Dr. Kevin Smith on Functional Medicine

 Can a simple change in chainring shape unlock more pedaling power? Tom Butler put oval chainrings on two bikes to find out. He also explores the value that bike clubs bring to a community — and suggests it might be bigger than many people think. Then Tom is joined by Dr. Kevin Smith, the clinician behind metabolicsolutions.net and the Chronic Conditions Center in Bethel Park, PA. Dr. Smith brings his knowledge of functional medicine to the podcast, helping listeners understand a more comprehensive view of health. 

LINK

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Transcript

Intro Plus Oval Chainrings Experiment

Tom Butler 0:04

This is the Cycling Over 60 Podcast, season 4, episode 12, Dr. Kevin Smith on Functional Medicine. And I'm your host, Tom Butler. Back on February 5th of 2025, I posted an episode with Garen where we talked about oval chain rings. I'm not gonna rehash what we covered there, but I do want to share an update. I now have oval chain rings on two bikes. One is my Truk FX3, which is my runaround town bike, and the other is my new Atsow Warkin. I'm hoping to get a short episode out on the Warkin soon, but that's for another day. Both bikes have a single chainring setup, and I decided to go oval because I felt like it could be a better fit for how I pedal. I actually bought an oval absolute black chainring over six months ago for the FX3, but I just never got around to putting it on. Then, when I was choosing components for the Warkin, I decided to try a Wolftooth oval chainring instead of what is standard. The biggest reason for going oval on the Warkin is that I plan to load that bike up with camping gear and do some bikepacking. I wanted to set it up to climb hills while carrying weight. And here's the thing, I don't think I generate a whole lot of power in a circular pedaling motion. I'm prepared to be wrong about that someday, but in the three years I've been riding a lot, I haven't been able to find much power through a full circular stroke, especially going uphill. I don't know if there's a way for me to get on some device and actually see how I'm generating power throughout a pedal stroke, but my gut tells me it's not even close to being in a circle. I've tried some exercises to make it better, but I don't see it improving at all. So I put the oval chain ring on the Warkin to see if I could feel a difference climbing. And honestly, I don't feel any difference at all. But it is a new bike with different gearing than the Roubaix, which is what I do most of my climbing on, so I thought maybe I just didn't have a good comparison. That's what finally got me to pull that absolute black chain ring off the corner of my desk and put it on the FX3. I've got a lot of miles on that bike, so I figured I'd have a better chance of actually feeling a difference. But I don't. Not really. And honestly, that's fine. That actually makes me feel like it's alright to just ride with the oval chain rings for a while and see what I see with performance measures over time. I can always switch back. For me, there's a lot of logic behind the decision, and like I said, we got into all of that in the episode earlier with Garen. Another thing I want to get into here is bike clubs. I've mentioned before that I'm the community and government relations director for the Tacoma Washington Bicycle Club. I've been looking at a question lately. Does the community actually need a bike club? That's a different question from do cyclists want to ride together? I'm looking at what's happening in American life right now. The Surgeon General declared loneliness, public health epidemic in 2023. Traditional civic clubs are collapsing. A market law school poll from early 2025 found that only 6% of American adults belong to a civic club like Rotary or League of Women Voters. The Elks, the Masons, the Lions Club, PTAs, they've all seen massive declines. But at the same time, which is a little odd, an AmeriCorps report found that community-based organizations have seen their highest levels of participation ever measured. People seem to want to connect and be engaged. And that's where I start thinking about bike clubs differently. A bike club brings people together for regular face-to-face interactions, gives an opportunity to build trust and relationships among people. Take the Tacoma Washington Bicycle Club. It's a nonprofit that's been around for over 50 years. We do advocacy, we support organizations like Second Cycle, a community bike hub that works to get everybody on bikes, regardless of resources, and the Foothills Rails to Trail Coalition, a group that looks after a world-class trail. A bike club isn't the same as rotary. Rotary was built around community service as a primary mission. A bike club is built around a recreational activity. The civic benefit is a byproduct, not the thing on the poster. But as the old civic institutions keep disappearing, I think there's a real role for activity-based groups like bike clubs to step into some of that space. I think it just takes some intention. There's also an environmental angle that I think gets overlooked. Transportation is the largest source of greenhouse gas emissions in the US, 29%, and most of that comes from passenger cars. Choosing a bike over a car just once a day cuts a person's transportation emissions by 67%. An Oxford study found that regular cyclists have 84% lower CO2 emissions from all their daily travel compared to non-cyclists. So is a bike club an environmental organization? Most members aren't showing up to save the planet, they're showing up to ride. But every member who rides to the store instead of driving, every new rider the club brings in, every piece of infrastructure the bike advocates for, that's environmental impact. A bike club is an environmental organization by effect, even if it's not always intention. I think most clubs work to advocate for infrastructure. For example, Tacoma Washington Bicycle Club works alongside Forevergreen Trails. They work to build the trail network, and the bike club brings riders to those trails and also brings an on-road perspective. And that's certainly a bigger picture of what a bike club does than just organizing rides. So to the question of whether or not a community needs a bike club, I think yes. And it's not just for riding, it's not just for organizing rides. I think the bike club can sit at the intersection of social connection, civic engagement, and environmental action. I think those three things are valuable to a community. I'd like to hear from you. If you're part of a bike club, why is it valuable to you? What does your club do for your community that doesn't get talked about enough? Send me an email. You can find my address in the show notes. I want to keep exploring this and your perspective matters. Here's the way I see it. There are a couple types of healthcare in my mind. If I get cut and it gets infected, I want a healthcare professional that can identify what is causing the infection and eliminate it. But I also want to have a strong immune system so that my body is able to maximize its ability to fight infection. So it is that second focus, the focus on a comprehensive approach to being healthy, that I would like to get more and more information on. I was introduced to Dr. Kevin Smith, and I wanted to talk to him because of his focus on chronic conditions. I felt like his area of practice could give a great perspective on functional medicine. Here is our conversation. Thank you, Dr. Kevin Smith, for joining me on the podcast today. Thank you for inviting me. It's a pleasure to be here. Now I wanted to have you on because you have a focus on chronic conditions. And I think there are few things that are more disruptive than like living with chronic pain. And I wanted to get your perspective on that. And I also wanted to hear from you about functional medicine.

Dr. Smith 7:40

Okay.

Tom Butler 7:40

So let's start here. Would you talk about how you became interested in helping people maintain health?

Dr. Smith 7:48

Okay, so I went to the Palmer College of Chiropractic in Davenport, Iowa, and I graduated from there in 2001. And when I graduated, I moved back to Pittsburgh, where I live, and I hung a shingle and I started to help people with things that you normally associate going to a chiropractor for, like things like back pain and knee pain, neck pain, headaches, migraines, auto accidents, sports injuries. And I was pretty good at what I did, and word was getting around, and my practice was growing. And but every once in a while, people would come in with some weird, mysterious problems that I could not fix using the tools that I was given in chiropractic school. Things like high blood pressure or thyroid disease or brain problems or GI problems, autoimmunity. And so that led me to wonder what am I missing? What could I do to help more people? And that led me to attend a lot of seminars and read books and see what I could do. And I started to explore clinical nutrition. And I started to go down that rabbit hole. And that eventually led me to become a board-certified clinical nutritionist. Then I started to learn a little bit more about lab testing and functional blood chemistry analysis and ear analysis. And that led me to the enter the world of functional medicine, which is a personalized patient-centered approach to health care. Now, there's two different types of health care that I found out in this country. There's the type of health care called allopathic health care. And allopathic health care is what most medical doctors practice. And they are concerned with chasing after symptoms, usually in the form of a chemical or a drug. Whereas the second type of health care, which is what I practice, that's called functional health care, functional medicine. And functional medicine is a ask the question, why? Why do you have high blood pressure? Why do you have constipation? Why do you have thyroid disease? What's what's the hidden root cause that's driving the problem in the first place? Medical doctors don't ask that question. They don't care. They just want to they want to push your physiology back to normal on paper so it looks good. And that's the what I would consider to be the insurance model of healthcare in this country.

Tom Butler 10:50

Now, have you maintained kind of a chiropractic practice alongside of the the blood chemistry testing and things like that?

Dr. Smith 11:00

Yes. So I'm about 50% of what I do is chiropractic care, and 50% of what I do is metabolic care. So I can reach into both worlds. So if it's the problem is more musculoskeletal, then I can use chiropractic stuff for that. And if it's more metabolic, then I can use like functional medicine for that as well.

Tom Butler 11:23

Now, my family is very familiar with chiropractic care. I'm curious from your perspective, do you think most people are now? Do you think there's still some misconceptions about chiropractic care? What is your experience with that?

Dr. Smith 11:38

Well, I think that things have gotten better for chiropractic in this country since I started to practice. When I got out of school about 25 years ago, there was a lot of professional bigotry that was going on. People feared what they didn't under didn't understand. And the fact remains, people don't really understand what chiropractic is and what it's not. And that that fear of the unknown is what drives a lot of the misconceptions. But I think that that's less and less today.

Tom Butler 12:18

That is has been a leader in chiropractic education through the years. Am I right about that?

Dr. Smith 12:25

Yes. Chiropractic was invented by D D D Palmer in 1895. And then his son, BJ Palmer, was the uh was the developer of chiropractic. And he promoted chiropractic, he had the biggest radio station on the west side of the Mississippi River. The biggest radio station the in the east side of the Mississippi River was KDKA radio in Pittsburgh and my hometown. But he he promoted it by through his radio station. And it was very, very popular on the on the on the airwaves. But it it's gone through a lot of different uh different types of uh iterations throughout the throughout his history. The the the the concept of bone setting is nothing new. I mean, Hippocrates, the father of medicine, was a bone setter, so it's been going on for thousands of years. More recently, there's another profession called osteopathy. The uh the profession started about 20 years prior to chiropractic, and chiropractic started in the 1895, and so it's been around for a long, long time.

Tom Butler 13:49

So I want to pull some things together here. You talked about chiropractic care, and you talked about like you were seeing some conditions coming in, and you're like, I want a different tool, and so you started looking, you started digging, started researching, and you've come to this concept that is called functional medicine, which I'm hearing is kind of a way to differentiate from traditional medical care in in the US. And and traditional might be a not the right word, but but a more prolific type of medical care. So so there is then this functional medicine aspect that you feel is helps you address kind of chronic conditions. I wonder if you could talk a little bit more about that. What is that role between functional medicine and chronic conditions?

Preventive Labs Before Full Disease

Dr. Smith 16:01

What the what I what I focus on is digging up the reason what is driving the problem in the first place. I believe that there's a time and a place for all healing. I'm not anti-physician, I'm not anti-demedicine. I believe that there's a time and a place for medicines, there's a time and place for surgery, there's a time and a place for chiropractic care, for physical therapy, for personal trainers, for massage therapists, acupuncturists, just literally everything. But I believe that we should start off by trying to resolve a problem using the most non-invasive, gentle therapies first. And then after you've given it an honest to goodness try to work, then you should proceed to the next level of invasiveness. Surgery is always going to be the most invasive thing you could ever do in your body, so you should only use that as a last-stitch resort, never as a first option. Now, the the things that are like the most gentle for your body are things like changing your diet or exercise more, going to the chiropractor, going to a massage therapist, things that don't involve putting toxic drugs in your body. All drugs have side effects. All drugs have the potential of causing harm. That's why you have to be very careful with what you're doing with that. It's not gentle at all. The number one cause of liver death and it's out there is Tylenol. And so because it's over-the-counter, people think, well, it's just fine. I can take up as much of this as I want. No, you can't. You have to be very careful. A lot of people develop gastric ulcers from taking too many non-steroidal anti-inflammatory drugs like ibuprofen or acetamin, acetaminostonyl, but like uh ibuprofen, motrin, things like that, they they all have the potential of having side effects, all of them. And so you have to be very, very careful.

Tom Butler 18:31

I just want to give a heads up to people listening that you know, this isn't about giving medical device here. There's this is just about education. And you know, you should have a relationship with a health practitioner that knows you, knows your individual situation, and you're working with to make this as far as making decisions for your personal health. Now you opened, you're the founder of the Chronic Conditions Center. And I'm wondering if you could talk about what you were hoping to bring to your community through the Chronic Conditions Center.

Dr. Smith 19:07

Well, what I want to do is is offer people more than just a superficial glossy overview, which is what you get when you chase down symptoms. There are there are conditions that don't show any symptoms whatsoever until it's largely too late to do anything about it. Like you can't feel your vessels filling up with plaque, you can't feel cancer cells forming in your body, you can't feel tooth decay, you can't feel early onset arthritis or degeneration of your joints. It's only after that problem or those problems have been there for so long that they develop a symptom. And by then, it's largely too late to fix the problem. So rather than focus on just symptom relief, I focus on what is driving the symptom in the first place. What can I do to fix this problem? So when I do lab testing, for example, one of the tests that I do is a baseline test and a lot of different biomarkers, and then I color code them for the report for the patient. So I color code them in green, yellow, and red. Green means that you're in the sweet spot. You're in the functional normal. Yellow means you're moving away from the ideal place that you should be. It's kind of like a yellow light. When you see a yellow light, that means slow down, you're going to come to a red light pretty soon. And if if the marker is color-coded red, that means you're in full-blown pathology. Now, if you're in full-blown pathology, the medical doctors even recognize that, and they say, let's do something about it. I think what we we need to figure out what's going on before you develop full-blown pathology. Like, for example, if your blood pressure is high, but it's not pathologically high, it doesn't require you to be on medications yet. But I still want to take a look at that and and recognize that that's a problem, that you are moving in the wrong direction, and that we need to get this corrected back to the normal area. Whereas the medical doctors might say, well, let's that's let's just wait until you're in full-blown crisis mode, and then we'll do something about it.

Tom Butler 21:40

I think that's an experience that I had. I mean, I I think that my A1C was uh in a problematic zone, and there were other things going on with me as well. But I think that that because I was on the quote edge of diabetes, I was in the pre-diabetic range, but on the edge of diabetes, I don't think it was taken as seriously as what was going on with me metabolically really warranted. Uh is that something that's an example of the dynamic you're talking about?

Prediabetes And Insulin Resistance

Dr. Smith 22:20

That's a perfect example. So the A1C, which is how much sugar is on your red blood cells, that's a very sensitive test. It's measured over 90 days, and uh the the lifespan of a red blood cell is about 90 days, about 120 days. You uh the the normal functional range for A1C is 4.8 to 5.6. And if you can maintain at you're at below 5.6 without medications, you there's no more diabetes. Uh endocrinologists feel that anything under 7.0 is fine, and for me, that's Not acceptable. I don't want to wait until you're at 7.0 to do something about it. The concept of prediabetes for most people can start off with as a condition called insulin resistance. So with the cells, the cell wall has a receptor site for insulin. And so the job, the purpose of insulin is to take a glucose molecule and shuttle it into the cell where it could be mixed with oxygen and burned as energy to make ATP. If the insulin cannot get the glucose molecules inside this cell, that's called insulin resistance. And so what happens is that the blood sugars build and build and build and climb and climb and climb in your bloodstream until the point that you develop type 2 diabetes. So when is the best time to fix this? Is it after you get type 2 diabetes or before?

Tom Butler 24:17

Yeah, definitely before.

Dr. Smith 24:19

Definitely before. So I don't want to wait until you have full-blown type 2 diabetes and you have out-of-control A1Cs and out-of-control serum glucose molecules. I want to address the problem before that it becomes a full-blown chronic condition. And that's what I want to bring to my community. I want to bring a little bit more, a little bit more preemptive work to get everything corrected before it becomes a big problem.

Tom Butler 24:56

There's a researcher at Yale University, Dr. Gary Schulman, and he made the observation that they were seeing, you know, this is in college students, that 50% of them were exhibiting muscle insulin resistance. And I think that's a fascinating observation. Would you be surprised to find out that 50% of the population has muscle insulin resistance?

Dr. Smith 25:24

No, I wouldn't be surprised at all because one of the storage sites in your body for glucose is skeletal muscle. And the other site is your liver. Everything starts with insulin resistance and then it spirals out of control from there. So I really want to work on that. One of the reasons that the current research is showing that there's so much insulin resistance is because of the prevalence of seed oils and causing chronic inflammation, and the cell walls cannot do their job as nature had intended to. So by there, there's a big push to remove or eliminate seed oils from restaurants and from foods and all that kind of stuff. So anything, anything that you can do to decrease your levels of chronic inflammation is going to help you with insulin resistance in your body.

Tom Butler 26:37

But it seems like there's so many things that are linked to inflammation that you know kind of this systemic inflammation is a huge chronic problem.

Dr. Smith 26:52

Well, every every disease that we know about has a is is has chronic inflammation written all over it. So if you look at arthritis, the word anything that ends in itis means inflammation of. So arthritis is inflammation of the joints, hepatitis is inflammation of the liver, dermatitis is inflammation of the of the skin, laryngitis is inflammation of the voice box, and so on. So every single disease out there, encephalitis, carditis, anything has as a problem with chronic inflammation.

Tom Butler 27:34

Do you find I that people aren't coming to you until they haven't found any relief from a traditional medical practice? Or are people becoming more aware and seeking you out before that?

Dr. Smith 27:56

I think that the the natural the natural thing would be to go to reach for the an over-the-counter remedy. And then if that doesn't what well, I should say when that doesn't fix the problem, then they go to the primary care physician, the family doctor, and they ask for something stronger. Can you write me a prescription for this? The thing that separates me again from what they do is that they're just focusing on alleviating symptoms using a glossy overview of the problem. They're not really digging too far down to figure out what is driving the problem in the first place. Is it due to anemia? Is it due to blood sugar problems? Is it due to cortisol issues that drive your autonomic nervous system? Is it due to sex hormone imbalance? Is it due to chronic inflammation, oxidative stress, GI problems, food sensitivities, chemical sensitivities, stealth unresolved infections like viral loads? What could be the root cause of the problem? And how can I identify exactly what those are?

Tom Butler 29:20

So that concept of the difference between chasing symptom relief and chasing the real issue. Yeah, uh it seems like we're becoming more aware in general about that. Do you think we're a long way from really embracing that concept as a nation? Or do you think we're close to that kind of winning out over the symptom relief?

Inflammation Shows Up In Everything

Dr. Smith 29:43

That's a great question. I believe that as a people, we are still obsessed with medications. And every time you turn on the TV, what are you going to see? A drug ad on TV. And the drug ads are just pushing a certain agenda, which is symptomatic relief. Whether it's you have an autoimmune disease and they're pushing a type of immune suppressant drug. Or if you have, if you want to get pregnant, if you don't want to get pregnant, if you go to the bathroom too often, if you can't go to the bathroom enough, if you can't sleep, if you're sleeping too much, they're always pushing some kind of a pill for alleviating a symptom. That's certainly an option, but that's not the only option available to you. When you go to a primary care physician, he's going to offer you drugs. That's what that's what he is. He's a druggist. The primary care physicians work with medicines to resolve a problem. And usually the PCPs work with about 12 different drugs. And if you can't be resolved by one of them, then he's going to refer you down the street to his golf buddy who works with another set of 12 drugs, and so on and so forth. Maybe you get prescription to see a physical therapist, or maybe you get a prescription to get a consultation from a surgeon. But there it's it's basically the same thing no matter who you are. It's all rooted in politics and money and tradition.

Tom Butler 31:26

Now I preach that exercise is medicine, and you know, preach is really not too strong a word, I think. How how I push it. But what do you think about that? What do you think the role of activity is as far as you know being functionally healthy?

Diet Basics And Personalized Nutrition

Dr. Smith 31:46

Well, I think that it's it's a very, very important component that is required for health for people. There's nutrition, there's hydration, there's sleep, there's exercising. There is maintaining your your posture and your joints through chiropractic care. There's managing your stress through meditation or uh journaling or whatever whatever gets you there. There's no such thought, there's no such thing as one size fits all when it comes to health. There's a lot of different components. And I tend to want to focus on the basics. I want to focus on like I if you want to see what's essential for health, I want to look at what's essential for life. And when it comes to what's essential for life, we know that you you have to eat, you have to you have to drink water, you have to sleep, you have to exercise. I mean, the the body was designed to move. And so the people that have the most trashed spines in my office are the people that sit down and work in front of computers all day, like your lawyers or CPAs or accountants. Those people are just they're wrecked with problems because they don't move very much. Whereas people that are like my electricians or plumbers or mechanics, they're always moving around, they're always using their bodies, and they don't have as many chronic musculoskeletal problems as the sedentary people do.

Tom Butler 33:42

Well, I sure see that difference because I literally could do nothing but sit in the computer from the computer all day long. And so, you know, the way that I feel is so much different if that if I do that. And you know, I just uh now that I'm active, it just is different on so many levels. I'm curious if you have some things in the nutrition realm, do you have some things that you particularly would like to steer people away from as far as what they're putting in their body?

Dr. Smith 34:20

Absolutely. So the standard American diet or the sad diet has is too loaded with ultra-processed foods. So, and and too much sugar, too much grains, too much dairy. And so I want to focus on lean meats, fruits, and vegetables primarily. And whenever I have a patient that starts with me, what I will I will I will start them with an autoimmune paleo diet, just to clean the system, get back to the basics. And uh I think that when it comes to what kind of diet that they use, there's again, there's no so there's no such thing as one size fits all. Some people do very well on a Mediterranean diet. Other people do very, very well on a ketogenic diet or a carnivore diet. So it depends on on your individual workup, your genetics, your individual symptoms. So, for example, if if it's a a person has a problem with diabetes, I will not put them on a Mediterranean diet. I'll more most likely interest them in a ketogenic diet or a carnivore diet, something that's ultra low carb, because that may be a better fit for them. Whereas another person may be better off with a Mediterranean diet, and I I just want I want to match the person to the right type of nutrition program that's right for them.

Tom Butler 36:07

You said one size doesn't fit all, one solution doesn't fit all. Yeah. But here's what I would say, and correct me, I I think you'll agree with me, but what does fit all is don't eat really high sugary foods. You know, eat more fiber than you think that you need to be eating. Stay away from all the the processed foods like the chips, stay away from the cookies, stay away from like 90% of what's in the grocery store, you know, become aware of the concept of ultra-processed foods. And it seems like for everybody, just you know, it's safe to say avoid those things. Is do you agree with that?

Dr. Smith 36:57

Yeah, yeah, I do. Like when you go to the grocery store, you want to shop the peripheral the periphery and leave the middle aisles alone because that's where they that's where the grocery stores put most of the junk food. If you want to see uh an example of what a typical American does go to a pro football game or a pro baseball game and see what they serve people. And it's pretty scary. They serve a lot of deep-fried foods, they serve a lot of convenience foods. Even when people are sitting around watching a game at home, they're just mindlessly snacking on stuff that's not very good for them.

Tom Butler 37:47

I think that's such an interesting observation. You know, they're they're serving that food in that environment for a reason, and it's not to give you the nutrition to get through the game.

Dr. Smith 37:59

No, it's not. It's it's economics. That's why a lot of companies today will will like like look at uh I don't really want to use a lot of call out a lot of names, but I'll just use Entonmans as an example. If you own Entonmans and you buy cooking fats and giant tubs, you don't want your cooking fats to spoil. You want to you want them to have a nice long shelf life. So, what's one way around that is to buy trans fats because they don't oxidize. They don't break down like regular cooking oils do. And so they buy a lot of trans fats, not because it's healthy for you, but because it's cheaper for them, which means that their profit margin is bigger. The same thing with Nabisco, the same thing with any type of brand name, baked good that you see sold in a grocery store, it's all driven by economics. It's not driven by what's in your best interests.

Tom Butler 39:13

Yeah, I think it's really important that people think about that. That there's going to be a lot of pressure from companies that are benefiting financially from us eating a lot of junk. They're finding things that people want to eat. They're finding things that I would say even there's at least an emotionally addictive element to them. And so to eat healthy is kind of swimming against that current of influence.

Processed Food And Drug Ads Incentives

Dr. Smith 39:45

Yeah, I agree. I think that that's one of the things that the food industry and the pharmaceutical industry have in common. They're neither of them care one iota about you and your health. They care about their shareholders, they care about profitability and economics. And so that's why they make these decisions for what they do. The pharmaceutical industry spends $12 billion a month on TV ads so you can either talk to your doctor to see if blank and blank drug is right for you all the time. And the United States and New Zealand are the only two countries in the world that direct to consumer marketing for drug ads is allowed. You're never going to see a drug ad in England or Mexico or Canada or Germany or Japan. They don't have it. They only have it in the United States and New Zealand. And those two countries have the highest cost per capita of health care of any place in the country in the world.

Tom Butler 40:55

I want to ask a bit about exercise. I'm wondering from your perspective, do you see some common mistakes when it comes to people taking on a new exercise program? Someone who's been inactive, and then it comes the first of the year, they're like, hey, I need to go out and act and be active. Do you see some mistakes that people make in doing that?

Dr. Smith 41:20

Yeah, all the time. As a chiropractor, I see a lot of problems with uh tendinitis, arthritis, plantar fasciitis, all these things. And so the probably the best advice that I can give people whenever they're starting off with a new exercise program or a new training program is to ease into it. Be patient, take your time very slowly, incorporate that stuff into your into your routine, and and uh gradually build your your time, the build up the level of intensity or the weights if if you're doing resistance training, is to build the resistance very, very slowly. But people are very impatient and they want instant gratification and they want fast results, and as a result, then they tend to hurt themselves.

Tom Butler 42:18

One thing that I I've seen is that it seems like the complexity of I mean, if we just talk about the shoulder joint, you know, the shoulder, shoulder area, it it's a super complex area. And so if I haven't been doing anything, and then I'm gonna decide, okay, I'm gonna start doing bench press, and I'm not patient, like you're saying, and I take off. There's if I have not been active, you know, for 20 years or maybe 30 years, there's all this like support mechanism there, all these muscles for support and everything that are easy to damage by not taking it slow and steady and being patient. Right.

Dr. Smith 43:12

Well, the the shoulder joint, as you correctly noted, is a very, very complex joint. It's got 18 muscles that insert into the joint. And so they all either have your primary movers or your secondary stabilizers, you have antagonists and agonists. And so I would say that probably the best money that you could spend and invest is to hire a personal trainer that could teach you proper form and give you a plan of action that you can handle at your age and in your level of fitness. Like a 22-year-old man is gonna be radically different from like a 60-year-old man in terms of what he can do and his flexibility, his strength, his recovery rate from exercise. All that stuff is gonna be very, very different and has to be really realistically personalized for him.

Tom Butler 44:13

Okay, so I'm gonna ask you this question. You know, it's a bit risky to ask you. Obviously, I'm an advocate of cycling. Um, I talk about if exercise is medicine, the bike is a medical device to deliver that medicine. Okay. And, you know, but as a chiropractor, uh is there a downside to cycling?

Train Smart With Fit And Form

Dr. Smith 44:38

I would just say the same thing before, just doing too much too soon and taking on more than your body can handle, and risking developing tendinitis or arthritis or something like that. It's a sign that that you're just doing something that you shouldn't have been doing so much so quickly. A lot of the movements that we have first started when we were learning how to. Roll over and crawl and stand and sit and run and all that kind of like primitive movements. If you skipped a stage somewhere during your development, it's gonna it could come back to bite you later on in life. So I think that the best thing you can do is to hire a professional to evaluate uh what you can do, what you can't do. There's there's a technique called functional movement screens that a lot of physical therapists can do, and they can find out what's your level of fitness, what's your level of flexibility, where are you prone to injury. So if you have a scoliosis, that could lead to joint problems in your in your spine if you overload them. And I think that Oh, go ahead. No, I was gonna say cycling is a very non-invasive type of exercise. It's not like running where you're constantly pounding your joints against the base, against the pavement, and it can that can that can really screw you up. I think that cycling or swimming are two of the uh fundamental exercises that I would recommend for people of all of all ages.

Tom Butler 46:32

One thing you talked about is getting some advice, and I I found that a professional bike fit, while it can be expensive, was incredibly valuable to me because I was not in a good position, you know, when I first bought my bike, my my first bike, and I rode in that position over and over again, you know, for hours and hours. And then having the professional bike fit, it was like, oh, okay, you know, this is this is how different a bike that actually fits me feels. And I felt like that was incredibly important for not repeating stress in a position that wasn't friendly.

Dr. Smith 47:18

So, what you're kind of talking about is the the area of of ergonomics. Ergonomics is the science of how your environment interacts with a person. Whether or not you're using a bike or you're talking about your bedding, making sure that you're flipping and rotating your mattress, you are buying a new mattress, you're adjusting your workstation at the right eye height, the monitor is the right position for your body. You're not hunching over, you're not having to reach for things. It doesn't seem like it's a big deal, but when you do things for eight hours at a time, it can become a big deal.

Tom Butler 47:58

Yeah, that repetition for sure makes a difference. I am curious about recovery and especially as I get older, how to facilitate good recovery. Uh what are your thoughts on that?

Dr. Smith 48:17

Well, I'm not a sports medicine expert, but what I would say is that the the population of people that I work with that typically have an injury of some sort, the best thing to to accelerate healing and repair is ice. Ice is a natural anti-inflammatory, it's a natural painkiller, it reduces inflammation, and you people tend to bounce back a lot faster after they use ice, more so than heat. And the other thing is using laser therapy. Laser accelerates healing down to the mitochondrial level and does a fantastic job at things like knee pain, hip pain, plantar fasciitis. And uh, I know that a lot of those problems plague a lot of cyclists.

Tom Butler 49:16

You say laser therapy, and you know, sometimes we think of lasers like cutting through metal or something.

Dr. Smith 49:23

Well, I'm talking about like cold laser. Cold laser doesn't have the capacity of cutting through through material. This is a laser that, like a super pulsed laser, like the kind that we use in the office, turns itself on and off every 200 billionths of a second. So it's so fast it doesn't it doesn't have the capacity of creating an increase in thermal temperature of the tissue and causing destructive forces of the of the tissue. What it does is it has an analgesic effect, which that's a medical term, it means painkilling. It reduces swelling, it reduces inflammation, and it causes a process to occur called photobiostimulation. Photo meaning light, bio meaning living tissue, and stim, and it stimulates the mitochondria of the cells to make more energy to repair and to heal at a very, very accelerated rate. A lot of people that have been involved with car accidents, sports injuries, even bicycle injuries could benefit greatly from using a super pulse called laser.

Tom Butler 50:42

Now, is that something that you're always going in and having a treatment done to you, or is that something you could find to do at home? How how is that accessible?

Recovery Tools Ice And Cold Laser

Dr. Smith 50:53

Well, you could do it at home, I guess. The the laser that I have is $20,000. So if you want to you want to invest that kind of money, I guess you could do it. Right. But it's different from, say, like a like an electronic therapy, like a tens unit. That is using electronic current to numb up the tissues. This is using light therapy, light therapy that penetrates below the surface of the skin to the target tissue. And a certain wavelength of light can penetrate at different depths below the surface of the skin. So if you if you ever see a rainbow, you notice that there's different colors of visible light. There's blue, there's purple, there's green, there's red. So blue light can penetrate two millimeters of depth below the surface of the skin. If it's red light, it could penetrate about 20 millimeters below the surface of the skin. If it's infrared light, it could penetrate up to 100 millimeters below the surface of the skin. So you want to get to the target tissue, the tissue that's causing some kind of a problem, whether it's a joint. I mean, if if it's your hips or your lumbar spine, that's a pretty thick area. It has to go pretty far down to arrive at the target tissue to create a metal an effect for there. If it's only going to go very superficial, it can't do its job.

Tom Butler 52:35

I read someplace that lower back pain is the least leading cause of disability worldwide. Do you I imagine you see that? What are your thoughts about lower back pain?

Dr. Smith 52:50

That kind of statistic wouldn't surprise me. There's so many people that have low back issues, they have pelvic issues, they have tailbone issues. If if you're doing a lot of sitting down, you're putting a lot of mechanical stress on that on that area. Some authors have opined that Homo sapien was not designed for sitting. We never sat, we squatted around the campfire, and we are we laid down to sleep, but not really doing a lot of a lot of sitting. In fact, that has created a lot of interest in standing desks. People to go up to their desk with their computer is and they stand and do their work while they're in the standing position.

Tom Butler 53:36

I haven't done that, but yeah, it's like one of those things that I I think I should be investigating, you know, because uh uh when I do a lot of writing, I'm spending a lot of time in a chair. So and I'm feeling it right now just talking to you.

Dr. Smith 53:54

So I bring I bring that out with everybody.

Tom Butler 53:57

Okay. Now, one thing that you focus on is migraines. And I feel very fortunate that I don't suffer from migraines, and I've known several people who get hard when they experience my migraine pain. And uh it's a huge subject, but are there some things that you'd like people to know about migraines?

Migraines Healthy Aging And Resources

Dr. Smith 54:22

There's a lot of different reasons why people get migraines or headaches. One of the most undiagnosed or misdiagnosed problems is called a cervicogenic etic. And a cervicogenic etic meaning cervical, meaning the neck, and genesis is the first book of the Bible. So that means that it originates in your neck. Now, the spinal nerves that leave the neck area are the ones that can go up into the head. And so if you have bones that are out of position, they're causing mechanical stress on the on the nerves, the nerves that go up into the in the into the head, that can trigger or initiate a migraine. There's a lot of other reasons why people have these problems. It could be due to hormonal reasons, it could be due to metabolic issues, skipping meals, maybe a hangover from drinking the night before. It could be a lot of different things. So, what's important when you have a migraine is that you get a proper workup from somebody that knows what they're doing. That's one of the things that frustrates me with traditional medicine, is that traditional insurance-based medicine. So when you go to a medical doctor, you're gonna get about seven minutes of face-to-face time. And he's gonna be spending a lot of that time pecking away on his laptop computer. If you go to a specialist, you're gonna get a little bit more time with him. But when you go to a functional medicine doctor, it's not uncommon for the consultation and exam to go an hour and a half, two hours long, because we're gonna be spending a lot of time with you finding out what is going on that how can we help you to get rid of this problem forever? Not just to mask your symptoms by giving you a drug, but by resolving the problem completely by figuring out what the root cause of the problem is and then eliminating that.

Tom Butler 56:33

What's the trek record like? Are you usually able to find ways to limit or eliminate migraine pain, or is it something that's difficult to address?

Dr. Smith 56:51

Everybody's a little bit different. Everybody's ever everybody brings with them a unique history, a unique set of stresses and traumas and dietary backgrounds and all that stuff. So I don't really I don't really know what the overall would be, but I would just say given what I've been told is a lot more satisfying than just giving somebody a Tylenol and hoping for the best. Gotcha. I would say that anything that I give you is gonna be better than what you have now.

Tom Butler 57:29

To wrap up here, what concepts would you like people to think about when it comes to healthy aging?

Dr. Smith 57:40

Well, I would say that to focus your energy on the basics, like nutrition, water intake, sleep, managing your stress, managing your joints and your your posture through chiropractic care, exercise, whatever, whatever works for you, whether it's bicycle or or getting in the pool or doing whatever, but just don't don't hurt yourself. Make sure you're using proper form. And I think that if you focus on the basics, you're gonna be generally in a better plus better place than you were if you just do what the average American does and just rely on convenience foods or highly processed foods.

Tom Butler 58:29

Yeah, and again, I think that's such a big thing to me is that you can't be the average American. If you want to live a long and healthy life, you just have to think outside of what is considered normal.

Dr. Smith 58:49

Yeah, I I would agree with you.

Tom Butler 58:51

And I think we're seeing a lot of people now who are 70, 80, 90 years old who have done done that for decades, where they've said, okay, I'm gonna reject what is normal, and I'm gonna brace something else that is better than normal, and we see the impact of that.

Dr. Smith 59:11

Well, we see we I see that that more and more people are accepting that the limitations of traditional medicine, and they are looking for something beyond that. So that's why I'm just advocating to anybody who will listen, just stick with the basics. Make sure that you're you're eating clean, you're eating very high-quality foods, you're staying well hydrated, you are getting plenty of sleep, you're exercising, you're going to the chiropractor, you're managing your stress, you're doing everything that is required for normal, healthy function. And ultimately that will add up and you will resolve a lot of problems. I mean, imagine if all we did was getting people to eat clean, how few are drugs that we'd have to rely on.

Tom Butler 1:00:07

Yeah, I love it. So, how can people find you? What's the best way for people to connect with what you're doing?

Closing Thoughts On Inflammation

Dr. Smith 1:00:14

The best way to connect with me is to go to my website at metabolicsolutions.net. And from there, you can read about me. You can read about what I do and who I help. I offer a free health test. It's it's about two minutes long and it's completely free. And it can tell you about where you are on the grand scheme of things, whether or not you just need a little bit more research or you're ready for a full-blown consultation. And if you need some help and you need some guidance, you can reach out to me through the website and we can have a conversation. But go to metabolicsolutions.net and do that, do that quiz. That'll that'll really really give you a lot of great insight as to how you're doing.

Tom Butler 1:01:05

And I'll put a link to that in the show notes for people to find.

Dr. Smith 1:01:08

Great.

Tom Butler 1:01:09

Thank you. So, Dr. Smith, thank you so much for this conversation. It's been really a blast. I'm so glad that I got to hear from you. Our listeners got to hear from you. And it's it's been great having you here and talking about these issues.

Dr. Smith 1:01:25

Well, thank you very much for having me. It was a it was a great pleasure for me, and I hope that your listeners get a lot of value out of this.

Tom Butler 1:01:33

All right. Well, I'll talk to you later, maybe sometime. Thank you very much. All right, bye now. Bye-bye. The conversation about inflammation was the part that I was the most happy to hear. He said every chronic disease that we know about has an inflammatory element to it. To me, that's a powerful statement. I hear that as the link to inflammation is something worth knowing everything I can about. For me, inflammation has shut down my rides. When I tried to ride across Washington State, I only made it two days. That was because of bursitis. It was a very painful display of the power of a small bit of inflammation. You can expect more information about reducing systemic inflammation in episodes to come. I hope my journey to pursue answers that work for me will also be useful to all of you. And remember, age is just a gear change.