1. Don’t play numbers with owner compensation. Pay yourself a market based wage and only take profit distributions when your company has matured enough to do so according to the four forces of cash flow.
2. The amount of productivity per dollar of labor is one metric that determines the success of your business
3. Don’t spend down your profit to avoid paying taxes. Getting 30 cents on the dollar is not a good strategy when you’re buying depreciating assets.

3 Actionable Takeaways

1. Get your owner salary correct (market based wage) first so that the books accurately reflect the state of your business.
2. Get your pre-tax profit before taxes to 10% as a minimum. Only hire when you push it up to 15%. Use profit thresholds to drive business decisions.
3. Determine a core (operating) capital goal for weathering up and down times in the market i.e. 6 months of overhead
4. Follow the four forces of cash flow like a finanical order of operations
   1. Pay your taxes – always set aside a percentage of profit for taxes
   2. Repay your debt – repay your debt with the rest of your profit
   3. Reach core capital target – contribute toward a goal amount of operating capital
   4. Take profit distributions – only when you have reached core capital target and repaid debt should you take profit distributions.

1. Being an expert and guide isn’t about having all answers. It’s about being a step ahead of your audience and showing them how you got where you are today. Its about being able to communicate new opportunities and unite people for a future-based cause.
2. The job of an expert is to create frameworks. Frameworks are a systematic synthesis of everything you’ve learned about a topic into bite sized chunks that the audience can understand.
3. Don’t create a improvement offer, create a new opportunity. Improvement offers say, I’m going to give you this product which is x amount better than the competition. New opportunity offers present a product as a totally new thing. This takes away the buyers sense that the price should be a certain amount and lowers the threshold for the person to buy it. Brunson gives 4 steps on how to create this type of offer in Secret #4.
4. To Create belief in the buyers mind about your product you have to learn to see their false belief and counteract them with stories. This may be the most powerful lesson from the whole book.
5. You have to sell people on the strategies before you can teach the tactics. Teaching tactics will ruin your pitch

Example of a Framework:

Brunson says there are 3 core groups of people in each marketplace:

• “The Diehard” is in love with the current product. Switching a Diehard to a new product requires a major identity shift
• “The Satisfied” uses the product they bought but isn’t in love with it. Switching the Satisfied to a new product requires a significant price or value benefit
• “The Frustrated” also use the product they bought, but they hate it. They’re actively seeking a better product that can fit their desires. Switching a Frustrated person to a new product requires finding them, gaining their trust, and giving them a small amount of education

3 Actionable Takeaways

1. My one sentence summary of my practice will be “We help the average joe who just wants to get our of pain achieve optimal whole-body health and wellness through specific chiropractic care and corrective exercise.”
2. I’m going to create, write down, and organize frameworks on specific topics that I am interested in. Then I’m going to test, name, and describe them, just as he outlines in Secret #1.
3. Brunson says to keep track of all the objections for your product. Then figure out what was the false belief that made them not want to buy your product. Then think of a story from your own life of how you overcame that false belief. Keep a list of stories for each false belief and grow your story inventory. Eventually, selling your product will come down to reading where the prospect is and telling the right story. He spends secrets 7-10 detailing how to create belief in your buyers with his frameworks.

This book was so tactical that it’s one your going to want to read yourself if you are interested in sales yourself. I’m still going through and trying to apply specific concepts from different chapters. Dan Silvestre has a fantastic summary of the book on his website for reference.

1. The most-important component of creating a sales machine is “pig-headed discipline and determination”. A lot of times in sales, its simply volume that we’re missing. If we are strategic, we are more likely to get more out of our efforts, but you still have to be extremely persistent.
2. Investing in your staff in the form of training, effective workshop meetings, and performance based bonuses can help sky-rocket your success. Being surrounded by the right people is paramount.
3. The ability to sell is vital when running a business. Being able to ethically see when someone needs your product and convert them on it is key. This skill is really the lifeblood of your business.

3 Actionable Takeaways

1. A good rule of thumb for time management is to keep a master list of everything you need to get done. Then, everyday, pick 6 things you will do that day. Each one should take, on average, one hour. If you have bigger tasks that take longer, either break them up into smaller ones or put less tasks in your day.
2. Hold workshops early when problems arise. Let the best solutions rise to the top and test them using data to measure if the problem is solved. If you strategically hold these workshops weekly or biweekly on the right problems you can see meteoric progress.
3. Choose your ideal client and pursue them radically, as detailed in the Dream 100 framework in strategy 9.

Summary

Strategy 1: Time Management Secrets of Billionaires

1. Touch it Once Rule: Act immediately to avoid repetition. Assess if you have time to address a task. If yes, tackle it immediately; if not, defer it until later.
2. Make Lists: Create a daily to-do list with a maximum of six high-priority tasks. Start with a master list and select six items daily.
3. Allocate Time: Plan how much time to dedicate to each task, ensuring your workday doesn’t exceed six hours to accommodate emergencies.
4. Plan Your Day: Schedule your day by the hour to accomplish your six important tasks effectively.
5. Prioritize: Arrange tasks in order of importance, completing the most critical ones first. Use an hourly calendar to assign time slots.
6. Throw Things Away: Evaluate if keeping a document is necessary. Discard unnecessary items or delegate them promptly.

Strategy 2: Instituting Higher Standards and Regular Training

In any effective business, training for employees needs to be scheduled regularly and systematized.

1. Lecture-Format Training: Ideal for subjects involving substantial information and data, particularly during the initial session. This format provides a structured overview and foundation.
2. Group-Questions Training: Enables employees to seek clarity and tailor information to their specific roles. Interactivity enhances engagement and retention, making the training more impactful.
3. Demonstration Training: Effective for teaching task-oriented skills, such as demonstrating a new script for cold calls. Follow-up role-playing sessions enhance comprehension and application of demonstrated techniques.
4. Hot-Seat Training: Focuses on improving employees’ skills in areas they’ve already received training. Through personalized feedback and targeted questioning, employees identify areas for improvement and refine their abilities.

Strategy 3: Executing Effective Meetings (Workshops)

Template for Workshops

Hold meetings with clear objectives. Should start with one problem in mind and have it on a whiteboard at the front.

Give each employee three minutes to come up with solutions. Everyone talks about their ideas. Vote on the best ones. Then implement the solutions with your best employees and track important metrics. Test it for a couple weeks and see if there is improvement.

Strategy 4: Becoming a Brilliant Strategist

Education-based marketing is the most effective strategy to get front of mind in the prospects head. Offering high-value education is the way to get in the door and your presentation shouldn’t pitch your product. It should:

1. Use market data to pinpoint the problem
2. Help the prospect feel the emotion of the problem
3. Provide evidence for a solution (making it a logical conclusion that their product is the solution without ever pitching it)

Strategy 5: Hiring Superstars

Holmes details the importance of hiring superstars in sales. Superstars are the people that thrive in their job from the get-go even without extensive training. They are confident, determined, and driven. He explains how to craft your hiring ad with this type of person in mind and how to interview them with a “trial-by-fire” type of approach.

Strategy 6: The High Art of Getting the Best Buyers

You need to have a “best-buyer” for your product. Clearly define who they are, why they are your best buyer, and figure out where to go get them.

Strategy 7: The Seven Musts of Marketing

Every outstanding marketing program, according to Holmes, contains seven “musts” that can turbocharge your sales efforts:

1. advertising
2. corporate literature
3. direct mail
4. public relations
5. market education
6. personal contact
7. the internet

Strategy 8: The Eyes Have It!

Holmes gives some types for utilizing visual appeal in your sales presentations:

• Each slide should contain only three to four bullet points.
• Use color to emphasize important information.
• Do not spend too much time on one section. Your audience stays more interested and focused when you move at a faster pace.
• Include factual information that teaches your audience something new at the beginning. This establishes relevancy and credibility for your product.
• Use stories with corresponding images or graphs. This helps your audience connect personally with the problems your product solves.
• Your presentation must focus on the individual customer’s needs and how you’ll help them solve a problem, not on the product’s great benefits.

Strategy 9: The Nitty-Gritty of Getting the Best Buyers

The “Dream 100” strategy, as outlined by Holmes, is a systematic approach to acquiring top-tier ideal clients. Here’s a detailed breakdown:

1. Choose Gifts and Create Your “Dream 100” Letter:
   • Select small, thoughtful gifts to send to your dream clients monthly to ensure brand recognition.
   • Accompany each gift with a personalized letter emphasizing the value proposition of your product or service.
   • For example, send a small stopwatch along with a letter highlighting the importance of time management and offering a free executive briefing on industry insights.
2. Create Your Dream 100 Calendar and Conduct Dream 100 Call Follow-Ups:
   • Develop a calendar outlining monthly promotional mailings to each dream client.
   • Include various promotional materials such as articles, press releases, surveys, promos, or newsletters.
   • Follow up each mailing with a phone call to further engage the client and answer any questions.
   • Use this opportunity to set up a meeting for a more detailed presentation of your offerings.
3. Present the Executive Meeting:
   • Secure a meeting with the prospective client and follow the educational marketing format.
   • Highlight key industry challenges or insights during the presentation.
   • Conclude with a subtle solution, emphasizing how your product or service can address the highlighted problems effectively.

Strategy 10: Sales Skills

Holmes elaborates on the importance of maximizing every interaction with dream clients by viewing sales as a multi-stage process. Here’s a breakdown of each stage:

1. Building Rapport:
   • Establishing a connection and building trust with the client is essential. This involves active listening, empathizing with their needs, and finding common ground.
2. Qualifying Your Buyer Based on Need:
   • Understand the client’s specific needs, challenges, and goals to determine if your product or service is a suitable solution. Qualifying helps prioritize resources and efforts towards prospects with genuine potential.
3. Building Value by Matching Your Product to Your Customer’s Buying Criteria:
   • Highlight the unique value propositions of your offering that align with the client’s needs and preferences. This involves demonstrating how your product or service addresses their pain points and delivers tangible benefits.
4. Creating a Strong Desire:
   • Foster enthusiasm and interest in your offering by showcasing its benefits and advantages. Use compelling storytelling, case studies, and demonstrations to evoke emotions and create a sense of urgency.
5. Overcoming Objections:
   • Address any concerns or objections the client may have regarding your product or service. This requires active listening, empathetic responses, and providing relevant information or solutions to alleviate doubts.
6. Closing the Sale:
   • Guide the client towards making a purchasing decision by presenting a clear and compelling call to action. This may involve negotiating terms, finalizing details, and securing commitment.
7. Follow-Up:
   • After closing the sale, maintain communication with the client to ensure satisfaction, address any post-sale concerns, and nurture the relationship for potential future opportunities. Follow-up reinforces trust, encourages repeat business, and facilitates referrals.

Strategy 11: Follow-up and Client Bonding Skills

Follow-up is vitally important in sales, Holmes focuses on three components:

1. Post-Purchase Dissonance:
   • Holmes highlights the concept of post-purchase dissonance, which occurs when a completed order is canceled due to dissatisfaction or changing circumstances. This underscores the need for sales professionals to anticipate and address potential buyer remorse or uncertainties post-purchase.
2. Importance of Subsequent Transactions:
   • Holmes emphasizes that the majority of revenue often comes from subsequent transactions rather than the initial sale. This underscores the significance of fostering long-term relationships with clients to maximize lifetime customer value.
3. Building Lasting Relationships:
   • Holmes suggests that transitioning from a salesperson to a trusted friend or advisor to the client is crucial for securing repeat business. By building rapport, understanding clients’ needs, and delivering exceptional service, sales professionals can establish lasting relationships built on trust and mutual benefit.

Strategy 12: All Systems Go

Strategy 12, “All Systems Go,” serves as a culmination of the previous eleven strategies, guiding you on how to measure and optimize your efforts for continued success. Here’s an overview of the key components:

1. Daily Affirmations:
   • Transform your goals into daily affirmations to embed them into your subconscious mind. By repeating affirmations regularly, you reinforce your commitment to achieving your objectives and maintain focus on your long-term vision.
2. Written Goals:
   • Document your goals to solidify them and stimulate your brain to start working towards their realization. Writing down specific, measurable goals, such as sales targets or business growth percentages, helps clarify your objectives and directs your actions accordingly.
3. Measurement and Improvement:
   • Regularly assess your effectiveness by measuring key metrics related to your goals. For example, track sales calls, follow-ups, and their outcomes to evaluate your performance. If results stagnate or fail to meet expectations, identify areas for improvement and adjust your strategies accordingly.

1. You’re not broken just because you struggle with anxiety.
2. Anxiety is simply an alarm system. The body is trying to tell you that something is wrong and you need to address it for your own safety. This alarm system can go haywire and become habitual, but it almost always starts with a legitimate trigger, whether concsiouc or subconscious.
3. Building a non-anxious life can be broken down into six daily choices that, with intentionality, can usher in waves of peace

3 Actionable Takeaways

1. Remember that I am not in charge of my life. I am not the master. I can’t control everything. Remember God’s role and that it’s a whole lot bigger than yours. Trust in that.
2. Be present and mindful. Turn off the music. Go for walks and think. Feel the pain of a workout. Feel the joy of connection with loved ones.
3. Push yourself to meet new friends and don’t only be complacent with current ones. Reach out to people and talk even when you don’t feel like it. Connection breeds peace. Lean on it.

Summary

Choosing Reality

Your body keeps the score. It knows things you may be consciously ignoring. It knows when you are about to lose your job. It knows you’re not taking care of your health. It knows when you’re not putting in the work you know you need to. Ignoring it is not a true option to have a peaceful life. Confront reality, listen to the alarms that your body is ringing, and address the source of the issue.

Choosing Connection

Dr. Doloney eloquently says that if your body will let you be lonely without waking you up at 3 AM to do something about it, it’s doing you a disservice. Your body knows the importance of connection. It’s not an option. It’s not a personality thing. You need deep connection and people that have your back in order to feel truly safe and at peace.

Choosing Freedom

Are you still doing Christmas the way your in-laws want you to? Does your boss run your life? Cultivating freedom in your life to make your own decisions is a prudent effort any way you can.

Choosing Health and Healing

Again, your body know when you’re not taking care of it. Taking care of your physical health is paramount to experience good mental health.

Choosing Mindfulness

We live a reactionary and distracted life these days. Finding even a moment to simply think to yourself can be rare. This constant stimulation and lack of presence plays a huge role in sounding our anxiety alarms. A simple daily meditation can make a world of difference. For me, choosing mindfulness looks like taking off my earphones when I workout every once in a while. Put down all electronic devices when talking to my wife at night.

Choosing Belief

This tenant turned out to be the biggest for me. I have grown up and remained a Christian my whole life. My faith has always been top priority but sometimes I become very entrenched in what I’m trying to do and forget that I’m not that master of my life. God can take the backseat and I can start thinking that everything is up to me. Remembering that I am not in control can be scary, but trusting in God’s plans leads to peace and an ever present feeling of joy.

The two root issues driving health care’s cost crisis—the appropriateness of care and pricing failures

3 Lessons

1. The driving root causes of surging medical prices are 1) excessively high costs of procedures and 2) the number of unnecessary procedures that are performed.
2. The unnecessarily high costs are due to a lack of pricing transparency, a sort of tug-of-war (the discount-markup game) between hospitals and insurance companies, and the number of unnecessary and predatory middle-men.
3. A large percentage of healthcare procedures are unnecessary. They are either performed for predatory profiteering reasons or more commonly because of a lack of standards between physicians of the same specialty.

3 Actionable Takeaways

1. If you are in an emergency situation, all you have to sign is the informed consent form. You technically do not have to sign and can even strike out the portion that says you will be liable for all payment.
2. Using a site like Healthcare Bluebook is a great way for patients to shop around for better-priced healthcare and create more of a free market
3. The downfalls of the healthcare industry aren’t simply greedy people at the top. It’s a whole system that is bloated in multiple areas with too many middlemen, a lack of price transparency to stimulate a free market, and too many unnecessary procedures. The author has promising hope for the future as there are companies now that are starting to disrupt the status quo. The book ends in a hopeful manner saying that change is in the future.

Summary – Why is Healthcare So Expensive

Screenings

• Early screening can be an effective way to catch diseases in their early stages, however, over-screening for disease can paradoxically become a bad thing. Vascular surgeons are a perfect example of this. Many times they will have screenings at places like churches and recruit patients for procedures. Oftentimes these procedures are based on questionable tests that are positive in a large number of people who don’t neccessarily need the procedure (high false positive rate). Dr. Makary says that surgeons can get isolated in their own ways. When two surgeons become isolated one may be performing surgeries on a large percentage of people that don’t need it without even being aware of this problem. He calls for benchmarks so that doctors should be informed if their rates of certain surgeries are deviated from an expected standard, indicating they may be performing unnecessary procedures.

Inflate–Discount Game with Insurance companies

• Because insurance companies pay for so many procedures, hospitals give insurance companies a discount on their services. Hospitals often raise their prices yearly to combat this issue, and in response the insurance company requests a steeper discount percentage. This cycle continues year after year causing the sticker prices of services to skyrocket. While an insurance company may only pay $5,000 for a surgery, the sticker price may be upwards of $25,000

PE firms and air ambulances

• This is an example of privatization gone wrong. Hostpitals used to own their helicopters but it was extremely expensive to run an air ambulance program. Eventually private equity companies took over this industry and developed a monopoly. Prices have raised to astronomical rates, causing patients to have to pay upwards of $50,000 for certain flights. These companies operate at a monstrous profit margin due to the lack of competition in the space.

Lack of Benchmarks i.e. caesereans on Fridays

• As mentioned before, Dr. Makary calls for the use of benchmarks to hold physicians accountable and inform them of their patterns. For example, physicians rates of caesareans were monitored and found to have a soaring rate on late friday afternoons. Is there a physiological reason for needed ceasareans at this time, or do doctors just want to get home on time on Friday? I have my guess. This isn’t even neccessarily malevolent. It may simply be unconscious bias in decision making but taking the massive amount of data we have and creating benchmarks for physicians can help inform doctors of times they may be performing innapropriate care.

Prescription benchmarks

• Opioid prescription is all over the place and physicians don’t have a good standard to look to when prescribing. One would think that specific surgeries have a set amount of opioids to prescribe, but the truth is it depends on the physician. To be quite frank, it often depends on when the doctor went to medical school and what was taught. This is crazy to me and seems like a simple reform. Dr. Makary said that their are organizations looking into creating prescription standards for different procedures so that there would be some level of standardization of care.

The Middlemen

• Pharmaceutical Benefits Managers (PBMs) are companies that manage the pharmaceutical benefit plans provided by Health Insurance. They are paid by the insurance company to negotiate deals with pharmaceutical companies and create a pricing structure that the health insurance will use for their patients. PBMs get paid for their services and they also make money on the spread. The spread is the markup from the price they paid the pharmaceutical company for a medication to the price they charge the insurance company. Dr. Makary says that this can soar up to 500% at times; meaning that a PBM may pay $10 for a drug and charge the Health Insurance (an indirectly the policy holder) $50 and pocket the spread of $40. He says that PBMs have clever ways to hide the spread and basically make it very hard for anyone to see this massive markup.
• Group Purchasing Organizations (GPOs) are companies that combine the purchasing power of companies and buy in bulk to get discounts on various equipment. For example, a GPO would negotiate with a hospital bed manufacturer to get the beds in bulk for many hospitals at a discounted price. This, in theory, could lower healthcare practice but in practice actually does the opposite. Manufacturers actually end up paying the GPOs to keep their equipment catalogued, raising the price of the product. As competition gets stiffer in an industry the manufacturer has to pay the GPO more and more to keep market share, continuously raising the price. In addition, since this is just a numbers game for the GPO, doctor’s get less and less say about the quality of their equipment. If an innnovative product comes onto the scene that a doctor wants, they better hope that the manufacturer has the massive capital to pay the GPO to catalogue it. Instead the mass of the GPOs usually just maintain the status quo.

Scientists were interested in why people feel the need to rub painful areas and proposed a theory to explain the phenomenon. That theory was proposed in 1965 and coined “The Gate Theory of Pain.”

To understand this theory, we first have to understand how normal sensation makes its way to the brain. The sensory component of the spinal cord is composed of many different tracts of neurons that come from everywhere in our body and go up to the brain. Basically, we have different types of receptors in our body that sense the outside world. Some receptors are sensitive to heat, some to touch, some to chemicals, and some to light.

You can think of each peripheral sensory neuron as a sensor with a wire to the brain with a few stops along the way. The first neuron starts at the surface of the skin and projects all the way to the entrance of spinal cord. The second neuron projects from that entrance of the spinal cord up to the brain in a region called the thalamus. The third neuron projects from the thalamus to the cortex, the region that causes the person to perceive the stimulus consciously.

All different types of sensation (light touch, pain, crude touch, vibration) have different neurons that are bundled together and run in parallel with similar stops along the way. Think of the electrical impulses of these neurons like cars going from point A to point B on the same road with two stop lights: one in the spinal cord and one in the thalamus (the points where these three neurons connect).

One last essential detail to understand is that different types of sensation (pain and touch) have different speeds of conduction through the neurons. This has to do with different levels of myelination. The fibers that carry proprioception and touch are myelinated whereas the fibers that transmit pain are not, which causes the electrical impulse to move much slower.

So think of it this way, touch is like a Ferrari and pain is like a Toyota Camry. They both are trying to go along the same road with the same stop lights to get to the same destination. But there’s one catch. If the Ferrari (touch) beats the Camry (pain) to the first stop light, it actually is able to turn the light from green to red, stopping the camry (pain) from getting to the brain– AKA “closing the gate”. Here’s a neurological schematic for how this actually works.

When you get adjusted, the deep sensory neurons within the spinal joints are stimulated. This stimulation causes a surge of sensory information up through the road to the brain. This stimulation then triggers a red light for the pain signals that are running in parallel, allowing only the touch and proprioceptive sensory information to get to the brain and keeping the pain from being felt in the brain. This effect, although temporary on its own, becomes extremely powerful when coupled with the proprioceptive surge we discussed previously, making chiropractic adjustments remarkably effective for pain relief.

If you’ve been wondering why adjustments feel like a miracle for pain relief, I hope this article helps explain the details of why that is. If you’ve been struggling with a nagging headache or a sore back, keep this information in mind and consider getting adjusted.

ApoE4 is a genetic isoform of the ApoE protein that is most associated with the develpment of Alzheimers disease (AD). This paper is a systematic review by Rhonda Patrick proposing a mechanism explaing why ApoE4 carriers respond better to docosahexaenoic acid (DHA) present in fish rather than in supplement form.

What they found

• Alzheimers disease is associated with impaired glucose uptake in neurons due to decrease glucose transports (GLUT1).
• Glucose is actually very important in neurons and prevents Tau phosphorylation, a known contributing factor to AD development.
• DHA helps increase GLUT1 transports, allowing more glucose into the neurons (a good thing).

• There are two common forms of DHA that are supplemented: Free DHA and DHA-lysoPC (the type found in fish).
• They are transported differently through the blood brain barrier differently.
• Think of this like getting to the VIP section of a Party. Free DHA wasn’t invited so it has to go through a side door when no one is looking to sneak though–biologically speaking, it goes through a tight junction between cells. DHA-lysoPC was invited to the party, so the bouncer lets him through and in with no problem–biologically speaking through the cell.

• This works well most of the time. But what if that side door was broken. That’s what happens in ApoE4. Now DHA-lysoPC is able to get through to the brain while Free-DHA is left hanging outside, unable to help with glucose metabolism.

Questions left unanswered

We still need outcome data in the for of RCTs to see if this proposed theory actually results in less incidence of alzheimer’s in ApoE4 carriers. However, it would be nearly impossible to have a high-powered enough study with a long enough duration to see any meaningful results.

Takeaway

It has been found that people with Alzheimer’s disease have impaired glucose metabolism in the brain. DHA from fish seems to have a unique mechanism to improve glucose metabolism in ApoE4 carriers, which may help prevent Alzheimer’s. Given the evidence surrounding omega-3 fat intake an improved health, ingestion of DHA in the phospholipid form (that found in fish) may be beneficial.

What is proprioception you ask?

Proprioception is essentially your body’s internal GPS system. Picture yourself closing your eyes and raising two fingers, then three, then four. Despite not being able to see, you can still sense the position of your fingers in relation to your body. It may seem trivial and uncomplicated at first, but now consider another picture. It’s a sunny day and you’re running down a gravel trail encountering rocks and undulations with every step you take as you descend a hill. Thankfully, with each step, tiny sensors in your feet send messages to your brain about how to compensate for the changing terrain, keeping you from falling.

This remarkable ability is facilitated by proprioceptors – the tiny joint position sensors that live within each of our joints. These ‘sensors’ are actually just neurons with specialized receptors that sense movement and send real time feedback up to the brain about the position of the joint. The brain then takes in the information from all of your joints and effectively creates a map of the whole body to coordinate movement as well as balance.

Now, let’s consider the spine, which is comprised over over 50 little joints, each of which contributes to the body’s proprioceptive map. When certain joints in the spine become fixated or restricted, they disrupt the flow of information to the brain. The proprioceptors go ‘offline’, so to say. This disruption creates gaps in the proprioceptive map, similar to missing pieces in a puzzle.

These gaps can lead to a distorted perception of the body position and movement, which can cause the brain to send out faulty motor commands. As a result, muscles can become ‘tight’, trigger points may develop, and, eventually, pain often follows. It’s like trying to navigate a maze with sections of a map missing – you’re bound to run into obstacles on the way.

This is where chiropractic care comes in. Chiropractors are trained to identify and address these restricted joints through precise adjustments. The high-velocity low amplitude thrust activates the proprioceptors within the joint and brings the joint back “online” to the brain. In doing so chiropractors help restore the proper communication between the joints and the brain.

Imagine a skilled cartographer meticulously filling out the missing sections in a torn map. Similarly, chiropractors help reconnect the dots in the proprioceptive map, allowing the body to regain its proper understanding of spinal joint position and movement.

By restoring proper proprioceptive function, chiropractic care not only alleviates pain but also improves overall mobility, coordination, and balance. A chiropractic adjustment functions like a reset to the body’s internal GPS, ensuring smooth navigation of all the movements that life demands.

Restoring proprioceptive function is only one contributing component to how and why chiropractic adjustments work. Follow along, because next week we’re going to talk about how chiropractic facilitates pain relief and promotes overall wellness.

1. Effectiveness is doing the right things well. It is a focus on contribution
2. Effectiveness is not the default state, but it can be learned.
3. Most people are not effective because they don’t know their strengths and they don’t know where they time is going.

3 Actionable Takeaways

1. Know thy strengths, and know thy time
   1. To know strength = Feedback analysis
      1. Take on new roles; predict your abilities; review 6 months later
      2. i.e. you volunteer at a chiropractic screening; predict your ability to make small talk with random people; review later to determine if your prediction stacked up with your actual performance.
      3. List some different roles and responsibilities and find what you don’t know if you are good at or not and go test it.
      Most people think they know what they are good at; they are usually wrong – Peter Drucker
   2. To know thy time = Time Log
      1. Track your work time for a week or two. Start with maybe just your 3 most important hours of work
      2. Set an alarm every hour and write down everything you got done in that hour. Even write down the little things.
      3. Then determine the amount of time each hour that was spent doing things that were a unique contributor to success. How much time did you spend doing things that only you could do; work that contributed, and used your strengths.
2. Create a stop doing list with your time log
   1. include all the common distractions, useless meetings, urgent but insignificant problems, and good but not great opportunities.
3. Create an offload list
   1. All the things that could be done by someone else just as well eif not better than by yourself.
      1. Cleaning, data entry, formatting documents, etc.
4. Create a To Do list
   1. After creating the stop doing and offload list, use your time audit to create a list of things that only you can do to make a unique contribution using your strengths.

Necessary Background

• Brown fat is a type of fat in the human (and other animals like mice) body that has a chief function of heating our body up.
• Instead of making ATP from fatty acids, it actually burns the fat and makes heat instead.
• The mechanism of turning food into heat rather than energy (calories) has been explored for weight loss for a while. Dinitrophenol (DNP) has an incredibly fascinating story about it worth looking in to. Back in the 1900s in the mining insdustry, people that dealt with TNT actually found that they were losing weight and sweating. They found out it was from a molecule called DNP and started taking it to lose weight. The TLDR of it was that people actually lost a ton of weight but some died from becoming hyperthermic.
• Brown fat is concentrated in an area right above your clavicle called the supraclavicular fossa, so the researchers measure skin temperature here as a proxy for brown fat activity.
• The Gold standard of brown fat activity measurement is a PET scan. If you give a person glucose that is labeled with a tracer, the PET scan can measure the brown fat uptake that glucose directly.

What they did and how they did it

• They took two groups: winter-swimmers (people who swam in the cold Nordic waters regularly) and non-winter-swimmers. They measured a couple things:
  • Metabolic Markers after Glucose Tolerance Test
  • Their sympathetic response (pulse and blood pressure) to sticking their hand in cold water
  • Their brown fat activity during a comfortable state and a cold state.
    • They used three measures for Brown fat activity:
      • PET scan during the end of cold exposure
      • Infrared thermography (over supraclavicular fossa) all other times during sleep
      • A little stick on thermometer (over supraclavicular fossa) called an iButton during sleep

What they found

• Winter swimmers have a colder core temperature at rest. (They conclude this might actually be the effect of sauna, which most winter swimmers use)
• Winter swimmers had no BAT glucose uptake at a thermal comfort state.
• Winter swimmers have higher cold-induced thermogenesis than control subjects, suggesting promise for cold exposure as a tool to improve metabolic health
• Human supraclavicular skin temperature varies with a diurnal rhythm. Winter swimmers have a unique peak in the morning, which needs to be studied more to understand if it matters.
• Overall Resting energy expenditure is greater in the winter swimmers than control.

Questions left unanswered

• It was very important that this study matched subjects by VO2 max. Their BMIs were matched but the control group had greater percentages of body fat, suggesting that the winter swimmers could simply have more muscular builds and greater fitness. That could explain the differences in energy expenditure and the improved metabolic markers in winter swimmers, however matching VO2 max makes that less likely.
• Are these metabolic changes transient? Do they disappear after stopping cold exposure?
• How much cold exposure is necessary to see these metabolic effects?

Takeaway

• Cold exposure affects brown fat in a somewhat confusing way. However, it seems to clearly overall have a positive effect on metabolism (Increased insulin sensitivity and increased metabolic rate). Exactly what is causing this effect is unknown. It is also unknown how much of this is simply due to cold exposure.
• With further studies, I would like to know exactly why metabolic rate is increasing, how much of that is due to cold (and not increased exercise), and how much these metabolic effects matter?