How Chiropractic Adjustments Impact Strength | Podcast Ep. 185

Hello and welcome to the Evidence Based Chiropractor. I AM your host, Dr. Jeff Langmaid. This week we are talking about a study which has the potential implication to dramatically impact the course of future chiropractic research over the next decade or more. It ties into stress strength, mechanism of action and some really cutting edge ways of discovering how an adjustment can impact the human body and the benefits that we can get from it. So this is an episode that you are going to want to stay tuned for. But as I said at the top this week we are talking research and we are talking about a paper titled Chiropractic Spinal manipulation alters TMS Induced eye wave excitability and shortens the Cortical silent period. I'll repeat that one more time and you can check it in the show. Notes. Chiropractic spinal manipulation alters TMS induced eye wave excitability and shortens the cortical silent period. This was published in the Journal of Electromyography and Kinesiology just a moment ago in 2018. So basically we know, right? Spinal manipulation has been shown to decrease pain and improve functional abilities related to a ton of musculoskeletal disorders really through a multi layered mechanism of action. When you give an adjustment, there's a facet component, there is a central nervous system component, there's a stretch response in the muscle spindle component, there's a disc component, there is a lot of components, a lot of things happen, right, A lot of mechanisms of action when you give an adjustment. And several published studies have examined the effects of altered afferent input due to spinal joint dysfunction. So what I mean by that is this. There's been plenty of studies out there that have showcased when a spinal joint isn't moving appropriately, the afferent input starts to change and not change in a beneficial way, let's put it that way. So this paper takes that research one step farther and examines the sensory motor effects of an adjustment. And the results are pretty exciting. The results indicate a shortening of the TMS induced cortical silent period and an increase in eye wave amplitude after an adjustment. We'll break down what that means in a couple moments. So and as they say, this has the ability to probably reflect the mechanism of increases in strength shown after an adjustment in previous studies. If you remember earlier this year we cited and all members of the Evans based chiropractor had it as a monthly research brief, the increase in cortical drive after an adjustment and how that tied to strength. So this kind of goes one step Farther and starts to examine, well, how's the mechanism of, how's that work, right? And that starts to become really exciting because as we start to develop our knowledge and understanding of that and that opens up in a massive array of clinical implications as we'll talk about. And the array of those clinical implications become pretty astounding because let's break down strength, right? Strengthening is a key component of everything from rehabilitation to sport specific performance enhancement. It really anything in the healthcare field, strengthening probably has some sort of component to it. So, you know, it appears as though an adjustment is probably an extremely beneficial treatment option in a wide array of health challenges. And, and I love papers like this because it not only touches upon, you know, pain relief, right, but it really harps towards performance. To me, that's where chiropractic can and should live is in the performance realm. It's about benefit, it's about quality of life. Now if somebody comes in with pain, right, that's a five alarm fire. You want to take care of that pain as quickly and as effectively as possible for that individual. But from there, many people do have hopes and dreams that go beyond pain relief, right? Many people have hobbies, quality of life issues, you know, benefits that they're for, beyond merely pain relief in being able to help guide those people. Whether it's through literally the act of giving adjustment, whether it's through the act of health coaching, whether it's fitness and exercise, you have a lot of tools in your tool belt that can be utilized by the people in your community and you can be their guide towards greater health and certainly greater quality of life. And that's where this paper starts to go. That's where it starts to get me excited about it. So let's dive into a few quotes from this paper, then we'll break down the application of it and how you can communicate, communicate it to your patients as well. So the researchers found chiropractic manipulation significantly increased the amplitude of the first eye wave. Finally, the cortical silent period duration was significantly reduced after a spinal manipulation in the lower limb muscle. All right, that's a good start. Give some context. Secondly, they found the changes observed in the eye waves and CSP duration in this study provide evidence that spinal manipulation can result in a significant increase in the excitability of the motor pathways to lower threshold motor units of the human tibia anterior muscle. Okay, so it's getting more specific on that first one. And finally, they found these findings may have important clinical implications as they provide support that spinal manipulation can be Used to strengthen muscles. That's where we're trying to get to with this one. And that's really the big take home message. Now when we talk about amplitude of that I wave, you might be thinking to yourself, well, what does that mean? Did it increase by 1%? Did it increase by 2%? I mean, 10% would be fantastic. Well, let's take a look at what the researchers found. I'm going to give you a hint. It is much more than that. So what they found is in the first, eye wave amplitude increased post manipulation by 90% on average. 90%. It gets even better. They found on the second eye wave amplitudes were increased post manipulation by 180% on average. That significantly changes. Now you might be saying to yourself, if you are wise, well, what happened to the control group? Were they just going to increase naturally? The answer to that is no. Following the control intervention, there is no significant change in the number of eye waves or the amplitude. So this starts to become a really big deal. We're talking about 90%, 180%. Those are big, big numbers. Now correlating that to what can happen clinically, that's a different discussion. But gosh, it's exciting to see where the research is going. So I mean, all methods of analysis for the cortical silent period duration resulted in a significant reduction following the spinal manipulation with no following the control intervention. So there's no question really that changes were occurring as far as what they were measuring. Which starts to become exciting because now we can start to say, okay, where is this teasing in the future? And to me that's the next step of this research, right? Is understanding what are those clinical implications and how can we utilize this. So in this paper they tease into the fact that, hey, there could be implications potentially in individuals who have suffered stroke, right? People who are having severe issues with strength. I'm putting words in their mouth a little bit, but that has a neurogenic component. So the signal is not getting through. If you could amplify that signal, amplify those waves, there's potential for major change. Now, I'm not saying the whole chiropractic profession should by any means switch over, nor do I think these researchers are switch over to stroke and rehab. But it starts to create some really exciting avenues and aspects. I always like to think back, we talked about it a few minutes ago, to the sports performance world. So in the sports performance world, we see chiropractic being utilized by every major professional sports team in the world. Really. I mean, down to the high school level in many places that take their high school sports seriously. And they might still have an athletic trainer, they might also have a therapist, they might have a medical doctor. So they have a lot of people that are in the crisis care aspects of what they do. But the chiropractor really can focus on the performance, the sport specific performance. What's going on with the biomechan? How can the. And this is where a chiropractor has so much tremendous value. I've spoken with TPI and OnBase U and Racket Fit Dr. Sean Drake, I think he's just doing such a great job with this sort of thing, is really focusing on the sports specific biomechanics and the sport specific performance enhancement that a chiropractor can assist with that falls outside the scope of some other health professionals. You know, the medical doctor might be there for those larger interventions, but it's largely hands off. The ATC might be there strictly for, you know, rehab, passive modalities, things like that. That's not to take anything away from those individuals. But where the chiropractor can really fit in is understanding the biomechanics, understanding the healthcare aspects and then anything that you can get from a performance aspect. So bridging the gap between the medical team and the coaching staff, that starts to become a really, really important job, a really, really important role on a team. But if you break it down, whether it's a sports team or an individual's life, the same thing holds true, right? If people are looking to get out there and have better performance in their daily life, it just basically improve their quality of life. I believe that there's no better person than a chiropractor to help guide them in that direction. We have all the tools, we have the tool set and research like this starts to showcase the breadth and depth of what we're able to do. I love research showcasing how we can help people with back pain. I love research showcasing how we can help people with neck pain, people suffering from headaches. That is exquisite important. We should have 99% of that market, we should have everything but the non red flag portion of that market as a first line option. We still have a long, long way to go before that happens. But that doesn't mean that I look away from the emerging and the cutting edge research showcasing man, we're getting 90, 90%, 180% big changes in amplitude that's happening within the nervous system post adjustment in that those amplitude directly correlate with strength and wow, that starts to become pretty compelling. It starts to get me really interested in what do the next five and ten years hold within the chiropractic literature and what can we expect to see and how does it break down ultimately to guidelines and algorithms? I love that stuff. This is an exciting paper. I'm definitely going to get it out there for all members of the Emma Space Chiropractor to share with the other docs in their community. Because it's something new, it's something different, it's eye opening, it's a different way to look at our profession, and it also teases that there's much more under the surface than meets the eye. And to me, there is nothing more beneficial from a marketing perspective than showcasing what's to come in the future and hinting at what might be available. So I'd encourage you to check out this paper. You can visit the Show Notes and check out the paper directly by clicking there. Also, if you have not left this podcast a rating or a review, that's what helps more and more docs find us. So I'd greatly appreciate it if you took a few moments to do that. And of course, if you want to build and expand your referral network, see what we have going on at the evidence basedchiropractor.com and I'll be back next week. But until then, I hope you have a great week in practice and I will talk to you soon.

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