Beyond the Love of Strength: Former USA Olympic Team Chiropractor, Dr. Steven Horwitz's athletic journey and remarkable recovery story

Dragon Door: How did you originally become interested in fitness, strength training, and bodybuilding?

Dr. Steven Horwitz: My original interest in fitness came from watching ABC’s Wide World of Sports back in the day. Ron Lyle was a boxer who did hundreds and hundreds of push ups and sit ups, unfortunately while in prison. I was just about to start junior high school when I saw the show, but wondered how many I could do. I was a lean active kid and found that I could knock out about 30 push ups. I decided that day that I wanted to get to 100, I may still have the sheet of paper where I kept track, and tried to add one a day. Through the course of several months I got to 100. Then I started doing sit ups and put up one of those old fashioned pull up bars that screws into the door jamb. That was my start!

Dragon Door: Did this early interest influence your decision to become a Doctor of Chiropractic?

Dr. Steven Horwitz: When I was in college I was still into fitness, but did the "guy weightlifting thing." Those were the days of no leg training, so I didn't learn to squat or deadlift—it was more upper body strength training, "pretty boy strength training" I'll call it. At Chiropractic school I discovered real weightlifting and made a lot of friends who were hardcore lifters. Tom Deters, who ended up running Muscle and Fitness magazine for a decade and a half, Victor Poletajev, a champion powerlifter who ripped his pec trying to bench 600lbs right before beginning Chiropractic school, and Neil Fried, a New Jersey state champion powerlifter who was my roommate. So, I learned how to really lift which was a great experience.

I also did some bodybuilding and won my height class in the 1986 AAU Collegiate Mr. America. The pictures are actually in Muscular Development magazine in 1986. It was a blast. I went from body building to powerlifting, met some great people, and got some great advice. When I graduated from Chiropractic school later in 1986, I realized that knowing how to train someone really helped when treating an injury, so I got my Certified Strength and Conditioning Specialist certification from the NCSA in 1988. This was cutting edge back at that time, but I thought it made sense to know about squatting, benching, and sprinting—the things that athletes do—if I was going treat injuries. People were either doctors or strength coaches, no one was both. Now it happens at higher levels as a standard of care for a select few, but it didn't exist back then.

 

Dragon Door: Did this approach lead to working with the USA Olympic Team in 1996?

Dr. Steven Horwitz: I had a very fortunate start. I moved to Maryland, started a practice, and really wanted to become the sports guy in my area. I ended up working with George Mason University. At the time, they had one of the best track and field programs in the country. The head athletic trainer was very open to chiropractic and welcomed me—he’s still one of my best friends. The coach was also behind what we were doing because George Mason had worked with chiropractors at different track meets but hadn’t found one who meshed with the program. At the time, the team physician, an orthopedic surgeon, wasn't a very open guy, but the coach really saw the benefits of chiropractic. I love telling this story… After I’d worked for part of a season, the coach said that we needed to meet with the orthopedic surgeon, Dr. Petrone. Coach Cook said, "During this 15-20 minute meeting, Dr. Petrone will tell you all the things you cannot do. Just bite your tongue and when he is finished just say ‘yes, Dr. Petrone.’" After the meeting, Coach Cook said, "Now we can do whatever the ‘blank-blank’ we want." Sure enough that’s exactly how it happened.

We ended up having a great relationship, and the orthopedic surgeon started referring patients to me, because I kept standard notes—he didn’t know that a chiropractor was capable of that! Yes, we are doctors and take notes like we're supposed to! And it worked out wonderfully. Even now, 30 years later, it’s very rare to have that kind of experience when everybody's on the same page—either with fitness clients, athletic groups or teams.

That's what led me to go to the Olympic Games. The trainer at George Mason, Frank Novakoski, sent in his application to the US Olympic Committee. They have a volunteer sports medicine program and he had been accepted. He was then invited to the Olympic Training Center in Colorado Springs. If they like what you do at the training center, then you'll be invited back. He came back from his experience at the Olympic Training Center in 1992 and asked me if I wanted an application. I filled out the application thinking I would never hear a word from them. But, two years later I got a call at my office from the United States Olympic Committee. They called to verify that they had my correct demographic information and sure enough, several weeks later I got the letter inviting me to the Olympic Training Center for 15 days in 1994.

God was looking over my shoulder, because the very first athlete I worked on was someone I’d worked on at the Mobil 1 Track and Field Invitational. So, on the first day, when all of the invitee volunteers hadn’t gotten to know each other yet, the first athlete walks in saying, "I remember you!" This was great because at the time athletic trainers were skeptical about Chiropractic. It felt like it was meant to be for me. Everything went really well that week, the sports medicine team had a great relationship, and my lifting and running experience was a huge help when treating the athletes.

Then I got the big letter inviting me to be on the staff for the 1996 US Olympic Team. When I called Frank to tell him I got "the letter" he had just received his too! So, we both went to the Olympic Games together and it was unbelievable!

Dragon Door: That must have been an amazing experience! Did you notice any patterns in what the athletes needed from you?

Dr. Steven Horwitz: I was fortunate to be one of the busiest guys there because the athletes all wanted hands-on care. It showed me that the best athletes, in any discipline, all have bodywork needs. We had about 40 people on the medical staff—a dozen MDs then me, and about 30 athletic trainers, a few of whom were also physical therapists. Some of the MDs came over to learn some of the hands-on techniques because they were just standing around doing nothing! The best thing I can share from the experience is to throw away the silly initials after your name, because it's all about the athlete. It doesn’t matter if you're a DC, an ATC, MD, DO, PT, ABCDEFG—it only matters that you can help the athlete. The Olympic Medical Team is made up of many really smart, motivated people collaborating in the interest of the athlete. It was the coolest month of my professional life.

This is also related to why I love the book Strong Medicine. It considers the complete picture along with all of the facets. It’s not just about one thing—kettlebells, lifting technique, workout programming, nutrition, supplementation—it’s about how everything is put together. That’s what really interests me.

Dragon Door: When did you first attend an RKC Workshop?

Dr. Steven Horwitz: When I was practicing in Maryland, my office was very close to the United States Secret Service James J. Rowley Training Center. I am very proud to say that my wife is a former United States Secret Service Agent, and so I treated many of the instructors from the center. One day in 2003, they brought over this "cannonball thing with a handle." I had only read about kettlebells but was excited about it, so they brought a 16kg one to my office. Around that same time, Pavel (who had come to the academy many times) was scheduled to come again and they invited me to spend the day. I was in my early 40s, so was pretty intimidating to train with Pavel, Steve Maxwell, and a bunch of young Secret Service Agents! It was just an awesome day and I fell in love with kettlebells.

I went to the RKC for the first time in 2007, and I did not succeed in passing. We had just adopted a little boy and I never should have gone out. I also had some physical challenges at the time. For my weight back then, I had to do 64 snatches with only one hand switch. And on the very first day, on that 61st snatch, the kettlebell flew out of my hand. I had no energy left and went home after that first day. Even though my ego was very badly damaged, I knew I needed to go home and plan for another day. But that day turned into years—just last year I finally got my RKC! It took me seven years, but I got it!

Dragon Door: Where did you do your RKC last year?

Dr. Steven Horwitz: Right here in Rockwall, Texas. We moved here from Maryland in 2013. I was very fortunate to meet Paul Britt, who is an awesome guy and RKC team leader. We were fast friends, so I took the RKC out here.

Dragon Door: Before our interview, you sent me a number of links about a very major surgery you had and how you recovered from it in record time. Can you tell us more about what happened?

Dr. Steven Horwitz: I have achalasia, which is a rare auto immune disease of the esophagus—the muscular tube that propels food towards the stomach. There are three muscular waves of motion that move the food down, and at the end of the esophagus there's a sphincter muscle that stays shut so that the gastric acids from the stomach don't come up, but it automatically opens to allow food down. The swallowing process is very neurologically and hormonally complicated, and achalasia basically causes a destruction of that process. The esophagus loses the ability to propel the food down, and the sphincter muscle stays shut, so food backs up. It’s very painful, uncomfortable, and in the end stages the food just sits there causing the esophagus to enlarge while the old food ferments. It’s a little gross like a blocked up drain. Since the esophagus is close to the heart, the enlarged esophagus can push on the heart and cause recurrent bouts of atrial fibrillation which I unfortunately experienced.

I ended up needing an esophagectomy, a surgery where they literally cut the esophagus out, pull it from between the ribs, and then pull the top of the stomach up to fashion a new tube. It's a very technically demanding surgery. When I talk to any surgeon and tell them that I've had an esophagectomy, they get very pale and their pupils dilate. Most people never really recover from it, and that’s why I’m so passionate about all of this. At the time of the surgery, my son was three and I was a pretty decent lifter. Before the surgery, I trained myself up like you wouldn't believe. I was able to do everything from the 100 rep in 5 minutes snatch test to rowing hard for 70 minutes on an ergometer before the surgery. I was in great shape but was told that I would never do it again after the surgery. That answer didn’t work for me.

So, I contacted people like Stewart McGill and asked about the valsalva maneuver and weightlifting during recovery. Usually, the only advice with regard to physical activity after surgery is not to lift more than 5lb for x number of weeks. Giving the same advice to an 80-year-old woman and a competitive weightlifter didn’t seem realistic to me. Dr. McGill was kind enough to speak with me, along with Mauro Di Pasquale, M.D., a physician in Canada who was also a world champion weightlifter, and many other very smart people.

I also arranged to have intravenous vitamin C in the hospital. My wife and I flew all around the country meeting surgeons. Esophagectomies are already rare, and most are performed for esophageal cancer, not for achalasia. Unfortunately, all the experts who we consulted agreed that I needed one. Things became even more complicated because each expert recommended a different surgical approach! Thankfully I had enough knowledge to research, then decide how I wanted to do it. I chose the University of Pittsburgh Medical Center, and surgeon Dr. Luketich who was the head of cardiothoracic surgery. I politely but firmly told him that I wanted to have intravenous vitamin C and that it was not negotiable. He said that it wouldn't bother his surgery, so he'd do it. I was shocked because I've been telling patients about IV vitamin C for 15 years and only one of my patients who needed orthopedic surgery found a surgeon who agreed to do it. I’d had a previous esophageal surgery and had had intravenous vitamin C. I didn’t need any pain medication after it and my recovery was just unbelievably fast. I also arranged to have acupuncture in the hospital.

 

While some hospitals also have integrative medical centers with MDs, acupuncturists, maybe chiropractors, massage therapists, and nutrition, you must ask if the integrative medical center is actually integrated into the hospital system. In 2010, the integrative medical center was integrated into itself, but not yet with the hospital system. When the acupuncturist came to my hospital bed, he had never before done acupuncture on a hospitalized patient!

So the nurses thought I was insane, since all they saw on a chart was a 50-year-old man getting an esophagectomy. I was supposed to be in the hospital for a minimum of 10 days and I told them that I would be out of there in 5 days. I’d lost a lot of blood because it’s a big surgery and they discovered that the surgeon who operated on me in 2006 left plastic clips in my esophagus! This slowed the removal of my esophagus during the esophagectomy and caused additional blood loss.

I was up and walking after being in the ICU for about 24 hours even though I had every tube on the planet sticking out of me. I told the nurses that human beings are supposed to walk and the only way I was getting out of there was walking—and I was out of there in 5 days!

Dragon Door: What are the benefits of intravenous vitamin C?

Dr. Steven Horwitz: It's amazing, safe, and it’s so restorative. One of the biggest issues in any surgery is the risk of pneumonia—if you want to take down pneumonia risk, then use IV vitamin C! The medical community thinks that's crazy. Even though my surgeon was the head of cardiothoracic surgery at the University of Pittsburgh Medical Center, he still had to go to battle with the pharmacy at his own hospital to get me IV vitamin C. Even though every other drug they were giving me could kill me, they were so concerned about vitamin C that I had to sign another release. But, I couldn’t afford to be bashful about it—it’s my life and I have a beautiful wife and young kid and I'm coming back. If I was the czar of surgery, whether you were having a wisdom tooth removed, an esophagectomy or anything in-between, you'd get intravenous vitamin C. It costs next to nothing, it can't hurt you, and it's like a miracle.

Now you can start to understand why I am so excited to be part of the Strong Medicine community. People can be so empowered by the training we offer and the nutritional advice—it's lifestyle, and it’s so powerful.

Dragon Door: What else did you do after your surgery to recover?

Dr. Steven Horwitz: I've also gone Paleo/Paleo-autoimmune. I did a ton of research before the surgery because I wanted to do everything in my power to recover. I also used PubMed.gov to get abstracts of medical studies and specific research on esophagectomies, and achalasia. Since PubMed.gov includes the email addresses of the study authors, I emailed about a dozen researchers and received nine responses—which was amazing. I wrote to them like a doctor would, including a concise review of my history. They responded because I was a rare case.

I’ve even written a book on achalasia called Living With Achalasia with this functional medicine approach. All of this is really important because it’s not about just one magic food, supplement, or exercise. It's not just one great night of sleep or one stress reduction technique; it's all of these things together. Thirty years ago, if I knew what I know now, I believe there would be zero chance that I would have needed the esophagectomy, I think I could have totally controlled this.

Strong Medicine should really be called Strong Health, Strong Lifestyle! I believe that Dr. Hardy used the term "medicine" not to reference its current definition (the science or practice of the diagnosis, treatment, and prevention of disease), but its original definition of service and healing. We shouldn't just think about disease care, we want to make changes before something becomes a disease. For example, diabetes is defined by a fasting blood glucose of about 126 and hemoglobin A1C above 6.5. And now there is "pre-diabetes" with numbers of 100-124 and 5.7-6.4. But what if someone’s blood glucose is running 97 all the time with A1C at 5.5? Instead of calling it pre-diabetes, we should be calling it a process gone awry and help the patient make changes. It’s like how new cars have tire pressure sensors which indicate when the pressure is a little low so you can top it off. In medicine we wait until there’s a "flat tire" and over the time it takes to become flat you've not only lost the tire, but you've probably ruined an axle. In functional medicine we notice that the tire pressure has dropped a point or two and simply top it off! What a different thought process!

In Chiropractic school we called it "dis-ease" and try to identify the process before it gets bad enough to be called a disease. It’s similar to what we do in the kettlebell world with Functional Movement Screens—we make sure to try and clean up the movement patterns before having someone do 100 reps with a blown shoulder, hip, etc. No one does an exercise perfectly the first time, but we let the person do it a little bit and we give them a little more correction. Over time we just keep perfecting that technique.

At the Purposefully Primitive Strength Seminar with Marty Gallagher and Kirk Karwoski, it was powerful to hear Kirk, a world champion, say "I gotta work on my squatting technique."

You can't stop learning—and there are so many resources. Over the past decade the communities—rehab, medical, lifting—have really meshed and now there are even MDs, DOs, and DCs who have gone to RKC and PCC workshops. Hopefully books like Strong Medicine will continue to bring all these communities together. Whether I learned it from the kettlebell community, the Kavadlo brothers or the powerlifting community, it's all really cool. All the things we learned and broke down this past weekend at the PCC are also awesome for rehab.

Dragon Door: What brought you to the PCC?

Dr. Steven Horwitz: Fun. And how cool is it that at almost 55, they taught me how to do a clutch flag? Now I can go to the park with my son and do a clutch flag! First of all, I’m a 55 year old with an 8 year old, and I want to be able to play with my kid!

 

Dragon Door: Earlier you'd mentioned rehab possibilities with the progressions taught at the PCC, which moves did you feel were especially effective or useful?

Dr. Steven Horwitz: For injury care and sports injury prevention, we have to go to the basics. Just yesterday I worked with two college kids—both D1 football players with a shot at the NFL. But these two tip-top players couldn’t squat! After I put one player through the FMS, he put a 45lb bar on his back but couldn’t squat while keeping his feet flat on the ground—even with his toes out like a duck. He said he squats this way with 600lbs, and I told him that his squat is hurting him and it’s no wonder he's had hip pain since high school. It’s very important to learn the basic movement patterns. Whether you're an FMS fan or not, you’ve got to have some kind of movement plan. But for crying out loud, you better be able to squat down!

In Western Civilization, we put shoes on kids, and don’t have to squat to go to the bathroom, so our movement patterns are terrible. Children in 1st grade don’t even know how to run because they're wearing thick shoes, haven’t learned how to use their feet, and their shoulder mobility stinks because they’ve been sitting too much. They can't even hang on a bar for 10 seconds!

The basics are so important. My son is eight and we don’t "train", but he can deadlift a kettlebell, jump off of a few steps and land in a good squat. At the first day of soccer practice, my son was the only kid on the team who could skip! And while I never played soccer, and am no expert with soccer skills, I can teach how to sprint, to stop, start, land, jump and move laterally. While some of the other kids can kick the soccer ball well, they won’t have the chance to, because my kids will beat them to the ball every time. We need to teach kids how to run, they have a hard time coordinating their opposite arms and legs—it’s neurological development. They need to crawl and roll on the ground. They need to learn that when the left knee comes up, the right arm comes forward. They need to learn that crisscross pattern and gain the brain development that comes with it. The function of the brain is really to guide movement.

Dragon Door: What goals are you working towards right now?

Dr. Steven Horwitz: I want to bring the complete picture to as many people as I can. I want to bring it to the achalasia community, as they need a lot of help, especially in nutrition. I am also really excited to work with our local children’s soccer league. I’m now on the board and have mentioned the importance of movement patterns. The new league president brought the idea to our town’s other sports leagues, and they’re all really jazzed about it.

As of August, I have had the privilege of volunteering at the Adaptive Training Foundation here in Dallas. It was started by Clint Bruce, a former Navy SEAL and run by David Vobora, former NFL linebacker. Their mission, "To restore hope through movement to those with physical impairments." Bringing my skillset to this group of amazing men and women is so rewarding!

There are so many great and knowledgeable people in our community. We need to bring kettlebells, calisthenics, nutrition, and lifestyle to more and more people. The Health and Strength Conference created a beautiful foundation where all these great ideas from smart minds came together. I want to keep learning and stay physically active. I don't practice Chiropractic full time anymore, but I don’t want to stop practicing, especially when I see two young guys like the D1 athletes who came in yesterday. It’s so frustrating because as good as they are, they could be so much better. Hopefully that's what I can bring to them. We need to bring good movement patterns into play and sports practices for boys and girls. I love working with the college and pro athletes, but the smile on a kid’s face is priceless.