Integrative Orthopedics | DailyDocTalk 56

Integrative Orthopedics | DailyDocTalk 56



hey everybody so I have been working on this course that I'm going to be offering that is a step aside from the actual regenerative injections that's more so focusing on what I'm kind of loosely calling integrative orthopedics which is this idea that there are certain things we can do outside of regenerative injections that can be beneficial to help people optimize from the actual injections they're getting maybe never need injections and basically just to help with their musculoskeletal orthopedic concerns using these different various approaches this is something that I've been thinking a lot about ever since I first started working with patients and chronic pain many years ago and it's developed into right now at least what I'm calling the cnames approach which is an acronym clearly because who would call something see names but an acronym that is the five six five main area C and a and the S man this has been along its Monday and it's but it's alright six six different areas in the body that we can look at to determine do we need to need to intervene here how much do we need to intervene and how are we going to intervene so the cnames approach then is going to be the connective tissue so that's going to be things like the tendons the ligaments the cartilage things like those are the the typical things that are going to be approached when we are doing the actual regenerative injections so we have cartilage we're now the nervous system this applies to the peripheral nerves that might have some neurogenic inflammation they're releasing substance P things like that but it also could be central nervous system how is your overall parasympathetic versus sympathetic nervous system functioning because that's going to change how you are perceiving pain how you are moving through life things like that then we're have the articulations so that's the actual joint proper is there any misalignment do we have cartilage degeneration is there a fixation or subluxation in particular joints that are going to be contributing to why patients aren't paying things like that the connective tissue right nervous we get articulation we have the metabolic system this is going to be things like obesity this is gonna be things like hyperglycemia or hyperinsulinemia so high blood sugar or high insulin levels things like you know inflammation whether it's systemic or local how can we look at that area and how can we kind of differentiate between those things and approach then to me the endocrine system and this is a big huge system so this is where we're gonna look at thyroid hormones adrenal hormones sex hormones the adipic kinds leptin out of penectomy we're gonna look at growth hormone igf-1 a whole host of different systems within the endocrine system that we can look to optimize in order to optimize our regenerative injection procedures and then the last is going to be the stem cell niche and that's going to be both local and it's going to be systemic and so the local stem cell niche is in any given area is usually the fat pads that are around that area so for the need for example we're gonna have the suprapatellar fat pad one of the infrapatellar fat pad those are two fat pads where there is a rich source of mesenchymal stem cells and peri vascular cells and pre adipocytes these things that have been shown to have regenerative capabilities because their progenitor cells or stem cells and they are going to help to repair the tissues that are surrounding it so that's the local No the systemic side of things we're gonna have the micro vascular bed basically the entire capillary tree capillary however you want to say US Canada but that's where the peri vascular cells are gonna live so peri vascular cells are these cells that line all of the blood vessels and we're talking with the capillaries here they went all the capillaries and when there is damage to the capillaries those peri vascular cells become activated they come off they become a mess and kimmel stem cell and then from there they're able to help modulate the immune system in the inflammatory response which is going to help in the orchestration of healing and again that's whether it's an acute injury like you rolled your ankle or we actually go in with an injection like PRP to stimulate a new healing response and so in the time that I've been working in were generative injection space one of the big things that has really been brought to my attention through patients is that the better the health of the patient before the procedure the better they are going to respond from the procedure and so that's what's really led me down this road of well how can I improve the health of the patient before a procedure after a procedure so that way we can maximize what we're getting out of the actual regenerative injection because my ultimate goal at the end of the day is to have is to spend time with patients to not just address the current concern that they're in such as their knee pain their neck pain their low back pain those types of things but also make them healthier as a whole human so that way when they leave my office meaning like the time that we spend together whether that's two months six months or three years they are better off than when they came in not just in the area that they can me with for example their pain but also other areas of their life their cardio metabolic health their sleep their risk of cancer all that kind of stuff has improved because we've been working together and so this is one of the things that I really try to focus on in clinical practice which is how do we integrate the whole human how do you take a 360-degree approach to healing in this patient so that way maybe we only need to do one stem-cell procedure and a PRP procedure to get you ninety percent out of pain as opposed to needing to do two or three stem-cell procedures because the your overall health is not fantastic and you also have a severe chronic degenerative condition such as grade 3 grade 4 osteoarthritis of the knee in multiple compartments and so if you are the take home I guess for you as if obviously if you're not working with me is if you are seeking out regenerative injection care and the provider that you're working with doesn't focus on this meaning you just go in get your injection and leave and then follow up on the inject make sure you spend the time to do things on your own that are going to be beneficial for your healing long-term that's making sure you're drinking enough water cutting out all that crap processed food that I've talked about over and over and over again no high fructose corn syrup no minimal minimal to no processed foods if you're gonna do processed foods 5 or less ingredients do some intermittent fasting some time restricted feeding making sure you are sleeping well enough and deep enough use blue light blockers if you need to in order to help increase melatonin production make sure that you are exercising and getting blood flowing multiple times a week so that way your body is better able to handle the healing that is going to be thrown at it when you get an injection I hope you appreciate this video kind of giving you more insight I guess into how my clinical mind works and how I see patients if this is something you like hearing more about my thought process on how I approach clinical problems please let me know below and I'll give you more of it thanks you

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