Ep. 333: Does Age = Pain? How to NOT Age Like Everyone Else!

0:00They say the only sure things in life are death and taxes. But talk to almost anyone over 30 and they might add joint pain to that list. You know, the normal aches and pains of aging, but is it normal or is it just common? My next guest is going to help us confront the three lives of aging as well as teach us how to advocate for ourselves at the doctor's office. She's a physical therapist with a fellowship in applied functional science and a nutrition educator diploma with decades of hands-on work in acute hospital care, outpatient rehab and nursing homes, and is currently serving as a chronic pain and health conditions consultant with have lifelong well-being. Today, she's going to help us learn how to not age like everyone else as we ask the question, is pain inevitable? This is the Curious Intervert podcast with me, Meredith. Around here, we explored taboo questions and societal blind spots. Please help me welcome the woman confronting normal with a passion for the practical and an obsession for vitality, Eileen Kupsoftis. Thanks for being here.

1:03Oh my goodness, thank you. I love that introduction. I just wanted to like jump up and down with everything you were saying. Good, good. Well, I'm really excited to have this conversation because I think aging and like midlife in the United States is weird and we should just take a moment to acknowledge how weird it is because on the one hand, it's so normal for us to be expected to age aesthetically well, that celebrities who decide not to have Botox or fillers make the news, and then in the same breath, you're talking with people and they say, oh, I have these bodily aches and pains, and it's also within the normal expectation for them to brush it off as, quote, getting older. So here's my first question. Okay. When both of those things are true in the society that we live in, how do we orient ourselves towards goals that are real? Well, you know, I always tell people the most important thing is can you do the things that

2:06matter to you or do you start losing the ability to do the things that matter to you? So most of what we expect to happen because it's, quote unquote, normal. It's not really normal. It's common. We see it everywhere, but I, you know, I did home care for a decade and I worked with a lot of people. I did acute care, hospital care, and I worked with a lot of people over 100 years old, and they showed me that they had full lives. They were still cooking and shopping and cleaning and doing their own finances and driving. You don't see that in the headlines. You don't see that. All you're going to see is, you know, this, this medical issue, that medical issue, this, and we've got the medical profession that kind of feeds into that as well. Well, you are whatever age, you are 62, you know, you are 75, you know, what do you expect at your age? And so we're kind of been preconditioned with this mainstream narrative that we're supposed to start losing the ability to do the things that matter. And it's not true. So what they were seeing is that when the cells

3:11are receiving what they need, what nourishes them, what provides life to them, they'll just keep going. So we know what we need because it's a little, it's confusing because I understand there's a little bit of evolutionary mismatch here, right? Because we have these ancient hardware and software, but we've got this advanced, you know, 5.0 environment that we're living in when we've got Wi-Fi and we've got Chick-fil-A and we've got all the things. We've got desk jobs. And so I feel like living up to our potential, whatever it is, is more challenging because it, by its very nature of the contrast of how our bodies are from an ancient perspective and how our world is from a societal perspective, they are in high contrast to each other. So because of that, we become weirdos, like health weirdos, automatically, if we do anything that isn't just completely with the flow

4:15of traffic. Yes, we have to be salmon swimming upstream, absolutely. And it's true because if you are hitting the drive-through every day coming home from work, if you're sitting all day, if you're not moving, you're going to experience what's considered decline from those things, but that's not decline, that's the body responding to not living life the way the body wants you to live your life, your body wants you to get up and move, your body wants you to walk, your body wants you to produce some effort and lift and push and pull and do things, your body wants you to drink water, your body wants you to eat healthy foods that are going to provide the nutrition, but is it getting it? As you said, our environment, it's a challenge. Well, the mindset part is a total challenge because of its counter-cultural nature and because if you believe that whatever health challenges,

5:17aches and pains are genetic or otherwise inevitable, I have met quite a few people that are like, hey, at this point, this is what they say. At this stage in the game, I might as well just enjoy what I like, live my life. You know, this is not the time to start giving up alcohol. I'm going to die soon anyway, whatever. So tell me what you've seen having as much field experience as you have had because I feel like that might set the stage better for a little bit more open-mindedness for all of us. Especially in the home care setting because you get to see people's environments, their intimate environments, their kitchen, what's on the kitchen counter? How are they living their life? And I saw a complete dichotomy of those who were recovering from a relatively minor illness. I mean, when somebody is 90-something and they get a really bad cold and it kind of goes into a little bit of an ammonia, they might go in the hospital for a day or so to need the medications, to recover from it, and then they go home. But because they were so active and had such healthy

6:24habits, they recovered very quickly and no problem. And I would go into their home making sure that always good. They didn't struggle getting in and out of their tub or whatever. They'd gotten a strength back and all of that. And I would see, you know, bowls of fruit on the table. They drank water. When I went to have them do some strengthening exercises, they didn't bulk. They were like, oh yeah, I exercise my whole life kind of thing. But then I would work with the flip side of that where someone would be maybe as young as their late 60s. And I go into their home. They're in a wheelchair. They've got a whole bunch of medications all over the kitchen counter because of lots of diagnoses. They're medically manipulating all those, those blood biomarkers to try to live longer. But it's not much quality. And they don't, they struggle to get out of the wheelchair without assistance. And they tell me, oh, I don't really like to exercise. I've never really exercised. And I want them to drink some water so that their muscles are hydrated. And your muscles can't grow without water. They're 78% water. And, oh, I don't really like water. I've never drank water. I just

7:27don't like water. And, you know, their counter is filled with all kinds of baked goods and sweet treats and junk food. And you don't see a piece of fruit anywhere. And I saw this. I saw this day in and day out the difference. So I mean, I'm not saying anybody deserves what's happening to them. But it's not a surprise if that's what their habits have been for years, decades that they end up different than someone else. I'm glad that you pointed out that you're not saying people deserve what they get at a certain age because I think in the States, we definitely have a strong culture of what's the word I'm looking for? Like, I don't know, maybe individualism or it's just rugged and dependent. So I'm not sure what it is. But it's very much like a, well, you should have known that before you made that decision kind of a vibe. And, you know, there's a lot, if you just look in any town, there's a lot of fast food going on. And it smells real good. And so there's

8:29a lot of opportunities to fall down this other path. I'm curious to hear for your patients that you've worked with who are on the opposite path, who are got the fruit on the table and they're working out. Like, what are we talking about? I mean, are they running ultra-marathons in their 90s or how well are they doing? Oh, no, they're not, they're not the kind of person who's spending three hours a day at the gym. They're just active. They're physically active. And I never really sat down and took details of, okay, what kind of exercises did you do? And how long did you spend at the gym? And, you know, this kind of thing and that kind of thing. I think on the flip side of this, which might be more helpful to people is people who are lacking strength, people who have lost muscle, people who have seen decline in their life. I have seen that turn around when people are doing the right things the right way. When they do start to move, I've seen people in their 80s. I'll never forget one guy. He was 86 and his wife had brought him into the clinic. And she said,

9:33yeah, he used to walk to the corner store every morning to get the paper. Well, he started sitting more and now I got to help him get out of the chair. So the doctor sent him here to get him stronger. And he looks up at me and he says, don't you think at my age, I should be allowed to rest. So that was kind of his mindset. And I looked down at him and I said, well, if you want your wife to dust you off once a day, that's so savage. He kind of looked at me a little bit surprised. But within two or three weeks, he was getting out of the chair like a shot. He had built his strength back in his legs. He didn't need help to get out of the chair. And his wife gave me a feather duster as a gift. That is brilliant. I love it. Yeah, at your age, you should be allowed to rest, but how do you want to rest? I mean, I've seen the misery and nursing home settings and the nursing home I worked in for nine years was one of the best in the area. We got the highest ratings

10:36from the health department when they came into assess. The residents were so well cared for. However, nobody ever wants somebody to have to help them do hygiene when they toilet. That is probably the worst nightmare anybody can ever nobody wants that. I don't care how professional the aids are or how well the facility is run. That's a proud thing. People would rather be independent with that. The same with eating your food. You don't want someone to have to cut up your food or God forbid, you have to have thickener in your water and you can't even drink regular water. It's thick because you have lost strength in the swallowing muscles because you become so deconditioned. I think it's really important for people to understand that nobody ever said a goal to go to a nursing home ever, but it happens by default. If we believe the mainstream

11:38narrative that we're supposed to decline, I'm sure the majority of your listeners believe that at some point as long as they live long enough, they will end up in a nursing home. It's not required. It's not a right of passage before you go below ground. You can live a quality independent life, but you have to know it first. If you don't think it's possible, you're not even going to go for it. And then you have to understand what are the things that matter most to spend your time on. For your patients that have done the best for the longest, who are they hanging out with? How are they finding community that operates like they operate? And I'm asking this because it might seem right, but I mean, if you think about, okay, let's pretend I'm much, much older and I'm trying to do this new thing that Eileen says is possible and not have a stranger wipe my tookus. Great. Love that idea. But when I want to hang out with my favorite people, they're always sitting at lunch

12:41and, you know, having the dessert and maybe, you know, a few cocktails, nothing terrible, but it's just like they, you invite them to go, okay, let's do a walk. Let's do a hike. And they're not interested in that. I'm sure that you've run across people in your clientele who have had this problem like, great, but how do I hang out with my friends or slash find additional friends so that I can do the act of things while not alone. Yes. Yes. And that can be a challenge. And unfortunately, once, once you start to understand that a lot of what we've been led to believe isn't really accurate, you're kind of ruined because you're going to hear these conversations everywhere. And you're going to realize it's like, oh my gosh, everybody's talking about they can't do this. They can't do that. I had an interview with someone the other day who was only 35. And he said when he hit 30, he had all of his friends telling him, just wait now, everything's going to start to, you know, you're going to realize you're getting older. It's crazy. So I mean, you know, I'm 67. I don't

13:46wake up in pain. I don't take any medications. I'm not an outlier. I'm not an anomaly or abnormal. I just do mostly the right things the right way, but I don't spend three hours a day in the gym. And I'm not perfect. I do enjoy things. There's a reason we have taste buds, but you know, like you mentioned with all of the fast food joints that are all over the place, they very specifically put additives in their foods to make them more addictive, to make us crave them more. It really isn't people's fault when they struggle with these things because the industry has done its best to promote sales. Their job is sales. Their job isn't your health. So it's waking up to those things is hugely important. But being around people who are like-minded, people who do understand that what they do matters, I'm actually loving it because I'm seeing this big surge of pickleball all over the place. And as a matter of fact, I have a cousin who's

14:49my age, exactly the same age. And they moved into kind of like a retirement area. And he plays pickleball like four times a week. He's fit as a fiddle. Oh my gosh, and strong and endurance. And so I think it's starting to turn around. I think people are starting to see that, wow, I can do stuff and I can have a life. And I don't have to just stop and wait for them to throw dirt on me. So in your work as a consultant, how much do you work with people on mindset and what they say? Because, you know, it's one thing to convince a friend to go on a hike with you. But it's quite another, as you pointed out, in that group of 30-year-olds to try to convince them to not talk about aging in a way that is like doom and gloom. You know, I used to work with someone who he's like, yeah, I'm 30. I mean, literally, he was like a baby. And he like barely 30. And he's

15:53like, yeah, knee pain. And I'd go over to his house and his wife would talk the same way. And there was like Oreos and Coke and whatever. And I was like, guys, you guys are so cool. Like, why do you talk like that? I mean, I figure if you talk different, maybe the actions will follow. But in your work as a consultant, is that ground zero or does that come after the action? Yeah, that's a really good question. It actually, it depends on the person because if they are using those, they have the habit of speaking that way, I do. I'll even say this is a funny story. So I had this young guy come in. He was, oh my gosh, I think he was 19 years old. And he had some knee pain. And he came in and he was saying all these things about how, you know, I'll probably be in a wheelchair by the time I'm 30. And I kind of read him the riot act. I said, why are you speaking death into your life? What are you doing? You got to stop doing that. And the funny part was is the very first session that I worked with him. We were able to switch off the knee pain because

16:56his hip wasn't firing properly. So I just had him improve rotation in the hip and the knee pain stopped. And he looked at me like, what did you just do? You know, like it was voodoo or something. And I said, no, we just, it's science. I mean, we got your hip working. So now your knee's okay. So he saw that it had nothing to do with age. But yeah, it's, it's, you have to, I've had people come into the clinic setting who didn't believe that anything they did was going to get them better. And they were told that they had to come to see me in order to get approval for some test or image or procedure. And so I'm looking at this person and I'm thinking until I can get their mindset to change, I won't be able to help them at all. And so we have a conversation. And then I'll do some little technique or some little method and they, they'll see a little change and I'll say, I think there's a chance that we can, you know, improve things here. I'm not telling you not to have the procedure, the imaging or whatever. But what do you say? We try a few things.

18:01And now they're starting to open their mind up that, huh, maybe there is something I haven't tried that might help. But until the mindset changes, yeah, I'm just going to spin my, spin my tail. Yeah. When the pain gets bad enough, people obviously go to the doctor, sometimes how they come to you. But usually it's, it's like if it's bad enough, usually it disrupts their sleeve and then they're like, okay, I'm going to go to the doctor and they go to the doctor. What have you seen as the most harmful mindsets when it comes to that doctor's appointment? Well, knowing how to navigate a doctor's appointment is a very good thing. And what I found is people tend to think they have to be a medical expert in order to make a good decision and they don't. The simple thing that I advise people is all you have to do is ask this one question. Well, it's kind of a two-parter. Okay, how much will this help me and what are my risks?

19:03And then decide from there. It's an easy pro and con decision to make. You don't have to be a medical expert, but you do have to ask that question because a lot of the times the medical expert may think they know what's best or they may be just recommending something thinking, well, we'll start there. And if you don't ask that question, I've had many people who do ask that question and they say, no, I don't really want to go that route. What else can we do? And then the doctor usually will have some other option. It's important to understand and I know this might sound a little odd to people. You are the one in charge of you. The doctor isn't in charge of you. And I've had many people come into a clinic setting or I've worked with and consulting who wish they did ask those questions and wish they had not said yes to a particular medication or procedure or surgery because they're still dealing with a fallout sometimes years later. So you have to understand what risk are you willing to take? You and the doctor might have a

20:08different opinion about what that is. So you've got to have that conversation for sure. And the doctor may assume that you are like that mainstream majority population person who is not going to be compliant to do at home exercises or make nutritional adjustments. Also, I think it's sometimes insightful to know that most physicians did not receive nutrition training in medical school. Most of them did not. So, you know, that's important. But I love the mindset of asking the doctor about possibilities and risks. I think that's really good because you're kind of letting them know the kind of person that you are as opposed to just showing up and instead you're like really preparing for that appointment. Yes, absolutely. And write your questions down before you go because you're going to forget he's going to be in a hurry or she's going to be in a hurry. And also know that they're there to give you their opinion, their advice.

21:08You can say no to it. You don't have to say yes. I remember there was a young man who had come and listened to a lot of lectures I did locally at different events. And he was in his 30s and he said, you know, before I heard you talk, I thought I had to say yes to whatever the doctor said. I didn't think I was allowed to say no. That's surprising. I find that you have to say yes to the doctor mindset is more of an older person's mindset. But you said he was just 30. Yeah. I know. I was surprised. Yes. Are you allowed to record your doctor's visits? I've heard mixed things on this. That's probably going to be a question you need to ask the doctor. Yeah, they might not be comfortable being recorded. That I'm not really sure about. So it may be better just to bring someone with you who takes notes. Yeah, it's always good to have someone else with you because you may forget something they said that's very important that you need to remember. Yes, always good to have a second set of years. Okay, so the questions were, how is this going to help me?

22:13What are the risks? And what was the third question again? Say the diagnosis is kind of a scary one and they're saying, okay, we're going to set you up for tasks and we're going to, you know, do this tomorrow and whatever. A lot of the times it doesn't hurt to say, is there a rush? Can I do some research? Can I look into some other things? Or do I need to do this immediately? And surprisingly, a lot of the times they'll say, oh no, you've got time. Yeah, you can take some time, you can take a couple of weeks to decide. So sometimes we think just because they're ready to set us up with everything and schedule everything that it has to be done right now. And you don't have time then to do any research or ask any questions. And a lot of the times it's not the case. It's not a big hurry. So that kind of leads to live aging number one, is that medical tests equal the perfect plan? Yes. So there is so many clinical studies that have been published now that show that whatever

23:14shows up on imaging doesn't always match the symptoms. And what I mean by that is people can have no symptoms whatsoever and have all kinds of things show up. I'm talking bulging discs in the cervical spine and their neck, herniated discs, meniscus tears, rotator cuff injuries, and they'll have no symptoms. And then there's also the people who have symptoms and nothing shows up on imaging. And then you've got people where they have symptoms and something does show up on imaging. So because of that, what I tell people is just because it shows up on imaging, it doesn't mean it's the cause of the problem. Because if you can have people with that issue who don't have symptoms, just because you do have it doesn't mean that's what's causing the symptoms. And I mean, there was a there was a study done. They imaged hundreds of people in a village and depending on their longevity, they had a lot of rotator cuff tears that showed up on imaging. Two-thirds of them

24:18had no symptoms. So and rotator cuff is probably one of the most common shoulder issues that everybody wants to blame for everything. And unfortunately, the majority of the time in the clinic setting, I would see people after rotator cuff surgery rarely before. Unfortunately, a lot of the times, I think we might have been able to prevent that surgery because the the shoulder, just to put it simply, there's 18 muscles that directly impact the function of the shoulder joint. Only four of them are the rotator cuff. And their job is to make the joint stable because it's the most mobile joint in the body. So it has a risk of being unstable. The other 14 muscles are what you use to push and pull and lift and do all the powerful things. And most people are completely unaware of this. The entire rest of the body is required to support the shoulder function. So what I mean by that is I had a football quarterback, 22 years old, who came in with shoulder tendonitis,

25:18and he had a very unstable ankle. There was nothing wrong with his shoulder. I never touched his shoulder after assessing it. But we restored the stability in his ankle. And after three or four sessions, he could do three hour, three man throws with no more pain in the shoulder. It was his ankle. It was an unstable ankle. I've worked with people who had shoulder issues, and it was a low back issue because you've got that big muscle called the latissimistorecy that attaches to the top of the shoulder bone. And when the low back is torqued, it's going to pull on that muscle, which pulls on the shoulder joint. So every time you reach your arm overhead, it's not aligned properly. So yeah, you can inject the shoulder, you can heat the shoulder, you can ice the shoulder, you can medicate the shoulder. But until you fix the low back torsion, which is a pretty simple thing to do, it's just a muscle energy technique. And then you calm down the lat Dorsey, which again is a simple technique called strain and counter strain, literally 15 minutes. And now the shoulder has full range in its back and proper alignment. And there's no more pain. So, but it wasn't the shoulder. So it's important for people to understand that they're a whole

26:23body. They're not a body part. And when they seek help for pain especially, whoever's helping them needs to know the whole body connection, or they're going to be limited in how much they can help them. So how do we navigate that part? Because how great that your patients had these fantastic results that were so unexpected, you know, that feels like such a Sherlock Holmes moment. Aha, it was the ankle in the library, you know, like how do you find those people, those clinicians who are going to work with you in that way without burning yourself out medically? Should you find someone with the word functional in front of their name? Or can you just, like, is there a cheat code of questions that if you ask your doctor, it will unlock the next level of care. Yeah. So, well, unfortunately, 93% of the people who go to the doctor for pain, which is like seven out of 10 reasons people go to the doctor is for pain. Top three is updating on medications,

27:26post-surgical or just a regular exam. Seven out of the 10 is for pain. And 93% of the time, they won't send them to therapy or anybody, they'll send, they'll prescribe a pain med or they'll send them to pain management or orthopedics. And a lot of the times, those people are going to do what they're trained to do and they're not necessarily trained to understand the connection. I mean, I think you're going to be hard put to finding orthopedists who will tell a football player who has shoulder pain that it's his ankle. So, so it's, what I have founded, and a lot of the, and I have this on some of my content and my websites and thing, is you need to ask questions, you need to call. And I know this is not mainstream knowledge, but that's why I do this work so that people can get this information out there. There are certain manual techniques that are extremely effective at restoring the function of the body. And they're going to be trained to look at the whole body because oftentimes the pain is not where the problem lies. So you have to

28:30know to look for that. And so there are certain techniques that I always tell people, I'll list them right now. One of my favorites is muscle energy technique. Another is strain and counter strain. And these techniques have been around for 100 years. Doctors of osteopathy use these primarily, but now I don't know, a lot of them are more like medical and not really doing the hands-on like they used to. Another one that's really, really functional is Mulligan's mobilization with movement. I mean, that can be almost a magic technique and it is relatively painless and will restore function very quickly. So with that little list in hand, that might empower a patient who is trying to get it as close to right the first time as far as physician fit by maybe calling and saying, hey, do any of your clinicians do any of the following? Would that be? Yes, that's what I can tell them. Just call local clinicians, call local clinics. Also, don't negate massage therapists. A lot of the manual techniques that I took the first

29:3315 years of my profession, I was addicted to taking manual coursework. I spent more on learning manual coursework after I graduated than I spent getting my license. And a lot of the times, those courses were heavily attended by massage therapists. So you might find a massage therapist out there that's extremely gifted in manual work. You might struggle to find a PT who knows muscle energy, but you'll find somebody in a different profession. So, but it's those techniques work. I've seen them work. And then, of course, the three-plane training, that's huge. I always tell people find somebody who's graduated from the Gray Institute, taken coursework from them in applied functional science, either certified or fellowship, because they're going to look at them as a whole body when it comes to movement training. Well, hey there, it looks like you're enjoying this episode so far. To get more episodes like this, double check that you've hit the follow button on your podcast listening app. And to get cliff notes of this episode emailed to you the week this airs, go to marithferreal.com, or you can email me at marithatmeritifferreal.com. Okay, back to the show.

30:39So many people really, and understandably so, get tripped up on the insurance bit of it. And this has really changed. And, you know, five years from now, this part of our conversation may not be evergreen. And that's okay. But it is a nagging thought when people try their best to have possibility thinking about their health and wellness and really shift into that vitality direction, as opposed to, you know, whatever the mainstream is offering at the moment. These practitioners who treat whole body who are just about finding the solutions, they're usually cash based. I will tell you my experience, but I want to know your professional opinion on this and what you have seen with your own eyes. My experience is that pain cash has been cheaper because the clinic will give you a discount for cash because they charge the insurance company about four times what the actual cost of the thing is. And then the insurance is like, I'll give you a half of that. And so then that's how they can keep their business open, understandably.

31:42But by being a cash patient, I not only get a discount, I pay upfront. And for the most part, I never hear from them again. I'm not going to get a bill three months from now. That's not even itemized. That I don't even know what it is. And then have to spend hours on the phone figuring out what it is. And I find my time valuable. So we have a high deductible account with an HSA and we just do it that way. And it works pretty good. However, we are fairly healthy. So am I living in my own personal naive lava land over here? Or what? Tell me what you're seeing. So it is going to depend on the person's current status, obviously. If somebody is on a lot of medications and they have to have a lot of follow-up visits to manage disease processes. And I say manage a lot of the disease processes that people deal with are actually reversible. I've seen many people eliminate the need for medications more often than not. So that's another mindset thing.

32:42You know, they have to understand that there are other options besides just taking medications for things. A lot of the times things can be reversed. So there's that. If you're of the mindset that your insurance needs to pay for everything, then you're going to be very limited in the services that you can get. A lot of clinicians who prefer cash-based, it's because they are tired of jumping through the hoops of the insurance companies, being limited in the services that they can offer and the time they can spend with people. You're typical, depending on the insurance, they might pay somebody $12 for 15 minutes of clinic time. That's not going to keep the doors open in a clinic. So now you've got the clinicians seeing three and four people per hour in order to keep the lights on in the clinic. And that is not quality care. You cannot treat three and four people per hour and get anything accomplished that's going to be effective. So those people are

33:45in that cattle prod type of an environment, you know, proud them in, proud them out. And those are the people when I'm standing in line at the market. I don't hear them say, oh, yeah, I did, I did beauty and it didn't work. And thinking I was probably a cattle place, unfortunately. So and that happened because of reimbursements because when HMOs and all of those things started coming into place, the clinics were being told they were only going to get this tiny amount. And unfortunately, I believe now I'm not involved in the politics of my profession. So I might be speaking out of turn, but I believe it might have been helpful if our profession had stood up and demanded proper pay so that we could provide proper care. And I think that would have made a difference. I do agree that if you are in a private pay clinic, you're going to get one-on-one care. You're typically going to get a full hour or at least 45 minutes, which is going to accomplish a lot. And you may only have to go a few times versus 12 times of the other. And when you think of the copays involved,

34:51if you're only getting 10 minutes of a clinician's time and you're paying a $25 copay and you do that 10 times, that's $250 and you didn't get better. But you might go to a private pay and pay for two hours and get help. And it would be the same or maybe even less depending on their fees. So you know, years ago, health insurance was for catastrophes. It was for if you got in an accident or you needed some emergency surgery or something else went on, kind of like your homeowners insurance. Homeowners insurance doesn't pay for you to replace a window unless a tree broke through it. But just maintenance on a home insurance doesn't pay for it. Yet we've decided that we want our health insurance to pay for maintenance. And it's one of the reasons it's so expensive. We want every single visit, every place we go, we want our insurance to cover it. And if it doesn't, we're not going to go. And yeah, yeah, it's okay. I could go off for another hour on this one, but

35:53well, I mean, it's relevant. There's a reason why you could probably go off on another hour of it because it's something that we all think about. I mean, I very cathartically watch those videos on Instagram where the physicians or the social workers are calling the insurance company and being like, what do you mean you won't pay for anesthesia for a, and you know, ovarian biopsy or whatever, like something bananas. Yeah, so it's something that I think a lot of people think about. Oh, yeah. Now they're doing surgeries and somebody will have a drain in from the surgery and they're sending them home the same day with a drain in their body. Are it absolute insanity? Yeah, it's wild for sure. And it's not great for the physician either. And that's just, it breaks my heart. And it also contributes to this mindset, I think. It becomes quite a cycle because you have people who like you pointed out say, I did physical therapy. It didn't work. And so they've just resigned to

36:53usually what I hear is people like, well, it's probably just bad genes. And I understand that that that would be a way to just quit thinking about it. It's just to say, well, all else shoulder shrug. Yeah, hopefully this conversation can inspire them a little bit. I want to talk about live aging number two because we're talking about doctor's offices. And I have been to the doctor where I was like, hey, hey, doctor, when I do this, when I move my head to the left, it hurts in my right shoulder. And no lie, they have definitely said, we'll stop doing that. And so lie number two is stop moving to stop hurting. Yes, yes. And it's probably one of the worst things we can do because the human body's designed for movement. It thrives on movement. And the joints need movement. The fluid that feeds the joints, the nutrition in that fluid gets exchanged through movement. So I mean, a lot of the listeners might be aware that if somebody's in ICU and they're not moving, they're on a ventilator, they have to have their joints mobilized

37:59because after about 72 hours, the joints will start to break down because of the lack of nutrition because of the lack of movement. Now, of course, somebody who's living their life, they're not going to be not moving for 72 hours. So that's not going to happen. But the more we move, the healthier our joints are. The healthier our muscles are, our facial system. It's very hydrated system. And it responds to movement, the proprioceptors in the body, the balance, the stability. So I think when people start to shrink their movement because of pain, they're shrinking their world, their ability to live their life, and that doesn't fix the problem. Usually movement will solve the problem, but you have to know the type of movement and find somebody who actually can help you, which I know can sort of be like a needle in a haystack kind of a thing. But movement, you know, we're designed for movement. We have to move. Yeah, it kind of goes back to the finding

38:59the right clinician to help you and interviewing them, interviewing their front office staff when you call in. Do you do XYZ? What about bone on bone pain? Like for a knee, let's say, the kind of pain that is requiring steroid injections to just live daily life and maybe even abrasions. Well, people might be surprised to hear a lot of the times arthritis is blamed for the pain and it's not the cause of the pain. Now, the the bone on bone thing and technically and anatomically, physiologically, that's not what's happening. However, it has worn away the lining to the joint and there's a lot of nerve endings there that are getting irritated because of the contact that shouldn't be there. So I've heard people stand at the kitchen sink doing home care and go to do a move and they sound like a haunted house. There's this kind of emotion that happens with their joints. So I'm very familiar with that whole issue. If it's that bad,

40:02there's movement isn't going to fix it. So you're going to need to figure out what's the best options for you at that point. You know, and sometimes the joint replacement is really the wisest option. If you've completely lost your quality of life and you can't function and the pain is unbearable and you know, there's nothing that can be done. But on the flip side of that, if it's not, if the joint is not completely shot, it's a lot of the times the arthritis is being blamed for the pain. I cannot tell you how many people who have come to see me who, you know, they had a diagnosis of arthritis of whatever joint. Just pick a joint and I would assess their movement and I would figure out, oh, this body part's not working right. That's what's causing this to be annoyed. Let's do something about it. Now, it's not always a miracle cure the first session and I'm not saying that I cure everybody 100% of the time, but a good majority of the time,

41:03we figure out what's going on and we can resolve their pain and I'm not waving a magic wand over the arthritis. So it's not always the causative factor. So you think maybe someone in that scenario might benefit from seeing like a functional physical therapist and just kind of seeing like where we have mobility, dysregulation and kind of suss it out. Yeah. Yeah. So I mean the three biggest culprits in the in the body that tend to wreak havoc on joints almost anywhere is the trunk, the airing of between the neck and the low back. Now, your shoulders are counting on the trunk to function right. Your neck is counting on the trunk to function right. Your low back is counting on the trunk to function right. And if the trunk's not functioning right, even when you take a long walk, that can cause problems in the knees and hips, other areas because there's this complex movement that needs to be occurring with every step you take in the trunk. And then the second

42:06place is the hips. We're doing a lot of sitting. So the back of the hip max, gluteus max, miss the power source is kind of shrunk, weakened, gone flaccid. And so now you've lost your power source. And then the front of the hips because you're sitting all that time, they get short. And so now when you go to stand up, you're feeling this pull on your low back, but that's those muscles in the front of the hip because they attach to the low back. And they don't want to get longer because they've been short for so long. They're like kind of annoyed. They're saying, hey, come on, sit back down. I liked it better that way. So. And then the outer hip, the inner hip, those are very, very required for a healthy gimme. And a lot of people don't train those areas. A lot of people when they're even doing regular exercises, they're just exercising in one plane of motion. They're only doing forward and back motions. They're very rarely doing rotation and side bending and all of that. And so those hips are huge at impacting low back function and knee function, but also shoulder function and neck function. So. And then the third part is the

43:10ankles. Most people have a history of some kind of an ankle injury. If they have pain going downstairs, it's almost always their ankle that's not it's lacking motion. So it's going to cause knee pain. If they have pain going upstairs, it's almost always the hip. So it's important, you know, even if they have knee pain going up or down, it's almost always below or above. So I wanted people to know that. And I cannot tell you how many times restoring ankle function has resolved chronic pain issues, even like their elbows. And I know that sounds crazy. But if every step you take is annoying your body, because it's not performing properly, it's going to wreak havoc. Yeah. Yeah. That's so interesting. Okay. Lie number three, our last lie. I need a stairless home to remain independent. Yeah. That's that is such a big fat lie. Oh my gosh. So I can tell you, I've had people tell me that their family member or their neighbors aunt or whatever

44:13lived in a house with stairs. They were pretty independent, but they had some medical issues, and they sort of ended up in this place where they'd get a little bit more care, kind of a senior setting. No stairs. And within two or three months, those people are almost always, now they need a lift chair, because they can't get out of the chair by themselves. They're using a walker, because they can't walk down the hall without assistance, because they lost the stairs. Stairs keep us fit. They keep us stronger. We need stairs. And one of the saddest things about that of all is when you look at the even the real estate industry, it is now promoting, you know, age in place homes, everything's on one level. You don't even have a step to enter the front door. And it's the worst thing that we could be doing. Absolutely. Yeah. That's such a counter cultural thought, you know, that kind of goes back to the what your little friend group is talking about,

45:13right? You know, if everyone is talking about how they are putting in elevators in their house or whatever, then that's a pretty good indication that you might need to not get rid of those friends, but add some new ones into the mix so that you can keep your mind right, which kind of leads me to our closing thoughts, which is the support that you offer, like your online community, and you've got some like academy courses that are also online. Tell us about that. I've got a lot of stuff that's free. I've got a YouTube channel. I have a lot of videos with movement education. I really want this information is not mainstream, but it really needs to be. So I'm really doing my best with a megaphone. I'm so thankful for what you do, so I can share this with your audience, but I also have a move without paying private club, which is online, and there's a free level membership where people can assess their own three-plane function. It's like a 23-minute video, and they can see, oh, my hips not doing this or my ankles not doing that, so they can learn where their own culprits are, which is why I named my book Pain culprits,

46:18because we've got to stop beating up the victim. So that's the, you know, the private club, and then I have the academy, which is why I named my book Pain culprits, because we have to be able to address those. Mindset being one of the most important things, but it's a beautiful community of people. I call them my students, but they're 50 plus some of them 70s and 80s, and they've decided that they don't want to be, they don't want to be common. They want to be abnormally uncommon, or normally uncommon, I guess is how we should say it, because it is normal to age well. So, oh, I love that. What a great way to wrap this up. Thank you so much. And can you share, if any, socials or your website too? Probably the best thing would forbid people go to the main website, which is have lifelong well-being, and I know that's a long handle, but it's have lifelong well-being. And I actually have a five-question quiz on there

47:20that they can answer, and then it will aim them at the websites, the resources, the content that will best address their concerns. Perfect. Thank you so much. This was great. Thank you. Thanks for listening. If you loved a couple of episodes of this show, help me let others know by leaving a rating and review on Apple Podcast. Just share where you're listening from and why you like to a certain episode. If you're listening on Spotify, you can't leave a written review, but you can leave a rating, and that is equally appreciated. And if you like this episode, you'll also like the one with a leading food addiction expert asking a food addiction is a character flaw, or a real dependence, designed by Big Food. That's episode 251. And stay tuned next week when I talk with an ESPN reporter who covered the NFL concussion cover up. Until then, keep a curious.