Dr. Eugene Capitano, BA, BSC, DC, DAC, ACSMPT is a renowned and highly experienced chiropractor in private practice in Winnipeg, Manitoba, Canada. Dr. Capitano brings his clinical experience to his current role as a lifestyle chiropractic health coach who focuses on the prevention of chronic lifestyle-related disease. In addition, he has established comprehensive protocols and standards for interdisciplinary rehabilitation coordinating physicians, chiropractors, physiotherapists, occupational therapists, and psychologists.

What is human optimization?

Optimization is the action of making the best or most effective use of a situation or resource. In this case, the human body is the resource, and thus we are trying to make the human body perform at its best given the situation. As a clinician and trainer, I have patients and clients who come to see me because of a particular problem or situation. It might be because their back hurts, or they want to run longer distances or faster times. My job is to help them solve that problem. Making them more robust and resilient allows them to optimize their own resource for longevity. In addition to physical optimization, we should also include the mind to achieve what I refer to as total human optimization.

What trends in the chiropractic industry are you most excited about?

Many patients have turned to wearables to track their own health. As such, chiropractors need to be aware of the technologies out there. This means using various devices, being knowledgeable about what they are measuring, and understanding how to help and encourage patients to make better choices about their lifestyle habits.

What can our readers suffering from back pain do at home to help ease the pain?

According to clinical guidelines, people who suffer from non-specific low back pain should nevertheless stay active. Contrary to what some people believe, activity avoidance will hinder recovery and only prolong disability. The best types of exercise and amount are debated among professionals. There is no evidence to show that one type of exercise is superior to another. Thus, I recommend that people choose an exercise or activity that they enjoy, and that they modify as required.

What is the ideal ergonomic office set up for people working from home?

With the increase in home office work in 2020, this is a very timely question. We know that prolonged sitting has negative health consequences, and thus should be avoided. If possible, purchasing a sit-to-stand desk is ideal, as it allows one to change positions frequently while still being able to perform work-related tasks. In addition, there are treadmill workstations. However, for many people these are cost prohibited. The other issue is that treadmill workstations are not sufficient to stimulate a significant increase in heart rate to allow for cardiac benefits. The most cost-effective advice I can offer is for people to get up from their desk at least once an hour and perform simple mobility exercises near their desk.

In your 25 years of chiropractic care, what has been the biggest change?

Until the late 1990s, a common treatment approach for lower back pain was to advise rest. The exact nature of rest varied from patient to patient, but typically it meant staying in bed most of the time. What we now know is this makes people worse. Sometimes, people with back pain do indeed need to rest, such as those with more severe sciatica. But for most people, not moving at all makes them worse instead of better. The other big change is the overutilization of imaging such as CT and MRI scans. We now know that two-thirds of people without back pain will show some kind of disc pathology. There are new clinical guidelines that, when followed, illuminate the need for unnecessary and early MRIs, which have been shown to exacerbate a patient’s low back pain. Providers and patients should be made aware that when early MRI is not indicated, it provides no benefits, and in fact worse outcomes are likely.  

What is Active Release Technique?

Active Release Technique, or ART, is a highly successful approach to the diagnosis and treatment of soft tissues including muscles, tendons, ligaments, nerves and fascia. ART practitioners must take a comprehensive course and become certified to perform the technique. It is effective for issues such as, but not limited to, low back pain, neck pain, elbow tendonosis, rotator cuff tendonosis, knee pain, shin splints, carpal tunnel syndrome, running injuries, and numerous other conditions. Professional athletes have been using ART for years. An ART provider uses his or her hands to evaluate the texture, tightness and movement of muscles, as well as the fascia, tendons, ligaments and nerves. Abnormal tissues are treated by combining precisely directed tension with very specific patient movements.

What advice do you have for our readers to unwind after an intense workout?

First, high-intensity interval training is very physically demanding. This type of training has gained lots of popularity over the years. As a chiropractor and trainer, I have witnessed many injuries due to over-training. The exercise field is full of performance coaches, trainers, and sports specialists, but there are few of what I call recovery specialists. One of the simplest and most critical elements that people can do to unwind is to experience good quality sleep, nutrition, and hydration. Without these three fundamental requirements, the body will not be able to repair and regenerate, thus leaving it prone to injury as workouts continue. In addition, there are other ancillary forms of therapies to unwind after an intense workout that require intervention. These include such things as massage, electrical stimulation, various compression treatments, and infrared saunas, just to name a few.

How do you relax your nervous system?

The autonomic nervous system can be divided into two parts: the sympathetic nervous system and the parasympathetic nervous system. When activated, the sympathetic nervous system is the fight-of-flight system, and beyond our volitional control. The parasympathetic nervous system for the most part is also involuntary, with the exception of breathing. That is ultimately the keyhole into maintaining incredible levels of recovery, and to relax the nervous system. Deep breathing turns on the parasympathetic system by way of the vagus nerve to a sufficient extent that it acts as a brake on the nervous system or stress response. There are other techniques such as yoga, tai chi, and other forms of mobility work that all use breathing in some form.

What is Personalized Activity Intelligence?

Personal Activity Intelligence, or PAI, is a science-backed health score that measures the heart health impact of physical activity. It gives you a personalized score based on your profile and heart rate data, which tells you if you’re doing enough physical activity. At the same time, it helps keep you motivated to keep moving. Maintaining a weekly PAI Score of 100 or more is associated with an average 25 percent risk reduction in cardiovascular disease mortality. Research has shown that those who achieved PAI but did not meet the weekly physical activity requirement of 150 minutes of moderate intensity activity or 75 minutes of vigorous intensity activity per week still received the same benefit. Conversely, those who met the physical weekly activity requirement, but did not reach weekly 100 PAI, did not experience the benefit.

What are your thoughts on Deprivation Therapy?

I define Sensory Deprivation Therapy as a means of depriving the mind of visual stimuli, auditory input and social interaction. Without the pressure of analyzing the world around us, the body lowers its levels of cortisol, which is the main chemical component of stress. The brain also releases elevated levels of dopamine and endorphins, which are the neurotransmitters of happiness. Floating removes the compression forces of gravity, thus decompressing the joints of the body — particularly the spine — causing a muscular relaxation effect. The treatment goal is to eliminate external stimuli, thus inducing deep relaxation and having subsequent positive health effects on stress and muscle tension pains. All of this takes place in a flotation tank. 

What advice do you have for students interested in a career in the chiropractic industry?

The American College of Sports Medicine and the International Council of Sports Science and Physical Education highlighted that 30 percent of today’s children are obese, and that in the past 44 years physical activity in the United States has dropped 32 percent. If action isn’t taken, half of the American and Chinese populations will be physically inactive by 2030. Although I don’t have the Canadian statistics, they would be similar to the U.S. Today’s youth are the first ever to have a shorter life expectancy than their parents’ generation. This will obviously place a significant burden on the health care system, as inactivity leads to serious health issues. As a student interested in the chiropractic industry you have an opportunity to make a difference in the health of the next generation, and be a part of solving this emerging health care crisis.