Audio Transcription:

Al Malmberg:  Welcome to this edition of Rocky Mountain Viewpoints, I am Al Malmberg we get a lot of ideas for the show from you so if you have any ideas please send us an email to and joining us this morning is Dr. Michael Farrell, D.C. and he is a Chiropractor and we are going to talk about scoliosis and the screening that you are having at your clinic at the Spine Correction Center of the Rockies in Fort Collins and so for the entire month of August and September free screenings.

Al Malmberg: Yeah that’s correct, unfortunately you know schools we used to think that schools would do screenings for our kids and that’s not happening anymore, you know it’s one of the things that had to go with some of the budgetary cuts.  And you can’t blame it, I mean with the size of some of the schools, it’s really difficult for the nurses to adequately screen all those kids.  So what we need parents to know is that that responsibility is kind of become theirs and most parents don’t have tools to deal with that.  And so we are doing it for free so they can get it checked.

Al Malmberg: Doctor, most of us, not much less, we can’t say Scoliosis but we don’t know what it is, what is it?

Dr. Michael Farrell:  Yeah, so scoliosis is, it’s an abnormal curvature of your spine, when you are looking at the spine you know either from the back or from the front in that anterior to posterior plan so it’s supposed to be straight up and down and if it’s start angling sideway so to speak, more than 10-degrees then you start labeling it scoliosis and then from there you know it varies in terms of curve type and size and severity of curvature.

Al Malmberg: Is that something that develops or are we are born with that?

Dr. Michael Farrell:  Good question, so scoliosis, most of the scoliosis cases are idiopathic, meaning that they don’t really know.  So yeah so what that means is obviously there is a genetic component that plays a role.  The geneticists, you know they have actually developed a genetic test now you can actually have your kids tested for the genetic disposition for them to have a curve that would require surgery, but there is other factors as well.  Biomechanics is probably one of the biggest factors that can come from, everything from trauma to just poor posture patterns can develop into scoliosis.  And then there is what scientists or researchers label other stuff, you know some researchers site fluoride and water, some site or not water but like high levels of fluoride in the environment or heavy metals, some sites or other neurotoxins, bacteria sometimes.  Those things we don’t really understand very well so we focus predominantly on the Biomechanics which is probably the most well understood and then managing the genetics if it’s a factor.

Al Malmberg: So treatment I understand there is a new treatment, you call it CLEAR, is that a correct?

Dr. Michael Farrell:  Yeah, so there is a new treatment for scoliosis that’s being developed and kind of spearheaded by you know biomechanically inclined chiropractors, not really traditional chiropractors where you go and get adjusted but this type of chiropractic is combining rehabilitation, all different types of new technologies, vibrational technologies and new technologies and then certain styles of active rehabilitation training.  So in the past patients were stuck with wearing a brace for 23 out of 24 hours a day and all the implications of that and then watch and wait if the curve was too small for a brace and then unfortunately surgery which you know long term the outcomes are not as favorable as we would like them to be.

Al Malmberg: If somebody has this, what is the prognosis for generally speaking here of course, is it something that can be taken care of?

Dr. Michael Farrell:  Yeah, it’s definitely something that can be treated with the new technologies, smaller curve of course are a little bit easier to treat but the curves that we treat in our clinic are you know from a size 11-degree CLEAR up to, I have one patient that has a 120 degree curvature, and so its all over the place, younger or some of our younger patients are probably you know 5, 6, 7 years old and our oldest patient is 92.

Al Malmberg: No kidding.

Dr. Michael Farrell:  Yeah.

Al Malmberg: I would think that the treatment is going to vary greatly from those in that age range of how you are going to do it?

Dr. Michael Farrell:  Yeah, exactly the condition changes dramatically throughout growth and then into adulthood.  And for a lot of the adults out there that are listening that maybe don’t have kids that have scoliosis but they have scoliosis themselves, it’s really important to remember that you know curves over 30-degrees will continue to progress into adulthood.  Unfortunately I get a lot of patients that come in and say, well my curve was at 32 when I stopped growing and now it’s in the 50s or 60s sometimes, so we can still treat them but you know it’s not something you don’t want to wait on.

Al Malmberg: If you have a severe curve and then some of the percentages you gave were extremely high to me anyway, can you live a quality life when it is that severe?

Dr. Michael Farrell:  Yeah, good question, with the more severe curves I mean there are implications associated with that.  Most of the time you know patients with larger curve types are dealing with pain syndromes, you know sometimes some respiratory issues, but yeah it’s really important for adults that have scoliosis to even continue to get it checked and lot of adults that we treat, you they are seeking treatment for a quality of life in terms of managing their pain or just controlling the curvature where it’s not going to get worse.  And obviously with kids it’s a different objective, the objective is to control the curvature and you know keep them out of brace and keep them away from surgery as much as possible.

Al Malmberg: How do you do that? How do you control it?

Dr. Michael Farrell:  It’s managing the risk factors associated with it, so genetics if they qualify we go ahead and get the genetic test and that shows us you know what their genetic deposition is to having a really progressive or severe curvature.  And then of course dealing with all of the biomechanical factors, so that can be everything from loss of a normal curvature that should be in the neck and to retraining the brain how to hold these things in place.  So the best way to think about our treatment strategy is we utilize what I call mix, fix and set.  Mix is the spine and the scoliotic patient is really locked into that scoliotic position, the ligaments themselves have an adoptive process where they shortened and even the muscles will adapt.  There is actually a large neurophysiological adaptive process that comes out of the brain as well.  So you got to go in there and during the mix phase, really loosen up all the muscles, tendons, ligaments and discs. Then the fix phase we go in and address any bad biomechanics that are occurring within the joints, usually through different types of spinal adjustments or spinal manipulation.  And then the fix is where we actually use pretty sophisticated traction chairs, they vibrate at a very specific frequency, helps the muscles learn a new position and then after that we do some reactive training which helps the brain kind of learn, I call it getting the brain onboard, we can start to teach the brain new posture patterns.

Al Malmberg: When you are talking about loosening up, how do you do that?

Dr. Michael Farrell:  Yeah, so it’s through, we have a lot of different types of equipment that do that everything from active rehab chairs to we have vibrational traction units, Flexion Distraction Tables where we use a certain type of ratchet system to literally you know pull the curvature straight and then the table sits there and flexes and warms up all the soft tissue.

Al Malmberg: Wow, how often do you have to do that then with the patients?

Dr. Michael Farrell:  Most of our patients come in and they usually come in for either an intensive treatment protocol or for kind of a standard protocol.  Intensive treatment protocols are designed for patients that are traveling more than you know an hour to get to our clinic, we treat patients from all over the Continental U.S., Alaska, I have some international patients that come up from Mexico and then they will come and they will stay at the clinic for 1 to 2 weeks and those guys are kind of doing treatment fulltime, they are in there for in between 5 and 6 hours a day having treatment done with the intensives.  So those are for patients that are traveling.  Our standard patients, are usually in office, depending on curve type in between somewhere between 15 and probably 35 treatment sessions, we usually do that over 2 to 3 months.

Al Malmberg: If there is a 30-degree bend in the spine, is that something that can be straightened with this treatment?

Dr. Michael Farrell:  Yeah so what we are seeing is it’s impossible to straighten them a 100%, but overall it is possible to you know stability is always the first objective, keep it from getting worse, but reduction usually is possible, usually we are able to reduce in between you know probably 25% to 50% and again depending on age, curve type you know genetics.  There is a lot of factors.

Al Malmberg: As a parent I am thinking back when my sons were little guys, I wouldn’t even have known what to look for, this never entered in my mind as a possible problem.  So as a parent, what do parents look for, observing their children?

Dr. Michael Farrell:  Yeah, I mean again with the elimination, unfortunately the school screenings which is where you know this used to get caught, parents are having to take more responsibility.  So what we started doing is starting to train parents how to look for a scoliotic conditions in their kids.  So probably the first thing that a lot of parents will notice is a lot of parents come in and they are just telling, look my kid was really bad posture, their head looks forward, maybe they have a shoulder that’s elevated or a particular concern actually is if you have a shoulder on the same side as an elevated hit or you know lot of parents coming and they will say, well my daughters wears you know striped dresses, the stripes don’t look even, you know that’s not normal, that doesn’t mean they have a short leg, that’s pretty rare.  So yeah those are things to look for, you know in the past everybody looked for like the back, but unfortunately for a lot of those patients by the time you see that bump, the curvature is already about a 30-degree, sometimes more severe.

Al Malmberg: Wow.  And once again this develops it gets worse over time?

Dr. Michael Farrell:  Yeah, I mean it’s classified in the mild, moderate and severe categories and you know based off of risk of progression and but curves over 30 get worse, regardless of age.  And so that’s definitely something that we are finding of course with kids you know we would like to catch them early if we can catch these kids early then you know stability is a lot easier to do and we can hopefully keep them out of bracing and surgery.

Al Malmberg: How common is this?

Dr. Michael Farrell:  About 4.5% of the population is said to have scoliosis, so it’s more common then you think it was start to be a lot more common in females but there are some new research coming out of the University of Utah that is pointing to the fact that the research don’t approve that females got it more, was done more during their initial growth spurts so when they were more likely to have curve progression.  So they did a research study with college kids and found that the deposition across the population was spread, it was 50-50.

Al Malmberg: Why would they have thought that it was more likely for girls? You have this and you were talking about the period of their lives whether they are experiencing the growth spurts, but guys go through the same spurts, do we not?

Dr. Michael Farrell:  Yeah they do but usually screenings in the past were done you know kind of in that junior high phase and for all those you know all those guys out there that are late bloomers, they are usually hitting their heaviest growth spurts little bit later than that, where the ladies usually were hitting it early, but still you know again the ladies are a little bit more disposed to that but they are not, you know we don’t really know why, some people say, well it’s estrogen in the ligaments or but again it doesn’t matter, I mean if you are male or female its going to create, it can create problems for sure.

Al Malmberg: I have got to ask you this, with the treatment, is there any pain involved with getting this treatment?

Dr. Michael Farrell:  Good question, so I get the question a lot, you know no most of our patients they don’t, they report like active soreness you know which you would experience from maybe going through a new athletic program –.

Al Malmberg: Or rehabilitation of a rotator cuff or whatever.

Dr. Michael Farrell:  Yeah exactly it’s not you know I wouldn’t qualify it as severe pain you know just muscle soreness and things like that.

Al Malmberg: Which is most of the time when you are going through any sort of rehabilitation you can expect that.

Dr. Michael Farrell:  Yeah, for sure.

Al Malmberg: But how do you explain that to the little folks that are coming in?

Dr. Michael Farrell:  Yeah, it’s interesting now because I work with a lot of teenage girls and a lot of pre-teens and I told myself I would never work with that population because it can be pretty challenging, but you know you just do your best to explain to them.

Al Malmberg: Yeah, I mean when we first started talking when you were talking about you know hooking people up, I went back to this Andy Griffith episode, on the Andy Griffith Show where they had to make Barney a little taller and they hung him in a closet, he had a leather harness around his head and they are hanging him from the pole in the closet, and they were stretching him out, I don’t know why that vision came into my mind, but I would think there is nothing like that?

Dr. Michael Farrell:  Yeah its different, a little bit different than that, I don’t know.

Al Malmberg: These things have changed.

Dr. Michael Farrell:  Things have changed technology has progressed.

Al Malmberg: So let me ask you some personal questions, you went into being a chiropractic, a physician, a doctor, how did you get into that field?

Dr. Michael Farrell:  You know I always loved working with and helping people and chiropractic right now is going through a lot of shifts in philosophies, how they think about things and I was always really passionate in school about this idea of combining chiropractic with rehab technologies and then we have been very blessed to be able to combined it with medical technologies as well as we have kind of medically integrated so we are fulltime, you know medical staff that work along side us now and it’s really exciting to have completely different mindsets and philosophies working together to the benefit of patients.

Al Malmberg: What’s the difference between a physical therapists and I have had therapy on various parts of my body over the years things have gone wrong, what’s the difference between the physical therapist and a chiropractor?

Dr. Michael Farrell:  Yeah, I mean.

Al Malmberg: And you are both doing the togging and the stretching and all of that?

Dr. Michael Farrell:  Yeah, I mean I think the differences is you know in an education level you know chiropractors have a little bit more education than the most of the physical therapist.  I think most physical therapists are really, really good at certain types of rehabilitation, stroke rehabilitation, post-surgical rehabilitation, you know my sister has gone through you know a health crisis over this last year and her physical therapists were like some of my favorite people.  They are really, really sophisticated.  I would say chiropractors, this new wave of chiropractors that are coming out, we are doing so much more than adjusting the spine anymore, you know that’s a thing of the past.  Now it’s, we are combining really advanced rehab technologies, spinal specific most of the time, you know in combination with the manipulation, probably the biggest thing between you know chiropractors and physical therapist is you know physical therapist, they see a lot of things as weak muscles.  And a lot of times the weak muscles are problematic but I see things as more smart muscles are dumb muscles depending on how well your brain is operating your system.  So the idea is to get the brain onboard so we use you know reactive training devices to do that, an example you know you could do a lot is you know when you are riding a bike, obviously you are contracting your leg muscles, your core muscles — but most people when you ask them well, what muscle do you working when you are riding a bike, they don’t know.  That’s because they are just responding to the environment it’s a balanced environment that I am going to respond.  So you know we use that style of training and it seems to work a little bit better at getting the deep core muscles involved because you know the brain can switch those on and trained them up.

Al Malmberg: You know I had a couple of physical therapists and I personally thought that you have to be sadist to go into that profession they seem to like giving people pain.

Dr. Michael Farrell:  Yeah, the good ones do for sure.

Al Malmberg: They would smile when you go, oh good this is working, well yeah like our chiropractor is the same way.

Dr. Michael Farrell:  Well, maybe I don’t know.  I mean I like to see patients getting results for sure, you know the pain stuff, I don’t know sometimes its like if you are stretching you know a muscle baste that’s anatomical or a range of motion that you know you can be damaging that but you know BTs by and large especially here in Fort Collins are dialed in, I mean they are good.

Al Malmberg: They are good, they really are.  No I am going to tell you I have never been to a chiropractor, I have never had the need and so the chiropractor is a more educated physical therapist in the ways of inflecting pain, I am just kidding.  I truly, my dad saw a chiropractor and swore by it, it’s a wonderful profession.  Let’s talk about the CLEAR Institute which is out ofMinneapolisand they developed the new procedure for alleviating I guess alleviate is not the proper word you use –?

Dr. Michael Farrell:  Yeah, I mean the CLEAR Institute it’s a nonprofit, it was started by a member, a chiropractor name Dr. Dennis Woggon who is a fantastic guy.  And you know really what we are doing you know with the nonprofit is we are developing these new technologies and new paradigms, new ways of thinking about treatment of Scoliosis, you know the bracing and surgery have been around for years and it really hasn’t changed, some of those surgical techniques have changed but it’s all the same, it’s all fusing the spine.  So really what we are trying to do is push for this paradigm shift to have this methodology or treatment of thinking shift.  You know the cool thing about our treatments is there aren’t any side-effects, outside of maybe a little bit of physical soreness.  So that’s a side-effect and then you know getting your spine straighten is always a positive side-effect, so it’s very favorable in that regard, the worst thing that can happen is that it doesn’t work.  And then you can still continue to pursue you know what we would be considered the traditional treatment methods.

So I think what you will see you know in the future as you know and as the U.S. and overseas as well we have clinics that are now over in Europe and Panama and as that continues to happen, and the research continues to pour in I think you will start to see that the CLEAR Institute and it’s method to treatment will be considered kind of the first treatment of choice and then it will move into more invasive treatment patterns.

Al Malmberg: I am glad you brought up the future because I was going to ask you that, what do you think, how do you feel about, what is the future going to be for chiropractic and where is this going to go I mean you are getting new methods developed all the time, do you have a vision, and can you look into your crystal ball what’s going to be like in 50 years?

Dr. Michael Farrell:  Yeah, I mean particularly in the realm of scoliosis treatment I think you are going to see this method that we are developing, I think that will become again the frontline, the new paradigm for scoliosis treatment especially for certain curve types as well as certain size of curvatures.  Obviously there is always going to be curves that you know that we are not able to treat with this method, they may have too strong the both genetic component or you know there maybe a different type and those will still require you know surgical intervention and things like that, but right now there is a lot of these curvatures that are kind of slipping through the cracks, you know they are ending up on that, in the brace and then surgery and we can prevent that for sure.  So yeah that’s what I see and you know and in terms of you know with the chiropractors and the chiropractic profession, it’s a very interesting time in the profession.  It’s really exciting to see chiropractors taking on more of an advanced role with the rehab and using spinal rehab in conjunction with manipulation to do cool things.  And then you know I am really big on multidisciplinary approaches.  I think that that really is the future for physical medicine for sure and for musculoskeletal rehab.

Al Malmberg: We looked at the other future, where has it come in the last 50 years, how has it changed?

Dr. Michael Farrell:  Yeah, I mean you know pretty significantly I mean when Dr. Woggon started treating you know Scoliotic patients even say 15, 20 years ago and that became a big passion and focus for him, the technology wasn’t there to really generate results that were lasting to generate results that would hold and so you know necessity is the mother of invention and he began working to create you know whether it’s machine or reactive training device that’s a lot more effective in terms of treatment of these curves.  So it’s come a long ways, in terms of that.  And it will continue to come you know even further now as we kind of take this next year, what point in the research now into some of the scoliosis societies and as that becomes published and recognition continues to elevate it will, it’s a very exciting time.

Al Malmberg: Does the chiropractic community, do you share information with the general practitioners and other physicians in the medical community?

Dr. Michael Farrell:  Yeah, definitely, it’s interesting because we are getting more and more referrals from chiropractors you know all over the U.S. and you know strangely enough not strangely enough but I am beginning to get referrals from you know orthopedists you know who are interested in our method of treatment for certain styles of curvatures.  So it’s definitely something you know awareness has to occur first and then that will continue to grow and change.

Al Malmberg: Is Scoliosis is that an area of expertise for you is that what you focus on?

Dr. Michael Farrell:  Yeah, I mean I would say you know probably between 30% to 50% of our patient base is scoliotic, so it’s a lot, we treat a lot of cases and you know I really enjoy treating patients that come from out of state as well, it’s kind of nice to introduce them to the Fort Collins and Loveland area and work on the cases.

Al Malmberg: Do most chiropractic, do you specialize in various areas?

Dr. Michael Farrell:  A lot of chiropractors do which I think is pretty exciting to see, you know there are some chiropractors that maybe specialize in neurology or pediatrics or things of that nature.  So you know right CLEAR is working with Parker College of Chiropractic down inTexastowards making this a part of their permanent curriculum rather than kind of a post-grad work environment.

Al Malmberg: If people want to learn about your clinic and about yourself, how do they go about doing you know if they want to find out what this all involves with getting the free screening for August and September, how do they do that?

Dr. Michael Farrell:  Yeah, I mean one of the easiest ways you can do is just to call the office and chat with you know kind of the boss of the office that’s Mr. Janna so you can call us anytime and the number there is (970) 658-5115 or if you are not at that point where you are ready to call, go ahead and you know jump online we have fantastic website that’s been developed and there is a tremendous amount of information on there and you can contact us through the website as well.

Al Malmberg: How many chiropractors do you have?

Dr. Michael Farrell:  Yeah there is myself and Dr. Cardwell, D.C. on site and then we are in the process was actually looking for another doctor to join our team and then we have a full nurse practitioner that’s there as well and then a medical doctor that kind of oversees our whole operation.

Al Malmberg: How many young patients have you had over the years that decide that they want to go into being a chiropractor?

Dr. Michael Farrell:  That’s a good question.

Al Malmberg: They have the hands on personal experience, I am curious.

Dr. Michael Farrell:  I think you know I have only been in active practice for about 6 years, but in that time I think we have already had I think 3 or 4 patients that have gone on to become chiropractors.

Al Malmberg: I can understand that.

Dr. Michael Farrell:  Yeah its fun I mean we are so passionate about what we do that it’s easy to infect other people for lack of a better term about you know how you can really have a significant impact on people’s lives.

Al Malmberg: Is it a profession that you would recommend having been in it?

Dr. Michael Farrell:  Yeah it’s fantastic, I wouldn’t recommend it for people that want to go out and you know get a high paying job it’s not like that but for people who are inclined they have a little bit of business inclination they want to own their own practice or participate and you know in exciting time and in the field then, yeah it’s a cool profession and you know with the aging baby-boomers, you know you guys are looking at –.

Al Malmberg: Thank you.

Dr. Michael Farrell:  No offense.

Al Malmberg: Thank you very much, you know I have my last class reunion which was a few years ago and I am not going to tell you, how many years that has been, I ran into an old friend that was a great athlete and this is what he went into and there is something about chiropractors that have a passion for it because when I asked him what he was doing, boy he was so passionate about talking about his practice and what he does and I came to find out that a lot of our fellow classmates have been patients of his and its pretty remarkable.

Dr. Michael Farrell:  Yeah it’s really exciting, I mean athletes you know there is another specialization that a lot of chiro is going to, you know with the athletes I mean this year at the Olympic games, you know bunch of my colleagues and I am getting all these pictures back you know and he is saying Bolt getting adjusted before he runs and in chiropractic is you know it’s huge in the athletic community for sure.

Al Malmberg: Yeah that doesn’t surprise me at all because you have more issues I think that they are dealing with perhaps than the general public.

Dr. Michael Farrell:  Yeah for sure.

Al Malmberg: I mean I mentioned the rotator cuff and I have had a bad rotator cuff for long time and you know there is going to be a point that I will have to get surgery but you know that’s where the physical therapists have come in and you know they rotate that thing and they want the pain to be felt because that means they are getting some no pain, no gain, by the way is that a true statement no pain, no gain, just kidding.

Dr. Michael Farrell:  I kind of think that it is, yeah on some level especially with dysfunctional soft tissue you know with the muscles and that.  You know when they become dysfunctional they just turn into big knots and so you got to sometimes push through that.  Our brain is really you know in this Scoliosis as well, it’s very good at adapting short-term for whatever stressors you are dealing with in the environment, whether that’s creating you know making spine grow sideways or whether that’s a frozen rotator cuff, but the long term you know the brain doesn’t have the ability to think about itself in that regard.  So yeah sometimes you have to teach it some new things.

Al Malmberg: Let’s talk about insurance, when you are talking about the CLEAR treatment the new procedure, is all those covered by insurance?

Dr. Michael Farrell:  Lot of it is and our practice you know we are big believers of having all the information upfront about you know if there is additional cost so it’s part of our new patient procedures or obviously the screening is completely free there is no cost even associated with that, but if you know, you were to have Scoliosis and coming as a patient then you know we are working through our new patient process and part of that is a consultation with our insurance staff and that way everybody is on the same page, if there is any out of pocket what that set insurance companies are paying for more and more of this treatment, it’s a lot you know it’s a lot cheaper than braces which sometimes are covered a lot of times aren’t and of course you know Scoliosis surgery is very expensive.

Al Malmberg: Yeah.  Now as a youngster, was I screened for this or did the teacher or maybe the nurse at the elementary school just observed us as students to see if they would see anything?

Dr. Michael Farrell:  Yeah, I don’t know, I know scoliosis screenings were mandated for a length of time in there and then you know and inColoradoand some states they are still mandated, but inColoradoyou know just with some of the challenges we are having with education, they had to cut that.

Al Malmberg: You know the economy.

Dr. Michael Farrell:  Yeah, I mean I know I was screened, I think when I was a kid I was screened you know two or three times, so yeah now it’s not happening.

Al Malmberg: Give us your phone number once again, please?

Dr. Michael Farrell:  It’s (970) 658-5115 and you can always Google, SpineCorrectionCenteror and you will find us there.

Al Malmberg: Dr. Farrell, pleasure to meet you and thanks for coming in.

Dr. Michael Farrell:  Thanks for having me.

Al Malmberg: It is fascinating.  We learned a lot about it.  Thank you very much.  And thank you for joining us today, on Rocky Mountain Viewpoint, if you have any ideas, something that might be of interest, please send an email to Rocky Mountain Viewpoints is a presentation of this CLEAR Channel of Northern Colorado Station.