I have probably watched some or all of most of the Super Bowls dating back to at least 1974 or 1975. I know I can remember the Minnesota Vikings (and Fran Tarkenton) losing to Pittsburgh in Super Bowl IX in 1975. That memory sticks with me because the Vikings were one of my favorite teams when I was growing up. I fondly remember running back Chuck Foreman, the “Purple People Eaters” defense, and quarterback Fran Tarkenton – a scrambling quarterback that preceded the likes of Michael Vick and Randall Cunningham.

Over all those years, the NFL Championship game – a “World Championship” as they call it – is, more often than not, a Super Bore. In recent years, the true entertainment has come from the commercials and the half-time shows – if that.

But Super Bowl XLVI was actually pretty entertaining. It even had a moment which may go down as one of the strangest, surreal moments in sport.

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In Parts I and II of this series, we took a little journey into the world of low back pain. As you look at the signs along the road, you come to realize that the low back pain paradox is reflective of the greater woes of the health care system as a whole. As I mentioned in Part I - as goes low back pain, so goes health care.

Solutions, however, oftentimes look more like a quilt of short-term patches more so than real systemic and cultural change. A little of this, a little of that, but no guiding foundational principles.

With that in mind, let's begin with one of the most important principles: the patient must be at the center of the equation. Solutions lie in the phrase "patient-centered care", not in political agendas or turf wars. If we then use science-based clinical guidelines as a framework for the low back pain paradox, then we stand to create a culture of patient-centered solutions. So what does this framework look like?

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I tried. I promise, I tried. Really, I did. I tried to keep politics out of the discussion. The last episode of the Rhubarb Report was politics-free. It is kind of like saying gluten-free or fat-free, only probably far healthier.

But you just can’t get away from it these days. When the reality TV series that is the Republican presidential debates produces countless sound bites, it can overwhelm the airwaves and the senses. In this election cycle, it seems to be getting more divisive, more bombastic, more insane, and more ridiculous. With that thought, I bring to you an all-politics Episode 33 of the Rhubarb Report. Sit back, relax, and enjoy that gluten and fat.

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I can remember a time not so long ago when only the crazy, hard-core runners would do a marathon. In that same fleeting memory, I can remember a time when only the crazy, hard-core triathletes would do an Ironman. Neither of these was something a sedentary person would even consider, much less put on their bucket list.

Oh, how times have changed. Here we are now in 2013, living in a world in which you can't throw a stone without hitting a marathon or Ironman finisher. In the same breath, however, the incidence of obesity is rising. Somehow there seems to be a growing chasm between the two.

What is going on here?

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