As chiropractors we love to “think outside the box.” We are natural contrarians.
I think that’s why many patients are attracted to us. They’re looking for an alternative to the traditional medical model that hasn’t solved their problems.
I’ve always considered this free-thinking and ability to question accepted norms as a superpower.
But what if there’s a dark side to this power?
Today we’re going to explore why limitations sometimes make us better, and how this applies to your practice and your patients.
I’m writing to you from Rome, where we’re preparing for the loooooong journey home tomorrow. Over the last 3 weeks we’ve covered most of Italy, from top to bottom and most points in between. The fast trains here are amazing… they get up to 300 km/hr.
One of the unexpected benefits of all that travel is having time to read and study. One book that I’ve really enjoyed is Inside the Box: How Constraints Make Us Better.
The central premise is simple:
Constraints don’t limit performance.
They create it.
This is opposite to the way most of us assume it works. We think that less limitation should logically lead to greater creativity. But the book makes a convincing argument that the opposite is actually true.
In fact, studies of creativity have shown that when the brain is given complete carte blanche to create, it generally defaults to the most common, tried-and-true strategies, leading to less creative outcomes.
This seems counter-intuitive, but neurologically it makes sense. Thinking is metabolically expensive, and the brain is wired to conserve energy wherever possible. So going with what’s worked previously is a sensible strategy.
It’s only when the obvious solutions are taken off the board, or when some limitations are put in place, that the brain is forced to innovate and come up with novel solutions.
This dynamic has led to many of the greatest musical compositions, literary works and technological advancements in history.
It also plays out in our daily lives.
One small example… yesterday we had one of our few “free” days of our trip. I asked the boys what they wanted to do with the day. And received the typical answer…
“I dunno.”
When given complete freedom of choice, this is by far the most common answer I get.
So I tried a different approach-
“I’ve looked up a few options, we could check out this water park, an exhibition of the largest Lego sculptures in Europe, or the Museum of Illusions… which would you like best?”
The funny thing is, this didn’t just limit their options… it also caused them to come up with several alternative options. By introducing some constraints, it actually engaged them in finding meaningful answers.
Another quick example relevant to our past few weeks…
Packing a smaller suitcase forces you to pack more effectively. We’ve been travelling for 3 weeks, with 4 adults and 2 kids, moving approximately every 3 days. That’s a lot of luggage… and Italy’s narrow streets, frequent steps and train network are definitely not built for it!
(One Airbnb we stayed in was perched on a cliff face overlooking the Gulf of Poets… incredible views, but over 80 steep, winding steps to get in and out… now that was a challenge!)
What I’ve noticed is that those with smaller suitcases have been just as prepared… those with bigger cases are just carrying more stuff they don’t need!
Of course, constraints can also be counterproductive. Too much limitation is restrictive. Like so many things in life, there’s a sweet spot.
The ideal zone is just enough constraint to force creative problem solving, without becoming enough to stifle it.
One place I see this play out is within the medical system. Many times in my career, I’ve seen a patient achieve a “medically impossible” outcome and report it to their doctor, only to be told…
“I don’t want to know about it.”
For years this confused me. Whenever a patient tells me they achieved an incredible result with a practitioner, modality or strategy the first thing I want to know is…
“How did you do that?”
However, one day a patient explained it to me… their doctor said to them “I don’t want to know because I can’t do anything with that information. I can only offer you approved approaches.”
That rang true. I was once in a mastermind group with an integrative doctor who was investigated and ultimately sanctioned by the board because she was writing far fewer prescriptions that her peers.
Too much constraint is not a good thing.
But the right amount can be transformative.
And it doesn’t matter whether the constraint is externally or internally generated. In fact, in the absence of external constraints, imposing your own can be incredibly helpful.
For example, if you give yourself a year to achieve a particular goal… chances are that it will take a year. If you insist on making it happen within 3 months… amazing things happen. You are forced to get creative.
Elon Musk has famously used this strategy in all of his companies to achieve seemingly-impossible deadlines (If you haven’t read the book: Elon Musk by Walter Isaacson, it’s another one I highly recommend.)
We’ve all experienced this- procrastinating on an assignment until the night before it was due, or neglecting to study until an all-night cram session before an exam.
However, we don’t have to wait for these external limitations to be imposed on us. We can strategically deploy them to create better outcomes.
For example, we’ve just implemented a major launch of our new Objective Testing Stack in my clinic. Some of the elements are things we’ve done for a long time. Others are new. However, the reporting, value and communication frameworkwe’ve placed around it are new (and I think, pretty cool. I’m excited to see what it creates for our patients.)
The stack includes posture photos, thermal images, vestibular testing, HRV, Insight electromyography and thermography spinal scans, Better Balance Orthotics testing and Omega 3/6 Balance Ratio testing.
The plan was to launch it before our Italy trip… but we just didn’t quite get there.
So instead of delaying it for a month, I set my team the challenge of pulling it off while we were away. As an added constraint, Jodie and I have had limited communication with the team during parts of our trip, which has encouraged them to problem solve without us.
They’ve done a great job.
In the first week they enrolled 32 patients and counting for the full testing stack (which is valued at $750.) My involvement has been extremely limited.
That’s the power of positive constraints.
Deploying systems in your practice is another example of constraints in action. A system is really just a productive constraint.
During the UAC event I attended in Tuscany, one of the docs asked me to do a training for his team on Better Balance Orthotics. In particular, he wanted help with teaching his associates effective systems for when and how to best utilise them.
He said… “We already know they’re great, but we need more effective systems to create more consistent results, especially for our newer docs.”
Every time I do this with a team, I watch their sales of orthotics skyrocket. But it’s not just their sales… it’s their clinical outcomes.
More patients get better, faster… and those happy patients refer other patients.
It happens in my own clinic too.
I shared recently how I’d adjusted over 100 cervical discs in a week after taking Dr. Simon King’s Afferentology course. [FBC#26]
The funny thing is, I first took Simon’s course almost 10 years ago, and at the time I thought the cervical disc screen and adjustment was the most valuable thing he taught me. I immediately saw how clinically powerful it was, and implemented it into my practice, including teaching it to all of my associates.
But I implemented it on a hit-and-miss basis.
I checked for it when I thought of it. But not as part of a defined system.
And as a result, I was missing literally hundreds of cases!
I now recognise this as a “lack of constraints” problem.
Like my kids when I asked them “What do you want to do today?” without any guidelines or boundaries, my brain was defaulting to what it knew best…
Even though that wasn’t always the best clinical solution.
In my recent updating of the Afferentology course, I didn’t really learn anything I didn’t already know about that correction. The assessment was the same one I learned years ago. The actual adjustment was the same (although I did refine my technique a little based on Simon’s guidance.)
What was different was the systematic process of checking it consistently with every patient.
And that made all the difference.
I went from finding it occasionally, to recognising that it was a near-universal problem affecting a huge percentage of my patient population. And systematically checking and correcting it made a significant difference to the clinical outcomes I was seeing.
I’ve been through a similar journey with Better Balance Orthotics. And I’ve seen many other clinics follow the same path.
When there are no constraints placed around how and when to assess patients for the orthotics, it tends to happen haphazardly.
Which produces haphazard results.
But when we introduced a specific constraint- “We check every patient as part of our new patient consultation…”
An interesting thing happened.
Just like my experience with the cervical discs, we found that many issues were hiding in plain sight, going undetected and unaddressed.
Once we started consistently addressing these, we observed all sorts of thingsimproving that we never previously associated with feet.
Things like shoulder problems, fatigue, concentration issues, neurological symptoms, hormonal problems, digestion, sleep quality… many of the things I’ve covered in previous FBC issues.
This led us to investigate and better understand the links between these conditions and Foot-Brain Function.
Which made us better at recognising those problems when we saw them.
And therefore, better at addressing them with more patients. And better at communicating the links between foot function, physiology and chiropractic.
In fact, much of what I’ve shared in these newsletters has been a direct result of implementing that simple constraint on how we utilised the orthotics in our practice.
Like I said, I see the same thing happen in other practices.
But then again… sometimes I don’t.
Sometimes I see docs who wear the orthotics, love the results they personally achieve… but fail to consistently implement in their practice.
Or they implement… but they struggle to get their associates to do the same.
I’ve always wondered why that was. Then just the other day I read an email by author Steven Kotler, one of the world’s leading flow researchers, and the answer clicked into place.
He described training 35,000 executives and high performers across 156 countries to massively increase their productivity by building flow states into their daily routines.
The results were impressive. I know someone who took the course, and he said it was amazing… but it was dense. He learned dozens of protocols, layered over the 16 weeks of the course. For him it was transformative.
But over the 8 years that the program ran, something interesting emerged.
The people who sustained results weren’t the ones who adopted the most protocols.
They were the ones who internalized a handful of mental models that changed how they saw performance itself. Everything else fell away. Not because it didn’t work—because, in Steven’s words… “Life has a way of eating your habit stack for lunch.”
And here’s the part that changed everything: the mental models transferred. A leader who’d internalized them could shift how other people saw the problem without prescribing a single habit.
That moved teams in ways that protocol-sharing never did.
When I read that it was like a lightbulb going off in my head.
This was the answer why some docs love their orthotics but don’t consistently provide the same benefits to their patients. This was the answer why some docs struggle to have their associates implement effectively.
They’ve taken on aspects of the protocol… but failed to fully internalize the mental model that underpins it all.
I remember when that shift occurred for me.
When I went from thinking I was offering a patient a helpful product…
To understanding the fundamental impact of having a patient walk out of my office without wearing Better Balance Orthotics.
The impact on their structure. Their spine. Their joints. On their physiology. On their energy levels. On the outcomes of their care in my office.
It went from being one more thing I had to do with patients, to being about raising the entire standard of care in my office.
To be honest, these days it doesn’t make any sense to me that a patient would be willing to invest in their health through chiropractic and not want to do everything possible to maximise the outcomes and longevity of their care.
If that shift hasn’t occurred for you yet, it’s ok… I didn’t arrive here overnight either.
But I really hope you get here. For your sake, but also for the sake of your patients and your team.
It all starts with putting the right constraints around how you assess, test for and utilise Better Balance Orthotics in your office.
And understanding that if that doesn’t make the level of difference you’re looking for…
Sometimes the biggest constraint may actually be in our mind.
It’s our worldview. Our paradigm.
What I’m hoping to do is to help shift you from “Feet are sometimes important in chiropractic care…”
To “Feet are a fundamental determinant of human health.”
(Of course they’re not the only one.)
When you make that shift, the procedures and protocols tend to naturally fall into place… and the results follow.
Cheers,
PS. If you or your team haven’t quite experienced that shift yet, and you’d like some help getting there, I’ve decided to make 3 breakthrough calls available where we will break down the paradigm that makes this all make sense and leads to massive action.
These will be 1-hour calls and will be available on a first-come-first-served basis. Normally these calls would be $1000. If you’d like to secure one for you and your team, send me an email wit the word CONSTRAINT and let me know what you feel your biggest block or challenge is.