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The Chiropractic Forward Podcast: Evidence-based Chiropractic Advocacy

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Recent Episodes

June 23, 2026

Manual Therapy Plus Exercise & Multidisciplinary Rehab For Low Back Pain

Host Dr. Jeff Williams, FIANM, DABFP, explores how combining manual therapy with exercise and multidisciplinary rehabilitation effectively improves low back pain outcomes.

April 29, 2026

PNF Stretching For Knee OA & A 50-Year Review Of Chiropractic Research

<h1>CF Episode 389: PNF Stretching For Knee OA & A 50-Year Review Of Chiropractic Research</h1> Today we’re going to talk about PNF Stretching For Knee OA And A 50-Year Review Of Chiropractic Research. First here’s that sweet sweet bumper music.   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! <iframe title="The Remarkable Truth About Chiropractic: A Unique Journey Into The Research" type="text/html" width="1200" height="550" frameborder="0" allowfullscreen allow="clipboard-write" style="max-width:100%" src="https://read.amazon.com/kp/card?asin=B096RST3WW"></iframe> <div class="wp-block-image"> <figure class="aligncenter"><a href="https://www.chiropracticforward.com" target="_blank" rel="noreferrer noopener"><img decoding="async" class="aligncenter" src="https://www.chiropracticforward.com/wp-content/uploads/2019/02/Screen-Shot-2019-02-13-at-2.38.16-PM-150x55.jpg" alt="Chiropractic evidence-based products" /></a></figure> </div>   <div class="wp-block-image" style="text-align: center;"> <figure class="aligncenter"><a href="https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2" target="_blank" rel="noreferrer noopener"><img decoding="async" src="https://www.chiropracticforward.com/wp-content/uploads/2018/03/Subscribe-on-Itunes-150x75.png" alt="Integrating Chiropractors" /></a></figure> </div>   <div class="wp-block-image" style="text-align: center;"> <figure class="aligncenter"><a href="https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through" target="_blank" rel="noreferrer noopener"><img decoding="async" src="https://www.chiropracticforward.com/wp-content/uploads/2018/07/Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg" alt="This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg" /></a></figure> </div>   <div class="wp-block-image" style="text-align: center;"> <figure class="aligncenter"><a href="https://player.fm/series/2291021" target="_blank" rel="noreferrer noopener"><img decoding="async" src="https://www.chiropracticforward.com/wp-content/uploads/2018/07/Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg" alt="This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg" /></a></figure> </div>   <div class="wp-block-image" style="text-align: center;"> <figure class="aligncenter"><a href="https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2" target="_blank" rel="noreferrer noopener"><img decoding="async" src="https://www.chiropracticforward.com/wp-content/uploads/2018/07/Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg" alt="This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg" /></a></figure> </div>   OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, judgmental, elitist, puffing on a pipe, pretentious kind of research. We’re research talk over a couple of beers. So grab you a 6-er. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. I’m so glad you’re lending me your ear, spending your time with me and we’re learning this stuff together. <h2>Things You Should Do</h2> <ul> <li>Go to Amazon and BUY my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. Easy to understand and easy to support everything you do. It’s on Amazon.</li> <li>Like our Chiropractic Forward Facebook page,</li> <li>Join our private Chiropractic Forward Facebook group, and then</li> <li>Review our podcast</li> <li>Check our website at chiropracticforward.com</li> </ul> <h2>Episode 389</h2> You have found yourself smack dab in the middle of Episode #389. Now if you missed our last episode, we talked about Shockwave Therapy for Hamstring Injuries and Vitamin D for Respiratory Infections. Make sure you don’t miss that info. Keep up with the class. <h2>On the Personal End of Things…</h2> Sorry, it’s been a week or two since the last podcast episode. I have been traveling a little bit. I just got back from Tampa, Florida, and my mastermind meeting with Dr. Kevin Christie. We had a great time out there. I just can’t explain to you how proud I am of that group that I’m a part of. It really does have some of the best minds and most talented individuals in the entire profession. I count myself as very fortunate for being asked to be a part of it. One of my colleagues is Vanessa Wilczak from Jacksonville, Florida. She and I have really buried ourselves in AI, and we have made a pretty effective team with regard to coming up with some pretty cool stuff that AI can do to help us in business. Vanessa recently took that a step further and has really created something very, very interesting. She figured out a way to make Claude work with a permanent storage or brain, if you will, so that when you are talking to Claude, it can reference and remember exactly what you’ve trained on it at all times. So, if you consider that you can train it on all of your office stats, all of your provider contracts and pay scales. All your fee schedules. Every statter, every report that you can think of that you can run through your EHR. And everything else that you have on your computer that’s relevant, then you sort of have a chief operating officer or chief financial officer or a CEO or whatever you want to call it. that has all of the financials and all of the information it could ever possibly need to help you make decisions going forward. That includes KPIs, or seeing gaps and opportunities that you wouldn’t normally see. For example, I was able to have a conversation with our new provider today that included very precise facts and figures that I wouldn’t have had… access to… Just two days ago. I was also able to give her very realistic and conservative. Ideas about patient numbers and potential income in the next year, and in the next two years. Then I was able to have… an effective conversation with our front desk about… some of our stats and how we can easily improve them. The potential is absolutely and 100% limitless when AI remembers what you have trained it on and can reference it at any point in any conversation you’re having. I’m training it on the medical side of things, too, for peptides, and IV therapy, and PRP on the research, and all of that good stuff. So it’s basically going to be one big, huge brain. for my clinic. And I could not be more excited. Vanessa really knocked it out of the park on this. So that’s why I’ve been busy, but I felt like it had been long enough since I had put out an episode. So we’re gonna throw this one together fairly quickly. I hope you don’t mind, but there’s a really great paper in this episode that you’ve just got to hear about. So don’t go anywhere. Let’s hop into the research. <h1>Item #1</h1> Alright, let’s jump into our first paper this week and it’s a good one for those of you treating knee pain — which I’m guessing is about 100% of you listening. This one is titled… “Effect of Proprioceptive Neuromuscular Facilitation on Pain and Joint Mobility in Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials” Remember, the citations can be found at chiropracticforward.com under this episode. Hu Z, Dong J, Zeng Y, He Z, Wang Q, Luo Q. Effect of proprioceptive neuromuscular facilitation on pain and joint mobility in knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials. PeerJ. 2026 Jan 16;20581. DOI: 10.7717/peerj.20581. PMID: 41561818. <h2>Why They Did It</h2> Knee osteoarthritis is one of the most common and debilitating conditions we see — pain, stiffness, loss of mobility, and that slow grinding decline in quality of life. Standard medical management tends to lean on pain medications, cortisone injections, and eventually surgery. In this they explore some conservative means. These researchers wanted to find out whether Proprioceptive Neuromuscular Facilitation — PNF — could make a meaningful difference in pain and knee range of motion for people with knee OA. Now if you’re not super familiar with PNF, it’s a rehabilitation technique that combines passive stretching with active muscle contractions to improve flexibility, strength, and motor control. <h2>How They Did It</h2> <ul> <li>This was a systematic review and meta-analysis following PRISMA</li> <li>They cast a wide net, searching seven major databases for randomized controlled trials from database inception all the way through August 2025.</li> <li>They ended up with five studies — 201 total participants — comparing PNF to control interventions, and four studies — 202 participants — comparing PNF to other rehabilitation techniques like soft tissue mobilization, neuromuscular exercise, and stretching.</li> <li>Primary outcomes were change in pain intensity and change in active range of motion.</li> </ul> <h2>What They Found</h2> Compared to control interventions, PNF showed significantly greater improvements in pain reduction. And it significantly improved knee active range of. Highly significant results on both fronts. When they compared PNF qualitatively against other rehab techniques — soft tissue mobilization, neuromuscular exercise, and stretching — results were more mixed. Not clearly better across the board, but not worse either. The strongest, most consistent signal was PNF versus no real intervention, and there it was a clear win. <h2>Wrap It Up</h2> PNF is a conservative technique producing significant reductions in pain and real improvements in joint mobility for knee osteoarthritis patients. Move the patient. Restore function. Reduce pain without putting something into their body or cutting them open. Sounds good to me, what about you?/ <h1>Item #2</h1> Alright, paper number two is one I have been waiting to talk about because it is a direct shot of espresso for your chiropractic soul. This one comes to us from a group out of Duke University School of Medicine — yeah, you heard that right — Duke — and it’s titled… “Chiropractic and Spinal Manipulation: A Review of Research Trends, Evidence Gaps, and Guideline Recommendations” Remember, the citations can be found at chiropracticforward.com under this episode and yes, one of our previous guests on the podcast is the esteemed Dr. Christine Goertz who we simply adore. Trager RJ, Bejarano G, Perfecto RP, Blackwood ER, Goertz CM. Chiropractic and Spinal Manipulation: A Review of Research Trends, Evidence Gaps, and Guideline Recommendations. J Clin Med. 2024 Sep 24;13(19):5668. DOI: 10.3390/jcm13195668. PMCID: PMC11476883. <h2>Why They Did It</h2> <ul> <li>The story of chiropractic research is a story of a profession that has been building its evidence base for over 50 years.</li> <li>Medicare authorized payment for chiropractic spinal manipulative therapy back in 1972 — and since then, utilization has grown, research has grown, and the profession has evolved.</li> <li>But how much has the research actually matured? And what do today’s clinical practice guidelines — the CPGs that medical organizations use to drive treatment decisions — actually say about spinal manipulation?</li> <li>That’s what this team set out to document.</li> </ul> <h2>How They Did It</h2> <ul> <li>They searched Scopus for all chiropractic-related research published from 1972 through 2024 — over five decades of literature — and analyzed publication trends and keyword evolution to track how the research landscape has changed.</li> <li>Then separately, they searched PubMed, Scopus, and Web of Science for clinical practice guidelines published between 2013 and 2024 that addressed spinal manipulative therapy.</li> <li>They were looking at what the guidelines say, and what conditions they cover.</li> </ul> <h2>What They Found</h2> <ul> <li>They identified 6,286 articles on chiropractic, and the publication rate trended upward across the entire period.</li> <li>The keyword analysis tells the story: early research focused on history, scope of practice, medicolegal issues, and regulatory concerns.</li> <li>Over time — as the profession gained footing and credibility — the keywords shifted to include randomized controlled trials and systematic reviews.</li> <li>That’s the arc of a profession doing the work.</li> <li>Here’s the number you want to remember: 90% of the guidelines favored spinal manipulation for low back pain.</li> <li>For neck pain? 100%. Every single one.</li> <li>And recent CPGs also supported SMT for tension-type headaches and cervicogenic headaches.</li> </ul> <h2>Wrap It Up</h2> Ninety percent for low back pain. One hundred percent for neck pain. I need you to sit with that for a second. Let that percolate, people. These are not numbers coming from a chiropractic trade publication. These are clinical practice guidelines — the formal, rigorous documents that major medical and healthcare organizations use to tell clinicians how to treat patients. And they are saying: use spinal manipulation. This paper is a gift. Print it out. Laminate it. Put it in your waiting room. When someone asks you — a patient, a skeptical physician, an insurance reviewer — whether there’s evidence for what you do, you hand them this. Over 50 years of growing, maturing, increasingly rigorous research culminating in guideline after guideline saying that spinal manipulation works for the spine-related disorders that walk through our doors every single day. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week. <h2>Store</h2> Remember the evidence-informed brochures and posters at chiropracticforward.com.   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! <iframe title="The Remarkable Truth About Chiropractic: A Unique Journey Into The Research" type="text/html" width="1200" height="550" frameborder="0" allowfullscreen allow="clipboard-write" style="max-width:100%" src="https://read.amazon.com/kp/card?asin=B096RST3WW"></iframe> <div class="wp-block-image"> <figure class="aligncenter"><a href="https://www.chiropracticforward.com" target="_blank" rel="noreferrer noopener"><img decoding="async" class="aligncenter" src="https://www.chiropracticforward.com/wp-content/uploads/2019/02/Screen-Shot-2019-02-13-at-2.38.16-PM-150x55.jpg" alt="Chiropractic evidence-based products" /></a></figure> </div>   <div class="wp-block-image" style="text-align: center;"> <figure class="aligncenter"><a href="https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2" target="_blank" rel="noreferrer noopener"><img decoding="async" src="https://www.chiropracticforward.com/wp-content/uploads/2018/03/Subscribe-on-Itunes-150x75.png" alt="Integrating Chiropractors" /></a></figure> </div>   <div class="wp-block-image" style="text-align: center;"> <figure class="aligncenter"><a href="https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through" target="_blank" rel="noreferrer noopener"><img decoding="async" src="https://www.chiropracticforward.com/wp-content/uploads/2018/07/Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg" alt="This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg" /></a></figure> </div>   <div class="wp-block-image" style="text-align: center;"> <figure class="aligncenter"><a href="https://player.fm/series/2291021" target="_blank" rel="noreferrer noopener"><img decoding="async" src="https://www.chiropracticforward.com/wp-content/uploads/2018/07/Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg" alt="This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg" /></a></figure> </div>   <div class="wp-block-image" style="text-align: center;"> <figure class="aligncenter"><a href="https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2" target="_blank" rel="noreferrer noopener"><img decoding="async" src="https://www.chiropracticforward.com/wp-content/uploads/2018/07/Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg" alt="This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg" /></a></figure> </div>   <h1>The Message</h1> I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! <h1>Contact</h1> Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms. We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. <h1>Connect</h1> We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. <h1>Website & Social Media Links</h1> <blockquote class="wp-embedded-content" data-secret="D4tpTnpgoQ"><a href="https://www.chiropracticforward.com/">Home</a></blockquote><iframe class="wp-embedded-content" sandbox="allow-scripts" security="restricted" title="“Home” — Chiropractic Forward" src="https://www.chiropracticforward.com/embed/#?secret=Vqu3B2Qi7B#?secret=D4tpTnpgoQ" data-secret="D4tpTnpgoQ" width="600" height="338" frameborder="0" marginwidth="0" marginheight="0" scrolling="no"></iframe> https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP: https://www.facebook.com/groups/1938461399501889/ Twitter: https://twitter.com/Chiro_Forward YouTube: https://www.youtube.com/channel/UCtcIrhlK19hWlhaOGld76Q iTunes: https://itunes.apple.com/us/podcast/chiropractic-forwardpodcast-chiropractors-practicing/id1331554445?mt=2 Player FM: https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forwardpodcast-chiropractors-practicing-through TuneIn: https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Prp1089415/ <h1>About the Author & Host</h1> Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger  The post <a href="https://www.chiropracticforward.com/pnf-stretching-for-knee-oa-a-50-year-review-of-chiropractic-research/">PNF Stretching For Knee OA & A 50-Year Review Of Chiropractic Research</a> appeared first on <a href="https://www.chiropracticforward.com">Chiropractic Forward</a>.

April 9, 2026

Shockwave Therapy for Hamstring Injuries and Vitamin D for Respiratory Infections

CF Ep. 388 – Shockwave Therapy for Hamstring Injuries and Vitamin D for Respiratory Infections Today we’re going to talk about Shockwave Therapy for Hamstring Injuries and Vitamin D for Respiratory Infections. But first, here’s that sweet sweet bumper music!   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! <iframe title="The Remarkable Truth About Chiropractic: A Unique Journey Into The Research" type="text/html" width="1200" height="550" frameborder="0" allowfullscreen style="max-width:100%" src="https://read.amazon.com/kp/card?preview=inline&linkCode=kpd&ref_=k4w_oembed_vcfM8pN8yNg88l&asin=B096RST3WW&tag=kpembed-20"></iframe> <div class="wp-block-image"> <figure class="aligncenter"><a href="https://www.chiropracticforward.com" target="_blank" rel="noreferrer noopener"><img decoding="async" class="aligncenter" src="https://www.chiropracticforward.com/wp-content/uploads/2019/02/Screen-Shot-2019-02-13-at-2.38.16-PM-150x55.jpg" alt="Chiropractic evidence-based products" /></a></figure> </div>  <div class="wp-block-image" style="text-align: center;"> <figure class="aligncenter"><a href="https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2" target="_blank" rel="noreferrer noopener"><img decoding="async" src="https://www.chiropracticforward.com/wp-content/uploads/2018/03/Subscribe-on-Itunes-150x75.png" alt="Integrating Chiropractors" /></a></figure> </div>  <div class="wp-block-image" style="text-align: center;"> <figure class="aligncenter"><a href="https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through" target="_blank" rel="noreferrer noopener"><img decoding="async" src="https://www.chiropracticforward.com/wp-content/uploads/2018/07/Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg" alt="This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg" /></a></figure> </div>  <div class="wp-block-image" style="text-align: center;"> <figure class="aligncenter"><a href="https://player.fm/series/2291021" target="_blank" rel="noreferrer noopener"><img decoding="async" src="https://www.chiropracticforward.com/wp-content/uploads/2018/07/Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg" alt="This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg" /></a></figure> </div>  <div class="wp-block-image" style="text-align: center;"> <figure class="aligncenter"><a href="https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2" target="_blank" rel="noreferrer noopener"><img decoding="async" src="https://www.chiropracticforward.com/wp-content/uploads/2018/07/Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg" alt="This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg" /></a></figure> </div> Welcome Back OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, judgmental, elitist, puffing on a pipe, pretentious kind of research. We’re research talk over a couple of beers. So grab you a 6-er. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. I’m so glad you’re lending me your ear, spending your time with me and we’re learning this stuff together. Things You Should Do Go to Amazon and BUY my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. Easy to understand and easy to support everything you do. It’s on Amazon. Like our Chiropractic Forward Facebook page. Join our private Chiropractic Forward Facebook group. Review our podcast on whatever platform you’re listening on — it really does make a big difference. And then check our website at chiropracticforward.com ──────────────────────────────────────────────────────────── Episode Number + Previous Episode Recap You have found yourself smack dab in the middle of Episode #388. <h2>Now if you missed our last episode, we talked about <a href="https://www.chiropracticforward.com/water-instead-of-diet-drinks-neuromobilization-in-the-chronic-neck/">Water Instead of Diet Drinks & Neuromobilization In The Chronic Neck</a></h2> Make sure you don’t miss that info. Keep up with the class. ──────────────────────────────────────────────────────────── Personal Happenings I would have to say that 2026 is really shaping up for us. I know that I’m still not back to pre-Covid numbers. However, it’s pretty standard for me to see 145 to 165 each week now. If you’ve been a long time listener, then you may recall the days when I was seeing 180 and even sometimes 200 in a week. So we are far from those numbers currently. And I’m kind ok with that. I did not like being that rushed and that busy. It made my life fairly miserable to be honest. However, with our new chiropractor, Dr. Easter, on board I bet we’ll see those sorts of numbers combined soon. I am impressed every single day with her and have zero doubt that her schedule will be busting at the seams before you know it. A friend of mine is Dr. Mark King, president of motion palpation Institute, and he happens to be in my mastermind group you always hear me talk about. I believe he has somewhere between five and seven associates so I guess he’s got it figured out. But what he said at the last mastermind meeting was that you need to be trying to give your associate somewhere around 15 new patients a month that you would personally have taken. You have to feed them to get them where they are really kicking butt and taking names and putting some money in their pockets right along with bringing patients and revenue to the clinic as well. With credentialing and all the things involved in that, I’m not able to shift that many her way just yet. However, that is definitely the plan when we were able and strictly on sending her cash new patients and her being able to start to cultivate her own patience here and there, we already have her up to about 25 a week or so sometimes more sometimes less. When you consider, she’s only had her license for a little over a month maybe two months, I think we’re in a good spot. Outside of that I have been studying for the California QME exam coming up next week and hopefully we knock that sucker straight out of the park into the windshields of the cars parked in the parking lot. And we can get well on our way performing QME‘s and building that revenue stream. QME is my path out of day today hands-on patient treatment. I’ll be 54 in August and if I can get down to just a day or 2 x 56. I’m gonna be a happy dude. OK, that’s it. Let’s get on with the research. Item #1 – Radial Shockwave Therapy + Rehab for Acute Hamstring Injuries Remember, the citations can be found at chiropracticforward.com under this episode. Citation: Crupnik J, Silveti S, Wajnstein N, Rolon A, Wuerfel T, Stiller P, Morral A, Furia JP, Maffulli N, Schmitz C. Radial ESWT combined with a specific rehabilitation program (rESWT+RP) is more effective than sham rESWT+RP for acute hamstring muscle complex injury type 3b: a randomized, controlled trial. British Medical Bulletin. 2025 Sep 2;155(1):ldaf009. DOI: 10.1093/bmb/ldaf009. Why They Did It Hamstring injuries are an absolute plague in sports. They’re one of the most common soft tissue injuries across virtually every athletic discipline — soccer, track and field, sprinting sports, you name it. The specific type we’re dealing with in this study is a type 3b injury, which is what the Munich Muscle Injury Classification calls a bundle or interfascicular tear — a structural, partial tear of the muscle, not just a minor strain. These are the ones that knock athletes out for weeks, and they carry a high re-injury rate. Conservative rehab is the standard treatment, but outcomes are often frustratingly slow, and there’s a real clinical need for adjunct therapies that can accelerate tissue recovery. Shock wave therapy has shown some promising signals in muscle healing, but at the time this trial was being designed, the evidence was thin. These researchers set out to test whether adding radial ESWT to a structured rehab program could meaningfully change the game for athletes recovering from these serious hamstring tears. How They Did It This was a prospective, randomized, double-blind, sham-controlled single-center trial conducted at the KinEf Sports Physiotherapy Center in Buenos Aires, Argentina. 40 semi-professional athletes with ultrasound-confirmed acute type 3b hamstring complex injuries who presented within 7 days of the injury. The athletes were randomized into two groups: the active treatment group received real radial ESWT combined with an 8-week structured rehabilitation program; the control group received sham rESWT Both patients and the assessors measuring outcomes were blinded to treatment assignment. The rESWT protocol consisted of nine sessions over three weeks — three sessions per week — with 2,500 radial shock waves per session at an energy density the patient could tolerate. The primary outcome was return-to-sport time. Secondary outcomes included post-treatment muscle strength, patient satisfaction, and re-injury rate. After the trial concluded, a small number of participants had their ultrasound images re-reviewed and 4 of the original 40 were re-classified as type 3a injuries and excluded — leaving a final analysis population of 36 athletes, 18 per group. What They Found The results clearly favored the group that received real rESWT. The athletes who received actual shock wave therapy combined with the rehabilitation program returned to sport significantly faster than those who received sham treatment plus the same rehab. Beyond faster return-to-sport, the rESWT group also showed superior post-treatment muscle strength and higher patient satisfaction scores. Re-injury rates were not significantly different between groups, though the sample size was modest. Wrap It Up Hamstring injuries are one of the most common and one of the most aggravating injuries that active patients and athletes deal with. Return to sport after a significant type 3b hamstring tear can take weeks, and the re-injury risk hangs over the athlete’s entire return. What this trial tells us is that we have a non-invasive, drug-free adjunct therapy — radial shock wave— that, when combined with a well-structured rehabilitation program, can meaningfully reduce recovery time and improve functional outcomes compared to rehab alone. This is important for those of us in the chiropractic and conservative care space. ESWT is a tool that fits squarely within evidence-based conservative management. No surgery. No injections. No drugs. Just targeted mechanical energy to the injured tissue to accelerate natural healing, combined with a progressive rehabilitation protocol. That is exactly the kind of multi-modal conservative approach that gets real results and that we should be able to offer our patients. Now, is this a massive trial? No — 36 athletes at a single center. But it’s randomized, it’s double-blind with a sham control, it’s published in the British Medical Bulletin — a well-respected peer-reviewed journal — and the findings are clinically meaningful. Add this to the growing body of evidence that says ESWT has legitimate utility in musculoskeletal care. If you’re working with athletes or active patients dealing with hamstring injuries, this is absolutely worth having in your clinical back pocket. ──────────────────────────────────────────────────────────── Item #2 – Severe Vitamin D Deficiency Linked to Higher Hospitalizations for Respiratory Tract Infections Remember, the citations can be found at chiropracticforward.com under this episode. Citation: Bournot AR, Hart KH, Johnsen S, Givens DI, Lovegrove JA, Ordóñez-Mena JM, de Lusignan S, Bartlett DB, Lanham-New SA, Darling AL. Association between serum 25-hydroxyvitamin D status and respiratory tract infections requiring hospital admission: unmatched case-control analysis of ethnic groups from the United Kingdom Biobank cohort. The American Journal of Clinical Nutrition. 2025. DOI: 10.1016/j.ajcnut.2025.101179. Why They Did It Respiratory tract infections — bronchitis, pneumonia, and their relatives — are a massive public health burden. Lower respiratory tract infections rank in the top 20 causes of death globally for people aged 50 to 74. For those 75 and older, they crack the top 10. We’ve known for a while that vitamin D has a role in immune function — it has documented antibacterial and antiviral properties. There’s been growing evidence that vitamin D deficiency may increase susceptibility to respiratory infections. But what was missing was hard, large-scale population data specifically tying vitamin D levels to actual HOSPITALIZATIONS for respiratory infections. This team out of the University of Surrey — working with colleagues from the University of Reading and Oxford — set out to fill that gap using one of the largest health databases in the world. How They Did It This was the largest study of its kind. The researchers analyzed NHS data from the UK Biobank — a massive cohort study with linked health records. They looked at 36,258 participants between the ages of 40 and 69. Vitamin D levels were measured via blood samples and cross-referenced against linked NHS hospital admission records for respiratory tract infections. Participants were categorized into vitamin D status tiers, with severe deficiency defined as below 15 nanomoles per liter, and sufficient levels defined as 75 nmol/L or above. They used survival analyses and binary logistic regression models to determine the relationship between vitamin D status and the rate of hospitalization. The analysis accounted for confounders including age, sex, BMI, lifestyle factors, socioeconomic status, and existing health conditions. What They Found Here’s the headline: people with severe vitamin D were 33 percent more likely to be hospitalized for a respiratory tract infection compared to those with sufficient levels. That’s a significant, clinically meaningful finding backed by a dataset of over 36,000 people. And the dose-response relationship is interesting. And basically the better your Vitamin D levels, the lower your risk of being hospitalized. The researchers also examined whether ethnicity modified this relationship, since vitamin D levels vary across ethnic groups — white participants had higher median levels, while Asian participants had lower. Despite those baseline differences, the association between deficiency and hospitalization risk was consistent across all ethnic groups. The risk of being severely deficient, however, falls disproportionately on ethnic minority communities, which is a public health equity issue worth flagging. Additional risk factors tied to higher hospitalization included obesity, male sex, being over 60, lower income, and statin use. Wrap It Up We know from the research that vitamin D deficiency is extremely common. Estimates suggest up to a billion people worldwide are deficient. A BILLION. And here we have one of the largest population studies ever conducted on this topic showing that severe deficiency is directly and significantly associated with a higher rate of landing in the hospital with a respiratory infection. This matters for us as practitioners in integrative, whole-person care. We are not just treating spines — we are caring for people. If your patients are walking around with severe vitamin D deficiency, you have an opportunity to identify that and address it. Especially your older patients, your patients with chronic conditions, those who work indoors The recommendation to supplement — particularly in winter months when sunlight exposure is limited — is well-supported and straightforward. It’s safe. It’s cheap. It’s widely available. And the data suggests it may be keeping your patients out of the hospital. That kind of simple, evidence-based preventive intervention is exactly the kind of whole-person care we should be championing. Test your patients’ vitamin D. Talk to them about supplementation. It matters. ──────────────────────────────────────────────────────────── Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week. ──────────────────────────────────────────────────────────── Store Remember the evidence-informed brochures and posters at chiropracticforward.com. Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! <iframe title="The Remarkable Truth About Chiropractic: A Unique Journey Into The Research" type="text/html" width="1200" height="550" frameborder="0" allowfullscreen style="max-width:100%" src="https://read.amazon.com/kp/card?preview=inline&linkCode=kpd&ref_=k4w_oembed_vcfM8pN8yNg88l&asin=B096RST3WW&tag=kpembed-20"></iframe> <div class="wp-block-image"> <figure class="aligncenter"><a href="https://www.chiropracticforward.com" target="_blank" rel="noreferrer noopener"><img decoding="async" class="aligncenter" src="https://www.chiropracticforward.com/wp-content/uploads/2019/02/Screen-Shot-2019-02-13-at-2.38.16-PM-150x55.jpg" alt="Chiropractic evidence-based products" /></a></figure> </div>  <div class="wp-block-image" style="text-align: center;"> <figure class="aligncenter"><a href="https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2" target="_blank" rel="noreferrer noopener"><img decoding="async" src="https://www.chiropracticforward.com/wp-content/uploads/2018/03/Subscribe-on-Itunes-150x75.png" alt="Integrating Chiropractors" /></a></figure> </div>  <div class="wp-block-image" style="text-align: center;"> <figure class="aligncenter"><a href="https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through" target="_blank" rel="noreferrer noopener"><img decoding="async" src="https://www.chiropracticforward.com/wp-content/uploads/2018/07/Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg" alt="This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg" /></a></figure> </div>  <div class="wp-block-image" style="text-align: center;"> <figure class="aligncenter"><a href="https://player.fm/series/2291021" target="_blank" rel="noreferrer noopener"><img decoding="async" src="https://www.chiropracticforward.com/wp-content/uploads/2018/07/Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg" alt="This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg" /></a></figure> </div>  <div class="wp-block-image" style="text-align: center;"> <figure class="aligncenter"><a href="https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2" target="_blank" rel="noreferrer noopener"><img decoding="async" src="https://www.chiropracticforward.com/wp-content/uploads/2018/07/Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg" alt="This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg" /></a></figure> </div>   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! ──────────────────────────────────────────────────────────── Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms. We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. ──────────────────────────────────────────────────────────── Website & Social Media Links <blockquote class="wp-embedded-content" data-secret="8JtgzR0uWy"><a href="https://www.chiropracticforward.com/">Home</a></blockquote><iframe class="wp-embedded-content" sandbox="allow-scripts" security="restricted" title="“Home” — Chiropractic Forward" src="https://www.chiropracticforward.com/embed/#?secret=xepRxmHWmM#?secret=8JtgzR0uWy" data-secret="8JtgzR0uWy" width="600" height="338" frameborder="0" marginwidth="0" marginheight="0" scrolling="no"></iframe> https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP: https://www.facebook.com/groups/1938461399501889/ Twitter: https://twitter.com/Chiro_Forward YouTube: https://www.youtube.com/channel/UCtcIrhlK19hWlhaOGld76Q iTunes: https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM: https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn: https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Prp1089415/ ──────────────────────────────────────────────────────────── About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger    The post <a href="https://www.chiropracticforward.com/shockwave-therapy-for-hamstring-injuries-and-vitamin-d-for-respiratory-infections/">Shockwave Therapy for Hamstring Injuries and Vitamin D for Respiratory Infections</a> appeared first on <a href="https://www.chiropracticforward.com">Chiropractic Forward</a>.

344 total episodes available with 5 transcripts

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