Wholistic Orthopedics...When East Meets West | Dr. John Ebnezar

[Applause]

holistic orthopedics when West meets

East I wanna ask is there anyone in this

hall who has not suffered from

musculoskeletal pain in their lives MS

conditions how significant they are it

is the second leading cause of

disability in America the cost of

treatment is extremely high one in four

Americans suffer from this complaint

this is not just restricted to America

it is applicable to worldwide here is

the story of a software engineer was 24

years old he came to me with acute low

back ache where underwent surgery at the

age of 20 years resurgent at 22 years

one more surgery at 24 years his problem

was not solved he contemplates suicide I

had read about a spa Leawood director

Manmohan Desai who committed suicide due

to chronic low back ache both were

treated by the conventional treatment

methods that failed them what is this

conventional treatment methods treating

by drugs

physio surgery is the conventional

treatment methods and both were treated

and it failed them

why times have changed so have diseases

lifestyle diseases are on the rise

communicable diseases are the decline

changing scenario of ms pain there are

two target groups lifestyle ms problems

working group less than 50’s like extras

here then geriatric problems older group

more than 50 years like you know some

senior citizens who are here we doctors

practice this conventional approach to a

deceased part we take the history we do

the examination we do the investigation

then come to a diagnosis then put the

patient a treatment with either drugs

physio or surgery we treat the puppy the

part and expect the patient to get well

it may work in these seven types of

orthopedic problems which are mostly

localized but it is found wanting in

lifestyle disorders modern complex

orthopedic problems are too complex to

handle with conventional treatments let

us look into this category one less than

50 years is a global problem

what is this lifestyle msps the neck

pain the back pain the tennis elbow the

shoulder pain the fibromyalgia carpal

tunnel syndrome knee pain and stress

there are ten peculiar challenges of

today’s lifestyle auto

conditions that makes conventionally but

ineffective what are those the certainty

lifestyles lack of exercise long

traveling herbs improper and irregular

diets extreme work pressure long working

hours work and peer pressure crumbling

family life habits like smoking alcohol

and/or drugs and then stress

conventional treatment methods are a

failure in these conditions because the

disease has got different dimension not

much of organic costs multiple regions

are involved stress quotient is very

high psychosomatic element drugs are not

an effective long-term solution surgery

is not an option for ello PS we need to

address all these incriminating factors

only then the treatment will be

successful parts and not patients were

being treated x-rays we’re being treated

MRIs were being treated positive factors

ignored treatment only with drugs fail

treatment research is not an option and

CT is destined for failure now look at

the second category the geriatric

automatic patients problems are of them

are indifferent and you can see our

lifespan is increasing in 1900 the

lifespan is 47 years now it is nearly 80

years geriatric population forms 8% of

our population today by 2050 will be 324

millions geriatric ultimate patients do

not have a single problem but have

multiple problems like diabetes

hypertension obesity heart disease other

muscular scheduler problems there are 10

picker challenges that make conventional

treatment ineffective what are those

comorbid conditions the geriatric

patients are associated with diabetes

hypertension heart disease obesity then

they have schoo musculoskeletal problems

like neck pain back pain frozen shoulder

osteoarthritis Co physical problems

failing eyesight failing hearing

poor balance poor coordination mental

problems like depression dejection

anxiety etc then Co emotional problems

retirement blues social problems Co

family problems Muslim most of them have

undergone bereavement separation so

there is Co financial problems they

don’t have money enough money co agency

problems industries the health insurance

government dumped the senior citizens

and the and the stress so as a result a

geriatric orthopedic patient suffers as

a whole physical mental emotional social

problems and this

fails in this particular group so the

limitations of treating patients with

mainly drugs in geriatric orthopedic

group is the long-term usage damages the

GI tract then keyword then kidney liver

then surgery the limitations

degeneration is seen in all the joints

in a geriatric patient we cannot replace

all the joints in a human being like

that we cannot make him a Robo so this

also fails I was disillusioned as I was

not able to provide relief to these

patients with the existing treatment

methods my foray into holistic Triplett

began in 2004 when my family friend mrs.

Harriet came to me with severe bilateral

ome severe pains medical treatment done

for many years had failed

she was suggested knee replacement and

so did I but she flatly refused as he

told me her sister-in-law had a

complication then she told me doc do

whatever you want to do but know don’t

operate on me so it’s she three were

challenged at me I was at my wit’s end

but I had to find an answer for her

margin also many problems are like this

ten-headed round us difficult to tackle

with a single arrow I mean a single

approach I needed a third option with an

x-factor non-operative options are not

effective surgical options are not

affect you third option is not available

thus began my journey into the world of

holistic medicine I heard one of my

friend giving a talk and I heard him

talk about homeopathy and yoga then it

stuck to me why not yoga and orthopedics

then I thought let me combine

orthopedics with yoga and could this be

the much-needed solution a holistic

solution so for this we needed a

paradigm shift we need to change from

conventional to wholesome we need to

change from DC centric to patient

centric for this we need to understand

who a human being is for me for an

orthopedic surgeon human being is made

of bones and joints but we have never

known what a real human is a real human

is made up of five layers the first

layer is the anomeric OSHA what we call

the physical body second layer is the

pranamaya kosha what we call the vital

energy and the third layer is the

monomeric OSHA what we call the mind and

the fourth is the Vigna mnemonic OSHA

it’s an intellect and discrimination and

finally it is an America shop which is a

bliss body this is a human being this is

who comes to us for treatment it is not

just bones and joints we need to take

human beings not joints not bones so

this was the concept then I thought can

this be

to combo I needed to research I was not

a little bit like gangsters who just

talked without doing any research no no

I want to do my research I wanted to

prove that it works then stand on this

podium and tell you that yes it works

because I didn’t want to be hypothetical

I didn’t want to float an idea just like

that

I wanted to research it then I thought

can this be a combo drugs non

pharmacological yoga could this be the

solution what we are looking for so my

twist with yoga began and I enrolled

myself as a PhD fellow at yes rasa yoga

in his crib angular and the first

orthopedic surgeon in the world to do so

to enroll as a PhD fellow then extensive

research followed it was a clinical

trial largest randomized control trial

over 250 patients and this work got me

the best research award where I prove

that when you add yoga into modern

orthopaedics treatment and the treatment

is fast successful patients are happy

then the research continued for back and

neck pain then for osteoporosis and for

fractures so I was the first author

prediction in the world to try yoga

therapy on fractures and I proved that

yoga therapy will accelerate fracture

healing and the rehabilitation times

comes down and this also got me the best

paper award then I had some 50

international publications of her work

in peer-reviewed and indexed journals

then I stand before you as an authority

having done research having seen having

published my work then I stand as

authority to speak to you then my

research became the basis for the strong

recommendations of the american academy

of orthopedic surgeon 2030 guidelines of

non or throw plastic treatment of Oh a

nice this Kos whose recommendations of

the benchmark for effective treatment

across the world strongly recommended my

methods of treatment which no Indian

orthopedics is has got this honor you

can look at this chart here

recommendation number one is the

self-management program light impact

exercise extra this is you know

recommended strongly by the a manic

Academy based on three high strength

studies of mine so it is recommendation

number one then comes up to puncture

physiotherapy manual therapy braised

glucosamine all those kind of

weight-loss are all secondary my mine

was the recommendation number one that

would not buy any in a small body it was

the AAA OS which gives recommendations

for the all the treatment in the world

so with this back

and I hit the headlines new said

non-surgical method of treating knee

osteoarthritis and other chronic

orthopedic problems while the whole

world was busy devising newer and newer

surgical innovation and implantation I

was visit developing methods to tackle

the mo piece pioneered holistic auto

feedings

I changed the concept from holistic to

holistic simply because that gave a

spiritual connotation mine was a

scientific based work the definition of

hell according to WH o was physical

mental social spiritual well-being my

concept was the same so I thought let me

change the word from holistic to

holistic so that’s what it was so all it

what is this holistic or that is all

about it is a simple human being

approach it is not a skeleton based

approach it’s a human based approach

this is the 12-step technique of

holistic orthopedics now let us evaluate

one by one what RIT one human therapy

what is this human therapy on what we

need to talk to our patients well talk

therapy this builds the rapp of the

patients so I can listen to the patient

well the doctors do not have time to

listen to the patients we are in such

great hurry lot of appointments are in

or their patients are the patients are

lined up outside so we don’t have time

to listen but we need to listen to our

patient because that elevates the fear

in them then touch the patients how many

of us touch even our own kith and kin I

don’t know how many of how I have hugged

your parents I don’t think that that’s a

lost art now so we need to touch our

patient which reassures them calms them

down and then hug therapy which is known

to release serotonin oxytocin which are

the feel-good hormones which reduces the

kata salts in the body artery in the

body then what does this human therapy

do it enhances the quality of our

treatment so that is what it does second

modality is pro forma therapy when a

patient comes to us we don’t hit the

investigation button first we hit the

pro forma button first

so this pro forma helps us to get a

whole body diagnosis a patient who comes

to me with knee pain is just not having

knee pain there may be other things

involved there may be diabetes there may

be a high potential they may be

depression so I do need to fill up the

pro forma once this is an international

questionnaire so once I do that I have a

complete diagnosis in front of me and

then then I can be judicious in my

investigations then judicious drug

therapy we need to change from

indiscriminate

drugging of the patient to tarisha’s

drug so that would reduce the

complications integrate the

physiotherapist not just one or two we

need to integrate the visual therapy

then therapeutic exercise which are

recommended by the modern orthopedic

surgeons like knee exercise neck

exercise back exercise has to practice

then this integrated yoga therapy is

model it is six it is a six step

technique loosening practice loosen the

entire body not just the part which is

painting which is hurt which is deceased

we need to loosen the entire body from

the toes to the head then comes instant

relaxation technique of one minute then

strengthening practice of the entire

body not just of the neck back it’s the

entire body and then this is followed by

qrt which is a three minute technique of

quick relaxation technique these are all

specialized yoga techniques which is not

in mind now in this in this forum I

cannot describe all this but I can just

do a gist of it then asanas standing us

now so pylons not prone us not sitting

us now selective asanas not that kind of

yoga exercise what you see on the TV

it’s not that it’s a research-based

steps which we choose and then finally

we have the deep relaxation technique of

seven minutes this is followed by

integrated relaxation of meditation

pranayama and yoga nidra so what does

this integrate yoga therapy do do in

modernity patients it is like hitting

many birds with a single stone it

loosens the entire body it strengthens

the entire body it improves the posture

gait balance coordination overall

benefits inputs overall health helps in

mind and emotional relaxation improves

the core musculoskeletal conditions what

we call morbidities and core mental

conditions then modality 8 is

integrating the health education we need

to tell our patients about muscular

skeletal structure mechanics function

importance of good posture and

musculoskeletal healthy lifestyle then

we need to tell the patient’s morality 9

diet therapy what we eat when to eat and

how much to eat because this is where

you know that there is lot of the lack

of awareness among patients and then the

supportive therapy patient needs to wear

the knee caps the collars the bells the

heel supports and the walking sticks

when to use them and how much to use

them then we have the reversal therapy

concept which says that we need to

reverse all the

this is modifiable factors these are

brought the disease in us without

attempting to undo it treating like any

Wholistic Orthopedics…When East Meets West | Dr. John Ebnezar | TEDxLBSIM