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There are various Americans that will be plying their craft in Brazil during the World Cup. Many of them will be representing other countries taking part in this tournament. This is the case with one particular chiropractor that will be part of the Italian national team.
Exclusive Interview:  Azzurri Chiropractor John Pietila
Italy national team chiropractor Dr. John Pietila

There are various Americans that will be plying their craft in Brazil during the World Cup.  Many of them will be representing other countries taking part in this tournament.  This is the case with one particular chiropractor that will be part of the Italian national team.   We're not just talking about Giuseppe Rossi, we're talking about Minnesota-based  sports chiropractor John Pietila.  

The good doctor took some time from his very busy schedule with the Azzurri over in Coverciano as the four-time World Cup winners prepare to take on the world in Brazil.  Dr. Pietila also was the official chiropractor with Serie A side Fiorentina, where he was able to bring some ground-breaking techniques that helped many players increase recovery time as well. 

SOCCERLY : Tell me about your experience with sports chiropractic and how you started working with teams in your career.

Dr. John Pietila: I was an athlete myself back in High School and College, specifically I ran track and field. I specialized in hurdles and other jumping events as well as the decathlon. During this time I had some pretty significant back pains, for which I went to a chiropractor. This got me interested in the idea of the profession for myself. In chiropractic school I did an internship with Dr. Steven Moe, who treats a lot of athletes. After I graduated he helped me start a clinic and we worked together for the next few years. The athletes found their own ways into my office. The more athletes I helped, the more referrals I got. Eventually on my journey I got involved with some specific techniques, Applied Kinesiology, and Functional Neurology.

 I started putting together my own philosophy and stumbled upon the idea of treating the causes of injuries rather then treating the injury itself. This led to the whole idea of injury prevention and later performance enhancement. I started working with some like-minded individuals who were working on accelerated injury recovery using the ARP Wave machine and athletic strength training. 

 The head doctor of Fiorentina, Dr. Paolo Manetti, was present at the lecture and was very impressed. We stayed in contact over the next year and my wife and I decided to take a vacation to Italy. While on vacation we happened to be in Florence and having a nice dinner with Dr. Paolo Manetti when he got a call that one of his athletes dislocated his shoulder. He asked if I would be interested in going to the stadium to treat the athlete as a demonstration to him. I agreed and did so the following morning. The athlete made such a surprising recovery that the head doctor offered me a full time position to work with the team. I started with the team in January of 2009 and had a very significant impact on the injury rates as well as the time for injury recovery. The word spread and I got asked by other teams to come and consult, or even train staff members in my system.

SOCCERLY: Tell me about your practice in Minnesota. Do you work closely with the sporting teams there?

Dr. John: My practice in MN is small, but busy and growing. We have 4 doctors and a therapist. We don’t necessarily specialize in sports injuries - we treat all types of conditions. For every athlete we treat, we may have 2-3 non-athlete family members referred to us. With our philosophy, a sports injury is no different than hurting your back shoveling snow. Therefore the treatment is basically the same. With our specific training in Functional Neurology, we see a big variety of complaints including; dizziness, numbness, pain, neurodegenerative disorders like MS, Huntingtons, or Parkinsons, double vision, headaches, concussions, weakness, bowel and/or bladder complaints, asthma, anxiety, OCD, and spectrum disorders such as ADHD, ADD, Autism and Dyslexia. We work with a few lower level teams now, but mostly individual athletes from all levels of sport come to our office for treatment.

SOCCERLY: You were the chiropractor for Fiorentina at one point. Tell me about that experience as it was a very interesting one.

Dr. John: I was initially hired for a 6-month trial period to prevent injuries and help accelerate the recovery of injured players. The head doctor meticulously tracked the statistics and by the end of the 6-month period he found the injury rate dropped from 26 injuries per 1000 training hours to only 4. He also found the average hamstring injury recovery time dropped from 54 days to only 14. Needless to say they asked me to stay for the next year. Since my wife and I wanted to start a family we decided to move back to MN after that year was over. But I still travel to Florence to work with the Fiorentina athletes 6-8 times/year.

SOCCERLY:   Were you always a football fan? Or was that something that you acquired living in Italy?

Dr. John:  I was not always a football fan. In fact I am not much of a sports fan at all. Although now, it is really fun to watch the athletes I have worked on compete - especially after getting to know them. I find the same is true even of sports in Minnesota. I really enjoy watching the Wild, Vikings, and Twins after getting to know some of the players.

SOCCERLY:  Your techniques were very revolutionary while in Serie A. What were you doing so differently compared to other clubs?

Dr. John: The basic difference was I was looking for and correcting the cause of the injury before the injury ever occurred. Most of the clubs were trying to do injury prevention in the weight room. Many of the exercises they were doing were actually causing more injuries.

SOCCERLY: Tell me a bit about the concepts behind the in-balance technique.

Dr. John: The In-Balance technique is now called the NeuroTarget System. The basic concept is that as force enters your body it needs to be absorbed by the muscle. If that happens you can continue the activity for as long as you want with no troubles. However, if force enters your body and is not absorbed properly by the muscle, the force will start to transfer to other areas - areas such as tendons, ligaments, cartilage etc. Since these areas are not designed to absorb force, this is when they become injured. Most people think the way to increase your ability to absorb force is to become stronger and this is true, to an extent. 

 A strength related injury is one in which more force enters the body than the athlete is strong enough to absorb. Take for example a car accident. Excessive force enters the body and the person becomes injured, no matter how strong they are. What about the person who is just jogging and their knee starts hurting, or the guy who bends down to pick up a pen and herniates a disc in his back? I can assure you, strength was not the causing factor in these situations. Due to this, I do not evaluate the strength of my patients. I look for another reason they were not able to absorb force. I believe the answer lays in the nervous system. The most basic way I can put it is that when force enters the body a joint receptor senses it and sends a signal to the brain. 

 The brain processes all of these signals and then sends signals back down to groups of muscles to absorb that force efficiently and quickly (before it transfers to another area). What happens over time is one part of the brain starts to slow down and get out of balance. This part of the brain is actually processing information a little bit slower. Think of it like the cycles per second a neuro loop can process a signal literally slows down a little bit. The net effect of this slowing is that it takes a little bit more time to process the same amount of information. This leads to a very slight delay in the timing of when the signal is sent down to the muscle and ultimately a slight delay in the timing of when the muscle turns on. This slight delay is what allows small forces to enter areas that it shouldn’t, like a disc in the back eventually causing a disc herniation. 

My NeuroTarget System is a system to check the timing of the muscle to determine what muscle is unable to activate at the appropriate time, then trace that muscle up through the nervous system to find where the delay is coming from. The treatment then becomes creating stimulation into the brain using chiropractic manipulation and other therapies. This stimulation activates the brain and makes it work faster, assuming the feedback is going to the specific area of the brain that has slowed down. That part of the brain can process signals faster and send those signals down to muscles to “turn them on” faster. This allows the muscle to once again absorb incoming force before it transfers to surrounding areas. 

This removes the cause of the injured tissue. (Remember the unabsorbed force is causing the injury.) Now the tissue can heal very quickly. This is also the reason many injuries keep reoccurring or never seem to resolve. The cause has not been dealt with. Even surgery to repair a torn ligament is only connecting the injured tissue. It is not removing the reason the ligament tore in the first place.

SOCCERLY: Is the concept just based on adjusting or are there more techniques involved or that you implement?

Dr. John: The main treatment is to use chiropractic manipulation coupled with specific therapies. It all depends on what part of the nervous system I am trying to create feedback to. For example, if the patient makes a fist with the right hand and I do a coupled reduction adjustment from the right side of the lower neck, that feedback will fire very strongly to the left frontal lobe. But if I do the same adjustment and have the patient move the right hand in a figure 8, the feedback will go more to the right cerebellum. So we need to use adjustments coupled together with other therapies to drive feedback to specific areas of the nervous system.

SOCCERLY: Do you do any type of holistic modalities to help out with physical as well as mental edge?

Dr. John: I think the mental aspect takes care of itself for a few reasons. The patient feels an immediate improvement in symptoms.. The patient also notices an immediate improvement in performance. I convince the patient that I can help them and they believe it. Although, it is important to address a patient’s thought pattern and sometimes we need to use specific thoughts coupled with adjustments to change the brain. I do find that it is more difficult to get the patient to do something to help himself or herself. It is easier for me to just do the work to balance the brain.

SOCCERLY:  How receptive were individuals outside of Fiorentina with your techniques?

I think people are pretty territorial. They are worried that I am going to put them out of work. This is just not true. In most of the clubs I have worked, once the other doctors and therapists finally understand what I am doing they couldn’t be happier to work along side me. Once they realize that I am going to get rid of the cause of the injury so they can come in and heal the injured tissue, they know I am just making their job easier. I also get lumped into the group of “regular” chiropractors. So an outsider who doesn’t understand what I am doing thinks I am the same as another chiropractor. There are actually over 150 different techniques within chiropractic, so there is a wide variety of what chiropractic is. So it is easy to dismiss me if they have already tried “chiropractic” and it didn’t work for them.

SOCCERLY:  Has that changed after seeing results?

Dr. John: It has changed a lot - for the better. People are starting to investigate what I am doing because they know something is happening. Like the saying goes, “the proof is in the pudding.”

SOCCERLY: Were there any concepts of yours that have evolved based on your experience abroad?

Dr. John: I think by the time I came over to Italy, I had pretty much laid the foundation of my philosophy. What did happen though was I was able to streamline the treatment protocols. In my office in MN I typically spend 20 minutes to an hour with a patient. In Italy, sometimes I need to treat a whole team in 2 hours. So I need to be fast and efficient.

SOCCERLY:  Having worked in the sports medicine field, the field undergo some tremendous breakthroughs in the past 10-20 years, especially here in the US. How much improvement have you seen in European (Italian) teams when it comes to the treatment of injuries and rehabilitation of them?

Dr. John: I think Europe is just as cutting edge as the United States, maybe even more. One thing I like is that a team, such as Fiorentina or the Italian National Team hires their medical staff separately. What I mean by that is they take the best doctor from hospital A, then the best physical therapist from clinic B, the best massage therapist from clinic C. They bring all the bests together and form a team. Those people are bringing in things the others have not seen or don’t use. This allows them to create the best medical team possible. In the US, the team typically contracts out the medical side of things to one specific hospital or group. So they are limited to only what that hospital has been exposed to or has available and nothing comes in from the outside. European teams are always looking for that edge, so they are more open to try something different or new, in my opinion.

SOCCERLY:  Tell me how you got to work with the Italian national team.

Dr. John: When I started with Fiorentina the head coach was Cesare Prendelli. He was very impressed with my work and also had a very successful season that year. Because of this he had an opportunity to move from Fiorentina to the National Team. Last summer he called me up and invited me to come to the Confederations Cup with them as a trial to see what kind of impact I could have on the team. Once that was over they immediately offered me a position for this year's World Cup. I was hired as part of the technical staff for performance enhancement and accelerated recovery after the matches.

SOCCERLY:   Which injury(ies) have you seen reduced most with the use of chiropractic?

Dr. John:  Mostly it is just the little nagging injuries. The ones not bad enough for an MRI, Surgery, Cortisone, Rehab, or rest. Those little injuries are dealt with very nicely with chiropractic. I know the head doctor likes it to because when a player comes in with a slight pain or ache, he can do an ultrasound and maybe some other tests, but typically doesn’t find anything. He happily brings the player over to me for a treatment. Where normally he would have to tell the player to use some ice and hope it will be better by tomorrow.

SOCCERLY:  What do you see, from a medical standpoint. When you see so many injuries leading to a tournament like the World Cup? Is there a way you change your treatment.

Dr. John: With any big tournament there will always be an increase in injuries because the intensity of the training and playing is much higher. In this case I do my best to evaluate every player every single day to make sure their nervous system in functioning optimally. This is the best I can do for preventing injuries.

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