sitting here thinking like every time you
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just test to figure out what's going
on you're applying a treatment. Absolutely,
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it's fascinating to think through. And
you would spoke a little bit earlier about
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working with other offices and how someone
might refer to you for a short period
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of time and then you send them
back. What type of other healthcare practitioners
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are you most often getting referrals from? How do you all fit with what
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you do specifically into that sports medicine
team, let's say for a college athlete
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or even a professional or an elite
athlete where they may have a lot of
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cooks in the kitchen, so to
speak, trying to make sure that they're
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in prime playing condition. How do
you guys fit into that with what you
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do. We get more referrals actually
from neurologists, which is really fun to
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say but also interesting because we get
we get like almost no referrals from chiropractors.
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Well get referrals from pts in chiropractic
offices. It's like part of it
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is the paradigm where we're so locked
in into a certain way that we don't
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really like see what else is available, and we're like, well, I
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know that if I keep on doing
it. I was at was the ACBSP
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Sports Symposium years ago and I was
looking at a case study and somebody got
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a concussion better in six months,
and I was like talking about it.
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He was like super Jazz, like, hey, look look who we did.
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And I'm sitting here like, we
do that in like two weeks,
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and so the I didn't say that
that we wrote, but the but the
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idea is what I was saying before
at the beginning. We don't overtreat,
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we don't oversell. What we do
is we're here to get people out of
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our office and make good connections with
people in the community. So what does
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it look like when somebody sees something
that may look like a history of concussion
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or and it goes past the ten
days that have to put into post concussion
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syndrome, or or there might be
associated neuroimmune stuff going on like post COVID,
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or they might have a dis autonomia
going on at the same time.
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Those are the cases to get and
over just to get checked out. I've
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sent people back saying this is not
a case that we can fix because there
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I've been to s seminars where one
guy in particular, we says chiropractors never
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find normal. We find normal.
We find times that we are therapies are
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not appropriate and we need to send
to a different location. But the purpose
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of what we do is we do
a really thorough exam. I had an
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autonomic neurologist in the Boston area once
I believe send yeah it was, he
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sent me a cardiac patient and I'm
like, this isn't my wheelhouse. But
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the guy on the phone said,
well, he said that I've seen enough
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people and if there was something going
on, you'd figure it out. And
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so I was like, that's a
really cool compliment, but I still think
359
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you're in the wrong place. But
if you're open to paying for it,
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I'd be happy to do the exam
and put this and see what I can
361
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put together and see where we can
get you. And we we ended up
362
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just sending you up to like a
different type of professional and I don't really
363
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know where it went with from there, but that's kind of what we do.
364
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We try this new thing in chiropractic
called playing well with others. That's
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very true, and you hit on
something just a second ago, and it
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actually segues really nicely with a question
we had come in through the chat.
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Someone was asking about what commonalities you're
seeing in post COVID cases as far as
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the cause of symptoms, if any, or are symptoms coming from where the
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virus affected the brains, So it's
very individualized. Are you seeing any trends
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with your post COVID patients? For
the sake of time, I was on
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a radio show on Wednesday of this
week talking about post COVID. We kind
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of like spiral them is like different
directions. But the first thing that we
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talked about really really dies into this, So I would highly recommend checking that
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out just you get a more full
answer. But to make it quick.
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Post COVID so concussion, it's not
just traumatic. It's an acquired brain injury.
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So you can get concussion symptoms from
things like whiplash you don't actually get
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the head. You can get concussion
symptoms from viral illnesses. We see a
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lot of patients coming through our office
with an epstein bar, a chronic line,
379
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a site of megalovirus or a COVID
how it changes. What's different about
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COVID in particular is it's there's a
lot of weird stuff going on there,
381
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which is why there's so much variability. Some person can go online and say,
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hey, I had it was nothing
as worse as the cold. If
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somebody else laying in a hospital it
reads that and be like I wish.
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And so what it comes down to
is your brain's adaptation. Your brain makes
385
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symptoms from different areas of the brain. If you're nuclear attracted, solitarius is
386
00:28:37.799 --> 00:28:41.799
firing too high, so it's revving
too hot. That's where nauja comes from.
387
00:28:42.319 --> 00:28:47.079
Yes, you can have other things
that can trigger nausea, but the
388
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pathway goes to that point and that's
where the brain fires too high and now
389
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you feel the nausea if you had. And that same system is all your
390
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cardio respiratory systems and your gustatory systems
as well, So you get all these
391
00:29:00.079 --> 00:29:03.319
weird neurological stuff all the same time. But in terms of what are the
392
00:29:03.359 --> 00:29:08.839
commonals and postcode patients, they look
like incustipations who have chronic low level inflammation
393
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due to a virus as opposed to
due to a knock to the head,
394
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and it's just from our perspective,
it's a very very similar ideology. The
395
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only thing different is, especially if
if there's somewhere near our Boston area,
396
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we use an violet colored laser that
is shown to be helped with more anti
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00:29:27.240 --> 00:29:33.680
viral antibiotic properties, so we'll use
that in combination with it. But we
398
00:29:33.720 --> 00:29:36.599
do get postcode patients coming out to
me here and I don't have a laser
399
00:29:37.000 --> 00:29:41.000
again for some reason, I'm just
like a simple office, but we still
400
00:29:41.000 --> 00:29:45.279
get good benefits because it's vestibular input. Two more quick notes there are there's
401
00:29:45.279 --> 00:29:51.480
a paper out there that shows that
unilateral mist good deficits create chronic inflammation,
402
00:29:51.920 --> 00:29:56.160
so people who are chasing the guns
all the time look the interear. And
403
00:29:56.200 --> 00:29:59.119
then there's also what was that other
thing I was going to say, You
404
00:29:59.160 --> 00:30:03.240
can get the same microglial ramification in
a viral in this that you can in
405
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a concussion, which could create those
long term effects, which is why,
406
00:30:07.839 --> 00:30:14.799
especially with what came out in the
NFL, there's it's so important to accurately
407
00:30:14.839 --> 00:30:18.319
diagnose and not just say well,
it's not that bad, because if you
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00:30:18.359 --> 00:30:22.759
can look beyond the subjective questions.
If you can do a proper, full
409
00:30:22.839 --> 00:30:29.839
cranial nerve exam for subjective complaints like
headaches and dizziness, then you might pick
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00:30:29.960 --> 00:30:33.359
up a lot of things that other
people are missing because they're kind of rushing
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00:30:33.400 --> 00:30:36.200
through because they already have an idea
in their head of what they think it
412
00:30:36.319 --> 00:30:41.599
is. I think that's very true, and I think practitioners are. I'm
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00:30:41.640 --> 00:30:44.599
sure you guys are constantly having to
kind of check yourself in the examine and
414
00:30:44.640 --> 00:30:48.680
be like, okay, like I
don't just need to let my bias come
415
00:30:48.720 --> 00:30:52.279
into this about A plus B doesn't
always equal. See every persons an individual,
416
00:30:52.319 --> 00:30:56.039
and I'm sure you see a ton
of that in your practice, as
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00:30:56.200 --> 00:31:00.519
do the other practitioners on here.
Do you have the link for the radio
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00:31:00.759 --> 00:31:03.960
interview that you were on that you
might be able to email me and I
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00:31:03.960 --> 00:31:07.200
can email that to everyone afterwards.
Yeah, I can send you that link.
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00:31:07.319 --> 00:31:10.279
I can also send you We'll get
them listed. We'll get him post
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00:31:10.319 --> 00:31:12.839
it up on the website and the
resource page as well soon. Yeah,
422
00:31:14.000 --> 00:31:17.759
can get you that link as well. Okay, that would be wonderful and
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00:31:17.839 --> 00:31:21.599
everyone. That way you can have
the full conversation and the full explanation.
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00:31:21.880 --> 00:31:26.440
As doctor Lovich was saying about long
COVID. We certainly want to be respectful
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00:31:26.440 --> 00:31:29.680
of everyone's time. We do try
to keep two one hour, but this
426
00:31:29.759 --> 00:31:33.759
has been incredibly informative. I think
even just our Q and A segment could
427
00:31:33.799 --> 00:31:37.240
probably go on for a whole another
hour just with the questions that have been
428
00:31:37.240 --> 00:31:40.960
coming in and the conversation. So
thank you again so much. We really
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00:31:40.960 --> 00:31:44.240
appreciate you coming on today. So
again, thank you so much, Doctor
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00:31:44.319 --> 00:31:47.119
Lovich. Thank you everyone for joining
us, and we will see you next
431
00:31:47.160 --> 00:32:00.960
time. Thank you, thank you. That's it for today's episode. Be
432
00:32:01.039 --> 00:32:05.440
sure to tune in for episode fifty
five, where we kick off a new
433
00:32:05.480 --> 00:32:08.759
training with doctor Ben Fergus, where
he'll teach you how to supercharge your skill
434
00:32:08.799 --> 00:32:14.440
set for clinical and financial success.
As you know, from time to time
435
00:32:14.480 --> 00:32:17.759
we like to take a break from
clinical topics and focus on the business related
436
00:32:17.799 --> 00:32:22.839
aspects of growing a successful practice.
These next two episodes are ones you'll want
437
00:32:22.880 --> 00:32:27.720
to be shure to bookmark and listen
to more than once. You won't want
438
00:32:27.720 --> 00:32:31.200
to miss it. Episode fifty five
drops in two weeks. You can subscribe
439
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to the Factor podcast on Apple,
Spotify, iHeartRadio, or the podcast app
440
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that works best for you. Give
us a five star rating to help us
441
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grow the show. Every little bit
helps. You'll also always find a link
442
00:32:44.480 --> 00:32:49.000
to download the PDF presentation from the
training featured in each episode, along with
443
00:32:49.039 --> 00:32:52.559
a link to view the full video
webinar recording. If you're more of a
444
00:32:52.640 --> 00:32:55.039
visual learner, so be sure to
check out the show notes and download those
445
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today. And last, but certainly
not least, we invite you to join
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us for a live hands on Factor
training in a city near you. Our
447
00:33:04.400 --> 00:33:09.319
hands on courses are for chiropractors,
physical therapists and PTA's athletic trainers and license
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massage therapists and offer up to sixteen
hours of continuing education credit. To view
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our full course schedule and register to
attend a live hands on course, visit
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Factor education dot com. That's Faktr
education dot com. We'll see you next
451
00:33:28.799 --> 00:33:34.319
time. Hey guys, If you
like what you heard today, I encourage
452
00:33:34.359 --> 00:33:42.400
you to visit our website at Factor
Hyphenstore dot com. That's spelled Faktr Hyphenstore
453
00:33:42.720 --> 00:33:45.279
dot com to find out more information
about all that we have to offer.
454
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We have a variety of online offerings
as well as our hands on Factor Rehab
455
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System course scheduled in cities around the
globe. Be sure to also check out
456
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our event calendar and bookmark any of
these upcoming live webinar dates coming up in
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the near future so you can join
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biggest compliment we can receive is for
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459
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your friends, colleagues, and classmates. You'll find all the important links,
460
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as well as info about our sponsors
in the show notes, so be sure
461
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to check those out.
1
00:00:17.960 --> 00:00:24.519
Factor spelled FA k t R stands
for Functional and Kinetic Treatment with Rehabilitation.
2
00:00:24.960 --> 00:00:29.239
Over the past decade, this unique
approach to treating pain and dysfunction has been
3
00:00:29.320 --> 00:00:34.560
utilized by healthcare providers on six continents, serving as a framework that guides clinical
4
00:00:34.600 --> 00:00:39.439
decision making and patient visits around the
globe on a daily basis. With this
5
00:00:39.479 --> 00:00:44.600
podcast, our goal is simple to
bring the best and brightest in clinical education
6
00:00:44.679 --> 00:00:50.759
to the forefront and empower practitioners with
cutting edge, evidence based content that improves
7
00:00:50.799 --> 00:00:57.280
patient outcomes and inspires healthcare providers to
continually evolve their approach to treatment. In
8
00:00:57.359 --> 00:01:00.840
each episode, we will feature a
training or interview with some of the top
9
00:01:00.880 --> 00:01:04.799
minds and healthcare in a short format
that is easy to digest, with actionable
10
00:01:04.840 --> 00:01:14.400
information that you can implement into practice
right away. Let's get started, guys
11
00:01:14.400 --> 00:01:18.359
A Welcome to the Factor podcast.
I'm your host, Jessica Riddle. If
12
00:01:18.359 --> 00:01:22.560
this is your first time tuning in, welcome and thanks for listening. In
13
00:01:22.599 --> 00:01:26.200
today's episode, we finish up our
two part training with doctor Michael Lovick titled
14
00:01:26.480 --> 00:01:30.879
Muscle Memory. How your brain uses
muscle tone to map the world. Now,
15
00:01:32.040 --> 00:01:36.959
muscle tone or muscle memory rather is
the ability of muscles to perform actions
16
00:01:36.959 --> 00:01:41.760
without neuronal input. It's related to
the brain's ability to map out the body
17
00:01:41.879 --> 00:01:48.000
using muscle tone and integrates with vestibular
and visual inputs. Today, Doctor Loovic
18
00:01:48.040 --> 00:01:52.840
will discuss the importance of understanding the
innerplay between the brain and body to help
19
00:01:52.879 --> 00:01:57.040
determine the root cause of seemingly unrelated
symptoms in your patients. We will also
20
00:01:57.159 --> 00:02:02.920
chat about the relationship between muscle memory
and chronic pain and how reflexogenic systems can
21
00:02:02.959 --> 00:02:07.919
be used to treat musculoskeletal cases that
are not responding to care. Today's guest
22
00:02:07.919 --> 00:02:14.639
speaker helping us navigate this topic is
doctor Michael Lovick, a Board certified chiropractic,
23
00:02:14.680 --> 00:02:20.879
functional neurologist and Board certified chiropractic sports
physician. He holds Masters of Science
24
00:02:20.879 --> 00:02:27.000
in sports Medicine with additional training in
brain based functional medicine and functional movement based
25
00:02:27.039 --> 00:02:31.120
rehabilitation. He has served as medical
director and a member of the medical staff
26
00:02:31.120 --> 00:02:37.319
for various organizations and events in professional, amateur, collegiate, and high school
27
00:02:37.319 --> 00:02:44.439
athletics. He specializes in integrating the
physical aspects of sports medicine and chiropractic care
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00:02:44.560 --> 00:02:50.439
with the brain's neurological and physiological systems
that are often overlooked. He's a partner
29
00:02:50.479 --> 00:02:54.560
of Delta S Performance Functional Neurology and
Sports Medicine with clinics in the Denver and
30
00:02:54.639 --> 00:03:00.560
Boulder metro areas, and clinical adjunct
faculty for Evidence space, concussion Management and
31
00:03:00.639 --> 00:03:07.360
care for the University of Western States
Sports Medicine program. All of that being
32
00:03:07.400 --> 00:03:13.479
said, with all of the accolades
and the functionalrology designations that doctor Lovic has
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00:03:13.479 --> 00:03:16.879
earned over the years, we are
super excited to have him tackling this very
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important and very cerebral, may I
say, topic for us today, So
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let's cue the intro music and get
started. So we talk about a couple
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of these artificial compensations that happen,
so balance and hypertenicity. If you have
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an issue with vestibular input through your
vestibular spinal tract to your core muscles,
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no matter how much balance training you
do, it's not going to fix the
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00:03:51.319 --> 00:03:57.520
vestibular issue, So you're going to
constantly be fighting against vestibular systems are always
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paired. Right, you have your
right end to your left post here and
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00:04:00.159 --> 00:04:03.639
now give your left horizontal and your
right horizontal. Now if the left horizontal
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00:04:03.759 --> 00:04:09.840
isn't working well, your right one
relative to it will be overfiring, which
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use the term escaping, which means
that you're going to get the constant perception
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of your rotating to the left if
you're always rotating to the left, even
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00:04:17.480 --> 00:04:20.639
if you're physically not, but your
brain thinks you are. Because remember,
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vestibular drives into appropriceptive. That means
all the muscles on the right post to
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your side of your body are going
to be pulling back and you're going to
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be creating muscular imbalances, and that
is home. So you can have pain
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00:04:35.600 --> 00:04:41.959
in patterns associated with that, and
you can do it yourself. Slightly turn
50
00:04:42.000 --> 00:04:45.959
your body to the left and then
rotate your trunk to the right and find
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the areas in your body. You
can feel a little bit more tension building
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00:04:49.480 --> 00:04:54.639
and next time the patient comes in
with a pain in that area, start
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to think, hey, maybe there's
a vestibular component. How can I test
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for this or how can I co
manage someone who contest for this muscle splinting.
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00:05:01.560 --> 00:05:06.920
We talked about that pretty straightforward joint
dysfunction. So if you work in
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00:05:08.000 --> 00:05:13.240
any sort of pt or chiropractic mindset, where you're using mobilizations or manipulations.
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00:05:13.879 --> 00:05:16.800
The whole concept of joint dysfunction in
an area might not be due to an
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00:05:16.800 --> 00:05:20.800
area due to a problem in that
area could be especially if it's post whiplash
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00:05:20.879 --> 00:05:27.240
or post concussion or developmental if they've
had it forever. It could be due
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to that increase in hypertenicity in that
localized segmental area because it's a segmental sensory
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apraxia, which means the brain can't
feel it well enough, so forgets how
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to move it, which locks it
down, creating a restricted area. So
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when you motion palpated or you try
to say, oh is this working,
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00:05:48.279 --> 00:05:53.000
how's that doing? And you start
moving things around, adjust in that area
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may not be the most appropriate thing
to do, because it could be coming
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from an area where the brain is
needs that to figure out where the body
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00:06:00.439 --> 00:06:05.000
is in space. So what do
I recommend if it's on the same side.
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00:06:05.639 --> 00:06:09.199
So let's say you're looking at it
from a cerebellum perspective and you're like,
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00:06:09.240 --> 00:06:12.319
Okay, the right cerebellum's not like
I found that seems to be doing
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00:06:12.319 --> 00:06:15.000
a little bit rougher, And I'm
finding all these areas on the left side
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of the body that are hypertonic.
Maybe hypertenicity is more of a compensation.
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I want to put input through to
that right cerebellum instead, I'm going to
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only hit the stuff on the right
side. I'm only going to move and
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motion palaply this stuff on the right
side of the body, and so the
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left side of the body I'm just
gonna leave alone and see what happens.
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More often than not, if you're
using this approach, you'll find that hey,
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00:06:38.720 --> 00:06:41.800
like two three days later, that
just kind of like quietly disappeared,
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00:06:42.360 --> 00:06:45.040
and the patient when you ask them
about it next time, you're like,
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00:06:45.519 --> 00:06:47.879
oh, yeah, I guess that's
gone. But you can use this through
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this sort of concept through a number
of different ways. And this is where
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I put all those reflexes down there. For people who like to read up
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00:06:56.120 --> 00:06:59.120
on things will read up on all
these reflexes and you'll start to say,
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like, oh wait, there's a
connection there. There's a thing there that
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00:07:01.079 --> 00:07:08.439
might be causitive correlated that where my
more musculo skeletal based approach might stop and
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00:07:08.519 --> 00:07:11.720
not be able to go that far, because essentially we're just kind of beating
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it into submission. One of the
problems is so, especially like with like
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00:07:15.600 --> 00:07:19.120
deep tissue, is you're creating a
ton of sensory stimulus into an area that
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00:07:19.199 --> 00:07:23.800
might be one of those compensations.
And if you're putting sensory stimulus into the
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00:07:23.879 --> 00:07:28.439
brain on the opposite side of where
you find the deficit, you might be
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00:07:28.480 --> 00:07:31.480
furthering that deficit. Where they'll feel
better in the moment they'll get up off
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of the table. The muscle is
longer because you've manually made it longer,
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00:07:36.800 --> 00:07:41.120
But what's going to happen as soon
they try to use it, It's going
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to shrink back up again because the
brain still needs that compensation to navigate the
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world appropriately. So I hope this
created a little bit of a paradigm shift
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for some people to think maybe there
is a little more of the brain to
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00:07:54.680 --> 00:07:59.480
look into. I always offer consoles, case reviews, anything like that with
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00:07:59.519 --> 00:08:03.040
anybody was interested. I'm always happy
to chat about it. It's the goal
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00:08:03.279 --> 00:08:05.519
is I feel like patient, but
I want patients to have the best patient
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00:08:05.560 --> 00:08:09.879
care they have. And if somebody
needs to ask a question, doesn't want
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00:08:09.879 --> 00:08:15.120
to feel like it's a weakness to
ask for help that I'm always there to
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00:08:15.120 --> 00:08:18.959
help. So for anybody who wants
to refer a patient my way go to
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00:08:18.040 --> 00:08:22.560
contact us page on our website and
click under new patient info have them fill
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00:08:22.560 --> 00:08:26.160
out to get started for him.
For everybody else, anybody who's a practitioner
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00:08:26.160 --> 00:08:28.439
of any sort has questions, I
wants to have hop up a phone call
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00:08:28.480 --> 00:08:31.240
with me to go over something you're
working with, or at least to ask
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00:08:31.240 --> 00:08:35.519
a question of like, Hey,
this is I'm trying to figure this system
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00:08:35.559 --> 00:08:37.840
out. How do I figure it
out? Practitioner referrals and case reviews.
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00:08:39.120 --> 00:08:43.039
And then if you want to come
shadow in office, either in Massachusetts,
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00:08:43.120 --> 00:08:46.480
Rhode Island, or Colorado, fill
out the form under shadowing our offices and
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00:08:46.519 --> 00:08:50.320
we're more than happy to have you
in here. And that's all I got.
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00:08:52.279 --> 00:08:56.840
I've tried a lot of different rubs
and different types of ointments and lotions
112
00:08:56.919 --> 00:09:01.039
before I used to use other top
goals and never had the success that I
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00:09:01.120 --> 00:09:09.559
now have with China Gel. China
Gel is my pain reliever of choice.
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00:09:09.639 --> 00:09:13.080
We use it in the office because
of its consistency and the response that I
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00:09:13.120 --> 00:09:18.320
get from the patients is what my
goal is. I want to get people
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00:09:18.399 --> 00:09:22.759
better. China Gel allows me,
as the practitioner to use instrument assisted techniques
117
00:09:24.080 --> 00:09:28.799
me as the practitioner to do ultrasound
and do many different techniques that I've learned
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00:09:28.799 --> 00:09:33.039
over the years in conjunction with China
Gel to get the maximum benefit for a
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00:09:33.039 --> 00:09:37.559
patient. It's the combination of my
skills as a chiropractor and what China Gel
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00:09:37.679 --> 00:09:43.120
has in it that allows the patient
to get better, faster, and more
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00:09:43.120 --> 00:09:50.080
effectual. Thank you so much,
doctor Levic. If you have questions,
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00:09:50.480 --> 00:09:54.600
please chat those in through the chat
feature there. We would love to hear
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00:09:54.639 --> 00:09:58.200
from you, and we'll start kind
of the live Q and A portion here.
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00:09:58.879 --> 00:10:03.200
Going back to what you saying earlier
about your practice, could you give
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00:10:03.240 --> 00:10:07.600
us kind of a little idea about
what your intensives look like. I know
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00:10:07.679 --> 00:10:13.120
sometimes you work with patients in these
intensive programs and do a lot of different
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00:10:13.159 --> 00:10:16.720
things. Could you tell us first
what type of patients are better suited for
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00:10:16.799 --> 00:10:22.320
and intensive and then walk us a
little bit through like what that process looks
129
00:10:22.320 --> 00:10:26.559
like in your office in terms of
length of time, zams, things like
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00:10:26.639 --> 00:10:30.759
that. So when you're looking at
it, intensive actually gets a little complicated
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00:10:30.799 --> 00:10:35.039
because you look at more psychosocial factors
as well. So let's say ideal,
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00:10:35.240 --> 00:10:39.720
which means no financial concerns, no
time concerns, and we can get a
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00:10:39.720 --> 00:10:43.600
person better. If we want to
create neuroplasticity and your brain, the best
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00:10:43.600 --> 00:10:48.320
way to do that is intensity and
repetition. Right when you're working with the
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00:10:48.399 --> 00:10:50.720
brain, you don't have to rest
as long as when you're working with a
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00:10:50.799 --> 00:10:56.759
muscle. So let's say it ideally
or a ton of hand waving gear,
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00:10:56.360 --> 00:11:01.679
we'll go when doing a workout with
like two A days. If you do
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00:11:01.759 --> 00:11:05.080
two A days every day for a
while, five days straight, that's pretty
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00:11:05.120 --> 00:11:11.080
like the body typically needs to recover. People are usually pooped that evening and
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00:11:11.120 --> 00:11:15.879
hopefully sleep well that night. When
we're talking about neurological rehab, if you
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00:11:16.000 --> 00:11:20.679
give them ten fifteen minutes of actual, like full on rest, like hey,
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00:11:20.720 --> 00:11:22.200
you lie down, you get naptime
in the dark, close your eyes.
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00:11:22.240 --> 00:11:26.840
I'll be back in fifteen minutes.
We do thirty minutes for most intensives
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00:11:26.840 --> 00:11:33.039
here. Then we can continue to
build neuroplasticity at a rate where we have
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00:11:33.080 --> 00:11:35.799
a controlled environment so that they don't
go back into the world, move weird,
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00:11:35.919 --> 00:11:39.639
do things weird, throw off the
stuff that we worked on, and
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then they come back and say,
all right, I felt better, and
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then it came back. We can
continue them rehabbing and getting better and better.
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I had a patient in here this
week. So what an intensive is
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is two hour examination, twenty eight
rehab sessions, and then a one hour
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reexam Monday through Friday. And so
I have a patient in here from the
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Los Angeles area and came in thinking
like it might be some sort of disononomia,
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some sort of pots, some sort
of weird thing that just creates muscule
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scaltle issues, including like some sort
of cog wheel rigidity in the legs where
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you're like, okay, there's some
weird nerrow stuff going on. And as
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we started working on it, we
realized it was a vestibular issue. There
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was a left postier canal, or
we'll call it a right end tier canal
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escape that was really like creating a
lot of haywire right endtier canal escape.
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You think that you're constantly falling forward, what is your body going to do
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the compensation it's constantly going to pull
your backwards into the left. Your left
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post or a hip is gonna be
super tight. What also counts as a
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posterior muscle your soas and so you're
going to be creating these artificial compensations where
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if I went in there and I
tried it a couple of times, I
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was like, all right, I'm
just gonna loosen up your so as.
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I'm gonna loosen up your glutes.
We're gonna do some glute activation type stuff
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and do all like the functional movement
rehab type stuff and say, hey,
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if we we're just gonna see what
happens. I even did one single drop
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on a drop table, separately,
not all at the same time, to
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say I'm going to do this,
throw you on a balance platform and see
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what happens, see what changes.
And every time we did anything with the
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muscles, it destabilized it, which
created an increase of symptoms until I was
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like, okay, well we're going
to move your leg out like this a
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few times to activate those left glued
stabilizers and like, oh, pain went
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away. So we were going through
this cycle and we realized that there was
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a vestibular issue that had to be
taken care of first and foremost, and
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we got that knocked out in like
a day and a half. That was
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easy, but then we spent the
rest of the week incorporating more of a
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functional movement thing. How do you
relearn how to use your hips, how
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to use your lower core, how
do you turn it into the appropriate motor
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and grams? And for people who
don't know what an end gram is,
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it's a code of your brain that
says this is how you move and coordinate
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a group of muscles to to do
a certain function. So we're trying to
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do is create a new motor and
graham And what's the easiest way to do
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that? Repetition and intensity where we
have her doing more fundamental movements and you
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can go to like DNS in that
kind of style, And I did,
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but I was using it, but
I was changing the exercise to bias.
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It based off a vestibular input,
so we can continue winding left post your
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canal into lower brain stem activation into
motor court of a spinal output. Does
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that make sense at all? Yeah, I know that's interesting. And I
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think another important question too is like, if I'm a doc in practice and
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I have a patient that might need
to be referred for further neurotreatment than I
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offer in my practice, what does
that typically look like? When should their
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kind of red flags start going off
where they say, hey, this is
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something that might be outside of what
we can off here. That's the toughest
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part right now, because a straight
up algorithm is at a functional model of
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when you draw this line, that's
when this is functional neurology. And before
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that can be we'll call it functional
movement. I would say when there are
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neurologically related symptoms, easy way to
know if it's a neurologically related symptom,
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go to the subjective symptom and out
with the subjective symptom form on the SCAT
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five. Any of those things,
including neck pain, could be neurologically related.
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And so when you see anything there, first step is to start putting
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a little closer eye on there and
say, okay, is there something deeper
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happening? Do I want to start
looking for things? So what you want
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to look for is ocular movements.
Can they keep their eye on a target
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when they're looking at you or do
they jump their eyes all over the place.
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And if you ask them to look
at something like a thumb, make
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sure it's outside of their convergence on
this. Number one error that I see
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in most people doing rehab is they
put the thumb right here or even here.
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You want the thumb to be further
than they could reach, because you
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want their eyes to be as at
least converged as possible within reason. Have
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them look at your thumb. If
they can keep their eye on a target,
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that doesn't mean that they have ocular
stability, because that's where these things
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come in. When you can keep
your eye on a target, you can
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use your frontelobe to inhibit the vestibular
error. So there's two ways to look
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into this, and they're a little
bit tough to do. You can throw
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them in goggles like that which put
them in the dark, and you can
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see how the eyes move when they
don't know where they are in space,
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they don't know where the world is, and you can see ocular instability.
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Or you can use an opthalmoscope and
you can look in the eye and you
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can have them cover the other eye. The light blocks out, the hand
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blocks out, so you can see
a spontaneous pystagmus. Sometimes you can see
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a bunch of ocular instability, like
if you're like, if you practice your
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up homoscope and you're having trouble getting
into the eye, it might not be
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your error. It might be their
eyes moving all over the place that they
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can control it. And then The
other thing you can do is have them
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line their back and then close your
eyes and you can put your like I
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use my thumbs like this. You
can put your thumbs on their eyelid and
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you can feel the lens as a
differentiation. You can feel the motion of
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the eyes. So there are ways
that you can look at ocular stability without
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having them look at something where they
can use their frontelope to suppress all the
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issues that are going on. One. I think you made an important point
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there too. You don't have to
have complicated equipment sometimes to make these determinations
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or to do these exams, which
is some people use a vibra pastor that
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costs fifteen hundred bucks. I'd take
a gilette raisor and take the sharp part
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off. That's a great way to
do that. Someone else wrote in with
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a question and said they're curious if
there's a neurocomponent in scoliosis cases. They
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said, the point you made to
work on the opposite side of the symptoms.
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Do you think or know if there
is a relationship to idiopathic scoliosis without
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clear structural ediology with the compensatory mechanisms
you mentioned, Yes, so scolios I'm
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not going to talk about congenital scoliosis, or we're not going to call about
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a structural scoliosis, but let's talk
about a functional scoliosis where everything is not
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structurally asymmetrical. They just have that
Remember what I was talking about before,
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where you could have structural asymmetry in
just the angle in which the interior is
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sitting. If you think of walking
as a series of controlled falls moving constantly
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throughout the world, You're constantly getting
more input into one side than the other,
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which is going to create differences in
neuroplasticity along the appropriate path associated pathways,
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which is going to create changes in
head tilt, which is going to
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create changes in rotation. It's going
to create changes in your cortical stability.
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If you have less will call approp
receptive awareness of the left side of your
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body, you make collapse into that. It can also change based off of
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your comfort and balance. For example, me personally, I have less awareness
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on the left side of my body
based off of like concussions and stuff.
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And so now is it less awareness, Like you can do a neuroexam on
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me and be like, oh,
yeah, there's a deficit. No,
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it's when you take all these like
real functional things and you put it under
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stress, that left side of the
body is just not going to be as
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aware. So if I was going
to default to a more stable side,
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I'm going to default to my right
side. Where are all my sports injuries?
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Right shoulder, right hip, right
knee. I tore my PCL skiing
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because I lost the ski on the
left side and I defaulted to the strong
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side and all the four went through
it. So these injuries that use sports
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related injuries you can get may be
associated with a vestibular or visual deficit,
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and for me, it was a
vestibular deficit that created changes with that.
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So yes, when you have these
neurocomponents, they can be related to a
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more of a functional scoliosis because they
just think that this is home because their
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heads like this make your eyes level
to the horizon. It's fascinating. It's
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really fascinating to think about. And
I think you made a very salient point
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there as well, Like, if
you're seeing athletes who continue to have injuries
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on one side of their body versus
another, is that something to look at?
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Is that something to kind of dig
a little bit deeper with? But
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if you're seeing all the athletes with
the injury on the same side of the
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body, and you start rehabbing and
really doing a ton of soft tissue work
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or joint manipulation on that side of
the body, and it's due to the
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other side of the body not having
the appropriate activation. You could be creating
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further brain and balance which is going
to create other issues. So if you're
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working on one thing and you're like, oh, now I'm getting less like
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headache coming out of nowhere, there
might be a time to look back and
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say like, Okay, do we
have multiple problems going on? Do we
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need to rehab a neurocomponent, which
for our office, like when we get
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referrals from other practitioners, they're usually
back in the other doctor's office within two
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to four weeks because we work what
we do works quick. We do many
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intenses with people where we see people
like three sessions in a day. We
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said three times a week, We'll
see him three times in a day,
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and we'll stack them and put them
all in a morning. So it works
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quick. But that but going along
with that same idea is they gets sent
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to us for more of that neuro
rehab perspective, and then we send them
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back for the muscile skeletal because we
don't need to do everything, and it's
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also a little more expensive, so
there for the patient to pay our prices
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for something that they can get quality
someplace else. But from back to a
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clinical perspective, yes, if you
start seeing injuries all on the same side
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of the body, start looking at
the other side. I have a story
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about this. A colleague of mine, Tyler, out in Idaho, he
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called me once because he had a
violinist who was having a bunch of forearm
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pain and he did he did,
like he went to school with me,
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so he did factor, he did
a number of other techniques and he was
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like trying to work on it and
he was like, nothing's changing. And
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I was like, do the same
exact thing, but on the other side
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of the body and it went away. He was like mind blown. Yeah.
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Yeah. He called me with more
expectives than I'd ever expected to set
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say in his life, and I
laughed. That's fascinating though, And it's
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it's interesting because we do talk about
this in our soft tissue courses as well
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in terms of what we're doing to
the body. And obviously doctor Riddle can
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speak much more eloquently about this than
I can. But there is so much
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input that's being You're inputting into the
CNS, affecting the central nervous system with
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what you're doing every time you touch
the body. And I think you're right
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if you just stop and only think
through the muscular skeletal, but then don't
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even consider the entire nervous system that's
also a part of that, you're really
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kind of missing the boat on some
things there. That was my favorite part
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actually, what I was like entire
proctic school learning about because I was learning
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neurostuff at the same time because apparently
I don't like having a life. But
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while I was going through it,
we were I remember going to class and
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being in class that we all palpated
the yes side. We had a one
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person and everybody went through and palpated
it. We all were talking about what
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side do we think restrictions were on? What did we think we were was
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going on? And I'm sitting there
thinking about it as I'm watching this,
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I was like, every time we
palpated, we're creating motion in there,
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and that motion is creating sensory awareness
to the brain, which is changing the
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activation which is going to send back
down and change where the restrictions are.
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And I think the purpose of it
was very good, which was there's variability
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just to what people feel. But
I'm sitting here thinking like every time you
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just test to figure out what's going
on you're applying a treatment. Absolutely,
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it's fascinating to think through. And
you would spoke a little bit earlier about
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working with other offices and how someone
might refer to you for a short period
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of time and then you send them
back. What type of other healthcare practitioners
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are you most often getting referrals from? How do you all fit with what
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you do specifically into that sports medicine
team, let's say for a college athlete
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or even a professional or an elite
athlete where they may have a lot of
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cooks in the kitchen, so to
speak, trying to make sure that they're
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in prime playing condition. How do
you guys fit into that with what you
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do. We get more referrals actually
from neurologists, which is really fun to
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say but also interesting because we get
we get like almost no referrals from chiropractors.
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Well get referrals from pts in chiropractic
offices. It's like part of it
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is the paradigm where we're so locked
in into a certain way that we don't
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really like see what else is available, and we're like, well, I
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know that if I keep on doing
it. I was at was the ACBSP
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Sports Symposium years ago and I was
looking at a case study and somebody got
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a concussion better in six months,
and I was like talking about it.
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He was like super Jazz, like, hey, look look who we did.
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And I'm sitting here like, we
do that in like two weeks,
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and so the I didn't say that
that we wrote, but the but the
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idea is what I was saying before
at the beginning. We don't overtreat,
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we don't oversell. What we do
is we're here to get people out of
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our office and make good connections with
people in the community. So what does
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it look like when somebody sees something
that may look like a history of concussion
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or and it goes past the ten
days that have to put into post concussion
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syndrome, or or there might be
associated neuroimmune stuff going on like post COVID,
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or they might have a dis autonomia
going on at the same time.
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Those are the cases to get and
over just to get checked out. I've
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sent people back saying this is not
a case that we can fix because there
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I've been to s seminars where one
guy in particular, we says chiropractors never
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find normal. We find normal.
We find times that we are therapies are
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not appropriate and we need to send
to a different location. But the purpose
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of what we do is we do
a really thorough exam. I had an
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autonomic neurologist in the Boston area once
I believe send yeah it was, he
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sent me a cardiac patient and I'm
like, this isn't my wheelhouse. But
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00:26:33.160 --> 00:26:37.960
the guy on the phone said,
well, he said that I've seen enough
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people and if there was something going
on, you'd figure it out. And
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00:26:41.680 --> 00:26:45.359
so I was like, that's a
really cool compliment, but I still think
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you're in the wrong place. But
if you're open to paying for it,
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I'd be happy to do the exam
and put this and see what I can
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00:26:49.720 --> 00:26:53.000
put together and see where we can
get you. And we we ended up
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just sending you up to like a
different type of professional and I don't really
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00:26:56.440 --> 00:27:00.640
know where it went with from there, but that's kind of what we do.
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00:27:00.680 --> 00:27:04.839
We try this new thing in chiropractic
called playing well with others. That's
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00:27:06.000 --> 00:27:08.319
very true, and you hit on
something just a second ago, and it
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00:27:08.359 --> 00:27:12.240
actually segues really nicely with a question
we had come in through the chat.
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00:27:12.839 --> 00:27:18.799
Someone was asking about what commonalities you're
seeing in post COVID cases as far as
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00:27:18.880 --> 00:27:23.000
the cause of symptoms, if any, or are symptoms coming from where the
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00:27:23.079 --> 00:27:27.680
virus affected the brains, So it's
very individualized. Are you seeing any trends
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00:27:27.720 --> 00:27:32.759
with your post COVID patients? For
the sake of time, I was on
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00:27:32.799 --> 00:27:37.839
a radio show on Wednesday of this
week talking about post COVID. We kind
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00:27:37.839 --> 00:27:40.920
of like spiral them is like different
directions. But the first thing that we
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00:27:41.000 --> 00:27:47.480
talked about really really dies into this, So I would highly recommend checking that
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out just you get a more full
answer. But to make it quick.
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Post COVID so concussion, it's not
just traumatic. It's an acquired brain injury.
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00:27:55.960 --> 00:28:00.759
So you can get concussion symptoms from
things like whiplash you don't actually get
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00:28:00.799 --> 00:28:06.000
the head. You can get concussion
symptoms from viral illnesses. We see a
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00:28:06.000 --> 00:28:08.240
lot of patients coming through our office
with an epstein bar, a chronic line,
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00:28:08.440 --> 00:28:14.200
a site of megalovirus or a COVID
how it changes. What's different about
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00:28:14.200 --> 00:28:17.880
COVID in particular is it's there's a
lot of weird stuff going on there,
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00:28:18.319 --> 00:28:21.559
which is why there's so much variability. Some person can go online and say,
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00:28:21.599 --> 00:28:22.519
hey, I had it was nothing
as worse as the cold. If
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00:28:22.519 --> 00:28:26.599
somebody else laying in a hospital it
reads that and be like I wish.
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00:28:27.200 --> 00:28:33.119
And so what it comes down to
is your brain's adaptation. Your brain makes
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00:28:33.160 --> 00:28:37.759
symptoms from different areas of the brain. If you're nuclear attracted, solitarius is
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00:28:37.799 --> 00:28:41.799
firing too high, so it's revving
too hot. That's where nauja comes from.
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00:28:42.319 --> 00:28:47.079
Yes, you can have other things
that can trigger nausea, but the
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00:28:47.119 --> 00:28:51.039
pathway goes to that point and that's
where the brain fires too high and now
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00:28:51.039 --> 00:28:55.519
you feel the nausea if you had. And that same system is all your
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00:28:55.559 --> 00:28:59.839
cardio respiratory systems and your gustatory systems
as well, So you get all these
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00:29:00.079 --> 00:29:03.319
weird neurological stuff all the same time. But in terms of what are the
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00:29:03.359 --> 00:29:08.839
commonals and postcode patients, they look
like incustipations who have chronic low level inflammation
393
00:29:08.960 --> 00:29:14.440
due to a virus as opposed to
due to a knock to the head,
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00:29:15.039 --> 00:29:19.039
and it's just from our perspective,
it's a very very similar ideology. The
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00:29:19.079 --> 00:29:22.640
only thing different is, especially if
if there's somewhere near our Boston area,
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00:29:22.759 --> 00:29:27.119
we use an violet colored laser that
is shown to be helped with more anti
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00:29:27.240 --> 00:29:33.680
viral antibiotic properties, so we'll use
that in combination with it. But we
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00:29:33.720 --> 00:29:36.599
do get postcode patients coming out to
me here and I don't have a laser
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00:29:37.000 --> 00:29:41.000
again for some reason, I'm just
like a simple office, but we still
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00:29:41.000 --> 00:29:45.279
get good benefits because it's vestibular input. Two more quick notes there are there's
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00:29:45.279 --> 00:29:51.480
a paper out there that shows that
unilateral mist good deficits create chronic inflammation,
402
00:29:51.920 --> 00:29:56.160
so people who are chasing the guns
all the time look the interear. And
403
00:29:56.200 --> 00:29:59.119
then there's also what was that other
thing I was going to say, You
404
00:29:59.160 --> 00:30:03.240
can get the same microglial ramification in
a viral in this that you can in
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00:30:03.319 --> 00:30:07.720
a concussion, which could create those
long term effects, which is why,
406
00:30:07.839 --> 00:30:14.799
especially with what came out in the
NFL, there's it's so important to accurately
407
00:30:14.839 --> 00:30:18.319
diagnose and not just say well,
it's not that bad, because if you
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00:30:18.359 --> 00:30:22.759
can look beyond the subjective questions.
If you can do a proper, full
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00:30:22.839 --> 00:30:29.839
cranial nerve exam for subjective complaints like
headaches and dizziness, then you might pick
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00:30:29.960 --> 00:30:33.359
up a lot of things that other
people are missing because they're kind of rushing
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00:30:33.400 --> 00:30:36.200
through because they already have an idea
in their head of what they think it
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00:30:36.319 --> 00:30:41.599
is. I think that's very true, and I think practitioners are. I'm
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00:30:41.640 --> 00:30:44.599
sure you guys are constantly having to
kind of check yourself in the examine and
414
00:30:44.640 --> 00:30:48.680
be like, okay, like I
don't just need to let my bias come
415
00:30:48.720 --> 00:30:52.279
into this about A plus B doesn't
always equal. See every persons an individual,
416
00:30:52.319 --> 00:30:56.039
and I'm sure you see a ton
of that in your practice, as
417
00:30:56.200 --> 00:31:00.519
do the other practitioners on here.
Do you have the link for the radio
418
00:31:00.759 --> 00:31:03.960
interview that you were on that you
might be able to email me and I
419
00:31:03.960 --> 00:31:07.200
can email that to everyone afterwards.
Yeah, I can send you that link.
420
00:31:07.319 --> 00:31:10.279
I can also send you We'll get
them listed. We'll get him post
421
00:31:10.319 --> 00:31:12.839
it up on the website and the
resource page as well soon. Yeah,
422
00:31:14.000 --> 00:31:17.759
can get you that link as well. Okay, that would be wonderful and
423
00:31:17.839 --> 00:31:21.599
everyone. That way you can have
the full conversation and the full explanation.
424
00:31:21.880 --> 00:31:26.440
As doctor Lovich was saying about long
COVID. We certainly want to be respectful
425
00:31:26.440 --> 00:31:29.680
of everyone's time. We do try
to keep two one hour, but this
426
00:31:29.759 --> 00:31:33.759
has been incredibly informative. I think
even just our Q and A segment could
427
00:31:33.799 --> 00:31:37.240
probably go on for a whole another
hour just with the questions that have been
428
00:31:37.240 --> 00:31:40.960
coming in and the conversation. So
thank you again so much. We really
429
00:31:40.960 --> 00:31:44.240
appreciate you coming on today. So
again, thank you so much, Doctor
430
00:31:44.319 --> 00:31:47.119
Lovich. Thank you everyone for joining
us, and we will see you next
431
00:31:47.160 --> 00:32:00.960
time. Thank you, thank you. That's it for today's episode. Be
432
00:32:01.039 --> 00:32:05.440
sure to tune in for episode fifty
five, where we kick off a new
433
00:32:05.480 --> 00:32:08.759
training with doctor Ben Fergus, where
he'll teach you how to supercharge your skill
434
00:32:08.799 --> 00:32:14.440
set for clinical and financial success.
As you know, from time to time
435
00:32:14.480 --> 00:32:17.759
we like to take a break from
clinical topics and focus on the business related
436
00:32:17.799 --> 00:32:22.839
aspects of growing a successful practice.
These next two episodes are ones you'll want
437
00:32:22.880 --> 00:32:27.720
to be shure to bookmark and listen
to more than once. You won't want
438
00:32:27.720 --> 00:32:31.200
to miss it. Episode fifty five
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451
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