Welcome to ChiroSecure’s Empowering Women in Chiropractic. The Facebook Live show for successful women by successful women. Proving once again, women make it happen.
Join us each week as we bring you the best in business growth, practice management, social media marketing, networking, leadership, and lots more. If it’s about women in practice and business, you’ll hear it here.
Now join today’s host, Dr. Nicole Lindsey, as she talks overhead, debt, and creating other sources of income. And now, here’s Dr. Nicole.
Hi, welcome. I’m Dr. Nicole Lindsey, founder of Dominate Chiromarketing, where I teach chiropractors how to build profitable relationships with MDs to grow their practice. I’m your host today.
First of all, before we jump in, I want to thank ChiroSecure for making this all happen. We appreciate them. I want you to show them the love, and make sure you spread the message. Share these shows, and let everybody know how awesome ChiroSecure is.
Today’s guest is Dr. Krista Burns. She’s a chiropractor. She’s an author. She’s a speaker. She’s a certified postural neurologist. Certified posture expert. She is the founder of the American Posture Institute, where she’s helped thousands and thousands of patients achieve better posture. She’s also leading the charge against digital dementia, which I want to ask her about that.
So, today’s topic is the postural neurology revolution. Welcome, Dr. Krista.
Thank you so much for the kind welcome. Thank you to you, to Dominate Chiromarketing, as well as ChiroSecure. It’s such an honor to be here.
Well, I can’t even imagine that you have time to do this with everything on your resume, and everything on your plate, but we appreciate it.
Let’s just jump in with postural neurology. What is postural neurology?
Well, thank you for asking. When I graduated school, I had a lot of questions of connecting the dots between neurology and chiropractic. I had actually done advanced training for years, and years, and years, and done thousands of hours of training in neurology. And when I started my practice, I still couldn’t understand how to apply that neurology into daily practice with the patients that I was seeing every day. That presented with tech neck, that presented with headaches, migraines, back pain. You know, our average patients. And so, I went on this mission of understanding more about postural correction, and then really connecting the dots where I feel like there was some gaps in our education. I wanted to bridge that between neurology.
Because we all know that we work with the neurologic system. This is certainly not the first time you’ve heard that, before today’s interview. However, can we fully explain it? Do we really understand why what we do impacts the brain? Do we understand how better inputs to the brain result in better outputs, resulting in better posture? Can we really explain that?
And so, I just went on this mission of understanding more. And then by having these brain-based solutions, assessments and corrections, we had the opportunity of sharing this with more and more practitioners through the American Posture Institute. Seeing the results that they were getting on a daily basis is absolutely life changing. The coolest part about it is that it’s predictable, it’s measurable, where we can see those outcomes pre and post, and have those predictable results every time. So, that’s postural neurology at its core. It’s really the neurology controlling the posture system, but the brain-based approach for assessments and corrections.
I love it. It almost sounds like something that all chiropractic students should be getting this information in school.
One of the comments that I get all the time is, “This is everything I wish I would’ve learned in school.” And that comment means a lot to me because it’s everything that I truly wish I would’ve walked out of school knowing and understanding. It took me years of starting my own practice, doing advanced neurology training and then going back through, even after the seminars, going back through all the neurology textbooks and implementing this stuff. Using my practice as a laboratory of creating these new systems. It wasn’t until almost a decade later, after studying advanced neuroscience for a decade, that I finally had those solutions and those answers.
They say that research is really me-search, meaning that you have these questions, and I was on a mission to find it out. After learning more about the neurology and really that brain-based connection, I had to share it with more people through the American Posture Institute.
Well, thank you for doing that. You know what’s really interesting, too, is that we talk about us being, as chiropractors, being neurology experts. We work on the nervous system. That’s what we’ve kind of been brainwashed to say, but yet we really don’t have a good understanding of how that works. At least I know I didn’t. And I went through chiropractic school. Of course I had PNS and CNS, and all of that. I couldn’t tell you. I don’t remember any of that. So, I love where you have taken this and have made it practical. I think that’s-
Yep. That’s what it’s all about. Because we’re not motivated to sit there and re-memorize our PNS books. The majority of us aren’t, anyway.
We look at Mrs. Jones, who’s scheduled at 9:00 AM on Monday, and we go, “How can we give Mrs. Jones the best care possible?” And I love that about everybody who’s watching today. Like I have your back on that. That’s why I’ve done all the research over here to package it together in practical solutions, so you can just take this information, implement it into practice.
Because it really is about the practical applications. Not just memorizing more neurology. I think it’s fun, but most people become overwhelmed by it. It’s not just about those memorizations, it’s about how can we take this and really apply it with all of our patients who come in on a daily basis. Not just the outlier patients, the ones that come in with back pain. Also the patients who come in with vertigo or seizures, but also Mrs. Jones who has neck pain. Right? How can we make sure that we have practical solutions for everybody?
Yes. And I, as you know, I teach chiropractors how to build relationships with MDs. I did a talk to neurologists, and what was interesting when it comes to posture, my talk to them was all about how headaches can be caused from forward head posture. They were dumbfounded. They really had never heard that before. Never thought about it. So, it’s really interesting that not only us as chiropractors, where there’s gaps in education and connecting the dots, but for healthcare providers as well.
Yeah, absolutely. And what I love about posture is that it’s really easy to communicate. You’re mentioning when it comes to sitting down with medical professionals. We all have a posture. Posture is a structural framework of your body. It’s very simple to communicate, because everybody understands it. This is words that they’re already using in the medical community, that we can also use in the chiropractic community, that make sense to both of us.
And what’s really wonderful about posture is we can show that there’s postural distortion patterns very simply with posture imaging. And then we can show those corrections over time when we monitor that, and we do pre and post posture imaging. Here’s the really great part about it, guys, is that we’re talking specifically about MD referrals, there isn’t a medicine to take to correct posture and digital dementia, which is a whole other topic. There’s no medicine to take for digital dementia. That creates the opportunity for us to be the first line of defense. But it really comes down to understanding it fully and then communicating it clearly.
Absolutely. For our listeners, we have chiropractic students, we have chiropractors, new and old, CAs, office staff listening to this. And when it comes to an assessment, like a protocol for correction, what can you give everybody? A little bit, a little piece, of something they can do now.
Let’s talk about a couple of assessments. Now, when it comes to postural neurology, we call it the eyes, spine, vestibular model for assessment and correction. Eyes, spine, vestibular. The reason we focus on the visual system is because your visual system, it controls your orientation in space. How we see our world is how we orient our bodies upright.
Now, what’s interesting about the visual system is there’s direct connections. There’s descending pathways from our visual system, as well as our vestibular system, that go to our cervical proprioceptors. And so, if we have visual system dysfunction and we see a postural distortion pattern in the cervical spine, we cannot expect that we can have longterm correction of the cervical spine without correcting that visual system.
Let me give you a couple of examples that we can all relate to.
If I have poor vision, which is cranial nerve number two, if I’m squinting forward, I’m constantly in forward head posture. Okay? We have these muscles controlling our eyes. When these muscles become fatigued or have dysfunction, and I can’t move my eyes in a certain direction. If I can’t look up into the right, what do I do? I develop a chronic head rotation looking up into the right. If I can’t converge my eyes to look here midline, then I develop a head tilt and a head rotation.
And so, if we don’t clear this out, of course the patient feels better after an adjustment and of course they look straight or as well after the adjustment. But these are the patients who come back in and say, “I felt great, but then it came back.” Well, did we really get to the underlying cause, is my question. So, keep doing what you’re doing. Keep adjusting the cervical spine, of course. But in addition to that, we want to check the visual system and give them at-home exercises.
Now, let me give you a little more background and then we’ll talk about assessments and correction. Now, the same is true with the vestibular system. We know the vestibular system is located within the inner ear and it has nuclei in the brainstem.
Here’s what’s so fascinating about the vestibular system. We know it controls equilibrium. We know that when we have dysfunctional visual or see in the vestibular system, patients can present with motion sickness and vertigo. But here’s what they can also present with, is poor balance and flexor dominant posture.
You guys have seen those patients that have this anterior postural hyperkyphosis. The difference between a postural and a structural hyperkyphosis, a structural hyperkyphosis is changing the structure of the bones. Meaning collapsed vertebrae, for example. That’s the structural cause of a C-shape spinal curvature.
Postural hyperkyphosis is an inability to resist gravity. What does the vestibular system do? It stimulates upright postural extension. Is that not amazing? So, your patients, then they come in, they have forward head posture, they have anterior rolling of their shoulders, they have anterior chest drop, they have this C-shaped spinal curvature. And if we’re not working with the vestibular system, they go, “Oh, thanks doc. I feel so much better.” And they leave. But then the second they get to their workspace, they can’t resist postural collapse because we haven’t worked with that vestibular system.
And so, if we skip the visual system, head posture distortion patterns will continue to get worse over time. If we don’t stimulate the vestibular system, they’ll continue to go into this flexor dominance, and continue to have the C-shaped spinal curvature. And so, in addition to the adjustments, which everybody’s already doing, and that’s why it’s eyes, spine, vestibular. We don’t leave out the spine. Of course we address the spine, right? But in addition to the spine, we have to stimulate the visual and vestibular systems.
Here’s an easy check that you guys can do. Number one for the visual system, all you have to do is take a pen, or even just your finger, and you’re going to hold it in front of the patient. I’m going to turn to the side a little bit, so you can see. You’re going to slowly bring it in. What you’re watching for is that the patient’s watching the tip of the pen. You’re watching for their ability to bring their eyes to midline. Okay? It’s called convergence. So, it looks just like this. It’s super simple, guys. It takes literally 20 seconds. You bring the pen in, and you watch for their ability to converge their eyes to midline.
If they cannot do this, or maybe they can do it just with one eye, and you see one eye goes out to the side, this is called your divergent eye. Converged, diverged. Converged, diverged. Converged, diverged. If it cannot converge to midline, this means that they can develop a head tilt and/or a head rotation.
And so, a super simple exercise that they can do, it’s going to take them one minute at home and it’s going to perfectly supplement that adjustment that you’re doing to the cervical spine, is they’re going to do near and far exercises? Okay? So many patients are just working at their computer. So, what are they doing? They’re just looking near, right? We need them looking far. What we’re going to do is near and far exercises. They just hold the pen tip here. They look here, converge, they look in the distance. Here, converge and hold for 10 seconds. Then look in the distance, and then repeat. Okay? Repeat that five times. Near and far. Okay? It’s going to take 30 seconds. I recommend they do it morning and afternoon. Okay?
Does that make sense?
So, let me know at this point if that makes sense. And this is super simple to implement. To hold that adjustment longer, and really have longterm postural correction results. Okay?
And then number two is with the vestibular system. So, two quick checks. First of all, I highly recommend everybody does posture imaging. Guys, I don’t even sell posture imaging software. There’s great ones out there that I just highly recommend everybody utilizes. For many reasons including communication, objective results, but specifically for the vestibular system. If you look at that posture image and you see postural hyperkyphosis, which is anterior rolling of the shoulders, C-shaped spinal curvature, this is an indication that we have vestibular system dysfunction. Okay? So, that’s your first check.
Number two is called one leg balance. It’s just like it sounds. It’s super simple. The patient stands on one leg, they have their hands by their side, they look straight forward. We want to see can they balance upright? Now, what you’re going to watch for is the side of initial postural sway. Initial postural sway. Initial postural sway. What tends to happen is they’ll shift slightly and then re-correct, and may shift further to the other side.
With initial postural sway, we lean towards the side of vestibular dysfunction. Okay? This gives us an indication that we need to stimulate the vestibular system, at least on that side. You can stimulate the vestibular system overall. But this gives us indication that we have vestibular system dysfunction if they can’t be on one leg with proper posture for 30 seconds. Is that easy?
Yeah, very easy.
So, we’re looking at a great posture image and we’re doing one leg balance. Okay?
Now if we want to rehab that in addition, again, to doing adjustments of the thoracic spine, which you guys are already experts at. In addition to that, I want them doing these two exercises at home.
Number one is one leg balance. This is where the assessment becomes a therapy, right? We want to make sure that they can balance upright on one leg for 30 seconds, proper posture. They need to do this at least twice per day. Both legs. Okay? As they can do this, have them progress and continue to challenge the vestibular system. How we continue to challenge them is with an instable surface. By closing their eyes and eliminating the visual field of gaze. Okay? So, make it more difficult. Perform it on whole body vibrations and other great progression. Okay? So, continue to progress them. They’re doing this for 30 seconds in the morning, 30 seconds in the evening.
In addition to that, Superman exercise. Okay? You guys have already learned Superman. Now it’s about implementing and knowing why we’re implementing, right? If the patient is going into flexor dominance, we need to stimulate upright postural extension. We have the vestibulospinal tract. Goes from the vestibular nuclei in the brainstem down to the thoracic spine, and it stimulates upright postural extension. So, when you’re have the patient lying on the ground and then they go up into a Superman, we’re reversing that flexor dominance and we’re going into extension. Okay?
It’s better to do less repetitions and hold this one. If they can hold for 30 seconds, which some of them we’ll have to work up to based upon their current level of fitness. We’ll work up to holding that for 30 seconds. And then from there, 45 seconds. And then from there, a minute. This is going to help build that extension to prevent more flexor dominance, because all of our habits are flexor dominant. Okay?
When it comes to exercises for the visual system, we’re doing near and far. For the vestibular system, one leg balance and Superman exercise. And if I can give one more lifestyle habit… Is this too much or is it-
No. I can’t wait to rewatch this and take notes. Because it’s so practical.
It’s super easy, right? Like these are things that are so simple to implement with what we’re already doing.
You don’t have to buy all this new equipment. You don’t change your practice completely. Keep doing what you’re doing, and then add these neurologic exercises to supplement the great results that you’re getting to make it more predictable and help the patient keep it longer. Right? That’s what we’re going for here.
My other recommendation for a lifestyle habit change is to sit on the posture cushion. Okay? Posture cushions are great for structural postural correction, but here’s why I love it for vestibular activation. When I am seated on a normal chair, it does not matter what posture I have. I can’t fall out of the chair. Literally, I can be hunched over. You watch people at a coffee shop, they’re in the worst postures you’ve ever seen. You go to the airport and it’s frightening, right? You see people hunched over their devices in this posture. That’s because they don’t fall out of their chair. Our world allows us to have the worst postures possible without falling over. Okay?
Our vestibular system resists gravity. And so, if we’re seated on an instable surface, if I start to kind of get lazy with my posture and I’m on an instable surface, guess what happens? I might fall off. The reason this is so beneficial is because I might fall off, my vestibular system activates and it brings me back to center. Okay? So, now I’m forced, I’m literally required to use my neurology, and use my posture system to stay upright. Which is what we should be doing, right?
But our modern world, we don’t have to. I can literally be hunched over like this and not fall over because of my environment. So, if I’m on an instable surface throughout the day, not only am I moving more, which is great for my disc health, which is great for mobility of the joints, but in addition to that, I’m using my neurology. I’m stimulating my vestibular system every time I move, and change my body position in relation to gravity. Okay? In addition to those exercises, give them a posture cushion as part of their posture kit.
And number one, this is a great product to have in your practice, but number two, they need it. Because the chair they’re sitting on, I can already guarantee you is not ergonomically designed to stimulate their neurology. And therefore, their posture is declining at the speed of technology.
Yes, and that’s a whole ‘nother topic. We’ll have to have you back, so we can talk about that. Because I watched your TED talk and I think it was amazing and I want to know more.
Thank you so much for sharing such great gems with us today. Things that we can implement right now. I know you have a certification course for us, for chiropractors, and other healthcare providers as well. As you can see, Dr. Krista knows her stuff. If you want to become certified, get with her. Pick her brain. Ask her questions.
But thank you so much for doing what you do for our profession, Dr. Krista. I really appreciate it.
Of course. It’s a pleasure.
And thank you all for watching today. Make sure you tune in next week to our show. We’ll keep delivering great information to our profession and to everybody out there. Thank you so much for joining us.
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