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Apr 12, 2023

Chiros and PTs: Can’t We All Just Get Along? with Dr. Brandon Parker

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Dr. Yoni Rosenblatt: What's up True Sports listeners, this is Yoni Rosenblatt. I want to thank you for sharing us for this episode. As always, we are constantly striving to dispel myths around sports physical therapy and educate you as to how to be a better sports physical therapist. One of the ways to do that is to introduce you to some of the other allied health professionals that may be caring for the athletes that are in front of you, and very specifically that is chiropractors. Now, we do not know a ton about chiropractic care as Sports PTs, and Dr. Brandon Parker is really gonna help us with that. He's gonna dispel a tremendous amount on this. He's gonna cover a bunch of topics, from evidence-based practice to joint manipulation to post-op care and all the things that chiropractors see, just like we do as sports PTs, and really how we can work together and learn together to put our best foot forward towards our patients.

Dr. Yoni Rosenblatt: As always, please listen, learn and then share this podcast with anyone around you who might benefit from it. You're doing us a tremendous service by doing so. Also, you are helping the profession of sports PT by sharing these conversations with your colleagues. If you're interested in joining True Sports Physical Therapy as a physical therapist, we are looking for great sports PTs. We have a number of openings across our company as we continue to grow to provide the highest levels of sports PT to the highest levels of athletes. After all, this is what sports PT should be. Feel free to reach us on Instagram @truesportspt. You can shoot me a personal email at Yoni, YONI@truesportspt.com. We would love to hear from you. Without further ado, here's Dr. Brandon Parker on all things sports chiropractic.

Dr. Yoni Rosenblatt: Okay. So in, in listening a little bit to the way you described your chiropractic education, I didn't hear yet you mention evidence-based practice, research, and I'd love to know more about how your graduate school and the chiropractic community as a whole approaches those topics.

Dr. Brandon Parker: Yeah, yeah. Very fair. And to be fair, there is a evidence-based classroom or a class that we have in the very beginning that kind of teaches us the basics on how to search for research, what is the criteria, or at least the level of proof that you need to establish, whether it be a meta-analysis going, so on and so forth. But the way they teach it, it was unbelievably boring. And if you looked around the room, you had people with their eyes glossing over and it kind of infuriated me 'cause it was like, guys, like this is your bottleneck to success here. If you truly wanna help people, you have to keep reading this stuff. But as I was saying earlier, when we had the tactical difficulties, I felt like if we created a more of a debate style class, I feel like people, well, two things would happen.

Dr. Brandon Parker: One, the people that did their research and really did their homework, they would have valid points and they would win, which would build upon their confidence as a practitioner. And for the people that didn't wanna do the research, it would be a shot in the ego in a good way 'cause I do believe that in our profession, whether it be PT or chiropractic, egos are one of the biggest things that get in the way of success. Whether it be you think it's this diagnosis, it's this diagnosis, you're keying on this diagnosis and you don't have the awareness to take a step back and either ask a peer, read some research or reevaluate what's going on, or most importantly, talk to the patient. If you don't have that awareness, it's most likely because of ego. So the evidence-based approach in chiropractic was very self-driven.

Dr. Yoni Rosenblatt: You had the opportunity to back up what you wanted to do, but I did notice that in chiropractic you're almost frowned upon if you found research that didn't hold the spinal manipulation to this holy grail that it's not; it's really not. It helps some people sometimes for a small amount of time. And I didn't want to be the guy that was known for adjusting, because if you're known for one thing that has a temporal effect, you're a bandaid. I couldn't be that. So as for the small group, I'm gonna go on a small tangent here 'cause I think this would give a little bit of background...

Dr. Yoni Rosenblatt: Go ahead. Because I want to get back also to that, that spinal manipulation as the end all, be all of health and wellness. We gotta get back, we gotta get back to that because that, I would love to dispel that notion. There's no way in hell that that is still taught, but you're gonna correct me if I'm wrong, but we'll come back to that. Go ahead. Where were we going?

Dr. Brandon Parker: So when I went into the chiropractic school, I didn't know about all the other stuff. I just knew that the experience that I had was awesome and I wanted to be at the same criteria level as that person. So get there. And I realized that like, it's almost like a religion in a sense that people blindly trust what they're being told without being critical of the information that they're absorbing. But I did also notice that chiropractics splits off into all these different branches. And that's why it's hard for me to say, hey, I'm a chiropractor, because I don't know the experience that the other person had with one. With the small group that I branched off into, which I would consider evidence-based practice regardless if it's anything, any profession, we were, we're highly critical of everything. And we were the Debbie Downers, if you will, because it's just like, hey, you can try that. It might not work. I'm like, oh, well why are you saying that? And it's just like, because that's the truth. And that goes back to what you were just mentioning.

Dr. Brandon Parker: I do feel like the subluxation is the Nike symbol of chiropractic. It's their brand. Like if you keep on saying subluxation, subluxation, subluxation, it's a word that people don't necessarily understand. They just, you said some fancy words and then you said subluxation, please fix it. I hated that. I hated the fact that we're making your nervous system healthy, whatever that means. There was just a lot of ambiguous claims with nothing to back it up, and to be very upfront, if I wasn't already that already, it's downright malicious and it's parasitic to take advantage of somebody's pain, say that their spines are misaligned. Meanwhile, we have colliders on the football field running into each other and nothing's being misaligned there and then telling them that if they don't get this fixed, they're gonna be ill. It makes no sense.

Dr. Yoni Rosenblatt: It makes no sense. Well, it doesn't make sense to me on the outside. I just figured I was missing something. Now when that's, are there schools, chiropractic schools that have totally veered away from that, from that theory or no? There are.

Dr. Brandon Parker: Yeah, there are. And when it comes to... So to go a step further, the schooling that I went through, there's politics, right? So there's basically, they know they have to teach a certain thing even though they believe something else. So what we would get is we would get the bookwork and then we would go after class and talk to the person and be like, hey, look, you have to learn it, it's for the boards, but this is what you should be doing. So it definitely comes down to the test. What's that?

Dr. Yoni Rosenblatt: It's infuriating because why does the test not match what we currently know?

Dr. Brandon Parker: Exactly. Exactly. You have all these people making and writing new questions each year to prevent cheating. Why can't these new questions be validated in newer research?

Dr. Yoni Rosenblatt: I think the answer is laziness and it could be that those people writing the exams, they're not treating, they're not updating. They're not realizing, hey, this works, this doesn't work or they're not reading the literature. I'm guessing, I don't know. I just did an interview with a PT. She was great. She was a year and a half outta school, went to a great school, graduated top of her class, all this stuff. She was working in Standard Gen Pop. The way we do it at True Sports is you come in, well I send you a case before you walk in and I'm gonna play the role of the patient.

Dr. Brandon Parker: Awesome.

Dr. Yoni Rosenblatt: And you are gonna treat me. And we do that for a number of reasons, but I wanna know how you think clinically and then we can talk through the case. Well, she nailed the ACL case. She did great with it. When we started getting towards the end and I'm like, okay, how would you handle this? How would you handle that? How would you progress this? How would you scale it? She starts talking about this arc of motion with an ACL post-op, how you cannot in an open kinetic chain go all the way to terminal knee extension. I'm like, that is just old... It's just old science. We won't do that anymore. But she's like, well, it was on the boards. I'm like, still... You're not alone is my point. I think that's gonna be the biggest takeaway from this conversation is this is such a similar field with similar experiences.

Dr. Yoni Rosenblatt: Okay. So talk about tangents. That was a long ass tangent. But bringing it all the way back to, they're teaching you what they're almost told to teach you, but then on the backside they'll be like, yeah, we don't really practice like that.

Dr. Brandon Parker: Yeah, that was basically it but then just kind of wait... Alright, so when I was in class, you would start at 7:00 AM and you would finish about 6:00. Like you were in class all day. So you would get this... It's distasteful to sit through all this monotonous stuff that you know it doesn't apply to your future practice, just to wait for the last 15 minutes of class to go up to 'em and go, haha, just kidding. No, just know this. So it's like, why am I spending a top dollar for this when a lot of the stuff that you're saying is just validating what I'm reading online? But at the end of the day, it's just like, okay, I need to get my license and then I just need to get outta here. So I do think that the overall schooling experience that I had taught me how to learn on my own, which I think is invaluable. So I don't think they meant that, but I do think that that alone is the reason why I have this, yeah, insatiable hunger to keep reading.

Dr. Yoni Rosenblatt: Yeah, and you're right. That is totally invaluable. That's how we're gonna get better every single day, by trying to get ourselves better. Okay. So let's dive in a little bit to some of that manipulation. Tell me where you, Brandon Parker, stand on how to use joint manipulation.

Dr. Brandon Parker: Right on. Yeah. So a lot of my practice is online and I do have an in-person practice. So the online side, it shows my practice style a little bit more because I feel like that's where I prioritize a lot of my treatment, and that's through the education, the validating somebody's pain experience, modifying their ADLs and stuff like that. Because if you can allow somebody to do what they truly love to do and they're not as burdened by their pain, their pain experience is gonna be better, their timeline prognosis will be better because instead of them saying, okay, you took me outta sports for the next six weeks, because that's the healing time, when am I gonna get back? When am I getting back? Or we just make a small modification, you can still do the things you love to do and you still heal in the same timeframe.

Dr. Brandon Parker: So that's kind of my main approach, is there, but when it comes to the hands-on modalities, whether it may be... It comes down to preference, right? If they were like, hey, I really want to get this area moving. I know that it's a temporary fix, I know that it's this and not that, then I go, okay, as long as you understand that you are informed about what's going on and what it is and you're not tying any unnecessary beliefs to it, then I'm completely fine with it. It's just, I'm very cautious that people... Because even with athletes, they get superstitious, right? Where they're just like, hey, I need that back adjustment before I get in, coach. It's just, if I don't get that, I'm not gonna shoot right and I'm not gonna run right. And he says, no, you will, but I'll do it anyways. But you need to understand that you definitely will.

Dr. Yoni Rosenblatt: So it's education. It's a lot of patient education that I'm hearing.

Dr. Brandon Parker: Exactly. It's not the best business model, but my goal is to eventually get fired in a good way where this, like, you've taught me everything and it's just like, all right, cool. Now go tell the next person so I don't have to, the next patient I get isn't somebody that is fear avoidant because they think their disc is gonna "pop out" or slip.

Dr. Yoni Rosenblatt: Okay. So now when you do your joint manipulation, when you do your manual therapy intervention, is it based on physical assessment? Is it based on radiographs? How are you assessing alignment?

Dr. Brandon Parker: Yeah.

Dr. Yoni Rosenblatt: The word alignment.

Dr. Brandon Parker: The whole obsession with alignment is insane to me. At the end of the day, you look at a human body, you're gonna see so much asymmetry. It's insane. You can take it a step further. Look at your kidneys, one's higher than the other. You have a liver on one side, right? So like, you're gonna eventually see... Another thing is sports related adaptations. You see a pitcher, oh my god, their internal rotation is god awful but that is a sports related adaptation. If I was obsessed with symmetry, and I was like, oh, we gotta fix that, you were undoing what the body just specifically adapted to, so therefore you're actually ruining their performance. So I'm not too like gung-ho on symmetry. I am, if we take it a step further and talk about like motor control and strength, I am a little bit more cognizant when it comes to that because strength is what, the number one thing we could do to protect ourselves from injury, and of course, motor control helps with strength, depending on what range of emotions you're doing.

Dr. Brandon Parker: But when it comes to me adjusting somebody, it's just hands on, it's find the restriction. By restriction I just mean like they can't really move that well right here and quick adjustment and then they send 'em on their way. I try to downplay the adjustment so much so that it's kind of like an afterthought intentionally, because if you want to temporary decrease your pain, you can do a small warm-up set of whatever movement that you're preparing for or if you want to temporary increase your range of motion, once again, small warm-up set, or you can also roll on a foam roller, which that has a whole host of myths attached to that. But I still think it's a tool that we shouldn't throw out of the window.

Dr. Yoni Rosenblatt: And you would say also you could manipulate a joint, a passive manipulation. Is that where you're going with that? Like how you can, an athlete can use that as well, hey, I can manipulate that neck, give you a little bit more range of motion. There are are hosts of other ways you could do it, but it's just a piece of the puzzle.

Dr. Brandon Parker: Right. And my preference is I try to... I'm not like "afraid", but I do try to stay away from adjusting that neck. I just really don't think it's worth it or necessary per se. There's plenty of other modalities that can get the same job done, and you're not risking that one in a million chance of the vertebral dissection. So once again, it's all about like risk-reward and why risk anything if you can get the same job done, right?

Dr. Yoni Rosenblatt: Yeah. I love that. Now walk me through the way you're structured your in-person practice. Agent walks in for an evaluation, how long are they with you? What does that evaluation consist of, and then what does the treatment look like?

Dr. Brandon Parker: Yeah, right on. So I mean it's very similar to my origin story, right? So hour for the first visit, I used to do hours across the board, but I felt like it was almost cumbersome. I was just like, we already got everything we've got to get done. So they see me for the first visit, we unpack everything we can, and I'm probably speaking maybe five minutes that whole 60 minutes, right? I am listening to everything that they have to tell me, and then from that circumstance, that's going to give me the runway that I need, or at least the direction I need to take, to see what's truly going on. I'm sure your schooling has also told you that 80% to 90% of the diagnosis is in the history. So at the end of the day if you listen to them, you only need to like perform maybe one to two tests.

Dr. Brandon Parker: So after getting the conversation done and validating the pain experience, then I'll do the one to two orthopedic test, which we know the spin and the, it's not that great, so we're just doing it to confirm more thought process and then from there it's just, we talk about potential treatments, right? So my treatment would be, hey look, I think that you can benefit from these particular movements, and during the time of movements you have the option of doing these things for pain management. I'm well aware that myofascial release can reduce pain temporarily, and if you feel like that's worth it to you, we do offer that service here. We do have all these other things that you can do, once again, symptom modification. But if you are just that type of person that would prefer just to do these exercises and then maybe ice or heat the knee at home and then come back to me, once you master those exercises, then that's perfect.

Dr. Brandon Parker: Then they'll come back to see me for a half an hour, which will probably be in a couple weeks, and then from there, I'll just make sure that they displayed mastery of those exercises, they're well informed about what's going on, and then we'll progress them. Now let's say they're not doing good, right? I give my patients full reign to message me on Instagram. Once again, not the best business model because I am busy, but if they're like, hey look, when I'm squatting my knee's hurting. Okay, let's make this knee dominant movement more of a hip dominant movement. Spread those legs out, point those toes out. Now the shin angle is more neutral and now you don't have to worry about that knee sheer as much, right? So it's those, I think that play by play, making sure that they can get to me when they can gives an invaluable service for people because they're not alone when trekking through their pain journey.

Dr. Yoni Rosenblatt: Yeah, that's really powerful. We gotta get you on the True Sports Home exercise app. But that aside, did you get any... Well, what pieces of that did you get through your graduate education? What pieces did you fill in yourself? 

Dr. Brandon Parker: You know what? I always like to say, now I'm gonna mess up the quote, but it's just like I'm just standing on the shoulders of giants, right? This is my opportunity to thank cold heartedly, his name is Jacob Harden. He was a big Instagram... I hate to say influencer because he's not, right? He was just giving out great information. I found him through a friend. He's like, oh yeah, he's like mentoring me. I was like, this guy is busy doing all these things and he's willing to meet us up at a coffee shop and just tell us about his thought process and he's a chiropractor. I've never seen this before.

Dr. Yoni Rosenblatt: Awesome.

Dr. Brandon Parker: So when I went to meet him and then learned how he practiced, I definitely modeled a lot of my stuff between what his approach was and my origin story chiropractor's approach was. But once again, that's kind of out of the scope of our schooling. And to be honest with you, the prototypical chiropractic model that you see is just the sheer... Honestly, it's only because that's how they get the most money, period. How can I bill as much credits as possible, as much units as possible in this amount of time? 'Cause that's gonna turn over as much profit as possible. And it's a great business model, right? You're gonna make a lot of money, but you're also going to have a lot of dissatisfied people that have complex pain problems. Now, if you're that type of person that has aches or pains and you go get a "tune-up" and you feel better, it's your money, so be it, but as long as it's under the right narrative.

Dr. Yoni Rosenblatt: Yeah, I think that makes a lot of sense. And obviously, you just couldn't live in that narrative, apparently, right?

Dr. Brandon Parker: No. God, no.

Dr. Yoni Rosenblatt: Certainly doesn't see it. And I think that is exactly what, by the way, gives both of our professions a poor name, 'cause the same thing happens in my world. And whether you're a personal injury clinic or whether you're strictly workers comp or whether you're simply cookie-cutter, you're gonna see the same thing in physical therapy, and it drives me absolutely insane, and that's why our practice is called True Sports Physical Therapy, because this is what I always thought it would be, this is what I thought it was when, I went to graduate school, by the way, I thought all PT was sports medicine, and it ain't, it's a lot of other stuff. But I think this is the best way to get people better, and the only reason I can think of to not do it this way is, like you said, dollars or maybe a lack of education, but at this point you don't have that excuse. I think 30 years ago you can come out of chiropractic school and it's all... You just couldn't find differently unless you ran into the guy who influenced you, but that's all you knew, that's all you saw. You don't have that excuse anymore. So dude, your practice sounds like a physical therapy practice. So tell me what's different about your chiropractic practice and True Sports Physical Therapy.

Dr. Brandon Parker: I'm gonna be honest with you, aside from not having a super sweet facility like you have, the protocols are pretty much the same. At the end of the day if everyone's practicing the same evidence, it's going to be the same practice. It's the same protocols in place now. My target audience as it may be right now is a little bit on the older side, so same scaling, progression, regression, bio-mechanic model and validating pain, but mine is just a little bit more home-based; just really trying to remove the barriers that a lot of people place on themselves. I don't have enough time or I don't wanna go to the gym 'cause people are looking at me or I'm not accountable enough. We're just like, okay, well, I just created a system that's going to remove a lot of those roadblocks, so now it's just you in front of the mirror. Why aren't you doing this? So that's the big thing.

Dr. Brandon Parker: I would say that, yeah, once again, it's just, if you are practicing the evidence, there is no difference between chiropractic and PT. I will say this though, our schooling did not touch upon post-surgical operation, and I feel like the only reason why I would take one on is because of my hands-on experience. And if it was just upon my actual schooling, I would never tell somebody to, hey, go see a chiropractor fresh out of school. So I think that is a little bit more of a focus on the PT realm, and that should be your wheelhouse, because I get afraid that if we're gonna load it too much, then the graft might not hold. So that's something that I would stay clear of.

Dr. Yoni Rosenblatt: Yeah. Well, that's really enlightening. I'll say though, I hate to dispel that myth, 'cause you just painted us in a really positive light, as being the post-op, but if... You said you would hesitate to go to a chiropractor that was fresh out of school, especially with a post-op, I would say exactly the same thing with PT because I don't think we get that. I just... We might get protocols, but we're not gonna know norms, we're not gonna know how to load a tissue properly, unless you're doing work on the outside, like you've done for yourself. So I really don't think it's so dissimilar. They do teach us in graduate school more of the orthopedic surgery, so we know like, what does an ACL repair look like intra-operatively? What do we know that it looks like on post-op day one? I'll tell you what they don't teach us. They don't teach us month three to six. And by the way, like you just said, are they really teaching as well? Like the example I gave of the PT with a year and a half experience, they're still teaching stuff that is not necessarily up-to-date. I'm painting with broad strokes, but I think we could get better at that, for sure. Is there another pathology that you would say, "You're way more of a chiropractic candidate than PT"?

Dr. Brandon Parker: Honestly, not necessarily. Now, I like to say it like this, just like, alright, if we're talking about a chiropractor and a PT both following the same practice, same protocols, 'cause evidence is informed, at this point, it's pick your flavor. "Do you like the guy with long hair and a beard, or do you like Yoni who owns multi sports facilities?"

Dr. Yoni Rosenblatt: I used to have long hair. I used to have long hair.

Dr. Brandon Parker: I honestly do... I have a deathly that this, I'm gonna wake up and it's gone. And it's gonna happen. It is.

Dr. Yoni Rosenblatt: Valid. That's a real fear. I do feel like we're looking at a before and after lecture, but yeah.

Dr. Brandon Parker: Wherever I lose on top of here, I'm just gonna grow on my face.

[laughter]

Dr. Yoni Rosenblatt: But here I am. Okay. But enough about me. So go ahead.

Dr. Brandon Parker: Yeah, so I mean, it's just pick your flavor at that point, 'cause at the end of the day, it's just the practitioner that you learned from, it's just their ability to break it down to a connection level that you prefer. I have plenty of people... I wouldn't say plenty, 'cause that sounds bad. But in my experience I've had multiple people that enjoyed the information that I was giving them; it just wasn't their style, wasn't their preferred method, they wanted some more hands-on. It's like, well, I'm on a computer screen. I can't really do that much, and I completely understand. Just, I hope that the information I've given you, you take it and implement it with the next person you work with. And once again, that does come down to ego. Is it a big ego hit when someone says, "Hey, this isn't working"? Of course, because I care. But you have to understand that different strokes for different folks, right?

Dr. Yoni Rosenblatt: Yeah, for sure. So along those lines, tell me, what do you wish chiropractors were better at?

Dr. Brandon Parker: Oh, for sure. Yeah, so there's a couple of things that I wish... [chuckle] I'll keep to this, 'cause I feel like this can be just the whole musculoskeletal community, but I'll do this one more specific for chiropractic. Chiropractic inherently teaches fragility, at least in my experience and in my schooling. It was a lot of, don't do this because you can do this, and it actually can spark a lot of fear-avoidance behavior, which we know is a whole pain cycle in itself. You can have a clean slate MRI and be in all the pain in the world because you're fearful of a particular movement, amongst all the other things that can influence it. So I do think that chiropractors need to stop coaching or teaching fragility, "If you don't do this, your adjustment's not gonna hold," which is not even a thing to begin with. You know, "Don't bend and twist because you're gonna slip a disc," and it's just like, "Well, bending and twisting is part of every day life. How about we build our tolerance and our preparedness in that position?" That's how I would see it. So there's that.

Dr. Brandon Parker: And then I would say that from my perspective on both physical therapy and chiropractic and all musculoskeletal community is stop, no-seboing people. You are trying to show how smart you are by using big words, which the second you use a big word you've already lost the patient, so who are you serving at this point? But then also just when you teach them what's going on, you have to make sure that it's concise, true, but it's painted in a positive light. That takes no time, and you're gonna make sure the person leaves not feeling like they need to be fearful of something. So I guess those are the two big things that I would say need to be improved.

Dr. Yoni Rosenblatt: Yeah, what's fascinating about that is it's not clinical, it's relationship, it's how it's taught, it's everything they don't cover in anyone's school necessarily very well, so I think there's so much value there. How do you relate to people and how do you learn to read people, read the room and meet that patient where they are, it's exactly what you said just earlier on in this conversation. What do you wish physical therapists were better at?

Dr. Brandon Parker: So aside from the... I might get some fire for this. But I think that there is a large obsession with the gate cycle, and with me working with, once again, fear-avoidant patients pretty often, you got these people that are like, "Did I evert, or did I invert here?" And just like, "Can you just walk? Just walk. Please." And it's just, when you get a fear-avoidant patient in front of you, you want to remove detail, take out... They're already in their head. Don't feed the machine here. I always like to say like it's... With people like that, keep it simple and basically just confront their expectations in the best way possible. If they're sitting there and they're saying like, "Every time I bend forward, it hurts," well, then I'd be like, "Okay, can you slouch into your chair?" And then they slouch in the chair. It's like, "How does it feel?" And it's like, "Well, the same." It's like, "Well, you've already started that position of forward flexion. That means that perhaps it might not be the position, it might just be the load, which means we can get you stronger and then we can basically get you back to doing the things you want to do." But, yeah, I don't wanna get on a soapbox here.

[laughter]

Dr. Yoni Rosenblatt: No, I want you on that soapbox, and I totally agree with those pieces. I think it's... Man, you just sound like a PT. I think the way... A good one. I think the way I like to look at it is Chiros have an awesome level of manual therapy knowhow; they are very good, by and large, about putting hands on patients, and just by doing that, whether it's a massage, whether it's manipulation, whether it's mobilization, that already just ingratiates you to the patient. And I just think that... I think, correct me if I'm wrong, that that's ingrained in your schooling. That does not show up very well in the PT schooling education side, so that's like a bucket that you guys have filled that I wish we could fill. Now, from an exercise standpoint and a progression standpoint, from a post-op standpoint...

Dr. Brandon Parker: I'm still here. I'm still here.

Dr. Yoni Rosenblatt: Okay.

Dr. Brandon Parker: I'm still here. One second. Told you, Jerry-rigged, but I'm here.

Dr. Yoni Rosenblatt: Okay, good. So I brought Marc Cesari into our clinic to teach us SFMA, which is standardly very PT-driven, but he was just awesome at, he filled that bucket. So I don't care what doctor you have; just you have filled that bucket. And I know I can learn from you and vice versa. I did a tremendous amount of manual therapy education because I thought that was just lacking. So if you can fill those things in, you're gonna take a step forward, at least, to being that practitioner, that well-rounded practitioner.

Dr. Brandon Parker: And ultimately, that is your job. You spent all this money and all this time to give the credentials as being a doctor, but at the end of the day that means nothing when you're in the room with the patient. I could just be... I mean, I know when I'm working with some people that they are taking my opinion with a grain of salt just to bring it back to their coach to see what the coach thinks, because at the end of the day, it's not about credentials, it's about who do they trust. And I'm fine with that. And that's what most people need to understand, stop getting the alphabet soup behind your name, like all these different certs and stuff like that, 'cause once again, they're just tools, and then focus on the person in front of you, and I guarantee you your patient outcomes are gonna go through the roof.

Dr. Yoni Rosenblatt: And that's what it's about. It's about the person in front of you and getting that patient to just achieve their goals. Whatever their goals are. Sit or stand without pain or less pain, making the NFL.

Dr. Brandon Parker: Yep. Exactly.

Dr. Yoni Rosenblatt: And that's just what it's about. Now, if you and I have very similar outlooks, doctorates, albeit, and different schools of thought, is there a place for a medical clinic or a musculoskeletal clinic with a physical therapist and a chiropractor working side by side?

Dr. Brandon Parker: That's a great question. And when it comes to... When it comes to scope of practice, I do feel like there is a large overlap, so I guess from a business side of things, maybe not. Maybe you could just, like you said, go to all these seminars and clean up where you don't know and then run your own thing. But I will say that I... So where I work in my in-person practice, it is multi-disciplinary. We do have a PT upstairs, and it's nice that people can stay in their wheelhouse, if you will, their specialties. 'Cause at the end of the day I like talking to people. I like getting down to the root of the cause, I also like doing the exercise stuff, but if I had to pick everything, I like talking to people. So how will I specialize in this, get to the root of the problem and hopefully create a plan that's perfect for you? And then I have the number one person that I can think about bring you through those movements, if you feel like you're unsure or uneasy about it. So once again, it just comes down to specialties, regardless of your doctorate or whatnot. It's, what do you like to do, because typically the thing you like to do is the thing you're best at, and how do you maximize your time in that, so hopefully you can maximize patient outcomes.

Dr. Yoni Rosenblatt: Yeah, that's awesome. I'm gonna tell you what I wish chiropractors would do or stop doing and then you're gonna tell me what you wish PTs would do or stop doing.

Dr. Brandon Parker: Gotcha. [chuckle]

Dr. Yoni Rosenblatt: I really want the chiropractor to stop telling the patient that they need to see the chiropractor once a week for the next 30 years.

Dr. Brandon Parker: Oh, God, it's so true. It's so dang true, and the amount of people that come to me from that. And I always have to unpack it where it's just like, "Yeah, and then they took an x-ray, said my neck was super straight," and just goes, "I'm gonna be honest with you, they took that X-ray as a sale, a fear tactic. Now they have something to point at, and we don't even know if that's actually your X-ray, and they're gonna sign you up on the spot and really use your emotion and your pain," and that's... It's predatorial, it's parasitic, and I hate that. And I have good news and bad news. I do think that the good side of things is there are more people practicing like me. We're inspiring a lot of people. I do have a seminar that I do run with another chiropractor that's chatting with me, and we target kids that are in school like, "Hey, you need to practice like this." But at the end of the day when you get out of school... And I'm sure that it was similar than what you had, is you get out of school and it's such an uncertain time, "What am I gonna be doing? Do I get a job somewhere else? Do I do this? Do I do that?"

Dr. Brandon Parker: And then you have these practice management people just get a hold of you and go, "Okay, do you want to not be a failure? You're gonna do this system 'cause it's been proven time and time again," and that's where you see these cookie-cutter setups where they can do just the bare minimum to build the insurance. Therapeutic exercise, the guy's sitting on a wobble chair. What are you talking about? Then you go there, you get adjusted, you get a little manual therapy and then they kick you out the door. Once again, that's a business.

Dr. Yoni Rosenblatt: That's what I was gonna ask you, is where do you guys learn that? Where do you learn the once a week for 30 years? Where does that come from? It comes from consultancies?

Dr. Brandon Parker: Yeah, that right there is not actually from our schooling, it's from the practice management people saying, "You wanna make a lot of money? This is how you have to do it." And because kids are so uncertain because... We have two business classes, but they're not business classes; they're kind of just like, "Hey, this is how you build, and this is the general setup that you should have" but the whole... I don't wanna use any specific names, but a lot of these practice management firms, it's essentially just, "How can we herd as much people through the door and out the door as quick as possible?" And that's why you see a lot of it is, is because it does get people money and then also it's, once again, the uncertain person that's gonna throw all their eggs into somebody else's basket 'cause that's where the trust lies. So if we were to have people... If I had a management firm, which it wouldn't work because it's not the most lucrative, like I said, I think that we would start to see a big trend if I didn't have the money behind it. So I do think that is the big, big thing of why we see that so often.

Dr. Yoni Rosenblatt: Yeah. Okay. So that's really illuminating to me. Now I kinda know where it comes from. And I'm thrilled to hear that you're changing that narrative. I think that's why we're having this conversation, is to change that narrative and ultimately get those patients better, quicker and more efficiently. So I obviously support that, but that's really eye-opening. Tell me what you want me to change about the way we practice, PTs.

Dr. Brandon Parker: I would say what, everything that you are doing and the content list that I've seen is something that I would like to see more across the board. And I understand that, once again, different flavors for different folks, but we need to stop, we need to... The traditional, oh, I'm sorry, the traditional physical therapy down here is, you walk into an open space, there's all the bunch of athletic training tables on the outside, there's an ultrasound, which we all know is so great, with the Stim pads, and then you have people just doing some band work. And just like, "Okay, they display competency with these bands. What do you do?" "Well, add another band." Or how about we progress it towards something that they're actually doing? And this is for a lot of rehab, it's not just PT, but those are the places that upset me because it can be what you are displaying. Even if you're not an athlete, if you train like one, you're gonna feel like a kid again, because what do kids do? They become athletes. They move around, they run around, they do all these things. But if you sit all day and then you go back to physical therapy and you do banded external rotations, how do you expect that to have a large effect on your life? You know what I'm saying?

Dr. Yoni Rosenblatt: I know exactly what you're saying. And why do you have to do banded external rotations three days a week under someone's supervision? That's... I'll answer your question for you. That's what PTs should change. Freaking hate that crap. And stop handing your patients off to techs who are currently in high school getting community service hours. That gives everyone a bad nam, and that's why Brandon Parker can't trust PTs, because of that trash.

Dr. Brandon Parker: I don't know about that though.

[laughter]

Dr. Yoni Rosenblatt: Sorry, I just lost my mind there. Okay, let me bring it all the way back because another thing that I'm dying to talk to you about is this mobility manual and some of the stuff and programming and planning that you're putting together. So tell them masses about what you got going on.

Dr. Brandon Parker: Yeah, so with the recent uptick in my following on Instagram, I realized that the information that I was posting was being well-received. It all started with me just trying to post exercises for my personal patients. I was just like, "I don't have enough time to show you this stuff, but I'm gonna send you a video personally for you." But I was like, "Okay, why don't I just post this on my Instagram?" So I started to do that, and of course, the followings started to come, and I was like, "Okay, if I can serve my patients and also serve the world, this seems to be the best avenue to take." So I'm creating this mobility manual series starting off with the lower back and hips of just it being seven mobility flow exercises, just a small 15-minute thing you could do each of the days of the week, and then it's paired with two e-books. The first e-book is 'Recovery 101'. Essentially, teaches people how to improve the basics of nutrition, improve their nutrition, improve their sleep, and also improve their stress management. We know if we can master those three pillars of recovery, our burden of pain will go down.

Dr. Brandon Parker: The other thing that we have is a community, because at the end of the day, if you look at any successful workout system or rehab system, they all have a sense of community and a sense of accountability. So it's my goal to start up this community, just be that bug in the ear saying, "Hey, if you haven't done this, try this," and then just continue to motivate people to try different movements, because at the end of the day, if we look at the world, let's just say United States as a whole, a mass majority are going to be de-conditioned, and if they just were to simply walk and do simple body weight exercises, they can tremendously help themselves. So this is my goal, to basically address the lowest-hanging fruits to help as many people as possible, and then hopefully, the people that are bought in, I can release the next thing and say, "Hey, you were here, now you're ready for this," and then, hey, who knows, I might get a couple in the NFL. No.

[laughter]

Dr. Yoni Rosenblatt: It's gonna be your old FNL. We'll see. That sounds really awesome. How do we find out more about that?

Dr. Brandon Parker: That's going to be released exclusively on my Instagram. There's going to be a link in the my bio. So as soon as you see that link, that's going to be access to the thing that I'm offering. But, yeah, things are slow-turning, which I'm learning in business world.

[laughter]

Dr. Yoni Rosenblatt: Yeah, it's always, anything worthwhile comes along slowly. So tell me or tell all the listenership, how do we find you on Instagram? 

Dr. Brandon Parker: Yeah, so you can find me at bs.parker. It's hilarious. My first name is Brandon, last name is Parker. The S means absolutely nothing. It was the only way that I can get b.parker in a handle because everything else was taken, so... [laughter]

Dr. Yoni Rosenblatt: We won't assume that BS is anything else other than your initials. Not even your initials. Okay. Okay, bs.parker, and there you'll be dropping that mobility manual. That is super exciting. It's such a great premise. And you really have just this awesome way about communicating both with myself, but also with patients that I've seen, and your ability to put up digestible content has been awesome.

Dr. Brandon Parker: Thank you.

Dr. Yoni Rosenblatt: So, yeah, you're doing everyone a service by everything that you're creating. And I really just wanna thank you for sharing some of the chiropractic outlook on physical therapy but also in patient care, 'cause I think it's such a... It's so lacking in the PT world, and there is no reason that we cannot continue to work together, to learn from one another for the betterment of our patients, and that is what it's about.

Dr. Brandon Parker: Amen, man. That's exactly what it's all about.

Dr. Yoni Rosenblatt: Awesome. Brandon, thank you so much for your time.

Dr. Yoni Rosenblatt: As always, I'm gonna ask you for a favor. Please listen, learn, and share our content, and leave us a five-star review wherever you consume your True Sports Pod. That little act of kindness will go a very long way to helping us and helping our profession. You can reach out directly to me with feedback on the pod, what you loved, what you didn't love and who you wanna hear from. Also, if you wanna join our team of outstanding sports PTs, shoot me a DM on Instagram @truesportspt or email me directly on yoni, Y-O-N-I, @truesportspt.com, because after all this is what sports rehab should be. Look forward to hearing from you all soon.

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