Broken Brains with Bruce Parkman
Broken Brains with Bruce Parkman is presented by The Mac Parkman Foundation
The mission of this show and the foundation is To serve as a source of information, resources, and communications to the community of parents, coaches/Athletic trainers, medical staff, and athletes that are affected by sports-related concussions and to raise awareness of the long-term implications of concussive and sub-concussive trauma to our children.
Broken Brains will also explore how Concussive Trauma impacts our Service Members and Veterans.
Join us every week as Bruce interviews leaders and experts in various Medical fields, as well as survivors of Concussive trauma.
Produced by Security Halt Media
Broken Brains with Bruce Parkman
Dr. Michael Lovich on Concussions, Brain Trauma, and Holistic Healing for TBI
In this episode of Broken Brains, host Bruce Parkman welcomes Dr. Michael Lovich, a concussion specialist and expert in neurological rehabilitation, to explore the hidden complexities of repetitive brain trauma.
From the sidelines of youth sports to the frontlines of military training, concussions and sub-concussive impacts are often overlooked—and underestimated. Dr. Lovich dives deep into the science behind brain injury recovery, breaking down phenomena like dysautonomia and glutamate excitotoxicity, and why observation and nuanced assessment are essential for early diagnosis.
They discuss the long-term effects of concussions, the danger of premature return-to-play protocols, and the rising concern of pediatric brain trauma. Dr. Lovich also shares why a holistic and multidisciplinary approach, including chiropractic care, is critical to healing from traumatic brain injuries.
Whether you're a veteran, athlete, parent, or practitioner, this episode delivers the tools, insights, and hope needed to navigate the invisible wounds of brain trauma.
Follow, share, like, and subscribe to Broken Brains with Bruce Parkman on Spotify, YouTube, and Apple Podcasts to stay informed and support the movement for better brain health awareness.
Broken Brains with Bruce Parkman is sponsored by The Mac Parkman Foundation
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Chapters
00:00 Introduction to Repetitive Brain Trauma
02:33 Dr. Michael Lovich's Journey into Brain Care
04:24 Understanding Concussion Symptoms
07:41 Observation Skills in Concussion Diagnosis
10:33 Tools for Assessing Concussions
11:19 Dysautonomia and Its Impact on Concussions
12:10 Sympathetic vs. Parasympathetic Systems
14:40 The Effects of Concussions on Autonomic Function
15:07 Identifying Hidden Concussions
17:42 Return to Play Protocols and Their Limitations
20:57 The Brain's Healing Process
24:28 Repetitive Head Impacts and Long-term Effects
28:30 Inflammation and Brain Health
30:51 Protecting Children's Brains from Trauma
31:50 Understanding Glutamate Excitotoxicity
34:13 The Impact of Sports on Brain Health
36:43 Concussion and Mental Health
39:57 The Role of Chiropractic Care in Recovery
51:48 Integrating Chiropractic Techniques for Brain Health
57:49 Finding the Right Care for Brain Health
https://www.mpfact.com/headsmart-app/
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LinkedIn: Michael Lovich
Instagram: deltasperformance
Website:deltasperformance.com
Produced by Security Halt Media
Hey folks, bruce Parkman here, welcoming you to another episode of Broken Brain, where we look at the issue of repetitive brain trauma in the forms of repetitive head impacts from contact sports and repetitive blast exposure to our veteran communities, and what these conditions are doing to the brains of our kids, our athletes and our veterans, and why you must pay attention Because this condition is not taught in our medical, nursing and psychological communities and very few people are able to make the correlation between contact sports and military service and mental health, leading to misdiagnosis and right now, which is the largest preventable cause of mental illness in this country. So we bring on patients, advocates, doctors, researchers, players to come on here and give you that 360-degree perspective on this issue so that you can protect yourself and the ones that you love. Today we have another amazing guest, dr Michael Lovick, calling in from Denver, colorado, where my daughter lives, as a nurse practitioner, psychiatric medicine. Dr Michael Lovick has about 18 consonants after his name, indicating that he's a very, very well-educated man. But he's a board-certified chiropractic, functional neurologist and sports physician that specializes in the brain and body health. As the founder of Delta S Performance, he leads clinical teams in Colorado, in Boston, so he's nationwide, focusing on functional neurology, sports medicine and concussion care. He has a list of education certifications like doctor of chiropractic, a master of science in exercise and sports space, bachelor of science in human biology. I don't even know where he got time to practice medicine, man.
Speaker 1:This guy is super well trained. His professional roles he's the founder and clinic director of delta s performance. He's a clinical adjunct faculty for the university of western states creator, instructor of evidence-based concussion management and care course, which we really want to dial in on this. And he's a team doctor for al colorado alpenglow, which is the professional women's ultimate Frisbee team, one of my favorite sports outside. I love that. I love those brain-safe sports out there. And he's a medical staff director for various professional, collegiate and amateur athletic organizations. And he's recognized for his innovative, evidence-based approach and his dedication to elevating the standard of care in neurological and sports rehabilitation, which is why we are on this call. Dr Michael Lovick, welcome to the show and thank you for coming on. So talk to us about. I mean, how'd you get into brain care? I mean, you're a concussion specialist. What led you out of all the, let's just say, the focuses of foci of chiropractic medicine that and and and and that are out there. Why concussions?
Speaker 2:so it's actually kind of funny. So 11 years ago I was skiing on mountain hood in oregon and there's this thing that happens, uh, at mountains like that where there's a, there's a water line, where you go from nice light, soft snow to dense, heavy, wet snow. I hit that, going pretty fast and exploded, for lack of a better term, and I got concussed. And when I was going through school, I went to the student. I was a student at the moment. I went to the student clinic. They were like, hey, you look fine to me.
Speaker 2:I went to major doctors in the Portland Oregon area, people who are neurologists, people who are so quote unquote, experts and they said you're, you're fine. But I knew that I wasn't fine, for for me, I knew that I needed to get back to the level of work that I knew I'd be able to do, and so I ended up saying, well, if nobody's going to figure this out, I might as well be the one to do it. And I ended up finding a provider in the Portland area who does the same work that I do the functional neurology and said, well, this is the direction I want to go in, because this is how people really need the help, and it goes back to something you said, which was that concussion prevention is probably the biggest mental health prevention, and I think that that is becoming more and more and more true as as our environment changes and things like that in the world.
Speaker 1:So what were you when you got hit? Now we call that a yard sale, right, I'm a skier man.
Speaker 2:So when you blast down the mountain and you come to an abrupt stop and stuff goes everywhere and you spend the next 15 minutes picking it all up. We call that a yard sale. At me he's like, wow, one of your pupils is huge right now and I was like, I don't know, I just feel kind of out of it. I didn't even know that I broke my knee at the time I tore my PCL. I just knew that I felt off. Something wasn't good. I took the red sled down with ski patrol after the yard sale.
Speaker 1:And the guy didn't believe me. He didn't believe me he, uh, he didn't believe that I was injured. He went down and got dumped out twice. So you know out of the sled.
Speaker 2:Yeah, god dang we're going down some blue groomers. I don't know if, uh, I don't know if it was that difficult, but I guess it was. So you know, you feel off, you feel like something's not quite right, and it doesn't necessarily mean that you can put a finger on it or have a quote, unquote diagnostic complaint of oh, I feel like I have a headache, or what you know. When you do the SCAT-6, you got the list of 22 things that you can fill out and say these are my symptoms that I feel A lot of them are so vague because the thing you're using to figure out and answer the question how am I doing today Is the thing you use to do. That is the thing that's injured. So how are you supposed to answer that question accurately?
Speaker 1:Right, no, and that's important for parents and kids. I mean, here you are. Were you a student at the time or were you already practicing?
Speaker 2:I was a student at the time.
Speaker 1:Yeah. So I mean you're sitting there knowing that you got banged up and you can't even recognize the symptoms of concussion, because that's the issue with subconcussive trauma or lower than concussive thresholds, that you've got to enlarge people, yet you don't have the symptoms that you would associate with the concussion stumbling around like that.
Speaker 2:So, but this, is the big problem concussion, because half the testing that you do is all like well, how did it feel when I did this, how do you feel when you do that? And if you think of it like that, then it's like what. We're asking so many questions that we're asking people who may not be able to feel their body to subjectively answer and that we're going based off that.
Speaker 1:Right, and the fact that the brain can't heal. I mean, how do you describe symptoms that don't exist yet? And let me ask you this question so you know you got patients here that you know a lot of our audience have had concussions. I've had multiple concussions in rugby and military training. I've had multiple concussions in rugby and military training. You know, from your perspective, you know how do we dial into that to let you know, outside of the, you know the issues that we're talking about from long-term exposure, but we're talking about a concussive event which happens to almost everybody in their lifetime, right? So how do we, you know, as a doctor, how do you dial into that? You know concussion, when all the questions that they ask are symptomatic, right, if you don't have symptoms, you know how can you, you know, recognize the fact that the brain's been impacted? And then you know, what do you tell your patients to do afterwards?
Speaker 2:You know it comes from good observation skills. That's one of the big things that I think separates us from a lot of the other approaches for concussion. You look for physical changes that you can see that show changes in brain function, eye movement changes. Look for vestibular changes, look for proprioceptive or where you think your body is in space changes, and it doesn't have to be this big pathological or outside of normal limits issue. There could be a number of things that are quote unquote normal, that are just abnormal enough that when you add them up they add up to something abnormal, and that is the main deal. So it's funny.
Speaker 2:My sister was going through vet school and she was doing her neurology coursework. And she was doing her neurology coursework and I said, how do you do your neuro exam on your patients when they can't answer the question? How did this feel? And there were a number of things that I've actually taken some of that observation skills and incorporate into my practice to get an idea. Now I'm not lifting up people's leg and saying, do you hop away, but the idea is, how can you figure out, how can you see these changes?
Speaker 2:There's been a change recently where people are now including the visual, something called BOMBS, the visual ocular motor screen. The way they're using it is they're looking at eye movements. It's like side to side, up and down, doing some head turns, and at the end of the day they're still just saying did it make your symptoms feel worse? But they're not looking at the quality of those movements and there are so many little details that you can find that you can then rehabilitate directly and based on that you can find the minutia that might be keeping a symptom around or keeping a poorer patient experience around. Instead of just kind of going for, let's just make it look normal if that makes sense.
Speaker 1:You know we have an app out there called HeadSmart and we've been looking to attach a pupillometer on there. So if a parent thinks their child is being concussed they might have a concussion, they can take a look at that. Thinks their child is being concussed, they might have a concussion? They can take a look at that Right now with these, the eye movement detectors that you use. Is that something you're holding in your hand or is that following your finger and looking at the eye? Is that a device? What are you using right now?
Speaker 2:If you know what you're looking for, thumbs work plenty well. If you're, the whole idea is you're looking for changes or movements that shouldn't be there. For example, if I had you look at my thumb and we followed it across, or if you were looking at like a bird flying across the sky, you should be able to keep your eyes on that bird following across. Your eyes shouldn't lag behind or then jump to catch up. Your eye should be leading ahead and jumping backwards, and hopefully they're not jumping over it back and forth and something called an oscillation, and those are things that can be seen to the naked eye.
Speaker 2:Regarding pupilometry, though, there is an app that we use and recommend. It's called reflex pro, and it's something that you can use with any iPad Pro and just kind of hold it up and give you good measurement of pupil dilation and constriction based off fatigue, and we use it often in checking out concussions and making sure that their autonomic integrity is there, because something that you might have seen now, with all the guests that you've had on this show, is a lot of concussions also have something called dysautonomia. Have you been are?
Speaker 1:you familiar with that term. That's a new one, man. Check that one on the audience, bro man, I couldn't even want to spell that Go ahead.
Speaker 2:Hey, no worries, dysautonomia it is D-Y-S-A-U-T-O-N-O-M-I-A You'll hear it a lot associated with COVID and post-COVID syndrome and POTS, things like that vasovagal syncope. Essentially, your autonomic system of sympathetic and parasympathetic should be tightly regulated, not a seesaw, like I always use the example. You go to a yoga class and every so often you'll get somebody a little overzealous, talking about how you want to be very parasympathetic and you want to have as little sympathetic as possible in order to be in a wellness state. And that's not how the science works. Because you don't want it to be all parasympathetic and not sympathetic, you want it to be tightly controlled, like a thermostat.
Speaker 1:Explain to the audience the parasympathetic and sympathetic aspects of physiology.
Speaker 2:So the easiest way to understand it and the most psychological way to think about it is parasympathetic is rest and digest. It is sitting, more stasis, calming, ability to absorb nutrients, things like that. Sympathetic is fight, flight, freeze. Those are the things. And they came out with a fourth term I saw recently, but it's still the same idea of more. Sympathetic means your pupils get big, blood flow comes towards your extremities so that way you're able to run and get away from a tiger or fight a tiger or something like that. It comes down to are you most people. It has morphed through different lenses into sympathetic meaning stress, and parasympathetic meaning calm.
Speaker 2:That, I think, is a little bit of a dangerous way to think about it, because it means that people start having a worldview where they think the way to fix the things I'm feeling is drive towards this parasympathetic activity. And if one is bad and one is good. But what I was going to say is they're both good, they both have checks and balances in there where when sympathetic starts going up, your parasympathetic will go up as well to balance that out, and same thing vice versa. And what I'm saying is you want it to be like a thermostat where, if you have it set on 70, you don't want it swinging from 60 to 80 back and forth, you want it swinging from 69 to 71, tightly controlled. So that's a lot of the things that we're looking at and when you're looking at pupils you can see those changes, you can see how stable the autonomics are and it gives us an opportunity to see are we making real meaningful physical changes with our patients just by seeing how they react from a light being shined in the eye within normal limits?
Speaker 1:Okay, and those are apps. Those are, and how are they affected by a concussion? They get, get out of whack, or how do you see that?
Speaker 2:So remember when I said I yard sailed and then I got a one pupil was bigger than the other. Typically when you see one people bigger than the other or two big pupils on both sides, those are usually associated with things like light sensitivity, but also is indicative of having some sort of brain dysfunction, because you're not reacting appropriately to the amount of ambient light around you. What you're having, what's happening, is you're fatiguing out and it's just defaulting to more sympathetic tone, so it's just going bigger and bigger, which means you're getting even more stimulus. That's probably more than your brain can handle at the time.
Speaker 1:So do you have patients that come into you and they don't even know they have concussions, or they, they don't even know that they've been. You know they, just they just know something's off. And then you know, you're, you're, you're finding out that they this like what's their reaction?
Speaker 2:you tell them yeah, you've had, you've had a concussion, you actually damaged your brain well, think about it like this there's not just traumatic concussion, there's acquired brain injury like metabolic concussion, talking about how the neuroimmune axis or things that change the uh, the immune system in your brain, can also create the same exact physiology of concussion without having a blast trauma or traumatic insult to your brain. Uh, really actually have a fun. I have a story about that. I was a when I was a student in portland, oregon, we were working at one of the three clinics uh, for experience. So we were working people who were on welfare, and one of the people she was an out-of-work hairdresser and she was. She was married, she has kids, but her entire life started spiraling after a car accident.
Speaker 2:And the way we found that out was I was doing my exam and I was like this is not a musculoskeletal pattern by itself, this is a concussion pattern. You've got slowed bowel movements. You've got gi tracks, things that are moving slowly. You probably heard about vagus nerve and things like that. Uh, yeah, but there's a lot of stimulants for that. We want to make the thing that stimulates it happen on its own as opposed to trying to do things directly for it. But we can talk about that later.
Speaker 2:But I was noticing all of like this entire pattern. I was something's going on in your brain and I asked have you ever been in a car accident before? And she said yeah, and she gave me the date and I was like, have you ever had like bowel movement issues and stuff like that? And she said I don't know. She went home and when I saw her two days later she said she called her ex-husband and said that since the car accident she didn't move her bowels for two weeks straight.
Speaker 2:She and that's when everything started spiraling out of control and she couldn't really handle life, including getting a divorce, including not being able to hold a job, including not being able to basically have forget great quality of life, have a minimum viable quality of life basically ended up where she was. And so a lot of patients that I'll have coming in now in my practice here usually patients self-select where they call me. They're calling me up, finding me and flying in or driving into work with me, knowing that they already have something going on. But when I work in other capacities, especially with some athletes, I'll be looking at them like your concussion is not fully healed there are. Yes, you are ready to return to play, but you still have neurological things going on that we want to work on.
Speaker 1:Let's talk about a little bit, because you know, concussion recovery is, you know it's an open book, right? I mean, everybody's got their. You know concussion recovery is you know it's an open book, right, I mean, everybody's got their. You know, I remember, when you know my concussions, I just went to work. Actually, when I woke up from most of my concussions on the rugby field, I just went down the other end and made a tackle. It was none of this recovery stuff.
Speaker 1:And then you have a job man. It's like, ah, I got to go to work, right stuff. And then you have a job man it's like, ah, I got to go to work Right. So, um, but you know, we have returned play in school, we have returned to play sport. You know professional leagues and I personally don't think they actually account for the neurological damage or dysfunction. And I and I think that, uh, you know, with some of the, you know the same, the same issues are in both categories kids who just identify through sports. They've got to get back on the team, they love their stuff, and athletes have got to pay the bills, man, right. So what are your opinions on the current return-to-play protocols that are being used at this time, some of them are time-based or whatever. What's your opinion on all that?
Speaker 2:There's a lot of external factors that are involved with that, including money, stakeholders, people play. We talk about high level pro sports, I mean, without going into individual football players. You can also think of it like OK, well, he's your quarterback, you got to get him back in and there could be pressure. It's the doctor's job to or the healthcare provider's job to be that boundary that looks after the welfare of the athlete and not just the. If they don't do this now, then they're going to miss out on a scholarship. In reality, if they don't, if they do this now, they might not even need the scholarship, if you know what I mean, unfortunately. So I okay. So the return to play thing, I think, is still kind of nebulous because there are certain standards that need to happen depending on which part of the healthcare industry you're in. The greater return to play program, that's inside the scat six, is still the one of the better ways to do it. Um, but I view it a little bit differently from my office, because we're looking for those finer points, those little details, I would say. Brains don't heal, they compensate, which allows a lot of patients to kind of get the breathing room that they needed in order to know that, hey, things might take longer to heal or things might take longer I look at it, see, too easy to say it's things might take longer to get back to normal, to get back to I don't feel awful while I'm doing this. And it comes down to the way the brain works. If you had your muscle, you tore your muscle. It heals, maybe some scar tissue now, but it's technically healed because the exact function of it has completely returned, because all it did was move your hand here to here. Right, if you have every single circuit in your brain as a network, from an individual memory to an individual motor task, to an individual psychological task, every single circuit in the brain needs to fire in a pattern and that's how you create the conscious experience of I remember my friend baking cookies, something like that. I remember my friend baking cookies, something like that. If some of those neurons are now gone or that circuit has now been rendered dysfunctional, then it's very possible that those things won't come back. No-transcript neuron starts sprouting again. So sometimes there is some viability to these things where some people think there isn't. But the other thing to think about is if your brain isn't healing and it's compensating, that means your brain is using a completely different system where it doesn't have this perfect map of where things are supposed to go, how things are supposed to be. It's just doing its best guess. So if you have a brain that is recovering from concussion and it says, well, now I have this perception that I'm always turning in this direction, what is it going to do? It's going to build up some sort of compensation that says, oh, I'm going to always pull in this direction.
Speaker 2:To balance out, it doesn't mean to fix the problem.
Speaker 2:It means that it created a temporary fix.
Speaker 2:Then it makes another temporary fix for any issue that causes.
Speaker 2:It makes another temporary fix for any issue that causes, makes another temporary fix for any issue that causes.
Speaker 2:Your brain doesn't care if you have headaches.
Speaker 2:Your brain doesn't care if you have pain.
Speaker 2:Your brain doesn't care if you have any other symptoms nausea, dizziness, any of these things.
Speaker 2:All it cares about can you stay upright, can you feed yourself, can you survive, and so a lot of times when patients come to us, we're looking at it and saying, all right, cool, so you have this layer that we've got to peel off, and then this layer that we have to peel off and we have to rehabilitate some of these basic things. So what I find is, instead of trying to chase the symptoms at the top, we get pretty good results by working on the basic fundamental reflexes that your brain uses for survivability and for a lot of other functioning. And then it creates a pretty simple way to understand concussions and takes it away from this big scary thing of I feel awful and I don't know what to do about it, and we turn it into sensory input, comes in, your brain figures out what it means and then you have a motor response or a psychological response. If you want to improve the motor or the psychological response, you improve the interpretation of it or you improve the sensory input coming in and so it makes it easier.
Speaker 1:Yeah, no, I mean but, and and that we're talking about a concussion. Right, we're talking about a singular event. Now, what happens when that athlete's in a sport with repetitive head impacts, like you know where that brain is continuously being jostled it by tackles, hitting soccer balls, checking in hockey, you know, hitting the head and wrestling gymnastics, whatever it is right. So, uh, what? What is that impact on that recovery process?
Speaker 2:Have you ever seen a brain like an actual brain?
Speaker 1:I have, I actually have. I've been to the B2CT center where they dissect them. I've seen lockers of them. Not pretty, Did you touch it? They wouldn't let us touch them. No, and they had already been processed for dissection. So I've never seen, but I'd never seen like a live, like not a live, but a real brain, like in its state, right yeah.
Speaker 2:When you have a brain, your whole brain, in your hand is processed for dissection, it's treated and it's significantly stiffer than it is naturally, significantly stiffer than it is naturally the actual. So the brain itself, the tissue, is very malleable. Think of it like jello, but instead of jello as like a single mass of sugar, jello and water, you have a ton of strands and those strands become the mass At any point in this first week of the class that we teach at university of western states. But at any point you can have shear stress, tensile stress, you can have stretching and twisting of these neurons, and just a stretch and twist on it can create an inflammatory response. You can then have some tears in those areas as well. But here's the thing if you've got 100 neurons that are there to move your arm like this and you break 15 of those, now you're at 85% capacity, you're still going like this right, but within the brain and when you're thinking about it like repetitive stress and repetitive things going on stretch, stretch, stretch, twist, twist, twist you're getting this repetitive microtrauma that changes functionality, creates a level of dysfunction and theoretically, according to a structural world and a structural world only, that should be fine as long as it doesn't break, but when you're working with a living system that is staying living through time. Structure can determine function, but function can determine structure. That's the difference between having something off axis in a shoulder joint and then your wear and tear over time creates the need for surgery, and so you can have that in the brain, where function now determines structure and it creates a change in the way the brain is structured.
Speaker 2:When you're talking about the repetitive trauma, the sub-concussive trauma that can happen over and over and over, talk about linemen crashing together, however many plays they run in a game you're talking about um, here's a scary one, but hopefully it's not that scary based off, we're saying how this can all be improved. We're talking about stopping short from as little as 10 miles an hour. If somebody's not paying attention, not ready for it, that's enough to create stretching and twisting of these neurons in a way that is in a car. In a car, yeah, just stopping, sure, not being ready for it, like we have these machines that put a ton of forces through our bodies and we don't feel it. I mean blast trauma is the perfect example where nothing touched you, just waves, just air pressure. Waves moving through your body is enough to create this effect and it just comes down to when you're working. When you're working with these cases, those often be taken into account. So but if you want to say, like, what happens when you see the, the BTE, the BTE sorry, the BUCTE concussion center, and the and the CTE center, it's repetitive microtrauma, which means it's an inflammatory pulse. It's another inflammatory pulse, it's another inflammatory pulse, layered and layered and layered. And what happens?
Speaker 2:Let's take another example of an inflammatory process gone wrong. What does arthritis look like in the hands? It's the same process. It's inflammation. It's the same process, it's inflammation. So we're not to say that inflammation is bad, because if you read into the literature on how memories are formed, it requires pro-inflammatory cytokines in order just to create a memory. So it's not like we want no inflammation. We want a healthy, appropriate amount of inflammation that's responding appropriately to threats in the body. But if you're looking at it from that perspective, arthritis in the hand is an inflammatory process gone wrong. And you look at the brains that undergo CTE, it's an inflammatory process gone wrong. And you see the same chewed up appearance.
Speaker 1:Yeah, and that stretching. There's all kinds of studies saying that once you start stretching the myelin and it starts, you know, micro tearing, then you lose a lot of the efficiency of the neuron in terms of transmission. So you and that's associated with other forms of mental health as well. So, even though the neurons remain intact, the myelin around them, once it starts stretching, does affect, you know, the health of the brain. And so, yeah, so you got all this structural dysfunction going on in the brain in terms of concussion Then.
Speaker 1:So what's your opinion on, like you know, kids' brains? So we are, you know, after you know there's not a lot of studies done on children, because it's almost impossible to get a child number one to stay still but to participate in studies. But if you look at what we're talking about in a healthy adult brain, I mean, you know, doesn't it make sense that if you've got a brain, not only that's, you know, younger, it's also developing, like it's not even fully whole yet it's still figuring out? I mean, the prefrontal cortex doesn't even start developing until 14, right, and you got all this.
Speaker 1:You have a concussion, then you got all this other you know damage going on because the kid keeps playing. Then you throw in neuroinflammation, which some of it's healthy, but this chronic state of neuroinflammation turns, you know, toxic over time. So I mean, when it comes to a child's brain, doesn't it make sense to just say stop. You know, when it comes to a child's brain, doesn't it make sense to just say stop moving the brain around? I mean, the kid's not even an adult yet.
Speaker 2:So there's two halves to this coin. There's one half, which is yeah, we want to protect children and make sure children aren't doing anything that is, let's say, course-altering to their life. The other thing to think about it, though, is which? So I'm giving you two people who has more neurons in their brain? A baby or a 50-year-old dancer?
Speaker 2:The baby I think the baby will have. The more amount of neurons the dancer is going to have, the more amount of neurons the dancer is going to have more connections in their brain. And at the end of the day because here's the thing there are processes that happen in the brain. We can talk about the pathophysiology of anxiety and depression and how that actually is from a brain perspective, before we even talk about the psych world is like from a brain perspective, before we even talk about the psych world. And what happens is in what involved is weaker neurons popping because they can't handle the stress I don't like the word stress because it gets taken in such inappropriate directions they can't handle the stimulus that is placed on them, they can't handle the physical demand, the metabolic demand that is placed on them, and so what they do is they drive too hard and they pop, and then all the glutamate and neurotransmitters inside there ping all the other neurons around them and creates a spreading wave of something called glutamate excitotoxicity. And glutamate excitotoxicity, which you see in concussion literature all the time, is a spreading wave of hyperactivity followed by spreading depression. So spreading depolarization is the term that, if you search for it, just spreading depolarization, and then it's spreading depression because after you have this depolarization, it's not a stroke. You don't have all neurons ineffective, but you have some neurons ineffective and now you have this spreading wave of depression where you have neurons that aren't working as well.
Speaker 2:And so the idea is, this is a natural process, this will happen. No one is going to have an, no one's going to be able to live a life where they where this doesn't occur, but part of this occur as this occurs. This shapes personality, this shapes the way that you think about things. This shapes the way that your brain functions and provides. I love the opinion where the mind is an output of the brain. So it shapes the way that your mind responds to the physical stimuli of the world.
Speaker 2:But this effect also happens with different things, like, you see, certain recreational drugs. This will happen and people view it as a positive effect because they're having a mind expansion thing, but in reality they're just having pathophysiology, self-chosen pathophysiology, and this process. If we can, instead of trying to prevent it, but if we can stabilize it, and if we can limit swinging too high, too low, then we have a better conscious experience. So, from this perspective, with kids, the number of factors that go into. When you're talking about kids playing sports, I'm of the agreement. Like I don't personally, like we grew up as a baseball family, not as a football family, and watching football players and things like that, especially working with a few, now not something that I have any desire to and I personally wouldn't put my kids at football. I would put them in other sports Also risk of injury, but it doesn't necessarily create sports. Also risk of injury, but it doesn't necessarily create the same risk of injury because it's not direct collision sport.
Speaker 1:Um, yeah, there's a big difference between you can break your leg or you can break your brain, and that's the, that's the whole. The whole issue here, um, is that you know it's like you said, like just synaptic pruning. There are processes which you know tate. You know, like you said, like the synaptic pruning, there are processes which you know which will eliminate some of the synaptic neuronal capabilities of the brain over time. Because that's life, that's the influence of drugs, alcohol, personal choices, whatever right.
Speaker 1:But when we start impacting specific regions of the brain, like the prefrontal cortex, temporal lobes, over and over and over again, this is, just know to me, unhealthy and especially when it comes down yeah, I mean, I mean it's it cannot have a positive impact. As a matter of fact, I, I told the nfl, I tell everybody, I said show me one study where it has been shown that jostling, shaking the brain, which is known to happen, is positive in any way, shape or form. The brain doesn't need exercise, not like's, not like a leg right Stop. So let's just prevent it and delay it until the brain's healthy or whatever.
Speaker 2:I think there are benefits for kids playing sports and kids getting out there and doing things that involve some level of competition and involve some level of teamwork and doing something where sometimes you've got to learn how to have grit and push through. But I do and this is a tough thing. But, like I said, I probably wouldn't let my kids play collision sports, but it depends. Like I feel like hockey would be something to play later on, but the checking part is a thing that isn't in the old release, so delay checking.
Speaker 1:You can play hockey at four, just don't check. You can play flag football till 14. You can play no head soccer you can play. You can play any sport in the world. Just keep the head out of it in the best interest of the child, in their future, that's all.
Speaker 2:so here's the question, though, since we already established that just stopping short from 10 miles an hour if, if you're not ready for it, is enough to create jostling of the brain and potential concussion Where's the threshold of which? Sports don't create any whiplash effect of the head Like? Ultimate frisbee laying out and diving Like we can't have an entire world of golfers. I think that might be a little tough to keep people interested right.
Speaker 1:But the issue is there are certain sports where, like football is one of the few sports where you can't take the head out of the game right without tackling. The point is, how do you eliminate exposure through? You know better, practicing like you can, you can. You don't have to tackle and practice all day to be good at tackling man, you know right. Just like you don't have to shoot guns every day to be good at shoot guns in the military. So the issue is total aggregate exposure and to prevent the damage.
Speaker 2:Now, yeah, to stop in a 10 feet away, how far away the exposure is. Does it have to be right after? Because you're talking about compounding inflammation where there is no ability and when you go through the. So there's a paper, it's been around for a while, it's called the metabolic cascade, the neurometabolic cascade of concussion by Giza and Havda, and there's another one that they put out called the new neurometabolic cascade, and if you read it line by line, you will see how long concussion physiology happens, from blood sugar dysregulation to a bunch of other processes. You're looking at two months later, sometimes that it's still happening and you might not even feel like you're having a concussion, or you might not even feel symptoms, but you'll still have this altered physiology. Then the question is at what point does another concussion create a second impact syndrome or create a compounding effect, even if they feel fine and they complete all the metrics?
Speaker 1:We funded a study that absolutely showed that the increase of suicidal reality and depression after concussion for the next 35 days. That's at the point where a lot of these children are deciding that, hey, I can't be here and nobody in there talking. Right, but to your point, not even a concussion. But what if you're back in the game, a repetitive head impact game? You're back practicing or tackling checking in hockey, whatever we have to, you know, brain health right to me is where chiropractic comes in. I'm learning a lot about the apex.
Speaker 1:I want to talk about that real quick and how that affects cerebral fluid flow, but we're just not fully on it. It's logic, right? We have to take care of these brains and we're not. I didn't take care of mine and I had a mental health breakdown two and a half years ago. I was diagnosed, been shot in the face, fragmentation, all kinds of stuff been around, thousands of explosions and bullets and all that stuff. But I hurt myself, didn't even know and I just drank my way through it.
Speaker 1:Here we're talking about what we're doing to our children and young athletes. I mean, the brain doesn't start developing till 25. And some people now saying that thing keeps going, man, it's still developing. It does, and so when people come to you and they have concussions, is there also aspects of mental illness involved with their symptomology? And then how do you treat that? I mean, are they doing you know? Because my question is what's the impact of SSRIs, ssnis and benzos on a brain that's recovering after a concussion, where there might be mental health symptoms, and these doctors are just chucking pills at people? How does that impact the recovery process?
Speaker 2:The current standard in concussion and, first and foremost, recommending specific prescriptions or anything like that is completely out of my scope. But the current the current recommendations for concussion, even in the SCAT-6, is don't medicate for symptoms, because then you won't know if they're getting better or worse. Cool, ok. The other, which again, there's also the part of it where you go to the health care provider they get paid, whether or not they write a script. They get paid whether or not the person comes in, and at the end of the day sometimes they're just saying, well, the patient's coming in and wanting something. If I tell them no, then they're going to have a bad experience and they just they're not. The doctor is not as bought in where they need to be and to say no, we do it the right way. So not as bought in where they need to be and to say no, we're going to do it the right way. They're so like. Here's the easy way out.
Speaker 2:There's also, but we can think about it from a you can play with those systems dopamine, serotonin, your catecholamines. You can play with those systems using supplements as well, which I see all the time used inappropriately, because anytime that you do anything that affects the brain, you're creating neurotransmission and you're creating growth in a direction and you're creating pruning in a different direction. So for patients who are coming in or coming with a laundry list of supplements, especially neurotransmitter active ones, first and foremost, they come in, they take a neurotransmitter test like blood or urine. How do you know if those neurotransmitters are coming from their brain, their gut or the microbiome? Absolutely I can't tell.
Speaker 2:I don't know anybody who can tell. And then they're like oh, your serotonin is low. Well, is the serotonin low because they are having a? Uh, because it's truly low. Is it low because it's not coming from the brain, gut or microbiome? Or is it low because it's not clearing? So you have, every time a neurotransmitter goes across and connects to another neuron, it has, it, gets attached to the receptor site, and then there's another process that allows it to actively release from the transmitter site. And if you don't have that release, then all of a sudden your brain's like I have enough serotonin, so it stops making serotonin. Does that make sense?
Speaker 1:Yeah, so let me ask you a question. You know a child comes in or an adult, right, they've got a concussion Are you asking anything about? And they say they have mental illness. Are we aware that they have mental illness whatever? They have mentals whatever? Are you asking any questions as part of your assessment on their contact sports or military experience history to determine if there could be a biological cause to their mental illness that could be from the sport, not from the concussion, that could be from their past?
Speaker 2:Absolutely, you do, we do Good for you man, awesome, our intake forms cover all that stuff. And we get complaints about the length of our intake form sometimes. And then when they come in, I'm like, well, which questions should we drop out? Not, dr.
Speaker 1:Lovick, you are one of the first professionals I've talked to, that you know. I don't know if you ever heard of the traumatic encephalopathy protocol, syndrome protocols. You know four basic questions that you can ask. You know that can at least say hey, you might have another issue here other than your concussion. Looking at your history, your concussions in the past, your military exposure, you probably should go see a neurologist and get your you know, your brain assessed, because you might have another cause of your mental illness. You're actually doing this.
Speaker 2:Yeah, because the mind is an output of the brain for you If you're not, if you're, if you're viewing the mind as a separate entity and the mind is output of the brain, or I know I hope nobody hates me for saying this, but I don't know if I care it's. Some people say no, the mind is the output of the soul and the body is completely separate. The mind is an output of your brain. Your conscious experience that you have is based off of different parts of your brain lighting up. There's an area in your brainstem called the nucleus tractus solitarius, where the top is cardiorespiratory, the bottom is gustatory oh no, I'm sorry. The top, the top, is gustatory, so taste and smell, and the bottom is cardiorespiratory. It controls that and modulates that. And if that system, if that nucleus remember I was saying fires closer to threshold, high firing, revved up, that's how you get the conscious experience of nausea. It comes from that. What, what you did before that might rev that up may is what we associate with it, like, oh, I ate something bad, so I'm nauseous. No, you ate something bad. It created a response. Now your nts is feeling that difference and then you get nausea. And if you don't get nausea, you might have, like you can have any dysfunction along that chain, along that pathway. And so, from what you were saying before about.
Speaker 2:Do we look at mental health Absolutely? But here's the issue, and this is one of my frustrations with the mental health revolution that we're currently experiencing that we're so focused on swinging the other direction of mental health is so important to look at. But then the treatments that they're being provided is only looking at the output. Going back into the, into there, they're looking at the symptoms. The symptom itself is the conscious experience and the personality behaviors that they do, because behaviors are based on the environment. You put them in absolutely. You put them in is 100 due to the sensory input that they get, because that's how they figure out what their environment is and the way their brain works. So they can figure out this sensory input means my world is this. And then it says, oh, so I'll react this way. And now we're saying, well, have you tried reacting differently or thinking about it differently? Why don't we just go to the physical aspect and improve that?
Speaker 2:So one of the projects I'm working on is I'm pouring through the literature now. I always said I wanted to write a book and I figured out what to write on. I'm working on a book right now of all the biological things that are directly correlated biological and metabolic, that are directly correlated in the literature to mental health issues, from tpo antibodies being directly correlated with bipolar syndrome to vertical nystagmus or spontaneous nystagmus in a vertical plane directly associated with you need to stop right now, because big pharma is listening, man, you're gonna be out.
Speaker 1:Now you started, you start impacting their pill industry, dude, you know.
Speaker 2:But you to your point, keep going, because I do believe that if we treated mental illness from a biological or a physiological, pathophysiological perspective, a lot of it um could be improved and it's not a near a sum game, which means the stuff that I'm doing and I'm talking about doesn't mean that if you do this you can't do everything else that the psych world does, but it does mean that we can't just sit and think that, oh well, if you think about it differently, or if you do these strategies or you talk about it or you have this because there's great example is so depending on if it's your left brain or your right brain. Each brain has a dominant hemisphere and a non-dominant hemisphere and that helps drive your personality and your and everything, because it's an output. If you have dysfunction in your dominant hemisphere, whichever side that is, you'll have certain phenomena and you'll usually it's reported as if you have dysfunction, the dominant hemisphere. You're going to kind of you ever know somebody that they got some stuff going on and there's like they don't notice data doesn't really affect them but and they don't take care of it because they're like, yeah, I don't know whatever. But you have other people who are like acutely aware of their own suffering and those are the people that have the non-dominant hemisphere having this dysfunction because their dominant hemisphere can look over and say something's not right and then they hyper-focus on it.
Speaker 2:Treatment for those is different. One of them involves getting out of your brain and into your body physical, like the people who work, who they do a really tough workout and they just feel better. And the other one is people get out of their body and into their head or into their brain, and those are the people who meditation work for. But there's a whole stigma where they have all of these wellness treatments that seem so simple but if they don't work for you. Now patients have come into my office saying I've been trying meditation and I've been trying these like belly breathing and parasympathetic triggering things to try and create this wellness for me, because I see it on Instagram, they see it on YouTube, they see it from their providers. This was if you have these things, you have patients coming in and they're saying meditation doesn't work for me and I feel bad because I feel like I'm failing something like that.
Speaker 2:It might not be. It's people are so quick and healthcare is so quick to blame the patient. It's not the patient's fault. It's their physiology, it's their body, their situation that they have won't improve from meditation. Their situation needs, they need to go and do a physical workout from this isolated perspective and so but here's the thing, there's, but you can always get deeper. You always can get further focused, and so a lot of the stuff that we do in the office is we're saying, okay, before we give you the generic advice, let's figure out exactly where the issue is. If you have a spontaneous asthmus in the vertical plane, we're going to work on that directly.
Speaker 2:If you have a, so BPPV is usually what happens when they have any sort of dizziness associated with it. But you can have very low level dizziness and that can be perceived as a patient just feeling like they're off. It's not like they're going to come in and say I'm dizzy. They're going to come in and say like I'm having these other weird things, my body hurts because I can't coordinate, and we're looking at it. And it's not that their inner ear is broken, it's that the software in their brainstem is now not receiving the information that it needs. And they have this the way I tell my students you can have 100% of something, you can have 5% of something and it still has an effect.
Speaker 1:So real quick, cause you know getting towards the end. Tell us how you know chiropractic work, cause that's something new to me Uh, affects, you know concussions. You know you think of brain, right, spine, neck down Right, so, and I've had my, I've had some very successful work done, uh, by chiropractors in the past, helped me out, help me out. So talk to us a little bit about how chiropractic medicine can help people with concussions or maybe those that have had a lot of subcust, of exposure from years of playing sports. You're dealing with, you know, nfl players. Now, how is you know I'm not talking about making my back feel better how are you impacting the brain? So?
Speaker 2:here's the thing If you're looking for a chiropractor that can do this kind of work, you're going to want to look for somebody who is trained in it. So the letters you're looking for are D, a, c and B. Now here's the thing. There's different levels of education that you can go and some people do have more training than others and more education can end up doing more. But those are the letters you're looking for.
Speaker 2:A regular chiropractor, even if they say they are a neurological chiropractor. There's a certain technique called uh, torque release technique. That's pure musculoskeletal. They say it is neurologically based and I I've had a lot of patients get kind of go that direction and then come back to me and they're all stressed out but they spent a bunch of money on something that wasn't, that was more marketing than what they were looking for. Look for the letters D, a, c and B. That's going to let you know if you have somebody who actually knows how to work with the central nervous system, the brain and the way it is is.
Speaker 2:Yes, we're doing musculoskeletal input, but mainly it's from the idea that I'm going to do sensory input to an area, because at the end of the day, if you were going to hold a gun to my head and say describe what you do as simply as possible, I would say. I make you know where your body is in space better. That's how we do concussion recovery and by doing that now, the sensory input of where your body is, the sensory input of where you think you are in relation to gravity so vestibular rehab, which we do. The sensory input of where you are in relation to the world visually so vision therapy, which is also things we do.
Speaker 2:And cognitive rehab, which is frontal lobe exercises, which is things we do. If you take all of those and combine them together, you're now creating a better experience and a better understanding of where you know your body is and when you move your body, it matches up to predictions, it matches up to where you think your body should be and it creates a better, more continuous experience for your brain and symptoms start to reduce. So for how do we do it? It's vision rehab, vestibular rehab, physical rehab, cognitive rehab.
Speaker 1:What about the apex? I'm hearing some work that's being done on the very top vertebrae that's helping spinal or cerebral spinal fluid move in and out and cleanse the brain. Is that something else that you focus on?
Speaker 2:Absolutely so. While we don't have like there are certain clinics out there that are upper cervical, specific clinics that will focus on that directly we do work on that as well as part of a bigger picture. Here's the thing when you're looking at the atlas and the axis and how that moves that was it. Sorry, man, my bad. Oh, you're good.
Speaker 2:How that moves, you can feel it, Like you can feel it on yourself. If you go right behind the jaw, right over here, you'll feel like a slight little bump and you'll feel on both sides and you can slide that side to side. Those are the transverse processes of your atlas and so if you push side to side you'll feel like, hey, yeah, it's more slid one way or the other or less slid, because that physically can't happen without creating a lot bigger effects. But from a concussion standpoint you'll see more tension one way or the other, where it'll be more restricted, and less motion in that spine one way or the other where it'll be more restricted, if we can, and less motion in that spine one way or the other.
Speaker 1:You'll also see.
Speaker 2:So if you have somebody like, this is a quick test that everybody can do. You just have them look up Does their chin track in front of their neck or is it twisted Things like that? There's a lot of different ways where you can see that, hey, maybe the muscle balance at the top of the neck because there see that. Hey, maybe the muscle balance at the top of the neck because there are so many overlapping muscles, the muscle balance at the top of the neck may be asymmetrical. And the other perspective is and we do this a lot with our patients we also do TMJ work.
Speaker 2:We work on the muscles inside and outside the mouth of the jaw, muscles inside and outside the mouth for the jaw. We do exercises for it. We work on some of the so cranial bones. While theoretically they do not, they are sutures, there is some motion to those cranial bones, and so we'll we'll end up doing work on those areas, working on those as well, creating motion in those areas that might have been changed when they, like you know, took a volleyball to the face, something like that.
Speaker 2:And so the whole idea is not hyper-focusing on one approach, but getting an idea of all the different inputs and outputs and what we can do. And so, from an upper cervical spine thing, these are where so we'll get patients with like tinnitus or changes in their hearing, and it comes from increased muscle tension in an area, reducing reverberation, reducing resonance in that area, and then we start working on the muscles of the jaw and then all of a sudden the hearing or the tinnitus improves. And it's not like we're doing anything miraculous I wouldn't. That's great with. That word is used. What we're doing is we're just going systematically, logically, through the different systems and working on them and seeing how they play together.
Speaker 1:Well, I mean, it's fascinating that you know chiropractic, you know practice can can impact concussions. And also to your point and thank God for you, doc is that you know it's just another way where our health care system can identify people that have had a lot of exposed subacusum trauma and can get them looking. Another what? Whether you've had a concussion or you've had many concussions or you have a history of repetitive head trauma, then you know this is something that doesn't take pills, but it takes people that know what they're doing. So before we go, doc, tell us about, you know your book, what's coming up next, how do people find you? And then you know, and then if they can't find you specifically in their area, united states who they should be working for.
Speaker 1:You mentioned the um. You know the, the, the letter d-a-c-n-b, and that is diplomat american chiropractic neurology board. Just look that up. And so tell us how they find uh, what, how they find you, so that they can uh get more information on their, on how to treat themselves so so I'm very Googleable, michael Lovitch, just do your search for that.
Speaker 2:There's also my business, deltasperformancecom. Go on there, if anybody wants yeah exactly If anybody.
Speaker 2:We do free 30 minute phone calls for anybody who's interested, because I'd rather people feel comfortable and confident coming in as opposed to showing up and cold turkey. So what we'll do is, uh, if you have the website, click the get started form. We will happily hop on a 30 minute phone call with you and answer any questions you have and see what we can see. If we were able if the case we're able to help with. Uh we are located in. Unfortunately, we're not located in Boston anymore. I used to have offices there, but now we're just Denver and Golden, colorado.
Speaker 2:But for people who are all over, I think that, like I said, the provider you're seeing is in. The doctor-patient relationship is always the most important part in that connection, and it doesn't mean that I'm the best for somebody. It could mean that, hey, maybe I could fix it, but I'm not the best fit and the patient's better off going to another provider. On my website, under resources, I have a functional neurology map. These are people that I have personally shadowed and seen and I was like, yeah, this is similar to what I do or this is, this is reasonable. Uh, and and I, there are plenty more that probably do great jobs as well, but in terms of, instead of just making a pay-to-play map, which I think is too too familiar in this country, I put a map up there that is yeah, dude, I just put a map of this. Yes, this is.
Speaker 1:These are people that I would see if I had this issue the ability to play with others is very important and not part of our society at this time. You're absolutely right, dr Lubbock. I cannot thank you enough for coming on the show today. What an amazing conversation, man. This is great, and thank you so much for assessing the past experience. This is the largest assessment gap that we have for this issue Outside of mental illness. There's no indicator that the brain's been harmed. Nobody asks these questions. The kids keep playing sports, the adults keep playing sports or they continue to spiral because we're not treating the brain. You are part of the solution. We need to get to treating the brain in order to prove mental health, and you're a big part of that, and thank you so much for the time today, folks, another great episode. What a fascinating conversation, man, after all the chiropractors I've been through in my life.
Speaker 1:Don't forget free book website Youth Contact Sports and Broken Brains the only book out there for parents. It Youth Contact Sports and Broken Brains, the only book out there for parents. It's for free. Read it, get it to your grandkids, send it, get advanced copies for Christmas I really don't care, but please get informed. Don't forget that the second international summit on repetitive brain trauma is taking place here in Tampa September 3rd and 4th. Go online and see. We got some amazing group of speakers out there. It's really getting looking a lot of fun this year and finally, take care of yourself, take care of the ones you love, take care of their brains you only got one and to protect it as best you can. God bless you all. We'll see you next time on the next episode of Broken Brains, with your host, bruce Parkman, sponsored by the amazing Mack Parkman Foundation.