In this episode of Health or Hoax, we talk about being new graduates from our Doctor of Chiropractic program, and the job opportunities that await new grads. There are many paths that a new chiropractor may take, including working as an associate doctor, starting their own practice, or buying a practice. Dr. Davis, Dr. Dan, and Dr. Blake discuss what they chose to do and why. 

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Dr. Anthony Davis: @shapeshiftwellness

Dr. Blake Loxtercamp: @blake.loxtercamp_dc

Dr. Dan Brown: @vectorsportandspine

Mass Psychogenic Illness is a really interesting phenomenon, where essentially a bunch of people get sick because they THINK they were exposed to a germ or virus or toxin, but in reality they weren't. They get all the same symptoms and sickness as if they had truly caught some nasty virus, but the symptoms being produced are entirely created by their own hyper-reactive nervous system. It's pretty interesting to consider how powerful our brains are in creating our physical experience.  . . 

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Please note, although this video is being released right after the coronavirus was declared a pandemic, this is in NO WAY meant to imply anything about the seriousness of the coronavirus. You should of course follow the advice of the world's experts, the CDC and the WHO to keep yourself and your community safe. . . 

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What is interesting to consider regarding the strange phenomenon of a Mass Psychogenic Illness is simply that our brains can do a lot of really dramatic stuff to attempt to protect us. Our immune systems are highly reactive to all kinds of things, so the panic and mass hysteria surrounding this pandemic may feed into your own personal fears and anxiety. Keep safe, take it seriously, but don't feed on fear. Feed on good, solid information, and meanwhile consider taking some quiet time away from your phone, away from the TV, and maybe have some time for self reflection, movement, or maybe reading a good book.  . . 

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Don't take a bad situation and make it worse by freaking out. Try to use self-quarantine and social distancing as a way to make some quiet personal time, or do something else that would be meaningful to you.  . . 

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CITATION: https://www.ncbi.nlm.nih.gov/pubmed/27294104 . .

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 Tarafder, Binoy Krishna & Khan, Mohammad Ashik & Islam, Mohammad Tanvir & Mahmud, Sheikh & Kabir, Md & Faruq, Imtiaz & Miah, Md & Arafat, S.M.. (2016). Mass Psychogenic Illness: Demography and Symptom Profile of an Episode. Psychiatry Journal. 2016. 5. 10.1155/2016/2810143.  . . 

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We sat down with Dr. Melissa MacDonald (DC ICSC CCSP® NREMT) to speak about when to return to play, when/if people really need to take time away from their sport or favorite activities due to injuries, and how movement and exercise can play a huge role in active rehab from musculoskeletal injuries. We spoke about the psychology that comes into play with injuries, and the importance of offering assurance and movement optimism to patients/players when they are in recovery.   

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There are many myths and dogmas about physical therapy, active care, and chiropractic care for injuries which revolve around fear of movement, and which lead to poor outcomes. Generally speaking for most injuries, the good news is that many people don't really need to take as much time away from activity as they may think, and can often return to play quickly with the help of a professional to guide them.   

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Visit Dr. Mac in Minneapolis, Minnesotta: https://www.macperformanceclinic.com/  

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🤔 Some people believe you can test for allergies by placing a glass vial with an allergen on/near a person, then testing the strength of a particular muscle for weakness. They believe weakness would indicate an allergy to the substance in the vile. . . 

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This study tested whether practitioners of “Health Kinesiology” (a subset of “Applied Kinesiology”) could accurately detect allergies to WASP VENOM in patients with a clear history of anaphalactic reactions, and who had been already been confirmed as having significant allergies to wasps. . . 

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❌They FAILED MISERABLY. . . 

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Proponents of Applied Kinesiology will argue that they get results! Well, even if your method is complete nonsesnse, you will still get results due to random chance! In this experiment, they simply had to guess between TWO vials, one with poison, and one with just salt water. They had a 50/50 chance, just like a coin flip, to get it right. So if they are actually doing something right, they should statistaclly perform better than a random coin flip. Well, they actually did WORSE THAN A COINFLIP. . . 

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The claim was an extraordinary claim to begin with, because it completely lacks any biological plausibility in the first place. Sure enough, when pressured by the rigors of science, Applied Kinesiology falls flat on its face. . . 

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🧙‍♀️Don’t let people scam you with magic tricks, folks. . . 

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📖CITATION: https://www.ncbi.nlm.nih.gov/pubmed/11926427 . 

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Lüdtke, R & Kunz, B & Seeber, N & Ring, Johannes. (2001). Test-Retest-Reliability and Validity of the Kinesiology Muscle Test. Complementary therapies in medicine. 9. 141-5. 10.1054/ctim.2001.0455. . . 

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Dr. Alex Sundin is a sports chiropractor (DC, CCSP, ICSC) in Maple Grove, MN, as well as a fellow in the Human Performance Center at Northwestern Health Sciences University (NWHSU) in Bloomington.   

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Find him here: Web: https://www.amplifymotion.com/ 

IG: https://www.instagram.com/amplifymotion/  

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We took time to speak with Dr. Alex about common chiropractic misunderstandings, by addressing common questions about what a chiropractor does, what they don't do, what subluxations are (and aren't), and what a chiropractic adjustment/manipulation does.  .

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Some people have the impression that all chiropractors believe in outdated ideas about "vertebral subluxations", but the truth is that most chiropractors have moved past this, and are very similar to physical therapists, in that they are primary care doctors for sports injuries, musculoskeletal pain, low back pain and many other conditions, but they happen to have a strong emphasis on joint health and biomechanics.  

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The nocebo effect is when a clinician's harmful or scary language makes the patient feel worse, not better. It's often thought of as sort of the opposite of the placebo effect. Our language matters a lot for healthcare. The words we use can heal, or our words can harm.  

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😱Are you accidentally scaring your clients/patients? . . 

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💬From the article: "Many patients with musculoskeletal conditions are anxious about their future and are naturally predisposed to see the negative rather than the positive. When we are physically and emotionally low, we not only hurt more easily, we also seek information that supports our vulnerabilities.( 11) Health professionals need a keen sensitivity to the ways in which patients hear their words and how those words may be misinterpreted." . . 

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😔People already seeking state aren't feeling very strong. Do you really want to make them feel even MORE vulnerable? . . 

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🦸‍♀💪Or do you want to EMPOWER THEM? . . 

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❓What other phrases need a reboot? . . 

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CITATION: Stewart, Michael & Loftus, Stephen. (2018). Sticks and Stones: The Impact of Language in Musculoskeletal Rehabilitation. Journal of Orthopaedic and Sports Physical Therapy. 48. 10.2519/jospt.2018.0610.  . . 

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https://www.jospt.org/doi/pdfplus/10.2519/jospt.2018.0610?casa_token=U40swbaxbzEAAAAA:-XYIt8RIHDqUN9ipeLtynwAV70B09EKw3J0JDRbDMH_iPxJDxSHx3cIRS_gSCOAfJFBk7zS1TR5u . . 

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The interface between the skin and fascia is frictionless. In manual therapies like chiropractic spinal adjustments and soft tissue release techniques, often it is thought that a thrust or a force is being applied to a bone or muscle at an oblique angle. It is thought that a clinician can be specific in regards to the specific direction they are pushing the targeted structure. If possible, this would be useful in attempting to mobilize a joint by pushing a bone into a certain rotation or flexion or any other specific direction. The only way that this would be possible is if the interface between the skin and the bone or muscle being targeted had FRICTION. Friction is needed to get a grip on these structures.  . . 

According to this paper, there is no friction in the skin-fascia interface. This means the only possible force vector for any manual therapy targeting structures deeper than the skin is from superficial to deep. Applying force at an angle is impossible, if the findings of this study are accurate. . . 

This does NOT mean that the therapies themselves aren't still useful, it just warrants a shift in how clinicians educate and think about what they are doing. It also makes things simpler and easier when you acknowledge the limitations of your technique.  . . 

Link to paper: https://www.lastsite.ca/wp-content/uploads/2017/10/Thefrictionalpropertiesatthethoraci.pdf . . 

Citation: Bereznick, David & Ross, James & Mcgill, Stuart. (2002). The frictional properties at the thoracic skin-fascia interface: Implications in spine manipulation. Clinical biomechanics (Bristol, Avon). 17. 297-303. 10.1016/S0021-9290(02)00014-3. . . 

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Host: Anthony Davis on FB/IG/YT @shapeshiftwellness / www.shapeshiftwellness.com

Often times, physical therapy exercises for low back pain are intended to be highly specific to the condition and the patient. This episode highlights a research article on low back rehab which compared specific or corrective exercises for back pain to general exercises, to see if it's worth the extra effort of coaching and performing more targeted exercises.   

CITATION: https://www.ncbi.nlm.nih.gov/pubmed/25770419 

Saner, Jeannette & Kool, Jan & Sieben, Judith & Luomajoki, Hannu & Bastiaenen, Caroline & Bie, Rob. (2015). A tailored exercise program versus general exercise for a subgroup of patients with low back pain and movement control impairment: SHORT-TERM results of a randomised controlled trial. Manual Therapy.  

Host: @blakeloxtercamp

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Does mindset matter? If you THINK you are healthy, could that possibly make you actually become healthier? How much do positive and affirmative beliefs about your own lifestyle and health actually impact your overall health?  

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In this study, women lost weight, body fat, and lowered their blood pressure just from being educated that they were already doing a good job being active. They weren't asked to change anything. They didn't do additional exercise, they didn't change their diet. They were just given some reassurance, and they lost weight and improved several markers of overall health.   

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What are the implications of this? Comment below and tell us why this would matter to YOU!  

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Citation: https://www.ncbi.nlm.nih.gov/pubmed/17425538 

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Crum, Alia J., and Ellen J. Langer. 2007. Mind-set matters: Exercise and the placebo effect. Psychological Science 18, no. 2: 165-171.  

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In this video we will take a look at whether or not having a positive attitude can ACTUALLY improve your health and reduce pain. We also take a look at the nature of chronic pain to see if it really is all in your head, and if so what can we DO about it? How can we change our attitudes and beliefs about pain? Does mindset matter for improving our health?

REFERENCES: 

Paper of focus  - Hanssen MM, et al. Can positive affect attenuate (persistent) pain? State of the art and clinical implications. Curr Rheumatol Rep (2017) 19: 80. https://doi.org/10.1007/s11926-017-0703-3

1. IASP Task Force on Taxonomy CoCP. Part 3: pain terms, a current list with definitions and notes of usage. In: Merksey H, Bogduk N, editors. Classification of chronic pain. Seattle: IASP Press; 1994.

2.  Strigo IA, et al. Association of major depressive disorder with altered functional brain response during anticipation and processing of heat pain. Arch Gen Psychiatry. 2008

3. van Middendorp H, et al. The effects of anger and sadness on clinical pain reports and experimentally-induced pain thresholds in women with and with-out fibromyalgia. Arthritis Care & Research. 2010

4. Burns JW, et al. Anger arousal and behavioral anger regulation in everyday life among patients  with chronic low back pain: relationships to patient pain and function. Health Psychology : Official Journal of the Division of Health Psychology, American Psychological Association. 2015

5.  Vlaeyen JW, et al. The fear-avoidance model of pain. Pain. 2016. Overview and update of leading biopsychosocial model in the study of (persistent) pain.

6. Zautra AJ, et al. Positive affect as a source of resilience for women in chronic pain. J Consult Clin Psychol. 2005.

7. Strand EB, et al. A Positive affect as a factor of resilience in the pain-negative affect relationship in patients with rheumatoid arthritis. J Psychosom Res. 2006

8. Thong ISK, et al. The buffering role of positive affect on the association between pain intensity and pain related outcomes. Scand J Pain. 2017

9. Roy M, et al. Cerebral and spinal modulation of pain by emotions. Proc Natl Acad Sci U S A. 2009

10. Steptoe A, et al. Neuroendocrine and inflammatory factors associated with positive affect in healthy men and women: the Whitehall II study. Am J Epidemiol. 2008

11. Steptoe A, et al. Positive affect and psychobiological processes relevant to health. J Pers. 2009

12. Zautra AJ, et al. Dynamic approaches to emotions and stress in everyday life: Bolger and Zuckerman reloaded with positive as well as negative affects. J Pers. 2005

13. Ong AD, Zautra AJ, Reid MC. Chronic pain and the adaptive significance of positive emotions. Am Psychol. 2015.

14. Garland EL, Fredrickson B, Kring AM, Johnson DP, Meyer PS, Penn DL. Upward spirals of positive emotions counter downward spirals of negativity: insights from the broaden-and-build theory and affective neuroscience on the treatment of emotion dysfunctions and deficits in psychopathology. Clin Psychol Rev. 2010

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