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 in 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. Hi,
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everyone, Welcome to the Factor Podcast. I'm your host, Jessica Riddle.
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If this is your first time tuning
in, welcome and thanks for listening.
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In today's episode, we kick off
a new two part training with doctor
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Michael Lovitch titled Muscle Memory. How
your brain uses muscle tone to map the
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world. I find the inner workings
of the human brain absolutely fascinating and when
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it comes to pain science, the
healthcare community has barely even scratched the surface
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when it comes to understanding the multifaceted
aspects of a very complex interaction between the
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brain and the body. In this
training, doctor Michael Lovitch will discuss how
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the brain maps out the body using
muscle tone and how that integrates with vestibular
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and visual inputs. A patient may
come into your office with several seemingly unrelated
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symptoms, and understanding this interplay between
the brain and the body can really help
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you better determine the root cause.
Today's guest speaker helping us tackle this topic
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is doctor Michael Lovitch, a Board
certified chiropractic, functional neurologist and Board certified
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chiropractic sports physician. He holds the
Masters of Science in Sports Medicine with additional
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training in brain based functional medicine and
functional movement based rehabilitation. He has served
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as both a medical director and a
member of the medical staff for various organizations
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and events in professional, amateur,
collegiate, and high school athletics. He
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specializes in integrating the physical aspects of
sports medicine and chiropractic care with the brain's
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neurological and physiological symptoms that are often
overlooked. He is a partner of Delta
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S Performance Functional Neurology and Sports Medicine
with clinics in the Denver and Boulder metro
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areas, clinical adjunct faculty, and
a course designer for evidence based concussion management
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and care for University of Western States
Sports Medicine program. Let's cue the intro
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music and get started. So today
we're gonna be talking about muscle memory.
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I know that muscle memory seems to
be a little bit of a I want
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to call it a hot topic by
any means, because it doesn't really have
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that much controversy behind it. But
you do see it used a lot in
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more lay person settings, and you
see it use more like throw and run
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in the gym all the time,
especially if you go on any sort of
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go on Instagram starts going through the
reels and you'll hear somebody talking about muscle
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memory every few times. Or maybe
that's just the algorithm throws me working in
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sports medicine. So one of the
things that we want to look at is
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okay, well, let's dive into
that. How can we use these concepts
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of muscle memory and specifically how does
your brain map out the world and you
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in it, So that way you
can and essentially create better outcomes with your
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patients or clients or whoever you're working
with by having a better understanding of how
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it works. You may have seen
that I started with a poll just to
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say, just to kind of see
what this group tends to do. I
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typically teach. I've taught a lot
of CEUs for state chiropractic associations and have
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taught like in services for pts working
with special specializing concussions and neurological rehab.
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And I'm always curious to see when
you get neurological symptoms do people do a
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cranial nerve example, where do people
kind of say, all right, well
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let me check everything else and see
if we get any improvement. So I'm
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generally interested in seeing that stuff,
and we're going to be going through things
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that you might want to be looking
for during a cranial nerve exam, at
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least from a muscule scalable perspective.
So one of the things is my presentation
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is made to answer questions as we
go. If it's a longer and more
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involved answer, I may say hey, we'll get back to that during the
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Q. And a part of that
is I like interacting with people as I'm
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talking, because I like to make
sure that this is tailored to the audience
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of people listening. So let's start. We're going to start up with just
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a quick overview of who's this talking
head? Why do I feel like I
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would be qualified to even speaking on
a topic like this. This is my
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office. This is what I've been
doing for I guess seven years now.
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My office is called Delta's Performance.
We are a functional neurology and sports medicine
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office. We specialize in neurological rehab. We do NERD rehab of concussions,
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pots post COVID syndrome. We work
with a lot of nerve degenerative conditions.
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We work with some nerve developmental conditions
as well. Smaller segment of the business.
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The name Delta S comes from entropy. The whole idea is that if
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you have a messy bedroom. If
you have a bedroom, everything in life
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goes into a state of more disorder. So if you don't spend time putting
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energy into it, it's going to
get messier, messier, there's gonna be
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more disorder, and essentially health can
be viewed the same way. If you're
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not actively making your health better,
it will get worse. So that's why
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I chose to name my business a
little bit more complicated of a name,
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but I think it works well with
our whole mission and approach. We specialize
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and pride ourselves on patient experience,
patient education, and just doing an ethical
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treatment model. In my opinion,
we don't take advantage of patients. We
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don't do overtreating, overselling, or
overcharging. We focus on being experts at
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our craft and we're more focused on
We're not afraid for people to shadow and
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learn from us because we're going to
keep moving forward and we say, hey,
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come on, keep up. We
have a collaborative approach. We try
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to work with other practitioners in the
field because we're not experts at everything.
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And we also know that sometimes patient
care works better when you have a different
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person focusing on a different piece,
because if you have one person who's trying
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to do all of it, you're
gonna the patient education and communication is going
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to sort of silo you into what
can you do? This is more of
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what we talked about. What I'm
saying before types of cases we see and
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this is our current team. We're
growing. We have another doctor joined the
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team later this year, So if
you're looking to collaborate with us or anything
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like that, or have any questions, please reach out. We're located in
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New England in three locations and Colorado
here in two locations. So muscle memory
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GAMA motor systems. Now. From
my perspective, I used to always say
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muscle memory isn't in the muscle,
it's in the brain. But it's way
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more nuanceding that when you start diving
into the details, we start diving into
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the actual pathways controlling it because there
are physiological changes at the muscle. So
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if we talk about just basic exercise
physiology textbook, it says it right in
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there that in order for you to
make changes, if you teach somebody anything
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new in the book, it says
right there, the first six weeks of
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any new motor pathway or made a
new motor angram is pure alpha motor activation.
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In other words, you're not training
the muscle for hypertrophy at that point.
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What you're doing is you're training the
muscle for control from the brain.
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But at the same time, what
we're looking at is how do things change
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physiologically at the muscle level that because
there are studies that show, hey,
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when you stop using something for six
months, it comes back faster than it
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did before. So there's a couple
of questions that we have to answer,
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and how can we use that in
a clinical model is the most important part.
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So this is where I always start
with every presentation, is how do
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you build a brain? Because what
we think the brain is there for isn't
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really what it's there for. It's
really very simple. It's there to answer
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two questions, where are you in
relation to the world around you? Where's
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the world around you in relation to
you? And it doesn't care about anything
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other than answering those two questions.
And that's why certain symptoms come out.
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And some of these symptoms start making
a lot more sense when you view it
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from this perspective because there's less deeper
meaning behind it, and it's more about,
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hey, my brain is just trying
to stay upright and navigate the world.
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And so when I have pain,
when I have symptoms of any type,
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those aren't seen as problems by the
brain. Those are seen as,
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oh, this is what I'm supposed
to make. This is the conscious experience
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you're supposed to have so I can
stay upright and navigate the world. So
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here is my simple schematic of how
your brain works. Might have seen these
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things before back in third grade when
you're learning math, and this is a
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function box. In a function box
in third grade, it's like the rule
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is plus three, and so if
your input is four, your output is
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seven. Right, So quick and
easy input are all your sensory systems,
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the five senses, plus your vestibular
system. Most importantly is a vestibular system,
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because that's evolutionarily the base system that
everything is plastered on top of.
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So if that thing's not working right, then all the other senses are going
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to be doing their best, but
it's going to be skewed. All that
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information goes into your brain, and
brainstem creates an interpretation of the world around
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you, and that interpretation is then
fed outward into your motor outputs and your
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psychological outputs. So yes, it
does get more complicated than this. Psychological
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and motor outputs can feed forward back
into the brain and brain sem to say,
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hey, did I do this correctly? Or this is the conscious experience.
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Let me affect this interpretation. But
at the same time, if you're
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trying to make long term changes in
the way the brain is working, you
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have to start with the sensory systems
coming in. That's time zero, and
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you have to continue with how the
brain and brains them integrates that information,
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because if we're not working with that
part, then it's going to be three
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steps forward, two steps back every
step of the way if it's not full
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three steps back. I've tried a
lot of different rubs and different types of
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ointments and lotions. Before I used
to use other topicals and never had the
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success that I now have with China
Gel. China Gel is my pain reliever
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of choice. We use it in
the office because of its consistency and the
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response that I get from the patients
is what my goal is. I want
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to get people better. China Gel
allows me as the practitioner to use instrument
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assisted techniques, me as the practitioner
to do ultrasound and do many different techniques
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that I've learned over the years in
conjunction with China Gel to get the maximum
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benefit for a patient. It's the
combination of my skills as a chiropractor and
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what China Gel has in it that
allows the patient to get better, faster,
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and more effectively. What is muscle
memory When you talk about it from
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a strength and conditioning perspective, it's
that muscles can drive behavior without an ronal
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input. You can react to things
without thinking about it. You can make
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a very large case for how muscles
and information coming from the muscles can create
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patterns and maybe you're just activating a
pattern that is already predetermined instead of the
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muscle itself saying Okay, this is
what I'm deciding to do. It's more
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I have a collection of things.
This is the information that I've received,
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I've seen this something similar to this
before. I'm going to react to it.
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But there is some evidence to show
that there is an end organ input
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because muscle related tests are easier to
perform with practice. Observations is that there
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are rapid return of muscle mass following
periods of inactivity supposed to say inactivity,
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and then you actually have increased quantity
of sarcomare nuclei for those who don't know
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sarcermare the muscle cell itself. You
can have increased nuclei that do not get
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lost within activity. The muscle will
atrophy or shrink, but the number of
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nuclei in this cell does not,
which is what is thought to be the
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reason why the muscle memory of hey, I haven't done this for a little
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bit, let me do it again, and then it comes back for the
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muick. So what I've noticed,
and this is the part that's my opinion,
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is I've noticed, at least for
popular science and popular culture, it's
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swung muscle memory through a strength training
filter, promoting it popularly as housing the
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muscle. But I'm here to tell
you that taking care of your brain and
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using a neurologically based approach may make
better results faster. What is the point
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of your muscles? The point if
the whole point of the brain is to
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navigate the world and to stand up, the point of your muscles are there
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to tell you where you are in
space, and do you have large muscles
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to move you around that space?
But what's the point of all those tiny
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muscles? So a lot of the
tiny muscles are there for appropriate reception.
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And when I'm teaching this, I
use this example of a rubber band.
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So let's say you had a rubber
band around your thumb and fore finger,
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as a picture implies, and you
pluck it. You're going to hear a
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sound. Right, If you do
not hear it and you want to make
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it louder, you make it tighter, right, you can pluck it makes
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a more resonant sound. The issue
that we have here is that what if
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the issue is not in the muscle
and the issues in the brain. So,
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for example, somebody comes over and
decides that they're going to be funny
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and punching the shoulder, give you
a dead arm. That muscle is going
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to tighten up. Why does that
happen? Because you've had some sort of
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blunt force trauma to the muscle.
It changes the signaling to the brain.
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The brain no longer can hear what
is going on in the muscle as clearly,
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and there's more static. This is
a very outdated analogy, but it's
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the only thing I can think of
at this point. When you were watching
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on an old TV, like when
I was like a young kid, and
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there was static, what did you
do? You just made it louder and
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listened through the static. That's what
your brain's doing. There's avern sensory information
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coming in front the muscle. It's
got a lot of static going on.
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It makes the muscle tighter through gamma
motor activation, which then creates better awareness
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of where that muscle is from appropriate
receptive standpoint, because again, your brain
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only cares about where your muscle is, so can use it a stands up
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right and then that muscle will maybe
it's sore, maybe as tightness, maybe
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it as a trigger point because of
the exact individual point that that compensation is
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needed in order to make the brain
function better and have awareness of the muscle
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might only be this big, and
that's to get your trigger point. What
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we're looking at here from a neurological
perspective is essentially, when you build this
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map of where your body is,
a lot of times, the symptom that
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you're chasing, and even the soft
tissue texture and hypertenicity that you're chasing maybe
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a compensation used by your brain to
better function in other areas the same way
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when an injury happens. Muscle splinting
isn't to protect the muscle. Muscle splinting
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is a normal reflex. It's a
reflexive action due to a couple different steps
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that stays there until your brain gets
better awareness of the muscle, or for
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some patients it doesn't get better.
It stays there because they never relearn how
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to move the muscle, because the
splinting created enough of an altered movement,
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alter kinematics, and why sometimes it's
not so much about passive working on the
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muscle, and sometimes it could be
active. We just need to teach the
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muscle how to move again. Oh, for those who don't know, not
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everybody has seen this. I've learned. So this is a sensory homoculous This
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is a map of basically what your
brain thinks your body looks at when you
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scale everything based off of the amount
of real estate that your brain gives to
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the somatosensory cortex. If you look
at that area your thumbs, your hands,
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they're huge, your low back,
your neck, the areas of if
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you think of the areas of the
most chronic pain, those are the tiniest
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areas, and you can get a
lot of cortical smudging and get a lot
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of central sesstimization in that area.
But it doesn't necessarily mean that. But
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it could be a motor pathway and
it could also be like a beta neurons
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being interpreted. So a beta typically
associated with appropriate reception, they could be
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interpreted as pain even though they're not
no susceptive in nature. Typically, I
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put these pictures in here because I
think it really shows all the tiny little
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muscles that do you really think that
those muscles are there to move the spine
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like I don't know half a centimeter
or it's are half a millimeter. In
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reality, those muscles are just there
to create tension and vibration, so that
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way you know where your spine is
in space, and there are so your
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rotatory's longest and breadst those are proper
receptive muscles. Your inner spinalis your inner
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transfer seraide. Muscles that owe one
or two segments aren't really there to create
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motion and movement. They're there to
show, hey, something did move because
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I'm being stretched. And then you
also have all these receptors in your body
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that tell you where you are in
space, like proceeding in core muscles too,
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smaller ones, roufining like endings,
neurotendus spindles if you're familiar with that
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is that's a goldie tendon organ a
gto or neuromuscular spindles. All of these
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things that are housed within the muscle
or the tendon of the muscle that tell
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you, hey, this is where
you are in space. So let's get
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more complicated, just because why not
not? Just is your sending cortical spinal
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pathways what control your muscles. You
also have vestibular control of muscles. So
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your vestibular spinal tract are the fastest
firing neurons in the human body, and
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its role is to respond to movement
through a gravitational field and keep the body
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upright so it can continue to navigate
the world. We already talked about earlier
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how your vestibular system is the system
that things are plastered on top of.
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But what is the only sensory stimulus
that is constant on your body at all
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times when you're here on Earth.
It's gravity, So that means that gravity
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is always pulling in a direction.
Your body is always trying to figure out
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where you are in relation to gravity. And from my clinical experience, when
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I get patients who have a vestibular
deficit, I always ask them a couple
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of questions. First question is do
you ever feel like you're falling backwards or
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forwards while you're laying down? And
the second question is is when you toss
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and turned during the night, do
you find you always rotate the same direction
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my personal opinion and hypothesis at this
point. I'm not a full on researcher,
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but my guess is that when you
have a vestibular deficit, let's call
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it a left horizontal conal deficit,
and they're lying down, so their head
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is now less in the gravitational in
the plane of gravity, which means you're
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reducing the amount of input coming into
your brain while you're laying down sleeping at
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night. Now you need more activation
because of that imbalance, So you continue
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to rotate yourself in the same direction
and that's what's giving little bursts of energy
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to make things function a little better
overnight. But down here on the this
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is taken so I post graduate training
through the Character Institute, and they have
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I got this off of Google.
This is something that's public on their website.
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Essentially, the whole purpose of what
you're establish system does is it stabilizes
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you in space and allows you to
figure out which way gravity is. So
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let's talk about that real quick.
So if you think so, we talk
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about like how your brain makes maps
of where your body is. What if
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there's a skew somewhere in those maps. What if your perception of where your
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body is in space. Has you
mapped out as being slightly leading to the
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left, even though you will know
you're standing straight up, You're going to
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create postural reflexigenic postural changes to pull
you back over where your brain thinks gravity
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is, or it's going to get
a couple of different things saying different messages.
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So, from a vestibular standpoint,
if one vestibular system, and if
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you look in the mirror, everybody
is asymmetric in some capacity. Let's say
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your face your head grew where half
is half is like call it ideal and
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the other half is a is a
little bit of skew. You're constantly getting
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changes or differences of the amount of
activation coming through your vestibular system just from
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walking around the world. You'll see
this in your patients than your clients because
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they're going to be talking to you, and they're gonna be talking to you
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like this. Or the head tilt
usually your rotation a tilt and a little
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bit of a tilt backwards because one
eyes higher than the other, they're balancing
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00:22:15.440 --> 00:22:17.680
it out. But if you see
that one eyes higher than the other and
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00:22:17.720 --> 00:22:21.720
they're imbalancing out and making it worse, that usually means that the brain is
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not adapting well to vestibular information coming
in and through reflexes cervical adaptations because your
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vestibular system connects directly to your upper
cervical neck and through ocular adaptations through the
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vestibulo ocular reflex, you'll have an
indirect change because the vestibulo ocular reflex connects
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00:22:45.240 --> 00:22:49.200
and the cervico ocular reflex also connects, creating this little triangle of If everything
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says the same thing, it's all
great. If it doesn't, then we
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00:22:52.720 --> 00:23:00.400
have skews. So here's that ocular
control of muscles the eyehead coordination. So
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00:23:00.440 --> 00:23:04.480
every time you move your eyes to
the left, you have those little proprioceptive
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00:23:04.559 --> 00:23:10.799
muscles contract and control to stabilize your
head on the top of your neck.
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If you have a ton of ocular
errors where you have like I was asking
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00:23:14.680 --> 00:23:18.720
during the question, do you do
a full cranial nerve exam when you check
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00:23:18.759 --> 00:23:21.680
age fields of gaze? Are you
just like, hey, they can move
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00:23:21.720 --> 00:23:26.039
their eyes in that direction, or
are you looking at it like what is
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00:23:26.079 --> 00:23:29.480
the quality of eye moving? Do
they have a number of catchups of cots?
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00:23:29.519 --> 00:23:32.559
Do they have a number of backups
of cots? Do they do they
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00:23:32.559 --> 00:23:37.599
have psychotic intrusions where their eyes are
like jumping and then coming back. All
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00:23:37.640 --> 00:23:41.079
of those things are errors that your
brain has to adapt for and your brain
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00:23:41.119 --> 00:23:45.240
has to correct for. And so
when we're talking about creating errors, what
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00:23:45.359 --> 00:23:52.079
is the muscular skeletal compensation based off
this? Well, now you have a
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00:23:52.119 --> 00:23:56.079
deficit or your muscles have to continuously
correct and at a point your brain is
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00:23:56.119 --> 00:24:00.880
going to be like, I'm continuous
correcting so much just clamping down on these
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00:24:00.920 --> 00:24:04.119
suboctipitals. This is why some patients
will come in with claritag and his pain
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00:24:04.200 --> 00:24:08.599
referral. But you go in and
you work on their cervical sponsibility, You
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00:24:08.640 --> 00:24:11.960
work on their shoulders, you work
on the whole kinetic chain. But it
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00:24:12.000 --> 00:24:15.039
doesn't touch it, or it makes
it better, but it doesn't go away
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00:24:15.240 --> 00:24:22.880
because the issue is ocular stability and
we need to create And this is one
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00:24:22.880 --> 00:24:26.119
of my questions of why do we
for anything with the headache, do we
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00:24:26.240 --> 00:24:30.039
check cranial nerve exam? Well,
no, If you don't check the cranial
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00:24:30.079 --> 00:24:33.720
nerve exam, how do you know
this not an oculomote or generated issue.
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00:24:33.839 --> 00:24:37.440
If you look at old movies,
you'll see how did they show stress?
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00:24:37.839 --> 00:24:41.720
And in an actor or actress,
they focus on the eyes and they show
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00:24:41.759 --> 00:24:45.200
the eyes darting in all directions at
the same time. What if that's what's
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00:24:45.200 --> 00:24:49.240
happening with the patient and that's something
that we're missing, something to look into.
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00:24:49.720 --> 00:24:53.680
Now. Fixing those things aren't necessarily
straightforward all the time. Sometimes it's
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a huge vestibular component to it.
But I mean, if you'll find it,
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00:24:57.279 --> 00:25:00.359
at least that's the ball rolling with, things can get better. You
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00:25:00.400 --> 00:25:04.480
also have cerebellar control of muscles as
well. So the one that I'm going
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00:25:04.519 --> 00:25:07.240
to focus on is down to the
bottom called the flocculus, which is the
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00:25:07.279 --> 00:25:14.119
flockum modular lobe. It's associated with
vertical eye movements, but it's a modifiable
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00:25:14.240 --> 00:25:19.119
accessory pathway through that vestibulocular reflex for
adaptive control. So it's part of your
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00:25:19.200 --> 00:25:23.680
learning mechanisms in the brain that say, okay, I did this. This
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00:25:23.720 --> 00:25:30.960
is how I coordinate these muscles.
And it's also associated with synaptic plasticity due
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00:25:32.000 --> 00:25:34.240
to retinal errors your eyes. So
in other words, when you have an
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00:25:34.240 --> 00:25:41.079
eye movement error, your cerebellum is
going to try and create corrections because it's
326
00:25:41.079 --> 00:25:44.839
going to remember things that have less
errors, and that's associated with the next
327
00:25:44.880 --> 00:25:48.039
system we're talking about before we do. Here's a fun local activity that everybody
328
00:25:48.079 --> 00:25:52.960
can do. If you take your
fingers like the pads of your I use
329
00:25:52.000 --> 00:25:56.359
the middle finger and you put it
right over your subocipitals and you move your
330
00:25:56.359 --> 00:26:02.000
eyes around, you'll feel your subocxipitals
these tiny little bursts, these tiny little
331
00:26:02.000 --> 00:26:10.160
twitches. That's your vestibulocular reflex.
That's your cervico ocular reflex and your vestibulo
332
00:26:10.200 --> 00:26:14.079
cervical reflex all working together. Because
when you move your eyes around, you
333
00:26:14.079 --> 00:26:18.359
can see how your muscles are twitching
automatically as a reflex. Last system that
334
00:26:18.400 --> 00:26:22.160
we're gonna be talking about is I
think the absolutely most important system, which
335
00:26:22.200 --> 00:26:26.559
is why it's plastered up on my
whiteboard at all times. All five loop
336
00:26:26.599 --> 00:26:33.319
through the basil ganglia. This is
the crude motor system that was paired to
337
00:26:33.359 --> 00:26:37.519
a thalamus, which is a crude
sensory pathway. So what is why is
338
00:26:37.519 --> 00:26:42.519
that important? Because evolutionarily, things
didn't start as complex as they are right
339
00:26:42.519 --> 00:26:47.880
now, and over millions of years
they got more complex. But if you're
340
00:26:47.880 --> 00:26:52.200
going to take it and pare it
down to the most simple, primal systems
341
00:26:52.200 --> 00:26:56.359
that we have. It's basil ganglia
and thalamus. Sensory information comes in basil
342
00:26:56.400 --> 00:27:03.039
ganglia, error corrects for that sensory
information and tries to make an output.
343
00:27:03.440 --> 00:27:10.000
It's associated with not just the error
processing, but predictive movements, predictive circuits,
344
00:27:11.200 --> 00:27:15.920
efficiency of movement, and your dopaminergic
pathways. One of the things that
345
00:27:15.960 --> 00:27:18.839
a lot of people think is like
dopamine is all about reward and all that
346
00:27:18.839 --> 00:27:23.279
stuff from a psychological perspective, yes, but what happens in the basil ganglia,
347
00:27:23.400 --> 00:27:32.039
which is dopamine fires from your substantial
nigra in the midbrain into the striatum
348
00:27:32.079 --> 00:27:37.000
and it's at a constant flow.
When you predict that you're going to do
349
00:27:37.079 --> 00:27:41.480
something like I'm going to drink and
it works, you get a little more
350
00:27:41.599 --> 00:27:45.039
dopamine to say, hey, that
worked, do it more this way.
351
00:27:45.440 --> 00:27:48.880
Let's say I did this and I
chucked it over my shoulder. A little
352
00:27:48.960 --> 00:27:52.519
less dopamine and that will train your
brain to do it less this way.
353
00:27:53.000 --> 00:27:59.519
So the most important part to think
of here is when you are creating any
354
00:27:59.599 --> 00:28:03.640
sort of change, when you are
making any sort of movement with the body,
355
00:28:03.079 --> 00:28:08.319
if you're patterning in errors, we'll
call that habituative therapy and vestibular rehab,
356
00:28:08.480 --> 00:28:12.519
or we'll call that, hey,
forms not perfect, or let's just
357
00:28:12.559 --> 00:28:17.119
say form is completely often wrong,
because it's okay to push through a form
358
00:28:17.160 --> 00:28:22.079
that's not perfect. But if you're
training a person to move or an eye
359
00:28:22.119 --> 00:28:26.680
movement that has an error in there, you can plasticize over the error and
360
00:28:26.720 --> 00:28:30.640
sort of lock in the symptom that
it might be causing, making it more
361
00:28:30.720 --> 00:28:33.720
difficult to then go and pull it
off and rehab it. So from a
362
00:28:33.759 --> 00:28:40.359
movement perspective and bring this back down
to muscles, your motor pathways are going
363
00:28:40.400 --> 00:28:45.880
to be learning through the basil ganglia
how to build on it and make more
364
00:28:45.920 --> 00:28:52.200
and more efficient movements. But if
the prediction doesn't match what happens, and
365
00:28:52.279 --> 00:28:55.680
they're putting in a situation where they're
just left to figure it out over and
366
00:28:55.720 --> 00:29:03.559
over, they may create symnatic plasticity
long term potentiation in a direction that's not
367
00:29:03.680 --> 00:29:08.680
effective, and in a direction that
is actually more what it is called counterproductive,
368
00:29:10.079 --> 00:29:12.279
because you're basically training them to move
inappropriately. And then you got to
369
00:29:12.319 --> 00:29:15.440
go back in a later date and
say, okay, well, let's try
370
00:29:15.440 --> 00:29:18.599
this other approach where you have to
sort of like pare down everything else.
371
00:29:19.039 --> 00:29:22.279
I've had that a few times in
office where a patient has come in where
372
00:29:22.319 --> 00:29:26.119
they were put in a boot or
a cast for something way too long because
373
00:29:26.119 --> 00:29:32.640
it was like a mile fascial issue
that was looked at as like a stress
374
00:29:32.680 --> 00:29:36.039
issue. So they say, well, let's just rest it for ten months,
375
00:29:36.680 --> 00:29:38.759
and now they have a movement disorder
there, So what do we have
376
00:29:38.759 --> 00:29:41.640
to do with put them back in
the boot for a period of time and
377
00:29:41.680 --> 00:29:48.799
then remap it little by little,
muscle by muscle because the issue of pain
378
00:29:48.880 --> 00:29:52.559
being that area isn't because there's a
threat on that area. It's because the
379
00:29:52.640 --> 00:29:57.960
brain has plasta size it learned that
pain in that area is normal and what
380
00:29:57.960 --> 00:30:03.359
you're supposed to feel through basil ganglionic
pathways, specifically the ones that look through
381
00:30:03.400 --> 00:30:17.200
the frontal lobe. That's it for
today's episode. Be sure to tune in
382
00:30:17.240 --> 00:30:22.519
for part two, where we will
discuss how reflexogenic systems integrate with musculo skeletal
383
00:30:22.559 --> 00:30:26.960
cases that aren't responding to care.
We'll also talk about how your brain decides
384
00:30:26.960 --> 00:30:32.759
to increase muscle tone and how to
see pass the artificial compensations to understand where
385
00:30:32.839 --> 00:30:37.000
changes are needed for your patients.
You won't want to miss it. Episode
386
00:30:37.039 --> 00:30:41.000
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sure to also check out our event
calendar and bookmark any of these upcoming live
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webinar dates coming up in the near
future so you can join us live.
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00:32:15.000 --> 00:32:17.119
And of course, the biggest compliment
we can receive is for you to help
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00:32:17.160 --> 00:32:21.799
us spread the word to your friends, colleagues, and classmates. You'll find
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00:32:21.799 --> 00:32:23.960
all the important links, as well
as info about our sponsors in the show
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00:32:24.000 --> 00:32:25.680
notes, so be sure to check
those out.
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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 in healthcare in a short format
that is easy to digest, with actionable
10
00:01:04.840 --> 00:01:11.159
information that you can implement into practice
right away. Let's get started. Hi,
11
00:01:11.239 --> 00:01:15.239
everyone, Welcome to the Factor Podcast. I'm your host, Jessica Riddle.
12
00:01:15.719 --> 00:01:19.159
If this is your first time tuning
in, welcome and thanks for listening.
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00:01:19.959 --> 00:01:25.120
In today's episode, we kick off
a new two part training with doctor
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00:01:25.159 --> 00:01:30.400
Michael Lovitch titled Muscle Memory. How
your brain uses muscle tone to map the
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world. I find the inner workings
of the human brain absolutely fascinating and when
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it comes to pain science, the
healthcare community has barely even scratched the surface
17
00:01:41.680 --> 00:01:47.760
when it comes to understanding the multifaceted
aspects of a very complex interaction between the
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brain and the body. In this
training, doctor Michael Lovitch will discuss how
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the brain maps out the body using
muscle tone and how that integrates with vestibular
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and visual inputs. A patient may
come into your office with several seemingly unrelated
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00:02:02.239 --> 00:02:08.240
symptoms, and understanding this interplay between
the brain and the body can really help
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you better determine the root cause.
Today's guest speaker helping us tackle this topic
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00:02:13.919 --> 00:02:20.280
is doctor Michael Lovitch, a Board
certified chiropractic, functional neurologist and Board certified
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chiropractic sports physician. He holds the
Masters of Science in Sports Medicine with additional
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training in brain based functional medicine and
functional movement based rehabilitation. He has served
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as both a medical director and a
member of the medical staff for various organizations
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and events in professional, amateur,
collegiate, and high school athletics. He
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specializes in integrating the physical aspects of
sports medicine and chiropractic care with the brain's
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neurological and physiological symptoms that are often
overlooked. He is a partner of Delta
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S Performance Functional Neurology and Sports Medicine
with clinics in the Denver and Boulder metro
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areas, clinical adjunct faculty, and
a course designer for evidence based concussion management
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00:03:04.919 --> 00:03:08.960
and care for University of Western States
Sports Medicine program. Let's cue the intro
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music and get started. So today
we're gonna be talking about muscle memory.
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I know that muscle memory seems to
be a little bit of a I want
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to call it a hot topic by
any means, because it doesn't really have
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that much controversy behind it. But
you do see it used a lot in
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more lay person settings, and you
see it use more like throw and run
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in the gym all the time,
especially if you go on any sort of
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go on Instagram starts going through the
reels and you'll hear somebody talking about muscle
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memory every few times. Or maybe
that's just the algorithm throws me working in
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sports medicine. So one of the
things that we want to look at is
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okay, well, let's dive into
that. How can we use these concepts
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of muscle memory and specifically how does
your brain map out the world and you
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in it, So that way you
can and essentially create better outcomes with your
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patients or clients or whoever you're working
with by having a better understanding of how
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it works. You may have seen
that I started with a poll just to
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say, just to kind of see
what this group tends to do. I
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typically teach. I've taught a lot
of CEUs for state chiropractic associations and have
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taught like in services for pts working
with special specializing concussions and neurological rehab.
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And I'm always curious to see when
you get neurological symptoms do people do a
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cranial nerve example, where do people
kind of say, all right, well
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let me check everything else and see
if we get any improvement. So I'm
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generally interested in seeing that stuff,
and we're going to be going through things
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that you might want to be looking
for during a cranial nerve exam, at
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least from a muscule scalable perspective.
So one of the things is my presentation
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is made to answer questions as we
go. If it's a longer and more
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involved answer, I may say hey, we'll get back to that during the
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Q. And a part of that
is I like interacting with people as I'm
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talking, because I like to make
sure that this is tailored to the audience
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of people listening. So let's start. We're going to start up with just
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a quick overview of who's this talking
head? Why do I feel like I
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would be qualified to even speaking on
a topic like this. This is my
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office. This is what I've been
doing for I guess seven years now.
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My office is called Delta's Performance.
We are a functional neurology and sports medicine
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office. We specialize in neurological rehab. We do NERD rehab of concussions,
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pots post COVID syndrome. We work
with a lot of nerve degenerative conditions.
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We work with some nerve developmental conditions
as well. Smaller segment of the business.
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The name Delta S comes from entropy. The whole idea is that if
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you have a messy bedroom. If
you have a bedroom, everything in life
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goes into a state of more disorder. So if you don't spend time putting
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energy into it, it's going to
get messier, messier, there's gonna be
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more disorder, and essentially health can
be viewed the same way. If you're
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not actively making your health better,
it will get worse. So that's why
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I chose to name my business a
little bit more complicated of a name,
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but I think it works well with
our whole mission and approach. We specialize
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and pride ourselves on patient experience,
patient education, and just doing an ethical
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treatment model. In my opinion,
we don't take advantage of patients. We
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don't do overtreating, overselling, or
overcharging. We focus on being experts at
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our craft and we're more focused on
We're not afraid for people to shadow and
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learn from us because we're going to
keep moving forward and we say, hey,
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come on, keep up. We
have a collaborative approach. We try
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to work with other practitioners in the
field because we're not experts at everything.
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And we also know that sometimes patient
care works better when you have a different
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person focusing on a different piece,
because if you have one person who's trying
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to do all of it, you're
gonna the patient education and communication is going
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to sort of silo you into what
can you do? This is more of
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what we talked about. What I'm
saying before types of cases we see and
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this is our current team. We're
growing. We have another doctor joined the
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team later this year, So if
you're looking to collaborate with us or anything
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like that, or have any questions, please reach out. We're located in
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New England in three locations and Colorado
here in two locations. So muscle memory
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GAMA motor systems. Now. From
my perspective, I used to always say
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muscle memory isn't in the muscle,
it's in the brain. But it's way
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more nuanceding that when you start diving
into the details, we start diving into
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the actual pathways controlling it because there
are physiological changes at the muscle. So
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if we talk about just basic exercise
physiology textbook, it says it right in
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there that in order for you to
make changes, if you teach somebody anything
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new in the book, it says
right there, the first six weeks of
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any new motor pathway or made a
new motor angram is pure alpha motor activation.
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In other words, you're not training
the muscle for hypertrophy at that point.
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What you're doing is you're training the
muscle for control from the brain.
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But at the same time, what
we're looking at is how do things change
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physiologically at the muscle level that because
there are studies that show, hey,
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when you stop using something for six
months, it comes back faster than it
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did before. So there's a couple
of questions that we have to answer,
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and how can we use that in
a clinical model is the most important part.
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So this is where I always start
with every presentation, is how do
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you build a brain? Because what
we think the brain is there for isn't
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really what it's there for. It's
really very simple. It's there to answer
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two questions, where are you in
relation to the world around you? Where's
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the world around you in relation to
you? And it doesn't care about anything
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other than answering those two questions.
And that's why certain symptoms come out.
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And some of these symptoms start making
a lot more sense when you view it
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from this perspective because there's less deeper
meaning behind it, and it's more about,
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hey, my brain is just trying
to stay upright and navigate the world.
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And so when I have pain,
when I have symptoms of any type,
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those aren't seen as problems by the
brain. Those are seen as,
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oh, this is what I'm supposed
to make. This is the conscious experience
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you're supposed to have so I can
stay upright and navigate the world. So
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here is my simple schematic of how
your brain works. Might have seen these
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things before back in third grade when
you're learning math, and this is a
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function box. In a function box
in third grade, it's like the rule
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is plus three, and so if
your input is four, your output is
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seven. Right, So quick and
easy input are all your sensory systems,
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the five senses, plus your vestibular
system. Most importantly is a vestibular system,
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because that's evolutionarily the base system that
everything is plastered on top of.
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So if that thing's not working right, then all the other senses are going
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to be doing their best, but
it's going to be skewed. All that
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information goes into your brain, and
brainstem creates an interpretation of the world around
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you, and that interpretation is then
fed outward into your motor outputs and your
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psychological outputs. So yes, it
does get more complicated than this. Psychological
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and motor outputs can feed forward back
into the brain and brain sem to say,
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hey, did I do this correctly? Or this is the conscious experience.
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Let me affect this interpretation. But
at the same time, if you're
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trying to make long term changes in
the way the brain is working, you
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have to start with the sensory systems
coming in. That's time zero, and
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you have to continue with how the
brain and brains them integrates that information,
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00:11:00.080 --> 00:11:03.399
because if we're not working with that
part, then it's going to be three
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00:11:03.399 --> 00:11:07.960
steps forward, two steps back every
step of the way if it's not full
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00:11:07.039 --> 00:11:13.840
three steps back. I've tried a
lot of different rubs and different types of
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ointments and lotions. Before I used
to use other topicals and never had the
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00:11:18.519 --> 00:11:26.000
success that I now have with China
Gel. China Gel is my pain reliever
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00:11:26.159 --> 00:11:31.360
of choice. We use it in
the office because of its consistency and the
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response that I get from the patients
is what my goal is. I want
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00:11:35.080 --> 00:11:39.879
to get people better. China Gel
allows me as the practitioner to use instrument
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00:11:41.000 --> 00:11:46.440
assisted techniques, me as the practitioner
to do ultrasound and do many different techniques
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that I've learned over the years in
conjunction with China Gel to get the maximum
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benefit for a patient. It's the
combination of my skills as a chiropractor and
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what China Gel has in it that
allows the patient to get better, faster,
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and more effectively. What is muscle
memory When you talk about it from
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a strength and conditioning perspective, it's
that muscles can drive behavior without an ronal
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input. You can react to things
without thinking about it. You can make
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a very large case for how muscles
and information coming from the muscles can create
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patterns and maybe you're just activating a
pattern that is already predetermined instead of the
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muscle itself saying Okay, this is
what I'm deciding to do. It's more
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I have a collection of things.
This is the information that I've received,
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I've seen this something similar to this
before. I'm going to react to it.
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But there is some evidence to show
that there is an end organ input
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because muscle related tests are easier to
perform with practice. Observations is that there
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are rapid return of muscle mass following
periods of inactivity supposed to say inactivity,
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and then you actually have increased quantity
of sarcomare nuclei for those who don't know
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sarcermare the muscle cell itself. You
can have increased nuclei that do not get
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lost within activity. The muscle will
atrophy or shrink, but the number of
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nuclei in this cell does not,
which is what is thought to be the
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reason why the muscle memory of hey, I haven't done this for a little
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bit, let me do it again, and then it comes back for the
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muick. So what I've noticed,
and this is the part that's my opinion,
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is I've noticed, at least for
popular science and popular culture, it's
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swung muscle memory through a strength training
filter, promoting it popularly as housing the
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muscle. But I'm here to tell
you that taking care of your brain and
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using a neurologically based approach may make
better results faster. What is the point
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of your muscles? The point if
the whole point of the brain is to
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navigate the world and to stand up, the point of your muscles are there
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00:14:01.360 --> 00:14:05.039
to tell you where you are in
space, and do you have large muscles
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to move you around that space?
But what's the point of all those tiny
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muscles? So a lot of the
tiny muscles are there for appropriate reception.
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And when I'm teaching this, I
use this example of a rubber band.
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So let's say you had a rubber
band around your thumb and fore finger,
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as a picture implies, and you
pluck it. You're going to hear a
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sound. Right, If you do
not hear it and you want to make
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it louder, you make it tighter, right, you can pluck it makes
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a more resonant sound. The issue
that we have here is that what if
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the issue is not in the muscle
and the issues in the brain. So,
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for example, somebody comes over and
decides that they're going to be funny
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and punching the shoulder, give you
a dead arm. That muscle is going
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00:14:48.399 --> 00:14:50.519
to tighten up. Why does that
happen? Because you've had some sort of
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00:14:50.559 --> 00:14:54.600
blunt force trauma to the muscle.
It changes the signaling to the brain.
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The brain no longer can hear what
is going on in the muscle as clearly,
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00:15:01.120 --> 00:15:05.279
and there's more static. This is
a very outdated analogy, but it's
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the only thing I can think of
at this point. When you were watching
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00:15:09.080 --> 00:15:11.559
on an old TV, like when
I was like a young kid, and
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00:15:11.600 --> 00:15:16.440
there was static, what did you
do? You just made it louder and
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00:15:16.559 --> 00:15:22.720
listened through the static. That's what
your brain's doing. There's avern sensory information
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coming in front the muscle. It's
got a lot of static going on.
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00:15:26.039 --> 00:15:31.960
It makes the muscle tighter through gamma
motor activation, which then creates better awareness
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00:15:31.960 --> 00:15:35.879
of where that muscle is from appropriate
receptive standpoint, because again, your brain
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00:15:35.919 --> 00:15:39.039
only cares about where your muscle is, so can use it a stands up
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00:15:39.240 --> 00:15:45.759
right and then that muscle will maybe
it's sore, maybe as tightness, maybe
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it as a trigger point because of
the exact individual point that that compensation is
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needed in order to make the brain
function better and have awareness of the muscle
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might only be this big, and
that's to get your trigger point. What
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we're looking at here from a neurological
perspective is essentially, when you build this
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map of where your body is,
a lot of times, the symptom that
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you're chasing, and even the soft
tissue texture and hypertenicity that you're chasing maybe
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a compensation used by your brain to
better function in other areas the same way
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when an injury happens. Muscle splinting
isn't to protect the muscle. Muscle splinting
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is a normal reflex. It's a
reflexive action due to a couple different steps
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that stays there until your brain gets
better awareness of the muscle, or for
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some patients it doesn't get better.
It stays there because they never relearn how
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to move the muscle, because the
splinting created enough of an altered movement,
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alter kinematics, and why sometimes it's
not so much about passive working on the
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muscle, and sometimes it could be
active. We just need to teach the
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muscle how to move again. Oh, for those who don't know, not
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everybody has seen this. I've learned. So this is a sensory homoculous This
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is a map of basically what your
brain thinks your body looks at when you
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scale everything based off of the amount
of real estate that your brain gives to
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the somatosensory cortex. If you look
at that area your thumbs, your hands,
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they're huge, your low back,
your neck, the areas of if
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you think of the areas of the
most chronic pain, those are the tiniest
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areas, and you can get a
lot of cortical smudging and get a lot
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of central sesstimization in that area.
But it doesn't necessarily mean that. But
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it could be a motor pathway and
it could also be like a beta neurons
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being interpreted. So a beta typically
associated with appropriate reception, they could be
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interpreted as pain even though they're not
no susceptive in nature. Typically, I
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put these pictures in here because I
think it really shows all the tiny little
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muscles that do you really think that
those muscles are there to move the spine
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like I don't know half a centimeter
or it's are half a millimeter. In
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reality, those muscles are just there
to create tension and vibration, so that
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way you know where your spine is
in space, and there are so your
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rotatory's longest and breadst those are proper
receptive muscles. Your inner spinalis your inner
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transfer seraide. Muscles that owe one
or two segments aren't really there to create
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motion and movement. They're there to
show, hey, something did move because
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I'm being stretched. And then you
also have all these receptors in your body
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that tell you where you are in
space, like proceeding in core muscles too,
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smaller ones, roufining like endings,
neurotendus spindles if you're familiar with that
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is that's a goldie tendon organ a
gto or neuromuscular spindles. All of these
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things that are housed within the muscle
or the tendon of the muscle that tell
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00:18:51.480 --> 00:18:53.720
you, hey, this is where
you are in space. So let's get
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more complicated, just because why not
not? Just is your sending cortical spinal
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pathways what control your muscles. You
also have vestibular control of muscles. So
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your vestibular spinal tract are the fastest
firing neurons in the human body, and
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its role is to respond to movement
through a gravitational field and keep the body
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upright so it can continue to navigate
the world. We already talked about earlier
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how your vestibular system is the system
that things are plastered on top of.
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But what is the only sensory stimulus
that is constant on your body at all
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times when you're here on Earth.
It's gravity, So that means that gravity
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is always pulling in a direction.
Your body is always trying to figure out
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where you are in relation to gravity. And from my clinical experience, when
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I get patients who have a vestibular
deficit, I always ask them a couple
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of questions. First question is do
you ever feel like you're falling backwards or
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forwards while you're laying down? And
the second question is is when you toss
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and turned during the night, do
you find you always rotate the same direction
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my personal opinion and hypothesis at this
point. I'm not a full on researcher,
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but my guess is that when you
have a vestibular deficit, let's call
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it a left horizontal conal deficit,
and they're lying down, so their head
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is now less in the gravitational in
the plane of gravity, which means you're
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reducing the amount of input coming into
your brain while you're laying down sleeping at
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night. Now you need more activation
because of that imbalance, So you continue
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to rotate yourself in the same direction
and that's what's giving little bursts of energy
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to make things function a little better
overnight. But down here on the this
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is taken so I post graduate training
through the Character Institute, and they have
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I got this off of Google.
This is something that's public on their website.
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Essentially, the whole purpose of what
you're establish system does is it stabilizes
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you in space and allows you to
figure out which way gravity is. So
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let's talk about that real quick.
So if you think so, we talk
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about like how your brain makes maps
of where your body is. What if
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there's a skew somewhere in those maps. What if your perception of where your
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body is in space. Has you
mapped out as being slightly leading to the
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left, even though you will know
you're standing straight up, You're going to
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create postural reflexigenic postural changes to pull
you back over where your brain thinks gravity
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is, or it's going to get
a couple of different things saying different messages.
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So, from a vestibular standpoint,
if one vestibular system, and if
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you look in the mirror, everybody
is asymmetric in some capacity. Let's say
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your face your head grew where half
is half is like call it ideal and
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the other half is a is a
little bit of skew. You're constantly getting
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changes or differences of the amount of
activation coming through your vestibular system just from
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walking around the world. You'll see
this in your patients than your clients because
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they're going to be talking to you, and they're gonna be talking to you
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like this. Or the head tilt
usually your rotation a tilt and a little
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bit of a tilt backwards because one
eyes higher than the other, they're balancing
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00:22:15.440 --> 00:22:17.680
it out. But if you see
that one eyes higher than the other and
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00:22:17.720 --> 00:22:21.720
they're imbalancing out and making it worse, that usually means that the brain is
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not adapting well to vestibular information coming
in and through reflexes cervical adaptations because your
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vestibular system connects directly to your upper
cervical neck and through ocular adaptations through the
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00:22:37.519 --> 00:22:45.240
vestibulo ocular reflex, you'll have an
indirect change because the vestibulo ocular reflex connects
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00:22:45.240 --> 00:22:49.200
and the cervico ocular reflex also connects, creating this little triangle of If everything
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says the same thing, it's all
great. If it doesn't, then we
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00:22:52.720 --> 00:23:00.400
have skews. So here's that ocular
control of muscles the eyehead coordination. So
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00:23:00.440 --> 00:23:04.480
every time you move your eyes to
the left, you have those little proprioceptive
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00:23:04.559 --> 00:23:10.799
muscles contract and control to stabilize your
head on the top of your neck.
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If you have a ton of ocular
errors where you have like I was asking
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00:23:14.680 --> 00:23:18.720
during the question, do you do
a full cranial nerve exam when you check
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00:23:18.759 --> 00:23:21.680
age fields of gaze? Are you
just like, hey, they can move
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00:23:21.720 --> 00:23:26.039
their eyes in that direction, or
are you looking at it like what is
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00:23:26.079 --> 00:23:29.480
the quality of eye moving? Do
they have a number of catchups of cots?
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00:23:29.519 --> 00:23:32.559
Do they have a number of backups
of cots? Do they do they
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00:23:32.559 --> 00:23:37.599
have psychotic intrusions where their eyes are
like jumping and then coming back. All
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00:23:37.640 --> 00:23:41.079
of those things are errors that your
brain has to adapt for and your brain
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has to correct for. And so
when we're talking about creating errors, what
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00:23:45.359 --> 00:23:52.079
is the muscular skeletal compensation based off
this? Well, now you have a
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00:23:52.119 --> 00:23:56.079
deficit or your muscles have to continuously
correct and at a point your brain is
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00:23:56.119 --> 00:24:00.880
going to be like, I'm continuous
correcting so much just clamping down on these
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00:24:00.920 --> 00:24:04.119
suboctipitals. This is why some patients
will come in with claritag and his pain
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00:24:04.200 --> 00:24:08.599
referral. But you go in and
you work on their cervical sponsibility, You
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00:24:08.640 --> 00:24:11.960
work on their shoulders, you work
on the whole kinetic chain. But it
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00:24:12.000 --> 00:24:15.039
doesn't touch it, or it makes
it better, but it doesn't go away
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00:24:15.240 --> 00:24:22.880
because the issue is ocular stability and
we need to create And this is one
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00:24:22.880 --> 00:24:26.119
of my questions of why do we
for anything with the headache, do we
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00:24:26.240 --> 00:24:30.039
check cranial nerve exam? Well,
no, If you don't check the cranial
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00:24:30.079 --> 00:24:33.720
nerve exam, how do you know
this not an oculomote or generated issue.
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If you look at old movies,
you'll see how did they show stress?
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And in an actor or actress,
they focus on the eyes and they show
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00:24:41.759 --> 00:24:45.200
the eyes darting in all directions at
the same time. What if that's what's
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happening with the patient and that's something
that we're missing, something to look into.
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00:24:49.720 --> 00:24:53.680
Now. Fixing those things aren't necessarily
straightforward all the time. Sometimes it's
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a huge vestibular component to it.
But I mean, if you'll find it,
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00:24:57.279 --> 00:25:00.359
at least that's the ball rolling with, things can get better. You
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also have cerebellar control of muscles as
well. So the one that I'm going
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00:25:04.519 --> 00:25:07.240
to focus on is down to the
bottom called the flocculus, which is the
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00:25:07.279 --> 00:25:14.119
flockum modular lobe. It's associated with
vertical eye movements, but it's a modifiable
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00:25:14.240 --> 00:25:19.119
accessory pathway through that vestibulocular reflex for
adaptive control. So it's part of your
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00:25:19.200 --> 00:25:23.680
learning mechanisms in the brain that say, okay, I did this. This
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00:25:23.720 --> 00:25:30.960
is how I coordinate these muscles.
And it's also associated with synaptic plasticity due
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00:25:32.000 --> 00:25:34.240
to retinal errors your eyes. So
in other words, when you have an
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00:25:34.240 --> 00:25:41.079
eye movement error, your cerebellum is
going to try and create corrections because it's
326
00:25:41.079 --> 00:25:44.839
going to remember things that have less
errors, and that's associated with the next
327
00:25:44.880 --> 00:25:48.039
system we're talking about before we do. Here's a fun local activity that everybody
328
00:25:48.079 --> 00:25:52.960
can do. If you take your
fingers like the pads of your I use
329
00:25:52.000 --> 00:25:56.359
the middle finger and you put it
right over your subocipitals and you move your
330
00:25:56.359 --> 00:26:02.000
eyes around, you'll feel your subocxipitals
these tiny little bursts, these tiny little
331
00:26:02.000 --> 00:26:10.160
twitches. That's your vestibulocular reflex.
That's your cervico ocular reflex and your vestibulo
332
00:26:10.200 --> 00:26:14.079
cervical reflex all working together. Because
when you move your eyes around, you
333
00:26:14.079 --> 00:26:18.359
can see how your muscles are twitching
automatically as a reflex. Last system that
334
00:26:18.400 --> 00:26:22.160
we're gonna be talking about is I
think the absolutely most important system, which
335
00:26:22.200 --> 00:26:26.559
is why it's plastered up on my
whiteboard at all times. All five loop
336
00:26:26.599 --> 00:26:33.319
through the basil ganglia. This is
the crude motor system that was paired to
337
00:26:33.359 --> 00:26:37.519
a thalamus, which is a crude
sensory pathway. So what is why is
338
00:26:37.519 --> 00:26:42.519
that important? Because evolutionarily, things
didn't start as complex as they are right
339
00:26:42.519 --> 00:26:47.880
now, and over millions of years
they got more complex. But if you're
340
00:26:47.880 --> 00:26:52.200
going to take it and pare it
down to the most simple, primal systems
341
00:26:52.200 --> 00:26:56.359
that we have. It's basil ganglia
and thalamus. Sensory information comes in basil
342
00:26:56.400 --> 00:27:03.039
ganglia, error corrects for that sensory
information and tries to make an output.
343
00:27:03.440 --> 00:27:10.000
It's associated with not just the error
processing, but predictive movements, predictive circuits,
344
00:27:11.200 --> 00:27:15.920
efficiency of movement, and your dopaminergic
pathways. One of the things that
345
00:27:15.960 --> 00:27:18.839
a lot of people think is like
dopamine is all about reward and all that
346
00:27:18.839 --> 00:27:23.279
stuff from a psychological perspective, yes, but what happens in the basil ganglia,
347
00:27:23.400 --> 00:27:32.039
which is dopamine fires from your substantial
nigra in the midbrain into the striatum
348
00:27:32.079 --> 00:27:37.000
and it's at a constant flow.
When you predict that you're going to do
349
00:27:37.079 --> 00:27:41.480
something like I'm going to drink and
it works, you get a little more
350
00:27:41.599 --> 00:27:45.039
dopamine to say, hey, that
worked, do it more this way.
351
00:27:45.440 --> 00:27:48.880
Let's say I did this and I
chucked it over my shoulder. A little
352
00:27:48.960 --> 00:27:52.519
less dopamine and that will train your
brain to do it less this way.
353
00:27:53.000 --> 00:27:59.519
So the most important part to think
of here is when you are creating any
354
00:27:59.599 --> 00:28:03.640
sort of change, when you are
making any sort of movement with the body,
355
00:28:03.079 --> 00:28:08.319
if you're patterning in errors, we'll
call that habituative therapy and vestibular rehab,
356
00:28:08.480 --> 00:28:12.519
or we'll call that, hey,
forms not perfect, or let's just
357
00:28:12.559 --> 00:28:17.119
say form is completely often wrong,
because it's okay to push through a form
358
00:28:17.160 --> 00:28:22.079
that's not perfect. But if you're
training a person to move or an eye
359
00:28:22.119 --> 00:28:26.680
movement that has an error in there, you can plasticize over the error and
360
00:28:26.720 --> 00:28:30.640
sort of lock in the symptom that
it might be causing, making it more
361
00:28:30.720 --> 00:28:33.720
difficult to then go and pull it
off and rehab it. So from a
362
00:28:33.759 --> 00:28:40.359
movement perspective and bring this back down
to muscles, your motor pathways are going
363
00:28:40.400 --> 00:28:45.880
to be learning through the basil ganglia
how to build on it and make more
364
00:28:45.920 --> 00:28:52.200
and more efficient movements. But if
the prediction doesn't match what happens, and
365
00:28:52.279 --> 00:28:55.680
they're putting in a situation where they're
just left to figure it out over and
366
00:28:55.720 --> 00:29:03.559
over, they may create symnatic plasticity
long term potentiation in a direction that's not
367
00:29:03.680 --> 00:29:08.680
effective, and in a direction that
is actually more what it is called counterproductive,
368
00:29:10.079 --> 00:29:12.279
because you're basically training them to move
inappropriately. And then you got to
369
00:29:12.319 --> 00:29:15.440
go back in a later date and
say, okay, well, let's try
370
00:29:15.440 --> 00:29:18.599
this other approach where you have to
sort of like pare down everything else.
371
00:29:19.039 --> 00:29:22.279
I've had that a few times in
office where a patient has come in where
372
00:29:22.319 --> 00:29:26.119
they were put in a boot or
a cast for something way too long because
373
00:29:26.119 --> 00:29:32.640
it was like a mile fascial issue
that was looked at as like a stress
374
00:29:32.680 --> 00:29:36.039
issue. So they say, well, let's just rest it for ten months,
375
00:29:36.680 --> 00:29:38.759
and now they have a movement disorder
there, So what do we have
376
00:29:38.759 --> 00:29:41.640
to do with put them back in
the boot for a period of time and
377
00:29:41.680 --> 00:29:48.799
then remap it little by little,
muscle by muscle because the issue of pain
378
00:29:48.880 --> 00:29:52.559
being that area isn't because there's a
threat on that area. It's because the
379
00:29:52.640 --> 00:29:57.960
brain has plasta size it learned that
pain in that area is normal and what
380
00:29:57.960 --> 00:30:03.359
you're supposed to feel through basil ganglionic
pathways, specifically the ones that look through
381
00:30:03.400 --> 00:30:17.200
the frontal lobe. That's it for
today's episode. Be sure to tune in
382
00:30:17.240 --> 00:30:22.519
for part two, where we will
discuss how reflexogenic systems integrate with musculo skeletal
383
00:30:22.559 --> 00:30:26.960
cases that aren't responding to care.
We'll also talk about how your brain decides
384
00:30:26.960 --> 00:30:32.759
to increase muscle tone and how to
see pass the artificial compensations to understand where
385
00:30:32.839 --> 00:30:37.000
changes are needed for your patients.
You won't want to miss it. Episode
386
00:30:37.039 --> 00:30:41.000
fifty four drops in two weeks.
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00:31:33.240 --> 00:31:41.160
a live course, visit Factor education
dot com. That's faktr education dot com.
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We'll see you next time. Hey
guys, if you like what you
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00:31:47.319 --> 00:31:52.079
heard today, I encourage you to
visit our website at Factor Hyphenstore dot com
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00:31:52.160 --> 00:31:59.599
that's spelled fak tr hyphenstore dot com
to find out more information about all that
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00:31:59.599 --> 00:32:01.960
we have to offer. We have
a variety of online offerings as well as
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00:32:01.960 --> 00:32:07.279
our hands on Factor Rehab System course
scheduled in cities around the globe. Be
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00:32:07.319 --> 00:32:10.440
sure to also check out our event
calendar and bookmark any of these upcoming live
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00:32:10.480 --> 00:32:14.880
webinar dates coming up in the near
future so you can join us live.
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00:32:15.000 --> 00:32:17.119
And of course, the biggest compliment
we can receive is for you to help
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00:32:17.160 --> 00:32:21.799
us spread the word to your friends, colleagues, and classmates. You'll find
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00:32:21.799 --> 00:32:23.960
all the important links, as well
as info about our sponsors in the show
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00:32:24.000 --> 00:32:25.680
notes, so be sure to check
those out.
