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The Chiropractic Forward Podcast: Evidence-based Chiropractic AdvocacyA podcast addressing Chiropractic care today. Where chiropractors have been and where Chiropractic seems to be headed as well as how integrated chiropractic practices can play a part in the healthcare landscape today and tomorrow. Author: 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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Shockwave Therapy for Hamstring Injuries and Vitamin D for Respiratory Infections
Thursday, 9 April, 2026
CF Ep. 388 – Shockwave Therapy for Hamstring Injuries and Vitamin D for Respiratory Infections Today we’re going to talk about Shockwave Therapy for Hamstring Injuries and Vitamin D for Respiratory Infections. But 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! Welcome Back 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. Review our podcast on whatever platform you’re listening on — it really does make a big difference. And then check our website at chiropracticforward.com ──────────────────────────────────────────────────────────── Episode Number + Previous Episode Recap You have found yourself smack dab in the middle of Episode #388. Now if you missed our last episode, we talked about Water Instead of Diet Drinks & Neuromobilization In The Chronic Neck Make sure you don’t miss that info. Keep up with the class. ──────────────────────────────────────────────────────────── Personal Happenings I would have to say that 2026 is really shaping up for us. I know that I’m still not back to pre-Covid numbers. However, it’s pretty standard for me to see 145 to 165 each week now. If you’ve been a long time listener, then you may recall the days when I was seeing 180 and even sometimes 200 in a week. So we are far from those numbers currently. And I’m kind ok with that. I did not like being that rushed and that busy. It made my life fairly miserable to be honest. However, with our new chiropractor, Dr. Easter, on board I bet we’ll see those sorts of numbers combined soon. I am impressed every single day with her and have zero doubt that her schedule will be busting at the seams before you know it. A friend of mine is Dr. Mark King, president of motion palpation Institute, and he happens to be in my mastermind group you always hear me talk about. I believe he has somewhere between five and seven associates so I guess he’s got it figured out. But what he said at the last mastermind meeting was that you need to be trying to give your associate somewhere around 15 new patients a month that you would personally have taken. You have to feed them to get them where they are really kicking butt and taking names and putting some money in their pockets right along with bringing patients and revenue to the clinic as well. With credentialing and all the things involved in that, I’m not able to shift that many her way just yet. However, that is definitely the plan when we were able and strictly on sending her cash new patients and her being able to start to cultivate her own patience here and there, we already have her up to about 25 a week or so sometimes more sometimes less. When you consider, she’s only had her license for a little over a month maybe two months, I think we’re in a good spot. Outside of that I have been studying for the California QME exam coming up next week and hopefully we knock that sucker straight out of the park into the windshields of the cars parked in the parking lot. And we can get well on our way performing QME‘s and building that revenue stream. QME is my path out of day today hands-on patient treatment. I’ll be 54 in August and if I can get down to just a day or 2 x 56. I’m gonna be a happy dude. OK, that’s it. Let’s get on with the research. Item #1 – Radial Shockwave Therapy + Rehab for Acute Hamstring Injuries Remember, the citations can be found at chiropracticforward.com under this episode. Citation: Crupnik J, Silveti S, Wajnstein N, Rolon A, Wuerfel T, Stiller P, Morral A, Furia JP, Maffulli N, Schmitz C. Radial ESWT combined with a specific rehabilitation program (rESWT+RP) is more effective than sham rESWT+RP for acute hamstring muscle complex injury type 3b: a randomized, controlled trial. British Medical Bulletin. 2025 Sep 2;155(1):ldaf009. DOI: 10.1093/bmb/ldaf009. Why They Did It Hamstring injuries are an absolute plague in sports. They’re one of the most common soft tissue injuries across virtually every athletic discipline — soccer, track and field, sprinting sports, you name it. The specific type we’re dealing with in this study is a type 3b injury, which is what the Munich Muscle Injury Classification calls a bundle or interfascicular tear — a structural, partial tear of the muscle, not just a minor strain. These are the ones that knock athletes out for weeks, and they carry a high re-injury rate. Conservative rehab is the standard treatment, but outcomes are often frustratingly slow, and there’s a real clinical need for adjunct therapies that can accelerate tissue recovery. Shock wave therapy has shown some promising signals in muscle healing, but at the time this trial was being designed, the evidence was thin. These researchers set out to test whether adding radial ESWT to a structured rehab program could meaningfully change the game for athletes recovering from these serious hamstring tears. How They Did It This was a prospective, randomized, double-blind, sham-controlled single-center trial conducted at the KinEf Sports Physiotherapy Center in Buenos Aires, Argentina. 40 semi-professional athletes with ultrasound-confirmed acute type 3b hamstring complex injuries who presented within 7 days of the injury. The athletes were randomized into two groups: the active treatment group received real radial ESWT combined with an 8-week structured rehabilitation program; the control group received sham rESWT Both patients and the assessors measuring outcomes were blinded to treatment assignment. The rESWT protocol consisted of nine sessions over three weeks — three sessions per week — with 2,500 radial shock waves per session at an energy density the patient could tolerate. The primary outcome was return-to-sport time. Secondary outcomes included post-treatment muscle strength, patient satisfaction, and re-injury rate. After the trial concluded, a small number of participants had their ultrasound images re-reviewed and 4 of the original 40 were re-classified as type 3a injuries and excluded — leaving a final analysis population of 36 athletes, 18 per group. What They Found The results clearly favored the group that received real rESWT. The athletes who received actual shock wave therapy combined with the rehabilitation program returned to sport significantly faster than those who received sham treatment plus the same rehab. Beyond faster return-to-sport, the rESWT group also showed superior post-treatment muscle strength and higher patient satisfaction scores. Re-injury rates were not significantly different between groups, though the sample size was modest. Wrap It Up Hamstring injuries are one of the most common and one of the most aggravating injuries that active patients and athletes deal with. Return to sport after a significant type 3b hamstring tear can take weeks, and the re-injury risk hangs over the athlete’s entire return. What this trial tells us is that we have a non-invasive, drug-free adjunct therapy — radial shock wave— that, when combined with a well-structured rehabilitation program, can meaningfully reduce recovery time and improve functional outcomes compared to rehab alone. This is important for those of us in the chiropractic and conservative care space. ESWT is a tool that fits squarely within evidence-based conservative management. No surgery. No injections. No drugs. Just targeted mechanical energy to the injured tissue to accelerate natural healing, combined with a progressive rehabilitation protocol. That is exactly the kind of multi-modal conservative approach that gets real results and that we should be able to offer our patients. Now, is this a massive trial? No — 36 athletes at a single center. But it’s randomized, it’s double-blind with a sham control, it’s published in the British Medical Bulletin — a well-respected peer-reviewed journal — and the findings are clinically meaningful. Add this to the growing body of evidence that says ESWT has legitimate utility in musculoskeletal care. If you’re working with athletes or active patients dealing with hamstring injuries, this is absolutely worth having in your clinical back pocket. ──────────────────────────────────────────────────────────── Item #2 – Severe Vitamin D Deficiency Linked to Higher Hospitalizations for Respiratory Tract Infections Remember, the citations can be found at chiropracticforward.com under this episode. Citation: Bournot AR, Hart KH, Johnsen S, Givens DI, Lovegrove JA, Ordóñez-Mena JM, de Lusignan S, Bartlett DB, Lanham-New SA, Darling AL. Association between serum 25-hydroxyvitamin D status and respiratory tract infections requiring hospital admission: unmatched case-control analysis of ethnic groups from the United Kingdom Biobank cohort. The American Journal of Clinical Nutrition. 2025. DOI: 10.1016/j.ajcnut.2025.101179. Why They Did It Respiratory tract infections — bronchitis, pneumonia, and their relatives — are a massive public health burden. Lower respiratory tract infections rank in the top 20 causes of death globally for people aged 50 to 74. For those 75 and older, they crack the top 10. We’ve known for a while that vitamin D has a role in immune function — it has documented antibacterial and antiviral properties. There’s been growing evidence that vitamin D deficiency may increase susceptibility to respiratory infections. But what was missing was hard, large-scale population data specifically tying vitamin D levels to actual HOSPITALIZATIONS for respiratory infections. This team out of the University of Surrey — working with colleagues from the University of Reading and Oxford — set out to fill that gap using one of the largest health databases in the world. How They Did It This was the largest study of its kind. The researchers analyzed NHS data from the UK Biobank — a massive cohort study with linked health records. They looked at 36,258 participants between the ages of 40 and 69. Vitamin D levels were measured via blood samples and cross-referenced against linked NHS hospital admission records for respiratory tract infections. Participants were categorized into vitamin D status tiers, with severe deficiency defined as below 15 nanomoles per liter, and sufficient levels defined as 75 nmol/L or above. They used survival analyses and binary logistic regression models to determine the relationship between vitamin D status and the rate of hospitalization. The analysis accounted for confounders including age, sex, BMI, lifestyle factors, socioeconomic status, and existing health conditions. What They Found Here’s the headline: people with severe vitamin D were 33 percent more likely to be hospitalized for a respiratory tract infection compared to those with sufficient levels. That’s a significant, clinically meaningful finding backed by a dataset of over 36,000 people. And the dose-response relationship is interesting. And basically the better your Vitamin D levels, the lower your risk of being hospitalized. The researchers also examined whether ethnicity modified this relationship, since vitamin D levels vary across ethnic groups — white participants had higher median levels, while Asian participants had lower. Despite those baseline differences, the association between deficiency and hospitalization risk was consistent across all ethnic groups. The risk of being severely deficient, however, falls disproportionately on ethnic minority communities, which is a public health equity issue worth flagging. Additional risk factors tied to higher hospitalization included obesity, male sex, being over 60, lower income, and statin use. Wrap It Up We know from the research that vitamin D deficiency is extremely common. Estimates suggest up to a billion people worldwide are deficient. A BILLION. And here we have one of the largest population studies ever conducted on this topic showing that severe deficiency is directly and significantly associated with a higher rate of landing in the hospital with a respiratory infection. This matters for us as practitioners in integrative, whole-person care. We are not just treating spines — we are caring for people. If your patients are walking around with severe vitamin D deficiency, you have an opportunity to identify that and address it. Especially your older patients, your patients with chronic conditions, those who work indoors The recommendation to supplement — particularly in winter months when sunlight exposure is limited — is well-supported and straightforward. It’s safe. It’s cheap. It’s widely available. And the data suggests it may be keeping your patients out of the hospital. That kind of simple, evidence-based preventive intervention is exactly the kind of whole-person care we should be championing. Test your patients’ vitamin D. Talk to them about supplementation. It matters. ──────────────────────────────────────────────────────────── 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-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM: https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-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 Shockwave Therapy for Hamstring Injuries and Vitamin D for Respiratory Infections appeared first on Chiropractic Forward.
