Dr. Dan is on a mission to make sure that the community thrives in life, rather than suffers. After an ice hockey injury, Dr. Dan was referred to his hometown natural health clinic. Through chiropractic care and physical rehabilitation, this office was able to assess the underlying weaknesses that led to the injury and provide long lasting results. Dr. Dan became obsessed with the idea of a collaborative, integrated health model. People deserve to have easy access to the best of both worlds; modern medical interventions and natural/preventative healthcare working together to provide high quality, customized solutions.
In this episode of TechTalk Podcast, Brad Cost, Dr. Jay Greenstein, and Dr. Dan Ruitenbeek sit down to discuss:
Just how Dr. Dan and his business partner started Shockwaves Centers of America.
Dr. Dan's mission to prop up the chiropractic industry, one machine at a time!
The role shockwaves play in helping people and healing people.
SHOW NOTES:
1:53 – Finding the need, then building an empire. “Going to chiropractic school, I never thought I would get into the world of medical or paramedical device distribution, sales or manufacturing. It was one of those things when you find a need somewhere and see no one else jumping in, so you find yourself doing it or letting it go by. I grew up in London, Ontario, Canada, and shockwave is a big part of the Canadian healthcare system. I was lucky enough that that was one of my jobs as a CA growing up. Fast forward, coming out into private practice, I tried to find somebody near me that I could refer anything gnarly that I couldn't do with my hands, like Achilles, plantar fascia, frozen shoulder. At that time, nobody had one nearby. Eventually, I got a secondhand one from Canada, drove it down here, started using it in the practice and was lucky enough to meet my business partner, who was first a shockwave client. David didn’t know what the technology was, but it was super helpful for him, and he wanted to get involved. I didn't know how to find suppliers or manufacturers or how to start selling it. He told me to work on the clinical side and he would make it happen on the other side. He's been a real saving grace for us. Going through the whole FDA process, getting all of our clearances, and being able to get this in the hands of people who are having great results has been just such an enormous blessing for us.”
5:06 – Affordable and chiropractic-specific. “It all started when I was looking for my own machine to purchase, right? I couldn't afford it. Minimum, I was looking at $30,000-$40,000 at that time. I couldn't afford it as a new doctor, the training wasn't very chiropractic specific (if you got any training at all), and, if you're lucky to get a secondhand one, there's no warranty. When we decided to build this company, I knew we needed a really strong warranty and very strong training. We needed it to be mostly chiropractic-specific because that's my realm of expertise. We also wanted it to be at a price range where you could finance it or buy it outright without it becoming a financial burden on the practice. We wanted you to get positive ROI really fast because we don't want you to turn into a shockwave practice. We want you to stay chiropractic and look at the body from a holistic mindset. Use this as a resource and as a benefit, but don't build your whole practice around one piece of technology.”
6:54 – Widening the scope. “My favorite thing about it is that we're keeping patients in the house rather than sending them out for an injection or an exploratory surgery. We're expanding our width to be able to help the people that are already coming to see and trust us. We’re also giving an opportunity for people that might not have sought out chiropractic care but see that you offer something for frozen shoulder or tennis/golfer's elbow. They get the opportunity to meet you because, nine times out of ten, the word chiropractor is scaring people away.”
9:07 – Making it a household name in the US. “Now, more so than ever, we are starting to understand more about it in the United States. Sometimes it gets confused because we get more information from other companies’ marketing instead of through the educational system. A lot of the universities are starting to teach it in their program, at least as a day seminar or part of the curriculum in PT and rehab. We have a free educational series that we give out to universities that want it. It is 40-year-old technology, and it's very much a household name in the European and Canadian systems. It is just 10 years behind in the States. Hopefully we can get it into every chiropractic school, so the students have some knowledge of what it is. It's just good for everybody to have a baseline knowledge of it.”
13:40 – Three channels of work. “Primarily, shockwave is used for chronic issues because it’s specified nano trauma. We're creating a stimulus to show your body that it needs to go and heal this area. It works in three different ways. The first one is mechanically sending energy to the tissue through sound waves to tell the body this is something you to clear up. That mechanical effort will help break down some scar tissue and fibrous adhesions while stimulating a bit of collagen production and fibrinogen – all stuff the body already sends to an acute injury but isn't sending to a chronic problem. Second, we have the biological transduction. The body will then send healing factors from the information that the stimulation provided, like more blood flow, nitric oxide production, different hormones to create more blood vessel pathways. Lastly, we have the neurological influx. We get some pain relief by inhibiting Substance P. We also get mechanoreceptor activity. If a joint hasn't been mobilized in a long time, we build back that brain tissue connection through sound waves, which is a great way to leave healthy tissue alone and take down stuff that's causing restriction and pain.”
15:35 – Coupling therapies. “It's revascularization. It's breaking down the calcium deposits that are restricting blood flow and stimulating the VEGF hormone to create more blood vessel pathways, which is going to work on any appendage. It's also great for chronic issues. Oftentimes, I like to say if you have your hands and a shockwave, you don't need any other tools in the practice. But in a lot of offices, it works great in tandem with laser. We'll do shockwave, then laser right after to keep promoting blood flow and anti-inflammatory effects. It works to decompress low backs that are really challenging. You can do shockwave, then decompression immediately after so the spot will move well because the soft tissue is out of the way. It doesn't have to be restricted to just itself. You can certainly partner it with all kinds of other therapies.”
16:57 – Is it painful? “The old school of thought was the more painful we can make it, the better results you're going to get. We are lucky these days that we have the research to negate that. It's all about the power I put into the shockwave handle that will reflect how deep I'm penetrating into the tissue. Chronic issues that have scar tissue that needs to be broken down will be a strong shockwave. If it's something that doesn't have a ton of scar tissue, then it's not going to be as strong of a shockwave. The old school of thought is not necessarily supported by research. We have to keep the subjectivity out of it because my pain threshold is going to be different than yours. The programs we have in there are a broad range of a certain degree of shockwave based on what the researchers told us have been successful in the past. It may be a little painful, but we never want to go over like a 3 or 4 out of 10.”
18:13 – How it works. “It's called mechanotransduction. We're creating a lot of kinetic energy with a bullet sliding back and forth. That energy is stopped at the tip and is then transmitted into the tissue. It is soundwaves, but it's rapidly changing the pressure of the tissue that it's treating, creating cavitations. The cavitations help eat away at scar tissue and that's what starts that biological cascade of healing that we're looking for.”
18:45 – Pre- and post-surgery. “We'll usually do half of a care plan pre-surgery and the other half post-surgery. Just like PT, we like to do prehab before they get the surgical intervention because they're stronger with the supporting muscles. I get to flush the tissue, provide a bunch of healing to that joint, and treat them. When they're already having some restriction of motion, they may have some fibers of scar tissue that we want to get rid of while they're in rehab. As much as I would love to say we keep everybody away from getting a joint replace, it's not real life. If they need a knee replacement, they're going to need a knee replacement. We just winna make sure we make their life as easy as possible before and after surgery.”
21:36 – What is the protocol? “We have protocols for almost 30 commonly seen things in the chiropractic office that you just plug and play. They do start with a range – once you press the button, it'll start at the low end, and you can always ramp up the power as you go. Because one research article is not going to give us all the information we can get on a particular issue, we nailed it down between this number of shockwaves, this power setting and this speed setting. For someone’s first time, it's always smart to start with a lighter shockwave. As long as you're within that wheelhouse or range that the machine has in there, you'll be just fine. You'll do some great things for them.”
22:26 – Biggest joy: helping people. “The biggest joy I get is the reason I went into chiropractic: to help people. I was a patient of chiropractic before I decided to become one - it was the only thing that helped me with my low back from my old injuries. I always knew I wanted to do something in healthcare, and I wanted to help people. For me, I'm a businessperson from a chiropractic standpoint. My wife and I have an incredible practice here in East Cobb with six providers. We’re the only integrated pediatric care center in all of Georgia. We have some awesome holistic nurse practitioners that take care of our kiddos. That's been really fun, but I have this terrible ADHD when it comes to business. I always knew I wanted to do something different, so when Dave approached me to build this together, I was all in. It's grown into something super important to me and David, where we see reports from doctors that are having such good success, both financially and for their patients. The last three years have been such a blessing. David and I are branching out to build a biohacking center in our town because we can't do too many things apparently. If you can build a great system and take a half step back from your practice, you can use your resources and skills as an entrepreneur. I don't think we get enough training in entrepreneurial techniques or skills when we're going through chiropractic school. You learn the school of hard knocks by making it in chiropractic first, then you can apply it to other things, still be successful and enjoy what you do. If any business I'm involved in in the future, if it's not helping people, I will fail. If it is helping people, then I might have a chance.”
25:27 - Hardest lesson learned. “I'm not the smartest person at this. If I don't know the answer, somebody else will and it's always worth spending the money on somebody who's an expert. You'll just waste a ton of time, money and energy trying to do yourself.”
30:18 – Educate yourself on shockwaves this year!
“One of our big goals for 2025 and moving forward is to elevate the education opportunities in the world of shockwave and how it applies to the chiropractic profession. The history in shockwave is pretty darn cool and it's a lot of fun to learn about, so definitely speaking engagements! We're just getting started in that realm. We're going to be in Kansas in September 2025, at Life University this year and we're definitely looking to do more on stage, in a small room setting for hands-on work, or a combination of the two. I love to educate, then play with the machines and teach people what it feels like. Even if they don't use it in their practice, they can understand what their patients have been through and better understand it.”
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