Episode 100.mp4: Audio automatically transcribed by Sonix
Episode 100.mp4: this mp4 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
Dr. Carol:
I want to go back to Hawaii.
Kim Pttis:
Me too.
Dr. Carol:
The only thing about going that’s hard.
Kim Pttis:
Is coming back.
Dr. Carol:
Yeah. And the air isn’t soft and the horizon has trees or buildings instead of the ocean forever. And do you know the Hawaiian word for family?
Kim Pttis:
Yes, it is ohana.
Dr. Carol:
Ohana. When we do the podcast, when we have a course, when we have an Advanced, then it’s clear it’s a community. And in the US, we call it community, but in Hawaii, it’s ohana or family.
Kim Pttis:
Hi and happy 100th episode.
Dr. Carol:
100 who would have guessed?
Kim Pttis:
Not us.
Dr. Carol:
That’s like a year and a half, right?
Kim Pttis:
I don’t know. It’s been like a time warp as far as the duration. But to think we’ve sat down and done this 100 times is a bit of a mind bending.
Dr. Carol:
Yeah, and it seems like it’s been a week.
Kim Pttis:
No, I know.
Dr. Carol:
Right? Doesn’t seem like 100.
Kim Pttis:
No, yet. It feels like family that we’ve done this. It’s like a big Italian Sunday dinner, right? It feels like this is just what we do on Wednesdays.
Dr. Carol:
Yeah. And you just sit and chat and. How are you? Oh, how’s your SI joint, by the way?
Kim Pttis:
Okay,I wanted to talk all about me today. No, I wanted to. You started us off. I want to unpack Hawaii because so much happened and there’s so many great stories there. And the theme of today is about being a teacher. And let me just start this off by there was a quote that I had open. I hope I still have it open here. And it says, There’s this little newsletter that I get once a week and when I came back from Hawaii the next day, this appeared and it said
“The role of teaching and learning is actually reversed in the thinking world because to teach is to learn.”
Dr. Carol:
Oh, yeah.
Kim Pttis:
I’ve found that to be so true. And you and I are constantly talking about all the things that we learn all the time from our patients. And that’s what I wanted to talk about a little bit. Teaching and learning and teaching and all the things. So we were in Hawaii. Everybody who doesn’t know, there is a master class of magic that happens. I don’t know. Not often enough. I’m not sure how often you typically go to Hawaii to do this or to Kona.
Dr. Carol:
This was the first time we’ve ever done it in Hawaii. It’s the first time it’s ever been more than two days. We usually do them once a year because we do so many Core and this year, because of last year, I needed a vacation. The master class Derek offered his place and Kona is my home. Aloha, Derek, and mahalo. Which means thank you. And so the master class was set up so that we had class from 9:00 in the morning till 1:00 in the afternoon. And the students most of them stayed at Derek’s B&B Huge family house.
Kim Pttis:
Guest house. Yes.
Dr. Carol:
Yeah. Guest house. And we stopped at 1:00, like for the first time in the history, somebody came up at 1:00 and asked me a question and said, No, it’s 1:00. I’m going snorkeling. So boundaries and you can ask me tomorrow. So we had five days of exchange and companionship and there’s no description. It’s John Meyer and JJ. Eduardo came from Italy. Like he flew from Rome to Hawaii. There was one girl, so he flew from one. He’s staying a month. He closed his clinic in Italy for a month. So there’s this snorkeling place that everybody should look up called Two-Step. And getting out at low tide was easy getting in, not so much. So I’m sitting there struggling to get on the shelf and all of a sudden, there’s these two men, JJ and John, hauling me up out of the water. It was wonderful. And so there was all that. But in the morning, because nobody was exhausted, everybody was relaxed and there’s no script. The theme of a master class is what do you need to know? To feel like you have a level of mastery that you didn’t have before. What are the holes? And sitting through sports and rehab, watching you work, I understood how it is absolutely that you are the second, the most necessary piece after the Core. But at some point, I want to talk about what we did to your SI joint, your back and your ribs, because that was.
Kim Pttis:
And I think that is just being on the other side of it, watching you work and go through it. Both of our worlds met together. So, go back and say what you just said, because there’s a lot to unpack with that first sentence, you said what they need, where the holes were. You said it.
Dr. Carol:
So the master class sounds like only masters can take it, right? Don’t know what else to call it. The master class has no script.
Kim Pttis:
Yeah.
Dr. Carol:
There’s no script. So the students have to get used to saying I don’t know this, but I want to know about this. And the purpose of the master class is to let the practitioners learn what they need to learn to take the next step in feeling mastery over the material.
Kim Pttis:
Right. And we always talk about this slide that I had put in the end of the sports course what a normal learning curve looks like and what an FSM learning curve looks like. And some people, when I show that, they get like a disgruntled look on their face.
Dr. Carol:
Oh, no.
Kim Pttis:
Yeah, because you go through waves and I’m sure you’re still continuing to go through this is you hit the point where you’re fixing almost everything and everybody that walks in the clinic until you don’t, until you’re stumped and FSM forces you to be better. And that’s what I love about it. I love that it forces you to think one step ahead or think one step backwards or lateral.
Dr. Carol:
Can I change the word forces to allows. So who was it? Somebody said, give me a lever. That is long enough and can move the world. FSM is the lever.
Kim Pttis:
Yeah.
Dr. Carol:
Yeah. So it allows you to do things and think about things in ways that you never would have thought of.
Kim Pttis:
I guess I say forced because I have just seen it extract people from their comfort zones more so than they would have ever gone willingly on their own.
Dr. Carol:
And there are always the first time. In 23 years of doing this. No more than that. 27 or 29 or something, I’ve never, ever done what we did with you on Saturday and Sunday. So can I tell that story?
Kim Pttis:
Let’s talk about it. Yes. This is a good thing.
Dr. Carol:
Because FSM is what allows us not only to think about things differently, but to see connections that you wouldn’t otherwise see.
Kim Pttis:
Yes.
Dr. Carol:
So Kim’s number one complaint was my left SI joint, sacroiliac joint, is sore. It hurts. And she has a chiropractor that’s been adjusting her left SI joint. In my world, the SI joint that hurts is the one that’s hypermobile. So if the left one hurts, it means the right one isn’t moving.
Kim Pttis:
Yes.
Dr. Carol:
So we tested it and sure enough, your left one was, like, too sloppy. Right. One was like a brick. And then we felt your lumber paraspinals and your psoas exquisitely tender on both sides. So in our world, that is scarring in the ureter. Scarring in the kidney, scarring in the bladder and sclerosis and the adipose. And the other thing that had you concerned was you had an x-ray that showed L4-5 thin degenerated, dark, scary. Oh, my God. Right. And for me, probably because I’m a chiropractor, but probably because I’ve been in practice for almost 30 years, I know that almost everybody has an L5-S1 disc, the next level below because of the way the spine is shaped. L4-5 is not normal. It should not be thin and beat up. And there’s the question why is L4-5 squished? L4-5 is stuck in between your SI joints. There’s your tight lumbar paraspinals and when you walk, your joints have to do this and your trunk has to do this. Your trunk has to rotate. If the trunk doesn’t move and the SI joints do move and you run 30 miles a week, something in the middle of your lumbar spine. Usually it’s L3-4. In your case it was L4-5. Something has to rotate. So there’s that little disc getting shared. But I didn’t know that. I didn’t know about your thoracics. But there was, why is it L4-5? What’s that about? So we reached up and touched your ribs and they were brick. They did not only not rotate, they did not move at all. The next question was, Have you ever had pneumonia? No. Have you ever had asthma? Oh, yeah, had asthma as a child. So there’s your scalenes pulling on your first rib. And when you have asthma, you have inflammation in the bronchi. And then there’s the little phrase inflammation leads to chronic inflammation leads to scarring. Eduardo and I took one side, he took the other. We treated scarring in the intercostal nerves and you were very brave. Scrunchy face, scarring in the periosteum, scarring in the blood vessels, and all of a sudden the ribs are moving and we thought we were done. But you came back in the next day and said, I wanted to go running this morning, but it didn’t feel right. Let’s look at this again. So, it didn’t feel right because when you went to flex your right hip, you could only flex it and externally rotate at the same time. Because we have FSM and because we think about what is the cerebellum trying to protect? If you were, the hip flexor, why would you have to externally rotate to bring the hip up? What are you trying to avoid? We went down in your abdomen. Scarring in the ovary. Nah-uh. Scarring in the tube. Nah. What else is down there on the right side? The appendix. We did scarring in the appendix and. It just disappeared. You made really faces when I touched your appendix. You’ve never had appendicitis. But any child that has the stomach flu. That doesn’t progress to full on peritonitis and appendicitis, tend to have appendicitis? Appendix gets scarred and the cerebellum says. Okay. I can protect that. We’ll just keep the mussels out of the way so it doesn’t have to move. We took the scarring out, and all of a sudden, your hip goes like this. At which point, Eduardo, who is an osteopath brings your knee up and it stops at maybe 95, 100 degrees. Somebody is flexible as you don’t think so? So that was the next step was scarring in the dura. And that’s why your SI joints were locked up, the dura was scarred on the right. Because that right hip wasn’t going to move because the scarring in the appendix and the scarring and the psoas. I’m hoping everybody can follow this or you can listen to it again. Anyway, we did that. Did the draw and the next day you had to figure out how to run for the first mile and then you ran ten miles and could have run ten more.
Kim Pttis:
Yes.
Dr. Carol:
That was like the high spot for me. It was so much fun for you.
Kim Pttis:
For me, it was because I’d been dealing with this SI joint and to anybody who runs out there, especially who runs a long distance, you get into this state where everything just moves and goes. And for me, that’s my meditative state. That’s where I get my ideas, that’s where I download information from the universe. And I’m able to figure out cases and parenting ideas and anything. And when there’s pain that unravels everything. So as a therapist who works with athletes, I thought I got a lot of the panic that they have when they have an injury. But when it’s affecting yourself, it’s a whole other level because I think we overthink things as we know so much about the body. And so because I had pain on the left side and because I found a chiropractor that would x-ray me and say, yes, you’re off and would just listen to my listen to me and say my SI is off. I know better than that. I know that wherever the pain is, doesn’t mean that is the causative factor. That is just where the pain is appearing in that moment. So right away, when I talk to you about it without even you looking at me, you’re like, SI is moving too much. It’s hypermobile. I’m like, Oh, because I don’t have pain anywhere else. But when I run, it’s that shearing. So when something’s moving and it’s not supposed to, it’s just that impact. I know better than that.
Dr. Carol:
And the pelvis has to rock like this.
Kim Pttis:
Yes.
Dr. Carol:
And the other thing I learned, I have never, ever in 29 years have never, ever done that flow on anybody, never put together L4-5, SI, psoas, ureter, kidney, fat pad, lungs, trunk. We even ran scarring in the pleura to get your chest moving. And then scoring in the dura. I’ve never done that before. That’s the part where FSM allows you to see the connections or it would force you accept. You can’t force somebody to see the whole picture. You can give them a three-dimensional camera that lets them look at it differently.
Kim Pttis:
And then just for everybody listening to, again, patient complained of left SI joint pain with degenerative disc L4-L5. If you just had those two pieces of information, you would probably run some sort of disc protocol and some sort of, I don’t know, whatever you would run for an Si joint pain. None of those frequencies would have done anything. Especially they wouldn’t have held it right. It’s not the disc. So right away you’re like, Yes, the disc is compressed, but why is it compressed? Especially at L4 L5.
Dr. Carol:
L5-S1. That’s normal.
Kim Pttis:
Absolutely. I think if you X-rayed anybody over the age of 35, we’re going to see a squishy L5-S1, especially in a runner, right? Where there’s just force or someone who sits. Anyways, So for you right away, like your first, that’s strange. So part of that is you knowing about disks and how things degenerate and that’s your background. But again, it was just always asking the question, But why? But how? But where? But why? But how? I would have never even thought about my rib cage because my asthma wasn’t that bad. I had terrible hay fever as a kid. Even now, living in California, my allergies crank up every spring because there’s just crazy stuff here. I take an inhaler before I go running, but I don’t think of myself as like an asthmatic. Until I experienced what it’s like when my ribs can do this and I’m doing the bucket handle motion as opposed to me breathing in that like, sagittal plane. So like when we see people who have asthma, they have hypertonic scalenes like everything in the anterior neck is always like holding on for dear life because they’re breathing. And I know that when I was running, especially when I start getting tired, I go into extension. So I try to get my breath this way as opposed to allowing my ribs to do what they’re supposed to do and how they’re supposed to move. So that was a religious experience, running for the first time with new lungs.
Dr. Carol:
The thing that FSM gives you is confirmation. We worked on you for a total of two hours and two days.
Kim Pttis:
Yeah.
Dr. Carol:
Total. So FSM gives you the ability to form a hypothesis. SI joint isn’t moving, your psoas, kidney, fat pad. And then there was a thing in your groin.
Kim Pttis:
Yeah.
Dr. Carol:
So you have this hypothesis. And in the normal world, it would take two months of twice a week and a lot of pain to just get the psoas. And for us that’s 40 minutes.
Kim Pttis:
As a manual therapist, I know what would have had to been done to get me where I’m at right now. So what you did in two hours, I can say without a shadow of a doubt is was would have been absolutely impossible for manual therapy alone to get those results. There’s no way. And especially with intercostals. So all those deep even like visceral treatment, there is absolutely no possible way. Something I want you to talk about as well besides going to appendix and things that I would have never gone to again, I would have never thought about going there
Dr. Carol:
Externally, that just didn’t make any sense to me.
Kim Pttis:
Super mechanical, wouldn’t have thought what is in the way or what is the femur trying to avoid? That way of thinking is so beautiful because most people would just think, Oh, the external rotators are hypervigilant and we need to turn them down or do you know what I mean like that. That would be the train of thought. Not what is the femur trying to avoid? What is in that quadrant? So we did a little bit of that repatterning towards the end of the first day, which was good because we are putting things back together. One of them you had, I think, three machines running. You had 40/89 running the whole time, which I also want to touch on because we sometimes think about 40/89 as afraid to move. I’m not afraid to move. I couldn’t wait to get treatment. I can’t wait to move better. So when you have your really motivated patients, don’t think that there’s no you don’t need to run it because it’s not about the conscious mind being excited to move. It is the primitive lizard brain that is thinking there’s just no way we can do this.
Dr. Carol:
And that diagram that I show of the knee pain when we get to the central nervous system doesn’t matter where the pain is peripheral. Absolutely everything. Physical.
Kim Pttis:
Yeah.
Dr. Carol:
Up the nerve. Up the cord. Through the Medulla and everything goes through the hippocampus.
Kim Pttis:
Yeah.
Dr. Carol:
Is this dangerous? Did this ever hurt? Ever. The amygdala gets to say, Yeah, it hurt and it really bothered me. And the thalamus says, Yep, I got a pattern for that pain, I remember that. So the three of them are all sitting there in the back room saying, I don’t know. So before it even gets to your sensory cortex or the frontal lobe, it’s filtered unconsciously through the hippocampus. And once you realize that everything goes through the membrane. If you’re not afraid to move it and you don’t get to vote.
Kim Pttis:
Right.
Dr. Carol:
Because it goes through the midbrain and then it goes back down to the cerebellum. It doesn’t go to the cerebellum first.
Kim Pttis:
Right.
Dr. Carol:
Coordinate movement?
Kim Pttis:
Yeah.
Dr. Carol:
Before the cerebellum even hears about it. There’s this millisecond where it goes up to the hippocampus and the hippocampus says to the cerebellum, This is dangerous. Figure it out. But don’t let her move that muscle that way. Got it? Cerebellum says. Yes, sir. Do we need to tell her? Nah, she doesn’t need to know. It’s all right.
Kim Pttis:
So yeah, so that was running the whole time on one machine. And when you think about all the places that you did, even on that first day, following up to my thoracics, there’s just no way you can expect your nervous system to be on board with undoing something as deep down as you were. Like I said, in the ovaries, ureter, Kidney, intercostals. On the second day, like when I wanted to go running, nothing hurt. SI pain was gone right away within that first hour.
Dr. Carol:
And we had one machine running just on 124/77 because it was only the lower joint that was hypermobile. We could tip your joint back. You had no nerve pain, but the lower joint was hypermobile and that’s just connective tissue. So we had one right across your sacrum.
Kim Pttis:
Yeah.
Dr. Carol:
Right across just 124/77, because the lower joint is a fibrous joint made out of just connective tissue.
Kim Pttis:
Right. Yes. So that was that. So the next day, waking up, no pain. That’s great. But there was like this feeling of apprehension that something was just wrong. And athletes tend to be really in tune with their bodies, which is cool. They’re motivated to do their activity, but they also know when something doesn’t feel right. And me knowing a little bit too much about biomechanics, was just really worried that I felt apprehensive because the biggest thing that I’ve done, what I was inspired to do, the whole like reboot or repatterning however you want to call it, is when you have an athlete returning to sport, especially impact sports. So football, basketball, hockey, they don’t have time to be scared. When they have the whole return to play, we have to get that athlete so confident and chomping at the bit to get back in, so they’re not afraid to move because when they’re afraid, that’s when they really get hurt again. So what my sweet spot was getting athletes back and getting them back where they weren’t getting re-injured and the patterning was all there. No more compensation, no delay, there’s no time for a delay. So when I came back the second day, if this was like a real clinic, if you’re charting it, you’d be like, wow, the pain was gone. That’s fantastic but when the mechanics have a delay or it feels off, and sometimes your patients just don’t know how to describe it.
Dr. Carol:
You were perfect at describing it because you said the only way I can bring my right leg up is an external rotation.
Kim Pttis:
Yeah.
Dr. Carol:
That’s a big clue. Colonel Mustard in the library with the candlestick, right?
Kim Pttis:
Yeah.
Dr. Carol:
Why would it do that?
Kim Pttis:
And then that’s what led us to the appendix, which was just brilliant and ridiculous.
Dr. Carol:
I thought it was the ovary or the Cecum.
Kim Pttis:
Yeah.
Dr. Carol:
And it’s not the ovary. 13/7, na, 13/4, not the tube. 13 and the bladder. Not that. 13 and Cecum. What else is down there?
Kim Pttis:
Yeah.
Dr. Carol:
No, it can’t be the 13/68. No, really? And as soon as we did scarring in the appendix. All of a sudden, your right leg just went straight.
Kim Pttis:
Yes.
Dr. Carol:
And in what world is that possible?
Kim Pttis:
I’m not sure. Thankfully and then Eduardo doing the work with the dura because that would just make sense also why your pelvis wouldn’t want to retrovert, right? When it’s being traction if there’s scarring there. So that was amazing.
Dr. Carol:
And just for the people that are listening and trying, we’re doing a master class right here on the air. So if you think about the fact that your ribs have not moved, when did you have asthma? You were 7, 8.
Kim Pttis:
Around there, yeah.
Dr. Carol:
Yeah. So your ribs have not moved in however many years. I’m not going to read out your age, so. Then what else hasn’t moved your ribs? We did scarring in the joint capsule and mobilized the rib heads. But also the dura in the thoracic spine has all these nerves that go out and so when we did scarring in the dura, we not only did the usual flex your knees, rotate your SI joints and your hips, but we rotated your trunk to free up the adhesions between the dura and the nerves. I’ve never done that combination. Never been done. It’s a matter of thinking your way through it. What is connected to what? And that all belongs to George Douglas. Ask why and that belongs to Harry. Ask why. Why is it doing that? Why is it doing that? I’m not going clear back to past lives and karma. But why is this doing that? Causing that. Causing that? Yeah.
Kim Pttis:
And for the practitioners out there too, sometimes we get lost in the B channels, like what else is down there? Especially the manual therapist. PTs like we’re so used to just thinking on the musculoskeletal side, what is the muscle look like? Is there a Bursa? Is there a tendon Bursa? We did Bursa as well with me, with my hips.
Dr. Carol:
The hamstrings.
Kim Pttis:
Because the Bursa is just get trashed, right? Find a way to run. And the Bursas are just like, okay, fine, I’ll just buffer everything. And then.
Dr. Carol:
That was the part where I said, Excuse me, I’m going to put my hand on your butt. The tuberosities are where all the bursas are.
Kim Pttis:
Yeah, and that was where I also would get pain running. But going back, don’t feel like you have to have the viscera and the reproductive system all burned in your brain. That’s why you have Netter. That’s why there’s software. Like I said, I’ll flip it open because I’ll make the excuse, like I want to show the patient here. I just want to show you where I’m working. But I am selfishly like, what the heck? Oh, there’s oh yeah, there’s that vessel and there’s this. Because you just you see it again with fresh eyes because you can’t. So this is what I mean about teaching and learning is teaching. And it all just comes together in this big, wonderful soup. When I did go running, I didn’t plan to do 10 miles. I thought I’m just going to go mile by mile and see how things were. The first mile, I felt like and I probably looked like the Tin Man because things were moving that hadn’t moved in 40 years. Things were firing that had been turned off for so long. And I had this weird foot pain on the lateral side of my right foot and it almost felt like plantar fasciitis. But it was just my gait and foot strike. Everything was just figuring it out. And there wasn’t anything bad about it. My deep thoughts were just like, You’re fine, we’ll figure everything out. And by the Second Mile, it was just beautiful. And it was Kona. So I just was like Forrest Gump. I just kept going. And then I turned around because I had to because the masterclass was starting. So shoot, I got to go back and go to class.
Dr. Carol:
But you have to tell them too. She was downhill the first 5 miles and then the last 5 miles was uphill coming home and her time per mile coming back uphill was faster than her time going downhill.
Kim Pttis:
Yeah That’s how you want to finish a run. Thinking that you could have gone more, right? That’s how you want to end it. And that’s how I want to end my treatments with patients. Like on that high note, feeling great, thinking, Wow, I could have done more of this, but we’ll save that for next time.
Dr. Carol:
And just so people that are listening can cut themselves some slack. You don’t get to this level of, this goes to that part of the purpose of the Core part of the purpose of the Masterclass, part of the purpose of this podcast is if you hear described the first time, then it’s easier for you to see it or to make those connections, or at least look for them.
Kim Pttis:
Yeah.
Dr. Carol:
If I hadn’t found your ribs in a block, I would have had to figure something else out. But given what was going on at L4-5, your ribs had to be a block. It just there’s no other way for L4-5 to do all the sharing.
Kim Pttis:
Yeah.
Dr. Carol:
So be patient with yourself during the learning curve. There’s a line in the Core.
Kim Pttis:
Yeah.
Dr. Carol:
Be patient with yourself. Because that is why the treatment plan is twice a week for 4 to 6 weeks is to give yourself time to figure it out, to give the patient time to show up with compensations that weren’t there before. Part of the reason we did with you in two days is that you are so kinesthetically aware. And you know your body. You know what it feels like. And you knew not to go running on Sunday morning, so we didn’t have anything to fix that you messed up on Sunday morning. It was like the perfect storm and we have, I don’t know, how long he’s been in practice, but Eduardo is a European osteopath, manual therapist, posturologist, whatever that is. I’m still not sure which is completely different than an osteopath here.
Kim Pttis:
Yeah.
Dr. Carol:
Close.
Kim Pttis:
Yeah,But just more magical
Dr. Carol:
And then. Right. My neck has been killing me for the last three months and Friday, after we worked on whoever we worked on, I asked Eduardo, would you mind working on my neck? And it’s okay. So he and Derek pushed the buttons. Eduardo worked them. I passed out. I had no idea what they were doing, but he basically was doing the supine cervical practicum and adhesions in the dura. He put the towel down at my sacrum. Once we’re all done with my neck and he starts rotating my hips. And the place it hurt was the C5-C6 fusion that I have. The Fusion was done right when he rotated my hips to the right. I had pain in my neck. Here at C5-6 on the left. So by the time they finished up with the dura, I was like, I’m still a whole new person. Thank you very much.
Kim Pttis:
Wow. We have a couple little questions. Let’s get to it One question here. 55-year-old, 190-pound female. L4-L5.
Dr. Carol:
How tall is she? That’s the thing. 190 pounds on somebody that’s 5 foot 4 is really heavy.
Kim Pttis:
Yeah.
Dr. Carol:
Five foot nine. Anyway.
Kim Pttis:
Pain radiates to side down the front of the left thigh. Like sciatica, Sciatica would be back.
Dr. Carol:
Okay, wait. First thing. Michelle, I hate to tell you, but the front of the left side. It depends on how front it is. But that’s the femoral nerve. Sciatica is down the back. L4 is the lower leg. L5 is the lower leg. Pain in the thigh is either the L1, L2 facet joint will radiate around to the front, but it doesn’t go down the thigh. Femoral nerve, right thigh muscle, she had a groin injury. Front of the left thigh is the side and the front. That’s L2, L1.
Kim Pttis:
So she’s 5 foot 5 inches. So 190 5 foot and 5 inches.
Dr. Carol:
Say again?
Kim Pttis:
She’s 5 foot 5 inches tall.
Dr. Carol:
Oh, 5 foot 5 inches. Okay. Yeah. Heavy. Trying to sleuth the case. Tight thigh muscle rectus femoris. She had a groin injury or ask her if she had a C-section. Weak abdominals
Kim Pttis:
Your previous FSM of C-section scarring.
Dr. Carol:
Okay, so we had a patient in the master class like this or maybe it was in the Core. When you have abdominal surgery, there is hole in the front at the lower part of the abdomen for the femoral plexus, iliac arteries, artery, vein, nerve lymph. All go through this little spot like right in the front. So she had a C-section which leads to bleeding depending on how badly it went and that can adhere the femoral nerve to the thigh. So the rectus femoris is going to be tight because… Three C-sections! Okay. So the cerebellum is not going to let you move the rectus femoris because it’s glued to a nerve, artery. Cerebellum doesn’t seem to mind too much about veins, but arteries are like a thing. So the artery and the nerve are here. And if you look at Netter and that one slide in the Core that shows the femoral plexus, the adductors run this way, the rect-fem and the quadriceps run this way. And the femoral nerve is a fan that goes in between the adductors and the quads.
Kim Pittis:
Yeah.
Dr. Carol:
And the rectus femoris is innervated by L1-2, anyway, isn’t it?
Kim Pittis:
Yes.
Dr. Carol:
I knew you’d know that. Weak abdominals. Yeah.
Kim Pittis:
Of course.
Dr. Carol:
When you cut through the bottom part. So C-sections are done with the little smiley face just above your pubic bone. And it goes through the same incision for all of them. So the lower abs are cut and most PTs are not… Nobody gets rehab after C-sections because they’re taking care of babies. When you have somebody strengthen their abs, they always strengthen them from the top. So there was one patient where we had her put her hand on her upper abs, put her hand on her lower abs and bring her pubic bone towards her nose without contracting the upper abs. When they did that to me, it took me 20 minutes to find my lower abs. So there’s that. Worse sitting for gardening, housework, occasional daily picking up after kids. Yeah. So go looking for adhesions in the femoral plexus. There’s more to this thigh muscle, but until you get rid of the adhesions in the femoral plexus, it’s not going to go anyplace.
Kim Pittis:
It truly is a rec-fem is your one of your quad muscles. Obviously, it crosses your knee. It’s the only quadricep that crosses the hip joint. It can really create a lot of zero-point tenderness on the ASIS and it will hold an anteverted pelvis. So any type there’s trauma on that anterior chain that rec-fem is going to try to splint to protect. So, I wouldn’t treat it because it’s secondary to everything else that’s going in. Tendon is super sensitive. So yeah, everything that you were talking about, is there a comment here saying that she was born pigeon-toed having to a connected foot brace to turn legs outward?
Dr. Carol:
Well, that means that the other thing you need to look at is the pectineus and the brevis and see if they’re adhered.
Kim Pittis:
Yeah.
Dr. Carol:
So if the external rotators don’t work well, if they’re not strong. In ballet, you have to externally rotate if you’re. Pectineus and brevis are tight. There’s no way to externally rotate.
Kim Pittis:
Yeah.
Dr. Carol:
So yeah, ballet wouldn’t work out. It’s not exactly the cause of her leg pain this far down the road, but I’m wondering why you say L4-5. What’s the sensory exam like? There was one case in the master class where we did, just somebody wanted to know how you use a pinwheel, so pick somebody out of the class. And 4 was hyperthetic, 5 was hyperthetic, S1 was hyperthetic, S2 was fine. L2 and L3 were fine. T2 in her arms was hypersensitive, but in her trunk it was fine. And S2 on the back of her head on the right-hand side was hypersensitive. Left was fine. And I said, what did you do that tipped your head back? And she said, Oh, I forgot. I hit a rock with my bike, held on to the handlebars and so she had a nerve traction injury at T2 and a crush injury to C2. And. Oh, my God. Okay. First went thumping L4 and L5 back into place. Okay. It’s. Yeah, I’m going to be fine. I just got back from Hawaii. I’m still, like, mellow. L4 and L5 are clearly not the problem. If you do a sensory exam and L4 and L5 are hot, then L4 and L5 might have something to do with it.
Kim Pittis:
Right.
Dr. Carol:
If the chiropractor is thumping L4 and L5 anteriorly, he’s going to end up causing facet joint pain. And if you look at the scleratomal diagram where L4 and L5 go, facet joints go to the front of the thigh. So, to lay on her stomach and you gently press on the L4 and L5 facets. If it makes her leg pain worse, then the pain in the front could be coming from the L4 or L5 facets. Her chiropractor is wrong. The nerves coming out to the left leg for the thigh at L4 and L5 don’t come from L4 and L5. They come from L3. Look at the dermatome map. So we spent some time looking at dermatome maps. And that’s where the pinwheel conversation came up. That was a master class question because I got them in my head because I do them all the time. 4 is the medial calf, 5 is the lateral calf How can somebody graduate from chiropractic college and not. Wow. Okay. Don’t let her go back, Michelle please, just don’t let her. Do whatever you have to do. Show her a picture of scleratomal pain and 5 minutes with her. That would be why he didn’t know where the nerves went because he didn’t do a sensory exam. And that was the whole point of the how to use a pinwheel conversation. Best 20 bucks you’re ever going to spend.
Kim Pittis:
Yeah.
Dr. Carol:
I’ll stop talking now.
Kim Pittis:
No, you’re fine. This is what we deal with. And when you’re a hammer, everything looks like a nail. So this is why we have so many different tools now in our tool belt. Because it’s not just a nail.
Dr. Carol:
But when you have a hammer and what is in front of you is a Phillips head screw, you really ought to figure out that you need to deal with the screw. But that’s okay. I’ll be fine now.
Kim Pittis:
Yeah, you’ll be fine. Okay. A couple more questions or comments. Alf asks the frequency for facets 157.
Dr. Carol:
Alf, the facets are complicated because the first thing we treat is 157. You get extra points, a little piece of cyber chocolate, the cartilage 157 sits in a divot.
Kim Pittis:
Yeah.
Dr. Carol:
In the joint surface. It periosteum and then the whole thing is covered with a joint capsule. So it’s 157. Then we treat 783, which is pain sensitive and 480 which is the joint capsule. And then yeah, so.
Kim Pittis:
I like to start with 783 only because that will take the pain down right away because when the facets are compressed, the periosteum is the pain generating part of it. So I always like to get them out of pain first, but then having to treat the joint surface or the cartilage part, 157 and then the capsule surrounding it.
Dr. Carol:
And then the practicum, we start with the cartilage because it softens the muscles that overlie the joint. So the longissimus cervicis, thoracis all the overlying muscles. You run inflammation in the cartilage and the muscles soften. So then you can feel the periosteum, like you can’t feel the cartilage, you can’t feel the periosteum. If those muscles are tight, run inflammation in the cartilage first, then the muscles soften. Then, you can actually feel the periosteum. Then the periosteum purrs. When you make.
Kim Pittis:
Periosteum can make a sound. It would totally purr. I also like to run 124 when the facets are really… Because it’s just that torn and microscopic, torn and broken when they’re just like sheared. It works nicely in the joint also 157.
Dr. Carol:
And then 91 in people under 60.
Kim Pittis:
Yeah.
Dr. Carol:
So if you think of calcium as little pieces of ground glass on the periosteum,
Kim Pittis:
Yeah.
Dr. Carol:
It’s 91 and the periosteum and then 217 which is ankylosis or calcium oxalate from the Advanced. That’s why you go to the Advanced. I can’t put anything more on the Core. It’s just.
Kim Pittis:
No.
Dr. Carol:
And no. And you run that hardening the ground glass in the periosteum and then hardening in the joint capsule because once you deal with the periosteum, then the muscles, totally disappear and then you can feel the capsule. It’s so much fun.
Kim Pittis:
It is so much fun. Debbie asks, do you run anything to make sure tissues that are stay released at the end of the treatment? For me, that’s the reboot part is, and 40/89.
Dr. Carol:
And the other thing to remember about 13 is where we think that the scar tissue or connective tissue is wound like a rubber band with little crosslinks. When the frequencies loosen the crosslinks and everything unwinds when it tries to go back together, they’re in a different place. They can’t go back together. So usually, if you do it right, the scar tissue doesn’t come back . Like with my neck, the mechanics of my neck are natural that I’m always going to end up with a 2-3 facet and some dural adhesions at C1. But I can get them treated every 3 to 6 months and it’s fine. Yeah.
Kim Pittis:
I think the point too is 13 that’s been the game changer is that frequency loves to be mobilized. So whether you’re doing manual treatment to mobilize the tissue or when they’re self-treating put themselves in a bit of a passive stretch or have them stretch through the range or move through the range helps again, once those cross-links are dissolved or mobilized or released, however you want to verbalize it. Yeah, they can’t find each other because the fibers are just in a better organized fashion, right? They’re just elongated.
Dr. Carol:
Yeah. Can’t get there Especially in people my age. Sometimes they’re going to come back for me, it’s a management problem, Right?
Kim Pittis:
Right. Yeah.
Dr. Carol:
So they’re going to come back.
Kim Pittis:
And it’s not just a certain age group. It’s in the athletic population. I am not going to stop running. My athletes are not going to play. There’s nothing wrong with management, you know what I mean? So like when people ask me, when will this be done? When do I stop coming? I’m like, you’re never going to stop coming. You’re going to continue. If I’m doing my job, you’re going to be continuing to move. And so you don’t stop taking your car to the shop. You’re going to continue to drive your car. It’s going to continue to need maintenance. So whether that maintenance is once every two weeks or once every two months is just that spot that we’re going to have to find.
Dr. Carol:
And the important thing is, yes, you’re coming back, but if I’m doing my job, we are not just banging on L4 or 5 the same way every time. We do something different because we fixed one thing and then compensations that were someplace else aren’t needed and they move differently and cause a different set of things.
Kim Pittis:
Yeah.
Dr. Carol:
And so the next time you see the person, it should be something. Oh, yeah, that doesn’t hurt anymore. But we did this.
Kim Pittis:
Yes. That’s a successful progression in my world. Yes.
Dr. Carol:
Yeah.
Kim Pittis:
There is one more thing. Maybe not. I think Derek just said SI connected to the appendix. Who knew? Yeah, exactly. Who knew?
Dr. Carol:
Yeah.
Kim Pittis:
59/39. That is bone. I’m not sure where that came from.
Dr. Carol:
For the facet. So we had a patient which they were literally going to fuse, everything from L1 to S1. And we did the cartilage, the periosteum, the joint capsule. And then he said, it feels like it’s in the bone.
Kim Pittis:
Okay.
Dr. Carol:
Okay. Then you if you look at a skeleton, the lamina and the bone at the facet joints is very thin. So the bone itself, if you have an accident where you do this, bone itself gets micro fractures in it. Right. And it’s a thing.
Kim Pittis:
Thanks, Lee, for the 100th. That’s just insane that it’s been 100.
Dr. Carol:
Yeah.
Kim Pittis:
We have two minutes. I want to just touch base on the fact that you’re going to be hosting the courses now in Troutdale, which is I can’t wait. The space there is fantastic. So look on the website for people who want to go. It’s like home going to your clinic and not only is the facility where the course is going to be or where the practicums are going to be, the space is just beautiful, but I think it’s very helpful for people to see your clinic and to see how you’ve integrated FSM and treatment rooms, because that’s always the hard part, is how do you envision it? And your clinic is pretty multifaceted. So you could envision a PT there, a massage therapist there, a chiropractor there. There’s lots of different ways. Medical doctor you can see that. So I urge everybody to attend a course there.
Dr. Carol:
And that was one of my favorite parts about the sports and rehab class was the last 3 or 4 slides where you talked about room 1, room 2, room 3 and how you keep multiple rooms going and what you need in each room and your towel warmer. And it’s how to implement it and we have so many different kinds of practitioners with different.
Kim Pittis:
Yes.
Dr. Carol:
Considerations that I can’t put it in the Core but in your.
Kim Pittis:
For, rehab, I think that model kind of works throughout the board. So that’s why it’s there. Okay. Here’s my quote.
Dr. Carol:
Okay.
Kim Pittis:
Goes back to the teaching that happened over the weekend. And as a practitioner, we are teaching our patients and our clients. So, thank you for lighting the way for all of us because been quite the journey for us all.
Dr. Carol:
And what could I do that would be more fun to see? There was a practitioner from Canada who came, and she’s an MD. And she was almost in tears at the end of the first or second day. And it’s just so grateful for how her practice has changed people. She’s able to help what she’s able to do. What could I do that is more fun? And how could I not do this? I’m not. Yeah, it’s not about money. It’s about changing the world. And that’s what people are doing. Ripples in the pond.
Kim Pittis:
Yes.
Dr. Carol:
Yay! Thank you. Thank you to Derek once again for hosting our amazing course. It was life-changing, like I will say that.
Dr. Carol:
Yeah it was. It was just was and will. And everybody needs to get used to the idea that we’re going to be back there at Derek, probably the last week or two weeks in August next year. Can you save our place maximum of? Yeah, maximum of what do we decide we could put in that room?
Kevin:
20.
Dr. Carol:
Maximum of 20. Wow. We had 17 this year. We can have one more table with three for everybody. It’s cozy.
Kim Pittis:
And the FSM Sports and Rehab, our new name, will be back again and I max out that class at 10 because we just need space. So book now we’ll get the date solidified.
Dr. Carol:
Yeah. It’ll be on the website because even Kevin is coming.
Kim Pittis:
Yes. Kevin.
Dr. Carol:
Yeah.
Kim Pittis:
Feels better.
Kevin:
Just to throw something in real quick. The stuff for Troutdale for 2024, it’s not listed yet, but if you go to the events, you’ll see the 23-24 calendar and you’ll be able to see what we have in mind for 2024.
Dr. Carol:
What he’s saying think is we haven’t solidified the 24 calendar except for the Advanced.
Kevin:
Register for everything.
Dr. Carol:
And the Advanced is 3 days because doing it in 2, we never get to the second half. And so we’ll have case reports. This is August and this is when I start harassing people to bring case reports for next year and start organizing the faculty suggestions for who you want to hear and what they want to say
Kim Pittis:
Sports course and a sports Advanced we get those two knocked out also. And it’s just the conventional.
Kevin:
Phenix event is ready for registration. The Troutdale ones that haven’t.
Kim Pittis:
Phenix is running out on the way so.
Dr. Carol:
Right and it looks like we’re going to Austria in September and then either before or after Austria, we’ll probably do London. Wow. Have one European course and we’ll do an Advanced and a Core in London. We probably won’t do Ireland. We’ll have the Irish come over to us.
Kim Pittis:
All right, everybody, It was great. Thank you all. 101 coming at you next week.
Dr. Carol:
That’s it. Bye bye.
The Frequency Specific Microcurrent podcast has been produced by Frequency Specific Seminars for entertainment, educational and information purposes only. The information and opinion provided in the podcast are not medical advice. Do not create any type of doctor-patient relationship and unless expressly stated, do not reflect the opinions of its affiliates, subsidiaries or sponsors or the hosts or any of the podcast guests or affiliated professional organizations. No person should act or refrain from acting on the basis of the content provided in any podcast without first seeking appropriate medical advice and counseling. No information provided in any podcast should be used as a substitute for personalized medical advice and counseling. FSS expressly disclaims any and all liability relating to any actions taken or not taken based on any contents of this podcast.
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