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Upper Cervical Success With Dr. John Stenberg

2 months ago

Arguably the most powerful adjustment in chiropractic is putting the atlas back in place and watching the body heal. Dr. Kevin Pecca talks about upper cervical success with his recurring guest, Dr. John Stenberg of Zenith Chiropractic and host of Atlas of Chiropractic Podcast. They explain why there are only a handful of upper cervical chiropractors despite it being a highly beneficial technique. Dr. John reveals why this method requires a high level of discipline and why upper cervical problems are not picked up by MRI or CT scans. They also discuss why the healing process is never linear and why it requires collaborative work between physicians and patients to be truly effective.


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Upper Cervical Success With Dr. John Stenberg

Welcome to a new episode of the show. I apologize, I took a hiatus from the show. A lot has changed since our last episode. I moved from New Jersey to Florida, setting up a second practice in the beautiful sunshine state. I'm starting to settle down here, going to start cranking out weekly episodes. I'm very excited to be back.

If there are any episodes or people you would like to read interviewed, you can direct message me on Instagram @DrKevinPecca or email me at You can also find all my social media, pages, Instagram @DrKevinPecca, TikTok @DrKevinPecca, Facebook at Montclair Upper Cervical.

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In this episode, we have a good friend of mine, Dr. John Stenberg. He is a Blair upper cervical doctor in Colorado Springs, Colorado at Zenith Chiropractic. He's been on the show about four times. I love talking to him about upper cervical. In this episode, we're going to go through the healing process, why there are not more doctors doing upper cervical chiropractic, the symptoms and conditions upper cervical chiropractors treat and much more. Without further ado, here is Dr. John Stenberg. I hope you enjoy this episode as much as I did.


Welcome everyone to a new episode of the show. I apologize, I took a hiatus from our last episode but we are rocking and rolling. I'm excited to crank out some new episodes. What better guest to have than one of my favorite Blair docs, Dr. John Stenberg, recurring guest? This might be his fourth time on the show. He is an excellent Blair doctor out of Colorado Springs, Colorado at Zenith Chiropractic.

He is also the host of the Atlas of Chiropractic. For those who have been following the Blair Chiropractic Podcast, it was rebranded so it's the same podcast. John, where can you find those episodes? Spotify, iTunes, all that?

All the above and on Instagram. If you connect there, all the episodes, clips and things get shared. It gives you at least a way to peruse the content and see what you like.

Little sneak peek of what episodes you want to turn in tune into. I like that. John, it's an honor to have you back on the show. I love talking to you because we started practicing around the same time, upper cervical. We've learned a lot in the past years. One of the most amazing things that you have an edge on people at, I believe, is you have probably interviewed the most upper cervical chiropractors in the entire field. What's that like for you? Do you gain a little piece of knowledge anytime you've interviewed people that have been doing this for 15, 20 or 25 years? What's that been like?

You and I early on understood the importance of creating content with these people and getting some of these conversations recorded and out there for people to encounter. We've had mentors that have helped us with things that have benefited us in so many different ways. I found that if you just reach out and ask the questions, people are so open to sharing so 100%. What I've learned is there are no rules. Early on in practice talking, if we were to think back to our early days and we were getting started, learning techniques, getting our practices going and all that stuff, you think there are all these hard and fast rules that you need to learn and follow.

What I've learned talking with different folks is that there's not one path to success. There's not one way to do things. There's not one perspective that you need to adopt. Talking with all these different people, I've come to appreciate a couple of things. One is there are no rules but there are certain things that you hear consistently. Those are the things that pay attention to.

The differences and the nuances that apply person to person, city to city and personality to personality are variations on the themes. If you can identify those top principles and concepts that everybody talks about and thinks are important, that's where you focus your attention. You do those and over time, you have the conversations. You start to notice that they all talk about some of the same things. That's when you know you're starting to get to the important parts.

It's very interesting. A lot of people have different starting points when they start upper cervical. The people that know they were going to do upper cervical, sometimes some of the doctors have been doing it for 20 to 25 plus years. I've heard this a couple of times. They'll only focus on the atlas for the first 3 to 5 years, which I found very interesting. How beneficial is that just to focus on one thing and hone your craft into one thing?

We usually talk to these people. They'll branch out and do some lower cervical. Sometimes they'll even do some stuff below T1. I always found that interesting, especially for new students coming into the practice. The amount of wipes you can change from one upper bone, the first bone in the neck, you can change. The most powerful adjustment in chiropractic is getting that atlas put back in place and watching the body heal.

That's 100% true. Even the folks that you talked to that did branch out a little bit always come back to that. My doctor who's been practicing for over 40 years at Blair upper cervical always constantly reiterates that with me. It's like, “If you get this part right and you do that thoughtfully, you prioritize that and make that the center, the foundation of what you have to offer people, there's nothing better.”

If you want to supplement or you want to try to fill in the gaps with other things, that's gravy in my opinion but there's no substitute for that. You can't stretch or exercise it away. You can't manipulate it. You have to do the right precision adjustment with that part of the spine to get it done right. It's worth it because I did the same thing. I spent the first three years going like, “Let me get this dialed in.”

I'm not saying I'm an expert. There are people that have been doing it for 30 years plus and are still working on honing their craft. I don't even know what I don't know about this yet. Let's start building our experience and that skill of doing a proper atlas adjustment with as many people as possible because everybody's different. With all the angles and approaches that we use, you need to get some time under your belt with this stuff to build your proficiency.

One question I get asked a ton is, which is changing, why does nobody do this technique? Why aren't there more upper cervical chiropractors out there? What are your thoughts on that, John?

I've got a couple of thoughts that some people might like and some might not. One is it's hard. It's not an easy practice to run or learn. It presents interesting challenges. That's why it's so beneficial. There's an equal and opposite reaction. It's a challenge to build these skills of not just adjusting but analysis, patient education and management communication.

The running of the practice is a little bit different because of how we manage folks. It's hard and that deters some people. A lot of people like it in theory but once they start doing it, it's like, “This is not what I thought it would be.” Some people might find their way out of it or maybe they start to deviate from the path a little bit because of the challenges.

It's funny. It's one of the only techniques where one of the mastery parts of it is knowing when to leave it alone. That's like mastery within itself. Put faith in your patient like, “This is healing.” Even though we present those obstacles, those healing parts have been under care for a couple of months and they're retracing. They're not feeling that great and to look that patient in the eye and say, “Your atlas is in. Your body is healing. We're going to leave it alone.” That is a complete 180 outside the paradigm of our healthcare model.

It requires discipline on the part of both the doctor and the patient to buy into the process. In this world, things move fast and people want quick results. Often, we get quick results but healing is different than getting relief. Healing takes time and relief might come sooner but creating the change that we want, the sustainable changes in people's health that we want requires time and discipline. That's part of what makes it hard.

Another challenge goes back to the upper cervical chiropractic profession. We've made it very difficult for chiropractors to do it. Meaning, there's been a certain narrative that you have to do C1 only. There are a lot of people that go, “I'd like to learn an upper cervical technique. I'd like to add this to my practice and be able to introduce these techniques.”

A lot of the technique organizations people say, “No, you have to get rid of everything else and do this exclusively.” That deters people. There's probably a certain percentage of chiropractors that would be doing a version of upper cervical or more upper cervical work if it was a little bit more approachable and not so exclusive feeling from the outside looking in. I appreciate why they do that because of the thing we were talking about. You can't wing it and half-ass it, get good results and do a good job of it.

You cannot half-ass the upper cervical.

There's a little bit of a paradox there. We want it to be approachable for chiropractors and not push them away and seem dogmatic but at the same time, we want to emphasize the importance of dedicating yourself to training in it. There are interesting challenges with it. Those are some of the reasons.

One of the big things too is the doctors don't want to take X-rays, especially the old model if you don't have a CBCT machine. I remember in the clinic, I would do stress and pressure tests. I was like, “I got this.” When I got into practice, I was like, “I'm going to take X-rays but I'll get most of my listings off palpation, stress and pressure.” That will get you in trouble because everybody's wired differently neurologically. It's a good tool to help you understand what's going on but there is nothing better than that gold-standard CBCT image. It tells you exactly what's going on.

I remember I took plain films in Dr. Ban's office, then I switched to digital and the setup. If you have a new patient in your office, you could be taking X-rays for 30 to 45 minutes to get all the views you want. We're going to see more people doing the upper cervical work with the CBCT machine because you set them up. It takes 1 or 2 minutes. You press that button and it's going to take fourteen seconds to capture that image. Before, I feel like a lot of the students got deterred because I'm going to spend 45 minutes taking X-rays on this patient. I want to adjust.

To have to take them again because you screwed it up. It's tedious. Even with technology advancing, there's still time required to analyze and develop your plan with that. I'm curious. Maybe someday there will be an AI algorithm or some program where you take the scan and it will give you listings or it'll calculate.

That is coming.

In the future, technology might make that a little bit more efficient but it is. It's one of those things. There are some tedious parts of the upper cervical. We get eager to get to that first adjustment and take care of folks. There are some steps that you need to take your time and do right so that everything that happens after that is done properly. It's a little bit slow on the front end. There's a lot of information, data and testing together but then you can run with it. That sets you up for long-term success.

I love the CBCT image in terms of patient care too because the patient can see what's going on in their neck. You can correlate the symptoms. If somebody's got such a huge torn C2 and their atlas is here and their C2 is over here, you can see the counter rotation. The patient can see it. They can link it and you can tell them, “Once we remove this, they're going to start to feel better.” We have a strong visual connection of why the patient's feeling the way they're feeling. Whereas the digital X-ray, you're like, “This is here. You see that.” I always see their faces.

There's something to that and I tell patients all the time, “I don't want you to take my word for it. I want you to be able to see what I'm seeing because it's your body. You're the one that is going to be going through this process. I want you to understand the things that I see that are important. You don't need to be able to be a radiologist or a chiropractor but you can see the changes that are significant.”

A lot of these people have already had a bunch of tests done. They've already been to a bunch of doctors who told them, “Everything's normal.” If they can look at that CT and go, “That does not look right,” it builds a lot of hope and confidence like, “We finally got onto something here that's going to make a difference.” They get the results and it reinforces the fact that there is hope that things are going to get better for you. We've identified some objective evidence that there is something wrong. That means a lot to people.

Most of our patients get their MRIs and regular CT scans done. They come into our office and say, “Why didn't my MRI or CT scan pick this up? Why did they say I was normal and I'm still feeling awful every day?” The answer to that question is nobody's looking at the misalignments like upper cervical chiropractors are looking. 1 or 2 millimeters can be detrimental to somebody's central nervous system. It can cause a pleura of neurological symptoms, brain fog, dizziness, headaches, migraines, numbness and tingling.

In MRIs, doctors are looking for big pathologies, degeneration, arthritis or stenosis. They're going to pick up on those things. If you've been told that your MRIs are normal and you have a ton of neurological stuff going on, one of the best things you can do is get to an upper cervical chiropractor that has that 3D imaging because it will start making a ton more sense of why you're feeling the way you're feeling.

You’re right and patients get frustrated. I try to encourage them, “Your doctors are doing what they know to do. They're trained in pathology. We work with dysfunction.” There is a spectrum between you having a disease like a tumor, a fracture, some infection in your spine or massive disc herniation and normal.

Most of the folks we work with are somewhere between that spectrum. All the bits and pieces might be proper. No damage or disease to them but it doesn't mean that they're working right. If you’re not working right and it's causing trouble for you physiologically, then that leads to symptoms. A lot of folks get stuck in that gray area of, “I don't have a disease but I'm also not okay.”

A lot of times, we can answer that question and fill in the gaps on, “Your brain MRI is normal. That's good news.” I know you didn't come up with an answer but it's better that your brain is not damaged. Let's do what we can to make your body work better because if it works and performs better, it'll heal and feel better. That's where we have a ton to offer. A lot of times, I'll go back and look at those MRIs and there are clues. If you know what to look for, there are signs.

They could pull both up.

Somebody could have identified that misalignment or structural issue if they knew what to look for. It behooves us as chiropractic professionals to create connections with other healthcare professionals and open their eyes to the things that they could notice so that those folks get the help they need. A lot of healthcare professionals are eager to help their patients but they don't know what they don't know. It's up to us to help them understand that and do it in a collaborative way. Not a way that's off-putting and diminishes their practice or knowledge but creates room for collaboration.

Dr. John, what's your thought process on the healing process by itself? In upper cervical, we get a lot of people in our offices with some serious neurological issues. I know when people see my adjustment videos, they think, “One adjustment that's going to fix everything and take all it away.” We do get those miracle cases. It doesn't happen all the time. You can feel much better after your first upper cervical adjustment but as you've been in practice for years, what does the healing process look like to you?

It's not linear. For a lot of people, unfortunately, they've been misled through advertisements and crappy sales pitches that are trying to get people to think that you should gradually, continually improve and get everything gets better day by day. That's not the way anything of value in life works. Healing follows the laws of nature. There are cycles and seasons to it. We should be able to see a trend in the right direction over time.

We got to reorient folks to thinking differently about healing compared to relief and refocusing on what is a way to measure progress over time so that as you're healing, you can remind yourself that there is positive change happening. There are days that are easy and days that are hard. Not everybody has the same metabolic capacity for healing, meaning their biochemistry and how their body heals is going to be different from person to person.

It's hard to even project as a doctor, tell somebody how they're going to heal. It's like, “I don't know exactly how you're going to heal. We'll be honest about that.” I like to tell folks a couple of things because they've got a few concerns. If you put yourself in the shoes of the patient, they have a couple of concerns that they want to know are being considered and addressed. Number one is, “Is this guy ripping me off doing something that's not helping? I'm coming here spending time and money and not getting anywhere.”

The only thing they have to anchor to is how they feel. They don't know the testing part of it. I always tell folks, “We should see things changing in the first 4 to 6 weeks. It doesn't mean everything's going to be better but if we're a month in and we have the right adjustment z data and we're doing the right things, we should see things change, both in what you can feel but things I can measure.” If we see that, we know that the healing process is taking place. We can double down on it and stick with it. It might take you another couple of months for that to come to fruition in a sustainable way or even longer than that. I don't know.

At that point, we're going to know that we're doing the right things and we're on that path. I tell them, “If we're not helping, I'll figure out why.” We'll troubleshoot how to facilitate healing. The other part of it is it's not all about chiropractic. When you talk about healing and the body's ability to adapt to its environment and the stressors that are put on it, there's a lot of stuff that goes on outside of our offices that impact how patients heal. We need to be aware and remember that and they need to be aware of it too.

As much as we want to take credit for every positive outcome, sometimes patients are doing other things that are helping themselves heal. Sometimes they're doing things that are actively limiting how effective we can be and how much they can heal. It's worth it, especially in the early few visits. Have conversations about their lifestyle, routine and habits and what's going on outside the office so we're aware of some of the obstacles that might present themselves or some of the things that might facilitate healing.

For the chiropractor, we have to keep it in context. I tell patients all the time, “There's a lot of life that happens between visits.” I'm thinking for myself, “Let alone for them.” There are other doctor's appointments and other things that they're trying and doing. There are sleepless nights, stress at home with family and work.

I like to remind folks that chiropractic care does not happen in a vacuum where nothing else in your life is impacting your results. We need to have open lines of communication with our patients about what's going on with them so that we can identify some of those challenges. Sometimes we get frustrated. We're like, “Why are we not getting where we need to go?” We might be missing one little piece of information about the lifestyle.

There are two parts to that. There are so many different ways the atlas and the axis can misalign. It's so important as a patient to give your upper cervical doctor a chance to figure out which adjustment is going to be right for you because it could take a few adjustments. There are so many different factors. It's a very sensitive area up here. Sometimes it's going to take your upper cervical doctor a few visits to understand, “We finally got it. This adjustment's going to hold best for you.”

As you know sometimes if you adjust somebody on one side, it's not holding as well. You can flip them around and pull the adjustment up. Sometimes people hold better that way. I like to tell people, “Give upper cervical care at least three months for your body to heal and for your doctor to know what adjustment works best for you.” There's also a factor on the other side of that coin, which you mentioned before. Sometimes, we don't know what's going on at home.

I have a funny story. One of my patients had a very challenging vertigo case. I was seeing him about two times a week for a month. He was not holding his adjustments. We re-X-rayed and did all the analysis. I had Dr. Jeff, my other doctor in our practice, look at it. We’re both putting the pieces together. Open the lines of communication with your patient.

This person was having his wife walk on his back every day after work up to the neck. There's not much I can do as a doctor when your wife is walking on your back, stepping on certain aspects of your spine. He was doing it every day, popping his atlas out. I didn't know that. As a doctor and as a patient, you want to have that open line of communication. Educate your patients on what to expect and what to stay away from. It's a two-sided coin. That's a great point you brought up there, John.

For patients, you can tell when someone is unrealistic with their expectations. As younger doctors, in those situations, we're like, “They’re not getting the idea that this is not a quick fix.” We're a little bit more eager to go like, “Maybe it would be. I don't know. Let's try.” Over time, I've got more confident to tell folks, “If you expect me to fix several decades worth of damage to your spine with one adjustment and you waited until the point where it's so bad that you can barely function, that's not reasonable. That's not realistic. We'll work on it but you got to admit that you didn't get this way overnight.”

You're not going to get out of this problem overnight either and that's okay. If you gained 100 pounds and you wanted to lose weight, you wouldn't show up to the gym and go, “Trainer, my life's been a wreck for six years. Put me through a session to get me back on track.” No. That's unrealistic. It's not the way the body works. It's not physiologically reasonable to assume that would work.

I was telling a lady, “There are very few things in healthcare that are as efficient as upper cervical.” One adjustment can make a huge difference and it can hold for a long time. You can make steady progress even with those speed bumps along the way. To maintain that over time, you come in once a month and get checked. Big deal. If you get adjusted a handful of times a year and it helps, you got to be kidding me. Who else can offer that?

What meal plan can you eat one healthy meal a month and stay healthy? What workout routine can you do once a month and stay healthy? It's unreal how efficient the upper cervical is in terms of creating momentum with the body and healing. In that way, we need to be mindful that we don't overpromise because we expect miracles. We do and see them. A lot of times, I've been guilty to be a little impatient with the healing process and go, “We're not getting it. Maybe we need to make a referral or do something else.”

I've even had patients say, “I don't want to go do anything else. Let's wait it out.” Sometimes people even intuitively know that it takes time. “I understand that I didn't get this way overnight.” Those are all great points. We need to remind ourselves as doctors to not get impatient because then we'll adjust inappropriately or prematurely, then as patients to buy in. You don't understand that it takes time. You're willing to commit to yourself, not to the chiropractor. You're investing in yourself and committing to your health. If you're willing to do that, you'll get the rewards. It's almost guaranteed.

People forget when they come in with upwards of ten neurological symptoms, things start to get better but then they start to hone in on one thing that's bothering them. If you have headaches, numbness, tingling, brain fog and dizziness, they'll come in and be like, “My dizziness is out of control.” You start talking to them like, “My migraines are gone. My brain fog is gone. The numbness and tingling aren’t there,” but they still getting the dizziness. I respect that.

I get that it's not fun to go through dizziness but there are a lot of great things happening. If you take a step back, the body's going to start to heal that as well. We've done a lot of great healing already. When you remove something, sometimes it magnifies another. There is some good healing going on in those cases too.

It's a good idea as a chiropractor to do progress evaluations periodically and check in with folks. Go back to that early conversation you had when you took a history and you talked about all the concerns because stuff gets off your radar. Almost every time, I do a progress evaluation. I ask, “How are you doing in this area?” They're like, “I don't even remember I had that. I don't even know when it went away. It's not a part of my life anymore.”

It's good to pay attention to the challenges and confront those head on but you do need to be mindful over time that sometimes things improve gradually. I like when things improve gradually. It seems like it's a little more stable. Some folks have these magical immediate health transformations with one adjustment. Sometimes their symptoms are volatile.

What goes up comes down.

They'll crash too. I tell folks, “Objectively, things are doing good. I know you're not feeling a ton of difference early on but this is perfect. This is the path you want to be on, which is gradual sustainable results.” It doesn't come in any one form or fashion. I tell folks all the time when we go through their exam report and explain what's going on, “People that come here with problems like yours, there's not a neck pain adjustment or migraine adjustment.” This is how it works in medicine.

People think, “I have this symptom, you'll do the adjustment for that symptom.” That's not the way it works. Back to the conversation about function, everybody that comes here and gets better with migraines, we treat them how they need it. We're going to target the dysfunction and focus our attention on improving that alignment, the health and function of the nervous system and the balance in the body. Those symptoms should improve.

There could be other things that are contributing to your symptomatology. If the symptoms improve slightly in plateau or they don't improve while all these other things do, we can start to troubleshoot and figure out what else you need to do to get relief. We try to keep the dysfunction at the center of it and focus our attention. All we can do as doctors is take care of that upper cervical subluxation and do that thoughtfully with systems and procedures that we know are tried and true.

As a doctor, if you get a little bit fixated on the symptoms and you start chasing that stuff around trying to force the issue with the healing process or the body, you can get yourself into trouble. I've done that too. You lose a little bit of your grounding and go, “I want that symptom to go away so I'm going to try to force it.” It doesn't work that way.

Dr. John, at the end of every episode, I'd like to ask all my guests, what is one piece of advice that has resonated with you over the years? It could be anything. It could be upper cervical or whatever you feel like is on your heart.

In thinking about this conversation and reflecting on the last years of practice, there's a process of self-discovery that needs to happen in your life. The times when we find the real nuggets of wisdom and the good things come from our hearts and minds put us on a path of making a positive change in life. It comes from times when we have a little bit of quiet and space from all the noise. The times when I've been the most confused and frustrated in practice were the times when I was letting too many people influence my idea of what I should want and what success should look like for me.

Spend some time with yourself, your thoughts, priorities and values. Identify what you want out of life. Find folks that can help you stay on a path towards what you want and create success for yourself. Identify what that means for yourself. I'm big into that because I've gone through different evolutions where I trusted myself and other times where I didn't.

The times when I didn't, I was looking for the answers outside of me where I got the most mixed up and confused. Listen to that still small voice and find ways to cultivate that because the more you pay attention to it, the more loudly it'll speak to you. That'll never lead you astray. That's worth investing in. It's worth cultivating that and building that up.

Dr. John Stenberg, thank you so much for coming to the show. Where can people find you, listen to your podcast and find you on social media?

Check out the Atlas of Chiropractic Podcast. It's pretty much anywhere you might be subscribing and listening. We talk about a wide range of topics related to the practice and science of upper cervical chiropractic. That's more for the healthcare providers and doctors. If you're a patient and you want to listen in on, “What are these folks talking about? How do I choose a good doctor,” there would be some nuggets there for you too. @Zenith_Cairo on Instagram is where I spend the most time on social media. I'm playing around with Threads. We're going to try that out and see.

What is that? I saw something pop up on my Instagram about Threads. I have yet to know. I don't know what that is.

It's the metaverse version of Twitter. It's more or less the same type of platform but it's interesting because there's a lot of organic interactions happening there. It's not full of bots, spammers and weird stuff. We’re having some conversations on there. My practice is in Colorado Springs and I have folks reach out all the time for a referral.

If you are looking for help and don't know what kind of chiropractor to find in your area, reach out to Zenith Upper Cervical Chiropractic. I'm happy to get you connected with a friend or a colleague closer to you because there are a lot of folks out there that can help you that aren't so out in the content space as Kevin and I and have it made as much of an effort to be visible. We'll help connect you because there are a lot of great thoughtful and excellent doctors that are there for you.

Dr. John, thank you for coming to the show. Would love to have you back anytime. We'll catch up soon. I'm excited to see you at the Blair Annual in Las Vegas.

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