Dermal traction, nerve pain and learning to fix your own back

This is session number 87 of the Performance Place Sports Care Podcast. Have you been subjected to lacism? Welcome to the Performance Place Sports Care Podcast, where you can learn about sports injury theory, rehab, diagnosis, and how to understand the doctor lingo you didn't understand at your appointment. And now, your host, Dr. Sebastian Gonzales. All right, everyone. I'm Sebastian. Thanks for joining me back with the podcast this week. This is going to be an extra special one today because I didn't know we were going to do this, but we did this on Facebook Live. This is the first Facebook Live video that I've ever done.

And I don't know anything about Facebook. I will encounter Facebook on my desktop. I will not use it on my phone. Actually, I didn't even have an app. So me and the guest today were fidgeting around on Skype and it kept cutting out on us. So we went straight to Facebook Live and did a, lo and behold, very quick Facebook Live decision. And we actually got a lot of interaction of it. So it was kind of cool. So if you hear some jumping around today, that is the reason. And you can watch that video if you go on to Dr. Philip Snell's Facebook page. Now, the person we're going to have on is Dr. Philip Snell. He's a doctor of chiropractic out of Portland, Oregon. He is a presentation speaker and an extremely smart dude. I met him recently at a seminar in Denver. We were in, let's see, let's see the timeline on this. It was January, February, it was February of 2018.

And he was a, he was a presenter at the rehab to performance first annual symposium. So it was a great seminar. If you have not gone to that, or if you're going to see it next year, plan to go on to it next year, I think you should definitely take that into consideration. Huge bang for your buck and great, great speakers. Now, Philip Snell is, he did a presentation there mainly on back pain as well as dermal traction technique. If you're a patient out there listening to this, just be aware there's going to be a little bit more technical stuff. But if you hang around, there are storytelling that we'll do. We joke around, so it should be entertaining enough to hopefully hold your attention on that.

Dermal traction is actually, it's an interesting thing that he actually came up with, with another person that I've had on the podcast before, Dr. Justin Dean. They were basically just yanking on people's skin, pulling up the skin, kind of pulling the skin away from the muscle, and they found some profound results with people's symptoms like myalgia parasitica, tightness in muscles, muscle knots, sciatica, things of that nature. Even neck pain with movement, these things responded to just lifting the skin. So, it's interesting, and it's definitely a newer thing. And the idea, at least if I can break it down to an easy term, is that most of the manual therapies that we do, at least a lot that people do to themselves, are compression in nature.

This one's basically the opposite. You're lifting the skin, so you're creating more space so the nerve can help itself out. He also is going to talk about a concept of fix your own back, and the reason why he got into creating that, and how it's going to relate to healthcare in the future here. Now, before I go into the actual interview, I'm going to tell you my story. This actually really happened. I was at a thing in Las Vegas, and I was by myself because there was not, like, I was the only one there, and I was, it was actually, I think it was for Ironman events. I was there by myself. I was just working with some athletes, so I really didn't have anything else to do when it was nighttime. So, I went out, and I was at the strip just walking around, and I encountered a, there was, I think it was like five o'clock. So, there's a security guard at a club, and I was like, you know what? I got nothing to do. I mean, I'll go to a club tonight. I haven't been to a club in so long.

Not that I love clubs, and by the way, I hate clubs, but I'm like, yeah, I got nothing to do. Let's just see what this is. But I didn't plan for that either. So, I went up to the security guard and said, hey, this is how I'm dressed right now. I got jeans on. If you can visualize this. I got jeans on. I got a v-neck. I got shoes. The shoes were Converse. Jack Purcells, by the way. Not just All-Stars. They were Jack Purcells, the expensive ones. So, I said, hey, man, I'm going to try to come back later and go to this club. Can I get in like this? And he's like, nah, man, you can't. He said it just like that. Nah, man. I said, how come? And he's like, well, cuz, your shoes. I said, what's wrong with my shoes? He's like, they got laces. And I said, okay, so what do I do? And he's like, you got to get shoes without laces. And I was thinking, you know, dress shoes have laces too, but apparently I need slip-ons, right? So, this is my story of lacesim. Drum roll. Actually, after that, I did ask him like, hey, if I get new shoes, can I come back and still come in? And he says, no, it's your shirt. And I said, why? And he's like, well, if there's no collar, I'm like, okay, how about if I cut another shirt and drape it in there? Is that a good enough collar? And he's like, nah, man, that was our end of our interaction. I didn't get in there that night. But I think dress codes are ridiculous, by the way.

I'll let that be known. So, let's go into the Facebook Live interview with Dr. Philip Snell. You're going to love this. Stay tuned to the very end. If you're looking at going to a seminar that he is presenting at, I think there is a, we mentioned a code in there, which is a discount, which one of the other people looking on Facebook, viewers on Facebook posted in there too. So, that's mainly for students. Here we go. Okay, everyone, as promised, there's an interview with Dr. Philip Snell. What's going on? Not a whole lot other than technological difficulties this morning. Right. But I think we've managed to actually get something going.

You've actually blown my entire mind about this Facebook Live today. Eric Haraldson did it for me last week. So, yeah, it's a decent way to get some things across here. Yeah. Do you go Facebook Live often? Is that a, or you're going to? No, this is the, this is the second time that I've done it. So, yeah, I think it's a decent way to kind of get the word out about stuff. Well, there's, there's definitely nine people watching you right now. So, I think that's more than typically who will watch me in this, in this studio. So, so for everyone that doesn't know, we are doing a Facebook Live one today. You probably can, I think you can see it in your archives, right? If you go to, what are you?

Phillip Snell DC on Facebook? Yeah, that'll get you. Okay. So, I thought some things that we would go into today would be, since we met at that conference, you had some great ideas with your fix your own back idea, dermal traction, and your, and maybe go into some case studies. But I guess before we even start into that, I guess we should preface this and say that we're, can we say in a way that patients will understand it, but clinicians will be intrigued and say, Hey, I need to learn this stuff. Which stuff? The, the fixture on back or the dermal traction or a little bit of both? Kind of all of them. Like all, we'll, we'll go into all of them, but I might ask you a couple like dumbed down questions about say this, how would you say this to a patient? You know?

Okay. Yeah. Well, we were talking just off camera here just a moment ago about the whole dermal traction method stuff. And, um, the, um, the, okay, Bobby, Bobby says the perspective of side-by-side action is pro level. Thanks, Bobby. I think as long as you don't move your head to your left, then we're good. Yeah. So, um, as far as the dermal traction stuff goes, um, I like to think of it as an extension of the work that McKenzie did at the nerve root, the level of the nerve root and that Alf Brigg, Bob Elvey, uh, Michael Shacklock and David Butler and others, uh, did at the peripheral level of understanding and appreciating the, um, the local needs, if you will, of, uh, neurology in the human body, uh, if it's compressed beyond a certain point or traction beyond a certain point, it, uh, becomes a bit unhappy about its environment and will tend to squeal. And, uh, it's in that squealing that it's sort of asking for us to, uh, improve the local, um, histochemistry around the nerve or to improve the, uh, blood flow of the nerve itself. So, uh, what we're doing with the dermal traction stuff has just carried it out to a smaller caliber of neurology, uh, more of the, uh, superficial cutaneous nerves. And those are nerves that many of us learn when we're in school and our anatomy classes and then promptly forget them unless it's, uh, say the lateral femoral cutaneous nerve. And we, uh, you know, have one name condition for that and neuralgia parasthetica. But, um, otherwise we kind of forget a lot of those nerves, maybe greater occipital neuralgia we'll talk about, uh, sometimes, uh, in terms of headache, um, phenomena, but, uh, really all of those, um, all of those superficial nerves have the potential to, uh, contribute to, uh, neuropathic pain syndrome. And unless you at least consider that possibility and explore it, then, um, from my experience, uh, and others that are playing with this stuff, you're probably leaving a lot of pain syndromes on the table untreated. Um, and the treatment is frightfully easy. Um, it can be, uh, as simple as just manual, uh, traction over the area.

Uh, you can use, you know, cupping types of things. Um, you could use stuff like, um, uh, instrument assisted, um, uh, tissue manipulation. Uh, Steve, uh, capabianco showed us some really nice things that they're using with rock blades, uh, with rock tape and, uh, how to finesse that and using certain movements and certain aspects of their, uh, very novel, uh, instrument assisted technique there as well. Yeah. They had the door handle, right? That was the main takeaway was a door handle. Yeah. Yeah. So you got it. So for everyone watching then, can you, can you yap your own dermal traction, your own herb point for me? I'm going to live on Facebook. I'm going to yap myself. What most people don't know is that I'm pretty much naked from the waist down right now.

So, uh, you know, I'm going to have to be very careful with this. Oh yes. Yes. Don't pan that camera down at all. I'm not at all. I'm keeping it rock solid and steady up above here, but, but here we are. Look at that. See that? It's so easy. Little, little dermal traction just behind mid belly of the SCM and then some rotation. Typically, uh, according to the way that we meet out the, uh, the, the particular methodology there, um, you ask a patient or a person, um, to describe a painful movement. And then with your understanding of the anatomy there, you, um, consider the possibility of, uh, entrapment of any of that superficial neurology. And simply in this case, it might be a patient that has pain with rotation as we demonstrated in Denver at the conference. Um, you can have a patient that has restricted range of motion and pain, say with right rotation. You might go here, apply a little bit here. Thanks, Bobby. Hashtag yap your herb. Well played. So we put a little, uh, traction here and then a rotation and ask the patient whether they are, uh, experiencing reduction in their symptoms, um, with that movement. And you, uh, objectively are looking as a clinician to see if there's an improvement in range of motion. And often the, the, the improvement is very dramatic and, uh, instantaneous. Now, just as often it might be a partial improvement, maybe 30% improvement in their pain. And if so, we'll just happen to do repetitions with it like that and then take the hand away and have them to repeat the movement and see if their range of motion has improved and their pain has decreased. Um, since, uh, with that particular point, herbs point, we've got, um, uh, we've got, uh, four particular nerves that go out there that come out from right behind the SCM there. Once the lesser occipital nerve, uh, the greater auricular nerve, transverse cervical nerve, and then my favorite, the, uh, supraclavicular nerve that drapes across the whole shoulder, kind of like a shawl. It's like the sexiest of the nerves or why is that?

It is. It is. Uh, because it, it covers more areas. Um, it actually has some slivers that go to the capsule along with the, uh, the suprascapular nerve. And, um, it, yes, as the name would infer, goes across the front and the supraclavicular nerve, but often those quote unquote trigger points that we're working on in the upper traps. Um, often, uh, if you just skin roll over the trap and in that area, along the course of that, you do herbs point here and then kind of just assess manually by skin rolling along the course of those nerves and see where it feels like the tissues are a little non-compliant, uh, a little bit dense and not moving so well, then you can, uh, kind of hone in on those areas and see if it works. And that's kind of what we did with Matt Ward, um, there in, uh, Denver.

And we went to herbs point, there was no change, but just assessing each one of those nerves, we found lesser occipital involvement seemingly from, uh, the palpatory findings. And when we opened up a little bit there, his range of motion immediately improved and his, uh, pain went down. So probably the biggest thing that people get all the patients get, um, kind of frustrated with on this stuff is you teach them how to do it and they do it and they feel better when they do it. And then the pain comes back and restricted range of motion comes back a little while later. And the, according to some of the research out there and the theoretical research of Jeff Bove and such, um, we need to open that, uh, that area up around the nerve frequently to allow for better blood flow until the body starts to take that range of motion back and the impediment or threat to the nerve is not causing the muscles around there to, um, uh, splint and guard the area.

So then just to recap on a couple ideas so that you mentioned that you kind of, you can skin roll along the knots of the, whatever muscle you're saying. So you're saying that the muscular response is from the nerve being sensitized. Is that what I'm hearing? Uh, yeah, that's exactly right. Um, John Quintner, uh, the lead author on a paper in rheumatology a couple of years ago talking about the, um, the change in the paradigm that we're having right now in, um, myofascial trigger points. Jeff Bove was second author on that paper, by the way. But, um, uh, Quintner was a, uh, student, I believe of Bob Elvey and Australia way back in the day.

And, um, Elvey was fond. Um, I've, so I've been told fond of saying that, um, muscles protect nerves, muscles protect nerves. When you're looking at clinical pain syndromes and stiffness and tightness of muscle, you know, we're, we're taught readily in school how to assess those type muscles. But if we don't ask ourselves why they're tight and start looking inside of the body's reaction and how it's trying to adapt to whatever environment you've placed it in, then, um, yeah, we can just start stretching away protective mechanisms and, uh, wind up with pushback. And oftentimes those are the spasms that we deal with in working with muscles.

So, so is there a, I know you probably get it a lot. Like people come in and they talk about the tightness of their muscles. Is there, when you, when you're doing this dermal traction, just pulling on the skin, is there some type of, uh, talk that you usually have to have about their past thoughts on if it's just tight because the muscles, the root issue, or then you talk about the nerves or something goes on there. Yeah. You know, one of, one of the cool things, um, I think about doing this, and this is kind of, um, playing that balancing act these days with emerging evidence, especially the emerging evidence that is, um, that has to do with, um, uh, pain neuroscience. Um, patients come in, maybe they, you know, like I just had one a couple of days ago with pain with rotation and they, their question to me was, um, well, I've had an x-ray of my neck and it demonstrates that there's osteoarthritis in my neck. And, um, I've been to chiropractors before and they just, you know, manipulate my neck and it feels better. And, um, I've been under the impression that the only way for me to really deal with this osteoarthritis in my neck, which is the cause in their mind of the restricted range of motion and the pain is to have my neck cranked around, uh, relatively regularly by a chiropractor. And you can see without saying anything, when you just apply a little bit of pressure or tension there over that area and very quickly have a change in, um, symptoms and an improvement in function, you can see the wheels start to grind in that person.

Like, wow, uh, what did you just do? Cause you certainly didn't change my joints or anything in that area by, by doing that traction that you're doing. So you can see in that particular case that their idea of, um, of what was causing their symptoms of being possibly, uh, uh, osteoarthritic and that being in their mind, often a linear process that doesn't have a happy ending typically, then, uh, they start to consider, wow, this could be very, very simple and superficial. And even more to the point, we improve their self-efficacy and their empowerment by showing them how to do it very quickly after that. I'll often follow up and say, yeah, isn't that cool that we can do that? Well, people would talk if I followed you around all day and did this. So I want you to, uh, replace my hand with yours and now do it yourself.

What would they say if you did follow them around all day? I'm, I'm sure they would, uh, they would assume we were doing some kind of, uh, internet stunt somewhere. But, uh, well, I think it's kind of like beautiful that actually, that the skin pole is, it's seemingly so simple yet it produces a result that, I mean, if you're really like cranking on them, they would think you're getting so deep that it is something else. Right. Yeah, exactly. And, and also people in the pain neuroscience community might say, well, you're creating a whole bunch of afferent input. My, my, my traction here and in all of these areas does not have to be noxious and you can test do a same side, an opposite side test as a screen to see if, um, uh, if that is, uh, are my messages popping up on the screen? Anybody that's on here? Are you seeing this?

Do you have messages? Yeah, yeah. I see people watching. I saw Marianne watching on there. Yeah, I did. I did too. And I see Alan Jinks over in, uh, the, uh, the, uh, Holland has just checked in as well. Hey, Alan, I hope your PhD work's going well. Um, yeah. The most active person on here is Bobby though. Hey, Stephen, by the way. Yeah. Bob, Bobby always likes to get on here and go with it, man. So Bobby says, so if this is seemingly an issue of afferentation changes to the cutaneous nerves, then would stem tends to be potentially more beneficial while yapping or, uh, DTMing as we say now, Bobby, those in the know, right? Um, but, uh, yeah, potentially, um, uh, to, to my mind, this is my bias. Um, to my mind, putting more things that I have to do that I have control over that the patient is more likely to attribute to the coolness of me and my office in, uh, in, up in the forefront. I tend to shy away from that.

I want to very quickly, as soon as I do this and the lights come on and they think, wow, that's magic or that's wizardry or sorcery. I want to disengage that thought pattern as quickly as I can and say, now you put your fingers there and do the same darn thing. And when they see that they can do things, uh, do that stuff themselves just as easily, then they take the reins and now they're the ones that are actually helping themselves. It's really crappy for business quite handed and quite honestly, because you, uh, you don't need to see people as frequently, uh, in our work in order to get them better. But, uh, as I've told the students that come through our office, you just have to get really good at doing new patient exams because, uh, you get a lot of, uh, a lot of referrals for that kind of stuff. Yeah. You, you had said something interesting at the symposium that you would, you'll, you'd rather leave pain on the table.

Well, I I'll say that it's sometimes I will leave pain on the table. Um, a little bit of pain in my patients as they walk out that they, that they've demonstrated their ability to be able to, um, to control. So maybe getting back to Bobby's question, maybe rather than going the extra mile and doing the, the tens and the, and the heat and everything to, uh, also do that, uh, to help with the condition and completely take away their pain, I might leave them with a little bit of pain that they can then demonstrate to themselves that they can control. That helps to keep them a little more to my mind, keep them a little bit more accountable and engaged in their own self-care rather than saying, gosh, I can't wait until next week when I get back with, uh, with, uh, with the doc and be able to have him fix me. I thought the beauty with you working on people though, we're working with people is that they get to see your awesome salmon pants. Uh, you know, but I, I disappointed, um, this past weekend and I've, I've, I've, I've gotten a surprising number of, uh, disappointing responses to the stuff that I wasn't wearing. Um, my, my, uh, we'll call them burnt umber pants or, uh, so, um, I, I, I, I, I shit you not this just last night, I was complaining to this, uh, about this to my wife somewhat half-heartedly and she being a, uh, um, take life by the throat kind of person. She goes right on and, uh, uh, online and found, she found some, uh, some humdingers. I, uh, I will be showing up. Yes, you got it. You got it. I can't wait. Hammer time. So, uh, yeah, I might be, I might be breaking some of those out at our, uh, next Portland course, um, for the clinical companion for Fixerone back in a couple of weeks. It's, uh, uh, going to be here in Portland. Well, our third in a row sold out show. Oh yeah. Third in a row. What's the, what's the sellout on that? Yeah.

Uh, it's about 30, uh, 30 people. We put an extra 10 on board for the Seattle course. Hey, Justin, I see you just came online as well. Uh, Dr. Justin Dean is on there. He's the, uh, co-creator of the Dermal Traction Movement, uh, also known as yap, uh, with me as well. He missed everything. He missed your herb yap. Uh, yeah, we, Justin, we were just, we were just herb yapping. We were just doing it, man. You missed it. By the way, on those videos, since I was going through them, you can see like Justin is just like half smiling. He's like, uh, there was one where there was the peck wiggle like that. He's like half smiling.

Yeah. This looks, this looks silly right now. Yeah. He was, he was, he was doing his best to try to, to keep a straight game face on all of that, but it didn't, it didn't help that, uh, we were poking him in the ribs and stuff the entire time trying to get him to giggle too. Yeah. So then moving into like, just the idea of, uh, the fix your own back seminar, um, talk about that and actually how you would correlate yap into that or Dermal Traction. What should we call it? Are you guys going Dermal Traction? Yeah, we're going DTM, uh, Dermal Traction, um, method. The reason why we're going that way, quite honestly, I mean, the, the reason why we initially started, um, to call it YAP is because we're basically poking fun of the name systems of manual therapy that are out there.

You know, everybody knows in order to have a successful manual therapy technique, it has to have an acronym of three letters. Typically some are going rogue these days and using only two. I don't know how they do it, but, uh, yeah, we were, we were kind of, uh, poking fun at that whole process. And, um, the, the, the poking fun has kind of actually hindered people taking it on because they think we're just, you know, we're just joking here. I mean, honestly, when we initially put the, started thinking about putting it together, um, we were going to get people all excited about a thousand dollar weekend course. And then for the registration page, we were going to Rick roll them, but, um, we just decided that might be a little bit too rude. So, uh, now, um, we're, uh, we're just doing a, um, uh, we're trying to change the name because people legitimately are looking at doing some case studies and such. And I've done some presentations as well in, um, in front of, uh, a bunch of specialty physicians at Kaiser and, uh, standing in front of 20 MDs and telling them that what you're, uh, the reason why they didn't have to put that hip patient, uh, into surgery was because you were yanking away their pain, um, was, was a little bit difficult. So I think we just needed to, uh, to put a fresher face on it. That's a little more acceptable, an acronym that's more acceptable. I don't know. I, I think that I think kind of maybe the reason why, like I always think grassroots, like why did something like get popular as it was just the ridiculousness of, of seeing your yank and someone's pain away. It might just have been the thing that you need to keep.

Never know. It might be, you know, for, at, at the very least, probably for the, uh, the, those, uh, those out there, many of them on this particular, uh, call is on their names. I see going across, uh, here, many of them will always have yap. Yeah. You know, it's, it's kind of, it's kind of like, it's kind of like when you have a favorite band when you're younger, you know, and then when you get a little older, you're like, yeah, I knew them before they were really big. Right. So I, I almost asked you at the symposium and, uh, I asked Cody on the side, actually, I'm like, I'm like, I want to know the background of why the fist, why the double thunderbolt and why the city? And then what drugs were you on where you thought that, yeah, all of these parts need to be part of this logo. I can break that down if you want. Cause I'm big, I'm big into symbology and that kind of stuff. But the, um, the thing that I, uh, was trying to hit with that, and, uh, there's been some pushback. Some people think it's too political. Um, you know, I'm, I'm in Portland, Oregon and here in Portland, we are, uh, uh, a little bit on the, the left coast, you might say. Right.

And, um, the, uh, the raised fist, uh, symbol is sort of a, uh, a product of the, uh, the workers party, um, uh, uh, and, uh, the wobblies back in the 1920s. The, um, I actually had no idea it was going to go to Steve. Yeah. Yeah. And, uh, and the idea of that is empowerment of the people. So, um, you know, many people remember the, uh, the athletes in the Olympics that one year, um, the gold and silver on the podium that raised their, uh, their hands overhead and drop their, their head. Um, it's, uh, it's sort of a classic, um, way of saying power to the people. And, uh, part of what we're doing with this is literally putting the hands of pain control in the hands of the, uh, putting the, uh, the, the pain control in the hands of the people.

And, uh, one of my, um, one of my, one of the people that I know that this has worked on very well is, uh, is a, uh, a graphic artist by the name of, um, Bruce Zick, Z I C K. You guys should check his stuff out on, uh, online. He's, uh, he used to be, uh, and still is, I guess, an illustrator for Marvel comics. Uh, I think he's done some stuff for dark horse, but he's also done a work for, um, Wilventon studios here in Portland. And also, um, uh, he's worked with George Lucas. He's worked with, uh, uh, Coppola. Um, he's worked with Steven Spielberg and, uh, he found a lot of benefit from that, uh, yap work and, um, offered to do the logo. So the logo is Portland skyline with Mount hood in the background. The green raised this because it's a green kind of, uh, you know, uh, green party kind of, uh, uh, populism up here in the Pacific Northwest.

And then the, uh, the logo was, uh, manual therapy and music for the mass, uh, manual therapy and movement for the masses. You can put music in there too, but yeah. Well, it almost, it almost looks like an album cover really. ACDC maybe. That's the idea, man. Uh, so then, God, I don't even know where to go from there. Ken, I'm kind of curious if we can foster some questions about that. If anyone has any questions about that, uh, the, the app logo, or if anybody's got any questions at all, um, nice to see some of you folks. Hey, there's Bo Beard is on here. I hope you guys enjoyed your ski time out in, uh, uh, where was it, Bo? Copper somewhere. You were in Colorado. I know you look like you're being very patient with Sloan. Uh, Nate Cashin's on here. Uh, Nate formerly here at, uh, Western States and, uh, now is out in the Midwest. Are you in the Dakotas, Nate? I think you are.

Okay. Yeah. So if anybody has any more questions on Yap on Facebook Live, then, uh, now's the time to ask because we're going to tangent off into fix your own back. We got 10 seconds. 10 seconds folks. 2, 3, 4, 5. Hi Fabiola. Fabi. Okay. So fix your own back then. Um, I kind of, I really liked the idea that we were talking about, uh, afterwards on this and it was, it seemed like almost like an empowerment of the people as well to set up places that can assist people in realizing they have an old, their own, uh, part in fixing their back. Does that sound right? Right. So tell everyone about that and what your vision is. Um, what I would like to see happen at some point, um, is we are exploring the concept of taking the methodology we use in our clinic, um, to address, uh, lumbar disc herniation. Uh, we're going to try to see if we can put that into a clinical model in a tight, um, uh, tight, small, um, lean clinic that makes sense economically and, um, handles one of the most expensive, um, uh, drains on public healthcare in our sphere and in any sphere, uh, the amount that we spend to manage, uh, the, the dysfunction or the disability and pain associated with, um, with, uh, uh, uh, lumbar disc herniation rivals what we spend on either, uh, diabetes or cancer annually in the United States. So we're looking to take what we've seen, uh, successful in the clinical environment, um, which that spawned the online, uh, site that I put together called fix your own back, which was, uh, targeting people that have that injury and are trying to make sense out of how to, uh, fix it as much as they can themselves. And they can do a whole lot for themselves. And now we're with the coursework, uh, as more docs have asked to, um, to have a share what we're exactly we're doing in clinic. And we teach the courses as we teach them. We want to create enough people that, uh, that are out there that when people contact me on, uh, the fixture on back site online and they're like, you know, I need a little bit more help than what the sites provided me. I need some hands-on work. I'd like to be able to refer them to people that have been exposed to this type of, uh, work so that, uh, that can help to improve the, the, the attendees to the course, improve their, um, uh, uh, patient recruitment.

And, uh, ultimately, uh, similar to what you see in other venues out there like a Rosti and such, uh, put together something that looks like a, um, a training center here in Portland and have people to come out and train. And then we could take our, uh, uh, marketing program into their community, license the, uh, their clinic as a fixture on back clinic, and then go and help them, um, reach out and liaise with local physicians, uh, MDs where those patients are and try to get those patients into their clinic and try to solve a problem. Uh, it's a public health issue. And this is a way, one more way to leverage, leverage technology to try to, uh, solve those problems.

So then I, I'm, I'm trying to think of some questions that some consumers might have. They're like, well, you have a fix your own back thing, but then you're trying to send me to a clinic. Can you elaborate a little bit on that? Uh, well, people, if people are in pain and trying to deal with this, as you well know from your work as well, um, they, they are looking for solutions and there are painfully few, pardon the pun, um, out there for them to manage that. Once you get beyond something that looks like, um, McKinsey or MDT kinds of treatment, and then you see people put into the, uh, the McKinsey purgatory and, uh, all they get is just repetitive end range loading, you know, lather, rinse and repeat. And they just do that. And that's the only thing they've got that nobody really bothers to spend the time to discuss with them the mechanics involved and the actual injury and the power that they have to prevent those, uh, injurious movements. So yeah, people will, um, um, they're looking for somebody to be able to help them. Um, I don't know if, uh, you know, I'm sure there will be some cynics out there. I think that this is just, you know, some kind of a, another glorified way of, uh, of, you know, getting people to into a clinical process that they don't really need, but you know, those cynics are going to be around. Um, I think folks, folks that know me and folks that know the kind of work that we're doing know that the, uh, the root, the root at what we're doing here is trying to help, um, from a public health standpoint and trying to empower patients. So, uh, the haters are always going to be there. Haters going to hate.

That's a Pikachu always said, I think. Yeah. Um, yeah, I mean, I, I, I agree with that. It's, um, it's funny. Actually, I was talking to Cody the other night cause I, I actually, it's funny. I did a, I did a podcast on how I had successfully defeated back pain years ago. And then right after that released, I had another episode, right? It was years and years later. I didn't knock on wood at that point. It was kind of a pain in the ass, but it wasn't really bad. So I went over to Cody to get an eval after about two weeks cause I realized that, uh, I was doing a poor job of managing myself or I was missing something. Right. So I've managed, he gave me some recommendations. I managed myself for probably about two, three months now and now baseball season is here right now. And this is going to release later on the podcast. But so I typically pay, play baseball and I've been asked like, Hey, are you going to play this year? I'm like, uh, I, and I realized at that point I have fear avoidance. Right. So I'm like, I feel good, but there's another problem here. So me and Cody were having a beer and I was like, look, I, I, I want you to manage my case and I want to go to someone like Brennan to then apply load because there is that purgatory. And I don't think, I personally think I'm too emotionally close to the injury where I cannot make a solid decision. And so when people manage their own back pain, I'm sure they only get so far, they get a success and then they need somebody. Right. So, so, so let me, let me ask, let me ask you, Seb, in that particular situation, what is it? Um, when you think about going back and playing baseball, what position did you play?

Outfield. So when you think about going back and you think about all the demands of you playing outfield and, um, and batting and running the bases, what's the first thing that comes to mind that you're wondering, I don't know if I can do that. Well, the first is that I realized that I've spent enough time over the last few months, not conditioning myself to play, which is concerning because you just can't go out and sprint. So general physical preparedness was lacking. Right. Um, and then if I would have thought about it a long time ago, I should have been doing that months ago. Right. Right. Um, probably the other thing is, so I've had a past history way back. My first back injury was in high school. Um, but it was from an impact at a base. So I'd say a little bit more traumatic, but eight months of rehab and all that kind of jazz and finally got back and very first swing, first game, first at bat, it hurt again. Yeah. It was like the swing.

The swing is what would get most people. And, and so, I mean, for, for those in FMS world, you know, that's a, probably a rotary stability issue. And, um, on the, the site, the fix your own backside itself, um, the way the thing is organized and the way that we treat it in clinic is you have an ordered process, uh, that you go through and rotary stability, uh, is part of the chapter five, uh, in the nine chapter program that, that goes along on the fix your own backside and what we teach in the, uh, the courses. So, um, before you get to that point, you would have already gotten well to the point where you are in your rehab now, and you would have demonstrated adequate endurance in your course, uh, your core muscles, um, per, per, um, McGill's functional capacity evaluation. And, uh, then, um, and then the, uh, beyond that, um, you would start to work on mobility in the hips and the upper back, uh, another area that would help to play into your, uh, to your swing there and making sure the power's coming out of your hips instead of applying power to the lower back while you're in that swing. And, uh, then you'd work on putting those together and using movements that look a lot like, you know, chops, swings, pal-offs, and that kind of stuff to really build, uh, your ability to manage load in that area. And then once you've got that in that, uh, have achieved some of that in the, um, the rehab setting, uh, then you go, go out and take a bat and start smacking on a heavy bag, you know, working on your strides and really getting a sense of how to apply load in that way and doing the same thing with your throws, uh, which is also going to require that same kind of thing.

Yeah. And that's definitely, um, uh, thanks for the advice by the way. Um, not always time you get, you don't always get this opportunity. Um, but yeah, yeah. So I agree. And what I experienced and see with people, um, is that a lot of them are very, they're very much okay with like, hey, I don't hurt. I think I'm not going to do that. I'm too old now. Right. I don't want, I don't want to feel that. Um, so I think that's why I think a program you're putting together is really good. Um, Bobby, Bobby has said eight months of rehab, dang, it must've been an injury. Um, actually, I don't think it was necessarily, they actually checked to make sure there was no, uh, parse fracture, which has a possibility. But, um, uh, I think actually, I think the first, uh, I think I take it back. It was five months of terrible or terrible rehab. And then three months, three months of better, the five months I think was when the swing reoccurred. I basically lost nearly an entire season. So, um, that's why I think it was eight months. It was just non-successful.

It was, it was not, it was a lot of, it was a lot of rolling, a lot of rest, a lot of ice, a lot of heat, things like that. It was very passive. So it didn't really allow me to do the stuff like your rotary stabilization and so on. Right. Right. So I'm sure that you see a lot of Clint. Why did you, why did you create the fix your own back thing? Cause the, you must seen there's a, there's a void out there. Um, you know, there's a blog on the site and there for, for those that are bored, you can go and read, uh, a, uh, one of the posts called, um, for the sake of Carl. Uh, the, the reason why I actually put the site together was kind of a, uh, a moment with a patient.

Um, and after taking a, a big burly guy that lifts weights, um, a lot, and that was kind of where his identity was, he'd been sidelined for months with a disc injury and in severe pain when he came in, um, after taking him through the first hour or so of, um, of our work, uh, I had him pulling weight from the floor again for the first time in many months. And, uh, he sat down and he started to cry, uh, in front of me. So it was a little bit of an awkward moment. And, um, I asked him what was up and he looked at me and he said, where in the hell was I supposed to learn this? And I didn't have an answer for him. Um, the, the idea of taking multiple disciplines of rehab, multiple disciplines of, of, um, of, of lines of inquiry in, in, uh, in the research and leveraging all of that into something that is easy to understand and easy to apply and damned effective at, at taking care of something that, you know, is among the, the more difficult pains that many of us will have in a life. I know I've had it. And, uh, that eight, nine or 10 out of 10 pain that really goes right to the heart of you as a man, especially with your, your feelings of, um, you know, uh, your feelings of whether or not you're going to be able to earn a living and provide for your family, um, with, especially with women that are dealing with young kids and such, whether or not they're going to be able to actually manage, um, uh, uh, being a good parent and taking care of the, uh, the needs of their children. This, this cuts right to the core, um, for a lot of people. And, um, I've, I felt like, uh, you know, I read Dante's Inferno and there's a, there's a special ring of hell, um, reserved for those that knew better, but didn't. And, uh, I, I've, I've always decided that, uh, I don't want to belong. I don't want to wind up in that particular place. So I'll, uh, stay out of there. I think, I think it's a good, it is a good thing. The, uh, I know I've, I've thought, I think, I think I might've told you about this when we were there, uh, that, um, I get frustrated with, with people coming in or not, not the people, but the, the lack of knowledge they come, they have come in and at least about very basic things surrounding their body and injuries and pain and so on. And I started, found myself just like, you know, like bitching about it. Right. And I'm like, I got to write to bitch about it if I don't try to do something to fix the problem. So I don't want to be in that ring of hell either. Right. And, and for those of you, uh, I'm just noticing here to the different folks that are, you know, coming and going on all of this, uh, for those of you that have listened to some of this and you think, uh, that you or some of your colleagues, um, might be interested in coming to some of these and just, um, put their name on here and put the, uh, put their name on so that they can come and get a little bit of an idea about what we're doing. We've got a course coming up, uh, and, uh, our next course that's not sold out is all the way out into, uh, I believe it's April, isn't it? Eric Haroldson, um, in Minneapolis. And, uh, then we got a course in LA and, uh, in, uh, June as well.

And Ben Ramos who just came on here is going to, uh, be the host there. So if any of you guys in say Minneapolis or LA, uh, areas think that, uh, you know, people that might want to come to that course, just tag their name on here so they can get a little bit of an understanding of what we're doing. You do have a true mastery of Facebook. I would have never thought that. May 5th and 6th, Eric says for, um, uh, um, the course in Minneapolis. That'll be just after my birthday. So we'll, uh, uh, Eric tells me we're going to have some, uh, what was it, Eric? We're going to do a, uh, a tri-tip or was it a brisket? I think it was a brisket and some homebrew.

So we'll have a good time. Homebrew, moonshine or beer? Uh, beer. Okay. Um, haven't had, haven't had the other since I left North Carolina once upon a time. Well, you do have glasses on, so maybe you had a little nip of it. It could be, it could be. Um, got it. You're 16th and 17th in LA and, uh, Ben Ramos is saying, uh, you better be there, Seb. Yeah, it's funny. We were, we were actually doing Instagram the other day and like, he kept sending me all these, like, go to this, go to this, go to this. I'm like, God, you're a fucking hype man for like all these like, yeah, uh, you, you will not find, you won't be able to catch up with Ben.

Ben has been running at that pace for so many years. I know a few people that have taken more continuing education and have applied themselves, uh, more diligently than that, that man, um, he is truly a force of nature and, uh, anybody down in the San Diego area that needs some help, check out flow force rehab and, uh, Dr. Ben Ramos. He is, uh, Ramos, not Ramos. I'm going with Ramos. I don't think he didn't deserve the right to have a correct name. Kind of like Teslas. I call them Tulsa's honestly. They don't deserve the right. Um, oh, so because this podcast is going to come out later than I think may, where would people find the, uh, next seminars if they were hearing it on there? Cause I'm sure you're going to add them to a site, right? Yeah. If you go to, uh, fixtureownback.com at the top of the page, there's a, uh, heading tab for, uh, clinical courses. And we try to keep that updated as well. Uh, at this point, we've got, um, the next course in Portland, which is sold out the next course in Seattle, which is sold out, uh, after that. Uh, then we've got Minneapolis, uh, in May, uh, LA and June. Um, we're looking, right now about the possibility of putting a course on it in July and New York, upstate New York and Albany. Um, we're, uh, out in August so I can take a little rest. And then in, uh, September, we come to Vancouver, BC. Um, then in November, we're looking at going into the great white. We've got, uh, Toronto and, uh, we're putting Winnipeg on the books now in November as well.

Nice. Um, look at Ramos down there. Ramos. So, and for everyone on that podcast, uh, uh, Ben's a huge hype man. Um, and so if you want a huge student discount for that course, it is flowforce, uh, rehab.com slash forward slash Dr. Philip Snell, which has those little, wait, all those, all those sub headings always have these little dashes in them. So put those little dashes between his name. Um, yeah, huge hype man there. Yeah. He's, he's a master. Yeah. Um, so for everyone that's, uh, at least watching on Facebook live, or we're going to foster some questions here, uh, we've spoken about dermal traction. We've spoken about fix your own back. Is there anything that you actually want to hear Dr. Snell speak about in those realms? Or is there anything that you really want to ask him, but didn't want to ask him to his face? Yeah. You want to hide behind your computer, man? You know, I feel, I feel like that whole interaction right there of like you getting close to the camera. I feel like that should be on the face of your website.

Come on, man. Screenshot this. Yeah. That, okay. I'm going to, Oh, DMACC came on. Oh, DMACC is here. We've been talking about Cody. Seb was mentioning Cody. This is Z Cody DMACC. So Cody, um, yeah, I said, I said, I said that our talk about the other night about how we're going to co-manage a little bit. Um, and, uh, Cody was actually going to bust in here and, uh, jump in the back of the screen and say, Hey, if we were still recording, but he had some patience. I'll imagine that man's got to work. Yeah. Right. Um, Cody come up with a good question that we can answer here. Um, cause you're going to tanned out some other things. Oh boy. I can't wait to hear this. Yeah. If you do, if you don't ask a question, I want you to get off of this, uh, thing. Bobby, by the way, uh, um, thanks for that. I saw that comment earlier. Thank you very much. Um, okay.

Dr. Snow, what's your, uh, what's your, what are your home is to say homes, dreams, hopes, dreams, and inspiration. Hopes, dreams, and inspirations. Huh? Um, you know, I just really want world peace, Bobby. And, um, uh, an end of the strangle, an end of the stranglehold of the NRA on politics in the United States. And, uh, I'd like for us all to just get along. You need a teddy bear if you're going to say that. Okay. Yeah, I do. Uh, I'm right here in my bedroom. I can reach over and grab the one that's right here on my bed. I'm sure you have like 15 throw pillows. You look like a throw pillow kind of dude.

I am a throw pillow kind of dude. Um, so, uh, then bring, bring to the two concepts together of, uh, let's see. I'm looking forward to Snell's course, a little rehab. Oh, the little, it's harder. Yeah, that's, that's Brian Gervais. He's, uh, one of the folks that's helping with, uh, putting the course together in Minneapolis with Eric Haroldson and Eric, uh, Reese. Oh, well, thank you, Eric. Thank you, Brian. That's very kind of you. Uh, let's see. Oh, screw you, Cody. You're actually going to ask real questions. Does passive extension really push the nucleus forward? Depends on who you ask and, uh, and who the patient is.

Before you, before you answer that, can you break that down into patient terms? Does standing up or laying down and bending backwards a whole bunch push the contents of the disc away from the nerve root? Uh, yeah, some of the McKinsey, uh, literature would suggest yes, uh, there was a paper by Jarvik, uh, that, uh, Mike Shacklock talks about in, um, his course. It's only, I believe if memory serves a cohort of nine people on, uh, MRI and, uh, thanks, Ben. Does the carpet match the drapes? Um, the, uh, the, uh, but as far as whether or not it actually pushes the disc away, um, when you do extension in that way, if there's a, a huge loss of hydrostatic pressure in the disc, then you can wind up with more likely, uh, delamination of the, uh, lamellar layers in the, uh, posterior portion of the disc. Um, if you can imagine that, if you've got layer upon layer upon layer and the hydrostatic pressure has lost so that the, um, uh, that there's not quite as much tension on that structure when you start to push, uh, then you'll wind up with the lamellar layers kind of separating like this. You've got part going out, part going in, and you're not, you don't really have the mechanical effect that you're, um, uh, that you're going to get. I'm not sure if I should repeat what, uh, Cody just said, but yes, yes, it does. Yes, it does, Cody. Um, and I, I've, uh, I was enjoying those Odell, uh, uh, beers there. I gotta say as our first Facebook live or at least my Facebook live podcast, um, I, I admire your dedication to not being distracted by these, uh, things flying across the screen and all these random questions.

Yeah. My, my, my, my focus game is strong. Tom Lotus, uh, joined on here, Tom, uh, great to see you here. Um, this guy is doing some truly remarkable stuff with the, uh, the folks at Research Institute in Chicago with, um, uh, Annie O'Sullivan and those, those folks with the, um, uh, pain classification. Uh, really like what it is for those of you that haven't, uh, taken in a world of hurt course or read the book world of hurt. You really ought to check that out. Uh, Brian Gervais has just had a new patient leave. His right leg was a mess. He had a prostate removed three days ago from his leg brain. Um, legs are in stirrups and cause significant pain.

Uh, zero strength, zero to five hip flexion could not lift only drag. Oh boy. Any tips will be helpful. Uh, Brian, that's a little more complicated and we're going to get in a Facebook, uh, uh, Facebook live there. We'll have to, uh, maybe PM that a little bit later. Let's, um, can we, can we go over a, a typical case then that you think that you would take through since we've talked about dermal traction, we've talked about fix your own back. Um, what is it, what's a typical type of presentation that you think would be awesome for this whole progress? Um, the, uh, I'm, I'm hemming and hawing because I got to be a little bit careful here because we had a, um, um, uh, baseball player in the clinic, uh, a few weeks ago. And, um, I think I talked about this in at least one of the sessions that we had at, uh, in Denver, but, um, um, one of my, uh, associates, uh, Dr. Um, cook, uh, Corey Peterson, who's absolutely fabulous doc, um, uh, works right there with me in the office in Portland. Um, Corey saw this guy and, uh, he'd been dealing with lower back pain and some radiating pain into his leg for, um, three months. Uh, the injury came, uh, from deadlifting in the gym. Uh, it was a pitcher pulling, uh, over 400 from the floor deadlifting. And, um, you know, I've got nothing in the world against deadlifting. It's the, the, the base note of what we do with the fixture on back program to, uh, help people with their, their, uh, their disc injury. But, um, he had injured himself with that was taught, uh, or was told by his orthopedist, uh, based on an MRI that the injury to his disc was not significant enough to be causing the symptoms that he was having. So then he was sent to a physical therapist here in town who, um, uh, well-known, uh, individual who following the doctor's, um, uh, notion of what was going on there decided that Jefferson curls were the things, uh, the thing to do with this guy. And he seemed to be getting worse with that. And that's when the, uh, uh, he was referred over to our clinic kind of, um, not in their referral network where he was, um, uh, where he was associated with. And his primary symptom, um, came on when he was studying, when he would be sitting with his legs outstretched in a chair in front of him, and he would bend forward to try to touch his foot. And he would get a zing down the back of his leg that was very reproducible there. And those of you that, you know, understand your orthopedic tests, it looks a whole lot like a seated slump test, right? So, uh, it was like shooting fish in a barrel for, uh, Dr. Peterson. And he very quickly had him, uh, uh, in the assessment and had him dialed, uh, had his pain gone, uh, for the first time in three months in the space of one office visit, and then has been progressing him steadily now to, through the strengthening program that we use to get him, uh, ready for spring ball a little bit better. So, um, the other things that we would throw in with that, um, you know, uh, Justin, uh, Dr. Dean, uh, put a video up not too long ago. Maybe he'll put it up on his, uh, profile page again of working with, uh, one of the athletes that we've seen in our clinic a lot, uh, Chris Duffin and helping to troubleshoot some other things that were going on and Chris after a back injury as well. And, uh, Justin found some involvement in a posterior femoral cutaneous nerve that helped to open up his range of motion very quickly when he was using that.

So, um, again, the, uh, the parlor trick of, um, the dermal traction method or yapping, uh, as somebody said during the course in Denver, um, you can't overlook the functional causes or the other structural contributors to the pain syndrome that is in front of you. You got to be, uh, thorough on all of those fronts. And just because you can make their pain go away a little bit with, uh, the dermal traction method, uh, you really probably shouldn't lean on that to be your, uh, end all be all. You should be doing other things as well. Well, I would imagine then with the, so with the dermal traction on, uh, on most people, then is it an attempt to get them to number one, desensitize the nerve and then also get them to manage their own pain, right? It's not an end all fix.

Correct. Um, yeah. I mean, if you think about it, uh, you know, the presence of pain with a movement pattern, it's going to cause adaptation. The body's going to move to try to avoid that pain. So you, it gets in the way of the rehab that you're trying to do. Um, so if you can get that pain off of the table relatively quickly so that the patient can move a bit more authentically, if you will, for lack of a better word, then, uh, it's a good, uh, it's a good place to go. And, uh, I think, and, um, and, and do that to try to get a little better quality movement and then maybe have the person do that before they do their workouts or their, um, their other, uh, athletic endeavors to try to get that out of the way. But you, from a functional standpoint, also want to be, you know, using your other systems of assessment and, uh, and, and such to try to figure out what the, the reason for that irritability and that neural, uh, those neural structures is. Okay. So, um, what would you tell a student who's graduating right now from PT chiropractic school or med school that they need to know about back and yap dermal traction?

Uh, I, I would, uh, I showed a video, um, there in, uh, Denver that, um, I've kind of kept under the wraps for a few years. Um, but I think it's worth pulling it out and getting a little scrutiny on it, but I would say, um, be neurocentric in your approach. Um, as LV said, uh, muscles protect nerves. So if you're not fully screening the neural compartment, everything from the smallest caliber neuro with the superficial and cutaneous, uh, nerves to the larger caliber neurology of the, uh, peripheral nerves to the nerve roots themselves to the, um, the top down phenomenon, the belief systems and enculturation associated with, uh, the, uh, that person's pain syndrome and their, um, uh, the, and the BPS model, uh, the psychosocial aspects there.

So be neurocentric in your approach, look for all of those, uh, irritability in all of those areas and work out from there. Um, Ben says, uh, I would tell them to come to the LA, LA course June 16 and 17. So I, I couldn't disagree with you. Right. Hey, Ben, what would you tell the public or the students, uh, the best food to eat the first year out of practice since you have no money? He's gonna, he's gonna roll with ramen. I'm sure. Yeah, it's probably good. It's good. It's good to see ramen there. Uh, I'm, uh, I haven't seen you in years, buddy, since, uh, down in Phoenix. Um, is there anything that you would like to recap as we start to close here? I mean, how can people reach you? I know you've got a couple different sites. Which one do you pay attention to the most?

Oh boy. Uh, that's, that's a great question because, uh, it's, it's, it's, when we haven't even talked about the third site, that one's my rehab exercise, which we're rebuilding right now, trying to get the dust off of it and, uh, make it work, um, a little tighter. Um, but, uh, yeah, you can, if people are trying to get in touch with me, Facebook here is a good way to go. Um, my email is drphillipsnell at gmail.com. That's two L's in philip. No dots, dashes, or underscores. Um, so those are good ways to get in touch with me. I do, uh, have an Instagram account and a Twitter account, but I, I pay, uh, much less attention to those feeds.

Mm-hmm. Um, I actually, I was going to tell you my, like, I, I liked actually the, the app course or the, uh, the, the platform. I think you guys did a really good job of videoing. Um, and I love the over voice. I was having your, your, uh, your voice echo in my sleep for a while there. Cause I watched enough time. That's, that's a little, that's a little creepy, but, uh, I'm just going to let that lay there. That's, that's what happens. Right there with my teddy bears. Yeah. And your, and your 15 throw pillows. No, it honestly happens. It's funny. Like when I was, I had any, any person I interview, I typically go through and I listened to all their podcasts, right? And if they have podcasts, videos, all that kind of stuff. So I make sure that I'm, I'm aware, but so actually this happened with McGill's stuff. I was, I listened to all of his stuff and then we talked a couple of times and I was reading his book and like, I'm like, I literally can hear your, your Canadian voice in my head. Yeah. So, um, yeah, I think that's all the questions I have for you. Is there anything you also want to say to people on Facebook live here before we close it out?

Uh, it's just fun. Uh, it's fun to kind of do these, uh, these types of thing and, um, and see the folks that I've become acquainted with a little bit online and have seen it, uh, at other venues and stuff over time and, uh, brings a smile and, uh, nice to see you guys out there doing good stuff in the world. Bobby, uh, Bobby Mozafari, when are you, uh, where are we going to see you? Which one of these courses? Um, and, uh, Will's coming on there at the end and Will, thanks for your help with, uh, my patient that I sent down to you a little while ago. And, uh, Bobby, where are we going to see you?

Where are you going, Bobby? Bobby, where are you going? But by the way, everybody, if you're, if you're looking to listen to this on, uh, the actual edited version later, uh, the podcast is Performance Place Sports Care Podcast. You can just find it on iTunes and Google Play and all that jazz. And, um, just want to make sure you can find all the stuff. We got other good people on there as well. Uh, yank away the flute. You just didn't do it right. Just didn't do it right, Brandon. Yeah. Yeah. You got to grab the tongue. I think you got to grab the, the uvula. Wait, what, what, what connects? What neurology connects to the lungs?

Don't start with me, man. Right. Um, okay. So, um, usually I say stay on the line and we'll talk after, but I don't know how this is going to happen when I shut it down. Um, uh, I'll tell you what, I'll close out the podcast here and then we stay on Facebook live until we want to close it out. Okay, Ron, that was an awesome interview with Dr. Philip Snell. Uh, the contact, so you can reach him at is yankawaypain.com. Uh, I don't know if that domain is going to change one day since they're changing the name, but I guess you can always, I, hopefully they would forward it on. So I have personally got on the site. Um, there's some interesting stuff on there and which I have used with patients that surprisingly, surprisingly, it sounds ridiculous, but yanking on the skin, pulling on the skin relieves pain with some cases, especially the ones that I've found is the, uh, front of hip groin pain. Surprisingly that works. And I honestly think in cases like that of, uh, hip pinching or hip labral tears, I think is overly diagnosed. Um, and even cases of impingement, uh, sometimes they're missed, but sometimes they're actually neural based, which is definitely a different course of action than if it was actually the hip itself. The other one is fixyourownback.com. Uh, go on there and reach out to him. He's a smart dude. He's nice. I'm sure he'll get back to you. Check out his Facebook page as well.

Um, if you guys are students and, um, this podcast obviously got a little bit technical, um, so I'm guessing the students, the only ones who lasted this long, um, or, or clinicians rather, if you're a student, actually, I'm, I'm beginning to put some more content together for you. After I went to the seminar that I met Dr. Snell at, I started to realize and just observe a lot of these students there. Um, the students were, they were great. I mean, they were, I wish I would have practiced closer to what they did when I was their age, but the, the questions they asked were, and this, I don't want this to sound like a bad way, but they just, they, they didn't know some basic things that are going to be needed for them to excel in their practice. They, the unfortunate situation is that like, so a lot of these students are very, the, I think they're very mindful of, um, creating, uh, treatment plans and treating patients very, uh, very, very well for what the patient has. You know, they, they organize things very uniquely for the patient. They do what's, uh, within the patient's self or a wellbeing first.

So I want them to keep practicing this way, but they're going to run into a couple, uh, problems as they come into their first year of practice, especially if they're starting their own. So I created on the way back from the seminar, I was on the, on the airline, just typing this furiously. And I finished it about three days after returning. Um, it was things that I think that they should know within the first year of practice. And they're things that I wish I would have known and that I figured out over time. Uh, one thing is just, you're going to run into a situation. If you are, if you are a new doc that you're going to owe, I owed 125, 30 grand. I don't even remember anymore. I had friends who owed $250,000. I mean, that's a lot of money to have to pay back. And it's freaky because you don't have any patients. You don't have any means to pay it back. And that loan is like student debt is like the worst because you can't, you can barely write off the interest anymore. So I wrote a whole section of the book just based upon how I paid off my loans within 10 years strategically and ethically. Um, there's a lot of other things that I will go into, I go into as well that I wish I would have known the first year of practice. So I want to make sure that there are a lot of good docs that remain, um, to their, their standard of care that would they have when they started, you know, being very excited to work with patients and, um, creating plans and treatments very unique for what the person needs. And I want to make sure that finances and hardships along the way, the first couple of years are not something that, that, uh, provides an issue or barrier for that. Um, you'll be able to find that ebook when it goes live. I'll put it in the show notes, um, as well as I will put it on to the podcast, uh, or sorry, the, uh, the website.

So that's p2sportscare.com. Uh, if you're looking for the show notes on this, it's slash the session number. Uh, I don't know what session number is off the top of my head, but you'll see it right there in iTunes or Google play or whatever the title of this episode is. So you'll find it in there and please download that book. Uh, it'll help you a ton. And remember, uh, the golden rule, you have to leave people better than how you found them. So make sure that you make someone's day today. Talk to you guys later.