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The Chiropractic Forward Podcast: Evidence-based Chiropractic AdvocacyAuthor: The Chiropractic Forward Podcast: Evidence-based Chiropractic Advocacy Language: en-us Genres: Alternative Health, Health & Fitness Contact email: Get it Feed URL: Get it iTunes ID: Get it |
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PNF Stretching For Knee OA & A 50-Year Review Of Chiropractic Research
Wednesday, 29 April, 2026
CF Episode 389: PNF Stretching For Knee OA & A 50-Year Review Of Chiropractic Research Today we’re going to talk about PNF Stretching For Knee OA And A 50-Year Review Of Chiropractic Research. First here’s that sweet sweet bumper music. Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, judgmental, elitist, puffing on a pipe, pretentious kind of research. We’re research talk over a couple of beers. So grab you a 6-er. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. I’m so glad you’re lending me your ear, spending your time with me and we’re learning this stuff together. Things You Should Do Go to Amazon and BUY my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. Easy to understand and easy to support everything you do. It’s on Amazon. Like our Chiropractic Forward Facebook page, Join our private Chiropractic Forward Facebook group, and then Review our podcast Check our website at chiropracticforward.com Episode 389 You have found yourself smack dab in the middle of Episode #389. Now if you missed our last episode, we talked about Shockwave Therapy for Hamstring Injuries and Vitamin D for Respiratory Infections. Make sure you don’t miss that info. Keep up with the class. On the Personal End of Things… Sorry, it’s been a week or two since the last podcast episode. I have been traveling a little bit. I just got back from Tampa, Florida, and my mastermind meeting with Dr. Kevin Christie. We had a great time out there. I just can’t explain to you how proud I am of that group that I’m a part of. It really does have some of the best minds and most talented individuals in the entire profession. I count myself as very fortunate for being asked to be a part of it. One of my colleagues is Vanessa Wilczak from Jacksonville, Florida. She and I have really buried ourselves in AI, and we have made a pretty effective team with regard to coming up with some pretty cool stuff that AI can do to help us in business. Vanessa recently took that a step further and has really created something very, very interesting. She figured out a way to make Claude work with a permanent storage or brain, if you will, so that when you are talking to Claude, it can reference and remember exactly what you’ve trained on it at all times. So, if you consider that you can train it on all of your office stats, all of your provider contracts and pay scales. All your fee schedules. Every statter, every report that you can think of that you can run through your EHR. And everything else that you have on your computer that’s relevant, then you sort of have a chief operating officer or chief financial officer or a CEO or whatever you want to call it. that has all of the financials and all of the information it could ever possibly need to help you make decisions going forward. That includes KPIs, or seeing gaps and opportunities that you wouldn’t normally see. For example, I was able to have a conversation with our new provider today that included very precise facts and figures that I wouldn’t have had… access to… Just two days ago. I was also able to give her very realistic and conservative. Ideas about patient numbers and potential income in the next year, and in the next two years. Then I was able to have… an effective conversation with our front desk about… some of our stats and how we can easily improve them. The potential is absolutely and 100% limitless when AI remembers what you have trained it on and can reference it at any point in any conversation you’re having. I’m training it on the medical side of things, too, for peptides, and IV therapy, and PRP on the research, and all of that good stuff. So it’s basically going to be one big, huge brain. for my clinic. And I could not be more excited. Vanessa really knocked it out of the park on this. So that’s why I’ve been busy, but I felt like it had been long enough since I had put out an episode. So we’re gonna throw this one together fairly quickly. I hope you don’t mind, but there’s a really great paper in this episode that you’ve just got to hear about. So don’t go anywhere. Let’s hop into the research. Item #1 Alright, let’s jump into our first paper this week and it’s a good one for those of you treating knee pain — which I’m guessing is about 100% of you listening. This one is titled… “Effect of Proprioceptive Neuromuscular Facilitation on Pain and Joint Mobility in Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials” Remember, the citations can be found at chiropracticforward.com under this episode. Hu Z, Dong J, Zeng Y, He Z, Wang Q, Luo Q. Effect of proprioceptive neuromuscular facilitation on pain and joint mobility in knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials. PeerJ. 2026 Jan 16;20581. DOI: 10.7717/peerj.20581. PMID: 41561818. Why They Did It Knee osteoarthritis is one of the most common and debilitating conditions we see — pain, stiffness, loss of mobility, and that slow grinding decline in quality of life. Standard medical management tends to lean on pain medications, cortisone injections, and eventually surgery. In this they explore some conservative means. These researchers wanted to find out whether Proprioceptive Neuromuscular Facilitation — PNF — could make a meaningful difference in pain and knee range of motion for people with knee OA. Now if you’re not super familiar with PNF, it’s a rehabilitation technique that combines passive stretching with active muscle contractions to improve flexibility, strength, and motor control. How They Did It This was a systematic review and meta-analysis following PRISMA They cast a wide net, searching seven major databases for randomized controlled trials from database inception all the way through August 2025. They ended up with five studies — 201 total participants — comparing PNF to control interventions, and four studies — 202 participants — comparing PNF to other rehabilitation techniques like soft tissue mobilization, neuromuscular exercise, and stretching. Primary outcomes were change in pain intensity and change in active range of motion. What They Found Compared to control interventions, PNF showed significantly greater improvements in pain reduction. And it significantly improved knee active range of. Highly significant results on both fronts. When they compared PNF qualitatively against other rehab techniques — soft tissue mobilization, neuromuscular exercise, and stretching — results were more mixed. Not clearly better across the board, but not worse either. The strongest, most consistent signal was PNF versus no real intervention, and there it was a clear win. Wrap It Up PNF is a conservative technique producing significant reductions in pain and real improvements in joint mobility for knee osteoarthritis patients. Move the patient. Restore function. Reduce pain without putting something into their body or cutting them open. Sounds good to me, what about you?/ Item #2 Alright, paper number two is one I have been waiting to talk about because it is a direct shot of espresso for your chiropractic soul. This one comes to us from a group out of Duke University School of Medicine — yeah, you heard that right — Duke — and it’s titled… “Chiropractic and Spinal Manipulation: A Review of Research Trends, Evidence Gaps, and Guideline Recommendations” Remember, the citations can be found at chiropracticforward.com under this episode and yes, one of our previous guests on the podcast is the esteemed Dr. Christine Goertz who we simply adore. Trager RJ, Bejarano G, Perfecto RP, Blackwood ER, Goertz CM. Chiropractic and Spinal Manipulation: A Review of Research Trends, Evidence Gaps, and Guideline Recommendations. J Clin Med. 2024 Sep 24;13(19):5668. DOI: 10.3390/jcm13195668. PMCID: PMC11476883. Why They Did It The story of chiropractic research is a story of a profession that has been building its evidence base for over 50 years. Medicare authorized payment for chiropractic spinal manipulative therapy back in 1972 — and since then, utilization has grown, research has grown, and the profession has evolved. But how much has the research actually matured? And what do today’s clinical practice guidelines — the CPGs that medical organizations use to drive treatment decisions — actually say about spinal manipulation? That’s what this team set out to document. How They Did It They searched Scopus for all chiropractic-related research published from 1972 through 2024 — over five decades of literature — and analyzed publication trends and keyword evolution to track how the research landscape has changed. Then separately, they searched PubMed, Scopus, and Web of Science for clinical practice guidelines published between 2013 and 2024 that addressed spinal manipulative therapy. They were looking at what the guidelines say, and what conditions they cover. What They Found They identified 6,286 articles on chiropractic, and the publication rate trended upward across the entire period. The keyword analysis tells the story: early research focused on history, scope of practice, medicolegal issues, and regulatory concerns. Over time — as the profession gained footing and credibility — the keywords shifted to include randomized controlled trials and systematic reviews. That’s the arc of a profession doing the work. Here’s the number you want to remember: 90% of the guidelines favored spinal manipulation for low back pain. For neck pain? 100%. Every single one. And recent CPGs also supported SMT for tension-type headaches and cervicogenic headaches. Wrap It Up Ninety percent for low back pain. One hundred percent for neck pain. I need you to sit with that for a second. Let that percolate, people. These are not numbers coming from a chiropractic trade publication. These are clinical practice guidelines — the formal, rigorous documents that major medical and healthcare organizations use to tell clinicians how to treat patients. And they are saying: use spinal manipulation. This paper is a gift. Print it out. Laminate it. Put it in your waiting room. When someone asks you — a patient, a skeptical physician, an insurance reviewer — whether there’s evidence for what you do, you hand them this. Over 50 years of growing, maturing, increasingly rigorous research culminating in guideline after guideline saying that spinal manipulation works for the spine-related disorders that walk through our doors every single day. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week. Store Remember the evidence-informed brochures and posters at chiropracticforward.com. Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms. We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website & Social Media Links Home https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP: https://www.facebook.com/groups/1938461399501889/ Twitter: https://twitter.com/Chiro_Forward YouTube: https://www.youtube.com/channel/UCtcIrhlK19hWlhaOGld76Q iTunes: https://itunes.apple.com/us/podcast/chiropractic-forwardpodcast-chiropractors-practicing/id1331554445?mt=2 Player FM: https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forwardpodcast-chiropractors-practicing-through TuneIn: https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Prp1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger The post PNF Stretching For Knee OA & A 50-Year Review Of Chiropractic Research appeared first on Chiropractic Forward.
