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You’re listening to the Balanced Bites podcast episode 229: Ask the Doc: Chiropractic & Self Care with Dr. Scott A. Mills
You’re listening to the Balanced Bites podcast episode 229.
Welcome to the Balanced Bites podcast with Diane Sanfilippo and Liz Wolfe. Diane is a certified nutrition consultant, and the New York Times bestselling author of Practical Paleo, The 21-Day Sugar Detox, and co-author of Mediterranean Paleo Cooking. Liz is a nutritional therapy practitioner, and the best-selling author of Eat the Yolks and The Purely Primal Skincare Guide. Together, Diane and Liz answer your questions, interview leading health and wellness experts, and share their take on modern paleo living with their friendly and balanced approach. Remember our disclaimer: The materials and content within this podcast are intended as general information only, and are not to be considered a substitute for professional medical advice, diagnosis, or treatment.
Diane Sanfilippo: Hey everyone! Welcome back to the show. Before we get into today’s show, let’s hear a word from one of our sponsors.
Diane Sanfilippo: Pete’s Paleo is a friend of the Balanced Bites podcast. They’re bacon is insanely delicious, and sugar free, and their premade paleo meals make your life so much easier when everything is getting busy and getting real food on the table is still a top priority, as it should be. Pete’s Paleo is now offering a 30-day gut healing kit containing bone broth, gelatin gummies, instant organic soup packs, and an E-cookbook. It’s the perfect complement to any anti-inflammatory diet. Get yours today at www.guthealingkit.com. Use code GRABACUPPABROTH to get $25 off; that’s an amazing deal. It’s GRABACUPPABROTH, C-U-P-P-A. And you can grab that code any time at www.BalancedBites.com to just read it and make sure you’re typing it in right. You can also use code BALANCEDBITES to get $5 off any of their regular meal plans. Check out www.PetesPaleo.com today. Pete’s Paleo; bringing fine dining to your cave.
1. News and updates from Diane [2:06]
Diane Sanfilippo: Alright, a couple of quick updates this week for you guys. February 27th, if you’re in the San Francisco Bay area, there’s an event at UCSF. I am not speaking, but I will be attending. Local peeps, you guys should definitely come check it out. There’s an Eventbrite link that we’ll put right in the show notes, so if you want to come join me, I’ll be there as an attendee. Chris Kresser is speaking, Robb Wolf, Michelle Tam, Chris Masterjohn; lots of other’s so it’s going to be a great event. I believe they are serving breakfast and lunch, as well. If you use code BALANCEDBITES you’ll get 20% off your ticket. So come see us there February 27th.
And Portland; March 17th we should have an RSVP ticket, etc., link for you guys really soon. I’m just trying to get some of the last details sorted out with Cultured Caveman, who is going to be catering the event. It’s going to be awesome; that’s going to be a 6 p.m. start, so mark your calendars and you’ll hear about that everywhere once tickets are available.
2. Something new that I’m into: facial hair [3:04]
Alright, well before we get into the official part of the interview, because I think a lot of you guys do know my guest today, who is sitting right next to me; I’m holding his hand. {laughs} It’s my husband, Dr. Scott A. Mills. He’s my guest today; we’re super excited to talk all about chiropractic. But before we do that, we’re going to talk about a new thing we’re into lately.
Dr. Scott Mills: Sounds good.
Diane Sanfilippo: What was the new thing we’re into lately? {laughs}
Dr. Scott Mills: {laughs} I’m fairly ritualistic, I don’t think I have a lot of new things. But one thing that is new in my life is a beard.
Diane Sanfilippo: {laughs}
Dr. Scott Mills: I grew facial hair since I’m taking a break from being in practice, and learning how to take care of my new beard.
Diane Sanfilippo: Alright, well I’ll say my new thing I’m into is the beard, because I like it.
Dr. Scott Mills: {laughs}
3. Introducing our guest, Dr. Scott A. Mills and chiropractic [4:02]
Diane Sanfilippo: Dr. Scott A. Mills is a chiropractor with a passion for empowering others with the knowledge and tools needed to eliminate pain and improve the way they move. In addition to his Doctor of Chiropractic degree, he holds a masters degree in exercise science, and worked as a collegiate certified athletic trainer for 6 years prior to his chiropractic career. His latest project is called the Full Body Fix.
The Full Body Fix is a series of corrective exercise video protocols designed to help equip you with proper techniques to overcome the most common aches and pains. And for those of you who have been long time listeners, you heard Dr. Scott with me on episode 183. If you didn’t hear that episode, and you enjoy today’s episode, please go back and listen to that one because I’m sure there will be some tips and tricks and information that we don’t get to cover today that we did cover in that previous episode.
Welcome to the dining room, honey.
Dr. Scott Mills: {laughs} Thanks so much for having me, stepping out from behind the ones and twos, normally my main objective with the podcast is making you and Liz and other guests sound good.
Diane Sanfilippo: Yeah, somehow I roped my chiropractor husband into editing the Balanced Bites podcast. So you guys know him typically as our announcer.
Dr. Scott Mills: Mm-hmm. “Welcome to the Balanced Bites podcast.”
Diane Sanfilippo: {laughs} But he’s actually a doctor. {laughs} So why don’t you give folks a little bit of background about the stuff that we’re answering today because I know you polled a bunch of questions, and we had people submit questions, and you’ve been working on the full body fix for a long time, and I think a lot of the questions that have come in, obviously we can talk about answers to those and I know that the reason for developing the program was to help people with this kind of beyond what you can do in an answer on the podcast, etc. So why don’t we kind of get into the questions.
Dr. Scott Mills: Yeah, we’ll do that. I think that’s a good way to go about it. We had actually a ton of questions pour in on Instagram and Facebook after you put out the call, and it’s, for me it’s great to see the feedback and the common questions and all, so {laughs} have an actual resource now to point people towards in addition to my blog at DrScottAMills.com. Now we have the FullBodyFix.com, which is, as you said, my corrective video program, which we’ll talk about more probably at the end. But yeah, we had some great questions come in.
Diane Sanfilippo: Is there an overarching theme to the questions, because I feel like one of the things we see every time we post something like this, or anything about a specific type of practice, whatever; there are always a lot of questions like, “can X type of practice help me with this problem.” So the questions we had here a lot of them were, “Can chiropractic help with this, can chiropractic help with that.” Can you give people sort of the high level overview of just what is chiropractic, why does it work, and why does it work for so many varied things that people don’t always think of. Because I think when you explain this, it really helps people to understand that it’s not about cracking your back or cracking your neck, and it’s not about just your spine.
Dr. Scott Mills: Sure.
Diane Sanfilippo: Why does it affect so many things, and how can people better understand this whole system?
Dr. Scott Mills: Yeah, I think that’s a good place to start and I think the best way to answer that is to kind of step back and look at the body from a holistic perspective, and that’s one of the things that chiropractors do best. We come from a perspective of holism, meaning we’re looking at the whole person, not just the symptom. And that starts with, and is our primary focus, with spinal health care. The reason the spine is so important is because it houses our central nervous system, our spinal cord, which connects the brain to the body and the body to the brain. So any problem in and around the spine can lead to any problem in and around the body. So because our nerves connect literally everything to everything, and control and coordinate all the health and healing within our body, that’s why we focus so much on the spine and that’s why we can help so many different things.
In addition to that, many of us specialize in taking care of the other joints and biomechanical symptoms in the rest of the extremities. So somebody on Instagram was like, “I have a non-chiropractic question. I have calf tightness.” I’m like, yeah we can help with that too if that’s what the practitioner has chosen to specialize in doing some extremities, as well.
Just like in any other medical or health care profession, chiropractors do end up specializing somewhat. So some of us like myself focus on kind of more biomechanics and functional movement assessment and restoration. Some people go into pediatrics in chiropractic, some people go into functional medicine, like our good buddy Dr. Will Cole, in Pittsburg. Shout out. And so on and so forth.
So yeah, when it comes to that classic question, can chiropractic help X, Y, and Z, we focus on trying to restore health the best we can from conservative means, non surgical, non pharmaceutical approach to health care, starting with improving and optimizing the function of the spine and the nervous system.
Diane Sanfilippo: So I think a good analogy for the stuff we do with nutrition so often is, we talk about getting the digestive system back on track, blood sugar regulation, all of that. You guys who have been listening for a long time know that when your digestion is off track, 80% of your immune system is living in your gut, your immune system, much like your ner
vous system, all these systems that we have, they all work together but they all also do so much at one time, it’s just this huge orchestra where it’s helping to direct all these specific instruments in the orchestra but the conductor of it, the whole system of it all together, it just has to be working well. I feel like the idea of chiropractic helping to perhaps; I don’t know if reset is the right word, some of the way our nervous system is working, the way our nerves are communicating things within our body.
Dr. Scott Mills: I like the word balance.
Diane Sanfilippo: To help balance things out.
Dr. Scott Mills: When you’re thinking about many of the people may be familiar with autonomic nervous system, and/or how processes in the body work automatically without us thinking about it. We have the parasympathetic, which is our rest and digest, and our sympathetic nervous system, which is our fight or flight response. So chiropractic care can really help balance those two systems out and find an equilibrium to create homeostasis and ultimately health.
Diane Sanfilippo: So, the one other thing I just want to draw your attention to for our listeners is; you guys ask a ton of questions about adrenal fatigue. Just before we get into some of the more biomechanical stuff and all of that, and adrenal fatigue and just exhaustion overall, too high cortisol levels all the time, high stress levels, all of that. If there’s one thing that everyone can use to support, I think, chiropractic for, even outside of; maybe you don’t have a specific injury or specific body ache and pain, which if you don’t {laughs} lucky you. Really, lucky you. I mean, I think probably everybody has something. But if you do feel like you’re dealing with high stress levels, a stressful life, a stressful job, running around with the kids; a million different things. I remember growing up, the whole time my mom always went to the chiropractor. Both my parents, but my dad doesn’t tend to run high strung nervous, my mom definitely runs that way. I remember she would always have chiropractic adjustments, it would really help to bring her back in balance and not be in that kind of frantic state so often. So I just want you guys to understand that that’s also something that I’ve seen chiropractic help so many people with outside of just, specific injuries, specific ache or pain. Because we are going to talk about a lot of specific things today.
4. What is subluxation and is it treatable? [12:20]
Dr. Scott Mills: Which is, yeah, and it’s a great lead in to our first question, which basically someone; let’s see, we had a couple of people actually question about the word subluxation. So, Jill Mac Nutrition and Jenna Mc on Instagram both kind of had this question; “What is subluxation, and is treating it legit?” {laughs} It’s one of those things that we definitely see a little bit of push back here and there about, but yeah, it definitely is legit and what I’d like to do is just kind of explain what that word means and why we talk about it in chiropractic and kind of what it’s all about.
So subluxation or vertebral subluxation complex, which is the long version, which is why we say subluxation, it’s a term used in chiropractic to describe what happens both biomechanically and physiologically when the spinal joints are not moving properly. So if you think about our 24 moveable vertebrae through the spine, those joints have to move in a lot of different directions freely. Sometimes they can get fixated, and that fixation or subluxation, can cause a cascade of negative events that can occur due to that lack of spinal mobility and it can create a lot of different problems.
So first, from a biomechanical perspective, the joint being stuck or fixated can actually increase the rate of degenerative joint disease, it can cause disk desiccation, which is also just dehydration or loss of water. It can also cause stiffness or inflexibility, which can lead to pain, which is a lot of the times what people come to see a chiropractor for, just spinal pain. Secondly, as I kind of alluded to in the beginning, the nerve roots that exit each level of the spine are actually branches off your spinal cord. This is the information super highway between your brain and your body; your spinal cord. So a fixated spinal joint or subluxation can actually negatively impact the communication of your nervous system from brain to body and body to brain. So chiropractic adjustments are designed to detect and correct these fixations or subluxations, thereby improving overall spinal mobility and health.
So that being said, it’s important to remember that in holistic health, it’s unwise to place 100% blame or cure into one basket. So I try to shy away from this kind of, I don’t know if it’s old school or just the language where we blame everything on the subluxation and as long as you get adjusted you’re going to be 100% healthy and you don’t have to worry about anything else. Just like you and Liz stress when you talk about healthy eating, it’s not just one thing. It’s not eliminating just gluten, or blaming only fat or only carbs. That’s reductionism and we want to focus on holism. So when I approach chiropractic care and this whole concept of subluxation, I really bring it back to that holistic health care perspective of; eat well, move well, think well, to try to basically look at the body from a holistic perspective.
But this can, and in my opinion should, include regular chiropractic checkups, at least once a quarter so a couple of times a year. My preference personally is once a month, I like to get checked and adjusted accordingly.
Diane Sanfilippo: I would like to get adjusted once a week {laughs}.
Dr. Scott Mills: {laughs}
Diane Sanfilippo: Can we take the table out.
Dr. Scott Mills: We can do that.
5. What is that popping noise? [15:47]
Diane Sanfilippo: So one of the things that I think people always have a question about, which this is me interjecting because I’ve just gotten this question all the time, and I know you get it all the time and I don’t know if it’s on the list here but I’m going to ask it. Let’s just get this out of the way; the cracking and popping sound, the; “I twist my neck and,” I mean, you guys I don’t do this anymore because {laughs} I married a chiropractor so I do not adjust my own neck, although there may be some twisting that I do now and then. But what is the sound; what’s happening when a chiropractor is kind of palpating on the spine, what are they looking for, and why does it make that sound? And also, we did have another question that was like; if I do something, for example foam rolling is a big one. Foam rolling anywhere along the spine I feel like we almost always sort of self adjust; we get those little pops and cracks and things like that. So can you explain what is the sound, what is the whole deal with it, and are people messing up an adjustment if they roll on a foam roller, because we had that question too.
Dr. Scott Mills: Yeah, that was a good question and that’s a great lead in. The popping or cracking sound that we hear during either an adjustment or when maybe people are stretching on their own, mobilizing on their own, it’s technically called cavitation. All it is is basically a conversion of pressure within a joint. So joints are sort of enclosed, usually by a capsule. There’s some pressure that can build up because of the fluid in the capsule. When you put it through that range of motion, sometimes that pressure can get converted to an audible sound.
So the sound in and of itself is not necessarily all that important, it just kind of happens. And the question about the foam rolling; I’ve had this happen, as well, when I mobilize my mid back, you’ll hear maybe some minor pops and clicks. That’s not unsafe, it’s not problematic. It’s just your normal stretching routine. That’s fine. When it becomes problematic is when we’re forcing the spine to move through a position in order to just make the popping sound. So when people quickly force their neck into a position because they know that will make a sound, that’s not a chiropractic adjustment, that’s just self manipulation. And it can actually cause problems, specifically hypermobility, or too much motion in those joints. And what happens most of the time when people are doing the forceful self manipulation, they’re sensing that something is wrong, they’re trying to address it, but they’re actually just creating more of a problem. What a chiropractic adjustment does is try to find and isolate the fixated joint and mobilize that fixated joint. When we do it ourselves, we’re just mobilizing a joint that’s already too mobile. Does that make sense?
Diane Sanfilippo: Yes.
Dr. Scott Mills: {laughs}
Diane Sanfilippo: I think most people end up cracking their necks; right?
Dr. Scott Mills: Yeah.
Diane Sanfilippo: They kind of look like they’re punching themselves in the chin, which I used to do that back in the day. Or kind of twisting in a chair. I’m definitely guilty of some of that; just marrying a chiropractor doesn’t fix all of your habits.
Dr. Scott Mills: No. {laughs}
Diane Sanfilippo: {laughs} But it does make sense, and I think I’ve always known intuitively that kind of pushing our own neck in a weird twisted direction doesn’t actually do something productive. Although we might think it’s providing some relief; I think there’s an element of, we feel like something is stuck and that will give us some relief, but it doesn’t really actually do that.
Dr. Scott Mills: Correct. In fact, it’s probably making it more chronic and more problematic for down the road. And also, if you guys are readers, and want to learn more about this, on my blog at DrScottAMills.com I have, one of my most popular posts is, I think it’s called chiropractic myth busters, and I answer that question as well as some of the other ones we’ll probably cover today, as well.
Diane Sanfilippo: And don’t forget you guys can read the transcript back.
Dr. Scott Mills: Oh yeah.
Diane Sanfilippo: I think sometimes when we get more technical with stuff, there will be a transcript so don’t forget you will have that.
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6. Best sleeping position and bed [20:47]
Diane Sanfilippo: Ok. So we have this question from Melissa. She asks, “What sort of bed is best, or which position is best to sleep in?”
Dr. Scott Mills: Right, so she was, I think complaining that she had some chronic hip pain, and she was suspecting that maybe her not so great bed was part of the problem. I get this question a lot, and my general recommendation is to get a mattress with firm support, so something that’s not really saggy or too soft or overly pillow topped, because when that happens you tend to sag through the spine as opposed to having it stable and aligned throughout your sleep cycle. And the other recommendation is basically a position one; which you have two options of sleeping.
Diane Sanfilippo: {laughs}
Dr. Scott Mills: {laughs} One is on your side, and one is on your back. If you sle
ep on your stomach, you need to learn how to sleep on one of those other two positions. Sleeping on your stomach creates a rotation component in your neck and an extension component in your lower back, which basically just is really, really harmful for your spine.
Diane Sanfilippo: Unless you’re going to sleep on a chiropractic table with your face down.
Dr. Scott Mills: {laughs} Yeah.
Diane Sanfilippo: {laughs} And you can breathe.
Dr. Scott Mills: That is the one exception, although most people probably do not sleep for 7 hours on a chiropractic table.
Diane Sanfilippo: I know some people who could fall asleep for 7 hours on a chiropractic table. {laughs} Alright cool. We have another question; well, what about a follow-up to that one about pillows.
Dr. Scott Mills: Pillows, yeah. So if you’re a side sleeper, you want to pick a pillow that takes up the space between your shoulder and your head so your neck is not tilted either too high or too low. And you can check this pretty quick; just get into position, and if the top of your head is tilting down, your pillow is too small, and if the top of your head is tilting up towards the ceiling it’s too big or too fat.
Diane Sanfilippo: That’s really interesting, and you guys, if you’re building muscle, men or women.
Dr. Scott Mills: {laughs}
Diane Sanfilippo: Guys, if you all of a sudden get jacked over the course of 6 months or a year, and you were using one pillow…
Dr. Scott Mills: Get a new pillow.
Diane Sanfilippo: You might need a pillow that’s a little bit bigger if your shoulder just got built up and now you’re laying on a bigger shoulder. Alright, so, question…
Dr. Scott Mills: Wait, face down. Or, face up.
Diane Sanfilippo: Oh, face up. Sorry.
Dr. Scott Mills: So if you’re a back sleeper.
Diane Sanfilippo: I ignored that because I mostly sleep on my side. {laughs}
Dr. Scott Mills: Yeah. {laughs} If you’re a back sleeper, it’s a little bit different. You want to actually pick a pillow that has a cervical curve to it. You’ll see these sort of “orthopedic” pillows that have a little bit of a C-shaped curve to them, that’s to fit in the back of your neck because that’s the normal shape of your cervical spine.
Diane Sanfilippo: Alright, well I sleep on my back and my neck, and I have one of those; I find it pretty comfortable. I don’t know. It seems ok.
Dr. Scott Mills: Right. You can do that as well, it’s just preferred that it’s that set up.
Diane Sanfilippo: Ok.
Dr. Scott Mills: Yeah, you’re fine. {laughs}
Diane Sanfilippo: Alright. You can check the pillow later to make sure, even though I’m sure he already checks it all the time.
Dr. Scott Mills: Already checked.
7. Best exercises for low back and sacrum [23:49]
Diane Sanfilippo: Already checked. Stacy is saying, “My back and sacrum are constantly getting out of alignment. I go to a good chiropractor, but is there more I can do. What exercises might be best?”
Dr. Scott Mills: Right, so typically when I see a question like this my immediate reaction is going to go towards the end of stability or stabilizing exercises. A chiropractic adjustment, as I said before, is really designed to mobilize stuck or fixated spinal joints. So if you’re not doing follow-up rehab or functional movement exercises or corrective exercises or rehab, whatever you want to call it. Lots of names for the same thing. You definitely want to add that in, especially for these spinal problems that kind of become chronic where it sort of feels like it “goes out” even though your back doesn’t actually go out, the muscles are spasming around it to try to stabilize the system and the area.
So my best recommendation for something like this is definitely a lot of stability exercises for the spine and the core, focusing on some posterior chain activities, things like really safe and light dead lifts, or supine bridges, and all these I cover in my Full Body Fix protocol for lumbar stability, so it’s a really good resource for that.
I also will typically check pelvic floor control, which sort of sounds a little bit strange probably for a low back issue, but a lot of times because we sit so much, our glutes are inactive, and that can actually create a lot of instability in and around the pelvic floor. So learning how to squat and do functional movements properly can really actually help stabilize the lower part of the spine.
Diane Sanfilippo: Ok. That’s a good one. I think sometimes when we’re training or working out, we can de doing lower body exercises. We can be squatting, we can be dead lifting, and those muscles, our glutes for example, as you were saying, might not actually be firing the way we want them to.
Dr. Scott Mills: Yes. That happens a lot.
Diane Sanfilippo: So even today, I was with the trainer today, and there was some exercise he had me doing that was a balance exercise, and he was like, ok you’re going to feel this in your abs, and your quads, and your glutes, and I was like, my glutes are not firing. So we did a couple of exercises to get that going, and always the; what were you calling it, the supine…
Dr. Scott Mills: Supine bridge.
Diane Sanfilippo: Bridges.
Dr. Scott Mills: I can explain that real quick even though it’s an audio medium here. If you just lie on your back, bend your knees so your feet are flat on the floor, and then all you do is push up through raising your pelvis off the floor by squeezing your butt, so you're basically…
Diane Sanfilippo: Thrusting. {laughs}
Dr. Scott Mills: Yeah, you’re basically thrusting. And actually, if you follow me on Instagram @FullBodyFix, I just put up a little clip of the lumbar stability, and that’s one of the exercises in there.
Diane Sanfilippo: Ok, cool. And one of the things we always do at the gym; {laughs}, you can do this to yourself, just kind of tap with your finger on your glute to tell your body, hey turn on right here!
Dr. Scott Mills: Hey! {laughs}
8. Lumbar disk problems and SI joint pain [27:07]
Diane Sanfilippo: Hey, wake up muscles! Alright cool. So we have questions about lumbar disk and SI joint questions. I guess there were a lot of these.
Dr. Scott Mills: Yeah! {laughs}
Diane Sanfilippo: So {laughs}
Dr. Scott Mills: Like every third one was lumbar disk, sacroiliac pain.
Diane Sanfilippo: Ok, so why don’t you just address some of the common problems, common issues, and what people can do about that.
Dr. Scott Mills: Yeah, so let’s do a little bit of an anatomy review before I talk too much about what to do to fix these. When we talk about a lumbar disk problem; the disk is the cushion between the bone along the whole vertebrae. In this case, we’re kind of focusing in on the lumbar spine or low back, which are the last 5 joints of the spine. So the disks are kind of basically cartilage with shock absorbing properties, and the problems that can occur with disks are basically when those joints stop moving well, like we talked about at the beginning, if there’s a subluxation there or fixation in the spine, the disk can get dehydrated, it can get injured, it can actually tear; the outer fibers can tear. That’s called a herniation; or the whole thing can bulge, which is a disk bulge. And it can get actually worse than that where the insides of the disk actually leak out. Yeah, that’s a herniation with some extra fun, not so fun.
So these are the really painful type of disk problems that many, many of you apparently are familiar with. I myself had this issue many, many years ago, and it took me a long time to kind of figure out the best way to overcome it. It’s why I think part of why I do what I do, before I was a chiropractor trying to figure out the best way to get through some of these issues.
Moving down a little bit in the spine in the sacroiliac joint or SI joint for short. This is the joint where basically the pelvis meets the lower back; our sacrum and our ileum kind of come together, and there’s a pretty thick ligament in that joint. It doesn’t typically become disrupted; it takes a lot of force to actually sprain that ligament in the SI joint, but a lot of times these lower back problems can kind of manifest in that sacroiliac joint area. If you’re not sure what I’m talking about, if you just reach behind and kind of poke around until you feel two separate pokey outy bones, {laughs} that’s kind of right where that SI joint is, off to the side of the spine.
Diane Sanfilippo: That’s the scientific term? The pokey outy.
Dr. Scott Mills: Yeah, yeah.
Diane Sanfilippo: Ok.
Dr. Scott Mills: That’s the technical term.
Diane Sanfilippo: {laughs}
Dr. Scott Mills: {laughs} So, many of you are having trouble with this and the reason is, I believe for the most part because our environment that we’ve grown up with is very biomechanically and physiologically incongruent with low back health. So what do I mean by that? We sit too much, we slouch too much, we don’t squat, we sit on toilets to go to the bathroom instead of squatting, same for birthing; you know, laying on their backs instead of being in a squat position. Basically that whole kind of biomechanical complex is just completely degenerated and turned off from a neurologic and biomechanical perspective. The ultimate result is kind of all this chronic pain.
So the solution there can be a couple of different things depending on the problem, but the general plan for lumbar disk or SI problems as I see it is kind of three-fold; one, ask yourself is there a joint restriction.
Diane Sanfilippo: Maybe ask your chiropractor.
Dr. Scott Mills: Yeah {laughs} ask your chiropractor, is there a joint restriction? If so, then we want to get a chiropractic adjustment. Is that joint not moving well, let’s get it moving well. Step one. Step two; is there joint instability? So this would be the opposite problem, where the joints are moving too much. If so, then the solution is going to be more along the lines of midline stability exercises, things where we’re getting things firing that have not fired well for many, many years.
And then kind of going along with that last one is, is there a functional movement deficiency and environmental change that needs to happen, whether it’s shifting your position at work, changing your workout routine; doing something different than what you’ve been doing for many, many years just to get things moving better.
Diane Sanfilippo: So would a standing desk be helpful for some people to not be sitting as much, or having the option of standing and sitting, all those different things? The way I see this from, I had an issue with some SI joint pain, I think it was last winter I was dead lifting and just pulled too heavy of a weight and then it just kind of started triggering some really sharp, bad pain that became chronic, basically, after I rested it and we were doing adjustments and all that stuff. But most of us, I think a lot of our listeners who are doing Crossfit or different types of workouts are sitting all day and then kind of going to the gym and we’re going from this sedentary, unsupportive of our low back, unstable; I mean, we’re just totally relaxed in a chair, right? And then we go and expect to warm up for 10 minutes and then lift heavy things. I feel like that sets us up, kind of, for this pain and some of these issues.
Obviously, we‘ve been doing a lot of midline stability exercises over the last year, and more functional movement stuff. I really very infrequently do I have any pain in that area any more, and it’s been a long time process of readjusting kind of my whole lifestyle to get rid of that pain. It’s not like, oh, 8 visits later your pain is gone.
Dr. Scott Mills: No.
Diane Sanfilippo: It’s not really like that.
Dr. Scott Mills: These problems almost never get better in less than a couple of months. So somebody out there who has been dealing with this for 6 or 8 months, that’s actually not that unique for a sacroiliac instability problem like you had. And exactly what we just talked about. The best solution for you ended up being getting with a trainer who basically would make you do the exercises {laughs} that I wanted you to do. And he’s sprinkled in a bunch of good ones, too.
Yeah, the time factor is definitely a huge one, and as far as the standing desk question; we have another desk worker question coming up, but my general take on that is you don’t want to swap one out for the other completely. I think ultimately our bodies respond best to adaptation. They love thriving on new challenges. So sitting for 8 hours is just as bad as standing for 8 hours, in my opinion. You would want to mix your environment as much as possible to shift things so they were not stuck in one static position for hours and hours at a time.
Diane Sanfilippo: Alright, so maybe ya’ll are going to get a stand up desk that has an adjustment, and then also a ball to sit on and then maybe one of those kneeling things, and all of your employers are going to be like; how many different desk situations do you need? But that will be fine. {laughs}
Dr. Scott Mills: Yeah, I know that’s now always; I’ve done a lot of ergonomic evaluation, I used to work with a bunch of different companies in Pittsburg as well as out of New York, and it’s not always practical to have, as you said, 3 different set ups. But maybe it is practical to take a 15-minute break and do 10 seconds of something else. Not a 15-minute break; a break every 15 or 20 minutes and do a few little activities. And that’s actually what my desk worker protocol is all about in the Full Body Fix.
Diane Sanfilippo: The Balanced Bites podcast is brought to you in part by the Full Body Fix. In addition to editing this podcast, Dr. Scott Mills, my husband, is a chiropractor who creates resources for athletes and every day people to eliminate pain and improve the way you move. The Full Body Fix is his recently released online video program that will teach you step by step exercises to overcome the most common aches, pains, and movement faults. From plantar fasciitis to lower back pain and sciatica, to carpal tunnel syndrome and elbow pain, the Full Body Fix has you covered. Learn more at FullBodyFix.com to see all the protocols, and enter code BALANCEDBITES for an extra $10 off your first purchase.
9. Stretch or strengthen for spinal injuries [35:49]
Diane Sanfilippo: Alright, we’ve got one from Melissa. She’s asking, “stretch or strengthen for spinal injuries?”
Dr. Scott Mills: Yeah, she wanted to know which is best. Hopefully at this point in the conversation you’ll know my answer is both {laughs} plus some other things. So a lot of people are familiar with mobility, or stretching and flexibility, and these things are good if there is restriction. A little less known is stability or stabilization exercises, which we’ve talked about, and have been a core part of physical therapy and rehab for a long time. And in addition to kind of combing mobility with stability for spinal injuries, I would also add specific chiropractic adjustments to address any underlying joint restrictions or neurologic imbalance; those are really important. And then lastly addressing any soft tissue adhesions or scar tissue that might be built up in surrounding musculature or soft tissue or fascia.
So, I haven’t talked about soft tissue adhesions yet today, but I specialize in a soft tissue technique called active release technique; you can find out more at ActiveRelease.com, what that’s all about. But basically, the idea is any time there is an insult to soft tissue, the body is going to lay down some scar tissue. Without removing some of that scar tissue, the body just simply won’t heal fully. So that’s where these techniques like ART or Graston come into play, to try to break up those adhesions and get the soft tissues healthy and healed.
10. Correcting poor posture [37:27]
Diane Sanfilippo: Alright, we have a question from Apron Warrior. {laughs}
Dr. Scott Mills: Yes, Apron Warrior wants to know. {laughs}
Diane Sanfilippo: “Can chiropractic correct poor posture?”
Dr. Scott Mills: So, it’s a good question. I think the answer is “yes” and “sort of.” So, combining chiropractic care with at home corrective exercises, as well as things like functional movement or fitness routines can actually correct a lot of postural issues, especially ones that have sort of been environmentally influenced, like we already talked about, to an extent. As long as there is not a congenital or traumatic postural distortion involved; so something like scoliosis or Sherman’s disease, which are congenital disorders that basically cannot be corrected fully. The correction in those cases are going to be pretty limited. But if it’s a postural issue that has come from just basically chronically sitting or chronically poor environmental factors, you can definitely help correct and start reversing that process.
And as many of you guys know, I’m sure, good posture really not only changes your overall appearance, it really changes your physiology. Better posture actually has been shown to lead better nervous system flow and circulation; blood flow. So work on your posture.
Diane Sanfilippo: I feel like a lot of what we do, working at a desk obviously, doesn’t help our posture, but then we get in the gym; what I see consistently; I still even see people, whether they’re on an exercise bike or a treadmill; I saw this one guy get off the treadmill this morning, and I just wanted to push my thumbs into his shoulders.
Dr. Scott Mills: Yeah.
Diane Sanfilippo: And pull his shoulders and his chest back and tell him to get on a rower instead of running just for a little while, just because it seemed like he needed some balance in the exercise. A lot of people do things that are not balancing out the fact that we’re hunched over the desk and most people, if you are a desk worker, from what I’ve seen. I mean, I’m not a trainer, but I’ve been training long enough and working at a desk long enough to know that most of us could be doing rowing type exercises and/or weighted rowing. Something that literally strengthens our back to also, I think, support what the chiropractic adjustment will do to help our nervous system out. But we’re just kind of hunched over and putting ourselves in that position for so long, and then our muscles just kind of cave over, and aren’t holding us up.
Dr. Scott Mills: Mm-hmm. Yeah, the general posture distortion that we see; it’s called upper cross syndrome where the pecs get tight and your scapular retractors, your upper back muscles become what’s called stretch weakened, where they’re just not firing. That’s why actually scapular retraction shows up in at least three of the protocols on the FullBodyFix.com. it’s super important to bring us back into good anatomical position.
11. Tingling pain in the neck and shoulder [40:35]
Diane Sanfilippo: Alright, so we’ve got a question here from Amelia. Amelia I am, is her handle. She’s got constant pain in the neck and shoulder with tingling from the neck to the shoulder, what can she do about that?
Dr. Scott Mills: Mmm. So anytime I see a symptom like that, I’m immediately flagging nerve irritation. Nerve root irritation out of the neck down into the shoulder is going to cause that kind of numbness or tingling or burning pain that some people are probably familiar with.
Diane Sanfilippo: Yikes.
Dr. Scott Mills: Yeah, not fun. But definitely fixable. There are a couple of different causes, and a couple of different solutions. So number one; I’m going to go back to our good old chiropractic assessment for detecting any kind of joint restrictions that could be irritating that nerve, because if that spinal level is not moving well, the nerve coming out of that hole could just be getting occluded or kind of crimped down or pinched.
Secondarily, if it’s moving ok through the spinal joint, but getting caught up in the soft tissue that it has to go through, then we’re going to be looking at; yeah, doing nerve flossing. {laughs}
Diane Sanfilippo: I was motioning the nerve flossing exercise.
Dr. Scott Mills: Which is one of the key protocols in the Full Body Fix protocol for things like carpal tunnel syndrome or sciatica. I teach basically this technique where we are able to actually move and mobilize the whole nerve tract through the soft tissue to remove any entrapments or adhesions that are kind of grabbing onto that nerve, thereby removing the compression and resolving the symptoms.
If that doesn’t work, active release technique, as I already mentioned, it’s great for removing those adhesions. And typically, we’re looking at the scalene muscles; the ones that Amelia is describing is typically going to get caught up in the neck muscles right to the side of the neck. These are very tender; don’t do these on your own, make sure you go to a professional for these. And then some follow up home care neck mobility stretches would be great.
Diane Sanfilippo: I definitely had issues with tingling; I think it was all the way down to my thumb, maybe.
Dr. Scott Mills: Yeah.
Diane Sanfilippo: Doing pull ups, and then I remember you had me doing some of the nerve flossing, and it pretty much went away right away from that.
Dr. Scott Mills: Yeah, that’s actually goes away pretty quick if you’re doing it properly.
12. Differentiating between soreness and injury [43:04]
Diane Sanfilippo: Cool. Alright, so this one is from Katie. Katie asks, “What’s the difference between muscle soreness and an injury that needs care?” I think that’s a really good question, and I think that’s one where it’s like, also just something is hurting at the gym, and it’s like, ‘is this hurting because I’m injured, or is this hurting because this is hard and it hurts because it’s hard work.”
Dr. Scott Mills: Yeah, so there’s lots of different layers to this question, I’ll try to tackle all of them. First, pain is subjective. It’s a subjective experience; we all experience it differently. So it can be a tricky sort of call on what type of pain am I having.
First, typical normal exercise induced muscle soreness, you may have a little bit of “burn” muscle burn, lactic acid burn during a sort of high intensity workout. This kind of pain can also lead to delayed onset muscle soreness pain, or DOMS, many of you are familiar with that term, maybe, for the next day or two but shouldn’t last more than two days. If it’s lasting more than two days…
Diane Sanfilippo: {laughs} Oops.
Dr. Scott Mills: Yeah. {laughs}
Diane Sanfilippo: Oops, my leg workout was too intense.
Dr. Scott Mills: Yeah, then you’ve done a little bit extra muscle damage. That isn’t necessarily problematic, it can still heal, it can still lead to actually increases in strength and hypertrophy. But, when we’re dealing with the kind of pain we want to sort of pay attention to and flag and see a professional about, we’re looking at joint pain; number one. Joints, we kind of know where those are, right? So if your shoulder is hurting deep in, that’s not typically a muscle problem, that’s a joint problem. Then you’ve potentially done some damage to the ligaments; ligaments hold bone to bone, or a capsule, or a nerve if it’s burning as we talked about in the last question. All those are a little bit more on the red flag side of things and we want to get them addressed.
Diane Sanfilippo: Do they tend to be sharper pains, or sometimes sharper, sometimes dull?
Dr. Scott Mills: Yeah, that was the other thing I was going to talk about, was onset. If you are in the middle of a workout and you go from a 0 out of 10 pain to an 8 out of 10 pain, that’s what we call an acute injury, and you’ve done damage and need to stop. That’s different than sort of; oh, it was a hard workout and afterwards I was sore and the next day I was having a little bit of trouble walking around, but not sharp, acute 8/10 and over pain. It’s just sort of in that 3-4-5 range that we’re not as worried about.
And if you’ve done acute damage, there may be other signs that you can look out for, which is actually bruising. If you’ve done significant muscle tearing, it can actually bruise. Warmth or redness around the area, if it’s a joint it might actually swell if you’ve done some damage. So those are things you can kind of look out for and go seek some attention.
Diane Sanfilippo: And that the pain doesn’t necessarily just go away because you rested it.
Dr. Scott Mills: No.
Diane Sanfilippo: It will probably come back either when you start working out again or maybe not even having to.
Dr. Scott Mills: Yeah, typically more serious injuries will just kind of hurt all the time regardless of activity.
Diane Sanfilippo: My rule of thumb when training is exactly what you described; it’s kind of like, if it goes from 0-8, if I just feel something that seems like it’s out of nowhere or maybe it was a 0 and then on first movement it’s like a 4 or a 5 and it kind of catches my attention, then I go to a second movement whatever it is and it hits that 8 or 9; I’m like, ok, that doesn’t feel good. That’s not you're in the workout and it’s your working hard; that’s a sign that you need to chill out for a second.
13. Including mobility as self care during workouts [47:11]
Diane Sanfilippo: Alright, Dee Dee is asking, “How can I best plan mobility and self care into the week.” I did see this question, because she was saying that she does her workout, and she has some stretches and things like that, but she’s not really sure a good plan of attack consistently.
Dr. Scott Mills: Great question, Dee Dee. One thing I want to say before I go through this; I’m actually going to be writing up and taking a video of this. I’ve already done the film for it. I’m working on creating a basic pre-activity warm up, sort of the ultimate warm up routine, so this will be going up I think I’m putting it in the Full Body Fix as a kind of add on, so keep an eye out for that. I’ll definitely post about it on my social media and whatnot.
My overall recommendation for how to work mobility and self care into your week is; hopefully you already have some sort of workout routine. I’m assuming that {laughs}. And if you do, my recommendation is to plan 20 minutes before any kind of intense activity to do this routine, which is first 5 minutes of low level heat; it’s just a walk, jog, get on the bike, row, maybe swim if you’ve got that available to you. Something that’s low impact that will start warming up the body.
Second, the next 5 minutes is moderate level dynamic movements, so we’re talking more about getting some functional movements, like air squats, or pushups, or doing mountain climbers, maybe jumping rope or doing some hollow body rocks, where you just kind of lie on your back and rock back and forth; sit ups. Anything where you’re moving the body a little bit more dynamically, developing a little bit more heat, and getting the body ready from a neurologic perspective. That’s the whole key that I think a lot of people; especially, I see it in Crossfit and weight lifting. People just jump into these movements. I’m like; you’ve got to get your nervous system ready for this kind of activity. You don’t want to be just jumping in there. And part of that is not doing a lot of soft tissue, deep soft tissue work prior to activity, because that can actually stimulate a relaxation response in your nervous system. So that’s kind of one of those keys. We want to save deep soft tissue mobility work for post workouts.
Diane Sanfilippo: That means the foam rolling and the lacrosse ball and stuff like that.
Dr. Scott Mills: Yes, foam rolling, lacrosse ball, all that stuff.
Diane Sanfilippo: Save that until after.
Dr. Scott Mills: Yeah.
Diane Sanfilippo: Ok, so then what’s next.
Dr. Scott Mills: Then the next 5 minutes, muscle activation stretching which is a little bit hard to describe, but basically instead of just doing passive stretching, I’m trying to break down a ground up sequence of events where you sort of stretch your calf by actively engaging your shin muscles, so bringing your toes up towards your nose. Or stretching your shin by actively pointing your ankle down and away from you. Does that make sense?
Diane Sanfilippo: Yeah. It does to me.
Dr. Scott Mills: So we do that all the way up the body; again, that’s more neurologic based, so we’re sort of stretching by doing muscle activation. And then the last 5 minutes, if you’ve got something like I do right now, which is I’m recovering from a hip injury, I’ll do 5 minutes of targeted problem focused work, where I’m actually targeting warming up that specific structure I’m worried about. Maybe if you’ve got a shoulder you’re coming back from, something like that. So that’s a 20 minute workout. I know it sounds like a lot;
Diane Sanfilippo: Warm up, you mean?
Dr. Scott Mills: Yeah. What did I say?
Diane Sanfilippo: You said work out.
Dr. Scott Mills: Oh, well it’s kind of a workout. {laughs}
Diane Sanfilippo: I think it’s just a good; to me, I’m looking at it written out, and this is a good way, a lot of us get to the gym and we’re like, ok I want to warm up, or; if you go to a Crossfit class and there’s no warm up, then you need to reconsider.
Dr. Scott Mills: Find a new box.
Diane Sanfilippo: Yeah. {laughs} But I know for myself, if I go to the gym and I’m going to lift that day, I’m like, ok I’m going to warm up, but what does that warm up really look like? This is kind of a nice little structure. For me, when you say 5 minutes of each of these, I’m like, well {laughs} maybe it will be 3 minutes of this, and 3 of that.
Dr. Scott Mills: 3 minutes, yeah.
Diane Sanfilippo: But still, I think the order of that makes sense, and I know that when I do train with Dave, for example.
Dr. Scott Mills: That’s what he does.
Diane Sanfilippo: This is kind of what we do.
Dr. Scott Mills: He does it naturally, yeah.
Diane Sanfilippo: We kind of move through it, we don’t put words to it, but I feel like once you get used to this kind of order of things where you just do a low level and then make that progression, you’ll just get used to, this is how I warm up, you know.
Dr. Scott Mills: Mm-hmm. And then the last thing that I would do is plan at least one recovery workout into your week, whether that’s yoga, whether that’s a recovery class, whether it’s just taking a bunch of stuff you’ve learned on your own from either my site or some of the other resources out there, taking what you normally would do on a workout day, taking it down a notch and spending time on whatever you need to spend time on.
Diane Sanfilippo: So then I think the other thing Dee Dee was probably asking in that question is, if you have an injury that you’re kind of working with and trying to target, in this set up you have 5 minutes of really focusing on that one thing.
Dr. Scott Mills: Mm-hmm.
Diane Sanfilippo: Is that kind of your general overall approach to keep it less stressful.
Dr. Scott Mills: Yeah.
Diane Sanfilippo: It’s not; ok, you better spend 30 minutes a day working on your hip. This just kind of works it into whatever else is going on. I’m sure if somebody has got an acute injury, they might have to be focused on it a lot more at different points in time.
Dr. Scott Mills: Maybe.
Diane Sanfilippo: This is a little bit more like prevention and maintenance?
Dr. Scott Mills: Both, and then also, I mean thinking about it from your overall weak structure, hopefully you’re doing some sort of workout or movement at least 3 times a week. That means you’re doing all these things 3 to 5 times a week. So even if you’re doing; so maybe you're somebody who has a low back problem. You’re still working out, but it’s been there for years. You’re trying to get through it. You grab the low back mobility/instability protocols off my site, then you’re doing these protocols 3-5 times a week inside of those 5 minutes. Because they don’t take that long to do, you’ve just got to do them.
Diane Sanfilippo: Mm-hmm. Alright, so you guys are going to get the benefit of that. It’s over time, just being consistent.
Dr. Scott Mills: Yeah, absolutely.
Diane Sanfilippo: Over time. We don’t have to be thinking; I have to do this specific thing for 30 minutes every day to heal myself.
Dr. Scott Mills: No.
14. #Treatyoself: single cup pour over coffee [53:31]
Diane Sanfilippo: It’s just being consistent all the time. Ok. Cool. Alright, time for some treat yoself.
Clip: Three words for you; Treat. Yo. Self.
Diane Sanfilippo: {laughs}
Dr. Scott Mills: {laughs} I get to do a treat yoself?
Diane Sanfilippo: You get to do a treat yoself.
Dr. Scott Mills: Mimosas.
Diane Sanfilippo: {laughs} Alright, so Dr. Scott, what’s your treat yoself of late?
Dr. Scott Mills: So probably; maybe about 2 months ago, actually when the weather started to get a little bit cooler here in San Francisco. {laughs}
Diane Sanfilippo: {laughs} We’re laughing because this is his first winter in San Francisco.
Dr. Scott Mills: Yeah.
Diane Sanfilippo: And he’s like, I’m not sure I can call this winter.
Dr. Scott Mills: So when it got real cold; you know, down to 50.
Diane Sanfilippo: {laughs}
Dr. Scott Mills: I started getting back to doing single cup pour over coffee in the morning. It’s not so much; well, I mean, it makes a great cup of coffee, if I do say so myself. {laughs}
Diane Sanfilippo: He thinks it’s not a treat. I think anything that feels special and like a little moment for yourself is a treat.
Dr. Scott Mills: Yeah.
Diane Sanfilippo: It doesn’t have to be expensive.
Dr. Scott Mills: No, but for me…
Diane Sanfilippo: Or sugary. {laughs}
Dr. Scott Mills: Ok, there’s two things. One, I buy really good beans. Jeremiah’s Picks, which is a local San Francisco bean; organic, dark French roast, beautiful. Perfect.
Diane Sanfilippo: Hipster beans. {laughs}
Dr. Scott Mills: They’re hipster beans probably {laughs} I don’t know. I’m not a hipster, so I don’t know. And then two, really for me it’s about the ritual. In the morning, I like to take the dog for a walk, come back, I’m a little cool so I have my warm, hot cup of coffee. And it’s just about the ritual of doing the grinds, and pouring the coffee. There’s something about that kind of ritual that helps; I don’t know, it gets me in a great mood for the day.
Diane Sanfilippo: It feels special. I definitely was making single cup pour over for a long time, but I’ve been totally on my iced coffee so we don’t share that little ritual in the morning at this point. But I feel you on it; I feel you. It’s definitely a good one.
Diane Sanfilippo: Alright guys, that’s it for this week with Dr. Scott. That went really quickly over here actually doing this one side by side, with my guest was totally different and a more fun experience, so I hope you guys enjoyed that. Don’t forget, you guys can find out more about Dr. Scott at DrScottAMills.com, and also his brand new program Full Body Fix at FullBodyFix.com. You can use code BALANCEDBITES for $10 off your first purchase there. So if you guy are looking for just more support in exactly what to do for different problems, different injuries, different aches and pains; whatever is going on with your body, FullBodyFix.com a whole bunch of protocols there in the program, totally affordable. I will be talking about this more to you guys, I’m sure, because I think it’s an amazing program. It’s going to cost less than 1 visit with a chiropractor would, and you have these resources forever to be using them on your own at home. You can use them on your phone, you can use them on the computer, etc. Downloads, all kinds of good stuff. Anyway, check him out at FullBodyFix.com. You can find him on Twitter and Periscope @ScottAMillsDC, and on Instagram @FullBodyFix.
And that’s it for this week. Don’t forget, you can find me, Diane, at http://dianesanfilippo.com and Liz at http://realfoodliz.com/. Don’t forget to hop on to our email lists for free goodies and updates you won’t find anywhere else on our websites or on the podcast. While you’re on the internet, leave us an iTunes review. We’ll see you next week.
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