Approaching Movement and Chiropractic from a Biopsychosocial Model | Podcast Ep. 153

Hello and welcome to the Evidence Based Chiropractor. I AM your host, Dr. Jeff Langmaid. Today we are going to talk about the close alignment between motion and healing. We're going to break it down from a biopsychosocial framework and we're going to talk about how that plays into your clinical role day in and day out with the patients that you see in your practice. And we're gonna talk about, I wanna talk about that in the context of motion and healing. So when I look and take a step back and look at what we do day in and day out as chiropractors, it's really about motion. Whether it's global motion with active care and rehab, whether it's regional motion with, let's say, sport specific training that can go global, of course, or whether it's all the way down to segmental motion and what we do with adjusting. So I'm gonna touch on the bio component, the psycho component and the social components of where I think it resides and where we're getting such great efficacy with what we do. Because when I look at the literature that is out there, when I really examine a biopsychosocial model, it's so in line with what we do as providers. Again, whether we're doing active care and rehab, soft tissue work, neurological work, adjusting itself, all of those items play such a role in the efficacy that we get with the care that we give. And quite frank, we just have better efficacy than nearly any other profession out there. When you really look at the literature and putting it together, I think a lot of that ties back to our emphasis as chiropractors on motion. So from a bio component of the biopsychosocial model, I wanted to look at what we do with adjusting and a biomechanical model of that. And where does motion and movement play a role? So when we give an adjustment, there are three primary things or items that we are going to address. Maybe four, we're going to address the facet. We're going to address, address the disc, certainly the muscle spindles within the muscles themselves, the Golgi tendon and the neurological component. But I'm gonna hit those first three pretty hard. So the facets we know as we age go through injury. The instantaneous axis of rotation migrates posteriorly across the disc space, increasing the load on facets. Over time. This causes the facets to encounter adhesions. It encounter facet disease, facet arthrosis, inflammatory conditions of the facets. All of that typically ste either from acute injury or a Long progression of time on planet Earth, where they are overloaded throughout time. So this is where we, of course, are able to address those facets, get them moving, get the slide better, reduce the adhesions, gap the facets. All of those things which are so, so important takes place with our primary treatment option, a chiropractic adjustment. Additionally, we know the facets are completely loaded with the nerve fibers, mechanoreceptors and nociceptors. So being able to gate the pain, so to speak, by increasing, increasing the mechanoreceptive information with a quick, fast adjustment is a huge advantage in reducing pain. We also talk about the disc, right? We just touched on the fact that the instantaneous axis of rotation migrates posteriorly throughout time. Additionally, in the outer annular fibers of the disc, small nociceptive fibers infiltrate from the end plates throughout time. So we become sensitized to pain as we get older in the disc space. Well, how do we combat that? Again, you're gonna hear that the answer is motion, right? When we are able to do, whether it's a flexion distraction technique, whether it's spinal decompression, whether it's an adjustment itself, there is input motion put into that disc space. Motion in the disc space ultimately equals a nutrient transfer. So it stimulates or activates the healing process. If there's annular tears, if there's challenges on those discs, motion is key. And of course, the muscles, if the muscles are spasmed to prot, there's perhaps nothing better than an adjustment. Soft tissue work is a key component of that. But getting an adjustment in there, getting that stretch response and relaxing the muscles so then your soft tissue work has more teeth, so to speak, is a very good way to go. So when we look at the bio component of a biopsychosocial model, what we do with a chiropractic adjustment plays exactly into where the benefits can be gained within treating the spine, facet, disc muscle, and ultimately the nervous system as well. When we start to go towards the psych component, I think this is where it's really interesting, and there's a lot of people doing some really interesting things in this realm. Greg Layman is one that comes immediately to mind for me. If you did not check out the interview I did with Greg earlier this year, I'd encourage you to do so. He certainly is one that is pushing this model forward. He is a great speaker, a funny guy, and super, super knowledgeable. She'll be sure to check out that interview or catch him when he is traveling to your Area for sure. But one thing that he brought up to me and stimulated my thought along this many moons ago was his conundrum in practice was when do I expose and when do I protect? So a patient comes in with an injury, we'll take the extremities out, we'll focus on the spine for the purposes of this episode. But I think it goes across the entire body. Somebody comes in with a low back injury, how do you know when to expose them to stimulus or versus protect them? And he said that was his greatest conundrum as a clinician in practice, day to day. And I think it's something we all need to keep in mind. But with that, he also would say that he lent towards expose more often than protect. Because a systematic controlled exposure is movement, right? It's getting people what hurts. Let's do that again. You know, I'm oversimplifying that, but moving through a painful range of motion in a controlled fashion with you, guiding an individual provides multiple benefits. Number one is that once you've suffered an injury, you're very sensitive to the motion, motion type that caused that injury. That's just psychological, you know, that's why it's the psych component. So you are very apprehensive about going through those motions. But being able to do them again, train again, and understand that every time you do it, it's not going to cause that injury is a huge hurdle to overcome. And that's where exposure comes in crucial. The other aspect of it is people are just on high alerts. Not only the sensitization, but they're also just on high alert to motions that could potentially cause the injury they suffered with in the past. So being able to control the exposure to that sort of stimulus and, or motion and movement as we're talking about today, can provide somebody with really significant benefits in their ability to get well and then to stay well. Because there's one thing to get people out of pain, but if they're walking around and protecting their body, not exposing it, now they're gonna run into compensatory issues. And we've all seen that many, many times in our careers, I am sure. But by controlling that early on, they're coming to you as a healthcare professional, by controlling that exposure early on, showing them that it's not going to cause an injury every time, that it's actually a good thing to do and that long term they are going to be okay, is why biopsychosocial, why the psych component is in there. And finally, as we Go towards the social componen. For me this is about, I always say, doing the things you love with the people that you love. So when you're unable to do the things that you love with the people you love, you're unable to enjoy your hobbies, your activities, you're unable to enjoy time with your friends and family, it becomes a struggle mentally. And this dell again, all these three things play together. But that can become very depressing, it can become very disheartening for people when they're unable to have the quality of life that they desire. And I'm telling you, if you look at advertising out there from some of the biggest groups, the biggest healthcare companies in the world, what are they talking about? They're talking about lifestyle benefit. That is typically when somebody's life people will deal with pain, but when their lifestyle starts to drag down, that's when they're looking for options and making the decision to come in to your office, quite frankly, or any other provider that they find that they believe and trust can get them back their quality of life. So from a social component, while the bio component is very hard science, right? Movement, facets, nervous system disc, the psych component is the progression moving through pain. Don't diminish the social component. The social component is what drives behavior. And when you can understand what people are unable to do and what people are striving for, that enables you to ethically fine tune your message and become the best option for them. As we talked about at the top, when we look at the literature across the board, what we do as chiropractors is one of the most safe, it's one of the most effective and quite frankly the sad part about it, one of the most underutilized healthcare professions the world has ever seen. So understand, look at your patient, understand your ideal patient if it's in your practice now or it's where, if you're early in practice and it's your ideal patient, as you build and grow your practice and speak that language, understand what's holding them back from the things that they love to do, make sure that is forefront in your ability to communicate and that can make a huge, huge impact. Because the flip side of this, when you're in an active rehab or an active treating capacity, is as people are able to socialize again and do the things they love, they are going to be exceptionally happy. That is going to reduce their re injury rate. It's also going to help them live more productive lives and quite frankly it's going to benefit your practice as they go out and tell all of their friends on the great work that you have done. So those were my thoughts this week on a biopsychosocial model and how movement and chiropractic are so intertwined with within that model. If you have any questions, hit me up jeff@the evidencebasedchiropractor.com if you have any topics you'd like to see me cover in future episodes, hit me up at the same spot. Jeff the evidencebasedchiropractor.com I hope you have a great week in practice and I will talk to you soon.

We appreciate you joining us for this episode of the Evidence Based Chiropractor. Learn more tips for explosive practice development@the evidencebasedchiropractor.com youm can also join the Premier MD monthly membership, enabling you to use what you just heard to maximize results in your office.