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Are You Dealing With Joint Pain and Considering Surgery? · Conversations: Special Guests with Preston Scott

• 0:03
  Speaker 1: All right, he listened to the show on the way in.
• 0:05
  Speaker 1: He knows what he's getting into walking into this studio,
• 0:07
  Speaker 1: but I'm staying a safe distance away. You know, we
• 0:10
  Speaker 1: believe in the six-foot rule around here. No, I'm just kidding.
• 0:14
  Speaker 1: I don't believe anything that man said. It's five past
• 0:17
  Speaker 1: the hour. It's third hour here of The Morning Show
• 0:18
  Speaker 1: with Preston Scott. Jared Runn on the program. And joining
• 0:21
  Speaker 1: me in studio once again is co-founder of JointStrong, the
• 0:23
  Speaker 1: website JointStrong.com. He is Chad Gray. And Chad and I
• 0:28
  Speaker 1: were just talking about the many things in my body
• 0:30
  Speaker 1: that have been helped by just learning some simple things.
• 0:34
  Speaker 1: But I've been teasing it all week long. Movement is
• 0:37
  Speaker 1: the best medicine. Share your premise.
• 0:41
  Speaker 2: So the human system is, if I kind of strip
• 0:47
  Speaker 2: away all the vital organs, of course, and strip away
• 0:50
  Speaker 2: the skin and the connective tissue or the muscle tissues,
• 0:55
  Speaker 2: and I look at kind of the base and foundation
• 0:57
  Speaker 2: of this body, it's a system of levers and pulleys.
• 1:01
  Speaker 2: Each joint is connected together by ligaments. Those ligaments are
• 1:06
  Speaker 2: the passive support system for the joint. That's what allows
• 1:10
  Speaker 2: movement to happen in the system. And the ligament is
• 1:12
  Speaker 2: very sensitive to not moving or being held in static
• 1:17
  Speaker 2: positions for long periods of time. Those tissues begin to
• 1:19
  Speaker 2: adapt and adjust and stiffen or harden. And fibrosis is
• 1:23
  Speaker 2: the medical term. And And that fibrosis or that hardening
• 1:28
  Speaker 2: or stiffening of those passive support systems leads to changes
• 1:31
  Speaker 2: in mobility in that joint structure, which changes the mechanics
• 1:34
  Speaker 2: of that system. And now it moves and now it operates.
• 1:36
  Speaker 2: It also creates the pain that most people experience as
• 1:39
  Speaker 2: we age. That fibrosis or stiffening or hardening of those
• 1:42
  Speaker 2: passive support structures, the ligaments, really begin to alter or
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  Speaker 2: change our normal ability to function. We've become very sedentary
• 1:58
  Speaker 2: in our culture, in our society, and that's been really
• 2:01
  Speaker 2: dominant in the last 50 years. I think 1976 was
• 2:04
  Speaker 2: kind of the tipping point, they call it, where there
• 2:07
  Speaker 2: was this transition away from primarily industrial and blue-collar workforces
• 2:12
  Speaker 2: into more sedentary kind of technology-based workforces where you sit
• 2:15
  Speaker 2: in the desk all day.
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  Speaker 3: Long and you don't move much.
• 2:17
  Speaker 2: We live in kind of a quarter to mid-range lifestyle,
• 2:22
  Speaker 2: and that loss of movement, that kind of lack of
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  Speaker 2: moving to what we call end range has a consequence.
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  Speaker 2: And we're all starting to experience it. We see it
• 2:31
  Speaker 2: showing up now in healthcare at an alarmingly high rate.
• 2:34
  Speaker 1: To the point that you're seeing patients with things that
• 2:41
  Speaker 1: maybe used to be reserved for the early stages of
• 2:45
  Speaker 1: senior living, this is now hitting young people. Young people
• 2:49
  Speaker 1: are coming in and you're seeing them because they're sedentary
• 2:53
  Speaker 1: as well.
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  Speaker 3: Well, it starts even at the age of seven or
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  Speaker 3: eight or nine now.
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  Speaker 2: You put a cell phone in a kid's hand and
• 3:00
  Speaker 2: all of a sudden they find themselves sitting for many
• 3:03
  Speaker 2: more hours a day than they used to. They don't
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  Speaker 2: ride their bike anymore. They don't climb a tree. They
• 3:06
  Speaker 2: don't run, hop, skip, and jump. They don't move the
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  Speaker 2: same way the kids used to move 20, 30, 40,
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  Speaker 2: 50 years ago before technology began to dominate the culture.
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  Speaker 2: And so it's really created an epidemiological transition is what
• 3:21
  Speaker 2: they call it now, whereby... The gradual shift from a
• 3:26
  Speaker 2: very active movement-based lifestyle, even for our teenagers and our
• 3:31
  Speaker 2: young adults, has led to now a gradual stiffening or
• 3:35
  Speaker 2: change in the mechanics of the primary joint systems, the spine,
• 3:38
  Speaker 2: the hip, the knee, the ankle. And now we're in
• 3:41
  Speaker 2: the clinical setting seeing an alarmingly high rate of 20
• 3:45
  Speaker 2: and 30-somethings coming in with conditions like you just mentioned
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  Speaker 2: that used to be reserved for folks in.
• 3:50
  Speaker 3: Their late 40s, early 50s, early 60s, 70s.
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  Speaker 2: So the sedentarism that has happened in our culture has
• 3:58
  Speaker 2: led to a dramatic shift in these patterns clinically and
• 4:02
  Speaker 2: in the health care system. And it's all, once again,
• 4:05
  Speaker 2: driven by lifestyle and behavior.
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  Speaker 1: When you say movement is the best medicine, we've got
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  Speaker 1: about 60 seconds in this segment. Kind of give us
• 4:15
  Speaker 1: what that means.
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  Speaker 2: So when we move, not only do the joint structures
• 4:19
  Speaker 2: stay limber and flexible and loose and allow us to
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  Speaker 2: kind of operate without pain and in a very highly
• 4:25
  Speaker 2: functional way. But we also create lean muscle mass. That
• 4:29
  Speaker 2: is another key problem that is developing now. Sedentarism leads
• 4:33
  Speaker 2: to a loss of lean muscle mass. And lean muscle
• 4:36
  Speaker 2: mass is what allows us to manage and control glucose
• 4:41
  Speaker 2: in the body. 80% of our glucose is consumed or
• 4:44
  Speaker 2: burnt by lean muscle. When someone sits all day long,
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  Speaker 2: not only do the joints begin to stiffen, but they
• 4:50
  Speaker 2: also begin to lose their muscle mass. They aren't engaging
• 4:53
  Speaker 2: the system at the same level of intensity as someone
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  Speaker 2: who's outdoors and very physical. And so as that lean
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  Speaker 2: muscle mass begins to leave us, then it's replaced with
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  Speaker 2: adipose tissue or fat, which leads to an inflammatory system,
• 5:10
  Speaker 2: basically creating some challenges for the other health-related disorders that
• 5:15
  Speaker 2: we can talk about, which are primarily metabolic in their origin.
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  Speaker 2: So inability to control glucose. once again becomes a byproduct
• 5:23
  Speaker 2: of not moving enough and not building enough of the
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  Speaker 2: lean muscle to support the system.
• 5:27
  Speaker 1: Boy, you talk about a word that's the enemy of
• 5:29
  Speaker 1: the body, inflammation.
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  Speaker 3: Yes.
• 5:31
  Speaker 1: 12 past the hour with Chad Gray, co-founder of Joint Strong,
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  Speaker 1: and my guest, my friend, has helped me a lot
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  Speaker 1: of different times, a lot of different parts of the body,
• 5:50
  Speaker 1: I just told him, I credited him with a return
• 5:52
  Speaker 1: to good golf this week. And just from simple things
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  Speaker 1: that you've taught me over the years. But you said
• 6:00
  Speaker 1: something in the last segment that I want you to
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  Speaker 1: expand on a little bit. And that is the role
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  Speaker 1: of motion to fight kind of the underlying challenges that
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  Speaker 1: a lot of people are facing in a lot of
• 6:12
  Speaker 1: different parts of their body.
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  Speaker 2: Yeah, so the things that are killing us nowadays, in
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  Speaker 2: the last 50 years specifically, are very different than the
• 6:22
  Speaker 2: things that called us 125 years ago. And we used
• 6:25
  Speaker 2: to die from infectious diseases, communicable diseases, the diseases of
• 6:29
  Speaker 2: bacteria and germs. But nowadays, we've got those things under
• 6:34
  Speaker 2: control with the use of some very specific pharmaceutical interventions.
• 6:40
  Speaker 2: The things that are killing us now are diseases of behavior.
• 6:43
  Speaker 2: They're chronic diseases, your metabolic syndrome, your diabetes, your heart disease,
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  Speaker 2: your cancers, your Alzheimer's, things like that. Those are the
• 6:50
  Speaker 2: four horseman conditions. And all of those conditions are directly
• 6:54
  Speaker 2: linked to the inability, once again, to control sugar, which
• 6:58
  Speaker 2: then again is directly linked to our loss of lean
• 7:02
  Speaker 2: muscle mass, our loss of movement in our culture. over
• 7:07
  Speaker 2: these last 50 years. As we transitioned into a sitting workforce,
• 7:11
  Speaker 2: the system began to change and adapt. You know, in 1976,
• 7:14
  Speaker 2: we talked about this earlier, when we transitioned primarily to
• 7:18
  Speaker 2: a sedentary lifestyle or sedentary work behavior, we, within five
• 7:23
  Speaker 2: years of that date and time, saw a dramatic shift
• 7:25
  Speaker 2: in the incidence and prevalence of osteoarthritis in the spine,
• 7:28
  Speaker 2: the hip, and the knee, the primary.
• 7:31
  Speaker 3: Joint systems that show up in medicine.
• 7:33
  Speaker 4: Mm-hmm.
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  Speaker 2: Within another five years after that, as the joint systems
• 7:38
  Speaker 2: began to fail us because we weren't moving enough, we
• 7:40
  Speaker 2: also saw a doubling of the incidence of diabetes in
• 7:43
  Speaker 2: this country. And we know now that those two condition
• 7:46
  Speaker 2: categories are linked. Our musculoskeletal system, as it begins to fail,
• 7:50
  Speaker 2: begins to ache, begins to hurt us.
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  Speaker 3: As we hurt, we move less.
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  Speaker 2: As we move less, we lose more muscle mass, and
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  Speaker 2: all of a sudden it becomes difficult for us to
• 8:00
  Speaker 2: control glucose. We create an insulin sensitivity issue then that
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  Speaker 2: begins to drive us into metabolic syndromes that lead to
• 8:09
  Speaker 2: type 2 diabetes. Type 2 diabetes is the leading cause of,
• 8:14
  Speaker 2: once again, the things that primarily kill us, heart attacks, strokes, cancers,
• 8:18
  Speaker 2: Alzheimer's and dementia, your neurodegenerative disorders. All of those condition
• 8:22
  Speaker 2: categories are directly linked to how much we move. People
• 8:25
  Speaker 2: that move more, people that, are more active and physical
• 8:29
  Speaker 2: and build more lean muscle mass and use the available
• 8:32
  Speaker 2: joint range of motion, have less disease in those categories.
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  Speaker 2: It's not a coincidence. They are intimately linked and bound together.
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  Speaker 2: The more we move, the healthier we are. The problem
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  Speaker 2: is we have an entire culture now built on convenience
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  Speaker 2: and luxury and, as I like to say, energy conservation.
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  Speaker 2: The polite way of saying we're getting a little lazy.
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  Speaker 1: Is it too easy? Is the dealing with this... Just
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  Speaker 1: too simple, straightforward, and easy for people who are looking
• 9:00
  Speaker 1: for complex reasons why, and it's really pretty simple?
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  Speaker 3: It's part of it.
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  Speaker 2: We trust in things that are complex and complicated and
• 9:08
  Speaker 2: that require experts to give us answers for or to,
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  Speaker 2: when in reality, it's quite simple. This body was designed
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  Speaker 2: and built perfectly to function at the highest levels possible.
• 9:20
  Speaker 2: When you engage it, when you use it, when you
• 9:23
  Speaker 2: take physical activity to certain heights and certain levels of intensity,
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  Speaker 2: the body thrives. It really desires full range of motion,
• 9:32
  Speaker 2: and it desires us being physical and being vigorous in
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  Speaker 2: our lifestyle. It maximizes the efficiency of every system that
• 9:40
  Speaker 2: is failing us right now in our society.
• 9:43
  Speaker 1: In about 15 or 20 minutes, we're going to open
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  Speaker 1: up the phone lines. And so if you want to
• 9:50
  Speaker 1: think about a question or you'd like to get Chad
• 9:53
  Speaker 1: to weigh in on something you're battling, um this is
• 9:56
  Speaker 1: a chance to call in and talk to somebody this
• 9:58
  Speaker 1: is what he does look aging isn't for sissies we
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  Speaker 1: know that but i can tell you that i've learned
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  Speaker 1: so much in the last several years that when i
• 10:09
  Speaker 1: start feeling some pain in a in a joint i
• 10:13
  Speaker 1: push i don't go the other way because i've watched
• 10:16
  Speaker 1: the results of that of shutting down and saying oh
• 10:19
  Speaker 1: it hurts uh-uh, I'm going to figure out why it
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  Speaker 1: hurts and I'm going to push. Maybe that's where you
• 10:24
  Speaker 1: are right now. Something's hurting. All right, 22 past the hour.
• 10:29
  Speaker 1: Chad Gray, JointStrong.com. That's a website that you can go to.
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  Speaker 1: I want to circle back, Chad, to something we kind
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  Speaker 1: of touched on and the number of young people that
• 10:39
  Speaker 1: you're seeing right now. I made a comment to you
• 10:41
  Speaker 1: just a second ago about professional golfers and young guys
• 10:45
  Speaker 1: having back surgeries and some even losing their careers over it.
• 10:48
  Speaker 1: And you made a statement that I thought was interesting.
• 10:50
  Speaker 1: You said it's not the golf swing.
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  Speaker 3: It's not the golf swing.
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  Speaker 2: It's the pattern of lifestyle and behavior outside of the
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  Speaker 2: sport because we see it across every sport that's out there. Baseball, basketball, football, golf, volleyball.
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  Speaker 3: You name the sport. Cornhole. Doesn't matter.
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  Speaker 5: Right.
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  Speaker 2: These kids are showing up at an alarmingly high rate
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  Speaker 2: with conditions that used to be reserved for older people.
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  Speaker 2: And it is a direct byproduct of their lifestyle, their
• 11:16
  Speaker 2: sitting positions, the poor postures that they have as a
• 11:22
  Speaker 2: standard part of their day that have become basically a
• 11:25
  Speaker 2: behavior or practice they can't escape from. Prolonged sitting produces
• 11:29
  Speaker 2: detrimental impacts on the lower spine, the lower neck, the hip,
• 11:33
  Speaker 2: the knee, and the ankle, especially the hip, knee, and ankle.
• 11:35
  Speaker 2: Those are load-bearing joint systems. And the way we're designed
• 11:38
  Speaker 2: is very specific and on purpose. The joint systems and
• 11:41
  Speaker 2: the cartilage that lines those joint surfaces has no blood
• 11:44
  Speaker 2: supply nor nerve ending in it. It is a system
• 11:47
  Speaker 2: that is designed to be compressed and loaded and move
• 11:49
  Speaker 2: through full range. Squatting is a perfect example of it.
• 11:53
  Speaker 2: My knee is designed as a simple hinge because it
• 11:56
  Speaker 2: is built to squat under load. When you squat under load,
• 12:00
  Speaker 2: the cartilage is compressed, and it forces the expression of
• 12:03
  Speaker 2: certain biochemical elements in the cartilage that makes the cartilage healthy.
• 12:08
  Speaker 3: It keeps it smooth and silky and frictionless.
• 12:11
  Speaker 2: When you sit all day long and you don't engage
• 12:14
  Speaker 2: the cartilages of the load-bearing joints, the hip, knee, and ankle,
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  Speaker 2: that cartilage begins to soften.
• 12:19
  Speaker 3: It begins to pit.
• 12:20
  Speaker 2: It begins to become irregular, and the high-friction environment develops,
• 12:23
  Speaker 2: and osteoarthritis becomes a dominant feature. And we're seeing this
• 12:27
  Speaker 2: once again start to happen in younger and younger populations.
• 12:30
  Speaker 2: Stiffness in the large joint systems, slightly bulging disc in
• 12:34
  Speaker 2: the lower lumbar spine, the lower neck. And it's all
• 12:37
  Speaker 2: a direct byproduct of how much sitting time we have
• 12:40
  Speaker 2: in our daily life now. And look at what kids
• 12:42
  Speaker 2: are doing all day long. They are sitting on screens
• 12:44
  Speaker 2: in front of phones for hours and hours on end.
• 12:47
  Speaker 2: And then they all of a sudden go out and
• 12:48
  Speaker 2: try to become active or try to work out. And
• 12:51
  Speaker 2: the system isn't prepared for that level of load or intensity.
• 12:55
  Speaker 2: and the system fails. And we blame it on the sport,
• 12:58
  Speaker 2: but it's not the sport. It's the inactivity and the
• 13:01
  Speaker 2: sedentary lifestyle that surrounds the sport and their occasional burst
• 13:06
  Speaker 2: of physical activity, but the dominant sedentary lifestyle and inactivity
• 13:11
  Speaker 2: that surrounds that.
• 13:13
  Speaker 1: It's... What I hear you describing is a guy who
• 13:16
  Speaker 1: suddenly walks into the weight room and thinks he's going
• 13:18
  Speaker 1: to bench press 250 pounds.
• 13:20
  Speaker 2: We used to laugh at these people and call them
• 13:21
  Speaker 2: the weekend wars. You know, they go out and play softball, soccer, football,
• 13:24
  Speaker 2: something on the weekend.
• 13:25
  Speaker 3: When they're in their 40s and they get hurt.
• 13:27
  Speaker 2: What's happening now to our teenagers and to our young
• 13:30
  Speaker 2: adults in their 20s because they go from extremely inactive
• 13:34
  Speaker 2: and sedentary to all of a sudden highly physical and active.
• 13:38
  Speaker 2: And the joint systems just aren't capable of tolerating that
• 13:40
  Speaker 2: level of load because they're not exposing the systems to
• 13:43
  Speaker 2: regular doses of that level of activity, load and intensity
• 13:47
  Speaker 2: often enough to prepare the system.
• 13:50
  Speaker 5: All right.
• 13:51
  Speaker 1: We have one line open, but that means we've got
• 13:54
  Speaker 1: three callers standing by that want to ask a question
• 13:56
  Speaker 1: or two. And with me is Chad Gray. He is
• 13:59
  Speaker 1: the co-founder of joint strong and the website joint strong.com.
• 14:03
  Speaker 1: I cannot recommend the website to you enough. Um, And
• 14:07
  Speaker 1: the idea we're kind of talking through is the importance
• 14:09
  Speaker 1: of movement. But we want to give Chad an opportunity
• 14:13
  Speaker 1: to hear from you. And so, Pat, thanks for calling in.
• 14:16
  Speaker 1: You're on the air with Chad Gray.
• 14:19
  Speaker 5: Yeah, hi, Preston. I'm currently having some shoulder problems. And
• 14:24
  Speaker 5: with my history with my knees, the last thing I
• 14:27
  Speaker 5: want is to have because they're already talking a shoulder
• 14:32
  Speaker 5: replacement and I'm having an MRI just later today. What
• 14:35
  Speaker 5: else can I do? I've got some exercises and some
• 14:38
  Speaker 5: strength bands and that kind of stuff. What else is
• 14:42
  Speaker 5: there to do that I could do to avoid any
• 14:45
  Speaker 5: kind of surgery?
• 14:46
  Speaker 1: Don't leave me. Go ahead, Chad.
• 14:48
  Speaker 2: So typically, when you've reached the point where they're wanting
• 14:52
  Speaker 2: to do an MRI and they're talking shoulder replacement surgery,
• 14:56
  Speaker 2: bands and exercise, general exercises, aren't going to be the solution.
• 15:00
  Speaker 2: You've got to study and analyze the movement of the
• 15:03
  Speaker 2: joint system. What does the quality of movement look like?
• 15:06
  Speaker 2: How much mobility is there in the joint in all
• 15:08
  Speaker 2: the directions.
• 15:09
  Speaker 3: That it's supposed to move in?
• 15:10
  Speaker 2: The shoulders, the ball, and socket joint, it's got about
• 15:12
  Speaker 2: six primary planes of motion available to it. And so
• 15:16
  Speaker 2: you want to study and analyze that movement pattern in
• 15:19
  Speaker 2: the joint, and you want to figure out How much
• 15:22
  Speaker 2: loss of motion is there? What are the most significant
• 15:25
  Speaker 2: losses of range of motion? And attack the loss of movement.
• 15:28
  Speaker 2: The pain in the joint system typically is a byproduct
• 15:31
  Speaker 2: of lost mobility in the joint, not necessarily weakness. That's
• 15:36
  Speaker 2: the mistake that a lot of people in the healthcare
• 15:38
  Speaker 2: system make, and a lot of patients assume incorrectly, is
• 15:41
  Speaker 2: that they just need more strength. They need to build
• 15:45
  Speaker 2: muscle around the joint that's aching. No, the joints need,
• 15:48
  Speaker 2: in their primary purpose, and function is to be able
• 15:52
  Speaker 2: to move to the end points that's available to them.
• 15:56
  Speaker 1: What would you say to him, and Pat, stick around,
• 15:59
  Speaker 1: what would you say to him about just the surgery route?
• 16:03
  Speaker 2: It's reserved for when everything else has failed. So if
• 16:06
  Speaker 2: we can't figure out how to get motion back in
• 16:09
  Speaker 2: the segment, if it has reached the point where it's
• 16:11
  Speaker 2: effectively frozen and it's locked in, calcified, stiff to the
• 16:16
  Speaker 2: point or arthritic to the point where there's no helping
• 16:18
  Speaker 2: the range of motion, that's when you get a joint replacement.
• 16:22
  Speaker 2: Shoulder joint replacements are a very different animal than hips
• 16:24
  Speaker 2: and knees are. They're not quite as effective and the
• 16:28
  Speaker 2: long-term outcome isn't nearly as good as it is on
• 16:31
  Speaker 2: hips and knees. And so it's one of those joint
• 16:34
  Speaker 2: systems that if I was considering having replaced, I would
• 16:37
  Speaker 2: make sure I exhausted every possible avenue conservatively.
• 16:41
  Speaker 3: First before I did it.
• 16:43
  Speaker 2: And I would start primarily once again with making sure
• 16:46
  Speaker 2: I targeted any movement losses in the joint, attacking that
• 16:50
  Speaker 2: movement loss, whether it hurts or not, and try to
• 16:53
  Speaker 2: regain mobility in the system. And typically what you'll see
• 16:56
  Speaker 2: and what we see clinically is when we attack the
• 16:57
  Speaker 2: movement loss and it comes back, it normalizes, the pain
• 17:02
  Speaker 2: follows very quickly and starts abolishing or going away. Function
• 17:05
  Speaker 2: returns to the shoulder. And most of these joints that
• 17:09
  Speaker 2: have been queued up for joint replacement don't get there.
• 17:12
  Speaker 1: Pat, thanks very much for calling in. I hope that's helpful.
• 17:15
  Speaker 1: And remember, you can always... visit the website, joinstrong.com. Bill,
• 17:19
  Speaker 1: you're up.
• 17:21
  Speaker 6: Hey, Chad.
• 17:21
  Speaker 7: Thanks for taking my call. So I also have shoulder
• 17:25
  Speaker 7: pain to my right shoulder. I think it might be
• 17:28
  Speaker 7: a rotator cuff injury. I've been dealing with this for
• 17:31
  Speaker 7: about 10 months. I feel like my range of motion
• 17:34
  Speaker 7: is pretty good, although it does hurt if I raise
• 17:37
  Speaker 7: my arm out to the side, out to the front,
• 17:39
  Speaker 7: or do any kind of overhead press motion. I have
• 17:43
  Speaker 7: been doing some PT and that seems to be helping
• 17:46
  Speaker 7: with these daily motion, the pain of the daily motion,
• 17:50
  Speaker 7: but it's not helping me at night. That's when I
• 17:54
  Speaker 7: really feel it. It wakes me up several times a night.
• 17:58
  Speaker 7: It feels like a burning in the center of my
• 18:00
  Speaker 7: shoulder joint. It really hurts and it wakes me up.
• 18:05
  Speaker 7: Anything I can do.
• 18:06
  Speaker 5: Yeah.
• 18:07
  Speaker 2: Highly unusual to have nighttime pain with a rotator cuff tear.
• 18:10
  Speaker 2: So The first thing I do is make sure that
• 18:14
  Speaker 2: I've got the spine clear because there is a cohort,
• 18:19
  Speaker 2: a large subgroup of people who have shoulder pain that
• 18:22
  Speaker 2: have neck-related problems. About 50% of the people we see
• 18:28
  Speaker 2: in the clinic with primary shoulder pain have a neck-related issue.
• 18:32
  Speaker 2: So the first thing I do is make sure I
• 18:34
  Speaker 2: screen through the neck and make sure that we're not
• 18:36
  Speaker 2: missing something here because burning pain at night typically implies something.
• 18:40
  Speaker 3: Related to a nerve. Not a rotator cuff.
• 18:43
  Speaker 2: So I would screen through the neck first and make
• 18:45
  Speaker 2: sure neck mobility was completely full in all planes and directions,
• 18:49
  Speaker 2: specifically rotating my head towards that shoulder pain. If I
• 18:52
  Speaker 2: can't turn towards the shoulder with my neck and head,
• 18:55
  Speaker 2: or I can't lead my head all the way back
• 18:57
  Speaker 2: to the furthest point backwards, then there may be a
• 19:01
  Speaker 2: neck component to this that's fooling people and fooling you
• 19:03
  Speaker 2: into thinking that the shoulder is the primary issue when
• 19:05
  Speaker 2: it isn't. That would be the first place I'd start
• 19:09
  Speaker 2: with that symptomatic presentation if you were in the clinic.
• 19:17
  Speaker 1: All right, we're going to get two more callers here
• 19:19
  Speaker 1: and then have a chance to wrap up. Chad Gray
• 19:21
  Speaker 1: from JointStrong.com. Fulton, thanks for being patient. You're on the air.
• 19:26
  Speaker 2: Thank you.
• 19:28
  Speaker 4: Even though I'm 79, I still work, not because I
• 19:31
  Speaker 4: need the money, but because it gets me out of
• 19:34
  Speaker 4: the house and movement. However, recently I found that getting
• 19:38
  Speaker 4: up from my behind the screen, standing up, I'm having
• 19:44
  Speaker 4: leg problems, pain. which then seems to lessen as I
• 19:51
  Speaker 4: start walking around and feel a little bit more limber.
• 19:54
  Speaker 4: Is there any vitamins that I can take to help
• 19:58
  Speaker 4: improve the situation?
• 20:00
  Speaker 5: No.
• 20:01
  Speaker 2: Think about what the body's telling you there. That symptom
• 20:03
  Speaker 2: is describing perfectly for you what it wants. It's telling
• 20:06
  Speaker 2: you that when you leave me still, I'm going to
• 20:09
  Speaker 2: stiffen and make you hurt worse. But if you get
• 20:11
  Speaker 2: me up and move me around, I'm going to make
• 20:13
  Speaker 2: you more limber and less hurtful. That pattern has a meaning,
• 20:18
  Speaker 2: and the meaning is you need to be using targeted
• 20:21
  Speaker 2: movements of whatever joint it is that's stiff when you
• 20:24
  Speaker 2: get up. Are you referring to the lower back being stiff,
• 20:27
  Speaker 2: or is it more the hip and the knee that's
• 20:28
  Speaker 2: stiff when you rise up?
• 20:30
  Speaker 4: It's more of the thigh, ankle joint. kneecap area.
• 20:35
  Speaker 2: Yeah, those joint systems are begging for more movement, more mobility.
• 20:39
  Speaker 2: So I would analyze and study the movement pattern at
• 20:41
  Speaker 2: my knee and my ankle and my hip and make
• 20:44
  Speaker 2: sure they have full available range of motion. If there's
• 20:47
  Speaker 2: any stiffness that shouldn't be in that joint system, you
• 20:50
  Speaker 2: need to attack that movement loss because the body is
• 20:53
  Speaker 2: screaming to you, hey, move me, don't leave me still.
• 20:57
  Speaker 2: Once again, that pattern consistently implicates the joint system is
• 21:02
  Speaker 2: the problem, and more movement is needed in that joint system.
• 21:05
  Speaker 2: That's the answer for every case I see in the
• 21:07
  Speaker 2: clinic that comes in with that description of pain.
• 21:11
  Speaker 1: All right, Fulton.
• 21:11
  Speaker 4: Thank you.
• 21:12
  Speaker 1: Thank you. Appreciate you calling in. One more call here.
• 21:15
  Speaker 1: And this is Jamie. Jamie, good morning.
• 21:18
  Speaker 6: Hey, good morning. How are you doing?
• 21:20
  Speaker 3: Good.
• 21:20
  Speaker 1: You're on with Chad Gray.
• 21:23
  Speaker 6: Okay.
• 21:23
  Speaker 1: Hey, Chad.
• 21:24
  Speaker 6: So I've got classic frozen shoulder, adhesive capsulitis in my
• 21:28
  Speaker 6: left shoulder. I like to stay active. I play golf weekly.
• 21:32
  Speaker 6: And it's been flaring up for about a year now
• 21:36
  Speaker 6: with zero relief. I've done the physical therapy. They've confirmed
• 21:40
  Speaker 6: it with the MRI. I've done all the exercises. I'm
• 21:44
  Speaker 6: trying to do everything right. And I've even had a
• 21:46
  Speaker 6: couple of steroid injections into the shoulder with very minimal relief.
• 21:52
  Speaker 6: How much longer am I going to have to deal
• 21:53
  Speaker 6: with this? I literally can't put my left hand behind
• 21:57
  Speaker 6: my back.
• 21:59
  Speaker 2: When you say you went to physical therapy, did they
• 22:01
  Speaker 2: do aggressive, targeted, in-range movement of the shoulder and teach
• 22:04
  Speaker 2: you how to do that on a three- or four-
• 22:06
  Speaker 2: or five-time-a-day basis?
• 22:09
  Speaker 6: They did. And I even bought the pulleys off of Amazon,
• 22:12
  Speaker 6: and I've been working with the door exercises. And it
• 22:16
  Speaker 6: helped a little bit, and I worked through the pain.
• 22:20
  Speaker 6: But it's still there. I mean, it's progressively gotten a
• 22:23
  Speaker 6: little bit better over, like, maybe the last six months.
• 22:26
  Speaker 6: I don't want to give up my golf game. But
• 22:29
  Speaker 6: I've been thinking about– I'm sorry, go ahead.
• 22:32
  Speaker 2: You need to move more, not less. So giving up
• 22:35
  Speaker 2: the golf game isn't going to help anything here. The
• 22:39
  Speaker 2: frozen shoulder syndrome is a fibrosis. It's a hardening or
• 22:42
  Speaker 2: a stiffening of the joint capsule around the shoulder. And
• 22:44
  Speaker 2: the only way to make that better is to remodel
• 22:46
  Speaker 2: the joint capsule. That requires targeted in-range movement of the joint,
• 22:50
  Speaker 2: specifically behind the back, into extension, which is the straight
• 22:55
  Speaker 2: backwards movement of the shoulder, and then aggressively overhead with
• 22:59
  Speaker 2: the shoulder as well using the doorframe like I think
• 23:01
  Speaker 2: you described a minute ago, those movements need to be
• 23:04
  Speaker 2: pushed aggressively to the point where it's almost unbearable to
• 23:08
  Speaker 2: move there. And you need to be doing that on
• 23:10
  Speaker 2: a three or four time a day basis, pushing into
• 23:14
  Speaker 2: that pain and stiffness aggressively enough to start breaking down
• 23:18
  Speaker 2: the scar tissue that's developed there. That's what a frozen
• 23:21
  Speaker 2: shoulder is. It's a fibrosis or a scarring of the
• 23:23
  Speaker 2: joint capsule around the shoulder joint. And it's not going
• 23:26
  Speaker 2: to get better with rest or inactivity. It's going to
• 23:30
  Speaker 2: get better with targeted in-range movement and you continuing to
• 23:33
  Speaker 2: go out and use and engage.
• 23:35
  Speaker 3: The joint physically.
• 23:38
  Speaker 6: Okay, and then one more quick question. I heard about
• 23:40
  Speaker 6: a procedure where they could put you under and then
• 23:43
  Speaker 6: manipulate the shoulder and try to break up some of
• 23:45
  Speaker 6: that inflammation. What are your thoughts on that?
• 23:48
  Speaker 3: Yeah, they're not breaking up inflammation.
• 23:50
  Speaker 2: What they're doing is trying to break up scar tissue,
• 23:52
  Speaker 2: the fibrosis, and the adhesions that bond and form to
• 23:54
  Speaker 2: the joint capsule. Um, it's a risky, it's a risky maneuver. Um, clinically,
• 24:00
  Speaker 2: you know, I've been doing this for 32 years. I've
• 24:02
  Speaker 2: seen a few of those come through. I don't typically
• 24:05
  Speaker 2: see them produce lasting long-term meaningful results. The thing that
• 24:08
  Speaker 2: we see most consistently help these is once again, a
• 24:11
  Speaker 2: daily regimen multiple times a day of targeted aggressive. And
• 24:15
  Speaker 2: I mean, aggressive end range movement of the shoulder joint.
• 24:20
  Speaker 6: Okay.
• 24:21
  Speaker 1: Jamie, thank you. I appreciate it. Remember, JointStrong.com would be
• 24:24
  Speaker 1: a place to go to get started on some alternatives. Chad,
• 24:29
  Speaker 1: we're wrapping up here. So any final thoughts for those
• 24:32
  Speaker 1: that are getting those MRIs and thinking about surgery?
• 24:36
  Speaker 2: You know, MRIs are, as the world of peer review
• 24:40
  Speaker 2: science says, they're incredibly sensitive but poorly specific. They see
• 24:45
  Speaker 2: a lot of things in most cases that are kind
• 24:47
  Speaker 2: of normal age-related changes that happen to all of us.
• 24:50
  Speaker 2: They're not always the primary producer of the symptom we have.
• 24:54
  Speaker 2: So don't always buy into what the MRI shows. There
• 24:57
  Speaker 2: are high rates of false positive using that diagnostic tool.
• 25:01
  Speaker 2: You need someone that is really good at physically examining
• 25:05
  Speaker 2: and screening through your joint problem to figure out what
• 25:07
  Speaker 2: it actually needs. The MRI can be very misleading, and
• 25:11
  Speaker 2: it oftentimes escalates the condition right into a surgical or
• 25:14
  Speaker 2: injection-based intervention. And those have their place, certainly. But the primary...
• 25:21
  Speaker 2: tool that needs to be used in figuring out these
• 25:23
  Speaker 2: problems is targeted in-range movement and exercise.
• 25:27
  Speaker 1: Remember, movement is the best medicine. And we're not just
• 25:30
  Speaker 1: talking about the skeletal structures and the joints. We're talking
• 25:34
  Speaker 1: about your health. And Chad, thanks so much for making
• 25:37
  Speaker 1: time and coming in.
• 25:38
  Speaker 3: Thank you, Preston.
• 25:39
  Speaker 1: Chad Gray, co-founder of JointStrong.com, my guest here on The
• 25:42
  Speaker 1: Morning Show with Preston Scott.