Can ChatGBT Give Good Advice To Chiropractic Patients?

Daryl C. Rich, D.C.,C.S.C.S.

[Core] Chiropractic and Wellness

CoreRoanoke.com

Many people know that I write these newsletters based upon my conversations with patients. These conversations spark great interest and debate in the office around many varied topics. This week several patients and I were discussing the future role of Artificial Intelligence and medicine. Specifically, can ChaptGBT give good advice for chiropractic patients?

So, I asked ChatGBT: “What are the best exercises to warm-up with in the morning?”. How did it do? It summarized the prevailing thoughts of most practitioners and YouTube videos on the topic. However, are these exercises the best ideas? Are they the right exercises for you? Read below to see how I graded each exercise recommended by the AI program.

 

From ChatGBT-

Introduction:
A good morning warm-up should be gentle, energizing, and designed to wake up your body while improving flexibility, circulation, and mobility. Here are some of the best exercises to start your day:

 

This is pretty good advice as you certainly need to give your body time to wake up and start moving in the morning with deliberate and intentional movements. I would suggest that the goals should not aim to increase flexibility in the morning, but rather try to increase mobility (the ability to move freely). Desiring to increase flexibility (overall range of motion) when your stability system is not awake could increase your likelihood of a back injury. Focus on waking up your stability system in the morning and increasing your mobility as your body allows. You can worry about improving your flexibility later in the day.

1. Cat-Cow Stretch (1-2 minutes)

• Start on your hands and knees in a tabletop position.
• Alternate between arching your back (Cow) and rounding it (Cat).
• This helps wake up your spine and improve posture.

This exercise gets an A+ in my book as it is an excellent choice for starting your morning. When performed slowly this exercise can help coordinate the stability system while improving the mobility of the spine and hips. Don’t feel like you have to push this exercise into a stretch, just move the spine slowly and feel the muscles begin to relax.

2. Standing Forward Fold with Spinal Roll-Up (1-2 minutes)

• Stand with feet hip-width apart, bend forward slowly, and let your arms hang.
• Roll back up to standing, one vertebra at a time.
• This stretches your hamstrings and loosens your lower back.

This exercise recommendation receives an F and I cannot disagree more with this recommendation. The idea of standing and rolling the body forward to create a forward bend in the low back and holding the position is very detrimental at any time of the day and even worse in the morning. Research has shown that you are most likely to herniate a disc in the very first hour of the day as your disc is swollen from being non-weight bearing at night. Further, when you relax and hang your arms, you are increasing the stress on the lumbar spinal discs, the Sacroiliac Joint, and the upper hamstrings. This is a recipe for injury and nervous system sensitization as you will likely stretch the sciatic nerve and irritate the nerve roots. I have seen many patients create their low back pain by performing this exercise. Please don’t do this stretch!

 

3. Dynamic Arm and Leg Swings (1-2 minutes each)

• Swing one leg forward and backward, keeping the movement controlled.
• Swing your arms side to side or in circles to loosen your shoulders and increase blood flow.

This exercise gets a B+ from me. While it is a good exercise, it is not a great exercise. It certainly will get some blood flowing and the movement can lubricate the big joints of the body. However, it does little to improve the stability system of the hips and shoulders. Combining this exercise or even replacing it with the Bird-Dog exercise may be a good alternative for most people.

4. Torso Twists (1-2 minutes)

• Stand with feet hip-width apart.
• Twist your upper body gently side to side, letting your arms follow naturally.
• This improves spinal mobility and warms up your core.

I give the torso twists a C grade. Why? If this exercise is performed as described, it can be perfectly safe. However, many patients give it more effort than needed and start twisting further than what is recommended. This creates a rotating effect through the low back and increases the risk of low back strain or lumbar disc herniation from this movement. As described above, end range movements on the disc early in the morning can create big problems for many patients. Instead of standing and performing the torso twists, how about simply going for a short brisk walk? The movement of the torso during the walk accomplishes the instructions above without putting the lumbar spine at risk by an overachiever.

 

 5. Sun Salutations (3-5 minutes)

• A yoga flow sequence that includes forward folds, lunges, planks, and gentle backbends.
• It’s perfect for loosening up your entire body and increasing circulation.

This yoga flow gets a partial grade of an F and a partial grade of an A+. The forward fold as described above is an awful exercise for the low back in the morning. However, a lunge, a plank (or a side plank), and a gentle backbend is perfect for the spine and hips in the morning. This combination accomplishes all of the big goals of improving circulation to the legs, increasing mobility of the hips, knees and ankles, and improves the stability system by challenging the core musculature. Instead of the forward folds try “Foundation Training’s” Founder exercise position as a great alternative to the harmful forward fold. This position teaches the brain to hold the spine stable while bending at the hip reducing your risk of low back strain and disc injury.

6. Dynamic Lunges with a Reach (1-2 minutes)

• Step one leg forward into a lunge while reaching both arms overhead.
• Alternate legs to stretch your hips, thighs, and shoulders.

Another A+ exercise in the morning. This great exercise improves mobility while enhancing the stability of the hips and torso. I would only add the suggestion to not only move straight forward with this lunge movement, but to also move to various angles. Think of standing on a clock and stepping towards each number on the clock face. Many of our movements in the day are not straight ahead but off to various angles to the side. It is a good idea to practice those types of movements in the morning to reduce injury.

 

7. Knee-to-Chest Stretch (Standing or Lying Down) (1-2 minutes)

• Pull one knee toward your chest, hold briefly, and switch legs.
• Helps stretch your lower back and hips.

Another F or D- if I was being generous. This exercise is widely taught by many practitioners and I know that I may be in the minority on this one, but hear me out. If the standing forward fold exercise from above creates flexion in the lumbar spine and this increases potential for lumbar spine strain or lumbar disc injury, then why would this exercise not do the same? If you can keep your low back from flexing, then this exercise may be of some slight assistance. For me, there are just better alternatives. Why not do a standing squat or wall slide? You can gain all of the benefits of the hip flexion without putting your lumbar spine in any harmful position. Try this in the shower in the morning and let the warm water help to increase the blood flow to the hips and back.

8. Side Stretches (1-2 minutes)

• Stand tall, reach one arm overhead, and bend gently to the opposite side.
• Alternate sides for a deep stretch through your sides and obliques.

I give this exercise a B+. The side stretch can be a great exercise to warm up the shoulders and mobilize the hips. You might feel a good stretch on the side of the body and even in the groin. When done gently this can be a good full body stretch that improves the big joints of the body. Again, my caution would be to not be aggressive with this and to allow the movement to come from the hips and upper thoracic spine. Be careful to not side bend through the lumbar spine excessively.

  

9. High Knees or Marching in Place (1-2 minutes)

• Gradually increase the intensity to elevate your heart rate and energize your body.

The grade for this exercise is a solid A. I love this exercise mostly for waking up the stability system and improving coordination.  When you raise one leg up the stance leg has to stabilize the hip and the core muscles have to stabilize the trunk. This is a great activity for the beginning of the day or the start of any workout. To make this exercise an A+, try moving to the rhythm of some music or a metronome. This gets the brain more involved and makes the exercise even better!

10. Neck Rolls (30 seconds each direction)

• Gently roll your neck in a circular motion to relieve tension and improve neck mobility.

This exercise gets a C+ from me. Patients often find this exercise to be the most helpful when their neck is only slightly stiff and sore. The more painful the neck condition the more I would recommend patients NOT to do this exercise. The stretching of the neck in this way can often pull and further irritate painful muscles. The best way to relieve a tight and painful neck is to go for a walk or try the cat/cow stretch from above.

 

Conclusion:

Artificial Intelligence is only as smart as the prevailing opinions of the most accepted data. If that data is faulty or if that data does not apply to the correct situation, then the usefulness of the intelligence can be compromised. What AI can’t understand is what circumstance the data is being applied to and in this case which patient should or should not be using the recommended exercise. This is where the proper advice from a competent provider will always be a more trusted source of instruction over AI. Here at [Core] we are thankful that you have placed that trust in us. Remember, it is our goal to help you become healthier than you have ever been.

 

Daryl C. Rich, D.C., C.S.C.S.