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Is it Your Atlas? Part 2 with Dr. Josh Silver

in 13 days

Atlas treatment may be focused on the upper cervical region, but its impact goes beyond just that. Making adjustments here has an overall impact on the entire body, particularly with its neurology. Dr. Kevin Pecca sits down once again with Dr. Josh Silver to share his work with post-concussion syndrome migraine, low back pain, neck pain, and vertigo. He talks about effective practices to hold your adjustments even longer, from doing simple neck twists, playing mobile games, to drinking (a considerable amount of) caffeine. Dr. Josh also explains where he sees his career going as he plans his move to a new clinic in Florida.

###Listen To The Episode Here:

Is it Your Atlas? Part 2 with Dr. Josh Silver

Welcome everyone to a new episode of the show. Be sure to hit the subscribe button and leave us a nice review to help spread the miracle message. You can also find me on Instagram, YouTube and Tik Tok @DrKevinPecca, Facebook @MontclairUpperCervical. If you have any questions or comments about the show, you can email me directly at DrKevinPecca@Gmail.com.

On the show, we have one of my favorite Upper Cervical doctors, Dr. Josh Silver. He is one of the best doctors I know that's so good at communicating the upper cervical message and how an upper cervical adjustment interacts with the neurology in your body. He's good at explaining it. He puts it in such simple terms that everyone can understand and it's truly amazing how an upper cervical adjustment has such a global effect on the entire body whether it's post-concussion syndrome, migraines, low back pain, numbness, tingling and vertigo.

Dr. Josh Silver explains it all. He also goes into a little bit about how you can hold your adjustments longer. It's always a pleasure to have him on the show. I always learn so much. I think you guys are going to love this episode. Please welcome, Dr. Josh silver. He is also an Upper Cervical Doctor in Santa Barbara, California. He also might be moving to Florida. Keep an eye on that.

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On the show, we have Dr. Josh Silver out of Santa Barbara, California. He is a phenomenal Upper Cervical Doctor. This is his second time on the show. His first episode is episode 31. It's one of the most viewed upper cervical episodes on the show. He is a brilliant doctor, good at connecting neurology and the upper cervical adjustment. Dr. Josh, thank you so much for coming on. How are you?

I'm doing great, Kevin. How are you?

I’m doing great. I know you've had a crazy couple of years. The last time I talked to you, you were in St. Petersburg and now you are in Santa Barbara. Do we hint at the next step or not?

We can. My plan is to relocate to Sarasota. We'll be opening Chiropractech. It is the working name where it is technology focus, using technology as our leverage for better health.

How does it work with you? Not only are you an upper cervical doctor. You have a Functional Neurology Diplomate. How does that work with your patients? Are you strictly upper cervical? Did you incorporate some functional neurology things?

I've been working in a functional neurology office for the last few years. I had to fit into their mold first before I could start to shape it to my mold. I have a practice where I evaluate what I think is the most important for the patient. If it is upper cervical then yes, they are an AOL patient but if it may just be a simple Epley maneuver, a migraine diet or different recommended exercises then I'm trying to be a little bit more selective of it.

The truth is that I love upper cervical. I dearly miss it. My future plan is that we start with upper cervical on everybody and then we supplement their care with either neurologic exercises, stimulations, nutrition diet or whatever it takes out of that scope because I think still from what I've seen, if the Atlas isn't right, it doesn't matter how many exercises I have them doing. They can’t reach perfection.

That's such a great combo because you clear out the Atlas, you got phenomenal results and then you still have a couple of those patients that some of the neurology is not budging 3 or 6 months into care. If you can implement some of the things you're talking about, that's a home run.

The big idea is that if somebody had a concussion, they've injured their inner ear on the right side and have this chronic vestibular loss on that then they will usually have a right head tilt to try to increase the output of that ear. It may affect their ability to hold or it may just be a secondary issue that unless we also work on that, they're not going to get perfect.

If somebody, let's say, can't do a quick eye motion to the left because that system isn't working right, they're going to recruit their neck every time they look to the left and that's going to add more stress onto their adjustment. That's where I think if we can use neurology to help the vestibular ocular system then they may be able to hold better.

That was my next question for you. Do you notice any correlation between doing some of the functional neurology and people holding their adjustments longer?

I definitely do. I have this one patient. She's got testing positive for cervicogenic vertigo. We do the rotary chair test and her dizziness kicks up but then when she's here, bracing her neck rotating, she's getting dizzy from that. That's all vestibular oriented. We adjusted her first. It helped with her headaches and it did budge the dizziness but I've got her doing these rotational exercises, she's doing some head tilting exercises and she's only needed one total adjustment.

Do you make sure the Atlas is in first and then start doing the exercises? Do you like to do the exercises first and then the adjust?

It's an art form. Part of being a doctor is deciding what comes first, chicken or the egg? With her, I said, “You've got a chicken and an egg. We’ve got to do both of them at the same time.” I'm not down to a system that everybody flows through yet but what we're headed towards is getting the right eye, which measures the eye movements then we're going to get a caps unit, which measures balance.

We're going to measure-measure, adjust, measure-measure and then treat what's left on the measurements after the adjustment. That way, if we can get their balance perfect, they're not sweating or falling over and they have better recruitment of a pair of spinal, back problems are going to get better, mid-back issues are really going to get the best results, that's how we treat the whole spine without touching it.

That's a good segue to one of the things I wanted to talk about. Over the years, we've both seen a really big kick up in Ménière’s disease, vertigo, ear ringing, tinnitus, balance issues, ear fullness. How does that correlate with the upper neck? How has the upper cervical been able to get those people better?

There are two distinctions here. We have cervicogenic dizziness and Ménière’s disease. They are two very different beings. Cervicogenic is a little bit more like floaty disoriented and they're going to get dizzy when they twist their neck, whereas Ménière’s patient, they get these attacks of fullness in their ear then they'll have ringing in their ear and spinning. Both of them are going to respond to upper cervical care but the mechanisms are different.

The thought is that in the cervicogenic dizziness group, what's happening is that this imbalance, muscle length and the upper cervical region is sending this type of corrupt input up to the brain stem that basically affects how it's going to integrate all of this proprioceptive information. I call this disorder in the boardroom.

The ear says, “You turn to the right.” I say, “You turn to the right,” but your misalignment's telling your brain that you turn to the left. This mismatch of input between your senses that give you a sense of where you are in space creates a feeling of, “Where am I?” which is dizziness. It can have an effect down onto the spine, causing you to lean or fall over and it can affect your eye movements.

The best test that we know of to determine if their neck is affecting their eyes room is what we call a smooth pursuit neck torsion test to see are their eyes smooth and if they crank their neck. Now their eyes start getting all over the place. The neck is corrupting eyes as well. We're going to be able to change that after adjustment.

When we're talking about Ménière's disease, that's not as much of a thing. This imbalance that I'm talking about is a constant for people. They have that misaligned stretched-out weird all day, every day. With Ménière's words, it’s episodic. I don't really expect it to be more of that afferent problem. It's more of a CSF problem. I'm starting to just clump CSF for the tibial artery or jugular vein.

All three of them can be affected by Atlas and I call it a plumbing problem. You got a plumbing problem of fluids coming in and out of that right side of your canal. All of a sudden, that is going to start to affect fluid levels in that inner ear. If that interior swells, now we have fullness in the ear, tinnitus and vertigo then Ménière's trifecta.

I have three active Ménière’s patients. The first one was we just did his Atlas and he is perfect when he's holding. He'll usually hold for about 4 or 5 months at a time. He goes out and plays racquetball. His neck pops. He started spinning literally that day and snaps right in. I have another Ménière’s patient who had already been coming here before me. He had already had his neck adjusted manually but we gave him these right gaze stability exercises. This was amazing. I put them on my balance plate and the guy's weighing 72 centimeters in 20 seconds.

*Is he supposed to be staying still? *

Relatively. We want it 20 centimeters, not 72. The Ménière’s was on the right side for him. I said, “I want you to look straight ahead, turn your head quickly to the right and slow back to neutral 1, 2, 3, 4 and 5.” I got him back up on the caps unit. Now his balance was measuring at 32 after 5 repetitions of that exercise.

What is that exercise you think doing to reprogram the neurology?

His inner ear is insightful from this Ménière’s disease. Every time you have a flare-up, that decreases the ability of this to work properly and give their brain input on that right ear. If we do a quick head turn to the right slow neutral, we're activating this every time we do one of those exercises and by just giving him five of them, we doubled his ability to stay balanced and stable. We've decreased the day-to-day dizziness. That was the remainder from Ménière’s disease. What I'm saying is that we have to mix and match depending on who the patient is but I still think that if we got this guy's Atlas done right then we would stop the episodes even though they are well suppressed from the exercises alone.

Dr. Josh, why do you think some Ménière’s patients, you put their Atlas, their upper neck back in and it's night and day, it's completely different and then sometimes you see that it has to take like 3, 4, 5, 6 months for them to even notice a shift?

I'm definitely a believer that there can be other problems. We know that Ménière’s disease is always made worse with sodium consumption, alcohol and caffeine. Sometimes adjustments alone aren't enough to get rid of the entire problem when they still have these habits that are creating more inflammation and swelling in that ear. My thing is, let's not just say Atlas and be done with it.

Let's be doctors and give them appropriate recommendations for them specifically and build on the Atlas. That may be the missing component of it or like I was saying earlier, they've had Ménière’s for twenty years. It’s because they have decreased input, they have a right head tilt and it's just going to take you more work to get them stable and holding. That's where I think the exercises in neurology can accelerate their recovery in upper cervical.

What is it about the sodium that throws people for a loop? That is just the common theme with a lot of Ménière’s patients.

Sodium is hydrophilic. It's just going to hold onto water molecules. In the attacks in Ménière’s, they have too much indolence in that ear. There is this too much fluid. Sodium is going to raise blood pressure. Naturally, it's going to accentuate that overproduction of that fluid inside that ear.

What about migraines, headaches in the upper cervical? How do we help out with those neurologically?

The plumbing is a big deal in migraine because they're finding that they're having decreased jugular, vein drainage things on migraineurs. We have other studies that show when the Atlas is torked. It can pinch that jugular vein close and create this backlog of fluid into the head. When you hear a migraine or that says, “I have this pressure in my head,” probably a jugular vein drainage issue, whereas if the patient says, “I get orthostatic hypertension, I stand up and get real dizzy,” more likely a vertebral artery issue.

Whereas if you had a patient that said, “My migraine feels like it's this pounding throbbing sensation.” Some new studies are showing that as an Atlas is misaligned and the cerebral spinal fluid becomes turbulent. I always explained turbulence as like you got a nice river and you throw a rock in the middle of it. It has to break up around that rock. Sometimes that CSF comes into a pulsation and you'll see on a motion MRI, the brainstem is getting dented with every heartbeat as that CSF does it. That's more of the throbbing type of migraine. The majority in my experience is C2 nerve issue is that when their Atlas is affected and it pinches a C2 nerve root, it's what we call loading up or filling up their bucket.

A migraine happens in what's called your trigeminal nucleus, which is what processes head and face pain. This head and face pain center receives input from C2, skull, sinuses and teeth. Sometimes if you're filling up that trigeminal bucket with pain here, it's enough to overflow the bucket and hit that migraine. My favorite patient of the whole year was this woman, Nicole. She came to our clinic about two years before I started. She went through their whole migraine program. She was doing electrical stimulation, laser, neuro exercises, diet hormones. It brought her from 5 to 4 migraines a week, which may not seem like a lot but that is a 20% improvement.

About three years later, she comes and sees me. I'm like, “We got to fix your neck.” She's like, “I don't have neck pain.” I'm like, “You got neck problems.” We adjusted her Atlas in doing advanced orthogonal. I have two follow-ups with her then she ghosts me. Eight months later, she shows up. She's like, “A week ago, my neck popped and started having migraines again. I went six months without a migraine after you fixed my neck.” With her, it wasn't so much the diet that was filling up her migraine bucket, stress or her eye movements. It was truly her neck when we found the off switch. It was my favorite story of the year.

Does that trigeminal bucket transfer over to trigeminal neuralgia with the same mechanism?

It sure can but you got to remember that there are different things that can fill up that trigeminal bucket like a bad tooth. It could be triggering migraine or trigeminal neuralgia. Sinus issues can be filling that bucket up. Atlas is going to fill it up quite a bit but it's the same exact mechanism. As a trigeminal, the nucleus becomes overstimulated and corrupted with pain fibers coming from this area, which is very rich and sensitive neurons, your brain can't fully perceive. I don't know where on the skull this pain is coming from. This is where I feel it. I've had five patients with trigeminal neuralgia in my career do marvelous with upper cervical.

Do you like to work with anybody that does TMJ jaw appliances or night guards? Do you think that has any effect in stabilizing the upper neck?

I know it has an effect. My involvement is limited. I did do a TMJ course through The Chiro Institute. I learned a little bit about soft tissue management for TMJ but I haven't had a patient yet who wasn't able to really hold very well from a jaw-related complaint. Have you spoken to Dr. Chris Chapman? He adjusts them. He puts an appliance in. He claimed that he only adjusts people 1.6 times over their lifetime.

Is it their jaw or their neck?

Their neck. He just their neck 1.6 times total with their having the appliance. I know it sounds too good to be true but we're going to have to start heading in that direction because the jaw and the Atlas are reciprocal. They're brothers and born on the same homologous tissues and embryo. They are connected. Jaw problems can create Atlas problems but Atlas problems can definitely create jaw problems. I've had patients where we adjust their Atlas on the right side and their TMJ pain on the left went away before I even knew that that was something that they were struggling with.

Let's talk big picture structural issues, a lot of people with low back pain. How is touching the upper neck ever going to solve low back pain, sciatica, numbness in the lower extremities and things like that?

I had a patient who asked me the same question. I stared at him straight in the eyes and I said, “You got to stop thinking upper neck and start thinking brainstem.” This is not about the neck. It's about the brainstem. That brainstem has all the pathways that go down to that lower back. There may be an argument to be made that in certain cases where we adjust their neck and their low back pain gets better, which is something we experience.

How do we explain that? Potentially we improve stenosis. Maybe the occiput was here and the Atlas was here. We opened that up took the pressure off the cord and descending neurons can control those muscles better and their backup better. Maybe we could make an argument that we've seen studies that show up or cervical care decreases inflammation in the body.

As their inflammation went down, their generalized low back pain got better. The one I want to drive home is the most important and it happens in every single patient that we ever see every day that’s affected, it is the asymmetry and the muscles up here. The asymmetry in these muscles creates problems of input from these muscles to the brainstems a balanced center as that balanced center becomes confused. It thinks you're here when you're here. It yanks you here to try to orient you correctly. Our body has these compensations that work their way down from the central vestibular corruption. That's what I need every upper cervical guy to have tattooed on their chest because of central vestibular corruption.

Speaking of tattoos, you got a little nice little Atlas one.

I talked about this for many years. I finally pull the trigger on it.

Is that your first tattoo too?

Yes and probably, my last.

You're very passionate about what you do. You love what you do. Where does that come from?

Changing lives.

What made you pick upper cervical?

I would start in chiropractic school. I went to chiropractic school to be the best bodyworker in the world. That led me to the question, “If I could only do one move on one person at one time but try to change your life forever, what is that move?” I searched chiropractic. I listened to thousands of doctors. The one thing they all had in common was that the Atlas was the most important. I got under Atlas care in school. It ended pretty much a tenure tension headache I'd been having, a headache chronic that I thought it was just normal to have a headache all day, every day.

Once that headache was gone, I could get full advantage of my life, maximize my destiny and excel as a leader because I'm not crippled by pain that was being caused by something so easy, small and obvious. Ten years of suffering could have been avoided if somebody had just told me a little bit sooner that's where I'm coming from is that when we change lives, save people and turn their lives around with this stuff, there was no better feeling in the world for me. It is my duty to continue to be passionate and push hard because I'm letting people die if I don't.

The next question is, “What is right?” I know that we need more research in upper cervical but now I'm more passionate about getting upper cervical right before we start to research it. I use the advanced orthogonal technique where we use X-rays to measure their misalignment and we program our machine to adjust their Atlas perfectly. I've spent the last five years trying to take that procedure further.

I've switched from X-rays to Cone Beam CT. I've been strictly on CBCT. I came up with an orthogonal analysis for it so we can actually measure angles off of it. That's been working marvelously for me. I just refer my patients to the dentist. He takes their scan. I do my analysis on it then what's really exciting is that we are installing lasers basically all over the adjusting room.

Now, when I'm sending a patient up on the table, I have a laser coming down from the ceiling and the back to show me where to position them. I am striving and I don't know if it's possible to get the perfect adjustment. To me, that is one that will last a lifetime in the absence of trauma if they have trauma and they slip, sure. Other than that, I don't think anybody should ever not hold if we can get the adjustment perfect enough, probably if we get the follow-up exercises right as well.

Also, minus some ligament instability and stuff like that. Let me know about this. We'll give them instability. Is that's a term that gets thrown around by patients, “I have ligament instability. It's probably not going to hold?”

I don’t know if you ever heard of the Sharp-Purser Test?

I think I learned this in school.

Hold their head, wiggle C2 around. If you hear clunking, sliding and their neurologic symptoms get worse, they may have instability. Outside of that, I say, “We did the instability tests. Ligaments are intact. It's not instability.”

What do our doctors think from the MRI reports? Is that term just getting thrown around loosely?

It's being underdiagnosed on the MRIs. I've had MRIs where I see a tornado or ligament and there was no note of it on the MRI. It may be more prevalent than we realize, especially with the number of whiplashes we have nowadays but I would never suspect it initially on a new patient because it's not going to be every patient. If 90% of my patients hold fine without an MRI, I don't want to crank up a $500 bill on to every single one of them for the few. Let me give you this. This is one of my favorite little hot clinical tips. If you suspect instability, especially in an Ehlers-Danlos syndrome case, aloe is a miracle for instability.

Is it rubbing on the upper neck? I tell them to take a shot of it every day. What aloe does is stimulate fibroblasts and fibroblasts build collagen and ligaments. I've been part of this board for years that treats Ehlers-Danlos with aloe. When I have a patient who doesn't hold, it's usually one of the first things I recommend is, “Take a break. Let's hit the aloe for a couple of weeks and then see if we can get it a more stable then.”

I have two patients with Ehlers-Danlos. I'm going to recommend that. I had an aloe guy on the show one time and he was like, “You have to watch out which products you get and everything.” Do you just tell them to go to Whole Foods or something? Do you recommend something?

George's is the company. They do really well with distilled and clean aloe.

I want to pick your brain also about the post-concussion syndrome, what you've seen in your clinic. That's the reason why I got into upper cervical and I see so many people going to upper cervical after they tried everything else. I want that to be the first stop for post-concussion syndrome. What is your clinical experience been with post-concussion syndrome? There's the upper neck that's involved. I just want to get your thoughts on that.

They did this incredible study on dizziness and post-concussion syndrome. They found that this procedure called a snag fixes dizziness 90% post-concussion syndrome. Literally, they take a towel and they're helping stretch their Atlas areas rotationally. 90% of dizziness and post-concussion may come from the neck whiplash alone. My analogy with a concussion is you're driving your car, you crashed and totaled the car but you decided to get it repaired. You repaired 90% of it but you didn't see that the axle was bent a little bit. The car doesn't drive perfectly but it's all a lot better than when you crash. Usually, there's not a brain problem as much as a system that's never recovered fully. The neck is one of what I really think about is five systems in concussion.

Every single one of my concussion patients, we start on their neck on day one but I know that the inner ear is usually injured in concussion. That's where some of these head ocular motor systems can be affected in concussion. You'll have patients who had a concussion. If you make them go cross-eyed, their headache starts pounding, not from moving their neck, just from the eye motion associated.

I'll treat that eye motion while I'm working on their neck, while I'm having their new vestibular exercises. Between the three of those, we did great with concussions these days. I have an over 90% improvement rating for most of my patients. A lot of times, we only do a week of treatment for them at our clinic.

We'll have them flying in from Colorado. They've had a concussion a few years ago and are still dizzy. At our clinic, we'll treat them 3 times a day for 5 days and call it an intensive. Every visit is neck, ears, eyes. Those are the three biggest things that you don't fix after the concussion. Number four is probably blood flow into the head, which is why cardio is so important for these people. Number five is the psychological burden associated with concussion.

People will spiral in their heads like, “Am I ever going to feel right? This and that hurts.” That will create anxiety, which will create more dizziness, headaches and hyperventilation. Number six is the cognitive deficits. Cognitive deficits can't link to Atlas. People will have problems with aspects of cognition like verbal memory, spatial memory or reaction speed.

Basically, I tell them to download Lumosity, Impulse or one of those little brain training games and practice the one you hate the most, whichever one frustrates you or pisses you off, that's what you need to be working on because that's exercising the weak part of your brain, the same thing with eye motions. If this makes you feel junky, practice what you suck at. If turning to the right makes you feel sick, practice it every day in small little doses but if turning your neck to the right triggers your symptoms, this is going to be an easy case for me.

Luminosity is a simple tool that they can just download on the app and they can get better at their little homework.

They could get a neuropsychologist to do the same thing for $4,000. I want to find the cheapest solutions to it. These games are amazing in what they can do.

We talked about a potential move to Florida. What would you like to see in a perfect world, your brand new clinic looks like in Florida, with the upper cervical and the functional neurology? What is that going to look like for you?

I've definitely thought about that quite a bit. I'm really all about objective measurements. A lot of functional neurology is subjective. It's like, “Let's do finger to nose. It looks okay. It looked a little dislocated.” I'm so over that. My goal is to drain the piggy bank on objective measurements. I'm going to have an eye measurement device, a balanced measurement, a posture measurement and then we'll have our Cone Beam. We'll add on more as we go. We're going to be good about having our pain questionnaire. If it's a low back pain patient, we're going to send them the questionnaire. What we're going to do is we're going to coordinate this with the Cone Beam software so that if we can measure a misalignment on this side in the last 10,000 people we saw and we consistently are finding X, Y and Z or trying to set ourselves up to be retrospective research, upper cervical clinic.

That's the angle of this is that we can dig into years of data. We may have a two-hour initial exam and I may have a CA that an hour of her runs out of plastics but we can charge or bill for that. Atlas is king. Atlas is where we start but after they start holding, we're either going to have tech. I'm thinking about the right eyes should be able to treat eye motions. For some of this interactive VR balance training, we'll treat more of those TBI cases probably head towards hyperbaric oxygen at some point and we'll see.

When do you start doing dietary recommendations?

With migraine and concussions, I usually tell them at my report of findings, “We can start right this minute.”

*Is it not just elimination? What are your thoughts on that?

We'll have people fly in from all over the country for migraine treatment for that intensive. We'll say, “Do the diet for three months then at the end of your diet, you'll be here.” 30% to 50% of those migraineurs were asymptomatic by the time they got to our clinic just from the dietary changes alone. It's a huge part of it. We start it as soon as possible. Migraine diet is simple. It's gluten-free, dairy-free, alcohol, caffeine. I usually have to fight people over caffeine but it is the biggest make it or break it with migraine.

What's the caffeine doing besides ramping up the system?

It's a vasoconstrictor. It's going to make your heartbeat go up. It's going to trigger a sympathetic system. What's going to happen is if somebody's having a migraine where their arteries are too dilated, which is something that happens during a migraine, the caffeine constricts those vessels and gives them short-term relief, which is why there's been caffeine and Excedrin.

As with every drug, if we take a stimulant, our body's response is to produce fewer stimulants. When you are off the caffeine, you become more based so dilated and you end up preparing and sending yourself up for more migraines. All these papers show that migraine is great for short-term relief but in the long-term, caffeine will cause more migraines if they continue to consume it.

Do you tell them they might feel a little worse for a couple of weeks while weaning off the caffeine?

I pretty much tell people that they may feel the worst before they feel better with everything I do because there've been times where I didn't mention that and people were surprised that the healing is not linear at all. We expect days 1, 2, 3 to be miserable, day 4 is to be a little bit better. We usually say, “Quit caffeine on a Friday so that Saturday and Sunday, you can be in bed recovering. Monday, Tuesday, you're ready to go again.” A concussion is a little bit simpler. We just try to eliminate gluten for 30 days because that can be inflammatory and then we try to push more for a calorie restrictive or an intermittent fasting type of routine for concussion unless they're hypoglycemic.

What's the fast thing benefits for concussions?

I've been doing intermittent fasting myself for many years. The whole idea is that if your body starts starving, it kicks into autophagy. Autophagy means to eat yourself. Your hungry neurons will start to debris and eat the waste products that are sitting between them. As there's less debris, you're going to have faster transmission. Fasting is good for towel accumulation. It's good for any plaque accumulation. The research shows that it's good for cognition, learning and different things like that.

I love the way you explain things. You make it very simple to understand. I've talked to some people before. They use big words. It's a fresh breath of air to talk to you and understand the neurology because you're really good at explaining it

Let me give you this. This is what's so important. When it comes to neuroplasticity and our brain’s ability to learn, there are three keys to it. One is repetition, doing it more often. One is intensity doing it stronger but number three is salience. Salience is how do you feel about what you're doing? If you think this is stupid, it’s not going to make a big change in your brain.

If you understand what I'm trying to tell you and why these exercises are going to help you, if they understand that and start to care about it, neuroplastically, they'll grow quicker and recover faster. I have to explain this because when I would say, “Do upright eye movements,” it wouldn't work but if I said, “Do upright eye movements to try to get your head back to a more neutral position,” it's going to work to figure out how to explain neuro in very simple terms, which was a learning process better.

Dr. Josh, where can people find you online, social media, everything like that?

I have a YouTube channel called, @UCSilver. It grew pretty much bigger than I ever thought it would. Mainly, I try to put up content for chiropractors but I've definitely had smart people from all over the web reach out to me, I mainly teach about upper cervical neurology on there. I plan on getting back into it because I feel like I've got a little bit of an influencer appeal in our small upper cervical world and it’s fun.

**That's how I found you. I found you as a student on your YouTube video. Your email was attached to the contents and I emailed you. You were nice enough to email me back. I was a struggling post-concussion kid 2 or 3 weeks into care. I was like, “Is this ever going to get better?” You're like, “Stick with it. It's good.” I can't thank you enough for that.

It's a perfect example of you never really knowing how far each in something you do is going to go. The most important thing we do is, “How can I help more people? How can I be a better doctor? How can I get better results for my people?” As long as that's what's driving us. We're going to kick the button. We're going to help so many people and have a great life doing that.

I like to ask all my guests this at the end of every episode, what is one piece of advice you would like to give the audience that's really resonated with you over the years? It could be absolutely anything.

I'm going to bring it back to the psycho biosocial model of pain that is that if you catastrophize, focus on your symptoms, talk about your symptoms and avoid doing the things that trigger your symptoms, you're going to get worse. If you practice what you suck at is my motto, if whatever it is that makes you feel worse, you start working on it a little bit every day and then you start increasing the mountain.

You do it whether it's a range of motion, an eye movement, sunlight or whatever it is, you're going to de-habituate yourself. Don't become a victim to fear. Fear drives disease. Stand up to the thing to your limitations and push into them a little bit because that's where the growth is made, not in the comfortable zone but in that uncomfortable gray area.

Dr. Josh, thank you so much for coming to the show. You are a wealth of knowledge in upper cervical and neurology. I would love to have you back anytime and best of luck to your future endeavors. I know you're going to do great.

We’ll catch up in a couple of years. I promise.

Thank you so much.

Have a good one.

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-Josh Silver

-Episode 31

-@UCSilver

About Dr. Josh Silver

Dr. Joshua Silver relocated to Santa Barbara from St. Petersburg, Florida, where he specialized in Advanced Orthogonal Procedure. He is a Diplomate in Functional Neurology, has a Kinesiology degree, doctorate of Chiropractic, and is a licensed massage therapist. He and Dr. Harcourt actually went to school together and have been good friends for over a decade. We are so excited to have him be such a strong addition to our practice! Dr. Silver worked as a Board Member and Teacher for the Advanced Orthogonal Institute, a speaker and teacher on how to correct complex problems in the upper neck. He has created 2 inventions for that technique and several modifications which are currently in use. Lastly, Dr. Silver is on the forefront of utilizing Cone Beam CT as the primary analysis for the technique. Dr. Silver's mother, Marla, worked as a physical therapist. During his youth, she would share her love for helping people and the human body. This developed a deep fascination which inspired him to pursue health care. He now strives everyday to honor her memory.

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