Latest / The Driven Athlete / From Joint Pain to Performance: Regenerative Medicine Meets Movement Science | Ep 99

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From Joint Pain to Performance: Regenerative Medicine Meets Movement Science | Ep 99 · The Driven Athlete

• 0:00
  SPEAKER_00: Welcome to the Peak Performance Podcast, your guide to optimizing your life one health tip at a time.
• 0:06
  SPEAKER_00: This podcast is designed to entertain and inform, not to provide medical or health advice.
• 0:12
  SPEAKER_00: Always consult your doctor when it comes to your personal health or before you make any changes to your diet, exercise, or lifestyle.
• 0:20
  SPEAKER_03: Ladies and gentlemen, welcome to the Peak Performance Podcast.
• 0:22
  SPEAKER_03: I'm Coach Kyle here with Dr.
• 0:24
  SPEAKER_03: K, and today we have a very special guest, Dr.
• 0:26
  SPEAKER_03: Kyle.
• 0:27
  SPEAKER_03: Yes.
• 0:28
  SPEAKER_03: Two Kyle's one podcast.
• 0:30
  SPEAKER_03: And for the record, everybody keeps calling me Dr.
• 0:32
  SPEAKER_03: Kyle.
• 0:33
  SPEAKER_03: I am not a doctor.
• 0:34
  SPEAKER_03: I am a health coach and a business guy.
• 0:36
  SPEAKER_03: That is actually Dr.
• 0:37
  SPEAKER_03: Kyle in this case.
• 0:39
  SPEAKER_03: So he is a sports PT, sports physical therapist.
• 0:43
  SPEAKER_03: And we're gonna have him on to talk about what do we look at when we're looking at root cause of degenerative conditions and joint pain and mobility issues and how that interacts with regenerative medicine and some of the things that Dr.
• 0:55
  SPEAKER_03: K does.
• 0:56
  SPEAKER_02: Yeah, totally.
• 0:57
  SPEAKER_02: No, thanks for having me.
• 0:58
  SPEAKER_02: I'm super excited to be here.
• 0:59
  SPEAKER_02: It's always cool to collaborate and talk with people that are nerds like I am on these kind of topics and stuff.
• 1:04
  SPEAKER_02: But yeah, I've always thought like, I mean, there's a huge relationship and cohesion marriage between like longevity centers type of services with regenerative medicine and then like the biomechanics sports rehab facilitating moving patterns to help heal people, you know, and get them back to function, you know?
• 1:20
  SPEAKER_02: Yep.
• 1:21
  SPEAKER_02: Remind me again, how long y'all been doing this at this location in West Palm?
• 1:26
  SPEAKER_01: We've been here for about a year before that was another practice.
• 1:28
  SPEAKER_01: So cool.
• 1:30
  SPEAKER_01: How many injections have you done?
• 1:32
  SPEAKER_01: Thousand plus thousands plus, really.
• 1:35
  SPEAKER_01: So you've done 200 plus on me.
• 1:37
  SPEAKER_01: That's nice.
• 1:37
  SPEAKER_01: Yeah, we're counting single holes.
• 1:40
  SPEAKER_01: Uh might be approaching a million at this point.
• 1:43
  SPEAKER_02: That's awesome.
• 1:44
  SPEAKER_02: That's always a good perk, you know, like being a partnership with that.
• 1:48
  SPEAKER_02: Get get easy accessibility and ability to get healed.
• 1:52
  SPEAKER_03: Depends on how you view it.
• 1:52
  SPEAKER_03: Uh I could be target practice.
• 1:54
  SPEAKER_02: Yeah, exactly.
• 1:55
  SPEAKER_02: A good guinea pig.
• 1:56
  SPEAKER_01: We were talking about that this morning.
• 1:57
  SPEAKER_01: It's everything that like I've developed that's like not standard, I've tested on him first.
• 2:02
  SPEAKER_03: Someone's got a guinea pig.
• 2:04
  SPEAKER_02: Yeah, it's funny.
• 2:04
  SPEAKER_02: Yeah.
• 2:05
  SPEAKER_02: I would say, like, well, another thing, because we actually just referred to somebody all, so yeah, just helping her out her knee, you know, but a question that she asked, and other people have asked me as well, is like, what is the resistance with stem cell regenerative approaches?
• 2:22
  SPEAKER_02: Why is it not like full force, full send research, let's develop this thing, versus resistance and scaling back accessibility?
• 2:31
  SPEAKER_02: Unless I'm wrong on that.
• 2:32
  SPEAKER_02: Like, has it opened up a lot more?
• 2:33
  SPEAKER_02: Because I I mean, what's what's y'all's thoughts on that?
• 2:35
  SPEAKER_03: A lot of the resistance there comes from the regulatory environment.
• 2:38
  SPEAKER_03: So the compliance and things that have been in place for many years.
• 2:42
  SPEAKER_03: This is opening up with the new law that just passed in Florida allowing the physician use of uh biologics therapies.
• 2:49
  SPEAKER_03: Um some things are gonna change in terms of how widely these are seen.
• 2:55
  SPEAKER_03: Um another problem is the the cowboy aspect of this field.
• 3:00
  SPEAKER_03: That's the wild west right now.
• 3:02
  SPEAKER_03: There are a lot of doctors and not doctors doing stem cell therapies that are in no way compliant and are not screened properly and may not be efficacious.
• 3:14
  SPEAKER_03: That's uh honestly the biggest one.
• 3:15
  SPEAKER_03: More than safety is is the the efficacy.
• 3:18
  SPEAKER_03: Maybe they're using products that are just not gonna work.
• 3:21
  SPEAKER_01: Yeah, so there's two parts to it.
• 3:22
  SPEAKER_01: There's the production of the stem cells, and then there's the administration of the stem cells.
• 3:27
  SPEAKER_01: So production, up until a couple years ago, it was actually pretty simple to get a license to produce stem cells.
• 3:33
  SPEAKER_01: It wasn't that expensive.
• 3:34
  SPEAKER_01: Minimal oversight, bad stuff happened, people got hurt, uh manufacturing facilities got sued, a lot of them got shut down.
• 3:42
  SPEAKER_01: Worst case example, there was one company, and I never use this company, but um, the way they would check for sterility of their product was they would hold up to the light.
• 3:51
  SPEAKER_01: And if it was clear, it passed.
• 3:52
  SPEAKER_01: If it was cloudy, they threw it out.
• 3:53
  SPEAKER_02: So that's not good.
• 3:54
  SPEAKER_01: Yeah, so that's what kind of opened all up.
• 3:56
  SPEAKER_01: Then the FDA enforced more strict standards on production, and that cleaned up a bunch of the companies, but there's still a few left and right that were kind of ducking and dodging.
• 4:06
  SPEAKER_01: They're slowly cleaning up a lot of the bad facilities, but ultimately, and the way the law is written, it's ultimately up to the doctor to decide if they're using a clean product or not, which isn't really fair to the doctor, because unless you go and unless you one have the background understanding of what you're looking for, and then two, go to the facility yourself, it's really hard to know if they're following proper guidelines.
• 4:28
  SPEAKER_01: The other part of it is administration.
• 4:30
  SPEAKER_01: So, yes, you have to select a good product, but then also what you do with it matters, you know, um, and what you promise with it matters because there's people out there promising that yes, stem cells will cure your completely debilitated knee that has literally nothing left that most people doing you know regenerative therapy would reject.
• 4:48
  SPEAKER_01: There's people out there saying, Yeah, stem cells are gonna cure you.
• 4:50
  SPEAKER_01: And then those people don't do well, they're mad because they lost out on five, ten thousand dollars.
• 4:54
  SPEAKER_01: And so that's kind of where the bad name starts to come from.
• 4:57
  SPEAKER_01: So a big part of it is being respectful to your field and knowing when to turn patients away because they're not good candidates.
• 5:04
  SPEAKER_02: When would that be?
• 5:05
  SPEAKER_01: Really severity of injury, a big part of the severity of injury, but honestly, a big part of its mental attitude as well.
• 5:10
  SPEAKER_01: If I have a patient that comes in and goes, I want to do this, but I really think it's not gonna work, and I think I'm wasting my money, I'll tell them, you know what, it's not gonna work for you.
• 5:18
  SPEAKER_01: You shouldn't be here.
• 5:19
  SPEAKER_01: Because patients that don't think it's going to work, it won't work.
• 5:22
  SPEAKER_02: Yeah.
• 5:22
  SPEAKER_02: I would say, like, and that's a blessing, like with a lot of the patients that we see in the demographic and the culture that we've established.
• 5:29
  SPEAKER_02: Yep, people come see us usually because they're very motivated.
• 5:31
  SPEAKER_02: You know, because we don't take insurance, like we're just we're out of pocket, you know.
• 5:34
  SPEAKER_02: So like people are gonna come see us, they're like, they want to get down to work and like let's fix this thing, you know.
• 5:40
  SPEAKER_02: And ultimately, like um, whereas in previous clinics that I've worked in the past, it's the same kind of rhetoric.
• 5:45
  SPEAKER_02: They're like, I'm just here messing around until the doc you know gets cleared with my MRI so I can have surgery.
• 5:50
  SPEAKER_02: Yep.
• 5:50
  SPEAKER_02: I'm like, then like what do you you know, like just what are we doing, you know?
• 5:53
  SPEAKER_02: But um, but anyway, yeah, they want to get to work, you know, that's good because like they it's more fulfilling for us and it reinvigorates our career, and we can actually like really hone in on our talents, knowledge, and skills and and get motivated to help people, you know?
• 6:07
  SPEAKER_02: Um and ultimately look down to like their movement patterns, you know.
• 6:11
  SPEAKER_02: In my opinion, I feel like the ultimate lens, like the the lens of how I perceive this, these things of like degenerative changes or just joint pain, all right, would be a movement system impairment that leads to certain structures getting overwhelmed and painful.
• 6:26
  SPEAKER_02: But like as an example of a baseball player who's like in high school or college and they have like anterior, like front shoulder pain, it's not that hard to figure out that like the biceps tendons lit up, the front part of their shoulder joints lit up, and maybe the rotary cuffs involved.
• 6:39
  SPEAKER_02: As like irritation.
• 6:40
  SPEAKER_02: But the question would be like if it's just overuse, then why aren't all your other teammates at the three-month mark or eight month week mark also having the same symptoms?
• 6:48
  SPEAKER_02: It's not just overuse, like you're doing something different comparative to your colleagues, right?
• 6:53
  SPEAKER_02: We'd like to investigate and look into like what are you doing differently then?
• 6:56
  SPEAKER_02: That's setting up your biceps tendon or your anterior shoulder capsule or whatever, or rotated cuff, setting it up to be overwhelmed and ultimately painful.
• 7:04
  SPEAKER_02: Because those are the victims, they're not the problem.
• 7:07
  SPEAKER_02: The problem would be like everything else around it that's not supporting it, making those things hang on for dear life or get overwhelmed, that's gonna be causing pain.
• 7:14
  SPEAKER_01: So stability structures are a key part of joint pain.
• 7:17
  SPEAKER_02: Yeah, 100%.
• 7:18
  SPEAKER_02: Yeah, totally.
• 7:19
  SPEAKER_02: Like it might be like this, it's my opinion, like what uh what we would call like a movement system impairment.
• 7:24
  SPEAKER_02: Um, that um if a if a joint moves in a certain direction easily, repetitively, with high forces, like a throw would be in the shoulder or running for the knee, right, or in the ankle for like Achilles, um, those structures are gonna get overwhelmed really easily.
• 7:39
  SPEAKER_02: But the surrounding stability and mobility, if it's too much mobility in surrounding joints, or a lack of mobility, hyper or hypo mobile, um, it's gonna set the stage for other things to have to overcompensate to make up for it.
• 7:52
  SPEAKER_02: So, anyway, we call like like knee tendinitis, right?
• 7:55
  SPEAKER_02: Front knee pain or front part of the shoulder pain, rotated cuff, biceps tendon, whatever.
• 8:00
  SPEAKER_02: That's like the fire alarm that's that's but that's blasting.
• 8:04
  SPEAKER_02: So, like solution, take advil and ice it and rest would be like stuffing a pillow and duct taping it against the fire alarm to muffle the sound, like, oh, it's better, it's not as loud, perfect.
• 8:16
  SPEAKER_02: Meanwhile, the fire is still going off.
• 8:18
  SPEAKER_02: It's like, well, why not just like solve the fire and then that will follow suit?
• 8:21
  SPEAKER_02: You know, that's kind of like where our thoughts are on that.
• 8:23
  SPEAKER_02: But yes, so surrounding muscular joint stability and then also mobility disparities of hyper or hypo, like too much mobility and not enough mobility in certain areas sets the stage for um things to get overwhelmed.
• 8:39
  SPEAKER_03: Yeah, and that's I think where the perfect marriage of like physical therapy, mobility, and building strength back merges with regenerative medicine.
• 8:50
  SPEAKER_03: Because if you can introduce into the system things that promote healing in strained or damaged structures, along with remapping those movements and actually fixing the movement impairments that you were mentioning, that's where you're gonna get not only potential regeneration, but also long-term relief from the pain.
• 9:15
  SPEAKER_02: Because if we don't fix that, and then the tissue's good, like hey, what's healing?
• 9:18
  SPEAKER_02: Totally, totally cool, we'll go back and do this exact same thing.
• 9:21
  SPEAKER_02: Yep.
• 9:21
  SPEAKER_02: It's just gonna happen again.
• 9:23
  SPEAKER_04: Yeah.
• 9:23
  SPEAKER_02: But but it's tricky though with like chronic degenerative arthritic changes for our 50 plus year old patients.
• 9:31
  SPEAKER_02: Of course, like, you know, we're not gonna go in there and regenerate cartilage or do surgery.
• 9:35
  SPEAKER_02: It's not what we do.
• 9:37
  SPEAKER_02: But there has been some evidence to show, which is interesting, of like low load repetitive compression of a joint for all the nutrients, like blood flow, synovial fluid, all that stuff, to help stimulate subchondrial healing that then layers up into some of the cartilaginous healing, cartilage healing over like year, like years, like two years of time.
• 9:59
  SPEAKER_02: Where I've been exposed to, you tell me what you think, but I've been exposed to some studies where um they take pre- and post-MRI and they have a control group versus like an experimental group.
• 10:07
  SPEAKER_02: The experimental group is doing like low load exercise and some manual therapy stuff to help facilitate the healing.
• 10:12
  SPEAKER_02: But and then the control group is not doing anything.
• 10:14
  SPEAKER_02: And the experimental group had improved vibrancy and thickness of cartilage, articular cartilage, over like a 12 to 18 month period of time on MRI.
• 10:24
  SPEAKER_03: In non-medical speak, basically, if they're doing rehab, just put an easy word on it.
• 10:30
  SPEAKER_02: Or like appropriate access.
• 10:32
  SPEAKER_03: Continuously, you're seeing improvements in cartilage.
• 10:35
  SPEAKER_03: Yeah, this is what they found.
• 10:36
  SPEAKER_03: So if you look at that, my main question is how many times per week?
• 10:41
  SPEAKER_03: What are they doing?
• 10:42
  SPEAKER_03: And what is going to be the patient compliance on something like that?
• 10:46
  SPEAKER_02: Super hard.
• 10:46
  SPEAKER_02: Because also to like the people that good question.
• 10:49
  SPEAKER_02: So, like frequency per week, I mean, it's between like three to four times a week.
• 10:54
  SPEAKER_02: And then it has to be below the pain threshold.
• 10:57
  SPEAKER_02: Where it's like, okay, what's good and what's not good?
• 10:59
  SPEAKER_02: Like, what should I do, what should I not do?
• 11:00
  SPEAKER_02: And usually our suggestion is like your pain will tell you.
• 11:03
  SPEAKER_02: If it's if it's causing pain, it's probably gonna be more irritating and allowing things to get broken down, it's not gonna be helpful.
• 11:09
  SPEAKER_02: It's not it's detrimental at this point.
• 11:11
  SPEAKER_02: But rather, like when you're done doing a workout routine or some rehab exercises, stuff like that, if you're leaving, feeling better than when you came in, like, okay, you're in a good spot.
• 11:20
  SPEAKER_02: And if you challenge up a little bit more, and it's like, ah, now I feel a little bit, okay, it's too much.
• 11:23
  SPEAKER_02: Right now we know your level of threshold of intensity is at this level.
• 11:28
  SPEAKER_02: If you go a little bit higher than that, it's gonna make it worse.
• 11:30
  SPEAKER_02: Okay, then we're right here for right now.
• 11:32
  SPEAKER_02: Next week, we'll see where you're at.
• 11:33
  SPEAKER_02: And then gradually making small incremental progressions over several months, if that's what they're talking about.
• 11:40
  SPEAKER_02: You know what I mean?
• 11:41
  SPEAKER_03: So, in those studies, like, I mean, have you do you have patients that like come in and you can consistently see them four times a week for two years?
• 11:48
  SPEAKER_02: No, no, of course not.
• 11:50
  SPEAKER_03: Yeah, so this is hard.
• 11:51
  SPEAKER_03: Yes, this is like this is and this is something I want to point out because like medical literature and science does this a lot.
• 11:57
  SPEAKER_03: They set up a study that does not simulate the real world environment at all.
• 12:02
  SPEAKER_03: So, like, this I think is where a good a good marriage of the regenerative medicine can help.
• 12:07
  SPEAKER_03: Totally.
• 12:07
  SPEAKER_03: Because you can shorten that time frame, right?
• 12:10
  SPEAKER_02: That's what I'm I'm super excited and like optimistic about what this type of medicine field can get into because I think it'd be, I mean, not just joints, but like systemic issues and chronic autoimmune disease, right?
• 12:24
  SPEAKER_02: From my understanding, too, stem cells, but uh like multiple sclerosis, is that correct?
• 12:28
  SPEAKER_02: And like stroke?
• 12:30
  SPEAKER_01: We're not gonna touch on those.
• 12:31
  SPEAKER_01: Let's put like okay, all right.
• 12:32
  SPEAKER_02: We'll get that another time.
• 12:34
  SPEAKER_02: Another conversation another time.
• 12:35
  SPEAKER_02: But anyway, um, but yeah, I'm super excited.
• 12:38
  SPEAKER_02: You know, I'm like, why aren't we fun?
• 12:39
  SPEAKER_02: Like, let's get after this, you know.
• 12:41
  SPEAKER_02: I think it's I mean, I think it's the a great you know, optimistic future.
• 12:45
  SPEAKER_03: Yeah.
• 12:46
  SPEAKER_03: I mean, I just uh I went to do I live up in Greenville, so I don't live here.
• 12:51
  SPEAKER_03: So I I visited a a PT of a PT friend of mine and he did an assessment.
• 12:56
  SPEAKER_03: It was like an hour and a half assessment.
• 12:57
  SPEAKER_03: I was like, are we done yet?
• 12:59
  SPEAKER_03: This is taking forever.
• 13:00
  SPEAKER_03: But um I've done I've done multiple rounds of PRP in the shoulder.
• 13:05
  SPEAKER_03: And then after my most recent round of PRP, I went to go see him and he gave me, I was like, dude, if you give me more than more than two things to do, I'm not gonna do it.
• 13:15
  SPEAKER_03: I'm just not gonna do it.
• 13:16
  SPEAKER_03: And he's like, Okay, do this one thing.
• 13:19
  SPEAKER_03: I was like, I can do one thing, and I did it, and then with that and that last PRP treatment, six weeks later, night and day.
• 13:27
  SPEAKER_02: Amazing.
• 13:28
  SPEAKER_03: And it was literally just a litter shoulder movement.
• 13:31
  SPEAKER_03: Yeah, that's awesome.
• 13:33
  SPEAKER_03: It takes 32 seconds a day.
• 13:35
  SPEAKER_03: But he spent an hour and a half trying to figure out the exact movement that I needed to do.
• 13:41
  SPEAKER_02: Yeah, that's good.
• 13:42
  SPEAKER_02: So do y'all also do stuff like that, like in the clinic, like, hey, you have this going on, we're gonna do these treatments, stem cell, and then be like, hey, we recommend these movements or like this stretch, this exercise, like whatever.
• 13:54
  SPEAKER_01: No, what I've learned there's patients, so you get stiff after injections, that's just par for the course.
• 14:01
  SPEAKER_01: And so what happens is if you leave someone at home alone to do nothing, or even to do stretches or exercises, they won't push themselves to the full range of motion.
• 14:10
  SPEAKER_01: So they actually end up losing range of motion if because they don't have a guiding external force to tell them, hey, no, move past right here, keep going, because you have that range of motion.
• 14:20
  SPEAKER_01: And so they end up just locking themselves up.
• 14:23
  SPEAKER_01: I see.
• 14:23
  SPEAKER_01: No, I I very much prefer external.
• 14:26
  SPEAKER_02: I mean, it's always better just like cooking, like it's always better when someone cooks for you, you know.
• 14:30
  SPEAKER_02: But layer in like there's a you have an appointment, you paid for it, like you have it set up, there's gonna be someone there that's gonna guide you.
• 14:38
  SPEAKER_02: Like people are way more compliant with that.
• 14:40
  SPEAKER_02: Yeah, uh, and so like you're asking, like, people are gonna come four times a week.
• 14:44
  SPEAKER_02: We have had that before, and it's a lot, you know.
• 14:48
  SPEAKER_02: There's two types of people.
• 14:49
  SPEAKER_02: They ask, what else can I do?
• 14:51
  SPEAKER_02: If I did, do you want me to do three sets of 12 on this or whatever, two sets of eight?
• 14:56
  SPEAKER_02: What if I did five sets of 20?
• 14:58
  SPEAKER_02: Would that make me better faster?
• 15:00
  SPEAKER_02: I'm like, no, no, no, no, like back down, you know, like you're doing too much.
• 15:03
  SPEAKER_02: Or like, what other exercises can I do?
• 15:05
  SPEAKER_02: And I'm like, I want you to stick to these four, right?
• 15:08
  SPEAKER_02: These these these four things.
• 15:09
  SPEAKER_02: Like, all right, and then come back next time, we'll re-reassess.
• 15:12
  SPEAKER_02: So they're like wanting to do more.
• 15:14
  SPEAKER_02: And that leads to like, I'm like, we don't want motivation and enthusiasm to turn into an overuse injury, right?
• 15:19
  SPEAKER_02: Like they're you're doing too much.
• 15:20
  SPEAKER_02: Whereas there's other people where they're like, they don't want to do anything.
• 15:24
  SPEAKER_02: That's me.
• 15:25
  SPEAKER_02: And they're like, like, why am I not getting better?
• 15:28
  SPEAKER_02: And I'm like, yo, you need to like do this, you know.
• 15:30
  SPEAKER_02: Like I would that's I'm not gonna see you again until you fix that.
• 15:33
  SPEAKER_02: Like, and usually and usually that's sleeping position, by the way.
• 15:36
  SPEAKER_02: That's like the first time we talk with people.
• 15:37
  SPEAKER_02: Yeah, I'm usually like, we need to light a fire into this person's uh butt a little bit more to get more enthusiasm out of what they're doing because they're not gonna get as much out of it.
• 15:45
  SPEAKER_02: And then I'm usually like it's gonna be a waste of time and money for everybody.
• 15:48
  SPEAKER_02: It's gonna make you look bad, make us look bad, like you gotta do this thing, you know.
• 15:51
  SPEAKER_02: I'm gonna text you tomorrow.
• 15:52
  SPEAKER_02: You just do your thing.
• 15:53
  SPEAKER_02: And the other people are like, we gotta reel you in a little bit, do less, you know.
• 15:56
  SPEAKER_02: Yep.
• 15:57
  SPEAKER_02: We don't want to turn into like a just a chronic irritation.
• 16:00
  SPEAKER_01: Makes sense.
• 16:01
  SPEAKER_03: Yeah, yeah.
• 16:02
  SPEAKER_03: I've found that uh after Doc has been trying to jam it through my thick skull for years, simpler is usually better.
• 16:11
  SPEAKER_03: Yes, yeah.
• 16:12
  SPEAKER_03: I love the complexity and I love the nuance, but if you can make compliance better, the outcomes are gonna be better.
• 16:20
  SPEAKER_01: Yeah, yes, people have lives and things and stuff to do.
• 16:23
  SPEAKER_01: And if you give them an hour of stuff to do every day, they simply just don't have the time.
• 16:27
  SPEAKER_01: One or the motivation, too.
• 16:28
  SPEAKER_01: Yeah, you gotta get it down to like one minute or less a day.
• 16:31
  SPEAKER_02: Yeah, one minute or less, yeah.
• 16:33
  SPEAKER_02: No, there's a lot of cute, you know, flashy things on on the grant on you know, socials and stuff of like exercises and like rehab stuff.
• 16:42
  SPEAKER_02: I'm like, man, this is like way too much.
• 16:44
  SPEAKER_02: You know, there's no one's gonna have like four bands and like a thing to do this exercise, you know.
• 16:49
  SPEAKER_02: Just a heads up, like that can get a little overwhelming, you know.
• 16:52
  SPEAKER_02: It's like a lot of cute, funny things on there, but like being simple is gonna be usually a lot more effective, you know, in consistency.
• 17:01
  SPEAKER_03: You mean you shouldn't stand on a BOSU ball while using three different bands and then do loaded weighted exercises?
• 17:07
  SPEAKER_03: And like do a yeah, exactly.
• 17:08
  SPEAKER_02: Dumbbell on your head balancing them.
• 17:10
  SPEAKER_02: Yeah.
• 17:11
  SPEAKER_02: That's funny.
• 17:11
  SPEAKER_03: Yeah.
• 17:12
  SPEAKER_03: And another thing I see on like that people will like talk to me about is like, yeah, I did this thing and and it was on Instagram and it was supposed to help my lower back pain, and then it really hurts now.
• 17:23
  SPEAKER_03: I'm like, well, maybe you should talk to our physician or a physical therapist and get the correct solutions for you instead of just doing something you saw on Instagram.
• 17:34
  SPEAKER_02: Yeah, yeah.
• 17:35
  SPEAKER_02: It's um I appreciate the you know the motivation.
• 17:38
  SPEAKER_02: Yeah, motivation's not the problem.
• 17:40
  SPEAKER_02: Cool.
• 17:41
  SPEAKER_02: Maybe a little bit you know, a little more purposeful guidance might be helpful.
• 17:44
  SPEAKER_02: Yeah.
• 17:45
  SPEAKER_02: I would always advocate for that.
• 17:46
  SPEAKER_04: Yeah.
• 17:47
  SPEAKER_03: Yeah.
• 17:48
  SPEAKER_03: The uh we're probably approaching our time, but I did want to ask you about your assessment process.
• 17:54
  SPEAKER_03: So someone comes into you, what does that look like?
• 17:57
  SPEAKER_03: Time frame, and just like very simply, like, hey, what does an assessment look like?
• 18:01
  SPEAKER_02: Yeah.
• 18:01
  SPEAKER_02: Um, so we're only an hour.
• 18:03
  SPEAKER_02: We don't do an hour and a half because of that reason.
• 18:05
  SPEAKER_02: It's just we have more concise, we can be concise, you know what I mean, and we can lock in our evaluation.
• 18:10
  SPEAKER_02: Um, and then every time comes someone comes in, we always reassess and like because things change.
• 18:13
  SPEAKER_02: So we're always course correcting, like, oh, okay, that might have been too much, not not the right path.
• 18:17
  SPEAKER_02: Like, we're always course correcting.
• 18:18
  SPEAKER_02: But anyway, we have to get a subjective, we've got to get the answers and so some of our questions, like, what happened?
• 18:24
  SPEAKER_02: What are you looking for?
• 18:25
  SPEAKER_02: Why did that like why do you think happened in the first place?
• 18:27
  SPEAKER_02: When did it first start?
• 18:28
  SPEAKER_02: How long has it been going on?
• 18:29
  SPEAKER_02: What does it feel like?
• 18:30
  SPEAKER_02: Where, what makes it feel better?
• 18:31
  SPEAKER_02: What are the aggravating things?
• 18:32
  SPEAKER_02: What have you tried already that that's worked or hasn't worked?
• 18:35
  SPEAKER_02: And then that gives us an idea of like that interview process, like the evaluation, like subjective questioning is gonna be the most value component of the assessment, in my opinion.
• 18:43
  SPEAKER_02: And then that's gonna dictate and direct some of the testing stuff that we do.
• 18:46
  SPEAKER_02: And that always gonna start like with just functional movement patterns.
• 18:49
  SPEAKER_02: Like we have to look at like if your shoulder is bothering you, like we're looking at your shoulder blade, the scapula, and to see how that is moving, and also just postural where it's starting.
• 18:57
  SPEAKER_02: If it's starting depressed and downwardly rotated or stuck in the mud, it already sets the stage for an impingement type mechanism in your shoulder.
• 19:06
  SPEAKER_02: Like, oh, your shoulder blade's already starting here.
• 19:08
  SPEAKER_02: That's part of our assessment.
• 19:09
  SPEAKER_02: Just posture, right?
• 19:10
  SPEAKER_02: Positioning.
• 19:11
  SPEAKER_02: And then same thing with spine, hip, knee, ankle, like all those things.
• 19:14
  SPEAKER_02: So we're looking at like the posture and positioning, and then a functional movement pattern, and then range of motion testing, like how well can you go up and down and bend forward and touch your toes, like for lumbar, spine, rotation, range of motion, hip mobility, knee and ankle mobility, all as it relates.
• 19:30
  SPEAKER_02: And then that's gonna dictate like what our provocative tests are gonna be.
• 19:34
  SPEAKER_02: And in addition to that, we're gonna ask like a specific movement that causes the pain.
• 19:39
  SPEAKER_02: Where if they're like my hip always hurts when I do squats, that's gonna be our asterisk sign.
• 19:43
  SPEAKER_02: That's gonna be our test retest test.
• 19:45
  SPEAKER_02: Like, show me your squat right now.
• 19:47
  SPEAKER_02: We'll clean some up things, clean some things up and be like, all right, so it hurts right now in the front when you squat like this, that's a really common thing.
• 19:53
  SPEAKER_02: Cool.
• 19:53
  SPEAKER_02: We're gonna use that later and then we go into treatment.
• 19:56
  SPEAKER_02: And usually the first thing we do with treatment is manual therapy.
• 19:58
  SPEAKER_02: We're a big manual therapy facility.
• 20:00
  SPEAKER_02: We I'm very um biased towards that, that it helps to set the stage for things to move and groove better.
• 20:06
  SPEAKER_02: If it's joint mobility disparities, like I said, where if some things are stiff and not moving well, we're gonna mobilize that to improve the mobility.
• 20:13
  SPEAKER_02: And then soft tissue restrictions are always gonna be a component too.
• 20:15
  SPEAKER_02: We have to get the soft tissue more pliable and extensible so that it can allow it to move better as well.
• 20:20
  SPEAKER_02: And then we're gonna follow up with corrective exercises.
• 20:22
  SPEAKER_02: And the corrective exercises is where it solidifies the changes we're looking for, fixing movement patterns, stabilizing and activating the things that we need to activate.
• 20:31
  SPEAKER_02: And then at the end of that, we're like, hey, feel okay, good.
• 20:34
  SPEAKER_02: Let's retest your squat or let's retest your shoulder movement and see how it feels.
• 20:38
  SPEAKER_02: And our expectation, day one, is going to be like an eyebrow raise moment.
• 20:42
  SPEAKER_02: We're like, I feel like a lot better.
• 20:44
  SPEAKER_02: Like, I don't feel it right now.
• 20:45
  SPEAKER_02: Like, perfect.
• 20:46
  SPEAKER_02: So we're on the right track.
• 20:47
  SPEAKER_02: Here's your homework.
• 20:48
  SPEAKER_02: Boom, boom, boom, boom.
• 20:50
  SPEAKER_02: These three, four, five, depending on the personality, of course, and what they want, right?
• 20:53
  SPEAKER_02: I'm like two things for one person, and then like we'd be like, I want to do this every we have people that do this, they do like an hour and a half exercise, rehab, fit.
• 21:01
  SPEAKER_02: Like, that's like they do.
• 21:02
  SPEAKER_02: They have a journal and they bring it in, they bring notes.
• 21:04
  SPEAKER_02: Yeah, so that's people we see.
• 21:05
  SPEAKER_02: Like, it's really cool.
• 21:06
  SPEAKER_02: So we're like, reel it in a little bit.
• 21:08
  SPEAKER_02: But anyway, so then we'll retest our squat and they're like, Man, are there shoulder raised?
• 21:11
  SPEAKER_02: I'm like, man, I feel a lot better.
• 21:12
  SPEAKER_02: I haven't felt like this in like six months.
• 21:14
  SPEAKER_02: Like, what did you do?
• 21:15
  SPEAKER_02: I'm like, cool, that's encouraging.
• 21:16
  SPEAKER_02: We're on the right path.
• 21:17
  SPEAKER_02: That means there's so there is a solution.
• 21:19
  SPEAKER_02: Things don't hurt for no reason.
• 21:20
  SPEAKER_02: This is the pathway we're gonna be on.
• 21:22
  SPEAKER_02: That's what day one looks like.
• 21:23
  SPEAKER_02: Part of the treatment, like the manual therapy, like the soft tissue, dry needling is a component I think is really helpful for soft tissue restrictions and guarding and tightness, and then it facilitates a healing response, really helpful with regenerative medicine modalities as well, like y'all.
• 21:38
  SPEAKER_02: And then like other just cupping, soft tissue, stripping, stuff like that.
• 21:40
  SPEAKER_02: But adrenaline can be really helpful too.
• 21:42
  SPEAKER_02: But that's day one.
• 21:43
  SPEAKER_02: That's what day one looks like.
• 21:44
  SPEAKER_03: All right, the reason I asked that is because NPT with regenerative medicine, the assessment is extremely important, right?
• 21:51
  SPEAKER_03: If you are guessing, like if your knee hurts and a doctor's like, okay, great, we're gonna do a joint injection right to the knee.
• 21:59
  SPEAKER_03: You're gonna feel great.
• 22:00
  SPEAKER_03: That's not a good path.
• 22:02
  SPEAKER_03: You have to find out what the problem is and then proceed from there.
• 22:05
  SPEAKER_03: Yeah.
• 22:06
  SPEAKER_03: So that's all of our time today.
• 22:08
  SPEAKER_03: Thank you for joining us on the Peak Performance Podcast, Dr.
• 22:10
  SPEAKER_03: Kyle.
• 22:11
  SPEAKER_02: Uh yeah, thanks for having me.
• 22:12
  SPEAKER_02: It was super cool.
• 22:12
  SPEAKER_02: I'm glad y'all brought me in, and it's always good to collaborate and get cool insights from experts like you guys, you know, on these on this field.
• 22:19
  SPEAKER_03: So if you want to learn more about Dr.
• 22:21
  SPEAKER_03: Kyle, we'll uh link his information down below in the show notes.
• 22:24
  SPEAKER_03: And this is Coach Kyle and Dr.
• 22:26
  SPEAKER_03: Kay.
• 22:27
  SPEAKER_01: Thank you guys.
• 22:28
  SPEAKER_01: We'll see you next time.
• 22:29
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