In today’s episode of the Building A Healthier Edmonton Podcast, I interview Dr. Jerome Fryer of Dynamic Chiropractic Clinic & Dynamic Disc Designs.
In todays episode we briefly discuss Dr. Fryer’s history and how turned away from the dark side, and decided on a career in natural health care.
Dr. Fryer shares his experience as a researcher on spinal dynamics and his use of MRI.
We describe how disc height loss is a common source of back pain, and strategies on how to maintain disc height to reduce back pain.
Dr. Fryer describes the 2 main causes of back pain-Stenosis and Disc herniation- and how they differ, and what to do about it.
Near the end of our chat, Dr. Fryer shares a secret strategy he gives his patients to INCREASE disc height throughout the day, without expensive tools, gadgets or pills.
Key Take Aways:
> Back pain is closely linked to loss in disc height
> Education, and KNOWING what is causing your pain is the most important factor in treatment and management of back pain.
> An accurate and detailed assessment is one of the most important part of your treatment, so you know what is causing your pain, and WHY.
> Minute changes in our bodies and spines, can make a drastic change on how we feel, and how well we function.
> As we get older, our discs dry out, and become more homogenous.
> Offloading the disc. may be an important strategy to help you alleviate your back pain.
> Whale spines are very big, and impossible to adjust…They are just too big, and too much tissue between their back, and their spines
Click Here To Access The Full Transcript Of This Episode With Dr. Jerome Fryer
There we go. Hi, welcome to the building, a healthier Edmonton podcast. I I’m with Dr. Jerome fryer. He’s a chiropractor out in the Nanaimo. He runs Dynamic Chiropractic Clinic and he’s also operating Dynamic Disc Designs, which is a, he builds models of different areas of the body. Good afternoon.
Yes. Good afternoon to you.
Well Doctor or Dr. Fryer. So tell me about you’re obviously a chiropractor. So tell me a little bit why you got into chiropractic in the first place I wanted to get into chiropractic because I, well, I, I had a sports background and I wanted to help people regarding their injuries and I wanted to make an impact.
Plus I had to kind of get going. I was wandering around and UBC and. What am I going to do with my life here? You know, so I didn’t want to live at home any longer, so I had to getgoing. So I had to choose a career and I chose chiropractic because it was natural. I liked the natural kind of theme behind chiropractic.
Pharma is. Big animal. And I thought, oh, I didn’t want to be biased with my education so Icould bring the best and the most natural therapeutics to my patients. And yeah, I just basically chose, it was either going to be an environmental lawyer help the planet, or I was going to help the people and it was like a toss up, so.
Okay. And it’s been 22 years now.
Oh, I see. Well, I’m glad you didn’t turn to the dark side there. No offense to any lawyers listening. That’s great. You went to health care and use the force.
So You have a lot of experience, obviously dealing with people with a lot of back problems, a lot of musculoskeletal pain.
Tell us a little bit about like how you, how you work in your clinic. There’s a bunch of different chiropractors. They do different things. So how is your kind of style of practice?
There’s not a bunch of different chiropractors. I’m the only one in this one clinic. So I just.Focused focused attention on patient education and you know, arriving at an appropriate,specific as specific as I could possibly possibly be for diagnosis.
And then. Map out a therapeutic plan for that specific person, you know, and everybody brings in their own little package of injuries and stress and, and, you know, right. So you have to be, you have to be adaptable to each case, but I Around 2000 in 2007, I started a research career too, and I started pushing with some research ideas I had and a lot of thethemes that came out of that research paper that was published in 2010, had to do with off loading.
So often when we know, well, we know there’s a common theme with. And it’s. If you lookat, you know, the full population who has back pain, one of the most common themes is that you will find disc height loss. You will very likely most probable is that the disc in these people have lost some. Okay. Some of them have lost quite a bit of height at a particular motion segment.
Sometimes a disc height is lost here and the one above is moving too much. For example, if you’ve got disc height loss, for example, at this one, well, the one above, because this is stiffened. Now the one above is moving more. So the theme that I have. That I constantly work on is keeping people tall, keeping disc Heights as tall as they can be minimizing the compressive loads over time.
Like for example, I just I was part of this study recently that was published in the journal of ergonomics. And just sitting here, you and I are losing height. Our disks are slowly compressing. And when a disc has lost its ability to maintain its own height, it loses its height. So, for example, with my patients, I’ll, you know, they’ll be leaning on the, you know, they will be leaning on the, on the arm rest.
And and I got the other hand kind of on their, on their leg. And I can tell already this is very likely a compressive issue because they’re naturally offloading with their arms to slow down. The compression in their spine. And I saw this with using upright MRI and in Scotland where we used an upright , you know, MRIs normally horizontal, but most people have symptoms when they’re vertical, whether they’re standing, whether they’re sitting first thing in the morning.
So I went to Scotland and used the first ever upright MRI. And I was invited to this clinic and we were measuring disc height changes, angular changes. At you remember those books that you’d flip through and it would be kind of animated, but each page would have a different sort of scene. So the character would move, right?
Well, we looked at 30 seconds. This is as tight as we can get with the MRI, 32nd images, every 30 seconds images of the discs. And I could see them just, they, they would, they were moving. So my theme, my clinic, for the most part on the therapeutic side of it is, is a balance out, balancing out the motion between each vertebrae and giving them strategies throughout the day to offload or to keep their tires pumped up.
Okay. I’m curious with that MRI couple questions here. Why, why do you think, or why aren’t standing MRIs more like readily done and. Yeah, let’s start with that question. Cause, because that, that seems so obvious because most of the problems when they are, like you said, when they’re standing, when they’re upright, I think the problem was in the execution of the technology.
So the most radiologists, all radiologists conventionally are trained with 1.5 Tesla magnet.So basically think of that, like a mega pixel camera. They are basically they’re For example, I’ll use a 10 megapixels megapixels, right? So all radiologists that are trained, they’re used to looking at 10 Meg megapixel images so they can zoom in, zoom out, zoom in, zoom out.
So they’ve got all these pixels, right? And then you go to the three Tesla, which is like some radiologists don’t even like looking at it because there’s so much detail that they don’t even know. They have a hard time. Report is too much detail for them, interestingly.Okay. So, but their standard is 1.5, but the upright MRI’s 0.6.
So what happened was when this got to market the radiologist would take these images and they go, this is only 0.6. I’m not reading. This is the only 0.6. I’m not reading this, but they’re not looking at the bigger picture of the motion and the load, the disc changes. I was actually authored. I I was a lead author on this paper and the, and the, and the anchor author was Dr.
Francis. Who actually pioneered the the upright MRI. He was the one that I gave this presentation to. So and so he told me this story about you know, why it hasn’t been sort of, it hasn’t been much of an uptake. It’s a.
Okay. So it has to do with that makes sense. So if you’re not used to seeing a certain image in a certain clarity, I suppose you could say, it’d be, you just wouldn’t be used to reading it.
So it’d be kind of like, not as detailed or yeah. Yeah, exactly.
They were like, you know, there’s not enough information here and this is a poor quality study you would think necessarily. Right. So, so they would just dismiss it. So that was. That’s kind of how it kinda got it. Didn’t get sort of integrated.
But there’s still research facilities. If you look at the research, you know, you look at, you know, when you bend the spine backwards, Right. You know, the disc bulge into the canal, pushing on the nerves and you bend forward in the annulus will come tight. It comes tight and the come comes off or the ligament folds on itself.
So there are aspects, and we know this with patients, we know this, that patients have pain when they walk for like, you know, whatever. To their mailbox or it could take them 10 kilometers. There is something going on. That’s different in there. And the models thatI’ve created take that dynamic component into the equation.
Even if it’s millimeters millimeters, when you are fractions of a millimeter of a root lit matters.
Yeah, that would, that’d be, I could make a huge impact on someone. You’re just slight movements. I see that. Well, obviously we both see that in practice. I’m curious what these MRI studies, where they really looking at disc Heights in like a healthy population where they didn’t have any pain or these in symptomatic.
Which studies you taught. So the one you mentioned where you had the functional or theMRI did the 32nd intervals and you, yeah, that was,
yeah, that was our study. So that was our study. So that’s when I went to Scotland and we took who we could get. We actually went in the hospital and we actually recruited nurses that were, that were that had a break.
And so for the most part, they were asymptomatic. And I didn’t, I didn’t screen out previous back pain or anything like that. I was just, I was getting who I could, because it was kind of a pie. It’s a pioneering study. Nobody had done that before. Right. So it was to get some baseline.
Okay. Yeah, that makes sense.
And for anyone who’s not familiar with the research it’s a long grueling process. And sometimes, especially with when you’re dealing with people, you need to get whoever you can get. I remember I did some research back in like my undergrad and yeah, it just takes way longer to do. And it’s It’s grilling basically.
Yeah. And when it’s self-funded too, this was something that you know, I, I pulled out of my own pocket to make this move because I was just excited about the idea that I had developed with this offloading exercise. So I was like, I don’t know. Let’s go let’s, let’s make this happen. So that, that too, right?
So some common issues with this offloading, it could be with a lot of people with back problems, as you mentioned, that lost a disc height. But it’s especially prevalent with people that as they get older someone who may have some narrowing in there, some stenosis, or if you’re having. Disc herniation say chronic disc bulge..
And then as you mentioned, you’re able to walk a certain distance. And then those symptoms gradually start building up where they’ve gradually started coming on, either back pain. And sometimes you can start getting that radiation into the legs, that sciatic pain. What are some strategies that you find useful for patients that are dealing with this kind of problems?
Okay, let me just go get something. I’ll be right back. I’ll ship for a demonstration purposehere.
So if you’re just, if you’re just listening to this doctor Fryer, he has some models that he’s kind of illustrated. So you may want to check out the video if so you describe the patient that has stenosis so quickly.
Here’s the, I just pulled the nerves out of the canal. Here’s the spinal canal and you can see how open it is.
All right. Lots of. All right. Lots of room for this guy. There are the nerves that go into yourlegs. These guys here. So this canal needs to remain open. Yeah, but you can see down here, there’s actually a disc that’s kind of bulging back a little bit. And if you can see that,right, right. So it actually can take up a little bit of space and then when you compress it, it takes up a little bit more space.
So over time, what happens is this is a relatively young spine because it’s got good disc height, but over time, this will lose its height and you can develop. Into this, which is where the disc flattens. All right. And then there’s osteoarthritis of the facet joints here. But importantly, if you look down the canal, right, it looked down the canal and you see a very tight canal.
And if you put a pin up this one, okay. Put a pin up. This one, it’s actually kind of. All right.So you asked me what sort of strategies are going to be helpful for people with this. I’m getting to it. Right. But for me, part of, part of my clinic and what I do here is I empower people with understanding what it is they have, so they can start making their own decisions about which exercises would be held.
Yeah, really make their own to start making educated decisions. So this, for example, that’s the front, right? This is the back. When people walk, the spine goes into extension a little bit and it compresses a little further and you can see that this gets tighter. It actually narrows the space. So, but if, when, what, what do these people, what do these people typically do?
Joseph? When they have symptoms, what do they like to do? Okay. So what does sit down, look like, looks like flexes. Okay. So let’s flex this and now look at that and look how much it didn’t take much. I just flex it like two degrees and look at that now. So that’swhy people can walk a certain distance. It starts to encroach on the nerves and then theysit in deflection.
Right. But remember when you sit in flexion, usually you’re compressing your disc again. Right. So you’re kind of not you’re you’re, you’re giving yourself some symptomatic relief,but are you targeting. The main issue, which is the disc height loss, not at times, right. It depends on what, how bad your stenosis is.
Right, right. So do you think that maybe doing something, you know, on all fours you see, can do, I’m not going to be able to get on all fours, like a quadruped right now you’re off. The disc is not under compression because you’re on a horizontal state. Right, right. I’ve got my hands on the ground here.
Right. And then, and then I’m more of a horizontal state then go into flexion probably better. Right. Okay. Yeah. Cause then you’re decompressing that disc as well as flexing that the spinal canal make more. Okay. That makes a lot of sense. Yeah. Okay, great. And how about someone with it would have been like a similar situation as well.
So those stenotic people, as there are typically you know, in their sixties and older and then a lot of times people, you know, if they’re younger, they may have like a disc herniation and they actually find movement can be helpful, but if they, if they move too much, They, you know, things get sore again.
Would you have like a similar strategy for, for this kind of population?
Well, and it really, it’s kinda difficult because these are pretty unique. AI it’s it’s, it’s, it’s it’s difficult to do that without a proper assessment. I was talking to general app generalities and, you know, so keep your readers, keep in mind.
Make sure you have a specific assessment and specific diagnosis before doing any of these exercises. Right. But you know, do you have a central canal stenosis or is it a lateralstenosis where the nerve root is being pinched on the outside? And for example, you talked about the younger population, right?
So why do the, does the, a younger population more likely to get a disc herniation or what is a disc herniation? Well, that is when you have a more pliable juicy, so to speak disc that actually is more maneuverable and it has a nucleus, which is in the middle and an annulus. There are actually two distinct tissues when you get.
Old, it becomes kind of one homogeneous kind of tissue, the nucleus kind of melds into the annulus and it becomes one kind of tissue here. You have a distinct different, so when you bend forward, remember that, you know, when some people would walk a certain distance and they’d feel better inflection, but with these people.
If they have this type of an injury where they have an annular fissure, which is like a little tear on the inside bending forward will actually spread open that Fisher and cause the nucleus to push posteriorly, like it’ll actually come back. Right. So that’s not so good. I had a recent case. You know, there’s certain, you hope that people are listening right.
When you talk and, and when you try to educate the models, help a lot. And I had a case Ididn’t didn’t, I haven’t seen this guy too often, you know, his back flares up, maybe see him once a year or something. Right. But he’d done something to his back and He was trying to say he was young guy and he was like determined to stretch it out,
Blue his disc right out. Right. You know, and I thought, you know, did I fail with my education? I don’t think so. I just think that he wasn’t listening and paying attention, you know? And it’s really unfortunate because I, when he came in, I was like,
I took took that to heart. I’m like, you’re a patient of mine and that happened, right. That’sjust, you should know better, you know? So it’s, it’s, it’s so understanding, you know, what it is is very, very important, you know? And I think now I heard that he’s like lined up for surgery and he doesn’t even, he doesn’t even need surgery, but he got kind of whisked away by.
That world. Right. And so anyways, so you gotta be minus. Right. You got to figure out, you got to go to somebody like Joseph to, you know, figure out specifically what’s going on before you start implementing a proper strategy. Right. So in this case, you know, someone comes in and they have Cynthia. They go, you know, I check their range of motion and I said, okay, bend forward.
And they go like this and I can see on their face, like, Ooh, it hurts. And then they go, like,you’re going to show me their range of motion. Yeah. You’ve seen that. I don’t know why people do that. It’s I’m not impressed with how far you can go. I just want to see how you respond. So I don’t know why people do that, but they do well because we’ve always prided ourselves on, on, you know, flexibility.
And you’ve gotta, you know, historically is like, can you touch your toes? Okay. You’re good to go. You’re in the army, you know? And also there’s history. But it’s all about the quality of motion. That’s that I’m more interested in. And, you know, so for example, if someone comes in and they have symptoms and flexion, what I’ll do is I say, okay, that’s good.
Don’t try to show off and show me how much you got here. Right? And then we’ll check extension and if they have good extension. Well, guess what, we’re going to be doing offloading exercises in extension to approximate and to pull those two tissues together, there’s a little fisher, it’s kind of like a cut in the skin.
And you want to like, if it’s really cut, guess what you gotta do. You gotta go get stitches. The spine is very similar. It likes to approximate. So this fibrocytes can kind of hang on and try to men. Right. But if you keep opening it up, are. And then it just becomes granulation tissue there and it becomes chronically inflamed and nerves start to grow in which I’ve demonstrated in here.
So yeah, I can go on and on and on, but I’d better.
Yeah. I think, I think good. I think the basic understanding here is you got to know what’s causing the problems so you can treat it and do the strategies on your own most appropriately and not. Because it feels like a tight muscle. Don’t just stretch it because oftentimes people will have disc problems and you just have back pain and quote, quote, unquote, just have back pain and you try to stretch it and you’ll be like, oh, that’s such a good stretch because I feel it.
But like, if it’s a disc problem, like you’re actually, you’re making it a lot worse. I remember I was listening in, on a presentation with Dr. William Morgan. Parker university president. And he was talking about a patient who they had they had a disc injury, it had an MRI, he had a disc injury and he started doing some rehab with a different person and they were trying to flex them because they’re like, oh, you can’t bend forward.
So we want to make you bend forward. Which was the wrong thing to do. And that just made this person have just exactly, as you described that this didn’t heal it got those nerve infiltration into the desk and then it was chronically inflamed and he has just persistent, persistent pain now. Well, what would you say is there, is there anything else that you’d like to mention today?
We talked a lot. Trying to maintain that disc height. Is there any strategies that you have ageneric? Obviously we talked about being specific but different things people can do to try to maintain the health of their discs?. Either nutritionally or exercise wise or otherwise, this is going to be a secret.
Don’t tell anybody. Okay. This one was actually when I went to Scott. And I was a young researcher. I was very excited about my protocol that I put together. So I had subjects sitting on a status of meter and I measured their height. Right. And then I got them to sit there for 15 minutes and then I measured their height again and went down and then I got them to do the exercise.
All right. Five times, five seconds. And their height went beyond the initial height. And I was so excited and then their height after seven minutes started to come down again. And I was so excited with a static meter because I was, I was going to go, I went to Scotland to measure it with MRI, and I said, okay, now the subject needs to go into the MRI now.
And Francis Smith, your reference to star wars in the beginning, he’s the Yoda of spine. He said, draw. You must lay the subject down for 10 minutes in order to neutralize the disc height. And I was like, I was like, that’s even more interesting than my, my exercise. So guess what? I encourage, I encourage people to take five to 10 minutes naps throughout the day to replenish.
Simple five to 10. If you look at the cycle, the diurnal cycle and disc height, it’s within the first five to 10 minutes that you get the greatest return on that disc height. So when you’re, you know, at the lunch, if you’re like sitting in Eaton, well, I guess you didn’t want to lay down and eat, but if you’re, if you’re resting and you’re sitting watching TV, or you’re watching your phone or something, guess what?
Get recumbent get recumbent for five to 10 minutes, not being lazy. Nothing’s going to get weak on you. You actually increase the disc height significantly and then reads like recharging your phone just where you go. Again. That to me is, has, I’ve helped countlesspeople by telling them, take a nap, right.
Seriously, that, and you don’t need to fall asleep. You just need to get. Right. Just lay down for five to 10 minutes. Yeah. Okay. I think I’m going to have a lot of employers kind of coming at me wondering why they need to get all these cots at work. That’s a great idea. Great. Well, thank you for sharing that.
Anything else you’d like to mention to our listeners today? Anything that I didn’t failed to ask you today? I don’t think. Okay. Great. Well, w what’s the best way for people to get ahold of you if they’re out into Nymo? If there are no someone out in BC, or if they’re curious about your models or any of the research that you’re doing?
Yeah. So my chiropractor website is drfryer.ca and my dynamic disc designs, which is thespine models is dynamicdiscdesigns.com. And I have some other websites. That’s, that’lldirect you to my research and all the testimonials from all over the world. Now these are being shipped all over the world because people are starting to really take notice on, on the posture and the mechanics that.
Yeah, your models are awesome. I have a couple of one at the office here. I got to get a couple more. But yeah, they really help kind of illustrate provide patients with that education so they know what’s happening. Th these are much better than the, the crappy plastic ones. I mean, the plastic ones that you see otherwise, cause this, it actually has like a functional model to it.
So you can see how everything actually changes dynamically. So I got one, you asked meif there’s anything that I wanted to share that. And I may know what that is. That is a blue whale spine. Those are actual real vertebrae of a blue whale that were donated to me by a fishermen. When I worked on the west coast in Tofino and you’re clueless and I strung them up.
There’s 11 of 56. So it’s right beside my cabinet, where I display my models to give people our proper scale comparison. So when they walk into the treatment room, Yeah, that’s suspended above them.
That’s pretty cool. I wonder what my colleagues here there, they treat animals as well. I’m wondering how they’d be able to adjust the belugas spine.
That’d be interesting, but it’s impossible. All the, all the soft tissue, right? Yeah.
Yeah. Cool. Well, thanks again, Dr. Fryer. And if anyone’s just said and what you’re doing, I’ll definitely reach out to him. He’s a wealth of knowledge, so everyone thank you for watching or listening. And we’ll talk to you next time.
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