#44 - Neck Training Solutions with Iron Neck, Part 2

Factor, spelled F-A-K-T-R, stands for Functional and Kinetic Treatment with Rehabilitation. Over the past decade, this unique approach to treating pain and dysfunction has been utilized by healthcare providers on 6 continents, serving as a framework that guides clinical decision-making and patient visits around the globe on a daily basis. With this podcast, our goal is simple: to bring the best and brightest in clinical education to the forefront and empower practitioners with cutting-edge, evidence-based content that improves patient outcomes and inspires healthcare providers to continually evolve their approach to treatment. In each episode, we will feature a training or interview with some of the top minds in healthcare in a short format that is easy to digest with actionable information that you can implement into practice right away. Let's get started. Hi guys, welcome to a new episode of The Factor Podcast. I'm your host, Jessica Riddle. Happy New Year, and I hope you guys are having a wonderful, incredible holiday so far. It is one of the last days of 2022, so we're really excited to be bringing this episode to you today. If this is your first time tuning in, welcome, and thank you for listening. If you're like most musculoskeletal practitioners, neck pain is a common complaint you see in your office. Many providers treat whiplash injuries and text neck, along with more serious issues like chronic migraines, cervicogenic headaches, and concussion, all of which can stem from dysfunction, trauma, or weakness in the cervical spine. And if you treat neck pain in your office, you've more than likely heard of the Iron Neck. Today, we wrap up part 2 of neck training with Iron Neck, where we will discuss the latest innovations in training technology and modalities for the neck and its support system. We'll also talk through evaluation practices and clear lines in scope of practice and examine peer-reviewed and credible research on neck strength and its effect on all populations. And who better to speak to this than Jacob Nelson, Director of Education for Iron Neck? Jacob Nelson is a kinesiologist, strength and conditioning coach, and athlete holding a lifetime obsession with strength and learning. He currently works with the Iron Neck as Director of Education, Programming, and Regional Manager, as well as the Head of Strength and Conditioning for the Raptors rugby team. In both positions, the goal is to blend functional neurology with standards of practice In order to make a performance-based training program that enhances all biological systems. Jacob began his career as a strength and conditioning assistant at Humboldt State University, where he received a degree in kinesiology with a teaching coaching emphasis. He also went on to receive his Strength and Conditioning All-American and CSCS designations from the NSCA, as well as served in an internship at NSCA headquarters. In over a decade in the field, he has worked with youth, high school, college, professional, and Olympic athletes as a strength and sports coach. In addition to being a strength and conditioning coach, he also holds certificates in functional movement screening, the Weck Method RMT, and is a licensed coach for USA Weightlifting, USA Kettlebell Lifting, and USA Rugby. Let's cue the music and get started with today's training.

So we'll talk a little bit about this. And so this is sort of the mechanics of the Iron Neck. Now I imagine a lot of you guys, you said bands and loops, so you've done this before, right? It's been a TheraBand or it's been a jump stretch band or it's been some sort of combination of both. We just hold on to this TheraBand and we create resistance and then we can operate from there. We can go about ranges of motion, we can do isometric work. We can do manual manipulation. So what the Iron Neck allows us to do is to hook this thing up. And you can see here, this is a 3rd class lever. And what we're looking to, to talk about here is how the Iron Neck engages, right? So in this picture, this fella's got his toes down into the floor. And if he doesn't stand up right with that posterior chain, so from all the way down from his feet all the way up to his head, has to be engaged a little bit. Otherwise he's going to be pulled into that anchor point and through that very pretty window there. So we just labeled this for everyone to see, right? There's load obviously coming from the band. This is like a 10-pound band. He's standing roughly 3 or 4 feet. So being able to quantify strength gains and range of motion gains is obviously very important to returning someone back to play or returning someone back to work. So we can quantify that with our jump stretch bands. We can put a small mark on the floor there and he can operate right there about 5 to 6 pounds worth of resistance. The force obviously is him, this fella here in the white t-shirt, standing up against that resistance. And then the fulcrum is on the floor, right? Because that's going to be the point where she pivots forward into. If he doesn't stand up against it, he will get pitched forward. Just a quick, like, picture here of the Iron Neck setup. So you can see in here he's got this Velcro strap. So what we do is to make it accessible to all people, we have 3 different front pad setups. They Velcro in and out of the front there. And then we'll have this, the larger part back here actually has an air pump where we'll pump air into it. So it's very easy to change between people, between position differences, like on a rugby team or in a physical therapy setup. If you've got someone that's got a great big watermelon-sized 8.5-inch hat head, and then you got someone that comes in like a small child or soccer player that's 12, 13 years old, like they probably We're going to use a different front pad for them. So what that does is it allows us to customize their internal setup, and then we're allowed to do a few things with the Iron Neck. So these are our foundational movements, and these were for a long time, this is all we had. This is what we talked about and we relied on users like yourselves and strength coaches and neurosurgeons that were using it in rehab setups to do that. I'll just note now, like, when we're talking about rehab and get a lot of questions about, is this axial loading our neck? So right now, our neck weighs about 3.3 pounds, which is less than the average head, human head. And then the new prototype that will come out sometime this year, it'll actually be about 2.5 pounds, 2.6 pounds, I think. So there is very minimal amounts of axial loading, right? Like, this would be like wearing a hat on a windy day. So It doesn't actually load the neck. And then what it does allow us to do is to train the neck isometrically. So all these ones, not all these movements obviously are isometric, right? Number 1, we have a look left and look right, and that's just rotation about the neck. So retracting the spine, making sure that we're in a good position, and then working pure rotation. The other one that we do in this one is a 360 spin, which is isometric. That one is retraction, standing up nice and tall, and as I spin, around the room, as if the Google car was taking pictures, that isometric tension switches sides, right? So as I'm looking at the anchor points pulling me forward, I'm going to retract and get a lot of that in between the shoulder blades, down the back of the neck, all the way down into the feet. And then as I spin around the room, as I spin to the right, get isometric tension on the right side. As I spin around, it's behind me. So now I'm working anterior part of the neck, which is directly affected By whiplash. So we're looking at developing that anterior part of the neck, which is just structurally weaker because we don't have things like traps and lats and things like that to sort of hunker down with. And then obviously I finish my circle and I get onto the left side. So phase 2 movements, we look at protraction and retraction. And these are based on assessments, right? These are, these are normal assessments that people would do. You come in with neck pain, sit down on the table. Can you turn your head left and right? No, I can't. Okay, well then we're We need to work on that. Phase 2 is actually protraction and retraction. If we had a pinched nerve, we had something going on, that pushing the chin out and retracting is changing angles, right? So it's a little more advanced, and it can be a little more difficult for people to get, especially if they have underlying issues, especially if they have weak parts in their neck or in there somewhere along the kinetic chain. Their head could be coming up or coming down. Obviously, we want to see them in a straight plane. So like a turtle coming out of a shell to check what time it is, or I use all kinds of analogies, submarine periscope, right? Like we want that periscope to be the same distance off the water the entire time. And then number 4 is the locked neck body turn. So that's another one where we're adding more of the kinetic chain into the picture. We're rotating, but the spine stays isometric. And we can do these all 4 cardinal directions relative to the anchor point. So looking at the anchor point would be north. We would do sets and reps looking at the anchor point north, and then we'd turn east. We turn south and then we turn west. Multiplanar movements now are things like diagonals. So what we'd actually do is we tilt the head down towards the air, we look down into a shirt pocket, and then we draw for this 45-degree line with the nose. So now we're looking at, again, if we go into that anatomy picture, we're looking at quite a bit of activation. And then the last one is the figure 8, and that was usually the one that's the most difficult for people to get. So we sort of build up to it because, as in martial arts, right, as we're little kids, we get our Our yellow belts and things like that, because we're doing kicks and punches out in front of us and then directly to us, 90 degrees to us. We then get different belt sizes and colors for working into other patterns, right? And then the last one, like, we don't come in on day 1 in karate class and learn a spinning heel kick, right? And like jump across the room. So those rotational movements are always saved for last. And the figure 8 is one of those ones. And if you haven't seen it yet, it looks a lot like Stevie Wonder playing the piano. It starts very small with this, like, through these head movements, right? And then as we gain proficiency, we get into very big ranges of motion. So essentially a figure 8 or a big infinity sign if you prefer. And then we can eventually, when appropriate, we add load and auxiliary exercises. So auxiliary exercises— this video of Mike Salemi, who's a very prominent kettlebell expert guy who competes and trains athletes from all over the world. Mike shot some videos for us in Austin when he was there last, and adding auxiliary exercises to the picture is, is very important, I think, not just to, to athletes, but to, to change the, the resistance levels, to change the stimulus, right? So Mike's doing a bottoms-up kettlebell here, and he'll do a 360 spin with that. So with the, with the tension floating around the neck, right, as he's, as he rotates around And then he's got this, this requirement of holding that kettlebell up that way, right? So if anyone's done these ones before or knows what— like, Mike's doing pretty well there with a, with a 16-kilo bell. So it's a lot of shoulder stability, right? It's a lot of grip strength. And we know that your grip strength is directly affected by your shoulder health and shoulder stability. So being able to hold a significant amount of weight there is one thing, and then adding the stimulus of the iron neck, right? So you got Everything in your neck, everything in that shoulder complex. So, and this is again, like the iron neck is working isometrically in that 360 spin, and then the shoulder is working isometrically. So obviously quite a— just some more stuff there from Mike, but he's just going through some of these auxiliary exercises for us. And great, great athlete and a guy who can share a lot about that. So load modifications. So this is something that applies directly to all of us, I think, is changing resistance levels. So some of the ones that we like the most are, again, like someone comes in with a very sore neck, like this might be too much. Like even the lightest band that we have, maybe standing up with any sort of neck resistance like that, asymmetric or otherwise, might be too much. So what we do is we try to look at attacking it in different ways and creating stability, right? So putting someone in a quadruped position. With a TheraBand and just stretching the TheraBand out with the hands so that we can get an appropriate amount of tension with stability so that someone is able to train and get some of that training effect. So again, we've used isometrics through hands, through TheraBands and other resistance tools. I know a lot of people will just use the towel, right? Put the towel on the head and do those things. Sport coaches are big fans of doing various isometrics, pushing your head against someone's leg at practice with your helmet on. So the load modifications are really only limited to who you are and how creative you want to be. We have quite a few physical therapists that have shared what they've done with us that we like a lot, but looking at from a seated position or things like that is a different topic. But changing, changing the load is obviously of great importance when we're trying to elicit a training response, and that needs to vary, right? That needs to vary from who you are and what you're intending to do And what, what is actually going on? Like, are you, are you injured or are you just training for performance?

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Varied positions. So this is one of my favorite ones. So this is a reverse Nordic. We're actually getting quite a big stretch through the, the anterior, you know, side of the hip. We're working isometrically and, and engaged in the posterior chain. And then it's concentric bits of work, like through the— to return to the starting position. So varied positions, I touched on it just a second ago, right? Like getting down in a quadruped position, Getting the angle of attack to change a little bit will change the requirements, and we can emphasize things like shoulder rehab. We can emphasize things like low back pain. We can look at putting you in a lunge position and seeing if you can, if you can survive in there, or if you can, if it changes what happens. So the varied positions are, are very important. Again, the F6 movements are great. They're a great way to get used to putting the iron neck on. Getting used to it. And then obviously we need to, we need to change the stimulus, right? We have to stimulate the organism to, to elicit a training response. So varied positions are another one that's very good to make it, to show how versatile a tool it is. Because even in this one here, like my hands are free, I'm able to move around a little bit and I can add or subtract resistance or, or stimulus. I wanted to thank you guys for, and gals, for coming in. For that. And then if there's any questions, I'd be happy to answer some, go through some Q&A with you guys. Awesome.

Thank you so much, Jacob. Great presentation. And I think we all learned a lot about, especially about the importance of the Iron Neck. One question I had, and one thing I'd love to learn a little bit more about is you had mentioned the founders really started this from a place of seeing a lot of their friends being impacted by concussion, having careers start short, et cetera. I'd love to know a little bit about their journey to arriving at this specific design. I'm sure there were a lot of different prototypes that were tried along the way and trial and error, so to speak.

Yeah. So the original one, Mike was on his own for the first couple of years and he, he saw the need for rotational strength and training in that run. We touched a little bit on rotary acceleration. I had a chat with a guy named Luke Keakley who was 8-year NFL MVP, defensive player in the Super Bowl. And he said the worst concussions that he had were actually ones where like the chin was taken away really quickly. So Mike saw that and the original Iron Neck was 13.5 pounds. It was made outta solid metal and like the track, if your hair was out over the track, it would lop it like right off. It was a good concept and just not applicable to everyone. You had to be a pretty big, strong person just to put the thing on and train with it. So our current CEO, Matt Schmidt, got involved in 2015 and we wanted to see if we could do more with it. So came in like looking at, it was all one piece and had to buy a small and a large version where the pad was molded into the front of it. And then we were able to then get to where we are now. So this is the 10th iteration that Andrew has on in our thank you picture with interchangeable front pads, the AirFit technology that pushes air into the back pad to lock it onto your individual head size. was sort of always there. That was a big key of it. But it's obviously quite a bit easier now with more of like a Reebok pump setup for your— for you, those of you that wore those in the '90s, being able to pump air in there easily and then release it all as you need to go. And then again, it's totally customizable to the, to the person. So yeah, we're into like the 10th or 11th version of it now. So from 13.8 pounds, solid, solid metal cast, milled out of a block of aluminum to where it is now, which is just about, I think it's going to be under 3 now. So it's going to be about 2.6 pounds in the newest version.

Very great. One of our attendees was asking about availability. Is this available to ship internationally? Do you guys ship all over the globe or are you primarily right now shipping within North America?

We ship all over the world. And I see a question here, is it available on Amazon? It is available on Amazon. So they can, you can get it. We work a lot with people from all over the world. The unfortunate business is taxes and duties. So trying to send them to Canada or trying to send them to Australia, those sorts of places, it's a little less favorable on the exchange rate. So what we're working on now is FDA approval for a medical device and we'll eventually be able to get around some of that. But yeah, it is available to ship worldwide.

Wonderful. Have you ever seen any of your clients or customers, maybe even some of the teams that you work with, utilize any gamification with Iron Neck where there may be specific targets? Or I know gamification is huge right now in a lot of rehab circles, and I'm just curious if there's been any application with Iron Neck.

Yeah, I'm fortunate to work with a functional neurologist named Chris Daley who works at S10 in San Diego where I was for a few years. Again, like trying to roll out programs and things like that and looking at attaching lasers. He had like a small laser pointer that he could put on top of the head and then, and then add the Iron Neck. And then you can look at target tracking, like how well those movements are. Plans to add an inclinometer and an app-based program where we'll be able to track ranges of motion and then track displacement. So some of those movements, we don't want the head to, to move around, right? Like we want to stay in an isometric format so that we don't get into ranges of motion that cause pain, or like we wanted to sort of start with that in-range isometric. So yeah, there's, there's a few. And again, like it's, we try really hard to make things accessible to folks. And then we really like are fortunate to have some great people working with it. And they show us quite a bit of stuff that they do. But yeah, so the gamification in, in those formats, right? Like Chris is working with people from central nervous system disorders to joint replacements and things like that. And his— and he's trying to add, get quality of life back and get rid of pain. So he does some very interesting things. And he works through a company called Z-Health, if anyone's familiar with them. I've been working with Z-Health for many years now. And Chris is a master trainer. So he has some very cool applications for it.

Very cool. We had some questions here about other resources For some research that's being done, journals, where would they go on the Iron Neck website to learn more about some of the research initiatives that you all are working on? I know you mentioned a little bit of your R&D work moving forward.

Yeah. So if anyone wants, we have a handout that we give to people. It's quite a bit of, we're working on a summation, right? So that it's not like 9 pages long, but support@iron-neck.com and they'll be happy to share. All the things that we're working on, like from supporting research to why we started doing neck training the way we're doing it, to the studies that we've done most recently that are involved with Iron Neck as using virtual reality and sensory motor stuff to come back from concussion assessment, but also as a rehab tool. Dr. Devaney at University of Connecticut is using it as a range of motion tool only. She wanted to see, could you assess people through active ranges of motion with it, and she'll be using it in a study to qualify ROTC candidates to see if there's a correlation between some of these range of motion issues that we have and if we can identify them early on and train. The other one that we have is from the US Air Force, and they looked at training with the Iron Neck or other modalities as well, but which one can provide training that will help pilots stay in the cockpit and not be medically disqualified. And then some of the ones that are on the way with COVID it was really hard to obviously get people in and get studies done. So Dr. Carrick of the Carrick Institute is running quite a few different studies for us, and he's looking at some of those biomarkers and looking at CTE concussion, and then other biomarkers through neck training that can help identify early onset dementia and things like that.

Thank you. That is very fascinating, and it sounds like you guys are really Doing a lot to progress in terms of this type of research for these specific conditions. And obviously CTE is something that's taken, I know, the sports world by storm, and we certainly want to continue to progress and move that forward. What are some next steps? I guess I know we're a little bit limited on time here, so I wanted to go ahead and wrap up. What would be next steps for people to get in touch with you if they have questions? If they wanted to learn a little bit more about some of Iron Neck's educational initiatives or trainings, things like that.

So again, we're hoping to roll out some, some more info on the website and make that easily accessible. All the videos, training videos, we have 10 training programs and 4 phases each that are available for free if they want to look at those sorts of things. But I'm happy to answer questions. It's just jacob@iron-neck.com. And I'm happy to share any of the supporting research or the things that I've been working on. So hopefully it'll be in there as soon as possible, but there is quite a bit of stuff going on, so it is taking us just a bit to make it a succinct sort of document for people. But we hope to have that out later this month, actually, just so that people can go on and see. They can look at links and they can look at the peer-reviewed information that we've, we've been both basing our work on and then working with other people and To see how, how much we can do.

Absolutely. Well, thank you so much. And Jacob, again, thank you so much for today. It's been a pleasure.

Thank you, everybody. Thanks, Jessica.

All right, guys, that's a wrap for our last episode of 2022. Be sure to tune in for episode 45, where we kick off a new training on upper extremity neurodynamics. With our friends at ChiroUp.com. ChiroUp co-founders, Dr. Tim Bertelsmann and Dr. Brandon Steele, will discuss nerve tension tests and nerve flossing maneuvers for carpal tunnel syndrome, pronator teres syndrome, cubital tunnel syndrome, radial tunnel syndrome, and many more. After listening to this 2-episode series, you'll walk away with proven real-world skills to diagnose and resolve some of the most common upper extremity neuropathies. You won't wanna miss it. Episode 45 drops in 2 weeks and will be our very first training of the new year. You can subscribe to The Factor Podcast on Apple, Spotify, iHeartRadio, or the podcast app that works best for you. Give us a 5-star rating and help us grow the show. Every little bit helps. And last but certainly not least, please be sure to visit our show notes for a link to sign up for our special end-of-year deals. There's still some time left. You still have a couple of days before we ring in the new year. We're offering some unprecedented savings on in-person and online course offerings, but only for those who take the time to click the link and get all the details. Don't wait. Visit the show notes now, click the link, and take advantage before the ball drops and 2023 arrives. Guys, the clock is ticking, so stop now, finish the episode, go to the show notes, and click on that link. We promise you'll be glad you did. Happy New Year from our entire team at Factor, guys. We'll see you next time. Hey guys, if you like what you heard today, I encourage you to visit our website at factor-store.com. That's spelled F-A-K-T-R-store.com to find out more information about all that we have to offer. We have a variety of online offerings as well as our hands-on Factor Rehab System course scheduled in cities around the globe. Be sure to also check out our event calendar and bookmark any of these upcoming live webinar dates coming up in the near future so you can join us live. And of course, the biggest compliment we can receive is for you to help us spread the word to your friends, colleagues, and classmates. You'll find all the important links as well as info about our sponsors in the show notes, so be sure to check those out.