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all right Dr Perry welcome to True Hope cast really appreciate your time today how are you what is going well I am

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doing I'm doing for our conversation today

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um it's a actually a little bit of a rainy day here in Colorado normally it's we have tons of Sun so it's uh it's nice

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to get a little reprieve in some sort of moisture up here in the mountains wonderful wonderful I'm glad to hear

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that you're well so just as an introduction to our audience can you just let everyone know who you are and

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what it is that you do yep so um like I said my name is Dr Perry Maynard and I

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am actually a board-certified chiropractic neurologist so some might be saying what what is

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that I've never heard of that so my doctorate is in Chiropractic and then

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just like kind of like any specialty within health care whether that be medicine uh doctor of osteopathic

0:53

medicine whatever it may be there are Specialties in board certifications within those professions so

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um I am board certified as a chiropractic neurologist which means that my by trade my doctorate is in

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Chiropractic but I went back and did a specialty and got board certified in clinical Neuroscience very similar to

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what you would have in other professions but sometimes people get a little confused when they say Chiropractic neurologist I've never heard about that

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so which is really cool because I think it it might blend nicely with what we talk about later about what we do in our

1:25

practice of how those things are all linked together but my practice is here in Denver Colorado it's myself and uh Dr

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Shane Stedman and I work a majority with uh concussions mild traumatic brain

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injuries a lot of you know your ear Disorder so things like vertigo balance

1:43

issues really honestly I tell people anything weird that goes wrong with the

1:49

brain we see so if you remember that show it was in the U.S called house

1:54

where is that kind of like a doctor who was kind of neurotic all over the place and you'd see and solve crazy cases I

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always tell people we're like the house of weird neurological cases but I like to think that both of us are a little

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bit more approachable than that doctor so crazy cases without the neuroticism

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so awesome I like that yeah wonderful amazing show when I studied nutrition

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and we had a lot of anatomy physiology and Western medicine I would call that my like junk uh studying sessions

2:25

watching House episodes and yeah it certainly takes a British actor to pull off the uh

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to pull off the wild character yeah but that's really cool so you so you did your doctorate for about seven years and

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then you went back to do Neuroscience like why like what what happened when

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you were done did you see gaps in the in the the studies or did you just like know that's kind of where you want it to

2:48

go and you needed to fill in some information like why did you kind of go back to to study that yeah no great

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question so originally in college I was a pre-med major with a biology major

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with a minor in Neuroscience so I had always been just kind of interested in

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the brain and I think people always get interested in things when there's weird things about themselves ever since I was

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kind of like younger but another big piece was I played uh division one football so I played football my entire

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life um so part of it also was selfishly you

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know as I finished up my career I started to see teammates on disability at 25 years old you know having

3:29

debilitating seizures having teammates die of seizures secondary to head injuries

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um so I think selfishly we all get into things because we want to kind of help ourselves and figure out you know what's

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going on in my brain and you know how do I keep from being 50 and not knowing who

3:47

I am or not knowing who my you know wife or children are you know plus I just always found the brain very fascinating

3:54

but either way originally when I went to school I really just wanted to do sports medicine I loved the

4:00

manual therapy aspect of Chiropractic I loved the manipulation the adjustment

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but I also loved the rehab I love that I could be kind of a hybrid of a PT and a

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Cairo which honestly you're you're seeing more where you're seeing pts and cairos that are very similar uh and do

4:17

very similar good work you know so that's originally what I wanted to get into and then while I was in school I

4:24

got exposed to uh Dr Ted Carrick who some would say is the Godfather of

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functional neurology so Ted Carrick is also a chiropractic neurologist um super he got his Fame when he worked

4:37

with Sydney Crosby back in the day so he was one of the main doctors who got Sydney Crosby back playing again from

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his concussion so that's where he got a lot of his Fame but kind of The Godfather of functional neurology and I

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listened to him speak when I actually was at the NFL combine and I was like wow this is really cool

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I didn't think I'd ever be able to use any of this like I learned it in undergrad and I'm going to chiropractic

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school and you're telling me I can do something with this Neuroscience degree or I can do things to change brain

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function this is really cool so I got involved heavily with the Carrick Institute when I was in uh was I was in

5:16

school and I started taking courses I took over probably 400 hours of

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continuing ed while I was in chiropractic school because I knew this is what I wanted to do so probably about

5:28

like a year into Cairo school I was like this is what I want to do

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um you know and then I had the fortunate ability to work with a Dr Glenn zelenski who is an amazing clinician up in

5:40

Portland Oregon he's got one of the best clinics I think in the world so I did my residency up there and worked up there

5:46

for a little bit and it was once I was immersed in it that I was kind of like this is what I want to do I love

5:53

Chiropractic and I love the manual therapy side but I personally was like I

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don't want to be just treating low back pain and neck pain I don't that just it didn't it didn't fascinate me uh versus

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realizing like wow I can take people with complex neurological conditions and I can do something to change them

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especially because traditionally there's nothing that's offered for these individuals besides medication therapy

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and sometimes physical therapy can you explain to us a little bit how

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a manual adjustment in a chiropractic session can influence

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and change your nervous system and I think with that question if you want to begin with maybe giving us a

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foundational explanation of like maybe what the nervous system is I think that when we

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think of I think when most people think of the nervous system we think of like you know the sensations and the feelings that we have you know whether that's a

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like peripheral nervous system or a central nervous system but I don't think I don't think we're really taught too

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much about like the differences between the two and then if you could blend that into how an adjustment can you know

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significantly change the way your nervous system like functions or how you experience pain

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Etc do you think you could do that for me for sure no that's a great question and I'm going to try to unpack stuff in

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the simplest form all right well when you're when you're looking at the the the the nervous system let's say like

7:21

you said traditionally it's split up into What's called the central nervous system and the peripheral nervous system

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so the peripheral nervous system is everything outside in essence the spinal

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cord so the nerve coming from the spinal cord to let's say my bicep we have a

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motor nerve which causes contraction of a muscle and we have a sensory nerve

7:45

that gives us feedback of Sensations all sorts of Sensations so uh like vibration uh kinesthetic

7:52

awareness like where a joint is which is going to be really important when it comes to adjustments um temperature hot

7:58

versus cold right so all of these different types of sensation are constantly being fed into my spinal cord

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and up into my brain to say here's where my arm is so traditionally when we think of the peripheral nervous system people

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think about like neuropathies so someone's got like a diabetic neuropathy the nerves in their hands are dying so

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they get this like numbness and tingling or maybe I have a herniated disc in my

8:22

neck it's pinching on a nerve and that's what's creating this radiating pain right that's that that's the peripheral

8:29

nervous system a lot of what we do is more effect the central nervous system so there's a lot

8:34

we can do to affect the peripheral but when we're thinking about Central it is everything from the spinal cord right so

8:41

the cord inside my spine up into the top of my brain now

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I think the best way to explain this the question is there's so many different areas of the brain right we have the

8:53

spinal cord we have What's called the brain stem which is where a lot of automated reflexes live so uh balance uh

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regulation of heart rate respiration uh my ability to sweat my ability to dilate

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my pupils right all of these things that are automated that we don't really think about okay and then we go a little bit

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step higher into what are called subcortical areas so sub below my cortex

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right which is like the big hemispheres everyone thinks about subcortical circuits are circuits that

9:25

play a huge role in regulating think of them as like the symphony coordinator they regulate to make all these reflexes

9:33

are working appropriately so if we kind of think of the brain we could think of it this way of there's a

9:39

controlled object which is let's say my hand well that that muscle has a controller

9:46

and it's the nerve and that nerve has a controller it's my spinal cord and that

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spinal cord has a controller it's my brain step and that brainstem has a controller it and see it goes up and up

9:59

right so there's hierarchy there's these primitive reflexes and then ultimately there's this executive part of my brain

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which people call our frontal lobe or our prefrontal cortex which really just makes sure all of this

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works which is cool because we have redundancy but you could have someone that could have a issue in their brain

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stem but if their frontal lobe Works appropriately they can make up for that right so it's all of these different

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levels and hierarchies but at the end of the day the argument of like what's the

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point of a brain is um is an interesting question right everyone's got their different theories

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but there's a lot of theories that I think make sense of one of the basic foundations of the

10:43

brain is to be able to explore our environment a big part of our brain is to understand

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the world around us so that we can interact with our world and this is why

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we see that so much of the brain has to do with interpreting sensation right

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it's like we said touch to my hand where is my wrist in space so is it here

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is it here is it here where is my head where's my head relative to my body

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where am I in gravity so how is my inner ear interpreting where my head is in the

11:19

world and then how is my vision telling me where's the world in reference to me

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honestly that is some of the biggest function that the brain plays a role all

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of these other things like appreciation for art for music for

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having relationships for being able to be empathetic those are all like the icing on the cake in this higher order

11:43

area but what you see is that when these other things start failing

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the brain preferentially throws out those other things to try to fix your

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sensory awareness and this is why I see concussion patients with dizziness and balance issues develop depression

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anxiety mood disorders and then you fix their balance issues and those things

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get better right because the brain says hey my priority is to make sure you don't fall who cares if you enjoy music

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anymore who cares if you know your neighbor's name you know what I mean those things those aren't life and death

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those are like if everything else is working appropriately you know um so so that's kind of I hope that's

12:27

helpful and giving an idea of Central versus peripheral so if we're talking about adjustments

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let's talk about how adjustments can affect the periphery so

12:39

everything from Pain to Central things so if we're thinking about an adjustment

12:45

really some of the theories are looking at an adjustment is you have different types of adjustment

12:51

but let's take a a high velocity what people think of of like uh you know someone cracking their neck right so you

12:58

have a quick accelerated movement through a joint so one of the first things that's happening is that one

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you're stimulating receptors within joints called mechanoreceptors So within

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all of our joints we have what are called mechanoreceptors and this is what tells me my head is slightly right

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farther right or it's left because they're kind of these hair cells that

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displace and this is a big reason why individuals who have whiplash injuries a

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lot of times will get dizziness from their neck because those receptors no longer give good feedback so those

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mechanoreceptors give feedback to my brain to say here's where my joint is in

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space so we know when we adjust we heavily affect those mechanoreceptors

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but we also affect the tone of muscles so another way that my brain knows where

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a joint is in space is that where my wrist is like this this muscle is short this is long

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and then I match that with the mechanoreceptors I match that with the stretch on my skin in the fascia to say

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here's where my hand is in space so from a local standpoint an adjustment is going to affect the the skin receptors

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the mechanoreceptors but it's going to alter muscle tone around a joint and

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sometimes can normalize muscle tone giving better feedback so there is a

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researcher named Heidi Havoc I think out of Australia I think she's got some

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really cool research in the Chiropractic realm on how adjustments affect brain function and she's got a cool analogy

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that I'm going to steal but think of each segment of your spine or each vertebra as a camera okay and that

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camera gives feedback of where that joint is in space when a joint becomes

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fixated or stops moving so let's say I have this wrist and normally my motion is that much motion

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and then I get an injury and now it's this much motion I'm depriving the brain

14:58

of this much information and I'm only giving it this much so let's say my neck

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is really tight the joint's not moving it can't feed information back up into

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the brain to compare to say does it match my inner ear and my vision so when

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you look at an adjustment it's got local effects on the mechanoreceptors and the muscles but by reinstating normal

15:23

function in a joint you improve the feedback to the brain I always tell patients it's like especially in

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whiplash your neck is like a radio station in like Arkansas in the middle of nowhere

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like you you got like two stations and it's like a Christian like gospel station and like a talk radio otherwise

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every other station is just pure static and so an adjustment or work to the neck helps

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to tune to where that station is now clear so that when my head is turned here

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I can now get matching signals from my inner ear my vision in my neck versus If

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my muscles are tight telling me that my neck is to the left but then I turn my head to the right and

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my inner ear says you turned your head to the right that's where people get nauseous and dizzy so adjustments help

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all these local things but then play a huge role in helping to remap where the

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body's in space so I look at adjustments as if I want to remap someone's body

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awareness adjustment is powerful so once again if I have a wrist injury the more

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I can manipulate something the more I'm going to drive feedback and so going

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back to your question about pain there's a few different theories pain of there's the pure like gait theory of pain like

16:42

if I have a burn right what do I do I instantly rub it and that's because proprioception right which is just touch

16:51

vibration all of those things actually inhibits pain at the spinal cord level so we have pain circuits that we can

16:59

inhibit at the spinal cord level which Chiropractic adjustments have been shown to be able to gait pain at the spinal

17:05

cord level but Heidi Havoc also has some really interesting research showing that you improve motor control of joints so

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there's a top down right so if I have this wrist and it it's kind of like doesn't move very well and I adjust it

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it improves the motor control I.E the way my brain Now controls that limb

17:27

which then can help with pain can help with smoothing out movement or to make

17:33

movement more coordination um and improve in essence the latency

17:38

for the time for a muscle to contract so example is I gotta shoulder that dislocates a

17:45

little bit more than I like um and I've had multiple surgeries from football and I love doing uh Brazilian

17:52

Jiu Jitsu not the most friendly thing on joints so one of the big problems that I

17:58

have is that I have no internal stability so that when someone goes to hit my arm

18:04

and I get movement that movement should be picked up by muscles and sensors in

18:09

my shoulder feedback to my brain and if I'm really fast I stabilize really quickly right this is like if you ever

18:16

have someone you're testing balance and you push them and you see how quick can they respond you're looking at how fast

18:22

is that signal from the muscle to the brain to then control it so going back to doing things with adjustments or

18:29

Chiropractic can improve that latency so now my shoulder can better respond to a

18:35

perturbation than maybe it did before foreign I think some of the big points I've

18:42

picked up there is the that hierarchy that kind of Cascade Event that you're talking about there's different levels

18:48

of of experience and neurological function and I'm sure that's um

18:54

mimicked in the body in many other types of like parallel Pathways especially like the kind of the hormonal system

19:00

from like your brain down to your ovaries or testes you know you have these different structures these they're

19:05

all dependent on each other they might be kind of maybe working independently of one another but like they're all

19:11

they're all in relation with each other you know they're I'm sure they're all communicating in they rely on each other

19:17

to get like the let's say the full the full picture and it really makes me think about when you I mean you're

19:23

talking about that and it was you know it's it's complex if you had no idea about the neurology or anything or

19:29

biology it could be difficult to understand so I would recommend like maybe going back to what going back 10 minutes

19:34

and listening to that again because it's really really a wonderful explanation and it really makes me think about how

19:40

um because that's so complex in so many different areas and there's many

19:47

mechanisms that you know help us create our reality through kind of our nervous

19:52

system and our senses Etc it makes me understand how it's so difficult for people to unders to not

19:58

understand like the energies and and Chrono mystical things around us that we can't actually see but are there like

20:05

you know you've got the examples of like you know like a like bees and flies and butterflies see see things in the

20:11

physical world that are completely different to us and I'm just thinking about like energy and frequency and all these other things that shape this

20:17

wonderful world that we're in and it makes me understand a little bit more how many people might not understand that considering how like complex our

20:24

nervous system is to allow us to kind of stay safe in our environment

20:30

and um you know get away from things if we need to because we have this physical body we have this mind and we have this

20:36

complex nervous system to make us like do that it's just that's very very cool so I appreciate you uh kind of sparking

20:41

that thought process for me I have a question in regards to you were talking about you were talking

20:47

about like um if you have a wrist injury now you have say you've got 100 Floor movement in

20:53

your wrist and you have this injury and let's say you've got 25 movement is there any research research in regards

20:59

to actually just not not attemptable if you if you can only move 25 percent

21:04

what about thinking about doing the whole movement because obviously like there's a connection between what your

21:10

body mechanistically can actually physically do with your wrist and your muscles ligaments tendons Etc and then

21:16

your brain obviously has got the comprehension of doing the four movements so is there any research

21:22

in regards to actually just not not doing it but thinking about doing that full range of movement to help the you

21:28

know help the actual wrist um heal yeah no uh that's a great point then

21:35

there definitely is there's a lot of cool research looking at how visualization can light up all the

21:43

pathways all the way up to the spinal cord so everything from you right because your brain is all about

21:49

so you have if you think about Movement we have what is called a feed forward mechanism which is that subconsciously I

21:57

think I want water my brain has rehearsed that like a dozen times before it even becomes conscious to me okay and

22:05

so my my frontal lobe my frontal lobe and my cerebellum they work kind of in opposite so let's say we're talking

22:12

about reaching my water bottle on the left my right frontal lobe or my right side of my brain controls my

22:19

left arm okay and so I say I want to grab this water bottle will they feed back and forth and the frontal lobe says

22:25

hey I'm just about goal directed Behavior like I just want to do this and the cerebellum in another part of our

22:30

brain called our basal ganglia they have the filing cabinet of how do you do it successfully how do you coordinate the

22:38

appropriate muscles to make it happen smoothly so they go back and forth a dozen or so times and then all of a

22:46

sudden they say okay frontal lobe here's what we're going to do and then they send that signal to my

22:51

spinal cord and everywhere else in the nervous system to say here's the plant so when you get feedback for doing the

22:58

plan let me know if you're correct or not so when I go to reach for this water bottle I'm getting feedback from my

23:05

entire arm and I'm saying does that match what I pre-predicted right and if it does I get a little bit of dopamine

23:12

and it says that was a great job do that again if I don't and let's say I reach for this water bottle and I miss it or I

23:20

get a little bit of a a Tremor right and ultimately this is where you see things like uh like Tremors or movement

23:28

disorders is there's a breakdown in selecting the appropriate movement pattern so going back to visualization

23:34

is that visualization lights everything else up up into that point right so it

23:40

doesn't necessarily make the movement happen but it can prime those circuits because we know that like when injuries

23:47

are cast or we even know with low back pain that we get cortical smudging you know

23:52

um I don't know why I'm blinking on the gentleman

23:57

um the two Gentlemens who wrote one of the early pain science books

24:03

um but either way there's it might come to me um but they were the ones that kind of

24:08

popularized this idea of cortical smudging which in essence is when there is chronic pain or disuse of a limb your

24:16

representation of that limb starts to in essence go away if you don't use it you do lose it you know and this is why you

24:24

can yeah there's some interesting studies looking at when individuals are casted being able to maintain a certain

24:29

amount of muscle mass compared to control subjects so there's clearly something even happening on a

24:35

physiological standpoint in the muscle that individuals who didn't do any visualization lost more muscle mass than

24:41

individuals who did so it's kind of like your priming that circuit

24:47

neurologically everyone just thinks muscle everyone thinks rehab I gotta make that muscle stronger and bigger but

24:54

they forget that strength is really your brain's ability to recruit motor units

24:59

right so it is a strength and power and explosiveness is 100 a neurological

25:05

event yes you need the muscle but you need your brain as well so um what's also cool about that as well

25:11

is that we'll use that a lot of times in in individuals with pain so if someone's got a wrist and it hurts to move by

25:18

visualizing pain-free ranges of motion you can start to train them that that's no longer a threat right that's where

25:24

things like mirror therapy play a role right mirror therapy uses certain circuits as well where you're getting

25:31

visual feedback as if your limb is moving but it's not actually moving so that's where I think

25:37

things like mirror therapy and visualization are super cool uh and there there is some definitely some cool research on those

25:44

yeah I just I just know there's research in regards to you know how you know how you can just you can create matter

25:49

through thoughts you know like you can just think about doing a bicep curl and they've done studies where you know they

25:55

see like you know it might even it might be small like maybe five or even to ten percent of like that muscle growth but

26:00

it's just amazing that you can think about doing the actual movement without doing it and actually getting getting some of

26:07

the actual physical benefits I think it's really really fascinating to be honest yes very very cool stuff I'm just

26:13

not sure if it had been done with um you know like a like a like broken or damaged tissue that needs to be healing

26:19

but it makes sense to me that you know if I have a particular injury or anything and I've got the time and space

26:24

to um to meditate I put my time I put my focus and I put my Awareness on that

26:30

particular area and I know that that's you know where I put my where I put my attention is where I put my energy so I

26:36

think that's a very cool aspect of it as well you mentioned something about balance issues and depression well is

26:42

that like can you can you take us through that connection because um yeah yeah I think that's very interesting we've got so many mental

26:48

health issues going on around the world you know we all experience depressive thoughts and anxious thoughts and for a

26:55

lot of people that can be constant it could be chronic but like is that sometimes connected to just like you

27:00

know balance issues yeah that's that's a great question I think you know when you look at depression right

27:07

we've always tried to nail it down to one simple mechanism as you saw recently kind of the the serotonin hypothesis is

27:13

finally we finally realize it's more complex than that yeah and now you're seeing a lot of people talk about it

27:19

from a inflammatory model which I think is correct as well I think where you see

27:25

this become relevant is in concussions and vestibular disorders or inner ear

27:31

disorders and so there's a few different theories so to answer your question yes you see

27:37

all the time when people have concussions and they have alterations to visual

27:43

processing auditory processing balance all of these things and they're

27:48

depressed and anxious and you think why those two aren't related and you improve

27:54

their visual processing their balance of those things is not uncommon that you

27:59

see things like mood get better and the question is like why would that happen few different reasons so

28:06

some of those things are controlled by the same area of the brain so this is

28:11

work out of a gentleman named Jeffrey shamaman and he's out of Harvard out of Mass general

28:18

and all of his research is on the cerebellum and affective disorders so

28:24

cerebellum is a part of our brain that sits underneath here in the base of my skull and it has everything to do with

28:31

coordinating movement so we we've always thought about it as coordinating movement so like my ability

28:37

to do write these rapid alternating movements

28:43

my ability to coordinate balance my ability to coordinate my we've always thought about it in a motor sense right

28:49

coordinating movement but what Jeffrey shaloman has shown is that it not only coordinates movement but it coordinates

28:55

thoughts and emotions right because they're all the same Loops they're just

29:02

different contexts right because they thought is a motor response we don't think of it

29:08

that way because there's not a muscle involved but it is an expression of cell right it is an expression of a let's say

29:14

this way it's an expression of a signal so this is an expression of a signal and

29:19

it's a movement my thought of being happy is an expression but just a feeling and so

29:26

that cerebellum that also has to do with coordinating balance also coordinates mood so in some cases it's just that

29:32

same area is enough is affected so vestibular disorders affect the cerebellum concussions are notorious for

29:39

affecting the cerebellum Strokes are notorious for affecting the cerebellum and that's where you can see some of

29:44

those mood disorders I think the last piece is think about I explained it to patients

29:51

this way so think of my cerebellum as being in charge of all the basic chores

29:59

of the house like kids should do let's say take out the garbage mow the lawn empty the dishwasher right or that like

30:06

my wife might say is my job as well they still fail sometimes right so that's the job of the kids right and the job of the

30:13

parents is to go to work pay the bills make sure all the really important things are done right

30:20

but all of a sudden let's say the kids decide to stop working for the day right

30:26

and they're like I'm not going to empty the dishwasher I'm not going to do any of these things and so Mom and Dad come home and they say now I have to do extra

30:33

work on top of what I was doing before no one you know no one else is going to mow the lawn okay I need to do that and

30:39

so what happens is you take resources from your executive brain right where depression comes from so depression

30:45

comes from your prefrontal cortex or lack of function there and so you move

30:51

all of your energy to make sure that you don't fall and you don't get dizzy that

30:56

there's no energy left to go towards mood so think of it as like allocation of resources and in concussions the

31:05

brain becomes very inefficient and it's very inefficient in how it allocates energy and currency

31:13

so then you just you may feel okay and then you go to work for four hours and you're like I'm so anxious or I'm wildly

31:20

depressed or the things I used to love doing I no longer love doing why is this happening

31:26

they have no juice left in that prefrontal cortex because it's spending

31:31

all of its time to sort out why you fall every time you stand up or every time you try to go down the stairs think

31:38

about it walking down the stairs you shouldn't think twice about it should be a piece of cake in a lot of my patients

31:44

they literally have to consciously think how do I take a step right and so

31:49

there's no energy left to do these higher order things like mood right because at the end of

31:57

the day if your brain thinks it's going to fall you don't care if you're happy or you're sad it just cares about you

32:02

not falling so that's kind of how I look at the connection between some of these sensory processing issues like balance

32:09

and then things like mood very interesting that resource allocation piece is is very fascinating

32:16

because yeah that again extends to many different systems within the body I

32:21

think of digestion primarily like you know if you're super stressed out and you've got all these other things going on that you may even just be

32:27

subconscious the so you may just be unconscious about your body's still having to deal with those things and

32:33

then it can't you know it's unable to do the normal things of breaking food down and making nutrition for you so then you

32:39

might have some digestive things come through so yeah that makes total sense to me thank you for that explanation

32:45

um have you with the last you know couple of years of wild stuff going on in the world have you seen any

32:51

um like common issues coming through the door like we've seen so many people like depressed and anxious and stressed out

32:58

through you know um covid lockdowns mandates Etc you know a lot of stressed

33:04

out individuals have you seen like more of a certain condition coming in or people coming in with new stuff coming

33:10

in is of any any patterns you've noticed in the last couple of years yeah actually

33:16

um we uh Dr sedron I who I know you chatted with a few weeks ago we were talking about this

33:21

um a huge influx of patients with what is called dysautonomia most specifically

33:29

what people know it by is what's called parts p-o-t-s and it stands for pastoral

33:34

so posture orthostatic so changing position relative to gravity

33:41

postural orthostatic tachycardia syndrome right this is in essence where individuals stand

33:47

and they either pass out they feel like they're going to pass out they stand up

33:53

and their heart goes to like 120 beats per minute in in the the hard part about pots is

33:58

that the best way I ever heard it explained is that the symptoms that people have

34:04

with pots is like your worst hangover right nausea diarrhea stomach hurts I

34:11

have a headache I have brain fog I feel dizzy I feel faint right and so the

34:16

problem with these individuals is that they get thrown to all these different Specialists of okay you have GI issues

34:22

so you have nausea and diarrhea go to a GI doctor okay you have joint pain go to

34:27

the rheumatologist okay you have dizziness and migraines go to the

34:33

neurologist oh your heart's racing fast go to the cardiologist but it's all coming like we may talk about it's all

34:39

coming from one etiology or one area so I am seeing a massive influx in

34:44

dysautonomia patients which in essence is an inability to regulate one's

34:49

autonomic nervous system or automated nervous system so there's a part of our nervous system

34:55

that is fully automated that regulates my breathing rate so my inhale my exhale

35:01

my heart rate so the rate the Rhythm how hard my heart contracts my blood

35:06

pressure the saliva in my eyes the mucus in my mouth my ability to sweat

35:13

my ability to regulate temperature all these things that we never think about my ability to control how much my gut

35:20

moves right so how long does it take for me to have a bowel movement so if people are constipated or have maybe more

35:28

frequent bowel movements all of this is controlled by the autonomic nervous system and so dysautonomia is a disorder

35:35

that causes that to not work and so we've been seeing a massive influx and I think a lot of this is is secondary to

35:42

covid because dysautonomia is notorious to happen post like viral infections so

35:48

it's kind of it's not funny but you're finally seeing the medical

35:53

establishment believe that infections can cause serious issues so I have a lot

35:59

of wine patients so I have a lot of Lyme disease patients who have been suffering for decades and no one has ever believed

36:06

them um right in in things like Lyme disease can cause things like this but covert is

36:12

finally open the healthcare Arena's eyes and like oh wow infectious diseases

36:19

don't just cause like coughs and sore throats right they can affect our brain and our neurology

36:25

um you know so I think that's honestly a big reason why I've been seeing a lot of dysautonomia

36:31

um you know so I think that I think early on maybe a huge influx in uh anxiety

36:38

like Dr Simon I talk about I think covid and the lockdowns just brought out

36:43

people who are already anxious so people who already had a tendency to be anxious you locked them up in a house for two

36:51

years that anxiety is going to multiply so we've definitely seen an increase in anxiety depression but the biggest thing

36:57

I'd say is that dysautonomia or more specifically uh pots cases

37:03

interesting well it makes sense I mean you've got like like hurt like herpes viruses you know that that hang out in

37:09

cranial nerves so I I don't know too much about like why viruses like nerve tissues have you got any

37:15

can you explain that at all is there is there any thought process behind that that's a great question

37:22

um you know I don't know if I actually have a great answer for that I know I have

37:28

heard individuals discuss I mean so when you look at let's take um like either certain viruses or spirochets right A

37:36

lot of times their goal is to is to not kill you right they want you to be their host if if a virus or a bacteria kills

37:45

you it's not going to do a very good job of being able to transmit to another host so a lot of times viruses will hide in

37:54

places that are very hidden from the immune system so sometimes like joint

37:59

tissue So synovium within joints but a lot of times in nervous tissue as well to try to hide from the immune system so

38:07

that that's part of the reason why it is or theorize especially in like Lyme disease is that it will change forms so

38:15

it will go from being what's called like a cell wall cell wall form so being in the cell wall to assist form so it

38:22

literally it will morph so some of these things more and they move into different tissues with the whole goal in essence

38:29

is to evade the immune system so that's why a lot of these things will lay down in brain tissue is that

38:34

traditionally the brain is thought of being separate from the rest of our immune system right right that's the

38:40

point of the blood-brain barrier as we're learning that's not totally the case and there is connections between my

38:48

body and my brain and viruses being able to get in there but when we have viruses

38:54

or inflammation or concussion that breakdowns our blood-brain barrier so now sometimes a virus that's in my body

39:00

can transmit now into my brain so there's multiple mechanisms so sometimes

39:06

I think it's just how a certain bacterial virus works it that it preferentially you know it may like an

39:13

area that's highly metabolic so the brain is highly metabolic so like take cancers for example right so cancers may

39:20

happen in certain tissues because they're highly metabolic or they turn over very frequently or they don't turn

39:26

over frequently so I think there's individually to certain infections but

39:31

sometimes infections end up there because of inflammation and they're floating into my bloodstream and then

39:37

all of a sudden you open up the barrier system and they're like here they come and then they end up in the brain which

39:42

is very common to see post-concussion yeah it's a very it's a very interesting idea like looking at like you know what

39:49

a virus a wall of bacteria you know actually like under a microscope looks like you know you can take the the

39:55

spirit chetta excuse me bacteria which you know responsible for for Lyme's disease and you can actually look at

40:00

that under a microscope and I'm pretty sure the etymology of spirit is something like Spiral long hair and you

40:07

can look at it as a and you can tell that that bacteria it's very very cool is designed to evade something the way

40:14

that it's you know built to coil in and embed itself and do its thing it's actually for a real deep into tissues

40:21

yeah if yeah if you look aside of the traumatic things it does to people in the long term it's actually quite

40:26

remarkable um actions from like a microorganism it's actually very very cool but yeah it's very interesting to to see how it

40:33

kind of like looks the work symbiotically with this very complex um nervous system and different systems

40:39

that we have that are obviously very very ancient and have you know worked with and against microorganisms for a

40:46

very very long time I'm going to switch things up a bit because that was awesome thank you for that um yeah I want to

40:52

talk about Sports Rehab a little bit so can you tell us how Neuroscience plays a role in in Sports Rehab

41:00

yeah no that's um that's super cool topic and I I was actually was with um another Sports Cairo that's in Denver

41:07

and he works with a lot of the pro teams and we kind of play around with that I think like we talked about earlier I think

41:14

traditional rehab has always been thought from a right a musculoskeletal or

41:21

you have a let's say an ankle injury let's ice let's stem let's do all these

41:28

local things to the ankle right and then let's do things to strengthen it but thinking of it from a just strengthening

41:34

the muscle versus maybe the connection so going back to like let's take an ankle Sprite so we know an ankle sprain

41:40

happens let's say there's a stretching of like ligaments tendons maybe a like a

41:46

bunch of micro tears there is changes to say like joint capsules things like that so there's a local event that occurs

41:52

which of course needs to be taken care of right we have inflammation that comes in to stimulate the immune system to

41:59

then clean out dead debris but then ultimately we want to bring things in that are healing so we we have a

42:06

metabolic aspect to an injury which is definitely important to control but like

42:11

we talked about earlier if I stretch all of a sudden a ligament or I stretch a

42:17

tendon or I affect the joint mechanoreceptors well now the feedback that that joint is giving to my brain is

42:24

inadequate and so now we may notice that like we talked about the latency so going back

42:30

to ankle control so if I'm on an unstable surface and I'm moving

42:36

when as soon as my ankle turns how we have to think about how much movement

42:42

has to be displaced before my brain gets it so if here's my ankle

42:47

and then here's fully inverted ideally I want a micro movement and then I can

42:52

recover but if there's a stretch and there's bad feedback from my joint to my brain maybe I have to go all the way to

42:58

here before all of a sudden I snap it back in So from the neurology standpoint

43:04

there is becoming more insane we need to do things to rehab things like proprioception right or kinesthetic

43:10

awareness we can't just rely on just strengthening the muscle we have to improve one the mind-body connection

43:16

between that joint in the brain but then we need to do things to improve the

43:24

motor controller how quickly I can detect a change in position get my brain

43:30

to understand that feedback and then correct it so I think that's one big piece when you're looking at um

43:36

rehab and Neuroscience another way so there there's actually in this would be a great and I can always put you in

43:42

contact there's a great group out of the the states but they teach all around the country called fnor so it stands for

43:50

functional neurological Orthopedic Rehabilitation it's taught by uh a guy

43:56

named David George and Stuart Fife Stuart Fife is a uh PT

44:02

um I want to say either I think out of the you might be out of the UK um and then David George is a uh a

44:11

chiropractor and a nurse practitioner they developed an amazing course that's all targeted towards rehab but a

44:18

neurocentric standpoint so it's all targeted towards chronic pain so what's interesting is let's take

44:25

um like an isometric contraction right so isometrics are used a ton right so for individuals who don't know an

44:31

isometric contraction in essence is a contraction where there's there's really no movement in a joint so my wrist is

44:36

here if I push it this way so if I'm pushing

44:42

my hand and it's not moving that is an isometric contraction so my muscles are

44:48

Contracting but there's no movement or change in the joint okay what's really

44:53

cool what they've shown is that isometric contraction but not just short but intense bouts of isometric

45:00

contractions can do a few different things one is they can have an analgesic effect or a pain modulating effect so

45:07

isometrics for like multiple minutes can have pain modulating effects that's one

45:12

thing the other cool thing is that they've shown that you can improve cortical smudging with isometrics so

45:19

minute and minute plus long isometrics help to regroove out that representation

45:24

of the lip so what's really cool is that different types of muscle contraction so

45:30

an isometric versus let's say an eccentric can have different effects on

45:35

the brain so when we're looking at an eccentric that might be like as I'm bringing the barbell down on a bench

45:41

press it's the it's the The Descent down to my chest right that is me controlling a controlling a weight

45:49

eccentrics have been shown to heavily influence another part of our brain called our

45:55

basal ganglia in our cerebellum once again like we talked about that has to do with controlling movement so there's a lot of

46:03

cool things of using actually eccentrics in Parkinson's patients so I'll use a

46:08

ton of eccentric or slow controlled movement because that helps to give better feedback of that limb so you can

46:16

see where we can use isometrics to stimulate different areas of the brain we can use eccentrics to

46:22

stimulate different parts of the brain and then we can do things where you look at

46:28

so going back to Movement we when we think about moving we have internally

46:34

generated movement or we may have visually guided directed movement so take a Parkinson's patient for example

46:41

they have a really hard time internally generating movement that's why one of the tests is a sit to stand test so it's

46:48

saying stand from this chair walk over there and they're terribly slow at doing it and part of it is because the

46:55

circuits in the brain that internally say go move aren't working but if you

47:01

have a Parkinson's patient and you give them like a laser target they move way quicker so like Parkinson's patients

47:08

will freeze when you get to like a door frame if you give them something to step over they can step over no problem

47:14

because you're giving them a visually guided movement that uses

47:19

a different motor Loop so part of the time is finding the loops in the brain

47:24

that don't work and either fixing them or finding another way to make it happen now I know this goes far beyond Sports

47:31

Rehab of what people are probably thinking about from like um you know a low back injury but it can

47:36

be taken all the way to the rehabilitation of someone like with Parkinson's because at the end of the day it's all just a spectrum a stroke in

47:44

Parkinson's is just a spectrum similar to low back

47:50

pain in that there's altered things going on in our nervous system it may have started with a mechanical injury

47:57

but it now has become a neurological phenomenon so you can use those same principles

48:03

kind of towards each other if that kind of makes sense and I know I might have gone on a little bit of a tangent of

48:09

some some things but I hope that that helps to show that there's so many ways that you can use

48:15

these things that are traditionally thought of in physical therapy that are muscle Centric but they have huge

48:21

impacts on the nervous system and on the brain is that a conventional thought

48:27

process in regards to somebody coming in who needs rehab like to to think about that type of way of looking at it or is

48:34

that is that alternative is that complementary is that something you have to you know you have to go to you do

48:39

your chiropractic doctorate and then you go back and do Neuroscience type of thing or you know is it is that something that usually happens within a

48:47

conventional setting or is that a bit out there yeah no I would say no it's getting there it's the research is there

48:53

the research is there clinicians and their ability to catch up or for schools to really implement it it's getting

48:59

there but it's not if you go to your traditional PCP or standard Ortho right

49:05

they're still heavily focused on the patho anatomical model right which means

49:11

you have a disc bulge that's why you're like you know that's why you're back's a mess or look at this this uh djd or this

49:19

uh degenerative joint disease that's why you have low back pain and no one's looking at well how does this person

49:25

move how do they stabilize what's the motor control of their low back do they

49:31

have control over their hip over their ankle well that's something we didn't chat about too is looking at the whole

49:37

kinetic chain which in essence is how well can my you know if we think about my low back my low

49:43

back isn't really set up for movement the way that the the joints in the spine are set up is really for like forward

49:49

and backwards motion the lumbar spine is not mechanically meant to get a ton of movement or a ton of rotation my

49:57

thoracic spine so my spine above and my hips are far more mobile and so those

50:02

are where I might get a little bit more mobility and um individual

50:07

um why am I blanking um a great cook is kind of the ones who

50:13

popularized this gray quick is a PT out of the US who started what's called FMS sfma he started with that concept of

50:20

areas of Mobility areas of stability so going back to the low back is

50:25

I really look at the low back as how well can it transfer load so if I'm throwing a ball

50:32

I need to transmit force from my legs to my arm what does that is a stable

50:37

canister in my abdominal wall to be able to transmit that Force so going back to

50:44

you know it's getting there but a lot of people don't a lot of people say you have a disc let's give you medications

50:52

for the pain let's ice let's rest you know when really I'm gonna make the

50:59

argument the faster you can load a tissue and get someone active again the better so I've kind of changed my tune

51:05

heavily where going back to let's take my own example of shoulder dislocation I

51:11

was loading it with 20 minutes worth of isometrics the next day after I had it

51:17

dislocated for three hours in the hospital right most people would put you in a sling and they say don't move it

51:24

for a few weeks ice it um and the dock that I work with that we work together in a lot of sports cases

51:30

is I was like well no because I one want to keep the muscle strong but two I want to keep my brain's

51:37

awareness of that joint to work and three I want to create an analgesic effect so literally I would load it in

51:43

different planes isometrically because I don't want to I don't really want to stress The Joint but I can feed my brain

51:50

information just like the visualization say hey your shoulder's still here it's still stable let's let's take care of it

51:57

let's heal it faster um so I think that's really the Paradigm of using neuroscience and Rehab is

52:03

getting away from the let's rest in ice to like how do we load this joint safely

52:09

as quick as possible so that we can heal it and and we can create or keep from

52:15

the least amount of atrophy not only in the muscle but atrophy in the brain as well very cool yeah I think that's um

52:23

it's a very interesting way of looking at things and you have to obviously looking at looking at a root cause and

52:29

obviously just they've said if you know if you blow your knee out playing football or you sprain your ankle or whatever and then you're going to see

52:34

your primary care practitioner they're going to be narrowed in on that particular area they might not be

52:40

looking at like what's your pelvis doing what's your spine doing what's your what's the top of your spine doing I

52:46

know for me personally I I I um I've done my knee I've done my right

52:51

knee a few times on the um on the medial side and like the third time I did it

52:57

it's usually six months out of playing soccer for for me when I do it I've done

53:02

it three times in the last like seven years and the last time I did it I went and saw a chiropractor about it because

53:07

I just felt there was I felt like it just wasn't my knee that was the problem because every time I've gone to see

53:13

someone it's always my knees my knee as my knee and then I started working with the chiropractor and it's quite clear there was some there was a something I

53:19

was doing every day like a million times like little bits that was like um compounding

53:25

to shift my pelvis up you know and then I end up finding out that my left glute

53:30

gets ridiculously tight my right Hip Flex gets ridiculously tight twists my pelvis up creates really a lot of

53:37

tension on my on my um on my um on my quad here which creates

53:43

that tension like an elastic bands when I'm playing football and I'm going to go in and like do like a passing movement or like going in for a tackle it's just

53:50

like kind of an injury just like waiting to happen but without being able to like step back and actually figure out that

53:56

okay my my problem is that I have um like you know tight really tight muscles in different areas that I'm not

54:02

knowing and it's it's functionally changing my my body it's quite really subtle ways that build up to create a

54:08

big problem so I'd have lower back issues as well along with the knee pain and I didn't connect that until I

54:13

started speaking with my my really experienced chiropractor and now as long as I stretch out my

54:20

glutes as long as I stretch out my hip flexors and my hamstrings and my calves as well then I have absolutely no

54:25

problems and it's just very interesting because not a lot of people will get to that point and I can guarantee 99 times out of 100

54:33

you go and speak to your doctor about like your your knee injury that you had you'd never ever get to the point of

54:39

like looking at like where your pelvis would be unless you got to a really really forward-thinking functional

54:45

practitioner and I just yeah it just feels that there's so many holes in the conventional idea of like what an injury

54:50

is and when you're talking about your shoulder as well where you would have it cast up or you'd have it like in a sling

54:56

or a broken leg like the first thing you do is like they cast it up and stop movement ice it you know like trying to

55:02

take the kind of take the pain away rather than thinking about like your leg is is much more than your leg you know

55:07

it's like it's your pelvis it's all these other things and I remember listening to a Brett Weinstein podcast

55:13

talking about how his son broke his leg and he uh they didn't they didn't cost up or

55:18

anything they wanted him to get moving with it as much as possible even if it was just thinking about movement or if it was just micro movement or doing

55:24

isometric like strength training in and around it how that can just benefit in so many different ways

55:32

in regardless to this whole idea of like isolate it keep it still rest ice and

55:37

just do these very very traditional things and it's just like I feel like it's 2022 there has to be your likes

55:42

there's there's got to be different ways of doing these things and when we use this reductionist idea of like medicine

55:47

it doesn't really serve the individual and the whole body and we're obviously just much more than that just like joint

55:53

that's got pain so it's just it's just interesting you know like the messages we get from Pain and yeah I'll ask about

56:00

concussions before because we're coming to the hour Point here and I don't want to miss this off but like what are some

56:07

of the um the key things that people can do with concussions like early and yeah because

56:15

I know it's you know concussions and like we had them we've had that movie come out and I think more people are

56:21

understanding tbis and you've got people taking their kids out of certain Sports and things which is totally up to them

56:28

there are certainly more dangerous sports than others but like what can people do like kind of like early on in

56:33

the in the whole treatment process to really support that healing and does that differ from a conventional

56:41

um methodology of treatment yes so it definitely is you know if you

56:46

look at what is offered by a majority of most in healthcare it is it is rest and

56:53

if you're at six months and you still don't feel better it's rest and if you're at a year it is well maybe you'll

56:58

never get back so that's that's what a majority do and that actually doesn't line up with what is called the

57:04

consensus statement so every four years uh the world's concussion experts get together and they create

57:11

What's called the concussion consensus statement for sports related concussions and actually if you look at the most

57:16

recent one or there's one in Berlin a few years ago and there's a more recent one

57:22

um I don't know if it's fully been released yet um right if you look at their consensus

57:27

statement after two weeks two to four weeks if an individual is not getting better they

57:34

need to seek some sort of care to have some sort of intervention because if it's not going to happen at two to four

57:40

weeks on its own most likely it's not going to or it's going to take a long period of time right that's why after

57:46

that four week period it's labeled as post-concussive syndrome so let's take a

57:51

step back what happens in a concussion because that can let us know what things

57:57

to do so on the metabolic side when we have a

58:02

concussion it's like our brain goes from being a fuel efficient Prius getting 40

58:08

miles to the gallon to a gas guzzling SUV getting five miles to the gallon so

58:13

one of the things we know is that happens during a concussion is that we become very metabolically inflexible so

58:21

our ability to utilize glucose becomes very inefficient this is why the

58:26

ketogenic diet has kind of gotten a ton of craze in the TBI Community is that in

58:32

a concussion you get the initial hit and then what sometimes leads to more

58:39

kind of damage within the brain is that the metabolic instability over the following few weeks because then the way

58:46

you burn through fuel is very inefficient and so then neurons start

58:52

going haywire and dying because they don't have stable energy so one of the big things is keeping

58:58

blood sugar stable but more specifically this is where sometimes we'll use things like the ketogenic diet so something

59:04

like a high fat low carb diet or will use things like exogenous ketones to

59:09

give the brain a different source of fuel now once again check with your doctor it's not for everyone but that's

59:15

where certain like dietary strategies can play a role is you want to stabilize energy right so we want things like

59:22

protein and keeping blood sugar stink well that's one another thing that happens is what's called

59:28

excitotoxicity so in a neuron you have

59:34

what are called sodium and potassium pumps so the balance between sodium and potassium allow different kind of

59:39

molecules in and it allows activation of a neuron so you get what is called Exciter

59:45

toxicity where you get this unstable electrical current in essence

59:51

around my neuron so the neuron electrically becomes very unstable and this is where in severe cases you see

59:58

things like seizures right this is why seizures occur post head injuries is because of the excitotoxicity of the

1:00:04

brain what's really cool is going back to ketogenic diets is ketogenic diets can

1:00:09

actually increase the amount of Gaba which is an inhibitory neurotransmitter so ketones

1:00:16

and ketogenic diets can help to improve uh Exciter toxicity from a supplemental

1:00:23

form this is where things like magnesium three and eight and magnesium glycinate

1:00:29

can actually be really helpful because that magnesium acts as a plug on that channel to help

1:00:36

slow down that excitotoxicity so once again we have some dietary strategies

1:00:42

things like magnesium can be helpful in in limiting that Exciter toxicity early

1:00:47

on okay and then we have inflammation that occurs so we know that when a head

1:00:53

injury happens we get a ton of inflammation which is normal but we don't want too much inflammation so this

1:00:59

is where um having an anti-inflammatory diet is really really important

1:01:05

the most research supplement that I'm aware of in the safest for inflammation

1:01:10

post ahead injury is actually fish oil so fish oil things like EPA and DHA anywhere between two to four grams has

1:01:18

some really cool research in turning off the inflammation or helping

1:01:23

to resolve the inflammatory response because when I have a concussion I get inflammation but then I need to have

1:01:30

anti-inflammation to then resolve it in some people it just stays going like

1:01:35

that so we have one we have energy imbalances right mitochondrial

1:01:41

dysfunction we have excitotoxicity or are too excited of a brain and then we

1:01:47

have inflammation so that's where having an anti-inflammatory diet things like Omega-3s magnesium can be

1:01:54

helpful early on um that's also where you know within the first few days like paying attention to

1:02:01

your threshold right you want to get back to living your life but think about it if you have that unstable neuronal

1:02:08

pool and you go to a rave two days after and there's flashing lights you're going

1:02:14

to cause most likely more damage because you're you're forcing those neurons to

1:02:20

work harder than their cable of doing so rest does have its role I always tell people

1:02:25

if something increases your symptoms more than two points so let's say your

1:02:30

headache is a two out of ten and you go to a movie and now it's a 5 out of ten that was too much

1:02:38

if it goes up by maybe one point then that's okay that's not that big of a stimulus like you can handle that

1:02:44

and then the last piece is blood flow so this is where I love exercise

1:02:50

the faster someone can get back to exercise the better exercises like medicine for concussions

1:02:56

because it helps to re-normalize blood flow within the brain so we know that

1:03:02

post-concussive syndrome sometimes is theorized by inefficiencies in blood flow in the brain so the ability to

1:03:10

regulate blood to different areas becomes effective with concussions and sometimes that doesn't renormalize and

1:03:16

this is why individuals have headaches maybe months to years after and there's some really cool research on aerobic

1:03:23

exercise more specifically sub threshold or what you would think of

1:03:28

as like zone two so like some of you might think of as zone two some might refer to it as

1:03:35

um like a ventilator uh like a ventilation threshold so at a pace where you can maintain a conversation so with

1:03:42

individuals as soon as we can we do what's called a buffalo concussion treadmill or bike test this is where

1:03:49

they hop on a bike or a treadmill we find at what point cardiovascularly do

1:03:55

they aggravate their symptoms and then we take a percentage and then we have them work at that heart rate and they'll do at 80 percent of that heart rate for

1:04:02

two weeks 20 minutes five times a day or five to five times a day five times a

1:04:07

week and then we reassess it in three weeks and we build threshold so what we're doing is we're using exercise to

1:04:13

re-normalize energy within the brain but also to improve blood flow so those are some

1:04:20

some kind of things that people can think about early on and I think my big key other as well is

1:04:26

um get assessed go see someone who specializes in this Arena and don't wait

1:04:32

if you're at a month and someone's telling you rest more no that's the

1:04:37

point you need to go see somebody if you're at six months and they're just telling you to rest more rest is not

1:04:42

going to do it if Russ was going to do it it would have done it within two to four weeks so I think my thing is be

1:04:48

proactive and be an advocate for yourself and get to someone who is trained in understanding concussions and

1:04:55

how to treat them that's cool yeah I mean it sounds like a delicate yet active approach because obviously we don't want to just like

1:05:01

sit and do nothing and sit in the dark and you know that can obviously bring on

1:05:07

depressive symptoms and you know spiral that processes even further and I'm sure

1:05:12

the idea of yeah getting back to movement getting back to like normalcy is is just as much

1:05:18

as part of the the healing process is actually like you know consuming foods that are anti-inflammatory and doing all

1:05:24

those other extra things so that's really great that was a really great assessment I appreciate it how can how

1:05:30

can people learn more about your practice and connect with you yeah definitely so um our website is

1:05:35

uh Integrated Health Systems um and we actually offer

1:05:41

um like free 30-minute consults which are actually a great way for people to call learn a little bit more about us

1:05:46

and also we kind of review cases uh sometimes we even work to find people in their their area so

1:05:54

um you know I know people in Canada I know people in Europe in Australia all around the country so it's also helping

1:05:59

to get people uh to the right places um I have social media as well on

1:06:04

Facebook at um doctor.perry.maynard and then on

1:06:10

Instagram at uh Dr Perry Maynard uh where you know we're posting uh free

1:06:17

webinars free educational content you know we usually do free webinars kind of once a month on

1:06:24

various topics um so I'd say those are the the main areas people can connect with me and then the last two are we were recently a

1:06:32

part of two books called the um concussion discussion and it was a book

1:06:39

written by myself in a variety of other doctors about Innovative treatments for concussions

1:06:45

beautiful well I will make sure that all that information is in the show notes so people can connect with you but thank

1:06:51

you so much for your time today Dr Perry I really appreciate it yeah thank you so much Simon it was a great time of course so um that is it for this episode of

1:06:58

True Hope cast which is the official podcast of true hope Canada yeah as I said all the information to connect with

1:07:03

Dr Perry will be in the show notes so you can get there don't forget to subscribe if you haven't yet iTunes leave us a review five stars on Spotify

1:07:10

if you've got the time but thank you so much everyone we'll see you next week

1:07:15

[Music] all right