How nutrition affects sports injury healing and arthritis

This is the Performance Place Sports Care Podcast, session number 43. I slap it to bass, big time. 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. Hey, it's Dr. Sebastian Gonzales again with the Performance Place Sports Care Podcast. Today, we have a guest on. He is going to be an amazing guest because we are talking about something that a lot of people actually don't know about. And it's really important if you have arthritis within your family, if you have a history or family history of rheumatoid arthritis, osteoarthritis, musculoskeletal injury, if you think that back pain and joint pain runs in your family, this is going to be a great podcast for you to listen to.

And so, this is Dr. Silverman is going to be the one that I'm interviewing. His name is Robert Silverman. And we met about 10 years ago at a conference, and I haven't spoken to him in a long time. We kind of dropped notes here and there and so on. And it's funny, we just started, I don't remember how we started talking at the conference, but it was interesting to see that he was putting out so much information in a very unique way. And back then, about 10 years ago, I didn't even think about doing things like, I just started doing videos and whatnot. But he was actually kind of creating a talk show a little bit.

So, he's putting his content information out there really uniquely. So, when we spoke recently, he said he wrote a book. It's called Inside Out Health, A Revolutionary Approach to Your Body by Dr. Robert Silverman. So, we're going to have him on. We're going to talk about things like how nutrition is important to arthritis and how things like tendonitis and joint pain and all the common things that you would get that you think are from overuse really are from chronic inflammatory states. And just to give you a little bit of history on Dr. Silverman. So, he's actually a diplomate with the American Clinical Board of Nutrition.

And this is actually really hard to do. Actually, he's one with the Chiropractic Board of Clinical Nutrition as well. I don't know if I've told you guys that I am actually a diplomate for the sports physician in chiropractic. And, I mean, it's a long process. I mean, we, I think, I spent about two years doing it. There was a lot of studying. I have quite a few colleagues that have gone through it as well. And you do learn a lot. And it's not an easy thing. And I know in ours, we had to provide, we had to make a research article. And mine was on Achilles tendonitis. So, it was a long, long process.

It's not an easy thing to get. In addition to that, he's been on Fox News Radio. He's been on Fox News, ABC News, CBS. Let's see what else. Wall Street Journal Live, it looks like. So, he's had a lot of publicity on these. And actually, if you look through his website, which is drsilverman.com, he's got a lot of certifications. I mean, like, it's like word soup after his name. So, he's going to be a great person to tell us about nutrition, clinical nutrition, why it's not just about getting shredded, and it's about the health, about the insides, how your insides look, not just your outsides. So, let's get right into the interview with Dr. Silverman.

All right. So, this is Dr. Robert Silverman. Dr. Robert, say hey, and tell us about yourself. Well, it's great to be here. Thanks, Sebastian Gonzales. It's my pleasure. I'm a chiropractor like you, and I started out specializing in sports injuries. I think that it was an excellent choice. It's so exciting to work with people who are sports-oriented, and really, the great thing about athletes is they understand their body, so you can get an immediate feedback and impact. And I've expanded on what I want to incorporate with people from the musculoskeletal sports that I wanted to start to do more functional medicine, and what I mean by that is adding nutrition and fixing the systems that may be malfunctioning in someone's body versus just looking at a symptom, which is truly the medical model of 2017, and unfortunately, it appears to be beyond.

So, I kind of incorporate manual rehab with nutritional biochemistry to kind of fix the body from the inside out. So, how many, I guess, rough percentage of cases of sports injuries, would you say there's a nutritional component to it? You know, I would believe there's a nutritional component to them all, because when you think about it, one, injury. Nutrition is a key component to help get the nutrients in, to help specific ligaments and tendons and muscles and cartilage heal. Even bone, then when you look at nutrition, nutrition is a key component for overall performance. You know, athletes are under tremendous strain, and they need specific or more nutrients than the average person.

And then overall wellness. And you know, one thing we don't look at in our athletes enough, and it's kind of disconcerting, is we don't look at their immune system enough. We take for granted that they're human beings, and we never think they can catch cold. And I can tell you one thing, if LeBron gets a cold tonight, it's game one, it's a problem. Yeah, I think you just dated the podcast right here. Bro, by the time they listen to it, we're going to know who wins the whole series. Well, that's all right. I'm a Knick fan, so my guys have been home for a while. Yeah, yeah. So, you bring up another point there, is that with the nutritional aspect, I know especially with young athletes, college, not necessarily as much as high school, but college athletes, I mean, they eat, I think a lot of them don't eat very well.

And especially, I know with distance runners, with female ones, there's, I think the rough estimation is about half or two-thirds have eating disorders, what do they call it, female athletic triad, or? Yep, female athletic triad. Yeah, so those people, I mean, those type of people, do you, how many bone injuries do you see on people who don't eat well? Or how many tendon injuries, is it only usually certain types of cases? Or is it widespread? You know, it's a great question. Number one, the college athletes don't eat well. I mean, my goodness, if you've ever gone to a college dorm or a college cafeteria, you see it really looks like institutional food.

It's all carbohydrates, it's all white flour, it's all things trying to fill somebody up for the next half hour. To speak to the female athlete triad, that is a great example, because the triad is that they have some sort of caloric debt or they're eating a poor diet, therefore that's part number one. Number two is they get amenorrhea, they have a menstrual cycle dysfunction or not having a menstrual cycle for a period of time, all leading to bone mass loss. So that's an interesting cascade where diet or lack of proper nutrients and energy lead to bone mass. And a lot of these college athletes, i.e., let's look at the females, will have this amenorrhea issue.

And that's something you have to check with even a retired female athlete. When you just look at your college athletes, they don't have a place to go. They don't even know who to ask. That'd be a great book, Sebastian. That may be the next thing you need to do. You do nutrition and sports performance for college athletes because they think like a tuna fish sandwich on white bread is the way to go or eat more potatoes to get big. Yeah, I could totally see it. Like, we'll show them how to go down the freezer aisle and look for Carl Budding with maybe some Hawaiian rolls and stick them together. I guess, yeah, and that would be actually nice having like a cookbook of things that they can actually eat that is easy and quick because a lot of times it's an issue with timing, you know?

So, but so you brought up a thing in your book and I did mention in the introduction that you have a book and I've been reading it and I got about probably 50 pages in and I had to stop on one section just because I thought this is a really good lead way into this podcast here. And on page 41 of by everyone, by the way, everyone, but the book is called Inside Out Health and you should look for it. I'll put a link onto the podcast notes and there's a section on page 41 where it says the arthritis link. And as I read through, it was talking about the introduction into the arthritis process, which everyone obviously thinks is a wear and tear of age.

Can you explain a little bit about like how tendon injuries then become the whole process and how this kind of starts? And it can start in high school or college or whatever, right? So Absolutely. And arthritis, unfortunately, has been called wear and tear. And that's what most of our patients and athletes think it is. And it is truly not. Arthritis is the body's poor response to inflammation. So you use the idea of a tendon. So when you damage a tendon, you strain it, if you will. You pull on it. Inflammation sets in. And inflammation, believe it or not, or low level inflammation is actually quite good for an injured tendon because it allows it to heal.

Most of the time, most of the problems is we have too much inflammation. When you have too much inflammation, it floats around systemically, damages the joint. And that's actually the start of arthritis. And that is the biggest key. And that's what I tell all my healthcare practitioners and all my patients. Arthritis is the body's poor response to inflammation. It is not wear and tear. Yeah. I saw the section you put on the, uh, uh, in the book as well. It was talking about a study from Stanford as well. They were saying that, uh, the RCO arthritic cartilage damage is basically, um, it's just, it's a, it's a beginning of the process, right? Or the inflammation is a beginning of the process. Yeah. Inflammation is without question, the beginning of the process. And the Stanford article was great in that, uh, they tested chicken soup with vegetables and they actually started a whole cascade of studies. And eventually they found out that a very undenatured collagen or chicken sternum, we've heard of bone broth and undenatured collagen and things of that nature, because it's cooked at such a low temperature, we don't break up the protein helix. It's a fabulous supplement to take to help with any kind of joint injury or slow the arthritic process in the joint down.

So if you, so then in theory, if we cook chicken soup at a higher temp and boil it, would that denature or break down that protein enough to where it's not really as usable or? Exactly. Now that's the problem. If you cook it at a high temperature, denatured, you break it down, you change the protein helix. And therefore when you consume it, it would now be inflammatory. First, if you do it where you keep it in the proper helix, it's now, um, health, um, healthy for the joints. It's very interesting. People say, well, look what I ate. Well, how'd you prepare it? Then if you really want to talk about food and whatever, whether it be chicken, meat or whatever, it's a bigger question is what did your meat or your source of food eat?

Yeah. Isn't there a, is there, I know that some people are, uh, I think it's called raw vegan or raw, right? They, they don't eat over a certain temperature. Is it like one 10 one? I mean, it sounds almost more than room temp sometimes in hot, hot places. Is there, I mean, is there something to that where we're not denaturing the proteins and the, um, aspects of the food? Well, yeah, that, that's the key component. They want to keep it as intact as they can, and they don't want to cook it. So they lose the enzymatic reactions. Now there's a lot to, to be said about raw food. Most of our juicing, our vegetables and fruits would be raw. If you think about it, there's, there's a little aside in there also. Um, and when you cook it too high, you, you burn it and you denature it. So I don't know about raw, but very low level cooked food is much better. Now, a good example of a raw food that's healthier than a cooked food would be broccoli.

Believe it or not, if you want broccoli to have its medicinal effects, you need to chew it because when you chew it, it releases, uh, an enzyme called myronase, not trying to get too heady. However, when you cook it, it kills myronase and it doesn't have all its positive effects. Wow. So, so most of the cooking shows that we're watching are, is a lot of that is, although it's, there's vegetables in it, it's really not, I mean, they're cooking almost everything there. I don't think I've seen a cooking show that, that prepares raw foods. Can you imagine just vegetable platters? Unbelievable. So when you really think about it, yeah. Now the only thing is like when you talk about carbohydrates and cooking, like we have something called now resistant starches, like a sweet potato, it's got to be cooked, cooled, and then reheated. And that's over a duration of time. Um, but again, the process in which we prepare the food is a key element to what we're going to get as far as nutrition availability. Huh? Um, okay. So actually I was thinking before we go too far in this, that since I'm still new to podcast and sometimes I forget to address the direction of the podcast. So I think I want to make sure that we, when we're talking about things, let's cater things probably to some actionable things and, uh, ways that high school, college, um, younger athletes can actually identify when they have a tendon injury and what they can do along the process to stop it from getting worse and becoming arthritis over the years, but then help prolong their career and make them play better. That sound easy? Oh, perfect. You want to talk about like a tendon injury or a sprained ankle or something like that? I'd love to do it. Yeah.

Give me a, uh, let's go with an Achilles issue on a, um, high school runner and give me like the rough process. Um, actually I'm sure you've had cases like this. Just tell me a story of a, of a case. I'm sure it's going to be interesting. Well, Achilles, unfortunately that's, you know, not an injury that heals that quick because the Achilles has the least amount of blood flow in the body. The, one of the things that I will tell most people in the mistake that a lot of athletes and people make is they try and heat an area. Do not heat it. Do not heat it. Uh, especially when you just injured or re-injured something, ice is really your choice. I know ice has been beaten up recently, but ice is a much better choice. No heat. If I had a dollar for every time everybody put heat on an injured or strained area, I'd be a very rich man because it just inflames everything. So number one thing is you want to do and get ice. Number two, you always want to look up and down what I call the kinetic chain above and below the area of injury. So, um, for that, a high school athlete, whoever he goes to, you want to analyze everything because when you think about the Achilles, the calf muscles are three muscles and they make the Achilles. In addition, with an Achilles injury, you want to see if it's what we call insertional, where we're really inserts on the bone or it's more in the belly where it would be more of a tendonitis or what we call a paratendinosis. Now that gets a little heady. The Achilles tendon is the only tendon in the body that's actually in another tendon versus just have a little covering, which we call a sheath.

So, um, if you have a little bump in your Achilles tendon, we usually call that paratendinosis. If you've got a little tendon, you know, tender spots by the heel, that's Achilles, uh, tendon, uh, itis. Um, if you're looking for treatments, you and I both know that we think active release is probably one of more forerunners in soft tissue work. So you want to do, have a doctor do a myofascial release. I'm a big proponent in getting some laser therapy. Laser has been shown, low-level laser has been shown to heal and certainly speed up healing in soft tissues. Achilles tendon falls in that category. And I think some of the biggest things that people can do when they have an Achilles or a foot type injury ankle is what we call proprioception. So it's balance training. Um, and I think that's one of the bigger takeaways that proprioception is the balance between your nervous and muscular system. So most people that have an Achilles tendon injury are going to walk funny because it hurts. So when it heals, people assume that they're going to move properly afterwards.

And that's just not the case. So doing some balance training, standing on one leg, standing on a wobble board, that's really going to enable you to retrain, uh, your brain and your muscular system together. So you move appropriately. Sounds good. Yeah, it was actually really comprehensive. I probably would have made it a little bit more long winded. Um, yeah, I think the only thing I would probably add is just, is just the, um, the overall mechanics of movement later. Cause sometimes the, uh, the compensatory movements that they get are based upon how long the injury is, you know? Um, how about the, give us a nutritional side of that one then?

Oh, Achilles tendinosis tendinitis. Yeah. Great, great idea. So I'm a big proponent of what we call proteolytic enzymes that they're called trips and chymotripsin and bromelain. Proteolytic enzymes are things that are easily, uh, consumed and they help with cellular debris and swelling and a little bit of tenderness in the first few days of an injury. In addition, big proponent of fish oils, omega-3s, EPA and DHA, you probably want to take two to four grams of that. That really helps with the modulation of inflammation. In addition, um, there's a couple of herbs that I really like and those herbs are called berberine and, uh, hops. They're great at not allowing, once you have an injury and inflammation come out, letting the inflammation raise too high and start getting some breakdowns. So essentially they stopped tendinitis from going to tendinosis and inflammatory condition to a degenerative condition. You may laugh, but I'm a big proponent that everybody should take a probiotic because I always want to keep your gut real healthy. 70% of your immune cells are in your gut. And one final consideration would be something called specialized pro resolving mediators.

They're the next step in fish oils and they help resolve the inflammatory process. Hmm. Like, so it brings it to a conclusion. Right. There's a resolution to inflammation. Some of the problems with inflammation, and this may be a little deeper than we wanted to go, we want inflammation. So everybody wants to live in an anti-inflammatory world. We, when we have an injury, we want a certain amount of inflammation because that inflammation allows for the healing process. We just don't want it to go too high where it starts damaging everything around and we want it to end and resolve. So the typical person has too much inflammation and it never dials it down. It dials some of the volume down, but it never shuts us off. We want that inflammatory process at some point to be shut off so it can move on to something else. Otherwise we're running around with inflammation and we're more susceptible to overall injuries and failing health. So how do we know what the, it sounds like there's some of the parameters to a normal range of inflammation, at least with an injury. How do, how do we know what the normal range is or if we're within it? It's a great, great question. You know, people come in and they're always saying, you know, I'm always getting hurt. I'm never responding to any kind of treatment.

You're probably inflamed. I'll tell you one thing. If people start gaining weight, they're inflamed. So things like that, I mean, there's blood markers that we can always test if you go to somebody who will prescribe or draw. So some really easy markers would be some C-reactive protein and some different cytokines and interleukins. They would be great markers to understand that we're running a low level inflammation. We're wearing away our soft tissues, our bones and basically our musculoskeletal health from the inside out. So with these, so with these blood markers and everything, are these, I'm sure everyone goes in for their yearly physicals. Are these things that are going to be tested there at their doctor's office, just in a general physical, or is it a different panel they got to ask for?

They're going to have to ask for a different panel, which is usually covered by insurance. And that's why they would want to go to a sports functional medicine type doctor, kind of like what you do. And a lot of the guys that we know, because they're going to really look at markers. So again, the typical blood test is going to look and just say, I'm going to have a heart attack today, but it's not going to tell you what you're looking for five or ten years down the road. So I always tell everybody, a very good doctor will give you like a reflection in the mirror. So they'll tell you why your foot's pronated, why one hip's higher than the other, why your cholesterol may be a little high. I think the sports chiropractic functional medicine doc kind of gets behind a mirror, tells you what the reflection is, but shows you how to change it for now and later. I always tell my patients, you're going to like me today, you're going to love me in ten years.

Do you get cards from, well, you've been practicing for how many years now? I've been in practice for 17 and a half years. So you know what? I do get some cards. And the worst one is, I kind of wish I don't have to tell you this, but you were right. And I'm like, yep, I feel good about that. And I'm happy I was right. And I'm happy you're doing better. That should be your next book, just a bunch of cards of people that came back good or bad, that just wanted to share. Self-reflections. So your book, actually why, and when did you write this book? I actually didn't look at the copyright date. It came out August 15th of 2016. It was an Amazon number one bestseller in eBooks and holistic medicine. And you know, I wrote the book because, you know, as you know, when you first start out being a doc and a chiropractor, you want to help the person around you. And then you do podcasts and speaking engagements because you want to help more people. And the book gives you another option and another venue in which to help people. Because you and I, and maybe many people like us are in this health revolution. We know that the most important thing that we can do is help people and give them their health and sustain their health.

Jim Rome said, and I tell all my patients, take care of your body. It's the only place you have to live. Yeah. Yeah. You can't move. You can't move from there. Right. Absolutely. Um, yeah, I, I, I, I liked the book so far. I was, uh, I didn't get through a lot. Like I said, just because I got to only that one section, I had to stick and I knew that with doing the podcast with you today, I couldn't, I couldn't dive everywhere. And I could sell we were getting into a detox, detoxing and, um, gosh, there was another section there. I was looking at two. I have it right in front of me, but, uh, how did you, because I, I wrote a book as well a long time ago and not that I don't like everything that I wrote in the book, but it's just, even when I had finished the book, I realized I could have added more and I felt like I, should I revise it or just stop now and just do a secondary version later? I mean, did you feel that way at all when you're writing the book? Oh, absolutely. I feel your pain, my friend. I do.

Um, cause things change so quick and, um, fortunately the, you know, having an editor and they're like, okay, it's done. Um, and there's always book too. Um, definitely. And it's an ongoing thing. And that's one thing that I think, you know, we should tell all our listeners, make sure you go to a practitioner who is up to date and always learning, whether taking seminars or reading or, um, things change so quick, the information out there doubles in seven years. And, um, you really want to go to a doctor, whether they're 25 or 95, still on the new information and able to ascertain what new stuff or what really works according to the data that's out there.

Yeah. I've actually learned, I feel like I've learned a lot more, even when I'm starting, starting these podcasts, just talking to people like you and just learning different ways you practice, like little tidbits, you know, like a little, uh, little nuggets that I can use throughout, like at least my time here treating people. So it's interesting, you know? Yeah. I, I feel that I learned doing the podcasts and, and, you know, even when I lecture the questions, the feedback, um, stuff that the docs want to show me. So as long as you're in an environment, a learning environment, and you're still inquisitive, I think you're going to somebody that's probably going to help you. I think when, you know, too many times we've seen doctors and not in any one field, but doctors in general, they just shut down, you know, nothing works. I've had it. It's time for a new practitioner. So you mentioned that people should find a certain type of doc that, that looks at everything's really comprehensively like they're a mirror and so on.

Do you have any guidelines or like questions that they could ask their docs? Because I'm sure they're searching for new people if they didn't weren't satisfied with the last one. How would they identify that they're the right, at the right place? Great question. And everybody needs a good primary care physician or somebody who's a functional medicine where they're really going to look and give them a physical and do leading edge blood markers to ascertain and get them a lens into what's going on and where they're pointed. Also, I'm a big proponent. Everybody needs a chiropractor. You know, I just got asked a question the other day. It was one of these myth-busting questions. They said, "Once you go to a chiropractor, you always have to go." And I said, "Well, why wouldn't you want to go?"

I mean, we're taking care of your whole musculoskeletal system, your central nervous system, which is your spine and your brain and the periphery. So why wouldn't you want to go? I mean, who better? I mean, and the literature bears this out. I mean, we've had three different articles over the last three months saying that the number one choice for lower back pain is chiropractic. Believe it or not, spinal manipulation. Spine Magazine talked about that. That's a major journal in the orthopedic growth in 2013. So who better with joint pain? Certainly lower back pain. And I'm not trying to pigeonhole us in any way, shape, or form. But eight out of 10 Americans at some point have lower back pain. It's a 765 billion, excuse me, diet industry. And chiropractors only see slightly more than 14% of the population. We are the choice for lower back pain, especially with all the literature now with non-steroid anti-inflammatories, Aleve, Advil and ibuprofen, raising your incidence of heart attack and pain opiates not working. To me, it's a literal no-brainer. And that's why people like you, I appreciate so much using these podcasts, taking time out of your day to get the message out to the people, because we can make that musculoskeletal health difference. Yeah. I really think that, I mean, there's, I mean, and I've been guilty of this before too. And you get like an ache or pain, you kind of just let it kind of sit there and let it go.

And you're like, it'll get better and so on. And I was actually, I wrote this article on rotator cuff tears and they're partial tears and so on. And I started out with figuring, you figured out that I think it was only two thirds of people with cuff tears. Actually, actually our one third only has pain. Of those one third, I think only 25% roughly ever seek care. I'm like, why would you not go to someone to help you? Like, regardless of it, I mean, they could throw holy water on you and if it works, who cares? You know, like just seek help from somebody. There's no reason to sit in pain, you know?

No, I agree. And I think you bring up the point that most people wait and want to see where the injury goes or if it goes away. And I think that we have to take a second and say, most musculoskeletal injuries don't go away. They're going to heal, but they're probably without proper treatment and exercise, rehab, uh, manual therapy and nutrition heal with scar tissue. And with that being said, you should probably get in to see your guy, your chiropractor in the first few days of injury where he can make the best bang for the buck and the biggest impact. People complain because he had waited three weeks. Now I have to do, you know, 12 treatments. I'm like, well, if he came in on day two or three, it'd be at six treatments.

You get the clinical outcome that you like. And that's, I think our message. Well, I did see, actually, I was going to ask you about this anyways, so I think it's a good time for it. So in the book, you wrote down the three phases of a, uh, or rough timeline of injury. I think it was for a tendon. So can you explain, so if someone were to get an injury right now, uh, how long should they wait to go and all that kind of stuff? Well, if they have an injury, you know, I mean, obviously if they sprain their ankle and it's swelling up like a watermelon, get in as soon as you can. But I'm a big proponent of getting in, getting work on or at least reaching out and say, what should I do? So for instance, if somebody calls me and I can't see them that day, which I always try to do, I can tell them here's some exercises. Uh, you know, I can email them over to have access to a whole exercise library. Let me get you some ice. Let's get the nutrition in there. We'll see tomorrow. Um, cause I'm a big proponent of active care. I think people wait too long.

They need to get in right away. Remember, most people choose those NSAIDs, Aleve, Advil, and ibuprofen. What they don't realize is it doesn't allow for muscles to heal. It doesn't allow for cartilage to heal. It doesn't allow for muscle to heal. It damages the gut lining and it increases their incidence of heart attack. So non-steroid anti-inflammatories do decrease pain, but they impair healing. What we're talking about, manual therapy and nutraceuticals decrease pain and promote healing. So clearly get to a practitioner who's going to purport that and, um, implement that in your daily regimen.

Mm-hmm. Oh, so I feel like a lot of people then would go, they go to those, uh, oral medications, mainly because they think it'll take pain away immediately. Um, in your opinion, then if they took the other process, how soon, how many hours, how many days, how many weeks would it take for someone, can it take for someone to feel better in good, uh, best case scenario? Because I know the different types of injuries. Right. Well, look, the drugs are going to work a little quicker. No one's going to say that they're not. Um, the nutraceuticals, uh, you know, the nutrients, the vitamins and the minerals that I recommend, usually they'll see a difference within a 24 to 48 hour period. I think I could wait that long. Yeah, it's not too bad. Yeah, it's not too bad at all. Um, so we talked about a tendon injury. Um, would you, would you advise any differently in regards to at least nutrition for a spinal or sorry, a cartilage spinal injury, such as a disc, um, or a, say a ridiculopathy or some type of leg pain going down, um, referred pain, sciatica quote unquote. Nutritionally. Yeah. So nutritionally, believe it or not, glucosamine and chondroitin, which we've always talked about in the knee, and it is positive, is a phenomenal choice for the disc. The glucosamine is great because it's made up of something called GAGS, which is actually the material that is inside the disc. The chondroitin is sort of like a water magnet and it sucks it in. And if you've really ever looked at a disc, you'd realize it's very soft jelly, almost like a liquid jelly. So that chondroitin really ensures to get the glucosamine. And so that would be a major, major choice. Uh, you said about the disc, um, goodness gracious. That was the other thing you asked me. Uh, no, ridiculopathy or so nerve, nerve pain.

Radiculopathy, sciatica. Studies from 2009 and 2010 indicate specifically 600 milligrams of alpha lipolic acid and 360 milligrams of gamma linoleic acid will resolve sciatica or radiculopathy quicker than any kind of surgery and or shot. And when you combine it with exercise rehab, you're going to get the best clinical outcome. Hmm. I think I might have to ask you if you can write some of these down for the notes or if people want to actually give, could they just email you or do you have something on your site with all this stuff? Great, great idea. Come, come to my Facebook, like my Facebook, drrobertsilverman. It's my professional page and you like me and you can just post any question. I have a full social media team and I'm happy to answer any question there and share any protocol. So it's Dr. Robert Silverman. Oh man, I like it. That's going to be good. I mean, there's so many people with, uh, radiating pain and sciatica. I mean, I would venture to say that, uh, it probably about a half amount of half back pain probably gets some type of radiating symptoms.

I mean, why not just do it anyways, you know? Agreed. Um, so we were talking, uh, about also, uh, how, or we're going to talk about, uh, systemic disease. And so we've already gone over musculoskeletal disorders, tendons, muscles, discs, back pain, things of that nature. Um, there's other types of odd conditions, obviously that, um, like, uh, MS or multiple sclerosis, uh, or inflammatory arthritis, such as rheumatoid arthritis. Um, these are things that at least in, in the patients that I've seen with it, like for me, their immediate referral, like I, like they freak me out. Cause I know that I, I can't, I don't, I don't want to like, uh, dabble with doing it poorly because I always, I mean, I'm not great at them. Um, but I know that nutrition at least is one way that you can deal with it. So do you have any certain suggestions for people like this or have you had patients with say like MS? You know, systemic inflammation is interesting. And you know, when you get to systemic inflammation, I always circle the gut. As I said earlier, 70% of your immune cells are in your gut and I'm a big proponent of keeping your gut integrity.

You know, we, uh, we, uh, we use this term leaky gut and essentially our gut is a semi permeable membrane. It's semi permeable because it doesn't want certain things like bigger things, like a protein there, a microbe, a virus to get through because if it gets through your gut, it's now going into your bloodstream. And that's why anything passing your gut that isn't supposed to can cause a systemic inflammatory response. So I'm a big proponent on keeping your gut in place. Um, again, I'm a big, uh, big suggestion would be a probiotic. Berberine is something also that I mentioned before that I like. It kills a lot of bad bacteria and, uh, something like a glutamine would also be a great choice to house the intestinal mucosal membrane. So when people think of systemic issues, start thinking gut health, or I just give everybody this, here's my GPS of health for your gut. Number one, gee, no gluten. Gluten means glue sticks on the inside of your intestinal tract.

The protein is too big. It cannot be broken down. It does not matter if you have celiac, which means you're allergic to gluten. You're sensitive. Everybody reacts negatively to gluten. So no gluten. As Jacqueline said, if man makes it, I won't eat it. The P processed foods. Just don't eat a processed food. It's real simple. Both processed foods have very long food labels. Strongly recommend to stay away from anything that has a lot of ingredients in a food label. Certainly, once again, if a man makes it, I won't eat it. It holds true there. And the last one, the S is sugar. The average American consumes 160 pounds of sugar. Sugar is a toxin deleterious to overall health. So if you start on your diet of GPS for health and for gut, you're probably going to have pretty good gut health.

Hmm. That is very easy. I like the system. GPS is so easy to remember. Yeah. I stole it from something that's in your car or whatever. No, they don't have that anymore in the car, I think. Or do you ever rent cars and they still offer that GPS to you? And you're like, no, I got a phone now. Yeah, that's right. The phone is a hundred times better. Agreed. Yeah. And then they, they offer you a Sirius XM radio and you're like, no, I have Pandora now. Right. Uh, yeah. So when you actually go to the grocery store, like actually are there, I mean, I would, I'm just envisioning you going to the store, walking around and just looking in people's baskets. Um, you know what that's like when it's near your practice. I mean, people run away from you. I can tell you this, no one says hello to me in the supermarket or the restaurant. Um, but yeah, I mean, it's interesting. I've taken a few patients with me and I said, let's just go through and let's just see what everybody's buying. And I'm talking, we're going into quality places, you know, like a whole foods and still making some very intriguing choices. Yeah. I, uh, definitely when I go through Costco, I look at people's baskets to see, and then they take mounds and mounds of cookies. And I, I'm not gonna lie. Do you want that pumpkin or that pumpkin pie when it comes seasonal? So great.

Uh, you know, one thing once in a while isn't going to change the world. It's just to consider everybody thinks every day they're supposed to have something that they shouldn't. And that may be a little bit much. So let's go into that a little bit too, actually, because the, I'm sure a lot of people, when they've tried to change their diet, regardless of for weight loss or for something like this, is there, is there a hangup that they have? They're like, you know, I, I need it. And I, I know that this, I feel this way sometimes and I joke, but it's also, I do feel this way is so if I don't eat some type of meat or protein for some reason, if it's only vegetables, I feel like I, my stomach is eating itself. I call it, it's like I ate enough vegetables, I thought, but I still feel like I'm hungry inside. Is there other, uh, I don't want to say excuses, but is there other excuses that people have where they're like, I can't change. This is just how I eat.

You know, you just said it. They don't want to change people. It's a behavioral thing. It's fascinating. They just don't want to change because change requires work. Change requires, maybe they did something wrong and it doesn't. It just means we progressed to a different part. And you know what? You really use the right word. If you could just get people to change their habits, their eating habits, the way they exercise or exercising and their movement habits, we'd have a much healthier society. Yeah. I mean, I feel like even with like, uh, exercise, I mean, within, within two weeks of them doing something consistently, like three to four days a week, at least they, I feel like there's much less resistance. I'd say easily over 15%, 50% of carrying on to the third week, but it's just like the first few weeks or the first few days.

It's just, it's like, uh, I mean, it's like you're beating a dead horse. It's just to try to get them in there to do something, you know? I agree. And, and that's where the frustration comes in for the practitioner because we so much want the patient to get healthier and patient doesn't understand. Sometimes it doesn't realize the value in that change. Yeah. Uh, I have a, I have a friend actually that he came in, uh, that I mean, I knew him since middle school and, uh, he, he had plantar fasciitis. He had foot pain and, uh, he's probably probably at that time he was probably about 70, 80 pounds overweight. And I laid him down on the table, pressed on his foot. And I'm like, does it hurt at all? Tell me where it hurts. And he's like, uh, none of that bothers me. I'm like, well, how can you make it hurt? And he stands up and he's, you just, all I have to do is stand on it. He's like, it hurts now. I'm like, okay. So I'm like, I'll tell you what, I'll treat you for free. As long as every time you come in, you've dropped two pounds within a week or so. I'm like, if not, then you're going to pay full price. Um, I'm like, you got to help me help you because I mean, definitely weight is an issue with that, especially that amount of the amount over. But, um, it was really, really hard to motivate him on it. So, um, he did get better, but I couldn't pull the trigger with charging him after that either. I should have just charged him. It would have done him. It probably would have helped him out more in the long run. Um, I agree. Yeah, no doubt. No doubt. So, uh, backtrack a little bit when you're talking about, uh, collagen and chicken soup and all that stuff. Uh, I started thinking about quality of product. Um, is there, cause there's so many different things for people to choose from. Uh, are there certain things that you look for when you're recommending certain types of, uh, supplements or are all of them good or what's the deal? Yeah, definitely. That is one of the bigger questions and people ask. So the key component is you want to be able to ensure what's on the labels in the bottle. So you compare apples to apples. Most people will take something off the shelf and say, well, it's comparable to what you carry in your office or what you recommend. And that is the case.

What you're looking for is a third party certification seal. And they are GNP, TGA, NSF or pharmaceutical grade. If they don't have any one or all of those four put it down because there's no guarantee what's on the labels in the bottle. And that's the biggest thing. Then if you really want to get a little more involved, you want to find out, did that company do studies on that particular formula ingredient? And of course, for me, I always suggest people say, well, you know, if I can get the same thing you're suggesting for six cents left on the shelf, what you and I bring and what other practitioners bring is the ability to individualize and customize the supplement for the patient's need, kind of like a coach. And you know, that may be the difference in a few cents in what's between on the shelf and what's in the doctor's shelf. So really look to someone who understands and is carrying something and has done their research on the product that they can guarantee that it's clean and effective.

Mm-hmm. And so with all the stuff that you mentioned too, like there was, I mean, there's a lot of different products or so there's a lot of different, uh, it's not products, but things, uh, that you would end up that people would end up eating or taking. Is there, are the, do people typically buy these things individually or are there blends where instead of taking multiple things, they just take one? Um, cause I bet like even me listening where I was like, Oh Jesus, a lot of stuff. Like I would imagine like patients would be like, they'd have like 20 bottles to sit in front of them and just get overwhelmed a little bit. So, uh, how, how does that typically go?

Well, I like to break down the formulas. I think you're really asking, you know, um, what's on the formula and what ingredients are. And I usually spend a lot of time with the patients, and that's why we do these YouTubes and podcasts and things of that nature, um, to really explain what the individual ingredients do and what they do in combination and, um, to make a formulation. And yeah, the patients really want to know. So my suggestion, one is if you're a patient, seek education. Two, if you're a practitioner, distribute education. Sounds good. I like it. That's what you're doing right now. Distributing education.

Yeah, exactly. That's exactly. Hopefully that's what we're doing today. Hopefully. And it's just my job to be able to promote the, promote the podcast. I'm still working on that part. It's a little bit harder. Um, great job. Thanks. Uh, so how can, or actually before we start closing up here, I just want to make sure that, uh, is there anything else that you think would be useful in these topics that we talked about? Um, anything else I didn't address? Questions you typically get? No, I mean, you've done a great job. I mean, we've covered a vast, uh, number of topics. I think this is great. People have something to take home. Uh, again, you know, go see a chiropractor, make sure that chiropractor is functionally oriented, both in movement, uh, is chiropractic treatment and in nutrition. Uh, remember the GPS of health, um, you know, no gluten, no processed food, no sugar. Uh, you know, if you guys have any questions, you know, DR Robert Silverman is the, uh, Facebook inside out health, a revolutionary approach to your body. Uh, it's an Amazon bestseller. Keep listening to the podcast. Hopefully we'll be on again. And I know he's doing a great job with a vast array of different kinds of practitioners.

And, uh, just remember everybody needs to value their health because it is a gift. Yeah. Thanks. I will, I will put, uh, I'm going to put the links in, uh, so if everyone goes to p2sportscare.com slash podcast, there'll be, um, all the notes and links that, uh, Dr. Silverman was talking about on there as well. So, well, uh, the book is actually a really good read so far. Uh, I'm not actually, I don't know if I told you when you said, I'll send you the book. I'm like, ah, I hate reading books, but this one is actually really good. It flows very well. It's very interesting to me. Um, and I, I probably over the course of the last five years, I think actually hard copy books rather than like short studies and so on like that. I want to say I've probably, uh, I probably read less than five. So you're, you're right up there in the five.

I feel special. Thanks. Yeah. It's awesome. Um, okay, cool. So everyone knows how to contact you. Uh, I will just, let me just close the podcast and just, uh, stay on the line for me and we'll talk a little bit after. Sound good. Okay, everyone. That was Dr. Robert Silverman. Uh, he is from White Plains, New York, and there is going to be all the links up on p2sportscare.com slash podcast. If you want to get all the information there. Uh, again, if you, this is your first time listening to the podcast, just, uh, get it on iTunes. And if you've accessed it off someone else's website, if they embedded it, go through iTunes to get it, to actually subscribe and please review it. Um, if you have questions that you'd like me to answer or one of the experts that we have on for certain types of topics, just tell me a story. Uh, go onto the website and p2sportscare.com. There's a voicemail button.

You can leave about a minute and a half of your story, get to all the major points. We have something to talk about. Um, and we'll feature that and your voice and your question are out on air with us. So, um, also if you have any more experts that you would like me to, uh, interview, I'd love to, to send them our contact information. It's all there on the site. Um, thanks for listening in and talk to you with you guys next week. Bye.