Latest / The Driven Athlete / What If The Biggest Limiter Is Not Your Body? | Ep 128

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What If The Biggest Limiter Is Not Your Body? | Ep 128 · The Driven Athlete

0:00
SPEAKER_00: If you're a driven, active person who wants to reach and pursue a higher quality life with some ambition, then guess what?
0:06
SPEAKER_00: This podcast is for you.
0:08
SPEAKER_00: This is the Driven Athlete Podcast.
0:12
SPEAKER_00: What's up, y'all?
0:13
SPEAKER_00: Welcome back to the Driven Athlete Podcast.
0:15
SPEAKER_00: Jimmy, Dr.
0:16
SPEAKER_00: Kyle.
0:17
SPEAKER_00: A question that we get a lot from patients is like, okay, cool.
0:21
SPEAKER_00: I'm on board.
0:22
SPEAKER_00: I want to fix my pain, but when is it going to get better?
0:24
SPEAKER_00: So like when am I going to be good?
0:26
SPEAKER_00: And uh that's a loaded question.
0:27
SPEAKER_00: It's hard, and I know it sucks, but the answer is commonly like it depends.
0:31
SPEAKER_00: All right.
0:32
SPEAKER_00: I know it's a bummer.
0:33
SPEAKER_00: Because we were like, and that on this date, you will be good.
0:36
SPEAKER_00: And you're going to have no pain and you're going to be back to doing your your whatever you want to do, play baseball, exercise, shoulder press, running on the beach, trending for your 5K at full go.
0:45
SPEAKER_00: On that date, you'll be good.
0:46
SPEAKER_00: Well, it doesn't really work like that.
0:48
SPEAKER_00: Um, and a part of that would be, and the answer to that is number one, uh a saying that I just heard somewhat recently that I liked was you can't force a plant to grow.
0:58
SPEAKER_00: Sometimes things need to just take time to heal.
1:01
SPEAKER_00: And so what it means by that is cellular turnover.
1:05
SPEAKER_00: We need tissues to heal.
1:07
SPEAKER_00: All right.
1:07
SPEAKER_00: If you're having issues in your tissues, those tissues need to heal up.
1:12
SPEAKER_00: Number one, they need to settle down.
1:14
SPEAKER_00: Um, and number two, uh, they need to they need to uh improve their structural integrity.
1:20
SPEAKER_00: Um, and that takes just some time.
1:22
SPEAKER_00: Okay.
1:23
SPEAKER_00: And we're gonna get into that in a minute, too.
1:25
SPEAKER_00: But the first thing I want to talk about is when will I get better?
1:28
SPEAKER_00: Well, for a non-traumatic injury, all right.
1:30
SPEAKER_00: This is somebody, this is the bread and butter that we see, which is I don't know what's what happened, but my shoulder just kind of started hurting.
1:36
SPEAKER_00: Like I felt a pinch when I was pressing overhead or doing shoulder raises or push-ups or whatever.
1:40
SPEAKER_00: It just started hurting.
1:41
SPEAKER_00: I didn't like fall.
1:42
SPEAKER_00: It where there wasn't one moment, it just became more pronounced.
1:46
SPEAKER_00: Same thing with low back.
1:47
SPEAKER_00: My low back started hurting.
1:48
SPEAKER_00: I just got it tight, you know, it's getting tighter.
1:50
SPEAKER_00: And I just noticed it for a while.
1:52
SPEAKER_00: Been going, I've been noticing it more pronounced maybe for the last four to five months.
1:56
SPEAKER_00: Um, initially, maybe my first noticing of it being tight was like maybe six to eight months ago.
2:02
SPEAKER_00: And then it's gotten more pronounced.
2:03
SPEAKER_00: And over the last couple of weeks, it's been very tight.
2:06
SPEAKER_00: I'm having some pain in my glute and my hamstring, which we would call like referred pain, like ridiculous.
2:11
SPEAKER_00: It's just referred pain, all right.
2:13
SPEAKER_00: A ref a pain referral pattern.
2:15
SPEAKER_00: But anyway, so that's non-traumatic.
2:18
SPEAKER_00: When will I get better?
2:19
SPEAKER_00: Well, the answer to that question is it depends on the severity of the issue, the current irritability, all right, the nature of it, all right, and then the stage, which would be like, how long has it been going on?
2:31
SPEAKER_00: All right.
2:32
SPEAKER_00: So um the severity be like, how bad of an issue has it been?
2:35
SPEAKER_00: Like, oh, my pain's like a three out of 10.
2:37
SPEAKER_00: It's not bad.
2:38
SPEAKER_00: Versus it's really progressed, it's like an eight, all right?
2:41
SPEAKER_00: It's bad.
2:42
SPEAKER_00: It hurts a lot.
2:43
SPEAKER_00: Irritability being um, how what's the tolerance level?
2:46
SPEAKER_00: Like, um, is it extremely irritable and sensitive?
2:49
SPEAKER_00: Like if you move one direction, it's like boom, it lights up and like boom, it hurts really bad.
2:53
SPEAKER_00: Or is like, you know, I can do a lot on it.
2:55
SPEAKER_00: It's not like very sensitive and irritable.
2:58
SPEAKER_00: Um, that would be a low irritability rate.
3:00
SPEAKER_00: That also plays in the equation of how long will it take for me to get better?
3:04
SPEAKER_00: The nature being like, is it chronic or is it acute?
3:07
SPEAKER_00: Um, and then also is it neurological versus there's no neural neural involvement and it's just purely musculoskeletal pain um versus preferred nerve pain, that also plays a role of like how long are things gonna get better?
3:20
SPEAKER_00: And then the stage being like, what stage are we at now?
3:22
SPEAKER_00: Is it acute, subacute, is it is it chronic?
3:25
SPEAKER_00: Um, so those all those factors kind of play a role.
3:28
SPEAKER_00: So if it's extremely severe pain, it's like a matter of eight out of 10, it's very debilitating.
3:34
SPEAKER_00: And it's very irritable.
3:35
SPEAKER_00: All right, like I can't move abruptly, I can't move a lot.
3:39
SPEAKER_00: I have to rest after a couple of hours of working because like it just builds up and hurts a lot.
3:44
SPEAKER_00: Um, the nate, there's some neurological involvement, right?
3:47
SPEAKER_00: I just have referred type pain too.
3:49
SPEAKER_00: Um, that just increases the level likelihood of it being more severe.
3:53
SPEAKER_00: And then the stage, it's been going on for like, you know, it's been going on for a year.
3:57
SPEAKER_00: It's kind of a long time.
3:58
SPEAKER_00: I mean, we're in the chronic stage at that point.
4:00
SPEAKER_00: That kind of an issue is gonna take a lot longer to get better than somebody who's um, you know, it just it just began a couple weeks ago.
4:08
SPEAKER_00: It's not that irritable.
4:10
SPEAKER_00: Um, it's not that severe.
4:11
SPEAKER_00: It's like a four at the worst.
4:13
SPEAKER_00: And I feel it constantly at a two.
4:15
SPEAKER_00: Um, it's just localized in my low back or localized on my shoulder.
4:18
SPEAKER_00: It's not going down my arm or something like that, or localized in my neck, and it's just tightness in my trap or my behind my neck, and I can't like bend up or down or sideways a little bit.
4:27
SPEAKER_00: Um, and then uh it's it's it's just it's uh subacute.
4:31
SPEAKER_00: It's not, it didn't just happen last week, but it's only been going on for a handful of weeks.
4:36
SPEAKER_00: That's gonna get better more quick, all right.
4:39
SPEAKER_00: Um, so those factors kind of all play a role, all right.
4:42
SPEAKER_00: Um, and the other contributing factors of is it gonna get better quickly or not, or when am I gonna be good better?
4:48
SPEAKER_00: Well, in addition to the severity of the issue, the irritability, the nature and the stage, all right.
4:53
SPEAKER_00: Also the age of the person, all right.
4:55
SPEAKER_00: So, like if somebody's like an 18-year-old freshman in college that has an issue that just began like three weeks ago and it's not that irritable and it's not that severe, um, and there's no neurological, like it's not radiating down their arm, it's just localizing their neck or just impingement in their shoulder type symptoms, like that's gonna get a lot better.
5:12
SPEAKER_00: That's gonna get better a lot faster, right?
5:13
SPEAKER_00: A couple weeks and they're gonna be good.
5:15
SPEAKER_00: They're gonna notice improvements pretty quickly.
5:17
SPEAKER_00: Whereas if somebody is yeah, uh like over the uh, you know, over the age of of 45, all right, um, they're a working adult with kids.
5:27
SPEAKER_00: Um, let's say the profile like this, all right.
5:29
SPEAKER_00: You're 64 years old, um not of your overweight, okay, um, smoker, they drink and they have a past medical history of diabetes, um, uh high blood pressure, um, congestive heart failure, all right.
5:44
SPEAKER_00: And the pain is really debilitating and bad.
5:47
SPEAKER_00: And it's like an eight out of 10.
5:48
SPEAKER_00: Um, it's very irritable, it's very sensitive, and they can't move very well.
5:52
SPEAKER_00: All right, you see where I'm going with this?
5:53
SPEAKER_00: It's been going on for like three years.
5:56
SPEAKER_00: All right.
5:56
SPEAKER_00: So a 64-year-old that's obese, that has congestive heart failure, uh, hypertension, um, uh diabetes, they smoke and they drink, they don't eat well, they don't exercise a lot, and they have all those other severe factors.
6:08
SPEAKER_00: Like it's been going on for a while, it's very painful and it hurts a lot, and it's irritable.
6:12
SPEAKER_00: Yo, that person's gonna take a while.
6:14
SPEAKER_00: All right, like it's like the ceiling of improvement is lower for somebody in that age demographic versus an 18-year-old that just brand new has an issue.
6:23
SPEAKER_00: Um, and then the likelihood of them getting better quickly is a lot lower.
6:27
SPEAKER_00: So the length of time for things to get better is gonna take a little, a lot longer.
6:32
SPEAKER_00: That plant to grow is gonna take a little longer and more, more nurturing and care and purposeful direction over a longer period of time.
6:41
SPEAKER_00: So all those factors kind of play a role.
6:43
SPEAKER_00: In addition to that, um, the willingness and commitment for them to get better.
6:48
SPEAKER_00: Like, I'm all in, let's get this thing better.
6:49
SPEAKER_00: I'm on a healing campaign.
6:51
SPEAKER_00: I'm on a campaign to get this thing better, full focus, full send.
6:55
SPEAKER_00: I'm just diving into just getting this better.
6:58
SPEAKER_00: Versus like, I'll come in, you know, I'll work on this stuff every other week, maybe, and then I'll do my exercises.
7:03
SPEAKER_00: I do them occasionally, but they're not gonna like what's the likelihood of that?
7:07
SPEAKER_00: Like, what do you think?
7:08
SPEAKER_00: You're right, like what's the likelihood of them getting better pretty quick?
7:11
SPEAKER_00: Probably not, all right.
7:12
SPEAKER_00: Um, compared to somebody who's like dove, I'm all in, let's let's focus on this thing and I want to get this thing.
7:17
SPEAKER_00: What what more can I do to get this better?
7:19
SPEAKER_00: I'm gonna I'm gonna have a net a pen and a pad, I'm gonna take notes, I'm gonna do, I'm gonna log what I need to do.
7:25
SPEAKER_00: We're also not talking about ruminating or being super neurotic over the pain or the issue, but being mindful and putting an appropriate effort into the cause, that's gonna be helpful.
7:34
SPEAKER_00: Definitely being, you know, over overly neurotic and um very uh ruminating over the issue and very um hyper-vigilant, all right.
7:43
SPEAKER_00: Hyper-vigilant on like I felt a little bit when I did this.
7:45
SPEAKER_00: Oh, I felt that.
7:46
SPEAKER_00: I'm gonna write everything that I feel.
7:48
SPEAKER_00: That is not also that crosses the line of being um of of not being helpful, all right.
7:54
SPEAKER_00: Because if uh we're super hyper-focused on the pain all the time, that rumination just brings more attention to it and it makes it more pronounced.
8:01
SPEAKER_00: So there's a balance.
8:03
SPEAKER_00: Be mindful and work on some stuff and be committed, but not at the point of over of crossing over the line of being neurotic and ruminating, all right, and being hyper-vigilant.
8:12
SPEAKER_00: Um the health profile of the person, like I said, is uh like their, you know, that age, um, their uh past medical history, um, their current lifestyle choices, and their like that all plays in the likelihood of getting better quickly.
8:25
SPEAKER_00: All right.
8:26
SPEAKER_00: Um, their overall intellect, as in like what's their understanding and what's the goal of what we're doing here?
8:31
SPEAKER_00: All right, do you understand the issue?
8:32
SPEAKER_00: Do you understand the um what we're trying to do of an overarching goal of like what's the whole plan, right?
8:38
SPEAKER_00: What does it all entail?
8:39
SPEAKER_00: Uh, can you wrap your head around that a little bit?
8:42
SPEAKER_00: Um and then their understanding of like pathology, that also kind of helps.
8:46
SPEAKER_00: Um, and then also support, being like social support, family support, social support.
8:51
SPEAKER_00: Um, do they have other uh uh other kind of home dynamics and relationship dynamics that are helpful and constructive and supportive, or uh home social relationship dynamics that there's underlying resentment involved?
9:08
SPEAKER_00: Um their spouse or their family members are um just not being helpful, as in like, oh, about you again.
9:15
SPEAKER_00: All right, we're gonna have to go to the doctor again for you, right?
9:18
SPEAKER_00: Like stuff like that.
9:19
SPEAKER_00: That kind of thing.
9:20
SPEAKER_00: I mean, that's not my job, not my role.
9:22
SPEAKER_00: I'm just saying that like that stuff does happen and um that plays a factor in somebody's likelihood of getting better pretty quick, right?
9:28
SPEAKER_00: So to answer the question, patient, right?
9:31
SPEAKER_00: To answer your question, how when will I get better?
9:34
SPEAKER_00: It depends on the severity, the irritability, the nature, and the stage, your age, your pathos medical history, your health profile, your optimism, how long this has been an issue, your willingness to commit to get better, um, the intellect behind the understanding, the pathology.
9:48
SPEAKER_00: Um, do you understand the goal, understand what we're trying to do here in total?
9:52
SPEAKER_00: And then social support.
9:53
SPEAKER_00: So all those things kind of play a role in like when am I gonna get better?
9:56
SPEAKER_00: So that depends on each person individually.
9:58
SPEAKER_00: So when we talk to somebody in a during an evaluation or during your treatment plan, those are the kind of conversations we're having.
10:04
SPEAKER_00: It's like you're really you're bought into this, like you want to get better, you're doing everything you can, cool.
10:09
SPEAKER_00: Like you're gonna and you're uh on the younger profile, like you're not 75 with an obese, but you're 38 and you're healthy, you have a healthier lifestyle choice, you've been exercising, you understand what's going on and you're committed, their likelihood of getting better is is quicker, right?
10:25
SPEAKER_00: Even if it's really severe and very irritable, their likelihood of getting better, that checkbox, check mark on the box is that this is helpful.
10:32
SPEAKER_00: Um, this is said this is going to be more challenging of a component for getting better.
10:36
SPEAKER_00: But overall, here's what we think based on your whole profile.
10:40
SPEAKER_00: So that's kind of the answer.
10:41
SPEAKER_00: All right.
10:42
SPEAKER_00: And that's for so that is for non-traumatic pain.
10:45
SPEAKER_00: That's different than traumatic pain.
10:47
SPEAKER_00: Traumatic being like I fell down the stairs or I've had a car accident or a work injury, like something fell on me on my shoulder, like a big piece of wood or something like that.
10:56
SPEAKER_00: Um, or I was playing sports and I twisted my knee and I heard a pop, right?
11:00
SPEAKER_00: Whatever.
11:01
SPEAKER_00: I sprained an ankle.
11:02
SPEAKER_00: So those would be traumatic injuries, right?
11:05
SPEAKER_00: That depends as well on the severity of the of the injury, um, the irritability of it, all right.
11:13
SPEAKER_00: Um, and then in addition, like their age, their past medical history, their length of time of issue, their willingness and commitment to get better, their health profile, their optimism around the issue of like, am I gonna get better or not?
11:25
SPEAKER_00: Like an overall optimism, their intellect behind, understanding the prof the pathology, and then their support, um, the social support.
11:32
SPEAKER_00: So there is a lot of overlap for sure.
11:34
SPEAKER_00: But for traumatic pain, that's let's there clearly it's it's a lot different um nature and manifestation of the issue.
11:41
SPEAKER_00: And uh another thing that people um so to answer the same, it's a very similar question, a lot of overlap.
11:47
SPEAKER_00: A lot of people say it's been a little while, but it still is hurting, and I feel it in my shoulder when I fell.
11:53
SPEAKER_00: I fell down, right?
11:53
SPEAKER_00: That's here, that's a classic thing right here, okay?
11:56
SPEAKER_00: Um, I fell, I tripped, and I landed on my arm, on my elbow, and it was a it was a big, it was a big bump.
12:02
SPEAKER_00: All right.
12:03
SPEAKER_00: Like I tell my kids, it was a huge bonk.
12:05
SPEAKER_00: I mean, you bonk pretty hard, right?
12:07
SPEAKER_00: Um, there's no fracture, all right, but um, you jammed your shoulder, you jammed your elbow, there was an impact, um, and you strained some your rotated cuff or whatever, trying to catch, and it was a big impact, right?
12:18
SPEAKER_00: It was a big jolt jolt and impact in the shoulder joint in your elbow.
12:22
SPEAKER_00: Um, and but there's no breaking, there's no bones broken.
12:25
SPEAKER_00: Okay, cool.
12:25
SPEAKER_00: You don't need surgery.
12:26
SPEAKER_00: There's not evidence of like a major rotator cuff tear because of the injury or even previous rotated cuff involvement.
12:31
SPEAKER_00: That would indicate the need for surgery.
12:34
SPEAKER_00: So the plan of action, what's the course of action?
12:36
SPEAKER_00: We're gonna do some range of motion, some physio, some range of motion, mobility, joint mobilizations, soft tissue work where it's appropriate to help facilitate blood flow and the healing process and tissue pliability and extensibility, and then corrective exercises.
12:50
SPEAKER_00: And part of the corrective exercises and the overarching goal of all that stuff is motion is lotion, blood flow, synovial fluid, nutrients and oxygen delivered to the joint in the injured areas to help facilitate the um the healing process and also not limit the amount of the sealing of range of motion afterwards.
13:08
SPEAKER_00: Because if you didn't do anything with that, you just held your arm in a sling forever.
13:11
SPEAKER_00: Like when you get out 12 weeks later, that's never never do it again, like you're not gonna be able to raise your arm up overhead very well compared to when you previously did, or if you did conservative physical therapy um interventions to help maintain the range of motion and regain that back.
13:24
SPEAKER_00: So all that stuff's been going on, cool.
13:26
SPEAKER_00: It still hurts, and it's been 12 weeks.
13:29
SPEAKER_00: Why?
13:30
SPEAKER_00: A huge thing that we have to not neglect that kind of goes overlooked is a bone bruise, all right, bone contusions.
13:36
SPEAKER_00: That for a traumatic injury, I fell on my knee, I fell on my arm and my shoulder, um, I fell backwards and hit and um I hit my back or whatever, or or fell backwards and hit my hip, like the side of my hip.
13:49
SPEAKER_00: Um, though those bony prominences get struck and it there's an impact on the bone.
13:55
SPEAKER_00: And bone bruises um are very common with that kind of thing.
13:59
SPEAKER_00: And the bone contusion, that that takes the longest to heal of all this other soft tissues, all right?
14:06
SPEAKER_00: Like if there's um um an impact of bruise on your arm on like their muscle or the on the skin, right?
14:12
SPEAKER_00: Um, that heals up pretty quickly, right?
14:14
SPEAKER_00: I mean cell turn cellular turnover is six to eight weeks.
14:17
SPEAKER_00: Usually in three weeks, people are gonna feel better.
14:19
SPEAKER_00: And six to eight weeks, they turn a corner.
14:22
SPEAKER_00: But bone bruises take a lot longer, and that's what contributes to the lingering pain.
14:26
SPEAKER_00: And that's something we can't neglect.
14:27
SPEAKER_00: And that's for an impact injury, right?
14:29
SPEAKER_00: So I fell down and landed on my shoulder or whatever.
14:32
SPEAKER_00: Um, I feel it's getting better, but like it still hurts inside my shoulder, it's still tender or whatever.
14:37
SPEAKER_00: That we can't neglect is a bone bruise.
14:39
SPEAKER_00: And usually in that conversation, there's a light bulb moment and an uh understanding of like, oh, that makes total sense, right?
14:46
SPEAKER_00: Um, and if they had imaging, that would show an MRI, like a bone contusion and edema like in the joint.
14:52
SPEAKER_00: And so those take 12 to 16 weeks to get to get better for an impact like that, 16 to 20 weeks for a bone bruise.
15:00
SPEAKER_00: Um, so those things linger and that can linger the pain.
15:03
SPEAKER_00: So that's you know, that's part of the part of the equation, you know, um of like when am I gonna get better?
15:07
SPEAKER_00: So it's something we can't neglect.
15:08
SPEAKER_00: And then the last component of like, when am I gonna get better and when can I go back to running or when can I go back to exercising or pushing myself or whatever?
15:16
SPEAKER_00: Surgery.
15:16
SPEAKER_00: All right.
15:17
SPEAKER_00: So if somebody had surgery, a surgical protocol is also different.
15:21
SPEAKER_00: Um again, the bottom, like there's a protocol that we have to follow, and tissues need to take time to heal.
15:27
SPEAKER_00: Um, so they need healing time, right?
15:30
SPEAKER_00: Um, overall to answer other questions like this for patients, cell cellular turnover rate is usually six to eight weeks.
15:38
SPEAKER_00: So if somebody had like a um, you know, an ACL repair reconstruction, a total knee replacement, a hip replacement, a rotated cuff repair, the um the overall uh general rule of thumb is that it takes six to eight weeks for cellular turnover rate for the tissues to improve and fortify their structural or integrity, enough of a turning point to where like there's enough of a structural integrity and change and improvement to where it can tolerate um and a lot more and more stress, as in like motion, right?
16:09
SPEAKER_00: And and activating the muscle tissue.
16:12
SPEAKER_00: Um, and then also um for things to feel better, right?
16:15
SPEAKER_00: For things to be less sensitive and irritable.
16:18
SPEAKER_00: So six to eight weeks is the turnover rate in general for a lot of soft tissue.
16:22
SPEAKER_00: Okay.
16:23
SPEAKER_00: After three weeks, you know, there's a there's people feel better, where it's like I'm noticing some improvements, we're going in the right direction, cool, but we're not there at that six to eight week where people usually turn a corner.
16:32
SPEAKER_00: We're like, I feel a lot better today.
16:33
SPEAKER_00: You know, like this past week, I've definitely felt an impro a lot, a significant improvement.
16:38
SPEAKER_00: I'm able to sleep better, I'm able to walk around better, I can bend it and move it better.
16:42
SPEAKER_00: Um, so that's a that's the cellular turnover um time frame, six to eight weeks.
16:47
SPEAKER_00: Um, it's important during that time though, like after surgery, rotated cuff, ACL reconstruction, total knee replacement, we definitely have to focus on range of motion.
16:56
SPEAKER_00: If you, if a person doesn't focus on and commit to a range of motion and some muscle activation totally too, but um the stiffness and the lack of mobility, the ceiling of how high of like the the raising the ceiling or lowering the ceiling of what's the capacity of my shoulder or my knee to move as well again, man, we gotta move it.
17:17
SPEAKER_00: Like that thing has to regain full motion by six to eight weeks because that turnover rate, things heal, the tissues heal in that capacity by that point more significantly.
17:28
SPEAKER_00: So the gains of range of motion after that point, after six to eight weeks, the window closes and the ceiling shortens and narrows significantly.
17:38
SPEAKER_00: So it's really that's where like we get hit the gas pedal on range of motion, even though it might be uncomfortable.
17:42
SPEAKER_00: I'm all about staying within like an appropriate discomfort range to not light things up more, make things more irritable during that acute phase of rehab and the early stages of post-surgical.
17:53
SPEAKER_00: But um, you have to move it, man.
17:55
SPEAKER_00: You gotta move that stuff.
17:56
SPEAKER_00: Otherwise, it's the window short, it's close, it closes down.
17:59
SPEAKER_00: The ceiling uh narrows and closes down too.
18:02
SPEAKER_00: And the likelihood of mobility is a lot less after that of making significant gains if they haven't already been made.
18:08
SPEAKER_00: Um, so that's really important.
18:10
SPEAKER_00: Um, so it takes time for tissue to heal, right?
18:13
SPEAKER_00: Um, and you can't force a plant to grow, right?
18:16
SPEAKER_00: Like this, your knee needs to heal.
18:18
SPEAKER_00: And we're facilitating the healing process with these mild interventions that we're doing right now, these appropriate stage appropriate interventions that we're doing currently in these early stages of like three weeks out, four weeks out, five weeks out, because it'll really set the stage for a better outcome in the future.
18:34
SPEAKER_00: Where if we don't focus on it now, the outcome in the future is a lot less, which is a bummer.
18:39
SPEAKER_00: And I've seen it, and it's a huge bummer.
18:41
SPEAKER_00: Um, I just don't know if the the um the severity and the gravity of that was uh conveyed well enough to the patient before surgery to be like, when you're out of surgery, you have a new knee, amazing, or your ACL is new, it's can reconstructed, but your knee's gonna hurt and it's gonna be stiff, and we have to move that thing, and you're not gonna feel new for like you know, like eight, 12 months.
19:07
SPEAKER_00: Like it's not, it's this is a journey, and the early stages really set the stage for a redder journey down the future.
19:13
SPEAKER_00: But anyway, for like when am I gonna get better?
19:15
SPEAKER_00: When am I gonna feel better?
19:16
SPEAKER_00: We can't force a plant to grow.
19:18
SPEAKER_00: Tissues do just need to heal, and we're facilitating that totally.
19:22
SPEAKER_00: And there's a protocol stage appropriate that we need to follow during the healing process to not make things worse, re-tear the surgical site, um, not light things up, but also not stagnate process of the process and limit the overall ceiling in the future by hitting the gas pedal now with stage appropriate interventions.
19:42
SPEAKER_00: Um, so that's part of it.
19:43
SPEAKER_00: So, like that that's the you can't force a plant to grow.
19:46
SPEAKER_00: Tissues do need to heal and we need to follow the protocol.
19:48
SPEAKER_00: When will I get better?
19:48
SPEAKER_00: Depends the it depends on each situation, like I was describing.
19:52
SPEAKER_00: Um but the other thing I was gonna say is um so with athletic individuals or driven people that are like, um, I want to, I I try, I'm I want to get going.
20:03
SPEAKER_00: All right, like I, but I can't.
20:05
SPEAKER_00: It sucks.
20:05
SPEAKER_00: Like I want to be able to walk longer, but my knee still hurts, or like it's getting swollen.
20:09
SPEAKER_00: Like, I want to do this.
20:10
SPEAKER_00: Like, why is it not getting better?
20:12
SPEAKER_00: That whole conversation we just had is part of it.
20:14
SPEAKER_00: The second part of it um that we can't neglect is like it's not you that's limiting you.
20:20
SPEAKER_00: It's just your knee.
20:21
SPEAKER_00: Your knee isn't ready for the impact yet.
20:23
SPEAKER_00: It's not you.
20:24
SPEAKER_00: We know that you want to get better.
20:26
SPEAKER_00: We need to give your knee some grace, or we need to give your shoulder some grace.
20:30
SPEAKER_00: All right, it's just not ready.
20:31
SPEAKER_00: It's not ready for that impact yet.
20:33
SPEAKER_00: It's not ready for that volume of that impact, and it's not ready for um that amount of of stress, the physical stress being placed on it yet.
20:44
SPEAKER_00: Like you can't walk a mile yet, all right?
20:46
SPEAKER_00: Let's walk a quarter mile and then stop.
20:49
SPEAKER_00: Live to fight another day and then do it again the next day.
20:51
SPEAKER_00: Live to fight another day, and incremental improvements and tolerance levels will increase and the threshold of tolerance will usually follow suit with the stage appropriate protocol.
21:01
SPEAKER_00: Um, but we can't force a plant to grow.
21:04
SPEAKER_00: We just need your knee and your tissues to heal and settle down, right?
21:08
SPEAKER_00: Um, and facilitate healing with the stuff that we're doing.
21:11
SPEAKER_00: But being overly aggressive will stifle progress and will stifle the healing process, which we don't want to do and nobody wants to do.
21:17
SPEAKER_00: So it's not you, it's just your shoulder or your knee.
21:21
SPEAKER_00: It's just not ready yet for that kind of impact.
21:23
SPEAKER_00: We know that motivation and enthusiasm isn't your issue, but we don't want motivation, motivation and enthusiasm to turn into an overuse injury or an overuse problem where things are just chronically not getting better.
21:34
SPEAKER_00: Um, it's just because you're just doing too much, right?
21:36
SPEAKER_00: But hey, it's not you, right?
21:37
SPEAKER_00: It's just your knee, it's just not ready.
21:39
SPEAKER_00: We need to allow that thing to settle down.
21:41
SPEAKER_00: We need to nurture this thing and and um facilitate stage appropriate interventions.
21:45
SPEAKER_00: Totally, we're just doing too much.
21:47
SPEAKER_00: So that impact tolerance um will increase incrementally, and it does improve better with stage appropriate interventions over time.
21:57
SPEAKER_00: So to answer the question, when will I get better?
22:00
SPEAKER_00: It's all that.
22:01
SPEAKER_00: It's that whole thing.
22:02
SPEAKER_00: All right.
22:02
SPEAKER_00: And that's case by case, an individual, and we have one-on-one conversations with our patients to go through where are you at and what do you need and what uh is the likelihood of you getting better at this stage or this these incremental touch points, these checkpoints.
22:16
SPEAKER_00: It's dependent on each person, you know, each of their health profile, their age, their um irritability, the stage of it, the um severity of the issue, right?
22:26
SPEAKER_00: Um, their past medical history, their length of time of the their willingness to commit to get better, I think is huge.
22:32
SPEAKER_00: And their optimism is huge.
22:33
SPEAKER_00: Their intellect behind understanding the pathology and what we're trying to do is huge.
22:38
SPEAKER_00: Their social support at home and their relationship dynamics is huge.
22:42
SPEAKER_00: I think it's way more impactful than people realize.
22:46
SPEAKER_00: All right.
22:46
SPEAKER_00: Like, imagine if somebody's like, they're yeah, they have a spouse or a family member that's like, hey, we're all in with you.
22:51
SPEAKER_00: We're gonna help you do this.
22:52
SPEAKER_00: Hey, did you do exercises?
22:53
SPEAKER_00: Hey, did you eat?
22:54
SPEAKER_00: Hey, did you get some sleep?
22:55
SPEAKER_00: Hey, don't forget to do this.
22:56
SPEAKER_00: I'm just checking on you.
22:58
SPEAKER_00: Did you do that?
22:58
SPEAKER_00: Versus like, uh, wow, it's all about you, right?
23:01
SPEAKER_00: We're going to another doctor's visit.
23:03
SPEAKER_00: Why aren't you better yet?
23:04
SPEAKER_00: You know, can you get back to work now?
23:05
SPEAKER_00: Right?
23:05
SPEAKER_00: Can you get back to work and start helping us out at the family?
23:08
SPEAKER_00: Because we need you, right?
23:09
SPEAKER_00: Like stuff like that is not helpful and it sucks.
23:12
SPEAKER_00: I don't, I'm, I mean, it's a bummer.
23:14
SPEAKER_00: That happens.
23:14
SPEAKER_00: Like I said, it's not my job.
23:16
SPEAKER_00: I don't really dive into that kind of stuff with people.
23:17
SPEAKER_00: I just bring to the table, hey, social support, family dynamics, and relationship support at home is a factor.
23:23
SPEAKER_00: Next thing, also stage.
23:25
SPEAKER_00: Now that's kind of like we talked, that's that's the touch point because I'm not gonna dive into their family dynamics by any means.
23:30
SPEAKER_00: That's not my job.
23:31
SPEAKER_00: Um, but those things are way more impactful than people realize of like to answer the question, when will I get better?
23:37
SPEAKER_00: When will I get back to running?
23:39
SPEAKER_00: Those are those are very um those are very impactful and have more weight than people think.
23:43
SPEAKER_00: So if any questions or any or any issues specifically that you have that you want to talk about, give us a call.
23:48
SPEAKER_00: We can at least chat on the phone, see what you're going on, and how we might be able to help you.
23:51
SPEAKER_00: Um, and uh, we'll catch you all next time.