Ep. 2: Eileen Kopsaftis – Retraining the Body and the Mind to Eliminate Pain

0:01 – excerpt from the episode
1:09 – intro; listen to discover a little more about your host. Martin will tell you a new lesser known fact about Dr. Maya!

1:47
Dr. Maya Novak:
We’re kicking off this podcast with an amazing guest and my colleague Eileen Kopsaftis. She is a Pain & Chronic Conditions Specialist and has been practicing physical therapy for 30 years. She specializes in manual techniques that correct biomechanical imbalances in the body. She teaches people how to resolve pain through effective self-care, and how to make informed decisions when it comes to healthcare and nutrition. Her passion is empowering others to have a lifelong wellbeing - because life is meant to be enjoyed, not endured. She is also the author of the book Pain Culprits. Eileen, welcome to the show…

02:29
Eileen Kopsaftis:
Thank you, Maya. It's a blessing to be here. I'm honored, I'm humbled and I'm so excited just to see you and for us to spend some time together.

02:40
Dr. Maya Novak:
I am so excited about this conversation as well because we had a few interviews together and I always enjoy everything that we discuss and all the things that we uncover. And now for those listeners that don't know you yet can you share a bit about yourself, about your journey? Why physiotherapy? How did you get into this?

03:01
Eileen Kopsaftis:
Yes. So it's an interesting story but I'll make it as brief as possible just to get the salient point. So when I was very little I wanted to be a doctor. When I was old enough to start medical school I realized I disagreed with the typical medical model of medically manipulating symptoms, and not addressing the root cause. So then I thought “Well, I've been studying nutrition for a long time now. Maybe I'll go into nutrition.” And I realized I disagreed with the four food groups and a lot of the things that were believed about food at the time. And if you argue with the professors you don't tend to get very good grades. And it was interesting because when I had requested the course manual from the college that I was interested in the nutrition course they had the physical therapy program. And when I looked at that I've always been very fascinated by the human body and how it works, and the more questions I asked the college it was almost like they were trying to talk me out of it. “Oh, it's a very challenging program” and God designed me in a way where you know when I hear the word challenge, you know, [laughs] I'm going to go at it and I'm going to get it. And so it motivated me to the point where nothing was going to stop me. And so I was a single mom and I worked my way through the physical therapy program. It was a challenge yes, but I knew that at the end of it I was going to be in a profession that I was rewarded every day by helping others - and there's no words to describe that. And then fast forward after being in the profession for gosh about 15 years I ended up in a nutrition educator diploma program. So I did do the education piece on nutrition as well. And so now I can help people with a very multi-prong approach.

04:51
Dr. Maya Novak:
Which is really important because I mean holistic approach is what really matters. We cannot just focus on 1 thing and expect then miracles. So it's really important that we look at healing through multiple lenses to really get the solution for the patient that needs it.

05:11
Eileen Kopsaftis:
Yes. I love that. And I often will tell people especially when I work with people one on one, and I've been doing that over Zoom for years, long before the world shut down. And it can be very effective when you're teaching people how to address what they need to address, right? They don't become dependent on me - they're empowered. You know, teach a man to fish. So what I tell people is each person is as unique as their fingerprint because we all have a different upbringing, different interpersonal relationships, different personalities, different histories. How did we nourish our bodies growing up? How do we nourish them now? What traumas? What injuries? What accidents? What things have we experienced? What harm have we been exposed to? You know, how much joy have we had? We're all extremely unique like a fingerprint. And so there is no catch-all cookie cutter approach to anyone when it comes to pain. And I believe that's why you know pain management programs and that can tend to fail miserably because they are using some science-based evidence program that doesn't encompass the whole person.

06:24
Dr. Maya Novak:
So would you say that is the main reason that pain treatments often fail? So that they don't look at the whole person?

06:34
Eileen Kopsaftis:
Yes, and in more than 1 level because as I said, each person's unique as a fingerprint. However, because as you know from my book I often repeated you know everything's connected to everything else and so when someone walks through the door with shoulder pain, for instance, they're only going to look at their shoulder. They're going to put this microscope up and they're going to look at all the structures in there and they might do X-rays, they might do imaging, you know, and MRIs, they might even do full-blown arthroscopic surgery. However, the shoulder is intimately impacted by the rest of the body. We don't take our shoulder off and put it on a shelf when we go to bed. Everything's connected. And you know everybody wants to beat up the rotator cuff. There are only 4 muscles in the rotator cuff and the rotator cuff's job is not to provide strength and function. It's to stabilize the joint as you use all the other muscles for strength and function. So we beat up the rotator cuff more often than not, we see injury in the rotator cuff and we think that's the problem. But the problem may be that there's an unstable pelvis and that shoulder girdle is trying to provide stability beyond its ability. And so all the muscles are not firing at the right time in the right way and that's what's caused the injury to the rotator cuff. The rotator cuff is not the problem, it's the victim.

07:57
Dr. Maya Novak:
Mhm.

07:58
Eileen Kopsaftis:
And so if all we do is treat the rotator cuff now we've ignored the cause and only addressed the symptom. And that person is never going to restore full function of their shoulder. So the problem with the evidence-based medicine is that it's isolated. It's, you know, T Colin Campbell wrote a book called Whole and he talks about reductionism. And when it comes to food we want to reduce the nutrition down to vitamins and minerals in different parts, and what do they do in the body but it's the whole. It's the totality of the whole that is more than the sum of its parts, right? The whole gestalt. So our bodies are the same way and we can't isolate body parts when somebody walks through the door or when I connect with someone I see what's happening in their body from their nose to their toes. No matter where their symptom is because something else is going to impact that. And we have to make sure we're not missing the causative factor or what I call the culprit and not beating up the victim.

09:04
Dr. Maya Novak:
Yes. Oh, this is such important topic because it's true that this is zooming in and zooming out… you know first we have zooming in and zooming out on the physical level and then we also have on the level when we have to look into the mental and emotional aspect of recovery. But it's, yes, it's so important because a lot of the times when we have pain in a certain body part first of all, it's that body part. So “I have the problem with that body part not with” you know, potentially “with something else”. And then we also forget about the rest. So emotions and all the anger or frustration or stress or you know all the worries and negative thoughts and so on.

09:53
Eileen Kopsaftis:
Yes.

09:54
Dr. Maya Novak:
So it is so important that we zoom in and then zoom out to really get the big picture.

10:00
Eileen Kopsaftis:
Absolutely. As a matter of fact I had a call this morning someone had reached out to me who had chronic neck and upper track symptoms since she was 6 or 7 years old. Now I don't know how old she is now, we didn't go deep into detail over the phone. I recommended some resources for her and she'll be contacting me again. But I asked her could she relate that to any type of an injury, an event? I said “It could have been an emotional event” you know, “maybe your parents got divorced. Maybe you moved.” And I'm not saying this is all in your head but when we experience something whether it's emotional, mental, or physical our body reacts in a similar way to all of those events by putting us into that fight or flight mode because we feel like we're in danger. We're in a fear mode and now all those chemicals cascade throughout the body that can wreak havoc and elicit pain and cause problems. You know, cortisol is the stress hormone and it's meant to keep us alive like maybe during a famine or if you're a prisoner of war. But it's not meant to be released in our body every single day over years. And most of us are very stressed and we're having those cortisol squirts every day, right?

11:10
Dr. Maya Novak:
Mhm.

11:11
Eileen Kopsaftis:
And that's going to wreak havoc in the short-term memory. It can create truncal obesity or deposit fat around the middle. I mean it does so many things to us that's harmful because it's not meant to be there all the time. And so we have to understand you know… So when I asked her this question and she said you know a lot of people had asked her that… you know “Why are you having this pain?” And I said “Well I'm not asking why you're having the pain. I'm asking if there was any event around the time that it began.” And so the only thing she could remember is that she had been adopted and she thinks that was around the time she was told that she'd been adopted. She said she didn't remember feeling traumatized by that fact, but as a 6 or a 7 year old who knows what kind of fear or whatever questions that put into her little body. And so as I told her “This isn't about the fact that you know you need counseling to resolve your pain. Let's see how that event is relating to why you can't resolve the issue.” And then of course, and I'm going to demonstrate later a beautiful technique to mobilize the thoracic spine because a lot of the times that just freezes up. And when that thoracic spine freezes up the neck, the upper shoulders, or the shoulders themselves, the low back those areas can respond. And the thoracic spine is often what I call a silent saboteur. You won't know that's the problem because it doesn't have symptoms but all the areas around it will, right? Or one area. And so we talked about it and there are practical things she can do physically. But as you said addressing that potential tie to an emotion and making sure that you work through that is going to help to permanently resolve the problem. To get you out of that fight or flight mode that you're in because of that memory.

12:59
Dr. Maya Novak:
Yes, and you know how many times patients are not asked these questions and it's so important - what was happening around that time when this started? So whether it's pain whether potentially is just, you know, a ‘regular’ accident - let's call it that. But it's important to look into what was happening around that period and so many people are not asking that questions and then, you know, as soon as we ask “So how is your emotional status or your mental status?” A lot of the times then a person can feel as not heard in regards to “Oh, so you think it’s just in my head?” But that's not the case as you just describe this.

13:48
Eileen Kopsaftis:
Yeah, it elicits a physical response in the body. So you're truly feeling those pains, those issues, those symptoms. You haven't made it up, you haven't caused it to happen, right? It's not like “It's your fault.” It's not like “What's wrong with you? Just get over it.” It's part of the equation that needs to be addressed so that we can have a permanent solution to the problem. Yes.

14:12
Dr. Maya Novak:
Exactly. Now, Eileen, are there any… When it comes to pain management are there any risks when it comes to this?

14:21
Eileen Kopsaftis:
Boy, that's a big can of worms right? [laughs] So one of my favorite things to tell people is “You want to be an informed healthcare consumer so that you can make better decisions and have improved outcomes.” I cannot tell you how many people have come into the clinic or connected with me via Zoom who say “I wish I knew then what I know now. I would have never agreed to taking that medication or have that procedure or have that surgery” Because they're still dealing with the fallout years later.

14:58
Dr. Maya Novak:
Yeah.

14:59
Eileen Kopsaftis:
So what I tell people is “You don't need to be a medical professional to make an informed decision. You don't need to be a doctor. You don't need to be an anatomist. What all you need to do is ask a very simple question. How well will this fix my problem and what are my risks?” That's a very simple question to ask. Now if the healthcare practitioner that you are conversing with is reluctant to share what the risks are then that's a problem.

15:35
Dr. Maya Novak:
Mhm.

15:36
Eileen Kopsaftis:
Because you don't want to put your future in someone else's hands when it comes to potential risks. That is your decision and your decision alone. Now, what I tell people when I work with them is “My job is to inform you and then your job is to tell me what you would like to do based on being informed.” Whether I agree with your decision or not is a moot point. I respect it but I know it's an informed decision now. Sort of like if somebody decides that you know they want to do something harmful to themselves and they know the risk they still decide to do it. But at least they know the risk, right? So these questions are not asked more often than not. And healthcare practitioners from what I've seen generally speaking are reluctant to tell the side effects or potential harm because they think now the patient won't make the decision that they think is best for them to make.

16:32
Dr. Maya Novak:
Mhm.

16:33
Eileen Kopsaftis:
So they sort of cherry pick the information they give them, right? I remember a case where I had a patient come in who was having horrific symptoms and I always get a med list. And I always inform them of the side effects of their meds if it's playing with what they're experiencing. And I know that we're going to be chasing our tail as long as that med is at play because we're not going to resolve the side effect of the med by anything that I do. And so I had this woman come in and I knew that her symptoms were based on the side effect of that medication. So I informed her and I said “You know it's outside the scope of my practice I'm not telling you to take or not take. Have an informed conversation with your prescribing practitioner.” And she became so angry not at me but at the practitioner because you may not believe this but the doctor told her “I want you to take this medication and I don't want you to look it up because I don't want you to end up getting the side effects that are reported.” She was kind of saying it was a self-fulfilling prophecy, right? If you read it it's going to come on you. So this woman did what she was told and didn't look it up. So she had no clue. And she had the worst side effects ever from this medication and had no clue it was because of the medication. And they sent her to physical therapy to address the symptoms. And so she was not a happy camper. [chuckles]

18:04
Dr. Maya Novak:
I can imagine.

18:06
Eileen Kopsaftis:
But yeah, we need to be informed, you know. Corticosteroid injections - there are studies that show that corticosteroid injections will actually increase the damage to a hip joint. If you look up the orthopedic surgical guidelines for osteoarthritis of the knee they are recommended not to perform corticosteroid injections in the knee. Because the data shows that there is no benefit and there is seen harm. You know with the studies done to the hip they see that the cartilage actually decreases. And they see more necrosis of the femoral head which means the bone cells are actually dying off and it happens rapidly with those who are getting the injection versus those who do not. And it was a well done study. They had their control group and they had their injection group and they even had a shoulder injection group. to rule out that “Well was it just because the steroid was in the system or is it because it was injected directly to the hip?” So it was a really well done study. There's a lot of really good studies out there that show that a lot of the things that we think are simple and done like that aren't necessarily the most beneficial and often carry more harm than benefit.

19:24
Dr. Maya Novak:
And these are conversations that we have to have and patients need to know that they have to ask these questions. Because this is really taking the responsibility for your healing, for your health. Because otherwise you are all the time not in the driver's seat but just the passenger. So everything that happens to you, you know… then, yes, it is easier to point the finger and blame everybody else, but at the end of the day we are the ones who are living with our decisions and how the body reacts. So if we did not do our own research that is so extremely necessary then yes, the consequences might be really negative. And thank goodness for health professionals like you who ask these questions who have these informed conversations. And you know my story with steroid injections. Well I declined it because I decide for myself that I don't want to put myself into risk even though it was many times said “You're not going to get better if you're not going to take these steroid injections”. And I said “Thank you very much but I think that I will” you know. And I did – I did get better.

20:45
Eileen Kopsaftis:
Yes! And the thing is you do have a medical background, right?

20:49
Dr. Maya Novak:
Yeah.

20:50
Eileen Kopsaftis:
You did have a degree. And people feel intimidated, you know, it's that “Oh, I can't make a decision. I'm not a doctor. I don't…” So I explain it very simply to people so that it removes that intimidation factor. It's reported that people spend more time researching where they're going on vacation than they do about their own healthcare, right. So your average person is not a travel expert, right? May have never been to that region but you'll do your research, you'll look it up. You'll spend time on the internet. You'll ask questions, you'll do research, right? And you're not intimidated because all that information is at your fingertips. Now that said when you go to research a particular medical issue or condition or disease process the information that comes out to you, you know, we're overwhelmed now. We have too much information coming at us and you've got a lot of conflicting opinions so that can be very challenging.

21:40
Dr. Maya Novak:
Mhm.

21:41
Eileen Kopsaftis:
Keep it simple. I mean when you go to buy a car and probably most of the people watching own a car, you're probably not a mechanic. You're probably not someone who works in a plant and you design the car but you researched what's the best car for you. What's the most safe, what's going to give you the best value, what's… right? And the same thing if you purchased a home. You may not be a construction worker or a contractor or a plumber but you did your research. What area do you want to live in? You know, do you want it to be with school district or not? Do you want it to be a 2 level, what style do you want, do you want something that's fairly new or older? Do you want…? I mean we spend hours doing research on these things that don't necessarily impact us for the rest of our lives the way that our health and our physical well-being do. So again, we don't have to be experts but not being afraid to ask the questions. And you can keep it simple “How well will this help me? What are my risks?”

22:45
Dr. Maya Novak:
And you know this might be… this problem I'm just thinking about. This is very much I think connected to the belief system that we have. Because most of us growing up… when something was wrong with our bodies we needed to go to someone who would tell us what to do. So we are not equipped in that regards, you know. Or it's “Oh, don't think about it. Just go to your doctor or just go to…” wherever, you know “to any kind of health professional.” Now when it comes to houses, of course we know about real estate agents. When it comes to cars we know about mechanics but no one has ever probably told us “Well you don't have enough insight to actually make your own decisions.” So It's kind of when it comes to our health I think it kind of slightly difficult to actually take that responsibility and say “Oh, let me just research that.” What do you think?

23:49
Eileen Kopsaftis:
Yes. Yes, and sometimes you know the human body and the human mind is extremely complex. And there are all kinds of motivations and all kinds of reasons we do what we do and we don't do what we don't do. And sometimes and I've seen this over the years it's not everyone but occasionally the issue is “If I become informed and I make the wrong decision now it's my fault.” Or “If I become informed and there are things that I need to do and I know I need to do them but I don't want to do them. It's too hard.” Or “It's too much change.” Or “I'm going to have resistance from my loved ones because if I have to change how I'm nourishing my body, my spouse isn't going to like that, my children aren't going to like that. I don't want to have to cook 2 meals.” So we start making all of these reasons, right?

24:53
Dr. Maya Novak:
Mhm

24:54
Eileen Kopsaftis:
We do our pros and cons and it was con to start doing the things that we know are best for us. And so you know I've worked with people and I know you have too. You're very gifted at this - helping people to navigate those challenges so that we can instill really good self-care and help us to have what I call lifelong well-being. It requires, you know, I tell people “Nobody ever set a goal to go to a nursing home. It happens by default, right?” I've never heard anybody say “Oh when I'm 85 I want to be sitting in a wheelchair in a nursing home.” No! But if we're not actively working to keep that from happening it'll happen by default. I've worked in nursing home settings I didn't see one person there who was ever happy to be there, even if it was really good care. Nobody wants to need help for hygiene when they use the bathroom, right? Nobody ever wants that for their future. But can't just leave it up to fate. We have strategies, we have things that we can do that are relatively simple. And I tell people “It's simple. It may not be easy because it requires change.” It requires a challenging change but usually the steps are pretty simple, right? I mean I know you work with people, you're not asking people to study a calculus book and memorize the equations. It's not that complex. It's fairly simple but it can be hard. But you know the rewards are so worth it. I've worked with people who when they do put the work in they cannot believe the difference in their life. I worked with someone today who I've worked with about… today was our sixth session, and she cannot believe the difference in her life. She had where she took the fastest showers on the planet because she would have a lot of pain standing in the shower. She was unstable. She would have… she would be diaphoretic. She would just sweat horribly from the fear of what was going to happen in the shower. She told me today and her face was glowing, she said “I took the longest shower the other day. I was cold. I never take hot showers always take cold.” She goes “Even my husband was like you were in there a long time,” she goes “and I loved it! I have never enjoyed a shower like I did that day.” I mean that's quality of life, right? She can put on her shoes now without eliciting severe pain. There's so many things in her life that have improved. You can't even put it into words but she had to do the work to get there.

27:39
Dr. Maya Novak:
Absolutely! Now doing the work. What would you say to someone who potentially has difficulties to stick to a program, to a movement program? Or they lose motivation in between. What do you usually tell your clients, your patients? How to stay motivated and how to actually stick to the program?

28:02
Eileen Kopsaftis:
Well, there's kind of two sides to the coin there. What I have found a lot of the times what keeps people from following through and being consistent is a lack of understanding why they're doing what they're doing. My profession is notorious for telling somebody “Do 10 of these 15 of those 10 of those and I'll see you in three days.” They don't explain what they're doing, why they're doing it, and how it's impacting their body. So I'm really big on educating people. I want them to understand how their body functions I want them to know how their muscles were designed to function. I don't expect them to become experts I don't expect them to memorize the names of the muscles or any of that or you know origin insertion. It's not about that. It's about knowing the basic understanding of the body that they're in and how it was designed to move so that their function is without pain and without limit. And I don't mean it means you know they can fly off a building but that they can do what do in life and have quality in life. They can garden, they can golf, they can pick up their grandchild. They can do their sport with more skill, and improve and enhance their sportability. So I explain to them what they're doing, why they're doing it, what it's intended to do, and this is something I do pretty much 100% of the time. I'll assess something, I'll give them a movement to address that and in that same session we reassess that movement or that activity that had issue and they see immediate benefit. They see “Oh, I can…” For instance, I had a young man who when he bent forward he had back pain. And so I'm assessing him and I assessed him manually this was in the clinic and I found a little something going on and I did some manual techniques but I did think that was it. So you know you get instincts after a while doing this for a long time. So I asked him to bend forward first without holding on to anything and yes, the pain was there. And then I asked him to hold on to the treatment table and bend forward and he could bend all the way down and had no pain when he was supported. So what this told me was I bet the muscles in the backside of his body are not lengthening under tension and controlling the movement. For some reason they're not doing their job. So what I had him do was a lot of exercises that kind of switch on those muscles, wake them up, get them to do their job correctly without pain. We spent about 15 minutes switching on the posterior chain of his body. I had him bend forward again and he could bend forward completely without support and no back pain. So that told him “Oh, my gosh, those exercises are what I need to be doing.” You think he was going to be motivated to do his homework? Absolutely!

30:56
Dr. Maya Novak:
[chuckles]

30:57
Eileen Kopsaftis:
So like I said there's the two sides to the coin. When someone sees immediate benefit of doing something they'll keep doing it. You know there was a study done many many years ago kind of off topic on people who had diabetic neuropathy, which is very painful, and when their diet was altered they were nourishing their bodies in a very different way, their diabetic neuropathy was gone. And then they did… so it was like maybe 7 years later… the majority of those people in the study were still eating the same way because who's going to go back to pain. And you'll have a lot of people say “Oh, nobody will change their diet.” Or “They won't stick with it.”

31:37
Dr. Maya Novak:
Mhm.

31:58
Eileen Kopsaftis:
Yeah, they will if it worked. Who doesn't want quality of life? So there's that, right? When people see results, they see success, they see benefits, they're going to keep doing it.
Now the flip side is those who may stop being consistent and I get contacted from people all the time you have a lot of online content and all you know, just as you do which helps a lot of people. They don't have to work with me one on one - there's a lot available for them and they'll contact me and they'll say “I was in your private club, I was doing everything, I was feeling great. I didn't renew my membership, I stopped doing it. I'm back in pain. I renewed my membership. I'm out of pain. I just wanted to let you know… So I guess I need to keep this up, right?” So you'll get that - you'll get that kind of that rebound. But usually from what I found if people really understand why they're doing what they're doing they're going to be a lot more compliant, and if they see results they're definitely going to stick with it. Yes, and I think a lot of the times people are taught to do things. They don't know why they're doing it and they don't see any benefit. So of course they're going to not be motivated to do it.

32:50
Dr. Maya Novak:
Absolutely. And you know I love how quickly the body can actually respond. It's not “Okay, I have to wait for a month, 2 months, 6 months…” I mean if someone is waiting for such a long time maybe it might be a good idea to look for another health professional who can help them because I don't think that we are built in a way that we have to wait for a really long time to see results.

33:17
Eileen Kopsaftis:
Right.

33:18
Dr. Maya Novak:
Am I wrong?

33:19
Eileen Kopsaftis:
No! Absolutely. I know when I saw people in the clinic I told them “If by visit 4 we haven't made a marked difference in your issues then we need to see what we're missing and who you might need to see beside me.” Absolutely.

33:31
Dr. Maya Novak:
But let's just make this clear. So okay, if we are here talking about chronic pain this is something that definitely what you just said “If we don't see any results by visit 4…” But let's just slightly talk about if someone let's say they had a fracture and they started going to physiotherapy I mean it takes a bit longer to actually get back that flexibility. I mean I know how it goes, you know… [chuckles] With my right ankle after my rock climbing accident it was not just “Oh, I need 4 visits and that's it.” So let just you know… we cannot compare apples and pears or oranges or however, it's called in English.

34:16
Eileen Kopsaftis:
Talking post serious injury or postsurgical that's a whole different story. I'm talking your average person who walks in who has this pain or that pain and you know we should be seeing some response that's positive by the fourth visit, right?

34:30
Dr. Maya Novak:
True.

34:31
Eileen Kopsaftis:
But if you're dealing with a serious injury, especially post-surgery, now we've got that whole healing that has to happen to seriously injured tissues. So that's a whole another ballgame. But the person ideally should be learning strategies that are addressing their pain in a positive way. They learn some breathing techniques, they learn some mind focused strategies. You know, get that vagus nerve to tell everything “It's all okay.” You know there are a lot of things we can do so they should be learning things that are helping them fairly quickly. But the healing process may still take some time depending on the seriousness of the injury. Yeah.

35:12
Dr. Maya Novak:
So those who are in pain and now these 30 minutes… I know that there are a lot of aha moments…. So is there hope or better to ask is it possible to train your body to reduce and potential also eliminate chronic pain? You gave a great example of that guy bending forward, but maybe people are a bit like “Aaa… I’m not sure. You don't know my example because I have this and this and this.” So is there hope? Is it possible?

35:50
Eileen Kopsaftis:
Absolutely! I think one of the first things is mindset. I mean there are studies that are done that show that if a person believes that what they're doing is going to help them they have a much better outcome than the person who doesn't. So belief systems matter, hugely. I mean I've had people come into the clinic who did not believe I could help them. They were 100 % convinced that it was a complete waste of time for them to come to see a PT but they had to come in order to get their disability or in order to have approval for their surgery or approval for their MRI or whatever it was that they needed approval for. So that's the only reason they were there. And they were adamant that there was nothing I could do to help them. And so until I could get them to change that mindset they were right.

36:38
Dr. Maya Novak:
Yeah.

36:39
Eileen Kopsaftis:
What we believe is right. So I would do my best to assess them and have them do some type of a movement that I knew could elicit some change that would start to get them to open up a little and think “Hmm. Yeah, that does feel a little better. I can reach a little further. I do have a little less pain when I do that. Maybe there is something that can help me.” So once we start to get that going, now we can move forward. No matter what I have seen and I've been doing this for just about 30 years I have never met anyone that we couldn't do something that provided benefit. And sometimes I've worked with people who were at end of life. They were with a very serious chronic disease condition that there was no coming back from and yet we could still improve the quality of their life. So there's… the body responds so well when you do the right things. It's phenomenal. I mean our body wants to heal, our body wants to repair itself.

37:53
Dr. Maya Novak:
Mhm.

37:54
Eileen Kopsaftis:
And so there are strategies, you know, addressing the neurofascial system. I had one woman come in who… she had a surgically installed spinal stimulator and she still had horrific pain and her days were basically spent…. You know her pain was either an 8 out of ten or a 10 out of 10. I mean there was no… So she came in to see me and I don't even remember why or how it ended up happening that she came to see me but I taught her a really simple, very gentle technique using the MELT method and she was shocked. And I'll never forget the look on her face and the sound of her voice when she said “I've never found anything that lessened my pain. This is the first time.”

38:45
Dr. Maya Novak:
Mmmm.

38:46
Eileen Kopsaftis:
You know I mean I wanted to start crying with her, right, but I think a lot of the times if we haven't been able to impact what we're experiencing in a positive way, we start to kind of lose hope. We start to get jaded. We start to believe there's nothing out there for us, and we think we've tried everything because we feel like we have. But a lot of the times all we've tried has been the traditional conventional medical model which is very limited in its scope. If I break my leg, you know, don't get me wrong - don't tell me to eat more broccoli, right? Take me to the hospital, I want my leg fixed. [chuckles] When it comes to fixing injuries and things we're pretty good at those. We can replace body parts that have been damaged beyond repair, that kind of thing. But when it comes to the healing and the repairing of the injury I think the medical profession falls far short. Because their only answer is, you know, pain medications, procedures, more surgeries. “Well, let's go in there and remove the scar tissue.” And then if they can't find anything on imaging now they put the blame on the patient, right? And now the patient thinks “Oh, it's all in my head. Nobody can find anything.” I tell them “That's good news! If they don't find anything on imaging it means your structure is intact. Let's get to work and fix you. That's great!” You know “That's exciting. It doesn't mean that you're crazy. It means that we can have 100% resolution here.” So I think it's hard sometimes because we feel like we've tried everything but we really haven't. And I truly believe I mean I am very open about the fact I'm a woman of faith. You know my relationship with God is very important to me. He's everything to me. But I know I'm everything to him I have that deep intimate relationship. And I believe God loves every single person on this planet the same. We are all precious to him and I believe he will lead us to what help we need. He will get us to that person, he will get... We just need to not close ourselves off and think “I've tried everything. There's no hope for me. I'm done.” I think that's probably the last thing we want to do.

41:04
Dr. Maya Novak:
Yes, and just taking action because if we are just waiting at home doing nothing - no research, no anything and we are just like in that hopeless state, of course, we cannot find a different kind of solution, right? So reaching out, reading, listening to podcasts like mine, conversations like this one. So it is very important and it's also what you talked about before - the beliefs. And really start breaking the belief that you have around your healing, around your health. Because very often and potentially you have also patients who come to you and say “Well you know what, I'm too old. Nothing is going to change because I am just too old. I'm not 20 anymore. I might be…” I don't know “40, 50, 60, 70, 80…” it doesn't matter.

41:54
Eileen Kopsaftis:
Yeah. Mhm.

41:56
Dr. Maya Novak:
So let's slightly talk about is aging with decline - is it avoidable? Can we… or it’s just “Okay, that's it. I'm too old.”

42:08
Eileen Kopsaftis:
I love that question because I was about to say sometimes people give up hope because they were told by a medical professional “There's nothing else we can do.”

42:16
Dr. Maya Novak:
Mhm.

42:17
Eileen Kopsaftis:
“You're going to have to learn to live with it.” Or “Unless you want surgery I don't want to see you back in my office.” You know some of the things that people are told is quite disheartening. And so you believe what they tell you because they're the expert. But as I often tell people “The expert you're listening to can only share what they know. People can't tell you what they don't know.” And there is a lot of healthcare professionals out there that have no clue about the things that I've trained in and that I teach people. They don't even know it exists. So it's not like we want to lay a blame game on people but we need to keep seeking. You know as you said do our research because there are people out there that are so gifted and so skilled and so experienced in what they do. It's jaw dropping. So we just need to find them, right? And this thing about aging - it's the same thing. I can say pretty much 100% of the time when I work with someone who is older and I have to remember I'm in that category now. It's so hard to… [chuckles] I did a talk in November on aging and my one slide said “It's weird to be the same age as old people.” [laughs]

43:31
Dr. Maya Novak:
[laughs]

43:36
Eileen Kopsaftis:
But the thing is what they hear constantly is “Well, what do you expect at your age? Well you know you are getting older.” You know, “Well at 75 of course you're going to have this or that.” Or I mean we have been literally brainwashed into believing that aging is a negative. That aging is this horrible thing that happens. Aubrey De Grey who's the author of… I'm trying to remember his book now. It has to do with aging and free radical damage, and I can't remember the title. Forgive me for that. But he's famous for a quote that says “Aging is a barbaric experience that no one should ever have to experience.”

44:23
Dr. Maya Novak:
Mhm.

44:24
Eileen Kopsaftis:
It's this but he calls it a phenomenon that no one should have to experience but he's talking about what we see commonly in people who age. And what I explain to people is “Just because something is common doesn't mean that it's normal.” And when you look up the definition of disease it says that it's abnormal cellular process. So disease is not normal. So why did we think it's normal to get it? It's abnormal. So aging with decline is actually abnormal but because it's so commonly seen we think “It's like a rite of passage. It's required.” We think you know “Well I can't go below ground until I need disposable underwear.” Or “I'm going to have pain in all my joints because that's just the golden age, the golden years. Ha ha.” No. I can't tell you how many people have spoken with me on the phone and shared with me you know they have this problem, and that problem, this medication but you know at my age that's normal. And they're younger than I am. [laughs]

45:34
Dr. Maya Novak:
[laughs]

45:36
Eileen Kopsaftis:
I don't even have Tylenol in my medicine chest. I thank God for my health but I work with him, right? I'm very blessed but I actively apply good strategies. And my mindset is “I am going to age really stinking well and I'm going to enjoy every year I walk on this Earth.” And so I don't have the mindset “Oh, I'm going to start falling apart. Oh this hurts, that hurts. Oh yeah, that's just normal.” No. If I start to experience a pain I realize “Oh I did 6 hours of research on the computer yesterday and I didn't get up and I didn't hydrate myself. I have to make sure I don't do that again.” So we just need to understand that. And I've worked with people, I've had people 100 years old doing squats in the parallel bars in nursing homes. You need to train according to your ability. It has nothing to do with your age. I had a gentleman who I went to his room, he was in the home care the nursing home. He'd been admitted because he had a total hip replacement and hip replacements have a lot of issues and he couldn't… His wife wasn't physically capable of helping the physical help that he needed as he recuperated. So he's in the nursing home and he's expected to be there a week or whatever. Because he was pretty fairly active before he had the surgery. So I go into his room and he was so sarcastic and snotty with me and I say this with a smile because I grew to love this man. I mean his name was Eugene and he was just… you just want to hug him until his head pops off. But he was so angry with me. He's like “Yeah, you're just going to have me sit and you're just going to straighten your knee and you're gonna…” And I'm like “Why would I have you do that? That's useless. That's not going to get you home.” And he goes “Exactly! That's what I told the other girl that was in here. That's not going to get me home. That's a waste of time.” I said “So you want to work hard’” And he goes “Absolutely! I want to get home.” I said “Well then come with me.” I brought him down to the gym and I worked him like a dog. But he was happy because I think he was home in five days and he ended up coming to see us in the outpatient clinic where I was part time to make sure that he rehabed that hip fully. And he got full restoration back, but… you know and he was in his 80s. I had a woman who was she was 88 years old, she was in there because she broke her leg. She lived alone and they were giving her these exercises you know “Let's sit in a chair and let's do all this stuff in the chair.” Do you know how she broke her leg? She was cleaning the snow off her roof. She was standing on a ladder and she slipped on the ladder.

48:04
Dr. Maya Novak:
88 years old!

48:05
Eileen Kopsaftis:
Do you think she was in a rocker and knit? No. She was running a farm. This woman knew how to work. So I have met so many people who were 100 years old or close who are still driving, still shopping, still doing their own finances, doing their own cleaning, doing their own cooking, extremely independent people. A hundred or more. I can't tell you how many of those people I met over the years. And so we have this mindset that “Oh, I'm going to…” And you know the biggest difference I saw in those people and I've written this in a lot of my articles and newsletter and my book and everything. The biggest difference I see when you walk into the home of the person who's in their 70s. They're stuck in a wheelchair, they just were in the hospital with some horrible disease that required a condition treatment and now they're back. And they can barely do anything, and they need all this help and they need home health aides and nursing and they're only in their 70s. And you look at their kitchen table or their dining room table and it's covered with excuse my French it's covered with crap. It's covered with doughnuts and sweets and all kinds of junk. They don't drink water. I tell them “Are you hydrated? You need some water.” “Well, I don't like water. It makes me go to the bathroom.” I'm like “Well, that's how it works - water in water out.” [laughs]

49:21
Dr. Maya Novak:
[laughs]

49:23
Eileen Kopsaftis:
And then I see the people who are 100 years old and maybe they got a cold and it turned into pneumonia and they had to stay 3 days in the hospital but they got out. They got home. They got their life back. Their house, you know, they got a bowl of fruit on the counter, they like water. They were active. They used to exercise before they got sick. But the other person “Oh, I don't like exercise. I've never exercised- I clean house - that's enough work.” You know I mean you see this difference right? So what happens when we experience the common effects of aging is truly because of the things that we're doing and the things that we're not doing. It's not really age that does it. And once we understand this… I mean I just hosted a boot camp An Age Without Decline boot camp. In 5 days I had people assess themselves, their balance, their stability, there are all kinds of things. By the fifth day their posture was improved, they were taller, their balance was better, their stability was better, and their pain was better. In 5 days! Now these people were older. You know a 20 year old isn't going to join An Age Without Decline boot camp. So you are never too old and it is never too late. And that's the only time I'll use the word ‘never’. [laughs]

50:46
Dr. Maya Novak:
[laughs] It's really about this expectation. Because I can tell you in… I’ve heard a few times in my life young people who said “Well, when I'm gonna be 40 I'm gonna be on pills. I'm going to take medication.” Or you know people in their 30s “Oh, I'm so afraid of aging because of what I see is not really something positive.” And when I work with clients and when this topic comes up and they have this perception of you know “I'm old.” Many times the kind of homework I give them is… “Look, we have internet - amazing thing…” Well it can also not be so amazing but you know we can find so many things. Their homework is. “Find stories, find videos of people of old age that… who are doing things that potentially is let's call that abnormal or that it shouldn't be happening. So start gathering the evidence that actually things are possible. That for your body is possible to thrive, to be active.” Not just on a wheelchair and waiting for the day to die. I mean this is a bit...

52:13
Eileen Kopsaftis:
Yes! I love that. That's beautiful, Maya. Beautiful. And I did research you know before I did my conference because I wanted some photos of these people doing these amazing things. And it's shocking how many of them out there are doing phenomenal things. There's this man named Sy Perlis who at 96 broke the world record for bench press. It was 187lbs and I asked everybody in the audience is there any man here who can bench press 187lbs? Nobody raised their hand. This man was 96. Now, the cool thing is he didn't start weight training until he was 60 and he didn't start competing until he was 82. And people say “Oh, but you know one of those myths: you're going to lose… You're going to have bone loss, you're going to have muscle loss.” He proved that's wrong. And it's not like he's abnormal. It's not like he's got some foreign you know DNA in his body. He's a human being. So yeah you see these people who they started running marathons in their 80s you know. There's a woman who 86-year-old yoga teacher in Australia - I found a picture of her doing a plank where the only part of her hands are on the ground and she's balancing her body on her upper arms and the whole rest of her body is off the ground. 86 years old. Yeah so I love… that homework is beautiful! Because when you start to see “Oh my gosh! Look at how many of these people are living quality lives doing fully physical things. And they're 80, 90, 100 years old.” It's phenomenal!

53:57
Dr. Maya Novak:
Exactly. But you know very often what we are bombarded with is negative news. So it's just everything that is wrong and so many people died and so many people got sick and so many tada da da da da. So it's really on us to educate and to find evidence. Yes.

54:17
Eileen Kopsaftis:
Yes. I love that. Yes.

54:19
Dr. Maya Novak:
So if you had to choose just 1 thing... So your #1 advice that you would give someone who is recovering from any type of injury, physical trauma. What is your number 1 advice? After everything that we said or maybe something else? What would you say to someone?

54:38
Eileen Kopsaftis:
I think the most important thing for people to remember is they are not a body part that walks through the door. We don't isolate a symptom. You have to be seen as a whole person. I remember when my mother was… it was over the last 15 days of life and there were I don't know at least a dozen different specialists who were going in and out of her room, and I paid attention to all of them. And they were always shocked when I'd say “Oh yeah, you're the one here for her kidneys.” Or “You're here for…” you know and they'd be shocked that I would remember that. None of them were looking at her as a whole body. They would all come in there and only see an organ.

55:23
Dr. Maya Novak:
Mhm.

55:24
Eileen Kopsaftis:
And yeah the medical chart is there and they can read through all the notes and see what everyone else has done but I can pretty much guarantee you they weren't taking the time to do that because they're seeing so many people. And I'm not here to point fingers or judge or disrespect the medical profession because you know most people who go to school for 12 years to help other people are good people. It's just the fact that the medical model is based on “We're going to isolate. We're going to treat. We're going to…” right? And they're all following the medical model, that's what they know. None of them saw as a whole person. None of them. And none of them… I remember it was thanksgiving, I was visiting my mom, I had to go home and make dinner for the family, and then I was coming back. I was visiting my mom with the kids. She had a little tachycardia, little quick heart rate, and the nurse had called the cardiology group and someone who didn't know her recommended a particular medication to address the tachycardia. I was there and I witnessed that conversation. I went home, the next thing I know they're calling me. She had bottomed out. They had to move her to ICU and I'm telling them “I bet it was the medication they gave her” It was diltiazem for blood pressure. And they were like “No, she's not on diltiazem.” I go “I was there when they had the conversation.” “No, she's not on diltiazem.” They went and looked at her chart. Yeah, they put her on diltiazem. So I know for a fact, they don't look at charts. [laughs]

56:47
Dr. Maya Novak:
Mhm.

56:48
Eileen Kopsaftis:
But my point is when I veer off this subject nobody was looking at her as a whole person. And when we have an issue we are a whole person. So if we have neck pain, shoulder pain, hip pain, knee pain, low back pain we need to make sure that whoever we interact with whether it's a physician an orthopedist a naturopath, a doctor of osteopathy, a massage therapist, a physical therapist, whoever we interact with an athletic trainer, they need to understand that I'm not a body part that walks through the door. I'm a whole person and I need to be seen as such. And it doesn't take long to assess a whole body. I can assess somebody's three planes function from nose to toes in 15 minutes. So we're not talking “It's a 3 hour process here.” I mean it might take an hour and a half up to 2 hours to figure out what's going on and teach the right things to start getting the person started. But you need to make sure that when you see someone they're not “Oh you're just a shoulder, I can't look at your back.” Or “Oh yeah, that's your knee and you're here for your back. So you'll have to make another visit for that.” I mean that's insanity because what if the 2 are very much related? Those muscles cross 2 joints. So it's really important that we are seen as a whole person or we find somebody who sees us as a whole person.

58:20
Dr. Maya Novak:
Absolutely. And that means physically as a whole person as well as going further into also emotional and mental and everything. So really a holistic approach. Not just “Yes, you have problems with shoulder” as you started this conversation with, right? And then it's just that shoulder and that's it and nothing else. So it's so important because we are more than just this bunch of cells together.

58:49
Yes, and we don't necessarily expect that one person that we see to address all of those topics but they need to at least acknowledge that those are important.

58:59
Dr. Maya Novak:
Absolutely! And that's why I am a huge fan of having really a healing team. So not expecting from 1 person to do everything but really have a big healing team - as big as possible, of course, but that those people, those individuals that you have exactly what you said that they acknowledge that there is more not just that one tiny tiny part.

59:27
Eileen Kopsaftis:
Right. And nobody ever tells them that you know “Well it's because you're at the age you're at,” right?

59:33
Dr. Maya Novak:
Yes. Now how about if we do that demonstration that you mentioned a few minutes ago? So what I would suggest is that for those listeners who are just listening if you could explain it in words so they can follow. But I also encourage listeners to go to my YouTube channel or to my website to watch the video of this demonstration. How does this sound?

1:00:01
Eileen Kopsaftis:
Yes, perfect. And I have actually done teleconferences and taught this over the phone where people couldn't see me and I had one woman who could not believe how much better her neck felt. So I know she understood what I was saying. [laughs]

1:00:14
Dr. Maya Novak:
Perfect! Well then please do that so that we all can enjoy this.

1:00:22
Eileen Kopsaftis:
Okay. So when we scheduled this time to do this I was thinking what would be 1 of the most impactful movements I could teach people that would have the most benefit. And what I realized was as I said earlier the thoracic spine is that silent saboteur. It's between the neck and the low back and it's kind of like Ginsu knives. Those who are old enough to know what that means it does everything - it bends forward, it bends backward, it goes sideways, it rotates. The thoracic spine is a very mobile part of the body however it's also the part of the body that tends to end up with restricted movement. Whether it's because of emotional trauma or it's because of injury or it's because we stop doing as much as we get older. It's notorious for not working really well in all 3 motions as we age, but it's not because of the aging process. It's because we stop doing things, we slow down, we're not using our arms as much, we're not doing activities. So that said I thought this would be the best thing to show people. And if anybody has you know chronic neck pain, shoulder issues, low back issues they might find that this really benefits them. Now I do want to caution people if they know that they have restrictions that they shouldn't do, you know, maybe somebody had scoliosis surgery and they've got a rod that goes through 12 levels of vertebrae in their back this might not be the best thing for them. So we don't know what's going on in people's worlds, right? So I would trust them to make the right decision for them. But what I'm going to teach is how to mobilize the thoracic spine. And I'm going to teach it in sitting because if we do it in sitting now the hips and the pelvis aren't going to have as much activity. And the thoracic spine really kind of has to do what we're asking it to do if it's capable. The #1 thing to remember is the movements are not to elicit pain. So if we have a movement that elicits pain then we do the movements that do not. And the really powerful thing about the human body is there are 3 planes of motion. We move forward and back, side to side, and we rotate right and left in those 3 planes of motion. If your thoracic spine is limited in 1 of them but it's really good in another one the more you work it and the one it's good at the more it helps it to do better in the one that it struggles in. So you kind of like build on your success. So, in other words, if you're not really good at side bending to the right but you're really good at side bending to the left then you just repetitively side bend left and before you know it your body can side bend right. It's phenomenal how the body can kind of heal itself that way. It's really, really, really fascinating. So...

01:03:07
Dr. Maya Novak:
Sorry to interrupt you. I mean this is really fascinating because in my mind or how I was thought was well if you have problems on one side “Yes, work on that side and do not try to overdo it on the other side.” Because if you are doing this then you know you're just going to get better and better on the good side and you're not going to improve on the bad side.

01:03:32
Eileen Kopsaftis:
So really good point, Maya, I'm so glad you mentioned that. So what happens is the body as a whole when you move in a certain direction the muscle is designed to get longer and control the movement. So our muscles, a lot of the times we think our muscles are meant to contract and shorten you know like we do bicep curls. But actually when our body starts moving the muscles are designed to get longer and control the movement. So if I go into side bend to the right what's happening is the left side of my body is getting longer and controlling that so that I don't fall out of my chair. But what's happening with the right side of my body is it's shortening and relaxing. It's not asked to do anything, it's kind of calming it down. So if my body doesn't like side bending to the left. That's because the right side of my body doesn't want to get longer. It's restricting that. So the more I side bend to the right the more relaxed and released the right side of my body gets and then I start “Oh, I can do both now.” It'll work. So it's sort of… there's a technique called Strain & Counter Strain where you shorten a muscle for a certain period of time and it stops resisting the movement because it's kind of like it says “Ahh…” You know “Calgon take me away.” The muscle just released and relaxed and now it can get longer again under tension. So that's kind of what happens when you're doing movements that your body likes. You're relaxing and helping those muscles that don't want to work so that they can start getting back to work. Does that make sense?

01:05:14
Dr. Maya Novak:
Perfect. Thank you so much for explaining this. I think this is a really important. And I’ve learned something new today.

01:05:21
Eileen Kopsaftis:
And the cool thing there's Tom Dalonzo-Baker created a method called Total Motion Release and it's fascinating. He will have everyone work the good side to fix the yucky side. And I've seen it happen. I've worked with people who've had a total knee replacement, we've worked the side that didn't have surgery and the knee replacement got better. I mean it can be jaw dropping. A woman who had massive surgery on a shoulder, she couldn't lift it. We worked to the good side and the surgery side dramatically improved in like 1 session. So it's phenomenal how the body can work. There's a lot of studies that show working the opposite side can improve things. Then, you know, electrical stimulation muscle strength. Oh my gosh I could talk about that for hours. But yeah working the opposite can be very beneficial. It doesn't create an imbalance, it doesn't make you stronger on the good side. It helps to reset the symmetry of the body.

01:06:21
Dr. Maya Novak:
That's amazing. Thank you.

01:06:24
Eileen Kopsaftis:
Okay, so for this movement what we're gonna do for those who can't see me, you're gonna sit in a chair and the goal is you're going to do 6 motions. You're going to kind of slouch forward. You're going to extend backward - I'll demonstrate for those who are on camera and I'll describe it more detailed. You're going to side bend right, side bend left, and you're going to turn right and turn left. Now there are 2 things you can try if you have a neck that is not happy. If you keep your eyes fixed which means you keep your… you're staring at the screen or you're staring at a mirror or you're staring at a picture on the wall and you move your trunk below your neck but you don't let your neck turn, what that can often elicit is mobilizing the neck from below and you may find that your neck feels much better because turning the neck requires the muscles to actively turn it. But if you are turning below then my neck still is looking in that direction but the muscles didn't have to actively do it and it can restore motion. It's a beautiful way to mobilize the neck from below. So if you have neck issues you may want to do this, keeping your eyes fixed and moving the trunk below the neck. And you might see that really helps your neck if you don't you can choose to do you know, just let your head be part of the equation so you've got your options.
And so the goal is to cross your arms. So your hands are on your shoulders and your arms are crossed in front of you and your elbows are resting against your chest. And the goal here is to move the thoracic spine. So I'm going to turn sideways for those who can see me and so the goal is you want to not just bend forward. So you don't want to bend at the waist and end up looking down at your shoes, right? That's not the goal because now we've just mobilized the lumbar spine and the hips. We want to mobilize the thoracic spine. So what you're going to do is you're going to kind of slouch. And it's like you're trying to bring your elbows into your belly button. And then you come back up to straight. It's just as important to completely come out of the motion as to go into the motion because you're loading the muscles, they're lengthening under tension, and then you're completely unloading them. So I'm going to slouch trying to get my elbows into my belly button. And then I'm going to come completely up to straight. So that's the forward motion. And you can do that up to 10 times. And then the backward motion isn't about just leaning back in the chair. And you want to come forward enough in your chair where the back of the chair won't stop you from doing the movement. But again, it isn't about reclining backward because again, that's only going to happen in the lumbar spine at the hips. We want to mobilize the thoracic spine. So what you're going to do is you're going to think your chest, your upper rib area near where your collarbone is, your clavicles. You want to think about that part of your body lifting up to the ceiling like you're making yourself taller. So I'm going to lift that up to the ceiling and you'll feel the curve in your low back will increase when you do this. And then you're going to kind of lean back with your shoulders and look up toward the ceiling unless you're keeping your eyes fixed. And then come back to neutral. So you're lifting your upper chest toward the ceiling, you're bringing your shoulders back and then come back to straight. Now you might feel this... between your thoracic spine and your lumbar, especially if that tl area has some restriction to it. The goal is to do the movement where it feels good to you and it doesn't hurt. Okay, there should be no pain when you do these motions. Now you can combine those 2 motions if you'd like. So you can slouch bring your elbows in towards your belly and then when you come up out of it lift the upper ribs up lean back with the head and shoulders. And you go back and forth between those two motions and your thoracic spine is going to really release when you do this. And when you do it repetitively and there's no pain your body's very happy. Your brain's not trying to keep you from doing something that's hurting yourself.
A lot of the times I tell people if you're doing… now it's different if you're recovering from an injury because no matter what you do could be painful, right? I mean if you just had surgery and you've got to start walking it might hurt to start walking. But if you're trying to resolve a chronic pain condition, if you're eliciting pain repetitively, your brain is trying to figure out a way to do the movement without eliciting pain. So what happens is your brain cheats. It uses the wrong muscles. It uses the wrong pathway and now you've just trained in dysfunction. So that's never what we want, right? We don't want dysfunction. So if someone feels pain when they do that forward slump, then don't do the forward slump. Just do the lift up and go back or vice versa. If that lifting up and going back is painful just do the slump and just keep coming completely out of it up to a nice straight posture, completely out of it up to a nice straight posture. You will notice that just doing that… if you're somebody who sits at your desk all day you may notice that that makes a huge difference for you. Now we've also got the side component and this you want to be sure you're going sideways in a way where you're not trying to just reach over and touch the floor on the side of your chair. So the goal here is to get the thoracic spine to side bend. So what I'll usually have people do is kind of put their hands on their ribs right down on the lower ribs, just above their belly. And we want to feel the rib cage going sideways. So if for instance, and I don't know if I'm going to mirror people or not, if I have my ribs go left you might to you had a look to the right but I'm going to shift my ribs sideways so that my head and shoulders my ribs are going left my head and shoulders are going right, my butt cheeks are still planted to the chair. I'm not shifting weight off a butt cheek and my feet are still flat on the floor. And then you come completely out of it up to straight. And then let's try the other side. I'm going to shift my ribs to my right and my head and shoulders go left and then I come back to straight. Now if one of those motions is painful but the other is not, stick with the one that is not. But if they're both, okay, you can go back and forth and you can go do that. Nice side bending now. It's important here to pay attention when you're doing the side bending that you're not bending forward. That you're not bending backward. You want to stay upright and I give people a little memory thing “Think if you had a glass wall in front of you and a glass wall behind you and you can't rotate. You can't bend forward. You have to stay up. And when you do your side bending you have to stay between those 2 walls.” So that'll keep you in that nice frontal plane motion.
And then of course the last one is rotation. Now for rotation ideally, if you want to keep your eyes fixed what you're trying to do is you're trying to turn and bring your shoulder under your chin. But if you're not worried about keeping your eyes fixed. You're going to turn and you're going to try to look behind you. Again here you don't want to shift the weight, your weight stays on both butt cheeks. But you'll notice that one knee kind of slides forward. So if I rotate to the right and I look behind me. It kind of feels like my left knee goes a little forward and my right knee comes back a little. And then if I rotate left as far as I can and look behind me it feels like my right knee is going forward a little and my left knee is coming back a little. So you'll feel that change and this is the same modification as I said with all the others. If rotating one direction creates discomfort don't do that direction. Stick to the one that does feel good. And you will notice… And I cannot tell you how many times in the outpatient clinic where someone couldn't go in one direction but they came back for their second session and they said “I can do both directions now and they both feel fine.” It's phenomenal how the body will restore itself. So just doing that once a day at the end of your workday or the middle of your workday. That thoracic spine can really wreak havoc on a lot of areas of the body and mobilizing it can very often alleviate pain.

01:15:35
Dr. Maya Novak:
Wow! This was an amazing demonstration. So it's basically not necessary that we are in pain and then we have to do this exercise – it’s just like a general healthy spine treatment or just program that you can do either potentially at the beginning of the day or as you said at the end, after the whole day of being in that position behind the computer.

01:16:01
Eileen Kopsaftis:
Yes. And if you keep your eyes fixed it can really help the neck. And I just realized there's one thing I didn't mention about the shoulder. A lot of the times people have limited flexion of the shoulder and again they think it's their shoulder but it's not. It's the thoracic spine. What a lot of people are unaware of, even a lot of therapists in my profession are not aware of is that. When you go into end range of that motion your thoracic spine needs to move into extension at the top of the T spine. And so if it's not doing that, it's going to stop your shoulder. So for those who can't see what I'm doing. If you're sitting and you raise your arm so that your fingers are pointing toward the ceiling and your elbow is straight. If you feel like you can't get your arm all the way back by your ear next to your head without your head leaning over towards your arm what you're going to feel is… if you can't get it all the way back it's because that thoracic spine is probably not extending completely. And if I turn sideways for those who can see me… if my shoulder, if you bring your shoulder up it kind of stops. If you don't let your body sit up straight. But as soon as you sit up straight and let your T spine extend, you get the rest of the motion. And you can see how much further my arm can go back. But that's not motion in the glenohumeral joint, that's not motion in the shoulder. That's motion required in the thoracic spine. So if you're trying to stretch your shoulder and get it to get those last few degrees and you're not addressing the thoracic spine, you're going to be limited in your success. So You know what? I just taught you might find really helps you to to gain that back.

01:17:44
Dr. Maya Novak:
And this is such a great insight because yes, again, we would think “Oh, I cannot extend my shoulder so the problem is in my shoulder,” but actually it is not. So this is such a great insight into what is really happening with the body.

01:18:01
Eileen Kopsaftis:
Yeah, and PTs are notorious for laying somebody on a table and trying to get those last few degrees, passively stretching the joint but are they paying attention what's going on in the thoracic spine? And again a PT can't teach what they don't know either. My profession's notorious for having extremely different levels of knowledge and skill.

01:18:18
Dr. Maya Novak:
Oh, Eileen, we could talk for another 3 hours I have a feeling. So potentially you know we're gonna do another interview because I know that people are really enjoying this and getting so many insights and aha moments. But let's wrap this up for now. The last question that I would like to ask you and it's completely out of the box. So it's not about pain, it's not about anything so just for fun. If you were stuck on a desert Island with an injury and could bring only 1 thing to help you feel amazingly well, what would that be and why?

01:18:59
Eileen Kopsaftis:
So I knew you were going to ask this question because you kindly allowed me to be prepared somewhat so I wouldn't be caught off guard. And I'm really glad that I did because I had to contemplate it. And I kind of waffled back and forth between 2 different answers. One answer was you know I might want to bring something that would help me physically, right? I might want to bring a MELT roller so that I can do MELT work and address my neurofascial system and all of that stuff. But then I realized because of you know what I explained earlier - my faith is very important to me and I truly know and believe that I know that God loves each and every one of us so much. We are so precious in his sight. I would probably want to bring my Bible because there's so much truth in there. There's so much love in there. There's so many promises in there. It would help me to keep my mental and emotional state healthy and strong and vibrant as my body healed.

01:19:59
Dr. Maya Novak:
Beautiful, beautiful, Eileen. I know that so many people are right now wondering where they can find more about you, watch your videos, maybe join any of your programs, get your book. Please share. What is the best address where can people find more about you?

01:20:17
Eileen Kopsaftis:
Yes, yes. So I do have several websites that offer different content. Probably the easiest thing would be for people to go to my main website which is www.havelifelongwellbeing.com. And on there you can sign up for my newsletter which I send out every month. I do a Friday value video every week. I do have a YouTube channel. So if you type in my name which most people can't spell you can… I have a lot of free education on my YouTube channel. I teach movement ED, I have so much free stuff out there. And that's so people can understand and learn “Wow, I can do this! This works. This makes such sense.” I mean I have people contacting me from all over the world. I just had a person today from Germany who said that she struggles a little. English is not her first language but she emailed and said that the boot camp that she attended it was the first time she learned any of that. She was in pain, could barely walk, her balance was off, and she learned so much in the boot camp. She's now able to go back to work and it made such a difference in her life. She said “And nobody's teaching me that here.” So you know I want everybody to get the megaphone out and share what they’ve learned today and set people free. You know there's so much misunderstanding out there. There are so many myths, even the myth of aging with decline. It's not a myth because it doesn't happen. It's a myth because it doesn't have to happen. So share these truths and you'll have lifelong wWell-being, right? Yes, that's the goal.

01:22:07
Dr. Maya Novak:
Eileen, thank you so much for being here, for sharing your knowledge, these insights, for educating us, and to help people get free from pain. So thank you so much.

01:22:19
Eileen Kopsaftis:
Yes, thank you, Maya, and your work is amazing as well. I recommend you all the time.

1:22:25
Dr. Maya Novak:
Thank you for tuning into today’s episode with Eileen Kopsaftis! If you enjoyed this episode, make sure you leave a review and subscribe if you haven’t already. The Mindful Injury Recovery Talks are available on Spotify, Apple, Google, Stitcher, and many other major streaming platforms.
Also, if you’d like to learn more about using the Mindful Injury Recovery Method, either for yourself, a loved one, or as an addition to your own healing practice, make sure you check out my book, Heal Beyond Expectations. It’s available on Amazon, in paperback and Kindle, and it’s a great extra healing resource. And if you would like to know how to work with me, either 1-on-1 or through my self-paced programs, head over to my website mayanovak.com and discover more about these options.