Centeno-Schultz Clinic - Podcasts

In this CCI Deep Dive episode, Dr. Centeno explains how specific symptoms point to specific types of craniocervical instability. Learn why looking up, looking down, or persistent dizziness each signal different structural failures—and how precise symptom reporting guides targeted, effective treatment instead of one-size-fits-all care. 

Dr. Centeno dives deep into whether you can use decreased flow in the IJV with head turn to diagnose symptomatic CCI due to compression of the internal jugular vein. He reviews the data and concludes that this information isn't helpful in figuring out which CCI patients have intracranial hypertension caused by craniocervical instability.

In this CCI Deep Dive episode, Dr. Centeno unpacks the evolution of the groundbreaking ePICL procedure—an enhanced, next-generation treatment for craniocervical instability. Listeners will learn how years of technical refinement, dual-imaging systems, and advanced targeting have led to unprecedented precision in stabilizing the upper neck. Discover why this innovation is reshaping anatomy understanding and why it’s currently performed exclusively at the Centeno-Schultz Clinic. 

Dr. Centeno breaks down why some patients experience significant flare-ups after the PICL procedure while others recover smoothly. This CCI Deep Dive episode explores the top five biological factors—central sensitization, inflammation, medication use, functional level, and cannabis—that shape recovery outcomes. Learn how understanding these drivers can help patients prepare, manage expectations, and improve healing after regenerative treatment. 

Dr. Centeno discusses how the presence of a retroflexed dens on an MRI doesn't mean that it's causing symptoms. He reviews research on this topic and discusses how a retroflexed dens plus CCI or craniocervical instability can cause symptoms.

https://youtube.com/live/8j2qbOAaDdE

 This episode of the CCI Deep Dive Podcast examines one of the most aggressively marketed—and most misunderstood—areas in regenerative medicine: umbilical cord, amniotic, and placental “stem cell” products. Drawing from published scientific investigations, the discussion breaks down why many of these birth-derived products do not contain functional living stem cells despite bold clinical claims. The episode walks listeners through the hard data, the extremely low viability rates (35–75%), and the destructive multi-step supply chain that degrades these cells long before they reach a syringe. It also contrasts these products with high-viability autologous options such as bone marrow conc...

 This episode of the CCI Deep Dive Podcast breaks down one of the most misunderstood topics in regenerative medicine: why platelet-rich plasma (PRP) works brilliantly for some patients and fails for others. Dr. Centeno and the team dissect the three major determinants of PRP success—blood draw volume, kit efficiency, and the patient-specific concentration required to trigger healing. They expose how common low-dose systems, poor technique, and unreported platelet concentrations in clinical trials have led to widespread confusion about PRP’s true effectiveness. This deep dive clarifies the science, the math, and the clinical realities behind producing genuinely high-dose PRP...

 In this CCI Deep Dive episode, Dr. Centeno explains the critical questions patients should ask before getting any neck injections. The discussion breaks down the five skill and technology levels of cervical spine injection providers—from outdated blind techniques to advanced, image-guided, upper-cervical procedures. Learn how to evaluate safety, precision, and provider expertise to ensure your treatment matches the complexity of your condition and minimizes risk. 

 In this CCI Deep Dive episode, Dr. Centeno examines how craniocervical instability (CCI) in the upper neck can disrupt one of the body’s most vital communication pathways—the vagus nerve—and trigger widespread problems like gastroparesis, dysautonomia, and POTS. Learn how small structural shifts at C1–C2 can interfere with digestion, heart rate, and immune regulation, and why restoring neck stability may hold the key to improving vagus nerve function and overall health. 

Dr. Centeno has a conversation with the IPA physical therapy founders about PT for CCI or craniocervical instability.

https://youtube.com/live/JghO6NHuUJE

 In this CCI Deep Dive episode, Dr. Centeno explores the surprising connection between the neck and jaw—how craniocervical instability (CCI) can trigger or worsen temporomandibular joint (TMJ) problems. Learn how weak deep neck stabilizers force chewing muscles to overcompensate, leading to jaw pain, clicking, and degeneration. The discussion unpacks why treating TMJ alone often fails and how restoring neck stability can be key to lasting relief. 

Dr. Centeno reviews whether craniocervical instability or CCI can cause ear symptoms.

https://youtube.com/live/6h5ZwW7-s_o

 In this episode of CCI Deep Dive, Dr. Centeno unpacks the anatomy and meaning of a retroflexed dens—a common but often misunderstood MRI finding at the top of the neck. Learn why this structural variation is usually harmless, how it can become problematic when paired with craniocervical instability, and how advanced nonsurgical treatments like the PICL and ePIC procedures use your body’s own cells to restore stability. A clear, practical breakdown for anyone navigating complex CCI reports or treatment options. 

Dr. Centeno reviews why social media posts touting "upper cervical injections" can be dangerous and how to avoid that danger.

https://youtube.com/live/i-a1djjgBHA

There was a problem with the slides not advancing, so here's another version of this talk: https://youtu.be/pOMQmdkdUDk

Still struggling with “post-concussion” symptoms that never seem to go away? In this CCI Deep Dive episode from the Centeno-Schultz Clinic, Dr. Centeno breaks down five simple ways to tell if your lingering headaches, dizziness, and brain fog are really coming from your neck—not your brain. Learn how motion, traction, palpation, treatment response, and imaging can reveal upper-neck instability as the hidden cause behind concussion-like symptoms. Tune in for practical, doctor-backed insights you can use to get closer to real answers and recovery. 

Dr. Centeno dives into why Chiari malformation symptoms aren’t just about brain structure. This episode reveals how craniocervical instability (CCI) and tiny muscle or nerve issues often drive symptoms—and why surgery isn’t always the answer. Learn how regenerative treatments like the PICL procedure can restore stability and help patients heal without invasive intervention.

Dr. Centeno interviews Todd Ball on using postural-based rehab to recover from craniocervical instability (CCI).

https://youtube.com/live/31Vkj1S0kUI

Dr. Centeno reviews the CXA measurement and the fact that it's a dynamic concept and what numbers are concerning, and which CXAs are probably not important.

https://youtube.com/live/Hr4UoHDBfgk

Dr. Centeno discusses ways to tell if you have Eagle syndrome or craniocervical instability.

https://youtube.com/live/0dGpUUKy1iI

Dr. Centeno discusses how headache patients can tell if they have a migraine or craniocervical instability (CCI)?

https://youtube.com/live/VkBM-rqxWoQ

Dr. Centeno discusses rehab and recovery from CCI or craniocervical instability. He reviews how this should be done for every level of functional disability.

Join CCI Communities:

PICL SubReddit: https://www.reddit.com/r/PICL/?rdt=58942
PICL Facebook Group: https://www.facebook.com/groups/ccjpicl/

Full Video: https://youtube.com/live/jql1i1E5dhU

Dr. Centeno reviews the differences between a CSF leak and CCI or craniocervical instability and provides simple tests to determine which diagnostic category makes the most sense for you.

Full Video: https://youtube.com/live/xhf10PDGkmM

Dr. Centeno discusses what we know about the effect of fluoroquinolone or "quinolone" antibiotics on ligaments.

https://youtube.com/live/DfALpFIplYQ

Dr. Centeno reviews five things you can do at home to self-manage carniocervical instability or CCI symptoms.

Helpful Links:

CCI Exercises: https://centenoschultz.com/cci-exercises/
AO Chiropractors: https://atlasorthogonality.com/doctors-directory/
NUCCA: https://nucca.org/directory/

https://youtube.com/live/vdfCtVix_mw

Dr. Centeno discusses the crossover between concussion and upper neck symptoms.

https://youtube.com/live/4UdlQ_pGquI

Dr. Centeno discusses patient testimonials for the PICL procedure used to treat craniocervical instability (CCI) patients.

https://youtube.com/live/p2K-bVZzvok

Dr. Centeno discusses the equipment, experience, and knowledge needed to perform a safe ePICL and C0-C1 facet procedure.

https://youtube.com/live/JJ4V7TR-NFU

An Interview with an Upper Cervical Chiropractic Expert: Julie Hunt

Dr. Centeno interviews Julie Hunt, D.C., a second-generation upper cervical chiropractor, about the different types of upper cervical chiropractic and how they can interface with craniocervical instability (CCI).

https://youtube.com/live/-eMyAuKDCWI

Dr. Centeno discusses why a thorough hands-on exam is needed to define the areas requiring treatment in a CCI patient.

https://youtube.com/live/6CDHPUYC_JY

Dr. Centeno discusses styloidectomy, C1 shaving (decompression), and Chiari surgery and why each procedure removes critical parts that stabilize the head on the neck.

https://youtube.com/live/I_YhZJsi-bg

Dr. Centeno reviews his imaging criteria to determine if a patient has craniocervical instability or CCI.

https://youtube.com/live/JdUj52RbKBc

Dr. Centeno reviews an online quiz to help patients determine if they may have symptomatic craniocervical instability (CCI).

https://youtube.com/live/ikJ7YAXgB70

Dr. Centeno reviews what we know and don't know about whether hyperbaric oxygen therapy can help stem cell or platelet-rich plasma treatments. The topic of HBOT and ligament healing is also discussed.

https://youtube.com/live/ySTrPgz7zh0

Dr. Centeno discusses if removing the styloid process or styloidectomy has a positive or negative impact on craniocervical instability or CCI.

https://youtube.com/live/3CxqLaibG1U

Dr. Centeno discusses what typical CCI symptoms look like versus atypical symptoms.

Full Video: https://youtube.com/live/Xbb3k0C-gy4

What is the Cervical Pelvis? - with Dr. Centeno, CMO of Regenexx

Full Video: https://youtube.com/live/pYsggS2Vlj0 

Dr. Centeno discusses that the PICL procedure, like any medical procedure, requires a final "go-no go" decision in the office. A discussion of the medical factors that could cause a PICL procedure to get canceled are reviewed.

Full Video: https://youtube.com/live/QwkMI58XXG4

Dr. Centeno reviews the things that he wants you to review right before the PICL procedure when the patient is in the office.

https://youtube.com/live/dj8xumgINLg

Dr. Centeno discusses Botox and CCI or craniocervical instability. What effect can Botox have on CCI? Does it usually help or hurt?

https://youtube.com/live/pgcZdZH10JM

Dr. Centeno interviews a German PICL patient who has craniocervical instability.

https://youtube.com/live/v6TwgacVNy8

Dr. Centeno discuss the two medical specialty treatment tracks headache patients get on and how being on the wrong track can cause misdiagnosis. The most common problem is that headaches coming from the neck or what's called "cervicogenic headache" is not identified.

https://youtube.com/live/Q9lWjK1goP0

Dr. Centeno interviews Dr. Rosa on the use of upright MRI in diagnosing craniocervical instability and the causes of ME.

https://youtube.com/live/cThLWLPkEBk

Dr. Centeno explores the practical challenges of offering the PICL procedure.

https://youtube.com/live/pWVQRTBYjZM

Dr. Centeno reviews the concept of vestibular migraine and what usually causes the problems in patients who get this troubling diagnosis.

https://youtube.com/live/NpuKBZmAAn0

Dr. Centeno discusses whether tight SCM and scalene muscles can cause vagus nerve syndromes in CCI patients.

https://youtube.com/live/zjQ3B83Ti1s

The Top 5 Things You Can Do at Home to Help Diagnose CCI - Dr. Centeno discusses simple things you can do at home to help determine if your symptoms are being caused by CCI.

https://youtube.com/live/DbhiOlvpgbY

Dr. Centeno helps CCI patients understand why conceptualizing their problems like a surgeon isn't always a good idea.

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Dr. Centeno discusses DMX findings in the context of normal or abnormal and what is just wear and tear.

Full video available at: https://youtube.com/live/jK7aKyEKtRc

Dr. Centeno discusses why taking oral steroid pills may harm the efficacy of your PICL procedure.

Full video available at: https://youtube.com/live/CM0UPbBUPMg

Dr. Centeno reviews how #kyphoscoliosis can produce CCI-like symptoms even without CCI being present.

Full Video Available at: https://youtube.com/live/ppq-rJ8aaBY

Dr. Centeno discusses the occipital nerves, CCI, and a procedure that can treat these structures.

Full Video available at: https://youtube.com/live/IBYXS8MLGd0 

Dr. Centeno reviews why an image showing CCI may not mean you have symptomatic CCI. This distinction is explained and how he views these two categories.

Full Video Available at: https://youtube.com/live/v-RGTByhvwg

Dr. Centeno discusses tendon dry needling and CCI and how this may or may not help cervical stability.

Full Video Available at: https://youtube.com/live/d2ixAbr7Iaw

Dr. Centeno reviews what CCI patients should do if they also have a lower neck disc bulge and are being offered surgery on that problem.

Full Video Available at: https://youtube.com/live/a0IvnR_SlAE 

CCI, or cranial cervical instability, has a sub-type that involves extra vertical movement of the skull up or down. Dr. Centeno discusses this type of CCI.

Full Video Available at: https://youtube.com/live/VbJEXMeyBCs

Dr. Centeno reviews the most common causes of headaches in craniocervical instability (CCI) patients.

Full video available: https://youtube.com/live/sycooVRdfl8 

Dr. Centeno reviews a case of severe C1-C2 arthritis and CCI symptoms missed by the reading radiologist.

Full Video Available at: https://youtube.com/live/F6NsRK8UVH4 

Dr. Centeno reviews the causes of dizziness or imbalance in patients with cranial-cervical syndrome or cranial cervical instability.

Full Video Available at: https://youtube.com/live/664Mnc0v61c

Dr. Centeno reviews the causes of POTS, tachycardia, gastroparesis, and inflammatory conditions in patients with craniocervical instability or CCI.

Full Video Available at: https://youtube.com/live/4J05cmLDvxQ

Dr. Centeno reviews the sub occipital muscles at the back of the head and their role in creating CCI symptoms and upper cervical problems.

Full Video Available at: https://youtube.com/live/Sm3kQ3WgHDQ

Dr. Centeno reviews the symptoms that come from the upper neck versus those related to a lower or mid-neck problem.

Dr. Centeno reviews the common causes of brain fog in CCI patients.

Full video available at: https://youtube.com/live/5kAfUQPVMaA

Dr. Centeno reviews how the suboccipital muscles can impact CCI patients and why they're critical for diagnosing what's causing headaches or dizziness/imbalance.

Full Video Available at: https://youtube.com/live/Ffz8BKzPJyA

Dr. Centeno reviews what causes tinnitus in CCI patients and the different types of tinnitus that neck instability patients may experience.

Full Video Available at: https://youtube.com/live/6_64DFvGmzY 

Dr. Centeno reviews a recent case of a patient who had a needle placed in the side of his neck by a nurse practitioner to treat CCI and the inherent risks of that type of procedure, and how best to keep yourself safe.

Full Video Available at: https://youtube.com/live/f_93oURIn9g 

Dr. Centeno discusses a patient who has CCI involving the alar, transverse, and posterior ligaments at C2-C3. What were his symptoms? How was this determined? Which types of CCI does he have? What treatment was recommended?

Full Video Available at: https://youtube.com/live/dnBCZEJYY58

Dr. Centeno discusses what's done in a posterior decompression surgery for Chiari malformation and how that impacts your options later for regenerative medicine or occipital blocks.

Full Video Available at: https://youtube.com/live/torS5DzDIK4 

Dr. Centeno discusses the role of the transverse ligament in craniocervical instability or CCI. He also discusses ADI and what's normal versus abnormal. Finally, the symptoms of this problem are discussed.

Full Video Available at: https://youtube.com/live/A0xhYtytD3E 

Dr. Centeno discusses cases documented on DMX where the atlas or C1 seems to flutter or jump with neck movement. He also reviews a case and discusses which ligaments are responsible for this flutter.

Full Video Available at: https://youtube.com/live/rg25xLF_JEA

Dr. Centeno discusses the use of DTI with FA measurements as a way to detect small amounts of spinal cord injury when routine MRI can't see problems.

Full Video Available at: https://youtube.com/live/-qmMbNJ58mI 

Dr. Centeno discusses new research that may show why some patients report getting CCI and alar ligament damage from a forceful head rotation manipulation.

Full Video Available at: https://youtube.com/live/whrktYfWTOo

Dr. Centeno educates patients on how to identify low-quality spine care involving PRP or "stem cells."

Full Video Available at: https://youtube.com/live/Bb3AsXL5WJA

Dr. Centeno discusses PRP use in the spine and the research that supports it. He also discusses using a DDD approach and a free-of-charge RCT study that Regenexx is running.

Full Video Available at: https://youtube.com/live/tN0yj1urxV8 

Dr. Centeno discusses the TOL and Barkow's ligament, which help to keep the dens affixed against the atlas.

Full Video Available at: https://youtube.com/live/90ztawYRC7k

Dr. Centeno reviews the lateral AO ligament and how it's associated with craniocervical instability or CCI.

Full Video Available at: https://youtube.com/live/7WleENqTc40

Dr. Centeno discusses TNCC or Total Nucleated Cell Counts and how they relate to bone marrow concentrate procedures.

Full Video Available at: https://youtube.com/live/YrVS4cDXVh4

Dr. Centeno discusses using ultrasound to diagnose intracranial hypertension. Is this helpful in CCI patients, and does it change the treatment plan?

Full Video Available at: https://youtube.com/live/AGopZAkeq6I

Dr. Centeno discusses the lateral AO oblique ligament and how it stabilizes the head on the neck, especially in head/neck extension (looking up). Its implications for CCI are also discussed.

Full Video Available at: https://youtube.com/live/nraCHqBaAb0

This is a video tutorial on the specific structures that can be injected during a PICL procedure to treat craniocervical instability or CCI.

Full Video available at: https://youtube.com/live/uCp5mWNKEII

Dr. Centeno discusses how levator scapula tightness could be a sign of craniocervical instability.

Full Video Available at: https://youtube.com/live/uJq0sllxfy4

Dr. Centeno discusses whether there is evidence that giving someone stem cells through an IV can treat craniocervical instability (CCI).

Full Video Available at: https://youtube.com/live/fe3dCOZGMKM

Dr. Centeno reviews whether a patient with bone spurs in the CCJ has CCI and whether this finding can be used to diagnose CCI.

Full Video Available at: https://youtube.com/live/SNiwV4suOfo

Dr. Centeno discusses whether your existing brain MRI may have findings that show intracranial hypertension and what to look for to determine if those findings have been missed.

Full Video Available at: https://youtube.com/live/zjq03dTLB5A

Patients often get DMX reports that have a bunch of findings, and only some of these are likely causing neck pain or other symptoms. How can you tell the difference?

Full Video Available at: https://youtube.com/live/mxrxZS3BxX0

Type 3 CCI means your C2-C3 is unstable, which can cause headaches, dizziness, and brain fog. Dr. Centeno discusses this type of craniocervical instability.

Full Video Available at: https://youtube.com/live/UQXXkvsYGXw

Dr. Centeno discusses how C1-C2 overhang or instability could cause sacral or tailbone pain.

Full Video Available at: https://youtube.com/live/euYj_35Mq9o

Dr. Centeno discusses type 1b craniocervical instability or CCI. He discusses how damaged anterior ligaments between the skull and C1 can cause this type of CCI.

Full Video Available at: https://youtube.com/live/0SaE05G27q4

Dr. Centeno continues his series on CCI types with a review of type 1d. This is where the skull rotates too much against the atlas or C1.

Full Video Available at: https://youtube.com/live/gIQUlBNBR5U 

Dr. Centeno discusses educating medical providers on CCI and the PICL procedure.

Full Video Available at: https://youtube.com/live/52PY13ibzJQ

Dr. Centeno discusses CCI type 1d, where the skull rotates excessively around the atlas or C1.

Full Video Available at: https://youtube.com/live/LG70xtVUV2c

Dr. Centeno discusses how various clinics claim to offer regenerative spine injection procedures, but what's offered is actually vastly different.

Full Video Available at: https://youtube.com/live/-eEFIX5otc4 

Dr. Centeno discusses the difference between an upper cervical injury and craniocervical instability.

Full Video Available at: https://youtube.com/live/2SuFHaassXc

Dr. Centeno discusses how you can see C2 rotation problems on DMX and what types of problems that can cause.

Full Video Available at: https://youtube.com/live/M33sV6wuK0U

Dr. Centeno discusses the idea of copying the PICL procedure used to treat CCI and the issues with that concept.

https://youtube.com/live/Scwn68n0UI4 

Dr. Centeno discusses how the transverse and other ligaments play a key role in type 2a craniocervical instability and how that impacts regenerative injection treatment.

Full Video Available at: https://youtube.com/live/kbEBef5NsFo

Dr. Centeno reviews the connection between careful diagnosis of SYMPTOMATIC CCI and treatment outcome. Meaning that there are patients with CCI on imaging, and that problem is not causing their symptoms.

Full Video Available at: https://youtube.com/live/b3Ifop6Zjk4

Dr. Centeno dispels the myths out there about stem cells and PRP.

Full Video Available at: https://youtube.com/live/36GpyWHiUVQ 

Dr. Centeno discusses the value of Digital Subtraction Angiography, or DSA, in safe upper neck injections.

Full Video Available at: https://youtube.com/live/0xIDZFy3RxM 

Dr. Centeno reviews recent posts from social media sites about "Stem Cells" and PRP and gives his opinion on these posts.

Full Video Available at: https://youtube.com/live/C7o8RbjRX2A

Dr. Centeno reviews CCI Type 1c, which is a type of craniocervical instability where the skull falls backward on C1, which can be due to shallow occipital condyles and ligament laxity.

Full Video Available at: https://youtube.com/live/1ZCZ81e6C_Y